Astonishing Evolution in Oropharyngeal Cancer with Immunotherapy: A Case Report.

Background: Head and neck cancer is particular due to its infiltrative nature and lymphatic extension, with multidisciplinary treatment. Immunotherapy may be a brand-new therapeutic approach.Case Presentation: We report a case of patient with advanced head and neck cancer resistant to cytotoxic treatment, with astonishing response to antibodies anti Programmed Death 1 (PD1).Conclusion: Further studies are needed in order to obtained predictive index of immunotherapy responding, aiming to select appropriately patients for this treatment.

Prevalence of vitamin D deficiency in an inpatient population in the Swiss Canton of Basel-Country.

AIMS: Vitamin D deficiency remains very common in the general population. Adding to the importance of this issue is the discovery that vitamin D plays a role in many other tissues apart from the bone, including muscle, brain, prostate, breast and colon. In this study, we investigated the prevalence of vitamin D deficiency in a large group of patients hospitalised in the cantonal hospital Basel-Country, and analysed the dependence of serum vitamin D concentrations on gender, time of the year and age. METHODS: We retrospectively analysed anonymised data received from the central laboratory of the cantonal hospital Basel-Country. The pool of data contains values obtained between 2013 and 2017 from 8861 patients aged between 18 and 102 years. If sequential measurements were available from a patient, only the first was used for the analyses. Vitamin D deficiency was defined as a serum concentration of <50 nmol/l and severe deficiency as <25 nmol/l. Vitamin D values between 50 and 75 nmol/l are considered a grey zone. Optimal values are >75 nmol/l. RESULTS: Mean ± standard deviation serum vitamin D concentration was 52.5 ± 30.5 nmol/l, with women having a higher mean of 55.5 ± 31.5 nmol/l as compared with 48.1 ± 28.6 nmol/l in men (p <10-5). Of the 8861 first measurements taken within the observation period, 4527 (51%) were vitamin D deficient with levels <50 nmol/l, including 1860 (21.0%) with levels <25 nmol/l. There was only a weak positive association of average vitamin D levels with age (p = 0.06). Women reached peak concentrations of 56.9 ± 35.4 nmol/l in the age group 90–102 years, whereas men reached peaks of 50.3 ± 31.9 nmol/l in 50–59-year-olds. Mean autumn and spring concentrations differed less (51.6 ± 29.6 vs 52.7 ± 30.7 nmol/l, respectively, p = 0.38) than mean summer and winter concentrations (57.1 ± 29.5 vs 48.0 ± 31.2 nmol/l, respectively, p <10-5). CONCLUSIONS: Vitamin D deficiency was a common finding in our cohort, affecting all age groups and occurring in over half (51%) of the values measured. As current guidelines recommend vitamin D concentrations >75 nmol/l, only 22.1% of measured values indicated adequate vitamin D levels. This issue should be addressed in order to improve quality of life and reduce medical costs.    .

The Flipside of Eradicating a Disease; Human African Trypanosomiasis in a Woman in Rural Democratic Republic of Congo: A Case Report.

Human African Trypanosomiasis (HAT) is a neglected disease caused by the protozoan parasites Trypanosoma brucei and transmitted by tsetse flies that progresses in two phases. Symptoms in the first phase include fever, headaches, pruritus, lymphadenopathy, and in certain cases, hepato- and splenomegaly. Neurological disorders such as sleep disorder, aggressive behavior, logorrhea, psychotic reactions, and mood changes are signs of the second stage of the disease. Diagnosis follows complex algorithms, including serological testing and microscopy. Our case report illustrates the course of events of a 41-year old woman with sleep disorder, among other neurological symptoms, whose diagnosis was made seven months after the onset of symptoms. The patient had consulted two different hospitals in Kinshasa and was on the verge of being discharged from a third due to negative laboratory test results. This case report highlights the challenges that may arise when a disease is on the verge of eradication.