Clinicopathologic Features of Lymphoproliferative Neoplasms Involving the Liver.

Background and Objectives: Primary hepatic lymphoproliferative neoplasms (PHL) are uncommon. This retrospective study is aimed to present the clinicopathological characteristics of PHL and compare to secondary hepatic lymphoproliferative neoplasms (SHL). Materials and Methods: Patients who were diagnosed with lymphoproliferative neoplasms involving the liver between January 2004 and December 2018 at a tertiary medical center in central Taiwan were included. The demographic and clinical data, radiological results and histopathological findings were reviewed and summarized. Results: We analyzed 36 patients comprising 6 PHL patients and 30 SHL patients. The median age at diagnosis tended to be younger in PHL than in SHL (59 vs. 63 years old, p = 0.349). Both entities had a small male predominance. The PHL patients tended to have higher levels of aspartate aminotransferase, alanine transaminase and serum albumin and lower levels of alkaline phosphatase, total bilirubin, γ-glutamyl transferase and lactate dehydrogenase compared with SHL, but there was no significant difference. Multiple mass lesions were the most common radiological finding in both groups. Diffuse large B-cell lymphoma was the predominant subtype in both groups (67% in PHL and 40% in SHL). The PHL patients had a longer median survival than the SHL patients (not reached vs. 3 months, p = 0.003). Conclusions: Although there was no significant difference between PHL and SHL in clinical, laboratory and radiological features, the SHL patients had very poor outcomes with a median survival time of 3 months. Effective therapies are urgently required for these patients.

Increased blood 8-hydroxy-2-deoxyguanosine levels in methamphetamine users during early abstinence.

BACKGROUND: Reactive oxygen species (ROS) are thought to play a role in the adverse physical and mental consequences of methamphetamine usage. The oxidative DNA adduct 8-hydroxy-2'-deoxyguanosine (8-OHdG) is a well-known biomarker of ROS-induced DNA damage. Currently, there is insufficient clinical information about methamphetamine-induced oxidative DNA damage. OBJECTIVES: This study examined differences in blood levels of 8-OHdG between methamphetamine users and non-users as well as alterations in 8-OHdG levels after 2 weeks of methamphetamine abstinence. METHODS: We recruited 182 methamphetamine users (78.6% of male) and 71 healthy controls (95.8% of male). Baseline serum 8-OHdG levels were measured in both groups using a competitive enzyme-linked immunosorbent assay. In methamphetamine users, 8-OHdG levels were measured again 2 weeks after baseline measurement. RESULTS: The results showed that methamphetamine users had significantly higher 8-OHdG levels (0.34 ± 0.13 ng/mL) than healthy controls (0.30 ± 0.08 ng/mL) (p < 0.001). The 8-OHdG levels did not alter after 2 weeks of methamphetamine abstinence (0.32 ± 0.12 ng/mL, p = 0.051 compared to baseline measurement; p = 0.12 compared to healthy controls). No significant correlations were observed between baseline 8-OHdG levels in methamphetamine users and post-abstinence interval, age of the first methamphetamine use, duration of methamphetamine use, or history of frequent methamphetamine use. CONCLUSION: Our findings suggest that methamphetamine users had an enhanced level of oxidative damage, which did not normalize during early abstinence. Future studies are required to determine the effects of long-term methamphetamine abstinence and potential confounders on 8-OHdG levels in methamphetamine users.

Serum brain-derived neurotrophic factor levels were reduced during methamphetamine early withdrawal.

Methamphetamine (METH) abuse is an increasing public health problem worldwide. Many of the METH-induced physical and mental problems are associated with the neurotoxic effects of METH. Animal studies have shown that brain-derived neurotrophic factor (BDNF) decreased after repeated amphetamine administration and increased at 30 and 90 days from psychostimulant withdrawal, suggesting that there might be a psychostimulant-induced neuroprotective dysfunction followed by a neuroadaptive process in the brain. However, current research on the role of BDNF in human METH addiction is limited, particularly during early withdrawal. The aim of this study was to assess the serum BDNF levels in METH abusers during the early withdrawal stage. Two groups of subjects were enrolled: (1) 59 DSM-IV METH abusers confirmed by board-certified psychiatrists during the first 3 weeks of withdrawal; (2) 59 age- and sex-matched healthy controls. We found that serum BDNF levels were significantly and constantly lower in the METH abusers during early withdrawal than those of the healthy controls. This indicates that METH abusers might have severe BDNF dysfunction and an impaired neuroprotective function after repetitive METH misuse.

Cardiovascular Risk Factors in Hospital Workers during the COVID-19 Pandemic: A Hospital-Based Repeated Measures Study.

Although many studies have investigated burnout, stress, and mental health issues among health care workers (HCWs) during the COVID-19 pandemic, few have linked these relationships to chronic physiological illnesses such as cardiovascular diseases. This study assessed changes in cardiovascular risk factors in HCWs and other hospital workers during the COVID-19 pandemic and identified vulnerable groups at a higher risk of increased adverse cardiovascular conditions. Five hundred and fourteen hospital employees ≥ 20 years of age underwent physical examinations and laboratory testing once before and once after the first wave of the pandemic in Taiwan during 2020 and 2021. Their sociodemographic characteristics and cardiovascular risk factors, including blood pressure, blood biochemical parameters, and body mass index, were collected. The differences between pre- and post-pandemic measurements of their biophysical and blood biochemical parameters were analyzed using pairwise tests. The post-pandemic increases in their parameter levels and cardiovascular risk as a function of underlying factors were estimated from multivariate regressions. HCWs showed significant increases in levels and abnormal rates of BMI, blood pressure, plasma glucose, and total cholesterol after the pandemic. Post-pandemic increases in BMI, waist circumference, and blood pressure were higher in females than in males. Workers with higher levels of education or longer job tenure had greater increases in BMI, triglyceride, and total cholesterol levels than other workers. Females had a higher incidence of abnormal BMI and hypertension than males (adjusted odds ratios [AORs] of 8.3 and 2.9, respectively). Older workers' incidence of hypertension was higher than younger workers' (AOR = 3.5). Preventive strategies should be implemented for HCWs susceptible to cardiovascular diseases during emerging infectious disease outbreaks.

Utility of cell block as an adjunct to liquid-based cytology for diagnosing papillary thyroid carcinoma.

BACKGROUND: Although liquid-based cytology (LBC) has gained popularity among clinical laboratories, it is unclear whether it is equivalent to conventional smears for making a definite diagnosis of papillary thyroid carcinoma (PTC). The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) suggests a definite diagnosis of PTC is preferred when there are at least one of three features (papillary architecture, psammomatous calcifications, and frequent pseudonuclear inclusions) plus other typical cytomorphological findings. This study evaluated whether an additional cell block (CB), prepared from the residual LBC material, could help improve the diagnosis of PTC. MATERIALS AND METHODS: A total of 62 cases with both ThinPrep LBC and CB preparations and histopathological follow-up of PTC were retrieved between November 2016 and March 2019. The ThinPrep LBC and CB slides were reviewed separately to identify any papillary architecture, psammomatous calcifications, or pseudonuclear inclusions for diagnosing PTC. RESULTS: Among the 51 cases with cytological diagnosis of PTC in the LBC+CB slides, the CB provided additional diagnostic information in 15 cases, which were initially diagnosed as suspicious for PTC based on the LBC slides alone. This information included papillary architecture (n=11), psammomatous calcification (n=1) and pseudonuclear inclusions (n=5). The number of specimens in the 51 cases containing at least one of the three features increased from 42 (LBC) to 51 (LBC+CB). The accuracy for diagnosing PTC increased from 58.1% for LBC alone to 82.3% for the LBC+CB examination. CONCLUSION: An adjunctive CB preparation may improve the LBC technique for diagnosing PTC.

Chinese version of the Delirium Rating Scale-Revised-98: reliability and validity.

BACKGROUND: Delirium is commonly seen in patients in consultation-liaison psychiatry. Assessing delirium severity is important in clinical practice. The Delirium Rating Scale-Revised-98 (DRS-R-98) has been already established as a valid and reliable tool to achieve this goal. This study was aimed to evaluate the reliability and validity of the Chinese version of the DRS-R-98 (DRS-R-98-C) in Taiwan. METHOD: We recruited 4 patient groups with delirium (n = 28), alcohol dependence (n = 9), dementia (n =11), and schizophrenia and bipolar disorder (n = 11) and evaluated them with DRS-R-98-C and Mini-Mental Status Examination (MMSE) by 2 psychiatrists at a single assessment session. RESULTS: The results showed that mean DRS-R-98-C total and severity scores in delirious patients were found significantly higher than those in other patient groups. Interrater reliability of the DRS-R-98-C between 2 raters was high, with intraclass correlation coefficient of .98 for severity scale and .99 for total scale. Internal consistency was high with a Cronbach's alpha coefficient of .85 and .86 for DRS-R-98-C severity and total scales. A significant inverse correlation was found between the DRS-R-98-C and the MMSE score (r = -0.63, P < .001) for either severity or total scale among 28 delirious patients. Area under the curve established by receiver operating characteristic analysis was .93 and .96 for severity and total scales, respectively. Optimal cutoff of total score was 15.5, with sensitivity of 89.3% and specificity of 96.8%. CONCLUSION: The DRS-R-98-C is a valid and reliable measure of delirium severity and can be used clinically to monitor the course of illness when administered serially.

Pharmacokinetics and efficacy of a direct switch from conventional depot to risperidone long-acting injection in Chinese patients with schizophrenic and schizoaffective disorders.

AIMS: This 12-week open-label study was designed to investigate the pharmacokinetics and efficacy of a direct switch from a conventional depot to long-acting injectable risperidone in patients with schizophrenia and schizoaffective disorder. METHODS: Men or women from 18 to 65 years old with a diagnosis of schizophrenia or schizoaffective disorder were eligible for participation if they had been treated with conventional depot for at least 8 weeks before study entry. Intramuscular long-acting risperidone was administered starting from 25 mg, with the dose flexibly adjusted every two weeks for 12 weeks from week 4. RESULTS: Of the 25 patients enrolled in this study, 21 completed at least one post-baseline assessment and were thus included in the analysis. The mean serum concentration of risperidone plus 9-hydroxyrisperidone was 29.1 ng/mL at the 12th week after switching, with an average injection dose of 31.25 mg long-acting risperidone every two weeks. The levels of active moiety of risperidone seemed to be higher in Chinese patients compared to those in Caucasian patients. Positive and Negative Syndrome Scale total scores (from 67.5 to 56.4; P = 0.002), scores for negative symptoms (P = 0.006) and general symptoms (P = 0.001) were improved significantly 12 weeks after the switch. Mean Extrapyramidal Symptom Rating Scale scores were improved significantly from 20.1 to 5.5 (P < 0.001). Significantly decreased levels of cholesterol and triglyceride were found at the 12th week. The levels of fasting glucose, low-density lipoprotein, high-density lipoprotein and bodyweight remained unchanged. CONCLUSIONS: These findings suggest that switching from conventional depot to long-acting risperidone is feasible with the advantage of symptom reduction and side-effect profile decrement.