Treatment of gastric varices with cyanoacrylate complicated by systemic embolization.

Acute gastric variceal bleeding is a life-threatening condition that could be effectively treated with endoscopic cyanoacrylate injection diluted with lipiodol. The mixture acts as a tissue adhesive that polymerizes when in contact with blood in a gastric varix. This work reports a patient that presented to the emergency department with upper gastrointestinal bleeding due to acute variceal bleeding, who developed systemic embolization following cyanoacrylate injection therapy. This complication culminated in cerebral, splenic and renal infarctions with a fatal outcome. Systemic embolization is a very rare, but the most severe complication associated with endoscopic cyanoacrylate injection and should be considered in patients undergoing this treatment.

LNDb v4: pulmonary nodule annotation from medical reports.

Given the high prevalence of lung cancer, an accurate diagnosis is crucial. In the diagnosis process, radiologists play an important role by examining numerous radiology exams to identify different types of nodules. To aid the clinicians' analytical efforts, computer-aided diagnosis can streamline the process of identifying pulmonary nodules. For this purpose, medical reports can serve as valuable sources for automatically retrieving image annotations. Our study focused on converting medical reports into nodule annotations, matching textual information with manually annotated data from the Lung Nodule Database (LNDb)-a comprehensive repository of lung scans and nodule annotations. As a result of this study, we have released a tabular data file containing information from 292 medical reports in the LNDb, along with files detailing nodule characteristics and corresponding matches to the manually annotated data. The objective is to enable further research studies in lung cancer by bridging the gap between existing reports and additional manual annotations that may be collected, thereby fostering discussions about the advantages and disadvantages between these two data types.

Influence of SPION Surface Coating on Magnetic Properties and Theranostic Profile.

This study aimed to develop multifunctional nanoplatforms for both cancer imaging and therapy using superparamagnetic iron oxide nanoparticles (SPIONs). Two distinct synthetic methods, reduction-precipitation (MR/P) and co-precipitation at controlled pH (MpH), were explored, including the assessment of the coating's influence, namely dextran and gold, on their magnetic properties. These SPIONs were further functionalized with gadolinium to act as dual T1/T2 contrast agents for magnetic resonance imaging (MRI). Parameters such as size, stability, morphology, and magnetic behavior were evaluated by a detailed characterization analysis. To assess their efficacy in imaging and therapy, relaxivity and hyperthermia experiments were performed, respectively. The results revealed that both synthetic methods lead to SPIONs with similar average size, 9 nm. Mössbauer spectroscopy indicated that samples obtained from MR/P consist of approximately 11-13% of Fe present in magnetite, while samples obtained from MpH have higher contents of 33-45%. Despite coating and functionalization, all samples exhibited superparamagnetic behavior at room temperature. Hyperthermia experiments showed increased SAR values with higher magnetic field intensity and frequency. Moreover, the relaxivity studies suggested potential dual T1/T2 contrast agent capabilities for the coated SPpH-Dx-Au-Gd sample, thus demonstrating its potential in cancer diagnosis.

Imaging Findings in Aspergillosis: From Head to Toe.

Aspergillosis is a mycotic infection induced by airborne fungi that are ubiquitous. Inhalation of Aspergillus conidia results in transmission through the respiratory tract. The clinical presentation is dependent on organism and host specifics, with immunodeficiency, allergies, and preexisting pulmonary disease constituting the most important risk factors. In recent decades, the incidence of fungal infections has increased dramatically, due in part to the increased number of transplants and the pervasive use of chemotherapy and immunosuppressive drugs. The spectrum of clinical manifestations can range from an asymptomatic or mild infection to a swiftly progressive, life-threatening illness. Additionally, invasive infections can migrate to extrapulmonary sites, causing infections in distant organs. Recognition and familiarity with the various radiological findings in the appropriate clinical context are essential for patient management and the prompt initiation of life-saving treatment. We discuss the radiological characteristics of chronic and invasive pulmonary aspergillosis, as well as some of the typically unexpected extrapulmonary manifestations of disseminated disease.

Multifunctional targeted solid lipid nanoparticles for combined photothermal therapy and chemotherapy of breast cancer.

Photothermal therapy has emerged as a new promising strategy for the management of cancer, either alone or combined with other therapeutics, such as chemotherapy. The use of nanoparticles for multimodal therapy can improve treatment performance and reduce drug doses and associated side effects. Here we propose the development of a novel multifunctional nanosystem based on solid lipid nanoparticles co-loaded with gold nanorods and mitoxantrone and functionalized with folic acid for dual photothermal therapy and chemotherapy of breast cancer. Nanoparticles were produced using an economically affordable method and presented suitable physicochemical properties for tumor passive accumulation. Upon Near-Infrared irradiation (808 nm, 1.7 W cm-2, 5 min), nanoparticles could effectively mediate a temperature increase of >20 °C. Moreover, exposure to light resulted in an enhanced release of Mitoxantrone. Furthermore, nanoparticles were non-hemolytic and well tolerated by healthy cells even at high concentrations. The active targeting strategy was found to be successful, as shown by the greater accumulation of the functionalized nanoparticles in MCF-7 cells. Finally, the combined effects of chemotherapy, light-induced drug release and photothermal therapy significantly enhanced breast cancer cell death. Overall, these results demonstrate that the developed lipid nanosystem is an efficient vehicle for breast cancer multimodal therapy.

Rational design of magnetoliposomes for enhanced interaction with bacterial membrane models.

There is a growing need for alternatives to target and treat bacterial infection. Thus, the present work aims to develop and optimize the production of PEGylated magnetoliposomes (MLPs@PEG), by encapsulating superparamagnetic iron oxide nanoparticles (SPIONs) within fusogenic liposomes. A Box-Behnken design was applied to modulate size distribution variables, using lipid concentration, SPIONs amount and ultrasonication time as independent variables. As a result of the optimization, it was possible to obtain MLPs@PEG with a mean size of 182 nm, with polydispersity index (PDI) of 0.19, and SPIONs encapsulation efficiency (%EE) around 76%. Cytocompatibility assays showed that no toxicity was observed in fibroblasts, for iron concentrations up to 400µg/ml. Also, for safe lipid and iron concentrations, no hemolytic effect was detected. The fusogenicity of the nanosystems was first evaluated through lipid mixing assays, based on Förster resonance energy transfer (FRET), using liposomal membrane models, mimicking bacterial cytoplasmic membrane and eukaryotic plasma membrane. It was shown that the hybrid nanosystems preferentially interact with the bacterial membrane model. Confocal microscopy and fluorescence lifetime measurements, using giant unilamellar vesicles (GUVs), validated these results. Overall, the developed hybrid nanosystem may represent an efficient drug delivery system with improved targetability for bacterial membrane.

New Frontiers in Colorectal Cancer Treatment Combining Nanotechnology with Photo- and Radiotherapy.

Colorectal cancer is the third most common cancer worldwide. Despite recent advances in the treatment of this pathology, which include a personalized approach using radio- and chemotherapies in combination with advanced surgical techniques, it is imperative to enhance the performance of these treatments and decrease their detrimental side effects on patients' health. Nanomedicine is likely the pathway towards solving this challenge by enhancing both the therapeutic and diagnostic capabilities. In particular, plasmonic nanoparticles show remarkable potential due to their dual therapeutic functionalities as photothermal therapy agents and as radiosensitizers in radiotherapy. Their dual functionality, high biocompatibility, easy functionalization, and targeting capabilities make them potential agents for inducing efficient cancer cell death with minimal side effects. This review aims to identify the main challenges in the diagnosis and treatment of colorectal cancer. The heterogeneous nature of this cancer is also discussed from a single-cell point of view. The most relevant works in photo- and radiotherapy using nanotechnology-based therapies for colorectal cancer are addressed, ranging from in vitro studies (2D and 3D cell cultures) to in vivo studies and clinical trials. Although the results using nanoparticles as a photo- and radiosensitizers in photo- and radiotherapy are promising, preliminary studies showed that the possibility of combining both therapies must be explored to improve the treatment efficiency.

Efficacy and safety clinical trial with efavirenz in patients diagnosed with adult Niemann-pick type C with cognitive impairment.

BACKGROUND: Niemann-Pick disease Type C (NPC) is a genetic, incurable, neurodegenerative disorder. This orphan disease is most frequently caused by mutations in the NPC1 protein, resulting in intralysossomal cholesterol accumulation. NPC1 is found in neuronal cell bodies, axon terminals and synaptosomes, suggesting it plays a role in lysosomal degradation pathway and in synaptic transmission. Neuronal function is especially vulnerable to NPC1 deficiency and synaptic changes seem a key element in disease development. Currently, Miglustat (Zavesca®) is the only approved treatment for NPC. However, preclinical evidence showed that low-dose Efavirenz reverted synaptic defects through pharmacological activation of the enzyme CYP46. METHODS: This is a single-center, phase II clinical trial to evaluate the efficacy and safety of Efavirenz in addition to standard of care in patients diagnosed with adult or late juvenile-onset NPC with cognitive impairment. All enrolled patients will be treated orally with 25 mg/d of Efavirenz for 52 weeks (1 year). Secondary objectives include evaluating clinical (neurological and neuropsychological questionnaires) and biological (imaging and biochemical biomarkers) parameters. DISCUSSION: NPC is still an unmet medical need. Although different therapeutic approaches are under study, this is the first clinical trial (to the best of our knowledge) studying the effects of Efavirenz in adult- and late-juvenile-onset NPC. Despite the small sample size and the single-arm design, we expect the results to show Efavirenz's capacity of activating the CYP46 enzyme to compensate for NPC1 deficiency and correct synaptic changes, therefore compensating cognitive and psychiatric changes in these patients. This study may provide direct benefit to enrolled patients in terms of slowing down the disease progression.

Chest Imaging in Systemic Endemic Mycoses.

Endemic fungal infections are responsible for high rates of morbidity and mortality in certain regions of the world. The diagnosis and management remain a challenge, and the reason could be explained by the lack of disease awareness, variability of symptoms, and insidious and often overlooked clinical presentation. Imaging findings are nonspecific and frequently misinterpreted as other more common infectious or malignant diseases. Patient demographics and clinical and travel history are important clues that may lead to a proper diagnosis. The purpose of this paper is to review the presentation and differential diagnosis of endemic mycoses based on the most common chest imaging findings.

Folate receptor-mediated delivery of mitoxantrone-loaded solid lipid nanoparticles to breast cancer cells.

The standard breast cancer therapy still faces major challenges due to non-specific tumor distribution and occurrence of dose-limiting adverse side-effects. Nanomedicine constitutes an appealing approach to improve the therapeutic index of different anti-cancer drugs. Given their biocompatibility, low-cost manufacture and easy surface modification, lipid nanoparticles, such as solid lipid nanoparticles (SLN), have a great potential for drug delivery in cancer therapy. In this work, SLN entrapping the antineoplastic drug Mitoxantrone (Mito) were developed and functionalized with Disteroylphosphatidylethanolamine-poly(ethylene glycol)-folic acid (DSPE-PEG-FA) ligand to improve blood circulation and tumor selectivity and limit the drug systemic side-effects. Nanoparticles presented adequate size and size distribution for intravenous injection and were stable for at least 6 months. Additionally, their hemocompatibility was demonstrated. Moreover, functionalized nanoparticles were able to improve the anti-cancer effect of the free drug, as assessed by the values of IC50 and the apoptotic effects in MCF-7 cells. Moreover, an enhanced cellular internalization of the functionalized SLN was demonstrated by confocal microscopy and flow cytometry studies. Finally, the cellular uptake of the SLN was found to occur via macropinocytosis and clathrin-mediated endocytosis, suggesting the involvement of (folate receptor) (FR)-mediated endocytosis. Overall these findings highlight that the developed SLN are efficient nanocarriers for the selective delivery of Mito to breast cancer cells.

The Magnetic Properties of Fe/Cu Multilayered Nanowires: The Role of the Number of Fe Layers and Their Thickness.

Multi-segmented bilayered Fe/Cu nanowires have been fabricated through the electrodeposition in porous anodic alumina membranes. We have assessed, with the support of micromagnetic simulations, the dependence of fabricated nanostructures' magnetic properties either on the number of Fe/Cu bilayers or on the length of the magnetic layers, by fixing both the nonmagnetic segment length and the wire diameter. The magnetic reversal, in the segmented Fe nanowires (NWs) with a 300 nm length, occurs through the nucleation and propagation of a vortex domain wall (V-DW) from the extremities of each segment. By increasing the number of bilayers, the coercive field progressively increases due to the small magnetostatic coupling between Fe segments, but the coercivity found in an Fe continuous nanowire is not reached, since the interactions between layers is limited by the Cu separation. On the other hand, Fe segments 30 nm in length have exhibited a vortex configuration, with around 60% of the magnetization pointing parallel to the wires' long axis, which is equivalent to an isolated Fe nanodisc. By increasing the Fe segment length, a magnetic reversal occurred through the nucleation and propagation of a V-DW from the extremities of each segment, similar to what happens in a long cylindrical Fe nanowire. The particular case of the Fe/Cu bilayered nanowires with Fe segments 20 nm in length revealed a magnetization oriented in opposite directions, forming a synthetic antiferromagnetic system with coercivity and remanence values close to zero.

Mitoxantrone-loaded lipid nanoparticles for breast cancer therapy - Quality-by-design approach and efficacy assessment in 2D and 3D in vitro cancer models.

Breast cancer is the leading cause of cancer-related deaths among women worldwide. The conventional chemotherapeutic regimens used in the treatment of this disease often lead to severe side-effects and reduced efficacy. In this study, a novel drug delivery system for the chemotherapeutic drug mitoxantrone (Mito) was developed using solid lipid nanoparticles (SLN). The production of the SLN was carried out using an organic-solvent-free, low-cost method and optimized using a Box-Behnken design. SLN presented adequate size for cancer-related applications, more than 90% of EE% and remained stable for at least 6 months. A much higher drug release was obtained at acidic pH (mimicking the endosomal compartment) than plasmatic pH, highlighting the potential of the nanosystem for tumor drug delivery. Additionally, SLN were non-hemolytic and cytocompatible, even at high concentrations of lipid. A significantly higher anti-cancer efficacy was obtained for Mito-loaded SLN comparing to the free drug at different concentrations in MCF-7 2D models. Finally, the nanoformulation was evaluated in heterotypic breast cancer spheroids showing capacity to penetrate the tridimensional structure and ability to induce a high anti-tumoral effect, similarly to the free drug. Overall, these results support that the developed SLN are effective Mito nanocarriers for the treatment of breast cancer.

Gold nanostructures as mediators of hyperthermia therapies in breast cancer.

Breast cancer is the leading cause of cancer-related deaths among women. Due to the limitations of the current therapeutics, new treatment options are needed. Hyperthermia is a promising approach to improve breast cancer therapy, particularly when combined with chemo and radiotherapy. This area has gained more attention following association with nanotechnology, with the emergence of modalities, such as photothermal therapy (PTT). PTT is a simple, minimally invasive technique that requires a near infrared (NIR) light source and a PTT agent. Gold nanostructures are excellent PTT agents as they offer biocompatibility, versatility, high photothermal conversion efficiency, imaging contrast and an easily-modified surface. In this review, we describe the molecular basis and the current clinical aspects of hyperthermia-based therapies. The emergent area of nanoparticle-induced hyperthermia will be explored, in particular gold nanostructure-mediated PTT, focusing on recent preclinical studies for breast cancer management.

Magnetic reversal modes in cylindrical nanostructures: from disks to wires.

Cylindrical magnetic nanowires are key elements of fast-recording and high-density 3D-storage devices. The accurate tuning of the magnetization processes at the nanoscale is crucial for the development of future nano-devices. Here, we analyzed the magnetization of Ni nanostructures with 15-100 nm in diameter and 12-230 nm in length and compared our results with experimental data for periodic arrays. Our modelling led to a phase diagram of the reversal modes where the presence of a critical diameter (d ≈ 30 nm) triggered the type of domain wall (DW) formed (transverse or vortex); while a critical length (L ≈ 100 nm) determined the number of DWs nucleated. Moreover, vortex-DWs originated from 3D skyrmion tubes, reported as one of the best configurations for storage devices. By increasing the diameter and aspect-ratio of nanowires with L > 100 nm, three reversal modes were observed: simultaneous propagation of two vortex-DWs; propagation of one vortex-DW; or spiral rotation of both DWs through "corkscrew" mechanism. Only for very low aspect-ratios (nanodisks), no skyrmion tubes were observed and reversal occurred by spiral rotation of one vortex-DW. The broad range of nanostructures studied allowed the creation of a complete phase diagram, highly important for future choice of nanoscaled dimensions in the development of novel nano-devices.

Massive Pulmonary Thrombosis Following Haemoptysis in Type IV Ehlers–Danlos Syndrome / Trombosis pulmonar masiva tras hemoptisis en el Síndrome de Ehlers–Danlos tipo IV

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Gastric metastases from invasive lobular carcinoma of the breast: Case report.

Invasive lobular carcinoma is the second most common type of invasive carcinoma of the breast. Although rare, invasive lobular carcinoma can lead to gastric metastases, which may appear several years after the initial diagnosis. The diagnosis is difficult, either because of its rarity or because of overlapping symptoms and imaging findings with primary gastric carcinoma. Immunohistochemistry is the key to diagnosis. We report a case of a 40-year-old woman with a previous history of invasive lobular carcinoma of the breast 2 years before, who presented recurrent and nonspecific gastrointestinal symptoms. Imaging findings revealed linitis plastica and the biopsy showed the presence of signet ring cell neoplasia. After gastrectomy, immunohistochemistry demonstrated diffuse expression of GATA-3 and the presence of estrogen receptors in some neoplastic cells with CK20-, leading to the final diagnosis of gastric metastases from invasive lobular carcinoma of the breast.

Kimura's disease: a rare cause of facial mass in a caucasian male patient.

Kimura's disease is an uncommon inflammatory disorder of unclear aetiology, mainly affecting young Asian descent males among their second and fourth decades of life. The disease typically emerges as a long-standing and painless subcutaneous mass lesion in the head and neck region, frequently associated with swelling of major salivary glands, particularly the parotid gland, and regional lymphadenopathy. Peripheral eosinophilia and high serum immunoglobulin E are also characteristic findings. We report a case and describe the imaging and pathological features of the disease in a 19-year-old Caucasian male, with review of the literature.

Magnetic Nanomaterials as Contrast Agents for MRI.

Magnetic Resonance Imaging (MRI) is a powerful, noninvasive and nondestructive technique, capable of providing three-dimensional (3D) images of living organisms. The use of magnetic contrast agents has allowed clinical researchers and analysts to significantly increase the sensitivity and specificity of MRI, since these agents change the intrinsic properties of the tissues within a living organism, increasing the information present in the images. Advances in nanotechnology and materials science, as well as the research of new magnetic effects, have been the driving forces that are propelling forward the use of magnetic nanostructures as promising alternatives to commercial contrast agents used in MRI. This review discusses the principles associated with the use of contrast agents in MRI, as well as the most recent reports focused on nanostructured contrast agents. The potential applications of gadolinium- (Gd) and manganese- (Mn) based nanomaterials and iron oxide nanoparticles in this imaging technique are discussed as well, from their magnetic behavior to the commonly used materials and nanoarchitectures. Additionally, recent efforts to develop new types of contrast agents based on synthetic antiferromagnetic and high aspect ratio nanostructures are also addressed. Furthermore, the application of these materials in theragnosis, either as contrast agents and controlled drug release systems, contrast agents and thermal therapy materials or contrast agents and radiosensitizers, is also presented.

Tailoring the Anodic Hafnium Oxide Morphology Using Different Organic Solvent Electrolytes.

Highly ordered anodic hafnium oxide (AHO) nanoporous or nanotubes were synthesized by electrochemical anodization of Hf foils. The growth of self-ordered AHO was investigated by optimizing a key electrochemical anodization parameter, the solvent-based electrolyte using: Ethylene glycol, dimethyl sulfoxide, formamide and N-methylformamide organic solvents. The electrolyte solvent is here shown to highly affect the morphological properties of the AHO, namely the self-ordering, growth rate and length. As a result, AHO nanoporous and nanotubes arrays were obtained, as well as other different shapes and morphologies, such as nanoneedles, nanoflakes and nanowires-agglomerations. The intrinsic chemical-physical properties of the electrolyte solvents (solvent type, dielectric constant and viscosity) are at the base of the properties that mainly affect the AHO morphology shape, growth rate, final thickness and porosity, for the same anodization voltage and time. We found that the interplay between the dielectric and viscosity constants of the solvent electrolyte is able to tailor the anodic oxide growth from continuous-to-nanoporous-to-nanotubes.