Small Cell Neuroendocrine Carcinoma of the Lung Discovered by Acute Appendicitis Metastasis: An Experience at Our Hospital.

Acute appendicitis is the most common cause of abdominal pain that requires surgery. Appendiceal cancer is rare, comprising nearly 4% of all gastrointestinal diagnoses. It is common to find neuroendocrine neoplasms due to metastasis in this site. Appendix tumors are usually asymptomatic; however, if they are advanced or have metastases, they can cause abdominal symptoms. Computed tomography (CT) is commonly used to diagnose acute appendicitis in these cases. CT usually shows an increased appendiceal diameter with thickening (>3 mm) of the appendiceal wall, an intraluminal fluid depth >2.6 mm, and periappendiceal inflammation. Histopathological findings confirm the diagnosis. Medical and surgical management depends on physical characteristics such as size, location, and degree of evolution. We present the case of a 77-year-old woman with a family history of well-controlled type 2 diabetes mellitus and hypertension. She was referred to our institution after four days of abdominal pain in the epigastrium and both flanks accompanied by fever. An abdominal CT showed left pleural effusion and appendicular thickening. Laboratory tests showed high blood glucose levels, leukocytosis at the expense of neutrophils, an increased platelet count, and decreased albumin and total proteins. The CT scan also showed a calcified granuloma in the anterior segment of the right upper lobe and an irregular image with partially defined hypodense borders in the liver in segment IVb. We report our experience with the diagnosis, management, and treatment decisions of this case. It is important to mention that the first diagnosis was acute appendicitis. This diagnosis motivated us to seek other symptoms and signs by direct questioning and imaging studies leading us to diagnose metastatic lung cancer.

Short-Term Interventions for Survivors of Intimate Partner Violence: A Systematic Review and Meta-Analysis.

Intimate partner violence (IPV) impacts millions of adults and children every year and can result in homicide, legal proceedings, the involvement of child welfare, and the need for emergency shelter for survivors and their families. Survivors of IPV may develop psychological and somatic symptoms to the trauma, including anxiety, depression, and other mental health related disorders in addition to facing numerous safety, financial, and social challenges. To reestablish stability, effective short-term interventions are needed in order to address these issues survivors face. This systematic review and meta-analysis summarizes the extant literature on short-term interventions for survivors of IPV. Twenty-one studies are included in the analysis and overall effect sizes calculations and moderator analysis were conducted. On average, effects sizes were large (g = 1.02) suggesting that most sort-term interventions are effective, however CBT-based interventions that were tailored to IPV survivors achieved the largest effect sizes. Results of this study are presented in a question and answer format with the intent to guide practitioners, researchers and policy makers. IPV survivors access services in a variety of shelter and outpatient settings and present diverse needs. Although this study contributes a systematic review of the existing literature on IPV, there are relatively few rigorous outcome studies and even fewer that reflect the diversity in this population and the complexity of responding to IPV in real-world settings.

Lateral diffusion, function, and expression of the slow channel congenital myasthenia syndrome αC418W nicotinic receptor mutation with changes in lipid raft components.

Lipid rafts, specialized membrane microdomains in the plasma membrane rich in cholesterol and sphingolipids, are hot spots for a number of important cellular processes. The novel nicotinic acetylcholine receptor (nAChR) mutation αC418W, the first lipid-exposed mutation identified in a patient that causes slow channel congenital myasthenia syndrome was shown to be cholesterol-sensitive and to accumulate in microdomains rich in the membrane raft marker protein caveolin-1. The objective of this study is to gain insight into the mechanism by which lateral segregation into specialized raft membrane microdomains regulates the activable pool of nAChRs. We performed fluorescent recovery after photobleaching (FRAP), quantitative RT-PCR, and whole cell patch clamp recordings of GFP-encoding Mus musculus nAChRs transfected into HEK 293 cells to assess the role of cholesterol and caveolin-1 (CAV-1) in the diffusion, expression, and functionality of the nAChR (WT and αC418W). Our findings support the hypothesis that a cholesterol-sensitive nAChR might reside in specialized membrane microdomains that upon cholesterol depletion become disrupted and release the cholesterol-sensitive nAChRs to the pool of activable receptors. In addition, our results in HEK 293 cells show an interdependence between CAV-1 and αC418W that could confer end plates rich in αC418W nAChRs to a susceptibility to changes in cholesterol levels that could cause adverse drug reactions to cholesterol-lowering drugs such as statins. The current work suggests that the interplay between cholesterol and CAV-1 provides the molecular basis for modulating the function and dynamics of the cholesterol-sensitive αC418W nAChR.