Diving Medicine: An Exciting Journey Through Time and Future Prospects.

Humans, led by their eternal wish to explore the unknown, have always wanted to perfect their diving skills and conquer the sea world. The adverse conditions experienced by divers brought about medical problems and a new field of medicine. Diving medicine serves the identification, treatment, and precautions against illnesses that are related to diving activities. While the development of diving equipment is advancing, divers have had the chance to reach greater depths for a longer time. Along with this success, a novel medical condition under the term 'decompression illness' (DCI) was introduced. Although the history of hyperbaric medicine is very long, progress in the field of mechanics has offered great contributions to the management of the disease. The first attempt at DCI guidelines was made by the US Navy in 1944-1945 and resulted in the creation of hyperbaric treatment tables. These tools received international recognition, offering a major advance. Hyperbaric-Diving Medicine holds an important place in modern medical science nowadays with indications for various diseases. At the same time, there is great scientific interest and a lot of research in the use of hyperbaric oxygen for several medical disorders, demonstrating great potential.

A Rare Case of Thyroid Metastasis From Colorectal Cancer: Diagnostic and Therapeutic Challenges.

The incidence of thyroid metastases among patients suffering from primary colorectal cancer is rare, and only a few cases have been described in the literature. As these metastases are usually asymptomatic, they most frequently present as incidentalomas on follow-up imaging. Hereby, we present and discuss an interesting case of metastatic sigmoid adenocarcinoma of the thyroid gland, diagnosed and treated at our institution.

Synchronous Gastric Adenocarcinoma and Diffuse Large B-Cell Lymphoma in the Pelvis: A Rare Case Presentation.

Multiple primary cancer (MPC) is defined as more than one primary tumour diagnosed at the same patient, either simultaneously or sequentially. Its incidence is low and varies in reporting among medical centers. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma (NHL) while gastric cancer (GC) is the fifth most frequently diagnosed malignancy. The aim of this article is to present a rare case of a female patient who was diagnosed with two synchronous malignancies, an adenocarcinoma of the stomach (SRCC) and an aggressive extranodal NH lymphoma (DLBCL) within 2 months. Given the fact that there is an expanding availability of more sensitive diagnostic and screening methods, we aim to increase surveillance amongst medical doctors and provide valuable information for further systematic analysis and identification of such rare cases of concurrent malignancies.

Skin metastases from gastric cancer, a rare entity masquerading as erysipelas: A case report.

Gastric cancer (GC) is the fifth most commonly diagnosed malignancy and the fourth leading cause of cancer death worldwide. Skin metastases from internal organs are rare; skin metastasis from GC occurs even more rarely than skin metastases originating from other organs, and is associated with systematic disease and poor prognosis. The present study described an interesting and rare case of an extensive skin rash in a 42-year-old man diagnosed with GC, which was mainly affecting his left hemithorax, abdomen and back. The rash masqueraded as erysipelas and was initially treated as such; however, it did not respond to antibiotics, corticosteroids and antihistamines. Due to its persistence and location, the rash was biopsied and GC metastasis was confirmed. Third-line chemotherapy was administered and the rash decreased in size; however, the patient suffered from disease deterioration with lung metastases and respiratory failure. The patient eventually died 4 months after the diagnosis of skin metastasis. In conclusion, cutaneous metastasis should be considered as a late and difficult to treat metastasis of GC, which requires high surveillance from medical oncologists, and a multidisciplinary approach for prompt and accurate diagnosis.

Mediastinal and hilar sarcoid-like reaction in a patient treated with dabrafenib and trametinib for metastatic melanoma: A case report and review of the literature.

BRAF/MEK inhibitors are considered standard of care in the treatment of advanced BRAF-mutated malignant melanoma, and have been, in rare cases, associated with granulomatous reactions, mostly limited to skin lesions. The present study reported the case of a patient with metastatic melanoma developing a sarcoid-like reaction manifesting as asymptomatic mediastinal and right hilar lymphadenopathy while on antineoplastic therapy with dabrafenib and trametinib. To the best of our knowledge, this is the first reported case of isolated lymphadenopathy as a manifestation of drug-induced sarcoid-like reaction under dabrafenib and trametinib. Overall, only 17 other cases of granulomatosis have been reported in the literature. Although uncommon, such reactions should be considered in the differential diagnosis of lymph node enlargement, and distinguishing them from tumor progress is important and can be challenging in clinical practice.

The potential role of the combined PARP-1 and VEGF inhibition in severe SARS-CoV-2 (COVID-19) infection.

INTRODUCTION: During the evolution of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, several drug candidates have been proposed for repositioning towards a quest for more effective treatments. METHODOLOGY: We reviewed recent literature (Pubmed, Google, Clinicaltrials.gov), as of the middle of May 2021, for evidence regarding the potential benefit from poly(ADP-ribose)-polymerase inhibitors and vascular endothelial growth factor blockade in severe SARS-CoV-2 infection. RESULTS: poly(ADP-ribose)-polymerase inhibitors have been suggested as potential agents against coronavirus disease 2019 (COVID-19) by a variety of mechanisms. vascular endothelial growth factor-associated vascular permeability is implicated with increased vascular leakage and pulmonary oedema. Thus, anti-angiogenesis factors, such as bevacizumab are being investigated in critically ill COVID-19 patients. CONCLUSIONS: The synergistic potential of these two classes of inhibitors in severe COVID-19 management could be beneficial. Further research should be carried out in order to support this hypothesis.

The Role of Exosomal Non-Coding RNAs in Colorectal Cancer Drug Resistance.

BACKGROUND: Colorectal cancer (CRC) is one of the most common types of cancer diagnosed worldwide with high morbidity; drug resistance is often responsible for treatment failure in CRC. Non-coding RNAs (ncRNAs) play distinct regulatory roles in tumorigenesis, cancer progression and chemoresistance. METHODS: A literature search was conducted in PubMed database in order to sum up and discuss the role of exosomal ncRNAs (ex-ncRNAs) in CRC drug resistance/response and their possible mechanisms. RESULTS: Thirty-six (36) original research articles were identified; these included exosome or extracellular vesicle (EV)-containing microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs) and small-interfering (siRNAs). No studies were found for piwi-interacting RNAs. CONCLUSIONS: Exosomal transfer of ncRNAs has been documented as a new mechanism of CRC drug resistance. Despite being in its infancy, it has emerged as a promising field for research in order to (i) discover novel biomarkers for therapy monitoring and/or (ii) reverse drug desensitization.

Circulating miRNA Expression Profiles and Machine Learning Models in Association with Response to Irinotecan-Based Treatment in Metastatic Colorectal Cancer.

Colorectal cancer represents a leading cause of cancer-related morbidity and mortality. Despite improvements, chemotherapy remains the backbone of colorectal cancer treatment. The aim of this study is to investigate the variation of circulating microRNA expression profiles and the response to irinotecan-based treatment in metastatic colorectal cancer and to identify relevant target genes and molecular functions. Serum samples from 95 metastatic colorectal cancer patients were analyzed. The microRNA expression was tested with a NucleoSpin miRNA kit (Machnery-Nagel, Germany), and a machine learning approach was subsequently applied for microRNA profiling. The top 10 upregulated microRNAs in the non-responders group were hsa-miR-181b-5p, hsa-miR-10b-5p, hsa-let-7f-5p, hsa-miR-181a-5p, hsa-miR-181d-5p, hsa-miR-301a-3p, hsa-miR-92a-3p, hsa-miR-155-5p, hsa-miR-30c-5p, and hsa-let-7i-5p. Similarly, the top 10 downregulated microRNAs were hsa-let-7d-5p, hsa-let-7c-5p, hsa-miR-215-5p, hsa-miR-143-3p, hsa-let-7a-5p, hsa-miR-10a-5p, hsa-miR-142-5p, hsa-miR-148a-3p, hsa-miR-122-5p, and hsa-miR-17-5p. The upregulation of microRNAs in the miR-181 family and the downregulation of those in the let-7 family appear to be mostly involved with non-responsiveness to irinotecan-based treatment.

Gene fusion analysis in the battle against the African endemic sleeping sickness.

The protozoan Trypanosoma brucei causes African Trypanosomiasis or sleeping sickness in humans, which can be lethal if untreated. Most available pharmacological treatments for the disease have severe side-effects. The purpose of this analysis was to detect novel protein-protein interactions (PPIs), vital for the parasite, which could lead to the development of drugs against this disease to block the specific interactions. In this work, the Domain Fusion Analysis (Rosetta Stone method) was used to identify novel PPIs, by comparing T. brucei to 19 organisms covering all major lineages of the tree of life. Overall, 49 possible protein-protein interactions were detected, and classified based on (a) statistical significance (BLAST e-value, domain length etc.), (b) their involvement in crucial metabolic pathways, and (c) their evolutionary history, particularly focusing on whether a protein pair is split in T. brucei and fused in the human host. We also evaluated fusion events including hypothetical proteins, and suggest a possible molecular function or involvement in a certain biological process. This work has produced valuable results which could be further studied through structural biology or other experimental approaches so as to validate the protein-protein interactions proposed here. The evolutionary analysis of the proteins involved showed that, gene fusion or gene fission events can happen in all organisms, while some protein domains are more prone to fusion and fission events and present complex evolutionary patterns.