Gelatinous Pleural Effusion: A Diagnostic Challenge for Pleural Mesothelioma in an 80-Year-Old Man.

BACKGROUND Gelatinous pleural effusion, due to raised hyaluronic acid, can be associated with pleural infection and malignancies, such as tuberculosis, metastatic pleural disease, and mesothelioma. This report is of an 80-year-old man presenting with a gelatinous pleural effusion and diagnosis of pleural mesothelioma. CASE REPORT An 80-year-old man with diabetes mellitus, ischemic heart disease, metastatic prostate cancer, 30-pack-year smoking history, and 5-year history of asbestos exposure (during his 30s), presented with a 4-week history of breathlessness and was found to have right-sided pleural effusion. Thoracic computed tomography (CT) showed mild right-sided pleural thickening. Pleural tap revealed exudative fluid, with a pH of 7.4, and unremarkable cytology and microbiology analyses. The patient was treated for pneumonia and para-pneumonic effusion and discharged home. He came back 5 weeks later with worsening of symptoms and re-accumulation of pleural fluid. Repeated thorax CT showed extensive right-sided pleural lobular thickening. Pleural tap again yielded an exudative fluid, with a pH of 7.37. Cytology and microbiology did not reveal any positive signs for malignancy or infection. This time the pleural fluid appeared gelatinous in consistency. Pleural biopsy showed atypical epithelioid mesothelial cells arranged in trabeculae, with a tubulo-papillary configuration. Also, immunohistochemistry panel showed tumor cells expressed calretinin, EMA, WT1, and D2-40, with negative TTF1, CEA, and BerEp4. Final diagnosis was epithelioid mesothelioma. CONCLUSIONS This report has shown that a gelatinous pleural effusion can be associated with malignant and inflammatory pleural diseases. In this case, imaging and pleural biopsy with histopathology confirmed a diagnosis of pleural mesothelioma.

Juvenile multiple sclerosis: addressing epidemiology, diagnosis, therapeutic, and prognostic updates along with cognitive dysfunction and quality of life.

Juvenile multiple sclerosis (JMS) is a rare but significant subtype of multiple sclerosis (MS) that affects a small percentage of patients under the age of 10 and 3-5% of all MS patients. Despite its rarity, JMS poses unique challenges in terms of diagnosis, treatment, and management, as it can significantly impact a child or adolescent's physical, cognitive, and emotional development. JMS presents with a varying spectrum of signs and symptoms such as coordination difficulties and permanent cognitive dysfunctions and may include atypical clinical features such as seizures, acute disseminated encephalomyelitis, and optic neuritis, making diagnostic evaluations challenging. Whilst the biology of JMS shares similarities with adult-onset MS, there exist notable distinctions in disease progression, clinical manifestations, and ultimate prognoses. The International Pediatric MS Study Group (IPMSSG) was founded in 2005 to improve understanding of JMS, but there remains a lack of knowledge and guidelines on the management of this condition. This review summarizes the current knowledge on JMS, including its epidemiology, clinical presentations, diagnostic challenges, current treatment options, and outcomes. Current treatment options for JMS include disease-modifying therapies, but JMS can also result in impaired quality of life and psychiatric comorbidity, highlighting the need for comprehensive care for affected children. Through gathering and analyzing scattered studies and recent updates on JMS, the authors aim to address the gaps in current knowledge on JMS and provide an improved understanding of appropriate care for affected children. By doing so, this review hopes to contribute to improving the quality of life and outcomes for JMS patients.

Effect of ferroelectric BaTiO3 particles on the threshold voltage of a smectic A liquid crystal.

The influence of small ferroelectric BaTiO3 particles on the planar-homeotropic transition threshold voltage in smectic A liquid crystals consisting of p-nitrophenyl p-decyloxybenzoate and 4-cyano-4'-pentylbiphenyl were studied by using capacitance-voltage (C-V) measurements. It was shown that the BaTiO3 particles significantly reduce the threshold voltage. The obtained result is explained by two factors: an increase of dielectric anisotropy of the liquid crystals and the formation of a strong electric field near polarized particles of BaTiO3. It was shown that the role of the second factor is dominant. The explanations of some features observed in the C-V characteristics are given.

Effects of daily consumption of probiotic yoghurt on inflammatory factors in pregnant women: a randomized controlled trial.

Previous studies have shown that inflammatory factors increases in pregnancy and is associated with several complications of pregnancy. The aim of this study was to assess effects of daily consumption of probiotic yoghurt on inflammatory factors in pregnant women. In a randomized clinical trial, seventy primigravid (the first pregnancy) and singleton pregnant women aged 18-30 years were assigned to two groups. Subjects consumed daily 200 g probiotic yoghurt containing Lactobacillus acidophilus La5 and Bifidobacterium animalis BB12 (10(7) CFU g(-1) for each) or 200 g conventional yoghurt for 9 weeks. Fasting blood samples were collected at baseline (28 weeks of gestation) and after intervention (37 weeks of gestation). Inflammatory factors, hs-CRP and TNF-alpha, were measured by Enzyme-linked Immunosorbent Assay (ELISA). Independent t-test was used to compare the two groups after intervention and paired-sample t-test compared variables before and after treatment. The results showed that the probiotic yogurt brought about a decrease in the serum hs-CRP level, from 10.44 +/- 1.56 to 7.44 +/- 1.03 microg mL(-1) (p = 0.041). There was no significant change in the conventional yogurt group in the serum hs-CRP level (12.55 +/- 1.57 to 14.51 +/- 1.62 microg mL(-1), p = 0.202). The probiotic yogurt had no effect on TNF-alpha (from 73.75 +/- 6.59 to 77.91 +/- 5.61 pg mL(-1), p = 0.633). Serum TNF-alpha did not change in the conventional yogurt group (p = 0.134). In conclusion probiotic yogurt significantly decreased hs-CRP in pregnant women but had no effect on TNF-alpha.