Prognostic factors affecting infantile medulloblastoma outcomes in the molecular era: a 12-year single-center experience from Egypt.

Aims: To assess the clinical, pathological and molecular characteristics (Sonic hedgehog and group 3/4 molecular subtypes expression) and treatment modalities for infantile medulloblastoma in correlation with outcomes. Materials & methods: A retrospective study of 86 medulloblastoma patients (≤3 years) was conducted. M0 patients <2.5 years received four cycles of chemotherapy followed by focal radiotherapy (FRT) and chemotherapy. Between 2007 and 2015, Metastatic patients <2.5 years received craniospinal irradiation (CSI) after the end of chemotherapy. After 2015, metastatic patients <2.5 years received CSI postinduction. Results: The hazard ratio for death was significantly higher in the FRT (HR = 2.8) group compared with the CSI group (hazard ratio = 1). Metastatic disease significantly affected the overall survival of the Sonic hedgehog group and the overall survival and event-free survival of group 3/4. Conclusion: Metastatic disease had a significant impact on outcomes. FRT is not effective in treating infantile medulloblastoma.

This study aimed to analyze the management of and prognostic factors affecting the outcomes of 86 young children (<3 years of age at presentation) diagnosed with medulloblastoma, an aggressive brain tumor that is commonly seen in this age group. All children had surgical operations aiming at resecting their tumors, followed by chemotherapy and irradiation. Study results showed that disease disseminated into the nervous system was associated with poorer outcomes compared with localized disease. Administration of local irradiation to the primary tumor site in the brain only, without exposing the spinal cord to radiotherapy, was associated with a higher risk of death.

Assessment of Quality of Life of Patients with Inflammatory Skin Diseases Using Skindex-16: A Cross-Sectional Multicenter Study.

Inflammatory skin diseases are highly prevalent, yet their impacts on patients' quality of life (QoL) are not addressed. In this cross-sectional study, the Arabic version of Skindex-16 was used to evaluate the symptomatic, emotional, and functional distress of patients with inflammatory skin disorders attending several outpatient dermatology clinics in Egypt and Saudi Arabia. Patients with ≥50% of the symptoms score, ≥50% of the emotions score, and ≥33% of the functioning score were considered having poor QoL. A total of 1,310 patients aged 30 ± 13 years (70.6% from Egypt and 29.4% from Saudi Arabia) were included in this study. Of them, 1,192 patients had inflammatory skin diseases, and 118 had facial nevi, who served as controls. Patients with inflammatory skin diseases had significantly worse QoL than those with nevi. Autoimmune bullous disease group showed the highest prevalence poor symptoms (56.8%), poor emotions (75.7%), and poor functioning (83.8%) of QoL. Women with acne and psoriasis were more likely to have poor symptoms than men (16.3% vs. 4.7% and 52.7% vs. 25.3%, respectively). In conclusion, inflammatory skin diseases had profound negative effects on patients' QoL. Age, sex, education, and marital status of patients can affect their perception of QoL.

Bronchoscopic management of endobronchial carcinoid presenting as asthma Mimic.

We report a 25-year-old woman with persistent dyspnea and wheezes that had been unsuccessfully treated with inhaled beta 2-agonists and steroids for about one year. Spirometry demonstrated a restrictive pattern. Chest CT demonstrated polypoidal lesion in left main bronchus. The lesion was excised via rigid bronchoscopy. Pathology showed a picture of typical bronchial carcinoid. In this patient, due to the lack of awareness, diagnosis of carcinoid was delayed for one year.