Secondary solid cancer following hematopoietic cell transplantation in patients with thalassemia major.

Hematopoietic cell transplant (HCT) recipients have a substantial risk of developing secondary solid cancers (SSCs). The aim of this retrospective study was to compare the incidence of SSC in a monocentric cohort of thalassemia major (TM) patients (n=122) who received HCT versus an hematopoietic cell donor monocentric cohort (n=122) and versus a large multicenter cohort of age- and sex-matched TM patients (n=244) who received conventional therapy. With a median follow-up of 24 years, 8 transplanted patients were diagnosed with SSC at a median of 18 years after HCT and at a median age of 33 years. Three patients died of cancer progression and 5 are living after a follow-up ranging from 10 months to 16 years after SSC diagnosis. The 30-year cumulative incidence of developing SSC was 13.24%. The occurrence of solid cancers in the hematopoietic cell donor cohort was limited to only one case for a significantly lower cumulative incidence (3.23%, P=0.02) and to 3 cases in the cohort of nontransplant patients for a significantly lower cumulative incidence (1.32%, P=0.005). This study shows that the magnitude of increased risk of SST is fourfold to sixfold for patients treated with HCT as compared with hematopoietic cell donors and nontransplant patients.

Dietary intake of cancer patients on radiotherapy.

UNLABELLED: The dietary intake of cancer patients can affect their nutritional status. OBJECTIVES: To assess the dietary intake and nutritional status of head and neck cancer patients on radiotherapy. METHODS: 24-hour recalls and anthropometric measures were taken during the first and third weeks of radiotherapy. RESULTS: Of the 62 patients, significant reductions were found in arm muscle area (p = 0.001) and arm muscle circumference (p < 0.001), and 69% of patients had an average weight loss of 5.7% in three weeks. With regards to their dietary intake, reductions were found in energy (26.5 kcal/kg/d-21.3 kcal/kg/d, p < 0.001), carbohydrate (196.9 g/d - 180.5 g/d, p = 0.020), protein (1.19 g/kg/d-0.93 g/kg/d, p = 0.009) and fat (44.4 g/d-33.1 g/d, p < 0.001) intakes during the study period. DISCUSSION: The changes that result from cancer radiotherapy led to reductions in dietary intake and negatively affected body composition measures.

Bilateral suprascapular nerve entrapment by glenoid labral cysts associated with rotator cuff damage and posterior instability in an amateur weightlifter.

Suprascapular nerve entrapment is a common condition in athletes. The entrapment is most frequently due to a "glenoid labral cyst" produced by joint fluid extrusion in consequence of labral degenerative changes. The bilaterality of the entrapment and the association with rotator cuff pathology are a rare evidence. We present the case of a 38-year-old amateur weightlifter with an history of left shoulder chronic posterior pain and progressive external rotation weakness, and with an acute right shoulder pain and weakness. Magnetic resonance imaging showed a bilateral glenoid labral cyst in association with partial tear of the supraspinatus tendon, atrophy of the infraspinatus muscle and type 2 SLAP lesion at the left shoulder and subacromial impingement syndrome (due to acromio-clavicular osteophyte), mild atrophy of the infraspinatus muscle and type 1-2 SLAP lesion at the right side.

Repetitive magnetic stimulation of the sacral roots for the treatment of stress incontinence: a brief report.

AIM: The aim of this study was to investigate the short and long-term effects of repetitive magnetic stimulation on the sacral roots in a homogeneous group of patients affected by stress incontinence. METHODS: Twenty women with urinary stress incontinence were randomly assigned to an active or a sham stimulation group. Fifteen-Hz repetitive magnetic stimulation of the sacral roots (S2-S4) was applied for 15 min. Patients were treated with magnetic stimulation for 3 days a week for 2 weeks (6 times in all). The clinical outcome was assessed before (T1) and 1 week (T2) and 1 month (T3) after stimulation. Main outcome measures were: the King's Health Questionnaire, the SEAPI-QMM scale and the amount of urinary loss in a 1-h pad test and stress test. RESULTS: At T2 patients in the active stimulation group showed improvement in health perception (P<0.001), social limitation (P<0.01), sleep/energy performance (P<0.05) and severity measure score (P<0.05) not observed in the sham stimulation group; a significant decrease in SEAPI-QMM score was noted only in the active group at T2 (P<0.05). These results were no longer observed at T3. We also observed a decrease in the amount of urine loss quantified with the pad test and stress test in the active stimulation group. CONCLUSION: Repetitive magnetic stimulation of the sacral roots has a short-term effect on some aspects of the quality of life of the patients, but it did not prove effective using quantified measurement.

Eclamptic encephalopathy: imaging and pathogenetic considerations.

Eclampsia is a rare condition peculiar to pregnant and puerperal women, characterized by clinical pre-eclampsia (hypertension, proteinuria, edema) and generalized seizures. Three cases of eclamptic encephalopathy are reported: CT and MRI demonstrated transient abnormalities in the cortical and subcortical regions of the posterior areas of the brain - namely, parieto-occipital lobes - associated with occasional involvement of basal ganglia and/or brainstem. Pathogenesis is still unclear. Strict similarity with the pathological findings characterizing hypertensive encephalopathy suggests that a focal impairment in cerebral autoregulation may be the cause of vasodilation and fluid extravasation leading to hydrostatic edema; selective involvement of posterior areas could be explained by their lesser degree of adrenergic innervation supporting circulatory autoregulation mechanisms.

[Prevalence of RDS in diabetic pregnancy]. / La prevalenza di RDS del neonato nella gravidanza diabetica.

The offspring of the diabetic mother is more significantly affected by RDS (Respiratory Distress Syndrome) than the healthy pregnancy's one in the same conditions. The RDS is one of the most important cause of perinatal morbidity and mortality. The etiology of this syndrome is recognized in the modified carbohydrates metabolism, in the apposite effect of insulin versus the cortisol action, and in the slower adsorption of the alveolar fluid following the Cesarean section. In fact the diabetic mother is frequently submitted to this intervention to end the pregnancy and especially in last years when the CS was of first choice at 35 weeks in the diabetic mothers. Actually the RDS appears in the 13% of the offspring of mothers affected by pregestational diabetes and in the 5% of the offspring of gestational diabetic mothers. Here we refer about the prevalence of RDS in a population of 55 diabetic mothers.