Factors Affecting Adenoma Risk Level in Patients with Intestinal Polyp and Association Analysis

Abstract Background Diffuse leptomeningeal glioneuronal tumor (DLGNT) has been recently described in the literature. The complete neuroimaging spectrum and histopathological characteristics of this entity are yet to be elucidated. In an endemic region, diffuse leptomeningeal enhancement on neuroimaging with associated communicating hydrocephalus is usually suggestive of infective meningitis and the patients are started on empirical anti-microbial therapy. However, it is important to consider other differential diagnosis of leptomeningeal enhancement in such cases, particularly if the clinical condition does not improve on anti-microbial therapy. An early diagnosis of a neoplastic etiology may be of particular importance as the treatment regimens vary considerably depending on the underlying disease condition. Case presentation In this case report, we describe a case of DLGNT with high-grade histopathological features which was initially managed as tubercular meningitis based on the initial neuroimaging findings. Due to worsening of the clinical course and subsequent imaging findings at follow-up, a diagnosis of DLGNT was considered and subsequently proven to be DLGNT with features of anaplasia on histopathological examination of leptomeningeal biopsy specimen. Conclusion This case highlights the importance of recognizing certain subtle finding on MRI which may help in an early diagnosis of DLGNT which is crucial for appropriate treatment.

Objectives: To determine the urothelial carcinoma and its association with age and gender. Study Design: Retrospective study. Setting: Pathology department of Liaquat university of Medical and Health Science. Period: One year from January 2016 to December 2016. Material and Methods: Four micrometer thick paraffin-embedded and formalin-fixed sections were prepared from transurethral resection6of bladder6tumor (TURBT) samples of urothelial carcinoma patients and were examined. Histological grading was categorized as low and high grades. All the data was collected by self-made proforma. Data was analyzed by SPSS version 20. Results: Total 83 cases were enrolled in current study; their mean age was 49.19+12.33 years. Males were found in the majority 51(61.4%) and females were 32(38.6%). Most common age group was 46-60 years 36(43.4%). According to the histological grading high grade was most common as 65.10%, and low grade urothelial carcinoma was 34.90%. There was no significant difference according to age of histological grading. Male gender was most common, while progression of disease was higher among females in contrast to males as high grade carcinoma was significantly higher among females, p-value 0.014. Conclusion: It was concluded that male gender is the contributing factor of urothelial carcinoma, but disease progression significantly high among females. No significant association has been found according to age.

Background The natural history of type 2 diabetes (T2D) in youth appears to differ from that in adults in that almost half of T2D youth in the “Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY)” study had a rapid decline in beta cell function. The rate of change in risk for cardiovascular disease (CVD) in youth with T2D is not known. We tested the hypothesis that CVD risk factors are highly prevalent and rapidly progress over time in youth with T2D using longitudinal assessments of hypertension (HT), microalbuminuria (MA) and dyslipidemia obtained during the TODAY clinical trial of adolescents with recent onset T2D. Methods A cohort of 699 adolescents, aged 10-17 years, <2 years duration of T2D, body mass index (BMI) ≥85th percentile, Hemoglobin A1c (A1c) ≤8% on metformin therapy were randomized to metformin alone, metformin plus rosiglitazone, or metformin plus an intensive lifestyle intervention and followed over an average of 3.9 years. (range 2-6.5 years). Primary outcome was loss of glycemic control. Quarterly BP and annual MA were monitored with initiation and titration of therapy (ACE inhibitor) to maintain BP <130/80 or <95th percentile for age, gender, and height and MA <30 mcg/mg. Statin drugs were begun for LDL cholesterol (LDLC) ≥130 mg/dL or triglycerides ≥300 mg/dL. Change in the prevalence of CVD risk factors was examined accounting for the effect of treatment group, time, glycemic control, gender, and race-ethnicity. Results In this cohort, 319 (45•6%) reached primary glycemic outcome. HTN was observed in 11•6% of subjects at baseline and 33•8% by end of study (average follow-up 3•9 years). MA was found in 6•3% at baseline and rose to 16•6% at study end. Participants with LDLC ≥130 mg/dL or statin use increased from 4.5% to 10.7%. Male gender and higher BMI significantly increased the risk for HTN. Higher levels of hemoglobin A1c correlated with the risk of developing MA and dyslipidemia. Conclusion The prevalence of CVD risk factors increased rapidly among adolescents with T2D regardless of diabetes treatment. The greatest risk for HTN was male gender and higher BMI. The risk for microalbuminuria and worsening of dyslipidemia was related to glycemic control. Measures to address CVD risk are needed early in the disease course in this high risk population.

Undifferentiated pleomorphic sarcoma constitutes less than 5 % of all sarcomas in adults and has been rarely seen in the breast and is dened as a group of pleomorphic, high-grade sarcomas in which any attempt to disclose their line of differentiation has failed . Most undifferentiated pleomorphic sarcomas(UPS) have occurred in their sixth and seventh decades of life and very rarely in adolescents and adults. We report a case of 24 year old female presented with painless lump in right breast and rapidly increasing in size for last 5 months. Iinitial diagnosis was made as sarcoma breast on the basis of physical and radiological examination. After that total mastectomy was done without axillary lymph node dissection, as lymphatic spread is very rare. But without histopathological examination and most importantly IHC-panel, it is impossible to make a denitive diagnosis of UPS breast.

Risk attitudes are relevant factors affecting production, management and investment decisions at the farm level. They are key factors related to farmers’ attitudes towards the environment and climate change. Several methodological approaches, which were considered to be preferable for measuring the level of risk of an economic agent, ranging from highly risk-tolerant to highly risk-averse attitudes, are available. The Multiple Price List (MPL) method is one of the stated approaches that is gaining relevance. In this study, we apply the MPL and relate the risk outcomes to farmers’ socio-economic characteristics and their perceptions of the environment and climate change. Data were collected using a face-to-face survey, carried out with a group of 370 farmers of an irrigation district, located in the northwest of Mexico. The results showed a risk level of about 0.32, according to the Constant Relative Risk Aversion (CRRA) coefficient, locating farmers of the region in a risk-averse group. The heterogeneity analysis showed that the socioeconomic factors and the perceptions of climate change are related to the farmers´ stated risk level. Farmers who are young women, with a tendency to use public support for structural investment, were shown to be risk-tolerant. Farmers considered floods, hail, diseases, pests, and weed growth incidences to be the most frequent weather patterns in the region.

Safety is the premise of efficiency and effectiveness in the port operation. Safety investment is becoming a vital part of port operation in current era in order to overcome different types of hazards the port operation exposed to. This paper aims to improve the safety level of port operation through analyzing its influencing factors and exploring the interactions between the safety investment and system risk level. By analyzing the key factors affecting the port operation and their mutual relationship within a man–machine–environment–management system, a decision-making model of safety investment in port enterprise was established by system dynamics (SD). An illustration example and a sensitivity analysis were carried out to justify and validate the proposed model. The results show that increasing the total safety investment of port enterprises, improving the safety management investment on personnel, and strengthening the implementation effect of investment can improve the degree of port security to a certain extent. The strength of the proposed work is its practical application in current scenarios using real time data and the ability to provide a baseline approach for port enterprises to formulate safety investment strategy.

Abstract Background Appendiceal inversion with neoplasia in adults is an extremely rare event with a reported incidence of < 0.01%. Preoperative diagnosis is very important for surgical treatment; however, it is very difficult to be exact. Case presentation The patient was a 60-year-old woman with complaints of intermittent abdominal pain. Computed tomography and colonoscopy revealed a cecal mass, which was diagnosed as a tubulovillous adenoma in the preoperative colonoscopic biopsy. At surgery, the appendix was found to be completely inverted into the cecum. The cecum was partially resected, and surgical pathology examination confirmed a tubulovillous adenoma of the appendix with local high-grade intraepithelial neoplasia. Conclusions Although preoperative diagnosis of appendiceal inversion with neoplasia may be often difficult due to its non-specific symptoms, clinicians should consider this disease entity when they encounter an intraluminal protruding cecal mass without visualization of the normal appendix on CT and colonoscopy.