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Pure alphafetoprotein producing neuroendocrine carcinoma of the stomach: A case report

Case Report of Open Journal of Gastroenterology and Hepatology Pure alphafetoprotein producing neuroendocrine carcinoma of the stomach: A case report Chen-Wei Chu1, Chien-ho Tsai2, Yu-Huan Huang3, Chun-I Tsai4, Swei-hsiung H Tsung5 1.Department of Medicine, Taipei Veterans General Hospital, Yuanshan branch, Yuanshan, Yilan, Taiwan. 2.Deparment of surgery, National Yang-Ming University Hospital, Yilan.Taiwan. 3.Department of Nursing, National Yang-Ming University Hospital, Yilan, Taiwan 4.Chun-I Tsai Medical Clinic. Yilan, Taiwan. 5.Department of Pathology, St Mary’s Hospital, Loudong, Yilan, Taiwan Alpha-fetoprotein-producing gastric carcinoma (AFP-GC) is a rare malignant tumor, and has been regarded as a distinct category because of its particularly aggressive biological behavior and poor patient prognosis. In the literature, AFP-GC was never reported in neuroendocrine carcinoma of the stomach. In this article, we described a 60-year old man who sought medical attention because of epigastric pain and poor appetite. His laboratory data were within normal limits except for elevated serum level of alpha-fetoprotein. He was found to have an ulcer on gastroscopic examination which led to the final diagnosis of AFP producing neuroendocrine carcinoma of the stomach. He underwent a radical gastrectomy followed by chemotherapy using leucovorin and 5-fluorouracil.His disease was brought under remission for only six months before radiological recurrence occurred. His recurrent disease was treated with irinotican plus cisplatin without a significant response. His prognosis looked grave. We reported the first case of AFP producing gastric neuroendocrine carcinoma to share our experience. Keywords: gastric cancer. Alpha-fetoprotein. Neuroendocrine carcinoma. Chemotherapy. Immunohistochemical stainings. Radiological recurrence ...

Dermatological adverse events of immune checkpoint inhibitors

Review Article of American Journal of Dermatological Research and Reviews Dermatological adverse events of immune checkpoint inhibitors Kevin Yang1, Khurram Yusuf2 1Dermatology, UAB School of Medicine, Birmingham, AL 35294 2Kendriya Vidyalaya, Jabalpur, MP 482004, India Treatment with immune checkpoint inhibitors is a landmark in the treatment of melanoma and other cancers. These treatments have been very effective and have increased the survival of cancer patients. The promise of immunotherapy also comes with a variety of adverse events. One of the common sites of immune related adverse events (irAEs) is skin. The cutaneous irAEs present a unique challenge to the success of immunotherapy. It is important to diagnose and understand the mechanism related to these cutaneous irAEs to increase the effectiveness of immune checkpoint inhibitor therapy. In this review, we have characterized the various cutaneous irAEs associated with immune checkpoint inhibitor therapies and their possible mechanisms. Keywords:checkpoint inhibitors, immunotherapy, adverse events ...

15q11.2 Deletion Syndrome: Expanding the Phenotype

Case Report of International Journal of Case Reports 15q11.2 Deletion Syndrome: Expanding the Phenotype Luis F. Escobar1*, Rebecca Carr1, 2, Lauren Bogue1 1Medical Genetics and Neurodevelopmental Center. 2Peyton Manning Children’s Hospital at St. Vincent, Indianapolis, In 46260.  Purdue University, Lafayette, In 47907. Background: Although multiple reports exist in the literature of patients with 15q11.2 deletion syndrome, the variability of the phenotype has made clinical delineation difficult. Neuro-developmental scores have not been previously reported. We present clinical findings in a group of 16 patients referred to our center for evaluation and management of neurodevelopmental difficulties. Methods: All patients were seen in our center between 2005 and 2016. They were seen by a clinical geneticist and their diagnosis of 15q11.2 deletion syndrome was confirmed by a microarray analysis. Bayley Scales of Infant Development was done and provided a mental developmental index and a motor developmental index. The data collected was then compared to previous reports in the literature of patients with 15q11.2 deletion syndrome. Results: The reviewed group consisted of 10 males and 6 female patients between the ages of 3 and 15 years. The most common clinical findings included developmental delay (94%),  hypotonia (88%), ADHD (75%), anxiety (50%), feeding difficulties (44%), autism (31%), dolichocephaly (25%), 2-3 toe syndactyly (19%), seizure activity (19%), and congenital heart disease (13%).  Additional findings included prominence of the metopic suture, epicanthal folds, micrognathia, ankle torsion, incontinence, and sleeping difficulties.  Our developmental evaluation by the Bayley Scales of Infant Development indicated an average Mental Developmental Index of 75 (NL = >85) and Motor Developmental Index of 75 (NL = >85) in the patients less than 3 years old.  Close to 43% of patients had an occipitofrontal circumference (OFC) greater than or equal to the 97th. Conclusion: The data provided here intends to expand the phenotype of the 15q11.2 ...

Design of Twin Screw Feather Extruder and Study of Screw Parameters

Research Article of American Journal of Agricultural Research Design of Twin Screw Feather Extruder and Study of Screw Parameters Haoze Li1, Ping Jiang1, Keying Li1, Huawei Liu1, Ping Zhang1, Guohai Zhang1* 1School of Agricultural Engineering and Food Science, Shandong University of Technology, Zibo, 255000, China. Poultry feathers are rich in amino acids and keratin resources, which is a kind of protein feed raw materials with high nutritional value. A twin-screw extruder was designed to deal with the environmental damage caused by the shortage of rapidly developing protein feed and the large amount of feather waste in China’s livestock breeding industry. The bulking machine can break the disulfide bond and hydrogen bond in feather keratin to form crude protein which can be absorbed by livestock. A kind of high-protein feed feather powder was developed while protecting the environment. The combination mode and rotation direction between two screws are discussed, the relationship between the key basic parameters of the twin screw is derived by combining the motion principle of the twin screw and the relative geometric position. It provides theoretical basis for determining screw parameters and working condition parameters in the following experimental research. Keywords: Twin screw extruder; Puffed feather powder; Screw combination; Twin screw structure ...

The New Approaches Therapeutics That Complement Medicinal Therapy of Patients in Mental Health: an Analysis

Review Article of American Journal of Psychiatric Research and Reviews The New Approaches Therapeutics That Complement Medicinal Therapy of Patients in Mental Health: an Analysis Francisco Henrique da Silva1, Matheus Alves Siqueira de Assunção2, Evandro Valentim da Silva2, and Fálba Bernadete Ramos dos Anjos2 1Department of Biochemistry, Federal University of Pernambuco, Recife, Pernambuco, Brazil 2Department of Histology and Embryology, Federal University of Pernambuco,  Recife, Pernambuco, Brazil Mental illnesses represent a challenge for healthcare worldwide. In Brazil, this reality is not different, with the Unified Health System (SUS) providing or improving the therapeutic treatment of patients assisted by public health policies, through the implementation of integrative and complementary practices in mental health patient therapy. Drug therapy associated with the increase in integrative practices contributes to improvements in the patient, in addition to promoting updates to the protocols and clinical guidelines that address pathologies of the mental nature. In this context, this chapter should analyze the main mental disorders, such as drug therapies used to treat these patients, as well as the use of integrative practices that complement the use of medications. Keywords:  New Approaches Therapeutics, Complement Medicinal Therapy, Mental Health ...

Autistic Espectrum Disorder – a New Perspective About the Early Diagnostic

Review Article of American Journal of Psychiatric Research and Reviews Autistic Espectrum Disorder - a New Perspective About the Early Diagnostic Mihai Sorin Dorobantu Pediatrician - Hospital 24 Hours Unimed São Carlos / SP; Family Medicine Physician City Hall São Carlos / SP; Preceptor of the School of Medicine of the Federal University of São Carlos / SP The term “autism spectrum disorder” (ASD) describes today a heterogeneous group of neurodevelopmental disorders with diverse etiologies. Autism spectrum disorder is obviously a neurodevelopmental disorder that seems to be a big challenge today for both: the family doctor and the pediatrician. The core of this disorder is mainly integrated by the patient’s communication and social interaction difficulties and by the presence of repetitive or restricted behaviors and / or interests. (AUGUSTYN, PATTERSON, TORCHIA, 2019 p. 1)1-10 Autistic Spectrum Disorder is a pervasive and permanent disorder. It has no cure, no especific treatment, and this must be clarified from the begining, however, early intervention can drastically alter prognosis and soften symptoms (SOCIEDADE BRASILEIRA DE PEDIATRIA, 2019) 1-10. To benefit from early intervention, the patient with autistic spectrum disorder needs an early diagnosis. The key to their better social integration is the time. It is obvious that children identified with risk for autism spectrum disorder should be referred to a specialist with the purpose to establishing the diagnosis. However, it is primarily up to the primary-care physician to identify children at risk through developmental follow-up, behavioral follow-up and eventually through a valid screening and clinical judgment. In fact, early, accurate and appropriate diagnosis usually requires a clinician with experience in diagnosis and treatment. However, the contribution of a multiprofessional team to assess key symptoms, functional impairment, severity, and comorbid conditions is very important. The management of this patient should be individualized according to the ...