Transverse myelitis related to COVID-19 infection

Journal of Neurology -     

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate‐type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations.     

The role of capsule endoscopy in suspected Crohn's disease

Capsule endoscopy (CE) revolutionized the small bowel examination. We emphasize the role of CE in suspected Crohn's disease, studying 24 investigations performed in the Institute of Gastroenterology and Hepatology. The global diagnostic yield was 54%, the specific diagnostic yield for Crohn's disease was 37.5%, the specificity was 100% and the retention rate was 4.1%. For maximum accuracy and efficiency, unitary administration and diagnostic criteria are needed, and for minimising the risk of complications, specific prior investigations would be suitable.     

Paraganglioma-like dermal melanocytic tumor: a case report with particular features

Childhood dermal tumors with melanocytic features is an unusual tumor that can create diagnostic confusion. Among them, paraganglioma-like melanocytic tumors- previous included in melanocytic tumors of uncertain malignant potential- has some particular histopathologic and immunohistochemical features. We describe a case of 13 years old girl with a paraganglioma-like dermal melanocytic tumor of the left leg.     

Presentation,patterns of care,and survival in patients with brain metastases

BACKGROUND:

It is largely unknown to what extent new oncologic treatment options have improved survival of patients with brain metastasis in recent decades. Therefore, a multi‐institutional time‐staggered analysis was performed.

METHODS:

Two cohorts of 103 patients each were analyzed, one treated between 2005 and 2009 and the other between 1983 and 1989, ie, approximately 20 years earlier. Stratified analyses by prognostic groups were also performed (graded prognostic assessment [GPA] and Radiation Therapy Oncology Group recursive partitioning analysis [RTOG‐RPA]).

RESULTS:

Patterns of care have changed significantly. Contemporary patients received focal treatments such as stereotactic radiosurgery and surgical resection far more frequently. Furthermore, systemic treatment was used more often in contemporary patients, both before and after diagnosis of brain metastasis. Improved survival was observed in the contemporary cohort (P = .03). The 1‐year survival rate increased from 15% (95% confidence interval [CI], 7%‐25%) to 34% (95% CI, 25%‐44%). However, this improvement was largely driven by patients with favorable prognostic features. More than 40% of the patients still belong to unfavorable prognostic groups with limited median survival and little improvement.

CONCLUSIONS:

Contemporary patients were managed on a much more individualized basis, requiring multidisciplinary case discussion and thorough assessment of prognostic features. Progress has been made, but the overall outcome needs to be improved further. Avoiding overtreatment in patients with poor prognosis is as important as aggressive treatment in patients who might survive for several years. Cancer 2011. © 2010 American Cancer Society.