Elevated Plasma S100B,Psychotic Symptoms,and Cognition in Schizophrenia

S100B is a calcium binding protein mainly produced by glial cells. Previous studies have shown elevated levels of S100B in patients with schizophrenia. We measured S100B levels in fasting plasma of 39 patients with schizophrenia and 19 adult healthy controls. We used linear regression to compare S100B between patients and controls. In patients only, we also investigated the relationship between S100B levels and psychotic symptoms (assessed by the Positive and Negative Syndrome Scale), and cognitive function (assessed by the NIH Toolbox Cognition Battery), respectively by calculating Pearson’s correlation coefficients. Mean plasma S100B was significantly higher in the patient group than in the control group. There were no significant correlations between plasma S100B and psychotic symptoms or cognition.     

Does one size fit all? Adaptive radiotherapy for bladder cancer: A feasibility study

IntroductionAdaptive techniques to deliver radiotherapy to the bladder may ensure treatment accuracy whilst sparing organs at risk. This study assesses the frequency of when an alternative plan to the current standard may be beneficial and establish the treatment resource implications of adaptive techniques. Assess the variation in accuracy of skeletal surrogate compared to the target. Additionally describes a training package for therapeutic radiographers evaluating CBCT datasets for adaptive techniques.MethodsA library of three plans was created for each patient, small, standard and large. Weekly CBCT and planar imaging data were acquired from 10 bladder cancer patients receiving radical radiotherapy. Bladder volumes from weekly CBCT were compared to the planning scan. Image registration was performed using bone and soft tissue structures on the CBCT images. A database of images was created to develop competency assessment and a training package.ResultsMatching to a skeletal surrogate may under estimate movement of the target. Bladder volume can vary significantly during the course of treatment, even in the presence of bladder preparation protocols. The additional time required to implement this technique is 4 min per fraction compared to standard treatment with planar imaging.ConclusionsThis feasibility study is a useful process to facilitate the implementation of adaptive techniques. However a limitation of this study is the low number of CBCT datasets evaluated. The advent of IGRT and adaptive techniques gives increased confidence to reduce margins, consequently facilitating hypo-fractionation, and may provide a gain in linear accelerator efficiency and reduce the number of hospital visits for the patient. CBCT paired with a development programme for therapeutic radiographers is an effective and efficient means of implementing adaptive radiotherapy.     

Buccal Mucosa Exfoliative Cell Prussian Blue Stain Co-Relates with Iron Overload in β-Thalassemia Major Patients

Thalassemics require regular blood transfusion therapy leading to iron overload in the body tissues, which is a major cause of morbidity and mortality in these patients. We hereby attempted to measure this iron overload by means of exfoliative cytology, a non-invasive and inexpensive technique. The aims and objectives of our study were: 1. To detect iron overload by oral exfoliative cytology using Perl’s Prussian blue stain in β-thalassemia major patients. 2. To correlate staining positivity with serum ferritin levels. Smears were obtained from buccal mucosa of 50 β-thalassemia major patients (who had taken more than 12 transfusions) and 25 healthy subjects of the same age group as controls. Smears were stained with Perl’s Prussian blue. Blood samples were taken from the study group for estimation of serum ferritin levels. Grading criteria were defined for assessing the Prussian blue positivity. Perl’s positivity was observed in 49 out of 50 of thalassemic patients (98%). 1 patient had Grade 0, 7 patients had Grade I, 5 had Grade II, 12 had Grade III, 14 had Grade IV while 11 patients had Grade V positivity. Spearman Rank’s Correlation Co-efficient was 0.38, signifying a weak positive correlation between positivity of buccal smears for Perl’s Prussian blue staining and respective serum ferritin levels. Perl’s Prussian blue staining of exfoliated cells from buccal mucosa can be used to assess iron overload in β-thalassemia major patients, as a screening as well as diagnostic tool. With the grading system we can give a semi-quantitative assessment of the same.     

Clinical characteristics,molecular profile and outcomes of myeloid sarcoma: a single institution experience over 13 years

Background: Myeloid sarcoma (MS) is characterized by extramedullary infiltration by immature myeloid cells. Owing to rarity of this disease, the clinical features and overall outcomes are yet to be clarified.

Objective: To define clinical characteristics, epidemiology, pathologic findings, treatment options and outcomes in MS.

Methods: We conducted a retrospective review of 23 patients diagnosed with MS at our institute over a period of 13 years (2002–2015).

Results: MS presented mostly as a manifestation of relapsed acute myeloid leukemia, seen in 39% of patients. Skin and subcutaneous soft tissues were the most common sites of anatomic involvement (69.5%). Ninety five percent (n?=?19) were positive for classical myeloid markers with either cytochemical staining (chloracetate-esterase, MPO), flow-cytometry (CD33, CD34, CD13 and CD117), or immunohistochemistry (CD34, CD43, CD68 and lysozyme). Of these, 52% were positive for CD33 (n?=?12), 35% for CD68 (n?=?8), 30% for CD34 (n?=?7), and 26% for lysozyme (n?=?6). Cytogenetic abnormalities were seen in 63% (n?=?12/19) patients on bone-marrow aspirate, with five patients displaying a complex (n?=?3) or monosomal (n?=?2) karyotype. Twenty seven percent patients with a normal karyotype had presence of deleterious mutations (FLT3, ASXL, STAG and JAK2) on further testing with myeloid mutation panel. The Median overall survival (OS) of the entire cohort was 15.9 months (95% CI, 7.4–24.4 months). The OS was significantly better for patients <65 years (24.6 vs. 3.4 months, p?=?0.009) of age, and for those attaining a complete remission (CR) to induction therapy (25.7 vs. 0.8 months, p?Conclusion: Failure to achieve CR with induction therapy, and age >65 years are associated with poor outcomes in MS. Allogeneic stem-cell transplant in first remission appears to be the most effective modality for achieving long-term remissions.     

Manoeuvres to Improve Endoscopic Visualization of Hypopharynx

The more progress achieved in endoscopy, the more superficial cancers in head and neck region have been diagnosed. There are, however, some areas difficult to observe, particularly the hypopharynx, due to closure of this space. Examination of hypopharynx form an essential part of head and neck examination especially in the suspected malignancies as well as in the cases with unknown primary. As the flexible fiber-optic nasopharyngolaryngoscopy forms an essential part of examination of hypopharynx, the present study aims to evaluate the effectiveness of various manoeuvres devised to aid in better visualization of the hypopharynx. The present prospective study is an observation carried out on 30 patients, which had been followed up for hypopharyngeal or laryngeal disease, in the OPD of the department of Otorhinolaryngology and head and neck surgery in Gandhi Medical College and associated hospital, Bhopal, M.P. In the present study, authors compared the visibility of subsites of hypopharynx in 30 patients undergoing trans nasal flexible fibre optic endoscopy in normal seated position and with head torsion, valsalva manoeuvre and the Killian position. The authors concluded that the above mentioned manoeuvres facilitated the visualization of the entire circumference of the hypopharynx during endoscopic examination, are non invasive and easy to perform and so should be included as a part of routine examination while performing flexible fibre optic endoscopy.     

PROP test: prediction of caries risk by genetic taste perception among the visually impaired children

The study sample consisted of 100 children with visual impairment aged 6–14 years. 6‐n‐propylthiouracil (PROP) sensitivity test was carried out. The Caries experience was recorded, estimation of Streptococcus mutans done and their taste likes and dislikes assessed through a food preference questionnaire. The Caries experience and S. mutans levels were highest in the non‐tasters, comparatively low in medium tasters and the least in the supertasters. Dietary preferences indicated tasters were sweet dislikers and non‐tasters, sweet likers. PROP test can be a useful tool in determining genetic taste sensitivity levels amongst the visually impaired children and thus used as a screening tool in those children who are at a high risk of developing dental caries.