The association of hypertensive disorders of pregnancy with small for gestational age and intertwin birthweight discordance

Available evidence shows conflicting results regarding the association between hypertensive disorders of pregnancy (HDPs)/preeclampsia (PE) and small for gestational age (SGA) and birthweight discordance (BWD). This retrospective study of 2131 twin pregnancies aimed to evaluate the association of HDPs/PE with the presence of SGA and BWD. The eligible pregnancies were categorized into four study groups: concordant pairs without SGA fetuses, discordant pairs without SGA fetuses, concordant pairs with SGA fetuses, and discordant pairs with SGA fetuses. We applied binary logistic regression models to compare the incidence of HDPs/PE and multinomial logit regression models to evaluate the severity of PE between the study groups. The models were adjusted for potential confounders. Increases in HDPs were observed in concordant (aOR, 2.33; 95% CI: 1.46–3.73) and discordant (aOR, 3.50; 95% CI: 2.26–5.43) pregnancies with SGA fetuses but not in discordant pregnancies without SGA fetuses (aOR, 1.42; 95% CI: 0.81–2.49); increases in PE were also found in concordant (aOR, 1.87; 95% CI: 1.08–3.23) and discordant (aOR, 3.75; 95% CI: 2.36–5.96) pregnancies with SGA fetuses but not in discordant pregnancies without SGA fetuses (aOR, 1.34; 95% CI: 0.71–2.52). Discordant pregnancies with SGA fetuses were associated with severe PE (aRRR, 3.48; 95% CI: 1.79–6.77), whereas concordant pregnancies with SGA fetuses were associated with only mild PE (aRRR, 2.54; 95% CI: 1.33–4.88). Our results suggest that SGA is associated with the development of HDP/PE, while discordant growth is associated with the severity of PE. These associations need to be further investigated using estimated fetal weight (EFW).     

Clinical effect of stem cell transplantation combined with 308-nm excimer laser therapy for 56 cases of vitiligo

Objective

To probe the clinical effect of stem cell transplantation in combination with 308-nm excimer laser therapy for vitiligo and to analyze its value in clinical application.

Methods

A total of 56 patients with stable non-segmental vitiligo in different parts who were not cured by other therapies visiting our hospital from March 2019 to December 2021 were enrolled as study subjects. They were treated by stem cell transplantation combined with 308-nm excimer laser therapy. The treatment efficacy was observed and analyzed.

Results

Among the 56 patients, 38 (67.85%) and 49 (87.5%) patients were cured at 6 and 12 months after treatment, respectively.

Conclusion

Stem cell transplantation combined with 308-nm excimer laser therapy for vitiligo achieves significant efficacy, with the cure rate far superior to that of other therapies for vitiligo. The therapy is worthy of popularization in the clinic.     

Diagnosis of anaplastic lymphoma kinase rearrangement in cytological samples through a fluorescence in situ hybridization–based assay: Cytological smears versus cell blocks

Anaplastic lymphoma kinase (ALK) status analysis of lung cytological specimens should be successfully encouraged in routine practice because biopsy specimens are not always available. To date, the US Food and Drug Administration has approved both fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) as diagnostic tests for identifying ALK‐positive patients eligible for treatment with crizotinib. Although ALK IHC is an optimal diagnostic tool, FISH becomes mandatory in equivocal cases. ALK FISH of paraffin‐embedded tissue material is still the gold standard, whereas the cytological specimen assay has not yet been completely standardized. Many controversial data have been reported on the adequacy of cytology cell blocks (CBs) versus conventional smears for FISH testing. This review discusses some critical issues related to ALK FISH of cytological samples, including the triaging of collected specimens to optimize the material, the use of CBs versus conventional smears, and alternative methods for an ALK rearrangement diagnosis. Conventional smears have the advantages of an immediate evaluation, no probe tissue‐related artifactual loss, no fixation‐related alterations, and usually sufficient material for an analytic preparation. On the other hand, CBs have several advantages, including the appropriate conservation of the tissue architecture, an absence of problems related to cell overlapping, and the ability to evaluate neoplastic cells in a dark field. Cancer Cytopathol 2017;125:303–312. © 2017 American Cancer Society.