Clear cell papulosis: Dermatoscopic findings and literature review

Clear cell papulosis is a rare skin condition that predominantly develops in patients of Asian background during their early childhood. We present a new case of clear cell papulosis of a 1‐year‐old Thai girl presented with multiple hypopigmented macules and papules on the lower abdomen and pubic area for 3 months and also review the previous 41 cases published in the literature since 1987. Herein, for the first time, we report the dermatoscopic features of clear cell papulosis that represents as depigmented homogenous structureless lesions. This would be beneficial for distinguishing clear cell papulosis from its differential diagnoses.     

Treatment of locally advanced rectal cancer: Controversies and questions

Rectal cancers extending through the rectal wall, or involving locoregional lymph nodes (T3/4 or N1/2), have been more difficult to cure. The confines of the bony pelvis and the necessity of preserving the autonomic nerves makes surgical extirpation challenging, which accounts for the high rates of local and distant relapse in this setting. Combined multimodality treatment for rectal cancer stage Ⅱ and Ⅲ was recommended from National Institute of Health consensus. Neoadjuvant chemoradiation using fluoropyrimidine-based regimen prior to surgical resection has emerged as the standard of care in the United States. Optimal time of surgery after neoadjuvant treatment remained unclear and prospective randomized controlled trial is ongoing. Traditionally, 6-8 wk waiting period was commonly used. The accuracy of studies attempting to determine tumor complete response remains problematic. Currently, surgery remains the standard of care for rectal cancer patients following neoadjuvant chemoradiation, where-as observational management is still investigational. In this article, we outline trends and controversies associated with optimal pre-treatment staging, neoadjuvant therapies, surgery, and adjuvant therapy.     

From presentation to paper: Gender disparities in oncological research

Gender disparities in scientific publications have been identified in oncological research. Oral research presentations at major conferences enhance visibility of presenters. The share of women presenting at such podia is unknown. We aim to identify gender-based differences in contributions to presentations at two major oncological conferences. Abstracts presented at plenary sessions of the American Society of Clinical Oncology (ASCO) Annual Meetings and European Society for Medical Oncology (ESMO) Congresses were collected. Trend analyses were used to analyze female contribution over time. The association between presenter's sex, study outcome (positive/negative) and journals' impact factors (IFs) of subsequently published papers was assessed using Chi-square and Mann–Whitney U tests. Of 166 consecutive abstracts presented at ASCO in 2011–2018 (n = 34) and ESMO in 2008–2018 (n = 132), 21% had female presenters, all originating from Northern America (n = 17) or Europe (n = 18). The distribution of presenter's sex was similar over time (p = 0.70). Of 2,425 contributing authors to these presented abstracts, 28% were women. The proportion of female abstract authors increased over time (p < 0.05) and was higher in abstracts with female (34%) compared to male presenters (26%; p < 0.01). Presenter's sex was not associated with study outcome (p = 0.82). Median journals' IFs were lower in papers with a female first author (p < 0.05). In conclusion, there is a clear gender disparity in research presentations at two major oncological conferences, with 28% of authors and 21% of presenters of these studies being female. Lack of visibility of female presenters could impair acknowledgement for their research, opportunities in their academic career and even hamper heterogeneity in research.     

Multikinase Inhibitor-Induced Hand–Foot Skin Reaction: A Review of Clinical Presentation,Pathogenesis, and Management

Multikinase inhibitors (MKIs) are targeted cancer therapies designed to inhibit multiple tyrosine kinase pathways responsible for tumor proliferation, growth, and survival. These agents are more able to target cancer cells and possess better safety profiles than conventional chemotherapies. However, MKIs can produce significant cutaneous adverse events, hand–foot skin reaction (HFSR) being the most clinically significant. Although not life threatening, HFSR can lead to MKI dose modification, interruption, or termination, potentially limiting the anti-tumor effect. This article summarizes the current knowledge concerning the epidemiology, clinical presentation, pathogenesis, histopathology, prognostic implication, and current evidence-based prophylactic and reactive treatment options for MKI-induced HFSR. Its high incidence and significant impact on the quality of life emphasizes the great need to understand the pathogenesis and improve management of this condition.     

Expression of oestrogen receptor α in the endometrium of porcine reproductive and respiratory syndrome virus-infected gilts

Porcine reproductive and respiratory syndrome (PRRS) virus infection often lead to infertility in gilts and sows. Nevertheless, the impact of PRRS virus on the endometrial function has not been fully elucidated. The present study aimed to determine the effect of PRRS virus infection on the expression of oestrogen receptor (ER) α in the endometrium of gilts. Uterine tissues from 54 gilts were classified into two groups according to PRRS virus detection using immunohistochemistry (26 positive and 28 negative samples). The reproductive status was classified as prepubertal, luteal and follicular phases. The expression of ERα in the epithelium, subepithelium and glandular tissue layers of the endometrium was determined by immunohistochemistry. ERα immunostaining was detected in 22.2, 13.5 and 33.6 % of the cells in the epithelial, subepithelial and glandular tissue layers, respectively. The ERα immunostaining in the glandular layer of the endometrium in follicular-phase gilts was higher than that in prepubertal gilts (46.1 and 15.2 %, respectively, P?=?0.011). The ERα immunostaining in the glandular layer of the endometrium was positively correlated with body weight (r?=?0.138, P?=?0.020) and average daily gain (r?=?0.169, P?=?0.005) of the gilts. The ERα immunostaining in all tissue layers of the endometrium with PRRS virus detection did not differ significantly compared to that without PRRS virus (P?>?0.05). However, in prepubertal gilts, the ERα immunostaining cells in the epithelial layer of PRRS virus negative (9.5 %) tended to be lower than PRRS virus positive (26.3 %, P?=?0.196) uterine tissues. This tendency indicates some impact of PRRS virus infection on the ERα expression in prepubertal gilts.     

Randomized, double-blinded, placebo-controlled trial of ondansetron plus dexamethasone with or without metoclopramide as antiemetic prophylaxis in patients receiving high-dose cisplatin in medical practice

Purposes  

Ondansetron plus dexamethasone are standard antiemetic agents for highly emetogenic chemotherapy. Metoclopramide is a dopamine antagonist, which may enhance efficacy of ondansetron and dexamethasone. The objective of this study was to assess the efficacy and tolerability of metoclopramide added to standard antiemetic regimen for prophylaxis of cisplatin-induced emesis.     

Pulmonary function and exercise capacity in children following lung resection surgery

Purpose

To study lung function and exercise capacity in children following lung resection surgery.

Methods

Children aged 6?C18?years who had lung resection surgery were studied and compared to normal children (age and sex matched). All had spirometry/body plethysmography and exercise stress test (performed by treadmill and modified Balke protocol).

Results

13 Patients and 13 controls were studied (age 13.2?±?3.3?years; 46.2?% male). The age at the time of lung resection surgery was 6.5?±?4.7?years. The time interval between post-surgery and the tests was 6.8?±?4.4?years. The most common indication for lung resection surgery was congenital lung malformations (61.5?%). 76.9?% of the patients had abnormal lung function. Exercise intolerance due to pulmonary limitations was found in 23.1?% of the patients. At the anaerobic threshold, the $ V_{{{\text{O}}_{2} }} /{\text{kg}} $ was not different between the patients and the controls. However, at the end of the exercise, the patients demonstrated lower peak $ V_{{{\text{O}}_{2} }} /{\text{kg}} $ than the controls (33.6?±?6.0 vs. 39.3?±?8.7?ml/min/kg; p?<?0.01).

Conclusions

Abnormal lung functions and exercise intolerance were found in children following lung resection surgery. Children who had lung resection surgery had lower exercise capacity than normal children if the exercise was beyond the anaerobic threshold.