Published: 2019-08-25

Abstract views: 944   PDF downloads: 572  

Pages 16-18

Current trends in targeted therapy of leukaemia and lymphoma

blankpage Mariastefania Antica, Josipa Skelin

Decades of cancer and leukaemia research have provided priceless insight into the molecular mechanisms underlying the development and maintenance of malignancies. The ultimate goal of these findings was, and still is, discovering discriminating factors enabling detection or treatment of tumour cells. An important achievement in this field has been the integration of protein chemistry, fluorescence detectors, nanoparticles, optical devices and computational devolvement integrated in the field of flow cytometry, fluorescence activated cell sorting FACS, data analysis and visualisation. Especially important is the onset of computational data mining tools like T-distributed Stochastic Neighbor Embedding (t- SNE), developed by van der Maatenand Hinton and further continuous progress of the machine learning algorithms for visualization of the huge amount of data produced from single cell FACS or mass cytometry analysis.

Abstract views: 1502   PDF downloads: 440   HTML downloads: 404  

Page 1-7

The most cited articles on the topic of health behaviors in Google Trends research: a systematic review

blankpage Willy Chou, Wei-Chih Kan, Tsair-Wei Chien, Hsien-Yi Wang

Background: Over the past decade, the use of Web-based data in public health issues has been proven useful in assessing various aspects of human behavior. Google Trends is the most popular tool to gather such information and has been applied to several topics with the most focused subject related to health and medicine. However, the most cited articles and the popular medical subject headings(MESH terms) on health behaviors in Google Trends research remain unknown. The web-based behavior requires to monitor and analyze on-line data for examining actual human behavior to predict and even prevent health-related issues that constantly arise in daily life.
Objective: This systematic review aimed at reporting and further presenting the most cited articles and the popular MESH terms on health behaviors in Google Trends (infodemiology) researches in health-related topics since 2009 to provide an overview of the topic burst for future research on the subject of health behavior.
Methods: Following the Meta-Analyses guidelines for selecting studies, we searched for the term “Google Trends[Title]” in PubMed databases since 2009, applying specific criteria for types of journal articles. A total of 86 published papers were extracted, excluding those that did not fall inside the topics of health and medicine or the selected article types. We then further categorized the published papers according to MESH terms using social network analysis(SNA)and selected the most cited articles that related to the health behavior in Google Trends.
Results: The most cited articles are those from the US in 2009(PMID= 19845471 cited 88 times) and the UK in 2013(PMID= 23619126 cited 74 times). The MESH term represented by Internet earns the highest impact factor(IF) and presents significantly different among term clusters(F(3,20)=15.79, p<0.001). The most number of citing journals is from PloS One. The most number of author affiliations is from the US.
Conclusions: The monitoring of online queries can provide insight into human behavior, as the phenomenon is significantly and continuously growing at present and in the future for assessing behavioral changes in health topics.

Abstract views: 771   PDF downloads: 506  

Pages 13-15

A complex presentation of body dysmorphic disorder, social phobia and unresolved grief

blankpage D.A. Lachmansingh

This case is a complex presentation of Body Dysmorphic Disorder (BDD), social phobia and unresolved grief in a 23 year old male with no social support. He appears to have benefitted immensely from a combination of Cognitive Behavioral Therapy (CBT), antidepressant medication and Occupational Therapy. Identification of patients with BDD presenting in surgical and medical practices is essential and can be facilitated by validated screening tools such as the Body Dysmorphic Disorder Questionnaire (BDDQ). At the moment, the best evidence-based treatment is CBT and Selective Serotonin Reuptake Inhibitors (SSRIs). Nonetheless, novel approaches to therapeutic applications include the investigation of eye-tracking focus on body parts in BDD.

Abstract views: 1067   PDF downloads: 465   HTML downloads: 387  

Page 5-8

Allopurinol-induced DRESS syndrome in the elderly: an exceptional form of iatrogenesis

blankpage Salem Bouomrani, Fatma Rekik, Safa Trabelsi, Souad Yahyaoui, Nesrine Belgacem

Introduction The Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a very rare iatrogenic accident that is characterized by its difficult diagnosis due to its clinical latency and heterogeneous clinic. The form induced by allopurinol remains exceptional and often ignored by clinicians, although potentially fatal. We are reporting an original observation of allopurinol-induced DRESS syndrome in elderly.
Observation A 64-year-old woman who had been treated with allopurinol for gout for three weeks, was hospitalized for a diffuse, erythematous and maculopapular cutaneous rash, associated with fever at 39°C, dyspnea, generalized lymphadenopathy, and a hyperkeratotic and desquamative plantar eruption. The biology showed eosinophilia at 860/mm3 and cytolitic hepatitis without cholestasis or hepatocellular insufficiency with ASAT at 230 IU/l and alanine aminotransferase ( ALAT) at 280 IU/l. The infectious, immunological investigation, as well as the search for underlying malignant neoplasia or hematological malignancy were negative. The skin biopsy was inconclusive. The diagnosis of a DRESS syndrome induced by allopurinol was retained. The evolution was rapidly favorable after stopping allopurinol and treatment with systemic glucocorticoids.
Conclusion The incidence of cutaneous reactions to allopurinol is estimated at 1.5/100,000 H/year. The DRESS syndrome, the most serious form of these reactions, remains exceptional. This particular form of toxicity deserves to be known by clinicians, especially since allopurinol is widely prescribed in the elderly.

Abstract views: 881   PDF downloads: 367   HTML downloads: 305  

Page 9-12

Quinine induced thrombotic microangiopathy and thrombocytopenia: A teaching hospital's perspective

blankpage Aaron J. Franke, William Paul Skelton IV

Although quinine is an infrequently prescribed drug, with malaria treatment being its only FDA-approved indication, unwitting exposure via beverages (e.g., tonic water), over the counter herbal remedies and illegal recreation drugs still occur. We present a unique case of a female patient who denied any known prior history of quinine exposure, who after being prescribed quinine tablets for restless leg syndrome, developed an immune-related thrombotic microangiopathy with thrombocytopenia and subsequent multi-organ failure. It was later elucidated that her only known potential source of prior quinine exposure was a remote history of crack-cocaine use. The patient survived this rare and severe inflammatory response with recovery of renal function and was able to discontinue dialysis.

Abstract views: 1021   PDF downloads: 419   HTML downloads: 312  

Page 1-4

Depression of the elderly revealing a primary hypothyroidism

blankpage Salem Bouomrani, Mouna Guermazi, Souad Yahyaoui, Safa Trabelsi, Latifa Ghanmi

Introduction       Psychiatric manifestations are exceptional during hypothyroidism and are not always easy to diagnose, especially since the clinical signs of hypothyroidism can be confused with those of the depressive syndrome. We report an original observation of depression of the elderly revealing an isolated primary hypothyroidism. 
Observation       A 78-year-old patient, followed for essential hypertension, well-balanced under monotherapy with calcium channel blockers, and without degenerative complications, was referred by her family doctor for depressive syndrome not improved by the specific treatment prescribed and correctly taken for six months. The clinical examination noted in particular macroglossia with dental impressions and dry and cracked skin. The biological assessment showed hypothyroidism with TSH at 28 μmol/l. Thyroid ultrasound showed atrophy of the thyroid gland. The thyroid autoimmunity (anti-thyroglobulin and anti-thyroperoxidase antibodies) was negative. The rest of the biological tests were in the normal range. The diagnosis of Riedel’s thyroiditis was retained and the patient was treated with levothyroxine in progressive doses until TSH normalization was achieved. The evolution on the psychiatric level was also favorable with disappearance of the signs of the depression and the anti-depressive treatment was discontinued. 
Conclusion       Depression is rare, complicating only 4% of overt hypothyroidism and its diagnosis is not always easy, especially in the elderly. Hormone replacement therapy significantly improves the depressive syndrome and protects against cognitive decline. Thus, hypothyroidism screening seems appropriate for any depressive syndrome in the elderly.