Chemotherapy reaction induced by ixabepilone,a microtubule stabilizing agent,mimicking extramammary Paget's disease in a patient with breast carcinoma

The histopathologic characteristics of reactions caused by the many novel anticancer agents are under‐recognized. We report a case of a 67‐year‐old female with locally advanced metastatic breast cancer, who initially presented with an extensive reticulated erythematous patch on the trunk caused by intravascular metastases confirmed by a skin biopsy. Owing to disease progression, she was started on ixabepilone, a mitotic inhibitor. While receiving ixabepilone, another skin biopsy was obtained and initially interpreted as extramammary Paget's disease. However, the biopsy showed metaphase arrest of numerous keratinocytes in the basilar and suprabasilar epidermis. Atypical epithelial cells were only present in the intravascular spaces similar to the initial biopsy. Given the temporal association between the initiation of ixabepilone therapy and the epidermal mitotic arrest, a diagnosis of chemotherapy reaction to ixabepilone was rendered. Ixabepilone is an analog of epothilone, a microtubule stabilizer causing mitotic arrest of the cell cycle approved for the treatment of metastatic and locally advanced treatment‐resistant breast cancer. The demonstration of epidermal mitotic arrest caused by ixabepilone is without precedent. The case emphasizes the importance of considering a chemotherapy reaction in the histologic differential diagnosis of epidermal mitotic arrest in a cancer patient receiving chemotherapy.     

Pre-marital predictors of marital violence in the WHO World Mental Health (WMH) Surveys

Social Psychiatry and Psychiatric Epidemiology - Intimate partner violence (IPV) is a pervasive public health problem. Existing research has focused on reports from victims and few studies have...     

Shedding Light on Alopecia Areata in Pediatrics: A Retrospective Analysis of Comorbidities in Children in the National Alopecia Areata Registry

Alopecia areata (AA) is a common autoimmune disease and it is challenging to predict which patients will have severe disease. The purpose of this retrospective study was to identify comorbidities in children enrolled in the National Alopecia Areata Registry. Atopic dermatitis was more common in patients with severe AA than in those with mild disease. The most common autoimmune comorbidities were vitiligo, psoriasis, thyroid disease, and juvenile idiopathic arthritis.     

The role of rheological changes of blood and hemostasis in the development of acute neurosensory hypoacusis

We studied blood rheology and hemostasis in patients with acute neurosensory hypoacusis (ANH) of different genesis to clarify correlations of these disorders with an ANH form. After examination 72 ANH patients (60 male and 12 female, age 19-68) were divided into three groups by ANH etiology: ANH of vascular genesis (group 1, 47 patients), ANH of viral genesis (group 2, 19 patients), ANH of traumatic genesis (group 3, 6 patients). Blood rheology was studied on viscosimeter Low-Shear 30 (Switzerland); hematocrit--on Autocrit (USA) centrifuge, platelet aggregation--on aggregometer Elvi 840 (Italy), coagulation--on coagulometer Tetra (Spain). Blood rheology and hemostasis in groups 2 and 3 were changed insignificantly, while in group 1 we registered disturbed microcirculation. Treatment with vasoactive drugs normalized both clinical picture of the disease and blood rheology, hemostasis. The highest activity was seen in use of the drugs tanakan and gincor fort.     

The study of mucociliary clearance of maxillary mucosa with radionuclide dynamic maxillary scintigraphy of various forms of maxillary sinusitis

Mucociliary transport and absorption of maxillary mucosa were studied in patients with different forms of maxillary sinusitis. Radionuclide dynamic maxillary scintigraphy specified functional characteristics of maxillary mucosa in respect to the form of its inflammation.     

General anesthesia tools in endovascular surgery of the conductive heart system

The anesthetic management course was analyzed in 224 patients who underwent nonvascular surgeries on the conductive heart system. Analgesic and anti-stress techniques, which do not affect the intracardial conductivity and ensure the successful outcome of surgery with spontaneous or auxiliary ALV, were designed on the basis of research. The above schemes were introduced in practice with their efficiency being confirmed. They are based on a balanced use of the new-generation non-steroid anti-inflammatory drugs, like Xephocam, bezodiazepines and fentanyl (when used at subnarcotic doses that do not affect the intracardial conductivity). The main analgesic component of lornoxycam was sufficient when used at a dose of 0.1 mg/kg and at a total dose of equal to or below 16 mg.     

Anesthesiology in the surgical treatment of supraventricular tachyarrhythmias

Different anesthesias were used in 197 patients operated for supraventricular tachiarrhythmias through a transvenous access. Hypnoanalgesia based on preventive injection of a potent nonnarcotic antiinflammatory agent xefocame (lornoxicame), drip infusion of propofol (2-3 mg/kg/h), and bolus injection of dormicum under conditions of spontaneous respiration proved to be the best method.