Sex differences in SARS-CoV-2 infections,anti-viral immunity and vaccine responses

The COVID-19 pandemic has revealed sex-based differences in anti-viral responses,with a higher rate of SARS-CoV-2 infections as well as a higher rate of morbidity and mortality in men than in women.Males and females also show disparate immune responses to COVID-19 infection,which may be important contributors to lower rates of infection,disease severity and deaths in women than in men.Here,the authors review sex differences in SARS-CoV-2 infections,anti-viral immunity and vaccine responses,putting forth the importance of sex,the underappreciated variables in vaccine response and disease infectivity.

Co-relation of SARS-CoV-2 related 30-d mortality with HRCT score and RT-PCR Ct value-based viral load in patients with solid malignancy

BACKGROUND Coronavirus disease 2019(COVID-19)patients with malignancy are published worldwide but are lacking in data from India.AIM To characterize COVID-19 related mortality outcomes within 30 d of diagnosis with HRCT score and RT-PCR Ct value-based viral load in various solid malignancies.METHODS Patients included in this study were with an active or previous malignancy and with confirmed severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection from the institute database.We collected data on demographic details,baseline clinical conditions,medications,cancer diagnosis,treatment and the COVID-19 disease course.The primary endpoint was the association between the mortality outcome and the potential prognostic variables,specially,HRCT score,RT-PCR Ct value-based viral load,etc.using logistic regression analyses treatment received in 30 d.RESULTS Out of 131 patients,123 met inclusion criteria for our analysis.The median age was 57 years(interquartile range=19-82)while 7(5.7%)were aged 75 years or older.The most prevalent malignancies were of GUT origin 49(39.8%),hepatopancreatobiliary(HPB)40(32.5%).109(88.6%)patients were on active anticancer treatment,115(93.5%)had active(measurable)cancer.At analysis on May 20,2021,26(21.1%)patients had died.In logistic regression analysis,independent factors associated with an increased 30-d mortality were in patients with the symptomatic presentation.Chemotherapy in the last 4 wk,number of comorbidities(≥2 vs none:3.43,1.08-8.56).The univariate analysis showed that the risk of death was significantly associated with the HRCT score:for moderate(8-15)[odds ratio(OR):3.44;95%confidence interval(CI):1.3-9.12;P=0.0132],severe(>15)(OR:7.44;95%CI:1.58-35.1;P=0.0112).CONCLUSION To the best of our knowledge,this is the first study from India reporting the association of HRCT score and RT-PCR Ct value-based 30-d mortality outcomes in SARS-CoV-2 infected cancer patients.

Stem cell therapy: A paradigm shift in breast cancer treatment

As per the latest Globocan statistics,the high prevalence rate of breast cancer in low-and middle-income countries has led to it becoming the most common cancer to be diagnosed,hence posing a major public health challenge.As per this data,more than 11.7%of the estimated new cancer cases in 2020 were due to breast cancer.A small but significant subpopulation of cells with self-renewing ability are present in the tumor stroma and have been given the nomenclature of cancer stem cells(CSCs).These cells display a high degree of plasticity owing to their ability to transition from the slowly cycling quiescent phase to the actively proliferating phenotype.This attribute of CSCs allows them to differentiate into various cell types having diverse functions.Breast CSCs have a pivotal role in development,metastasis,treatment resistance and relapse of breast cancers.This review focuses on the pathways regulating breast CSC maintenance and the current strategies that are being explored for directing the development of novel,targeted,therapeutic approaches for limiting and eradicating this aberrant stem cell population.

Breast carcinoma with metastasis to the gallbladder:an unusual case report with a short review of literature

Gallbladder metastases are very rare and usually arise from malignant melanoma, renal cell carcinoma and cervical carcinoma. Breast carcinoma tnetastatic to the gallbladder is extremely rare and only 4 cases have been reported in the English literature. We hereby report a 54-year-old lady who was diagnosed as having breast carcinoma and underwent modified radical mastectomy. One month after the operation, she developed acute abdomenal pain and underwent cholecystectomy after clinical investigation. Histopathological examination revealed metastasis to the gallbladder. Being considered a patient with tnetastatic breast carcinoma she was subjected to taxane and anthracycline-based palliative chemotherapy. Later she had CNS involvement and died of the progressive disease soon after few months.

Spinal cord compression secondary to bone metastases from hepatocellular carcinoma

骨头转移在主要肝细胞癌(HCC ) 是稀罕的。脊髓压缩(SCC ) 由于骨头，转移与肺和胸在病人通常发生癌，和变形 HCC 是 SCC 的一个不平常的原因。脊髓压缩是一种 oncologic 紧急情况，治疗延期能导致不可逆的后果。因此， SCC 能由于 HCC 是骨头转移的潜在的复杂并发症的了解具有在能改进生命的质量和病人的幸存的早治疗的开始的意义，如果更早诊断了。这篇论文由于骨头转移与 SCC 的改变的表明描述主要 HCC 的四个盒子。首先与相应于骨头转移地点的骨头疼痛的症状而非联系肝的病理并且最后的症状介绍的第一个病人开发了 SCC。第二个病人，作为有 HCC 诊断了，在病，他与以后的固定为经历了紧急情况椎板切除术的功课期间导致截瘫的发达额外的硬脑膜的 SCC。第三个病人此后不久开发了 SCC 主要诊断并且不得不经历紧急情况椎板切除术。波斯特椎板切除术他有好神经病学的恢复。作为 SCC 的第一表明首先根的疼痛而非坦率的截瘫地介绍的第四个病人。

Malignant ascites with omental metastasis: a rare event in prostate cancer

Prostate cancer is the most common type of male malignancy in the world and approximately 10-20%of prostate cancer shows a metastatic disease at initial diagnosis commonly to the bones,vertebrae,ribs,long bones,and skull.However,prostate cancer metastasis to the omentum with malignant ascites is extremely uncommon.In this study,we report such a case,which also highlights a repeatedly negative ascetic fluid cytology even with multiple omental metastatic nodules.The purpose of this case report is to provide awareness to physicians for this rare occurrence.

Avoiding second donor site and the second set of neck vessels in a case of absent peroneal skin perforators

This report describes the procedure of a case in which the skin paddle of the free fibula flap derived its supply solely from a soleal musculocutaneous perforator originating from the posterior tibial system.In contrast,the osteo-muscular component was supplied by the peroneal vascular system.We harvested the skin paddle with its vascular supply from the posterior tibial artery separately,and the osteo-muscular fibula was harvested with its supply from peroneal vessels.In this way,we avoided violation of the second donor site for the skin paddle.In addition,we used the distal end of peroneal vessels to salvage our skin paddle instead of sacrificing another set of neck vessels for anastomosis.This technique may also be utilised in cases where the neck vessels may not be available due to previous surgeries,radiation therapy,or decision by the surgery team to not sacrifice two sets of neck vessels for anastomosis.

EGFR mutation--a commonly neglected mutation in squamous cell lung carcinoma

Lung cancer is the leading cause of cancer-related death worldwide.Advances in molecular biology have unveiled various targetable mutations with epidermal growth factor receptor(EGFR)being most common.EGFR testing is recommended for all locally advanced or metastatic adenocarcinoma lungs but recommendation in squamous histology is uncertain.However,just on the basis of histology,EGFR testing should not be withheld in patients diagnosed as squamous cell cancer on small biopsy,in females,never smokers and Asians.We report two cases with squamous cell lung cancer diagnosed on small biopsy,in non smoker females with EGFR mutations emphasizing the importance of testing in such population.