A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

A 7-year-old castrated male Persian cat presented with a cutaneous mass and an increase in serum amyloid A concentration. Fine needle aspirates of the mass indicated lymphoma, which was also the top differential diagnosis on histopathologic examinations. Immunohistochemically, neoplastic cells tested negative for anti-CD3, PAX5, CD20, and c-Kit, but positive for MUM1, CD79α, and CD138, suggesting extramedullary plasmacytoma. There were tumor-infiltrating non-neoplastic CD3+ T and CD20+ B cells. Practitioners should be aware of feline plasmacytoma characterized by lymphoma-like cytologic and histologic features. The present study is valuable in providing the first clinical evidence that proves the immunogenicity of feline plasmacytoma.

The brain houses vital hormonal regulatory structures such as the hypothalamus and pituitary gland, which may confer unique susceptibilities to critical illness-related corticosteroid insufficiency (CIRCI) in patients with neurological disorders. In addition, the frequent use of steroids for therapeutic purposes in various neurological conditions may lead to the development of steroid insufficiency. This abstract aims to highlight the significance of understanding these relationships in the context of patient care and management for physicians. Neurological disorders may predispose patients to CIRCI due to the role of the brain in hormonal regulation. Early recognition of CIRCI in the context of neurological diseases is essential to ensure prompt and appropriate intervention. Moreover, the frequent use of steroids for treating neurological conditions can contribute to the development of steroid insufficiency, further complicating the clinical picture. Physicians must be aware of these unique interactions and be prepared to evaluate and manage patients with CIRCI and steroid insufficiency in the context of neurological disorders. This includes timely diagnosis, appropriate steroid administration, and careful monitoring for potential adverse effects. A comprehensive understanding of the interplay between neurological disease, CIRCI, and steroid insufficiency is critical for optimizing patient care and outcomes in this complex patient population.

Traumatic brain injury (TBI) is a global health and socio-economic problem, resulting in significant disability and mortality. Malnutrition is common in TBI patients and is associated with increased vulnerability to infection, higher morbidity and mortality rates, as well as longer stays in the intensive care unit and hospital. Following TBI, various pathophysiological mechanisms, such as hypermetabolism and hypercatabolism, affect patient outcomes. It is crucial to provide adequate nutrition therapy to prevent secondary brain damage and promote optimal recovery. This review includes a literature review and discusses the challenges encountered in clinical practice regarding nutrition in TBI patients.The focus is on determining energy requirements, timing and methods of nutrition delivery, promoting enteral tolerance, providing enteral nutrition to patients receiving vasopressors, and implementing trophic enteral nutrition. Enhancing our understanding of the current evidence regarding appropriate nutrition practices will contribute to improving overall outcomes for TBI patients.

Decompressive craniectomy (DCE) and cranioplasty (CP) are surgical procedures used to manage elevated intracranial pressure (ICP) in various clinical scenarios, including ischemic stroke, hemorrhagic stroke, and traumatic brain injury. The physiological changes following DCE, such as cerebral blood flow, perfusion, brain tissue oxygenation, and autoregulation, are essential for understanding the benefits and limitations of these procedures. A comprehensive literature search was conducted to systematically review the recent updates in DCE and CP, focusing on the fundamentals of DCE for ICP reduction, indications for DCE, optimal sizes and timing for DCE and CP, the syndrome of trephined, and the debate on suboccipital CP. The review highlights the need for further research on hemodynamic and metabolic indicators following DCE, particularly in relation to the pressure reactivity index.It provides recommendations for early CP within three months of controlling increased ICP to facilitate neurological recovery. Additionally, the review emphasizes the importance of considering suboccipital CP in patients with persistent headaches, cerebrospinal fluid leakage, or cerebellar sag after suboccipital craniectomy. A better understanding of the physiological effects, indications, complications, and management strategies for DCE and CP to control elevated ICP will help optimize patient outcomes and improve the overall effectiveness of these procedures.

Mannitol, derived from mannose sugar, is crucial in treating patients with elevated intracranial pressure (ICP). Its dehydrating properties at the cellular and tissue levels increase plasma osmotic pressure, which is studied for its potential to reduce ICP through osmotic diuresis. While clinical guidelines support mannitol use in these cases, the best approach for its application continues to be debated. Important aspects needing further investigation include: 1) bolus administration versus continuous infusion, 2) ICP-based dosing versus scheduled bolus, 3) identifying the optimal infusion rate, 4) determining the appropriate dosage, 5) establishing fluid replacement plans for urinary loss, and 6) selecting monitoring techniques and thresholds to assess effectiveness and ensure safety.Due to the lack of adequate high-quality prospective research data, a comprehensive review of recent studies and clinical trials is crucial. This assessment aims to bridge the knowledge gap, improve understanding of effective mannitol use in elevated ICP patients, and provide insights for future research. In conclusion, this review aspires to contribute to the ongoing discourse on mannitol application. By integrating the latest findings, this review will offer valuable insights into the function of mannitol in decreasing ICP, thereby informing better therapeutic approaches and enhancing patient outcomes.

PURPOSE: Anaphylaxis is an immediate allergic reaction characterized by potentially life-threatening, severe, systemic manifestations. While studies have evaluated links between serious illness and posttraumatic stress disorder (PTSD), few have investigated PTSD after anaphylaxis in adults. We sought to investigate the psychosocial burden of recent anaphylaxis in Korean adults.METHODS: A total of 203 (mean age of 44 years, 120 females) patients with anaphylaxis were recruited from 15 university hospitals in Korea. Questionnaires, including the Impact of Event Scale-Revised-Korean version (IES-R-K), the Korean version of the Beck Anxiety Inventory (K-BAI), and the Korean version of the Beck Depression Inventory (K-BDI), were administered. Demographic characteristics, causes and clinical features of anaphylaxis, and serum inflammatory markers, including tryptase, platelet-activating factor, interleukin-6, tumor necrosis factor-α, and C-reactive protein, were evaluated.RESULTS: PTSD (IES-R-K ≥ 25) was noted in 84 (41.4%) patients with anaphylaxis. Of them, 56.0% had severe PTSD (IES-R-K ≥ 40). Additionally, 23.2% and 28.1% of the patients had anxiety (K-BAI ≥ 22) and depression (K-BDI ≥ 17), respectively. IES-R-K was significantly correlated with both K-BAI (r = 0.609, P < 0.0001) and K-BDI (r = 0.550, P < 0.0001). Among the inflammatory mediators, tryptase levels were lower in patients exhibiting PTSD; meanwhile, platelet-activating factor levels were lower in patients exhibiting anxiety and depression while recovering from anaphylaxis. In multivariate analysis, K-BAI and K-BDI were identified as major predictive variables of PTSD in patients with anaphylaxis.CONCLUSIONS: In patients with anaphylaxis, we found a remarkably high prevalence of PTSD and associated psychological distresses, including anxiety and depression. Physicians ought to be aware of the potential for psychological distress in anaphylactic patients and to consider psychological evaluation.
Adult ; Anaphylaxis ; Anxiety ; C-Reactive Protein ; Depression ; Hospitals, University ; Humans ; Hypersensitivity ; Interleukin-6 ; Korea ; Multivariate Analysis ; Necrosis ; Prevalence ; Prospective Studies ; Stress Disorders, Post-Traumatic ; Tryptases