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We identified two systematic reviews that together included two primary studies, both observational studies. We concluded that we are uncertain whether the treat and extend regimen is superior in terms of visual gain, decrease in retinal thickness, number of injections and serious adverse effects at 12 months in comparison with the pro re nata regimen, because the certainty of the existing evidence has been assessed as very low.Edwards syndrome or trisomy 18 is a complex entity that involves the musculoskeletal, craniofacial, cardiovascular, and neurological systems. Its genetics are varied, presenting both in a complete and mosaic type. Survival rarely exceeds the first year of life. Its phenotype characterization is not pathognomonic, so karyotype is essential for diagnosis, prenatally by amniocentesis and cordocentesis by FISH technique. We present the case of an eight-year-old girl who has survived with this condition despite presenting tetralogy of Fallot and serious cardiac malformations. Diagnosis began with prenatal screening ultrasound at 16 weeks and detailed ultrasound, with amniocentesis and amniotic fluid karyotype, with a result of 47 XX+18. She has been treated by multiple medical specialties, due to musculoskeletal, joint, neurological, metabolic, and cardiovascular complications that have limited her quality of life. The management of these patients requires a multidisciplinary medical team, and counseling for parents should include aspects related to survival, frequent complications, and risk-benefit to be evaluated before subjecting the minor to complex or corrective surgical interventions.A 44-year-old man, previously healthy, consulted for a three-month history of asymmetrical polyarthralgia with inflammatory features involving small and large joints. A few days later, he developed erythema covered by pustules in the nail folds and progressive degeneration of the nail plate of the left thumb, with severe functional limitation. The physical exam showed well-defined erythematous scaly and pustular plaques in the first and third fingers of the left hand, with severe onychodystrophy, which was a key aspect in the diagnosis of acrodermatitis continua of Hallopeau. Other signs of the psoriatic spectrum were observed erythematous patches of the scrotum, erythematous scaly plaques with hemorrhagic crusts on both knees, and dactylitis. The diagnosis of inverse psoriasis, plaque psoriasis, and pustular psoriasis, respectively, were confirmed by histopathology and, with the CASPAR criteria, psoriatic arthritis. This case is of particular dermatological interest due to the variety of psoriatic manifestations recognized in a single patient and because of the poorly described association between acrodermatitis continua of Hallopeau with psoriatic arthritis.BACKGROUND Autoimmune myelofibrosis (AMF) is a rare clinicopathologic entity of bone marrow fibrosis that occurs in association with autoimmune disorders. Steroids are very effective for treatment of AMF and the disease has a good prognosis and should be distinguished from primary myelofibrosis. CASE REPORT A 49-year-old man with bleeding and petechial hemorrhage of the extremities presented to our institution. His platelet count was 1×10⁹/L. Bone marrow aspiration revealed a dry tap, and bone marrow biopsy confirmed small lymphocyte infiltration and increased reticular fibers, consistent with immune thrombocytopenia. Testing for mutations in JAK2, MPL, and CALR was negative. Because the patient had a history of Raynaud's phenomenon, he was suspected to have collagen disease. Anti-Sjögren's-syndrome-related antigen-A antibody testing, Schirmer's test, and fluorescein staining all came back positive, which led to a diagnosis of Sjögren's syndrome. Given the bone marrow findings, the patient also was diagnosed with AMF. Treatment with steroids resulted in an immediate improvement in his platelet count. CONCLUSIONS In the present case, treatment with steroids resulted in prompt improvement in platelet counts and subsequent marrow biopsy showed MF-0 reticulin fibrosis. Bone marrow fibrosis rarely is seen in association with autoimmune disease, and its significance and mechanism are still to be determined.BACKGROUND Extranodal natural killer (NK)/T-cell lymphomas are rare neoplasms that result in the destruction of mid-facial tissues. Infrequently seen in ear, nose, and throat clinical practice, they are often misdiagnosed and treated as chronic sinusitis, which delays proper diagnosis. This study aimed to describe the insidious course of NK/T-cell lymphomas, nasal type. CASE REPORT A 36-year-old woman with a 2-year history of recurrent exacerbation of chronic sinusitis and allergies was admitted to our clinic. Multiple endoscopic sinus surgical procedures were performed. Repeated histopathological tissue examinations revealed extranodal NK/T-cell lymphoma, nasal type. Positron emission tomography combined with computed tomography (PET-CT) was performed to assess the extent of the disease. The patient was treated with antibiotics, steroids, and antifungal drugs for many months before the definitive diagnosis was made. The patient was eligible for modified SMILE chemotherapy; however, the patient died suddenly from septic shock several days before the beginning of treatment. CONCLUSIONS Chronic rhinosinusitis with progressive necrosis of sinonasal tissue that persists despite adequate antibacterial and antifungal treatment should prompt further investigation. In such cases, it is important to consider the diagnosis of NK/T-cell lymphomas, nasal type. Early diagnosis increases the opportunity for successful treatment.BACKGROUND Direct 3-bromopyruvate chemotherapy often causes side effects. We thus aimed to construct and evaluate folic acid-modified 3-bromopyruvate liquid crystalline nanoparticles (3BP-LCNP-FA) and assess their targeted antitumor effects in tumor-bearing nude mice. MATERIAL AND METHODS A liquid crystalline nanoparticle formulation was screened, and the structure was characterized using polarizing light- and transmission electron microscopy. selleck chemicals The folate target was then synthesized and characterized using differential scanning calorimetry and proton nuclear magnetic resonance spectroscopy. In vitro, human CNE-2Z and MDA-MB-231 tumor cells were used to evaluate 3BP-LCNP-FA effects on tumor cell morphology and proliferation. Different drug formulations were administered to tumor-bearing nude mice to observe the treatment effects. Hepatic and renal toxicities were assessed using hematoxylin and eosin-stained liver, kidney, and lung sections along with serological analysis of liver and kidney injury markers (e.g.
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