Vol 3-1 Mini Review

Intracranial Subdural Empyema – A Mini Review

Joseph Yoon1*, Claire Maree O’Bryan3, Michael Redmond1,2

1Department of Neurosurgery, Royal Darwin Hospital, Darwin, Northern Territory, Australia

2Kenneth G Jamieson Department of Neurosurgery, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia

3Flinders University, Darwin, Northern Territory, Australia

Intracranial subdural empyema is a rare but devastating infection of the brain. With improvements in investigations and treatment, the previously seen mortality of 100% has now been reduced to 4-9%. The underlying factor in this improvement is the reduction in time to treat. To achieve this, the first barrier is identifying the possibility of the condition. There have been multiple case reports, series, and retrospective studies on the matter, but over time the clinical epidemiology has changed. In this report, we give a up to date review of the infection and highlight the important features clinicians should consider when assessing patients with possible intracranial subdural empyema.

DOI: 10.29245/2689-9981/2019/1.1149 View / Download Pdf
Vol 3-1 Commentary

Commentary on the Role of Antibiotics for Renal Tumor Ablation

Zachary Sitton*, Daniel Crawford, Eric vanSonnenberg, Paul Kang

The University of Arizona College of Medicine – Phoenix, Phoenix, AZ, USA

DOI: 10.29245/2689-9981/2019/1.1152 View / Download Pdf
Vol 3-1 Case Report

Steroid Sans Chemotherapy in a Case of Tuberculous Pleural Effusion: A Novel Proposition or a Recipe for Disaster?

Gyanshankar P. Mishra1*, Ninu P. Babu2

1Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

2Dept. of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India

Tubercular pleural effusion is one of the extrapulmonary forms of tuberculosis. We herein report the case of a thirty-five-year-old female diagnosed with Tubercular pleural effusion who inadvertently took steroid monotherapy for four weeks sans antitubercular chemotherapy. On follow up she showed clinico radiological improvement. The case report discusses the potential role of steroids in current management of tubercular pleural effusion.

DOI: 10.29245/2689-9981/2020/1.1154 View / Download Pdf
Vol 3-1 Commentary

Deaths due to COVID-19 in Affected Countries

Piryani Rano Mal1*, Piryani Suneel2, Bhandary Shital3

1Department of Internal Medicine, Universal College of Medical Sciences, Bhairahawa, Nepal

2Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

3School of Public Health, Patan Academy of Health Sciences, Lalitpur, Nepal

DOI: 10.29245/2689-9981/2020/1.1156 View / Download Pdf
Vol 3-1 Review Article

The Fascination of Cytokine Immunological Science

Paolo Lissoni1*, Giusy Messina1, Francesco Pelizzoni2, Franco Rovelli1, Fernando Brivio1, Alejandra Monzon1, Nadal Crivelli1, Arianna Lissoni1, Simonetta Tassoni3, Andrea Sassola1, Sonja Pensato1, Giuseppe Di Fede1

1Institute of Biological Medicine, Milan, Italy

2Cardiological Surgery Division, Niguarda Hospital, Milan, Italy

3Effata Institute, Lucca, Italy

Today, it is known that all human biological functions are under two fundamental regulatory systems, consisting of the endocrine system and the cytokine network. Moreover, it has been shown that the cytokines released from the activated immune cells do not influence only immune functions, but also the whole biological system, including the various metabolic activities, the cardiovascular system, and the functionless of the neuroendocrine system itself. Unfortunately, despite the well-demonstrated importance of cytokines in maintaining the status of health, from a clinical point of view the routine evaluation of the cytokine system still remains unconsidered to establish the status of health, since it is investigated only in severe conditions, such as septic shock, disseminated intravascular coagulation and respiratory distress, which have been demonstrated to be due to an abnormal endogenous production of inflammatory cytokines, namely IL-6, TNF-alpha, and IL-1 beta. This clinical deficiency was depended on several factors, particularly on the complexity of cytokine interactions themselves, but also on the decision to use artificial molecules, such as monoclonal antibodies against the various cytokines, to counteract their eventual abnormally enhanced endogenous production, rather than to investigate the mechanisms responsible for their altered production and to correct eventual alterations. The main reason of the complexity of the cytokine network is related to the fact that the interactions occurring among the different cytokines are often founded on positive feedback mechanisms, then on reciprocal stimulatory actions, while the endocrine system is substantially based on negative feedback circuits. The aim of the present review is to propose a synthetic knowledge regarding the main effects and the source of origin of each single interleukin discovered up to now, to elaborate a first preliminary fundamental physiology of the cytokine network.

DOI: 10.29245/2689-9981/2020/1.1155 View / Download Pdf
Vol 3-1 Original Research Article

Human Papillomavirus (HPV) Viral Proteins Substitute for the Impact of Somatic Mutations by Affecting Cancer-Related Genes: Meta-analysis and Perspectives

Zisheng Shang1, Valentina L. Kouznetsova2,3, Igor F Tsigelny2-5*

1MAP Program UC San Diego, La Jolla, California, USA

2Moores Cancer Center UC San Diego, La Jolla, California, USA

3San Diego Supercomputer Center, UC San Diego, La Jolla, California, USA

4Department of Neurosciences, UC San Diego, La Jolla, California, USA

5CureMatch Inc. San Diego, California, USA

Purpose: Although a strong association between human papillomavirus (HPV) and a variety of cancers has long been established, infection by HPV alone has been shown to be insufficient for the induction of cancer, with a large number of HPV infections regressing without causing cancer. Additionally, HPV-negative cases have worse prognosis rates than HPV-positive ones across a multitude of cancer types. The reasons behind these phenomena are poorly understood. We try to explain it.

Methods: In this meta-analysis study, we first compared the mutation sets of HPV-positive and HPV-negative cancers using data from the Cancer Genome Atlas (TCGA) and from open published sources. Then, focusing on the genes that are exclusively mutated in HPV-negative head and neck cancer, we used KEGG pathways and reviewed literature to investigate how HPV can mimic the effects of mutations in those genes and thereby trigger carcinogenesis despite the absence of those mutations.

Results: Using TCGA mutation frequencies of significantly mutated genes stratified by HPV status, we extracted 17 genes exclusively mutated in HPV-negative cancers and detailed the HPV infection mechanisms that are largely able to mimic the effects of mutations in 13 of these genes. Through our literature searches and pathway analyses, we also presented antitumor effects caused by HPV infection that reduce carcinogenic efficiency and could contribute to the prognosis difference.

Conclusion: Our findings confirm that HPV infection substitutes for some, but not all, somatic driver mutations required for the induction of cancer by mimicking the effects of those mutations through various virus–host interaction mechanisms, thereby accelerating the cancer-related pathways.

DOI: 10.29245/2689-9981/2020/1.1157 View / Download Pdf