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Pathology Competencies in Medical Education and Educational Cases: Update 2023.

Pathology is a core component of medical school curricula because understanding the pathogenesis of the disease is foundational both for diagnostic efficiency and optimal use of ancillary resources in patient care. The Pathology Competencies for Medical Education (PCME) were developed as a national resource of expectations of pathology knowledge for medical students. The PCME are composed of three competencies: disease mechanisms and processes, organ system pathology, and diagnostic pathology and therapeutic pathology. The learning goals and learning objectives of the PCME that were first publ

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… Objective HPCD2.7: Disseminated Intravascular Coagul ation . Discuss disseminated intravascular coagulation in terms of etiologies, pathogenesis, clinical presentation, and course. Objective HPCD2.8: Inherited Hemophilia . …

Treatment of Leptomeningeal Carcinomatosis in a Patient with Metastatic Pancreatic Cancer: A Case Report and Review of the Literature.

Pancreatic cancer is the fourth leading cause of cancer-related death with a median survival of 3-11 months when metastatic. We present a patient with metastatic pancreatic cancer and an exceptional response to initial systemic chemotherapy with FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin). Despite evidence of disease control on body imaging, he developed symptomatic leptomeningeal disease and brain metastases 29 months into treatment. He received aggressive treatment with capecitabine and irinotecan, intrathecal topotecan, and eventually bevacizumab. He did well for 36 w

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… He was found to have sepsis, complicated by septic shock, disseminated intravascular coagulation, and developed a hospital-acquired aspiration pneumonia after endotracheal intubation. …

An Italian cartography of VEXAS-related thrombosis.

Thrombotic events (TEs) occur in up to 40% of patients with vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic (VEXAS) syndrome, but data on its clinical-genomics features and anticoagulation strategies are limited. To gain more insight into this, we conducted a two-step study evaluating the prevalence and outcome of TE in VEXAS. First, among 1086 patients followed for TEs, 198 were men aged >40 years with unprovoked thrombosis and no known thrombophilia; 21 also had at least one VEXAS-compatible feature and underwent UBA1 exon 3 testing. No UBA1 mutation was detected in these 21 pat

Rhabdomyolysis secondary to COVID-19 infection and vaccination: a review of literature.

Rhabdomyolysis (RML), characterized by the breakdown of skeletal muscle fibers and the release of muscle contents into the bloodstream, has emerged as a notable complication associated with Coronavirus disease 2019 (COVID-19) infection and vaccination. Studies have reported an increased incidence of RML in individuals with severe COVID-19 infection. However, the exact mechanisms remain unclear and are believed to involve the host's immune response to the virus. Furthermore, RML has been documented as a rare adverse event following COVID-19 vaccination, particularly with mRNA vaccines. Proposed

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… Late concerns, on the other hand, include acute renal failure and disseminated intravascular coagulation. … The spectrum of complications varies from slight increases in creatinine phosphokinase levels to severe medical crises such as compartment syndrome, intravascular fluid depletion, disseminated intravascular coagulation, pigment-induced acute kidney injury (AKI), and cardiac arrhythmias ( 1 , 32 ). …

Cardiovascular toxicities associated with novel cellular immune therapies.

AbstractOver the past decade, T-cell-directed therapies, including chimeric antigen receptor T-cell (CAR-T) and bispecific T-cell engager (BTE) therapies, have reshaped the treatment of an expanding number of hematologic malignancies, whereas tumor-infiltrating lymphocytes, a recently approved cellular therapy, targets solid tumor malignancies. Emerging data suggest that these therapies may be associated with a high incidence of serious cardiovascular toxicities, including atrial fibrillation, heart failure, ventricular arrhythmias, and other cardiovascular toxicities. The development of these

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… . § Coagulopathy refers to reporting of any of the following events: disseminated intravascular coagulation, elevated PT/aPTT, elevated INR, and elevated D-dimer. || When applicable, the reported AEs are from the FDA drug insert because it provides more comprehensive data on the reported CVAEs. ¶ Reported …

Neutrophil extracellular traps in homeostasis and disease.

Neutrophil extracellular traps (NETs), crucial in immune defense mechanisms, are renowned for their propensity to expel decondensed chromatin embedded with inflammatory proteins. Our comprehension of NETs in pathogen clearance, immune regulation and disease pathogenesis, has grown significantly in recent years. NETs are not only pivotal in the context of infections but also exhibit significant involvement in sterile inflammation. Evidence suggests that excessive accumulation of NETs can result in vessel occlusion, tissue damage, and prolonged inflammatory responses, thereby contributing to the

Unexpected and Deadly: Three Cases of Bone Marrow Necrosis.

Bone marrow necrosis (BMN) is a rare pathological diagnosis, with an incidence of 0.3% to 2%. It is most often associated with hematological malignancies and less commonly due to solid tumors, infections, medications, sickle cell disease, chemotherapy, radiotherapy, or idiopathic causes. We reviewed bone marrow biopsies performed in our institution from 2009 to 2019 and found three cases of BMN. Two cases were secondary to neoplastic causes, while the third one was possibly from alcohol abuse.

Sex Differences in Cancer-Associated Thrombosis.

Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in oncology, arising from complex interactions between tumor biology, host factors, and anticancer therapies. Growing evidence indicates that biological sex and gender-related factors modulate both thrombotic risk and clinical expression of venous thromboembolism (VTE) in patients with cancer. In this narrative review, we summarize current epidemiological, biological, and clinical data on sex- and gender-related differences in CAT across solid and hematologic malignancies. Men generally exhibit a higher overall inci

Innovations in cancer immunotherapy: chimeric antigen receptor T-cell therapy (CAR-T).

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… In advanced cases, disseminated intravascular coagulation, multi-organ failure and death can occur. 10 Both corticosteroids and the interleukin-6 (IL-6) receptor antagonist, tocilizumab, can ameliorate CRS manifestations. …

EARLY COMPLICATIONS IN THE ORTHOPEDIC TREATMENT OF BONE METASTASES.

OBJECTIVE: To assess the early complications in the orthopedic treatment of metastatic bone lesions and the factors associated with these complications. METHOD: There were assessed, retrospectively, 64 patients that underwent surgical treatment for bone metastases, analyzing the complications that occurred in the pre-operative and early post- operative period and associating them with the tumor origin, type of procedure done, the need of blood reposition before the surgery, the need of new surgical procedures and the mortality due to the complications. RESULTS: Early complications in the tre

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… Harrington et al. (2) analyzed 375 pathological fractures by BM and observed as complications: 13 infections, 11 thromboembolic complications, two cases of disseminated intravascular coagulation and one case of metastatic spread on the surgical site. …

The pathogenesis, diagnosis, prevention, and treatment of CAR-T cell therapy-related adverse reactions.

Chimeric antigen receptor (CAR)-T cell therapy is effective in the treatment of refractory/relapsed (r/r) hematological malignancies (r/r B-cell lymphoblastic leukemia, B-cell lymphoma, and multiple myeloma). In addition, it is being explored as a treatment option for solid tumors. As of 31 March 2022, seven CAR-T therapies for hematological malignancies have been approved worldwide. Although CAR-T therapy is an effective treatment for many malignancies, it also causes adverse effects. The incidence of cytokine release syndrome (CRS), the most common adverse reaction after infusion of CAR-T ce

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… CRS, cytokine release syndrome; ICANS, immune effector cell-associated neurotoxicity syndrome; DIC, disseminated intravascular coagulation; BBB, blood brain barrier; CSF, cerebrospinal fluid; CNS, central nervous system; LVEF, left ventricular ejection fraction; IL, interleukin; Ang-2, angiopoietin-2 … Severe CRS can induce disseminated intravascular coagulation (DIC), multiple organ toxicity ( Figure 1C ) (adult respiratory distress syndrome, ICANS, cardiac dysfunction, cytopenia), and even death ( Neelapu et al., 2018a ; Ganatra et al., 2019b ; Sterner and Sterner, 2021 ). …

Biology and Diseases of Dogs

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… Disseminated intravascular coagulation is often a secondary complication. The severity and course of leptospirosis depend on the causative serovar and the age and immune status of the patient. Diagnosis and differential diagnosis. … Differential diagnoses for thrombocytic ehrlichiosis include E. canis infection, immune-mediated thrombocytopenia, and disseminated intravascular coagulation (DIC). Prevention and treatment. Prevention and treatment for E. platys is the same as described for E. canis, above. …

Research Advances on Targets and Mechanisms in Cancers Complicated by Cardiovascular Diseases.

PurposeCancers complicated by cardiovascular diseases (CVDs) are increasingly becoming major limiting factors affecting patients' long-term quality of life and clinical outcomes. Systematic identification of therapeutic targets and their clinical development status is crucial for optimizing treatment strategies. Therefore, this study aimed to establish a target-based analytical framework to systematically map the distribution, developmental stage, maturity, and mechanistic characteristics of clinical trials investigating tumors co-occurring with CVD, thereby identifying potential therapeutic t

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… Advances in the diagnosis and treatment of disseminated intravascular coagulation in haematological malignancies. Int J Hematol . 2021;113(1):34–44. doi: 10.1007/s12185-020-02992-w 33. Falanga A, Marchetti M. Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity. …

Hemophagocytic Lymphohistiocytosis (HLH) in Patients with Tick-Borne Illness: A Scoping Review of 98 Cases.

Hemophagocytic lymphohistiocytosis (HLH) secondary to tick-borne infections is a rare but potentially life-threatening syndrome. We performed a scoping review according to PRISMA guidelines to systematically analyze the existing literature on the topic. A total of 98 patients were included, with a mean age of 43.7 years, of which 64% were men. Most cases, 31%, were reported from the USA. Immunosuppression was present in 21.4%, with the most common cause being previous solid organ transplantation. Constitutional symptoms were the most common, observed in 83.7% of the patients, while fever was r

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… Timely recognition and antibiotic treatment are paramount, as fulminant purpura can result in tissue necrosis, disseminated intravascular coagulation, and, often, fatal outcomes [ 107 ]. … The unusual case of babesiosis causing disseminated intravascular coagulation with hemophagocytic lymphohistiocytosis Clin. Case Rep. 2021 9 e04744 10.1002/ccr3.4744 34484774 PMC8405534 20. Jacquot R. Gerfaud-Valentin M. Lega J.C. Becker A. Jamilloux Y. Seve P. …

Application of Chimeric Antigen Receptor T Cells in the Treatment of Hematological Malignancies.

T cell immune protection plays a pivotal role in the treatment of patients with hematological malignancies. However, T cell exhaustion might lead to the possibility of immune escape of hematological malignancies. Adoptive cell therapy (ACT) with chimeric antigen receptor T (CAR-T) cells can restore the activity of exhausted T cell through reprogramming and is widely used in the treatment of relapsed/refractory (r/r) hematological malignancies. Of note, CD19, CD20, CD30, CD33, CD123, and CD269 as ideal targets have shown extraordinary potential for CAR-T cell therapy and other targets such as C

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… Moreover, Jiang et al. found that CRS caused by CAR-T cell therapy would further lead to disseminated intravascular coagulation (DIC) and proposed the application of immunosuppressive agents and corticosteroids for early and appropriate interventions for CRS-related coagulation disorders, which could …

Women with Gaucher Disease.

Gaucher disease is an inherited disorder in which there is a deficiency of the enzyme glucocerebrosidase, which leads to the accumulation of glucosylceramide. Although much scientific evidence is now available, there is still limited data on the impact on the different life stages of women with this disease. Among other alterations, a delay in menarche has been described, although it has not been related to fertility problems. Menorrhagia is relatively frequent, being related to the presence of thrombocytopenia, thrombocytopathies or coagulation disorders. On the other hand, pregnancy planning

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… Disseminated intravascular coagulation in obstetric disorders and its acute haematological management. Blood Rev. 2009;23:167–176. doi: 10.1016/j.blre.2009.04.002. 35. Simchen M.J., Oz R., Shenkman B., Zimran A., Elstein D., Kenet G. …

CAR-T Cell Therapy in Hematological Malignancies: Current Opportunities and Challenges.

Chimeric antigen receptor T (CAR-T) cell therapy represents a major breakthrough in cancer treatment, and it has achieved unprecedented success in hematological malignancies, especially in relapsed/refractory (R/R) B cell malignancies. At present, CD19 and BCMA are the most common targets in CAR-T cell therapy, and numerous novel therapeutic targets are being explored. However, the adverse events related to CAR-T cell therapy might be serious or even life-threatening, such as cytokine release syndrome (CRS), CAR-T-cell-related encephalopathy syndrome (CRES), infections, cytopenia, and CRS-rela

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… intravascular coagulation (DIC). … Without timely and effective intervention, a part of patients with coagulopathy may further develop disseminated intravascular coagulation (DIC), accompanied by the poor prognosis ( 9 , 156 , 158 ). Table 2 Toxicities related to CAR-T cell therapy and effective solutions. …

Prognostic factors and skeletal-related events in patients with bone metastasis from gastric cancer.

The number of studies on bone metastasis (BM) from gastric cancer (GC) is currently limited. Therefore, the aim of the present study was to investigate the characteristics, skeletal-related events (SREs) and prognosis of GC in patients with BMs. Data from 60 patients with BMs from GC were retrospectively retrieved and patient-, tumor- and BM-related characteristics were analyzed. Kaplan-Meier survival curves were analyzed using the univariate log-rank test. Multivariate analyses were conducted using the Cox proportional hazards model. The median patient age was 63.5 years (range, 26-83 years).

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… BM in GC is often associated with a rapidly deteriorating clinical course and extremely poor prognosis, due to combined bone marrow metastasis causing hematological abnormalities, such as disseminated intravascular coagulation (DIC). …

37th International Symposium on Intensive Care and Emergency Medicine (part 2 of 3) : Brussels, Belgium. 21-24 March 2017

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Review of oncological emergencies in small animal patients.

Oncological emergencies can occur at any time during the course of a malignancy and need to be recognized promptly to maximize successful outcomes. Emergencies are characterized as chemotherapy-induced, paraneoplastic syndromes, or directly related to the neoplasm. Prompt identification with treatment of these emergencies can prolong survival and improve quality of life, even in the setting of terminal illness. This review aims to educate the reader on the pathophysiology, clinical presentation and treatment of some of these emergencies, and to review the current veterinary literature to help

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… Coagulopathies are present in the majority of patients; disseminated intravascular coagulation (DIC) occurs in approximately 50% of dogs with HSA (Filppi et al . 1991 ; Maruyama et al . 2004 and Mischke et al . 2005 )., Fine needle aspiration of any masses may be attempted, but can be non‐diagnostic, … Veterinary Surgery 23 , 101 – 106 . 8191668 10.1111/j.1532-950x.1994.tb00453.x Maruyama H. , Miura T. , Sakai M. , Koie H. , Yamaya Y. , Shibuya H. et al. ( 2004 ) The incidence of disseminated intravascular coagulation in dogs with malignant tumor . …