Goblet cell adenocarcinoma (GCA) is a rare tumor described exclusively in the appendix, comprising < 1% of gastrointestinal tumors. The 2019 WHO classification of tumors of the digestive system has renamed and defined it. This study aims to analyze the clinical presentation and evaluate the histomorphological profile of GCA. A retrospective search of our database was done spanning a period of 10.5 years (July 2014-January 2025). Clinicopathological features were analyzed. Fourteen patients included had a median age of 50 years at the time of diagnosis with a male to female ratio of 1:0.75. Six patients presented with symptoms of acute to subacute intestinal obstruction. On imaging, these patients revealed circumferential thickening in the ileocecal region. Three of the female patients presented with symptoms predominantly pertaining to the gynecological tract. Histopathological evaluation revealed tubules and clusters of goblet-like mucinous cells with a variable number of endocrine cells and Paneth-like cells. Overall mean survival was 26 months and the median survival was 24 months. Recognition of GCA warrants a high degree of suspicion as they may present to different clinical departments owing to highly variable presentation and can be mistaken for signet ring cell adenocarcinoma on biopsy samples.
BACKGROUND: Early differentiation between Alzheimer’s disease (AD) and fronto-temporal dementia (FTD) remains challenging due to overlapping clinical features and structural MRI findings. Functional MRI techniques such as arterial spin labelling (ASL) and proton magnetic resonance spectroscopy (¹H‑MRS) offer non‑invasive assessment of cerebral perfusion and metabolism that may precede overt structural changes. OBJECTIVE: To evaluate the role of ASL and ¹H‑MRS in early detection and differentiation of AD and FTD, and distinguishing these entities from age-related changes. METHODS: Fifteen patients each with AD, FTD and healthy controls underwent 3D-Pseudocontinous ASL-MRI and MRS in addition to routine imaging on 3T MRI system. Visual rating scales were used for assessment of regional atrophy. Regional cerebral blood flow (CBF) was quantified using ASL, and metabolite ratios (NAA/Cr, mI/Cr, NAA/mI) were assessed in the anterior and posterior cingulate gyri using MRS. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis. RESULTS: FTD demonstrated predominant frontal and anterior temporal atrophy with corresponding hypoperfusion, while AD showed parietotemporal and posterior cingulate involvement. Mean CBF in the anterior cingulate gyrus differentiated FTD from controls with a sensitivity of 86.6% and specificity of 80% at cut‑off of 31.91 ml/100 g/min. Posterior cingulate hypoperfusion differentiated AD from controls with a sensitivity of 86.6% and specificity of 73.3% at cut‑off of 38.29 ml/100 g/min. On MRS, NAA/mI ratio was significantly decreased in anterior cingulate gyrus in FTD compared to both AD and controls at cut-off value of 8.56 in controls with a specificity and sensitivity of 86.6 % and 83.3% respectively, whereas in AD patients, cutoff value was 14.75 with sensitivity and specificity of 86.6% each. CONCLUSION: The use of functional neuroimaging techniques as an adjunct to conventional MRI can provide unique insights into the changes seen in neurodegenerative diseases in the form of disease-specific patterns of differences in perfusion and metabolism.
Colchicine has been shown to mitigate inflammation and reduce adverse cardiovascular events. However, evidence from clinical trials has been mixed regarding its efficacy in cardiovascular prevention among patients undergoing cardiac surgery. We aimed to evaluate the association between colchicine use and cardiovascular outcomes in patients undergoing cardiac surgery. We conducted a systematic literature search on various electronic databases for relevant studies from their inception until July 15, 2025. Randomized controlled trials (RCTs) with two arms—one with colchicine as an intervention and the other with placebo—in patients undergoing cardiac surgery were included. Risk ratios (RRs) and weighted mean differences (WMDs), along with 95
