◥Despite strong biological rationale for the use of type-I IFNs for the treatment of acute myeloid leukemia (AML), their usage is limited to few hematologic malignancies. Here, we propose that innate immune sensing machinery, particularly the stimulator of IFN genes pathway, may be exploited to deliver antileukemic effects in AML. Has Acute Myeloid Leukemia Treatment Stagnated?Acute myeloid leukemia (AML) is a malignancy of the bone marrow driven by proliferation of immature myeloid cells (1, 2). Current treatment is relatively standardized, including chemotherapy with anthracycline/cytarabine combination, for which most patients reach complete clinical response, followed by either consolidation chemotherapy or allogeneic stem cell transplantation (SCT; ref.3). Efficacy of current standard-of-care chemotherapeutics is limited, associated with serious toxicity, and has changed little in the past four decades, warranting the need for new therapies. Use of type-I IFNs for AML treatment dates back to the early 1980s, with several clinical trials using recombinant and modified formulations of type-I IFNs for patients relapsing upon hematopoietic SCT or postremission strategy to prevent recurrence (4). However, with only modest clinical outcome, firm conclusion regarding the efficacy of type-I IFN could not be made. Emerging evidence now suggests targeting innate immune sensing mechanisms that regulate type-I IFN activity in response to viral infections may be exploited and refined to deliver antileukemic effects in AML rather than systemic delivery of type-I IFN regimens.The "Traditional" Type-I IFN in AML Type-I IFNs are recognized as antiviral cytokines, induced in response to viruses. In addition to virus-infected cells, they are also secreted by T cells, macrophages, and natural killer cells, and activate lymphocytes in the immediate vicinity to develop their cytotoxic potential (5). This drives amplification of the lytic arm of the immune response, which may form the basis of their antitumoral activity. Type-I IFNs have been used to treat hematologic malignancies, such as hairy cell leukemia, chronic myeloid leukemia, and other myeloproliferative neoplasms. The FDA approved IFNa (IFNa2b) in 1986 for the treatment of hairy cell leukemia in the United States. However, type-I IFN has not been a treatment option in AML due to inconsistent patient response and toxicities ranging from fever, skin rash, somnolence, generalized seizure, and autoimmune symptoms to thyroid dysfunction and acute graftversus-host disease (GVHD; refs. 4,6). Type-I IFN signaling appears to negatively impact the development of leukemia, in line with its downstream functions, such as increase in rate of apoptosis, increase in AML immunogenicity, and decrease in cell proliferation (7). Despite this, it is unclear as to why type-I IFN treatment for AML is not as robust an envisioned.

Bladder herniation through the inguinal canal is a rare condition, accounting for only 1–4% of all inguinal hernias. Most patients are asymptomatic or have atypical symptoms. 65-year-old male who presented with gross hematuria, right inguinal swelling. Diagnosed preoperatively by CT scan to have bladder neoplasm within a right inguinal vesical hernia. Patient. Underwent TURBT and hernia repair. Inguinal bladder hernia is rare and occurs more commonly in obese male patients above 50 years of age. CT scan is the radiological modality choice to confirm the diagnosis prior intervention to avoid intraoperative complications such as bladder injury.

Purpose To investigate the relationship between urinary stone type and the type of crystals in the urine. Patients and Methods This retrospective study involved 485 patients with urinary stones treated at King Saud University Medical City from May 2015 to June 2017. Clinical data were obtained from medical records. Different statistical analysis methods were applied, including basic contingency analysis, analysis of variance, logistic regression, discriminant analysis, partition modeling, and neural network evaluations. Results Of 485 patients, 47 had crystals detected by urinalysis. The most common type of crystal was calcium oxalate (n = 31), which had the highest association with calcium oxalate stones. Uric acid crystals (n = 8) were associated with uric acid stones. The neural network model used for determining the sensitivity and specificity showed an R-square value of 0.88, with an area under the curve of 0.94 for calcium oxalate, 0.94 for carbonate apatite, and 1.0 for uric acid. Conclusion The predictive algorithm developed in the present study may be used with a patient’s clinical parameters to predict the stone type. This approach predicts the stone types associated with certain patient characteristics with a high sensitivity and specificity, indicating that the models may be a valuable clinical tool in the diagnosis, management, and monitoring of stone diseases.

Seizure and anesthesia is a topic necessitating more studies to understand its mechanism. Some anesthetic agents triggers seizures, while others can control it. We are here reporting a case of apparently healthy young adult patient who underwent diagnostic cystoscopy and urethral dilatation under general anesthesia and who developed seizure immediately after admission to the postanaesthetic care unit.