Non-Hodgkin's Lymphoma (NHL) rarely presents during pregnancy and primary mediastinal large B-cell lymphoma (PMLBCL) accounts for approximately 2.5% of patients with NHL. The case of a 22-year-old woman who was diagnosed with Stage IIA PMLBCL during week 13 of her intrauterine pregnancy is described. The staging consisted in computed tomography (CT) of the chest and magnetic resonance imaging (MRI) of the abdomen and pelvis. She was managed with R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) for a total of six cycles and, because of the early presentation during the second trimester, she received the entire chemotherapy course during the pregnancy. She delivered a healthy baby at 34 weeks of pregnancy and a 18FDG-PET/CT scan demonstrated complete remission after delivery. After 20 months of follow up she remains with no evidence of disease and her 1-year-old son has shown no developmental delays or physical abnormalities. PMLBCL, although an uncommon subgroup of DLBCL, may present during pregnancy and R-CHOP should be considered as one suitable option in this complex scenario.

After secretion by the heart, atrial natriuretic factor (ANF) circulates in plasma, whereas C-type natriuretic peptide (CNP), which is found in abundance in the endothelium, may regulate vascular tone in a paracrine manner. However, there is little information on the effect of CNP on renal microvessels. We hypothesized that CNP dilates the afferent arteriole via the nitric oxide pathway, whereas ANF acts directly on vascular smooth muscle cells. When we perfused rat kidneys with minimal essential medium and bovine serum albumin at 100 mm Hg and examined the juxtamedullary afferent arterioles, neither CNP nor ANF was found to have any effect. When the peptides were added to arterioles preconstricted with norepinephrine, CNP and ANF dilated them in a similar fashion; diameters increased by 25 +/- 4% (n=7) and 29 +/- 6% (n=6) at 10(-7) mol/L, respectively (P < .008). Pretreatment with 10(-4) mol/L N-nitro-L-arginine methyl ester (L-NAME) or 5 x 10(-6) mol/L indomethacin blocked CNP-induced dilation; dilation by ANF was unaffected by indomethacin (52 +/- 25%, n=5) and potentiated by L-NAME (73 +/- 14%, n=5). Thus, CNP dilates the afferent arterioles via the prostaglandin/nitric oxide pathway, whereas ANF dilates them directly. This difference may be important in controlling glomerular hemodynamics.

Aim: To compare the accuracy and reliability of cone beam computed tomography (CBCT) and electronic apex locator (EAL) in determining the working length (WL). Background: A comprehensive literature search was conducted across several databases and gray literature. A total of 1,358 potentially relevant journal articles were identified with publication dates ranging from 1996 to 2017. After screening and applying the inclusion and exclusion criteria, five studies were identified as eligible for review. Data extraction was completed in two blinded pairs, cross-referenced and subsequently merged. Discrepancies were resolved through collaborator mediation. Meta-analysis was not undertaken due to heterogeneity between included studies. Review results: In all five studies, no statistically significant difference was found between CBCT and EAL measurements of WL. The reliability of CBCT compared with EAL was not determined. Conclusion:Due to significant heterogeneity between the included studies, the accuracy of CBCT compared to EAL couldn't be determined. Based on limited evidence, CBCT appeared to be as accurate as EAL. There was weak evidence suggesting that CBCT was reliable. Also the superiority of one method over the other could not be determined. These results should be interpreted judiciously. Further research is required to conclusively evaluate the accuracy and reliability of CBCT compared with EAL. Clinical significance: Preexisting CBCT scans may be appropriate for WL determination but acquiring a new CBCT for endodontic treatment is inadvisable due to cost and the as low as reasonably achievable (ALARA) principle.