The reduction-oxidation state of NAD + /NADH is critical for cellular health with NAD + and its metabolites playing critical roles in aging and pathologies. Given the inherent autooxidation of reduced dinucleotides (i.e. NADH/NADPH), and the well-established differential stability, the accurate measurement of NAD + and its metabolites is technically challenging. Moreover, sample processing, normalization and measurement strategies can profoundly alter results. Here we developed a rapid and sensitive liquid chromatography mass spectrometry-based method to quantify the NAD + metabolome with careful consideration of these intrinsic chemical instabilities. Utilizing this method we assess NAD + metabolite stabilities and determine the presence and concentrations of NAD + metabolites in clinically relevant human samples including cerebrospinal fluid, erythrocytes, and primate skeletal muscle.

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Primary pleural lymphoma is a rare type of lymphoma that accounts for only 0.3% of all non-Hodgkin's lymphomas. The rarity and nonspecific clinical presentation of primary pleural lymphomas pose a diagnostic challenge for clinicians. We present an atypical case of primary pleural lymphoma in an elderly patient without any associated pleuro-pulmonary disease, immunosuppression, or history of lymphoma. To our knowledge, this is one of the first described cases of a primary pleural lymphoma with such a presentation.

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e12585 Background: Paget disease of the breast is a malignant tumor that comprises only 1-3% of all breast carcinomas. It may coexist with an underlying ductal carcinoma in situ or present alone without additional carcinomas. Due to the rarity of this carcinoma and minimal literature available, we intend to identify potentially important prognostic factors, particularly those of socioeconomic origin. Methods: We performed a retrospective investigation of 5,918 patients diagnosed with Paget Disease of the breast from the NCDB between 2004-2018. Patient demographic and clinical characteristics such as household income, insurance status, treatment center type, and treatment center location were extracted from the database. Survival rates were compared using Kaplan-Meier curves, log-rank test, univariate and chi-square analysis. Data were analyzed using SPSS statistics 27. Results: African American patients had higher mortality rates than Caucasian patients (p < 0.005). Patients with underlying intraductal carcinoma of the breast had the highest survival rates (p < 0.001). Patients who received immunotherapy as part of the treatment plan had a significantly higher survival rate than those who did not (136.97 vs. 144.24 months respectively, p < 0.001). Patients coming from lower median household incomes had significantly lower survival rates. Specifically, patients with a household income of less than $38,000 had a lower mean survival rate compared to those with a household income of greater than $63,000 (122.74 months compared to 140.63, respectively, p < 0.001). Those with private insurance had a higher mean survival time than those with Medicaid and no insurance (170.60, 138.13, and 130.69 months respectively, p < 0.001). Patients from counties in metro areas with populations of 1 million or more had a significantly higher survival rate than those from counties in metro areas with less than 1 million (p < 0.003). In addition, patients treated at academic centers had a higher mean survival rate than those treated at non-academic centers (p < 0.001). Conclusions: Our results show significant variation in survival rates among patients based on their socioeconomic and treatment center characteristics. Additional research targeting patients with these characteristics can lead to improved clinical outcomes.