Background Few studies have addressed the clinicopathological features of colorectal cancer (CRC) that express programed death-ligand 1 (PD-L1). Various assays and scoring methodologies were used and thus inconsistent results were obtained. In this study, we aimed to investigate the relationship of PD-L1 expression in CRC with various clinicopathological variables using a standardized assay and scoring algorithm. Design Tissue microarrays were constructed from 91 random cases of CRC diagnosed at King Hussein Cancer Center (KHCC). Immunohistochemical (IHC) staining using the monoclonal antibody 22C3 was performed. Scoring using the standard “Combined Positive Score” (CPS) method was done. CPS of ≥1 was considered positive. Various clinicopathological features were collected from the medical records of the patients. Results Of the 91 cases, 49 (53.8%) were PD-L1 positive (CPS ≥1). PD-L1 expression was more frequent among moderately differentiated carcinomas (43 of 72 (59.7%) were positive compared to 6 of 19 (31.5%) poorly differentiated cases ( P = 0.029)); among node negative cases (21 of 24 (87.5%) N0 cases were PD-L1 positive in contrast to 28 of 67 (41.8%) N1/N2 cases ( P = <0.001)); among mucinous subtype (12 of 15 (80%) of cases ( P = 0.02)); and among mismatch repair deficient (dMMR) (16 of 16 (100%) versus 11 of 30 (36.6%) MMR proficient ( P = <0.001)). Age, gender, localization, and T or M stages were not significantly associated with PD-L1 expression. Conclusion PD-L1 expression in CRC is associated with favorable prognostic features; namely, lower grade, N0, mucinous variant, and dMMR tumors.

Introduction While appendicitis is considered one of most common acute surgical conditions, several studies have reported abnormal histopathological findings in appendectomy specimens; however, sending all appendices to histopathology is not yet routinely done.Here we report many unusual findings. Those unusual findings played a role not only in confirming acute appendicitis as a cause of the presentation in some cases but also discovering etiologies that mimic it with great impact on its management. Methods Between January 2011 and December 2017, a total of 1510 patients were operated with appendectomy for a primary diagnosis of acute appendicitis. Among them, a total of 72 patients had incidental histopathologic findings in association with acute appendicitis or other pathologies instead of acute appendicitis. A retrospective analysis for those 72 patients was performed with all data being retrieved from the electronic health record system. Results Patients ages ranged between 4 and 71 years with a mean age equal to 23.1 years (SD = 14.2). Majority of patients were women (n = 52; 72.2%). Sixty of the seventy-two cases were seen in patients with negative appendectomies (n = 333) with an overall rate of 18% among this group of patients. The remaining 12 patients had additional findings in histopathology specimens beside acute appendicitis (n = 1131) with an overall rate of 1%. The most commonly reported pathologies were serositis, ovarian cysts, and Enterobius vermicularis in descending frequency. Conclusion Identification of unusual histopathological findings during microscopic examination of resected appendices is more common in female patients and in patients with negative appendectomy. histopathologic assessment of specimens will allow detection of congenital, infectious or malignant pathologies that mimic acute appendicitis clinically even in the absence appendicitis microscopically.

The proliferation of electronic content and limited exposure of children to books in Jordan has made both parents and health-care providers more concerned about healthy child development. This research aimed to determine if pediatric primary prevention programs were helpful in reducing screen-time and improving reading habits of children in Jordan, and if there was a correlation between these two factors. Parents attended classes on various topics, one of which dealt with screen-time and reading. Six months later, they were surveyed on these topics. The test group (took the relevant class) and control group (did not take the class) included 30 families each. The mean screen-time was above the recommended guideline of 2 h/day in both groups. Only 37% of the families in the test group, and 17% in the control group followed the guideline. A significant difference in screen-time between the groups was found only during weekends. When asked about the ideal screen-time, parents from the test group reported screen-times that were significantly closer to the recommendations, showing an increase in knowledge, but not a significant change in behavior. Parents, also, believed that children’s exposure to books should be at the much later age of 3–4 years, with actual exposure being < 1 h/day. Moreover, no correlation was found between screen-time and reading time. These findings suggest that short, evidence-based classes helped raise awareness, but were not sufficient for parents to fully adopt the guidelines. Programs that promote behavior modification should be explored to reinforce knowledge gained from educational classes.

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