Anshuman Panda

How land levelling shapes productivity and resilience — it should be recognised as a critical tool that improves efficiency, supports crop diversification, and strengthens the economic stability of rural households

Shock-related thyroid changes are a rare radiological finding, considered part of the hypovolemic shock complex. It is characterized by thyroidal and perithyroidal edema without direct thyroid injury, typically seen in severe trauma. Very few cases have been described in the literature. We report a case of a 15-year-old male who presented in hemorrhagic shock following a road traffic accident. Whole-body computed tomography (CT) imaging demonstrated heterogeneous thyroid enhancement with perithyroidal edema, consistent with shock-related thyroid changes, in the absence of direct thyroid trauma. The patient also sustained a high-grade splenic injury requiring emergent laparotomy and splenectomy, along with orthopedic intervention for a femur fracture. Thyroid function tests were normal, and the patient gradually improved with appropriate surgical and supportive management. The radiological features of shock-related thyroid changes are distinct and must be differentiated from direct thyroid injury or adjacent vascular damage. The underlying pathophysiology is uncertain, but proposed mechanisms include third-spacing of resuscitative fluids or thyroidal hypoperfusion during profound hypovolemia. Recognition of this entity is crucial as it is self-limiting and does not require specific thyroid-directed intervention. Shock-related thyroid changes are a rare but important secondary imaging finding in the setting of severe trauma and hypovolemic shock. Awareness of this condition can help avoid misdiagnosis and unnecessary investigations.

A growing body of recent work suggests the possibility of heterogeneous ribosomal composition. We recently observed subtype-specific mRNA and copy number variation signatures of human ribosomal proteins (RPs) in cancers from human adults, but whether such subtype-specific RP mRNA signatures are also present in human pediatric cancers is currently unknown. In this study, we analyzed mRNA expression data from multiple large pediatric cancer datasets to test for heterogeneity in RP mRNA signatures. We found that different pediatric cancer types have different RP mRNA signatures, sometimes multiple RP mRNA signatures within the same pediatric cancer type, which can be subgroup/subtype-specific (e.g., in Medulloblastoma) or cell-of-origin-specific (e.g., in Acute Lymphoblastic Leukemia (ALL)). In B-cell ALL, we found two RP mRNA subtypes with significantly different prognoses. Consistent with our recent findings in adult cancers, the RP mRNA signature in pediatric cancer is heterogeneous and subtype-specific and may have clinical relevance.