bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial clinical and laboratory parameters triaging non-pharmaceutical acute pediatric poisoned patients for potential adverse outcomes: a three-year retrospective study
Authors: El-Sarnagawy Ghada N , Ghonem Mona M , Helal Nadia E
Published: January 2023

Identifying high-risk pediatric patients with non-pharmaceutical poisoning is crucial to avoid prospective complications and decrease the evident hospital economic burden. Although the preventive strategies have been well studied, determining the early predictors for poor outcomes remains limited. Therefore, this study focused on the initial clinical and laboratory parameters as a triage of non-pharmaceutical poisoned children for potential adverse outcomes taking the causative substance effects into account. This retrospective cohort study included pediatric patients admitted to Tanta University Poison Control Center from January 2018 to December 2020. Sociodemographic, toxicological, clinical, and laboratory data were retrieved from the patient’s files. Adverse outcomes were categorized into mortality, complications, and intensive care unit (ICU) admission. Out of enrolled 1,234 pediatric patients, preschool children constituted the highest percentage of the patients investigated (45.06%), with a female predominance (53.2%). The main non-pharmaceutical agents included pesticides (62.6%), corrosives (19%), and hydrocarbons (8.8%), mainly associated with adverse consequences. The significant determinants for adverse outcomes were pulse, respiratory rate, serum bicarbonate (HCO3), Glasgow Coma Scale, O2 saturation, Poisoning Severity Score (PSS), white blood cells (WBCs), and random blood sugar. The cutoffs of serum HCO3 < 17.55 mmol/l, WBCs >8,650 cells/microliter, and PSS > 2 points were the best discriminators for mortality, complications, and ICU admission, respectively. Thus, monitoring these predictors is essential to prioritize and triage pediatric patients who require high-quality care and follow-up, particularly in aluminum phosphide, sulfuric acid, and benzene intoxications.
Considering developmental neurotoxicityin vitrodata for human health risk assessment using physiologically-based kinetic modeling: deltamethrin case study
Authors: Maass Christian , Schaller Stephan , Dallmann André , Bothe Kathrin , Müller Dennis
Published: January 2023

Developmental neurotoxicity (DNT) is a potential hazard of chemicals. Recently, an in vitro testing battery (DNT IVB) was established to complement existing rodent in vivo approaches. Deltamethrin (DLT), a pyrethroid with a well-characterized neurotoxic mode of action, has been selected as a reference chemical to evaluate the performance of the DNT IVB. The present study provides context for evaluating the relevance of these DNT IVB results for the human health risk assessment of DLT by estimating potential human fetal brain concentrations after maternal exposure to DLT. We developed a physiologically based kinetic (PBK) model for rats which was then translated to humans considering realistic in vivo exposure conditions (acceptable daily intake [ADI] for DLT). To address existing uncertainties, we designed case studies considering the most relevant drivers of DLT uptake and distribution. Calculated human fetal brain concentrations were then compared with the lowest benchmark concentration achieved in the DNT IVB. The developed rat PBK model was validated on in vivo rat toxicokinetic data of DLT over a broad range of doses. The uncertainty based case study evaluation confirmed that repeated exposure to DLT at an ADI level would likely result in human fetal brain concentrations far below the in vitro benchmark. The presented results indicate that DLT concentrations in the human fetal brain are highly unlikely to reach concentrations associated with in vitro findings under realistic exposure conditions. Therefore, the new in vitro DNT results are considered to have no impact on the current risk assessment approach.
Pneumoperitoneum caused by pneumatosis cystoides coli
Authors: Chang Ting-Wei , Tsai Feng-Chi
Published: January 2023

Pneumatosis cystoides intestinalis (PCI) is a rare disease with the incidence of 0.03% in the general population, and the symptoms are diverse, ranging from asymptomatic to life-threatening scenario. Herein, we present a case of pneumatosis cystoides coli with pneumoperitoneum and an unknown origin of septic shock undergoing exploratory laparotomy. A 70-year-old woman with a history of Bechet disease was admitted to the internal medicine department because of Bechet disease with acute exacerbation, and she received high-dose steroid therapy. Emergency computed tomography of the abdomen disclosed diffuse pneumatosis coli with pneumoperitoneum and mild ascites. Ischemic bowel disease was highly suspected. Exploratory laparotomy was done with intraoperative findings of an intact gastrointestinal tract without ischemic change and gas within the wall of the colon. Pneumoperitoneum could be a life-threatening condition and also be a nonsurgical scenario. Arterial gas examination could be a considerable clue to distinguish pneumatosis cystoides coli–related pneumoperitoneum from surgical pneumoperitoneum. Close and serial observation of clinical presentation, laboratory examination, and image study would be helpful to identify the possible etiologies of pneumoperitoneum. Laparoscopic exploration may also be a safe and feasible option to examine the integrity of the gastrointestinal tract.
Validation of risk scores for allograft failure after liver transplantation in Germany: a retrospective cohort analysis
Authors: Moosburner Simon , Wiering Leke , Roschke Nathalie N. , Winter Axel , Demir Münevver , Gaßner Joseph M.G.V. , Zimmer Maximilian , Ritschl Paul , Globke Brigitta , Lurje Georg , Tacke Frank , Schöning Wenzel , Pratschke Johann , Öllinger Robert , Sauer Igor M. , Raschzok Nathanael
Published: January 2023

A growing number of clinical risk scores have been proposed to predict allograft failure after liver transplantation. However, validation of currently available scores in the Eurotransplant region is still lacking. We aimed to analyze all clinically relevant donor and recipient risk scores on a large German liver transplantation data set and performed a retrospective cohort analysis of liver transplantations performed at the Charité—Universitätsmedizin Berlin from January 2007 until December 2021 with organs from donation after brain death. We analyzed 9 previously published scores in 906 liver transplantations [Eurotransplant donor risk index (ET-DRI/DRI), donor age and model for end-stage liver disease (D-MELD), balance of risk (BAR), early allograft dysfunction (EAD), model for early allograft function (MEAF), liver graft assessment following transplantation (L-GrAFT7), early allograft failure simplified estimation (EASE), and a score by Rhu and colleagues). The EASE score had the best predictive value for 3-month, 6-month, and 12-month graft survival with a c-statistic of 0.8, 0.77, and 0.78, respectively. In subgroup analyses, the EASE score was suited best for male recipients with a high-MELD (>25) and an EAD organ. Scores only based on pretransplant data performed worse compared to scores including postoperative data (eg, ET-DRI vs. EAD, p<0.001 at 3-month graft survival). Out of these, the BAR score performed best with a c-statistic of 0.6. This a comprehensive comparison of the clinical utility of risk scores after liver transplantation. The EASE score sufficiently predicted 12-month graft and patient survival. Despite a relatively complex calculation, the EASE score provides significant prognostic value for patients and health care professionals in the Eurotransplant region.
Serratia Infection Epidemiology Among Very Preterm Infants in the Neonatal Intensive Care Unit
Authors: Coggins Sarah A. , Edwards Erika M. , Flannery Dustin D. , Gerber Jeffrey S. , Horbar Jeffrey D. , Puopolo Karen M.
Published: January 2023

Background:

Serratia spp. are opportunistic, multidrug resistant, Gram-negative pathogens, previously described among preterm infants in case reports or outbreaks of infection. We describe Serratia late-onset infection (LOI) in very preterm infants in a large, contemporary, nationally representative cohort.

Methods:

In this secondary analysis of prospectively collected data of preterm infants born 401–1500 grams and/or 22–29 weeks gestational age from 2018 to 2020 at 774 Vermont Oxford Network members, LOI was defined as culture-confirmed blood and/or cerebrospinal fluid infection > 3 days after birth. The primary outcome was incidence of Serratia LOI. Secondary outcomes compared rates of survival and discharge morbidities between infants with Serratia and non-Serratia LOI.

Results:

Among 119,565 infants, LOI occurred in 10,687 (8.9%). Serratia was isolated in 279 cases (2.6% of all LOI; 2.3 Serratia infections per 1000 infants). Of 774 hospitals, 161 (21%) reported at least one Serratia LOI; 170 of 271 (63%) cases occurred at hospitals reporting 1 or 2 Serratia infections, and 53 of 271 (20%) occurred at hospitals reporting ≥5 Serratia infections. Serratia LOI was associated with a lower rate of survival to discharge compared with those with non-Serratia LOI (adjusted relative risk 0.88, 95% CI: 0.82–0.95). Among survivors, infants with Serratia LOI had higher rates of tracheostomy, gastrostomy and home oxygen use compared with those with non-Serratia LOI.

Conclusions:

The incidence of Serratia LOI was 2.3 infections per 1000 very preterm infants in this cohort. Lower survival and significant morbidity among Serratia LOI survivors highlight the need for recognition and targeted prevention strategies for this opportunistic nosocomial infection.
Pneumonia in Children During the 2019 Outbreak in Xiamen, China
Authors: Zhang Jinqiang , Zhuo Zhiqiang , Xu Yongjun , Bai Dingzhen , Wang Chuning , Cai Jiehao , Zeng Mei
Published: January 2023

Background:

To understand the regional epidemiology and clinical characteristics of adenovirus pneumonia in hospitalized children during the 2019 outbreak of respiratory adenoviruses in China.

Methods:

We analyzed the epidemiologic trend of adenovirus in children hospitalized for acute lower respiratory tract infections in Xiamen in 2019. Adenovirus was identified using direct fluorescent antibody detection. During the peak seasons of adenovirus epidemic, 170 adenovirus-positive specimens were obtained for molecular typing, and the clinical data were collected.

Results:

Among the 9890 children hospitalized for acute lower respiratory tract infection, 609 (6.2%) were tested positive for adenovirus. The detection rate of adenovirus was significantly higher in boys than in grils (9.5% vs. 4.6%, P < 0.05). Adenovirus activity increased markedly between April and August with the prevalence of 7.3%–12.4%. During the outbreak season, type 7 accounted for 70.6%, followed by type 3 (28.8%) and type 4 (0.6%). Of the 155 cases of adenovirus pneumonia, the median age was 3.0 years (range: 4 month to 9 years), 153 (98.7%) had fever with a mean fever duration of 9.04 ± 5.52 days, 28 (16.5%) had wheezing, 93 (60%) showed segmental or lobar consolidation with atelectasis and 13 (8.4%) showed pleural effusion. Forty-six (29.6%) cases developed severe pneumonia, 7 (4.1%) required mechanical ventilation and 2 (1.2%) died. Younger age, longer duration of fever and higher fever spike were more frequently seen in severe cases (P < 0.05). Twenty-five (16.2%) had C-reactive protein ≥ 40 mg/L, and 91 (58.7%) had procalcitonin ≥ 0.25 mg/L.

Conclusions:

Adenovirus types 7 and 3 caused the outbreak of adenovirus pneumonia in community children during late spring to summer in 2019 in Xiamen. The majority of adenovirus pneumonia resembles bacterial pneumonia. The incidence of severe pneumonia was high when type 7 predominantly prevailed. Adenovirus type 7 was more common in severe cases than in nonsevere cases.
Tocilizumab for Treatment of Children and Young Adults With Severe Acute COVID-19: Experience at a Quaternary-care Children’s Hospital
Authors: Teoh Zheyi , Danziger-Isakov Lara , Courter Joshua D. , Frenck Robert W. , Grimley Michael S. , Marsh Rebecca A. , Paulsen Grant C. , Phillips Christine L. , Spearman Paul , Chima Ranjit S. , Schulert Grant S.
Published: January 2023

We describe the clinical characteristics and outcomes of 16 children and young adults with severe acute COVID-19 who were treated with tocilizumab. Patients who were discharged by day 28 were more likely to be treated with tocilizumab earlier in their COVID-19 illness and had lower ferritin and interleukin-6 levels compared with those who were not discharged by day 28.
Decreasing Incidence of the Multisystem Inflammatory Syndrome in Children Over 3 Pandemic Waves
Authors: Eleftheriou Irini , Maritsi Despina , Lampidi Stavroula , Charisi Konstantina , Vantsi Petrina , Skourti Kleopatra , Filippatos Filippos , Amplianitis Ioannis , Dimou Despina , Papadopoulou-Legbelou Kyriaki , Papadopoulou-Alataki Efimia , Kampouridou Parthena , Koletsi Patra , Fotis Lampros , Vergadi Elena , Gkentzi Despoina , Farmaki Evangelia , Papaevangelou Vassiliki , Galanakis Emmanouil , Grivea Ioanna N. , Syrogiannopoulos George A. , Spoulou Vana , Spyridis Nikos , Michos Athanasios , Roilides Emmanuel , Tsolia Maria N.
Published: January 2023

In this nationwide retrospective study, a substantial decline in the incidence of multisystem inflammatory syndrome in children over 3 successive pandemic waves characterized by different severe acute respiratory syndrome coronavirus 2 variants was documented—from 3.4 of 1000 to 1.1 of 1000 and finally to 0.25 of 1000 confirmed severe acute respiratory syndrome coronavirus 2 positive cases (P < 0.0001), respectively, whereas clinical findings and severity did not significantly vary.
Treatment of Infants and Children With SARS-CoV-2 Monoclonal Antibodies: A European Case Series
Authors: Rau Cornelius , Auer-Hackenberg Lorenz , Deubzer Hedwig E. , Schwabel Elisabeth , Jaros Maria , Diederichs Antonia , Lehrnbecher Thomas , Holm Mette , von Linstow Marie-Louise , Martin Luise , Dinges Sarah Svenja , Rothensteiner Maria , Siepermann Meinolf , Strenger Volker , von Both Ulrich , Teig Norbert , Brinkmann Folke , Leeb Franziska , Zeitlinger Markus , Kobbe Robin , Götzinger Florian
Published: January 2023

Background:

Although severe COVID-19 in children is rare, those with certain pre-existing health conditions are more prone to severe disease. Monoclonal antibodies (mAbs) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are potent antiviral agents that reduce adverse clinical outcomes in adults, but are commonly not approved for use in pediatric patients.

Methods:

We retrospectively evaluated mAb treatment in children <12 years of age or <40kg with SARS-CoV-2 infection between January 1, 2021, and March 7, 2022, in 12 tertiary care centers in 3 European countries.

Results:

We received data from 53 patients from Austria, Denmark and Germany. Median age was 5.4 years [0–13.8, interquartile range (IQR) = 6.2], and median body weight was 20 kg (3–50.1, IQR = 13). The most frequent SARS-CoV-2 variant in this study, if known, was Omicron, followed by Delta and Alpha. Pre-existing conditions included immunodeficiency, malignancy, hematologic disease, cardiac disease, chronic lung disease, chronic liver disease, kidney disease and diabetes. Forty-two patients received sotrovimab (79%), 9 casirivimab/imdevimab (17%) and 2 bamlanivimab (4%). All but 1 patient survived. Median duration of hospital stay was 3 days (0–56, IQR = 6). Seven patients required treatment in an intensive care unit, and 5 required high-flow nasal cannula treatment. Potential side effects included neutropenia (6/53, 11%), lymphopenia (3/53, 6%), nausea or vomiting (2/53, 4%), rise of alanine transaminase (1/53, 2%) and hypotonia (1/53, 2%).

Conclusions:

MAb treatment was well tolerated by children in this cohort.
Role of Noroviruses in Sporadic Acute Gastroenteritis Cases from Children Attending a Large Referral Children’s Hospital in Buenos Aires City, Argentina
Authors: Gentile Ángela , Areso María Soledad , Degiuseppe Juan Ignacio , Orqueda Ana , Turco Marisa , Sabbaj Liliana , Rodrigo Adriana , Juárez María del Valle , Stupka Juan Andrés
Published: January 2023

Background:

Noroviruses (NVs) are recognized as the leading cause of sporadic and epidemic acute gastroenteritis worldwide, in all age groups. Although there is increasing knowledge that NVs are responsible for many acute gastroenteritis outbreaks in Argentina, studies to estimate prevalence in sporadic cases are scarce.

Methods:

A descriptive, observational and cross-sectional study was conducted with children under 5 years with acute gastroenteritis attending the outpatient department at the “Ricardo Gutiérrez” Children’s Hospital (RGCH) in Buenos Aires City between June 2017 and June 2021. Sociodemographic, clinical and epidemiologic data were recorded. Stool samples were tested and genotyped for norovirus. Association between norovirus detection and demographic and clinical variables was assessed.

Results:

A total of 350 children with acute diarrhea were included, of which stool samples were collected for 332 (94.9%). Norovirus was detected in 81 cases (24.4%). Vomiting and moderate/severe diarrhea were more frequent in norovirus-positive than norovirus-negative children. However, the presence of watery diarrhea and a history of rotavirus vaccination were significantly associated with norovirus etiology. GII and GII.4 were the most frequently detected genogroup and genotype, respectively.

Conclusions:

NVs were detected with high frequency, mostly in children between 6 months and 2 years old, reinforcing the hypothesis of a newly updated scenario of norovirus predominance over rotavirus. Watery diarrhea, complete vaccination against rotavirus and vomiting are 3 key parameters that should raise suspicion of possible norovirus gastroenteritis. Continuous and active norovirus surveillance in this age group is important because children represent a priority group for norovirus vaccine design and development.
SARS-CoV-2 Antigenemia is Associated With Pneumonia in Children But Lacks Sensitivity to Diagnose Acute Infection
Authors: Damhorst Gregory L. , Verkerke Hans P. , Harrington Kristin R.V. , McLendon Kaleb , Lu Austin , Perez Maria A. , Hussaini Laila , Anderson Evan J. , Stowell Sean R. , Roback John D. , Lam Wilbur A. , Rostad Christina A.
Published: January 2023

Background:

Nucleocapsid antigenemia in adults has demonstrated high sensitivity and specificity for acute infection, and antigen burden is associated with disease severity. Data regarding SARS-CoV-2 antigenemia in children are limited.

Methods:

We retrospectively analyzed blood plasma specimens from hospitalized children with COVID-19 or MIS-C. Nucleocapsid and spike were measured using ultrasensitive immunoassays.

Results:

We detected nucleocapsid antigenemia in 62% (50/81) and spike antigenemia in 27% (21/79) of children with acute COVID-19 but 0% (0/26) and 15% (4/26) with MIS-C from March 2020–March 2021. Higher nucleocapsid levels were associated with radiographic infiltrates and respiratory symptoms in children with COVID-19.

Conclusions:

Antigenemia lacks the sensitivity to diagnose acute infection in children but is associated with signs and symptoms of lower respiratory tract involvement. Further study into the mechanism of antigenemia, its association with specific organ involvement, and the role of antigenemia in the pathogenesis of COVID-19 is warranted.
A review of venous thromboembolism risk assessment models for different patient populations: What we know and don’t!
Authors: Mehta Y , Bhave A
Published: January 2023

Venous thromboembolism (VTE) is a common cause of morbidity and mortality in hospitalized patients. Globally, it is also the third leading vascular disease, after myocardial infarction and stroke. The incidence of VTE is reportedly higher in Western countries than in Asian countries. However, recent reports suggest an increasing incidence of VTE in Asian countries, including India. Since VTE is largely a preventable disease, early identification of risk factors can lead to disease prevention or the adoption of appropriate prophylactic measures. To this end, several VTE risk assessment models (RAMs) have been developed and validated for different populations who are at risk of developing VTE, such as hospitalized patients with medical illness/surgical indication, patients with cancer, and pregnant women. Evidence indicates that the systematic use of RAMs improves prophylaxis rates and lowers the burden of VTE. Given the increasing burden of VTE in the Indian population and poor prophylaxis rates, the implementation of systematic RAMs in routine clinical practice might ameliorate the disease burden in the country. We have assessed the evidence-based utilities of available RAMs and have delineated the most common and suitable RAMs for different populations including coronavirus disease 2019 affected patients. This review depicts the current status of implementation and validation of RAMs in the Indian scenario. It also highlights the need for additional validation studies, improved awareness, and implementation of RAMs in clinical practice for lowering the burden of VTE.
Pomalidomide-induced lung injury: A case report
Authors: Vivien Alexandre , Ancel Julien , Godet Sophie , Dury Sandra , Perotin Jeanne-Marie , Deslee Gaetan , Launois Claire
Published: January 2023

Rationale:

Pomalidomide is an immunomodulatory imide drug used in multiple myeloma and in Kaposi sarcoma.

Patient concerns:

A 72-years-old male, treated for multiple myeloma with dexamethasone, pomalidomide and daratumumab, presented dyspnea, hypoxemia, biological inflammatory syndrome, ground glass opacities on computed tomography scan (CT-scan) and lymphocytic and eosinophilic alveolitis, with no specific cytologic or microbiological findings, 2 months after pomalidomide initiation.

Intervention and outcome:

Antibiotics were started after bronchoscopy. No improvement was noted in dyspnea and biological inflammatory syndrome after 5 days of treatment. Pomalidomide was then discontinued, with continuation of Daratumumab-Dexamethasone, resulting in a rapid recovery of symptoms and CT-scan anomalies. No recurrence of dyspnea was observed during the 15 months of follow-up.

Diagnoses:

Pomalidomide-induced lung injury

Lessons:

Pomalidomide-induced lung injury is a rare and serious adverse event that can occur early after Pomalidomide introduction. As pomalidomide use is increasing, the identification of drug toxicity as a possible cause of lung injury appears important. We report a rapid recovery of symptoms and CT-scan anomalies after pomalidomide discontinuation.
Three-dimensional printing designed customized plate in the treatment of coronal fracture of distal humerus in teenager: A case report
Authors: Cao Changpeng , Xing Haiyang , Cao Faxin , Du Zhipeng , Wang Gang , Wang Xiyao
Published: January 2023

Rationale:

Because of the complicated anatomy and considerable change in size and morphology with age in teenagers, the appropriate internal fixator of coronal shear fracture of distal humerus is difficult to choose, and therefore, the fixation of this kind of fracture is difficult and controversial. Furthermore, distal humeral fractures in teenagers often involve the epiphysis, the rigid fixation of fracture and the simultaneous minimally invasive and protection of the epiphysis are contradictory. Coronal shear fractures of the distal humerus in teenagers are great challenge for orthopedic surgeons. Three-dimensional (3D) printing designed customized plate in the treatment of coronal fracture of distal humerus in teenager is a potential satisfactory choice in the treatment of the complex fractures.

Patient concerns:

A teenager suffered from an elbow joint injury due to a fall while running, resulting in pain, swelling and limited movement of the elbow joint. The epiphyseal has not closed in this patient, conventional surgical procedures have great traumatic and invasive, and to some extent affect bone growth in children.

Diagnoses:

Coronal shear fracture of right distal humerus according to computed tomography scan.

Interventions:

We used 3D printing technology to design an internal fixation device for this patient, which was to treat the distal humeral coronal shear fracture in a teenager via an anterior approach to the elbow joint, and finally the child was instructed to perform immediate postoperative functional exercises and rehabilitation.

Outcomes:

Radiographic reexamination performed 1 day and 2 month after the operation showed that the internal fixation was in good position, no fracture displacement. the patient was instructed to perform active flexion and extension internal and external rotation of the right elbow 6 weeks postoperatively. The Mayo elbow function score was excellent 5 months postoperatively. The range of motion of the elbow was (15°–130°)

Lessons:

The treatment of coronal shear fractures of the distal humerus in teenager is controversial at present. This report 3D printing technology designed customized plate in treatment of such fractures showed satisfactory results, which provides a feasible method for the treatment of fractures without suitable internal fixation devices in the future.
School-based intervention for academic stress management and school adjustment among industrial technical education students: Implications for educational administrators
Authors: Ogakwu Nneka Vera , Ede Moses Onyemaechi , Agu Patricia U. , Manafa Ifeyinwa , Ezeaku Felicia , Onah Sebastian O. , Okereke Godwin Keres Okoro , Omeke Faith C. , Agbigwe Ifeanyichukwu B. , Oneli Joy Obiageli
Published: January 2023

Background:

The high level of academic stress and maladjustment in the school environment led to this study to investigate the management of academic stress and school adjustment among university students using rational emotive behavioral therapy.

Methods:

The study adopted a pretest-posttest control group design. A total of 97 students participated in the study and were measured using an academic stress scale and academic adjustment scale at 3 points.

Results:

The results of the multivariate statistics indicated the improvement in the management of academic stress and academic adjustment among Industrial Technical Education students following their participation in the rational emotive behaviour therapy (REBT) treatment and those in the waitlisted control group (WCG) at 3 points. After the treatment, a second assessment shows that the REBT treatment had a significant effect on improvement in academic stress management and academic adjustment among Industrial Technical Education students and was subsequently sustained at follow-up assessment. It was also found that there is no interaction effect of groups and gender.

Conclusion:

This study suggests that the reduction in academic stress and improvement in the academic adjustment were due to exposure to rational emotive behavioral therapy. Therefore, school counselors should reach out to students that experiencing a high degree of stress and maladjustment and assist them using rational emotive behavioral therapy.
Analysis of eEF1A2 gene expression and copy number in cervical carcinoma
Authors: Zheng Weinan , Jin Fuyuan , Wang Fang , Wang Luyue , Fu Shaowei , Pan Zemin , Long Haichen
Published: January 2023

Objective:

To explore and analyze the expression of eukaryotic translation elongation factor 1 alpha 2 (eEF1A2) gene in cervical cancer tissues, its relationship with patient survival, gene mutations, and changes in copy number in cervical cancer and chronic cervicitis tissues.

Methods:

The expression of the eEF1A2 gene in cervical cancer and its relationship with patient survival were analyzed using gene expression profile interactive analysis. Changes in eEF1A2 expression in cervical cancer tissues were analyzed using cBioPortal, a portal for cancer genomics analysis. The eEF1A2 copy number in cervical cancer tissues and chronic cervicitis tissues was determined by real-time fluorescence quantitative polymerase chain reaction. The relationship between the expression of eEF1A2 protein and the clinical stage, pathological grade, and patient survival of cervical cancer was analyzed by the database: The Human Protein Atlas, an integrated repository portal for tumor-immune system interactions.

Results:

Gene expression profile interactive analysis database analysis showed no significant differences in the expression of eEF1A2 between cervical cancer and normal cervical tissues (P > .05). The eEF1A2 gene expression level was not correlated with the survival of cervical cancer patients (P > .05). Analysis of the cBioPortal database showed that 18 of 297 cervical cancer patients had eEF1A2 gene changes, including missense mutation, splice mutation, amplification, and messenger RNA increase. There was no significant difference in eEF1A2 gene copy number between cervical cancer and chronic cervicitis (P > .05). The Human Protein Atlas and an integrated repository portal for tumor-immune system interactions database analysis of immunohistochemical data showed that eEF1A2 protein expression was no significant difference in clinical stage, pathological grade and patient survival of cervical cancer (P > .05).

Conclusion:

The eEF1A2 gene was mutated in cervical cancer tissues. The eEF1A2 gene copy number was not associated with changes in the expression of the eEF1A2 gene in cervical cancer tissues.
Unimpaired outcomes in 18-month-old borderline viable twins born at 22 weeks: A case report
Authors: Alrawi Wafaa , Atrak Taisser , Abuobayda Ashraf , Elmansoury Nabil , Elnakeib Omar , Lonikar Abhijeet
Published: January 2023

Rationale:

A gestational age of 22 to 23 weeks is the lower threshold for selective active intervention. Few infants delivered at a gestational age of 22 to 23 weeks survive if resuscitated. Among those who survive, most develop severe complications, especially in cases of multiple births at the limit of viability.

Patient concerns:

We report the intact survival of extremely preterm twins, a girl (Twin A) and a boy (Twin B), weighing 504g and 475g, respectively, born at the edge of viability at 22 2/7 weeks gestation without significant morbidity.

Diagnoses:

extremely preterm twins born at the edge of viability at 22 2/7 weeks.

Interventions:

Twin A required 6 weeks of mechanical ventilation. She received conventional and high-frequency oscillation ventilation. She was extubated to noninvasive positive airway pressure ventilation at 28 weeks and 2 days post conception. Twin B required longer duration of invasive ventilation lasting 11 weeks. Moreover, he had several episodes of feeding intolerance and abdominal distension. However, his serial abdominal radiographs showed nonspecific findings. The gastric tubes were eventually removed from both twins. Full oral feeding was successful on discharge.

Outcomes:

Both infants are presently in good condition.They were discharged home with a full oral feeding, and without any respiratory support. Now they are 18-month-old with unimpaired development.

Lessons:

This report would support healthcare providers in decision-making. It highlights the importance of perinatal and neonatal management optimization to improve survival rates and clinical outcomes of periviable birth. In addition it emphasize the individuality of each case and the need to consider the parents’ wishes in the management decision.
Lymphangiomatosis presented with melena and chylous ascites: A case report
Authors: Nie Rui , Gao Jie , Yang Wei , Lu Hong , Ren Qian
Published: January 2023

Introduction:

Lymphangioma, a rare benign tumor of the lymphatic system, is called lymphangiomatosis when it involves >1 organ, which is more rarely complicated with thoracic obstruction, the relationship between them remains unclear. With the development of enteroscopy, clinicians know more about small intestinal lymphangioma and attempt to treat it through enteroscopic injection sclerotherapy(EIS).

Patient concerns:

A 59-year-old male firstly manifested with gastrointestinal bleeding after a gastric perforation, who was diagnosed with lymphangiomatosis by balloon-assisted enteroscopy and abdomen CT showing >1 organ with multiple cysts besides the small intestine. The patient received an EIS, then the melena disappeared. Surprisingly he came back because of refractory ascites confirmed to be chylous by chemical tests 7 months later.

Diagnosis:

Lymphangiography could not determine the location of lymphatic leakage, Ultrasonography showed stenosis of the left cervical part of the thoracic duct.

Intervention:

On the condition that medical treatment is ineffective, thoracic duct exploration and lysis of fibrous adhesion were performed.

Outcomes:

Ascites significantly reduced at last.

Lessons:

Lymphangiomatosis is the malformation of the lymphatic system involving multiple organs, it has a possibility to be associated with thoracic obstruction. Capsule endoscopy and enteroscopy are effective methods to diagnose small intestinal lymphangioma, and EIS is an effective therapy.
Non-surgical treatment of giant tumor-like lumbar disc herniation based on enhanced MRI: A case series
Authors: Shen Xueqiang , Lin Shun , Jiang Hong , Liu Jintao , Yu Pengfei
Published: January 2023

Rationale:

In recent clinical follow-up, it has been vertified that resorption in lumbar disc herniation (LDH) could be of great curative effect in non-surgical treatment for LDH. However, reports of resorption in giant tumor-like LDH are rarely mentioned due to its risk of irreversible neurological damage which could be caused by long-term non-surgical treatment. In our clinical observations, we have found that enhanced MRI helps to distinguish LDH from intradural tumours and to predict the probability of resorption in LDH. We analyzed 8 patients with giant tumor-like LDH who underwent non-surgical treatment, and these patients had resorption during follow-up. All patients were examined with enhanced MRI before treatment, and the type of “bull’s eye” sign classification was determined by images. The MRI protrusion volume(VP), resorption rate(HR%) and JOA score of patients at the first visit and the last follow-up were recorded.

Patient concerns:

8 patients of Han ethnicity were admitted to the department of orthopedic complaining of low back pain for 1week to 12months. They were diagnosed with giant tumor-like LDH by enhanced MRI.

Diagnoses:

These patients were diagnosed with giant tumor-like LDH.

Interventions:

We adopted a non-surgical treatment plan for the patients, including taking oral non-steroidal anti-inflammatory agents and performing rehabilitation exercise. In consideration of the risk of irreversible neurological damage, patients were closely observed during treatment and follow-up. Once the following conditions occur, surgical treatment is required immediately: The symptoms are not signifcantly relieved after 3 to 6 months of non-surgical treatment; The symptoms are aggravated by non-surgica treatment; The clinical manifestations of cauda equina syndrome.

Outcomes:

After treated with oral non-steroidal anti-inflammatory agents and rehabilitation exercise, the resorption was accompanied by clinical symptom relief. No neurological damage occurred in all patients, and the clinical symptoms did not recur in the subsequent follow-up.

Lessons:

Clinicians should fully consider the possibility of resorption prior to surgical treatment in patients with giant LDH. We can predict the probability of resorption in patients with giant LDH based on enhanced MRI. For patients with a high probability of resorption, we can choose non-surgical treatment in the absence of progressive neurological impairment and cauda equina syndrome.
Exploring the mechanism of Xiaoqinglong decoction in the treatment of infantile asthma based on network pharmacology and molecular docking
Authors: Chen Daman , Chen Qiqi , Zhao Kaibo , Guo Yongqi , Huang Yuxin , Yuan Zehuan , Cai Yujia , Li Sitong , Xu Jiarong , Lin Xiaohong
Published: January 2023

To explore the mechanism of Xiaoqinglong decoction (XQLD) in the treatment of infantile asthma (IA) based on network pharmacology and molecular docking. The active ingredients of fdrugs in XQLD were retrieved from Traditional Chinese Medicine Systems Pharmacology database and then the targets of drug ingredients were screened. The disease targets of IA were obtained from OMIM and Gencards databases, and the intersection targets of XQLD in the treatment of IA were obtained by Venny 2.1 mapping of ingredient targets and disease targets. Cytoscape software was used to construct active ingredient-intersection target network. The potential targets of XQLD in the treatment of IA were analyzed by protein-protein interaction network using STRING platform, and the Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were obtained by R Studio software. AutoDock was used to perform molecular docking for verification. In this study, 150 active ingredients of XQLD were obtained, including quercetin, kaempferol, β-sitosterol, luteolin, stigmasterol, and so on. And 92 intersection targets of drugs and diseases were obtained, including interleukin 6 (IL6), cystatin 3, estrogen receptor 1, hypoxia inducible factor 1A, HSP90AA1, epidermal growth factor receptor and so on. There were 127 items of Gene Ontology enrichment analysis and 125 Kyoto Encyclopedia of Genes and Genomes enrichment results, showing that apoptosis, IL-17 signaling pathway, tumor necrosis factor signaling pathway, P13K-Akt signaling pathway and other pathways may play a key role in the treatment of IA by XQLD. The results of molecular docking showed that the key active ingredients including quercetin, kaempferol, β-sitosterol, luteolin, stigmasterol, and the core targets including IL6, cystatin 3, estrogen receptor 1, hypoxia inducible factor 1A, HSP90AA1, and epidermal growth factor receptor had good binding activity. Through network pharmacology and molecular docking, the potential targets and modern biological mechanisms of XQLD in the treatment of IA were preliminarily revealed in the study, which will provide reference for subsequent animal experiments and clinical trials.
Upregulation of MAD2L1 mediated by ncRNA axis is associated with poor prognosis and tumor immune infiltration in hepatocellular carcinoma: A review
Authors: Liu Sizhe , Miao Mingsan , Kang Le
Published: January 2023

Background:

The mortality rate and prognosis of patients with hepatocellular carcinoma (HCC) are well known. A variety of highly malignant human cancers express mitotic arrest deficient 2 like 1 (MAD2L1), a transcription factor that plays a critical role in their development and progression. However, MAD2L1’s particular mechanisms and effects on HCC remain uncertain.

Methods:

We performed a pan-cancer analysis for MAD2L1 prognosis and expression using The Cancer Genome Atlas and Genotype-Tissue Expression data in the present study. MAD2L1 may act as an oncogene in HCC, and a combination of in silico analyses, including expression, survival, and correlation analyses, were performed to identify non-coding ribonucleic acids (ncRNAs) that contribute to MAD2L1 overexpression.

Results:

In conclusion, MAD2L1 is most likely regulated by HCP5/miRNA-139-5p/MAD2L1 in HCC based on its upstream ncRNA-related pathway. A significant positive association was also found between MAD2L1 levels and tumor immune cell infiltration, immune cell biomarkers, and immune checkpoint expression.

Conclusion:

Our findings demonstrate that ncRNA-mediated upregulation of MAD2L1 in HCC is closely related to poor prognosis and tumor infiltration.
Meta-analysis comparing the perioperative efficacy of single-port versus two and multi-port video-assisted thoracoscopic surgical anatomical lung resection for lung cancer
Authors: Li Yuan , Dai Tianyang
Published: January 2023

Background:

As a new surgical procedure for non-small cell lung cancer, single-port video-assisted thoracoscopic surgery (VATS) has lately gained popularity; nevertheless, it is unknown if single-port VATS offers any advantages over multi-portal. The study aims to assess the different impacts of using single-port VATS versus 2-port or multi-port VATS such as operation and drainage time, blood loss volume, number of resected lymph nodes, and hospital stay in lung cancer patients.

Methods:

Inclusion criteria included studies from different languages that compare single-port against 2 or multi-port VATS. The outcomes of these studies were analyzed using a random-effect model and it was used to calculate the mean difference with 95 percent confidence intervals to quantify the impact of different surgical techniques on clinical parameters.

Results:

Single or Uni-portal video-assisted thoracoscopic surgery results in significantly lower drainage time after surgery compared with 2-port (P = .03) and multi-port (P < .001) VATS. In contrast to the resection of lymph nodes, there was no significant difference between uni-port and 2-port (P = .49) or multiport (P = .29) VATS. While operation time, blood loss, complications, and hospital stay were significantly lower in uni-port compared with multi-port VATS (P = .04, P = .002, P < .001, respectively), but not with 2-port VATS (P = .44, 0.06, P = .13). There were no significant differences between uni-port and multi-port VATS regarding conversion rate, mortality, and staging.

Conclusion:

Single or Uni-portal video-assisted thoracoscopic surgery has high efficacy and lower side effects compared with multi-port regarding the perioperative outcomes. Two-port VATS has similar results with uni-port in several parameters.
Aberrant pancreas adenocarcinoma in the stomach: A case report and literature review
Authors: Petrauskas Vidas , Stulpinas Rokas , Mickys Ugnius , Luksaite-Lukste Raminta , Strupas Kestutis , Poskus Eligijus
Published: January 2023

Rationale:

Aberrant pancreatic tissue in the gastrointestinal tract is a relatively common finding. However, malignant transformation is extremely rare. Herein, we report a case of ectopic pancreatic ductal adenocarcinoma in the stomach wall.

Patient concerns:

A 38 year old male presented with nausea, bloating, abdominal distention and weight loss for 4 months.

Diagnoses:

Endoscopy of upper gastrointestinal tract was performed twice with 2 months interval and a stenotic pyloric part was observed with a suspected submucosal lesion. It was sampled both times, however the pathology findings of the mucosal biopsies were unremarkable with no identifiable neoplastic structures. CT scan and MRI was performed and showed a thickened pyloric wall with a submucosal lesion 15 × 15 mm in diameter. Blood levels of tumor markers carcinoembrionic antigen and carbohydrate antigen 19-9 were within a normal range.

Interventions:

Pyloric stenosis progressed and the patient underwent a Billroth type I distal gastric resection with D2 lymphadenectomy. Pathologic examination revealed a well differentiated ductal adenocarcinoma arising in the heterotopic pancreatic tissue (Heinrich type III). The resection margins and lymph nodes were free of tumor. The patient received adjuvant chemotherapy with 6 courses of XELOX.

Outcomes:

No disease recurrence is reported in 12 months follow-up.

Lessons:

Aberrant pancreatic ductal adenocarcinoma in the stomach is a rare finding, however this pathology should be included in the differential diagnosis of gastric submucosal lesion causing pyloric stenosis.
Diagnosis and management of extramedullary plasmacytoma in nasal cavity: Clinical experience and literature review
Authors: Hu Hongyu , Hu Xianwen , Hu Guomei , Li Dandan , Cai Jiong
Published: January 2023

Nasal extramedullary plasmacytoma (EMP) is a rare plasma cell tumor that occurs in the soft tissue of the nasal cavity, and its imaging characteristics are still unclear. The purpose of this study was to investigate the clinical features, imaging findings, treatment, survival analysis, and prognosis of nasal EMP, and to provide a systematic review of the patients we treated and the published literature. A 45-year-old female patient who presented with epistaxis with nasal obstruction was recommended for magnetic resonance imaging to assess the nature of the lesion. On magnetic resonance imaging, abnormal signal shadow can be seen in the right nasal cavity. Diffusion weighted imaging showed signal of the lesion was significantly limited, presenting high signal, with a low apparent dispersion coefficient, and the lesion was significantly enhanced on contrast-enhanced scan. Combined with the clinical manifestations of the patient, who was initially considered to have a hemangioma. She underwent endoscopic nasal surgery under general anesthesia to remove the mass, and the final pathology confirmed it was EMP. However, the final pathology confirmed EMP. Five months later, the patient came to our hospital for follow-up and underwent fluorine-18-fluorodeoxyglucose/positron emission tomography/computed tomography scan, which showed no recurrence of the lesion and no transformation of multiple myeloma. The nasal EMP imaging findings were mostly soft tissue masses with uniform density or signal, which were significantly enhanced by enhancement scan, high signal on diffusion weighted imaging and low signal on apparent dispersion coefficient. Immunohistochemical staining for CD38, CD138, and CD79a was positive in most of the cases evaluated, while CD20 and CD10 were negative. The absence of dilated features, infiltrative features and the presence of significant contrast enhancement may be relatively specific imaging findings of nasal EMP. The prognosis of nasal EMP is good, and recurrence, metastasis, and transformation into multiple myeloma are rare. Because the lesions are sensitive to radiotherapy, surgical resection combined with radiotherapy is a more effective treatment.
Genotypic distribution of human papillomavirus and phylogenetic analysis of E6 and E7 gene of HR-HPV variants isolated from Pakistani population
Authors: Ahmed Sameen , Vajeeha Ayesha , Idrees Muhammad , Hussain Abrar , Munir Rakhtasha , Zaidi Gulshan , Zahid Khadija , Ahmed Rizwan , Fatima Zareen , Rafique Shazia , Achakzai Niaz M.
Published: January 2023

High-risk-human papillomavirus (HR-HPV)-induced cervical cancer is the second most common cause of death among females worldwide. HPV16 is the most prevalent HR-HPV infection worldwide. This study found the genotypic distribution of HR-HPV in the local population and investigated the sequence variations among the E6 and E7 oncogenes of the local HPV16 genotype to the E6 and E7 oncogenes of the foreign HPV16 genotypes and constructed a phylogenetic relationship based on nucleotide sequence comparison among the variants identified in our study along with previously reported isolates that were obtained from different regions of the world. The samples were collected from patients with cervical cancer. Genomic DNA was extracted, and HR-HPV genotypes were determined using real-time PCR. The HPV16 E6 and E7 genes were amplified and sequenced. A HPV16 phylogenetic tree was constructed using the maximum likelihood method with MEGA 7. HPV16 was the most prevalent human papillomavirus (HPV) type identified in the present study. HPV16 isolates belonged to the A1 sublineage of the European branch. Twenty-one nucleotide sequences were included in this analysis. The first, second, and third codon positions are also included. The final dataset included 776 positions.