bluuebunny/crossref_metadata_2025 huggingface dataset:
High-throughput proliferation and activation of NK-92MI cell spheroids via a homemade one-step closed bioreactor in pseudostatic cultures for immunocellular therapy
Authors: Lin Jhih-Ni , Kuan Che-Yung , Chang Chia-Ting , Chen Zhi-Yu , Kuo Wei-Ting , Lin Jason , Lin Yu-Ying , Yang I.-Hsuan , Lin Feng-Huei
Published: November 2024

The NK-92MI cell line has displayed significant promise in clinical trials for cancer treatment. However, challenges persist in obtaining sufficient cell quantities and achieving optimal cytotoxicity. The proliferation of natural killer (NK) cells involves the formation of cell aggregates, but excessively large aggregates can impede nutrient and waste transport, leading to reduced cell survival rates. In this study, a custom bioreactor was designed to mimic pseudostatic culture conditions by integrating brief mechanical rotation during a 6-h static culture period. This method aimed to achieve an optimal aggregate size while improving cell viability. The findings revealed a 144-fold expansion of 3D NK-92MI cell aggregates, reaching an ideal size of 80–150 µm, significantly increasing both cell proliferation and survival rates. After 14 days of culture, the NK-92MI cells maintained their phenotype during the subsequent phase of cell activation. Moreover, these cells presented elevated levels of IFN-γ expression after IL-18 activation, resulting in enhanced NK cell-mediated cytotoxicity against K562 cells. This innovative strategy, which uses a closed suspension-based culture system, presents a promising approach for improving cell expansion and activation techniques in immunocellular therapy.
Postpartum modern family planning among women living with HIV attending care at health facilities in Busia County, Kenya
Authors: Tebagalika Florence Zawedde , Kimuli Derrick , Walusimbi Dennis , Nyang’echi Edna , Ndunyu Louisa
Published: November 2024

Background

For women living with the human immunodeficiency virus (WLHIV), preventing untimed pregnancies during the postpartum period reduces vertical transmission and improves other maternal and child health outcomes. In Kenya, Busia County’s HIV prevalence and mother-to-child transmission rate are higher than the national average yet uptake of postpartum family planning (PPFP) is generally low. This study examined health system factors influencing the consistent use of PP modern FP methods among WLHIV in Busia County.

Methods

A retrospective study involving 314 WLHIV with children aged 12–24 months who were chosen using systematic random sampling was conducted from February to March 2024 from outpatient clinics in Busia County. Additionally, 14 health providers were purposively sampled as key informants. Quantitative data was collected using a pretested questionnaire, while qualitative data was gathered through key informant interview guides. Quantitative data was analyzed using STATA 15 with descriptive statistics, logistic regression, and Chi-square tests, while a deductive thematic analysis was used for qualitative data.

Results

The mean age of the participants was 32.06 (± 6.00) with the majority (51.27) aged between 25 and 34 years, married (74.84%) and unemployed (77.39%). Overall, 73.25% had used postpartum (PP) modern family planning (FP) methods, but only 52.55% reported consistent use throughout the first year postpartum. The only factors found to increase the odds of PPFP use were being married (aOR 3.34, 95% CI 1.58–7.07, p = 0.002), being escorted by a preferred person during seeking maternal and child health services (aOR 2.29, 95% CI 1.36–3.83, p = 0.002), and perceiving that they were provided information on all types of FP (aOR 2.33, 95% CI 1.19–4.16, p = 0.012). Persistent stock-outs and inadequate counseling hindered consistent PPFP use.

Conclusion

The study identified gaps in the consistent use of PP modern FP methods among WLHIV in Busia County, influenced by the availability of FP information and health system factors. Addressing stock-outs and improving counseling during clinic visits and pregnancy are crucial for improving FP service delivery and reducing maternal and child health risks in high HIV-incidence areas like Busia County.
Is retinal vein occlusion highly associated with an increased risk of myocardial infarction? A systematic review and meta-analysis
Authors: Chen Kai-Yang , Chan Hoi-Chun , Chan Chi-Ming
Published: November 2024

Background and objective

Retinal vein occlusion (RVO) and acute myocardial infarction (MI) are significant vascular events that impact patient health and mortality. Both conditions share common risk factors, such as hypertension, diabetes, and atherosclerosis. This study investigated the potential connection between RVO and MI, particularly among younger individuals, to improve preventive measures and management protocols.

Method

A systematic review and meta-analysis were conducted, adhering to the PRISMA and MOOSE guidelines. Multiple databases, including PubMed, Scopus, MEDLINE, ScienceDirect, and ClinicalTrials.gov, were exhaustively searched until August 24, 2024. Studies were selected based on their reports of the association between RVO and MI risk. Quality assessment was performed using the Newcastle-Ottawa Quality Assessment Scale, and data were pooled using a random-effects model with hazard ratios and 95% confidence intervals.

Result

Twelve studies comprising 371,817 participants were included. Meta-analysis revealed a pooled hazard ratio of 1.324 (95% CI, 1.238–1.415), indicating a significant association between RVO and increased MI risk (p = 0.0001). Subgroup analysis for central retinal vein occlusion (CRVO) showed a hazard ratio of 1.691 (95% confidence interval [CI] 1.142, 2.502, p = 0.009) with moderate heterogeneity (I2 = 36%), whereas branch retinal vein occlusion (BRVO) yielded a non-significant hazard ratio of 1.167 (95% CI 0.843, 2.106, p = 0.444; I2 = 33%). Publication bias was identified (Egger’s test, p = 0.036) and addressed through trim-and-fill adjustment, maintaining statistical significance.

Conclusion

Our meta-analysis shows a strong association between CRVO and a 69.1% increased risk of MI, while BRVO shows no significant correlation. Overall, RVO is linked to a 32.4% elevated risk of MI. Despite slight publication bias, adjusted analyses confirm reliability, indicating that improved cardiovascular monitoring for RVO patients, especially those with CRVO, is essential to mitigate MI risk.

Clinical trial number

Not applicable.
Cancer of Unknown Primary Site: A New Era of Practice-Changing Approaches to Diagnosis, Staging, and Precision Therapy
Authors: Greco F. Anthony
Published: November 2024

The enigmatic syndrome of metastatic cancer of unknown primary (CUP) site has frustrated physicians and patients for decades. There has been debate whether CUP is a single biologically distinct cancer or a constellation of many different cancers with clinically undetectable anatomic primary sites. For the past 40 years, the diagnosis of a specific cancer type for most patients was indeterminate, and fit patients were usually treated as a single cancer with the same empiric chemotherapy (EC) regimens with poor overall results. The aggregate data from autopsies, clinical observations, specialized standard pathology, molecular testing, and several clinical trials support CUP as a multitude of clinically occult invasive primary tumors requiring different site-specific therapies (SSTs). In the past several years, improved genomic testing has been used, and the addition of molecular-guided therapies (MGTs) and immunotherapy (IO) has been shown to be superior for many different advanced cancers. Two older randomized prospective trials conducted before the advent of IO and most MGT failed to show a better outcome for patients with molecularly diagnosed cancers who received SST (tailored chemotherapy regimens) versus EC, although patients with more responsive tumor types appeared to benefit. Two recently reported randomized trials documented the clinical relevance of molecular diagnosis and comprehensive genomic profiling. The administration of improved precision SST guided by molecular diagnosis and characterization revealed significantly improved outcomes compared with EC. The management of patients with CUP is undergoing rapid change including the diagnosis of the presumed primary tumors, TNM staging for selected patients, molecular profiling, and an expanded improved role of precision therapies highlighting the rapid emergent new era of practice changing standards of care.
Deficits of Molecular Prognosis/Diagnosis Studies in Underserved Populations
Authors: Medford Arielle J. , Moy Beverly
Published: November 2024

Molecular prognostic and diagnostic tools allow for targeted cancer surveillance, prognostication, and treatment, and these assays have the potential to improve the lives of patients and their relatives. The impact of these advances, however, is not uniform across populations. Underserved communities frequently do not have the same level of access to novel assays, and the clinical application of these tools is often limited by disproportionate representation of White and European ancestry populations in foundational data, as well as limited diversity in clinical trials. In this review, we highlight major advances in clinical molecular assays, key areas of disparity, and contributing factors. We then list ongoing and future areas of intervention to improve access to and efficacy of molecular assays across populations, so that we as a community may work to improve equity at this critical area of cancer care.
Specialty Tobacco Treatment Implementation in Oncology: A Qualitative Study
Authors: Bird Jennifer E. , Chladek Jason S. , D'Angelo Heather , Minion Mara , Pauk Danielle , Adsit Robert T. , Conner Karen L. , Zehner Mark , Fiore Michael , Rolland Betsy , McCarthy Danielle
Published: November 2024

PURPOSE

In 2017, the National Cancer Institute (NCI) funded the Cancer Center Cessation Initiative (C3I) to implement and expand tobacco treatment programs in routine oncology care. Many C3I programs developed specialty care programs staffed by tobacco treatment specialists (TTSs) to deliver evidence-based treatment to adult patients who smoke. People involved in specialty tobacco treatment programs can help to identify implementation strategies and adaptations that may enhance tobacco treatment reach and effectiveness in cancer care and help more patients with cancer quit using tobacco.

METHODS

We conducted semistructured interviews with TTSs from 21 C3I-funded cancer centers and applied content analysis to interview transcripts from 37 TTSs and 17 respondents in other program roles. We used the Consolidated Framework for Implementation Research to code interview data. We identified final themes and implementation strategies and adaptations recommended by respondents on the basis of these codes.

RESULTS

Respondents shared that implementation of specialty tobacco treatment programs in cancer care settings could be facilitated by training staff to provide patient connection to services, incorporating prescription of no- or low-cost cessation medications, hiring additional staff to deliver tobacco treatment, allocating space to the program, and automating electronic health record workflows.

CONCLUSION

TTSs and others involved in specialty tobacco treatment in NCI-designated cancer centers identified ways to improve tobacco treatment access, use, and effectiveness by (1) adapting specialty tobacco treatment delivery to meet patient needs; (2) facilitating referrals and pharmacotherapy coordination; and (3) committing staffing, space, and support resources to tobacco treatment programs. Key program participants suggested that these approaches would help more oncology patients connect with evidence-based tobacco treatment and quit smoking.
Clinical Applications of Circulating Tumor DNA Profiling in GI Cancers
Authors: Battaglin Francesca , Lenz Heinz-Josef
Published: November 2024

Over the next few years, the analysis of circulating tumor DNA (ctDNA) through liquid biopsy is expected to enter clinical practice and revolutionize the approach to biomarker testing and treatment selection in GI cancers. In fact, growing evidence support the use of ctDNA testing as a noninvasive, effective, and highly specific tool for molecular profiling in GI cancers. Analysis of blood ctDNA has been investigated in multiple settings including early tumor detection, minimal residual disease evaluation, tumor diagnosis and evaluation of prognostic/predictive biomarkers for targeted treatment selection, longitudinal monitoring of treatment response, and identification of resistance mechanisms. Here, we review the clinical applications, advantages, and limitations of ctDNA profiling for precision oncology in GI cancers.
Cigarette Smoking Impairs Cardiorespiratory and Metabolic Response at Peak Incremental Exercise and during Recovery in Young, Physically Active Adults
Authors: Borrelli Marta , Doria Christian , Toninelli Nicholas , Longo Stefano , Coratella Giuseppe , Cè Emiliano , Rampichini Susanna , Esposito Fabio
Published: November 2024

Purpose: Cigarette smoking (CS) induces systemic changes that impair cardiorespiratory and muscular function both at rest and during exercise. Although these abnormalities are reported in sedentary, middle-aged smokers (SM) with pulmonary disease, few and controversial studies focused on young, physically active SM at the early stage of smoking history. This study aimed at assessing the impact CS on cardiorespiratory and metabolic response during an incremental test and the subsequent recovery in young, physically active SM without known lung or cardiovascular disease.

Methods: After pulmonary function evaluation, 12 SM (age: 22±2 yr; body mass: 75±8 kg; stature: 1.78±0.06 m; 12±4 cigarette/day for 6±2 years; mean±SD) and 12 non-smokers (CTRL; age: 23±1 yr; body mass: 76±8 kg; stature: 1.79±0.08 m) matched for age and exercise habits, underwent an exhaustive incremental step test (25 W/2 min) on a cycle ergometer. Pulmonary O2 uptake (V’O2), expiratory ventilation (V’E), heart rate (f
H) responses and lactate concentration were assessed during the test and subsequent recovery.

Results: Despite similar static lung volumes, SM reported lower peak expiratory flow (-23%; P = 0.003) and maximal voluntary ventilation (-10%; P = 0.003). At submaximal exercise, no differences in the cardiorespiratory and metabolic were noted between the two groups. However, SM exhibited ventilatory (P < 0.01) and lactate thresholds at lower work rates (P = 0.01). At peak exercise, SM exhibited lower V’O2 (-8%; P = 0.02), mechanical power (-11%; P = 0.02) and V’E (-9%; P = 0.01). During recovery, SM showed longer time constants (τ) in V’O2 (+52%; P = 0.002), V’E (+19%; P = 0.027) and f
H (+21%; P = 0.022) and smaller f
H at 30 s of recovery (HRR30; -31%; P = 0.032).

Conclusions: These results are compatible with an early CS-related impairment of the cardiorespiratory and metabolic function even in young individuals with relatively short smoking history.
Predictors of Resistance Training Behavior among Glucagon-like Peptide 1 Medication Users
Authors: Kompf Justin M. , Rhodes Ryan E.
Published: November 2024

Introduction

Obesity is a chronic condition affecting around 650 million adults globally, with significant health implications such as cardiovascular disease and type 2 diabetes. Glucagon-like peptide 1 (GLP-1) medications have shown efficacy in promoting weight loss among obese individuals, although the weight loss is associated with undesired muscle breakdown. In this study, we investigate the psychosocial determinants of resistance training (RT) behavior among GLP-1 medication users, utilizing the Capability, Opportunity, and Motivation Behavior (COM-B) model.

Methods

A 1-wk longitudinal study design was adopted, involving members of a medical weight loss program (95.3% female; body mass index, 32.8 ± 7.0 kg·m−2, 48.8 ± 9.9 yr old), assessing correlates of RT participation through an online survey.

Results

Psychological capabilities (b = 0.39, standard error (SE) = 0.14; P = 0.004) and reflective motivation had direct effects on frequency (b = 1.27, SE = 0.52; P = 0.02). Automatic motivation (b = 3.40, SE = 1.22; P = 0.005) and physical opportunities (b = 2.05, SE = 0.92; P = 0.02) had direct effects on duration, and psychological capabilities (b = 0.41, SE = 0.18; P = 0.03) and automatic motivation (b = 0.27, SE = 0.13; P = 0.04) had direct effects on intensity. Psychological capabilities directly or indirectly influenced all RT participation characteristics, suggesting a critical role of planning and self-monitoring in fostering RT adherence.

Conclusion

For GLP-1 users engaging in RT, targeted behavioral interventions may be useful to mitigate muscle loss. Behavior change strategies should focus on psychological capabilities integrating planning and self-monitoring to enhance RT participation, with future research needed to confirm these results in more diverse and larger populations.
Protocol for a co-design study for the development of a chronotherapeutic mobile health behaviour change intervention targeting light exposure among older adults
Authors: Alkaff Zahrah Alwi , Murukesu Resshaya Roobini , Del Villar Denz , Spitschan Manuel
Published: November 2024

Through its wide-ranging effects on human physiology and behaviour, daily light exposure is an important environmental modulator of healthy ageing. Integrating mobile health (mHealth) technology with behaviour change strategies offers a promising approach to optimise light exposure and positively impact sleep, rest-wake cycles, cognitive function, and mood at scale. This study aims to develop the LightSPAN mHealth behaviour change intervention to optimise light exposure across the lifespan. Employing a co-design methodology, the study comprises two distinct workstreams. The first focuses on conceptualising the theoretical framework and implementation strategies through a comprehensive review of light exposure interventions, behaviour change theories, mHealth user personas, and recommendations for designing mHealth interventions for older adults. The second workstream centres on co-designing the intervention, involving consultation with community service providers and engagement with older adults at ageing community centres (≥60 years of age). Community service providers will be consulted through open-ended discussions (target n=5). Older adult participants (n=20) will engage in telephone interviews, focus group discussions and prototyping workshops to explore older adult participants’ characteristics, needs, preferences, and mHealth intervention design elements and co-design the LightSPAN mHealth behaviour change intervention. The insights generated in these co-design components will ensure that the intervention addresses the needs of its future users.
Diagnosis and correction of phonetic and phonemic underdevelopment in preschoolers
Authors: Shashkina Gul'nara , Uvarova Tat'yana , Chereshneva Viktoriya , Terent'eva Tat'yana , Krasnoperova Elena , Yacenko Sofiya , Pokrovskaya Ol'ga
Published: November 2024

The textbook presents options for lectures, practical and seminars with students aimed at updating knowledge on the discipline "Speech Therapy (FFN)". It clarifies and complements ideas about phonetic and phonemic underdevelopment (FFN): clinical typology and psychological and pedagogical characteristics of preschoolers with FFN; organization of speech examination, structure and content of correctional work of a speech therapist with children with FFN in accordance with the training and upbringing program; issues of interaction between teachers of a preschool educational organization and the work of a speech therapist with parents.
Meets the requirements of the federal state educational standards of higher education of the latest generation.
For students of higher educational institutions studying in the field of "Special (defectological) education", graduate students, teachers, speech therapists starting their practical work in an educational organization, as well as teachers of preschool educational organizations working with children with FFN.
Economía de la financiarización: problemática regional del cultivo del arroz en la meseta de Ibagué
Authors: Alba Sanabria Sandra Milena , Oviedo Ramírez Claribeth , Salamanca Santos María del Pilar , Uribe Sarmiento John Jairo
Published: November 2024

En este capítulo se analizan los cambios recientes del cultivo del arroz en Colombia como consecuencia del fenómeno de la financiarización, expresado para este sector en los tratados de libre comercio (TLC). Estos han condicionado en gran medida al Estado a la normativa del mercado mundial y, por consiguiente, han agravado las condiciones de lugar “periférico” del país con respecto a un “centro” de desarrollo económico, para este caso Estados Unidos.
Educación, conflicto y construcción de paz: dinámicas educativas en un territorio de frontera
Authors: Quiroga Emmanuel , Vega Vicente
Published: November 2024

El objetivo del presente capítulo es describir las dinámicas de las actividades educativas en el municipio de Planadas, sur del Tolima, considerando este territorio como una frontera cuya configuración y representación está en permanente disputa entre diversos actores. Lo anterior significa considerar las afectaciones experimentadas por cuenta del conflicto armado que ha vivido Colombia en las últimas décadas, y los diferentes esfuerzos en torno a la contribución de los procesos educativos en la construcción de paz en la región, así como en la integración a cadenas productivas de alcance global, como la que corresponde al café.
Research on Ecological Restoration Strategies for Abandoned Mines Based on Ecology-Oriented Development
Authors: Wang Ning , Tan Deqing
Published: November 2024

The ecological restoration of abandoned mines poses a significant challenge within China’s broader efforts toward the protection and restoration of the nation’s ecosystems. Based on the ecology-oriented development (EOD) model, a differential game framework for the ecological restoration of abandoned mines was constructed in this study, involving both government and corporate entities as players. Our analysis focused on various factors, including investment levels in ecological restoration quality, the quality of ecological restoration itself, investment levels in environmentally sensitive industry development, the quality of environmentally sensitive industries, environmentally sensitive product pricing strategies, and profit dynamics for both players across four distinct modes. Our findings reveal several key insights. First, extending the government’s concession period incentivizes enterprises to increase investment in both the quality of ecological restoration of abandoned mines and the development of environmentally sensitive industries. Second, the government should prefer the cooperative mode to introduce social capital for the ecology-oriented development of abandoned mines. Third, in noncooperative mode, for technology-intensive industries, the government’s industrial support policy is more mutually beneficial; conversely, for labor-intensive industries, the ecological restoration compensation policy yields higher mutual gains. Lastly, differentiated incentive policies implemented by the government across various modes prompt the input of enterprises in ecological restoration quality and environmentally sensitive industry development. Based on these findings, we offer specific policy recommendations to guide governmental efforts in promoting EOD for the ecological restoration of abandoned mines.

Funding: This work was supported by the Sichuan Office of Philosophy and Social Science [Grant SC22C004] and the National Social Science Fund of China [Grant 22XKS015].
Bad Apples on Rotten Tomatoes: Critics, Crowds, and Gender Bias in Product Ratings
Authors: Aguiar Luis
Published: November 2024

This paper shows that movie crowd reviewers provide evaluations that are biased against movies with a stronger female presence relative to professional critics.
Performance of soybean and corn in sandy soil subjected to increasing doses of micronutrients
Authors: Alves Júnior Wilmar Pereira , Ribeiro Diego Oliveira , Silva Andrisley Joaquim da , Schenkel João Alfredo de Carvalho , Pereira Rogério Machado , Oliveira Job Teixeira
Published: November 2024

At a global level, it is estimated that between 30% and 50% of agricultural production is influenced by the use of commercial fertilizers. The objective of this study was to evaluate the performance of soybean and corn subjected to doses of fertilizers containing multiple micronutrients. The experiment was conducted on the Água Limpa Araras property, in the 2022/2023 season. The experimental design adopted was randomized blocks, consisting of six treatments and four replicates, totaling 24 experimental units. Treatments were Fert Micro BR 12 fertilizer doses of: 0; 25; 50; 75; 100 and 125 kg ha-1. Leaf B, Mn and Zn contents were within the range considered ideal for soybean and corn crops, except in the corn crop, where the leaf Mn content in the control treatment and at a dose of 25 kg ha-1. Soybean and corn responded to the application of fertilizer containing multiple micronutrients. Soybean responded linearly with the increase in the dose of fertilizer containing multiple micronutrients, reaching a grain yield of 5,535 kg ha-1 with a dose of 125.0 kg ha-1. For corn, the maximum estimated dose of fertilizer containing multiple micronutrients was 115.8 kg ha-1, with grain yield of 12,454.48 kg ha-1.
Rehabilitation services for childrenwith disabilities during the COVID-19 pandemic in the United Arab Emirates: Experiences of parents
Authors: Mysore Sunitha Bhagavathi , Djuric Dragana , Zeghan Adam , Oudeh Areen , Al Qerem Belal , Al Humaidan Abdulla , Hussain Salem Alyafei Amina , Al Jarrah Muhammed
Published: November 2024

Introduction: The Covid -19 pandemic brought changes in professional practice across the globe. Children with disabilities received rehabilitation services remotely throughout the lockdown periods to contain the virus in the United Arab Emirates. This paper explores the experiences of parents of children with disabilities who received remote rehabilitation services during the Covid-19 pandemic.Methods: A survey was developed by the study team in English and Arabic. Demographic data, characteristics of children, family circumstances, access to rehabilitation, use of assistive tools, financial and psychological implications on parents and children, and future use of remote therapy. It was deployed to the parents through the rehabilitation centers and was analyzed using descriptive statistics with frequencies and percentages.Results: The survey was completed by 239 parents whose children with disabilities received the rehabilitation services remotely mainly through telerehabilitation. The pressure and psychological impact on parents were high, reporting frustration (44.8%), and anxiety (59.8%), although (70.3%) recognized the importance of continued care for the child.Conclusion: Telerehabilitation was the means during the pandemic to ensure continued care in the UAE. In the future, remote rehabilitation will be appropriate in specific situations when there is limited or no access to the center. Future research should explore thecontinued use of telerehabilitation and its effectiveness.
Anthropometric differences of Roma and Non-roma newborns in Virovitica-Podravina County
Authors: Šegregur Jadranko
Published: November 2024

The aim of this work is to assess anthropometric parameters of the Roma newborns in Virovitica-Podravina County and comparethem with the values for the non-Roma group. This retrospective investigation includes 204 Roma and 408 non-Roma newborns,born at the maternity ward of the Virovitica General Hospital in the period from 1991 to 2010. Various parameters, such as birthweight and length, head perimeter, as well as the ponderal index and percentile values of birth weight, were assessed. Roma newborns have, on average, 321.7 g smaller weight, 1.3 cm smaller length and 0.7 cm smaller head perimeter at birth, compared tonon-Roma newborns. The ponderal index was found to be 0.06 less for Roma newborns, with higher frequency of hypothrophicnewborns, according to the percentile values of the birth weight. The differences in anthropometric parameter values of Roma andnon-Roma newborns may be due to the ethnic identity, but also due to the impact of the surroundings and the lifestyle of the population itself. Assessed data could provide a better understanding to, and political direction for the improvement of the reproductive,as well as the overall health of the Roma population.
Staged reconstruction of radial longitudinal deficiency and thumb aplasia – case report and a review of the literature
Authors: Kralj Rok , Tadić Karlo , Kurtanjek Mario , Weber Daniel Max , Zürich Hospital , Višnjić Stjepan
Published: November 2024

Purpose: Presentation of surgical treatment of a girl with type IV radial longitudinal deficiency and type IV thumb hypoplasia as well as review of the most relevant literature published in the previous 25 years.Methods: The treatment consisted of placement of an external fixator and subsequent distraction in the radioulnar and proximodistal axis as the initial procedure followed by radialization according to Buck-Gramcko around the 2nd birthday, 10 weeks after the primary procedure. The last step of the treatment was a pollicization of the index finger performed before the 4th birthday.Results: The surgical treatment resulted with a very favorable outcome – a clinically stable wrist, radiologically well aligned carpus over the ulna and an index pollicised in such a manner that enables adequate opposition to the other fingers.Conclusion: A review of literature in the last 25 years shows that radialization of the ulna with a preceding distraction offers benefits over centralization alone. Distraction of the wrist protects the distal ulnar growth plate and thus promotes growth. Soft tissue release with a bilobar flap can also provide a good outcome as wells as a microvascular joint transfer from the 2nd toe whereas the latter requires advanced microsurgical skills.
Neinfektivna unilateralna cervikalna limfadenopatija u djece - prikaz pacijenata
Authors: Bukovec Petra , Kranjčec Izabela , Gašparov Slavko , Živić Helena
Published: November 2024

Servikal lenfadenopati, çocukların birinci basamak doktorlarına gitmesinin en yaygın nedenlerinden biridir. Yani, 4 ila 9 yaş arası çocukların %90'ında , boyunda genişlemiş bir lenf düğümü gözlemlenir; bu, çoğunlukla viral veya bakteriyel etiyolojiye bağlı akut bir enfeksiyonun neden olduğu ve ayakta tedavi ortamlarında teşhis edilip tedavi edilebilen bir durumdur. Önemli ölçüde daha küçük ama önemli sayıda vakada, altta yatan neden malignite veya kapsamlı tedavi ve farklı tedavi gerektiren çok çeşitli diğer ciddi durumlardır. Boyun lenf nodu büyümesinin daha nadir, enfeksiyöz olmayan nedenleri olan üç hastayı sunuyoruz; tek merkezli Castleman hastalığı olan genç bir adam, germinal merkezlerinin ilerleyici dönüşümü olan bir ergen ve yanlışlıkla servikal lenfadenopati tanısı konan parotitli bir bebek. Unisentrik Castleman hastalığı tanısı, 7 ay süren kalıcı tek taraflı servikal lenfadenopatiden sonra genç bir erkekte çıkarılmış bir lenf nodunun patohistolojik analizi ile teşhis edildi; bu hastanın PETCT ile hastalığın yayılımını ekarte etmek için takip edilmesi önerildi. 3 ay süren lenfadenopatili bir ergene, kapsamlı radyolojik ve enfeksiyöz tedavi sonrasında germinal merkezlerin progresif dönüşümünün patohistolojik-klinik tanısı konuldu. Hastalığın kronik tekrarlayan bir seyir ile karakterize olduğu, bir yıl içinde etkilenen lenf nodunun üçüncü kez çıkarılmasını bekleyen sunulan hastanın vakasıyla doğrulanmıştır . Viral parotit, servikal lenfadenopatiyi taklit edebilen bir durumdur, tıpkı 3 günlük submandibuler şişliği olan 6 aylık erkek bebekteki üçüncü hastada olduğu gibi. Yukarıdakilerle birlikte ayrıntılı öykü ve klinik muayenenin önemine dikkat çekmekle birlikte, çocuklarda lenfadenopatinin daha az sıklıkta görülen, enfeksiyon dışı nedenlerini de hatırlatmak isteriz; bu nedenle sistematik tanı yaklaşımının gerekli olduğu bir durumdur.
Znanja i stavovi o nespuštenim testisima – potreba za edukativnom intervencijom
Authors: Bašković Marko , Čolić Tonko , Mašić Mario , Zaninović Luca , Čizmić Ante , Bojanac Ana Katušić , Ježek Davor
Published: November 2024

Cilj: S obzirom na loše pokazatelje dobi orhidopeksije za kongenitalnu skupinu nespuštenih testisa, cilj ovoga rada bio je istražitiznanja i stavove specijalizanata/mladih specijalista pedijatrije, obiteljske i školske medicine o navedenoj problematici jer upravo suoni, u većini slučajeva prvi kojima se roditelji obraćaju za pomoć i mišljenje.Metode: Znanje i stavovi specijalizanata i mladih specijalista ispitani su pomoću anonimnog online upitnika, temeljenog na najnovijim spoznajama i smjernicama. Prikupljanje podataka provedeno je putem besplatnog programa Google Forms®. Kako bismoutvrdili odstupaju li dobiveni odgovori od odgovora koje bismo očekivali pod određenom hipotezom, odgovori su uspoređivani korištenjem hi-kvadrat testa uz razinu statističke značajnosti od 5%.Rezultati: Upitnik je ispunilo 129 specijalizanata/mladih specijalista, od kojih većina smatra kako za vrijeme studiranja i specijalističkog usavršavanja nisu dovoljno čuli i naučili o nespuštenim testisima, kako svoje znanje o problematici nespuštenih testisa smatrajunezadovoljavajućim te kako se u dosadašnjoj karijeri nisu susreli sa smjernicama koje govore o dijagnostici i liječenju nespuštenihtestisa. Odgovori na većinu pitanja, koja su se temeljila na najnovijim smjernicama, bili su nezadovoljavajući. Gotovo 2/3 ispitanikasmatra kako se o dječacima s nespuštenim testisima u Republici Hrvatskoj ne vodi pravodobna briga i liječenje, a 1/3 ispitanikaključni problem vidi u primarnim pedijatrima, obiteljskim liječnicima te u timovima školske medicine.Zaključci: S obzirom na dobro poznate posljedice nepravodobnog liječenja nespuštenih testisa u dječaka, rezultatima analize ankete kojima ne možemo biti zadovoljni potrebno je ozbiljno pristupiti. Stoga potičemo buduće edukativne intervencije, utemeljene nadokazima, koje će za cilj imati bolju informiranost o problematici nespuštenih testisa i u konačnici vremenski pomak samih orhidopeksija k ranijoj dobi.
Anafi laksija ovisna o hrani, potaknuta naporom – prikaz bolesnice s osvrtom na praktični pristup problemu
Authors: Topalušić Iva , Jureković Irena Ivković , Marković Asja Stipić , Jakuš Bernarda
Published: November 2024

Anafi laksija ovisna o hrani, potaknuta naporom (engl. food dependent exercise induced anaphylaxis, FDEIA) poseban je oblik preosjetljivosti na hranu posredovan IgE protutijelima, koji se javlja u bolesnika koji unutar nekoliko sati od konzumacije određene namirnice budu izloženi tjelesnoj aktivnosti. U djece je posebice rijedak, a najčešće je uzrokovan pšeničnim brašnom, iako ga mogu uzrokovati i druge žitarice, ribe, plodovi mora, orašasti plodovi, kikiriki, jaje, mlijeko i druga hrana. Dijagnoza se postavlja temeljemkarakterističnih simptoma koji se pojavljuju tijekom ili nekoliko sati nakon tjelesne aktivnosti, kojoj prethodi ingestija određene hrane, in-vitro i in-vivo pretraga te provokacijski pokusi. Sama tjelesna aktivnost ili konzumacija hrane u odsustvu tjelesne aktivnosti, neizaziva simptome. U ovom radu prikazujemo 17-godišnju bolesnicu koja je pokazala FDEIA-u nakon konzumacije proizvoda odpšeničnog brašna. Iako rijedak, ovaj je entitet potrebno poznavati kako bi se izbjegle životno ugrožavajuće alergijske reakcije, a temelj dijagnoze je detaljna anamneza.
Dojkinje i dojenje u Zagrebu kroz povijest – od kraja devetnaestog stoljeća do kraja Drugog svjetskog rata
Authors: Horvat Katarina , Grgurić Josip
Published: November 2024

U tekstu će se navesti pojedini podaci o dojkinjama i dojenju u razdoblju od kraja devetnaestog stoljeća do Drugog svjetskog rata.Krajem 19. stoljeća dojkinje se moglo zaposliti za plaću koja nije bila mala, što pokazuje da se njihov posao smatrao važnim. S drugestrane, u ovom je razdoblju bilo učestalo davanje dojenčadi na dojenje na ladanje tj. na selo gdje bi se za njih brinule strane osobe,ponekad i bez dovoljne pažnje. Kako bi se ovo popravilo, pojedini istaknuti liječnici poduzeli su određene korake. Dio rada na zaštitidojenčadi odnosio se i na promoviranje dojenja. Ovaj rad provodio se, među ostalim, i u Gradskom dječjem ambulatoriju u Zagrebukoji je započeo s radom 1908. te Središtu za socijalno-higijenski rad sestara pomoćnica koje je započelo s radom 1930. Briga o zdravlju dojenčadi bila je i dio preventivne zdravstvene politike Kraljevine Srba, Hrvata i Slovenaca (SHS), a rad na ovom polju nastavit ćese i u narednom razdoblju
The Effect of Play Activities for COVID-19 Positive and MIS-C Pediatric Patients on the Anxiety and Fear of Children and Their Parents
Authors: Buyuk Esra Tural , Erdeniz Emine Hafize , Uzsen Hatice , Odabasoglu Emel , Koyun Merve
Published: November 2024

Aim: This study aims to determine the effects of play activities for COVID-19 positive and MIS-C pediatric patients on the anxiety and fear of children and their parents. Methods: This is an experimental study that was prepared through STROBE. The study population consisted of 38 children treated in a university hospital COVID-19 unit. The Children’s Anxiety Meter-State and the Children’s Fear Scale were administered before and after the play activities. The parents’ fear and anxiety were assessed using the COVID-19 Phobia Scale and the Beck Anxiety Inven- tory. The book and coloring set was prepared in advance and delivered to the experimental group in a package. After the sets were given to the parents, the parents read the book to their children the same day. Afterward, they were asked to color pictures of coro- navirus precautions together with the children. SPSS 22.00 package program was used to analyze the study data. The Mann-Whit- ney U test was used to compare independent groups, and Wilcoxon analysis was used to analyze dependent variables before and after the play activities. Results: Based on the children’s anxiety and fear scores in the experimental group, significant differences were found before and after the play activities and significant differences between the anxiety scores (<0.05) of parents and children. However, no significant difference was found between post-play anxiety and fear scores of children in the experimental group and the scores of the control group. Discussion: The experimental group had low mean anxiety and fear scores after the play activities. Play activities should be used to reduce the anxiety and fear of children who are treated in isolation in hospitals during the COVID-19 pandemic. Even if children are restricted to isolation rooms, their daily routines should be maintained, and their parents should be supported.
Neurological symptoms in Schimke immuno-osseous dysplasia in a 11-year-old girl: a case report
Authors: Badeński Andrzej , Badeńska Marta , Trembecka-Dubel Elżbieta , Grzywna-Rozenek Ewa , Kluczewska Ewa , Szczepańska Maria
Published: November 2024

Background: Schimke immuno-osseous dysplasia (SIOD, OMIM 242900) is a rare, autosomal recessive, pleiotropic disease caused by mutations in the SMARCAL1 gene. SIOD is characterized by a triad of symptoms, i.e., progressive kidney disease due to focal segmen- tal glomerulosclerosis (FSGS), spondyloepiphyseal dysplasia and T-cell immunodeficiency. Additionally, heterogeneous neurological symptoms are often observed in the course of the syndrome. Case: The authors describe the case of a 14-year-old girl with SIOD, who presented with recurrent neurological symptoms, such as migraine-like headaches, diplopia and seizures. She was born at 34 weeks of pregnancy with hypotrophy (1280 g) and short stature (44 cm). Nephrotic-range proteinuria, the first symptom of the disease, was detected at the age of 4 and a half years. Significant immunodeficiency was also observed. She was finally diagnosed with Schimke immuno-osseous dysplasia on account of two pat- hogenic variants, c.836T>C (p.F279S) and c.2542G>T (p.E848X) identified in the SMARCAL1 gene. Conclusions: This report describes the clinical features and neuroimaging findings of a patient with SIOD. It also presents a possible correlation between neurological events and the Schimke disease, which should be considered during the diagnostic process.
Utjecaj uvođenja pisanog protokola u kliničku praksu rodilišta na smanjenje broja dojilja s oštećenim bradavicama
Authors: Kunina Banana , Dimnjaković Jelena , Bošković Sandra
Published: November 2024

Bol i oštećenje bradavica (ragade) prilikom dojenja povezani su s ranim prestankom dojenja. Ragade se intervencijom osoblja rodilišta mogu spriječiti obzirom, jer su najčešći uzroci nepravilan položaj pri dojenju i loš hvat. Pisani protokoli olakšavaju rad osoblju tepoboljšavaju kliničke ishode. Cilj istraživanja bio je utvrditi utjecaj uvođenja pisanog protokola na broj dojilja koje se iz rodilišta otpuštaju s ragadama radi prevencije ranog prestanka dojenja. Prospektivno istraživanje na Odjelu babinjača. Protokol je sažeti dokument s uputama primaljama za pristupanje dojilji s bolnim bradavicama kako bi se spriječilo oštećenje. U prvoj fazi istraživanja(trajanje dva mjeseca) primalje su samo skupljale polazišne podatke, u drugoj fazi (jedan mjesec) započeto je educiranje o uzrocimanastanka ragada i o primjeni protokola, u trećoj (šest mjeseci) primalje su se služile protokolom. Od ukupno 2067 porođaja podatcisu zabilježeni za njih 1292 (62,5%). U trećoj fazi bilo je manje oštećenja bradavica stupnja >1 prema Morbacheru u odnosu na prvufazu (4,8% vs 9,8%, p=0,007), više majki za koje su primalje procijenile da doje u nepravilnom položaju (5,2% vs 1,5%, p=0,003) te daje hvat loš (15,6% vs 8,1%, p=0,0006). U drugoj fazi, u odnosu na prvu, zabilježeno je više majki s nepravilnim položajem (1,8% vs1,5%, p=0,003) i hvatom (18,9% vs 8,1%, p=0,001). Učestalost uporabe šeširića s vremenom se smanjivala (po fazama 22,4%, 19,6%,17,2%, p=0,112). Primjena pisanog protokola dovela je do smanjenja broja dojilja koje se otpuštaju s ragadama većeg stupnja, te doosvještavanja primalja o položaju dojenja i hvatu.
Kontrola djetetova ponašanja u ordinaciji dentalne medicine
Authors: Milanović Marija , Jovanović Željko
Published: November 2024

Oralno zdravlje je bitna stavka u čovjekovom cjelokupnom zdravlju. Briga za oralno zdravlje započinje već u najranijoj dobi, te je bašprvi posjet ordinaciji vrlo važan za formiranje pozitivnog djetetovog stava. Upotrebom metoda za kontrolu ponašanja djece u ordinaciji dentalne medicine postiže se postupno privikavanje djeteta na cjelokupno okružje ordinacije i njegov sadržaj, smanjuje semogućnost pojave dentalnog straha i anksioznosti, te se oblikuje ponašanje djeteta koje je suradljivo i spremno na obavljanje dentalnih intervencija. Ostvarenom dobrom komunikacijom s djetetom i roditeljima, te empatijom i ispravnim pristupom prilikom radapostiže se uspjeh u liječenju najmlađih pacijenata na obostrano zadovoljstvo.
Neuronska ceroidna lipofuscinoza – najčešća neurodegenrativna bolest u djetinjstvu
Authors: Kravljanac Ružica
Published: November 2024

Cilj: Neuronska ceroidna lipofuscinoza pripada skupini lizosomskih poremećaja, obuhvaća četrnaest tipova bolesti i najčešća je neurodegenerativna bolest u djetinjstvu. Cilj je ove publikacije da se liječnici upoznaju s načinom i značenjem ranog otkrivanja oboljelih od NCL-a.Metode: Analiza literature i podataka iz povijesti bolesti pacijenata liječenih u Institutu tijekom posljednjih 20 godina.Rezultati: Glavna karakteristika NCL-a je progresivni tijek bolesti koji zahvaća motoričko i kognitivno propadanje, epileptičke napadaje, a zbog zahvaćanja retine dolazi do progresivnog slabljenja vida sve do sljepila. Postoji genotipsko-fenotipska korelacija uzrastai početka ispoljavanja bolesti, brzina progresije, težine i kontrole epilepsije, izraženost psihijatrijskih poremećaja itd. Također postojikorelacija između genske mutacije i načina na koji se raspoređuju depoziti lipofuscina u stanici, a koji se vide elektronskim mikroskopom. Liječenje djece oboljele od neuronske ceroidne lipofuscinoze veliki je izazov. Palijativno liječenje koje obuhvaća i epilepsiju odključnog je značenja. Za liječenje pojedinih oblika NCL-a postoji mogućnost primjenom enzima koji nedostaje, kao što je slučaj kodkasnog infantilnog oblika (CLN2), ili genskom terapijom koja je u fazi kliničkog ili eksperimentalnog ispitivanja.Zaključak: Poznavanje ključnih kliničkih karakteristika, ranih simptoma i algoritma u dijagnostici NCL-a od velikog je značenja uranom otkrivanju bolesti. Rano otkrivanje dobiva na značenju u „novoj eri“ u kojoj je sve više lijekova za liječenje neuroprogresivnih,dosad neizlječivih bolesti kao što je i NCL, a važno je i u prenatalnoj dijagnostici.
Neurološke manifestacije mukopolisaharidoza
Authors: Kero Mijana
Published: November 2024

Mukopolisaharidoze su skupina rijetkih progresivnih bolesti nakupljanja koje se javljaju u oko 1:25000 osoba. Uzrokovane su nasljednim djelomičnim ili potpunim nedostatkom lizosomnih enzima koji sudjeluju u razgradnji glikozaminoglikana. Djelomično razgrađeni glikozaminoglikani nakupljaju se u većini stanica i izvanstaničnom tkivu te se pojačano izlučuju urinom. Klinička slika je složena i može varirati od teških poremećaja, koji završavaju smrću već u prvim mjesecima ili godinama života, do onih koji se očituju sblagim simptomima i imaju normalan životni vijek. Česti simptomi uključuju dysostosis multiplex, kraniofacijalnu dizmorfi ju, hepatosplenomegaliju, ukočenost i kontrakture zglobova, kardiomiopatiju, bolest zalistaka, česte respiratorne infekcije, a u nekim oblicima je zahvaćen i središnji živčani sustav. Enzimsko nadomjesno liječenje za MPS tip I., II., IV.A, VI. i VII. uz transplantaciju koštane sržikod MPS-a I. poboljšale su prognozu u mnogih bolesnika. No enzimsko nadomjesno liječenje ne sprječava razvoj neuroloških manifestacija. Teška i životnoograničavajuća priroda neurokognitivnih problema kod bolesnika s MPS-om traži ranu dijagnozu i liječenjekako bi se ograničila ireverzibilna oštećenja tkiva. Učinkoviti tretmani MPS poremećaja moraju imati za cilj spriječiti ili zaustaviti razvoj kako somatskih tako i neuroloških manifestacija. Precizni klinički opis neuroloških manifestacija kod pacijenata, kao i razumijevanje patološke osnove u njihovoj podlozi, može pomoći u ranoj identifi kaciji bolesnika, dizajniranju kliničkih studija i razvojuučinkovitih terapija.