bluuebunny/crossref_metadata_2025 huggingface dataset:
Giant cell arteritis with myeloperoxidase anti-neutrophil cytoplasmic antibody seropositivity in a patient with systemic sclerosis
Authors: Kitahara Yoshihiro , Nakamura Rie , Kawai Makiko , Hirakawa Tetsu , Hamada Arisa , Mito Mineyo , Nakano Kikuo
Published: January 2023

To the best of our knowledge, systemic sclerosis with overlapping characteristics of both microscopic polyangiitis and giant cell arteritis (i.e. microscopic polyangiitis involving the superficial temporal artery or giant cell arteritis with myeloperoxidase anti-neutrophil cytoplasmic antibody seropositivity) has not been reported previously. An 82-year-old woman with diffuse cutaneous systemic sclerosis experienced dyspnoea on exertion and fever. No signs of infection were observed on computed tomography. Her fever persisted despite antibiotic treatment for occult bacterial infection and secondary Clostridioides difficile–associated diarrhoea. Microscopic polyangiitis was suspected because of myeloperoxidase anti-neutrophil cytoplasmic antibody seropositivity, and giant cell arteritis was suspected as a differential diagnosis due to swelling of the superficial temporal artery. Arterial biopsy revealed inflammatory cell infiltration with granuloma formation. Based on the presence of granulomatous inflammation in the superficial temporal artery, we concluded that giant cell arteritis with myeloperoxidase anti-neutrophil cytoplasmic antibody seropositivity occurred as a complication. After glucocorticoid therapy, her fever and dyspnoea on exertion improved with a gradual decline in the serum myeloperoxidase anti-neutrophil cytoplasmic antibody levels. It is possible that vasculitis occurs as a complication in patients with systemic sclerosis in cases where the fever persists and cannot be explained by systemic sclerosis itself, infectious disease, or malignancy. Clinicians must be careful not to prematurely diagnose microscopic polyangiitis based on myeloperoxidase anti-neutrophil cytoplasmic antibody seropositivity or giant cell arteritis based on the swelling of the superficial temporal artery. Careful evaluation of the presence of granulomatous inflammation in an arterial biopsy specimen is essential to differentiate between microscopic polyangiitis and giant cell arteritis.
Enhancement of protein translation by CRISPR/dCasRx coupled with SINEB2 repeat of noncoding RNAs
Authors: Cao Congcong , Li Aolin , Xu Chaojie , Wu Baorui , Liu Jun , Liu Yuchen
Published: January 2023

The use of new long noncoding RNAs (lncRNAs) as biotechnological or therapeutic tools is still in its infancy, despite recent efforts to uncover their involvement in various biological processes including mRNA translation. An important question is whether lncRNA functional elements can be used to target translation of mRNAs of interest by incorporating the RNA-targeting CRISPR tools. The CRISPR/dCasRx-SINEB2 technology was developed in this research by coupling the sgRNA of a catalytically inactive Type VI-D Cas13 enzyme (CasRx) to an integrated SINEB2 domain of uchl1 lncRNA that promotes the translation of targeted mRNA. It has been demonstrated to be effective and adaptable in selectively increasing the expression of a variety of exogenous and endogenous proteins with a variety of functions with minimal off-target effects. dCasRx-SINEB2 is currently the sole CRISPR-related technique for translational control of gene expression, and works just as well or even better than the traditional RNAe tool under comparable conditions. Additionally, human cancer cells can be prevented from proliferating and migrating both in vitro and in vivo by dCasRx-SINEB2-targeted mRNA translation of transcripts encoding for antitumor proteins, including PTEN and P53. The present study provides an innovative protein enhancement method that will have several applications in biopharmaceuticals production and cancer research.
Structural predictions of protein–DNA binding: MELD-DNA
Authors: Esmaeeli Reza , Bauzá Antonio , Perez Alberto
Published: January 2023

Structural, regulatory and enzymatic proteins interact with DNA to maintain a healthy and functional genome. Yet, our structural understanding of how proteins interact with DNA is limited. We present MELD-DNA, a novel computational approach to predict the structures of protein–DNA complexes. The method combines molecular dynamics simulations with general knowledge or experimental information through Bayesian inference. The physical model is sensitive to sequence-dependent properties and conformational changes required for binding, while information accelerates sampling of bound conformations. MELD-DNA can: (i) sample multiple binding modes; (ii) identify the preferred binding mode from the ensembles; and (iii) provide qualitative binding preferences between DNA sequences. We first assess performance on a dataset of 15 protein–DNA complexes and compare it with state-of-the-art methodologies. Furthermore, for three selected complexes, we show sequence dependence effects of binding in MELD predictions. We expect that the results presented herein, together with the freely available software, will impact structural biology (by complementing DNA structural databases) and molecular recognition (by bringing new insights into aspects governing protein–DNA interactions).
Structure of a 28.5 kDa duplex-embedded G-quadruplex system resolved to 7.4 Å resolution with cryo-EM
Authors: Monsen Robert C , Chua Eugene Y D , Hopkins Jesse B , Chaires Jonathan B , Trent John O
Published: January 2023

Genomic regions with high guanine content can fold into non-B form DNA four-stranded structures known as G-quadruplexes (G4s). Extensive in vivo investigations have revealed that promoter G4s are transcriptional regulators. Little structural information exists for these G4s embedded within duplexes, their presumed genomic environment. Here, we report the 7.4 Å resolution structure and dynamics of a 28.5 kDa duplex-G4-duplex (DGD) model system using cryo-EM, molecular dynamics, and small-angle X-ray scattering (SAXS) studies. The DGD cryo-EM refined model features a 53° bend induced by a stacked duplex-G4 interaction at the 5’ G-tetrad interface with a persistently unstacked 3’ duplex. The surrogate complement poly dT loop preferably stacks onto the 3’ G-tetrad interface resulting in occlusion of both 5’ and 3’ tetrad interfaces. Structural analysis shows that the DGD model is quantifiably more druggable than the monomeric G4 structure alone and represents a new structural drug target. Our results illustrate how the integration of cryo-EM, MD, and SAXS can reveal complementary detailed static and dynamic structural information on DNA G4 systems.
Risk prediction in early childhood sonic hedgehog medulloblastoma treated with radiation-avoiding chemotherapy: Evidence for more than 2 subgroups
Authors: Tonn Svenja , Korshunov Andrey , Obrecht Denise , Sill Martin , Spohn Michael , von Hoff Katja , Milde Till , Pietsch Torsten , Goschzik Tobias , Bison Brigitte , Juhnke Björn-Ole , Struve Nina , Sturm Dominik , Sahm Felix , Bockmayr Michael , Friedrich Carsten , von Bueren André O , Gerber Nicolas U , Benesch Martin , Jones David T W , Kool Marcel , Wefers Annika K , Schüller Ulrich , Pfister Stefan M , Rutkowski Stefan , Mynarek Martin
Published: January 2023

Background

The prognostic impact of clinical risk factors and DNA methylation patterns in sonic hedgehog (SHH)-activated early childhood desmoplastic/nodular medulloblastoma (DMB) or medulloblastoma with extensive nodularity (MBEN) were evaluated to better identify patients at risk for relapse.

Methods

One hundred and forty-four patients with DMB (n = 99) or MBEN (n = 45) aged <5 years and treated with radiation-sparing approaches, including intraventricular methotrexate in 132 patients were evaluated.

Results

Patients with DMB had less favorable 5-year progression-free survival than MBEN (5y-PFS, 71% [DMB] vs. 93% [MBEN]). Patients aged >3 years were associated with more unfavorable 5y-PFS (47% [>3 years] vs. 85% [<1 year] vs. 84% [1–3 years]). DNA methylation profiles available (n = 78) were reclassified according to the 2021 WHO classification into SHH-1 (n = 39), SHH-2 (n = 38), and SHH-3 (n = 1). Hierarchical clustering delineated 2 subgroups among SHH-2: SHH-2a (n = 19) and SHH-2b (n = 19). Patients with SHH-2b medulloblastoma were older, predominantly displayed DMB histology, and were more often located in the cerebellar hemispheres. Chromosome 9q losses were more frequent in SHH-2b, while few chromosomal alterations were observed in SHH-2a. SHH-2b medulloblastoma carried a significantly increased relapse risk (5y-PFS: 58% [SHH-2b] vs. 83% [SHH-1] vs. 95% [SHH-2a]). Subclassification of SHH-2 with key clinical and cytogenetic characteristics was confirmed using 2 independent cohorts (total n = 188). Gene mutation analysis revealed a correlation of SHH-2a with SMO mutations.

Conclusions

These data suggest further heterogeneity within early childhood SHH-DMB/MBEN: SHH-2 splits into a very low-risk group SHH-2a enriched for MBEN histology and SMO mutations, and SHH-2b comprising older DMB patients with a higher risk of relapse.
Back Pain Consortium (BACPAC): Protocol and Pilot Study Results for a Randomized Comparative-Effectiveness Trial of Antidepressants, Fear Avoidance Rehabilitation, or the Combination for Chronic Low Back Pain and Comorbid High Negative Affect
Authors: Wasan Ajay D , Edwards Robert R , Kraemer Kevin L , Jeong Jong , Kenney Megan , Luong Kevin , Cornelius Marise C , Mickles Caitlin , Dharmaraj Bhagya , Sharif Essa , Stoltenberg Anita , Emerick Trent , Karp Jordan F , Bair Matt J , George Steven Z , Hooten William M
Published: January 2023

Objective

Patients with chronic low back pain (CLBP) and comorbid depression or anxiety disorders are highly prevalent. Negative affect (NA) refers to a combination of negative thoughts, emotions, and behaviors. Patients with CLBP with high NA have greater pain, worse treatment outcomes, and greater prescription opioid misuse. We present the protocol for SYNNAPTIC (SYNergizing Negative Affect & Pain Treatment In Chronic pain).

Design

A randomized comparative-effectiveness study of antidepressants, fear-avoidance rehabilitation, or their combination in 300 patients with CLBP with high NA. In the antidepressant- or rehabilitation-only arms, SYNNAPTIC includes an adaptive design of re-randomization after 4 months for nonresponders.

Setting

A multisite trial conducted in routine pain clinical treatment settings: pain clinics and physical and occupational therapy treatment centers.

Methods

Inclusion criteria include CLBP with elevated depression and anxiety symptoms. Antidepressant and rehabilitation treatments follow validated and effective protocols for musculoskeletal pain in patients with high NA. Power and sample size are based on superior outcomes of combination therapy with these same treatments in a 71-subject 4-arm pilot randomized controlled trial.

Conclusions

SYNNAPTIC addresses the lack of evidence-based protocols for the treatment of the vulnerable subgroup of patients with CLBP and high NA. We hypothesize that combination therapy of antidepressants plus fear-avoidance rehabilitation will be more effective than each treatment alone.

Trial registration

ClinicalTrials.gov ID: NCT04747314.
The Impact of Baseline Anxiety on Drug Placebo Separation and Drug/Placebo Response in an Acute Schizophrenia Clinical Trial—A Post-hoc Analysis
Authors: Kott Alan , Brannan Stephen , Wang Xingmei , Daniel David
Published: January 2023

Objectives

We sought to evaluate the impact of baseline anxiety levels on drug placebo separation and drug and placebo response in acutely psychotic schizophrenic subjects.

Methods

In this post-hoc analysis, modified intent-to-treat Positive and Negative Syndrome Scale data were obtained from a phase 2, multi-center, 5 week, randomized, double-blind, placebo-controlled trial of KarXT in hospitalized adults with DSM-5 schizophrenia experiencing an acute exacerbation or relapse of symptoms. We investigated the impact of anxiety on drug placebo separation and drug and placebo response in 2 ways. In the first set of analyses, we dichotomized the data based on the absence or presence of anxiety symptoms. In the second set of analyses, we categorized subjects by levels of anxiety. All analyses were conducted using generalized linear models with normal distribution and identity link function.

Results

On average, subjects entering the trial were suffering from a moderate level of anxiety. Subjects with no baseline anxiety had a significant increase in placebo response, a decrease in drug response and did not separate drugs from placebo. With increasing levels of baseline anxiety, a larger drug placebo difference was observed.

Discussion

Our analyses identified that absence of anxiety at baseline was associated with a loss of signal at end of treatment between drug and placebo driven by a differential effect on placebo and treatment response. The effect observed was not related to the overall baseline symptom severity and was not mediated by improvement in anxiety itself. Interpretation of the results is caveated by the retrospective nature of the analyses.
Neonatal Resuscitation
Authors: Karlsson Lina , Gustafsson Ulrica , Thernström Blomqvist Ylva , Wallström Linda , Broström Anders
Published: January 2023

Background:

Teamwork during neonatal resuscitation is essential. Situations arise quickly and unexpectedly and are highly stressful, requiring pediatric registered nurses (pRN) to respond effectively and in a structured manner. In Sweden, pRNs work in all pediatric settings including the neonatal intensive care unit. The experience and actions of pRNs are seldom explored, and studies within this area could develop and improve strategies for neonatal resuscitation situations.

Purpose:

To describe pRNs' experiences and actions during neonatal resuscitation.

Methods:

A qualitative interview study based on the critical incident technique was performed. Sixteen pRNs from 4 neonatal intensive care units in Sweden were interviewed.

Results:

Critical situations were divided into 306 experiences and 271 actions. pRNs' experiences were divided into 2 categories: individual- and team-focused experiences. Critical situations were managed by individual- or team-focused actions.
Does Topical Anesthesia Alter the Outcomes of Vascular Laser Procedures? Review of Vasodynamic Effects and Clinical Outcomes Data
Authors: Glover Caitlyn , Richer Vincent
Published: January 2023

BACKGROUND

Topical anesthesia has vasodynamic effects within the skin and therefore has the potential to change the presence of hemoglobin as a chromophore before intense pulsed light (IPL) and vascular laser treatments. It is unclear whether this is clinically relevant. Global consensus on the use of topical anesthetics in this context is lacking.

OBJECTIVE

Review the effects of topical anesthetics on the skin microvasculature and the clinical implications of such effects on vascular treatments.

METHODS

PubMed and Medline searches were performed to identify studies examining the vasodynamic effects of topical anesthesia on skin and evaluating differences in efficacy of IPL and vascular laser treatments with or without topical anesthetic use.

RESULTS

Published studies reveal variable effects of different topical anesthetic agents on skin microvasculature. Only 3 controlled studies that directly examined the effect of topical anesthesia on clinical outcomes for pulsed dye laser (PDL) treatment of vascular conditions were identified. They did not support a difference in clinical outcomes with or without the use of topical anesthesia before PDL treatment.

CONCLUSION

Although topical anesthetic agents have vasodynamic effects within the skin, there is currently insufficient evidence to advise against their use before light and laser-based vascular treatments.
Dermatologic toxicities of chemotherapy: an educational intervention for skin of color women with breast cancer
Authors: Ahmad Maham , Saeed Sabrina , Olamiju Brianna , Silber Andrea , Leventhal Jonathan
Published: January 2023

Background:

Minority patients are more likely to require dose adjustments for chemotherapy, with cultural barriers and access to medical care cited as contributory factors.

Objective:

We sought to pilot an educational intervention, in the form of a pamphlet, to evaluate the effectiveness of this tool in teaching skin of color (SoC) patients about potential dermatologic toxicities of chemotherapy that are relevant to their skin type.

Methods:

At a chemotherapy infusion center, SoC patients (n = 26) who were receiving chemotherapy for breast cancer voluntarily consented to read an educational pamphlet and complete a series of survey questions before and after this educational intervention.

Results:

Most participants identified as female (96%), African American/Black (81%), and non-Hispanic (85%); all respondents had obtained at least a high school degree. Survey responses revealed a significant increase in knowledge about the potential dermatologic effects of cancer treatment after this intervention. Notably, 100% of participants either agreed or strongly agreed that they would like to see other doctors use this educational tool as a form of patient education, that they would recommend this pamphlet to other patients who are starting cancer treatment, and that the pamphlet was easy to understand.

Limitations:

Limitations of this study include small sample size and single-institution recruitment, which may limit generalizability. Furthermore, this study only included patients who are proficient in English.

Conclusion:

This study pilots an effective educational tool that addresses dermatologic toxicities of chemotherapy that are relevant to SoC patients. Further multi-institutional studies with larger sample sizes and translation to other languages can overcome the limitations of this pilot study.
Predictive value of high-sensitivity troponin for significant coronary artery disease in new-onset atrial fibrillation with rapid ventricular response
Authors: Butt Zaran A. , Fitzgerald Gerald , O’Dea Grace , O’Herlihy Fergus , Casey Aoife , Bennett Kathleen , Murphy Ross T. , Sheehan Richard
Published: January 2023

Background

High-sensitivity troponin-T (HS-cTnT) levels are often measured in patients presenting with atrial fibrillation (AF), with many subjected to unnecessary invasive assessments. The significance of a normal or mildly raised HS-cTnT in this context is poorly understood. This study aimed to determine the predictive value of HS-cTnT for significant coronary artery disease (CAD) in new AF with rapid ventricular response. We also compared the discriminative ability of HS-cTnT to suspected angina for significant CAD.

Methods

We examined patients presenting with new AF to two tertiary Irish centers in a defined period. Those included had HS-cTnT taken at presentation and subsequent ischemic evaluation.

Results

Of 5350 cases screened for inclusion, 281 were deemed eligible. Of these, 148 and 133 patients had a positive and negative index HS-cTnT, respectively. Of those with negative HS-cTnT, 13 (9.8%) had significant CAD versus 51 (34.5%) with positive HS-cTnT (P < 0.001). Positive Hs-cTnT status remained significant upon multivariate analysis (OR, 2.9; 95% CI, 1.37–6.14; P = 0.005). A similar model where HS-cTnT was replaced with suspected angina produced an OR of 1.64 (95% CI, 0.75–3.59; P = 0.213). A logistic model determined optimal cutoff value for HS-cTnT to be less than 30 ng/l, producing a negative predictive value of 91.8% and area under the receiver operative curve of 83.36.

Conclusion

HS-cTnT exhibits potential as an effective screening biomarker to predict nonsignificant CAD in new rapid AF, allowing more targeted and rationalized ischemic testing. HS-cTnT may also be a more accurate predictor of significant CAD than clinically suspected stable angina.
Percutaneous coronary intervention or medical therapy in patients with severe aortic stenosis and coronary artery disease undergoing transcatheter aortic valve implantation: a real-world analysis using data from an international network
Authors: Nunes Rafael Amorim Belo , Alves da Costa Leandro Menezes , Scudeler Thiago Luis , de Carvalho Cantarelli Marcelo José , Castello Helio , de Figueiredo Oliveira Gustavo Bernardes , Avezum Junior Álvaro
Published: January 2023

Patients undergoing transcatheter aortic valve implantation (TAVI) due to severe aortic stenosis have a high prevalence of coronary artery disease (CAD). As many of them have high surgical risk, CAD treatment in this group has typically been carried out with optimal medical treatment or paired with percutaneous coronary intervention (PCI). However, the best approach in this scenario is not well established. We aimed to evaluate 5-year cardiovascular outcomes in patients with aortic stenosis and chronic CAD treated with medical treatment alone compared to PCI coupled with medical therapy before or during TAVI. We used data from a large multinational electronic health record network (TriNetX). Patients aged 18 years or older with severe aortic stenosis and CAD who underwent TAVI in the last 10 years before the analysis were considered eligible. Five-year Kaplan–Meier curves and hazard ratios were calculated. We identified 19 058 patients undergoing isolated TAVI and 2277 patients undergoing TAVI and PCI. Using propensity matching scores, 2277 patients in each group were compared. The 5-year cumulative incidence of MACE was 22.92% in the isolated TAVI group, vs. 25.91% in the PCI-TAVI group. The probability of the composite primary outcome was not significantly different between the isolated TAVI group vs. the PCI-TAVI group [53.1 vs. 47.6%, adjusted hazard ratio (HR) 0.92, 95% confidence interval (CI), 0.80–1.05]. In a real-world study of patients with CAD and severe aortic stenosis, the 5-year probability of death, acute coronary syndrome and ischemic stroke did not differ between patients undergoing isolated TAVI compared to patients undergoing PCI before or during TAVI.
The impact of the Coronavirus disease 2019 on hospitalizations for coronary artery revascularization: results from California State Inpatient Database
Authors: Rubens Muni , Ramamoorthy Venkataraghavan , Saxena Anshul , Ruiz Pelaez Juan Gabriel , Chaparro Sandra , Jimenez Javier
Published: January 2023

Background

Coronavirus disease 2019 (COVID-19) outbreak has negatively impacted routine cardiovascular care. In this study, we assessed the impact of COVID-19 pandemic on percutaneous coronary artery intervention (PCI) and coronary artery bypass grafting (CABG) hospitalizations and outcomes using a large database.

Methods

The current study was a retrospective analysis of California State Inpatient Database (SID) during March–December of 2019 and 2020. All adult hospitalizations for coronary artery revascularization were included for the analysis. ICD-10-CM diagnosis and procedure codes were used for identifying hospitalizations and procedures. The primary outcome was inhospital mortality, and secondary outcomes were hospital length of stay, stroke, acute kidney injury, and mechanical ventilation. Propensity score match analysis was done to compare adverse clinical outcomes.

Results

PCI hospitalizations (relative decrease, 15.0%, P for trend <0.001) and CABG hospitalizations (relative decrease, 16.4%, P for trend <0.001) decreased from 2019 to 2020, while viral pneumonia hospitalizations increased (relative increase, 1751.6%, P for trend <0.001). Monthly PCI and CABG hospitalization showed decreasing trends from January 2019 to December 2020. Propensity score match analysis showed that the odds of inhospital mortality (OR, 1.12; 95% CI, 1.01–1.24), acute kidney injury (OR, 1.12; 95% CI, 1.06–1.17), and ARDS (OR, 1.89; 95% CI, 1.18–3.01) were higher among patients who received PCI in 2020.

Conclusion

Results of our study indicate that initiatives such as encouraging patients to receive treatments and controlling the spread of COVID-19 should be instituted to improve PCI and CABG hospitalizations.
En-bloc resection of non-muscle invasive bladder cancer: does it really make a difference?
Authors: Tonin Elena , Shariat Shahrokh F. , Schiavina Riccardo , Brunocilla Eugenio , D’Andrea David
Published: January 2023

Purpose of review

Transurethral resection of bladder tumour (TURBT) followed by pathology investigation of the obtained specimens is the initial step in the management of urinary bladder cancer (UBC). By following the basic principles of oncological surgery, en-bloc resection of bladder tumour (ERBT) aims to overcome the limitations associated with conventional transurethral resection, and to improve the quality of pathological specimens for a better decision making. The current bulk of evidence provides controversial results regarding the superiority of one technique over the other. The aim of this article is to summarize the recent data and provide evidence on this unanswered question.

Recent findings

Despite heterogeneous and controversial data, ERBT seems to have a better safety profile and deliver higher quality pathologic specimens. However, the recent evidence failed to support the hypothesized oncological potential benefits of ERBT in the initial surgical treatment of patients with UBC.

ERBT has gained increasing interest globally in the past decade. It continues to represent a promising strategy with a variety of features intended to solve the inherent limitations of TURBT. However, the current quality of evidence does not allow solid conclusions to be drawn about its presumed superiority compared with the conventional technique.
Hyperglycemia and Other Glycemic Measures Throughout Therapy for Pediatric Acute Lymphoblastic Leukemia and Lymphoma
Authors: Demedis Jenna , Scarbro Sharon , Suresh Krithika , Maloney Kelly , Forlenza Gregory P.
Published: January 2023

Transient hyperglycemia during induction chemotherapy is associated with increased morbidity and mortality in patients with acute lymphoblastic leukemia (ALL). Treatment with glucocorticoids, asparaginase, and stress are the proposed causal factors. Although these risks are not exclusive to induction, glycemic control throughout the remainder of ALL/lymphoma (ALL/ALLy) therapy has not been described. Furthermore, prior research has been limited to transient hyperglycemia. This study aimed to characterize glycemic control throughout ALL/ALLy and to evaluate risk factors and outcomes associated with increased mean glucose and glucose coefficient of variation (glucose CV) during induction chemotherapy. The records for 220 pediatric/young adult patients, age 1 to 26 years, who underwent treatment for ALL/ALLy from 2010 to 2014 at Children’s Hospital Colorado were retrospectively reviewed. Measures of glycemic control were calculated for each cycle. For the cycle with the highest mean glucose, induction (n=208), multivariable models were performed to identify potential risk factors and consequences of increased glucose. Highest mean glucose by cycle were induction 116 mg/dL, pretreatment 108 mg/dL, delayed intensification 96 mg/dL, and maintenance 93 mg/dL; these cycles also had the most glycemic variability. During induction, patients with Down syndrome, or who were ≥12 years and overweight/obese, had higher mean glucoses; age and overweight/obese status were each associated with increased glucose CV. In multivariable analysis, neither induction mean glucose nor glucose CV were associated with increased hazard of infection, relapse, or death.
Hodgkin Lymphoma in Children and Adolescents of Northern Greece: 25-Year Results and Long-term Follow-up
Authors: Kourti Maria , Papakonstantinou Eugenia , Papagianni Andromachi , Arsos George , Ioannidou Maria , Pantoleon Athina , Antari Vassiliki , Palabougiouki Maria , Kouskouras Konsatntinos , Venizelos Ioannis , Κoletsa Triantafyllia , Cheva Angeliki , Anastasiou Athanasia , Totikidis George , Tragiannidis Athanasios , Galli-Tsinopoulou Assimina , Hatzipantelis Emmanuel
Published: January 2023

Aim of this study was to evaluate the long-term therapeutic outcome and treatment-related complications in Hodgkin disease. We reviewed the medical records of 93 patients diagnosed with classic Hodgkin lymphoma, treated, and followed-up during the last 25 years. The cohort study included 49 males and 44 females with median age 11.8 years old (range: 3.95 to 17.42 y). The most common subtype was nodular sclerosis in 47/93 (50.5%). B symptoms were present in 15/93 (16.1%). From January 2009 until December 2020, 55 (59%) patients diagnosed with Hodgkin lymphoma were treated according to European Network for Pediatric Hodgkin Lymphoma (EURONET)-PHL-C1 protocol. Concerning outcome, a total of 89/93 patients are alive. Relapse occurred in 7/93. Second malignancies are reported in a total of 5 patients, 3 solid tumors (thyroid cancer, breast cancer, and osteosarcoma), and 2 acute myeloid leukemias. The overall survival and event-free survival for the whole cohort were 95.7% and 83.9%, respectively. Disease-free survival was 92.5%. Although a considerable high fraction of patients with Hodgkin disease can achieve continuous complete remission, they are at a high risk of developing long-term treatment-related complications. High curative rates as well as prevention of late effects can be achieved by implementation of individualized treatment strategies and innovative treatments.
Slow Binocular Reading in Amblyopic Children Is a Fellow Eye Deficit
Authors: Kelly Krista R. , Jost Reed M. , Hudgins Lindsey A. , Stager David R. , Hunter Jeffrey S. , Beauchamp Cynthia L. , Dao Lori M. , Birch Eileen E.
Published: January 2023

SIGNIFICANCE

Amblyopic children read 25% slower than their peers during binocular silent reading.

PURPOSE

We compared binocular reading to fellow eye reading to determine whether slow reading in amblyopic children is due to binocular inhibition; that is, the amblyopic eye is interfering during binocular reading.

METHODS

In a cross-sectional study, 38 children with amblyopia and 36 age-similar control children who completed grades 1 to 6 were enrolled. Children silently read grade-appropriate paragraphs during binocular reading and fellow eye reading while wearing ReadAlyzer eye-tracking goggles (Compevo AB, Stockholm, Sweden). Reading rate, number of forward saccades, number of regressive saccades, and fixation duration were analyzed between groups and between viewing conditions. We also examined whether sensory factors (amblyopia severity, stereoacuity, suppression) were related to slow reading.

RESULTS

For amblyopic children, binocular reading versus fellow eye reading did not differ for reading rate (176 ± 60 vs. 173 ± 53 words per minute, P = .69), number of forward saccades (104 ± 35 vs. 97 ± 33 saccades/100 words, P = .18), number of regressive saccades (21 ± 15 vs. 22 ± 13 saccades/100 words, P = .75), or fixation duration (0.31 ± 0.06 vs. 0.32 ± 0.07 seconds, P = .44). As expected, amblyopic children had a slower reading rate and more forward saccades than control children during binocular reading and fellow eye reading. Slow reading was not related to any sensory factors.

CONCLUSIONS

Binocular reading did not differ from fellow eye reading in amblyopic children. Thus, binocular inhibition is unlikely to play a role in slow binocular reading and is instead a fellow eye deficit that emerges from a disruption in binocular visual experience during development.
Clinical Predictors and Biomarkers in Children With Sepsis and Bacterial Meningitis
Authors: Castagno Emanuele , Aguzzi Sonia , Rossi Lorenza , Gallo Rachele , Carpino Andrea , Ricceri Fulvio , Urbino Antonio F. , Bondone Claudia
Published: January 2023

Objectives

Sepsis and meningitis in children may present with different clinical features and a wide range of values of inflammatory markers. The aim of this study was to identify the prognostic value of clinical features and biomarkers in children with sepsis and bacterial meningitis in the emergency department (ED).

Methods

We carried out a single-center, retrospective, observational study on 194 children aged 0 to 14 years with sepsis and bacterial meningitis admitted to the pediatric ED of a tertiary children's hospital through 12 years.

Results

Among epidemiological and early clinical features, age older than 12 months, capillary refill time greater than 3 seconds, and oxygen blood saturation lower than 90% were significantly associated with unfavorable outcomes, along with neurological signs (P < 0.05). Among laboratory tests, only procalcitonin was an accurate and early prognostic biomarker for sepsis and bacterial meningitis in the ED, both on admission and after 24 hours. Procalcitonin cut-off value on admission for short-term complications was 19.6 ng/mL, whereas the cut-off values for long-term sequelae were 19.6 ng/mL on admission and 41.9 ng/mL after 24 hours, respectively. The cut-off values for mortality were 18.9 ng/mL on admission and 62.4 ng/mL at 24 hours.

Conclusions

Procalcitonin, along with clinical evaluation, can guide the identification of children at higher risk of morbidity and mortality, allowing the most appropriate monitoring and treatment.
Anal Sphincter Defect and Fecal Incontinence
Authors: Mansi Sherief , Vaz Karla , Santucci Neha R. , El-Chammas Khalil , Graham Kahleb , Rosen Nelson G. , Kaul Ajay
Published: January 2023

Anal sphincter defects can lead to fecal incontinence. The relationship between the extent of defect and continence is controversial. Magnetic resonance imaging (MRI) of the pelvis can assess anal sphincter defects. Transrectal ultrasonography (TRUS) is used to assess sphincter integrity in adults. We present a 17-year-old male with history of sexual abuse, rectal prolapse, and fecal incontinence. MRI showed a small defect that did not explain his clinical presentation. TRUS identified more extensive defects which were not picked up by MRI. The patient had rectopexy, and his rectal prolapse and fecal incontinence resolved. TRUS was superior in identifying sphincter defects compared with MRI. Our case also highlights that continence is possible despite large sphincter defects in pediatric patients. This may reflect the compensatory mechanism of residual sphincter in the absence of the aggravating factors like rectal prolapse.
Time Is Money in Case of a Button Battery Ingestion
Authors: Bosschaert Charlotte , Van Renterghem Katrien , Van de Putte Dirk , Matthyssens Lucas , Vande Velde Saskia , De Bruyne Pauline , De Bruyne Ruth , Beel Emma , Van Biervliet Stephanie
Published: January 2023

Button battery (BB) ingestion is a preventable pediatric health hazard with important morbidity and mortality due to complications. We present 3 pediatric patients with a complicated course after BB ingestion and discuss current guidelines. Urgent endoscopic removal is necessary for every BB impacted in the esophagus. A new strategy before endoscopic removal is the administration of honey or sucralfate. During endoscopy, rinsing the esophageal mucosae with acetic acid can neutralize the alkalic environment and prevent late complications. Prevention of ingestion needs to be pursued by increasing awareness and changing legislation of packaging of BB.
Individual and Neighborhood Characteristics Associated With Confirmatory and Follow-up Blood Lead Testing Among Children With Elevated Blood Lead Levels
Authors: Chen Yeh-Hsin , Ma Zhen-qiang , Watkins Sharon M.
Published: January 2023

Objectives:

The aim of this study was to assess the proportions and likelihood of children who receive confirmatory and follow-up blood lead testing within the recommended time frames after an initial capillary elevated blood lead level (EBLL) and confirmed EBLL, respectively, by individual and neighborhood-level sociodemographic characteristics.

Design:

We linked and used blood testing and sociodemographic characteristics data from a Pennsylvania birth cohort including children born between 2017 and 2018. Generalized linear mixed models were constructed to examine the associations between sociodemographic factors and having recommended confirmatory and follow-up testing.

Setting:

A population-based, retrospective cohort study.

Participants:

In this birth cohort, children who underwent at least 1 BLL test were followed up to 24 months of age. Children with a first unconfirmed (n = 6259) and confirmed BLL (n = 4213) ≥ 5 μg/dL were included in the analysis.

Main Outcome Measure:

Children had confirmatory and follow-up testing within the recommended time frames.

Results:

Of the children with unconfirmed and confirmed EBLLs, 3555 (56.8%) and 1298 (30.8%) received confirmatory and follow-up testing, respectively. The proportions of the 2 outcome measures were lower among children experiencing certain sociodemographic disadvantages. In the univariate analyses, lower initial BLLs, older age, non-Hispanic Blacks, lower maternal educational levels, maternal Medicaid, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) enrollment, maternal smoking, and higher quartiles of neighborhood poverty and old housing were associated with lower odds of having confirmatory and follow-up testing. However, in multivariate models, children with lower initial BLLs, older age, maternal smoking, and non-Hispanic Blacks were significantly less likely to have confirmatory and follow-up testing.

Conclusions:

There were deficiencies in having recommended confirmatory and follow-up blood lead testing among children, especially those with sociodemographic disadvantages. Public health agencies and stakeholders should finetune policies to improve follow-up testing in conjunction with primary and secondary preventions for early detection and reduction of lead exposure among targeted children at risk of lead poisoning.
Oklahoma Tobacco Helpline Utilization and Outcomes by Diabetes Status
Authors: Martinez Sydney A. , Hasan Afsheen , Boeckman Lindsay M. , Beebe Laura A.
Published: January 2023

Context:

Diabetes and cigarette smoking are major causes of morbidity and mortality. Individuals with type 2 diabetes (T2D) who smoke are at an increased risk of smoking- and diabetes-related morbidity and mortality.

Objective:

We examined utilization patterns, satisfaction, and tobacco cessation outcomes among persons with T2D to determine whether the Oklahoma Tobacco Helpline is an equally effective intervention for tobacco users with T2D compared with those without diabetes.

Design:

This study was a retrospective cohort design using registration and follow-up data from a state tobacco quitline.

Setting:

We examined Oklahoma Tobacco Helpline registration data from July 2015 to June 2021 to compare Helpline utilization among individuals who self-reported a previous diagnosis of T2D compared with those not reporting a diagnosis of diabetes.

Participants:

Oklahoma Tobacco Helpline registrants enrolled in a call program, either the single- or multiple-call program, who reported diabetes status at baseline. We compared tobacco use history, program enrollment, and services received for individuals self-reporting T2D with those without diabetes.

Main Outcome Measures:

We compared 30-day point-prevalence abstinence at 7 months and evaluated program satisfaction.

Results:

Registrants with T2D were more likely to receive a higher intensity of services including the number of coaching calls and the amount of nicotine replacement therapy. At 7-month follow-up, 32.3% of registrants with T2D and 35.1% of those without diabetes reported 30-day point-prevalence abstinence, but the differences were not statistically significant.

Conclusions:

While findings demonstrate similar effectiveness, more research is needed to better understand why the prevalence of tobacco use remains high among individuals with T2D and how to improve cessation in this population.
Evaluation of “Care Plus,” A Multidisciplinary Program to Improve Population Health for Patients With High Utilization
Authors: Valente Jessica , Bundy Richa , Martin Melanie , Palakshappa Deepak , Dharod Ajay , Rominger Robert , Feiereisel Kirsten
Published: January 2023

With rising health care costs, health systems have adopted alternative care models targeting high-need, high-cost patients to improve chronic disease management and population health. Intensive primary care teams may reduce health care utilization by tackling medical and psychosocial needs specific to this patient population. This study presents health care utilization trends from a high-intensity primary care program that employs a multidisciplinary team (including clinicians, psychologists, pharmacists, chaplaincy, and community health workers) and community partnerships. Using descriptive statistics and Poisson rates of differences, this study evaluates patient and utilization characteristics of those enrolled (n = 341) versus declined (n = 54) program participation from 2013 to 2020. Both enrolled and declined patients experienced significant reduction in emergency department and inpatient utilization, but differences between enrolled and declined patients were not statistically significant. Programs aimed at decreasing health care utilization for high-need, high-cost, medically complex patients may be best supported by interventions that simultaneously address social and behavioral health needs.
18F-FDG PET/CT of a Rare Sternal Osteoblastoma in a Man With History of Lymphoma
Authors: Liang Jie , Huang Wen-Shan , Lan Wen-Zhen , Li Yong , Xu Jie-Hua
Published: January 2023

A 27-year-old man, with a history of non-Hodgkin lymphoma 8 years ago, was admitted due to 9 months of persistent sternal pain. Chest CT revealed a mass in the sternum. 18F-FDG PET/CT was performed, demonstrating a radioactive accumulation mass in the sternum, accompanied by massive osteogenesis and osteolysis. Histological and immunohistochemical analysis of ultrasound-guided fine-needle aspiration biopsy samples confirmed the diagnosis of aggressive osteoblastoma. We present a rare case of aggressive sternal osteoblastoma, instead of lymphoma recurrence, on 18F-FDG PET/CT in an adult with history of lymphoma.
Clinical Observation of Microplasma Radiofrequency Technology Combined With Glucocorticoid Injection in the Treatment of Hundreds of Cases of Hypertrophic Scar After Early Deep Burn and Scald
Authors: Qu Chun’an , Su Xueshang , Hu Jintian , Zhan Sien , Li Zehui , Liu Yue , Wang Lianzhao
Published: January 2023

Background:

To investigate the clinical efficacy and safety of microplasma radiofrequency technology combined with glucocorticoid injection in the treatment of hypertrophic scarring after early deep burns and scalding.

Methods:

A total of 150 patients with hypertrophic scars after early deep burns from June 2018 to June 2021 were randomly divided into 3 groups, with 50 cases in each group. The patients were treated with compound betamethasone injection (Group A), microplasma radiofrequency technique (Group B), and compound betamethasone injection combined with microplasma radiofrequency technology (Group C). Each course of treatment included 5 standard treatments, and they were performed 6 weeks apart. Each patient was analyzed using the Vancouver scar scale and visual analogy scale after each treatment. The results were compared over time and across groups using repeated measurement analysis of variance.

Results:

A total of 138 patients in these 3 groups completed this study. As treatment continued, the Vancouver scar scale value of Group C decreased more rapidly than that of Group A and Group B, and the difference was statistically significant (P<0.05). In the improvement of scar pain and itching, there was little difference between Group C and Group A (P>0.05), but both were better than Group B, and the difference was statistically significant (P<0.05). Regarding the incidence of adverse reactions, there was little difference between Group C and Group B (P>0.05), but the incidence of adverse reactions was lower than that of Group A, and the difference was statistically significant (P<0.05).

Conclusion:

Microplasma radiofrequency combined with glucocorticoid injection in the treatment of hypertrophic scarring after early deep burns is effective, safe, and has a low incidence of adverse reactions, and it merits clinical promotion.
Taylor–Couette and related flows on the centennial of Taylor’s seminal
Philosophical Transactions
paper: part 1
Authors: Lueptow Richard M. , Hollerbach Rainer , Serre Eric
Published: January 2023

In 1923, the
Philosophical Transactions
published G. I. Taylor’s seminal paper on the stability of what we now call Taylor–Couette flow. In the century since the paper was published, Taylor’s ground-breaking linear stability analysis of fluid flow between two rotating cylinders has had an enormous impact on the field of fluid mechanics. The paper’s influence has extended to general rotating flows, geophysical flows and astrophysical flows, not to mention its significance in firmly establishing several foundational concepts in fluid mechanics that are now broadly accepted. This two-part issue includes review articles and research articles spanning a broad range of contemporary research areas, all rooted in Taylor’s landmark paper.

This article is part of the theme issue ‘Taylor–Couette and related flows on the centennial of Taylor’s seminal
Philosophical Transactions
paper (part 1)’.
Analysis of physicochemical properties and antioxidant activities
of commercial tteokbokki sauce in Korea
Authors: Oh Geon , Lim June Seok , Cho Geun-hee , Choi Sun-Il , Han Xionggao , Men Xiao , Lee Se-Jeong , Jung Sang Mi , Kwon Min Hee , Song Yeong Rae , Lee Ok-Hwan , Ra Moon Jin
Published: January 2023

This study investigated the physicochemical properties (total soluble solid,
salinity, pH, Hunter color value, moisture content, and viscosity), total
dietary fiber (TDF) content, free sugar content, and antioxidant activities
(total flavonoid content, total phenolic content, and DPPH and ABTS radical
scavenging activities) of 11 types of commercial tteokbokki
sauce products in Korea. The pH values of the tteokbokki sauce
products were 4.62-5.83, total soluble solids were 34.60-59.40 °Brix, and
salinities were 2.89-5.77%. The lightness (L), redness (a), and yellowness (b)
of the Hunter color value were 23.94–43.08, 4.32–22.49, and 1.67–19.88,
respectively. The moisture contents in the tteokbokki sauce
products were in the range of 27.73-53.20% and the viscosity values were
373.57–7,246.33 cP. The TDF contents determined by enzymatic-gravimetric method
were in the range of 0.64–4.47 g/100 g, and the free sugar contents of the
tteokbokki sauce products were 13.45-32.87 g/100 g. The
eleven types of tteokbokki sauce products all contained
fructose, glucose, and sucrose. The total flavonoid and phenolic contents of the
tteokbokki sauce products were 0.12-0.36 mg RE/g and
1.14-1.82 mg GAE/g, respectively. The DPPH and ABTS radical scavenging
activities of the tteokbokki sauce products were 32.98-87.41%
and 18.45-74.72%, respectively. Pearson correlation analysis revealed that the
total phenolic and flavonoid content, as well as the DPPH and ABTS radical
scavenging activities were positively correlated (r=0.651-0.918) with the
antioxidant activities. These results provide basic data for commercial
tteokbokki sauce in Korea.