bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic resonance imaging target fusion biopsy vs. transrectal ultrasound-guided biopsy - A comparative study of ISUP score upgrading risk in the ﬁnal radical prostatectomy specimen
Authors: Guimarães Thiago , Gil Miguel , Medeiros Mariana , Andrade Vanessa , Guerra João , Pinheiro Hugo , Fernandes Francisco , Pina João , Lopes Dias João , Campos Pinheiro Luís
Published: September 2022

Objectives: The aim of this study was to com-pare the risk of International Society of Urological Pathology (ISUP) score upgrading between magnetic resonance imaging targeted fusion biopsy (MRI-TB) and tran-srectal ultrasound-guided biopsy (TRUS-B) in the ﬁnal radical prostatectomy (RP) specimen pathological report.Materials and methods: This retrospective single center study included 51 patients with prostate cancer (PCa) diagnosed with MRI-TB and 83 patients diagnosed with TRUS-B between October/2019 and July/2021. We compared the rates of ISUP score upgrading between both groups after robotic-assisted radi-cal prostatectomy (RARP) and the speciﬁc transition of each ISUP score based on biopsy modality. The rate of ISUP score concordance and downgrading were also assessed. To deﬁne the intra and interobserver concordance for each ISUP score in biopsy and RP specimen for each biopsy modality, the Cohen’s Kappa coefﬁcient was calculated. ISUP scores and biopsy modal-ity were selected for multivariate analysis and a logistic regres-sion model was built to provide independent risk factors of ISUP score upgrading.Results: The difference of the rate of upgrading between MRI-TB group and TRUS-B group was statistically signiﬁcant (p = 0.007) with 42.2% of patients of TRUS-B group experiencing an upgrade in their ISUP score while only 19.6% in MRI-TB group. Concordance and downgrading rates did not statistically differ between the two groups. Strength of concordance using Cohen’s Kappa coefﬁcient was fair in both groups but higher in MRI-TB group (TRUS-B group k = 0.230; p < 0.001; concordance: 47%vs. MRI/TB group k = 0.438; p < 0.001; concordance: 62.7%). Biopsy modality and ISUP 1 on biopsy were independent predic-tors of ISUP upgrading after RP.Conclusions: MRI-TB is highly accurate with lower risk of PCa upgrading after RP than TRUS-B. Patients with ISUP 1 on biopsy have greater susceptibility to upgrading their ISUP score.
A consensus-based approach on the management of patients with both psoriasis and psoriatic arthritis in the dermatological and rheumatological settings in Italy: The ADOI PSO-Amore Project
Authors: Cusano Francesco , Sampogna Francesca , Brunasso Vernetti Alexandra Maria Giovanna , Stisi Stefano , Sandri Gilda , Malara Giovanna , Naldi Luigi , Pellegrino Michele , Tripepi Giovanni Luigi , Di Luzio Paparatti Umberto , Agnusdei Concetto Paolo , Bonifati Claudio , Celano Antonella , Corazza Valeria , D'Agostino Federica , De Pasquale Rocco , Filippucci Emilio , Foti Rosario , Galdo Giovanna , Gai Fabiana , Ganzetti Giulia , Graceffa Dario , Maccarone Mara , Mazzotta Annamaria , Melchionda Gennaro , Molinaro Francesca , Paoletti Franco , Tonolo Silvia , Vercellone Adriano , Vitetta Rosetta , Massone Cesare , Sebastiani Gian Domenico
Published: September 2022

Psoriasis is a complex disease often needing a multidisciplinary approach. In particular, the collaboration between dermatologist and rheumatologist is crucial for the management of patients suffering from both psoriasis (PSO) and psoriatic arthritis (PsA). Here we report a series of recommendations from a group of experts, as a result of a Consensus Conference, defining the circumstances in which it is preferable or even mandatory, depending on the available settings, to rely on the opinion of the two specialists, jointly or in a deferred manner. Indications are given on how to organize a 3rd level joint Dermatology- Rheumatology care unit, in connection with 1st and 2nd level clinicians of both specialties, GPs, and other specialists involved in the management of psoriasis. A potential patient journey is suggested, that can be used as a basis for future design and validation of national and/or local diagnostic therapeutic and assistance pathways.
Mechanical Thrombectomy in Acute Ischemic Stroke
Authors: Rajan Jayadevan E , Kannath Santhosh K , Sabarish Sekar , Arun K , P Varma P Ravi , Sreedharan Sapna E , Sukumaran Sajith , Sylaja PN
Published: September 2022

Background:

In patients with acute ischemic stroke with large vessel occlusion, various angiographic features are important in patient selection and predicting outcome.

Objective:

We evaluated angiographic features like collaterals, clot burden score, angiographic recanalization, number of passes, and intracranial atherosclerotic disease (ICAD) with the functional outcome at 90 days.

Materials and Methods:

This was a retrospective analysis of prospectively collected data of 163 patients with acute ischemic stroke with large vessel occlusion who underwent mechanical thrombectomy within 24 hours of symptom onset. Angiographic data were reviewed blinded to clinical data. The outcome was defined as modified Rankin scale (mRS) at 90 days (good outcome mRS ≤2)

Results:

The median age of patients was 60 years and 34.4% were females. The median National Institutes of Health Stroke Scale (NIHSS) and Alberta Stroke Programme Early CT Score (ASPECTS) at admission were 17 and 6, respectively. On bivariate analysis, ASPECTS was >6, clot burden score was ≥7, recanalization of TICI was ≥2b, absence of ICAD, showed a positive correlation with the good outcome at 90 days (P-values of 0.003, 0.0001, and 0.03, respectively). Multiple attempts of device passes were associated with poor recanalization (P = 0.001) and it was seen more in ICAD patients. On multivariate analysis, independent predictors of poor outcome were clot burden score <7 (P = 0.043) and TICI score <2b (P = 0.048). Out of 41 patients (26%) with ICAD, 29 had a poor outcome at 90 days.

Conclusion:

Lower clot burden and less degree of recanalization were associated with poor outcome in acute ischemic stroke due to Large vessel occlusion (LVO). The presence of ICAD also predicted poor outcome.
Postoperative Early Lumbar Drainage Can Reduce the Duration of Fever or Infection in Patients with Complicated Intracranial Tumors after a Long Operation Time
Authors: Wu Yingxi , Zhang Yunze , Wu Yang , Zhu Gang , Xue Yafei , Qu Yan , Zhao Tianzhi
Published: September 2022

Background:

Intracranial fever or infection is one of the common complications after craniotomy, especially for complicated intracranial tumors such as deep skull base tumors.

Objective:

We used early cerebrospinal fluid (CSF) drainage with a preplaced lumbar drainage (LD) tube after surgery and observed whether this procedure could reduce the rate and duration of fever or infection.

Material and Methods:

The authors conducted a retrospective study of 142 patients who underwent complicated intracranial tumor surgery with no less than four hours of dural opening at the Center of Neurosurgery of Tangdu Hospital. The LD group underwent preoperative LD placement, intraoperative CSF release and postoperative continuous drainage, but the control group received routine craniotomy without preoperative LD. The primary outcomes included the rate, duration, and hospital length of stay (LOS) for patients with fever or infection after surgery, as compared between the two groups. The second outcome included complications related to LD and the rate of postoperative CSF leakage.

Results:

There were 22 patients in the LD group and 23 patients in the control group who presented with delayed fever, which was supposed to be caused by intracranial infection or aseptic inflammation. The median duration of delayed fever in the LD group was obviously lower than that in the control group (7.762 ± 3.129 days vs 11.73 ± 5.239 days), and there was a statistically significant difference (P = 0.0046). In addition, there was a significant reduction in the median postoperative LOS (12 [8,10,15,21] days in the LD group vs 15 [9,13,20,28] days in the controls). Moreover, there was no significant difference in complications related to LD between the two groups. Three patients with brain herniation were observed in the LD group compared with one patient in the control group. All four patients had contemporary mild-to-moderate neurologic disorders after surgery or conservative treatment. Additionally, the rate of CSF leakage in the LD group was 5.41% (4/74), which was lower than that in the control group (8/68, [11.76%]), although there was no significant difference (P = 0.174).

Conclusions:

For patients receiving complicated intracranial lesions following a long operation time, postoperative early LD was beneficial for the treatment of patients with fever or infection. It not only reduced the duration of infection or fever in postoperative patients but also decreased the postoperative LOS. We should minimize the complications related to LD by careful and standardized LD and management processes, and ensure the effectiveness and safety of this treatment.
Using Multiple Logistic Regression to Determine Factors Affecting Delaying Hospital Arrival of Patients with Acute Ischemic Stroke
Authors: Amani Firouz , Fattahzadeh-Ardalani Ghasem , Sharghi Afshan , Jafarizadeh Raana
Published: September 2022

Background:

Early treatment of ischemic stroke patients who arrive at the hospital ≤4.5 hours after the onset of symptoms with recombinant tissue plasminogen activator is more beneficial and very important.

Objective:

This study is aimed to investigate the factors delaying the hospital arrival of patients with acute ischemic stroke by using multiple logistic regression analysis.

Methods and Materials:

This descriptive cross-sectional study was done on patients diagnosed with acute ischemic stroke who were referred to Ardabil city Training and Research hospital at 2018. All patients and/or patient relatives were interviewed and data were collected through a checklist including demographic and clinical data of patients to explore the involved factors delaying hospital arrival of patients and then analyzed using multiple logistic regression analysis.

Results:

Of all included patients, only 25.3% arrived at the hospital in ≤ 4.5 hours. By using multivariate logistic regression analysis, living in cities (P = 0.007), cigarette consumption (P = 0.032), having valvular heart disease (P = 0.008), and gender (P = 0.049) were factors associated with an early arrival to the hospital.

Conclusions:

Results showed that most of the patients had a considerable delay in arriving at the hospital in ≤ 4.5 hours. Thus, providing health promotion strategies to improve society awareness of early symptoms of stroke, training of local physicians about the importance of early arrival of stroke patients, and more extended ambulance services in all cities and rural areas are necessary for better management of acute stroke patients in this area.
FTY720 Attenuates Cerebral Vasospasm After Subarachnoid Hemorrhage Through the PI3K/AKT/eNOS and NF-κB Pathways in Rats
Authors: Kuai Feng , Zhou Jianping , Qiu Yuchen , Gao Yang
Published: September 2022

Cerebral vasospasm (CVS) is a major complication of subarachnoid hemorrhage (SAH). Inflammation and nitric oxide (NO) have become increasingly recognized as key pathogenic contributors to brain injury in this condition. We aimed to examine the role of FTY720 in CVS after SAH. Endovascular perforation was used to establish an SAH model. Seventy-five male Sprague–Dawley rats were randomly divided into five groups: sham, sham + FTY720, SAH + saline, and two SAH + FTY720 (0.5 and 1 mg/kg) groups. The results showed that FTY720 treatment in both the surgery and nonsurgery groups decreased the counts of leukocytes and lymphocytes 72 hours after SAH. TNF-α (tumor necrosis factor alpha) and IL-1β (interleukin 1 beta) in both the cerebrospinal fluid (CSF) and the hippocampus were decreased, and the NF-κB (nuclear factor kappa B) pathway was inhibited. The levels of apoptotic proteins were downregulated. FTY720 promoted NO generation by activating the PI3K/AKT/eNOS pathway. CVS and neurological deficits in the SAH rats were ameliorated after FTY720 treatment. Compared with the sham-only animals, FTY720 treatment in the nonsurgery group did not increase mortality. These results indicated that FTY720 could alleviate CVS due to its anti-inflammatory and antiapoptosis effects and the promotion of NO generation. FTY720 may be effective in the clinical treatment of SAH patients.
Determination of Predictors of Brain Injury in Very Preterm Infants – A Retrospective Cohort Study
Authors: Abiramalatha Thangaraj , Devi Usha , Nagaraj Suhas , Ramya Gurujala Mahadeva , Tangirala Susmitha , Chandrasekaran Ashok
Published: September 2022

Background:

Despite decades of research, there is inadequate evidence on the etiological factors of brain injury in preterm infants.

Objective:

To study the perinatal risk factors for preterm brain injury and to assess their strength of association.

Methods:

In this retrospective cohort study, we included infants born at <32 weeks' gestation and had either magnetic resonance imaging (MRI) or cranial ultrasound (CUS) performed at term equivalent age. Significant brain injury was diagnosed based on Kidokoro global brain injury score was ≥4 in MRI or cystic periventricular leukomalacia in CUS.

Results:

Among the 698 infants, 48 had significant brain injury and 650 were taken as controls. In multiple logistic regression, intraventricular hemorrhage (IVH) grade 3-4 [adjusted odds ratio, 92.892 (19.495-442.619)], culture-positive sepsis [4.162 (1.729-10.021)], prolonged ventilation [3.688 (1.087-12.510)], and small for gestational age (SGA) [2.645 (1.181-5.924] were associated with greater risk of preterm brain injury.

Conclusion:

Severe IVH, culture-positive sepsis, prolonged ventilation and SGA were significant risk factors for preterm brain injury with severe IVH being the most significant contributing factor.
”PTFE Sleeve Graft” Technique to Remove Neurovascular Conflict in Micro Vascular Decompression for Trigeminal Neuralgia
Authors: Sinha Ajit K. , Jain Shrey , Vyas Medha A. , Krishnankutty Muralikrishnan
Published: September 2022

Background:

Microvascular decompression (MVD) of the trigeminal nerve is a well-accepted nondestructive procedure for trigeminal neuralgia. Usually, Teflon (PTFE) puff or felt graft techniques, which are most commonly used, are associated with arachnoiditis and recurrence among other complications. We use the “sleeve graft” technique using PTFE to separate the neurovascular conflict and here we describe our experience with the same in 376 cases.

Objectives:

To study the outcomes in 376 patients treated with sleeve graft technique for trigeminal neuralgia.

Materials and Methods:

For a period of 18 years, from 2002 to 2020, all cases of medically refractory trigeminal neuralgia were subjected to the “sleeve graft” technique for MVD. Pre- and post-operatively, pain score was given according to Barrow Neurological Institute pain intensity score. Cases were observed for any complications and pain relief in short and long-term follow-up.

Results:

In total, 376 cases of refractory primary trigeminal neuralgia cases, among which 198 patients underwent MVD with no prior intervention, 158 underwent MVD following percutaneous ablative procedure, 13 were “Revision MVD” previously done at other centers, and four were post gamma knife failure. There was no incidence of arachnoiditis or recurrence of symptoms. Further, 368 (97.8%) patients had complete recovery from symptoms while eight (2.2%) had partial recovery after 5 years of follow-up. Complications included hearing loss (n = 1), temporary hypoesthesia (n = 45), and permanent hypoesthesia (n = 7).

Conclusion:

“PTFE Sleeve Graft” technique to remove the neurovascular conflict in micro vascular decompression (MVD) for trigeminal neuralgia is a safe and effective technique that yields better results.
Radiological Evaluation of Anatomical Extensions of Gliomas Based on White Fiber Tracts
Authors: Shah Abhidha , Vutha Ravikiran , Goel Atul
Published: September 2022

Background:

We speculate on the origin and extensions of gliomas based on our understanding of anatomy of the subcortical network, radiological evaluation and surgical experience.

Objective:

We recently classified the white fibers of the brain into four horizontal and one vertical group. The role of this classification in understanding the origin and spread of gliomas is analyzed.

Materials and Methods:

A series of 220 consecutive radiological images of patients with low and high grade gliomas were retrospectively evaluated. The classification discussed was applied to these images to study the location and direction of growth of the gliomas.

Results:

Our results identify that gliomas arise and spread along a named white fiber tract and displace the adjoining tracts. Gliomas that arose from arcuate fibres either remained limited to a gyrus or extended to the adjacent gyri along the course of the arcuate fibres. Gliomas arising from the LAF spread in the direction of the affected tract. Gliomas arising from the CF tended to involve both the hemispheres and extended across the midline.

Conclusion:

This radiological evaluation of gliomas correlated well with our proposed anatomical classification of white fibers. Gliomas probably originate in the fiber tract and grow along its extension. The adjoining fiber tracts form a reliable barrier to its spread. The surgical implication of the understanding is outlined in brief here and evaluated in details in part B of this study.
Effect of the Non-N-Methyl-D-aspartate Receptor of the Glutamatergic System of the Pedunculopontine Tegmental Nucleus on Cardiovascular Responses in Normotensive and Hydralazine-Induced Hypotensive Rats
Authors: Hosseiniravesh Mohammad Reza , Hojati Vida , Mohebbati Reza , Khajavirad Abolfazl , Shajiee Hooman , Shafei Mohammad Naser
Published: September 2022

Background:

Glutamate is an important excitatory neurotransmitter in the pedunculopontine tegmental (PPT) nucleus. The cardiovascular effect of glutamate and its non-N-methyl-D-aspartate (NMDA) receptor in the PPT is unknown; therefore, we evaluated glutamate and its non-NMDA receptor on cardiovascular parameters in normotensive and hypotensive induced by hydralazine (HLZ) in rat.

Materials and Methods:

After anesthesia, the femoral artery was cannulated for recording of cardiovascular parameters. Microinjection of drugs was done stereotaxically. L-Glutamate (L-Glu) and 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) (an antagonist of nonNMDA receptor) were microinjected into the PPT in normotensive and HLZ hypotensive rats. Changes (Δ) of mean arterial pressure (MAP), systolic blood pressure (SBP), and heart rate (HR) were obtained and compared with the control group.

Results:

In normotensive rats, L-Glu significantly increased SBP and MAP (P < 0.001) and decreased HR (P < 0.01), whereas CNQX alone did not significantly effect. Coinjection L-Glu + CNQX significantly attenuates the cardiovascular effect of L-Glu (P < 0.05 to P < 0.01). In hypotension induced by HLZ, SBP and MAP significantly decrease but HR did not change. In HLZ groups, L-Glu significantly improves (P < 0.05) and CNQX deteriorated hypotension induced by HLZ (P < 0.05). Coinjection of L-Glu + CNQX also attenuates the effect of L-Glu on Δ MAP and Δ SBP. In hypotension, ΔHR induced by L-Glu was significantly higher than CNQX (P < 0.01). In L-Glu + CNQX group, ΔHR also was lower than L-Glu (P < 0.05).

Conclusion:

Our findings revealed that glutamatergic system of the PPT in both normotensive and hypotension induced by HLZ plays a pressor with bradycardic responses that partly mediated by non-NMDA receptor.
EPIYA Motif Genetic Characterization from Helicobacter pylori Isolates in Distinct Geographical Regions of Iran
Authors: Estaji Fatemeh , Nasr Esfahani Bahram , Zibaee Saeed , Sanei Mohammad Hossein , Moghim Sharareh
Published: September 2022

Background:

This study aimed to determine the current EPIYA motifs of the cagA gene in Helicobacter pylori isolates from patients with gastric disorders, and evaluate the association between these patterns and the clinical outcome of H. pylori infection in different geographical regions of Iran.

Materials and Methods:

We examined 150 patients with gastrointestinal disorders from the central and eastern regions of Iran. The detection of H. pylori and screening of cagA was performed by polymerase chain reaction (PCR). The pattern of the motifs was determined by PCR followed by sequencing.

Results:

The overall prevalence of H. pylori was 66.3% in eastern (Mashad) and 50.6% in the central (Isfahan) part of Iran. The frequency of cagA-positive strains in Mashad and Isfahan were 63.4% and 56.7%, respectively. The pattern of EPIYA motif was as follows: 43 (79.6%) ABC, 7 (12.9%) AB, 4 (7.4%) ABCC, and one (1.9%) ABCCC. We also identified a novel EPIYA C sequence motif which showed association with gastric cancer (GC). The relationship between the frequency of specific EPIYA motifs and GC was statistically significant (P < 0.05).

Conclusions:

This is the first report for the determination of the cagA EPIYA motif of H. pylori in the Northeast and center of Iran. The prevalence of cagA positive H. pylori between the two regions was significant (P ≤ 0.05). All isolates of the H. pylori cagA were western type (ABC). The increase in the number of EPIYA-C repeats was associated with GC (P ≤ 0.01).
Linking Farmers' Perception of Biodiversity, Subjective Well-being and Conservation in the Tandilia System in the Southern Pampas of Argentina
Authors: De Rito Mara , Auer Alejandra , Mikkelsen Claudia , Herrera Lorena
Published: September 2022

Much research has focused on the study of society-nature relations, guided by people's perception of nature, well-being and environmental behaviour in relation to this interplay. The perception of farmers on these topics has been less explored, but it is fundamental to enquire into this issue in order to understand the decisions they make in their production units and how these decisions influence their environment. This research explored the link between farmers' perception of biodiversity, their subjective well-being, and conservation practices in the Tandilia System in the Southern Pampas of Argentina. The information obtained from semi-structured interviews with farmers was analysed through Thematic Analysis. Potential associations between farmers' perceptions of biodiversity, subjective well-being and land management practices were investigated. Although most farmers were aware that agricultural practices negatively affect biodiversity and that contact with nature generates well-being, inconsistent narratives were noted when they talked about their own practices. Their awareness of biodiversity and well-being does not necessarily translate into more sustainable practices.

Abstract in Spanish: https://bit.ly/3zy5pq8
Exploring a Comprehensive Behavioural Model to Investigate Illegal Sea Turtle Trade in Cabo Verde
Authors: Ribeiro Morgan Casal , Patino-Martinez Juan , Agues Janete , Marçal-Correia Alexandra , Nuno Ana
Published: September 2022

Successful conservation outcomes often depend on changing human behaviours that negatively impact biodiversity, such as unsustainable wildlife harvesting or illegal wildlife trade (IWT). However, inclusive psychology models that examine motivations of those behaviours have been underutilised in IWT contexts. This research examines the drivers of illegal harvesting and consumption of sea turtles on Maio, Cabo Verde (West Africa), by adapting data from interviews (n=20) and questionnaires (n=325) into the Comprehensive Action Determination Model, an environmental psychology theoretical framework. Initial findings suggest local behavioural motivations have changed over time, but key beliefs remained intact. Structural equation modelling showed intention to consume turtles is influenced by positive attitudes towards consumption, but interviews suggest normative personal and social beliefs are becoming relevant to consumptive behaviour mitigation. The same seems true of harvesting, reportedly performed mostly by young men looking to sell turtle by-products. Overall, results indicate the beliefs underlying harvest and consumption behaviours are distinct, such that outreach initiatives must be designed to address each. Results demonstrate how conceptual models developed in underutilised disciplines can be adapted to expand the transdisciplinary tools available to conservation practitioners. Embracing behaviour-focused approaches is crucial to address the intricate cultural and contextual factors of IWT.

Abstract in Portuguese: https://bit.ly/3Aj9xuu
Relationship between Dermatitis and Joint Replacement
Authors: Jung Joon Woo , Son Minkook , Jeong Soo Hyun , Kim Kwang Joong , Kim Kwang Ho , Park Eun Joo
Published: September 2022

Background:

Joint replacement is an important surgery for replacing a damaged joint with prosthesis. Implants used for joint replacement are made of metal, plastic, and ceramic. Skin reactions, such as dermatitis, can occur due to a hypersensitivity to these external substances.

Aims:

The aim of this study was to find the relationship between joint replacement and dermatitis.

Methods:

A nationwide population-based retrospective cohort study was performed using the National Health Insurance Service Database of the Republic of Korea. A total of 40,218 patients who underwent joint replacement were enrolled as the operation group and 40,218 controls were also enrolled. A cox proportional hazard regression model, and Fine and Gray regression model were used to compare the risk of dermatitis between the two groups.

Results:

Dermatitis occurred in 9.2% of the operation group and 9.1% of the control group, and no statistical difference was observed between the two groups. According to the Cox proportional hazard regression model, and Fine and Gray regression model, the risk of dermatitis did not increase in the operation group compared to that in the control group. However, the risk of dermatitis increased 1.20-fold in the operation group compared to that in the control group aged <60 years according to the Fine and Gray regression model (95% confidence index (CI) = 1.05–1.37, P = 0.0008). Conversely, no difference in dermatitis risk was observed between the two groups aged ≥60 years.

Conclusions:

We found that the risk of dermatitis increased after joint replacement in those aged <60 years.
A Comparative Study of the Efficacy of Intralesional 5 Fluorouracil vs Combination of 5 Fluorouracil with Triamcinolone Acetonide in Keloids
Authors: Monteiro Rochelle C , Bhat M Ramesh , Martis Jacintha , Kamath H Ganesh
Published: September 2022

Context:

Keloids are defined as scars that invade the adjacent tissues and rarely regress. In recent years, antimitotic drugs have been used in the management of keloids with promising results. This study highlights the effectiveness of 5-fluorouracil (5-FU) in keloids.

Aims:

To study the efficacy of intralesional 5-FU in keloids as a solo agent and in combination with triamcinolone acetonide and to study the side effects of both the drugs.

Methods and Materials:

A total of 30 patients with keloids were randomly allocated into two groups. Group A received 50 mg/mL of 5-FU intralesionally. Group B patients received a combination of 40 mg/mL of intralesional triamcinolone acetonide and 50 mg/mL of 5-FU. The patients were observed for immediate and delayed complications and the treatment was continued for a total of 3 months.

Statistical Analysis Used:

ANOVA, Mann–Whitney test, Fisher's test, Chi-square test.

Results:

The patients in both groups showed a significant reduction in the size and thickness of the lesions. The reduction in the length of keloid was highly significant in both the groups but in comparison, there was no statistically significant difference in the reduction of lesions among both the groups. Hence, both modalities of treatment can be claimed to be equally efficacious. The therapeutic response was good to excellent in most patients with only one patient opting out of the therapy in the 5-FU group due to the inability to tolerate the pain. The common side effects noted were pain, itching, ulceration, burning sensation, and bulla formation.

Conclusions:

5-FU, both as a single agent or in combination with steroids is equally efficacious in reducing the keloid size. The side effects are lesser with the combination group.
A Clinico-Demographic Profile and Sexual Behaviour Pattern in Attendees of Designated STI/RTI Clinic Having Sexually Transmitted Infections with Special Reference to HIV Seropositivity
Authors: Datta Jayanti , Patra Aparesh C. , Ghosh Arghyaprasun , Roy Sudipta , Das Nilay K.
Published: September 2022

Introduction:

The dynamics of sexually transmitted infections (STIs) are influenced by sexual behaviour (age of first sexual exposure, number of sexual partner/s, sexual orientation, mode of intercourse, addiction, occupation, correct and consistent use of condom). The presence of the human immunodeficiency virus (HIV) influences the clinical pattern of STIs and the course of disease too.

Objective:

Our study was conducted to find the prevalence of STIs among attendees of a designated STI/RTI clinic (DSRC) with the description of clinico-demographic profile and sexual behaviour and association of HIV seropositivity with STIs.

Methods:

Ours was an institution-based cross-sectional study conducted at DSRC after obtaining ethics committee approval and consent from patients. Clinical diagnosis, demographic profile and sexual history were obtained after maintaining audio-visual privacy.

Statistical Analysis:

Medcalc, version 10.2 was used.

Results:

Among 167 patients attending DSRC during the study period, 76 having sexual dysfunctions were excluded. The major STIs diagnosed were primary syphilis (6.59%), secondary syphilis (2.2%), herpes genitalis (42.86%), condyloma acuminata (26.37%), molluscum contagiosum (5.49%), genital candidiasis (7.69%), bowenoid papulosis (3.3%), genital scabies (4.4%) and chancroid (1.1%). Sexual orientations were heterosexual (64.83%), lesbian (1.1%), gay (12.1%), bisexual (17.58%) and with an animal partner (4.4%). Among the total study population, 8.8% was rapid plasma reagin (RPR) reactive and 12.1% was Integrated Counselling and Testing Centre (ICTC) reactive. Among the total patients who used condoms (n = 49), only 15 (16.4% of total participants) used condoms correctly and consistently. Peno-vaginal mode of intercourse (n = 78) was found to be most common followed by oro-insertive (n = 42), oro-receptive (n = 34), ano-insertive (n = 24), ano-receptive (n = 17) and digital insertion (n = 20).

Conclusion:

Sexual behaviour influences the disease outcome in patients with reproductive tract infection (RTI)/STI.
The Clinical Phenotypes of Cutaneous Leishmaniasis in Central and Southwest Regions of Yemen
Authors: Muthanna Ahlam M. , Malhomme Helena D. , Schwartz Robert A. , Al-Qubati Yasin A.
Published: September 2022

Background:

Cutaneous leishmaniasis (CL) is endemic in Yemen. CL displays a spectrum of typical and atypical morphologies yet understudied in the central and southwest regions of Yemen.

Aims and Objectives:

To identify the typical and atypical clinical phenotypes of CL in the central and southwest regions of Yemen.

Materials and Methods:

A survey of 145 patients who visited Prof. Al-Qubati Clinic in Taiz between 2010 and 2015, was conducted.

Results:

Children and residents of the rural areas were at high risk of exposure to the insect vector. The typical phenotype was single (67%), facial (58%) and ulcerated nodule (35%). Other usual phenotypes were small ulcers (21.4%) and non-ulcerative papules and nodules (21%). Unusual phenotypes constituted 12% of the cohort and included psoriasiform, eczematous, erysipeloid, lupoid, verrucous, large ulcerative, leishmania recidivens, satellite, granulomatous infiltrative and hyperkeratotic plaques. Mucous membrane involvement was evident in 10.6% and was also polymorphic.

Conclusion:

CL has many morphologic patterns in central and southwest regions of Yemen, some are clinically deceptive.
Assessment of Mucosa-Associated Epithelial Chemokine, Thymus-Expressed Chemokine, Periostin and Zonulin Levels in Infants With Atopic Dermatitis
Authors: Koksal Burcu Tahire , Zengin Hatice Yagmur , Ozbek Ozlem Yılmaz
Published: September 2022

Background:

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Skin and gut are the organs that first encounter antigens and environmental triggers. The mechanisms behind the relation between skin and gut immune responses in AD have not been identified yet.

Aims and Objectives:

To investigate mucosa-associated epithelial chemokine (MEC/CCL28), thymus-expressed chemokine (TECK/CCL25), periostin and zonulin levels in infants with AD.

Materials and Methods:

Children under one year old participated in the study. We used a propensity matching score. We included 39 infants who had active AD lesions at the time of evaluation. Serum MEC/CCL28, TECK/CCL25, periostin and zonulin levels were measured.

Results:

We examined age and sex matched 39 infants with AD and 39 healthy infants. Median value of zonulin was lower in infants with AD [49.2 (27.1–71.8) ng/mL] compared to healthy controls [58.5 (27.3–80.8) ng/mL] (P < 0.001). Infants with zonulin levels ≤55.15 ng/mL had 11.64 times more risk of developing AD than the infants with zonulin levels >55.15 ng/mL. Infants whose MEC/CCL28 levels were ≥8.3 ng/mL had 5.83 times more risk of developing AD than the infants with MEC levels <8.3 ng/mL. Duration of AD and SCORAD index score did not show correlation with MEC/CCL28, TECK/CCL25, periostin and zonulin levels.

Conclusion:

Low zonulin levels and high MEC/CCL28 levels in infants may show an increased association with AD.
Schwannoma in the Buccal Mucosa-An Unusual Presentation
Authors: Anekar Jayaprasad , Kumar Krishna S. , Baipadavu Jayalakshmi , Supriya H , John Ivin E.
Published: September 2022

Intraoral schwannomas are rare benign neural neoplasm that originates from the Schwann cells of the peripheral nerves and present as asymptomatic, solitary, slow-growing, submucosal mass and their occurrence is seen in the second-third decade of life. The most favored intraoral sites are the tongue, palate, buccal mucosa, floor of the mouth, gingiva, and lips. Histopathological examination with immunohistochemistry is the gold standard for the diagnosis. As malignant transformation and recurrence rate is rare, surgical excision is the preferred treatment. This article provides an insight into a rare case of schwannoma of the buccal mucosa with a review of the literature.
Electronic Cigarettes Use and Pharmacological Strategies as an Intervention for Tobacco Cessation
Authors: Nagi Ravleen , Muthukrishnan Arvind , Reddy Sujatha S. , Nagaraju Rakesh
Published: September 2022

Tobacco use is a single leading preventable cause of death worldwide. It contains nicotine, which is one of the most addictive psychoactive drugs; thus, successful quitting becomes a challenging process. Occupation has a profound influence on tobacco use patterns, and in the majority of scenarios, users are unable to achieve abstinence to maintain the need for the psychoactive effect of nicotine to cope up with job stresses and to remain energetic. Various tobacco cessation aids are available with variable success rates. Electronic cigarettes (e-cigarettes) or vaping has become popular, particularly in Western Countries and among occupational workers as they contain less harmful chemicals than combustible cigarettes and can help heavy smokers to quit the habit. Reports of short- and long-term health effects of vaping have currently led to a ban on the production, manufacturing, and advertising of e-cigarettes. Pharmacological interventions such as bupropion and varenicline have been proven to provide long-term abstinence; however, neuropsychiatric side effects limit their use. This paper focusses on the hypothesis that whether the electronic nicotine delivery system (ENDS) or vaping and pharmacological interventions are an effective tobacco cessation interventions.
Evaluation of Patterns of Mandibular Bone Invasion in CBCT of Patients with Oral Squamous Cell Carcinoma
Authors: Shenoy Prashanth , Archana P , Chatra Laxmikanth , Veena KM , Prabhu Rachana V. , Shetty Prathima
Published: September 2022

Background:

One of the crucial factors in the pretreatment analysis of patients with oral squamous cell carcinoma (OSCC) is the detection of the presence of bony invasion. This will indicate aggressiveness, and its patterns may also express the conduct of the lesion. The extent of bony invasion by the tumor will alter the treatment planning and increases the morbidity rate and quality of life.

Aim:

To evaluate the mandibular invasion patterns in cone beam computed tomography (CBCT) of patients with OSCC.

Methodology:

A total of 31 CBCT images of OSCC involving the mandible with bony invasion were included and assessed for various invasion patterns. Bony invasion is classified into three patterns: erosive, infiltrative, and mixed.

Results:

Descriptive analysis was carried out to assess the frequency among various bony invasion patterns. Chi-square test was carried out to find significance between the inferior alveolar nerve canal (IANC) involvement among various patterns of OSCC, which found be to be highly significant.

Conclusion:

Erosive pattern is the common pattern observed and the mixed pattern was the most frequently associated pattern with the IANC involvement.
Critical illness color-coded warning stickers
Authors: Prasad V. S. V. , Basha Shaik Jilani , Dayal Anjul
Published: September 2022

Background:

Pediatric visits to children's hospitals are mostly outpatient and emergency room (ER) based. In busy outpatient departments (OPD) and ERs, children are reviewed quickly, and instructions are given to parents for management at home. Communication from physicians to the parents of the child may be deficient and incomplete, due to the high workload and other priority tasks. The purpose of this study was to assess the utility of simple color-coded information stickers for the OPD/ER file of the child for parents to recognize danger signs in their child to seek help early again if required.

Subjects and Methods:

This is a prospective observational study conducted on 1036 children in the age group of 1 month–18 years at a tertiary care hospital in Telangana state of India, for 1 year from January 2018 to January 2019.

Results:

Fifty-three of the patients were male, and the majority of them were in the 1–5-year age group. The perceived utility of the stickers was 85.3% in the affirmative. Only 14.7% felt they were not useful. Reasons for revisits to the ER/OPD were fever (33%), respiratory causes (37.7%), gastroenteritis causes (18%), head injury (9%), and epistaxis (1.5%).

Conclusions:

A simple color-coded sticker system used in busy OPDs and ERs in children's hospitals might prove to be a low-cost-effective communication tool for parents to utilize to recognize danger signs and report back for care when necessary.
Incidence of new morbidity based on Functional Status Scale in children on discharge from pediatric intensive care unit of a developing country
Authors: Haque Anwarul , Bhatti Shoaib , Ahmed Saira A , Muhammad I Zafar
Published: September 2022

Background:

Recently, short-term outcome among survival of children from pediatric intensive care unit (PICU) is assessed using the Functional Status Scale (FSS). New morbidity was defined as an increase in FSS score of ≥3 points from baseline to discharge from PICU. The objective of the study was to assess the incidence of newly acquired morbidity based on FSS in children on discharge from PICU.

Subjects and Methods:

A cross-sectional retrospective study was conducted on children (1 month–15 years) who were discharged alive from PICU from November 2021 to January 2022. The functional status was evaluated using FSS on the 1st day of admission and discharge from PICU to measure newly acquired morbidity.

Results:

Of a total of 200 patients, 155 patients were included in the study. The mean age was 3.79 ± 3.76 years, and 63.2% (98) were male. The mean PRISM score was 12.99 ± 5.22. The most common diagnostic categories were acute respiratory illnesses (41.3%) and infectious diseases (23.2%). The median FSS was 6.00 on admission, and the mean FSS on discharge was 7.02 ± 2.22. The incidence of morbidity was 12.2% (19/155). Young children and children with neurological diseases were highly associated with new morbidity in critically ill children on discharge from PICU. However, there was no statistical significance. The mortality rate was 11.5% during the same period.

Conclusions:

The incidence of new morbidity in critically ill pediatric patients at PICU discharge was 12.2%. Young age and children with neurological diseases were at high risk for new morbidity. Most of the patients (>94%) were discharged with good functional status.
Acute myocardial infarction post-gastrointestinal bleeding
Authors: Su Xin , Li Junlei , Du Lijuan , Wei Yuzhen , Li Haiyu , Sang Haiqiang
Published: September 2022

Background:

Gastrointestinal bleeding (GIB) complicating acute myocardial infarction (AMI) is a severe clinical condition with treatment contradiction and poor prognosis. This study aimed to evaluate the rate of in-hospital mortality in patients with GIB who subsequently suffered from AMI and to explore the potential risk factors for this condition.

Methods:

In this retrospective study, a total of 77 patients diagnosed with GIB, who subsequently suffered from AMI, were enrolled from January 2013 to March 2022. Demographic, laboratory, and clinical data were collected. The in-hospital mortality was the outcome of interest. Logistic regression analysis was used to investigate the potential risk factors of in-hospital mortality.

Results:

Among the 77 patients included in this study, 62 (80.52%) were males. The mean age of patients was 65.88 ± 12.15 years, and 48 patients (62.34%) were non-ST-segment elevation myocardial infarction (NSTEMI). There were 16 (20.78%) cases of in-hospital deaths. The subjects who died showed higher levels of white blood cell count (13.05 ± 5.76 vs. 9.31 ± 4.07 × 109/L, P = 0.003) and troponin I (TnI) (9.23 ± 9.17 vs. 4.12 ± 5.03 μg/L, P = 0.003). Besides, there were higher proportions of cardiogenic shock (81.25% vs. 26.23%, P < 0.001) and mechanical ventilator usage (75.0% vs. 11.48%, P < 0.001) among the patients who died. The multivariate logistic regression analysis showed that white blood cell count (odds ratio [OR] 1.19, 95% confidence interval [CI] 1.02–1.39, P = 0.030), cardiogenic shock (OR 12.18, 95% CI 3.06–48.39, P = 0.017), and mechanical ventilator usage (OR 7.21, 95% CI 1.28–40.51, P = 0.025) were independently associated with in-hospital mortality.

Conclusions:

The in-hospital mortality of patients with GIB who subsequently develop AMI is high. White blood cell count, cardiogenic shock, and mechanical ventilator usage are independent predictors of in-hospital mortality.
О суммируемых решениях одного класса нелинейных интегральных уравнений на всей прямой
Authors: Khachatryan Khachatur Aghavardovich , Petrosyan Haykanush Samvelovna
Published: September 2022

В работе исследуется один класс нелинейных интегральных уравнений с некомпактным монотонным оператором Гаммерштейна-Немыцкого на всей числовой прямой. Данный класс уравнений находит широкое применение в различных областях естествознания. В частности, такие уравнения возникают в математической биологии и в теории переноса излучения. Доказывается конструктивная теорема существования неотрицательного нетривиального суммируемого и ограниченного решения. Изучается также асимптотическое поведение решения на $\pm\infty$. В конце работы приведены конкретные примеры указанных уравнений, удовлетворяющие всем условиям доказанной теоремы существования. В одном важном частном случае удается также доказать теорему единственности в определенном классе существенно ограниченных функций.
Библиография: 13 наименований.
Модификация конструкции Пуанкаре и ее применение в $CR$-геометрии гиперповерхностей в $\mathbf{C}^4$
Authors: Beloshapka Valerii Konstantinovich
Published: September 2022

Обобщение гомологического оператора Пуанкаре - модифицированная конструкция Пуанкаре - ранее была использована для оценки размерности группы локальных автоморфизмов произвольного ростка вещественно аналитической гиперповерхности пространства $\mathbf{C}^3$. В настоящей работе для гиперповерхности в $\mathbf{C}^4$ доказана следующая альтернатива: либо эта размерность бесконечна, либо она не превосходит $24$-х. При этом $24$ реализуется лишь для невырожденной гиперквадрики (одной из двух). Если гиперповерхность $2$-невырождена в точке общего положения, то оценку можно улучшить до $17$, а если $3$-невырождена, то до $20$.
Библиография: 18 наименований.
О проблеме делителей Карацубы
Authors: Iudelevich Vitalii Victorovich
Published: September 2022

В работе получена верхняя оценка для суммы $\Phi_a(x) = \sum_{p\leqslant x}1/(\tau(p+a))$ при $x\to +\infty$, где $\tau(n)$ - функция делителей, $a\geqslant 1$ - фиксированное целое число, а $p$ пробегает подряд идущие простые числа.
Библиография: 14 наименований.
Colonization Dynamics of LBK Farmers in Europe under Geostatistics Test
Authors: Brigand Robin , Dubouloz Jérôme , Weller Olivier
Published: September 2022

Exploiting a database developed during a previous research project, this study uses factor analyses, GIS techniques and basic geostatistics to evaluate in detail the agro-ecological determinants of the first Neolithic diffusion in continental temperate Europe (the Linearbandkeramik or LBK), as well as its underlying settlement dynamics around half a millennium (5550–4925 BCE). More than 6600 LBK site locations, spread from Moldavia to Normandy, are initially assessed for their informative coherence and ability to offer a unified perspective on the evidence established at more local and regional levels. Most of these data can be used to define the broad geo-pedological options involved in the location of sites across Europe; loess substrate was far from being an exclusive settlement choice and a variety of soils, typically of medium moisture, were exploited. LBK farmers thus had a great capacity to adapt to the different geographical contexts they encountered. With regard to settlement dynamics in Central and Western Europe, the data reveal a systemic interplay between creation, stability and abandonment of sites, supporting the diffusion of the LBK subsistence system. The progressive decline in the number of new sites was compensated by an increase in their stability until the last stage of the expansion process. At this point, abandonments became widespread without significant renewal, except in the westernmost regions. The easternmost parts of Europe could not be integrated in the large-scale temporal modelling, since the chronological data available in the database are insufficiently precise. Shedding new light on the systemic variability of the geo-environmental options followed by these early farmers and highlighting some modalities and spatial-temporal limits of the resilience of their agro-sylvo-pastoral system, our overall analysis confirms and somewhat clarifies current interpretations of the LBK phenomenon.