bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Vitamin D Receptor Gene Polymorphisms with Serum Vitamin D Levels in a Greek Rural Population (Velestino Study)
Authors: Divanoglou Natalia , Komninou Despina , Stea Eleni A. , Argiriou Anagnostis , Papatzikas Grigorios , Tsakalof Andreas , Pazaitou-Panayiotou Kalliopi , Georgakis Marios K. , Petridou Eleni
Published: June 2021

Background/Aim: An alarming increase in vitamin D deficiency even in sunny regions highlights the need for a better understanding of the genetic background of the vitamin D endocrine system and the molecular mechanisms of gene polymorphisms of the vitamin D receptor (VDR). In this study, the serum levels of 25(OH)D3 were correlated with common VDR polymorphisms (ApaI, BsmI, FokI, and TaqI) in 98 subjects of a Greek homogeneous rural population. Methods: 25(OH)D3 concentration was measured by ultra-HPLC, and the VDR gene polymorphisms were identified by quantitative real-time PCR followed by amplicon high-resolution melting analysis. Results: Subjects carrying either the B BsmI (OR: 0.52, 95% CI: 0.27–0.99) or t TaqI (OR: 2.06, 95%: 1.06–3.99) allele presented twice the risk for developing vitamin D deficiency compared to the reference allele. Moreover, subjects carrying 1, 2, or all 3 of these genotypes (BB/Bb, Tt/tt, and FF) demonstrated 2-fold (OR: 2.04, 95% CI: 0.42–9.92), 3.6-fold (OR: 3.62, 95% CI: 1.07–12.2), and 7-fold (OR: 6.92, 95% CI: 1.68–28.5) increased risk for low 25(OH)D3 levels, respectively. Conclusions: Our findings reveal a cumulative effect of specific VDR gene polymorphisms that may regulate vitamin D concentrations explaining, in part, the paradox of vitamin D deficiency in sunny regions, with important implications for precision medicine.
Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis
Authors: Urrunaga-Pastor Diego , Chambergo-Michilot Diego , Runzer-Colmenares Fernando M. , Pacheco-Mendoza Josmel , Benites-Zapata Vicente A.
Published: June 2021

Introduction: Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. Methods: We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Results: Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, I2: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, I2: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, I2: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. Conclusions: The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.
Epiploic Appendagitis: A Riddle for Right Lower Quadrant Pain!
Authors: Bains Lovenish , Bahadur Akshay , Lal Pawan , Bhatia Rahul , Singh Nirmala , Kaur Daljit
Published: June 2021

Epiploic appendagitis (EA) is inflammation of epiploic appendages, which are pedunculated fatty structures, extend from the cecum to the rectosigmoid junction, and are covered by the peritoneum. Torsion, infarction, and inflammation of it present with acute lower abdominal pain and localized tenderness in a well-looking patient. It poses as diagnostic conundrum due to its rarity and not picked by conventional radiography. A 50-year-old male presented with pain in RLQ for past 1 day, which kept on increasing without any other symptoms. His abdomen was soft with tenderness localized to the right lower quadrant (RLQ), classically at McBurney’s point along with mild peritonism. Rest laboratory test, chest, and abdominal X-ray were normal except slight leukocytosis. Ultrasound was inconclusive. A working clinical diagnosis of appendicitis was made. Patient did not consent for surgery and was started on antibiotics with pain killers. With no significant improvement, he underwent CT scan which revealed focal area of soft-tissue attenuation along the lateral wall of ascending colon with fat stranding. He was diagnosed as EA and improved on conservative treatment. EA of RLQ of abdomen mimics acute appendicitis and can be considered as an uncommon differential diagnosis in presence of radiological findings of normal-appearing appendix. CT is the investigation of choice, and treatment is essentially conservative. Further, if appendix is found normal at exploration, surrounding epiploic appendages of the cecum and ascending colon should also be evaluated carefully for inflammation/hematoma/gangrene, besides looking for Meckel’s diverticulum.
Clinical Exome Sequencing Enables Congenital Sialidosis Type II Diagnosis in Two Siblings Presenting with Unreported Clinical Features from a Rare Homozygous Sequence Variant p.(Tyr370Cys) in NEU1
Authors: Flores-Contreras Elda Ariadna , García-Ortiz José Elías , Robles-Espinoza Carla Daniela , Zomosa-Signoret Viviana , Becerra-Solano Luis Eduardo , Vidaltamayo Román , Castaneda-García Carolina , Esparza-García Eduardo , Molina-Aguilar Christian , Hernández-Orozco Angélica Alejandra , Córdova-Fletes Carlos
Published: June 2021

Sialidosis is a rare autosomal recessive disease that presents with progressive lysosomal storage of sialylated glycopeptides and oligosaccharides caused by homozygous or compound heterozygous sequence variants in the neuraminidase 1 (NEU1) gene. These sequence variants can lead to sialidosis type I and II; the latter is the most severe and presents prenatally or at early age. However, sialidosis diagnosis is challenging, especially in those health systems with limited resources of developing countries. Consequently, it is necessary to dip into high-throughput molecular diagnostic tools to allow for an accurate diagnosis with better cost-effectiveness and turnaround time. We report a 4-member pedigree segregating an ultrarare missense variant, c.1109A>G; p.Tyr370Cys, in NEU1 as detected by whole-exome sequencing. Two short-lived siblings, who presented with previously unreported clinical features from such a homozygous sequence variant, were diagnosed with sialidosis type II. Additionally, we present a novel molecular model exhibiting the consequences of the variant in the sialidase-1 tridimensional structure. This study allowed us to provide a definitive diagnosis for our patients, increase our understanding of this pathogenic variant, and improve genetic counseling.
Tissue Transglutaminase Impairs HTR-8/SVneo Trophoblast Cell Invasion via the PI3K/AKT Signaling Pathway
Authors: Cheng Mi , Liu Zequn , Ji Wanqing , Zheng Jie , Zeng Huiqian , Guo Fang , He Ping
Published: June 2021

Objectives: The pathogenesis of preeclampsia (PE) is associated with impaired trophoblast invasion, which results in placental insufficiency. Our earlier studies demonstrated that tissue transglutaminase (tTG) is highly expressed in human PE serum. However, whether tTG participates in trophoblast invasion remains unclear. The aim of the present study was to determine the role and mechanism of tTG in regulating matrix metalloproteinase (MMP)-2/MMP-9 expression to reduce trophoblast invasiveness in PE. Methods: HTR-8/SVneo cells were transfected with a lentivirus vector and small interfering RNA targeting tTG. The protein level was detected by Western blotting. Cell proliferation and apoptosis were assessed by MTS and flow cytometry assays, respectively. Cell invasion was investigated by Transwell assay. In addition, the influence of tTG on PI3K and AKT mRNA levels in HTR-8/SVneo cells was evaluated using reverse transcription-quantitative PCR. Results: tTG-overexpression inhibited HTR-8/SVneo cell proliferation and invasion and promoted apoptosis. In addition, upregulation of tTG induced an increase of PI3K and phosphorylated AKT and a decrease of MMP-2 and MMP-9 expression. tTG-knockdown significantly promoted the proliferation and invasion of HTR-8/SVneo cells and inhibited the apoptosis. Furthermore, the PI3K expression level was reduced, and the MMP-2/MMP-9 protein levels were increased. Conclusion: Taken together, the present study demonstrated that tTG-overexpression inhibited HTR-8/SVneo cell invasion via reducing the expression of MMP-2 and MMP-9 by activating PI3K/AKT signaling pathway, which may lead to the occurrence or development of PE. The present data provide new insights into modulation of tTG expression as a potential therapeutic target for PE.
B-Cell Lymphoblastic Lymphoma in Relapse Presenting as a Uterine Mass: A Case Report and Review of Literature
Authors: Abou Chakra Rim , Najib Bernard , Abdallah Wael , Akiki Mira , El Khoury Lea , Atoui Ali , Moubarak Malak , Atallah David
Published: June 2021

B-cell lymphoblastic lymphoma (LBL) is a highly aggressive malignant proliferation of lymphoblasts of B-origin grouped with acute lymphoblastic leukemia. Multiple studies demonstrated the various sites of involvement in adult LBL. The involvement of the uterus as a site of relapse for such disease is rare. We herein report the case of relapsed B-cell LBL mimicking endometrial sarcoma. The patient is a 56-year-old female patient known to have B-cell LBL on chemotherapy. She presented with abdominal pain and fever. Positron emission tomodensitometry-computed tomography showed the presence of a uterine mass with bilateral iliac lymph node involvement. She underwent surgery with mass removal and pathology showed relapsed B-cell LBL.
Bilateral Distal Clavicle Nonunion: A Case Report
Authors: Guenbdar Mouad , Bennani Mourad , Cherrad Taoufik , Zejjari Hassan , Louaste Jamal , Amhajji Larbi
Published: June 2021

Bilateral clavicle nonunion is extremely rare (4 published cases), and no case of bilateral distal clavicle nonunion has been reported in the literature. We present the case of a 75-year-old patient followed up for chronic obstructive pulmonary disease, presenting a bilateral fracture of the distal clavicle type “Neer 1” following a road traffic accident and orthopedically treated. After 1 year, the patient complained of mild pain at both shoulders occasionally in cold weather and during an unusual effort without neurovascular symptom associated. The shoulder radiographs showed bilateral distal clavicle nonunion. We chose a conservative treatment because of the mild symptomatology, advanced age, and limited functional demands. The functional outcome was satisfactory. The therapeutic decision in the treatment of the bilateral distal clavicle nonunion is difficult, whereas the therapeutic indications are based on symptomatology, functional impairment, age, comorbidities, and functional demands.
A Scoping Review of Current Guidelines on Dietary Fat and Fat Quality
Authors: Schwingshackl Lukas , Zähringer Jasmin , Beyerbach Jessica , Werner Sarah S. , Nagavci Blin , Heseker Helmut , Koletzko Berthold , Meerpohl Joerg J. ,   on behalf of the International Union of Nutritional Sciences (IUNS) Task force on Dietary Fat Quality
Published: June 2021

Introduction: We conducted a scoping review of dietary guidelines with the intent of developing a position paper by the “IUNS Task force on Dietary Fat Quality” tasked to summarize the available evidence and provide the basis for dietary recommendations. Methods: We systematically searched several databases and Web sites for relevant documents published between 2015 and 2019. Results: Twenty documents were included. Quantitative range intake recommendations for daily total fat intake included boundaries from 20 to 35% of total energy intake (TEI), for monounsaturated fat (MUFA) 10–25%, for polyunsaturated fat (PUFA) 6–11%, for saturated-fat (SFA) ≤11–≤7%, for industrial trans-fat (TFA) ≤2–0%, and <300–<200 mg/d for dietary cholesterol. The methodological approaches to grade the strength of recommendations were heterogeneous, and varied highly between the included guidelines. Only the World Health Organization applied the GRADE approach and graded the following recommendation as “strong”: to reduce SFA to below 10%, and TFA to below 1% and replace both with PUFA if SFA intake is greater than 10% of TEI. Conclusion: Although the methodological approaches of the dietary guidelines were heterogeneous, most of them recommend total fat intakes of 30–≤35% of TEI, replacement of SFA with PUFA and MUFA, and avoidance of industrial TFA.
Novel Compound Heterozygous Mutation c.3955_3958dup and c.5825C>T in the ATM Gene: Clinical Evidence of Ataxia-Telangiectasia and Cancer in a Peruvian Family
Authors: Rodriguez Richard S. , Cornejo-Olivas Mario , Bazalar-Montoya Jeny , Sarapura-Castro Elison , Torres-Loarte Mariela , Rivera-Valdivia Andrea , Sullcahuaman-Allende Yasser
Published: June 2021

Pathogenic and likely pathogenic variants in the ATM gene are associated both with Ataxia-telangiectasia disease or ATM syndrome and an increased cancer risk for heterozygous carriers. We identified a novel compound heterozygous mutation c.3955_3958dup (p.Asp1320delinsValTer) and c.5825C>T (p.Ala1942Val) in the ATM gene in a Peruvian patient with progressive ataxia combined with other movement disorders, mild conjunctival telangiectasia and increased alpha-fetoprotein, without history of recurrent infection or immunodeficiency. We also determined the carrier status of the family members, and we were able to detect gastric and breast cancer at an early stage during the cancer risk assessment in the mother (c.3955_3958dup). Here, we describe clinical evidence for the novel compound heterozygous mutation and c.3955_3958dup not previously reported.
Extracorporeal Albumin Dialysis in Liver Failure with MARS and SPAD: A Randomized Crossover Trial
Authors: Wallon Grégoire , Guth Cécile , Guichon Céline , Thevenon Sylvie , Gazon Mathieu , Viale Jean-Paul , Schoeffler Mathieu , Duperret Serge , Aubrun Frédéric
Published: June 2021

Introduction: Liver failure is associated with hepatic and extrahepatic organ failure leading to a high short-term mortality rate. Extracorporeal albumin dialysis (ECAD) aims to reduce albumin-bound toxins accumulated during liver failure. ECAD detoxifies blood using albumin dialysis through an artificial semipermeable membrane with recirculation (molecular adsorbent recirculating system, MARS) or without (single-pass albumin dialysis, SPAD). Methods: We performed a randomized crossover open trial in a surgical intensive care unit. The primary outcome of the study was total bilirubin reduction during MARS and during SPAD therapies. The secondary outcomes were conjugated bilirubin and bile acid level reduction during MARS and SPAD sessions and tolerance of dialysis system devices. Inclusion criteria were adult patients presenting liver failure with factor V activity <50% associated with bilirubin ≥250 μmol/L and a complication (either hepatic encephalopathy, severe pruritus, or hepatorenal syndrome). For MARS and SPAD, the dialysis flow rate was equal to 1,000 mL/h. Results: Twenty crossovers have been performed. Baseline biochemical characteristics (bilirubin, ammonia, bile acids, creatinine, and urea) were not statistically different between MARS and SPAD. Both ECAD have led to a significant reduction in total bilirubin (−83 ± 67 μmol/L after MARS; −122 ± 118 μmol/L after SPAD session), conjugated bilirubin (−82 ± 61 μmol/L after MARS; −105 ± 96 μmol/L after SPAD session), and bile acid levels (−64 ± 75 μmol/L after MARS; −56 ± 56 μmol/L after SPAD session), all nondifferent comparing MARS to SPAD. Conclusion: A simple-to-perform SPAD therapy with equal to MARS dialysate flow parameters provides the same efficacy in bilirubin and bile acid removal. However, clinically relevant endpoints have to be evaluated in randomized trials to compare MARS and SPAD therapies and to define the place of SPAD in the liver failure care program.
A Case of Pulmonary Adenocarcinoma Presenting with Diffuse Cystic Lesions
Authors: Adrian Benjamin , Priou Pascaline , Cadranel Jacques , De Chabot Gonzague , Rousselet Marie-Christine , Urban Thierry , Gagnadoux Frédéric
Published: June 2021

The main causes of diffuse cystic lung diseases include lymphangioleiomyomatosis, pulmonary Langerhans cell histiocytosis, Birt-Hogg-Dubé syndrome, lymphoid interstitial pneumonia, light chain deposition disease, Pneumocystis jirovecii pneumonia, hypersensitivity pneumonitis, and desquamative interstitial pneumonia. Diffuse cystic lung diseases are rarely caused by a malignant process, which are secondary to metastases from sarcomas and gastrointestinal and gynecologic adenocarcinomas. Here, we present a rare case of invasive pulmonary adenocarcinoma associated with progressive diffusion of cystic lesions, revealed by chronic cough and progressive shortness of breath. It is important for clinicians to be aware of this unusual imaging manifestation of lung cancer, to avoid misdiagnoses.
Sirolimus for the Management of Verrucous Venous Malformation: A Case Report and Literature Review
Authors: Al-Furaih Ibrahim , Al-Marzoug Alanoud , Al-Qadri Nada , Al-Ajlan Saad
Published: June 2021

Verrucous venous malformation (VVM) is a vascular malformation that is rarely reported in the literature which has vascular and hyperkeratotic components affecting mainly the extremities, difficult to treat, and often associated with complications mainly bleeding, ulceration with secondary infections, and limitation of movement. In this article, we report a successful improvement of VVM with sirolimus.
Complex Chromosome-Positive Acute Myelogenous Leukemia Identified 16 Months following the Completion of Capecitabine Chemotherapy for Early-Stage Colon Cancer
Authors: Jaruhathai Sureerat , Phornvoranunt Uraree , Wannasirikul Waran
Published: June 2021

Capecitabine is an oral chemotherapy that is used to treat several cancer types, including breast, gastrointestinal, hepatobiliary, and ovarian. The use of antimetabolites in cancer therapy has generally not been associated with leukemogenesis. In this report, we demonstrate a case of capecitabine-related acute myeloid leukemia that was diagnosed 16 months after the completion of treatment for early-stage colon cancer, by a complex chromosome analysis 48,XY,6,del(7)(q22),+8,+13,t(13;17)(q12;p13),t(13,21)(q12;122),+mar [Gazi Med J. 2018 Jan;29(1):57–58]. This is the first report to our knowledge of the development of t-AML in a patient with early-stage colon cancer that was caused by capecitabine. We should use capecitabine with caution. Further studies are essential to investigate capecitabine-triggered leukemogenesis.
Establishment of Rat Models of Different Pathological Types of Hypersensitivity Pneumonitis Using Pigeon Droppings
Authors: Li Yafang , Lian Zhichuang , Wang Wenyi , Niu Zongxin , Ding Wei , Wu Chao , Yang Xiaohong
Published: June 2021

Background: The pathogenesis and pulmonary histopathological characteristics of hypersensitivity pneumonitis (HP) are not yet fully understood. Therefore, we established animal models of HP of different stages, aiming to provide support for research on this disease. Methods: We established rat models of pigeon breeder’s lung of different pathological types by creating freeze-dried allergen powder from fresh pigeon feathers, dander, and other droppings. Freeze-dried allergen powder suspensions of pigeon droppings were used to establish 2 rat models of HP, one by aerosol inhalation and one by airway instillation, and the rats were sacrificed after different lengths of time to observe the pathological changes in their lung tissues. Results: By the 40th week after allergen inhalation, granulomas were the main changes in the model, without fibrotic changes. When using airway instillation to establish the model, at the 20th week, group 1 (low dose + twice/week) and group 2 (medium dose + twice/week) showed granuloma changes, but no fibrosis; group 3 (high dose + once/week) and group 4 (high dose + twice/week) both showed obvious pulmonary fibrotic changes, but the death rate of rats in group 4 was greater. Conclusions: Both aerosol inhalation and airway instillation of freeze-dried pigeon allergen powder can successfully establish an HP model. The airway instillation method can cause pulmonary fibrotic changes in a short time, and the pulmonary pathological changes of animal models manifest with an obvious time-dose effect.
Pretreatment Positron Emission Tomography with 18F-Fluorodeoxyglucose May Be a Useful New Predictor of Overall Prognosis Following Lenvatinib Treatment
Authors: Kawamura Yusuke , Kobayashi Masahiro , Shindoh Junichi , Kobayashi Yuta , Okubo Satoshi , Muraishi Nozomu , Iritani Soichi , Fujiyama Shunichiro , Hosaka Tetsuya , Saitoh Satoshi , Sezaki Hitomi , Akuta Norio , Suzuki Fumitaka , Suzuki Yoshiyuki , Ikeda Kenji , Arase Yasuji , Hashimoto Masaji , Kumada Hiromitsu
Published: June 2021

Background and Aim: The aim of this study was to identify the utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) as a predictor of overall prognosis in patients with hepatocellular carcinoma treated with lenvatinib. Methods: Forty-eight consecutive patients who received lenvatinib treatment were reviewed. The oncological aggressiveness of tumors estimated using 18F-FDG-PET/CT was investigated by the analysis of progression-free survival (PFS), post-progression survival (PPS), and overall survival (OS). Multivariate analysis was used to identify potential confounders for OS during lenvatinib therapy. Results: Using the Modified Response Evaluation Criteria in Solid Tumors, a tumor-to-normal liver ratio (TLR) ≥2, indicating higher oncological aggressiveness in HCCs, was associated with a better objective response to lenvatinib than a TLR <2 (78 vs. 62%), resulting in a similar PFS (p = 0.751). Because of a significantly worse PPS, OS with a TLR ≥2 was poor compared to a TLR < 2 (p = 0.012). Multivariate analysis confirmed that a TLR ≥ 2 was associated with poor OS (hazard ratio, 2.709; 95% CI, 1.140–6.436; p = 0.024). Analysis of 24 patients who received a repeat 18F-FDG-PET/CT showed that daily changes expressed as ΔTLR × 103/day over the treatment course tended to be different among the types of subsequent treatment. A R0 resection and lenvatinib-TACE sequential therapy provided good disease control (median, −4.593 and −0.024, respectively) compared with other treatments (median, 5.278) (p = 0.075). Conclusion: Lenvatinib has acceptable disease control regardless of estimated tumor differentiation. A high TLR (≥2) is a poor prognostic factor of OS following lenvatinib treatment, while ΔTLR × 103/day provides useful information of disease control status.
A High Masticatory Muscle Tone Predicts the Risk of Malnutrition and Frailty in Inpatient Older Adults: A Cross-Sectional Study
Authors: Shih Yin-Hwa , Hong Zhen-Rong , Hsia Shih-Min , Yang Shang-Yu , Shieh Tzong-Ming
Published: June 2021

Introduction: The prevalence of malnutrition among inpatient older adults is as high as 20∼50%. Masticatory performance is known to affect the nutritional status of individuals. However, an objective measurement to reflect the real status of masticatory muscle performance is lacking at the bedside. Methods: This pilot study analyzed the masticatory performance using surface electromyography (sEMG) of masticatory muscles that measures both muscle strength and muscle tone at the bedside. The nutritional status was measured using the Mini Nutritional Assessment tool. The handgrip strength was measured using a hand dynamometer. The statistical data were analyzed using SPSS 25 software. Results: The data revealed that female inpatient older adults more frequently had substandard handgrip strength (p = 0.028), an at-risk and poor nutritional status (p = 0.005), and a higher masseter muscle tone (p = 0.024). Inpatient older adults with an at-risk and poor nutritional status had an older age (p = 0.016), lower handgrip strength (p = 0.001), and higher average masseter muscle tone (p = 0.01). A high masseter muscle tone predicted the risk of having an at-risk and poor nutritional status. The at-risk or poor nutritional status predicted having a substandard handgrip strength by 5-fold. Conclusions: A high masticatory muscle tone predicts malnutrition and frailty. Medical professionals should combat masticatory dysfunction-induced malnutrition by detecting masticatory muscle performance using sEMG and referring patients to dental professionals. Additionally, encouraging inpatient older adults to perform oral motor exercise is recommended.
Colonic Metastasis of Primary Lung Cancer
Authors: Bhutta Salman Idrees , Ahmed Yasar , Zahid Talal , Rehman Habib ur , Nur Mutaz M. , Mahmood Tariq , Calvert Paula
Published: June 2021

The colon is an uncommon secondary site for metastasis of lung adenocarcinoma. Distinguishing primary colonic carcinoma from metastatic spread of lung carcinoma can be difficult. We present a case of a patient with lung adenocarcinoma who, on abdominal computed tomography scan examination, was found to have a sigmoid tumor that was thought to represent a synchronous primary colorectal adenocarcinoma. Histological examination of endoscopic sigmoid tumor biopsies confirmed this to be metastasis from the lung adenocarcinoma. The patient subsequently developed major rectal bleeding and deteriorated significantly. This case also illustrates the poor prognosis association with colorectal metastasis of lung cancer.
Central Hepatectomy in a 6-Month-Old Child with Hepatoblastoma following Chemotherapy
Authors: Ho Huu Thien , Mai Trung Hieu , Nguyen Thanh Xuan , Nguyen Kim Hoa thi , Pham Nhu Hien , Nguyen Huu Son
Published: June 2021

A hepatoblastoma in a 6-month-old child was initially considered unresectable because of diffuse liver involvement. The patient received 4 courses of cisplatin with an interval time of 2 weeks. A computed tomography scan after 4 courses of chemotherapy showed shrinking of the tumor, which made it resectable, and the tumor was removed by central hepatectomy. The patient was able to eat a regular diet on the fourth day and was sent home on the seventh day, after the operation. The pediatric oncologist followed the patient with liver ultrasonography and alpha-fetoprotein and administered 2 more cycles of cisplatin.
The Effect of TISSEELTM on Confined Bowel Perforation: An Experimental Study
Authors: Frountzas Maximos , Pergialiotis Vasilios , Stergios Konstantinos , Nikolaou Christina , Katafygiotis Patroklos , Lazaris Andreas C. , Schizas Dimitrios , Perrea Despina N. , Nikiteas Nikolaos , Toutouzas Konstantinos G.
Published: June 2021

Objective: During the last decades, surgeons of several specialties presenting different levels of expertise in colon handling have been involved in laparoscopic procedures. The aim of the present experimental study was to investigate the feasibility of TISSEELTM versus the conventional suture placement technique on confined bowel lesions in rats. Methods: Twenty-four Sprague-Dawley rats underwent confined bowel perforation and were divided into three groups: the SUTURE group (sutures were used), the SUTURE + TISSEELTM group (sutures and TISSEELTM were utilized), and the TISSEELTM group (only TISSEELTM was used). Blinded histopathologic analysis followed animal sacrifice. Results: The median weight of the rats was 526 ± 50 g. A single animal had hematochezia on the first postoperative day. Cessation of bleeding at the perforation margin was indicated intraoperatively after TISSEELTM application. Animals in the TISSEELTM group presented less intraperitoneal adhesions and lower hemorrhagic infiltration compared to animals of the two other groups. In addition, animals in the TISSEELTM group showed thrombus formation at the bowel perforation site compared to animals of the two other groups (p = 0.042). Histopathologic analysis demonstrated reduced inflammatory reaction (p = 0.003), diminished fibrosis (p = 0.001), and better tissue regeneration (p = 0.000) in the TISSEELTM group compared to the other two groups. Conclusion: Application of TISSEELTM at the perforation site was associated with increased regeneration of the intestinal wall and less inflammatory and fibrotic reaction compared to suture placement. However, more experimental and clinical studies should be conducted before implementation in humans.
Assessment of the Role of a Second Evaluation of Capsule Endoscopy Recordings to Improve Diagnostic Yield and Patient Management
Authors: Blanco-Velasco Gerardo , Pinho Rolando , Solórzano-Pineda Omar Michel , Martínez-Camacho Claudia , García-Contreras Luis Fernando , Murcio-Pérez Enrique , Hernández-Mondragón Oscar Victor
Published: June 2021

Introduction: The diagnostic yield (DY) of small-bowel capsule endoscopy (SBCE) varies considerably according to its indication. Some strategies have been used to increase DY with varying results. The intention of this study was to identify whether evaluation of the SBCE recordings by a second reviewer can increase DY and change patient management. Methods: One hundred SBCEs with different indications, already read by an endoscopist were read by a second blinded endoscopist. When the results of the 2 readings were different, the images were discussed by the endoscopists; if no consensus was reached, they took the opinion of a third endoscopist into account. All the participating endoscopists had experience in reading SBCEs (i.e., >50 per year). The SBCE findings were divided into positive (vascular lesions, ulcers, and tumors), equivocal (erosions or red spots), and negative. The interobserver agreement and the increase in DY were assessed as well as the percentage of false-negatives (FNs) in the first evaluation. Results: The indications for SBCE were small-bowel bleeding (SBB) in 48 cases, Crohn’s disease (CD) in 30, and other causes (iron-deficiency anemia, small-bowel tumors, and diarrhea) in 22. There was substantial interobserver agreement between evaluations (κ = 0.79). The findings in the first evaluation were positive in 60%, equivocal in 20% and, negative in 20%. In the second evaluation, 66% were positive, 18% were equivocal, and 16% were negative. The increase in DY with the second reading was 6% (p = 0.380), i.e., 6.3% for SBB, 4.4% for CD and 9.2% for other indications, resulting in a change in management of 4% of the patients. FNs in the first SBCE reading were found in 4% of the SBCEs. Discussion: A second evaluation of the SBCE recordings identified significant pathology that the first evaluation had missed, resulting in a nonsignificant 6% increase in DY and a change in the management of 4% of the patients.
Serum Human β-Defensin 2 Is Increased in Angioedema Accompanying Chronic Spontaneous Urticaria
Authors: Tra Cao Thi Bich , Cha Hyun-Young , Yang Eun-Mi , Choi Bo-Youn , Park Hae-Sim , Ye Young-Min
Published: June 2021

Introduction: Chronic spontaneous urticaria (CSU) is a common cutaneous disease caused by mast-cell degranulation. Human β-defensin 2 (HBD2) is a well-known antimicrobial peptide that is also a pruritogen inducing vascular permeability via non-IgE-mediated mast-cell degranulation. Objective: We investigated the associations between serum HBD2 levels and the clinical characteristics of CSU patients. Methods: Serum samples from 124 CSU patients and 56 healthy controls were screened for the levels of HBD2 and translationally controlled tumor protein (TCTP)_ by using ELISA. The urticaria activity score over 7 days (UAS7) was used to measure disease activity in CSU patients. Accompanying angioedema was self-reported. Results: Serum HBD2 levels were higher in the CSU group than in healthy subjects (median [interquartile range], 84.1 [43.5, 142.5] vs. 59.5 [26.7, 121.5], p = 0.034). In CSU patients, serum HBD2 level was negatively correlated with the peripheral basophil percentages (Spearman’s rho = −0.229, p = 0.01) and vitamin D levels (−0.262, p = 0.02), but positively correlated with TCTP levels (0.252, p = 0.006). In CSU patients, HBD2 level was higher in those with than without angioedema (101.7 [50.9, 184.2] vs. 66.7 [37.9, 132.0], p = 0.019). It did not differ by aspirin hypersensitivity or atopy status, or autologous serum skin test positivity. Conclusion: A known mast-cell degranulator, HBD2 was elevated in the sera from CSU patients compared to healthy controls and may be involved in the pathogenesis of accompanying angioedema.
Cutaneous Horn of the Glans
Authors: Ribeiro Camilla Santos , Azulay David Rubem , Quintella Danielle Carvalho , Cuzzi Tullia , Ramos-e-Silva Marcia
Published: June 2021

Cutaneous horn is a protuberance constituted by compact keratinous material, with a hard consistence similar to a horn, which occurs more frequently in photoexposed areas. The authors describe a case of cutaneous horn on the glans considered a rare location. Verrucous carcinoma was the histopathological diagnosis of the base of the horn and lichen sclerosis, the precursor lesion.
Recommendation and Acceptance of Counselling for Familial Cancer Risk in Newly Diagnosed Breast Cancer Cases
Authors: Kast Karin , Häfner Julia , Schröck Evelin , Jahn Arne , Werner Carmen , Meisel Cornelia , Wimberger Pauline
Published: June 2021

Background: In clinical routine, not every patient who is offered genetic counselling and diagnostics in order to investigate a familial cancer risk predisposition opts for it. Little is known about acceptance of counselling and testing in newly diagnosed breast cancer cases in Germany. Methods: All primary breast cancer cases and patients with DCIS (ductal carcinoma in situ) treated at the University Hospital of Dresden between 2016 and 2019 were included. The number of tumor board recommendations for genetic counselling on the basis of the GC-HBOC risk criteria was recorded. Acceptance was analyzed by number of cases with counselling in the GC-HBOC-Center Dresden. Results: Of 996 primary breast cancer and DCIS cases, 262 (26.3%) were eligible for genetic counselling. Recommendation for genetic counselling was accepted by 64.1% (168/262). Of these 90.5% (152/168) opted for molecular genetic analysis. The acceptance rate for counselling increased between 2016 and 2019 from 58.3 to 72.6%. Altogether, 20.4% (31/152) patients were found to carry a pathogenic variant in the breast cancer genes BRCA1 or BRCA2. Conclusion: Acceptance of recommendation is increasing as clinical consequences augment. Optimization in providing information about hereditary cancer risk and in accessibility of counselling and testing is required to further improve acceptance of recommendation.
Atypical Presentation of Esophageal Squamous Cell Carcinoma Masquerading as Diffuse Severe Esophagitis
Authors: Abbas Hafsa , Ghazanfar Haider , Ul Hussain Ali Naqqi , Baiomi Ahmed , Ihimoyan Ariyo
Published: June 2021

Esophagitis is described as an inflammation of the esophagus and can result from multiple etiologies. Esophageal squamous cell carcinoma (ESCC), presenting as diffuse esophagitis in the absence of a mass or lesion, is rare. We present a case of a 61-year-old man who presented to the gastroenterology clinic for dysphagia and heartburn of 3 months duration. The patient had lost about 15 pounds unintentionally over 6 months. The patient underwent esophagogastroduodenoscopy, which revealed significant diffuse Grade 4 esophagitis without any overt bleeding. Random biopsies were taken with cold forceps from proximal, middle, and distal esophageal segments because of the striking endoscopic appearance. Histopathology revealed high-grade dysplasia and carcinoma in situ. The patient underwent endoscopic ultrasound (EUS) of the esophagus, which revealed a focal lesion. EUS-guided fine-needle aspiration showed squamous cell carcinoma of the esophagus. ESCC usually presents as a mass or a gross lesion seen on endoscopy. However, it rarely presents as severe diffuse esophagitis seen on routine endoscopy. From our observation, it would be reasonable for physicians to bear this unusual endoscopic presentation in mind and perform multiple random biopsies if encountered with such a case to rule out the possibility of any underlying malignancy.
Speech Performance among Healthy Malay Female Speakers during Dual Tasks and Sentence Complexity
Authors: Binti Mohamad Ismail Farah Najihah , Chu Shin Ying , Gan Kok Beng , Park Hye Ran , Lee Jaehoon , Barlow Steven M. , A. Razak Rogayah
Published: June 2021

Objectives: This study aimed to identify how different dual tasks influence speech performance among young Malay speakers by manipulating the complexity of sentences. Fifteen female speakers (20–30 years old) were audio recorded while executing a series of simple and complex sentence repetition tasks. Methods: Hierarchical linear modeling was conducted to examine the effects of task (speech task only, speech + cognitive tasks, speech + linguistic tasks, and speech + manual tasks) and sentence complexity (simple vs. complex), as well as their interaction on 3 outcome measures (word accuracy rate [WAR], response reaction time [RRT], and duration of sentence [DoS]). Results: Significantly higher WAR were found when participants read the sentences only compared to when they completed another task simultaneously. The pairwise comparison further revealed that the conditions of speech + manual tasks produced the lowest WAR. For RRT, participants responded significantly faster when they only read the sentences (mean = 1.36, SE = 0.17) than when they read the sentences and conducted another task at the same time (mean = 1.66, SE = 0.14; p < 0.0001). A pairwise comparison showed that the conditions of speech + manual tasks produced the longest DoS. Neither the effect of sentence complexity nor the interaction between task and sentence complexity was statistically significant across WAR, RRT, and DoS. Conclusions: The results augment what is known about interference between speech and other concurrent tasks and provides evidence that divided attention affects manual task performance more than other tasks. In addition, sentence complexity did not affect speech performance in healthy adults. This paradigm could be used in future studies to serve as a clinical marker that can potentially distinguish mild cognitive impairment from normal aging.
The impacts of information asymmetry in determining bank spreads
Authors: Barbosa Renato Cesar Ottoni , Marçal Emerson Fernandes
Published: June 2021

Um grande esforço de pesquisa tem sido feito para avaliar os determinantes dos spreads bancários. Neste estudo utilizam-se os dados da pesquisa do Banco Mundal Doing Business para avaliar em que medida a assimetria informacional influencia o nível de spread bancário. Os resultados encontrados neste trabalho sugerem que os spreads sofrem influencia do nível de assimetria informacional. Nas taxas de baixo risco (prime rates) um grau pequeno de assimetria informacional pode reduzir de 2 a 4% o nível do spread. Conjectura-se que maiores reduções podem ser obtidas para dívidas de maior risco. A metodologia econométrica utilizada consiste em técnicas de painel estático. Para confirmar ou refutar os resultados deste trabalho estudos com amostra maiores devem ser feitas assim que novas informações sobre a pesquisa Doing Business estejam disponibilizadas.
Segurança, controle e monitoramento versus direitos fundamentais: Uma análise do projeto de lei "Marco Civil da Internet"
Authors: Machado Jorge Alberto Silva , Queiroz Alcimar
Published: June 2021

O Ministério da Justiça realizou uma consulta pública e formulou um projeto de lei para o estabelecimento de um quadro jurídico baseado em direitos civis para o uso da internet. O objetivo principal é criar uma estrutura de direitos e responsabilidades para o uso da web, bem como as condições para fornecer acesso a dados privados armazenados pelos provedores de conteúdos da internet. Com essa lei, espera-se melhorar a resolução de conflitos relacionados com privacidade e a liberdade de expressão na internet, garantindo direitos fundamentais, ao invés de criminalizar práticas sociais disseminadas ou restringir direitos.
Orçamento executivo como ferramenta do processo de planejamento e controle de custos de obras públicas
Authors: Santos Adriana de Paula Lacerda , Garcia Luciana Emília Machado
Published: June 2021

O objetivo deste artigo e apresentar uma lógica de execução do orçamento executivo para ser utilizado em obras públicas e que possa auxiliar no seu processo de planejamento e controle de custos de obras públicas. Para tanto, realizado um estudo de caso em uma Instituição Federal de Ensino Superior (IFES). Após a coleta e análise dos dados foi verificado que o método mais usual de planejar as obras de engenharia no setor público baseia-se na elaboração de desenhos de projetos e no orçamento convencional. Tal metodologia tem apresentado ser ineficiente frente ao grande número de aditivos contratuais e das obras fora do prazo de execução e/ou não concluídas na IFES. Com a implantação do orçamento executivo, ajustado à realidade da IFES, foi possível identificar que existem possibilidades significativas de melhora no processo de gerenciamento das obras púbicas.
O que fazer da pedra e cal? A experiência de ensino de políticas de cultura no Bacharelado em Gestão de Políticas Públicas da Universidade de São Paulo
Authors: Köhler André Fontan
Published: June 2021

O trabalho apresenta e discute a disciplina políticas de cultura do Bacharelado em Gestão de Políticas Públicas, em 2012, que versou sobre as políticas patrimoniais brasileiras. Cara a essa experiência de ensino é a noção de que, no campo da agenda governamental e políticas públicas, há um contraste entre a importância (conceitual e formal) e a falta de importância (real e efetiva) do patrimônio histórico e artístico nacional. Além disso, a temática não é devidamente abordada nos bacharelados de gestão e políticas públicas, nem conta com suficiente literatura analítica, histórica e de estudos de caso, no Brasil. O trabalho apresenta, como objetivo-fim, avaliar a disciplina, no que tange sua contribuição à formação de discentes de Gestão de Políticas Públicas e do Bacharelado em Lazer e Turismo. A metodologia de pesquisa consistiu em, além de revisar a experiência de lecionar a disciplina, entrevistar cinco discentes matriculados(as) - três aprovados(as) e dois(uas) reprovados(as). O artigo revela que a disciplina teve os seguintes méritos: a) a mescla de alunos(as) de Gestão de Políticas Públicas e Lazer e Turismo; b) a oportunidade de os(as) discentes descobrirem uma área até então ignorada no supracitado campo; e c) ter propiciado aos(às) discentes a reflexão sobre o conceito de nacional, travando contato com seu lado formativo e simbólico. Como pontos negativos, destacam-se os seguintes: a) a atuação profissional na área ainda não é avaliada como promissora e atrativa pelos(as) discentes; b) a disciplina careceu de maior contato com gestores(as) públicos(as) com atuação na área patrimonial, através de aulas e palestras; c) parte do corpo discente não teve o necessário empenho na disciplina; e d) a viagem técnica deveria ter contemplado, ao invés de Iguape, uma cidade patrimonial que melhor retrata os problemas comuns ao patrimônio cultural brasileiro.
Structural Connectivity Remote From Lesions Correlates With Somatosensory Outcome Poststroke
Authors: Koh Chia-Lin , Yeh Chun-Hung , Liang Xiaoyun , Vidyasagar Rishma , Seitz Rüdiger J. , Nilsson Michael , Connelly Alan , Carey Leeanne M.
Published: June 2021

Background and Purpose:

Changes in connectivity of white matter fibers remote to a stroke lesion, suggestive of structural connectional diaschisis, may impact on clinical impairment and recovery after stroke. However, until recently, we have not had tract-specific techniques to map changes in white matter tracts in vivo in humans to enable investigation of potential mechanisms and clinical impact of such remote changes. Our aim was to identify and quantify white matter tracts that are affected remote from a stroke lesion and to investigate the associations between reductions in tract-specific connectivity and impaired touch discrimination function after stroke.

Methods:

We applied fixel-based analysis to diffusion magnetic resonance imaging data from 37 patients with stroke (right lesion =16; left lesion =21) and 26 age-matched healthy adults. Three quantitative metrics were compared between groups: fiber density; fiber-bundle cross-section; and a combined measure of both (fiber-bundle cross-section) that reflects axonal structural connectivity.

Results:

Compared with healthy adults, patients with stroke showed significant common fiber-bundle cross-section and fiber density reductions in 4 regions remote from focal lesions that play roles in somatosensory and spatial information processing. Structural connectivity along the somatosensory fibers of the lesioned hemisphere was correlated with contralesional hand touch function. Touch function of the ipsilesional hand was associated with connectivity of the superior longitudinal fasciculus, and, for the right-lesion group, the corpus callosum.

Conclusions:

Remote tract-specific reductions in axonal connectivity indicated by diffusion imaging measures are observed in the somatosensory network after stroke. These remote white matter connectivity reductions, indicative of structural connectional diaschisis, are associated with touch impairment in patients with stroke.
Psychological characteristics of Japanese attitude toward COVID-19: Sanitary masks and “jishuku” (self-restriction)
Authors: Abe Tsuneyuki , Raevskiy Alexander E.
Published: June 2021

Relevance of the article. COVID-19 is a serious global problem, that humanity is facing today. Different countries provide various measures to confront the epidemic. But not only measures differ from country to country, but people’s attitude to this problem is also quite different. In Japan the number of victims is relatively low, and it can be suggested that several socio-psychological factors of the Japanese society underlie this phenomenon. Aim of the current research is to describe psychological measures of confronting COVID-19 in Japan, and to analyze religious, cultural and psychological features of the Japanese people, that could predeterminate the effectiveness of measures conducted by the Japanese government to confront the epidemic. Course of the research. Current article is devoted to the two main features of Japanese policy confronting COVID-19: sanitary masks and self-restriction policy (jishuku). The attitude of the Japanese people to the epidemic, and the measures conducted by the government are analyzed from psychological point of view. Also, basic social and psychological factors that supposedly helped to control the epidemic and the features of governmental policy in confronting COVID-19 are described. Results. Important feature of the Japan’s anti-COVID-19 policy was an absence of strict measures suppressing individual freedom. But in spite of that, government’s appeal for the mask use and social distance was carefully followed by the people. It can be probably explained by a historically based tendency of the Japanese people to conduct themselves in accordance with the social rules, a daily habit of sanitary masks usage, and also a special attitude to cleanliness and hygiene. Conclusion. Fight against COVID-19 requires systematic, coordinated and constructive approach, use of several scientific disciplines, human resources and technological solutions. Probably the Japanese experience in this problem would help international community to confront epidemic.