bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of Human Umbilical Cord Mesenchymal Stem Cells in Rat Spinal Cord Injury Model
Authors: Sun Xue-Cheng , Wang Hu , Ma Xu , Xia Hong-Fei
Published: April 2023

The treatment of spinal cord injury (SCI) is a hot topic in clinic. In this study, female rats were selected and randomly divided into four groups (normal, sham, SCI, and mesenchymal stem cells [MSCs] groups). Hemostatic forceps were used to clamp the spinal cord for 1 min to establish the SCI animal model in rats. The levels of proinflammatory factors in the blood of each group were compared 4 h after operation. The motor function of hind limb was estimated by Basso, Beattie & Bresnahan Locomotor rating scale (BBB scale) at 3 months after surgery, the spinal cord tissue from the experimental area was obtained and stained histologically and immunohistochemically. Basso, Beattie & Bresnahan Locomotor rating scale results indicated that human umbilical cord (HUC) MSCs transplantation could improve the walking ability in rats with the SCI. Human umbilical cord mesenchymal stem cells substantially upregulated the secretion of anti-inflammatory factors and downregulated the secretion of proinflammatory factors, and promoted the repair of the SCI and inhibited the increase of glial cells induced by the SCI. Human umbilical cord mesenchymal stem cells transplantation can partially recovered the motor ability of rats with the SCI through promoting the regeneration of nerve cell and the expression of neural related genes, and inhibiting inflammatory reaction.
Beyond donation to organ utilization in the UK
Authors: Ibrahim Maria , Callaghan Chris J.
Published: April 2023

Purpose of review

Optimizing deceased donor organ utilization is gaining recognition as a topical and important issue, both in the United Kingdom (UK) and globally. This review discusses pertinent issues in the field of organ utilization, with specific reference to UK data and recent developments within the UK.

Recent findings

A multifaceted approach is likely required in order to improve organ utilization. Having a solid evidence-base upon which transplant clinicians and patients on national waiting lists can base decisions regarding organ utilization is imperative in order to bridge gaps in knowledge regarding the optimal use of each donated organ. A better understanding of the risks and benefits of the uses of higher risk organs, along with innovations such as novel machine perfusion technologies, can help clinician decision-making and may ultimately reduce the unnecessary discard of precious deceased donor organs.

The issues facing the UK with regards to organ utilization are likely to be similar to those in many other developed countries. Discussions around these issues within organ donation and transplantation communities may help facilitate shared learning, lead to improvements in the usage of scarce deceased donor organs, and enable better outcomes for patients waiting for transplants.
Correlation between blood group, Rh, and obesity with colorectal carcinoma among patients attending Al-Kindy Teaching Hospital/Baghdad: a case–control study
Authors: Abdulsattar Safaa H. , Hasan Riyadh M. , Hindoush Laith N.
Published: April 2023

Background:

Several studies had been conducted on the association between blood group ABO and the risk of gastrointestinal malignancies, such as gastric and pancreatic cancer. Studies have also been conducted on the risk of obesity with colorectal carcinoma (CRC). It is unclear whether there is an association between blood group ABO and CRC and which group is more affected.

Aim:

The aim of this study was to show an association between the ABO blood group, Rh factor, and obesity with CRC.

Patients and Methods:

One hundred and two patients with CRC were included in our case–control study. Blood group, Rh factor, and BMI were estimated and compared with a control group of 180 Iraqis who came to the Endoscopy Department of Al-Kindy Teaching Hospital for preoperative control colonoscopy between January 2016 and January 2019.

Results:

The overall distributions of ABO and Rh factor were comparable between patients (41.17% A+, 5.88% A−, 6.86% B+, 2.94 B−, 1.96% AB+, 1.96% AB−, 37.25% O+, and 1.96% O−) and controls (26.66% A+, 1.11% A−, 20% B+, 1.11 B−, 13.3% AB+, 1.11% AB−, 34.44% O+, and 2.22% O−). Statistically, there were significant differences between patients with CRC and control subjects in terms of their blood groups. The A+ group was found in 42 cases (41.17%), followed by O+ in 38 cases (37.25%). Their BMI ranged from 18.5 to 40 kg/m2. Overweight patients were more common in 46 cases (45%) followed by obesity class І 32 cases (32.37%) with aP-value of 0.00016. Sixty-two of the patients with CRC (60.78%) were male and 40 cases (39.21%) were female. Their ages ranged from 30 to 79 years with a mean age of 55.49 years. CRC 37 cases occurred in the age group of 60–69 years (36.27).

Conclusion:

In this study, a statistically significant association was found between the occurrence of CRC and patients with blood group A+, O+, overweight, and obesity class І.
Primary extragastrointestinal stromal tumor of the prostate: review of the literature and case report
Authors: Benabdallah Wajdi , Ben Othmane Mouna , Ouahchi Ines , Mestiri Sarra , Belkacem Oussama , Bouassida Khaireddine , Hmida Wissem , Jaidane Mehdi
Published: April 2023

Introduction and importance:

The extragastrointestinal stromal tumor (EGIST) is defined as a mesenchymal neoplasm arising from soft tissues outside the gastrointestinal tract, and the prostate is a rare presentation site.

Case presentation:

A 58-year-old man was presented with lower urinary tract symptoms for 6 months. A digital rectal examination revealed a markedly enlarged prostate with a smooth, bulging surface. Prostate-specific antigen density was 0.5 ng/ml. MRI of the prostate showed an enlarged prostatic mass with hemorrhagic necrosis. Transrectal ultrasound-guided prostate biopsy was performed and pathological reports suggested a gastrointestinal stromal tumor. The patient refused radical prostatectomy and received only imatinib treatment.

Clinical discussion:

The diagnosis of EGIST of the prostate is extremely rare and depends on the histopathologic features with immunohistochemical results. The treatment is essentially based on radical prostatectomy, but there are other therapeutic modalities associating surgery with adjuvant or neoadjuvant chemotherapy. For patients refusing surgery, treatment with imatinib alone appears to be a therapeutic solution.

Conclusion:

Despite the rarity, EGIST of the prostate should be included in the differential diagnosis of patients presenting with lower urinary tract symptoms. There is no consensus regarding the treatment of EGIST, and the patients are treated as per the risk stratification.
Malignant carotid body tumor: a report of two cases
Authors: Alfawaz Abdullah A. , Albloushi Dalia , Quttaineh Danah , Alsafran Salman , AlQabandi Omar , Albader Marzouq
Published: April 2023

Introduction and importance:

Carotid body tumors (CBT) are neoplasms that originate from chemoreceptors of the carotid body. They are neuroendocrine tumors that are usually benign but may have malignant potential. Malignancy is diagnosed with evidence of lymph node metastasis, distant metastasis, or disease recurrence. Multiple imaging modalities are used to diagnose CBTs and the treatment of choice is surgical excision. Radiotherapy is used for unresectable tumors. In this case, series we describe two cases of malignant paragangliomas that were diagnosed and operated on at a tertiary hospital in Kuwait, by the vascular team. Malignant CBTs are rare, documentation of the cases encountered and the subsequent management and outcome is important to give us a better understanding of the disease.

Case presentation:

Case one– A 23-year-old woman presented with a right-sided neck mass. History, physical examination, and appropriate imaging suggested malignant paraganglioma with evidence of lymph node, vertebral, and lung metastases. Surgical excision of the tumor and regional lymph nodes was done. Histopathological assessment of the retrieved specimens confirmed the diagnosis.

Case two – A 29-year-old woman presented with a left submandibular swelling. She was appropriately investigated, and the diagnosis of a malignant carotid body tumor was made with evidence of lymph node metastasis. Surgical resection of the tumor with clear margins was done and histopathological analysis of the resected specimen confirmed the diagnosis.

Clinical discussion:

CBT’s are the most common tumors of the head and neck. Most are nonfunctioning, slow growing, and benign. They typically present in the fifth decade of life but can occur at a younger age in individuals who carry certain genetic mutations. Both cases of malignant CBT’s that we encountered occurred in young women. Furthermore, the 4-year and 7-year history in case number one and two, respectively, supports the fact that CBTs are slow growing tumors. In our case series, the tumors were surgically resected. Both cases were discussed in multidisciplinary meetings and were referred for hereditary testing and radiation oncology for further management.

Conclusion:

Malignant carotid body tumors are rare. Prompt diagnosis and treatment is important to improve patient outcomes.
Clinical manifestations of delayed reaction following mass hornet envenomation: a case report
Authors: Bhattarai Urza , Acharya Anil , Shrestha Ram Sharan , Gautam Arun , Anand Ayush , Manandhar Srista , Sharma Sanjib Kumar
Published: April 2023

Introduction:

Delayed reaction following mass hornet envenomation is associated with various clinical manifestations.

Case Presentation:

The authors present a case of a 24-year-old male from eastern Nepal, who presented following mass envenomation by hornet stings. He had progressive yellowish discoloration of skin and sclera, myalgia, fever, and dizziness. He had passage of tea-coloured urine followed by anuria. Laboratory investigations suggested acute kidney injury, rhabdomyolysis, and acute liver injury. The authors managed the patient with supportive measures and haemodialysis. There was complete recovery of liver and renal function in the patient.

Discussion:

The findings in this patient were similar to other cases reported in the literature. These patients must be managed supportively, with few requiring renal replacement therapy. Most of these patients recover completely. In low-middle-income countries like Nepal, delay in seeking care and delay in reaching care is associated with severe clinical manifestations. Delayed presentation can lead to renal shutdown and mortality; hence, early intervention is simple, and, crucial.

Conclusion:

This case highlights the occurrence of delayed reaction following mass envenomation by hornets. Also, the authors show an approach to managing such patients, similar to managing any other case with acute kidney injury. In these cases, an early simple intervention can prevent mortality. It is crucial to train healthcare workers regarding toxin induced acute kidney injury and the importance of early identification and intervention.
PIK3CA-related overgrowth spectrum (PROS): a rare case report
Authors: Kalo Cedra , Khana Firas , Jazmati Aya , Kalo Sima , Ishkhanian Silva , Kayyali Alae , Sawas Taher
Published: April 2023

Study Design:

Case report.

Introduction and Importance:

The purpose of this study is to report an extremely rare case of PIK3CA-related overgrowth spectrum.

Case Presentation:

A 12-year-old boy presented with severe overgrowth in the left lower limb causing severe movement restriction and decreased quality of life.

Interventions and Outcome:

Episodes of myiasis were manually treated through mechanical removal and the patient was placed on rapamycin therapy for managing vascular malformations.

Conclusion:

CLOVES syndrome is a rare overgrowth disorder that can be confused with other overgrowth syndromes; however, clinical and imaging findings are essential for pinpointing the correct diagnosis as genetic sequencing may not always prove reliable.
Retroperitoneal desmoid-type fibromatosis: a case report
Authors: El Charif M. Hadi , Tarhini Hawraa , Dushfunian David , Al Harake Hassan , Khasawneh Hala , Abi Saad George , Khalife Mohamad , Sbaity Eman
Published: April 2023

Introduction and importance:

Desmoid-type fibromatosis (DF) is a rare subtype of soft tissue sarcomas that most commonly occurs in the anterior abdominal wall. When occurring in the retroperitoneum, DF is usually part of familial syndromes while only rarely sporadic. This makes it imperative to report any instance of experience with DF and the oncological outcomes of the different approaches to management. We report two cases of sporadic and severe DF occurring in the retroperitoneum at our institution.

Case presentation:

The first case is a male that presented with urinary obstruction symptoms and underwent surgical resection of the tumor that extended into the left kidney. The second case is a female with a history of recurrent desmoid tumors of the thigh and was incidentally diagnosed with retroperitoneal DF on imaging. She underwent tumor resection and radiotherapy; however, the tumor recurred with urinary obstruction symptoms that required another surgical resection. Histopathological characteristics and radiological imaging of both cases are described below.

Clinical discussion:

Desmoid tumors often recur, thus significantly influencing the quality of life which is reflected in one of our cases. Surgery remains a mainstay treatment, and both cases presented in this report required surgical resection of the tumors as symptomatic and curative measures.

Conclusion:

Retroperitoneal DF is a rare entity, and our cases add to the scarce literature available on the topic, which may well contribute to the formulation of practice-changing recommendations and guidelines focused on this rare variant of DF.
The use of chloroquine with or without adjuncts in the effective management of scorpion sting in the tropics: case reports
Authors: Udohchukwu Okereke Promise , Obumneme Okereke Wisdom , Collins Uche , Philemon Ugwuanyi , Arinze Ibeh David , Daniel Ginger-Eke Ikenna
Published: April 2023

Introduction and importance:

Scorpion Sting is a common occurrence in the tropics caused by scorpion envenomation on unsuspecting victims. The sting causes severe pain and may be much more fatal depending on the age and size of the patient and the scorpion specie as well as other factors. Effective treatment is needed specially to alleviate pain. Many parts of the tropics have little or no data describing the use of Chloroquine in managing scorpion sting. These cases show how chloroquine can be used in without other drugs to achieve pain control.

Case presentation:

Patients presented with pain emanating from the right big toe and medial arch, respectively. The said pain had same manifestation and intensity in both patients and followed same course but radiated higher in up to the ipsilateral flank in the first patient but was limited to the ipsilateral iliac region of the second patient.

Clinical discussion:

The sites showed signs of inflammation with pain being most prominent. Diagnosis of scorpion envenomation were made based on the given history. The pain was eliminated using chloroquine given intramuscularly at the site of scorpion sting.

Conclusion:

Scorpion sting can occur at any time in the tropic and lidocaine only cannot alleviate pain. Chloroquine can be used in managing scorpion sting as it also has many other benefits that can make it more preferred to the other conventional approaches used.
Rectal prolapse as a manifestation of inflammatory bowel disease with celiac disease in a 2-year-old male: a rare case report
Authors: Martini Nafiza , Kara Tahhan Nour , Aldarwish Mohamad S. , Mahmoud Jaber
Published: April 2023

Introduction and Importance:

The co-occurrence of inflammatory bowel disease (IBD) and celiac disease (CeD) is uncommon. The typical sign of this co-occurrence is malabsorption which leads to anemia, diarrhea, and malnutrition. In rare cases, recurrent rectal prolapse may also occur.

Case presentation:

A 2-year-old Syrian male baby presented with failure to thrive and chronic diarrhea for 18 months, along with recurrent rectal prolapse for the last 6 months. Biopsies taken confirmed a diagnosis of stage 3b celiac disease according to the Marsh classification. Furthermore, biopsies taken confirmed a diagnosis of IBD. Then, a high-fiber diet to manage IBD and celiac diet were both needed simultaneously, with signs of rectal prolapse, diarrhea, and bloating, occurring when either or both diets were stopped.

Clinical discussion:

The diagnosis was initially explained by the malnutrition and anemia. Even after the gluten-free diet, the patient showed no improvement in diarrhea and developed inferior gastrointestinal bleeding suggested anal fissure, infectious colitis, polyps, IBD, or solitary rectal ulcer syndrome. The relationship between celiac disease and IBD, in children, is still unclear. Current studies suggest that such co-occurrence is associated with higher risks of developing other autoimmune-related disorders, growth and puberty delay, and comorbidities.

Conclusions:

In the cases of pediatric co-occurrence of IBD and celiac disease, a conservative therapy consisting of two-fold diets for the two diseases should be tried first. If this step succeeds in controlling the clinical picture, it removes the necessity of introducing immunological pharmacologic treatments that may induce unfavorable side effects in a child.
Kindler syndrome: a rare case report from Syria
Authors: Edrees Souma , Jarkas Natalie , Hraib Munawar , Al-Yousef Khaled , Baddour Roula
Published: April 2023

Kindler syndrome is a rare autosomal recessive inherited disease. The authors report a case with unique presentation that has never reported before in the medical Literatur” lanugo hair”. This is a case of a 13-year-old Syrian child, who presented with difuse fine face hair, and serious urinary complications. Kindler syndrome is characterized by acral skin blistering beginning at birth, diffuse cutaneous atrophy, photosensitivity, poikiloderma, and various mucosal findings. Highlighting a set of clinical diagnostic criteria; which is used only if a genetic test is not available
Pregnancy and complete atrioventricular block: a case report
Authors: López Bryam , Batallanos Milagros
Published: April 2023

Introduction:

Bradycardia in pregnancy due to complete atrioventricular block (CAVB) is a rare but serious occurrence that can be life-threatening to the mother and fetus. Patients with CAVB may be asymptomatic, but symptomatic cases require urgent and definitive management.

Case presentation:

The case of a 20-year-old primigravida with previously undiagnosed CAVB who attended the obstetric emergency service in labor is presented. The route of delivery was vaginal without complications. The decision was made to implant a permanent dual-chamber pacemaker on the third day of the puerperium, and the patient did no present cardiovascular symptoms during outpatient follow-up.

Clinical discussion:

CAVB is a rare but serious condition in pregnancy that can be congenital or acquired. While some cases are relatively benign, others can lead to decompensation and fetal complications. There is no consensus on the best delivery route, but vaginal delivery is generally safe unless contraindicated for obstetric reasons. Pacemaker implantation may be necessary in some cases and can be performed safely during pregnancy.

Conclusion:

This case highlights the importance of cardiac evaluation in pregnant patients, especially those with a history of syncope. It also highlights the need for adequate and urgent management in symptomatic cases of CAVB in pregnancy and adequate evaluation to decide when to implant the pacemaker as a definitive measure.
Laparoscopic sigmoidectomy postopen aortic replacement for abdominal aortic aneurysm: a case report
Authors: Fujimoto Goshi , Deguchi Takashi
Published: April 2023

Introduction and importance:

Colectomy for colorectal cancer after an open aortic replacement (OAR) for abdominal aortic aneurysms has high perioperative complication and mortality rates.

Case presentation:

The authors report the case of an 87-year-old man who underwent laparoscopic sigmoidectomy. The patient presented with edema of the lower legs and face, and blood test results indicated anemia. The patient had a history of OAR for an abdominal aortic aneurysm 9 years prior, a left common iliac artery aneurysm, and a jump bypass graft. A colonoscopy revealed a type 2 lesion in the sigmoid colon; he was diagnosed with moderately differentiated adenocarcinoma. Preoperative computed tomography did not show any obvious lymph node or distant metastases. Laparoscopic sigmoidectomy with D3 lymphadenectomy was planned. During surgery, the use of the lateral approach allowed sigmoid mesocolon mobilization while confirming the presence of the artificial arteries. As the approach to the root of the inferior mesenteric artery was difficult, D1 lymphadenectomy was performed. No evidence of anastomotic leakage or artificial artery infection was observed postoperatively.

Clinical discussion:

Intra-abdominal adhesions due to the prior OAR makes sigmoid mesocolon mobilization difficult. In cases where laminar structure cannot be recognized, other landmarks are needed.

Conclusions:

After OAR, artificial arteries can be used as landmarks during colectomy. Although laparoscopic surgery is technically challenging, the magnified view provides an advantage in identifying these landmarks. Patients’ surgical records for the previous OAR should be checked, and the positions of the vessels and ureters should be elucidated preoperatively using computed tomography.
Newly diagnosed PRES in a sickle cell diseased patient: a case report
Authors: Gurumurthy Vaishnavi , Jain Gauri
Published: April 2023

Sickle cell disease has many clinical impacts, one such rare finding is systemic hypertension although the literature to support it is debatable. Hypertension along with other key components of sickle cell pathology is one of the reversible causes of posterior reversible encephalopathy syndrome (PRES). Although its triggering factors and pathophysiology is not well documented, hypertension is one of the easily reversible causes of PRES. A well-controlled blood pressure is an aim for reversibility and future recurrence of PRES. However, the addition of other medications like anticonvulsants (levetiracetam and lacosamide) to prevent seizures as a consequence of PRES still remains debatable. Considering the case reported below, the addition of Hydroxyurea to the treatment can be another cause of the recurrence of PRES and needs to be weighed for its risks and benefits.
Antineuronal autoantibodies induced paraneoplasic syndrome in schizophrenia spectrum disorders: case report
Authors: Jaballah Fares , Ben Hamed Nouha , Hamzaoui Sayma , Ayadi Mohamed A. , Zgueb Yosra , Jomli Rabaa
Published: April 2023

Background:

Secondary psychiatric symptoms are usually suspected when there is an atypical presentation of the symptoms or a lack of response to psychotropic medication.

Case presentation:

Our case is about a woman aged 62 years old, with a history of mental disorder who presented psychiatric symptomatology after years of being stabilized by antipsychotics. She was later investigated due to a mass in her breast. Carcinoma was diagnosed, and her psychiatric symptomatology was resolved after the tumerectomy.

Discussion:

The therapeutic difficulty is the major problem of psychic disorders in the context of paraneoplastic syndrome. Several literature review have suggested a relationship between schizophrenia and antineuronal antibodies in the context of paraneoplastic syndrome. Treating the tumor can solve psychiatric symptoms better than psychotic treatment.

Conclusions:

The aim of our study is to highlight the importance of a complete medical evaluation to identify the psychiatric presentations of organic disorders associated with psychiatric manifestation and to ensure an early diagnosis.
Pediatric CHANCE fracture treated by lumbar lacing technique: a case report
Authors: Haouas Mohammed Yassine , Makhchoune Marouane , Faham Ibtissam , Jihri Abdelhamid , Lakhdar Abdelhakim
Published: April 2023

This paper presents the case of an 7-year-old girl victim of a road accident. The neurological examination revealed a conscious patient without any sensory or motor deficit and she had intense lumbar pain. The lumbar computed tomography scan found a chance fracture at the level of L3. the patient was operated under general anaesthesia with a sublaminar lacing fixation of L2–L3 similar to the lacing of C1C2 in upper cervical trauma. The follow-up was good The control X-ray was satisfied with a complete reduction and restoration of the lumbar lordosis and the patient was discharged from the hospital on the fifth day following the intervention. this article shows that sublaminar lacing can be as effective as pedicle screw fixation, thus preserving bone growth
Osteophyte-related medial collateral ligament injury in asymptomatic osteoarthritis following minor trauma: a case report
Authors: Asavanapakas Panpaporn , Parinyakhup Wachiraphan , Boonriong Tanarat , Boonsri Pattira , Laohawiriyakamol Teeranan , Chuaychoosakoon Chaiwat
Published: April 2023

Introduction and importance:

A proximal deep medial collateral ligament (MCL) injury usually occurs in high-impact sports such as football or hockey. This injury is not common in low-energy trauma but the predisposing factor, in this case, was an osteophyte located next to the deep MCL ligament, which had likely caused degenerative changes to the ligament from chronic irritation, resulting in reduced strength of the ligament.

Case presentation:

A 78-year-old Thai female presented with left knee pain 1 h after a low-energy trauma caused by a fall. The MRI showed deep MCL and medial meniscal root injuries, a nondisplaced lateral femoral condyle, and also revealed a large osteophyte near the midpart of the MCL, with a blunt persistent projection from the osteophyte pushing against the MCL where the injury was located. She was treated with a knee brace, a gait aid for walking, and analgesic pain control. Her symptoms gradually improved over the next few weeks.

Clinical discussion:

If an osteophyte touches a ligament, it can cause degenerative changes to the ligament from chronic irritation, resulting in reducing the strength of the ligament and may be causing some degree of degenerative changes and tightening of the MCL in its at-rest state, resulting in an increased chance of injury when it is required to resist a sudden external force, even from a minor trauma.

Conclusion:

When there is an osteophyte pushing against a ligament, there is an increased chance of ligament injury when even a minor trauma stresses that ligament.
Factors associated with hypertension among diabetic patients in Gamo Zone, Southern Ethiopia, 2021: case-control study
Authors: Kefelew Etenesh , Getahun Firdawek , Damtie Addisalem , Dawite Firehiwot , Gebeyehu Selamawit , Hailu Tadiwos , Temesgen Rodas , Abebe Getachew , Abebe Mesfin
Published: April 2023

Background:

The prevalence of hypertension in diabetic patients is nearly twice that of non-diabetic patients. The presence of both hypertension and diabetes accelerates complications and raises the risk of death. Thus, identifying determinants of hypertension in diabetic patients is critical for preventing the development of devastating acute and chronic complications, as well as diabetes-related death.

Methods and materials:

A case-control study was carried out in public hospitals of Gamo Zone, Southern Ethiopia. To select study participants, a systematic random sampling technique was used. The KOBO toolbox was used to collect data, which was then exported to the IBM SPSS version 25 software package for analysis. Bivariate and multivariable logistic regression analyses were performed to identify factors associated with hypertension in diabetes patients, and variables in the multivariable logistic regression analysis with a P value less than 0.05 were declared significantly associated at a 95% CI.

Results:

In this study, age greater than or equal to 50 years [adjusted odd ratio (AOR)=4.08, 95% CI (1.41, 11.82)], higher body mass index [AOR=3.23, 95% CI (1.40, 7.66)], and higher waist to hip ratio [AOR=2.15, 95% CI (1.12, 4.13)] were significantly associated with hypertension in diabetic patients.

Conclusions:

This study found that factors associated with hypertension among diabetic patients included older age (>50 years), a high waait to st#to#hip ratio, and a higher body mass index. The concerned health authorities and healthcare providers in the study area should focus on those identified factors to prevent hypertension among diabetic patients.
Morphometric analysis of foramen ovale, foramen spinosum, and foramen rotundum of human skull using computed tomography scan: a cross-sectional study
Authors: Bhattarai Rakshya , Panthi Sagar , Yadav Gopal K. , Bhandari Siddhartha , Acharya Rochana , Sharma Ananta , Shah Pratima K. , Koirala Sarun , Bhattarai Manoj , Gupta Mukesh K. , Khanal Bhawani
Published: April 2023

Background:

There is limited literature of objective assessments of foramina of skull base using computed tomography (CT) scan. This study was carried out to analyze the dimensions of foramen ovale (FO), foramen spinosum (FS), and foramen rotundum (FR) using CT scan imaging of the human skull and their associations with sex, age, and laterality of the body.

Materials and methods:

A cross-sectional study was carried out in the Department of Radiodiagnosis and Imaging at BP Koirala Institute of Health Sciences (BPKIHS), Nepal using a purposive sampling method. We included 96 adult patients (≥18 years) who underwent CT scan of the head for any clinical indications. All those participants below 18 years, inadequate visualization or erosions of skull base foramina, and/or not consenting were excluded. Appropriate statistical calculations were done using the statistical package for social sciences (SPSS), version 21. The P-value of less than 0.05 was considered statistically significant.

Results:

The mean length, width, and area of FO was 7.79±1.10 mm, 3.68±0.64 mm, and 22.80±6.18 mm2, respectively. The mean length, width, and area of FS was 2.38±0.36 mm, 1.94±0.30 mm, and 3.69±0.95 mm2, respectively. Similarly, the mean height, width, and area of FR was 2.41±0.49 mm, 2.40±0.55 mm, and 4.58±1.49 mm2, respectively. The male participants had statistically significant higher mean dimensions of FO and FS (P<0.05) than the female participants. There were statistically insignificant correlations of dimensions of these foramina with age and between the left and right side of each foraminal dimensions (P>0.05).

Conclusions:

The sex-based difference in dimensions of FO and FS should be clinically considered in evaluating the pathology of these foramina. However, further studies using objective assessment of foraminal dimensions are required to draw obvious inferences.
Knowledge of danger signs of pregnancy and health-seeking action among pregnant women: a health facility-based cross-sectional study
Authors: Gesese Shumiye Shiferaw , Mersha Eleni Adimassu , Balcha Wondu Feyisa
Published: April 2023

Background:

In many developing countries maternal morbidity and mortality are challenging issues. Increasing the knowledge of women about the danger signs of pregnancy is the first essential step to reduce the adverse outcomes of pregnancy and delay in deciding to seek obstetric care, which in turn improves early detection of obstetric complications. This study aimed to assess knowledge of danger signs of pregnancy and health-seeking action among pregnant women.

Methods:

A health facility-based cross-sectional study was conducted in public health facilities from 1 March 2017 to 30 April 2017 on 414 pregnant mothers. The data were collected by systematic random sampling technique, entered into a computer using Epi data 3.5, and analyzed using Statistical Package of Social Sciences version 20.0. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a confidence interval of 95% and a P value of less than 0.05 considered statistically significant.

Results:

This study identified that 57.2% of pregnant women had good knowledge of the danger signs of pregnancy. Pregnant women who are found in the age group of 25–29 [adjusted odds ratio (AOR)=3.35, 95% CI=1.13–9.96], and ≥30 years (AOR=8.11, 95% CI=2.23–29.45), mothers who live in urban area (AOR=5.26, 95% CI=1.96–14.15), primary education (AOR=4.85, 95% CI=2.07–11.41), secondary and above educational level (AOR=6.90, 95% CI=3.28–14.49), employed mother (AOR=5.18, 95% CI=1.65–16.27), being multigravida (AOR=7.24, 95% CI=3.86–13.58), knows that danger signs of pregnancy may cause severe complications (AOR=9.94, 95% CI=5.23–18.93), knew what to do if they faced danger signs of pregnancy (AOR=3.37, 95% CI=1.14–9.93), knew when did they go to a health facility if they faced danger signs of pregnancy (AOR=3.97, 95% CI=1.67–9.47) and faced at least one danger signs of pregnancy in current pregnancy (AOR = 5.40, 95% CI=1.46–19.99) were significantly associated with knowledge of danger signs of pregnancy. The proportion of mothers who experienced danger signs of pregnancy was 27 (6.5%) and among them, 21 (77.8%) had an appropriate health-seeking action, which is visiting a health facility.

Conclusion:

In this study area, the knowledge of pregnant women about the danger signs of pregnancy was low, while the practice of the mothers in response to danger signs of pregnancy was encouraging. Therefore, it is needed to the empowerment of women by increasing access to get an education, especially for rural women.
Surgical research in Colombia part 3: Authorship and publications of Colombian medical students in surgery in Colombian medical journals—cross-sectional study
Authors: Lozada-Martinez Ivan David , Acevedo-Lopez Nicole , Acevedo-Lopez Domenica , Picón-Jaimes Yelson Alejandro , Dominguez-Alvarado Gonzalo , Cabrera-Vargas Luis Felipe , Torregrosa-Almonacid Lilian , Guevara-Cruz Oscar , Narvaez-Rojas Alexis Rafael ,   Colombian Future Surgeons Collaborative Group
Published: April 2023

Introduction:

Research training, scientific activity and publications are cornerstones of academic surgery. Knowing the activity and trends of medical students aspiring to become surgeons it allows to identify gaps and skills to be strengthened. Currently, there is no data on the authorship and scientific activity of medical students in surgery in Latin America and Colombia.

Methods:

A bibliometric cross-sectional study was carried out, in which the Colombian medical journals were reviewed from 2010 to 2020. The articles with topics in general surgery and subspecialties where the authorship of medical students could be identified, were selected. Data on the sociodemographic and scientific characteristics of the authors and their publications were extracted and analyzed.

Results:

A total of 14 383 articles from 34 Colombian medical journals were reviewed. From 2010 to 2020, 807 articles related to surgery were published in Colombia. The most frequent typology of these articles was original articles (n=298; 37%), followed by case reports (n=222; 28.2%) and reviews (n=137; 17.3%). A total of 132 medical students and 141 authorships and were found, specifically in 9.9% (n=80/807) of these publications, with a higher frequency in original articles (n=32; 40%) and case reports (n=29; 36.2%). Collaboration of students with professors or surgeons was evidenced in 97.5% of the publications.

Conclusions:

The authorship of Colombian medical students in scientific publications in surgery in Colombian medical journals was low. From 2010 to 2020, student authors were found in 1 out of every 10 publications, mainly in original articles and clinical cases.
Palliative Care in the New Era of Lung Cancer Treatment
Authors: Borneman Tami , Koczywas Marianna
Published: April 2023

Lung cancer remains the most common malignancy and is recognized as having significant impact on quality of life. Advances in lung cancer treatment over the past decade have been significant, with new agents extending life, even in late-stage disease. The purpose of this study was to evaluate palliative care needs and use of supportive care services in a randomly selected sample (N = 99) of patients with lung cancer. Results indicated that despite treatment advances, these patients continue to have significant symptom and quality of life concerns and to receive limited palliative care or supportive care services. Integration of palliative care is needed in the new era of lung cancer treatment.
Complex Care Needs at the End of Life for Seriously Ill Adults With Multiple Chronic Conditions
Authors: Murali Komal Patel , Merriman John D. , Yu Gary , Vorderstrasse Allison , Kelley Amy S. , Brody Abraham A.
Published: April 2023

Understanding the complex care needs of seriously ill adults with multiple chronic conditions with and without cancer is critical for the delivery of high-quality serious illness and palliative care at the end of life. The objective of this secondary data analysis of a multisite randomized clinical trial in palliative care was to elucidate the clinical profile and complex care needs of seriously ill adults with multiple chronic conditions and to highlight key differences among those with and without cancer at the end of life. Of the 213 (74.2%) older adults who met criteria for multiple chronic conditions (eg, 2 or more chronic conditions requiring regular care with limitations of daily living), 49% had a diagnosis of cancer. Hospice enrollment was operationalized as an indicator for severity of illness and allowed for the capture of complex care needs of those deemed to be nearing the end of life. Individuals with cancer had complex symptomatology with a higher prevalence of nausea, drowsiness, and poor appetite and end of life and lower hospice enrollment. Individuals with multiple chronic conditions without cancer had lower functional status, greater number of medications, and higher hospice enrollment. The care of seriously ill older adults with multiple chronic conditions requires tailored approaches to improve outcomes and quality of care across health care settings, particularly at the end of life.
Prolonged Grief Disorder and the DSM
Authors: Zachar Peter , First Michael B. , Kendler Kenneth S.
Published: April 2023

In the early 1990s, a research group that included Holly Prigerson and Charles Reynolds established that disordered grief overlaps with depression and anxiety but is not the same. They also developed a research inventory for studying disordered grief. Subsequently, Prigerson focused on measuring disordered grief using advanced psychometric techniques. Because treatment for grief-related depression reduced symptoms of depression but not grief, Katherine Shear was recruited to develop a more effective therapy. Prigerson came to conceptualize disordered grief as prolonged grief that is associated with negative outcomes. Shear came to conceptualize disordered grief as intense grief that is complicated by features that interfere with adaption to the loss. In 2013 a hybrid disorder composed of criteria from both groups was placed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) appendix. Under the leadership of the DSM Steering Committee, a summit meeting in 2019 helped break an impasse, and a revised prolonged grief disorder became an official DSM diagnosis.
Personality Disorder Diagnosis Among Justice-Involved Veterans
Authors: Holliday Ryan , Desai Alisha , Edwards Emily R. , Borges Lauren M.
Published: April 2023

Justice-involved veterans are more likely to experience myriad mental health sequelae. Nonetheless, examination of personality psychopathology among justice-involved veterans remains limited, with studies focused on males within correctional settings. We examined Department of Veterans Affairs (VA) electronic medical records for 1,534,108 (12.28% justice-involved) male and 127,230 (8.79% justice-involved) female veterans. Male and female veterans accessing VA justice-related services were both approximately three times more likely to have a personality disorder diagnosis relative to those with no history of using justice-related services. This effect persisted after accounting for VA use (both overall and mental health), age, race, and ethnicity. Augmenting and tailoring VA justice-related services to facilitate access to evidence-based psychotherapy for personality psychopathology may promote optimal recovery and rehabilitation among these veterans.
Temporal Location of Changes in the US Suicide Rate by Age, Ethnicity, and Race
Authors: Messias Erick , Salas Joanne , Wilson Lauren , Scherrer Jeffrey F.
Published: April 2023

Suicide rates differ over time. Our objective was to determine when significant changes occurred by age, race, and ethnicity in the United States between 1999 and 2020. National Center for Health Statistics WONDER data were used in joinpoint regression. The annual percent change in suicide rate increased for all race, ethnic, and age groups, except for those 65 years and older. For American Indian/Alaska Natives, the largest increase occurred between 2010 and 2020 for those with ages 25 to 34 years. For Asian/Pacific Islander, the largest increase occurred among those 15 to 24 years old between 2011 and 2016. For Black/African-Americans, the largest increases occurred between 2010 and 2020 among 15- to 34-year-olds. For Whites, the largest increase occurred between 2014 and 2017 among 15- to 24-year-olds. Between 2018 and 2020, suicide rates significantly declined among Whites 45 to 64 years of age. Among Hispanics, significant increases in suicide rate occurred between 2012 and 2020 among those with ages 15 to 44 years. Between 1999 and 2020, the contour of suicide burden varied by age groups, race, and ethnicity.
PULMONARY VASCULAR ENDOTHELIAL GLYCOCALYX DEGRADATION CONTRIBUTES TO ACUTE LUNG INJURY IN EXPERIENCING HEATSTROKE
Authors: Cao Jingjing , Ding Chengjia , Huang Jieen , Chen Yanzhu , Chen Yi
Published: April 2023

Objectives: This study investigated the role and potential involvement of pulmonary vascular glycocalyx degradation in acute lung injury in rats with severe heatstroke (HS). Methods: Rats in an established HS model were exposed to a heated environment for 60 min in an incubator (temperature, 40°C ± 2°C; humidity, 65% ± 5%). Following pretreatment with heparanase III (HPSE III) or heparin, pathological lung injury, arterial blood gas, alveolar barrier disruption, and hemodynamic changes were evaluated. The vascular endothelial structures of the lungs were examined using electron microscopy. The concentration of Evans blue dye in the lungs and arterial blood gas were assessed. An enzyme-linked immunosorbent assay was used to quantify the plasma concentration of heparan sulfate proteoglycan. The expression of glypican-1 and syndecan-1 in pulmonary vessels was measured using immunofluorescence. Western blots were used to detect the expression of TNF-α, IL-6, and vascular endothelial biomarkers in the rat lungs. Pulmonary apoptosis was assessed using a TUNEL (terminal dUTP nick end labeling) assay, and the concentrations of malondialdehyde were measured. Results: Glycocalyx shedding aggravated lung injuries. Severe histopathological damage was observed, and indexes of lung function deviated from abnormal ranges. In addition, pulmonary vascular endothelial cells were disrupted. Compared with the HS group, the plasma concentration of heparan sulfate proteoglycan significantly increased in the HPSE group (P < 0.05). The expression of glypican-1 and syndecan-1 decreased, and the extravasation of Evans blue dye increased (P < 0.01). Endothelial biomarker expression increased in the lung tissue, whereas occludin expression decreased. Moreover, TNF-α and IL-6 were overexpressed following heat stress. Furthermore, apoptosis of pulmonary tissues and the concentration of malondialdehyde in rat lungs increased in the HS and HPSE groups. Conclusions: Heatstroke induced pulmonary glycocalyx degradation, which increased vascular permeability and aggravated vascular endothelial dysfunction, contributing to apoptosis, inflammation, and oxidation in the pulmonary tissues.
Energetic connectivity of diverse elasmobranch populations – implications for ecological resilience
Authors: Shipley Oliver N. , Matich Philip , Hussey Nigel E. , Brooks Annabelle M. L. , Chapman Demian , Frisk Michael G. , Guttridge Annie E. , Guttridge Tristan L. , Howey Lucy A. , Kattan Sami , Madigan Daniel J. , O'Shea Owen , Polunin Nicholas V. , Power Michael , Smukall Matthew J. , Schneider Eric V. C. , Shea Brendan D. , Talwar Brendan S. , Winchester Maggie , Brooks Edward J. , Gallagher Austin J.
Published: April 2023

Understanding the factors shaping patterns of ecological resilience is critical for mitigating the loss of global biodiversity. Throughout aquatic environments, highly mobile predators are thought to serve as important vectors of energy between ecosystems thereby promoting stability and resilience. However, the role these predators play in connecting food webs and promoting energy flow remains poorly understood in most contexts. Using carbon and nitrogen isotopes, we quantified the use of several prey resource pools (small oceanic forage, large oceanics, coral reef, and seagrass) by 17 species of elasmobranch fishes (
n
= 351 individuals) in The Bahamas to determine their functional diversity and roles as ecosystem links. We observed remarkable functional diversity across species and identified four major groups responsible for connecting discrete regions of the seascape. Elasmobranchs were responsible for promoting energetic connectivity between neritic, oceanic and deep-sea ecosystems. Our findings illustrate how mobile predators promote ecosystem connectivity, underscoring their functional significance and role in supporting ecological resilience. More broadly, strong predator conservation efforts in developing island nations, such as The Bahamas, are likely to yield ecological benefits that enhance the resilience of marine ecosystems to combat imminent threats such as habitat degradation and climate change.
Natural genetic variation in a dopamine receptor is associated with variation in female fertility in
Drosophila melanogaster
Authors: Lyman Richard F. , Lyman Rachel A. , Yamamoto Akihiko , Huang Wen , Harbison Susan T. , Zhou Shanshan , Anholt Robert R. H. , Mackay Trudy F. C.
Published: April 2023

Fertility is a major component of fitness but its genetic architecture remains poorly understood. Using a full diallel cross of 50
Drosophila
Genetic Reference Panel inbred lines with whole genome sequences, we found substantial genetic variation in fertility largely attributable to females. We mapped genes associated with variation in female fertility by genome-wide association analysis of common variants in the fly genome. Validation of candidate genes by RNAi knockdown confirmed the role of the dopamine 2-like receptor (
Dop2R
) in promoting egg laying. We replicated the
Dop2R
effect in an independently collected productivity dataset and showed that the effect of the
Dop2R
variant was mediated in part by regulatory gene expression variation. This study demonstrates the strong potential of genome-wide association analysis in this diverse panel of inbred strains and subsequent functional analyses for understanding the genetic architecture of fitness traits.