bluuebunny/crossref_metadata_2025 huggingface dataset:
Appropriate Use of Aspirin in the Primary and Secondary Prevention: Results From the ASSOS Study
Authors: ÇELİK OĞUZHAN , ÇİL CEM , BAŞARAN ÖZCAN , DEMIRCI ERKAN , TANIK VEYSEL , ALTUNTAS EMINE , SANCAR KADRIYE MEMIC , Orscelik Ozcan , YETIM MUCAHIT , BEKAR LUTFU , KARAARSLAN OSMAN , OZLEK BULENT , ÖZLEK EDA , GOKCEK AYSEL , DOGAN TOLGA , RESULZADE MUBARIZ MURAT , KAYA CAGLAR , KUCUK EMRAH , KIRIS TUNCAY , Demirtas Abdullah Orhan , CIVAN MURAT , ASOGLU RAMAZAN , DOĞAN VOLKAN , BİTEKER MURAT
Published: March 2022

Objective: Indications and appropriateness of aspirin use have not been
well investigated in Turkey. Therefore, the aim of this study is to
investigate the prescription patterns and appropriateness of aspirin in
a real-world clinical setting. Methods: The ASSOS study is a
cross-sectional, multicenter registry involving consecutive cardiology
patients who were using aspirin. Patients were divided into two groups
according to the use of aspirin; primary prevention and secondary
prevention group. The indication of aspirin use was evaluated according
to 2016 the European Society of Cardiology (ESC) and 2016 the United
States Preventative Services Task Force (USPTF) guidelines in the
primary prevention group. Results: A total of 5007 patients (mean age
62.15± 11.05, 39% female) were enrolled. The primary prevention group
included 1132 (22.6%) patients and the secondary prevention group
included 3875 (77.4%) patients. Of the 1132 patients, inappropriate use
of aspirin was determined in 100% of the patients according to the ESC
guidelines, and 71 % of the patients according to the USPTF guidelines.
Conclusion: Although there are considerable differences between the
USPTF and the ESC guidelines with respect to recommendations for aspirin
use in primary prevention, inappropriate use of aspirin in Turkey is
frequent in real-world practice for both guidelines.
OUTCOME OF TREATING PEDIATRIC LANGERHANS HISTIOCYTOSIS WITH LCH III IN TERTIARY CENTER, SAUDI ARABIA.
Authors: Almohammadi Abrar , Abdalla Khalid , Shehada Musa , Baothman Abdullah
Published: March 2022

Langerhans cell histiocytosis (LCH) is a rare disease affects any age
and any organ; its presentations and outcome vary from self-healing
lesions to life-threatening disseminated disease. This study evaluates
the outcome of treating children diagnosed with Langerhans cell
histiocytosis (LCH) at Oncology Center, Saudi Arabia. Procedure: Through
a retrospective study design, the researchers reviewed the medical
records and electronic files of all children (aged from 0-≤ 14 years)
who had been diagnosed and treated for LCH at Princess Norah Oncology
Center (PNOC), King Abdelaziz Medical City, Saudi Arabia, in the period
from January 2000 to December 2019 (n=33). Results Males constituted
(66.7%), with remarkable dominance of Saudis (93.9%). The median age
at diagnosis was 28 months (IQR=49 months); (42.4%) were diagnosed
before reaching their second birthday. Fourteen patients (42.4%) had
multisystem (MS-LCH) involvement, of which 13 patients with risk organ
(RO) (+) and one patient without risk organ (RO) (-). Most of the
patients received LCH III protocols. Reactivation occurred in 11
patients (33.3%), and two deaths (6.1%) occurred in cases with MS (RO)
(+) progressive disease. The overall survival was 93.9%; with no
statistically significant difference in event free survival observed
between patients with multisystem compared to single system involvement.
Conclusion Excellent outcome of LCH is associated with single system
involvement and worse outcome (reactivations, or morality) is determined
by multi-organ involvement especially at younger age less than 24
months. Understanding of pathophysiology and genetic molecular
background could lead a novel therapy that warrants a prospective
clinical trial.
Therapeutic concentrations of varenicline increase exocytotic release of catecholamines from human chromaffin cells in the presence of nicotine
Authors: Jiménez-Pompa Amanda , Sanz-Lázaro Sara , Hone Arik , Rueda-Ruzafa Lola , Medina-Polo José , González-Enguita Carmen , Blázquez Jesús , Rios Cristobal de los , McIntosh J , Albillos Almudena
Published: March 2022

Background and Purpose: Cardiovascular side effects from varenicline,
and a case report of a hypertensive crisis event in a patient with
pheochromocytoma being treated with varenicline, have been reported. The
goal of the present study was to determine if such side effects might
derive, in part, from increased exocytosis of secretory vesicles and
subsequent catecholamine release triggered by varenicline in chromaffin
cells of the adrenal gland. Experimental Approach: We performed
electrophysiological plasma membrane capacitance (Cm) and carbon fiber
amperometry experiments to evaluate the effect of varenicline on
exocytosis and catecholamine release, respectively, at concentrations
reached during varenicline therapy (100 nM). Experiments were conducted
in the absence or presence of nicotine, at plasma concentrations
achieved right after smoking (250 nM) or steady-state concentrations
(110 nM), in chromaffin cells of the adrenal gland obtained from human
organ donors or rats. Key Results: Varenicline increased the exocytosis
of secretory vesicles and the release of catecholamines from human
chromaffin cells in the presence of nicotine. Comparable results were
found using rat chromaffin cells; varenicline alone or in the presence
of acute or steady-state concentrations of nicotine found in human
plasma increased exocytosis. These effects were not due to an increase
of Cm or currents triggered by the nicotinic agonists alone. Conclusion
and Implications: Therapeutic concentrations of varenicline in the
presence of nicotine increased exocytosis and catecholamine release from
human chromaffin cells. These results should be taken into account in
nicotine addiction therapies when varenicline is used.
Identification of candidate genes endowed with surpassing productivity traits and tolerance to salinity stress from activation tagged lines of rice
Authors: Kota Vamseeraja , Sekhar Kalva , Vudem Dashavantha Reddy , Reddy Attipalli , Rao Khareedu Venkateswararao
Published: March 2022

World-wide crop productivity is hugely impacted by diverse
eco-environmental conditions. In the present investigation, activation
tagged (AT) lines of rice endowed with improved agronomic attributes
have been analyzed for tolerance to salinity stress besides
identification of genes associated with these attributes. Under salinity
stress conditions, AT lines exhibited increased seed germination rates,
improved plant growth and development at vegetative and reproductive
stages as compared to wild-type (WT) plants. Furthermore, AT lines
disclosed enhanced plant water content, photosynthetic efficiency,
stomatal conductance, water use efficiency and maximum quantum yield
when compared to WT plants, leading to improved yields and delayed onset
of stress symptoms. Moreover, AT lines revealed effective antioxidant
systems causing decreased accumulation of reactive oxygen species and
delayed salinity stress symptoms compared to WT plants. Reduced
accumulation of malondialdehyde with concomitant increases in proline
and soluble sugars of AT lines further endorsing their improved stress
tolerance levels. TAIL and qRT-PCR analyses of AT lines revealed Ds
element integrations at different loci and respective overexpression of
identified candidate genes involved in various aspects of plant
development and stress tolerance. Accordingly, the AT lines plausibly
serve as a rare genetic resource for fortifying stress tolerance and
productivity traits of elite rice cultivars.
Fracture parameters evaluation for cracked nonhomogeneous enamel based on nonhomogeneous finite element method and virtual crack closure technique
Authors: Cai Yan , E Changyong , Zhou Liming
Published: March 2022

To solve the fracture parameters of enamel accurately, we established
computational nonhomogeneous enamel models and constructed the fracture
element of enamel dumb nodes, based on enamel mineral concentration,
nonhomogeneous mechanical properties, and nonhomogeneous finite element
method. We constructed the user subroutines UMAT and UEL in ABAQUS to
solve the energy release rates of nonhomogeneous enamel structure with
cracks. The stress intensity factors of central cracks, three-point bend
and compact stretched enamels, double-edge notched stretched enamels and
kink notched stretched enamels were determined. By comparing with
analytical solutions, we proved the fracture element of enamel dumb
nodes is highly accurate, simple and convenient, and the cracks can be
other elements rather than singular or special elements, and show
versatility and other advantages. The stress intensity factor of dental
enamel can be solved more realistically. Thus, a new numerical method
for prevention and treatment of dental diseases is provided.
General enzyme-driven rule of metabolic scaling with body mass and evolution in organisms
Authors: Li Liyan , Wang Gen-Xuan
Published: March 2022

The origin and dynamics of the metabolic scaling is a fundamental
problem in ecology. The famous power law was queried by the notable
variations of the power exponent and the non-log-linear curvature of
metabolic scaling. Here, we proposed a novel enzyme-driven model of
metabolic scaling based on the hypothesis that the key enzyme
constrained the relative rate of both metabolism and growth based on the
basic biochemical evidences. The predictions were tested by the broad
range of compiled database from prokaryotes to higher animals. The
results showed that: (1) both metabolism (Q) and body mass (m) were
increased with the rate-limiting enzyme activity exponentially, (2) both
natural logarithmic metabolism (lnQ) and body mass (lnm) were limiting
resource dependent, and (3) lnQ was lnm dependent, that is the
non-log-linear scaling, when Q and m had the different half-saturation
constant of substrate response (KQ ≠ Km) and log-linear scaling when KQ
= Km, which showed how and why the variation of scaling dynamics and the
exponent. The results mean that the dynamics of metabolic scaling may be
mainly originated from the enzymatic dynamics and the lnQ and lnm
dependent model may be more general than the power law of metabolic
scaling.
Modeling and Optimization of some optical properties of cowpea seeds for Automation Sensing Operations.
Authors: Audu John , Aremu Ademola
Published: March 2022

Artificial intelligent and automation are the modern trends to
industrial development. The objective of this study is to determine,
model and optimize some optical properties of bulk cowpea grains
varieties relevant for automation. Three varieties with five moisture
levels were used. Colour properties were determined using chroma meter
while the absorbance and transmittance properties were determined using
spectrophotometer. Direct reflection property was calculated using
Beer-Lambert equation. Quartic model was found to be the best for colour
properties while quadratic model for absorbance and reflection
properties. Quadratic model was not sufficient enough to describe the
transmittance property. All models developed were found to be
significant at p < 0.05 and were also confirmed. Optimal
values for selecting sensors to identify, classify or sort cowpea seeds
using the optical properties studied were developed.
Absence of Left Atrial Appendage in an Atrial Fibrillation Patient: Congenital or Acquired?
Authors: LI LEI , FENG QIUTING , YOU CHUNYUAN , JIN YAN , CAO JIANING , YANG JUN
Published: March 2022

We report the case of a drug-refractory paroxysmal atrial fibrillation
patient without a left atrial appendage (LAA) proven by transesophageal
echocardiography and cardiac computed tomography prior to catheter
ablation. Absence of the LAA seems to be congenital according to
existing reports. In our case, 3-dimensional electroanatomical mapping
indicated that there were large areas of low-voltage electrograms and
scar tissue on the anterior wall, but few remaining high-voltage
potentials at the usual location of the LAA, which were replaced by just
a small uplifted area. These findings suggest that the absence of the
LAA in our patient was acquired.
Mis-diagnosis of genital organ tuberculosis ending in a severe Asherman syndrome: A case report
Authors: Hajati Azadeh
Published: March 2022

This case describes a female who had long lasting primary infertility,
labelled with polycystic ovarian syndrome, who showed no response to the
given related treatments. Hysterosalpingography, which was performed as
part of the IVF preparation, showed Asherman syndrome and calcified
lymph nodes. Subsequently, further evaluations confirmed tuberculosis.
The case highlights the necessity and importance of the proper
assessment of the patients presenting with infertility for early
detection of genital TB, to prevent end-stage disease.
Comparison of hidden blood loss between laparoendoscopic single-site myomectomy and conventional laparoscopic myomectomy
Authors: zhu sennan , chen qiuyu , Qi Lifang , Chen Miaomiao , Du Xinyi , chen yao , zhao yu , zhang qiong
Published: March 2022

Objective: To evaluate and compare hidden blood loss (HBL) in
laparoendoscopic single-site myomectomy (LESS-M) and conventional
laparoscopic myomectomy (CLM). Design: Retrospective cohort study.
Setting and population: Patients underwent laparoscopic myomectomy from
July 2019 to October 2020 at the Second Affiliated Hospital of Wenzhou
Medical University Methods: We collected data and calculated the HBL
according to the Nadler and Gross formula, and identified its risk
factors by multiple linear regression analysis. Main outcome measures:
Visible blood loss(VBL)，total blood loss(TBL), and HBL. Results: The
VBL was 115.4±180.6 mL in the LESS-M group; however, the HBL was
364.3±252.6 mL, accounting for 74.4±22.4% of true TBL. The VBL in the
CLM group was 187.9±198.5 mL, and the HBL was 306.8±304.7 mL, accounting
for 58.9±30.2% of true TBL. The HBL as a % of true TBL in LESS-M group
was more than CLM group (p=0.000). Conclusions: HBL accounted for a
significant percentage of TBL in conventional laparoscopic myomectomy.
Paying attention to perioperative blood changes and a full understanding
of the HBL might promote postoperative recovery of patients.
Funding：This study was financially supported by the Medical and Health
Research Project of Zhejiang Province of China [grant No.
2018KY127], the Natural Science Foundation of Zhejiang Province
[grant No. LY20H040005], the Public Welfare Science and Technology
Project of Wenzhou City [grant No. Y2020087]. Keywords: Hidden blood
loss, laparoendoscopic single-site myomectomy, conventional laparoscopic
myomectomy, leiomyoma, risk factors.
Are birth outcomes in non high-risk children related to hospital birth volumes? A systematic review
Authors: Walther Felix , Küster Denise , Bieber Anja , Malzahn Jürgen , Rüdiger Mario , Schmitt Jochen
Published: March 2022

BACKGROUND: There is convincing evidence that birth in hospitals with
high birth volumes increases the chance of healthy survival in high-risk
infants. However, it is unclear whether this is true also for non
high-risk infants. OBJECTIVES: Systematic review on effects of
hospital’s birth volume on mortality, mode of delivery, readmissions,
complications and developmental delays in non high-risk infants. SEARCH
STRATEGY: EMBASE and Medline supplemented by citing and cited literature
of included studies and expert panel highlighting additional literature,
published between Janu-ary/2000 and February/2020. SELECTION CRITERIA:
Publications in English or German language reporting effects of birth
volumes on mortality in term or all births in countries with neonatal
mortality <5/1000. DATA COLLECTION AND ANALYSIS: We undertook
a double-independent title-abstract- and full-text screening and
extraction of study characteristics, critical appraisal and outcomes in
a qualitative evidence synthesis. MAIN RESULTS: 13 retrospective studies
with mostly acceptable quality totaling 6.254.431 births and 51.907.405
deliveries were included. Heterogeneous volume-thresholds, risk
ad-justments, outcomes and populations hindered a meta-analysis.
Qualitatively, four of six studies reported significantly higher
perinatal mortality in lower birth volume hospitals. Volume-outcome
effects on neonatal mortality (n=7), stillbirths (n=3), maternal
mortality (n=1), caesar-ean sections (n=2), maternal (n=1) and neonatal
complications (n=1) were inconclusive. CONCLUSION: Analyzed studies
indicate higher rates of perinatal mortality in hospitals with low birth
volumes. Due to heterogeneity of studies, data synthesis was complicated
and a meta-analysis was not possible. Therefore international core
outcome sets should be defined and implemented in perinatal registries.
Ethnic Differences in Antipsychotic treatment responses in Early Intervention in Psychosis
Authors: Chakraborty Nandini , Ahmed Shiraz , Booth Hanna , Aswat Hawa
Published: March 2022

Background Ethnic variations in pathways to early intervention in
psychosis (EIP) have been studied. However it is important to explore
the ethnic variations in response to pharmacological treatment in EIP.
Aims To look at ethnic variation in response to antipsychotics. Method
Electronic patient records in December 2018 were perused for: 1.
Sociodemographic details including ethnicity 2. Prescribed antipsychotic
and dosage to which the patient had responded Results White, Black and
Asian ethnic groups responded mostly to Olanzapine. The largest
proportion of the mixed ethnic group responded to Aripiprazole. The
White and Asian groups showed the best responses to Lurasidone at 74 mg.
There was a slight response in the mixed and other ethnic group only at
the higher dose of 111 mg. The medication has not been used with any
benefit in the Black ethnic group. Conclusion The complex differences
highlighted amongst ethnic responses to treatment make a case for
multi-centric studies to further explore ethnic differences in early
intervention treatments. This will help streamline offered treatments to
maximise response in EIP.
Multi-omics responses of red algae to intertidal desiccation during low tides
Authors: Huang Lin-Bin , Peng Ling-Na , Yan Xing-Hong
Published: March 2022

The blades of intertidal red algae Pyropia haitanensis can lose
90% cellular water during low tides, thus is a good material for
exploring mechanisms of tolerance to intertidal desiccation. Here,
multi-omics responses of blades to a single stress of desiccation (SS)
or triple stress containing desiccation, high-temperature and high-light
(TS) were determined. Differentially expressed genes (DEGs) and proteins
(DEPs), and accumulated metabolites (DAMs) were analyzed in pairs. The
results showed that several DEGs/DEPs, DEGs/DAMs, and DEPs/DAMs
participated in Glyoxylate and dicarboxylate metabolism (ko00630) and
Carbon fixation in photosynthetic organisms (ko00710), and several
DEGs/DAMs enriched significantly in Ether lipid metabolism (ko00565).
DEGs/DAMs of ko00630 enriched significantly under both stress
conditions, DEGs/DAMs and DEPs/DAMs of ko00710 enriched significantly
under SS and TS, respectively. Therefore, we speculated that plasma
membrane responded first to intertidal desiccation and activated stress
signal transduction. Organic acids and amino acids involved in
osmoregulation were then synthesized and accumulated, meanwhile, energy
metabolism was reduced to prevent the accumulation of reactive oxygen
species and cellular damage. These pathways worked together to protect
blades of P. haitanensis from intertidal desiccation during low
tides, which further provided new ideas for breeding cultivars with
improved resistance to abiotic stress caused by global warming.
A giant mass filling the left atrium
Authors: Gonçalves Fernando , Borges Sara , Moreira José
Published: March 2022

A middle-aged woman presented to the emergency department with
unspecific symptoms developing over 2 weeks. Multimodality imaging
revealed a large mass filling the left atrium with a large base adherent
to the fossa ovalis and flow obstruction. After surgical extraction, the
anatomopathological analysis was compatible with a primary benign
cardiac tumor.
Optimization and Characterization of Laccase from Ganoderma multipileum and biodegradation of Cr(VI)
Authors: Umar Aisha
Published: March 2022

An efficient laccase producing fungus Ganoderma multipileum was
identified by ITS regions of DNA by constructing phylogenetic tree. This
work showed the first-time an efficient fungal producer G. multipileum
laccase using guaiacol substrate. The aim of this study is to obtain a
purified laccase and to determine the applicability of this enzyme for
bioremediation. Environmental and nutritional conditions were optimized,
which enhanced the enzyme production up to 4.5 folds. The % age yield
enhanced by optimized cultural conditions. A Glacc113 of 75.5 kDa was
purified by 80% ammonium sulphate precipitation and characterized under
different parameters. This enzyme exerted optimal activity at pH 3.0 and
70 ◦C. The catalytic parameters Km and Vmax was 1.4617 (mM) and 1.817
(mM min-1), respectively for guaiacol.
Impact of Arg175His mutation on the dynamical patterns of full-length human p53 protein
Authors: Mustafa Morad , Gharaibeh Mohammed
Published: March 2022

p53, a tumor suppressor protein, is essential for preventing cancer
development. Although individual domains of the human p53 have been well
analyzed, no study has experimentally revealed a full-length structure
of human wild-type p53 protein at atomistic level. The presence of all
human p53 domains in one structure will help in showing the correlated
interactions among these domains, thus, leading to enhance our
understanding about the dynamics of this protein and its mutant forms.
In this study we have modeled five human p53 forms, namely, inactive,
distal-active, proximal-active, distal-mutant, and proximal-mutant
forms. These forms have been investigated in this study by gaussian
accelerated molecular dynamics simulations in OPC water model at
physiological temperature and pH. On the basis of the observed dynamical
patterns, all wild-type forms can achieve better conformational
stability through dimerization or tetramerization process. The dynamical
patterns and free-energy profiles of the wild-type forms highlight the
most vulnerable sites to mutations; that is, p53–DNA and p53–p53
interfaces. On the other hand, principal component and clustering
analysis methods on Arg175His mutant forms reveal two distinct
conformational states (clusters); extended and compact clusters. The two
clusters of each mutant form reveal negative cavities near the mutation
site, which can be used for drug screening studies. The observed compact
structures in the conformations of Arg175His mutant forms may indicate
formation of aggregation.
Validation Of An Algorithm For Automatic Arrhythmia Recognition And 3D Mapping In A Porcine Model
Authors: Guerra Peter , Yarnitsky Jonathan , Macle Laurent , Sablayrolles Yannick , Lavoie Catherine , Nakar Elad , Ben-Dor Amir , Bartal Meir , Khairy Paul
Published: March 2022

Introduction: Atrial tachycardias (AT) can present multiple sites of
origin or circuits which complicates mapping, requiring creation of
separate activation maps per site. Objective: To evaluate the
Intra-Cardiac Pattern Matching (ICPM) software that automatically
detects and assigns different arrhythmia sources to separate 3D
activation maps in a porcine model. Methods: To simulate different ATs,
continuous pacing at same cycle length was performed from 2-3 right
atrial (RA) sites (2 screw-in leads and mapping catheter) for 60-90
seconds before alternating. RA was continuously mapped with a
48-electrode high-density mapping catheter (Octaray). The operator
manually switched and added points to the respective maps when the AT
changed. Conversely, the ICPM algorithm (Carto Mapping system)
automatically assigned each beat to its respective map. Pacing
electrodes were repositioned to create a second set of maps. Offline
analysis (manual and automatic maps) was performed comparing local
activation times (LAT) and mesh coloring values of adjacent points
(<5 mm apart). Differences <10 msec were considered
a match. Results: Twenty-three different pacing sites were analyzed in 6
swine with 1 manual/1 automatic map per site (46 maps); and 40,176
points were compared (manual and automatic). Individual LATs for manual
and automatic maps were compared and matched 91.2% of the time
(variance of <10 ms). Mesh coloring values matched using the
same criteria. Conclusion: The ICPM algorithm accurately identified
changing atrial activation sites and assigned points to appropriate maps
>90% of the time compared to manual acquisition.
The Laryngeal Mask Airway in Medical Malpractice
Authors: Eltorai Ashley
Published: March 2022

Introduction: The laryngeal mask airway (LMA) is an airway management
device commonly used during general anesthetics. In this study, a
nationwide comprehensive legal database was searched for all medical
malpractice cases involving an LMA and analyzed according to the
clinical context in which the LMA was implicated. Methods: Cases were
identified using Westlaw Edge, a legal database covering 8 million
United States federal and over 100 million state dockets. All cases
containing the search terms “anesthesiology” and “malpractice” were
retrieved, and results were then narrowed to those cases containing
“laryngeal mask airway” within their text. Cases were excluded if they
did not allege malpractice by an anesthesiologist or the listing was a
duplicate case listing. Results: Of the over 500 cases identified, 9
remained for analysis after application of inclusion and exclusion
criteria. Three of the cases (33%) involved use of the LMA as a rescue
airway device when endotracheal intubation was unsuccessful. Two (22%)
alleged aspiration of gastric contents during a general anesthetic with
an LMA, and another two (22%) described inadequate ventilation with an
LMA that necessitated progression to endotracheal intubation.
Discussion: This study helps to better elucidate the role of the LMA in
anesthesiology practice by describing related malpractice case outcomes.
It is clear from this case series that entry of a defendant verdict does
not necessarily indicate that the circumstances surrounding LMA use in
that case were congruent with standard of care, as multiple other
elements are required to prove medical malpractice. Nevertheless, the
analysis of malpractice cases involving LMAs can provide useful clinical
insight.
Local existence-uniqueness of positive solutions for tempered fractional differential equations with p-Laplacian operators
Authors: Zhou Bibo , Zhang Lingling
Published: March 2022

In this paper, we are concerned with a kinds of tempered fractional
differential equation Riemann-Stieltjes integral boundary values problem
involving p−Laplacian operator. By means of the sum-type mixed monotone
operators fixed point theorem based on the cone Ph, not only the local
existence of unique positive solution is obtained, but also two
successively monotone iterative sequences are constructed for
approximating the unique positive solution. Finally, we present an
example to illustrate our main results.
Immunophenotypic shifts during minimal residual evaluation in a case of leukemic form of Anaplastic large cell lymphoma ALK+
Authors: Canellas Maria Clara , Bruno-Riscarolli Enrico , Ferreira-Facio Cristiane , Lopes Daiana , Botafogo Vitor , Sutter Deborah , Pontes Roberia de , Land Marcelo , Milito Cristiane , Costa Elaine
Published: March 2022

This study aims to describe immunophenotypic studies at diagnosis and
follow up of a pediatric patient with leukemic phase of ALK+ anaplastic
large cell lymphoma (ALCL) by multiparametric flow cytometry (MFC). An
8-color MFC combination of antibodies allowed to identify neoplastic
cells in concentrations until 0.02% during minimal residual disease
(MRD) monitoring. Immunophenotypic shifts occurred in key markers as
CD30, CD7, CD2 and CD5, however neoplastic cells were clearly
discriminated from normal populations. MFC can be a useful tool for ALCL
diagnosis and MRD monitoring and may support therapeutic decisions.
A Nine-Year-Old Male with Barth Syndrome and Cardiac Transplant Presenting with Hyperviscosity Syndrome caused by EBV-Negative Plasmacytoid PTLD
Authors: Li Yixian , Tal Adit , Offenbacher Rachel , Corral Nicolas , Bansal Neha , Ding Juan , Gennarini Lisa , Ostrodka Leanne
Published: March 2022

Posttransplant lymphoproliferative disorder is a rare but well-known
complication in solid organ or hematopoietic transplant recipients
secondary to immunosuppression. It can range from a cellular hyperplasia
to a classic lymphoma. We describe a case of a nine-year-old male with
Barth syndrome and a history of cardiac transplantation who developed
plasmacytoid EBV-negative PTLD, an extremely rare entity in the
pediatric population, and the evolvement of his PTLD to a more
aggressive plasma cell neoplasm.
A case of direct congenital Gerbode defect misdiagnosed as left to right ventricle shunt and literature review
Authors: Du Bowen , Bai Kai , Wu Pengfei , Lu Yanan , Sun Kun
Published: March 2022

The direct congenital Gerbode defect was a rare type of ventricular
septal defect (VSD) causing a communication between the left ventricle
(LV) and right atrium (RA). In this case, only LV-to-right ventricle
(RV)shunt was found preoperatively. But in operation, the defect was
located at the interventricular septum between the tricuspid (TV) and
mitral valves (MV) where the shunt was from LV to right atrium (RA) and
septal TV dysplasia was found. The shunt might be LV-to-RA and the blood
flow into the RV through the defect of TV. This article discussed why
the preoperative ultrasound misdiagnosed this type of shunt and reviewed
the literature of Gerbode defect.
The role of peripheral eosinophilia in diagnosing lung disorders: experience from a single pneumonological center
Authors: Fijolek Justyna , Wiatr Elzbieta , Piotrowska-Kownacka Dorota , Roszkowski-Sliz Kazimierz
Published: March 2022

Rationale, aims and objective: Eosinophilia is rare, but one of the
important reasons to refer patients to pneumonological centers.
Determining its etiology has practical implications for therapeutic
intervention and disease prognosis. The study aimed to determine the
role of peripheral eosinophilia in the diagnosis of lung disorders.
Methods: The prospective study included 46 consecutive patients
diagnosed with peripheral eosinophilia with coexisting respiratory
symptoms and/or radiologically detected lung lesions. All patients
underwent standard diagnostic procedures, including a detailed clinical
history review, physical examination, routine laboratory tests with
basal cardiological examinations, and serological tests to detect
parasites and allergies. Other procedures carried out depended on the
symptoms of each patient. Results: Severe eosinophilia (≥5,000 cells/μL)
was associated with extrapulmonary involvement and constitutional
symptoms. Skin, heart, and pleural diseases were more frequent in these
patients than in patients with mild or moderate eosinophilia (p=0.010,
p=0.040, and p=0.007, respectively), and only these patients showed
signs of kidney disease (p=0.006). Vasculitis was significantly more
frequent in the severe eosinophilia group (p=0.048) than in the other
two groups. In patients with moderate eosinophilia (1,500-5,000
cells/μL), extrapulmonary symptoms were less common, although signs of
cardiac involvement were confirmed in 44% of subjects. In this group,
vasculitis was the most commonly observed disease (42% of cases). Mild
eosinophilia (<1,500 cells/μL) was mainly associated with
airway disease. In this group, vasculitis and interstitial lung diseases
were identified, but most were not typically connected with
eosinophilia. Conclusion: Identification of peripheral eosinophilia
essentially determines diagnostic procedures in patients with lung
disorders and can be a useful indicator of disease etiology.
Assessment of Cognitive Function and Brain Volume among Survivors of Pediatric Hematological Malignancies: Case- Control Study
Authors: Osman Amira , Ali Amany , Sayed Heba , Atta Haism , Ahmed Shimaa , Aliedin Nelly , Elhamed Mohamed Abd , Shibl Azza
Published: March 2022

ABSTRACT Background: As the survival rates of pediatric malignancies
increased, many survivors experienced various long-term effects.
Cognitive dysfunction may be one of the hazardous late effects among
this critical age group. This study aimed to evaluate the cognitive
functions, brain volume, and risk factors affecting them among survivors
of hematological malignancies. Methods: This case-control study was
conducted on 68 survivors of hematological malignancies, with a mean
follow-up period 2.1± 1.2 years (ranged from 1 to 6.2 years). Age and
sex-matched 68 child were selected as a comparison group. Detailed
clinical and therapeutic data were collected from patients’ records.
Assessment of cognitive function was done using Arabic version of the
Stanford-Binet Test (version IV). Quantitative volumetric assessment of
the brain was done using the NeuroQuant study (NQ). Results: The cancer
survivors showed significantly lower levels in IQ and their subitems
than the control group. Brain atrophy was observed in the NQ impression
in the majority of our survivors. AML survivors had significantly lower
volumes of thalami, white matter, and hippocampus than other survivors.
Many risk factors had a significantly adverse effect on different IQ
subitems, such as radiotherapy (RTH), high cumulative doses of
methotrexate (MTX), and prednisone. While low white matter volume (WMV)
was observed with higher mean cumulative doses of MTX and
anthracyclines. Conclusions: Survivors of pediatric hematological
malignancies showed significant cognitive impairment, this can be
attributed to neuronal degeneration (brain volume loss). RTH, high
cumulative doses of MTX and steroids were the most prominent risk
factors.
Is the HPV-test more cost-effective than cytology in cervical cancer screening? An economic analysis from a middle-income country
Authors: Vale Diama , Silva Marcus , Discacciati Michelle , Polegatto Ilana , Teixeira Julio , Zeferino Luiz
Published: March 2022

Objective: To report a modelling study using local health care costs and
epidemiological inputs from a population-based program to access the
cost-effectiveness of adopting hrHPV test. Design: A cost-effectiveness
analysis based on a microsimulation dynamic Markov model. Data and costs
were based on data from the local setting and literature review.
Setting: Indaiatuba, Brazil. The city has adopted the hrHPV test
replacing cytology since 2017. Sample: After calibrating the model, one
million women were simulated in hypothetical cohorts. Methods: Three
strategies were tested: cytology to women aged 25 to 64 every three
years; hrHPV test to women 25-64 every five years; cytology to women
25-29 years every 3 years and hrHPV test to women 30-64 every five years
(hybrid strategy). Main outcome measure: Quality-adjusted life-years
(QALY), assessed by the Incremental Cost-Effectiveness Ratio (ICER).
Results: The hrHPV testing and the hybrid strategy were the dominant
strategies. Costs were lower and provided a more effective option at a
negative incremental ratio of US$ 37.87 for the hybrid strategy, and
negative US$ 6.16 for the HPV strategy per QALY gained. Reduction on
treatment costs would influence a reduction in ICER, and an increase in
the costs of the hrHPV test would increase ICER. Conclusions: Using
population-based data, the switch from cytology to hrHPV testing in the
cervical cancer screening program of Indaiatuba is less costly and
cost-effective than the old cytology program. Funding: UNICAMP (research
project), Indaiatuba City and Roche Diagnostics (program).
Newly developed ad hoc molecular assays shows how eDNA can witness and anticipate the monk seal recolonization of central Mediterranean
Authors: Valsecchi Elena , Coppola Emanuele , Pires Rosa , Parmegiani Andrea , Casiraghi Maurizio , Galli Paolo , Bruno Antonia
Published: March 2022

The monk seal, the most endangered pinniped worldwide and the only one
found in the Mediterranean, has suffered a drastic decline in the last
few decades. Nowadays molecular techniques allow to detect minute
amounts of DNA released in the environment (eDNA) by any organism. We
present three qPCR-assays targeting the monk seal mitogenome. The assays
were soundly tested on an extensive/diversified sample set (n=73),
including positive controls from Madeira breeding population and two
opportunistic Mediterranean eDNA-sample collections (offshore/coastal)
from on-going projects. Monk seal DNA was detected in 47.2% and 66.7%
of the samples collected in the Tyrrhenian from a ferry platform
(2018-2019) and in the Pelagie archipelago (2020) respectively,
anticipating (up to 2 year) visual observations occurred subsequently in
proximity of the sampled areas. In the Tyrrhenian, detection occurrence
increased between 2018 and 2019. Monk seal DNA recoveries were commoner
in night-time ferry-samples, suggesting nocturnal predatory activity in
pelagic waters. The proposed technique provides a non-invasive and yet
highly-sensitive tool for defining the monk seal actual range, its
recovery rate and pinpoint coastal/offshore localities where
prioritizing conservation.
Reconstruction of the Left Atrium for Atrial Fibrillation Ablation using the Machine Learning CARTO 3 m-FAM Software
Authors: Schwartz Arie , Chorin Ehud , Mann Tomer , Levi Yuval , Hochstadt Aviram , Margolis Gilad , Viskin Sami , Banai Shmuel , Rosso Raphael
Published: March 2022

IIntroduction: Atrial fibrillation (AF) ablation requires a precise
reconstruction of the left atrium (LA) and pulmonary veins (PV).
Model-based FAM (m-FAM) is a novel module recently developed for the
CARTO system which applies machine-learning techniques to LA
reconstruction. We aimed to evaluate the feasibility and safety of a
m-FAM guided AF ablation as well as the accuracy of LA reconstruction
using the cardiac computed tomography angiography (CTA) of the same
patient LA as gold standard, in 32 patients referred for AF ablation.
Methods: Consecutive patients undergoing AF ablation. The m-FAM
reconstruction was performed with the ablation catheter (Group 1) or a
Pentaray catheter (Group 2). The reconstruction accuracy was confirmed
prior to the ablation by verification of pre-specified landmarks of the
LA and PVs by intracardiac echocardiogram (ICE) visualization and
fluoroscopy. A cardiac CTA performed before the ablation was used as
gold standard of LA anatomy. For each patient, the m-FAM reconstruction
was compared to his/her cardiac CTA. Results: The m-FAM reconstruction
was accurate in all patients regardless the catheter used for mapping.
In 12% re acquisition of the LA landmarks was necessary to improve the
accuracy. m-FAM time was shorter in group 2 while the M-Fam fluoroscopy
time was similar. Pulmonary vein isolation was achieved in 100% of
patients without major complications. The m-FAM reconstructions
accurately resemble the cardiac CTA of the same patients. Conclusions:
The m-FAM module allows for rapid and precise reconstruction of the LA
and PV anatomy, which can be safely used to guide AF ablation.
No association between proton pump inhibitor use and dementia risk: data mining of US Food and Drug Administration adverse event reporting system
Authors: wu bin , Hu Qiaozhi , Tian Fangyuan , Wu Fengbo , Li Yuwen , Xu Ting
Published: March 2022

AIM: Proton pump inhibitors (PPIs) were widely used around the world.
Studies suggested conflicting results between PPIs treatment and the
risk of dementia. This study examined the association between PPIs and
dementia risk by mining the US FDA Adverse Event Reporting System
(FAERS) database. METHODS: We identified six PPI agents and adverse
reports of dementia based on FAERS database from 2004 to 2019. We
employed reporting odds ratio (ROR) and proportional reporting ratio
(PRR) to detect the signals of dementia relevant to PPIs. We also
analyzed characteristics of PPI reports, compared dementia events
between short- and long- duration PPIs treatment. RESULTS: We identified
2104 dementia cases with PPIs treatment. We did not detect significant
signals between PPIs and dementia, ROR = 0.99, 95%CI 0.94 - 1.03, PRR =
0.99, 95%CI 0.95 - 1.03, even in gastroesophageal reflux disease cases
ROR = 0.65, 95%CI 0.58 - 0.73, PRR = 0.67, 95%CI 0.60 - 0.74. No
significant differences of dementia events were detected between short-
and long- duration groups, the OR (95%CI) of the 6 months, 1 year, 3
years and 5 years comparison were 0.85 (0.68 - 1.06), 0.92 (0.71 -
1.18), 0.81 (0.57 - 1.15) and 0.79 (0.52 - 1.22), respectively.
CONCLUSIONS: Based on the current FAERS data mining, we discovered no
association between PPIs use and the risk of dementia.
Effect of high frequency oscillatory ventilation combined with pulmonary surfactant in the treatment of acute respiratory distress syndrome after cardiac surgery: a prospective randomized controlled trial
Authors: zheng yirong , lei yuqing , liu jianfeng , wu honglin , xu ning , huang shuting , cao hua , chen qiang
Published: March 2022

Objective: This study aimed to evaluate the effects of pulmonary
surfactant (PS) combined with high-frequency oscillatory ventilation
(HFOV) or conventional mechanical ventilation (CMV) in infants with
acute respiratory distress syndrome (ARDS) after congenital cardiac
surgery. Method: A total of 61 infants with ARDS were eligible and were
randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31)
between January 2020 and December 2020. The primary outcomes were the
improvement of the arterial blood gas analysis. The incidence of
mechanical ventilation duration, length of hospitalization, and the
incidence of complications were considered as secondary outcomes.
Results: A total of 61 infants completed the study. In HFOV + PS group,
the blood gas analysis results were significantly improved
(P<0.05), while, duration of mechanical ventilation and length
of hospitalization were shorter than CMV + PS group (P<0.05).
But the incidences of complications had no statistical significance
between the two groups (P>0.05). Conclusions: Compared with
the CMV + PS group, HFOV + PS significantly improved the ABG variables
and shortened the length of hospitalization and mechanical ventilation
in infants with ARDS after cardiac surgery.
A Chronic Eyelid Lesion in a child: Multi-Disciplinary Approach to Diagnosis, Treatment and Management of a Highly Atypical Histiocytic Lesion
Authors: Ramgopal Archana , Mukhtar Sabrina , Segal Julia , Yu Jenny , Picarsic Jennifer , Tersak Jean , Allen Steven
Published: March 2022

Malignant histiocytic neoplasm with histiocytic sarcoma phenotype is a
rare malignant neoplasm, distinguished by malignant cells with
phenotypical characteristics of mature tissue histiocytes. Histiocytic
sarcoma typically presents as a primary malignancy, although it can also
present as a secondary malignancy, and is rarely seen in the pediatric
population. Due to the rarity of this condition, diagnosis of
histiocytic sarcoma is difficult and considered a diagnosis of
exclusion. We describe a unique case of a chronic upper eyelid lesion
with biopsy findings of a highly atypical histiocytic neoplasm
concerning for histiocytic sarcoma in a child treated with excision and
observation alone.
Total cholesterol and Intensive Care survival in patients treated with Veno-Arterial Extracorporeal Life Support; A preliminary single-centre experience
Authors: Haan Maarten de , Haanschoten Marco , Kreeftenberg Herman , Lanen Patrix , Houterman Saskia , Straten Bart van , Hamad Mohamed Soliman
Published: March 2022

Objective Veno-Arterial Extra Corporeal Life Support (VA ECLS) is widely
used as an effective device for patients in cardiogenic shock. The need
for predictive markers that daily guide physicians in the evaluation of
these patients could be of great value. Our aim was to investigate the
role of cholesterol value during VA ECLS in predicting the Intensive
Care Unit (ICU) survival. Methods Between January 2013 and November
2019, 67 patients with VA ECLS due to cardiogenic shock were included in
this study. Demographic data, laboratory values, ICU data and outcomes
were collected. Cholesterol was measured during morning routine blood
samples. The minimal cholesterol value during the ICU stay was
registered. Groups were stratified by minimal cholesterol cut-off point
of 2.0 mmol/L. Logistic regression analysis were performed to identify
variables associated with ICU survival. Results The ECLS duration was
not significantly different (p=0.36) between the non-survivors (median
5.0 (2.0-7.5) days) and survivors (median 6.0 (1.8-12.0) days). The
minimal cholesterol level was significantly lower (p=0.04) in
non-survivors group (1.54 (1.00-1.87) mmol/L) compared to survivors
(1.85 (1.38-2.24) mmol/L). By using logistic regression analysis,
minimal cholesterol level of ≥2.0 mmol/L was associated with a higher
ICU survival (p=0.02; OR 3.77; 95% CI 1.20-11.81). Conclusion
Cholesterol level could be an additional marker for ICU survival of
patients with cardiogenic shock on VA ECLS. A larger cohort of patients
is necessary to determine total cholesterol as a specific risk factor
for survival in these patients.
Toe distal phalanx Ewing Sarcoma: Excellent response to neoadjuvant chemotherapy. A case report.
Authors: Luna Andrés Piolatti , Lozano Cristina Nova , Ortega Elena Carceller , Almero Laura Pino , Muñoz Javier Navarro , Muñoz Ara Almécija
Published: March 2022

Ewing sarcoma (ES) rarely involves acral regions as the foot. A
4-year-old white female presented with a growing and painful violaceous
nodular lesion at the fourth right toe, which appeared 4 months prior to
the consultation. MRI reported a nonspecific soft tissue tumor with
intense homogeneous contrast uptake. Histopathological examination
revealed CD99 positive, small, round, blue cells. EWS-FLI1 fusion gene
translocation was detected, consistent with ES. In this report, the
authors show the notable response to neoadjuvant chemotherapy of an
infrequent foot phalangeal ES.
Wilms Tumor with Mulibrey Nanism: A Case Report and Review of Literature
Authors: Upasana K , Thakkar Dhwanee , Gautam Dheeraj , Sachdev Manvinder , Yadav Anjali , Kapoor Rohit , Raghunathan Veena , Dhaliwal Manider , Bhargava Katikeya , Nair Sandhya , Sharma Jaiprakash , Rastogi Neha , Yadav Satya
Published: March 2022

Mulibrey-Nanism (Muscle-liver-brain-eye nanism= dwarfism) is a rare
syndrome. The underlying TRIM37 mutation predisposes these children to
develop tumors frequently. Wilms tumor has been reported to be
associated with this syndrome. Here we report a 2-year-old boy with
Wilms tumor and Mulibrey-Nanism and review the published similar cases.
Our patient had associated atrial septal defect, atrial flutter and an
episode of cardiac arrest along with other features of Mulibrey Nanism.
We managed him successfully with chemotherapy and surgery. A total of 14
cases (including present case) of Wilms tumor have been reported in
Mulibrey-Nanism. Longest survivor has been 15-year-old.