bluuebunny/crossref_metadata_2025 huggingface dataset:
8Spheres conformal microspheres as embolic agents for symptomatic uterine leiomyoma therapy in uterine artery embolization (UAE): A prospective clinical trial
Authors: Zhang Yiwen , Xu Yanneng , Zhang Xun , Zheng Bo , Hu Wei , Yuan Gang , Si Guangyan
Published: March 2023

To evaluate the treatment efficacy of uterine artery embolization (UAE) using 8Spheres conformal microspheres for symptomatic uterine leiomyoma. In this prospective observational study, 15 patients were enrolled and underwent UAE by 2 experienced interventionalists from September 1, 2018, to September 1, 2019. All patients underwent menstrual bleeding scores, the symptom severity domain of the Uterine Fibroid Symptom and Quality of Life questionnaire scores (with lower scores indicating mild symptoms), pelvic contrast-enhanced magnetic resonance imaging, ovarian reserve tests (estradiol, prolactin, testosterone, follicle-stimulating, luteinizing, and progesterone), and other appropriate preoperative examinations within 1 week before UAE. During follow-up, menstrual bleeding scores and the symptom severity domain of the Uterine Fibroid Symptom and Quality of Life questionnaire scores were recorded at 1, 3, 6, and 12 months after UAE to assess the efficacy of symptomatic uterine leiomyoma. Pelvic contrast-enhanced magnetic resonance imaging was performed 6 months after the interventional therapy. Biomarkers of ovarian reserve function were reviewed at 6 and 12 months after treatment. All 15 patients successfully underwent UAE, without severe adverse effects. Six patients experienced abdominal pain, nausea, or vomiting, all of which improved significantly after symptomatic treatment. The menstrual bleeding scores declined from baseline (350.2 ± 61.9 mL) to (131.8 ± 42.7 mL), (140.3 ± 42.4 mL), (68.0 ± 22.8 mL), and (64.43 ± 17.0 mL) at 1, 3, 6, and 12 months, respectively. The symptom severity domain scores at 1, 3, 6, and 12 months postoperatively were significantly lower and statistically significant compared to the preoperative scores. The uterus and dominant leiomyoma volumes decreased from baseline (340.0 ± 35.8 cm3), (100.6 ± 24.3 cm3) to (266.6 ± 30.9 cm3), (56.1 ± 17.3 cm3) at 6 months after UAE, respectively. Moreover, the ratio of leiomyoma volumes and uterus decreased from (27.4 ± 4.5%) to (18.7 ± 3.9%). At the same time, there was no significant effect on changes in the biomarkers of ovarian reserve levels. Only the changes in testosterone levels before and after UAE were statistically significant (P < .05). 8Spheres conformal microspheres are ideal embolic agents for UAE therapy. This study showed that 8Spheres conformal microsphere embolization for symptomatic uterine leiomyoma could effectively relieve heavy menstrual bleeding, improve the symptom severity of patients, reduce the volume of leiomyoma, and have no significant effect on ovarian reserve function.
Prediction tool for disability progression and mortality in older adults eligible for Japanese long-term care insurance: Koriyama study
Authors: Fujita Takaaki , Iokawa Kazuaki
Published: March 2023

This study aims to create a simple model for predicting disability progression and death among older adults with Japanese long-term care insurance certification. This retrospective study analyzed the anonymized data provided by Koriyama City. The participants were 7706 older adults who were initially certified to be support levels 1 and 2 or care levels 1 and 2 for the purpose of obtaining Japanese long-term care insurance. The results of the certification questionnaire at the initial survey stage were used to create decision tree models intended to predict whether disability progression and death would occur within 1 year. In support levels 1 and 2, among those who scored both “daily decision making” item as other than “possible” and the “taking drugs” item as other than “independent,” 64.7% had an adverse outcome. In care levels 1 and 2, among those who scored both the “shopping” item as “totally dependent” and the “defecation” item as other than “independent,” 58.6% had an adverse outcome. The accuracy of classification of the decision trees were 61.1% in support levels 1and 2, and 61.7% in care levels 1 and 2. The overall accuracy of the decision tree is low, making it impractical to use it for all subjects. Nevertheless, based on the results of the 2 assessments in this study, the process of identifying a particular group of older adults at a high risk of an increased need for long-term care or possible death within a year is very simple and useful.
Fibrothecoma of broad ligament with minor sex cord elements: Case report and brief literature review
Authors: Chen Yanjun , Zhou Peng , Chen Jianlin
Published: March 2023

Rationale:

Sex cord-stromal tumors are always found in ovary, but the occurrence of this kind of tumor at extraovarian locations is extremely rare. Up to now, the case concerning fibrothecoma of broad ligament with minor sex cord elements has not been reported, and it is extremely challenging to diagnose before surgery. In this case report, we summarized pathogenesis, clinical features, laboratory finding, imaging studies, pathology, and therapeutic schedule of this tumor, with the aim of raising awareness and attention to this type of disease.

Patient concerns:

A 45-year-old Chinese woman was referred to our department with intermittent lower abdominal pain for about 6 years. On examination, both ultrasonography and computed tomography revealed she had a right adnexal mass.

Diagnosis:

Based on the results of histology and immunohistochemistry, the final diagnosis was confirmed as fibrothecoma of broad ligament with minor sex cord elements.

Interventions:

This patient underwent laparoscopic unilateral salpingo-oophorectomy with excision of the neoplasm.

Outcomes:

Eleven days post-treatment, the patient complained that the symptoms of abdominal pain was disappeared. There is no evidence of disease recurrence 5 years after laparoscopic surgery according to the consequences of radiologic examination

Conclusion:

The natural history of this kind of tumor is uncertain. Although main treatment of this neoplasm might be surgical resection and good prognosis can be achieved, we believe that long-time follow-up is extremely important in all patients diagnosed as fibrothecoma of broad ligament with minor sex cord. Laparoscopic unilateral salpingo-oophorectomy with excision of the tumor should be recommended to these patients.
Pelvic ultrasound finding of late-onset bladder erosion after transobturator tape for female stress urinary incontinence: A case report
Authors: Lou Yelin , Hu Yang , Zhou Yibo
Published: March 2023

Rationale:

Mid-urethral sling is a gold-standard procedure for stress urinary incontinence because of its high efficacy and low complication incidence. Moreover, mesh erosion into the bladder is a rare complication.

Patient concerns:

The 63-year-old patient visited our gynecology clinic with complaints of gross hematuria and was diagnosed with bladder erosion by ultrasound 6 months after transobturator tape procedure.

Diagnoses:

The 2D ultrasound found the sling in the bladder wall perforation, which can lead to the formation of bladder stones. Meanwhile, 3D ultrasound showed the left side of the sling crossed the bladder mucosa at 5 o’clock.

Interventions:

The sling and bladder stones were removed by holmium laser.

Outcomes:

The patient underwent a follow-up pelvic ultrasound at 6 months, which showed no erosion mesh under the bladder mucosa.

Lessons:

Pelvic ultrasound could accurately evaluate the location and shape of the tape, which is important for a reasonable surgical plan.
Application effect evaluation of hybrid biochemistry teaching model based on WeChat platform under the trend of COVID-19
Authors: Ding Jianing , Ji Xinye , Zhu Kangle , Zhu Huixia
Published: March 2023

With WeChat platform as the carrier, we explored the effect of online and offline mixed teaching mode applied to Biochemistry teaching. One hundred and eighty-three students from the 4-year nursing major of Xinglin College of Nantong University in 2018 and 2019 were used as the observation group, using online and offline hybrid teaching methods, and 221 students majoring in 4-year nursing from Xinglin College of Nantong University in 2016 and 2017 were the control group, where the traditional classroom teaching method was adopted. The usual stage scores and final scores of the observation group were significantly higher than those of the control group (P < .01). The micro-lecture videos, animations, and periodic assessment methods of the WeChat platform under “Internet+” can greatly stimulate students’ interest in learning, thereby significantly improving academic performance and autonomous learning ability.
Machine-learning-based analysis of the sensitivity and specificity on lipid-lowering effect of one-month-administered statins
Authors: Liu Huiqin , Jiao Ronghong , Wang Lingling , Feng Fei , Zhao Xiaohui , Yang Juan
Published: March 2023

Few predictive studies have been reported on the efficacy of atorvastatin in reducing lipoprotein cholesterol to be qualified after 1-month course of treatment in different individuals. A total of 14,180 community-based residents aged ≥ 65 received health checkup, 1013 of whom had low-density lipoprotein (LDL) higher than 2.6mmol/L so that they were put on 1-month course of treatment with atorvastatin. At its completion, lipoprotein cholesterol was measured again. With < 2.6 mmol/L considered as the treatment standard, 411 individuals were judged as the qualified group, and 602, and as the unqualified group. The basic sociodemographic features covered 57 items. The data were randomly divided into train sets and test ones. The recursive random-forest algorithm was applied to predicting the patients response to atorvastatin, the recursive feature elimination method, to screening all the physical indicators. The overall accuracy, sensitivity and specificity were calculated, respectively, and so were the receiver operator characteristic curve and the area under the curve of the test set. In the prediction model on the efficacy of 1-month treatment of statins for LDL, the sensitivity, 86.86%; and the specificity, 94.83%. In the prediction model on the efficacy of the same treatment for triglyceride, the sensitivity, 71.21%; and the specificity, 73.46%. As to the prediction of total cholesterol, the sensitivity, 94.38%; and the specificity, 96.55%. And in the case of high-density lipoprotein (HDL), the sensitivity, 84.86%; and the specificity, 100%. recursive feature elimination analysis showed that total cholesterol was the most important feature of atorvastatin efficacy of reducing LDL; that HDL was the most important one of its efficacies of reducing triglycerides; that LDL was the most important one of its efficacies of reducing total cholesterol; and that triglyceride was the most important one of its efficacies of reducing HDL. Random-forest can help predict whether atorvastatin efficacy of reducing lipoprotein cholesterol to be qualified after 1-month course of treatment in different individuals.
Expression and prognostic impact of DNA-PK in human lung cancer
Authors: Tirilomi Anna , Elakad Omar , Yao Sha , Li Yuchan , Hinterthaner Marc , Danner Bernhard C. , Ströbel Philipp , Tirilomis Theodor , Bohnenberger Hanibal , von Hammerstein-Equord Alexander
Published: March 2023

Among all cancer patient’s lung cancer is the leading cause of death. Prognostic biomarkers continue to be investigated for the detection and stratification of lung cancer for clinical use. The DNA-dependent protein kinase is involved in mechanisms of DNA damage repair. Deregulation and overexpression of DNA-dependent protein kinase is associated with poor prognosis in various tumor entities. In this study, we investigated the expression of DNA-dependent protein kinase in relation to clinicopathological features and overall survival in patients with lung cancer.

By immunohistochemistry, expression of DNA-dependent protein kinase was analyzed in 205 cases of lung cancer; 95 cases of adenocarcinoma, 83 cases of squamous cell lung carcinoma and 27 cases of small cell lung cancer and correlated with clinicopathological characteristics as well as patient’s overall survival.

In patients with adenocarcinoma, a significant correlation between strong expression of DNA-dependent protein kinase and worse overall survival was found. No significant association was observed in patients with squamous cell lung carcinoma and small cell lung cancer. Strong detection of DNA-dependent protein kinase expression was most evident in small cell lung cancer (81.48 %), followed by squamous cell lung carcinoma (62.65 %) and adenocarcinoma (61.05 %).

In our study, expression of DNA-dependent protein kinase was associated with poor overall survival in patients with adenocarcinoma. DNA-dependent protein kinase could serve as a new prognostic biomarker.
High expression of HILPDA is an adverse prognostic prognostic factor in hepatocellular carcinoma
Authors: Wang Xiao , Zou Aoshuang , Zhang Jinhe , Gao Guochuan , Shan Wenting , Li Jun , Liu Xia
Published: March 2023

Hepatocellular carcinoma (LIHC) is a malignant tumor arising from hepatocytes or intrahepatic bile duct epithelial cells, which is one of the common malignancies worldwide. Better identification of liver cancer biomarkers has become one of the current challenges. Although hypoxia inducible lipid droplet associated (HILPDA) has been reported to be associated with tumor progression in a variety of human solid cancers, it has rarely been reported in the field of hepatocellular carcinoma; therefore, in this paper, RNA sequencing data from TCGA were used to analyze the expression of HILPDA and differentially expressed genes (DEGs). In addition, functional enrichment analysis of HILPDA-associated DEGs was performed by GO/KEGG, GSEA, immune cell infiltration analysis and protein-protein interaction network. The clinical significance of HILPDA in LIHC was calculated by Kaplan–Meier Cox regression and prognostic nomogram models. R package was used to analyze the combined studies. Thus, HILPDA was highly expressed in various malignancies, including LIHC, compared with normal samples, and high HILPDA expression was associated with poor prognosis (P < .05). Cox regression analysis showed high HILPDA to be an independent prognostic factor; age and cytogenetic risk were included in the nomogram prognostic model. A total of 1294 DEGs were identified between the high and low expression groups, of which 1169 had upregulated gene expression and 125 had downregulated gene expression. Overall, high expression of HILPDA is a potential biomarker for poor outcome in LIHC.
A new immune checkpoint-associated nine-gene signature for prognostic prediction of glioblastoma
Authors: Jin Xiao , Zhao Xiang
Published: March 2023

Glioblastoma (GBM) is a highly malignant neurological tumor that has a poor prognosis. While pyroptosis affects cancer cell proliferation, invasion and migration, function of pyroptosis-related genes (PRGs) in GBM as well as the prognostic significance of PRGs remain obscure. By analyzing the mechanisms involved in the association between pyroptosis and GBM, our study hopes to provide new insights into the treatment of GBM. Here, 32 out of 52 PRGs were identified as the differentially expressed genes between GBM tumor versus normal tissues. And all GBM cases were assigned to 2 groups according to the expression of the differentially expressed genes using comprehensive bioinformatics analysis. The least absolute shrinkage and selection operator analysis led to the construction of a 9-gene signature, and the cancer genome atlas cohort of GBM patients were categorized into high risk and low risk subgroups. A significant increase in the survival possibility was found in low risk patients in comparison with the high risk ones. Consistently, low risk patients of a gene expression omnibus cohort displayed a markedly longer overall survival than the high risk counterparts. The risk score calculated using the gene signature was found to be an independent predictor of survival of GBM cases. Besides, we observed significant differences in the expression levels of immune checkpoints between the high risk versus low risk GBM cases, providing instructive suggestions for immunotherapy of GBM. Overall, the present study developed a new multigene signature for prognostic prediction of GBM.
Prevalence of fatigue functional and social impairment among patients with rheumatic diseases compared to patients without: A cross-sectional comparison
Authors: Almalag Haya M. , Almaghlouth Ibrahim , Dabbagh Rufaidah , Alsalem Abdulaziz R. , Alrajban Fahad N. , Algarni Saleh A. , Alosaimi Faisal N. , Alassaf Meshal I. , Alshamrani Muhammad A. , Alzomia Sulaiman , Alanazi Boshra , Alalwan Tareq , Alkhalaf Abdulaziz , Bedaiwi Mohamed , Omair Mohammed A.
Published: March 2023

Rheumatic diseases (RD) are chronic diseases that significantly affect the lives of patients. Assessing health outcomes through a patient-reported outcome measurement information system (PROMIS) is essential for RD management. Moreover, these tend to be less favorable among individuals than among the rest of the population. This study aimed to compare PROMIS between RD patients and other patients. This cross sectional study was conducted in the year 2021. Information about patients with RD was obtained from the RD registry at King Saud University Medical City. Patients without RD were recruited from family medicine clinics. Patients were contacted electronically through WhatsApp© to complete the PROMIS surveys. We compared the individual PROMIS scores between the 2 groups using linear regression, adjusting for sex, nationality, marital status, education level, employment, family history of RD, income, and chronic comorbidities. There were 1024 individuals (512 with RD and 512 without RD). The most common RD was systemic lupus erythematosus (51.6%), followed by rheumatoid arthritis (44.3%). Individuals with RD reported significantly higher PROMIS T-scores for pain [β = 6.2; 95% confidence interval (CI) = 4.76, 7.71] and fatigue (β = 2.9; 95% CI = 1.37, 4.38) compared to those without RD. Moreover, RD individuals reported lower physical functioning (β = −5.4; 95% CI = −6.50, −4.24) and social interaction (β = −4.5; 95% CI = −5.73, −3.20). Patients with RD in Saudi Arabia, particularly those with systemic lupus erythematosus and rheumatoid arthritis, have significantly greater impairment in physical functioning and social interaction and report higher levels of fatigue and pain. Addressing and ameliorating these negative outcomes is necessary to improve quality of life.
Efficacy of albumin-bound paclitaxel combined with nedaplatin in neoadjuvant therapy for esophageal squamous cell carcinoma: A single-center retrospective observational study
Authors: Chen Jiakuan , Zhu Jianfei , Zhang Yan , Wang Wenchen , Xia Yanmin , Zhao Jinbo , Jiang Tao
Published: March 2023

This study was designed to observe the efficacy and safety of albumin-bound paclitaxel plus nedaplatin as neoadjuvant therapy in patients with esophageal squamous cell carcinoma (ESCC). From April 2019 to Dec 2020, patients with ESCC who underwent Mckeown surgery at our center were analyzed retrospectively. All patient received 2 to 3 cycles of albumin-bound paclitaxel combined with nedaplatin before surgery, tumor regression grade (TRG) and American National Cancer Institute Common Toxicity Criteria version 5.0 were used to evaluate its efficacy and safety. TRG grades from TRG 2 to TRG 5are considered effective in chemotherapy, TRG 1 stands for pathological complete response (pCR). A total of 41 patients were included in this study. All patients achieved R0 resection. According to the TRG classification, the number of patients assessed for TRG 1-TRG 5 were: 7 cases, 12 cases, 3 case, 12 cases and 7 cases. Its objective response rate and pCR were 82.9% (34/41) and 17.1% (7/41), respectively. We found that hematological toxicity is the most common adverse events of this regimen, with an incidence of 24.4%, followed by digestive tract reactions, with an incidence of 17.1%. Hair loss, neurotoxicity and hepatological disorder are the others, their incidence was 12.2%, 7.3%, and 2.4%; and chemotherapy related deaths were no found. Notably, 7 patients achieved pCR without recurrence or death. Survival analysis showed that patients with pCR may have longer disease-free survival (P = .085) and overall survival (P = .273), although the difference was not statistically significant. As neoadjuvant therapy for patients with ESCC, albumin-bound paclitaxel combined with nedaplatin has a higher pCR rate and less side effects. It is a reliable choice for ESCC patients as neoadjuvant therapy.
Mesothelial cyst of uterus in a nullipara patient: A case report
Authors: Ren Xiu-Cong , Liu Wei , Hu Li-Rong , Mao Min
Published: March 2023

Introduction:

Uterine mesothelial cysts represent a diagnostic challenge because of their low incidence, with very few cases reported in the English literature.

Patient concerns:

We report the case of a 27-year-old nullipara woman complaining of self-discovery of a mass in the abdomen for 1 week. Supersonic examination revealed a pelvic cystic lesion measuring 8.9 × 8.2 cm. The patient underwent exploratory single-port laparoscopic surgery and had a large uterine cystic mass located within the posterior wall of the uterus.

Diagnosis:

After excision of the uterine cyst, the final histopathological diagnosis was uterine mesothelial cyst.

Interventions:

We treated her with a single-port laparoscopic uterine cystectomy.

Outcomes:

Close follow-up of the case for 2 years showed that the patient was free of any symptoms, and no recurrence was noted.

Lessons:

Uterine mesothelial cysts are extremely rare. They are often misdiagnosed by clinicians as extrauterine masses or cystic degeneration of leiomyomas. This report aims to share a rare case of uterine mesothelial cyst and improve gynecologists’ academic vision of the disease.
Prevalence of unprotected anal intercourse and associated factors among male students who have sex with men in Qingdao, China: A cross-sectional study
Authors: Yang Xuebin , Yu Yingying , Song Xin , He Lili , Fu Yong , Zhang Jianwen , Wang Xiaojun , Zhang Huaqiang
Published: March 2023

The significant rise of human immunodeficiency virus (HIV) epidemic among young students has become a new feature of acquired immune deficiency syndrome in China, and unprotected anal intercourse (UAI) among male students who have sex with men (SMSM) played a central role in this process. The aim of this study was to investigate the prevalence of UAI, as well as analyze the factors associated with UAI among SMSM in Qingdao, China. From May 2021 to April 2022, men who aged 15 to 30, studied in a high school or college in Qingdao and had anal sex with men in the past 6 months were recruited through snowball method relying on the nongovernmental organization. An anonymous electronic questionnaire was administrated to collect information on socio-demographic characteristics, sexual behaviors, substance use before sex, HIV prevention services and self-esteem. Univariate and multivariate logistic regressions were used to assess factors related to UAI. Among the 341 SMSM included in the study, 40.5% engaged in UAI in the past 6 months. Being migrants from other provinces [odds ratios (OR) = 2.04, 95% confidence intervals (CI): 1.10–3.78], failing to use condoms for the first anal intercourse (OR = 3.38, 95% CI: 1.85–6.18), drinking alcohol before sex (OR = 2.31, 95% CI: 1.25–4.28) and being low level self-esteem (OR = 1.77, 95% CI: 1.09–2.87) were positively associated with UAI. SMSM who had homosexual intercourse more than once a week (OR = 1.76, 95% CI: 1.03–3.00) or had multiple male sex partners (OR = 1.99, 95% CI: 1.20–3.30) were more likely to engage in UAI. Received peer education in the past 12 months (OR = 0.48, 95% CI: 0.27–0.86) was associated with lower odds of UAI. The situation of UAI among SMSM in Qingdao was a public health issue of concern. It is necessary to take targeted measures, such as focusing on first-time sex, advancing sexual health education, expanding peer education, implementing alcohol use screening and maintaining the self-esteem of SMSM, so as to reduce the occurrence of high-risk behaviors among SMSM and curb the spread of HIV on campus.
Evaluation and management of male genital tract infections in the setting of male infertility: an updated review
Authors: Rivero Marco-Jose , Kulkarni Nikhil , Thirumavalavan Nannan , Ramasamy Ranjith
Published: March 2023

Purpose of review

Male infertility may be secondary to male genital tract infection (MGTI) in an estimated 15% of cases. In the absence of overt clinical signs, evaluation for MGTI beyond semen analysis is not well established. Therefore, we review the literature on the evaluation and management of MGTI in the setting of male infertility.

Recent findings

A set of international guidelines recommends semen culture and PCR testing, but the significance of positive results remains unclear. Clinical trials evaluating anti-inflammatory or antibiotic treatment report improvements in sperm parameters and leukocytospermia, but data on the effect on conception rates are lacking. Human papillomavirus (HPV) and the novel coronavirus (SARS-CoV-2) have been associated with poor semen parameters and decreased conception rates.

The finding of leukocytospermia on semen analysis prompts further evaluation for MGTI, including focused physical examination. The role of routine semen culture is controversial. Treatment options include anti-inflammatories; frequent ejaculation; and antibiotics, which should not be used in the absence of symptoms or microbiological infection. SARS-CoV-2 represents a subacute threat to fertility that should be screened for in the reproductive history along with HPV and other viruses.
Evidence-based review of nonantibiotic urinary tract infection prevention strategies for women: a patient-centered approach
Authors: Stair Sabrina L. , Palmer Cristina J. , Lee Una J.
Published: March 2023

Purpose of review

There is a growing interest in nonantibiotic prevention strategies for recurrent urinary tract infections (rUTIs). Our objective is to provide a focused, pragmatic review of the latest evidence.

Recent findings

Vaginal estrogen is well tolerated and effective for preventing rUTI in postmenopausal women. Cranberry supplements at sufficient doses are effective in preventing uncomplicated rUTI. Methenamine, d-mannose, and increased hydration all have evidence to support their use, although the evidence is of somewhat variable quality.

There is sufficient evidence to recommend vaginal estrogen and cranberry as first-line rUTI prevention strategies, particularly in postmenopausal women. Prevention strategies can be used in series or in tandem, based on patient preference and tolerance for side effects, to create effective nonantibiotic rUTI prevention strategies.
Treatment options for multidrug-resistant Gram-negatives in urinary tract infections
Authors: Zollner-Schwetz Ines , König Elisabeth
Published: March 2023

Purpose of review

Infections due to multidrug-resistant (MDR) Gram-negative bacteria are challenging to treat because of limited treatment options and potential side effects of less frequently used anti-infectives. In the past few years, several new antimicrobial agents effective against MDR Gram-negatives have become available. This review focuses on the treatment options for complicated urinary tract infections (cUTIs) caused by MDR Gram-negatives.

Recent findings

The novel combinations, betalactam or carbapenem and betalactamase inhibitor, ceftazidime/avibactam and meropenem/vaborbactam, are effective for infections caused by KPC-carbapenemase-producing pathogens. Imipenem/relebactam, another carbapenem/betalactamase inhibitor combination, has been approved for the treatment of cUTI. However, data on the efficacy of imipenem/relebactam against carbapenem-resistant pathogens is still limited. Ceftolozane/tazobactam is mainly used for the treatment of MDR Pseudomonas aeruginosa infections. For the treatment of cUTI caused by extended-spectrum betalactamases producing Enterobacterales aminoglycosides or intravenous fosfomycin should be considered.

To ensure prudent use and to avoid the development of resistance to novel anti-infective substances, an interdisciplinary approach, including urologists, microbiologists, and infectious disease physicians, is strongly advised.
The reemergence of the human monkeypox: strengthening Africa’s epidemic preparedness and response system
Authors: Ayorinde Toluwase A. , Olufadewa Isaac I. , Adesina Miracle A. , Oladele Ruth I. , Oladoye Moyinoluwa J. , Adene Tejumade , Asaolu Oluwadarasimi
Published: March 2023

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone ‘viral,’ spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a ‘One Health’ approach will offer fresh insight into the human–animal–environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.
Intra-articular platelet-rich plasma vs. corticosteroid injections efficacy in knee osteoarthritis treatment: a systematic review
Authors: Idres Fatima A. , Samaan Michel
Published: March 2023

Background:

Osteoarthritis (OA) affects the entire joint structure. The most injured joints are the hands, knees, and hips. OA is a common disease all over the world, and a cause of disability in the elderly; hence, medicine is facing a steady challenge to find effective therapeutics to relieve the pain, improving symptoms for a better quality of life for patients.

Purpose:

To compare the results, in the recent literature, of intra-articular injection of platelet-rich plasma (PRP) and corticosteroids (CSs) in osteoarthritic knees at early and mid-term postinjection.

Methods:

A PubMed and CENTRAL (Cochrane Central Register of Controlled Trials) database search was performed. Initial screening yielded 108 randomized controlled trials, 17 results, and 17 others were added after updates. The final review includes nine randomized control trials, with outcome evaluating of knee OA by Western Ontario and McMaster Universities Arthritis Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Scale Index, and Visual Analog Scale.

Results:

PRP and CS intra-articular injections both are safe and effective treatments in knee OA for alleviating pain, and improving symptoms. It seems that PRP injections have prolonged and shown better improvement in some studies. However, the results do not prefer one method over the other.

Conclusion:

Up till now, it is not easy to draw firm conclusions about prioritizing PRP or CS injections for knee OA treatment due to the limitation of this review.
Mystical and mythological believes not only limited to psychiatric diseases? A dynamic overview of medicine
Authors: Sumbal Anusha , Sumbal Ramish
Published: March 2023

The concept of supernatural forces has always been part of medicine and allied science. These beliefs play a pivotal role in the patient-healthcare bond and disease awareness. Traditionally it was believed that psychiatric illnesses are mostly linked with mythologies and paranormal beings since most mental diseases appear to be lunatic and have no rational ground. Paradoxical to this conventional belief we discovered that mythological beliefs have penetrated all fields of medicine. Porphyria, hepatomegaly presenting with photosensitivity, are associated with “vampirism.” Similarly, holoprosencephaly, a congenital anomaly presenting facial deformity is thought to be cyclops folktales. Epilepsy though is simply a neurologic illness believed to be “demonic possession.” Patients of pellagra, a deficiency of vitamin B3 are thought to be werewolves. Thus, we found the presence of mythological association in all types of illnesses. We expect our healthcare infrastructure to not limit their management to counseling patients suffering from psychiatric illnesses only.
Serum vitamin D and antinuclear antibody level in oral lichen planus patients: a cross-sectional study
Authors: Nosratzehi Tahereh
Published: March 2023

Background:

Vitamin D is a secosteroid prohormone that regulates the immune system. Antinuclear antibody (ANA) is a protein antibody made against substances inside the nucleus of cells. Serum vitamin D and ANA levels progress to psoriasis and oral cancer. The present study aimed to measure the serum vitamin D and ANA levels in patients with oral lichen planus (OLP), an autoimmune and precancerous disease.

Methods:

We conducted this cross-sectional study on patients with OLP (n=50) and healthy individuals (n=50). We used the enzyme-linked immunosorbent assay method to measure serum vitamin D and ANA levels and Mann–Whitney U-test and t-test to analyze data.

Results:

The present study showed that 14 (28%) patients with OLP had vitamin D deficiency, and 18 (36%) had insufficient vitamin D. Further, 9 (18%) and 15 (30%) of the participants in the control group suffer from vitamin D deficiency and insufficient vitamin D level, respectively. Results showed a significant relationship between levels of serum vitamin D in both groups. The level of ANA positive in patients with OLP was 6 (12%). The results of the t-test showed no significant difference between the mean serum ANA levels in the two nodes with an 80% confidence interval (P=0.34).

Conclusion:

Researchers of the present study reported low serum vitamin D in many OLP patients. Due to the prevalence of vitamin D deficiency in society, we need to perform comprehensive studies to evaluate the deficiency’s effects on pathogenesis.
Evaluation of the coexistence of pilonidal sinus disease and hirsutism in female patients: a retrospective cross-sectional study
Authors: Akbulut Sami , Caliskan Alper , Yilmaz Davut , Atay Arif , Garzali Ibrahim Umar , Yagmur Yusuf
Published: March 2023

Background:

This study aimed to investigate the coexistence of pilonidal sinus disease (PSD) and hirsutism in female patients.

Materials and methods:

The demographic and clinical data of 164 female patients who underwent surgery for PSD between January 2007 and May 2014 were evaluated for this retrospective cross-sectional study. Data collected for this study were age, BMI, the modified Ferriman and Gallwey scale (mFGS) for hirsutism, main symptoms, type of surgery, early postoperative complications (wound infection, wound dehiscence), recurrence, and follow-up. The independent variables are hirsutism (mFGS scores) and BMI. Dependent variables are early postoperative complications and recurrence.

Results:

The median age was 20 years (95% CI for median: 19–21 years). According to the BMI, 45.7, 50.6, and 3.7% of patients were considered normal, overweight, and obese, respectively. According to the mFGS, 11, 9.8, 52.4, and 26.8% of patients were considered to have none, mild, moderate, or severe hirsutism, respectively. Fourteen (8.5%) patients had developed recurrence. Recurrence developed in six patients with primary closure, five patients with Limberg flaps, two patients with Karydakis, and one with marsupialization. There was no statistical difference between recurrent and nonrecurrent patients in terms of BMI (P=0.054) and mFGS (P=0.921). On the other hand, BMI was statistically significantly higher in those who developed early postoperative complications than in those who did not (P<0.001).

Conclusion:

PSD is no longer a ‘men’s only disease’. BMI increases the risk of early postoperative complications, but this association was not found between BMI and recurrence. Prospective multicenter studies are needed on the relationship between PSD and hirsutism.
SARS-COV-2-related superior mesenteric artery thrombosis resulting in pneumatosis intestinalis complicated by pneumatosis portalis in a young male: a case report
Authors: Aryal Sajiva , Bhattarai Vikash , Sharma Suraj
Published: March 2023

The novel coronavirus disease-2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 is a highly contagious disease that has rapidly spread throughout the world. In addition to respiratory complications, the virus has also been linked to damage other organ systems as well as coagulopathy. The features and clinical spectrum of COVID-19 are continually emerging, with growing evidence of its connection to thrombosis in various systems. In this case report, the authors present a case of COVID-19 infection in a young male patient who had superior mesenteric artery thrombosis with pneumatosis intestinalis complicated by hepatic portal venous gas.
Neurogenomics in Africa: current state, challenges, opportunities, and recommendation
Authors: Aderinto Nicholas , AbdulBasit Opeyemi Muili , Amao Oluwatimilehin
Published: March 2023

Neurological diseases are becoming more common in Africa. Current estimates indicate that Africa has a significant burden of neurological illnesses, though it is unclear what fraction of the burden may be linked to genetic transmission. In recent years, there has been a significant expansion in the knowledge of the genetic basis of neurological illnesses. This has been made possible mainly by the positional cloning research paradigm, which uses linkage studies to pinpoint specific genes on chromosomes and targeted screening of Mendelian neurological illnesses to identify the causative genes. However, there is currently very little and unequal geographic knowledge about neurogenetics in African people. The lack of collaboration between academics studying neurogenomics and bioinformatics contributes to the scarcity of large-scale neurogenomic investigations in Africa. The primary cause is a shortage of funding from the African government for clinical researchers; this has resulted in heterogeneity in research collaboration in the region as African researchers work more closely with researchers outside the region due to pulling factors of standardized laboratory resources and adequate funding. Therefore, adequate funding is required to elevate researchers’ morale and give them the resources they need for their neurogenomic and bioinformatics studies. For Africa to fully benefit from this significant research area, substantial and sustainable financial investments in the training of scientists and clinicians will be required.
Computer-related ophthalmic syndrome in teachers of a University of the Province of Cañete
Authors: Uribe-Hernández Yrene C. , Ochoa-Paredes Fernando F. , Meneses-Claudio Brian A. , Tello-Aguilar Carmen P. , Buendía-Aparcana Roberto R. , Pacheco Alex
Published: March 2023

Introduction and Importance:

Virtual education has impacted the vision of people during the coronavirus pandemic, as by spending more time on the computer, it compromises the eye health of the person causing long-term visual problems. So the objective of this investigation is to assess computer-related ophthalmic syndrome in teachers of a University of the Province of Cañete.

Methods:

This is a quantitative, nonexperimental, descriptive, cross-sectional study on a total population of 63 teachers, who answered a digital survey using the sociodemographic data and the Computer Vision Syndrome Questionnaire.

Clinical Discussion:

From the results it can be observed that the results of computer ophthalmic syndrome in the university teachers of the province of Cañete, where 51 (81%) of the teachers do not present the computer vision syndrome and 12 (19%) presented with the computer vision syndrome.

Conclusion:

The population conducting virtual education as well as the students should be educated on the measures to be taken to prevent computer ophthalmic syndrome and its consequences.
Recurrent acute pancreatitis in an adult female with sickle cell disease: A case report
Authors: Sharma Aayushi , Khadka Bibek , Sharma Anupam , Shah Kunda B. , Shrestha Amar N.
Published: March 2023

Introduction and Importance:

Although risk factors such as cholelithiasis and vaso-occlusive crises exist in sickle cell disease, acute pancreatitis and its recurrence are considered rare complications manifesting as acute abdomen.

Case Presentation:

A 33-year-old female with sickle cell disease and established cholelithiasis presented to the center with acute abdomen. After examination, investigation, and contrast enhanced computed tomography, acute pancreatitis was diagnosed. Conservative management was done and cholecystectomy was planned but delayed due to low hemoglobin. In the interval she presented again with similar features and diagnosed with of recurrence. After conservative management and after optimization of patient’s hemodynamic status, laparoscopic cholecystectomy was finally performed. Postoperative period and follow-up visit after 2 months were uneventful.

Clinical Discussion:

As the features of pancreatitis and vaso-occlusive crisis are similar, the former should be considered as a differential diagnosis of acute abdomen in sickle cell patients. Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis in these patients. However, some issues related to management such as preoperative transfusion and prophylactic cholecystectomy are still debated. This uncertainty caused delay in surgery which may have contributed to the recurrence of pancreatitis in our patient. As the risk of recurrence is possible after the first attack, standard guidelines are required for the definite management of the cause.

Conclusion:

This case report adds to the limited literature on recurrent acute pancreatitis in sickle cell patients and points out the need for studies on developing management guidelines in such patients and need for prophylactic treatment.
Diffusely infiltrative squamous cell carcinoma of the esophagus resembling scirrhous gastric cancer: a case report
Authors: Aoki Hikaru , Kawada Hironori , Hanabata Yusuke , Shinkura Akina , Matsui Jun , Izumi Ai , Yamashita Tokuyuki , Kurimoto Makoto , Tamura Jun
Published: March 2023

Introduction and Importance:

Diffusely infiltrative squamous cell carcinoma of the esophagus is rare and difficult to diagnose.

Case presentation:

The patient was a 75-year-old woman whose chief complaints were dysphagia and upper abdominal pain. Esophagogastroduodenoscopy and biopsy revealed squamous cell carcinoma at the abdominal esophagus. After neoadjuvant chemotherapy, esophagogastroduodenoscopy showed diffuse thickening and poor distensibility of the stomach wall. We suspected scirrhous gastric cancer and performed multiple biopsies, which revealed no evidence of malignancy. We then performed staging laparoscopy. There were no apparent changes in the serous membrane of the stomach, but peritoneal lavage cytology revealed squamous cell carcinoma. Thus, we made a diagnosis of squamous cell carcinoma of the esophagus with diffuse invasion of the stomach. Intraoperative pathological diagnosis revealed that there was greater diffuse submucosal invasion of the oral esophagus than we expected, and we had to resect the esophagus at the level of the middle thoracic esophagus. Despite multidisciplinary treatment (surgery, chemotherapy, and radiotherapy), the patient died 20 months after the initial diagnosis.

Clinical discussion:

In this case, although biopsy did not lead to a diagnosis, peritoneal lavage cytology led to the correct diagnosis. Moreover, it was impossible to preoperatively predict the exact extent of the expansion because of diffuse submucosal invasion.

Conclusion:

When diffusely infiltrative squamous cell carcinoma of the esophagus is suspected, peritoneal lavage cytology may be useful for confirming the diagnosis; however, it should be assumed that accurate preoperative evaluation of the range of diffusely infiltrative squamous cell carcinoma is difficult.
Isolated diffuse intestinal ganglioneuromatosis presented as a redundant sigmoid colon: a case report
Authors: Al Samaan Fadi , Alhimyar Maryam , Alhalbouni Mohammad , Aldirani Alaa , Assad Lina
Published: March 2023

Introduction and Importance:

Diffuse intestinal ganglioneuromtosis is a benign tumor of the enteric nervous system, that almost always occurs in children with systemic syndromes. Whereas isolated cases in adults are exceedingly rare.

Case Presentation:

A 38-year-old man presented with refractory chronic constipation. An abdominal computed tomography scan revealed a redundant sigmoid colon, then he underwent a sigmoid colectomy. Histopathologic examination showed diffuse ganglioneuromatosis. However, the patient was in good health 18 months after surgery.

Clinical Discussion:

Intestinal ganglioneuromas commonly occur in children with systemic syndromes such as multiple endocrine neoplasia type 2B and neurofibromatosis type 1. The most frequent symptoms are abdominal discomfort, constipation, ileus, weight loss, appendicitis, and obstruction in more severe cases. surgical resection is the standard management in diffuse ganglioneuromatosis.

Conclusion:

Although diffuse ganglioneuromatosis is uncommon, it should be considered in patients with refractory constipation.
Phenotypes of a female patient with novel de novo frameshift ARX variant identified by whole-exome sequencing: a case report
Authors: Iskandar Kristy , Herini Elisabeth S. , Triono Agung , Hadiyanto Marissa L. , Nugrahanto Andika P. , Gunadi
Published: March 2023

Introduction and importance:

Variants in the aristaless-related homeobox (ARX) gene cause a diverse spectrum of phenotypes of neurodevelopmental disorders (NDD) in male patients. This article describes the role of genetic testing using whole-exome sequencing (WES) in detecting a novel de novo frameshift variant in the ARX gene in a female patient with autism, seizure, and global developmental delay.

Case presentation:

A 2-year-old girl with frequent seizures, global developmental delay, and autistic features was referred to our hospital. She was the second child of consanguineous non-affected parents. She had a high forehead, mildly prominent ears, and prominent nasal root. A generalized epileptiform discharge was noted in her electroencephalography. Brain MRI revealed corpus callosum agenesis, cerebral atrophy, and a left parafalcine cyst. The WES result showed a likely pathogenic variant identified as a novel de novo deletion in exon 4 of the ARX gene, which creates a frameshift variant. The patient is on dual therapy of antiepilepsy drugs, physiotherapy, speech therapy, occupational therapy, and oral motor exercises.

Clinical discussion:

Variants in the ARX gene can result in various phenotypes in males transmitted from asymptomatic carrier females. However, several reports showed that the ARX variants might cause phenotypes in females with milder symptoms than affected males.

Conclusion:

We report a novel de novo ARX variant in an affected female with a NDD. Our study confirms that the ARX variant might cause remarkable pleiotropy phenotypes in females. Moreover, WES could help to identify the pathogenic variant in NDD patients with diverse phenotypes.