Airway Complications from an Esophageal Foreign Body

MRSL: a causal network pruning algorithm based on GWAS summary data

Causal discovery is a powerful tool to disclose underlying structures by analyzing purely observational data. Genetic variants can provide useful complementary information for structure learning. Recently, Mendelian randomization (MR) studies have provided abundant marginal causal relationships of traits. Here, we propose a causal network pruning algorithm MRSL (MR-based structure learning algorithm) based on these marginal causal relationships. MRSL combines the graph theory with multivariable MR to learn the conditional causal structure using only genome-wide association analyses (GWAS) summary statistics. Specifically, MRSL utilizes topological sorting to improve the precision of structure learning. It proposes MR-separation instead of d-separation and three candidates of sufficient separating set for MR-separation. The results of simulations revealed that MRSL had up to 2-fold higher F1 score and 100 times faster computing time than other eight competitive methods. Furthermore, we applied MRSL to 26 biomarkers and 44 International Classification of Diseases 10 (ICD10)-defined diseases using GWAS summary data from UK Biobank. The results cover most of the expected causal links that have biological interpretations and several new links supported by clinical case reports or previous observational literatures.

Foreign body Swallows with Airway Affection in Pediatrics

Aims

The current work aimed at evaluating how FBI can cause respiratory distress and stridor as well as their severity according to age, gender, lodgment site, and type of the object. Factors influencing morbidity and mortality among studied patients will be deliberated as well.

Methods

It is a hospital-based descriptive study where all children between birth and 16 years of age who were admitted to Sohag University Hospital, Egypt from January 1st, 2018, to December 31st, 2020, for FBs removal were analyzed. All cases were subjected to complete history taking, physical, radiological, and bronchoscopic examination.

Results

A total of fourteen [14] patients were presented with FBI based on a full history, examination, and essential investigation. The vast majority 92.9% of presented cases (13 out of 14) were less than 6 years old. 50% of them (50%) (7 out of 14) were less than one year old. Most cases presented early within a few hours after ingestion (71.4%). Two [2] patients had predisposing conditions like mental retardation and cerebral palsy. 28.6% of cases presented late (> 24 h after aspiration). Except for one case where a cervical oesophageal approach was needed. Endoscopic extractions of foreign bodies were successfully done. 50% of patients required admissions to the Pediatric Intensive Care Unit (PICU). The mortality rate was 14.3%.

Conclusion

FBI is a common clinical emergency in children younger than 6 years. A high index of suspicion is the keystone for diagnosis. Early detection and management are crucial for a positive outcome.