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Ji S, Zhang J, Zhao X, Lu K, Yang P, Wang Y. A case of primary large cell neuroendocrine carcinoma of the breast. Asian J Surg 2024:S1015-9584(24)00506-2. [PMID: 38519317 DOI: 10.1016/j.asjsur.2024.03.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/14/2024] [Indexed: 03/24/2024] Open
Affiliation(s)
- Shuaichong Ji
- Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to North China University of Science and Technology, Shijiazhuang, 050051, Hebei Province, China
| | - Jiayi Zhang
- Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to North China University of Science and Technology, Shijiazhuang, 050051, Hebei Province, China
| | - Xiangdong Zhao
- Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to North China University of Science and Technology, Shijiazhuang, 050051, Hebei Province, China
| | - Kewen Lu
- Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to Hebei Medicine University, Shijiazhuang, 050051, Hebei Province, China
| | - Pei Yang
- Department of Thyroid and Breast Surgery, Hebei General Hospital Affiliated to Hebei Medicine University, Shijiazhuang, 050051, Hebei Province, China
| | - Yuexin Wang
- Department of Thyroid and Breast Surgery, Hebei General Hospital, No.348 Peace West Road, Shijiazhuang, 050051, Hebei Province, China.
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Wei M, Jiang W, Wang R, Xiao B, Zhan Q. Langerhans cell histiocytosis of the skull in 23 children. Eur J Med Res 2024; 29:136. [PMID: 38368348 PMCID: PMC10874530 DOI: 10.1186/s40001-024-01727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 02/12/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVE To explore the clinical features, diagnosis, treatment and prognosis of Langerhans cell histiocytosis (LCH) of the skull in children. METHODS This study retrospectively summarized the clinical manifestations, treatment methods and follow-up status of children with skull LCH who were admitted to the Department of Neurosurgery of Shanghai Children's Hospital from January 2014 to June 2021. RESULTS A total of 23 patients confirmed by histology as LCH received hospitalization treatment, including 14 males and 9 females, aged (5.76 ± 3.86) years old. The clinical manifestations were mostly incidentally discovered head masses that gradually enlarged (19 cases, 82.61%). Only 2 cases are affected by multiple systems, while the rest are affected by single systems. 9 patients were involved in multiple skull lesions, and 14 patients had local skull lesions. All patients underwent surgical intervention, with 17 patients undergoing total resection and 6 patients undergoing biopsy. 21 patients received chemotherapy after surgery. The median follow-up was 2.46 years (range 0.33-6.83 years). 21 patients had their symptoms and signs under control or even resolved, and 2 patients experienced recurrence during follow-up. The overall control rate reached 91.30%. CONCLUSION Personalized treatment plans according to different clinical types. Regular outpatient follow-up is crucial to monitor disease recurrence and late effects.
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Affiliation(s)
- Min Wei
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Wenbin Jiang
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Rui Wang
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Bo Xiao
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China
| | - Qijia Zhan
- Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Rd. 355, Shanghai, People's Republic of China.
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Dib El Jalbout J, Sati H, Ghalloub P, El Bejjani G, Karam R, Mago A, Salame M, Saoudi L, Desangles AB, Emmanuel N. Morgellons disease: a narrative review. Neurol Sci 2024:10.1007/s10072-024-07361-7. [PMID: 38319480 DOI: 10.1007/s10072-024-07361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/22/2024] [Indexed: 02/07/2024]
Abstract
Morgellons disease is characterized by the persistent delusion of skin infestation, ultimately inflicting wounds and impairing quality of life. There is insufficient and conflicting research pertaining to this condition, imposing challenges on clinicians in understanding, diagnosing, and treating it. In this review, we summarize the available literature on Morgellons disease including its historical evolution, epidemiology, proposed pathophysiology, underlying structural and functional brain pathologies, typical and atypical clinical presentations, diagnosis, and treatment. A comprehensive review of the literature was conducted on PubMed, Embase, and Scopus using specified keywords. Selected articles were screened by two independent reviewers based on set inclusion and exclusion criteria. Conflicts were resolved by a third reviewer as needed. No limit to the date of selected articles was set due to the scarce literature available on the subject. Morgellons disease is an underdiagnosed entity, owing mostly to the lack of an established pathophysiology and treatment guidelines. While many authors classify it as a type of delusional infestation (DI), others correlate MD with an underlying spirochetal infection, namely Lyme disease. Neuroimaging studies have revealed abnormalities in the "fronto-striato-thalamo-parietal network", a finding common to patients with DI, in addition to alterations in structures related to the "Itch Processing Pathway". Patients tend to extract fibers from their skin lesions and place them in a match box hence the term "match box sign". The diagnosis is that of exclusion, requiring extensive work up to rule out secondary causes and differential diagnoses. Treatment is largely based on the use of antipsychotics, with or without cognitive behavioral therapy. Despite being a diagnosis of exclusion, clinicians must be aware of this entity and have a profound understanding of the pathogenesis underlying it. Upon clinical suspicion, secondary Morgellons should always be ruled out through a thorough history taking, physical examination, and laboratory exams. Despite the challenges brought by the heterogeneous presentation of the condition and the paucity of research revolving around it, the great impact that Morgellons disease has on patients' quality of life forms a pressing need for its adequate detection, diagnosis, and treatment.
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Affiliation(s)
- Jana Dib El Jalbout
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Heba Sati
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | - Perla Ghalloub
- Faculty of Medicine and Medical Sciences, University of Balamand, Koura, Lebanon
| | - Grace El Bejjani
- Department of Internal Medicine, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - Rim Karam
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Arpit Mago
- Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | - Marita Salame
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Lara Saoudi
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | | | - Nancy Emmanuel
- Department of Dermatology, Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, São Paulo, Brazil.
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Srivastava P, Gupta S, Bamba C, Daniel R, Kaur P, Kaur A, Panigrahi I, Mandal K. Neurofibromatosis type 1: Clinical characteristics and mutation spectrum in a North Indian cohort. Heliyon 2024; 10:e23685. [PMID: 38226287 PMCID: PMC10788438 DOI: 10.1016/j.heliyon.2023.e23685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/28/2023] [Accepted: 12/09/2023] [Indexed: 01/17/2024] Open
Abstract
Background Neurofibromatosis type 1 (NF1) is a unique, highly penetrant neuro-cutaneous disorder with a wide range of manifestations. Though the clinical diagnosis of NF1 is straight forward, there can be other disorders which mimic NF1, especially its cutaneous features. Here we describe the clinical and mutation spectrum of a series of individuals whose primary diagnosis was NF1 or NF1 related disorders. Methods We have screened 29 unrelated individuals who fulfilled the clinical criteria of NF1. Whole exome sequencing (WES) was done in all individuals except one with suspected microdeletion syndrome with NF1 in whom Cytogenetic microarray (CMA) was done. Results Out of 29 suspected patients, 25 had germline pathogenic/likely pathogenic variants involving NF1 gene. Five novel and 20 known variants in coding and non-coding regions were identified, among them 7 variants were deletions (28%), 7 nonsense (28%), 3 splice-site (12%), 4 missense (16%), 2 duplications (8%) and 2 (8%) were contiguous deletions. In those where NF1 variants were not detected, 3 had neurofibromatosis type 2 (NF2) and 1 rare autosomal recessive form of Elher Danlos syndrome. Conclusion We hereby present the wide range of manifestations in different age groups and the mutation spectrum ranging from small scale variants to contiguous gene deletion syndromes involving NF1 gene. We highlight the usefulness of molecular testing and its importance in tumor surveillance and genetic counseling in this disorder.
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Affiliation(s)
- Priyanka Srivastava
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Shifali Gupta
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Chitra Bamba
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Roshan Daniel
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Parminder Kaur
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Anupriya Kaur
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Inusha Panigrahi
- Genetic Metabolic Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, 160012, India
| | - Kausik Mandal
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences (SGPGIMS), Lucknow, India
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Gao YS, Li Q, Zhou H, Zhang ZQ, Feng H, Liu GF, Shen Y. Enhancing clinical awareness: retrospective analysis of neurosyphilis cases and diagnostic predictors for early recognition and treatment. Neurol Sci 2024:10.1007/s10072-023-07285-8. [PMID: 38177969 DOI: 10.1007/s10072-023-07285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE This is a retrospective analysis of clinical data from individuals diagnosed with neurosyphilis, aiming to enhance healthcare professionals' understanding of the disease and expedite early diagnosis and intervention. METHODS A retrospective analysis was conducted on the clinical records of 50 patients who received a diagnosis of symptomatic neurosyphilis and were admitted to the Neurology Department during the period spanning January 2012 to December 2022. RESULTS Clinical manifestations encompassed diverse phenotypes, with syphilitic meningitis accounting for 16% of cases, characterized by symptoms such as headache, blepharoptosis, paralysis, blurred vision, and tinnitus. Meningovascular syphilis presented in 36% of cases, exhibiting episodic loss of consciousness, limb numbness, and limb convulsion. Paralytic dementia manifested in 36% of cases, featuring symptoms such as memory loss, sluggish response, and slow movement. Tabes dorsalis was observed in 12% of cases, presenting with weakness, numbness, and staggering. Routine cerebrospinal fluid (CSF) analysis indicated abnormal white blood cell counts in 60% of patients, while biochemical testing revealed abnormal protein content in 52% of patients. Notably, statistically significant differences were observed between patients with interstitial and parenchymatous neurosyphilis (Z = 2.023, P = 0.044) in terms of CSF protein content. Electroencephalogram (EEG) results were abnormal in six patients, and imaging studies unveiled diverse findings in 46 patients. CONCLUSION The study highlights the importance of neurological and/or ocular symptoms in diagnosing symptomatic neurosyphilis. Individuals with hypomnesia should be closely monitored for potential neurosyphilis. Integrating clinical manifestations, laboratory tests, EEG, and imaging can reduce misdiagnosis. This comprehensive approach shows promise in improving early identification and management of neurosyphilis.
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Affiliation(s)
- Ying-Shu Gao
- Department of Dermatology, Beijing Tiantan Hospital, Capital Medical University, No. 119 of Nansihuanxilu Street, Fengtai District, Beijing, 100070, China
| | - Qing Li
- Department of Dermatology, Beijing Tiantan Hospital, Capital Medical University, No. 119 of Nansihuanxilu Street, Fengtai District, Beijing, 100070, China.
| | - Heng Zhou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Zai-Qiang Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Hua Feng
- Department of Dermatology, Beijing Tiantan Hospital, Capital Medical University, No. 119 of Nansihuanxilu Street, Fengtai District, Beijing, 100070, China
| | - Gai-Fen Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Yuan Shen
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
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Hanaoka M, Kobayashi T, Droma Y, Ota M, Kobayashi N, Wada Y, Kitaguchi Y, Koizumi T, Kubo K. Clinical and Pathophysiological Features of High-altitude Pulmonary Edema in the Japanese Population: A Review of Studies on High-altitude Pulmonary Edema in Japan. Intern Med 2024:2533-23. [PMID: 38171855 DOI: 10.2169/internalmedicine.2533-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
High-altitude pulmonary edema (HAPE) is a life-threatening, noncardiogenic pulmonary edema that occurs in unacclimatized individuals rapidly ascending to high altitudes above 2,500 m above sea level. Until the entity of HAPE was first identified in a case report published in Japan in 1966, the symptoms of severe dyspnea or coma occurring in climbers of the Japan Alps were incorrectly attributed to pneumonia or congestive heart failure. The Shinshu University Hospital serves as the central facility for rescuing and treating patients with HAPE in the region. Over the past 50 years, a series of studies have been conducted at Shinshu University to gain a better understanding of the characteristics of HAPE. This review summarizes the major achievements of these studies, including their clinical features, management, and pathogenesis of HAPE, particularly in the Japanese population.
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Affiliation(s)
- Masayuki Hanaoka
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
| | - Toshio Kobayashi
- Department of Internal Medicine, Kakeyu Misayama Rehabilitation Center, Japan
| | - Yunden Droma
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
| | - Masao Ota
- Department of Internal Medicine, Division of Hepatology and Gastroenterology, Shinshu University School of Medicine, Japan
| | - Nobumitsu Kobayashi
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
| | - Yosuke Wada
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
| | - Yoshiaki Kitaguchi
- First Department of Internal Medicine, Shinshu University School of Medicine, Japan
| | - Tomonobu Koizumi
- Department of Comprehensive Cancer Therapy, Shinshu University School of Medicine, Japan
| | - Keishi Kubo
- Emeritus professor of Shinshu University School of Medicine, Japan
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Werkl P, Rademacher J, Pleyer U. HLA-B27-positive anterior uveitis : Clinical aspects, diagnostics, interdisciplinary management, and treatment. Ophthalmologie 2024; 121:12-22. [PMID: 38085287 DOI: 10.1007/s00347-023-01960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 02/03/2024]
Abstract
Acute anterior uveitis (AAU) associated with human leukocyte antigen (HLA) B27 is the most common form of noninfectious intraocular inflammation and is considered to be a separate clinical entity. Young adults between the ages of 20 and 40 years are predominantly affected. The HLA-B27 positive AAU typically presents as a unilateral, fulminant disruption of the blood-aqueous humor barrier, which is accompanied by pronounced cellular infiltration and fibrinous exudation. Other characteristics are reduced intraocular pressure and a high tendency to relapse, which can also involve the partner eye. Patients with HLA-B27 positive AAU share a high risk for other genetically associated diseases, especially spondylarthritis, chronic inflammatory bowel diseases and psoriasis. As up to 40% of those affected have a systemic disease that has not yet been diagnosed, the ophthalmologist is of major importance for early detection.
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Affiliation(s)
- Peter Werkl
- Universitätsaugenklinik Graz-LKH-Universitätsklinikum Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Austria
| | - Judith Rademacher
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Uwe Pleyer
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- Universitäts-Augenklinik, Charité, Campus Virchow Klinikum-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, 13355, Berlin, Germany.
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Wali AS, Ali MM, Bibi R, Rahim A. The clinical manifestations and pregnancy outcomes of COVID-19 infection at a tertiary care hospital. Pak J Med Sci 2024; 40:S15-S20. [PMID: 38328663 PMCID: PMC10844904 DOI: 10.12669/pjms.40.2(icon).8949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/06/2023] [Accepted: 11/15/2023] [Indexed: 02/09/2024] Open
Abstract
Objective To evaluate clinical presentation and pregnancy outcomes in pregnant women with Covid-19 infection in our local tertiary care from lower middle-income country. Methods A retrospective study was conducted at Obstetrics & Gynecology department, Sheikh Saeed Memorial Hospital (SSMH) of The Indus Hospital and Health Network (IHHN) from March 2020 to August 2021. Data of 422 admitted pregnant women with COVID-19 infection was retrieved for demographic and clinical information, laboratory tests, pregnancy outcome, and neonatal outcomes on RED-Cap and analyzed on SPSS 26. Univariate and multivariable logistic regression analyses were performed to estimate odds ratios (OR) for symptomology with categorical variables and feto-maternal outcome. Results Of the total 422 pregnant women, 24.4% were symptomatic, 74.7% exhibiting mild symptoms. Largely reported symptoms were fever (71.8%), cough (36.9%) and body ache (35.0%); while odds of symptomatic COVID-19 infection was less in educated pregnant women (OR 0.3; 95% CI 0.1-0.9) compared to uneducated. Amongst maternal comorbidities, odds of having symptomatic COVID-19 infection were 3.8 times (95% CI 1.1-13.0) in women with chronic hypertension and 5.5 times (95% CI 2.9-10.4) in women with diabetes. Symptomatic women had significantly greater incidence of miscarriages (p= 0.009), PPROM (p= 0.001), preterm birth (p= 0.000), preeclampsia (p= 0.000), placental abruption (p= 0.006) and maternal ICU admission (p= 0.000) than asymptomatic patients. Still birth was higher (6.4% vs 1.3%, p-value= 0.013) in symptomatic group. The odds of having severe maternal outcome were higher (OR=3.5; 95% CI 1.9-6.0) in symptomatic pregnant women. Conclusion Majority of pregnant women were asymptomatic. Symptomatic women with COVID-19 infection had an increased risk of adverse feto-maternal outcome.
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Affiliation(s)
- Aisha Syed Wali
- Aisha Syed Wali, Consultant, Obstetrics & Gynecology Department, Sheikh Saeed Memorial Hospital (SSMH), The Indus Hospital and Health Network, Karachi, Pakistan
| | - Maria Mushtaq Ali
- Maria Mushtaq Ali Office of the Research, Innovation and Commercialization (ORIC). The Indus Hospital and Health Network, Karachi, Pakistan
| | - Rabia Bibi
- Rabia Bibi Obstetrics & Gynecology Department, Sheikh Saeed Memorial Hospital (SSMH), The Indus Hospital and Health Network, Karachi, Pakistan
| | - Anum Rahim
- Anum Rahim Department of Community Health Sciences, Agha Khan University, Karachi, Pakistan
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Altan L, Metin Ökmen B, Tuncer T, Sindel D, Fatih Çay H, Hepgüler S, Sarıkaya S, Ayhan F, Bal A, Bilgilisoy M, Çapkın E, Cerrahoğlu L, Çevik R, Dülgeroğlu D, Durmaz B, Duruöz T, Gürer G, Gürsoy S, Hizmetli S, Kaçar C, Kaptanoğlu E, Ecesoy H, Melikoğlu M, Nas K, Nur H, Özçakır Ş, Şahin N, Şahin Ö, Sarıdoğan M, Faruk Şendur Ö, Sezer İ, Taşçı Bozbaş G, Tıkız C, Uğurlu H. Correlation of clinical signs and magnetic resonance imaging findings in patients with lumbar spondylosis. Arch Rheumatol 2023; 38:512-520. [PMID: 38125064 PMCID: PMC10728734 DOI: 10.46497/archrheumatol.2023.9806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/23/2023] [Indexed: 12/23/2023] Open
Abstract
Objectives The purpose of the study was to contribute further to this debated topic by investigating the correlation of magnetic resonance imaging (MRI) findings with the clinical picture in lumbar spondylosis patients. Patients and methods This multicenter retrospective study (as part of the epidemiological project of the TLAR-OASG [Turkish League Against Rheumatism-Osteoarthritis Study Group]) included 514 patients (101 males, 413 females; mean age: 63.6±10.8 years; range, 40 to 85 years) who were diagnosed as lumbar spondylosis by clinical examination and direct X-ray between December 2016 and June 2018. Demographic characteristics of patients, Visual Analog Scale for pain, presence of radiating pain, Roland-Morris disability questionnaire, straight leg raise test, deep tendon reflexes, neurogenic intermittent claudication symptoms, any decrease of muscle strength, and abnormality of sensation were recorded. Lumbar MRI findings of the patients were recorded as positive or negative in terms of disc herniation, intervertebral disc degeneration, root compression, osteophytes, spinal stenosis. Statistical analysis was done to assess the correlation between the clinical symptoms, physical examination, and MRI findings. Results Correlation analysis of the MRI results and the clinical findings showed a significant correlation between straight leg raise test and root compression (p<0.001, r=0.328) and a significant correlation between neurogenic intermittent claudication and spinal stenosis (p<0.001, r=0.376). Roland-Morris disability questionnaire had a significant correlation with all MRI findings (p<0.05, r<0.200). Conclusion The results of this study corroborate the notion that diligent patient history and physical examination are more valuable than MRI findings, even though a higher incidence of abnormal MRI findings have been obtained in patients with disability and dermatomal radiating pain.
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Affiliation(s)
- Lale Altan
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Uludağ University School of Medicine, Bursa, Türkiye
| | - Burcu Metin Ökmen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Türkiye
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Türkiye
| | - Hasan Fatih Çay
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Simin Hepgüler
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Selda Sarıkaya
- Department of Physical Medicine and Rehabilitation, Bülent Ecevit University Faculty of Medicine, Zonguldak, Türkiye
| | - Figen Ayhan
- Department of Physical Medicine and Rehabilitation, Atılım University Medical School, Ankara, Türkiye
| | - Ajda Bal
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Meral Bilgilisoy
- Department of Physical Medicine and Rehabilitation, Health Science University, Antalya Training and Research Hospital, Antalya, Türkiye
| | - Erhan Çapkın
- Department of Physical Medicine and Rehabilitation, Karadeniz Technical University Faculty of Medicine, Trabzon, Türkiye
| | - Lale Cerrahoğlu
- Department of Physical Medicine and Rehabilitation, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Remzi Çevik
- Department of Physical Medicine and Rehabilitation, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
| | - Deniz Dülgeroğlu
- Department of Physical Medicine and Rehabilitation, University of Health Sciences Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Türkiye
| | - Berrin Durmaz
- Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Tuncay Duruöz
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Marmara University Faculty of Medicine, Istanbul, Türkiye
| | - Gülcan Gürer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Savaş Gürsoy
- Department of Physical Medicine and Rehabilitation, Gaziantep University Faculty of Medicine, Gaziantep, Türkiye
| | - Sami Hizmetli
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
| | - Cahit Kaçar
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Ece Kaptanoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Başkent University Faculty of Medicine, Zübeyde Hanım Hospital, Izmir, Türkiye
| | - Hilal Ecesoy
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Karamanoğlu Mehmetbey University Faculty of Medicine, Konya, Türkiye
| | - Meltem Melikoğlu
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Atatürk University Faculty of Medicine, Erzurum, Türkiye
| | - Kemal Nas
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology and Immunology, Sakarya University Faculty of Medicine, Sakarya, Türkiye
| | - Hakan Nur
- Department of Physical Medicine and Rehabilitation, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Şüheda Özçakır
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Uludağ University School of Medicine, Bursa, Türkiye
| | - Nilay Şahin
- Department of Physical Medicine and Rehabilitation, Balıkesir University Faculty of Medicine, Balıkesir, Türkiye
| | - Özlem Şahin
- Department of Physical Medicine and Rehabilitation, Cumhuriyet University Faculty of Medicine, Sivas, Türkiye
| | - Merih Sarıdoğan
- Department of Physical Medicine and Rehabilitation, Istanbul Üniversitesi-Cerrahpaşa, Cerrahpaşa Tıp Fakültesi, Istanbul, Türkiye
| | - Ömer Faruk Şendur
- Department of Physical Medicine and Rehabilitation and Algology, Medicana International Hospital, Izmir, Türkiye
| | - İlhan Sezer
- Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Akdeniz University Faculty of Medicine, Antalya, Türkiye
| | - Gülnur Taşçı Bozbaş
- Department of Physical Medicine and Rehabilitation, Adnan Menderes University Faculty of Medicine, Aydın, Türkiye
| | - Canan Tıkız
- Department of Physical Medicine and Rehabilitation, Celal Bayar University Faculty of Medicine, Manisa, Türkiye
| | - Hatice Uğurlu
- Department of Physical Medicine and Rehabilitation, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Türkiye
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10
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Hajra D, Nair AV, Chakravortty D. Decoding the invasive nature of a tropical pathogen of concern: The invasive non-Typhoidal Salmonella strains causing host-restricted extraintestinal infections worldwide. Microbiol Res 2023; 277:127488. [PMID: 37716125 DOI: 10.1016/j.micres.2023.127488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Invasive-Non-Typhoidal Salmonella (iNTS) are the major cause of health concern in the low-income, under-developed nations in Africa and Asia that lack proper sanitation facilities. Around 5% of the NTS cases give rise to invasive, extraintestinal diseases leading to focal infections like osteomyelitis, meningitis, osteoarthritis, endocarditis and neonatal sepsis. iNTS serovars like S. Typhimurium, S. Enteritidis, S. Dublin, S. Choleraesuis show a greater propensity to become invasive than others which hints at the genetic basis of their emergence. The major risk factors attributing to the invasive diseases include immune-compromised individuals having co-infection with malaria or HIV, or suffering from malnutrition. The rampant use of antibiotics leading to the emergence of multi-drug resistant strains poses a great challenge in disease management. An extensive understanding of the iNTS pathogenesis and its epidemiology will open up avenues for the development of new vaccination and therapeutic strategies to restrict the spread of this neglected disease.
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Affiliation(s)
- Dipasree Hajra
- Department of Microbiology & Cell Biology, Indian Institute of Science, India
| | - Abhilash Vijay Nair
- Department of Microbiology & Cell Biology, Indian Institute of Science, India
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11
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Lai Q, Zhao Y, Yan H, Peng H. Advances in diagnosis, treatment and prognostic factors of gastrointestinal DLBCL. Leuk Res 2023; 135:107406. [PMID: 37944240 DOI: 10.1016/j.leukres.2023.107406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023]
Abstract
Gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL) is an extremely aggressive form of B-cell non-Hodgkin lymphoma (BNHL) which has complex histological characteristics and manifests a high degree of heterogeneity in terms of clinical, morphological, immunological, and genetic features. GI-DLBCL mainly spreads by infiltrating neighboring lymph nodes, and common gastrointestinal complications (GICS) such as obstruction, perforation, or bleeding, frequently arise during the progression of the disease, posing significant challenges in both diagnosing and treating the condition. Meanwhile, the incidence of GI-DLBCL has been gradually increasing in recent years, and its strong invasiveness makes it prone to being misdiagnosed or completely missed. In clinical practice, over half of the patients diagnosed with the disease are in stage III or stage IV. What makes it worse is that certain patients may not exhibit a favorable response to chemotherapy. All these lead to intricacies in management of this disease. Unfortunately, there is currently no large prospective study or evidence-based medical evidence to provide clear guidance on treatment decisions for this specific type of lymphoma. Neither do physicians have a consensus regarding the optimal approach to address this condition. Recent studies have identified the presence of various prognostic factors that significantly impact survival in GI-DLBCL, which demonstrates the unique particularity of GI-DLBCL, and could help optimize the clinical decision.
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Affiliation(s)
- Qinqiao Lai
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Zhao
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Haiqing Yan
- Department of gastric and abdominal cancer ward, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Hongling Peng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China; Hunan Engineering Research Center of Cell Immunotherapy for Hematopoietic Malignancies, Changsha, Hunan, China.
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12
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Yang SF, Xie XF, Lu WH, Lan P, Liu H, Jin L. The association of serum anti-PLA2R antibody and glomerular PLA2R antigen staining with clinical manifestations and outcomes in membranous nephropathy. Clin Exp Nephrol 2023; 27:1060-1066. [PMID: 37668806 DOI: 10.1007/s10157-023-02399-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 08/20/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Phospholipase A2 receptor (PLA2R)-associated membranous nephropathy (MN) was manifested as seropositive for PLA2R antibodies (SAb) and/or glomerular PLA2R antigens' (GAg) deposits. According to the test of SAb and GAg, PLA2R-associated MN can be divided into SAb + /GAg-, SAb-/GAg + , and SAb + /GAg + groups. The clinical characteristics and outcomes of the three groups need to be further evaluated. METHODS 184 PLA2R-associated MN patients were enrolled. SAb was measured by enzyme-linked immunosorbent assay with a cut-off value of 14 RU/mL. GAg was detected by immunofluorescence using a paraffin section of renal biopsy samples. Clinical characteristics and the decline of eGFR were compared among the 3 groups. RESULTS There were 33 SAb + /GAg-, 46 SAb-/GAg +, and 105 SAb + /GAg + PLA2R-associated MN patients reviewed. Clinical characteristics, such as the level of proteinuria, serum albumin, as well as eGFR, were comparable between the SAb + /GAg- and SAb + /GAg + patients. While SAb-/GAg + patients exhibited mild clinical manifestations as evidenced by higher serum albumin (P < 0.001) and lower proteinuria (p = 0.049) compared with SAb + /GAg + patients. After 21.96 ± 7.39 month follow-up, the eGFR decrease was no difference between the SAb + /GAg- and SAb + /GAg + patients. SAb-/GAg + patients had a lower rate of the > 20% eGFR decline as well as a 50% eGFR decline compared with the SAb + /GAg + patients (10.87% vs 30.48%, p = 0.013; 0.00% vs 4.76%, p = 0.324). CONCLUSIONS Our study showed that the clinical manifestations of SAb + /Gag- patients were the same as those of double-positive patients, while SAb-/GAg + patients exhibited mild clinical manifestations and slower eGFR decline compared to the double-positive patients.
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Affiliation(s)
- Shi-Feng Yang
- Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, 710061, Shaanxi Province, China
| | - Xin-Fang Xie
- Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, 710061, Shaanxi Province, China
| | - Wan-Hong Lu
- Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, 710061, Shaanxi Province, China
| | - Ping Lan
- Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, 710061, Shaanxi Province, China
| | - Hui Liu
- Biobank, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Li Jin
- Department of Nephrology, Kidney Hospital, The First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an City, 710061, Shaanxi Province, China.
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13
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Wu X, Zhang X, Qian S, Shi C, Li X, Feng X, Zhu L, Ge J, Li Z, Zhang M. The experience of diagnosis and treatment for TAFRO syndrome. Ann Hematol 2023; 102:3515-3520. [PMID: 37713125 DOI: 10.1007/s00277-023-05435-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Early identification, diagnosis and treatment of TAFRO syndrome are very importants. We retrospectively analysed 6 patients with TAFRO syndrome. Their clinical manifestations, treatment methods, survival and other aspects were summarized. All patients were pathologically diagnosed with Castleman's disease, with fever, an inflammatory storm state and varying degrees of anasarca. All patients received steroid therapy; four of them also received chemotherapy, and 1 received rituximab. Of the 3 patients with severe disease, only 1 patient who received the recommended dose of glucocorticoids survived. Early administration of glucocorticoids can improve the prognosis, especially in patients with severe disease, and adequate glucocorticoids are important.
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Affiliation(s)
- Xiaolong Wu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xudong Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Siyu Qian
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Cunzhen Shi
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xin Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Xiaoyan Feng
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Linan Zhu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Jingjing Ge
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Zhaoming Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, People's Republic of China.
- Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, 450052, Henan, People's Republic of China.
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14
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Lin F, Yang K, Lin X, Jin M, Chen L, Zheng FZ, Qiu LL, Ye ZX, Chen HZ, Lin MT, Wang N, Wang ZQ. Clinical features, imaging findings and molecular data of limb-girdle muscular dystrophies in a cohort of Chinese patients. Orphanet J Rare Dis 2023; 18:356. [PMID: 37974208 PMCID: PMC10652577 DOI: 10.1186/s13023-023-02897-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 08/31/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Limb-girdle muscular dystrophies (LGMDs) are a group of heterogeneous inherited diseases predominantly characterized by limb-girdle muscle weakness and dystrophic changes on histological analysis. The frequency of LGMD subtypes varies among regions in China and ethnic populations worldwide. Here, we analyzed the prevalence of LGMD subtypes, their corresponding clinical manifestations, and molecular data in a cohort of LGMD patients in Southeast China. METHODS A total of 81 consecutive patients with clinically suspected LGMDs from 62 unrelated families across Southeast China were recruited for targeted next-generation sequencing and whole-exome sequencing from July 2017 to February 2020. RESULTS Among 50 patients (41 families) with LGMDs, the most common subtypes were LGMD-R2/LGMD2B (36.6%) and LGMD-R1/LGMD2A (29.3%). Dystroglycanopathies (including LGMD-R9/LGMD2I, LGMD-R11/LGMD2K, LGMD-R14/LGMD2N and LGMD-R20/LGMD2U) were the most common childhood-onset subtypes and were found in 12.2% of the families. A total of 14.6% of the families had the LGMD-R7/LGMD2G subtype, and the mutation c.26_33dupAGGTGTCG in TCAP was the most frequent (83.3%). The only patient with the rare subtype LGMD-R18/LGMD2S had TRAPPC11 mutations; had a later onset than those previously reported, and presented with proximal‒distal muscle weakness, walking aid dependency, fatty liver disease and diabetes at 33 years of age. A total of 22.0% of the patients had cardiac abnormalities, and one patient with LMNA-related muscular dystrophy/LGMD1B experienced sudden cardiac death at 37 years of age. A total of 15.4% of the patients had restrictive respiratory insufficiency. Muscle imaging in patients with LGMD-R1/LGMD2A and LGMD-R2/LGMD2B showed subtle differences, including more severe fatty infiltration of the posterior thigh muscles in those with LGMD-R1/LGMD2A and edema in the lower leg muscles in those with LGMD-R2/LGMD2B. CONCLUSION We determined the prevalence of different LGMD subtypes in Southeast China, described the detailed clinical manifestations and distinct muscle MRI patterns of these LGMD subtypes and reported the frequent mutations and the cardiorespiratory involvement frequency in our cohort, all of which might facilitate the differential diagnosis of LGMDs, allowing more timely treatment and guiding future clinical trials.
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Affiliation(s)
- Feng Lin
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
| | - Kang Yang
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
| | - Xin Lin
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
| | - Ming Jin
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China
| | - Long Chen
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
| | - Fu-Ze Zheng
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China
| | - Liang-Liang Qiu
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China
| | - Zhi-Xian Ye
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
| | - Hai-Zhu Chen
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China
| | - Min-Ting Lin
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China
| | - Ning Wang
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China.
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China.
| | - Zhi-Qiang Wang
- Department of Neurology and Institute of Neurology, The First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Fuzhou, 350005, Fujian, China.
- Fujian Key Laboratory of Molecular Neurology, Fuzhou, 350005, China.
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Wanlapakorn N, Thongpan I, Sarawanangkoor N, Vichaiwattana P, Auphimai C, Srimuan D, Thatsanathorn T, Kongkiattikul L, Kerr SJ, Poovorawan Y. Epidemiology and clinical characteristics of severe acute respiratory infections among hospitalized children under 5 years of age in a tertiary care center in Bangkok, Thailand, 2019-2020. Heliyon 2023; 9:e22300. [PMID: 38045212 PMCID: PMC10692904 DOI: 10.1016/j.heliyon.2023.e22300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 12/05/2023] Open
Abstract
Background Acute respiratory infections (ARIs) are common in children and can range in severity from mild self-limiting illnesses to more severe conditions such as pneumonia and respiratory failure. Data on the epidemiology of viral and bacterial pathogens causing ARIs in children are scarce in this region. This study aimed to investigate the epidemiology and clinical manifestations of pathogens in children aged ≤5 years presenting with severe acute respiratory infection (SARI) in Bangkok, Thailand. The impact of rapid multiplex PCR-based testing on clinical management is also explored. Methods This cross-sectional study enrolled consecutive children aged ≤5 years presenting with SARI at a tertiary care centre in Bangkok, Thailand, between 2019 and 2020. Nasopharyngeal swabs were collected once at admission, and viral and bacterial pathogens were tested using the QIAstat-Dx respiratory panel. Results A total of 169 children were enrolled in this study. At least one pathogenic virus was detected in 91.7 % of participants. Based on the final diagnoses made upon discharge, 30.2 % had upper respiratory tract infection, whereas 66.3 % had lower respiratory tract infection. Pneumonia was the most common diagnosis (59.2 %). The most common pathogen identified was rhino/enterovirus (45.2 %), followed by respiratory syncytial virus (31.6 %) and parainfluenza virus (14.2 %). Co-infection was found in 15.4 % and was not associated with increased disease severity. Conclusions This study provides additional insights into the pathogen profiles, clinical diagnosis, and co-infection combinations of ARIs in hospitalized children. This information is useful for diagnosis and treatment of ARIs, as well as implementation of appropriate infection control measures and guidance for future vaccine policy development.
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Affiliation(s)
- Nasamon Wanlapakorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ilada Thongpan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Abigail Wexner Research Institute at Nationwide Children's Hospital, Center for Vaccines and Immunity, Columbus, OH 43205, USA
| | - Nasiri Sarawanangkoor
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Preeyaporn Vichaiwattana
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chompoonut Auphimai
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Donchida Srimuan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thaksaporn Thatsanathorn
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Lalida Kongkiattikul
- Division of pulmonology and critical care, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Stephen J. Kerr
- Biostatistics Excellence Center, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- FRS(T), the Royal Society of Thailand, Sanam Sueapa, Dusit, Bangkok, 10300, Thailand
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16
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Chen ZM, Fan XQ, Zhou YX. Retrospective analysis of 16 cases of lumbar hernia. Heliyon 2023; 9:e22235. [PMID: 38045220 PMCID: PMC10692800 DOI: 10.1016/j.heliyon.2023.e22235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Background Through a retrospective analysis of 16 cases of lumbar hernia, we discussed the anatomical basis, clinical manifestations, diagnosis, and treatment of this rare condition. Methods We collected medical data of 15 patients with a primary lumbar hernia and one patient with a secondary lumbar hernia treated in the General Surgery Department of Wuxi No.2 People's Hospital between January 2008 and June 2021 and analysed their demographic, preoperative, and postoperative data. Results All patients underwent elective surgery performed by the same treatment team for superior lumbar hernias. The median area of the hernia defect was 12 cm2. Fifteen patients underwent sublay repair, and one underwent onlay repair. The median operative time and blood loss were 48 min and 22 mL, respectively. The hernia contents were extraperitoneal fat in 15 patients and partial small intestine in one. The median visual analogue scale score on postoperative day 1 was 3. A postoperative drainage tube was placed in three cases but not used in 13. The median duration of hospital stay was 5 days. Postoperative incision infection occurred in one case. During the follow-up period, no postoperative complications, including haematoma, seroma, incision infection or rupture, recurrence, and chronic pain, occurred in the other 15 cases. Conclusion Lumbar hernias are rare and can be safely and effectively treated by open tension-free repair.
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Affiliation(s)
- Zhi-ming Chen
- Department of General Surgery, Jingjiang People's Hospital, the Affiliated Hospital of Jiangsu Vocational College of Medicine, Jingjiang Ctiy, Taizhou, Jiangsu, 214500, China
| | - Xin-qi Fan
- Department of General Surgery, Wuxi NO.2 People's Hospital, Jiangnan University Medical Center, JUMC. Wuxi, Jiangsu, 214000, China
| | - You-xin Zhou
- Department of General Surgery, Wuxi NO.2 People's Hospital, Jiangnan University Medical Center, JUMC. Wuxi, Jiangsu, 214000, China
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Radhakrishnan N, Liu M, Idowu B, Bansari A, Rathi K, Magar S, Mundhra L, Sarmiento J, Ghaffar U, Kattan J, Jones R, George J, Yang Y, Southwick F. Comparison of the clinical characteristics of SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) infected patients from a single hospitalist service. BMC Infect Dis 2023; 23:747. [PMID: 37907849 PMCID: PMC10617227 DOI: 10.1186/s12879-023-08714-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/16/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND While existing evidence suggests less severe clinical manifestations and lower mortality are associated with the Omicron variant as compared to the Delta variant. However, these studies fail to control for differences in health systems facilities and providers. By comparing patients hospitalized on a single medical service during the Delta and Omicron surges we were able to conduct a more accurate comparison of the two varaints' clinical manifestations and outcomes. METHODS We conducted a prospective study of 364 Omicron (BA.1) infected patients on a single hospitalist service and compared these findings to a retrospective analysis of 241 Delta variant infected patients managed on the same service. We examined differences in symptoms, laboratory measures, and clinical severity between the two variants and assessed potential risk drivers for case mortality. FINDINGS Patients infected with Omicron were older and had more underlying medical conditions increasing their risk of death. Although they were less severely ill and required less supplemental oxygen and dexamethasone, in-hospital mortality was similar to Delta cases, 7.14% vs. 4.98% for Delta (q-value = 0.38). Patients older than 60 years or with immunocompromised conditions had much higher risk of death during hospitalization, with estimated odds ratios of 17.46 (95% CI: 5.05, 110.51) and 2.80 (1.03, 7.08) respectively. Neither vaccine history nor variant type played a significant role in case fatality. The Rothman score, NEWS-2 score, level of neutrophils, level of care, age, and creatinine level at admission were highly predictive of in-hospital death. INTERPRETATION In hospitalized patients, the Omicron variant is less virulent than the Delta variant but is associated with a comparable mortality. Clinical and laboratory features at admission are informative about the risk of death.
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Affiliation(s)
- N Radhakrishnan
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - M Liu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - B Idowu
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - A Bansari
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - K Rathi
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - S Magar
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - L Mundhra
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - J Sarmiento
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - U Ghaffar
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - J Kattan
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - R Jones
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - J George
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA
| | - Y Yang
- Department of Statistics, Franklin College of Arts and Sciences, University of Georgia, 310 Herty Drive, Athens, GA, 30602, Greece.
| | - F Southwick
- Division of Hospital Medicine, Department of Medicine, University of Florida College of Medicine, 6362 NW 41st Ave, Gainesville, FL, 32606, USA.
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18
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Na J, Chen X, Zhen Z, Gao L, Yuan Y. Anomalous right coronary artery originating from the aorta: a series of nine pediatric cases. BMC Pediatr 2023; 23:546. [PMID: 37907926 PMCID: PMC10617201 DOI: 10.1186/s12887-023-04377-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND To investigate the clinical manifestations, prognosis, and possibly related genes of anomalous right coronary artery originating from the aorta (ARCA-L) in children. METHODS This case series study included pediatric patients diagnosed with ARCA-L at the Department of Cardiology in Beijing Children's Hospital affiliated to Capital Medical University, between January 2017 and December 2019. RESULTS Nine pediatric patients (aged 3 months to 12 years, 4 boys) were included. Two cases presented with cardiac insufficiency as their primary manifestation, while the remaining seven had post-infection or post-exercise symptoms such as chest pain, chest tightness, long exhalation, lack of strength, and dizziness. Six patients displayed varying degrees of ST-T changes on the electrocardiograph, while two patients had a reduced left ventricular ejection fraction (LVEF) of 20-32% according to echocardiography. Multislice computed tomographic angiography confirmed the presence of ARCA-L in all patients. One patient underwent the unroofing technique. The remaining eight received conservative treatment. After a follow-up of 2-64 months, eight children had a good prognosis and survived. One child experienced sudden death due to aggravated heart failure. Whole exome sequencing revealed that one child tested negative, one had mutations in the RYR2 and LDB3 genes, and the remaining four patients had a mutation in the GDF1, LRP6, MEF2A, and KALRN genes, respectively. CONCLUSIONS ARCA-L in children might have a wide variation in clinical manifestations and a risk of sudden death. The occurrence of the disease might be associated with genetic defects.
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Affiliation(s)
- Jia Na
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Xi Chen
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Zhen Zhen
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Lu Gao
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Yue Yuan
- Department of Cardiology, Beijing Children's Hospital Capital Medical University, National Center for Children's Health, Beijing, 100045, China.
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19
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Boyvat A, Oktem A, Kalay Yildizhan I, Ates A, Yalcindag N, Koksoy C, Yucesan C. A Comparison of Adult and Juvenile Behcet Patients and a Look at Clinical Trends: Retrospective Data from a Turkish Follow-Up Cohort Study. Dermatology 2023; 239:958-965. [PMID: 37793347 DOI: 10.1159/000534316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 09/24/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Previous reports indicate that juvenile Behçet's disease (BD) may have a different course than adult BD. However, as a direct comparison with adult Behçet patients has only been made in a limited number of studies, the issue is still controversial. OBJECTIVES The primary aim of our study was to compare clinical manifestations in a large cohort of juvenile and adult Behçet patients registered in a single centre. The secondary aim of our study was to compare the data of newly diagnosed patients registered between 1998 and 2020 with the data of those registered between 1976 and 1997. METHODS Data were collected retrospectively from medical records of patients registered between 1998 and 2020. Juvenile BD was defined as fulfilment of International Criteria for Behçet's Disease at or before 16 years of age. RESULTS A similar course of disease was noted in juvenile and adult Behçet patients with no significant difference in the frequency of mucocutaneous findings, major organ involvement, and positivity of the pathergy test. A comparison of the periods, 1976-1997 and 1998-2020, revealed no significant difference in the prevalence of mucocutaneous lesions and major organ involvement. CONCLUSIONS Our results indicate that juvenile and adult Behçet patients have a similar course with a similar frequency of clinical manifestations. Contrary to reports suggesting an overall tendency to milder disease over time, no decrease in the risk of major organ involvements was observed. A significant trend towards a decline in pathergy test positivity was noted.
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Affiliation(s)
- Ayse Boyvat
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ayse Oktem
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | | | - Askın Ates
- Department of Internal Medicine, Division of Rheumatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Nilufer Yalcindag
- Department of Ophthalmology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Cuneyt Koksoy
- Department of Surgery, Baylor College of Medicine/The Methodist Hospital, Houston, Texas, USA
| | - Canan Yucesan
- Department of Neurology, Faculty of Medicine, Ankara University, Ankara, Turkey
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20
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Herrero-Martínez JM, Sánchez-Ledesma M, Ramos-Rincón JM. Imported and autochthonous dengue in Spain. Rev Clin Esp 2023; 223:510-519. [PMID: 37507047 DOI: 10.1016/j.rceng.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
Dengue is globally the most important arboviral infection. It is caused by the dengue virus and it is generally transmitted by Aedes mosquitoes' bites (Ae aegypti or Ae albopictus). In Spain it was initially eradicated in the 20th century, together with the Ae aegypti vector, and currently most of the cases reported in Spain are imported by travelers from countries with dengue transmission (imported dengue). However, in recent years, cases of dengue have been described in people residing in Spain who had not traveled to areas with known transmission (autochthonous dengue), transmitted by Aedes albopictus (the so-called tiger mosquito), present especially in the Mediterranean basin. Therefore, a good knowledge of this potentially severe disease is required, so that it can be diagnosed early, and managed correctly, thus reducing its mortality, as well as its eventual autochthonous transmission.
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Affiliation(s)
- J-M Herrero-Martínez
- Servicio de Medicina Interna, Hospital Universitario 12 de Octubre-Imas12, Madrid, Dpto. de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - M Sánchez-Ledesma
- Unidad Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario de Salamanca- IBSAL, Salamanca, Dpto. de Medicina, Universidad de Salamanca, IBSAL, Salamanca, Spain
| | - J-M Ramos-Rincón
- Servicio de Medicina Interna, Hospital General Universitario Dr. Balmis; Dpto de Medicina Clínica Universidad Miguel Hernández; Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España.
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21
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Shen Y, Li D, Cao Q, Hu M, Hou Z, Xu L, Li Y, Hong D. Risk factors of vestibular migraine-related brain white matter lesions. Acta Neurol Belg 2023; 123:1833-1839. [PMID: 36071312 DOI: 10.1007/s13760-022-02076-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 08/22/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE AND PURPOSE Migraine is related to white matter lesions (WMLs), and attack frequency and duration in migraine patients are thought to increase WMLs. However, the relationship between vestibular migraine (VM) and WMLs remains unclear. This study explored the risk factors for WMLs in VM patients and provided a basis for the prevention of WMLs in VM patients. METHODS A large single-center cross-sectional study of patients with VM was conducted. None of the patients had comorbidities, such as hypertension and diabetes, or adverse lifestyle habits (smoking and drinking). All patients were divided into WML + and WML- groups after assessment of WMLs using magnetic resonance imaging (MRI). After collecting the patient's detailed medical history, statistical analysis was performed. RESULTS In univariate analysis, the frequency of vertigo was statistically significant between the WML + and WML- groups. However, there was no significant difference in other clinical features. Multivariate regression analysis found that the frequency of vertigo (OR 2.399; 95% CI 1.014-5.679; p = 0.046) was an independent risk factor for WMLs. High frequency of vertigo episodes showed more pronounced risk factors (OR 9.607; 95% CI 1.061-87.014; p = 0.044). CONCLUSION These results substantiate that vertigo frequency is an independent risk factor for WMLs in VM. A high frequency of vertigo episodes is more likely to be associated with WMLs than a low frequency. These results suggest a possible approach to the prevention of WMLs in VM patients.
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Affiliation(s)
- Yu Shen
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Yong Wai Zheng Street 17, Nanchang, Jiangxi, China
| | - Defu Li
- School of Public Health, Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, Jiangxi, China
| | - Qian Cao
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Mengyao Hu
- The Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhou Hou
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lijun Xu
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yanping Li
- Department of Neurology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Yong Wai Zheng Street 17, Nanchang, Jiangxi, China.
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22
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Shintouo CM, Shey RA, Yengo BN, Yaah NE, Teh RN, Ngwese RA, Ayong L, Vanhamme L, Souopgui J, Ghogomu SM, Njemini R. Effects of the suspension of mass drug administration during the COVID-19 pandemic on onchocerciasis prevalence in the Bandjoun and Massangam health districts, West Region of Cameroon. Acta Trop 2023; 246:106999. [PMID: 37549841 DOI: 10.1016/j.actatropica.2023.106999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/26/2023] [Accepted: 08/04/2023] [Indexed: 08/09/2023]
Abstract
Onchocerciasis is an infectious disease of public health and socio-economic importance in most parts of Sub-Saharan Africa. The objective of this study was to evaluate the effects of the suspension of implementation activities towards combating onchocerciasis in the Bandjoun and Massangam health districts in the West Region of Cameroon as a consequence of the COVID-19 pandemic. Data on socio-demographic and clinical characteristics were obtained using a structured questionnaire. All participants in both health districts were examined for the presence of clinical manifestations of onchocerciasis. In addition, two skin snips were obtained from the knee of each participant and examined for the presence of microfilaria. All data were categorized, coded, entered in a database, and analysed using SPSS version 23.0. A total of 229 participants in the Bandjoun health district and 378 in the Massangam health district were recruited for the study. In both health districts, there was no significant difference between male and female participants in terms of the clinical manifestations of onchocerciasis. The prevalence of nodules was 8.7% in the Bandjoun health district and 20.6% in the Massangam health district while the prevalence of microfilaria carriers in Bandjoun and Massangam health districts was 3.5% and 3.7%, respectively. Except for the Tsesse and Lemgo communities in the Bandjoun health district, there was a reduction in the prevalence of microfilaria in the communities that were studied when compared to previous data obtained before the disruption of control programmes activities. Overall, in both health districts, elderly individuals bear the largest burden of onchocerciasis. Based on the results obtained, we conclude that the temporary suspension of Neglected Tropical Disease control programme activities by the World Head Organization as a result of COVID-19 may have resulted to recrudescence of O. volvulus transmission in hypoendemic communities in the Bandjoun health district.
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Affiliation(s)
- Cabirou Mounchili Shintouo
- Department of Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon
| | - Robert Adamu Shey
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon; Department of Molecular Biology, Institute of Biology and Molecular Medicine, IBMM, Université Libre de Bruxelles, Gosselies Campus, 126040 Gosselies, Belgium
| | - Bernis Neneyoh Yengo
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon
| | - Ntang Emmaculate Yaah
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon
| | - Rene Ning Teh
- Department of Zoology and Animal Physiology, University of Buea, Buea, Cameroon
| | - Roland Akwelle Ngwese
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon
| | - Lawrence Ayong
- Malaria Research Unit, Centre Pasteur Cameroon, Yaounde´, Cameroon
| | - Luc Vanhamme
- Department of Molecular Biology, Institute of Biology and Molecular Medicine, IBMM, Université Libre de Bruxelles, Gosselies Campus, 126040 Gosselies, Belgium
| | - Jacob Souopgui
- Department of Molecular Biology, Institute of Biology and Molecular Medicine, IBMM, Université Libre de Bruxelles, Gosselies Campus, 126040 Gosselies, Belgium.
| | - Stephen Mbigha Ghogomu
- Department of Biochemistry and Molecular Biology, Faculty of Science, University of Buea, P.O. Box 63 Buea, Cameroon.
| | - Rose Njemini
- Department of Gerontology, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium; Frailty in Ageing Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, B-1090 Brussels, Belgium.
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23
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Li Y, Si Z, Zhao W, Xie C, Zhang X, Liu J, Liu J, Xia Z. Tuberous sclerosis complex: a case report and literature review. Ital J Pediatr 2023; 49:116. [PMID: 37679848 PMCID: PMC10485941 DOI: 10.1186/s13052-023-01490-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 06/29/2023] [Indexed: 09/09/2023] Open
Abstract
Tuberous sclerosis complex (TSC) is an autosomal dominant disorder with different initial symptoms and complex clinical manifestations. A 14-year-old female patient presented with persistent fever and severe headache. Medical imaging examinations revealed multiple abnormal intracranial lesions. The patient had previously been misdiagnosed with "encephalitis and acute disseminated encephalomyelitis" after visiting numerous hospitals. Eventually, by combing the characteristics of the case and genetic testing results, the patient was diagnosed with TSC accompanied by Mycoplasma pneumoniae infection. The purpose of this case report and literature review is to improve understanding of the clinical diagnosis and treatment of TSC so as to avoid misdiagnosis, missed diagnosis, and overtreatment.
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Affiliation(s)
- Yanlin Li
- Department of Neurology, Shandong Institute of Neuroimmunology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, China
| | - Zhihua Si
- Department of Neurology, Shandong Institute of Neuroimmunology, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, 250014, China
| | - Wei Zhao
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, China
| | - Cong Xie
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, China
| | - Xu Zhang
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, China
| | - Ju Liu
- Laboratory of Microvascular Medicine, Medical Research Center, Shandong Provincial Qianfoshan Hospital, Shandong University, 16766 Jingshi Road, Jinan, 250014, China
| | - Jinzhi Liu
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, China.
- Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, 67 Dongchang West Road, Liaocheng, Liaocheng, 252000, China.
- Department of Gerontology, Cheeloo College of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, 44 Wenhua West Road, Jinan, 250012, China.
- Department of Geriatric Neurology, Shandong Provincial Qianfoshan Hospital, The First Affiliated Hospital of Shandong First Medical University, 16766 Jingshi Road, Jinan, 250014, China.
- Department of Neurology, Cheeloo College of Medicine, Liaocheng People's Hospital, Shandong University, 44 Wenhua West Road, Jinan, 250012, China.
| | - Zhangyong Xia
- Department of Neurology, Liaocheng People's Hospital and Liaocheng Clinical School of Shandong First Medical University, 67 Dongchang West Road, Liaocheng, Liaocheng, 252000, China.
- Department of Neurology, Cheeloo College of Medicine, Liaocheng People's Hospital, Shandong University, 44 Wenhua West Road, Jinan, 250012, China.
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24
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Casares-Marfil D, Esencan D, Alibaz-Oner F, Çefle A, Yazıcı A, Duzgun N, Aşık MA, Özbek S, Cinar M, Alpsoy E, Bilge SY, Kasifoglu T, Saruhan-Direskeneli G, Direskeneli H, Sawalha AH. Clinical trait-specific genetic analysis in Behçet's disease identifies novel loci associated with ocular and neurological involvement. Clin Immunol 2023; 253:109657. [PMID: 37271218 PMCID: PMC10529450 DOI: 10.1016/j.clim.2023.109657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/26/2023] [Accepted: 05/25/2023] [Indexed: 06/06/2023]
Abstract
Behçet's disease is a complex inflammatory vasculitis with a broad spectrum of clinical manifestations. The purpose of this study was to investigate the genetics underlying specific clinical features of Behçet's disease. A total of 436 patients with Behçet's disease from Turkey were studied. Genotyping was performed using the Infinium ImmunoArray-24 BeadChip. After imputation and quality control measures, logistic regressions adjusting for sex and the first five principal components were performed for each clinical trait using a case-case genetic analysis approach. A weighted genetic risk score was calculated for each clinical feature. Genetic association analyses of previously identified susceptibility loci in Behçet's disease revealed a genetic association between ocular lesions and HLA-B/MICA (rs116799036: OR = 1.85 [95% CI = 1.35-2.52], p-value = 1.1 × 10-4). The genetic risk score was significantly higher in Behçet's disease patients with ocular lesions compared to those without ocular involvement, which is explained by the genetic variation in the HLA region. New genetic loci predisposing to specific clinical features in Behçet's disease were suggested when genome-wide variants were evaluated. The most significant associations were observed in ocular involvement with SLCO4A1 (rs6062789: OR = 0.41 [95% CI = 0.30-0.58], p-value = 1.92 × 10-7), and neurological involvement with DDX60L (rs62334264: OR = 4.12 [95% CI 2.34 to 7.24], p-value = 8.85 × 10-7). Our results emphasize the role of genetic factors in predisposing to specific clinical manifestations in Behçet's disease, and might shed additional light into disease heterogeneity, pathogenesis, and variability of Behçet's disease presentation across populations.
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Affiliation(s)
- Desiré Casares-Marfil
- Division of Rheumatology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Deren Esencan
- Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey
| | - Fatma Alibaz-Oner
- Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ayşe Çefle
- Division of Rheumatology, Department of Internal Medicine, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Ayten Yazıcı
- Division of Rheumatology, Department of Internal Medicine, Kocaeli University, School of Medicine, Kocaeli, Turkey
| | - Nursen Duzgun
- Division of Rheumatology, Department of Internal Medicine, Ankara University, School of Medicine, Ankara, Turkey
| | - Mehmet Ali Aşık
- Division of Rheumatology, Department of Internal Medicine, Çukurova University, School of Medicine, Adana, Turkey
| | - Süleyman Özbek
- Division of Rheumatology, Department of Internal Medicine, Çukurova University, School of Medicine, Adana, Turkey
| | - Muhammet Cinar
- Division of Rheumatology, Department of Internal Medicine, University of Health Sciences Turkey, Gulhane Faculty of Medicine, Ankara, Turkey
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University, School of Medicine, Antalya, Turkey
| | - Sule Yasar Bilge
- Division of Rheumatology, Department of Internal Medicine, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Timucin Kasifoglu
- Division of Rheumatology, Department of Internal Medicine, Osmangazi University, School of Medicine, Eskisehir, Turkey
| | | | - Haner Direskeneli
- Division of Rheumatology, Department of Internal Medicine, Marmara University, School of Medicine, Istanbul, Turkey
| | - Amr H Sawalha
- Division of Rheumatology, Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA, USA; Division of Rheumatology and Clinical Immunology, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Lupus Center of Excellence, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Immunology, University of Pittsburgh, Pittsburgh, PA, USA.
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25
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Deb S, Mondal R, Lahiri D, Shome G, Roy AG, Sarkar V, Sarkar S, Benito-León J. Norovirus-associated neurological manifestations: summarizing the evidence. J Neurovirol 2023; 29:492-506. [PMID: 37477790 PMCID: PMC10501950 DOI: 10.1007/s13365-023-01152-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023]
Abstract
Norovirus, a positive-stranded RNA virus, is one of the leading causes of acute gastroenteritis among all age groups worldwide. The neurological manifestations of norovirus are underrecognized, but several wide-spectrum neurological manifestations have been reported among infected individuals in the last few years. Our objective was to summarize the features of norovirus-associated neurological disorders based on the available literature. We used the existing PRISMA consensus statement. Data were collected from PubMed, EMBASE, Web of Science, and Scopus databases up to Jan 30, 2023, using pre-specified searching strategies. Twenty-one articles were selected for the qualitative synthesis. Among these, seven hundred and seventy-four patients with norovirus-associated neurological manifestations were reported. Most cases were seizure episodes, infection-induced encephalopathy, and immune-driven disorders. However, only a few studies have addressed the pathogenesis of norovirus-related neurological complications. The pathogenesis of these manifestations may be mediated by either neurotropism or aberrant immune-mediated injury, or both, depending on the affected system. Our review could help clinicians to recognize these neurological manifestations better and earlier while deepening the understanding of the pathogenesis of this viral infection.
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Affiliation(s)
- Shramana Deb
- Department of Neuroscience, S.N. Pradhan Centre for Neuroscience, Kolkata, India
| | - Ritwick Mondal
- Department of Clinical Pharmacology and Therapeutic Medicine, IPGMER and SSKM Hospital, Kolkata, India
| | - Durjoy Lahiri
- Department of Cognitive Neurology, Baycrest Health Sciences and Rotman Research Institute, University of Toronto, Ontario, Canada
| | - Gourav Shome
- Division of Molecular Medicine, Bose Institute, Kolkata, India
| | - Aakash Guha Roy
- Department of Internal Medicine, SSKM and IPGMER Hospital, Kolkata, India
| | - Vramanti Sarkar
- Department of Neuroscience, S.N. Pradhan Centre for Neuroscience, Kolkata, India
| | - Shramana Sarkar
- Department of Internal Medicine, SSKM and IPGMER Hospital, Kolkata, India
| | - Julián Benito-León
- Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
- Research Institute (i+12), University Hospital “12 de Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
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Chenchula S, Ghanta MK, Amerneni KC, Rajakarunakaran P, Chandra MB, Chavan M, Gupta R. A systematic review to identify novel clinical characteristics of monkeypox virus infection and therapeutic and preventive strategies to combat the virus. Arch Virol 2023; 168:195. [PMID: 37386209 DOI: 10.1007/s00705-023-05808-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/02/2023] [Indexed: 07/01/2023]
Abstract
Since May 2022, there has been a global increase in the number of Mpox virus (MPXV) cases in countries that were previously considered non-endemic. In July 2022, the World Health Organization (WHO) declared this outbreak a public health emergency of international concern. The objective of this systematic review is to examine the novel clinical features of Mpox and to assess the available treatment options for managing the disease in patients who are afflicted with it. We conducted a systematic search in several databases, including PubMed, Google Scholar, Cochrane Library, and the grey literature, from May 2022 to February 2023. We identified 21 eligible studies, which included 18,275 Mpox cases, for final qualitative analysis. The majority of cases were reported in men who have sex with men (MSM) and immunocompromised individuals with HIV (36.1%). The median incubation period was 7 days (IQR: 3-21). The novel clinical manifestations include severe skin lesions on the palms, oral and anogenital regions, as well as proctitis, penile edema, tonsillitis, ocular disease, myalgia, lethargy, and sore throat, without any preceding prodromal symptoms or systemic illness. In addition, fully asymptomatic cases were documented, and various complications, including encephalomyelitis and angina, were noted. Clinicians must be familiar with these novel clinical characteristics, as they can aid in testing and tracing such patients, as well as asymptomatic high-risk populations such as heterosexuals and MSM. In addition to supportive care, currently, there are several effective prophylactic and treatment strategies available to combat Mpox, including the vaccines ACAM2000 and MVA-BN7, as well as the immunoglobulin VIGIV and the antivirals tecovirimat, brincidofovir, and cidofovir against severe Mpox infection.
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Affiliation(s)
- Santenna Chenchula
- Department of Pharmacology, All India Institute of Medical Sciences, Bhopal, India.
| | - Mohan Krishna Ghanta
- Department of Pharmacology, MVJ Medical College and Research Hospital, Bangalore, Karnataka, India
| | | | | | | | - Madhavrao Chavan
- Department of Pharmacology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Rupesh Gupta
- Department of Internal Medicine, Government Medical College, Shahdol, Madhya Pradesh, India
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Chamani S, Mobasheri L, Rostami Z, Zare I, Naghizadeh A, Mostafavi E. Heavy metals in contact dermatitis: A review. J Trace Elem Med Biol 2023; 79:127240. [PMID: 37331278 DOI: 10.1016/j.jtemb.2023.127240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023]
Abstract
Contact dermatitis is an inflammatory skin reaction caused by direct contact with chemical substances in the environment and can either be irritant or allergic in nature. The clinical symptoms of contact dermatitis, include local skin rash, itching, redness, swelling, and lesions. Nowadays, 15-20% of people have some degree of contact dermatitis, which can be more or less severe. Immune responses in allergic contact dermatitis (ACD) are due to the effects of cytokines and allergen-specific CD4+ and CD8+ T cells on the skin. Acids and alkalis such as drain cleaners, plants such as poinsettias, hair colors, and nail polish remover, are all prominent causes of irritant contact dermatitis (ICDs). Heavy metals are metallic elements with a high atomic weight that are hazardous in low quantities and are known to cause dermatitis after systemic or local exposure. Nickel (Ni), chromium (Cr), lead (Pb), and copper (Cu) are among the most common heavy metals used in various industries. Metal allergies may cause ACD and also systemic contact dermatitis (SCD). Contact dermatitis is detected by laboratory tests such as patch testing, lymphocyte stimulation test (LST), and evaluation of cytokine production by primary cultures of peripheral blood mononuclear cells. This article presents an update on the epidemiological and clinical characteristics of ACD and SCD caused by three heavy metals (Cr, Cu, and Pb). Ni is not discussed due to recent coverage. Furthermore, the effects of contact sensitivity to some other heavy metals, such as gold (Au), cobalt (Co), palladium (Pd), and mercury (Hg) are discussed.
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Affiliation(s)
- Sajad Chamani
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Leila Mobasheri
- Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zeinab Rostami
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Iman Zare
- Research and Development Department, Sina Medical Biochemistry Technologies Co. Ltd., Shiraz 7178795844, Iran
| | - Ali Naghizadeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran.
| | - Ebrahim Mostafavi
- Stanford Cardiovascular Institute, Stanford University School of Medicine, Stanford, CA 94305, USA; Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
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Lightner JS, Chesnut SR, Cory T, Sellers S, Woods L, Skarbek A, Willis-Smith N, Valleroy E, Colbert S, Witt J. Changes in HIV knowledge and interest among nursing and public health students at a large Midwest University: Outcomes of implementing the National HIV Curriculum. Nurse Educ Today 2023; 125:105802. [PMID: 36989636 DOI: 10.1016/j.nedt.2023.105802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Ending the HIV epidemic requires additional healthcare and public health workers who are competent in HIV prevention and treatment. The National HIV Curriculum was developed to increase competency in HIV among healthcare workers in the US. OBJECTIVES The purpose of the current study was to examine the impact of implementing the National HIV Curriculum (NHC) for nursing and public health students. DESIGN This study employed a single-arm, cohort intervention design. SETTING This study was conducted at large, public university in the Midwestern United States of America in a state noted for high HIV transmission. PARTICIPANTS Undergraduate nursing, graduate nursing, and undergraduate public health students participated in this study. METHODS An online survey of nursing and public health students was conducted following implementation of the NHC at a large, public university in the Midwest. Students were assessed on knowledge and interest of HIV using a bootstrapped paired-samples t-test approach. RESULTS Participants (N = 175) were enrolled in the undergraduate nursing program (n = 72, 41.14 %), graduate nursing (n = 37, 21.14 %) public health (n = 37, 21.14 %), medicine (n = 10, 5.71 %), and biological, biomedical, and health sciences discipline (n = 19, 10.86 %). Overall, results suggest a consistent gain in knowledge of working with individuals living with HIV of 1.42 points (on a 4-point scale). About half (47.43 %) of all students increased interest to work with individuals living with HIV in the future. CONCLUSION The NHC increased knowledge and interest in students across a broad range of nursing, public health, medicine, and other disciplines. This study suggests that universities can integrate the curriculum across undergraduate and graduate programs. Students at varying degree levels may benefit from the NHC. Future longitudinal studies should be conducted on the career choices of those students exposed to the NHC.
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Affiliation(s)
- Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA.
| | - Steven R Chesnut
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Tracy Cory
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sherri Sellers
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Latoya Woods
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Anita Skarbek
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Nancy Willis-Smith
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Ella Valleroy
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA; Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA; School of Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Sharon Colbert
- The Collaborative to Advance Health Services, School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Jacki Witt
- The Collaborative to Advance Health Services, School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
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Kulthanan K, Ungprasert P, Jirapongsananuruk O, Rujitharanawong C, Munprom K, Trakanwittayarak S, Pochanapan O, Panjapakkul W, Maurer M. Food-Dependent Exercise-Induced Wheals/Angioedema, Anaphylaxis, or Both: A Systematic Review of Phenotypes. J Allergy Clin Immunol Pract 2023; 11:1926-1933. [PMID: 36997120 DOI: 10.1016/j.jaip.2023.03.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Food-dependent exercise-induced allergic reactions can manifest with wheals, angioedema, and anaphylaxis, alone or in combination. OBJECTIVE To systematically review the clinical manifestation, culprit foods and exercise, augmenting factors, comorbidities, and treatment options of each phenotype. METHODS Using predefined search terms, we assessed and analyzed the relevant literature until June 2021. Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations were applied to this systematic review. RESULTS A total of 231 studies with 722 patients were included. The most common phenotype was anaphylaxis with wheals, angioedema, or both, reported in 80% of patients. This was associated with a higher number of anaphylactic episodes, augmenting factors, and use of on-demand antihistamine compared with the least common phenotype, anaphylaxis without wheals or angioedema, reported in 4% of patients. Anaphylaxis with wheals/angioedema was also associated with distinct characteristics compared with stand-alone wheals, angioedema, or both, in 17% of patients. Patients with anaphylaxis were older at the time of disease onset, less often had a history of atopy, showed more positive results in response to food and exercise provocation tests, had a more restricted spectrum of culprit foods, and more often used on-demand epinephrine. CONCLUSIONS The three phenotypes of allergic reactions to food and exercise differ in clinical characteristics, triggers, and response to treatment. Knowledge of these differences may help with patient education and counseling as well as disease management.
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Affiliation(s)
- Kanokvalai Kulthanan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Patompong Ungprasert
- Department of Rheumatic and Immunologic Diseases, Cleveland Clinic, Cleveland, Ohio
| | - Orathai Jirapongsananuruk
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chuda Rujitharanawong
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanyalak Munprom
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Oraya Pochanapan
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Waratchaya Panjapakkul
- Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Marcus Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Fraunhofer Institute for Translational Medicine and Pharmacology, Allergology and Immunology, Berlin, Germany.
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Ibrahim AA, Mohammed HS, Elsaid NMAB, Salim AA, Fathy EG, Hasaneen NM. Risk factors for polycystic ovary syndrome among women of reproductive age in Egypt: A case control study. Afr J Reprod Health 2023; 27:41-50. [PMID: 37715673 DOI: 10.29063/ajrh2023/v27i6.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, associated with an increased risk of multiple diseases, and its pathogenesis is not fully understood. Purpose: identify risk factors for Polycystic Ovary Syndrome in reproductive-aged Egyptian women attending an outpatient gynecological clinic at a specialized hospital of Obstetrics and Gynecology in Port Said City, Egypt. The study population included 248 women; 124 women suffered from PCOS and 124 Non-PCOS. Methods: - Case-control study was conducted among women. PCOS women were diagnosed clinically by transvaginal ultrasound and laboratory investigations. Data were collected using; I) a structured interview questionnaire, including socio-demographic status, medical and family history, menstrual and obstetrical history and lifestyle habits, and clinical examination; II) anthropometric parameters; III) perceived stress scale. The mean age of cases was 26.18±0.45 years. The most common risk factors for PCOS were urban residence, high education, working, insufficient income, history of anemia, hypertension, cancer, and family history of PCOS and infertility, increasing body mass index, fast food, and drinking of coffee. The study concluded that the significant risk factors for polycystic ovarian disease in Egypt women included socio-demographic characteristics, medical and family history, increasing body mass index, and lifestyle habits. This study recommended that Polycystic Ovary Syndrome women follow a healthy diet and exercise regularly.
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Affiliation(s)
- Asmaa Abobakr Ibrahim
- Obstetrics and Gynecological Nursing, Faculty of Nursing, Suez Canal University, Egypt
| | - Heba Saber Mohammed
- Obstetrics and Gynecological Medicine, Faculty of Medicine, Suez Canal University
| | - Noha M Abu Bakr Elsaid
- Public Health, Community, Environmental and Occupational Medicine Department, Faculty of Medicine, Suez Canal University, Egypt
- Basic Medical Sciences Department, Faculty of medicine, King Salman International University, South Sinai, Egypt
| | - Almaza A Salim
- Family Medicine, Faculty of Medicine, port said university
| | - Ebtehal G Fathy
- Family and Community Health Nursing, Faculty of Nursing, Suez Canal University, Egypt
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Carabalí-Isajar ML, Rodríguez-Bejarano OH, Amado T, Patarroyo MA, Izquierdo MA, Lutz JR, Ocampo M. Clinical manifestations and immune response to tuberculosis. World J Microbiol Biotechnol 2023; 39:206. [PMID: 37221438 DOI: 10.1007/s11274-023-03636-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 04/29/2023] [Indexed: 05/25/2023]
Abstract
Tuberculosis is a far-reaching, high-impact disease. It is among the top ten causes of death worldwide caused by a single infectious agent; 1.6 million tuberculosis-related deaths were reported in 2021 and it has been estimated that a third of the world's population are carriers of the tuberculosis bacillus but do not develop active disease. Several authors have attributed this to hosts' differential immune response in which cellular and humoral components are involved, along with cytokines and chemokines. Ascertaining the relationship between TB development's clinical manifestations and an immune response should increase understanding of tuberculosis pathophysiological and immunological mechanisms and correlating such material with protection against Mycobacterium tuberculosis. Tuberculosis continues to be a major public health problem globally. Mortality rates have not decreased significantly; rather, they are increasing. This review has thus been aimed at deepening knowledge regarding tuberculosis by examining published material related to an immune response against Mycobacterium tuberculosis, mycobacterial evasion mechanisms regarding such response and the relationship between pulmonary and extrapulmonary clinical manifestations induced by this bacterium which are related to inflammation associated with tuberculosis dissemination through different routes.
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Grants
- a Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia
- a Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia
- a Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia
- a Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, Bogotá 111321, Colombia
- b PhD Program in Biomedical and Biological Sciences, Universidad del Rosario, Carrera 24#63C-69, Bogotá 111221, Colombia
- c Health Sciences Faculty, Universidad de Ciencias Aplicadas y Ambientales (UDCA), Calle 222#55-37, Bogotá 111166, Colombia
- d Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45#26-85, Bogotá 111321, Colombia
- e Medicine Department, Hospital Universitario Mayor Mederi, Calle 24 # 29-45, Bogotá 111411. Colombia
- e Medicine Department, Hospital Universitario Mayor Mederi, Calle 24 # 29-45, Bogotá 111411. Colombia
- f Universidad Distrital Francisco José de Caldas, Carrera 3#26A-40, Bogotá 110311, Colombia
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Affiliation(s)
- Mary Lilián Carabalí-Isajar
- Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, 111321, Bogotá, Colombia
- Biomedical and Biological Sciences Programme, Universidad del Rosario, Carrera 24#63C-69, 111221, Bogotá, Colombia
| | | | - Tatiana Amado
- Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, 111321, Bogotá, Colombia
| | - Manuel Alfonso Patarroyo
- Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, 111321, Bogotá, Colombia
- Faculty of Medicine, Universidad Nacional de Colombia, Carrera 45#26-85, 111321, Bogotá, Colombia
| | - María Alejandra Izquierdo
- Medicine Department, Hospital Universitario Mayor Mederi, Calle 24 # 29-45, 111411, Bogotá, Colombia
| | - Juan Ricardo Lutz
- Medicine Department, Hospital Universitario Mayor Mederi, Calle 24 # 29-45, 111411, Bogotá, Colombia.
| | - Marisol Ocampo
- Fundación Instituto de Inmunología de Colombia (FIDIC), Carrera 50#26-20, 111321, Bogotá, Colombia.
- Universidad Distrital Francisco José de Caldas, Carrera 3#26A-40, 110311, Bogotá, Colombia.
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Zhang C, Wang Y, Chen Y, Zhou H, Hong Q, Yu X, Ng TK, Cen LP. Acute phase clinical manifestations of patients with Vogt-Koyanagi-Harada disease in Southern China. BMC Ophthalmol 2023; 23:199. [PMID: 37147563 PMCID: PMC10161656 DOI: 10.1186/s12886-023-02952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 04/28/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUNDS To characterize the acute phase clinical manifestations and visual outcomes of the patients with Vogt-Koyanagi Harada (VKH) disease in southern China. METHODS In total, 186 patients with acute-onset VKH disease were recruited. The demographic data, clinical signs, ophthalmic examinations, and visual outcomes were analyzed. RESULTS Among the 186 VKH patients, 3 were diagnosed as complete VKH, 125 as incomplete VKH, and 58 as probable VKH. All patients visited the hospital within 3 months of onset and complained of decreased vision. For the extraocular manifestations, 121 patients (65%) referred neurological symptoms. Anterior chamber activity was negative in most eyes within an onset of 7 days, which increased slightly with onset beyond 1 week. Exudative retinal detachment (366 eyes, 98%) and optic disc hyperaemia (314 eyes, 84%) were commonly observed at presentation. A typical ancillary examination helped with the diagnosis of VKH. Systemic corticosteroid therapy was prescribed. The logMAR best-corrected visual acuity improved significantly from 0.74 ± 0.54 at baseline to 0.12 ± 0.24 at the 1-year follow-up visit. The recurrence rate was 18% in the follow-up visits. Erythrocyte sedimentation rate and C-reactive protein were significantly correlated to VKH recurrences. CONCLUSION Posterior uveitis, followed by mild anterior uveitis, is the typical initial manifestation in the acute phase of Chinese VKH patients. Visual outcome improvement is promising in most patients receiving systemic corticosteroid therapy in the acute phase. Detection of the clinical features at the initial onset of VKH could facilitate early treatment and better vision improvement.
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Affiliation(s)
- Chuhua Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Yun Wang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Yun Chen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Hui Zhou
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Qiuxia Hong
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Xiuying Yu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
| | - Tsz Kin Ng
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China
- Shantou University Medical College, Shantou, 515041, Guangdong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Ling-Ping Cen
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, Guangdong, China.
- Shantou University Medical College, Shantou, 515041, Guangdong, China.
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Li Y, Yang L. Clinical manifestations and vision-related quality of life in pediatric uveitis. Indian J Ophthalmol 2023; 71:2162-2167. [PMID: 37202942 PMCID: PMC10391409 DOI: 10.4103/ijo.ijo_2648_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To analyze clinical manifestations, visual ability, and quality of life in pediatric uveitis and to explore factors affecting visual ability and quality of life. Methods This cross-sectional study included 40 patients with pediatric uveitis in the database of Ophthalmology of Peking University First Hospital. All patients completed the Cardiff visual ability questionnaire for children (CVAQC) and pediatric quality of life inventory measurement models (PedsQL4.0). Results A total of 40 cases (68 eyes) with pediatric uveitis were included in this study. Better visual acuity in the better eye was predictive of lower CVAQC, education, and distance vision scores. Better visual acuity in the worse eye was predictive of a lower CVAQC score and distance vision. Better CVAQC scores were predictive of lower PedsQL4.0, physical health, psychosocial health, and school functioning scores. Conclusion Patients with pediatric uveitis tend to be seriously affected by ocular complications. The visual ability of patients with pediatric uveitis decreases significantly. Better visual acuity in the better eye is associated with better total visual ability, education, and distance vision. Better visual acuity in the worse eye is associated with better total visual ability and distance vision. Health-related quality of life is related to vision ability in pediatric uveitis.
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Affiliation(s)
- Yiran Li
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
| | - Liu Yang
- Department of Ophthalmology, Peking University First Hospital, Beijing, China
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Mongkolchaiarunya J, Wongthanee A, Kasitanon N, Louthrenoo W. Comparison of clinical features, disease activity, treatment and outcomes between late-onset and early-onset patients with systemic lupus erythematosus. A sex- and year at diagnosis-matched controlled study. Adv Rheumatol 2023; 63:20. [PMID: 37127712 DOI: 10.1186/s42358-023-00297-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/25/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Several studies have compared the clinical features and outcomes of late- and early-onset systemic lupus erythematosus (SLE) patients. However, these previous studies were uncontrolled. The current study aimed to compare late- and early-onset SLE patients while controlling for sex and year at diagnosis (± 1 year). METHODS The medical records of SLE patients in a lupus cohort from January 1994 to June 2020 were reviewed. Late-onset patients were identified as those with an age at diagnosis ≥ 50 years. The early-onset patients (age at diagnosis < 50 years) were matched by sex and year at diagnosis with the late-onset patients at a ratio of 2:1. Clinical manifestations, disease activity (mSLEDAI-2K), organ damage scores, treatment, and mortality were compared between the two groups. RESULTS The study comprised 62 and 124 late- and early-onset patients, respectively, with a mean follow-up duration of 5 years. At disease onset, when comparing the early-onset patients with the late-onset patients, the latter group had a higher prevalence rate of serositis (37.0% vs. 14.5%, p < 0.001) and hemolytic anemia (50.0% vs. 33.9%, p = 0.034) but lower prevalence rate of malar rash (14.5% vs. 37.1%, p = 0.001), arthritis (41.9% vs. 62.1%, p = 0.009), leukopenia (32.3% vs. 50.0%, p = 0.022) and lymphopenia (50.0% vs. 66.1%, p = 0.034). The groups had similar SLE disease activity (7.41 vs. 7.50), but the late-onset group had higher organ damage scores (0.37 vs. 0.02, p < 0.001). The rates of treatment with corticosteroids, antimalarial drugs, or immunosuppressive drugs were not different. At their last visit, the late-onset patients still had the same pattern of clinically significant differences except for arthritis; additionally, the late-onset group had a lower rate of nephritis (53.2% vs. 74.2%, p = 0.008). They also had a lower level of disease activity (0.41 vs. 0.57, p = 0.006) and received fewer antimalarials (67.7% vs. 85.5%, p = 0.023) and immunosuppressive drugs (61.3% vs. 78.2%, p = 0.044), but they had higher organ damage scores (1.37 vs. 0.47, p < 0.001) and higher mortality rates/100-person year (3.2 vs. 1.1, p = 0.015). After adjusting for disease duration and baseline clinical variables, the late-onset patients only had lower rate of nephritis (p = 0.002), but still received fewer immunosuppressive drugs (p = 0.005) and had a higher mortality rate (p = 0.037). CONCLUSIONS In this sex- and year at diagnosis-matched controlled study, after adjusting for disease duration and baseline clinical variables, the late-onset SLE patients had less renal involvement and received less aggressive treatment, but had a higher mortality rate than the early-onset patients.
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Affiliation(s)
- Jarukit Mongkolchaiarunya
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Antika Wongthanee
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nuntana Kasitanon
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Worawit Louthrenoo
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Martins JG, de Castro Figueiredo Bordon K, Moreno-González JA, Almeida B, Pardal P, Lira A, Candido D, Arantes EC, Procópio R. On the noxious black Amazonian scorpion, Tityus obscurus (Scorpiones, Buthidae): Taxonomic notes, biology, medical importance and envenoming treatment. Toxicon 2023; 228:107125. [PMID: 37054995 DOI: 10.1016/j.toxicon.2023.107125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 04/15/2023]
Abstract
Tityus obscurus has caused mild, moderate and severe accidents of medical relevance in the eastern Brazilian Amazon and French Guiana. Tityus obscurus has sexual dimorphism although males and females have uniform black coloration. In the Amazon, one of the habitats of this scorpion is seasonally flooded forests (igapós and várzeas). However, most stings occur in terra firme forest areas (non-flooded region), where most rural communities are located. Adults and children stung by T. obscurus may experience an "electric shock" sensation for more than 30 h after the sting. Our data shows that people inhabiting remote forest areas, including rubber tappers, fishermen and indigenous people, with no access to anti-scorpion serum, use parts of native plants, such as seeds and leaves, against pain and vomiting caused by scorpion stings. Although there is a technical effort to produce and distribute antivenoms in the Amazon, many cases of scorpion stings are geographically unpredictable in this region, due to the lack of detailed knowledge of the natural distribution of these animals. In this manuscript, we compile information on the natural history of T. obscurus and the impact of its envenoming on human health. We identify the natural sites that host this scorpion in the Amazon, in order to warn about the risk of human envenoming. The use of specific antivenom serum is the recommended treatment for accidents involving venomous animals. However, atypical symptoms not neutralized by the available commercial antivenom are reported in the Amazon region. Facing this scenario, we present some challenges to the study of venomous animals in the Amazon rainforest and possible experimental bottlenecks and perspectives for establishing a method aimed at producing an efficient antivenom.
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Affiliation(s)
- Jonas Gama Martins
- Pós-Graduação em Genética, Conservação e Biologia Evolutiva, Instituto Nacional de Pesquisas da Amazônia (INPA), Manaus, AM, Brazil.
| | - Karla de Castro Figueiredo Bordon
- Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jairo A Moreno-González
- Division of Invertebrate Zoology, American Museum of Natural History New York, Central Park West at 79th Street, 10024-5192, New York City, NY, USA
| | - Bruno Almeida
- Instituto Federal de Educação, Ciência e Tecnologia do Pará, Campus Itaituba, PA, Brazil
| | - Pedro Pardal
- Laboratório de Entomologia Médica e Animais Peçonhentos, Núcleo de Medicina Tropical, Universidade Federal do Pará (UFPA), Belém, PA, Brazil
| | - André Lira
- Universidade Federal de Campina Grande, Centro de Educação e Saúde, Cuité, PB, Brazil
| | - Denise Candido
- Laboratório de Artrópodes, Instituto Butantan, São Paulo, Brazil
| | - Eliane Candiani Arantes
- Departamento de Ciências BioMoleculares, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Rudi Procópio
- Pós-Graduação em Biotecnologia e Recursos Naturais da Amazônia, Universidade do Estado do Amazonas (UEA), Manaus, AM, Brazil
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May D, Kponee-Shovein K, Mahendran M, Downes N, Sheng K, Lefebvre P, Cheng WY. Epidemiology and patient journey of Rett syndrome in the United States: a real-world evidence study. BMC Neurol 2023; 23:141. [PMID: 37016355 PMCID: PMC10071755 DOI: 10.1186/s12883-023-03181-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 03/24/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Rett syndrome (RTT) is a neurodevelopmental disorder that almost exclusively affects females and is associated with high clinical burden. However, literature characterizing the real-world journey of patients with RTT is limited. This study provided an overview of the epidemiology, patient characteristics, clinical manifestations, healthcare resource utilization (HRU), costs, and treatment patterns of patients with RTT in the US. METHODS IQVIA™ Medical Claims Data and Longitudinal Prescription Data (11/01/2016-10/31/2019) were used to identify female patients with RTT, with the first observed diagnosis defined as the index date. Annual incidence and prevalence of RTT were assessed over the entire study period; clinical manifestations, all-cause and RTT-related HRU and costs, and treatment patterns were evaluated during the observation period-from the index date to end of clinical activity or end of data availability, whichever occurred first. Results were further stratified into pediatric (< 18 years) and adult (≥ 18 years) subgroups. RESULTS In 2019, prevalence and incidence of RTT was 0.32 and 0.23 per 10,000 enrollees, respectively. Among 5,940 female patients (pediatric: 3,078; adult: 2,862) with mean observation period of 2.04 years, the most prevalent clinical manifestations were neurological disorders (72.8%), gastrointestinal/nutritional disorders (41.9%), and orthopedic disorders (34.6%). The incidence rate of all-cause HRU was 44.43 visits per-patient-per-year and RTT-related HRU comprised 47% of all-cause HRU. Mean all-cause healthcare costs were $40,326 per-patient-per-year, with medical costs driven by home/hospice care visits, therapeutic services, outpatient visits, and inpatient visits. RTT-related healthcare costs comprised 45% of all-cause healthcare costs. The most prevalent supportive therapy and pharmacologic agent were feeding assistance (37.9%) and antiepileptic drugs (54.8%), respectively. Trends were similar by subgroup; although, rates of HRU were generally higher among pediatric patients relative to adult patients (all-cause: 52.43 and 35.86, respectively), which translated into higher mean healthcare costs (all-cause: $45,718 and $34,548, respectively). CONCLUSIONS Patients with RTT have substantial disease burden, including prevalent clinical manifestations, high rates of HRU and annual healthcare costs, and reliance on pharmacologic and supportive therapies. These findings underscore the unmet need for effective therapies to target the multifactorial manifestations of RTT.
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Affiliation(s)
- Damian May
- Acadia Pharmaceuticals Inc., 12830 El Camino Real, Ste. 400, San Diego, CA, 92130, USA.
| | - Kalé Kponee-Shovein
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
| | - Malena Mahendran
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
| | - Nathaniel Downes
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
| | - Kristy Sheng
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
| | - Patrick Lefebvre
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
| | - Wendy Y Cheng
- Analysis Group, Inc., 111 Huntington Avenue, 14th floor, Boston, MA, 02199, USA
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Li Y, Zhou Q, Liu C, Sun C, Sun H, Li X, Zhang L. Epidemiology, clinical characteristics, and treatment of children with acute intussusception: a case series. BMC Pediatr 2023; 23:143. [PMID: 36997992 PMCID: PMC10061978 DOI: 10.1186/s12887-023-03961-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 03/20/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND To summarize the clinical and epidemiological characteristics of acute intussusception. METHODS This retrospective study included pediatric patients with acute intussusception admitted to the Department of Pediatric Surgery, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University, from January 2014 to December 2019. RESULTS A total of 402 infants/children were included (301 males and 101 females) with a mean age of 2.4 ± 1.5 years (2 months to 9 years). Thirty patients (7.5%) had a history of cold food intake, diarrhea, and upper respiratory infection before disease onset. Paroxysmal abdominal pain and crying occurred in 338 patients (84.1%). Eight patients (2.0%) had the typical triad, 167 (41.5%) had vomiting, 24 (6.0%) had bloody stools, and 273 (67.9%) had palpable abdominal mass. The average intussusception depth was 4.0 ± 1.4 cm. Air enema reduction was performed in 344 cases: 335 (97.3%) were successful. Fifty-eight patients were treated with intravenous phloroglucinol (2 mg/kg), and 53 (91.4%) were successful. Sixty-five patients suffered relapses, with a relapse rate of 16.8%. CONCLUSIONS Pediatric acute intussusception is common. There was no obvious etiology. The clinical manifestations are mostly atypical. Abdominal pain is the most common complaint. Air enema reduction is an effective treatment. The recurrence rate is high.
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Affiliation(s)
- Yan Li
- Department of Scientific Research, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Qi Zhou
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Chao Liu
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Chao Sun
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Hao Sun
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Xiang Li
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China
| | - Lei Zhang
- Department of Pediatric Surgery, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Qingdao, China.
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Szabo S, Zayachkivska O, Hussain A, Muller V. What is really 'Long COVID'? Inflammopharmacology 2023; 31:551-557. [PMID: 36964860 PMCID: PMC10039447 DOI: 10.1007/s10787-023-01194-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/26/2023]
Abstract
The previous acute respiratory diseases caused by viruses originating from China or the middle east (e.g., SARS, MERS) remained fast developing short diseases without major sequalae or any long-lasting complications. The new COVID-19, on the other hand, not only that it rapidly spread over the world, but some patients never fully recovered or even if they did, a few weeks later started to complain not only of shortness of breath, if any, but general weakness, muscle pains and 'brain fog', i.e., fuzzy memories. Thus, these signs and symptoms were eventually labelled 'long COVID', for which the most widely used definition is 'new signs and symptoms occurring 4-8 weeks after recovering from acute stage of COVID-19'. The other most frequent manifestations associated with long COVID include headache, loss of memory, smell and of hair, nausea, and vomiting. Thus, long COVID is not a simple disease, but complex disorder of several organ systems malfunctioning; hence, it is probably more appropriate to call this a syndrome. The pathogenesis of long COVID syndrome is poorly understood, but initial and persistent vascular endothelial injury that often triggers the formation of microthrombi that if dislodged as emboli, damage several organs, especially in the brain, heart and kidney, by creating microinfarcts. The other major contributory mechanistic factor is the persistent cytokine storm that may last longer in long COVID patients than in others, probably triggered by aggregates of SARS-Co-2 discovered recently in the adrenal cortex, kidney and brain. The prevalence of long COVID is relatively high, e.g., initially varied 3-30%, and recent data indicate that 2.5% of UK population suffers from this syndrome, while in the US 14.7% of acute COVID-19 patients continued to have symptoms longer than 2 months. Thus, the long COVID syndrome deserves to be further investigated, both from clinical and basic research perspectives.
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Affiliation(s)
- Sandor Szabo
- School of Medicine, American University of Health Sciences, 1600 East Hill St., Signal Hill/Long Beach, CA, 90755, USA.
| | - Oksana Zayachkivska
- School of Medicine, American University of Health Sciences, 1600 East Hill St., Signal Hill/Long Beach, CA, 90755, USA
| | - Alamdar Hussain
- School of Medicine, American University of Health Sciences, 1600 East Hill St., Signal Hill/Long Beach, CA, 90755, USA
| | - Veronika Muller
- School of Medicine, American University of Health Sciences, 1600 East Hill St., Signal Hill/Long Beach, CA, 90755, USA
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
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Li MY, Wang QH, Chen RP, Su XF, Wang DY. Pathogenesis, clinical manifestations, diagnosis, and treatment progress of achalasia of cardia. World J Clin Cases 2023; 11:1741-1752. [PMID: 36970002 PMCID: PMC10037292 DOI: 10.12998/wjcc.v11.i8.1741] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023] Open
Abstract
Achalasia cardia, type of esophageal dynamic disorder, is a relatively rare primary motor esophageal disease characterized by the functional loss of plexus ganglion cells in the distal esophagus and lower esophageal sphincter. Loss of function of the distal and lower esophageal sphincter ganglion cells is the main cause of achalasia cardia, and is more likely to occur in the elderly. Histological changes in the esophageal mucosa are considered pathogenic; however, studies have found that inflammation and genetic changes at the molecular level may also cause achalasia cardia, resulting in dysphagia, reflux, aspiration, retrosternal pain, and weight loss. Currently, the treatment options for achalasia focus on reducing the resting pressure of the lower esophageal sphincter, helping to empty the esophagus and relieve symptoms. Treatment measures include botulinum toxin injection, inflatable dilation, stent insertion, and surgical myotomy (open or laparoscopic). Surgical procedures are often subject to controversy owing to concerns about safety and effectiveness, particularly in older patients. Herein, we review clinical epidemiological and experimental data to determine the prevalence, pathogenesis, clinical presentation, diagnostic criteria, and treatment options for achalasia to support its clinical management.
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Affiliation(s)
- Ming-Yue Li
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Qing-Hua Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Run-Peng Chen
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Xiao-Fang Su
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
| | - Dong-Yang Wang
- School of Nursing, Binzhou Medical University, Yantai 264003, Shandong Province, China
- Faculty of Nursing, Mahidol University, Nakhon Pathom 73170, Thailand
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Zhang MY, Bao M, Shi DY, Shi HX, Liu XL, Xu N, Duan MH, Zhuang JL, Du X, Qin L, Hui WH, Liang R, Wang MF, Chen Y, Li DY, Yang W, Tang GS, Zhang WH, Kuang X, Su W, Han YQ, Chen LM, Xu JH, Liu ZG, Huang J, Zhao CT, Tong HY, Hu JD, Chen CY, Chen XQ, Xiao ZJ, Jiang Q. [Clinical and genetic characteristics of young patients with myeloproliferative neoplasms]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:193-201. [PMID: 37356980 PMCID: PMC10119718 DOI: 10.3760/cma.j.issn.0253-2727.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objectives: To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN). Methods: In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients. Results: 1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion: Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.
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Affiliation(s)
- M Y Zhang
- Peking University People's Hospital, Beijing 100044, China
| | - M Bao
- Peking University People's Hospital, Beijing 100044, China
| | - D Y Shi
- Peking University People's Hospital, Beijing 100044, China
| | - H X Shi
- Peking University People's Hospital, Beijing 100044, China
| | - X L Liu
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - N Xu
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - M H Duan
- Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
| | - J L Zhuang
- Peking Union Medical College Hospital, CAMS & PUMC, Beijing 100730, China
| | - X Du
- Department of Hematology, Shenzhen Second People's Hospital (First Affiliated Hospital of Shenzhen University), Shenzhen 518035, China
| | - L Qin
- The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Zhenzhou 471003, China
| | - W H Hui
- Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - R Liang
- Xi Jing Hospital, The Fourth Military Medical University, Xi'an 710032, China
| | - M F Wang
- Second Hospital of Shanxi Medical University, Taiyuan 030001, China
| | - Y Chen
- Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - D Y Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
| | - W Yang
- Shengjing Hospital Affiliated to China Medical University, Shenyang 110020, China
| | - G S Tang
- Nanfang Hospital, Southern Medical University, Guangzhou 510080, China
| | - W H Zhang
- First Hospital of Shanxi Medical University, Taiyuan 300012, China
| | - X Kuang
- Kaifeng Central Hospital, Kaifeng 475000, China
| | - W Su
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Y Q Han
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
| | - L M Chen
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China
| | - J H Xu
- Department of Hematology, the First Hospital of Qiqihar, Qiqihar 161005, China
| | - Z G Liu
- Shengjing Hospital Affiliated to China Medical University, Shenyang 110020, China
| | - J Huang
- The Fourth Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 322000, China
| | - C T Zhao
- The Affiliated Hospital of Qingdao University, Qingdao 266003, China
| | - H Y Tong
- The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou 310003, China
| | - J D Hu
- Fujian Medical University Union Hospital, Fuzhou 350001, China
| | - C Y Chen
- Shandong University Qilu Hospital, Jinan 250012, China
| | - X Q Chen
- Northwest University School of Medicine, Xi'an 710069, China
| | - Z J Xiao
- Institute of Hematology and Blood Diseases Hospital, CAMS & PUMC, National Clinical Research Center for Blood Diseases, The State Key Laboratory of Experimental Hematology, Tianjin 300020, China
| | - Q Jiang
- Peking University People's Hospital, Beijing 100044, China
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Li M, Shi Y, Yang S, Yang W. Melanoma misdiagnosed as cerebral hemorrhage. Asian J Surg 2023:S1015-9584(23)00323-8. [PMID: 36907739 DOI: 10.1016/j.asjsur.2023.03.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023] Open
Affiliation(s)
- Mengjie Li
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yunbo Shi
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Simin Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Weimin Yang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
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Poe J, Sriram S, Mehkri Y, Lucke-Wold B. Electrolyte Imbalance and Neurologic Injury. CNS Neurol Disord Drug Targets 2023; 22:CNSNDDT-EPUB-129526. [PMID: 36790006 PMCID: PMC10425572 DOI: 10.2174/1871527322666230215144649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/09/2022] [Accepted: 12/20/2022] [Indexed: 02/16/2023]
Abstract
Neurologic injury continues to be a debilitating worldwide disease with high morbidity and mortality. The systemic sequelae of a neural insult often lead to prolonged hospital stays and challenging nutritional demands that contribute to poorer prognoses. Clinical management of a given condition should prioritize preserving the homeostatic parameters disrupted by inflammatory response cascades following the primary insult. This focused review examines the reciprocal relationship between electrolyte disturbance and neurologic injury. A prolonged electrolyte imbalance can significantly impact morbidity and mortality in neurologic injuries. A detailed overview of the major electrolytes and their physiologic, iatrogenic, and therapeutic implications are included. The pathophysiology of how dysnatremias, dyskalemias, dyscalcemias, and dysmagnesemias occur and the symptoms they can induce are described. The manifestations in relation to traumatic brain injury, status epilepticus, and acute ischemic stroke are addressed. Each type of injury and the strength of its association with a disruption in either sodium, potassium, calcium, or magnesium is examined. The value of supplementation and replacement is highlighted with an emphasis on the importance of early recognition in this patient population. This review also looks at the current challenges associated with correcting imbalances in the setting of different injuries, including the relevant indications and precautions for some of the available therapeutic interventions. Based on the findings of this review, there may be a need for more distinct clinical guidelines on managing different electrolyte imbalances depending on the specified neurologic injury. Additional research and statistical data on individual associations between insult and imbalance are needed to support this potential future call for context-based protocols.
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Affiliation(s)
- Jordan Poe
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Sai Sriram
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Yusuf Mehkri
- Department of Neurosurgery, University of Florida, Gainesville, USA
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El-Kassas M, Alboraie M, Elbadry M, El Sheemy R, Abdellah M, Afify S, Madkour A, Zaghloul M, Awad A, Wifi MN, Al Balakosy A, Eltabbakh M. Non-pulmonary involvement in COVID-19: A systemic disease rather than a pure respiratory infection. World J Clin Cases 2023; 11:493-505. [PMID: 36793640 PMCID: PMC9923857 DOI: 10.12998/wjcc.v11.i3.493] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 11/07/2022] [Accepted: 01/05/2023] [Indexed: 01/23/2023] Open
Abstract
During the early phase of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), diagnosis was difficult due to the diversity in symptoms and imaging findings and the variability of disease presentation. Pulmonary manifestations are reportedly the main clinical presentations of COVID-19 patients. Scientists are working hard on a myriad of clinical, epidemiological, and biological aspects to better understand SARS-CoV-2 infection, aiming to mitigate the ongoing disaster. Many reports have documented the involvement of various body systems and organs apart from the respiratory tract including the gastrointestinal, liver, immune system, renal, and neurological systems. Such involvement will result in diverse presentations related to effects on these systems. Other presentations such as coagulation defects and cutaneous manifestation may also occur. Patients with specific comorbidities including obesity, diabetes, and hypertension have increased morbidity and mortality risks with COVID-19.
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Affiliation(s)
- Mohamed El-Kassas
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Mohamed Alboraie
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Mohamed Elbadry
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Reem El Sheemy
- Department of Tropical Medicine, Minia Faculty of Medicine, Minia University, Minia 61511, Egypt
| | - Mohamed Abdellah
- Department of Internal Medicine, Al-Azhar University, Cairo 11884, Egypt
| | - Shimaa Afify
- Department of Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo 11451, Egypt
| | - Ahmad Madkour
- Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11731, Egypt
| | - Mariam Zaghloul
- Department of Hepatology, Gastroenterology and Infectious Diseases, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh 33511, Egypt
| | - Abeer Awad
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo 11451, Egypt
| | - Mohamed-Naguib Wifi
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo 11451, Egypt
| | - Amira Al Balakosy
- Department of Tropical Medicine, Ain Shams University, Cairo 11451, Egypt
| | - Mohamed Eltabbakh
- Department of Tropical Medicine, Ain Shams University, Cairo 11451, Egypt
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Fan W, Zhang Q, Wei M, Fan Z, Jiang T. Clinical Study on Gonococcal Infection of the Penile Raphe. Urol Int 2023; 107:510-516. [PMID: 36649697 DOI: 10.1159/000528429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/22/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Gonococcal infection of the penile raphe is rarely encountered in the clinical setting. The study aimed to understand the incidence, sites, clinical manifestations, and treatment of gonococcal infection of the penile raphe. METHODS We enrolled men with gonococcal infection of the penile raphe and men with urethral gonorrhea from January 2010 to December 2021. All patients' demographic data and clinical characteristics were recorded. All patients were treated with ceftriaxone. Incision and drainage were performed in patients with non-ruptured abscesses. Nodules and sinus tract-like lesions that did not resolve after 1 month of treatment were excised. RESULTS Among 2,736 men who presented with urethral gonorrhea from January 2010 to December 2021, 5 (0.18%) had accompanying gonococcal infection of the penile raphe. An additional two men presented with gonococcal infection of the penile raphe without urethritis. Thus, 7 (0.26%; confidence interval, 0.11-0.56%) of 2,738 men had urethral gonorrhea or gonococcal infection of the penile raphe confirmed both clinically and by laboratory testing. Lesions were present in the frenulum of the prepuce and at the median aspect, proximal end, distal end, and both the proximal and distal ends of the penile raphe. The lesions manifested as abscesses, ulcers, a nodule, and a nodule with a sinus-like lesion. All lesions exhibited tenderness. All seven patients were cured after treatment. CONCLUSION Gonococcal infection of the penile raphe is a rare, atypical type of involvement of the male urogenital tract by Neisseria gonorrhoeae. It may be a local complication of urethral gonorrhea or an independent primary infection. The proximal end, distal end, and median aspect of the penile raphe can be infected by N. gonorrhoeae. Cutaneous lesions present as abscesses, ulcers, nodules, and sinus-like lesions. Ceftriaxone is effective, but sinus-like lesions require surgery.
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Affiliation(s)
- Wenge Fan
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Qingsong Zhang
- Department of Dermatology, Traditional Chinese Medical Hospital of Changshu City, Changshu, China
| | - Mei Wei
- Department of Dermatology, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Zhijiang Fan
- Department of Urinary Surgery, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
| | - Tingwang Jiang
- Department of Clinical Laboratory, First People's Hospital of Changshu City, Changshu Hospital Affiliated to Soochow University, Changshu, China
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Werkl P, Rademacher J, Pleyer U. [HLA-B27 positive anterior uveitis : Clinical aspects, diagnostics, interdisciplinary management and treatment]. Ophthalmologie 2023; 120:108-122. [PMID: 36633629 DOI: 10.1007/s00347-022-01793-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 01/13/2023]
Abstract
Acute anterior uveitis (AAU) associated with human leukocyte antigen (HLA) B27 is the most common form of noninfectious intraocular inflammation and is considered to be a separate clinical entity. Young adults between the ages of 20 and 40 years are predominantly affected. The HLA-B27 positive AAU typically presents as a unilateral, fulminant disruption of the blood-aqueous humor barrier, which is accompanied by pronounced cellular infiltration and fibrinous exudation. Other characteristics are reduced intraocular pressure and a high tendency to relapse, which can also involve the partner eye. Patients with HLA-B27 positive AAU share a high risk for other genetically associated diseases, especially spondylarthritis, chronic inflammatory bowel diseases and psoriasis. As up to 40% of those affected have a systemic disease that has not yet been diagnosed, the ophthalmologist is of major importance for early detection.
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Affiliation(s)
- Peter Werkl
- Universitätsaugenklinik Graz - LKH-Universitätsklinikum Graz, Medizinische Universität Graz, Auenbruggerplatz 4, 8036, Graz, Österreich
| | - Judith Rademacher
- Medizinische Klinik für Gastroenterologie, Infektiologie und Rheumatologie, Division of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Deutschland.,Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - Uwe Pleyer
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Deutschland. .,Universitäts-Augenklinik, Charité, Campus Virchow Klinikum - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, und Berlin Institute of Health, Berlin, Deutschland.
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Khalloufi C, Joudar I, Jalal M, Lamrissi A, Bouhya S. Atypical presentation of preeclampsia. Case report. Int J Surg Case Rep 2022; 103:107860. [PMID: 36628900 PMCID: PMC9843282 DOI: 10.1016/j.ijscr.2022.107860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Atypical pre-eclampsia cases are those that develop before 20 weeks of gestation and after 48 h after delivery and or have some of the signs and symptoms of preeclampsia without the usual hypertension or proteinuria which make them difficult to diagnose. CASE PRESENTATION Our aim is to report a case of atypical preeclampsia (before week 20 of gestation) associated with a HELLP syndrome and analyze the clinical features of atypical forms, assess differential diagnosis and highlight the progress in biochemical and biophysical markers that may help with diagnosis. CLINICAL DISCUSSION Severe early pre-eclampsia (before 32 weeks of pregnancy) is associated with a risk of maternal mortality 20 times higher than after 37 weeks, and a higher risk of perinatal complications. Its symptoms are variable and reflect multisystem dysfunction. CONCLUSION Despite the refinement of diagnostic tools available to clinicians, there are still clinical presentations that fall outside the definitions. Any good clinician must be aware of the atypical forms in order to initiate correct management without delay and thus avoid increasing maternal and perinatal morbidity and mortality.
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Affiliation(s)
- Chadia Khalloufi
- Maternity, University Hospital Abderrahim Harouchi, Casablanca, Morocco; Faculty of Medicine and Pharmacy, University Hassan II, Ain chock BP 5366, 20000 Casablanca, Morocco.
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Hou Y, Dong L, Lu X, Shi H, Xu B, Zhong W, Ma L, Wang S, Yang C, He X, Zhao Y, Wang S. Distinctions Between Fecal and Intestinal Mucosal Microbiota in Subgroups of Irritable Bowel Syndrome. Dig Dis Sci 2022; 67:5580-5592. [PMID: 35879512 DOI: 10.1007/s10620-022-07588-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 04/14/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Recent studies have shown that changes in the intestinal microbiota contribute to the pathogenesis of irritable bowel syndrome (IBS). This study aimed to investigate the characteristics of the fecal and intestinal mucosal microbiota in IBS patients, and the correlation between microbiota and clinical manifestations. METHODS Fecal and intestinal mucosal samples were collected from 14 constipation-predominant IBS (IBS-C) patients, 20 diarrhea-predominant IBS (IBS-D) patients, and 20 healthy controls (HCs). 16S rRNA gene sequencing and fluorescence in situ hybridization were used for the analysis of samples. RESULTS Community richness and diversity of the fecal microbiota in IBS patients were significantly reduced compared with the HCs. The mucosal samples in IBS patients showed decreased Bifidobacterium and increased Bacteroides caccae compared with HCs; Eubacterium and Roseburia were decreased in IBS-C patients and increased in IBS-D patients. A comparison of the fecal and mucosal microbiota in IBS patients showed significantly increased Bifidobacterium in fecal samples and a decrease in mucosal samples in IBS-C patients; Bacteroides caccae and Roseburia were significantly reduced in fecal samples and increased in mucosal samples of IBS patients. A correlation between microbiota and clinical manifestations in IBS patients showed that Bacteroides caccae and Roseburia in fecal samples and Bifidobacterium and Eubacterium in mucosal samples were associated with abdominal pain and distention. CONCLUSIONS Distinct differences exist between the fecal and intestinal mucosal microbiota in IBS patients, with the changes in the latter appearing more consistent with the pathophysiology of IBS. Changes in intestinal microbiota were associated with the clinical manifestations in IBS.
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Affiliation(s)
- Yangfan Hou
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China.,Pulmonary and Critical Care Medicine, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Lei Dong
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Xiaolan Lu
- Department of Gastroenterology, Shanghai Pudong Hospital, Shanghai, 201399, China
| | - Haitao Shi
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Bing Xu
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Wenting Zhong
- International Medical Ward, Xi'an Jiaotong University Medical College First Affiliated Hospital, Xi'an, 710061, China
| | - Lin Ma
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Shuhui Wang
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Caifeng Yang
- Departments of Gastroenterology, Xi'an City First Hospital, Xi'an, 710002, China
| | - Xinyi He
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Yidi Zhao
- Emergency Department, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China
| | - Shenhao Wang
- Department of Gastroenterology, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an, 710004, China.
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Zhang X, Zhang N, Ren YY. Review of risk factors, clinical manifestations, rapid diagnosis, and emergency treatment of neonatal perioperative pneumothorax. World J Clin Cases 2022; 10:12066-12076. [PMID: 36483838 PMCID: PMC9724522 DOI: 10.12998/wjcc.v10.i33.12066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/16/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
Perioperative neonatal pneumothorax (NP) is rare but very fatal. Most of the surgeries and treatments in the neonatal period are time-limited or emergent, and there are often some risk factors for pneumothorax before surgery. Physicians, surgeons and anesthesiologists need to identify possible risk factors for pneumothorax before surgery in preterm babies, patients receiving mechanical ventilation and those with underlying lung disease. The clinical presentation of NP is nonspecific, and patients may rapidly develop life-threatening complications if not promptly diagnosed and managed. This review highlights recent progress in the identification of risk factors, clinical manifestations, diagnosis and management of NP during the perioperative period.
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Affiliation(s)
- Xu Zhang
- Department of Heart Center, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266034, Shandong Province, China
| | - Ning Zhang
- Department of Clinical Laboratory, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266034, Shandong Province, China
| | - Yue-Yi Ren
- Department of Heart Center, Women's and Children's Hospital Affiliated to Qingdao University, Qingdao 266034, Shandong Province, China
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Hanif FM, Majid Z, Ahmed S, Luck NH, Mubarak M. Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective. World J Virol 2022; 11:453-466. [PMID: 36483109 PMCID: PMC9724207 DOI: 10.5501/wjv.v11.i6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/17/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has become a global challenge of unprecedented nature since December 2019. Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement, in approximately 5%-10% of patients, the disease is severe and involves multiple organs, leading to multi-organ dysfunction and failure. The liver and gastrointestinal tract are also frequently involved in COVID-19. In the context of liver involvement in patients with COVID-19, many key aspects need to be addressed in both native and transplanted organs. This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease, patients with pre-existing liver diseases and liver transplant recipients. A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.
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Affiliation(s)
- Farina M Hanif
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Zain Majid
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Shoaib Ahmed
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Nasir H Luck
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Muhammed Mubarak
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
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50
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Li Y, Yu M, Lu M. Pathophysiology, clinical manifestations and current management of IL-1 mediated monogenic systemic autoinflammatory diseases, a literature review. Pediatr Rheumatol Online J 2022; 20:90. [PMID: 36253853 PMCID: PMC9575291 DOI: 10.1186/s12969-022-00728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Systemic autoinflammatory diseases (SAIDs) are hyperinflammatory and immune-dysregulation conditions that present in childhood. This kind of disease is a rare disease with early-onset, severe condition and difficult diagnosis, which seriously affects the growth and development of children. Most children need a genetic diagnosis. However, with the limitation of access to genetic testing and the detection of somatic mutations, the diagnosis of SAIDs remains challenging. IL-1 is one of the important cytokines involved in the pathogenesis of SAIDs. Here we briefly review monogenic SAIDs mediated by aberrant IL-1 production, with the aim to further understand the pathogenesis, clinical manifestations and treatments of IL-1 mediated SAIDs. METHODS Literature reviews were performed using "PubMed" and "Web of Science" by searching for the terms "autoinflammatory diseases" and "IL-1". RESULTS Monogenic SAIDs mediated by IL-1 include MKD, FMF, TRAPS, PAAND, PAPA, CAPS, DIRA, Majeed syndrome, NAIAD, NLRC4-MAS, PFIT, APLAID. Monogenic SAIDs have early onset, various clinical manifestations and difficult diagnosis, so early recognition and early treatment can reduce the complications and enhance the quality of life. CONCLUSIONS There are many kinds of IL-1 mediated SAIDs. Pediatricians should be alert to SAIDs in the face of the patients with repeated fever, repeated rash and poor effect of routine treatment. The patients should be carried out with gene testing and treatment in time.
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Affiliation(s)
- Yandie Li
- grid.13402.340000 0004 1759 700XDepartment of Rheumatology Immunology and Allergy, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Heath, NO.57 Zhugan Lane, Yan-an Road, Hangzhou, 310003 China
| | - Meiping Yu
- grid.13402.340000 0004 1759 700XDepartment of Rheumatology Immunology and Allergy, Children’s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Heath, NO.57 Zhugan Lane, Yan-an Road, Hangzhou, 310003 China
| | - Meiping Lu
- Department of Rheumatology Immunology and Allergy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Heath, NO.57 Zhugan Lane, Yan-an Road, Hangzhou, 310003, China.
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