Common Cause Research Articles

Time trends in liver cancer mortality rates in Montenegro from 1990 to 2018.

Liver cancer is the third most common cause of cancer-related deaths worldwide. Hepatitis B and C infections are the main factors affecting mortality. During recent years, Montenegro conducted activities on eradication of viral hepatitis according to the global strategy for the primary prevention of liver cancer mortality. The objective of this study was to assess the liver cancer mortality trend in Montenegro for the period of 1990-2018 using regression techniques. liver cancer mortality data in Montenegro from 1990 to 2018 were collected. Mortality rates were age standardized to the World Standard Population. The joinpoint, linear and Poisson regressions were used to assess liver cancer mortality trends both overall and gender specific. The mortality trend was constant, with no significant increase or decrease in mortality rates both at the overall level and by gender. The number of cases, however, increases significantly at the overall level by an average of 1.4% per year [average annual percentage change (AAPC) (95% confidence interval, CI): 1.4 (0.5-2.3); P = 0.004] and in women by 1.9% per year [AAPC (95% CI): 1.9 (0.8-3.1); P = 0.002]. In men, there was no change in the number of cases. The three age groups most burdened by mortality from liver cancer were 65-74 (34.9%), 75-84 (26.6%) and 55-64 (25.8%). The consistent implementation of prevention measures and hepatitis virus infection treatment has played a role in partially favorable liver cancer mortality trends in Montenegro. It is crucial to closely monitor guidelines for this cancer and give particular attention to the elderly population as the most affected.

The Effect of Task-Oriented Training and Progressive Resisted Exercise on Upper Limb Function and Quality of Life in Chronic Stroke Patients

Introduction: Stroke is defined as a neurological deficit subjected to acute focal injury of the Central Nervous System (CNS) due to vascular cause. The cause may be several embracing cerebral infarctions. Stroke is the third leading cause of death and the most common cause of disability among adults. Many studies have shown that motor impairment is a common factor leading to disability in stroke survivors. Improving the deficient motor power and strategies will reduce motor disability (Task-oriented training is given mainly for improving Functional performance). Need for the Study: Studies have shown a significant effect on motor function post-stroke with several techniques like conventional exercise, Proprioceptive Neuromuscular Facilitation (PNF), and Brunnstorm techniques. The effect of the treatment was significant because the weak muscles were strengthened, and the tight muscles were relaxed. However, there is a scarcity in the literature related to the effect of task-oriented training on motor performance in subjects with chronic stroke. Hence this study is undertaken. Methods: The study was carried out in the OPD of the College of Physiotherapy- Dayananda Sagar University-Bangalore on a sample size of 40 subjects for 6 months. It was a randomised clinical trial where subjects were split into two groups with task-oriented training and Progressive Resisted Exercises (PRE). The therapy was 30 minutes/session for 5 days /week for 4 weeks. Results: Task-oriented training showed significant changes within the group from pre- and post-trial and between the group effects, thus demonstrating it to be more significant in enhancing motor performance compared to mere strengthening exercises. Conclusion: The current study demonstrates that task oriented training compared to Progressive Resisted Exercises (PRE) works efficiently in improving upper limb functions and quality of life. The improvement in motor performance varied but the Chedoke Arm and Hand Activity Inventory and Stroke Impairment Scale showed quite significant improvement post-rehabilitation with task-oriented training compared to Progressive Resisted Exercise.

Photodynamic Therapy and Cardiovascular Diseases.

Cardiovascular diseases are the third most common cause of death in the world. The most common are heart attacks and stroke. Cardiovascular diseases are a global problem monitored by many centers, including the World Health Organization (WHO). Atherosclerosis is one aspect that significantly influences the development and management of cardiovascular diseases. Photodynamic therapy (PDT) is one of the therapeutic methods used for various types of inflammatory, cancerous and non-cancer diseases. Currently, it is not practiced very often in the field of cardiology. It is most often practiced and tested experimentally under in vitro experimental conditions. In clinical practice, the use of PDT is still rare. The aim of this review was to characterize the effectiveness of PDT in the treatment of cardiovascular diseases. Additionally, the most frequently used photosensitizers in cardiology are summarized.

Intra-Articular Hyaluronic Acid for Osteoarthritis of the Hip, Shoulder, and Ankle

What Is the Issue?
 
 Osteoarthritis (OA) is a chronic disease of the joints, such as the hip, shoulder, and ankle. OA causes the joints to be painful, unstable, and less functional. In adults 55 years and younger, joint trauma is a common cause of OA.
 Hyaluronic acid (HA) is a naturally occurring molecule found in human cells that provides lubrication when injected into the joint. HA injections are a less invasive option than surgery, with potentially fewer complications.
 To support decision-making about treating hip, shoulder, or ankle OA in adults 55 years and younger, it is important to understand the potential benefits and harms of using HA in this population.
 
 What Did We Do?
 
 We reviewed the clinical effectiveness of high molecular weight (MW) injection of HA in adults between the ages of 18 and 55 years with OA of the hip, shoulder, or ankle joints to guide decisions on the use of high MW HA injection.
 An information specialist searched for peer-reviewed and grey literature sources published on January 1, 2013 to December 12, 2023. One reviewer screened citations and selected and critically appraised the included studies.
 
 What Did We Find?
 
 The evidence for this report was based on observational before-and-after studies. We found no relevant comparative studies examining the effect of high MW HA versus placebo or no treatment.
 While most studies reported post-treatment outcome improvements, it is uncertain whether high MW injection of HA improves pain, function, and disability in adults 55 years and under with hip, shoulder, or ankle OA. This is due to the low-quality evidence, small sample sizes, and methodological problems. Serious side effects of high MW HA were not reported.
 
 What Does This Mean?
 
 Due to the uncertainty of the clinical effectiveness evidence, health care providers and decision-makers may consider other factors when considering high MW IA-HA for patients with hip, shoulder, or ankle OA; these factors could include acceptability, feasibility, costs, health equity, and patient values and preferences.
 Future research from randomized studies in large populations is needed to understand the effectiveness and safety of high MW HA injections for hip, shoulder, and ankle OA.

Evaluating the photodynamic efficacy of nebulized curcumin-loaded liposomes prepared by thin-film hydration and dual centrifugation: In vitro and in ovo studies

Lung cancer, one of the most common causes of high mortality worldwide, still lacks appropriate and convenient treatment options. Photodynamic therapy (PDT) has shown promising results against cancer, especially in recent years. However, pulmonary drug delivery of the predominantly hydrophobic photosensitizers still represents a significant obstacle. Nebulizing DPPC/Cholesterol liposomes loaded with the photosensitizer curcumin via a vibrating mesh nebulizer might overcome current restrictions. In this study, the liposomes were prepared by conventional thin-film hydration and two other methods based on dual centrifugation. The liposomes' physicochemical properties were determined before and after nebulization, showing that liposomes do not undergo any changes. However, morphological characterization of the differently prepared liposomes revealed structural differences between the methods in terms of lamellarity. Internalization of curcumin in lung adenocarcinoma (A549) cells was visualized and quantified. The generation of reactive oxygen species because of the photoreaction was also proven. The photodynamic efficacy of the liposomal formulations was tested against A549 cells. They revealed different phototoxic responses at different radiant exposures. Furthermore, the photodynamic efficacy was investigated after nebulizing curcumin-loaded liposomes onto xenografted tumors on the CAM, followed by irradiation, and evaluated using positron emission tomography/computed tomography and histological analysis. A decrease in tumor metabolism could be observed. Based on the efficacy of curcumin-loaded liposomes in 2D and 3D models, liposomes, especially with prior film formation, can be considered a promising approach for PDT against lung cancer.

(088) Unconsummated Marriage: A Systematic Review of Etiological Factors and Clinical Management

Abstract Introduction Unconsummated marriage (UCM) is the inability of the heterosexual married couple to have penovaginal sexual intercourse. Objective To systematically review current evidence regarding the etiological factors and clinical management of UCM. Methods A comprehensive bibliographic search on the MEDLINE, Scopus, Web of Science, and Cochrane Library databases was performed in June 2023. Studies were selected if they described married couples (S) who never had sexual intercourse (PI) in case report or case series (D) evaluating the related causes and/or management (E) and reporting data with qualitative, quantitative or mixed methods (R). Quantitative data were reported as found in the original studies. Evaluation of level of evidence and quality of studies were based on Oxford Centre for Evidence-Based Medicine 2011 and Murad scale, respectively. The review was reported according to PRISMA statement and registered in PROSPERO with ID CRD42023433040. Results A total of 27 studies including 1,638 males and 1,587 females were selected (Fig 1). Eight articles (29.6%) were case-report involving a single couple and 19 studies (70.4%) were case series. Mean (range) Murad score was 4.1 (1–8) showing low-intermediate overall study quality. All articles had a level of evidence of 4. Most of the studies were reported from Egypt (5, 18.4%), Israel (4, 14.9%), and USA (4, 14.9%) (Fig 2). Mean age of males and females varied between 24.2 and 37.6 years and from 21 to 27.4 years, respectively. The reasons for the medical visit that led to the diagnosis of UCM were inability to consummate in 23 studies (85.2%), inability to conceive in 1 article (3.7%), and mixed in 3 papers (11.1%). The mean duration of UCM before a medical visit varied from 7 days to 3.5 years. Eight studies involving both men and women showed that vaginismus (8.4–81%) and ED (10.5–61%) were the most common causes of UCM. Three articles reported that 16.6–26% of all UCM cases were due to both male and female factors. Basic sex education was advised in all treatment programs. A multidisciplinary therapeutic approach involving urologist, gynecologist, psychiatrist, and physiotherapist was applied to 135 patients, achieving a consummation rate of 97%. Sildenafil 50 mg on demand for 1–3 months was used in the management of ED leading to a consummation rate of 84.6–100%. Tadalafil was prescribed both on-demand and daily, achieving consummation rates of up to 91%. Vaginismus was treated with desensitization sessions and graded vaginal dilators, leading to penetrative intercourse in 66.6–100% of cases after 1 month-5 years of therapy. Strengths & Limitations: The first systematic review covering the entire spectrum of UCM. The low quality of most of the included papers and the large percentage of UCM cases are probably not published. Conclusions ED and vaginismus are the most reported causes of UCM; however, a strong psychological component certainly underlies a significant number of cases. A multidisciplinary approach based on strategic integration of sex education, medical therapy, psychosexual support, and surgical treatment would seem the most suitable option to manage couples with UCM. Disclosure No.

Occupational skin carcinogens

Occupational skin cancer may manifest when employees are under exposure to one specific carcinogenic substance or more in the workplace. Workplaces often have higher concentrations of carcinogens compared to any other setting. The most common causes of skin cancer in the workplace are ultraviolet radiation, ionizing radiation, polycyclic aromatic hydrocarbons, and arsenic. However, there is only a limited number of studies on skin cancer from occupational exposure. Skin cancers that are considered mainly work-related are non-melanoma skin cancers. Their most common variants are basal cell carcinomas, squamous cell carcinomas, and actinic keratosis. Two factors that reduced the risk of occupational carcinogen exposure are as follows: a better understanding of skin cancer risk factors involved in industrial processes and better control of the use of ionizing radiation. However, the exposure risk to ultraviolet radiation at dangerous levels remains. Worse still, this risk is often not considered. Yet, the prevention and risk reduction for occupational skin cancer requires the elimination of the contact of all carcinogens present in the workplace with the employees’ skin. Additionally, to encourage and facilitate the early recognition and management of premalignant and malignant skin lesions, training should be given to those working under higher skin cancer risk, and periodic examinations should be performed.

COMPARATIVE EFFECTIVENESS OF ENTECAVIR VERSUS TENOFOVIR FOR PREVENTING HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC HEPATITIS B: A COMPREHENSIVE SYSTEMATIC REVIEW

COMPARATIVE EFFECTIVENESS OF ENTECAVIR VERSUS TENOFOVIR FOR PREVENTING HEPATOCELLULAR CARCINOMA IN PATIENTS WITH CHRONIC HEPATITIS B: A COMPREHENSIVE SYSTEMATIC REVIEW

Three or four doses of intravenous immunoglobulin G treatment for isoimmune hemolytic disease: A case series and literature review.

Neonates affected by isoimmune hemolytic disease (HDN) are at risk of developing severe hyperbilirubinemia. Studies show that increasing levels of bilirubin impact neonatal neurodevelopment. To avoid complications associated with exchange transfusion, intravenous immunoglobulin G (IVIG) is used to treat hyperbilirubinemia. We included all infants who received more than two doses of IVIG treatment for isoimmune hemolytic disease. We analyzed the incidence of side effects associated with IVIG treatment and the rate of exchange transfusion. A retrospective chart review performed between October 2011-October 2022 at East Carolina University Health identified neonates who received more than two doses IVIG for HDN. Neonates of postmenstrual age greater than 28 days old, receiving less than three doses of IVIG or received IVIG for other indications were excluded. The occurrences of adverse events, demographics and use of other medical therapies were reviewed. Eleven neonates were included in the case series. Most common cause of severe hyperbilirubinemia was attributed to ABO incompatibility. Six patients (54%) received three doses of IVIG, and five patients (45%) received four doses of IVIG with bilirubin levels decreasing below exchange transfusion. No treatment exceeding four doses of IVIG was reported, nor adverse events during treatment. In this cohort of neonates with HDN, bilirubin levels decreased after treatment with multiple doses of IVIG. Future research on recommendations of optimal total number doses of IVIG to reduce the risk for exchange transfusion.

(128) Penile Replantation in Patient with Klingsor Syndrome; Case Report and Review of Literature

Abstract Introduction Penile amputation has multiple etiologies including self-mutilation, work-related accidents, circumcision, assault motivated by jealousy, rage and feelings of betrayal and animal attacks. By far self –mutilation due to underlying psychiatric disorders (Klingsor Syndrome) are the commonest cause. Re-implantation is the gold standard for management, however it may always not be possible to achieve because of significant local ischemia, tissue damage and prolonged duration post trauma. Objective We are reporting our experience with one case of Klingsor Syndrome and its stepwise management. Methods A 31 years old male Schizophrenic patient self-mutilated his penile shaft due to fixed illusion (get rid of devil in his penis). He also attempted to remove his entire scrotum. His father brought his son with the amputated penile part put in ice. Immediate application of wet saline towel to penile stump and putting of amputated penile part into cold iced saline. Anti-tetanic serum was given together with i.v. antibiotics. Urology team, Plastic microsurgery team together with Psychiatry treating consultant all were emergently called at once. Amputated penile shaft was prepared by the microsurgeon to identify the dorsal artery, vein and nerves and marked by micro-bulldogs. Urology team started by fixation of s.p. cath and preparing, cleaning penile stump. End-to end anastomosis of the urethra was done. Next, the corporal bodies, were reattached using interrupted sutures. Dorsal vein and artery were re-anastomosed microsurgically Results Few days post-operatively skin necrosis started inspite of positive needle brick to the glans indicating healthy underlying glans. Second stage debridement of necrotic skin with later skin grafting resulted in cosmetically and functionally excellent penis regarding erectile and voiding functions Conclusions Penile amputation is a rare surgical emergency mostly found in the literature as isolated case reports. Klingsor syndrome is well known etiology for this type of penile injury and warrants psychiatric control. A multidisciplinary approach involving a urologist, micro-vascular surgeons as well as a psychiatrist ensures good outcome. Microvascular re-implantation remains the treatment of choice with the highest probability of adequate cosmetic as well as functional outcomes Disclosure No.

(271) Assessment of Varicocele Bilaterality in Infertile Men

Abstract Introduction Varicocele is the most common correctable cause of male factor infertility. It has always been a debatable subject as regard how it affects fertility and the best way to treat. However, there is a wide consensus nowadays that varicocelectomy improve male fertility potentials. Proper assessment of the disease bilaterality is crucial not to miss one side and not to jeopardize treatment outcome. Objective The primary outcome measure was to assess disease bilaterality and the secondary outcome measure was to report on improvement in semen 3 and 6 months post varicocelectomy and pregnancy rate 1 year post surgery. Methods This prospective study was conducted between January 2019 and January 2022. Infertile males with varicoceles underwent microsurgical subinguinal varicocelectomy by expert uroandrologists. Patients who were referred as unilateral varicoceles had their CDUS repeated for assessment of missed concomitant contralateral varicocele. Then, patients who were diagnosed with bilateral varicoceles underwent bilateral subinguinal ligation straight away. Those who were referred with unilateral varicocele had their palpable sides operated on first; then the contralateral side was also explored using an intraoperative Doppler device and the maximal vein diameter was measured. Patients came for follow for at least 6 months after surgery to evaluate any complications and assess improvement in semen parameters. Gynecologists also reported on normal pregnancy rate 1 year after surgery. Results A total of 329 cases completed the study. A hundred cases (30.4%) were initially referred as unilateral varicoceles and 229 (69.6%) as bilateral varicoceles. After reassessment of the study population, bilaterality of varicocele was found to be as high as 98.5% (324/329). This is statistically significantly higher than initial US (P<0.001). Repeat CDUS strongly correlated with the intraoperative measured varicocele diameter [r=0.9, P<0.001]. Moreover, sperm parameters showed significant improvement 3 and 6 months post varicocelectomy. Normal pregnancy after 1 year of surgery occurred in 118 cases (35.9%). Conclusions Varicocele bilaterality is underreported. Thorough assessment by expert radiologists and andrologists is of paramount importance not to miss significant pathology or hazard treatment outcome. Disclosure No.

Preventing septic implant failures in osteoporotic hip fractures using antibiotic-loaded functionalized nanocement

Osteoporosis is a prevalent skeletal disorder and the most common cause of debilitating hip fractures, primarily affecting post-menopausal women and elderly people. Implants used to stabilize osteoporotic fragility fractures are susceptible to bacterial infections, which further deteriorate the implantationsite. In the current study, we developed a nanocement-based treatment for tackling hip implant infection in an osteoporotic rat model. The development of osteoporosis was confirmed by an 80% decrease in serum estradiol levels and a further reduced T-score value of −4.170 ± 0.411 for femur neck canal. Further, an infected K-wire was implanted in femoral neck canal to induce implant-associated osteomyelitis. In order to combat infection and promote bone healing, it was followed by debridement and implantation of rifampicin-loaded nanocement functionalized with various combinations of bone marrow MSCs (bMSC) exosomes, bone morphogenetic protein-2 (BMP-2) and zoledronic acid (ZA). The findings of this study demonstrated the potential of exosomes as an alternative for reducingBMP-2 dosage, and the treatment promoted successful bone regeneration withenhanced mechanical strength, and a significant decrease in bacterial load. Improved bone remodeling and matrix deposition at the implantation site were confirmed by DXA, micro-CT, and histology. Further, immunohistochemical staining showed increased expression of collagen I and CD31, which indicated bone matrix deposition and vascularization, respectively, while reduced expression of α-SMA and NOS2 confirmed a reduction in fibrosis and inflammation, respectively. Overall, our one-step treatment strategy has the potential to prevent implant-associated bone infection in osteoporotic hip fractures, promote bone formation, and enhance the mechanical strength of osteoporotic bone, thereby preventing subsequent secondary fractures.

Prosthetic stomatitis and etiology of formation

Denture stomatitis is a common inflammation of the mucous membrane covered by the denture, which is caused by yeast-like fungi of the genus Candida. Candida albicans is considered the most common cause of denture stomatitis. It occurs under removable dentures due to several causative and contributing factors. If left untreated, this disease can lead to fatal systemic candidal infections. Denture-associated candidal stomatitis, clinically described in the literature, is a localized or generalized inflammation of the oral mucosa in association with a removable denture. During this inflammatory process, Candida biofilms and the patient’s immune response play a significant role. Among the microorganisms in this mixed biofilm, Candida species easily multiply and transform from a saprophyte into an opportunistic pathogen. In this situation, the presence of a prosthesis plays an important role. In particular, Candida albicans is capable of interfering with the body’s innate immune system to cause infection. Additionally, edentulous older adults wearing dentures may experience an imbalance and decreased diversity of the oral microflora. The present narrative review focuses on the presentation of denture stomatitis in patients who wear dentures and, in particular, on the involvement of Candida albicans sp. associated with this pathology.

Phosphorylated CPI-17 and MLC2 as Biomarkers of Coronary Artery Spasm-Induced Sudden Cardiac Death.

Coronary artery spasm (CAS) plays an important role in the pathogeneses of various ischemic heart diseases and has gradually become a common cause of life-threatening arrhythmia. The specific molecular mechanism of CAS has not been fully elucidated, nor are there any specific diagnostic markers for the condition. Therefore, this study aimed to examine the specific molecular mechanism underlying CAS, and screen for potential diagnostic markers. To this end, we successfully constructed a rat CAS model and achieved in vitro culture of a human coronary-artery smooth-muscle cell (hCASMC) contraction model. Possible molecular mechanisms by which protein kinase C (PKC) regulated CAS through the C kinase-potentiated protein phosphatase 1 inhibitor of 17 kDa (CPI-17)/myosin II regulatory light chain (MLC2) pathway were studied in vivo and in vitro to screen for potential molecular markers of CAS. We performed hematoxylin and eosin staining, myocardial zymogram, and transmission electron microscopy to determine myocardial and coronary artery injury in CAS rats. Then, using immunohistochemical staining, immunofluorescence staining, and Western blotting, we further demonstrated a potential molecular mechanism by which PKC regulated CAS via the CPI-17/MLC2 pathway. The results showed that membrane translocation of PKCα occurred in the coronary arteries of CAS rats. CPI-17/MLC2 signaling was observably activated in coronary arteries undergoing CAS. In addition, in vitro treatment of hCASMCs with angiotensin II (Ang II) increased PKCα membrane translocation while consistently activating CPI-17/MLC2 signaling. Conversely, GF-109203X and calphostin C, specific inhibitors of PKC, inactivated CPI-17/MLC2 signaling. We also collected the coronary artery tissues from deceased subjects suspected to have died of CAS and measured their levels of phosphorylated CPI-17 (p-CPI-17) and MLC2 (p-MLC2). Immunohistochemical staining was positive for p-CPI-17 and p-MLC2 in the tissues of these subjects. These findings suggest that PKCα induced CAS through the CPI-17/MLC2 pathway; therefore, p-CPI-17 and p-MLC2 could be used as potential markers for CAS. Our data provide novel evidence that therapeutic strategies against PKC or CPI-17/MLC2 signaling might be promising in the treatment of CAS.

Evaluation of the efficacy of trigger points combined with extracorporeal shock waves in the treatment of plantar fasciitis: heel temperature and plantar pressure

BackgroundPlantar fasciitis (PF) is the most common cause of heel pain. Among conservative treatments, extracorporeal shock wave therapy (ESWT) is considered effective for refractory PF. Studies have shown that applying ESWT to the trigger points (TrPs) in the triceps surae may play an important role in pain treatment in patients with PF. Therefore, the purpose of this study was to combine the concept of trigger points and ESWT to explore the effect of this combination on plantar temperature and pressure in patients with PF.MethodsAfter applying inclusion and exclusion criteria, 86 patients with PF were recruited from the pain clinic of Huadong Hospital, Fudan University and randomly divided into experimental (n = 43) and control groups (n = 43). The experimental group was treated with extracorporeal shock waves to treat the medial heel pain point and the gastrocnemius and soleus TrPs. The control group was only treated with extracorporeal shock waves at the medial heel pain point. The two groups were treated twice with an interval of 1 week. Primary measurements included a numerical rating scale (NRS) score (overall, first step, heel pain during daily activities), and secondary measurements included heel temperature, Roles–Maudsley score (RMS), and plantar pressure. All assessments were performed before treatment (i.e., baseline) and 6 and 12 weeks after treatment.ResultsDuring the trial, 3 patients in the experimental group withdrew from the study, 2 due to interruption of the course of treatment by the COVID-19 epidemic and 1 due to personal reasons. In the control group, 3 patients fell and were removed due to swelling of the heel. Therefore, only 80 patients with PF were finally included. After treatment, the two groups showed good results in NRS score (overall, first step, heel pain during daily activities), RMS, and plantar temperature, especially in the experimental group, who showed a significantly better effect than the control group.ConclusionESWT of the heel combined with the triceps trigger point of the calf can more effectively improve the pain, function and quality of life of refractory PF than ESWT of the heel alone. In addition, ESWT of the heel combined with the triceps trigger point of the calf can effectively reduce the skin temperature of the heel on the symptomatic side, indicating that the heel temperature as measured by infrared thermal imaging may be used as an independent tool to evaluate the therapeutic effect for patients with chronic PF. Although extracorporeal shock waves combined with TrPs treatment can cause changes in the patients’ gait structure, plantar pressure is still difficult to use as an independent tool to evaluate the therapeutic effect for PF.Trial registrationRegistered in the Chinese Clinical Trial Registry (www.chictr.org.cn) on 12/17/2021 with the following code: ChiCTR-INR-2,100,054,439.

Maternal and neonatal factors associated with neonatal jaundice in Jordan: a case-control study

Background/Aims Neonatal jaundice is a common cause of hospitalisation. This study aimed to identify maternal and neonatal factors associated with neonatal jaundice among hospitalised neonates in north Jordan. Methods This was a case control study involving 312 mothers and their neonates (106 cases, 206 controls), recruited from two governmental hospitals in north Jordan. A structured interview was used to collect data. Neonatal medical records were accessed for clinical data. Results Maternal factors associated with higher risk of jaundice included having higher education, being employed and having had a caesarean section. Neonatal factors associated with higher risk of jaundice included being preterm, receiving <5 feeds per day and having ABO incompatibility. Conclusions Using evidence-based guidelines for the assessment and management of risk factors helps to reduce the prevalence of jaundice requiring hospitalisation among neonates. Raising mothers' awareness of neonatal jaundice through interventions and education sessions during antenatal care, in particular for high-risk mothers, is also likely to help reduce its prevalence.

Long-term prognosis after stapled and hand-sewn ileal pouch–anal anastomoses for familial adenomatous polyposis: a multicenter retrospective study

PurposeThe long-term prognosis of stapled and hand-sewn ileal pouch–anal anastomoses in familial adenomatous polyposis patients in Japan remains unknown. This study aimed to compare the overall survival in familial adenomatous polyposis patients who underwent stapled or hand-sewn ileal pouch–anal anastomosis.MethodsThis multicenter retrospective study was conducted at 12 institutions in Shizuoka Prefecture, Japan. The clinical outcomes of 53 eligible familial adenomatous polyposis patients who underwent stapled (n = 24) and hand-sewn (n = 29) ileal pouch–anal anastomosis were compared.ResultsThe median follow-up duration was 171.5 months. The incidence of adenoma in the remnant rectum or anal transitional zone and metachronous rectal cancer was significantly more common in stapled ileal pouch–anal anastomosis (adenoma: stapled, 45.8%, vs. hand-sewn, 10.3%, p = 0.005; metachronous rectal cancer: 29.2%, vs. none, p = 0.002). The number of deaths was remarkably higher in stapled ileal pouch–anal anastomosis (p = 0.002). Metachronous rectal cancer was the most common cause of death. Overall survival was worse in stapled ileal pouch–anal anastomosis than in hand-sewn ileal pouch–anal anastomosis (120 months, 90.7% vs. 96.6%; 240 months, 63.7% vs. 96.6%; p = 0.044). Cox regression analysis revealed the independent effects of preoperative advanced colorectal cancer and stapled ileal pouch–anal anastomosis on overall survival.ConclusionStapled ileal pouch–anal anastomosis negatively affected the overall survival of familial adenomatous polyposis patients. Therefore, hand-sewn ileal pouch–anal anastomosis is recommended for better prognosis in these patients.

Small Bowel Perforation Due to an Unusual Foreign Body

Gastrointestinal perforation is one of the most common causes of acute abdomen presenting to the casualty. However, gastrointestinal perforation due to ingestion of foreign body is rare and is usually encountered in children, psychiatric patients and in alcoholics. Most of the foreign bodies pass through the GI tract without any complications. Only about 1% are known to cause complications such as perforation. Fish or chicken bones, dentures, toy parts, coins, toothpicks are the most commonly encountered foreign bodies. In this report, we present a case of a 60-year-old male who presented to the emergency department with acute abdomen secondary to ingestion of an unusual foreign body that lead to perforation and underwent exploratory laparotomy for removal of the foreign body.
 Gastrointestinal perforation is one of the most common causes of acute abdomen presenting to the casualty that needs a timely surgical intervention.[1] Important sites of gastrointestinal perforation are stomach, duodenum, small bowel (jejunum, small intestine), appendix, colon and rectum.
 The most common causes of gastrointestinal perforation include peptic ulcer disease, diverticulitis, carcinomas, IBD, ischemia of bowel wall and infrequently foreign bodies.[2]
 Foreign body ingestion as seen in children is unintentional and can be deliberate in psychiatric patients.[3] In general, many of these foreign bodies travel through the gastrointestinal tract without causing complications. Only about 1% cases of ingested foreign bodies cause complications such as hollow viscus obstruction and/ or perforation which are usually life threatening and have poorer outcomes if diagnosis is delayed.[4,5] CT is the imaging tool of choice. Such conditions require immediate surgical intervention such as exploratory laparotomy or laparoscopic or endoscopic removal can be attempted in case of stomach or duodenal foreign bodies.
 Here in the following case report, we present an atypical case who arrived at the emergency room with acute abdomen following a foreign body consumption and underwent exploratory laparotomy for retrieval of foreign body.

Theoretical approaches to psychopathology: common cause approach vs. network approach

The common causes (CC) approach is popular in psychopathology research, but nowadays, some experts consider this approach unfit to explain mental disorders. On the other hand, as a new approach, the network approach (NA) claims can provide a better explanation for understanding mental disorders. This study aims to determine the differences between NA and CC approach in psychopathology research. This research is a scoping review study using twelve articles. We searched for articles September-December 2020 in the Scopus and Science Direct databases. The results of the analysis of these articles show a fundamental difference between the two perspectives. The difference lies in the perspective of mental disorders, how to measure symptoms of mental disorders, treatment of mental disorders, and views on comorbidities. Each approach has advantages, although some articles support that NA is the better approach to studying mental disorders. To decide which approach is appropriate for psychopathology research, researchers should adapt it to the research objectives. Perspectives on psychopathology will determine how to answer the research questions and analyze the data.

The effect of a health belief model-based education on nutritional behavior and biochemical factors of patients with myocardial infarction: A line follow-up experimental study.

Myocardial infarction is a common cause of hospitalization, and nutritional behaviors are risk factors in such patients. The present study aimed to determine the effect of education based on the health belief model on nutritional behavior and indices in patients with myocardial infarction. The present experimental study examined patients with myocardial infarction in 2021. Seventy-two patients with myocardial infarction were randomly divided into intervention and control groups. The intervention group received educational interventions based on the health belief model in four 60-min sessions for 3 months. The constructs of the health belief model, nutritional behavior, and indices were measured using a valid questionnaire before, 1, and 3 months after the intervention. At the end, the study data was analyzed using SPSS version 22 software. There was a significant difference between the two groups in the mean scores of knowledge, perceived susceptibility, perceived severity, perceived benefits, self-efficacy, nutritional behaviors,and body mass indexafter the intervention (p < 0.05); however, no significant difference was found in the field of perceived barriers (p > 0.05). Biochemical factors also had a significant difference after the intervention (p < 0.05). Educational intervention based on the health belief model is effective for myocardial infarction patients and has a significant impact on the constructs of perceived sensitivity, perceived intensity, perceived benefits, and self-efficacy as well as biochemical factors, so it can be used to improve the nutritional status of patientssuffered from a myocardial infarction.