Correct Treatment Research Articles

(159) Factors and Management Strategies for Addressing Reduced Glans Engorgement Following Inflatable Penile Prosthesis: A Scoping Review

Abstract Introduction Inflatable penile prosthesis (IPP) provides a reliable stiffness along the length of the penile shaft, yet patients may express dissatisfaction as it may still differ from their recollection of their previously normal erections. A common complaint is reduced engorgement of the glans penis, which can manifest as subjective reduction in penile length or the feeling of a cold insensitive glans. Patient factors often ensure a sound justification for this complaint, namely vasculogenic erectile dysfunction (ED) or their corporo-glandular morphology despite a well-sized and well-positioned implant. Objective In this study, we sought to identify factors that may contribute to reduced glans engorgement and possible management strategies. Methods Intervention: Any method of treating or avoiding reduced glans engorgement post-IPP. Population: Men undergoing IPP insertion or men with glans complaints post-operatively Inclusion Criteria: Articles published in English with full text available and objective outcome measures Search Strategy: Literature search was performed in June 2023 using Medline, PubMed, Embase and Scopus. PubMed search included both “Mesh” protocols and “free text” to capture the correct study population and intervention utilized. Review Type & Analysis: Although an initial systematic model was considered, a scoping model was ultimately selected due to the limited literature and inconsistent outcome measures. This approach aimed to identify gaps in knowledge and provide an overview of the existing literature, thus informing future studies in this area. The variability in outcome measures across studies prevented higher-powered analyses from being conducted. Results Initial search strategy retrieved 98 non-duplicate studies with 40 being selected for initial screening after applying inclusion criteria. Ultimately, a total of 7 articles were included and categorized by theme: Cavernous-sparing technique (1–3); Pharmacotherapy for post-IPP glans complaints (4–7) (Table 1 & 2). The cavernous-sparing technique described aims to limit disruption of cavernous tissue around the implanted cylinder. This was achieved by omitting dilatation and using Furlow directly for measurements, or by intraoperative intracavernosal (IC) prostaglandin followed by dilatation only with size 7 or 8 Hegar alone. In all studies that compared penile dimensions, girth was significantly greater in the cavernous-sparing group. A higher proportion of men in this group also had detectable cavernous arteries, thicker residual corporal tissue, better residual tumescence post-IPP and demonstrated significant increases in both PSV and EDV post-PDE5i, compared to no PDE5i. Men who had standard dilatation also responded to post-IPP PDE5i but fewer had identifiable cavernous artery and had significant increase in only PSV, compared to no PDE5i. Other articles relating to post-IPP pharmacotherapy unanimously demonstrated that post-IPP glans engorgement was improved. This equated to reported statistically improved satisfaction when compared to the IPP alone groups, as measured by IIEF and EDITS questionnaires. Post-IPP PDE5i were better tolerated than intraurethral alprostadil, which was associated with discomfort. Conclusions Post-IPP pharmacotherapy appears to enhance residual erectile tissue engorgement. It can be used as an adjunctive after-care measure. Cavernous-sparing techniques show the importance of viable residual tissue for improved prosthetic erections. More comprehensive studies are needed to enhance patient experience and explore the microanatomical and hemodynamic role of residual tissue post-IPP. Disclosure No.

Sutton-Kadir Syndrome can be treated safely with endovascular embolisation alone.

Sutton-Kadir Syndrome (SKS) describes true inferior pancreaticoduodenal artery (IPDA) aneurysms in the setting of coeliac artery (CA) stenosis or occlusion. Although rare, SKS aneurysms can rupture and cause morbidity. Due to its rarity and lack of controlled treatment data, correct treatment for the CA lesion is currently unknown. Our aim was to assess if endovascular embolisation alone was safe and effective in treatment of SKS aneurysms, in emergent and elective settings. Secondary objectives were to describe presentation and imaging findings. A retrospective cohort study of patients treated at Sir Charles Gairdner Hospital between January 2014 and December 2021 was done. Data on presentation, diagnostics, aneurysm characteristics, CA lesion aetiology, treatment and outcomes were extracted from chart review. Twenty-four aneurysms in 14 patients were identified. Rupture was seen in 7/15 patients. Most aneurysms (22/24) were in the IPDA or one of its anterior or posterior branches. Median arcuate ligament (MAL) compression was identified in all. There was no difference in median (IQR) maximal transverse diameter between ruptured and non-ruptured aneurysms (6 mm (9), 12 mm (6), P = 0.18). Of ruptures, 6/7 had successful endovascular embolisation and 1/7 open surgical ligation. Of non-ruptures, 6/7 had successful endovascular embolisation, 1/7 open MAL division then endovascular CA stenting and aneurysm embolisation. No recurrences or new aneurysms were detected with computed tomography or magnetic resonance angiography over a median (IQR) follow-up period of 30 (10) months in 12 patients. Endovascular embolisation of SKS aneurysms without treatment of MAL compression is safe and effective in both the emergent and elective settings.

Ignorance of critical race theory predicts White Americans’ opposition to it

AbstractAcknowledging systemic racism, a key tenet of Critical Race Theory (CRT), may be threatening to many Americans but it can also reduce racial biases. However, anti‐CRT legislation prohibits learning about racism, thus highlighting the mutually reinforcing relationship between systemic racism and the production of ignorance. We assessed White Americans’ knowledge about CRT through participant‐generated definitions (Study 1, N = 199) and via a true/false questionnaire (Study 2, N = 194), and its relation to opposition to CRT. Opposition to CRT was associated with a less accurate understanding of CRT, even when controlling for political orientation. Content analyses revealed that opponents of CRT deny anti‐Black racism, believe CRT harms Whites, and view discussing race as divisive. Based on these themes, we developed a meta‐cognitive corrective intervention in Study 3 (N = 289). Participants who received corrective feedback after taking a multiple‐choice test about CRT showed a larger decrease in their opposition to CRT than those in the control condition.

WITHDRAWN: Mandibular osteonecrosis involving tooth germ in children: A rare case report with a 6-year follow-up

IntroductionOsteonecrosis involving permanent tooth germ in deciduous dentition is a rare condition that could affect the dental and maxillofacial development without correct intervention. Case presentationThis case report presents a rare case of mandibular osteonecrosis involving one permanent tooth germ induced by arsenic trioxide in a 4-year-old Chinese girl. Clinical examinations revealed an unhealed wound with alveolar bone exposure, and radiographic evaluations suggested the necrosis of the surrounding alveolar bone. The sequestrectomy without extended curettage, and removal of the affected permanent tooth germ were performed along with systemic antibiotics therapy. No recurrence of the lesion and no complication were noted at six-year follow-up. Clinical discussionWe presented a case of mandibular osteonecrosis in deciduous dentition with ideal prognosis after timely sequestrectomy without extended curettage. Although the disease-free edge is recommended for drug-induced osteonecrosis in adults, this treatment plan was made in reference to the only similar case and recovery potential of pediatric jaws. ConclusionThis is the first drug-induced mandibular osteonecrosis case involving permanent tooth germ in children. Our results suggest that a conservative treatment regimen without extended curettage may be an option for young patients with osteonecrosis in jaws.

Synovial sarcoma: the misdiagnosed sarcoma.

Synovial sarcoma is a rare and highly malignant soft tissue sarcoma. The inconspicuous and diversity of its early symptoms make it a highly misdiagnosed disease. The management of synovial sarcomas is challenging as they are rare and have a poor prognosis. Early and correct diagnosis and treatment are critical for clinical outcomes. Misdiagnosis or delayed diagnosis can have devastating consequences for the patient. The detection of SS18 gene rearrangement is considered a powerful tool in establishing the diagnosis of synovial sarcomas. Biopsies and testing for gene rearrangements are recommended for all patients in whom SS cannot be excluded. Surgery is the mainstay of treatment for synovial sarcomas. Neoadjuvant/adjuvant radiotherapy is recommended for patients with big tumors (>5 cm) or positive resection margins, and neoadjuvant/adjuvant chemotherapy is recommended for patients with high-risk tumors or advanced diseases. This article reviews synovial sarcomas from the perspectives of clinical and radiological presentation, histological and cytogenetic analysis, differential diagnosis, treatment, and prognosis.

Intrabulbar, Intraorbital and Intracranial Perforating Eye Injury with Foreign Body: A Case Report

Ocular trauma is a significant cause of preventable blindness and visual impairment worldwide. Eye globe perforation can happen due to work with sharp tools or different particles that are spread during work with metals, wood, and other solid substances.We present the case of a 14-year-old male patient admitted as an urgent case at the Ophthalmology Department in 2014 due to a perforating eye injury with a foreign body – a 7 cm rusty metallic nail in the right eye. The X-ray of the orbit revealed that the foreign body had penetrated the eyelid, the eye eyeball, and through the orbit and its posterior wall, penetrated the skull and 2 cm in the brain. Under general anesthesia, we performed the anterior chamber lavage, excision of the prolapsed iris, and pupilloplasty. The anterior chamber was reconstructed using a saline solution (0.9% NaCl) and air. The patient was treated conservatively with antibiotics and steroids for 10 days; there were no signs of wound filtration, hypotonia, or endophthalmitis. Due to the limited resources for the posterior segment surgery, the patient was referred to another center for pars plana vitrectomy (PPV) after 10 days of hospitalization in the Department of Ophthalmology at the University Clinical Center of Kosovo. After PPV with silicon oil and cataract surgery, the patient could see the light and its projections (BCVA = L+P+). We followed up on the patient until September 2022, there were no signs of bulbus atrophy, and the visual acuity remained the same, BCVA = L+P+. The correct diagnosis and treatment at the right time play a leading role in achieving one of the main goals of surgical treatment of perforating eye injuries, which is the preservation of the anatomical structure and the physiology of the eye.

The natural history of aneurysms incompletely occluded by placement of a flow diverter: a multiinstitutional study.

Treatment of intracranial aneurysms by flow diversion is safe and effective and is increasingly popular. However, the correct treatment paradigm for aneurysms incompletely treated by initial placement of a flow diverter has not been established, nor have the subsequent natural history and occlusion rates of such aneurysms. The authors sought to outline the natural history of such aneurysms, which to date have been considered partially treated. The authors retrospectively reviewed consecutive cases from 6 high-volume neurointerventional services, including all cases in which the first follow-up imaging after placement of a flow diverter showed incomplete occlusion of the aneurysm, and for which subsequent clinical and/or radiological follow-up was available. All included patients were treated with the Pipeline Flex embolization device or the Pipeline Flex embolization device with Shield Technology. Subsequent radiographic and clinical outcome data were collected and analyzed using the Kaplan-Meier survival function. A total of 263 patients with persistently patent aneurysms on first follow-up imaging after flow diversion were identified. Of these, 204 had clinical follow-up and 152 had additional imaging follow-up. Of this final cohort, 148 aneurysms were unruptured, and 4 were ruptured. The average aneurysm size by maximum dimension was 10.8 mm. The average recorded follow-up was 27.8 months in the cohort, with some patients followed for as long as 9 years from treatment. Over the course of 403 person-years of follow-up, no delayed aneurysm ruptures were recorded. Both with and without retreatment, aneurysms showed a trend toward progressive occlusion over time. Complications related to device placement were low. Aneurysms that have been incompletely treated by flow diversion have a benign natural history with progression toward occlusion over time, with or without retreatment.

Successful outcomes in juvenile justice: Overcoming community based and correctional challenges

AbstractThe juvenile justice system has long struggled with practices for understanding, preventing, and intervening in delinquency. Debates concerning youth delinquency, diversion efforts, and effective rehabilitation have consistently been examined. However, the answers to most of these fundamental approaches remain unresolved. Mental health is a major concern for juveniles under a correctional treatment program, but the juvenile justice system lacks individualized mental health services, having devastating and unfair results on youth in need. Through research, professional development, and advocacy, youth who are especially vulnerable to experiencing the undesired outcomes that result from receiving inadequate and inappropriate services will gain better outcomes.

Effect of the Social Safety Net on Child Labor and School Retention in Bangladesh: Empirical Evidence from Hies 2016

ABSTRACT: In Bangladesh Social Safety Net (SSN) interventions are intended to achieve specific goals, e.g., reduction in poverty, decrease in early school dropout, and nutrition supplementation. This study investigates the effectiveness of SSN participation on less explored goals of child labor reduction and school retention in Bangladesh. Empirical evidence is provided to evaluate the success of existing programs to combat child labor and early school dropout. This study utilizes the Household Income and Expenditure Survey (HIES), 2016 of Bangladesh. We employ the Propensity Score Matching (PSM) framework to show the causal relationship between SSN participation and its impact on the use of child labor and school retention. Given the nature and availability of data, the matching method provides us an estimate of the impact of SSN based on a quasi-experimental setting. We estimate counterfactuals based on observed characteristics of the household that affect both SSN participation and our outcome variables. Our results suggest that households that receive SSN tend to employ less child labor domestic or paid compared to their counterparts. Our Propensity Score Matching (PSM) results show that SSN participation reduces child labor prevalence in Bangladesh by 2.4% to 2.9%. This is an indication that families essentially substitute SSN income with child labor earnings. Thus, SSN programs in Bangladesh are effective in reducing child labor though the magnitude is not overwhelming. On the contrary, our results show that children from SSN-participating families have a higher incidence of early school dropout. This may be due to inefficiency or poorly designed programs that effectively keep the children in school. We estimate early school dropout is higher by 3.6% to 6.6% for households that receive SSN compared to the control group. Our findings are important for policymakers to redesign the programs that retain children in school. We suggest targeted interventions that will help to keep these children in school, which is conducive to human capital accrual and increasing lifetime earnings. Additionally, our insights will assist policymakers in rethinking SSN coverage, efficient selection of beneficiaries, and initiation of the correct intervention.

Method of Selecting Surgical Treatment for Children with Congenital Deformity of the Spine and Thorax

Introduction. Spinal anomalies are considered to be the most severe pathology of the axial skeleton. Intrauterine formation of deformity with its subsequent progression during growth is the reason for the need for surgical intervention. The prevalence of patients with congenital scoliosis in the total structure of spinal deformities is up to 2%. In terms of the malignancy of the course of the disease, children with unsegmented rod and rib synostosis represent one of the most unfavorable groups of patients. Aim. To perform a comparative analysis of the results of surgical treatment of children with congenital scoliosis with unilateral lateral vertebral segmentation disorder and rib synostosis using different techniques. Methods. The work is a monocenter cohort study of “case-control” type (III level of evidence). The design of the work is a monocenter cohort retro and prospective study. The results of surgical treatment of patients between 2010 and 2020 were analyzed. The study included 45 patients aged 3 to 7 years with the diagnosis of congenital scoliosis with unilateral lateral segmentation disorder of vertebral bodies and rib synostosis. The patients were divided into 2 groups depending on the surgical treatment method applied. In the first group (n = 24), patients underwent thoracoplasty with implantation of an individual rib/rib/vertebral distractor; in the second group (n = 21), patients underwent spinal surgery in the scope of vertebrotomy at the apex of the curvature and correction of the deformity with a multifocal spinal system. The data of medical records, as well as MSCT, radiographs, and pulse oscillometry were included in the analysis of the results. Results. Me (median) of scoliosis before treatment in group 1 patients 58.5, IQR = 19.75; after treatment — Me = 40.0, IQR = 20.0. Me of kyphosis before surgery 22, IQR = 4.5; after surgery Me = 26.0, IQR = 4.0. In the second group, Me of scoliosis before treatment 58.0, IQR = 3.0; after treatment, Me = 20.0, IQR = 6.0. Me of kyphosis before surgery 22, IQR = 2.0; after surgery Me 28.0, IQR = 4.0. When comparing MSCT data, group 1 patients showed an increase in lung tissue volume by 21% of the initial lung volume, in group 2 the increase amounted to 27%. The analysis of external respiratory function indices demonstrates improvement of reactive component indices by 21.1%, frequency dependence of resistive component by 46.4%, resistive component by 50% in group 1 patients, in group 2 there is an improvement of reactive component indices by 21.1%, resistive component by 50.9% and frequency dependence of reactive component by 46.7%. Conclusion. Corrective intervention on the spine at an early age makes it possible to achieve effective correction of the deformity; similar changes are observed both in lung volume and functional state of the respiratory system due to the mediated correction of the thorax shape.

Blockchain-secure patient Digital Twin in healthcare using smart contracts.

Modern healthcare has a sharp focus on data aggregation and processing technologies. Consequently, from a data perspective, a patient may be regarded as a timestamped list of medical conditions and their corresponding corrective interventions. Technologies to securely aggregate and access data for individual patients in the quest for precision medicine have led to the adoption of Digital Twins in healthcare. Digital Twins are used in manufacturing and engineering to produce digital models of physical objects that capture the essence of device operation to enable and drive optimization. Thus, a patient's Digital Twin can significantly improve health data sharing. However, creating the Digital Twin from multiple data sources, such as the patient's electronic medical records (EMR) and personal health records (PHR) from wearable devices, presents some risks to the security of the model and the patient. The constituent data for the Digital Twin should be accessible only with permission from relevant entities and thus requires authentication, privacy, and provable provenance. This paper proposes a blockchain-secure patient Digital Twin that relies on smart contracts to automate the updating and communication processes that maintain the Digital Twin. The smart contracts govern the response the Digital Twin provides when queried, based on policies created for each patient. We highlight four research points: access control, interaction, privacy, and security of the Digital Twin and we evaluate the Digital Twin in terms of latency in the network, smart contract execution times, and data storage costs.

Endovascular Management of Pelvic Trauma: The Interventional Radiology Point of View

Background: Traumatic pelvic injuries are associated with high injury severity scores and significant morbidity and mortality. Active bleeding is the most common cause of death among those patients. Due to limitations of surgery for pelvic hematomas, angiographic treatment is at the forefront of pelvic trauma management.Objective: The present article aims to discuss the available endovascular treatment modalities, and common angiographic treatment strategies and techniques.Conclusion: Interventional radiologists plays a key role in the management of patients with pelvic trauma. New standardized protocols are needed to minimize the time spent on deciding the correct treatment for each patient.

Differences and Effects of Eye Contact in Chinese and Foreign Non-Verbal Communication

With the accelerated development of China's economy and society, China and other countries in various areas of fruitful exchanges and cooperation, China's citizens to cross-cultural exchanges are also increasingly frequent, the correct treatment of cultural differences between Chinese and Western non-verbal communication not only to a certain extent to avoid conflicts in the interaction, but also more importantly, it can lead to further exchanges between the two cultures, and complement each other's strengths and weaknesses. As business English majors, they need to study not only from the aspect of language communication, but also from the aspect of non-verbal communication to study the differences, influences and cultural characteristics in cross-cultural communication between China and the West. In addition to verbal behavioral communication, body language and eye contact in non-verbal behavioral communication are also very important. This paper starts from the eye contact in non-verbal communication, seeks for an angle that can be borrowed and learned, which can help the development of the individual, and contribute to the effective cross-cultural communication.

Biological therapy of severe bronchial asthma in a child

Currently, bronchial asthma is a global health problem, due to its high prevalence, economic component, as well as a violation of the social adaptation of children suffering from this disease. This article is devoted to a detailed analysis of the clinical case of a patient born in 2009 with an established diagnosis of Bronchial asthma, atopic form, severe persistent partially controlled course, which initiated therapy with a genetically engineered biological preparation of a humanized monoclonal antibody against IgE – omalizumab. However, in subsequent years, the patient’s condition was unstable, severe seizures were repeated, she was repeatedly hospitalized in the department where infusion therapy was performed and basic therapy was reviewed, dose adjustments and administration regimens of monoclonal antibodies to IgE (omalizumab) were carried out. A retrospective analysis of the results of objective, instrumental and laboratory examinations of the patient was also carried out over the past three years, when the child received the genetically engineered drug omalizumab without interruption. Taking into account the severe course of AD, the lack of control over the disease against the background of basic therapy with combined drugs in combination with therapy with monoclonal antibodies to IgE (omalizumab), it was decided to correct treatment and initiate therapy with a genetically engineered drug, recombinant human monoclonal antibody IgG4 (dupilumab). This clinical example once again shows how personalized the approach should be when prescribing therapy to patients with severe asthma, and also dictates the need to develop new diagnostic methods and management tactics for patients with uncontrolled forms of this disease.

Normal and malaligned talonavicular fusion alters cadaveric foot pressure and kinematics.

Talonavicular (TN) fusion is a common treatment for TN arthritis or deformity correction. There is incongruous evidence regarding remaining motion at the talocalcaneal and calcaneocuboid joints after TN fusion. Additionally, the effects of a malaligned TN fusion are not well understood and alignment of the fusion may be important for overall foot integrity. This project assessed the kinematic and kinetic effects of neutral and malaligned TN fusions. Ten cadaveric feet were tested on a gait simulator in four conditions: unfused, fused in neutral, fused in varus, and fused in valgus. The fusions were simulated with external fixation hardware. An eight-camera motion analysis system and a 10-segment foot model generated kinematic data, and a pressure mat captured pressure data. Simulated TN fusion was achieved in eight feet. From unfused to fused-neutral, range of motion (ROM) was not eliminated in the adjacent joints, but the positions of the joints changed significantly throughout stance phase. Furthermore, the ROM increased at the tibiotalar joint. Plantar pressure and center of pressure shifted laterally with neutral fusion. The malalignments marginally affected the ROM but changed joint positions throughout stance phase. Pressure patterns were shifted laterally in varus malalignment and medially in valgus malalignment. The residual motion and the altered kinematics at the joints in the triple joint complex after TN fusion may subsequently increase the incidence of arthritis. Clinical significance: This study quantifies the effects of talonavicular fusion and malalignment on the other joints of the triple joint complex.

Surgical Treatment of Persistent Pseudomonas aeruginosa Bacteraemia After n-Butyl-2-cyanoacrylate for Gastric Bleeding Varices.

n-Butyl-2-cyanoacrylate (NCBA) is an effective therapeutic option for bleeding gastric varices but can sometimes be associated with adverse effects. Persistent bacteraemia is an unusual complication with a high mortality rate. We report the case of a 34-year-old man with history of cirrhosis due to Wilson's disease and severe portal hypertension who was hospitalized as a result of upper gastrointestinal bleeding secondary to fundic varices that were treated with NCBA. Eight weeks after the bleeding episode he was readmitted with a 14-day history of fever and chills. Pseudomonas aeruginosa was isolated from blood cultures. He presented with persistent P.aeruginosa bacteraemia despite correct antibiotic treatment. A PET-CT scan was performed to rule out infection source, and inflammatory changes at the NCBA site plug were found. A presumptive diagnosis of NCBA plug infection was considered. The case was evaluated by multidisciplinary board and indicated liver transplantation as treatment. However, the patient's bacteraemia persisted and therefore a vertical gastrectomy to remove the NCBA plug was performed. P.aeruginosa was also isolated from the plug. The patient was discharged with ceftazidime plus ciprofloxacin to complete 6weeks after surgery and he remained asymptomatic. Any foreign material such as NCBA is susceptible to being infected and should be considered in patients with persistent breakthrough bloodstream infections. The individualized treatment is recommended in this complex scenario.

Autoimmune Movement Disorders Complicating Treatment with Immune Checkpoint Inhibitors.

Immune checkpoint inhibitors (ICI) may trigger autoimmune neurological conditions, including movement disorders (MD). The aim of this study was to characterize MDs occurring as immune-related adverse events (irAEs) of ICIs. A systematic literature review of case reports/series of MDs as irAEs of ICIs was performed. Of 5682 eligible papers, 26 articles with 28 patients were included. MDs occur as a rare complication of cancer immunotherapy with heterogeneous clinical presentations and in most cases in association with other irAEs. Inflammatory basal ganglia T2/fluid attenuated inversion recovery abnormalities are rarely observed, but brain imaging is frequently unrevealing. Cerebrospinal fluid findings are frequently suggestive of inflammation. Half of cases are associated with a wide range of autoantibodies. Steroids and ICI withdrawal usually lead to improvement, even though some patients experienced relapses or a severe clinical course. MDs are a rare complication of ICIs that should be promptly recognized to offer patients a correct diagnosis and treatment.

Pancreatic tuberculosis: a case report

Tuberculosis is a bacterial infection secondary to Mycobacterium tuberculosis with highest burden within low socioeconomic communities. Most individuals with tuberculosis infection are immunocompromised due to underlying medical conditions such as human immunodeficiency virus. However, tuberculosis can manifest in immunocompetent individuals although the incidence is significantly less. Pancreatic tuberculosis is exceedingly rare with autopsy series revealing pancreatic tuberculosis <5% of tuberculosis infected individuals. This case report will discuss a 16-year-old female presenting with pancreatic tuberculosis masquerading as possible pancreatic malignancy. Emphasis is placed on the challenging diagnostic nature of pancreatic tuberculosis as it presents with non-specific clinical symptoms which are in keeping with a wide range of differential diagnoses. Once correctly diagnosed pancreatic tuberculosis presents the potential of cure. It is for this reason whilst a rare diagnosis clinicians should be mindful of pancreatic tuberculosis to ensure timely correct treatment is pursued and unnecessary surgical procedures avoided.

Rhinovirus infection and co-infection in children with severe acute respiratory infection during the COVID-19 pandemic period

ABSTRACT Rhinovirus causes respiratory tract infections in children and is found in co-infections. The objective of this research was to study the clinical profile of rhinovirus infection and co-infection in children with severe acute respiratory infection (SARI) during the COVID-19 pandemic period. We included 606 children ranging in age from 0.1 to 144 months of age from March 2020 to December 2021, hospitalized in the Pediatric Intensive Care Unit (PICU). The samples were collected by secretion from the nasopharynx region. A total of 259 children were tested positive for viral infection, 153 (59.07%) of them had a single rhinovirus infection and, 56 (36.6%) were aged between 60.1 and 144 months. Nine types of co-infections were identified and were found coinfection with three or more viruses (22/104, 21.15%). Observing the seasonality, the number of cases was similar between 2020 (49.53%) and 2021 (51.47%). Patients with a single infection (86.88%) and coinfection (67.30%) were more likely to have coughed. Patients with co-infection required the use of O2 for longer than those with a single rhinovirus infection. Hemogram results obtained from individuals with a single infection had higher levels of urea when compared to patients with co-infection with and other respiratory viruses. Multiple correspondence analyses indicated different clinical symptoms and comorbidities in patients with co-infection compared to those with single infection. The results found that the rhinovirus was much prevalent virus during the pandemic period and was found in co-infection with other virus types, what is important to diagnostic for the correct treatment of patients.

Use of Abzolem ® in Pressure Injuries: Experience of an Exploratory Study

Introduction: Pressure injuries represent a significant and prevalent public health problem in bedridden and institutionalized patients. The correct management of pressure injuries is essential for preventing complications, enhancing patient well-being, and reducing the overall burden on healthcare systems. It underscores the importance of a holistic and patient-centered approach to wound care. Preventive measures and the action of a multidisciplinary team are essential to the correct treatment of pressure injuries. There are multiple active dressings and topical solutions to treat and protect the wounds, among them the hyperoxygenated fatty acids, such as Abzolem®. Objective: Evaluate and verify the effectiveness and safety of the use of Abzolem® in the treatment of patients with pressure injuries grade I and II. Materials and methods: an exploratory study was carried out on 6 patients residing in a long-term establishment in Santiago of Chile with grade I and II pressure injuries in which Abzolem® was used for twice-daily dressings. Results: The use of Abzolem® led to a significant improvement in grade I pressure injuries in 10 ± 3 days and grade II pressure injuries in 15 ± 3 days, without related adverse events and with good tolerance by patients. Conclusion: The use of hyperoxygenated fatty acids, such as Abzolem® corresponds to a safe therapeutic alternative, easy to apply, and effective in the treatment of grade I and II pressure injuries.