Diagnosis Research Articles

Quand penser à l’existence d’un trouble spécifique du développement et des apprentissages associé au TDAH de l’enfant ?

After the initial recommendations in 2014 on child attention deficit hyperactivity disorder (ADHD) published by the French Haute Autorité de santé (HAS), followed in 2018 by those devoted to specific learning and developmental disorders, and the new recommendations on child ADHD published in the third quarter of 2024 by the HAS, the issue of comorbidities between ADHD and other neurodevelopmental disorders remains a daily challenge for both families and professionals. This work therefore suggests that professionals who have suspected or diagnosed ADHD in a child or adolescent broaden their consideration, particularly concerning specific developmental and learning disorders that may be associated. They should rely on already available information, particularly from schools, and on screening tools accessible to primary and secondary care physicians before prescribing any additional assessments. Neurodevelopmental disorders include a large variety of conditions involving ADHD, motor disorders (among them developmental coordination disorder [DCD]), language and communication disorders (among them specific language disorder [SLD]), specific learning disorders (SLD) (written language both on the receptive and expressive side and mathematical disorders), autism spectrum disorders (ASD), and intellectual development disorder. We propose herein a brief description of these potential comorbid conditions, together with alert signs, which might give clues towards a diagnostic procedure of associated troubles. Moreover, comorbidities are often potential differential diagnosis. We therefore propose in our publication the tables published by the French HAS to help professionals to be aware of these conditions, with alert signs. Prevalence of these comorbidities benefit from our preliminary but exhaustive data from Parcours de Santé TSLA Occitanie on the prevalence of ADHD among complex neurodevelopmental disorders (NDD) with an estimation of more than 80% of concerned children and adolescent being eligible to a diagnosis of ADHD, representing an incidence of 5.6% between age 6 to 15. Among diagnosed ADHD children, comorbidities remain the rule, with specific learning disorders involving reading and spelling (dyslexia/dysorthographia): 46 to 62%, followed by developmental disorders: 41%, developmental language disorders: 24%, and specific learning disorders of mathematical abilities: 17%. This high-level of comorbidities confirms the need for each child to benefit from a multidisciplinary evaluation in various areas of development, particularly to detect secondary difficulties in learning (written language and math) or development (language, motricity), which might be masked by significant behavioural difficulties, or more subtly by pure inattention forms with primarily academic impact. Other comorbidities also need to be investigated, both towards social abilities, and secondary emotional consequences or comorbidities of ADHD including anxiety and depression. Our work also reviews data from literature about the conceptual framework between comorbidity and cause/consequence relationships, within a more comprehensive developmental perspective of various cognitive functions.

Refining Penile Trauma Management: Introduction of the Penile Trauma Score

ObjectivesTo introduce the Penile Trauma Score (PTS), a new statistically driven classification system aimed at enhancing the management of penile trauma by providing clinically relevant treatment protocols. MethodsA retrospective review was conducted of 34 men with penetrating penile injuries at the Elvis Presley Level 1 Trauma Center, Memphis, from January 2014 to December 2016. Variables assessed included injury mechanism, location, depth, and follow-up outcomes related to voiding and erectile function. Odds-ratios were calculated using superficial penile injury as the control group. ResultsBased on physical examination findings and odds ratios calculated, the PTS was developed. Results indicated that higher PTS scores necessitated surgical intervention, while lower scores could be managed nonoperatively. Follow-up showed no missed injuries or reported dysfunctions, validating the PTS's effectiveness. ConclusionsThe Penile Trauma Score (PTS) represents an important modification in the classification and management of penile trauma. By integrating practical, easily identifiable injury characteristics, the PTS facilitates more streamlined surgical decision-making and potentially reduces unnecessary diagnostic procedures. However, further prospective studies with larger sample sizes and longer follow-up are needed to fully validate the PTS’s clinical utility.

Comprehensive Insights into Glomerulonephritis and Interstitial Nephritis: Mechanisms, Diagnosis, and Management

Investigate on kidney poison has been commended by new molecular ways, with an distinction on IMR and genetic susceptibility. The story accentuates custom-made treatment tactics and housings into the complexities of Glomerulonephritis and Interstitial Nephritis therapies in order to augment results for patients suffering from these kidney diseases. From theory to action: a synthesis of insights in glomerulonephritis and interstitial nephritis This abstract assortments thoughts from several sources to offer a complex lookout that both contests and reinforces present thinking. It offers healthcare practitioners a full toolkit for treating glomerulonephritis and interstitial nephritis by combining academic acquaintance with real-world applications.A more accurate system has been unconventional to identify interstitial nephritis and glomerulonephritis. Guided Therapeutic Terrain: Administration Tactics for Glomerulonephritis and Interstitial Nephritis. This demonstration confers many systems to so long as successful patient care, including pharmacological treatment and lifestyle changes. It provides health care physicians with a comprehensive toolset for treating glomerulonephritis and interstitial nephritis by integrating academic knowledge and practical implementations. The paper includes a comprehensive examination of advanced diagnostic procedures as well as current approaches for diagnosing glomerulonephritis and interstitial nephropathy. Through the integration of molecular biomarkers, modern tomography technologies, and modified medicine, the debate aims to give new approaches for quick and accurate diagnosis.

Robust Methods for Assessing the Characteristics of Locomotor Activity Based on Markerless Video Capture Data

Introduction. Analysis of locomotor activity is essential in a number of biomedical and pharmacological research designs, as well as environmental monitoring. The movement trajectories of biological objects can be represented by time series exhibiting a complex multicomponent structure and non-stationary dynamics, thus limiting the effectiveness of conventional correlation and spectral time series analysis methods. Recordings obtained using markerless technologies are typically characterized by enhanced noise levels, including both instrumental noise and anomalous errors associated with false estimates of the location of the points of interest, as well as gaps in the trajectories, promoting an urgent need in the development of robust methods to assess the characteristics of locomotor activity.Aim. Development of robust methods for assessing the characteristics of locomotor activity capable of efficient processing of noisy recordings obtained by markerless video-based motion capture systems.Materials and methods. In order to assess the characteristics of locomotor activity, the relative movements of body parts of laboratory animals were analyzed using the stability metrics of the mutual dynamics of their trajectories, their relative delays, as well as the relative duration of the recording fragments when relatively stable mutual dynamics could be observed. The local maxima of the cross-correlation function of two body fragments, the minima of the standard deviation of the difference between their Hilbert phases, as well as their relative delays, were used as the metrics of mutual dynamics.Results. The considered phase metrics were shown to explicitly reflect changes in locomotor activity, while the assessment of time delays using phase metric was shown to be prone to periodic error. The above limitation could be largely overcome using the correlation metrics, assuming that phase and correlation metrics could be combined.Conclusion. The proposed robust methods provide stable estimates of the characteristics of locomotor activity based on markerless video capture recordings, altogether increasing the efficiency of diagnostic procedures and assessment of the therapeutic effect during rehabilitation.

Classification of Diabetic Retinopathy Severity Using Deep Learning Techniques on Retinal Images

In order to diagnose DR by utilizing the grayscale intensity and texture information extracted from the fundus image, deep learning approach is used. The writers came up with the strategy on their own. The APTOS 2019 Blindness Detection (APTOS 2019 BD) dataset is employed. extensively during the course of this investigation. A method powered by deep learning was used to locate and recover the photos. We use a large number of image processing methods, as well as two ways to feature extraction, and one method for feature selection. Because of this, the F-measure is 92.3% (0.5%), and the classification accuracy is 93.2% (with an error margin of 0.32%). Durability and dependability of the approach that was proposed have been shown by performance-related criteria for the operation. There is a possibility that classification performance might be improved using a weighted ensemble model that makes use referring to the models EfficientNet-B0, B5, and B7.This research highlights the need of extra diagnostic procedures being performed by medical experts in order to avoid incorrect diagnoses as well as false positives.

Diagnosis of laryngopharyngeal carcinoma through office-based flexible laryngoscopy as a reliable alternative for biopsies under general anesthesia: Faster diagnostics with equal oncological outcome

PurposeDiagnostic endoscopy with biopsy under general anesthesia (DE-GA) is still considered as the established standard to assess laryngopharyngeal cancer patients. Office-based flexible laryngoscopic biopsy (FLB) offers an alternative, but the effect on oncological outcome remains uncertain. Therefore, the diagnostic process and survival of patients undergoing FLB, compared to those undergoing DE-GA were evaluated. MethodsPatients suspected of laryngopharyngeal cancer who underwent FLB were evaluated. Patients with FLB-confirmed squamous cell carcinoma (SCC) were matched with DE-GA patients based on tumor site, T-classification, N-classification, age, and p16 overexpression. Time from first visit to diagnosis (FVD), time to treatment interval (TTI), disease-specific survival (DSS) and overall survival (OS) were analyzed. ResultsFLB yielded a definitive diagnosis in 155/164 (95 %) patients. No complications were observed. Ninety-eight of the 124 patients in which FLB revealed a SCC received curative treatment and were compared with 98 matched patients who underwent DE-GA. Median FVD interval was 6 days after FLB and 15 days after DE-GA (p < 0.001). Median TTI interval (FLB: 28 days, DE-GA: 28 days) was equal (p = 0.91). Oncological outcomes were comparable (p > 0.05) between FLB (OS: 2-yr: 76 %, 5-yr: 42 %; DSS: 2-yr: 86 %, 5-yr: 85 %) and DE-GA groups (OS: 2-yr: 76 %, 5-yr: 50 %; DSS: 2-yr: 81 %, 5-yr: 79 %). ConclusionFLB in the outpatient setting demonstrates a high diagnostic accuracy, is safe, accelerates the diagnostic process and has no negative effects on clinical outcome compared to DE-GA. Therefore, FLB should be considered as the standard diagnostic procedure in patients suspected of laryngopharyngeal cancer.

HFE and Non-HFE Hereditary Hemochromatosis Based on Screening of 854 Individuals: 12 Years of an Iranian Experience.

Introduction: The genetics of hereditary hemochromatosis (HH) is understudied in Iran. Here, we report the result of genetic screening of 854 individuals, referred as "suspected cases of HH," to a diagnostic laboratory in Iran over a 12-year period. Materials and Methods: From 2011 to 2012, 121 cases were screened for HH using Sanger sequencing of HFE exons. After 2012, this method was replaced by a commercial reverse hybridization assay (RHA) targeting 18 variants in the HFE, TFR2, and FPN1(SLC40A1) genes and 733 cases were screened using this method. Results: From the total studied population, HH was confirmed by genetic diagnosis in only seven cases (0.82%): two homozygotes for HFE:C282Y and five homozygotes for TFR2:AVAQ 594-597 deletion. In 254 cases (29.7%), H63D, C282Y, S65C, and four other HFE variants not targeted by RHA were identified. Although the resulting genotypes in the latter cases did not confirm HH, some of them were known modifying factors of iron overload or could cause HH in combination with a possibly undetected variant. No variant was detected in 593 cases (69.4%). Conclusion: This study showed that the spectrum of genetic variants of HH in the Iranian population includes HFE and TFR2 variants. However, HH was not confirmed in the majority (99.2%) of suspected cases. This could be explained by limitations of our genetic diagnostics and possible inaccuracies in clinical suspicion of HH. A cooperative clinical and genetic investigation is proposed as a solution to this issue.

The importance of a One Health approach in preventing human Rift Valley fever infections in Uganda

Rift valley fever (RVF) is an endemic viral zoonosis in Uganda that causes sporadic outbreaks. In May 2021, a 19-year-old woman from Kasaana Village, Kiruhura District, Western Uganda was diagnosed with RVF. In addition, five case patients identified from the same village were immunoglobulin (Ig) M–seropositive for RVF virus (RVFV), all with a history of contact with livestock. We interviewed farmers in Kasaana Village to find out whether their livestock had recently experienced any sign of RVF (livestock abortions and neonatal mortality). We conducted a veterinary records review at the regional animal diagnostic laboratory and a case search for livestock that had a recent history of abortion or neonatal mortality. Among 162 livestock (94 cattle and 68 goats) from four farms reporting one or more abortions during March-June 2021, 57 (33 cattle and 24 goats) were randomly selected for testing for RVFV using enzyme linked immunosorbent assay. Verbal reports from farmers and veterinary records review revealed increases in livestock abortions and neonatal mortality during March-May 2021, before the human cases occurred. Serological testing indicated that eight (14%) livestock, including three (9%) cattle and five (21%) goats, were IgM-seropositive for RVFV. The presence of anti-RVFV IgM antibodies in sera suggested current infection in livestock, corroborating livestock abortions within the same period. Hence, human RVFV infections likely resulted from contact with infected animal products. The recurring pattern of livestock abortions observed before human RVFV infections in Uganda indicates a gap in the zoonotic disease surveillance system, through which reports on such events should trigger rapid response to detect disease, control spread among animals, and prevent spillover to humans. An expanded One Health approach on collaboration and information sharing on such events could facilitate RVF risk reduction in humans in Uganda.

Assessment of the evidence yield for the calibrated PP3/BP4 computational recommendations

Purpose: To investigate the number of rare missense variants observed in human genome sequences by ACMG/AMP PP3/BP4 evidence strength, following the calibrated PP3/BP4 computational recommendations. MethodsMissense variants from the genome sequences of 300 probands from the Rare Genomes Project with suspected rare disease were analyzed using computational prediction tools that were able to reach PP3_Strong and BP4_Moderate evidence strengths (BayesDel, MutPred2, REVEL, and VEST4). The numbers of variants at each evidence strength were analyzed across disease-associated genes and genome wide. ResultsFrom a median of 75.5 rare (≤1% allele frequency) missense variants in disease-associated genes per proband, a median of one reached PP3_Strong, 3-5 PP3_Moderate, and 3-5 PP3_Supporting. Most were allocated BP4 evidence (median 41-49 per proband) or were indeterminate (median 17.5-19 per proband). Extending the analysis to all protein-coding genes genome wide, the number of PP3_Strong variants increased approximately 2.6-fold compared with disease-associated genes, with a median per proband of 1-3 PP3_Strong, 8-16 PP3_Moderate, and 10-17 PP3_Supporting. ConclusionA small number of variants per proband reached PP3_Strong and PP3_Moderate in 3424 disease-associated genes. Although not the intended use of the recommendations, this was also observed genome wide. Use of PP3/BP4 evidence as recommended from calibrated computational prediction tools in the clinical diagnostic laboratory is unlikely to inappropriately contribute to the classification of an excessive number of variants as pathogenic or likely pathogenic by ACMG/AMP rules.

A randomized, double-blind, placebo-controlled study on immune improvement effects of ethanolic extract of Echinacea purpurea (L.) Moench in Korean adults.

Echinacea purpurea (L.) Moench (EP), a medicinal plant native to North America, is now cultivated in various regions including Europe. With increasing popularity of Echinacea in Korea recently, a human clinical trial was conducted to evaluate immune-enhancing efficacy and safety of EP 60% ethanolic extract (EPE) in Koreans. Eighty volunteers were recruited for this randomized, double-blind, placebo-controlled clinical trial. They were randomly divided into two groups and given either a daily dose of 200 mg of EPE or a placebo. All participants underwent testing for Natural Killer (NK) cell cytotoxic activity, serum cytokine levels (IL-2, IL-6, IL-10, IL-12, IFN-γ, TNF-α), Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21), and Multidimensional Fatigue Scale (MFS) during this study to assess changes in outcomes. After 8 weeks of EPE consumption, a significant increase in NK cell cytotoxic activity compared to the placebo was observed. Additionally, serum cytokine levels of IL-2, IFN-γ, and TNF-α also significantly increased following EPE consumption. However, no significant changes were observed in WURSS-21 and MFS before and after EPE consumption. Throughout the 8-week study period, no adverse reactions were reported in relation to EPE consumption, and there were no clinically significant changes in diagnostic laboratory tests or vital signs in the EPE group. These results indicate that consumption of EPE could lead to immune improvement without any adverse effects. This clinical trial was the first to demonstrate beneficial effects of EPE consumption on immunity in Korean adults.

Development of a method of teaching trainee doctors foreign language professional communication based on an integrated approach

Introduction. The integrated approach, being one of the innovative approaches in teaching a foreign language for professional communication, contributes to the parallel development of both students’ foreign language communication skills and their professional competencies within a single academic course. To attain effective outcomes in the dual objective of training, it is crucial not only to meticulously choose the integrated course content, considering its subject-thematic focus, but also to devise a practical training method that mirrors the specifics of future medical specialists' professional activities. The aim of this research is to develop a method of teaching trainee doctors foreign language professional communication based on an integrated approach. Materials and methods. First year trainee doctors of the Clinical Laboratory Diagnostics specialty of Derzhavin Tambov State University (Russian Federation) were the participants of the experimental study. In the control group (N = 20), students studied the language for special purposes, and in the experimental group (N = 20) students studied using an integrated approach. Evaluation of students’ progress was based on seven criteria. The Student's statistical t-test method was used for the results process. Results. The integrated approach effectiveness was confirmed during experimental study, which reflected the mastery of the professional thesaurus by trainee doctors (t=3.19 at p≤0.05), in the development of writing (t=4.8 at p≤0.05), speaking skills (t=4.8 at p≤0.05) and solving professional cases on the studied language (t=2.17 at p≤0.05). However, the study did not confirm the integrated approach advantages in the grammatical speech skills formation of trainee doctors (t=1.45 at p&gt;0.05), in the development of listening skills (t=1 at p&gt;0.05) and reading skills (t=1.45 at p&gt;0.05). The results obtained can be explained by the fact that by the beginning of experimental work, students had already developed the following language and speech skills at a high level (B1-B2). Conclusion. The novelty of the study is in the development of a method for teaching trainee doctors professional foreign language during an integrated course. The prospects for the work are to further study the potential of the integrated approach in teaching students who speak the language at level A2-B1. It is anticipated that the effectiveness of the integrated learning method will be evaluated on a group of students with a foreign language communicative competence level of A2-B1. Additionally, the methodology is of research interest as it aims to identify the speech skills of foreign language interaction, categorized by types of speech activity, in a specific professional field of communication.

Lemniscate intestinal loop through an internal hernia after Roux-en-Y gastric bypass cause of coecum mobile. A case report

The internal hernia is a typical complication after laparoscopic Roux‑en‑Y gastric bypass surgery. In most cases, there are chronic symptoms that only lead to a diagnostic laparoscopy during the diagnostic exclusion procedure. Less common is acute internal hernia with devastating pain, ileus symptoms and even the development of intestinal gangrene. Although this case describes a typical constellation, it posed a particular challenge because it resulted in mesenteric lemniscate‑like torsion through the Petersen pouch. Case presentation. A 29‑year‑old patient presented to our emergency department with abdominal pain, complained of sudden epigastric pain that lasted overnight, and radiated into the back with a permanent belching every 10 seconds. Four weeks ago, the patient received an abdominoplasty, complaining of postprandial nausea, meterorism and constipation afterwards. 19 months ago, a Roux‑en‑Y gastric bypass with a weight of 109 kg and a body mass index of 42.6 kg/m2 was done. The current body weight was 60 kg and the body mass index was 23.4 kg/m2. After focused assessment with sonography for trauma and the detection of dilated intestinal loops, an abdominal computer tomography (CT) was performed. Radiologically, the suspicion of mesenteric malrotation was confirmed. The SWELL (CT‑graphic swirl sign, excess weight loss &gt;95%, liquid in abdomen CT scan) score was positive with a CT‑graphic swirl sign and an excess weight loss of 108.9% (&gt; 95%), no chylus or ascites. We discussed an immediate, necessary diagnostic laparoscopy. Based on the ileocoecalpol, it was not possible to establish a proper assignment of the detached gastrointestinal tract. The exploration of the sigmoid colon as the only fixed point revealed that this was a complete fixed twisting of the right intestinal part with a twist of the caecum into the right upper abdomen through the Petersen space. This necessitated a laparotomy to manually cancel Bernoulli’s lemniscate‑like loop and perform a mesenteric defect suture of the mesenteric space of Brolin and the Petersen space with a non‑absorbable suture. The intestinal loops and patient recovered quickly. The dismission was on the 4th post‑operative day. Conclusions. The internal hernia after gastric bypass remains a diagnostic challenge despite advances in imaging. Due to the increasing number of patients undergoing bariatric surgery, this differential diagnosis must always be considered in the case of abdominal complaints. In addition to the excess weight loss of &gt;95%, this case shows that a recent abdominoplasty can also provoke an internal hernia.

Implementation Rate of Physical Rehabilitation in Neonatal Intensive Care Units in Japan: A Retrospective Observational Study.

Background and Objective: The benefits of physical rehabilitation for very-low-birth-weight infants (VLBWI) have been reported in previous studies; however, the implementation rate of physical rehabilitation in this population remains to be clarified. This study aimed to examine the implementation rate of physical rehabilitation among VLBWI admitted to the neonatal intensive care unit (NICU) using real-world data. Material and Methods: This observational study obtained data from a nationwide administrative database associated with the diagnostic procedure combination (DPC) system in Japan (2014-2019). The participants were 30,464 infants admitted to the NICU between 2014 and 2019. The overall NICU physical rehabilitation rates and background factors of the participants were examined. Results: The overall physical rehabilitation rate in NICUs was 18%. Infants born at <28 weeks of age and extremely low birth weight infants (ELBWI) were more likely to receive physical rehabilitation interventions. The length of stay at the NICU and hospital, as well as the rate of discharge, were higher in patients who received physical rehabilitation than those in infants who did not. Conclusions: One-fifth of all patients admitted to the NICU received physical rehabilitation interventions. Extremely preterm infants and ELBWI were more likely to receive physical rehabilitation interventions. We need to consider ways to increase physical rehabilitation intervention rates in the NICU.

Complete dorsal wall agenesis of the sacral canal in a Greek population: an osteological study

Introduction: The failure of closure of the dorsal wall of the sacral canal (SC) has been known since the eve of modern osteology, appearing in prehistoric times. Variants include partial or complete absence of the dorsal wall of the SC. SC presents a pathway for minimally invasive therapeutic and diagnostic procedures for spinal diseases and for ensuring analgesia and anesthesia in operations, including labor and genitourinary surgery. Aim: Our objective is to verify the incidence of complete agenesis of the SC dorsal wall in Greek population. Material and methods: We collected 155 adult dry sacra of known sex from the Third Cemetery of Athens for the study of the dorsal wall of the sacrum. Damaged or variated sacra were excluded. We also performed an exhaustive review of the relevant literature and compared our results with those of international studies. Results: Complete dorsal wall agenesis of the sacral canal was found in three cases (1.93%), two men (1.29%) and one woman (0.64%). Our review examines its incidence in other populations and explores the possibility of regional or racial correlation. Conclusion: Knowing the complete dorsal wall agenesis of the sacral canal by medical professionals is crucial for avoiding complications in spinal surgery, anesthetics and obstetrics, as well as in the differential diagnosis of neurological and urological diseases.

The Open SprayBot: A high-throughput paper spray mass spectrometry platform for disease screening

Newborn disease screening increases survival, improves quality of life and reduces treatment costs for healthcare systems. Mass spectrometry (MS) is an effective method for metabolic screening. However, conventional analytical methods require biofluid handling and cooling conditions during transport, making the logistics difficult and expensive, especially for remote regions. ’Paper-spray’ (PS) ionization generates a charged solvent spray from samples deposited on paper strips. Therefore, samples can be applied on a suitable matrix and shipped as dried spots to diagnostic laboratories with standard postal or messenger services. We built a robotic platform, the ’Open SprayBot’, to automatically analyze paper-deposited samples via PS-MS and increase the sample throughput. The system is operated via RUMBA32 and Arduino Mega boards. A commercial syringe pump and power supply provide solvent application and electrical current required for PS-MS. The usability of the Open SprayBot was demonstrated by quantifying palmitoyl-l-carnitine, a common biomarker in newborn screening.

Hodgkin Lymphoma in Children: A 16-year Experience at the Children's Welfare Teaching Hospital of Baghdad, Iraq.

Childhood Hodgkin lymphoma (HL) is an eminently curable disease. Good outcomes can be achieved even in resource-limited settings, and the focus is increasingly on limiting long-term toxicity. Contemporary treatment incorporates a risk-stratified, response-adapted approach using multiagent chemotherapy with/without low-dose radiotherapy. Many developing countries continue to use ABVD-based regimens due to limited acute toxicity, cost, and ease of delivery. We herein report the outcomes of childhood HL diagnosed and treated in an Iraqi single centre over 16 years. Children ≤14 years old with biopsy-proven HL were enrolled. Most patients received ABVD chemotherapy or COPP/ABV when Dacarbazine was unavailable. Radiotherapy was not available. Three hundred-three children were consecutively newly diagnosed with HL; 284 were considered eligible for the retrospective analysis (treatment refusals 9; deaths before therapy 5; initially diagnosed of non-Hodgkin lymphoma 5). ABVD scheme was administered to 184 children (65%), COPP/ABV to 83 (29%), and other schemes to the remaining 17 patients. Complete response (CR) was achieved in 277 (98%); 4 (1.4%) showed disease progression, and 1 had stable disease. Four patients in CR abandoned therapy and were in CR at the time of analysis, 2 died from infection. Relapse occurred in 42 patients (15%). The 15-year OS and EFS are 89.7% and 70.3%, respectively. In this single Centre, over 16 years, almost 90% of children suffering from HL survive, despite the numerous limitations in diagnostic procedures, shortage of chemotherapy, no radiotherapy facilities, absence of effective second-line treatments, and finally, therapy abandonment for social and financial reasons.

Update on radiation protection of the thyroid gland

In recent years, concern about the effects of ionizing radiation on exposed individuals has led to the need to regulate and quantify the use of diagnostic and therapeutic techniques. Geopolitical events in recent times have also increased the population's perception of insecurity regarding ionizing radiation, and we increasingly face patients reluctant to undergo certain types of scans in our nuclear medicine services and, albeit less frequently, in radiology services. This article aims to summarise the extent to which ionizing radiation is present in our daily lives and how diagnostic and therapeutic procedures can affect our health, particularly from the perspective of their effects on the thyroid gland, one of the body's most radiation-sensitive organs.

Early Management for Fracture-Related Infection: A Literature Review.

Fracture-related infections (FRIs), as shown in the literature, represent one of the main complications of trauma surgery. They are a consequence of an implant-related "biofilm" formation and are a challenge for surgeons, microbiologists, and infectious disease specialists. For a correct diagnosis, careful clinical evaluation, to look for signs/symptoms attributable to an infectious condition, and instrumental examinations, to highlight the site of infection, its extent, and its severity, are both essential. Unfortunately, due to the lack of data in the literature, there is no consensus about guidelines on the diagnosis and treatment of FRIs. The purpose of this study is to present an up-to-date concept evaluation of the diagnostic procedures and treatment options available in the management of fracture-related infections.

Assessing Oral Cancer Awareness Among Dental Students in Van Province, Turkey

Objective: The aim of this study was to assess and compare oral cancer awareness among 3rd year and 5th year undergraduate dental students in Faculty of Dentistry, Van Yüzüncü Yıl University. Methods: A validated questionnaire testing oral cancer awareness was distributed to third and fifth year dental students at Faculty of Dentistry, Van Yüzüncü Yıl University. A total of 140 students participated in this survey. Knowledge of oral cancer risk factors and diagnostic procedures, dental students' attitudes towards oral cancers, management practices related to oral cancer and sources of oral cancer information were evaluated using 25 questions. The level of significance was set at p

Navigating nephrotoxic waters: A comprehensive overview of contrast-induced acute kidney injury prevention

Contrast-induced acute kidney injury (CI-AKI) is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality. Its pathophysiology, although not well-established, revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney. Critically ill patients, as well as those with pre-existing renal disease and cardiovascular comorbidities, are more susceptible to CI-AKI. Despite the continuous research in the field of CI-AKI prevention, clinical practice is based mostly on periprocedural hydration. In this review, all the investigated methods of prevention are presented, with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.