Frequency Of Abnormalities Research Articles

Embryonic stem cell factor FOXD3 (Genesis) defects in gastrointestinal stromal tumors.

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms, believed to originate from the interstitial cells of Cajal (ICC), often caused by overexpression of tyrosine kinase receptors (TKR) KIT or PDGFRA. Here, we present evidence that the embryonic stem cell factor FOXD3, first identified as 'Genesis' and involved in both gastrointestinal and neural crest cell development, is implicated in GIST pathogenesis; its involvement is investigated both in vitro and in zebrafish and a mouse model of FOXD3 deficiency. Samples from a total of 58 patients with wild-type GISTs were used for molecular analyses, including Sanger sequencing, comparative genomic hybridization, and methylation analysis. Immunohistochemistry and western blot evaluation were used to assess FOXD3 expression. Additionally, we conducted in vitro functional studies in tissue samples and in transfected cells to confirm the pathogenicity of the identified genetic variants. Germline partially inactivating FOXD3 sequence variants (p.R54H and p.Ala88_Gly91del) were found in patients with isolated GISTs. Chromosome 1p loss was the most frequent chromosomal abnormality identified in tumors. In vitro experiments demonstrate the impairment of FOXD3 in the presence of those variants. Animal studies showed disruption of the GI neural network and changes in the number and distribution in the ICC. FOXD3 suppresses KIT expression in human cells; its inactivation led to an increase in ICC in zebrafish, as well as mice, providing evidence for a functional link between FOXD3 defects and KIT overexpression leading to GIST formation.

Clinical utility of peripheral blood laboratory testing in the diagnostic workup of prurigo nodularis: A multicenter cohort study

Prurigo nodularis (PN) is a chronic inflammatory skin disease associated with several systemic comorbidities. However, there is lack of evidence supporting specific laboratory testing in the diagnostic workup of PN patients. To characterize the frequency and severity of clinical laboratory abnormalities in PN patients compared to controls. Cross-sectional study of adult patients between October, 2015 and August, 2021 using TriNetX, a global health records database encompassing over 74 million patients. A total of 12,157 PN patients were matched to 12,157 controls. Significantly, greater proportions of PN patients had moderate-to-severely decreased hemoglobin, elevated transaminases, decreased albumin, increased bilirubin, increased serum creatinine, decreased estimated glomerular filtration rate, higher hemoglobin A1c levels, and alterations in thyroid stimulating hormone. Our data identifies associated laboratory abnormalities in PN patients but is unable to support a causal relationship. PN patients are more likely to have laboratory abnormalities on renal, hepatic, hematologic, endocrine, and metabolic laboratory testing, demonstrating a role for systemic testing in the diagnostic workup of PN patients.

Safety and toxicity of cabozantinib monotherapy in patients with advanced renal cell carcinoma: a Russian multicenter observational study

Aim. To assess the safety and to analyze an influence of cabozantinib monotherapy toxicity on treatment efficacy in unselected Russian patients with metastatic renal cell carcinoma (mRCC).
 Materials and methods. Medical data of 92 patients with verified mRCC were included in the study. The median age of the patients was 56 (1979) years, most of them - 60 (65.2%) were of male gender. Twenty five (27.2%) persons had Eastern Cooperative Oncology Group performance status (ECOG PS). At the time of cabozantinib monotherapy start 5 (5.4%) patients had favorable, 54 (58.7%) intermediate, and 33 (35.9%) unfavorable prognosis by International Metastatic Renal Cancer Database Consortium (IMDC) model. Eighty-three (90.2%) patients were pretreated, including 76 (82.6%) patients who previously received anti-angiogenic agents. All patients were administered with cabozantinib monotherapy (60 mg/day); dose adjustment was performed according to the instruction.
 Results. Adverse events (AEs) were reported in 81 (88.0%) of 92 patients; 30 (32.6%) AEs were grade 34. Toxicity-related dose reduction of cabozantinib was required in 28 (30.4%), treatment interruption in 15 (16.3%), and discontinuation in 2 (2.2%) patients. The most common AEs were hypertension (69 patients, 75.0%), asthenia (47 patients, 51.1%), diarrhea (43 patients, 46.7%), and palmar-plantar erythrodysesthesia (43 patients, 46.7%). The most common severe AEs were: arterial hypertension (17 patients, 18.5%), diarrhea (6 patients, 6.5%), and palmar-plantar erythrodysesthesia (2 patients, 2.2%). The most frequent laboratory abnormalities during therapy were elevated serum transaminases (33 patients, 35.9%), anemia (13 patients, 14.1%), and thrombocytopenia (10 patients, 10.9%). No previously unreported AEs or laboratory abnormalities were observed. There was a significant increase in progression-free survival (hazard ratio 2.5; 95% confidence interval 1.05.9; p=0.046) and overall survival (hazard ratio 3.0; 95% confidence interval 1.28.3; p0.025) in patients with treatment-related arterial hypertension.
 Conclusion. The observational study confirmed the acceptable safety profile of cabozantinib in the first and subsequent lines of treatment in mRCC patients. No new safety signals were identified. Treatment-related arterial hypertension may be a favorable predictor of survival.

Vestibular and Oculomotor Findings in Vestibular Migraine Patients.

Vestibular migraine (VM) is the most frequent etiology of recurrent spontaneous episodic vertigo. Vestibular and oculomotor abnormalities have been described in VM; however, the diagnosis is currently based on symptoms. The objective of this study was to determine the most frequent abnormalities in videonystagmography (VNG), caloric testing (Cal) and video head impulse test (vHIT) in patients with VM. A retrospective cohort study was conducted, including all VM and probable VM patients seen from January 2021 to July 2022. Demographics, auditory symptoms and results via VNG, Cal and vHIT were evaluated. VNG results were compared with a control group. Sixty patients, 81.7% with VM and 18.3% with probable vestibular migraine, were included. VNG revealed the following abnormalities: 21.7% spontaneous nystagmus; 33.3% positional nystagmus, mostly central; 26.7% optokinetic nystagmus; 56.7% smooth pursuit abnormalities and 70% saccade test abnormalities, mostly velocity and latency. An abnormal unilateral caloric response was seen in 22.9%, while vHIT revealed a low gain in at least one canal in 21.7%, and saccades were seen in at least one canal with normal gains in 18.3%. Concordant results between Cal and lateral vHIT were seen in 77.1% of cases. Although VM is a clinical diagnosis, vestibular and oculomotor abnormalities are commonly seen. The most frequent oculomotor findings were an abnormal saccade test, abnormal smooth pursuit and central positional nystagmus.

The impact of low ambient temperature on cardiovascular health

Abstract Extreme weather events and climate change have witnessed a substantial increase in recent years, leading to heightened concerns. The rise in abnormal ambient temperatures, both in intensity and frequency, directly and indirectly impacts cardiovascular health. While the impact of high ambient temperatures on cardiovascular response is a common concern in the context of global warming, the significance of low temperatures cannot be overlooked. The challenges posed by low temperatures contribute to increased cardiovascular morbidity and mortality, posing a significant threat to global public health. This review aims to provide an overview of the relationship between low ambient temperature and cardiovascular health, encompassing the burden of cardiovascular outcomes and underlying mechanisms. Additionally, the review explores strategies for cold adaptation and cardioprotection. We posit that to optimize cold adaptation strategies, future research should delve deeper into the underlying mechanisms of cardiovascular health in response to low ambient temperature exposure.

BCL6 Protein Expression Identifies Cases without BCL6 Gene Rearrangement in Non-Germinal Centre Diffuse Large B- Cell Lymphoma Cases

BCL6 gene rearrangements are the most frequent cytogenetic abnormality in Diffuse Large B-Cell Lymphoma (DLBCL), occurring in up to 64% of cases, suggesting a poorer prognosis and response to therapy. The aim of this study was to calculate the accuracy and predictive power of BCL6 IHC in identifying BCL6 gene rearrangements. A search for DLBCL cases was performed on the laboratory information system. We retrospectively analysed 46 cases of DLBCL, and correlated BCL6 protein expression with gene rearrangement status. Of the 46 cases, 39 (84.78%) showed positive BCL6 protein expression by IHC. In comparison, only 10 (21.74 %) samples presented with gene rearrangements. There were 8 cases positive for BCL6 IHC with gene translocations and 5 cases were negative for both protein expression and gene rearrangements. BCL6 IHC had a sensitivity of 80% and a specificity of 14%. Furthermore, the Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were 21% and 71%, respectively. BCL6 rearrangement was more common in cases with a Non-Germinal Centre (GC) Cell of Origin (COO) (45.5%) as compared to the GC group (14.3%). When stratifying the analysis according to the COO, the sensitivity and NPV of BCL6 IHC in the non-GC group were both 100%, while the same parameters were considerably poorer in the GC cases. BCL6 protein expression did not correlate with the presence of BCL6 gene rearrangements in HIV related DLBCL cases. However, lack of BCL6 protein expression may be used to identify cases without a BCL6 gene rearrangement, particularly in non-GC COO.

Prognostic significance of CCND1 amplification/overexpression in smoking patients with esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is the main subtype of esophageal cancer, with 5-year survival rate less than 30%. In order to offer an individual therapeutic approach, it is necessary to identify novel prognostic factors to recognize high-risk patients. Given the high frequency of CCND1 abnormalities and the important biological effects of smoking in ESCC, we explored the potential relationship between CCND1 abnormalities and smoking in ESCC patients. CCND1 status was examined by fluorescence in situ hybridization and immunohistochemical staining in ESCC tissue microarrays (n = 519). CCND1 amplification and cyclinD1 overexpression were found in 53.2 and 34.1% ESCC, respectively. CCND1 amplification (P = 0.142 for DFS and P = 0.191 for OS) and cyclinD1 overexpression (P = 0.035 for DFS and P = 0.092 for OS) tended to be poorer prognostic factors in all patients. Among smoking patients, those with CCND1 amplification had significantly poorer prognosis, with a median DFS and OS of 25.0 and 30.0 months compared to not reached and 52.0 months for those without CCND1 amplification (P = 0.020 and 0.018). A similar trend was found in the 68 patients with cyclinD1 overexpression (P = 0.043 and 0.048). Further univariate and multivariate analysis revealed CCND1 amplification was independently poorer prognostic factor in smoking patients, which was not found in non-smoking patients. Smokers with CCND1 amplification or cyclinD1 overexpression have poorer survival, which help us to identify distinct groups of patients with apparently poorer outcome and would enable appropriate follow-up and treatment strategies.

A Swine Model of Traumatic Brain Injury: Effects of Neuronally Generated Electromagnetic Fields and Electromagnetic Field Stimulation on Traumatic Brain Injury-Related Changes.

Background and objective Traumatic brain injury (TBI) has been associated with aberrations in neural circuitry attributable to the pathology resulting in electromagnetic field (EMF) changes. These changes have been evaluated in a variety of settings including through novel induction sensors with an ultra-portable shielded helmet and EMF channels with differences identified by comparing pre-injury and post-injury states. Modulation of the EMF has undergone cursory evaluation in neurologic conditions but has not yet been fully evaluated for clinical effects in treatment. Target EMF stimulation using EMF-related changes preoperatively to postoperatively has not yet been attempted and has not been completed using induction sensor technology. Our objectives in this study were twofold: we wanted to test thehypothesis that targeted stimulation using an EMF signal generator and stimulator to abnormal thresholds identified by real-time measurement of EMFs may enable early resolution of EMF changes and treatment of the TBI as modeled through controlled cortical impact (CCI); we also aimed toassess the feasibility of attemptingthis using real-time measurements with an EMF shielded helmet with EMF channels and non-contact, non-invasive induction sensors with attached EMF transmitters in real-time. Methods A singular Yucatan miniswine was obtained and baseline EMF recordings were obtained. A CCI of TBI and postoperative assessment of cortical EMF in a non-invasive, non-contact fashion were completed. Alterations in EMF were evaluated and EMF stimulation using those abnormal frequencies was completed using multiple treatments involving three minutes of EMF stimulation at abnormal frequencies. Stimulation thresholds of 2.5 Hz, 3.5 Hz, and 5.5 Hz with 1 V signal intensity were evaluated using sinusoidal waves. Additionally, stimulation thresholds using differing offsets to the sine wave at -500 mV, 0 mV, and 500 mv were assessed. Daily EMF and post-stimulation EMF measurements were recorded. EMF patterns were then assessed using an artificial intelligence(AI) model. Results AI modeling appropriately identified differences in EMF signal in pre-injury, post-injury, and post-stimulation states. EMF stimulation using a positive offset of 500 mV appeared to have maximal beneficial effects in return to baseline. Similarly targeted stimulation using thresholds of 2.5 Hz and 5.5 Hz with a positive 500 mV offset at 1 V allowed for recovery of EMF patterns post-injury towards patterns seen in baseline EMF measurements on stimulation day seven (postoperative day 17). Conclusion Stimulation of neural circuits with targeted EMF in a sinusoidal pattern with targeted thresholds after measurement with induction sensors with shielding isolated to a Mu-metal and copper mesh helmet and EMF channels is efficacious in promoting neuronal circuit recovery to preoperative baselines in the TBI miniswine model. Similarly, our findings confirm the appropriateness of this translational model in the evaluation of brain neuronal circuit EMF and that preoperative and post-trauma differences can be appropriately assessed with this technology.

Screening of subclinical functional hemoglobin and red blood cell abnormalities among blood donors of Fayoum University Hospital in Egypt: Are RET-He, and IRF useful screening tools?

BackgroundThe effectiveness of red cell transfusion in a given blood unit that relied on both quantity and quality of donated cells undoubtedly affects prognostic outcomes. ObjectiveWe aimed to determine the frequency of subclinical functional hemoglobin and red cell abnormalities in donated blood of Fayoum University Hospital in Egypt. Additionally, to assess the usefulness of reticulocyte mean hemoglobin content (RET-He) and immature reticulocyte fraction (IRF) as screening measures for such abnormalities. Material and methodsThis cross-sectional study enrolled 200 volunteer blood donors who met the national standard criterion of blood donation. Complete blood count with reticulocyte parameters, serum ferritin, sickling test, G6PD assay, Mentzer index, and naked-eye single tube red cell osmotic fragility test were carried out. ResultsFunctional red cell abnormalities represented 44 % of this cohort. Out of them, 4.5 % had iron deficiency, 11 % had a positive sickling test, 19 % had G6PD deficiency, and 9.5 % had suspicious thalassemia. The sensitivity and specificity test for RET-He in selective identification of functional hemoglobin abnormalities in donated blood were 83.3 % and 61.2 %, respectively at a cutoff value of 26.9. Though there was no statistically significant effect of RET-He on the selective detection of G6PD deficiency, IRF had a statistically significant high level with a p-value of 0.04. ConclusionSubclinical functional red cell abnormalities seem to be prevalent among blood donors. Reticulocyte/ erythrocyte indices could be useful screening tools for red cell abnormalities. Further studies are required for assessing the impact of transfusing such abnormalities to neonates and other critical recipients.

Damage on DNA and hematological parameters of two bat species due to heavy metal exposure in a nickel-mining area in central Brazil.

Exposure to heavy metals in mining zones is a significant threat, which can affect ecosystem services and contribute to the decline of wild bat populations. The present study investigated the impacts caused by mining on two bat species in central Brazil, the nectarivorous Glossophaga soricina and the frugivorous Carollia perspicillata. The bats were collected from a nickel-mining zone (treatment) and a protected area (control). The leukocyte profile of each species was compiled and genotoxicity (comet assay) and mutagenicity (micronucleus test) were determined using the appropriate procedures. Glossophaga soricina presented significantly higher frequencies of eosinophils and monocytes in the mining zone in comparison with the protected area, whereas C. perspicillata presented higher frequencies of lymphocytes in the mining zone, but significantly lower frequencies of monocytes. Concomitantly, G. soricina also presented a higher frequency of DNA damage, although no variation was found in this parameter in C. perspicillata when comparing environments. We also found no significant differences between populations in terms of the frequency of micronuclei and other nuclear abnormalities. Overall, the results of the study indicate that bats are susceptible to immunological disorders and DNA damage in mining zones, with the nectarivorous G. soricina appearing to be relatively more susceptible and thus a potentially effective bioindicator of the impact of contamination in these environments.

Analysis of optimized phase locked loop for grid synchronization of solar PV system under grid disturbances

AbstractIn this work, an optimal phase locked loop (PLL) is employed to estimate the fundamental grid frequency and phase angle under grid disturbances, which largely reduces the frequency and phase error. Conventional synchronous reference frame (SRF) offers considerable results for balanced grid conditions but has poor performance under grid disturbances with improper phase detection. In this regard, gravitational search algorithm (GSA)‐based optimization is utilized to optimally tune the proportional and integral (PI) gain values of conventional SRF PLL, which ensures the proper tracking of fundamental phase angle and frequency even during abnormal grid conditions, that is, voltage unbalance, frequency variations, high‐frequency harmonics, and phase variations. Further, integral square error (ISE) criteria, settling time, and overshoot are considered as objective functions to obtain the optimal value of current gain, present in the control loop of a grid‐tied solar photovoltaic (PV) system. The supremacy of the proposed work, compared to SRF and optimal SRF PLL, is tested with MATLAB®/Simulink studies and verified by dSPACE‐1104‐based hardware‐in‐loop (HIL) results for real‐time validation.

Cytogenetic profile of Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan.

To determine the frequencies of different cytogenetic abnormalities in patients of Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan. It was descriptive cross-sectional study conducted in Hematology Department of a Tertiary care referral institute from June 2015 to July 2017. All newly diagnosed cases of Acute Leukemia were analyzed. Cytogenetic analysis was performed on bone marrow aspirate samples using Giemsa-trypsin banding technique. Karyotypes were identified and interpreted according to ISCN criteria. A total of 355 newly diagnosed patients of Acute Leukemia were analyzed. Out of these, 180 patients had AML and 175 had ALL. In Acute Myeloid Leukemia chromosomal abnormalities were detected in 28.2 % cases. Of these the common ones included t(8;21),t(15;17),+8, Inversion 16 and Monosomy 7. Other abnormalities included Complex karyotype, Down's syndrome related AML, Hyperdiploidy, del 16q,-8,+Y and t(3p;17q)del 10. In Acute Lymphoblastic Leukemia chromosomal abnormalities were detected in 40% cases. Common ones included Hyperdiploidy, Tetraploidy and t(9;22). Other abnormalities included t(1;19) and t(2;8)t(8;14). Cytogenetically favorable abnormalities are commonest occurring chromosomal defects in both Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia in Northern Pakistan, i.e., t(8;21) in AML and Hyperdiploidy in ALL.

Midterm follow-up of healthy young adults with moderate to severe COVID-19: pulmonary and extrapulmonary disease sequelae

BackgroundFollow-up studies on coronavirus disease 2019(COVID-19) were mainly focused on short-term sequelae in patients with comorbid diseases. The aim of this study was to investigate the pulmonary and extrapulmonary sequelae of moderate to severe COVID-19 in the midterm follow-up of healthy young adults.MethodsIn this prospective cohort study, we used the hospital information system (HIS) to identify patients who had recovered from moderate to severe COVID-19 without comorbidity. All eligible patients were invited to participate in the study. Participants were asked to fill out a set of questionnaires to evaluate fatigue, anxiety, and post-traumatic stress disorder (PTSD). They also underwent chest computed tomography (CT) scan, pulmonary function test (PFT), and tissue doppler imaging (TDI) echocardiography. A blood sample and a 12-lead electrocardiogram (ECG) were obtained.ResultsA total of 50 recovered patients and 12 healthy controls were enrolled in the study. Fifteen out of 50 patients received intensive care. Patients had significantly higher fatigue and anxiety scores than controls. PTSD criteria were met in 29 out of 50 patients. Ground glass opacities, nodules, and subpleural lines were the most frequent abnormalities in chest CT scans of patients. Patients had significantly lower left ventricular end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) than controls (P value 0.019 and < 0.001, respectively).ConclusionsAccording to our findings, COVID-19 survivors might experience anxiety, fatigue, PTSD, pulmonary impairment, leading to reduced cardiac function up to 6 months after discharge.

Sperm chromosomal abnormalities in infertile men with failed intracytoplasmic sperm injection (ICSI)

BackgroundMale infertility is a major health problem with multi-factorial etiology. Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of men with severely compromised semen parameters and improved their chances of achieving pregnancy. However, many concerns have been raised about ICSI safety; in part owing to utilizing aneuploid sperms from infertile men, which may be associated with an increased incidence of chromosomal aneuploidies in ICSI pregnancies. The aim of the study was to determine the incidence of sperm aneuploidies for chromosomes 13, 18, 21, X, and Y in semen of infertile males with failed ICSI. This will assist infertile couples and enable them to make informed decisions. For this purpose, sperm aneuploidy frequency for chromosomes 13, 18, 21, X, and Y was evaluated by multicolor fluorescence in-situ hybridization (FISH) in 35 patients with abnormal semen parameters, and 10 normozoospermic healthy men who served as controls.ResultsSperm aneuploidies for chromosomes 13, 18, 21, X, and Y in semen from infertile men with failed ICSI were detected at higher frequencies than controls. Patients had significantly higher disomy, nullisomy, diploidy, and polyploidy frequencies compared to controls.ConclusionsInfertile men with failed ICSI have a significantly increased frequency of sperm chromosome abnormalities compared to controls. Fluorescence in situ hybridization facilitated the study of numerical chromosomal abnormalities in human sperm nuclei (sperm FISH). Sperm FISH, prior to the application of assisted reproductive techniques, saves a considerable amount of time and resources.

Mutagenicity, hepatotoxicity, and neurotoxicity of glyphosate and fipronil commercial formulations in Amazon turtles neonates (Podocnemis expansa)

Pesticides are considered one of the main causes of the population decline of reptiles worldwide, with freshwater turtles being particularly susceptible to aquatic contamination. In this context, we investigated the potential mutagenic, hepatotoxic, and neurotoxic effects in neonates of Podocnemis expansa exposed to substrate contaminated with different concentrations of glyphosate and/or fipronil during embryonic development. Eggs collected from the natural environment were artificially incubated in sand moistened with pure water, water added with glyphosate Atar 48® at concentrations of 65 and 6500 μg/L (groups G1 and G2, respectively), water added with fipronil Regent® 800WG at 4 and 400 μg/L (groups F1 and F2, respectively) and, water added with the combination of 65 μg/L glyphosate and 4 μg/L fipronil or with 6500 μg/L glyphosate and 400 μg/L fipronil (groups GF1 and GF2, respectively). For mutagenicity analysis, we evaluated the frequency of micronuclei (MN) and other erythrocyte nuclear abnormalities (ENAs), while for evaluation of hepatotoxicity and neurotoxicity, livers and encephalon were analyzed for histopathological alterations. Exposure to pesticides, alone or in combination, increased the frequency of erythrocyte nuclear abnormalities, particularly blebbed nuclei, moved nuclei, and notched nuclei. Individuals exposed to fipronil exhibited congestion and inflammatory infiltrate in their liver tissue, while, in the encephalon, congestion, and necrosis were present. Our study confirms that the incubation of eggs in substrate polluted with glyphosate and fipronil causes histopathological damage and mutagenic alteration in P. expansa, highlighting the importance of using different biomarkers to evaluate the ecotoxicological effects of these pesticides, especially in oviparous animals.

Structural and functional abnormalities of the tongue: An epidemiological study from a tertiary care center

Background: The tongue is a prominent muscular organ of the oral cavity and the integrity of the tongue mucosa frequently can reflect the overall health of an individual. There are a number of notable structural and functional alterations that can affect the tongue. These changes may be symptomatic or asymptomatic. Hence, the aim of the present study was to determine the prevalence of structural and functional abnormalities of the tongue in a population reporting to a tertiary care center. We also assessed the prevalence of the normal variants and evaluated the normal tongue protrusion measurement in the study population. Methods: The cross-sectional study included 1,143 dental outpatients above 18 years of age who visited the Department of Oral Medicine and Radiology between October 2021 and February 2022. Demographic details of the patients were noted. Participants were asked questions regarding any symptoms or abnormalities noticed pertaining to tongue. The tongue was examined thoroughly for any structural/ functional abnormalities. The maximal tongue protrusion for each participant was measured by asking them to extend the tongue out. Medical history, drug history and social history were recorded. Results: The study included 564 male and 579 female participants; tongue lesions were positive in 66.5% of the study population. Coated tongue (26.2%) was the most frequent structural abnormality that was noted in the present study. Taste dysfunction (4.6%) was the most frequent functional abnormality. The lesions were most in the anterior two thirds (4.2%) of the tongue. Conclusions: The results of the present study showed that tongue lesions were present in 66.5% of the population. Careful and detailed evaluation of the tongue examination is mandated in routine dental checkup. This shall help in prompt identification of various etiological factors causing structural and functional abnormalities of the tongue.

Dilemmas in the Management of Acute TBI: A Prospective Observational Study of Anterior Pituitary Dysfunction and Its Correlation with Outcome

Abstract Background The frequency and pattern of endocrinal abnormalities among patients with traumatic brain injury occur more frequently than previously suspected. Objective The aim of this study was to assess anterior pituitary dysfunction in patients with moderate-to-severe traumatic brain injury and outcome after treatment. Material and Methods One hundred patients with moderate-to-severe head injury presenting within 48 hours of injury were enrolled. Blood samples of all patients were taken for the hormonal assay at second day, at 2 weeks, 1 month, 3 months, and 6 months. Patients were evaluated by Glasgow coma scale (GCS), Glasgow outcome score (GOS), and hormone profile. Results The median GCS score was 10/15. Forty-four patients were operated and 56 patients were managed medically. Seven operated patients expired; 30 patients had good recovery. In conservative group, 46 patients had good outcome and two patients died. Cortisol and thyroid hormone values were changed prominently, followed by prolactin and growth hormone. On univariate analysis, association of GOS with fT3, fT4, serum prolactin, and serum cortisol was seen. On multivariate analysis, strong correlation of GOS with f T4 values was seen (p = 0.008) Conclusion Most of the hormonal deficiency occurs in immediate phase. Hormonal screening should be done to improve long term outcome.

Prevalence of Neuroradiological Abnormalities in First-Episode Psychosis

Individuals presenting with first-episode psychosis (FEP) may have a secondary ("organic") etiology to their symptoms that can be identified using neuroimaging. Because failure to detect such cases at an early stage can have serious clinical consequences, it has been suggested that brain magnetic resonance imaging (MRI) should be mandatory for all patients presenting with FEP. However, this remains a controversial issue, partly because the prevalence of clinically relevant MRI abnormalities in this group is unclear. To derive a meta-analytic estimate of the prevalence of clinically relevant neuroradiological abnormalities in FEP. Electronic databases Ovid, MEDLINE, PubMed, Embase, PsychINFO, and Global Health were searched up to July 2021. References and citations of included articles and review articles were also searched. Magnetic resonance imaging studies of patients with FEP were included if they reported the frequency of intracranial radiological abnormalities. Independent extraction was undertaken by 3 researchers and a random-effects meta-analysis of pooled proportions was calculated. Moderators were tested using subgroup and meta-regression analyses. Heterogeneity was evaluated using the I2 index. The robustness of results was evaluated using sensitivity analyses. Publication bias was assessed using funnel plots and Egger tests. Proportion of patients with a clinically relevant radiological abnormality (defined as a change in clinical management or diagnosis); number of patients needed to scan to detect 1 such abnormality (number needed to assess [NNA]). Twelve independent studies (13 samples) comprising 1613 patients with FEP were included. Of these patients, 26.4% (95% CI, 16.3%-37.9%; NNA of 4) had an intracranial radiological abnormality, and 5.9% (95% CI, 3.2%-9.0%) had a clinically relevant abnormality, yielding an NNA of 18. There were high degrees of heterogeneity among the studies for these outcomes, 95% to 73%, respectively. The most common type of clinically relevant finding was white matter abnormalities, with a prevalence of 0.9% (95% CI, 0%-2.8%), followed by cysts, with a prevalence of 0.5% (95% CI, 0%-1.4%). This systematic review and meta-analysis found that 5.9% of patients presenting with a first episode of psychosis had a clinically relevant finding on MRI. Because the consequences of not detecting these abnormalities can be serious, these findings support the use of MRI as part of the initial clinical assessment of all patients with FEP.

Metabolic risk factors in prepubertal and pubertal patients with overweight and obesity.

Metabolic syndrome (MetS) is a cluster of conditions linked to obesity that increases cardiovascular risk. We evaluated the frequency of clinical abnormalities associated with overweight and obesity in childhood, to determine whether a diagnosis of MetS is appropriate in this population. Cross-sectional study with 116 pubertal and prepubertal children with a mean age (SD) of 10.9 (2.5) years, with overweight and obesity. We defined MetS using the International Diabetes Federation criteria, regardless of the age. 45 patients met the criteria, 20 had at least one metabolic abnormality in addition to a high waist circumference (WC), and seven with WC below percentile 90th, had at least one metabolic abnormality. The prepubertal had higher zBMI [3.1 (2.6-3.8) vs. 2.8 (2.4-3.3); p=0.037], less lean body mass (kg) [27.13 (7.3) vs. 34.13 (9.8); p=0.005] and a similar frequency of non-alcoholic fatty liver disease (NAFLD) compared to the pubertal [44.7 vs. 35.9; p=0.323]. Prepubertal with NAFLD had higher zBMI, lower HDL levels, higher TG/HDL ratios and higher fat percentages; while pubertal with NAFLD had higher WC/height, aspartate aminotransferase and oxaloacetic transaminase. The diagnosis of MetS in childhood is not fundamental. Individualized management, focusing on the earliest age groups, in which we identified a more severe degree of obesity, should be done. We also recommend screening for NAFLD in all ages, due to the high prevalence observed.

Lesiones en la mucosa oral de personas con rosácea

IntroductionRosacea is a chronic inflammatory disease that mainly affects women’s skin over the age of 30. Rosacea’s importance lies in that it can lead to ocular mucosa alterations, degenerations in the psychosocial aspect of the person who suffers from the disease, among other alterations. Interestingly, rosacea modifies the levels of matrix metalloproteinases in the crevicular fluid, suggesting that rosacea may cause changes at the oral level. Apart from the evidence that exists, up until now, the presence of lesions in the oral mucosa has not been investigated. ObjectiveIdentify the frequency and type of abnormalities in the oral mucosa in individuals with rosacea. Materials and methodsThe subjects were selected by convenience previously diagnosed with rosacea by an expert dermatologist. Everyone was 18 or older. Individuals with systemic diseases (lupus, diabetes, psoriasis, rheumatoid arthritis, etc.) were excluded from the study. Before the mucosa exam, a clinical record was made from the information provided by the patient and for the oral cavity mucosa, an intraoral clinical examination was carried out by observing and palpating structures and possible lesions. Results20 subjects were included with a diagnosis of rosacea, 95% of them were woman and the average age was 32.15. The frequency of abnormalities in the oral mucosa was 20%, the more frequent type and location was oral ulcer and yugal mucosa, respectively. ConclusionThe results of this study showed that 20% of the subjects studied presented oral lesions that varied between ulcer, petechia and taint, the ulcer being the most frequent.