Frequent Signs Research Articles

Characteristics of Laryngopharyngeal Reflux in Patients with Chronic Cough Induced by Gastroesophageal Reflux Disease.

Objective: To summarize the characteristics of laryngopharyngeal reflux in patients with chronic cough induced by gastroesophageal reflux disease (GERD). Materials and Methods: The clinical data of patients with chronic cough induced by GERD treated at our hospital were retrospectively analyzed, including their reflux symptom index (RSI), reflux finding scores (RFS), and results of oropharyngeal pH monitoring. Results: There were 44 patients in total, including 21 males and 23 females. The average history of chronic cough was 29.60 (29.60 ± 37.60) months. In addition to coughing, all patients had at least 2 symptoms of laryngopharyngeal reflux disease (LPRD), and their RSI averaged 15.66 (15.66 ± 6.33). The most frequent symptoms were cough, throat clearing, excessive phlegm, or postnasal drip. All patients had LPRD signs, with an average RFS of 10.89 (10.89 ± 2.81). The most frequent signs were erythema or hyperemia/vocal cord edema, posterior commissure hypertrophy, and diffuse laryngeal edema. There were 42 patients (42/44, 95.45%) whose RSI and/or RFS were abnormal. Oropharyngeal pH monitoring identified 10 patients (10/44, 22.72%) with abnormal Ryan scores. Conclusions: All patients with chronic cough induced by GERD had symptoms and signs of LPRD, and most of them had an abnormal RSI and/or RFS and could be diagnosed with suspect LPRD. A part of the patients had LPR episodes according to Dx-pH monitoring, most of which occurred in the upright position. These results indicated that most patients with chronic cough induced by GERD may have suspected LPRD simultaneously and that cough was one of their LPRD symptoms.

Dental Management in Children with Incontinencia Pigmenti (Bloch-Sulzberger Syndrome): Case Reports and Literature Review

Introduction: Incontinentia Pigmenti (IP) is a multisystem genodermatosis characterized by cutaneous, neurologic, ophthalmologic, and dental abnormalities. Skin alterations are the main characterestic of IP. They can change and even disappear over time, in contrast, dental ones are permanent and considered as the most frequent extra cutaneous signs. The aim of this work is to present two rare clinical reports of Incontinentia Pigmenti and to adress its frequent orofacial manifestations in the dental litterature. Case Reports: In this paper, we report two clinical cases of incontinencia pigmenti in two female patients, five and nine years old, who were first examined by a dermatologist due to skin changes and then referred to our pediatric dentistry department in la Rabta hospital for oral examination. We managed these cases in collaboration with the pediatric department. We also conducted a research in the following electronic databases: PubMed and google scholar using the following keywords: ("Incontinentia Pigmenti" AND "Child" AND "Tooth Abnormalities”), from 2011 to 2021, to compare dental findings in our patients with literature. Discussion: The most representative dental features of IP are: delayed tooth eruption, agenesis, high arched palate, peg like and malformed teeth, affecting both primary and permanent teeth. Therapeutic management of our patients consisted in the replacement of absent teeth with an aesthetic and functional space maintainer. The assessment of orofacial manifestations in Children with Bloch Sulzberger syndrome indicates that it appears almost exclusively in females and is usually lethal in males. The clinical expression of this disease found in our patients reflects the Data reported in the literature. The latter showed that the presence of symptoms other than skin changes is important if dermatological signs are subtle, which is in accordance with both our patients’ clinical expression. The most relevant finding of this review is the observation that most IP patients with odontological findings had the congenital absence of six or more teeth opposed to our second patient who had only one absent tooth. Conclusions: Incontinencia pigmenti is of a good prognosis but it may affect patients' quality of life hence the importance of knowing this syndrom and its oro-facial characteristics in order to obtain a correct diagnosis and apply an appropriate approach treatment.

Risk Assessment of Noise Pollution in a Cement Plant: Perspectives and Recommendations

Introduction: noise is an acoustic phenomenon producing an auditory sensation considered unpleasant or annoying.Exposure to high sound levels over 85 dB(A) can affect the auditory system and other extra-auditory systems Our study had the general objective of evaluating the impact of noise related to noise exposure in the Lafarge Holcim Guinea factory. Material and methods: This was a prospective descriptive study lasting 6 months from March 01, 2022 to September 01, 2022. It focused on the 150 workers at the Lafarge Holcim Guinea plant and their work areas. Results: during our study, we recorded 131 workers who met our selection criteria. Our study population was young with an average age of 40.7 years with extremes of 26-53 years. About the measurement 3 areas out of 10 had a noise level above 85 dB(A). The most frequent signs felt during or after work were whistling/buzzing with 55%. Only 48.1% regularly used this PPE and caps were the most used PPE. Conclusion: at the end of this study, it appears that the workers are mainly exposed to noise and have hearing problems. Despite the availability of PPE, many workers do not use it; however, better communication on the risks associated with noise pollution and the establishment of regular supervision of the correct wearing of PPE would improve the protection and safety of workers.

Frequency of atypical pulmonary manifestations of COVID-19 patients on chest CT-scan: a cross-sectional study

BackgroundChest CT is a crucial diagnostic tool in COVID-19 due to its high sensitivity. Typical chest CT findings such as reversed halo sign, vascular enlargement, and air-bronchogram are commonly recognized in the pandemic, but finding atypical signs is essential to diagnose. We aimed to investigate the prevalence of the atypical manifestations during the two months of 2022 and compare the results to studies conducted before its outbreak.MethodsThose patients with positive, positive RT-PCR tests were reevaluated to see if they met the inclusion and exclusion. Demographic information of patients, including age and sex, was recorded. The computed tomography (CT) examination was carried out using a 100-slice scanner (Philips Brilliance 6 CT Scanner). Two radiology specialists evaluated SARS-CoV-2 RT-PCR-positive patients for atypical pulmonary CT findings separately. The obtained data were evaluated using R software version 4.1.1.Results606 confirmed COVID-19 cases were included in this study based on inclusion and exclusion criteria during January and February 2022. 55% of patients were female, and the median age was 56 (IQR: 42, 69). More than half of the patients (59%) had atypical findings on their pulmonary CT examination. These findings showed that pleural abnormalities were the most frequent atypical finding. Among pleural abnormalities, pleural thickening was the most common (17%). The double halo sign represented the least frequent atypical sign (0.2%).ConclusionsAtypical findings were more prevalent in this study than its predecessors, while we acknowledge that other factors, such as study design and patient population, could have impacted it. The presence of atypical signs generally was not correlated with specific demographic groups, while some of these signs were more frequent in particular groups.

Mpox in Northeast Brazil: Spatiotemporal analysis and predictors associated with confirmed diagnosis.

The mpox outbreaks reported in several countries from May 2022 have shown an epidemiological profile different from that observed in previous years, raising a global public health alert. This issue is particularly important for Brazil, the second country with the highest number of mpox cases. Herein, we performed a retrospective cross-sectional study on mpox cases notified in Pernambuco state, northeastern Brazil, between July 2022 and March 2023. Confirmed mpox cases were analyzed in a space-time series and their social and clinical characteristics were compared with those of suspect-negative cases, including a multivariate logistic regression to identify predictors associated with a positive diagnosis. A total of 1493 suspected mpox cases were reported, of which 362 cases (24.2%) were confirmed and distributed in 33 municipalities. Most mpox cases occurred between epidemiological weeks (EW) 33 and 39 of 2022, with the highest moving average in EW 34 and 35 (36 and 31.5, respectively). The most frequent clinical signs and symptoms were rash (87.3%), fever (60.2%), headache (45.3%), and genital/perianal lesions (40.3%). In the multivariate analysis, three variables showed considerable performance in predicting a positive mpox diagnosis (area under the ROC curve = 0.87; 95% CI: 0.84-0.90): sexual orientation (nonheterosexual; OR: 23.08; 95% CI: 13.97-38.15), male sex (OR: 2.05; 95% CI: 1.10-3.85), and multiple partnerships (OR: 1.95; 95% CI: 1.15-3.32). Overall, in addition to the detailed spatiotemporal description of mpox cases, which may contribute to appropriate public health measures, our study brings insights into mpox epidemiology by describing predictors associated with a positive diagnosis.

Frequency of and associations with alterations of medical emergency team calling criteria in a teaching hospital emergency department

BackgroundMedical emergency team (METs), activated by vital sign–based calling criteria respond to deteriorating patients in the hospital setting. Calling criteria may be altered where clinicians feel this is appropriate. Altered calling criteria (ACC) has not previously been evaluated in the emergency department (ED) setting. ObjectivesThe objectives of this study were to (i) describe the frequency of ACC in a teaching hospital ED and the number and type of vital signs that were modified and (ii) associations between ACC in the ED and differences in the baseline patient characteristics and adverse outcomes including subsequent MET activations, unplanned intensive care unit (ICU) admissions and death within 72 h of admission. MethodsRetrospective observational study of patients presenting to an academic, tertiary hospital ED in Melbourne, Australia between January 1st, 2019 and December 31st, 2019. The primary outcome was frequency and nature of ACC in the ED. Secondary outcomes included differences in baseline patient characteristics, frequency of MET activation, unplanned ICU admission, and mortality in the first 72 h of admission between those with and without ACC in the ED. ResultsAmongst 14 159 ED admissions, 725 (5.1%) had ACC, most frequently for increased heart or respiratory rate. ACC was associated with older age and increased comorbidity. Such patients had a higher adjusted risk of MET activation (odds ratio [OR]: 3.14, 95% confidence interval [CI]: 2.50–3.91, p = <0.001), unplanned ICU admission (OR: 1.97, 95% CI: 1.17–3.14, p = 0.016), and death (OR: 3.87, 95% CI: 2.08–6.70, p = 0.020) within 72 h. ConclusionsACC occurs commonly in the ED, most frequently for elevated heart and respiratory rates and is associated with worse patient outcomes. In some cases, ACC requires consultant involvement, more frequent vital sign monitoring, expeditious inpatient team review, or ICU referral.

Clinical Profile of Patients with Anemia in a Tertiary Care Hospital

INTRODUCTION Anemia is a common health problem with nonspecific symptoms often overlooked leading to adverse health outcomes. This study aims to assess the clinical profile, types, and etiologies of anemia. MATERIAL AND METHODS In this hospital based cross-sectional study, patients with anemia were enrolled through convenience sampling. Relevant history, physical examination, and investigations were performed. Statistical package for social sciences software version 20 was used to enter and analyze the data. Categorical variables were expressed as frequencies and percentages. Continuous variables were expressed as median (range). The associations were analyzed by using Fisher's exact test or Chi-square test, as appropriate. RESULTS Out of 193 patients, 151 (78.2%) were females. The median age was 49 years (range 18-87 years). Most frequent symptoms were easy fatiguability (76.2%), breathlessness on exertion (30.1%), and light headedness (21.8%). Most frequent signs were pallor (75.6%), tachycardia (23.8%), glossitis (16.1%), and nail changes (15.5%). Majority (79.3%) had moderate and 17.1% had severe anemia. Iron deficiency (59.1%) and anemia of inflammation (28%) were common etiologies. Iron deficiency anemia was most commonly due to nutritional deficiency. Age was significantly associated with the type and etiology of anemia. CONCLUSION Moderate anemia was the most common presentation. Easy fatiguability, breathlessness on exertion, and light headedness were most common symptoms, while pallor, tachycardia, glossitis, and nail changes were the most common signs. Iron deficiency anemia and anemia of inflammation were most common etiologies. Iron deficiency anemia was more common in younger patients, while anemia of inflammation was more common in older patients.

715 The Acute Abdomen: Have You Ruled Out Splenic Torsion?

Abstract Background Splenic torsion is very rare, with approximately 500 cases reported worldwide and an incidence of 0.2% (1). The aetiology is thought to be hypermobility of the spleen’s supporting ligaments enabling migration to the pelvic or iliac region of the abdomen. The presentation can range from asymptomatic to a surgical emergency. It is thought that the under-diagnosis of this condition leads to the higher prevalence of surgical emergency type presentations. Aim We present a rare case of an acute abdomen, secondary to torsion, due to a massive splenic cyst. A literature review detailing the most common symptoms, signs and investigations in adult patients is reported, to aid the reader rule out this rare but life-threatening condition in clinical practice. Method We performed a PubMed search using the terms ““splenic torsion” or “twisted spleen” or “wandering spleen””. Only acute (&amp;lt;3months) (3) symptomatic presentations in adult human patients (&amp;gt;18years), who had confirmed splenic torsion were included. Of the 220 case reports/series found, 100 did not meet the inclusion criteria, were not accessible in English, or did not describe the patient symptoms. Results Of the 120 acute splenic torsion adult cases between 1974-2022 evaluated, the most common symptom was abdominal pain (95%) then vomiting (34.2%). The most frequent sign was abdominal mass (61.7%). Diagnosis was most commonly confirmed by CTAP (76.7%). Conclusions Splenic torsion is an important differential in the acute abdomen patient presenting with abdominal pain, vomiting and a palpable mass. This life-threatening condition can usually be excluded by CTAP.

Personality trait analysis during the COVID-19 pandemic: a comparative study on social media

The COVID-19 pandemic, a global contagion of coronavirus infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has triggered severe social and economic disruption around the world and provoked changes in people’s behavior. Given the extreme societal impact of COVID-19, it becomes crucial to understand the emotional response of the people and the impact of COVID-19 on personality traits and psychological dimensions. In this study, we contribute to this goal by thoroughly analyzing the evolution of personality and psychological aspects in a large-scale collection of tweets extracted during the COVID-19 pandemic. The objectives of this research are: i) to provide evidence that helps to understand the estimated impact of the pandemic on people’s temperament, ii) to find associations and trends between specific events (e.g., stages of harsh confinement) and people’s reactions, and iii) to study the evolution of multiple personality aspects, such as the degree of introversion or the level of neuroticism. We also examine the development of emotions, as a natural complement to the automatic analysis of the personality dimensions. To achieve our goals, we have created two large collections of tweets (geotagged in the United States and Spain, respectively), collected during the pandemic. Our work reveals interesting trends in personality dimensions, emotions, and events. For example, during the pandemic period, we found increasing traces of introversion and neuroticism. Another interesting insight from our study is that the most frequent signs of personality disorders are those related to depression, schizophrenia, and narcissism. We also found some peaks of negative/positive emotions related to specific events.

Prognostic role of glomerular electron microscopy lesions in IgA nephropathy: "the devil is in the details".

Transmission electron microscopy enables examination of ultrastructural glomerular changes; while this tool has already been appliedin IgA nephropathy (IgAN), limited information exists on the prognostic valuein this disease. We aimed to systematically investigate ultrastructural lesions and assess their role in predicting the evolution of IgA nephropathy toend-stage kidney disease. A single-center retrospective study was performed on 107 consecutive IgAN patients (median age 42years, 67% male, estimated glomerular filtration rate 46mL/min, proteinuria 1.0g/g) between 2010 and 2015, who were followed-up until end-stage kidney disease, death, or end of study (January 2021). A pathologist evaluated the Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental glomerulosclerosis (S), and Tubular atrophy/interstitial fibrosis-Crescents (C) (MEST-C) score and transmission electron microscopy lesions according to a comprehensive protocol that encompassed all glomerular structures. Patients were followed up for a median of 7.1years; 32 (43%) reached end-stage kidney disease. Patients who reached kidney failure had higher comorbidity score, more frequent arterial hypertension, lower estimated glomerular filtration rate, and higher MEST-C score. In terms of transmission electron microscopy lesions, patients who progressed to end-stage kidney disease had more frequent podocyte activation, effacement, and presence of microvilli; more frequent signs of endothelial cell activation and fenestration; higher mesangial cell proliferation. In theunivariate Cox proportional hazard regression, higher MEST-C score and lesions detected bytransmission electron microscopy in podocytes, endothelial cells, and mesangial cell proliferation were associated with shorter kidney survival time. In themultivariate Cox proportional hazard regression, only higher MEST-C score, presence of podocytes with microvilli, and mesangial cell proliferation were associated with end-stage kidney disease. This study shows that, besides the MEST-C score, the presence of podocytes with microvilli and mesangial cell proliferation are associated with poor kidney survival in IgAN patients, highlighting the prognostic value of lesions detected bytransmission electron microscopy.

Clinical and immune features of human parvovirus B19 infection in allogeneic stem cell transplantation recipients: A retrospective monocentric study.

Human parvovirus B19 (B19V) infection is associated with pure red cell aplasia (PRCA) in immunocompromised patients; however, the spectrum of manifestations associated with B19V in allogeneic hematopoietic stem cell transplantation recipients (alloHSCT) has rarely been reported. In this study, we aimed to report clinical and immune features of B19V infection after alloHSCT. We retrospectively collected and analyzed clinical and microbiological data of all transplanted patients with B19V DNAmia or tissue infection detected by polymerase chain reaction (PCR) in our center from 2010 to 2021. We report 35 cases of B19V infections in 33 patients. Median time from transplant to B19V first PCR positivity was 6.9 months (interquartile range (IQR) [1.6-18.9]). No preferential immune profile, type of transplantation or conditioning was identified. Hematological impairment was the most frequent sign, followed by rash and fever. Unconventional clinical forms were also detected, such as acute myelitis and myositis. For some cases, the direct relationship between symptoms and B19V infection was difficult to prove but was suggested by targeted tissue PCR positivity. When hematological impairment was not at the forefront, reticulocytopenia helped to diagnose B19V infections. Treatment was mainly based on high dose intravenous immunoglobulin. Although hematological impairment was the most frequent sign, B19V can affect multiple targets and lead to atypical manifestations. Because of its heterogeneous clinical presentation, B19V infection is likely under-diagnosed. Diagnosis of unusual B19V organ involvement needs combination of arguments which can include targeted tissue PCR.

CLINICAL AND PATHOANATOMICAL PARALLELS OF THE HEART DAMAGE DUE TO COVID-19

The aim – to investigate the clinical and pathomorphological features of the heart damagein patients who died due to COVID-19 pneumonia.Materials and methods. A retrospective analysis of the medical records of 556 patients,hospitalized to Lviv Clinical Emergency Care Hospital in January- February 2021, witha diagnosis of COVID-19 pneumonia and 90 reports of pathological examination ofthe causes of death of patients with COVID-19 pneumonia was carried out. Clinicalparameters (demographic data, comorbidities, presence of COVID-19 pneumoniacomplications, complaints, medical history, results of physical examination andadditional laboratory and instrumental investigations, performed during hospitalization,including levels of NT-proBNP and troponin, determined by immunofluorescence method)and results of pathological examination were evaluated.The results. During life, most patients who died due to COVID-19 pneumonia werediagnosed with acute respiratory distress syndrome (ARDS), the development of multipleorgan failure, rarely PE. They showed significantly lower capillary blood oxygensaturation indicators compared to similar indicators of recovered patients, as well asan increase in markers of systemic inflammation (level of leukocytes and interleukin-6),fibrin degradation products (D-dimers) and markers of multiorgan failure (creatinine,NT-proBNP, troponin I). The most frequent pathomorphological signs of heartdamage in patients with COVID-19 were interstitial edema with hyperemia (63.5 %) and fragmentation of cardiomyocytes (34.1 %). Every fourth patient had mononuclear cell infiltration, which was associated with increased level of NTproBNP, oxygen saturationdecrease in capillary blood, and increase in aspartate aminotransferase. Myocardialinfarction, pericarditis, and myocarditis occurred more rarely in patients with COVID-19.Conclusions. The variety of clinical scenarios of heart damage requires a high level ofsuspicion in the early stages of the disease and the use of appropriate investigations toidentify its cause.

Ocular surface in posterior segment surgery.

Nowadays, the technological breakthroughs of mini-invasive vitreo-retinal surgery improved the perioperative management and the outcomes of millions of patients. The most common procedures include pars plana vitrectomy, episcleral surgery, intravitreal injections, and laser photocoagulation. Potential sight and non-sight-threatening side effects have been reported during the follow-up period. Ocular surface disbalance can be induced by the aforementioned procedures, resulting in mild to severe ocular discomfort symptoms. This condition may recognize different causes such as pre-existing or concomitant diseases of the external eye, the surgical procedure damage of the anatomical or physiological structures of the ocular surface, the prolonged side effects induced by the chronic topical treatment that may be toxic to the external eye.In addition to the most frequent dry eye-related signs and symptoms, subconjunctival haemorrhages, corneal epithelium damage, partial loss of corneal sensitivity or changes in corneal nerve density could postoperatively affect our patients.In conclusion, any surgical trauma directed to the posterior segment of the eye may cause the loss of the ocular surface homeostasis. Ophthalmologists should not only recognise and treat, but possibly prevent, all patients' symptoms that could manifest in the postoperative time.

Assessment of Symptoms, Pregnancy Outcome, and Health-Related Quality of Life among PCOS women Treated with Myo inositol and Metformin

PCOS is a complicated endocrine disorder that mostly affects between 5% and 10% of women who are of reproductive age. Obesity, hyperandrogenism, and oligo- or anovulation are frequent clinical PCOS signs.&#x0D; Objective: the study was designed to evaluate the effect of combining Metformin and Myoinositol; the main insulin-sensitizing drugs on improving symptoms and HRQOLQ in PCOS women.&#x0D; Materials and Methods: A study was a prospective, interventional, comparative clinical study conducted on 54 patients (aged 18-40 y) who are divided into three groups: group1 patients allocated to receive Myo-inositol(4g), group2 patients allocated to receive Metformin(1g) and group3 patients allocated to receive Myo-inositol(4g) + Metformin(1g) all for 3 months. Baseline and after 3 months, patients’ information and health related quality of life were documented.&#x0D; Result: Metformin and Myoinositol resulted in symptoms improvement within each study groups as (68.8%, 87.5% and 94.1%) for group 1,2 and 3 respectively, only 4 patients from all groups became pregnant. Also, significant change in HRQOLQ in all study groups after three months of treatment were reported.&#x0D; Conclusion: combining Myoinositol with metformin results in improved PCOS symptoms and pregnancy outcome in addition to improved patient’s quality of life.

The immune mechanism of the nasal epithelium in COVID-19-related olfactory dysfunction.

During the first waves of the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, olfactory dysfunction (OD) was reported as a frequent clinical sign. The nasal epithelium is one of the front-line protections against viral infections, and the immune responses of the nasal mucosa may be associated with OD. Two mechanisms underlying OD occurrence in COVID-19 have been proposed: the infection of sustentacular cells and the inflammatory reaction of the nasal epithelium. The former triggers OD and the latter likely prolongs OD. These two alternative mechanisms may act in parallel; the infection of sustentacular cells is more important for OD occurrence because sustentacular cells are more likely to be the entry point of SARS-CoV-2 than olfactory neurons and more susceptible to early injury. Furthermore, sustentacular cells abundantly express transmembrane protease, serine 2 (TMPRSS2) and play a major role in the olfactory epithelium. OD occurrence in COVID-19 has revealed crucial roles of sustentacular cells. This review aims to elucidate how immune responses of the nasal epithelium contribute to COVID-19-related OD. Understanding the underlying immune mechanisms of the nasal epithelium in OD may aid in the development of improved medical treatments for COVID-19-related OD.

Hairdressing Practices and Alopecia among Women Aged 15 to 45 in Bamako

Introduction: Alopecia is the pathological loss of hair, a frequent sign in dermatology whose etiologies are multifactorial. Alopecia in women can lead to a loss of self-esteem leading to depression and thus alter the quality of life. Better knowledge of the etiologies will make it possible to prevent certain types of alopecia in women and to improve case management. The aim of this work is to study the causes of alopecia in women aged 15 to 45 in the dermatology department of the National Center for Support in the Fight against Disease (CNAM). Methods: This was a descriptive cross-sectional study from February 2018 to February 2019, all women aged 15 to 45 consulting in the service during the study period. Case definition: alopecia any patient between the ages of 15 and 45 consulting for localized or diffuse hair loss. Results: We recruited 102 cases of alopecia out of 7223 women, i.e. a prevalence of 1.41%. The 25-35 age group represented 39%, with an average age of 28. Married women numbered 48, or 47.06%. Civil servants accounted for 28.43%. 87.25% of cases resided in urban areas. The duration of disease progression ranged from 1-12 months for 48.04% to 1-3 years for 36.28% and more than 3 years for 15.68%. The styling practices found in our cases: weaving, straightening, additions, represented respectively (97.06%, 53.92%, 72.54%); braids with addition every 04 weeks was practiced by 30 of our cases. Potash was used by 72.54% of cases for straightening. Our patients straightened their hair at a periodic rate of 3 months for 31.51% of cases, a rate of 6 months for 26.03% of cases. Alopecia was frontal seat, Traumatic alopecia was found in 33.33% of subjects practicing straightening. Rural women suffered from inflammatory causes (P=0.00005). Close straightening sessions expose to the risk of traumatic alopecia (P=0.03). Conclusion: The etiologies of alopecia are dominated by traumatic causes. This underlines the harmful effect of certain styling practices in ...

Characteristics of a trauma population in an ambulance organisation in Sweden: results from an observational study

BackgroundGlobally, injuries are a major health problem, and in Sweden, injuries are the second most common reason for ambulance dispatch. However, there is a knowledge gap regarding the epidemiology of injuries requiring assessment by emergency medical services (EMS) in Sweden. The aim of the present study was to describe the prehospital population with injuries that have been assessed and treated by EMS.MethodsA randomly selected retrospective sample was collected from 1 January through 31 December 2019 in a region in southwestern Sweden. Data were collected from ambulance and hospital medical records.ResultsAmong 153,724 primary assignments, 26,697 (17.4%) were caused by injuries. The study cohort consisted of 5,235 patients, of whom 50.5% were men, and the median age was 63 years. The most common cause of injury was low-energy fall (51.4%), and this was the cause in 77.8% of those aged > 63 years and in 26.7% of those aged ≤ 63 years. The injury mechanism was a motor vehicle in 8.0%, a motorcycle in 2.1% and a bicycle in 4.0%. The most common trauma location was the residential area (55.5% overall; 77.9% in the elderly and 34.0% in the younger group). In the prehospital setting, the most frequent clinical sign was a wound (33.2%), a closed fracture were seen in 18.9% and an open fracture in 1.0%. Pain was reported in 74.9% and 42.9% reported severe pain. Medication was given to 42.4% of patients before arrival in the hospital. The most frequent triage colour according to the RETTS was orange (46.7%), whereas only 4.4% were triaged red. Among all patients, 83.6% were transported to the hospital, and 27.8% received fracture treatment after hospital admission. The overall 30-day mortality rate was 3.4%.ConclusionAmong EMS assignments in southwestern Sweden, 17% were caused by injury equally distributed between women and men. More than half of these cases were caused by low-energy falls, and the most common trauma location was a residential area. The majority of the victims had pain upon arrival of the EMS, and a large proportion appeared to have severe pain.

Ассоциации лептина и адипонектина у больных синдромом раздраженного кишечника с избыточной массой тела и ожирением

Irritable bowel syndrome (IBS) in overweight and obese individuals is characterized by a more severe course than in patients with normal weight. The purpose. To assess the level of adipokines (leptin and adiponectin) in blood serum, the correlation of these laboratory markers with the clinical manifestations of IBS, quality of life, eating habits, and signs of anxiety and depression based on the results of using a special questionnaire in patients with IBS. Material and methods. An open cohort cross-sectional study was conducted with the inclusion of 175 participants aged 18 to 44 years (mean age 30.06 ± 6.15 years). Group 1 included 100 obese or overweight IBS patients aged 18 to 44 years (mean age 30.63 ± 6.37 years, BMI 25.88 ± 6.28 kg/m2). In group 1, subgroup 1A included 50 people with IBS associated with overweight or obesity. In subgroup 1B – 50 people suffering from IBS, with normal weight. Group 2 included 75 people without IBS, aged 19 to 43 years (mean age 29.31 ± 5.81 years, BMI 27.80 ± 6.20 kg/m2). Subgroup 2A included 50 non-IBS participants who were overweight or obese. Subgroup 2B included 25 apparently healthy participants. IBS symptoms were assessed using a 10-point scale. Using verified questionnaires, the severity of gastrointestinal symptoms, the presence of anxiety and depression, the level of specific anxiety, quality of life and eating habits were assessed. Results. IBS patients with overweight and obesity are characterized by higher levels of leptin and low levels of adiponectin than patients with normal weight (Mann – Whitney test, p &lt; 0.05). Adipokine levels correlate with high cravings for sweet, fatty, starchy, and salty foods. A higher concentration of leptin is characteristic of patients suffering from IBS with a predominance of constipation (Mann – Whitney test, p &lt; 0.05). High levels of leptin and low levels of adiponectin in overweight and obese IBS patients correlate with more severe symptoms of abdominal pain, flatulence, poor quality of life, and more frequent signs of anxiety and depression (Spirmen test p &lt; 0.05, Mann – Whitney test, p &lt; 0.05). Conclusion. The results obtained suggest a significant role of adipokines in the formation of more severe symptoms in IBS patients with overweight and obesity compared to patients with normal weight

WHAT IS THE CONTEMPORARY MANAGEMENT OF ACETABULAR RETROVERSION?

Acetabular retroversion (ARV) is a cause of femoroacetabular impingement leading to hip pain and reduced range of motion. We aimed to describe the radiological criteria used for diagnosing ARV in the literature and report on the outcomes of periacetabular osteotomy (PAO) and hip arthroscopy (HA) in its management.A systematic review using PRISMA guidelines was conducted on the MEDLINE, CINAHL, EMBASE, COCHRANE database in December 2022. English-language studies reporting outcomes of PAO, or open or arthroscopic interventions for ARV were included.From an initial 4203 studies, 21 non-randomised studies met the inclusion criteria.Eleven studies evaluated HA for ARV, with average follow-up ranging from 1 to 5 years, for a cumulative number of 996 patients. Only 3/11 studies identified ARV using AP standardized pelvic radiographs. The most frequent signs describing ARV identified were: Ischial Spine Sign (98% of patients), Posterior Wall Sign (PWS, 94%) and Crossover Sign (COS, 64%); with mean Acetabular Retroversion Index (ARI) ranging from 33% to 35%. 39% of HA patients had all three radiographic signs. Clinically significant outcomes were reached by 33–78% of patients.Eight studies evaluated PAO for ARV, with a follow-up ranging from 2 to 10 years, for a cumulative number of 379 patients. Five of the eight studies identified ARV using standardized radiographs. ISS, COS and PWS were positive in 54%, 97% and 81% of patients, respectively with 52% of PAO patients having all three radiographic signs. Mean ARI ranged from 36–41%. Clinically significant results were reported in 71%–78% of patients.The diagnostic criteria for ARV is poorly defined in the literature, and the quality of evidence is low. Studies on HA are more likely to have used lenient diagnostic criteria. It remains difficult to recommend which cases maybe more suitable for treatment by HA rather than PAO.

Distal Upper Limb Tremor during Walking in Parkinson's Disease.

Distal upper limb tremor during walking (TW) is frequently observed in Parkinson's disease (PD) but its clinical features are unknown. To characterize the occurrence and the clinical features of TW in comparison to the other types of tremors in PD. Fifty-one PD patients with rest tremor were evaluated off- and on-treatment. Occurrence, body distribution, severity and latency of TW and of other tremor types were assessed. TW was present in 78% of the PD patients examined. TW body distribution and severity were similar to those of rest and re-emergent tremor but different from the postural tremor presented by the same patients. TW latency, observed in 85% of patients, was on average 5.8 s. Dopaminergic treatment significantly improved TW, rest, and re-emergent tremor severity but left TW latency unaffected. TW is a frequent motor sign in PD and is likely a clinical variant of rest tremor.