High Incidence Research Articles

Association of oral manifestations with severity of the disease in ulcerative colitis patients

ObjectiveInflammatory bowel diseases (IBD), such as Crohn’s disease (CD) and ulcerative colitis (UC), are chronic conditions primarily affecting the intestines. This study aims to identify the nature and frequency of oral symptoms and signs in patients with ulcerative colitis and to explore the connection between these complications and the activity of the disease.MethodsThis descriptive-analytical study involved ulcerative colitis patients who visited the gastroenterology clinic at Shahid Sayad Shirazi Hospital in Gorgan, along with an equal number of healthy companions as a control group in 2019. A gastroenterology internist assessed the disease severity through clinical examination and a simple clinical disease activity index for colitis patients. The collected data were then analyzed statistically using SPSS version 19.ResultsThe average age of patients in the case group was 41.84 ± 11.66 years, while in the control group it was 40.43 ± 12.67 years. There was a significant correlation between difficulty swallowing, burning sensation in the mouth, vomiting, acidic taste, the presence of oral ulcers, and a coated tongue with the severity of disease activity (p < 0.05). However, no significant relationship was found between other variables and the severity of disease activity (p > 0.05).ConclusionThe results of this study confirm that as the severity of ulcerative colitis increases, the occurrence of oral lesions also rises, particularly during severe disease activity. Among oral symptoms, dry mouth had the highest incidence, followed by bad breath and changes in taste. The most common oral lesions observed were a coated tongue, grooved tongue, and oral ulcers, respectively.

Genotypic characterization of β-lactamase resistant Salmonella species isolated from different quail houses and their susceptibility to extracts of thyme and chitosan, and Saccharomyces Cerevisiae

ABSTRACT This study aimed to identify Salmonella species in two systems for quail raising (deep litter system and cages system). Determination of antibiotic susceptibility, β-lactamase resistance genes profile and susceptibility to chitosan, thyme extract and S. cerevisiae was examined. Fifteen Salmonella isolates were isolated from eighty cloacal swabs examined, with a higher incidence from those of deep litter systems than cage housing systems. Regarding the environmental samples, Salmonella was higher in the deep litter system than in cage housing. Serological identification of 27 salmonella isolates typed them into 8 Salmonella spp. including S. Tsevie, S. Infantis, S. Kentucky, S. Typhimurium, S. Larochelle, S. Molade, S. Enteritidis and S. Labadi. The profile of β-lactamase-resistance genes revealed the presence of blaTEM and blaSHV genes in S. Typhimurium and S. Infantis; blaTEM and blaCTX-M1 genes in S. Enteritidis and S. Molade, while S. Kentucky and S. Tsevie were positive for the blaCTX-M1 gene only. S. Larochelle was negative for all of them. Thyme and chitosan extract showed that S. cerevisiae had the highest inhibitory activity against the tested strains. In conclusion, farms with superior biosecurity and hygiene practices will reduce the risk of pathogens and eliminate the need for prophylactic antibiotics, thereby preventing antibiotic resistance.

Headache disorders: a persistent public health challenge for the under 50s.

Currently, neurological diseases has surpassed cardiovascular diseases as the primary cause of global disease burden. Among these, headache disorders are the most prevalent and have emerged as the main cause of disability in people under 50 years old in recent years. Since the release of GBD 2021, there has been no comprehensive systematic exposition on the burden of headache among individuals under 50 years old and a forecast for future burdens. This study aims to quantify the global, regional, and national burden of headache disorders among people under 50 from 1992 to 2021 and to predict future trends in order to provide policy makers with precise and effective epidemiological evidence. This study extracted the incidence, prevalence, and DALYs data related to headache disorders in the 5-50 age group from the GBD 2021. After age-standardizing the data, we used joinpoint regression analysis and health inequity analysis to analyze the burden and temporal trend of headache disorders and predicted the future disease burden and changes based on the age-period-cohort model. By 2021, the case number of global incidence, prevalence and DALYs have increased by 35, 39, and 41%, respectively, over the past 30 years. The incidence and prevalence of tension-type headache (TTH) are significantly higher than those of migraine, but migraine causes greater health burdens. The burden is higher for female than for male. In terms of age, youth aged 25-29 years had the highest incidence in 2021, with an age-standardized rate (ASR) of 13,454.64 (95%CI, 9,546.96-18,361.36) per 100,000 population. Nationally, the highest ASR of incidence and prevalence are found in Norway, and the most damaging to health is found in Belgium. Among the five sociodemographic index (SDI) categories, the middle SDI has the highest number of cases (190 million in 2021). It is worth noting that the forecast shows that by 2046 the three indicators will reach 680 million, 2.33 billion, and 41 million, respectively, indicating that the burden of headache disorders in this age group will continue to persist. Globally, the burden of headache disorders in people under 50 years of age remains significant and has not improved over the past 30 years, especially in regions with high SDI. Headache problems will continue to pose a serious public health challenge for this age group for some time to come. This study reveals the burden and distribution of headache disorders in this age group, providing important basis for governments and policymakers to accurately and effectively allocate health care resources, strengthen prevention and management strategies, and respond to this global health problem.

Comparing the effectiveness of universal admission testing and risk-based testing at emergency admission for preventing nosocomial COVID-19: a multicenter retrospective cohort study in Japan.

To compare the effectiveness of universal admission testing (UAT) and risk-based testing (RBT) in preventing nosocomial coronavirus disease 2019 (COVID-19) after the implementation of strict infection control measures. Retrospective multicenter cohort study. Five community hospitals in Japan. 14,028 adult patients admitted emergently from June 1, 2022, to January 31, 2023. We calculated crude incidence density rates of community-acquired COVID-19 (positive test ≤4days postadmission), hospital-acquired COVID-19 (positive test ≥8days postadmission), total postadmission COVID-19 (all cases of positive test postadmission), and primary cases (sporadic and index cases). A generalized estimating equation model was used to adjust for local incidence (new COVID-19 patients per 100,000 population), single-bed room proportion, and admission proportion of patients older than 65years. The weekly local incidence in the study areas was less than 1,800 per 100,000 population (1.8%). Two hospitals implemented RBT and 3 implemented UAT. The median admission testing rate was higher in the UAT group than in the RBT group (95% vs 55%; difference 45.2%, 95% CI, 40.3%-48.8%). Crude and adjusted analyses revealed no significant associations between incidence density rates (IRR; >1 indicates higher incidence with UAT) and admission strategies for any of the outcomes: community-acquired cases (adjusted IRR = 1.23; 95% CI,0.46-3.31), hospital-acquired cases (1.46; 0.80-2.66), total postadmission COVID-19 (1.22; 0.79-1.87), and primary cases (0.81; 0.59-1.12). Compared with risk-based testing, universal admission testing may have limited additional benefits in preventing nosocomial COVID-19 transmission during a period of low-moderate local incidence.

A Retrospective Analysis of Human Cutaneous Leishmaniasis Epidemiology During 2016 - 2021 in Hoveyzeh County, Khuzestan Province, Iran

Background: Leishmaniasis, a significant neglected tropical disease, is caused by obligate intracellular protozoa of the Leishmania genus. Objectives: This research aimed to investigate the epidemiology of cutaneous leishmaniasis (CL) from 2016 to 2021 in Hoveyzeh county. Methods: This study is a retrospective, cross-sectional, descriptive study based on available data. The study population included all individuals treated and followed up in health care centers who were clinically diagnosed with CL and confirmed by laboratory tests. Results: Among the 628 individuals diagnosed with CL, 324 (51.6%) were male, and 304 (48.4%) were female. The average age of the patients was 16.58 ± 15.17 years. The highest proportion (45.4%) of cases occurred in the 0 - 10-year age group, highlighting the vulnerability of children, while those above 50 years had the lowest incidence (3.7%). Approximately 68.2% of patients resided in urban areas, with the remainder living in rural settings. The hand was the most frequently affected area (44.5%), and the maximum number of lesions reported in a single individual was 25. Most patients (46.82%) were treated with topical glucantime along with cryotherapy. Disease incidence showed seasonal variation, with the highest number of cases reported in autumn (54%) and a significant peak in December (22%). The highest incidence year was 2016 (30.3%). Conclusions: Effective strategies to combat this disease should include comprehensive public awareness campaigns focused on health education, early recognition of symptoms, and transmission methods. Promoting personal protective measures is crucial for disease prevention efforts.

Multiple Sclerosis: Appearance after Covid Vaccination

Background: Multiple sclerosis (MS) is a chronic autoimmune disease that primarily affects the central nervous system, often emerging in young adults. In the context of the global COVID-19 vaccination campaign, concerns have been raised about the potential link between vaccination and autoimmune conditions, including MS. This study aims to assess the incidence of MS post-COVID-19 vaccination across different age groups and vaccine types, with a specific focus on identifying at-risk populations. Methods: A retrospective cohort study was conducted using publicly available registries, case reports, and clinical data. The study included 450 individuals who developed MS after receiving a COVID-19 vaccine, with an analysis performed on incidence rates, relative risk (RR), and demographic factors such as age, sex, and vaccine type. The data was compared with a control group of 3,000 vaccinated individuals without MS onset. Results: The overall incidence of MS among vaccinated individuals was 15 per 100,000. Adults aged 18-40 years had the highest incidence (18 per 100,000), while children under 12 had the lowest (3 per 100,000). Females were disproportionately affected, accounting for 63.3% of MS cases, with an incidence of 18 per 100,000 compared to 12 per 100,000 in males. A higher proportion of cases were linked to mRNA vaccines, particularly Pfizer-BioNTech (54.4% of total cases), though no statistically significant difference was observed among vaccine types. The relative risk of MS in vaccinated adults was 1.35 (95% CI: 1.12-1.60) compared to the general population. Conclusion: While there is a slight increase in the incidence of MS among adults following COVID-19 vaccination, particularly with mRNA vaccines, the overall risk remains low. No significant increase in MS risk was observed in younger populations. The benefits of vaccination against severe COVID-19 far outweigh the potential risks of MS onset. Ongoing surveillance and further research are essential to better understand vaccine-related autoimmune responses.

Independent role of atherosclerotic plaque composition and extension in predicting the risk of cardiac events: a CLIMA substudy.

To investigate two different approaches to determine patient risk to develop cardiac events: the burden of coronary atherosclerosis, as assessed by the Gensini score, and plaque morphology, as assessed by intracoronary optical coherence tomography (OCT). We assessed the Gensini score and OCT features of plaque vulnerability in 847 patients from the CLIMA registry. Patients were divided into four Gensini quartiles. The main study endpoint was the 1-year composite of cardiac death, myocardial infarction (MI) and/or target vessel revascularization (TVR). A total of 56 patients (6.6%) experienced the one-year main composite endpoint. The composite endpoint was significantly affected by the Gensini score (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.11-1.81, p = 0.005), with a low incidence in the first Gensini quartile (Q1 1.3%) and a higher incidence in the remaining groups (Q2 8.3%, Q3 8.9% and Q4 8.3%). At the multivariable analysis, the combined four OCT criteria (HR 6.4, 95%CI 3.0-13.7, p < 0.001), thin fibrous cap (HR 2.9, 95%CI 1.7-5.0, p < 0.001), lipid arc > 180° (HR 2.1, 95%CI 1.2-3.6, p = 0.010), minimum lumen area < 3.5 mm2 (HR 1.7, 95%CI 1.01-3.0, p = 0.047) and the Gensini score (HR 1.4, 95%CI 1.1-1.8, p = 0.017) were independent predictors of the main composite endpoint. In this post-hoc analysis of the CLIMA study, the burden of coronary atherosclerosis as assessed by the Gensini score and OCT plaque characteristics were independent predictors of cardiac events. Patients with the largest atherosclerosis burden and with plaque vulnerability by OCT were at the highest risk of poor outcome. Clinicaltrials.gov identifier: NCT02883088.

Loop-Mediated Isothermal Amplification Assay Using Gold Nanoparticles for Detecting Treponema pallidum subspp. pallidum.

Venereal syphilis in humans is caused by Trepenoma pallidum subspp. pallidum. A study has shown that 30,302 individuals in Thailand had syphilis in 2020, with a male-to-female ratio of 1:0.8 and the highest incidence rate at ages between fifteen and twenty-four. This research aimed to develop a loop-mediated isothermal amplification assay using gold nanoparticles (LAMP-AuNPs). Analytical sensitivity, diagnostic specificity, accuracy, and predictive values for each technique are provided. The diagnosis sensitivities of polymerase chain reaction using agarose gel electrophoresis (PCR-AGE), loop-mediated isothermal amplification assay using agarose gel electrophoresis (LAMP-AGE), and LAMP-AuNPs were 116 ng/µL, 11.6 ng/µL, and 11.6 ng/µL, respectively. We evaluated the analytical specificity using PCR and a LAMP-based assay, and there was no cross-reactivity to Leptospira interrogans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, human immunodeficiency virus (HIV), and healthy humans. After analyzing 400 serum samples of patients suspected of syphilis, the LAMP-AGE and LAMP-AuNPs assays displayed 100% diagnostic sensitivity scores, 91% diagnostic specificity scores, 95.5% accuracy rates, 100% positive predictive values (PPVs), and 91% negative predictive values (NPVs), the positive likelihood ratio (LR+) was 11.11, while the negative likelihood ratio (LR-) was 0. Conversely, for PCR assays displayed 100% diagnostic sensitivity scores, 94.5% diagnostic specificity scores, 97.25% accuracy rates, 100% PPVs, and 94.5% NPVs, LR+ was 18.18, and LR- was 0. The LAMP-AuNPs technique demonstrates rapidity, affordability, and convenience, rendering it well-suited for point-of-care applications in the diagnosis, prevention, and management of pathogenic infections.

The spatial-temporal variations and influencing factors of COVID-19 case fatality rate: a worldwide study in 30 countries from February 2021 to May 2022.

To evaluate the variations in COVID-19 case fatality rates (CFRs) across different regions and waves, and the impact of public health interventions, social and economic characteristics, and demographic factors on COVID-19 CFRs, we collected data from 30 countries with the highest incidence rate in three waves. We summarized the CFRs of different countries and continents in each wave through meta-analysis. Spearman's correlation and multiple linear regression were employed to estimate the correlation between influencing factors and reduction rates of CFRs. Significant differences in CFRs were observed among different regions during the three waves (P<0.001). An association was found between the changes in fully vaccinated rates (r s =0.41), population density (r s =0.43), the proportion of individuals over 65years old (r s =0.43), and the reduction rates of case fatality rate. Compared to Wave 1, the reduction rates in Wave 2 were associated with population density (β=0.19, 95%CI: 0.05-0.33) and smoking rates (β=-4.66, 95%CI: -8.98 - -0.33), while in Wave 3 it was associated with booster vaccine rates (β=0.60, 95%CI: 0.11-1.09) and hospital beds per thousand people (β=4.15, 95%CI: 1.41-6.89). These findings suggest that the COVID-19 CFRs varied across different countries and waves, and promoting booster vaccinations, increasing hospital bed capacity, and implementing tobacco control measures can help reduce CFRs.

Prevalence of Disordered Eating Risk Attitudes in Youth Elite Male and Female Football Players.

Objectives: Examine the prevalence of risk behaviors for the development of eating disorders in academy footballers of the Liga MX, compare sociodemographic data and highlight the participants' perceptions regarding the influence of the sports environment and external pressure on their relationship with food and their bodies. Methods: A cross-sectional study was carried out with 536 footballers (331 men and 205 women) in the categories U14, U16, U18 men and U15, U19 women of Liga MX with prior consent from their clubs and strict confidentiality measures. The data were collected via Google Forms using the Eating Attitudes Test (EAT-26). Results: Of the participants, 13.4% met or exceeded the cut-off point on the EAT-26. The highest prevalence was observed in the Female U19 category. The reflections indicated that the sports environment and external pressure affect the relationship with food and bodies in a significant proportion of participants. Conclusions: The study highlights a high prevalence of risk behaviors for eating disorders in Liga MX football players, with a higher incidence in the female categories, also evidencing a multifactorial etiology.

Predictive value of serum hepcidin levels for the risk of incident end-stage kidney disease in patients with chronic kidney disease: The KNOW-CKD

Introduction: Despite the pivotal role of hepcidin in the development of anemia among the patients with chronic kidney disease (CKD), the association between serum hepcidin levels and CKD progression has been never investigated. We here hypothesized that elevation in serum hepcidin levels might be associated with the risk of incident end-stage kidney disease (ESKD) among the patients with pre-dialysis CKD. Methods: A total of 2,109 patients with pre-dialysis CKD at stages 1 to pre-dialysis 5 were categorized into the quartiles by serum hepcidin levels. The study outcome was incident ESKD. The median duration of follow-up was 7.9 years. Results: The analysis of the baseline characteristics revealed that unfavorable clinical features were in general associated with higher serum hepcidin levels. The cumulative incidence of ESKD was significantly differed by serum hepcidin levels, with the highest incidence in the 4th quartile (P &lt; 0.001, by log-rank test). Cox regression analysis demonstrated that, compared to the 1st quartile, the risk of incident ESKD is significantly increased in the 4th quartile (adjusted hazard ratio 1.372, 95% confidence interval 1.070 to 1.759). Penalized spline curve analysis illustrated a linear, positive correlation between serum hepcidin levels and the risk of incident ESKD. Subgroup analyses revealed that the association is significantly more prominent in the patients with advanced CKD (i.e., estimated glomerular filtration rate &lt; 45 mL/min/1.73 m2). Conclusion: Elevation in serum hepcidin levels is significantly associated with the risk of incident ESKD among the patients with pre-dialysis CKD.

The incidence of benign and malignant tumors among adults with long-term physical disabilities

People with long-term physical disabilities also suffer from different types and nature of tumors as well as general population. Unfortunately, the information about the frequency of these diseases among the specified contingent is very deficient. The objectives of the study were to determine the incidence of benign and malignant neoplasia among the adults and elderly with physical disabilities and to indicate the risk factors for the appearance and development of tumors in this population. In this descriptive survey, 186 people, living in the largest home on the Balkan Peninsula for adults and elderly people with long-term physical disabilities were studied in 2021. 82.79% of the residents were over 51 years of age and almost all of them are inhabited by two residents. 42.47% of the respondents were men and 57.52% – women. Data on the demographic characteristics of the respondents, including their personal lifestyle and self-reported diagnosis of presence and/or history of a tumor formation, were collected through a semi-structured interview. The verification of the collected information about the incidence of benign and malignant lesions among adults with physical disabilities was carried out by means of the application of the second research method – content analysis based on the medical records. For processing and analysis of the collected data, it was used statistical software – IBM SPSS Statistics V21.0. The results showed a significantly high rate in the prevalence of tumor formations in the sample – 24.19%. The pre-cancerous formations have the highest incidence among residents – 42.22% with the most common variant – chronic form of cholecystitis combined with cholelithiasis (37.77%). Prostatic hyperplasia and uterine leiomyoma are the leading benign lesions in male residents – 11.11%, in female respondents – 11.11% respectively. The predominant form of cancer is breast carcinoma – 8.88%. The research found a high prevalence of tumor formations among adult patients with long-term physical disabilities. The harmful impact of a number of behavioral habits and health determinants significantly contributes to this negative tendency.

Management Strategies and Outcomes of Type 2 Diabetes in Urban and Rural Populations of Bangladesh

Introduction: Type 2 diabetes (T2D) is a chronic metabolic disorder marked by insulin resistance and poses significant health risks, including cardiovascular diseases, vision impairment, nerve damage, and kidney failure. The disease is linked to a reduced life expectancy and increased risks for complications like dementia and cancer, highlighting the urgent need for effective management strategies tailored to urban and rural populations. Aim of the study: This study aimed to identify the management strategies and outcomes of T2D in urban and rural populations of Bangladesh. Methods: This cross-sectional study was conducted in the Department of Anaesthesia Analgesia and Intensive Care Medicine, National Institute of Cardiovascular Disease and Hospital (NICVD). Dhaka, Bangladesh during the period from July 2023 to Jun 2024. A total of 200 participants were included in the study, with 100 patients from urban areas and 100 from rural areas. The study encompassed both male and female participants, who underwent treatment in both indoor (hospital-based) and outdoor (outpatient) settings. Result: A total of 200 participants were included in the study, with 100 patients from urban areas and 100 from rural regions. Among urban respondents, 35% were aged 20-30, while the rural group had a higher representation in this age group at 45%. The study revealed that individuals with higher education levels in rural areas had a lower prevalence of T2D, while overweight participants had a higher incidence in both urban and rural settings. In rural regions, the risk of T2D was notably higher among those who consumed caffeinated drinks and were less physically active, while these factors did not significantly influence T2D risk in urban populations. Additionally, urban participants exhibited a correlation between T2D and hypertension. Conclusion: Our study presents a comprehensive strategy to tackle the rising prevalence of T2D in urban and rural areas. Key elements include promoting...

Network Pharmacology Approaches Used to Identify Therapeutic Molecules for Chronic Venous Disease Based on Potential miRNA Biomarkers.

Chronic venous disease (CVD) is a prevalent condition in adults, significantly affecting the global elderly population, with a higher incidence in women than in men. The modulation of gene expression through microRNA (miRNA) partly regulated the development of cardiovascular disease (CVD). Previous research identified a functional analysis of seven genes (CDS2, HDAC5, PPP6R2, PRRC2B, TBC1D22A, WNK1, and PABPC3) as targets of miRNAs related to CVD. In this context, miRNAs emerge as essential candidates for CVD diagnosis, representing novel molecular and biological knowledge. This work aims to identify, by network analysis, the miRNAs involved in CVD as potential biomarkers, either by interacting with small molecules such as toxins and pollutants or by searching for new drugs. Our study shows an updated landscape of the signaling pathways involving miRNAs in CVD pathology. This latest research includes data found through experimental tests and uses predictions to propose both miRNAs and genes as potential biomarkers to develop diagnostic and therapeutic methods for the early detection of CVD in the clinical setting. In addition, our pharmacological network analysis has, for the first time, shown how to use these potential biomarkers to find small molecules that may regulate them. Between the small molecules in this research, toxins, pollutants, and drugs showed outstanding interactions with these miRNAs. One of them, hesperidin, a widely prescribed drug for treating CVD and modulating the gene expression associated with CVD, was used as a reference for searching for new molecules that may interact with miRNAs involved in CVD. Among the drugs that exhibit the same miRNA expression profile as hesperidin, potential candidates include desoximetasone, curcumin, flurandrenolide, trifluridine, fludrocortisone, diflorasone, gemcitabine, floxuridine, and reversine. Further investigation of these drugs is essential to improve the treatment of cardiovascular disease. Additionally, supporting the clinical use of miRNAs as biomarkers for diagnosing and predicting CVD is crucial.

Targeting esophageal carcinoma: molecular mechanisms and clinical studies.

Esophageal cancer (EC)is identified as a predominant health threat worldwide, with its highest incidence and mortality rates reported in China. The complex molecular mechanisms underlying EC, coupled with the differential incidence of esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC) across various regions, highlight the necessity for in-depth research targeting molecular pathogenesis and innovative treatment strategies. Despite recent progress in targeted therapy and immunotherapy, challenges such as drug resistance and the lack of effective biomarkers for patient selection persist, impeding the optimization of therapeutic outcomes. Our review delves into the molecular pathology of EC, emphasizing genetic and epigenetic alterations, aberrant signaling pathways, tumor microenvironment factors, and the mechanisms of metastasis and immune evasion. We further scrutinize the current landscape of targeted therapies, including the roles of EGFR, HER2, and VEGFR, alongside the transformative impact of ICIs. The discussion extends to evaluating combination therapies, spotlighting the synergy between targeted and immune-mediated treatments, and introduces the burgeoning domain of antibody-drug conjugates, bispecific antibodies, and multitarget-directed ligands. This review lies in its holistic synthesis of EC's molecular underpinnings and therapeutic interventions, fused with an outlook on future directions including overcoming resistance mechanisms, biomarker discovery, and the potential of novel drug formulations.

A Study on Hollow Viscus Perforation in a Tertiary Care Hospital in South India.

Introduction Hollow viscus perforation refers to the perforation of the gastrointestinal tract, including the stomach, intestines, or other hollow organs, leading to leakage of the contents into the peritoneal cavity. This paper aims to explore the disease burden of hollow viscus perforation in Sree Balaji Medical College & Hospital in Chennai, India, and its relation to patients' age and sex and analyze the etiology of hollow viscus perforation. Materials and methods This single-center retrospective study was conducted between May 2022 and August 2023, with a sample size of 100 patients. Data were extracted from the hospital's medical records based on the study's parameters. Results Our study shows that among the study group, hollow viscus perforation was more common in males (n = 78; 78%) than females. The highest incidence was observed in the 41-50 age group (n = 35; 35%), with the mean age being 43 years. The most common cause of perforation was a duodenal ulcer. Wound infection was the most frequent postoperative complication, affecting less than one-third of the patients (n = 29; 29%), followed by pneumonia and acute respiratory distress syndrome. Although large intestinal pathology affected only eight patients in the sample, it showed a high case fatality rate, with one-quarter of the patients (n = 2; 25%) succumbing to the condition. Conclusion Hollow viscus perforation is a life-threatening condition that requires prompt recognition and treatment. The etiology is diverse, ranging from peptic ulcer disease and malignancy to trauma and inflammatory conditions. Early diagnosis and aggressive management are essential for improving the outcome for patients with this condition.

Characteristics of Lumbar Pars Interarticularis and Pedicle Stress Injuries by Sport in 902 Pediatric and Adolescent Athletes: A Retrospective Study

Background: Recent studies utilizing magnetic resonance imaging (MRI) for the evaluation of symptomatic lumbar spondylolysis in pediatric and adolescent athletes have indicated that upper level lumbar involvement has a higher incidence than previously reported. There has been a paucity of literature evaluating sport-specific patterns of lumbar spondylolysis, specifically upper versus lower level involvement. Purpose: To assess the potential risk factors for upper level stress injuries of the lumbar spine in pediatric and adolescent athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: The medical records of 902 pediatric and adolescent athletes (364 female, 538 male; mean age, 14.5 ± 2.1 years) diagnosed with symptomatic pedicle and pars interarticularis stress injuries at 2 academic medical centers (July 2016 to June 2021) were reviewed. All patients had undergone MRI at the time of diagnosis. Only patients with pars/pedicle edema on MRI were included. Data regarding single-sport specialization, sport participation, sport category by biomechanics (axial rotation vs extension/axial loading), and vertebral level of injury over the 5-year period were analyzed. Stress reaction or active spondylolysis (SRAS) was the terminology used to designate grade 1, 2a, or 3 stress injuries according to the adapted Hollenberg classification system on MRI. Upper level vertebrae were defined as L3 or superior, whereas lower level vertebrae included L4 or inferior. Results: Of the 902 patients with SRAS injuries, most (n = 753 [83.5%]) had exclusively single-level lower stress injuries, while 67 (7.4%) had multilevel stress injuries. There were 82 athletes (9.1%) who had single-level upper stress injuries. Athletes with upper level pars/pedicle stress injuries were older at the time of diagnosis (15.8 ± 1.9 vs 14.3 ± 2.1 years, respectively; P < .001), had a shorter duration of low back pain before presentation (2.50 ± 2.70 vs 4.14 ± 6.73 months, respectively; P < .001), were more likely to specialize in a single sport (43.9% vs 32.3%, respectively; P = .046), and had a lower incidence of active spondylolysis on MRI at the time of diagnosis (42.7% vs 59.8%, respectively; P = .004) compared with athletes with lower level stress injuries. Athletes with lumbar stress injuries who specialized in a single sport had nearly twice the odds of having upper level involvement compared with multiple-sport athletes (adjusted odds ratio, 1.80 [95% CI, 1.06-3.04]; P = .03). Athletes with active spondylolysis on MRI at the time of diagnosis had nearly half the odds of having upper level involvement (adjusted odds ratio, 0.55 [95% CI, 0.33-0.91]; P = .02). Conclusion: Age at the time of diagnosis, duration of low back pain, single-sport specialization, and presence/absence of active spondylolysis on MRI at the time of diagnosis were primary predictors of whether an athlete’s lumbar stress injury was classified as either upper or lower level involvement. Overall, the variables included in multivariate analysis were modest predictors, explaining only 15.1% of the variance in the rates of lumbosacral stress injuries classified by spinal level. These specific biomechanical factors and other potential contributors to these findings warrant further investigation.

Research Progress on Photothermal Therapy of Malignant Tumor Cells

Malignant tumors, also known as cancer, are among the diseases with the highest incidence and mortality rates in the world. Photothermal therapy (PTT) involves injecting materials with high photothermal conversion efficiency (PTA) into the human body and using the principle of photothermal conversion to kill malignant tumor cells at the lesion site with high temperatures. This paper reviews various methods of photothermal therapy for malignant tumors, summarizes the basic therapeutic logic of photothermal therapy, and forecasts the future development prospects of this treatment method.

Cutaneous tuberculosis of the pinna: A rare entity

IntroductionCutaneous tuberculosis (CTB) is a rare form of extrapulmonary tuberculosis (TB), accounting for only 1% to 2% of all extrapulmonary cases. It typically affects the face, and to a lesser extent, the neck or chest, with a higher incidence among young women. In Malaysia, TB is endemic; however, CTB involving the pinna is exceptionally rare. Consequently, there is often a delay in diagnosis and treatment due to frequent.AimThis case report aims to emphasize the presentation, diagnosis, and subsequent management of cutaneous pinna tuberculosis, supplemented by a review of the existing literature on this disease.Case studyWe present an 83-year-old patient with painful left auricular swelling and deformity and pus discharge for 4 months. His condition did not improve despite prolonged antibiotics treatment and multiple incision and drainage done.Results and discussionExamination under anaesthesia, wound exploration extended incision and drainage was performed, revealing auricular cartilage necrosis, tissue biopsy confirmed the presence of &lt;i&gt;Mycobacterium tuberculosis&lt;/i&gt;.Conclusions(1) A non-healing auricular wound despite adequate antibiotics treatment should raise suspicion of TB. (2) Bactec is the most rapid and sensitive culture for tuberculosis. (3) Complications of pinna TB include pain, non-healing wound and permanent ear deformity.

Survey on the occurrence of Aspergillus section Nigri species in grapes cultivated in Umbria (central Italy) and influence of several factors on their distribution

AbstractSecondary bunch rots caused by Aspergillus species belonging to the section Nigri, commonly called black aspergilli, pose a serious threat to grapes yield and quality. Due to their ability to produce ochratoxin A (OTA), they are considered the primary source of contamination of this mycotoxin in grapes. In this study, a three-year survey was realized to assess the occurrence of black aspergilli in grapes harvested in the Umbria region, a very important grapevine cultivation area in central Italy, by fungal isolation and phylogenetic analysis. In addition, the influence of growing season, vineyard location, farming system and grapes growth stages on black aspergilli distribution was examined. Phylogenetic analysis of the 208 obtained isolates showed the presence of three black aspergilli species: Aspergillus tubingensis, Aspergillus welwitschiae and Aspergillus uvarum. Interestingly, A. carbonarius, one of the most important OTA producers, was not detected in the surveyed years. A. tubingensis, whose ability to produce OTA is controversial, was always the most isolated species followed by A. welwistichiae (OTA producer). The species A. uvarum (unable to produce OTA) was detected only in one surveyed year with a low incidence. A. tubingensis was always the species with the highest incidence, regardless of location, and farming system. Growth stage appeared to influence the incidence of the three species, that, in the case of A tubingensis, was lower during setting in comparison to berries pea-size and berries harvest-ripe. Finally, in the setting and berries pea-size stages, a stereomicroscope analysis, showed that flower debris was the substrate from which black aspergilli mainly developed prior to colonizing berries and bunches.