Incidence Of Lesions Research Articles

Non-Conventional Dysplasia in Patients with Inflammatory Bowel Disease and Colorectal Adenocarcinoma: A Case-Cohort Study.

Patients with inflammatory bowel disease (IBD) face increased risk of colorectal cancer (CRC). While the natural history of conventional dysplastic precursor lesions has been well-studied, the neoplastic potential of recently described non-conventional (NC) IBD-associated colonic mucosal lesions is unclear. We aimed to assess the incidence of antecedent NC lesions in patients with IBD who developed CRC. A case-cohort study was performed to include patients with a diagnosis of IBD with or without CRC who underwent at least two surveillance endoscopic procedures at our institution between 1/1/2007 and 5/31/2023. NC lesions included serrated change and indefinite for dysplasia. Detection rates pre- and post-introduction of high definition (HD) surveillance colonoscopy were compared. In total, 87 patients with IBD and CRC and 200 patients with IBD without CRC were identified. Of the cases, a majority had ulcerative colitis (n=52, 60%), most commonly with extensive involvement (n=46, 89%). Conventional (HR 2.18, 95% CI 1.34-3.52) and NC (HR 2.28, 95% CI 1.59-3.26) lesions were associated with increased risk of CRC. Conventional lesions in the post-HD era appeared to have a stronger association with CRC (HR 2.79, 95% CI 1.62-4.77) than NC lesions (HR 1.62, 95% CI 0.86-3.06). Both conventional and NC lesions seem to be associated with increased risk of CRC. Conventional lesions are more strongly associated with CRC than NC lesions in the post-HD era, but misclassifications in the pre-HD era may have resulted in a biased increased risk estimate for NC lesions.

Predictors of subclinical metastasis to non-sentinel lymph nodes for patients having clinically localized cutaneous melanoma

Introduction. The use of modern adjuvant drug therapy in cases of cutaneous melanoma with sentinel lymph node (LN) (SLN) metastases reduced frequency of performance of completing lymphadenectomy. However, until now, domestic and foreign clinical recommendations indicate possibility of using this procedure in patients with an unfavorable prognosis while criteria are not provided for assessing the risk of non-sentinel LN (NSLN) damage and the need to perform lymphadenectomy.Aim. To identify predictors of high risk of metastasis in NSLN in patients with cutaneous melanoma with subclinical metastases in SLN.Materials and methods. The study included 92 patients with clinically localized cutaneous melanoma (cT1–4N0M0), who showed subclinical lesions as a result of SLN biopsy, and therefore underwent a final lymphadenectomy.Results. In the examined group, 26 (28.3 %) patients, along with SLN lesions, showed metastases in NSLN. Recognition of several active LNs during radionuclide mapping of SLNs is associated with a significantly higher risk of NSLN damage – in 42.3 % vs 15.2 % in the group with radiopharmaceutical activity only in SLNs (p = 0.018). Tumors thickness of >2 mm is also associated with a high frequency of NSLN metastasis (100 % of cases). No metastasis to other LNs was observed in tumor thickness of <2 mm. In ulcerated melanomas, the incidence of NSLN lesions was 92.3 % (p = 0.02). Only subcapsular localization of SLN metastases is associated with a relatively low incidence of NSLN metastasis (13.3 % of cases) as compared with parenchymal, mixed localization, and multifocal lesion (42.9 % of cases) (p = 0.002). For SLN metastases > 4 mm in size, a incidence of NSLN damage was higher than for metastases of <4 mm in size (43.3% vs 19.3%; p <0.05), as that for invasion of LN structures of > 2 mm in size versus invasion of <2 mm in size (44.4% vs 15.7 %; p = 0,003). The identified predictors of NSLN involvement in practice are often combined forming a pattern of predictors. The number of prognostic parameters in the pattern has a significant effect on the incidence of NSLN lesions (<0.001). In particular, the presence of 2 or less predictors is associated with low risk of metastasis in NSLN (0–12.5 % of cases), 3-5 predictors - with a relatively high risk (37.5–44.4 % of cases), 6 predictors – with a very high risk (80 % of cases).Conclusion. Recognition of predictors of metastasis in NSLN and their number allows us to decide on the need to perform final lymphadenectomy in patients with cutaneous melanoma with subclinical metastases in SLN. Conducting the final lymphadenectomy in patients with a high risk of multiple lesions of regional LNs will provide better locoregional control over stage III cutaneous melanoma and will create optimal conditions for adjuvant drug therapy.

Incidence of the Pathological lesions in Lung and Associated Lymph Nodes of Slaughtered Cattles in Babylon Abattoir

Incidence of the Pathological lesions in Lung and Associated Lymph Nodes of Slaughtered Cattles in Babylon Abattoir

Internal carotid dissection after the motorcycle accidents

Dear Editor, Extracranial carotid artery dissection (CAD) is one of the major consequences of blunt head and neck trauma, and a main etiology of ischemic stroke in young adults; the carotid lesions are described in accidents of motorcycle drivers with or without the helmet [1-5]. Blunt cervical vascular injury is a nonpenetrating trauma to the carotid or vertebral arteries caused either by direct neck injury or by the shearing of these cervical vessels; the estimated incidence of vascular lesions is low, only near 1% of the blunt trauma.

An Investigation of Dairy Cattle Welfare in Commercial Iranian Farms: Results from Animal- and Stockperson-Based Measures

Dairy cow welfare can impact both the economic performance of an individual farm and the public perception of the sector, thus influencing the sustainability of the dairy farming industry. Intensive dairy farming in Iran started in the 1940s, but there is limited data available regarding dairy cattle welfare in the country. Therefore, the aim of this study was to design and use a comprehensive bespoke welfare assessment protocol in intensive Iranian dairy farms to provide baseline data for Iran and other countries with similar farming systems. The protocol consists of animal-based, stockperson-based, and resource-based measures. The first part of the welfare assessment protocol (being presented in this paper) was developed from the existing literature and contained 11 animal-based and 2 stockmanship measures. The protocol was applied in 62 intensive dairy cattle farms in five arid and semi-arid provinces of Iran. Welfare Quality sample size suggestions were used to reach the minimum sample size for all animal-based measures except for the locomotion score, where either the whole milking herd was scored or all cows in the early lactation (<150 days in milk) group. Results show that there was a good focus on nutrition management on the farms. Lameness prevalence and the incidence of hock lesions were too high, although within the range seen in many housed cows outside Iran. In addition, 13.5% of cows had damaged ears. The prevalence of dirty legs was high (≥80% of cows), and the hygiene score was unrelated to the farming system. Finally, the extremely high median prevalence of tail damage (60%) indicates a significant welfare issue that needs to be addressed with urgency.

The timing and safety of topical timolol treatment for superficial infantile hemangioma: a retrospective cohort study

Numerous studies have shown that topical timolol is effective in treating infantile hemangioma (IH) with minimal adverse events. However, consensus is lacking on optimal timing, dosage, frequency, and safety parameters for this treatment. This study aims to explore the timing and safety of topical timolol treatment for superficial IH. A retrospective analysis included pediatric IH patients who underwent topical timolol treatment at the Department of Pediatric Surgery of Sichuan Provincial People’s Hospital between January 2019 and January 2023. Medical records were reviewed for patient information, lesion characteristics, outcomes, and complications. Topical timolol was administered to 666 IH patients. Median follow-up was 10 months. 480 cases had excellent or good outcomes, while 186 had fair or poor outcomes. Patients ≤ 3 months had better outcomes than those > 3 months (Z = 4.713, P < 0.001). Small IH had better outcomes than large IH (Z = 1.991, P = 0.046). Lesion locations did not significantly affect outcomes (H = 10.252, P = 0.114). Respiratory problems occurred in 58 (8.7%) cases, localized skin irritation occurred in 48 (7.2%) cases, sleep disturbance occurred in 30 (4.5%) cases, and residual skin lesions occurred in 26 (3.9%) cases. In 59 (8.8%) cases the IH had relapses.Conclusions: Topical timolol is safe and effective for IH. Patients who are aged 1 < months ≤ 3 or have small (1.5 cm < max diameter ≤ 5 cm) IH are more likely to experience better outcomes. It also may reduce the incidence of residual skin lesions and relapse. Therefore it may be a useful alternative therapy option for superficial IH.What is Known:• β-blockers are now considered to be first-line treatment of infantile hemangioma.• Topical timolol treatment is safe and effective for infantile hemangioma.What is New:• Patients who are aged ≤ 3 months or have a max diameter ≤ 5 cm infantile hemangioma are likely to experience better outcomes by topical timolol treatment.• Topical timolol treatment may reduce the incidence of residual skin lesions and infantile hemangioma relapses.

Preventing and management of mouth ulcers caused by orthodontic

Orthodontic-induced mouth ulcers are a common complication arising from mechanical irritation and increased plaque accumulation during treatment. These painful lesions significantly impact the comfort and compliance of patients undergoing orthodontic care. Various factors contribute to their development, including appliance design, oral hygiene, dietary habits, stress, and systemic conditions like nutritional deficiencies. Effective prevention and management strategies are essential to mitigate these effects and enhance patient outcomes. Prevention focuses on minimizing mechanical trauma through improved appliance designs such as rounded brackets and self-ligating systems, and the use of protective barriers like orthodontic wax and silicone strips. Maintaining optimal oral hygiene with adjunctive tools, antimicrobial rinses, and dietary adjustments plays a pivotal role in reducing plaque accumulation and preventing mucosal injuries. Behavioral interventions, including stress management and addressing parafunctional habits, further support ulcer prevention. Management approaches include the use of topical treatments like corticosteroid-based ointments and bio-adhesive gels to alleviate pain and promote healing. Low-level laser therapy (LLLT) accelerates tissue repair and provides analgesic effects, emerging as an effective adjunctive treatment. In more severe cases, systemic antibiotics or anti-inflammatory medications may be employed to control secondary infections and support immune responses. Patient education is critical in ensuring adherence to these strategies, emphasizing the importance of dietary modifications, stress control, and consistent oral care. Comprehensive care combining innovative technologies, evidence-based treatments, and personalized patient support addresses both the etiology and impact of orthodontic-induced ulcers. These integrated strategies not only reduce the incidence and severity of lesions but also improve overall patient satisfaction and treatment compliance. As advancements in materials and therapeutic modalities continue, the potential for enhanced outcomes in orthodontic care grows, ensuring better quality of life for patients during treatment.

Impact of HPV Catch-Up Vaccination on High-Grade Cervical Lesions (CIN2+) Among Women Aged 26-30 in Northern Norway.

Human papillomavirus (HPV) is the primary cause of high-grade cervical lesions and cervical cancer worldwide. In Norway, HPV vaccination was introduced in 2009 for seventh-grade girls and extended through a catch-up program from 2016 to 2019 for women born between 1991 and 1996. This study evaluates the impact of the catch-up vaccination program on the incidence of HPV and high-grade cervical lesions in Troms and Finnmark. We analyzed data from 40,617 women aged 26 to 30 who underwent cervical screening between 2009 and 2023 in Troms and Finnmark, including 1850 women with high-grade cervical lesions (CIN2+) on biopsy. Using linear regression, we assessed trends in high-grade lesion incidence per 1000 screened women and the association between vaccination status and HPV-16/18 incidence. Between 2017 and 2023, the incidence of high-grade cervical lesions significantly decreased: CIN2+ decreased by 33.4%, and CIN3+ decreased by 63.4%. Significant reductions in HPV-16/18-associated high-grade cervical lesions were observed among vaccinated women, with the proportion of CIN2+ cases due to HPV-16 and 18 decreasing from 56.8% in 2017 to 40.7% in 2023, reflecting a 55.8% reduction in the absolute number of cases caused by these high-risk HPV types. Comparing unvaccinated women aged 25-26 in 2016 and vaccinated women in 2023, HPV-16 incidence decreased from 5.1% to 0.1%, and HPV-18 incidence decreased from 3.3% to 0.0%. The catch-up vaccination program significantly reduced the incidence of HPV-16/18 and high-grade cervical lesions in Troms and Finnmark, even with the lower vaccination coverage observed in the catch-up program. These findings demonstrate the effectiveness of HPV vaccination programs in reducing HPV infections and associated cervical lesions.

Analysis of the clinicopathological and imaging features in breast intraductal papillary lesions with or without pathological nipple discharge

With the popularity of breast screening, more and more intraductal papillary lesions (IDPL)were detected by ultrasound or mammography, which is a spectrum of diseases ranging from benign to malignant lesions. Patients with pathological nipple discharge (PND) may indicate IDPL, but it is difficult to clarify their biological characteristics before the operation. As to patients with IDPL without PND, it is even an enormous challenge to differentiate their benign or malignant characteristics. Therefore, to avoid inadequate treatment, it is necessary to analyze the clinicopathological and imaging characteristics of patients with papillary lesions before surgery for the preliminary diagnosis of benign or malignant papillary lesions. 267 cases of IDPL with or without PND, namely PND group and non-PND group, were studied using continuous clinical data from October 2020 to September 2023. We analyzed the clinicopathological and imaging characteristics in the two groups of patients with malignancy compared with benign patients. Meanwhile, these characteristics were analyzed in malignant papillary patients with PND or not. 267 patients were pathologically diagnosed with IDPL during three years, accounting for 15.4% of surgical cases of the same period. There were 55 patients with malignant lesions (20.6%), including 28 cases in the PND group (16.5%) and 27 cases in the non-PND group (27.8%), and the incidence of malignant lesions was higher in the non-PND group than that of the PND group. There was a close correlation between age and malignant lesions in the two groups; the number of patients older than 50 years in malignant patients (74.5%) exceeded that of benign patients (42.5%). There were nearly one-third of malignancies in patients with nipple bloody discharge, and the rate increased to 50% when the patient was older than 50 years, but the malignant rate was meager in patients without bloody discharge. There were some factors relating to malignancy in non-PND patients, including age, lesion size, the distance from the nipple to the lesson (DFNL), and abnormal mammogram; there was a significant difference in this positive manifestation between benign and malignant patients. In malignant intraductal papillary lesions, 40.8% of the cases were invasive carcinoma in the non-PND group, higher than in the PND group (10.7%). Meanwhile, immunohistochemistry was more likely to be hormone receptor-positive (92.6%) and Her-2 negative in the non-PND group, compared with the PND group. Breast IDPL is a common disease, among which malignant lesions are higher than reports in previous literature. There are some clinical and imaging manifestations indicating malignancy; patients more than 50 years old with bloody nipple discharge are at high risk of malignancy. When old non-PND patients have more significant lesions, remote DFNL, and abnormal mammograms, there is a high probability of malignancy in them. Although there are different biological characteristics in malignant IDPL with or without PND, they are all low-grade malignancies compared with traditional breast cancer.

Prevalence, Incidence and Predictors of Anal HPV Infection and HPV-Related Squamous Intraepithelial Lesions in a Cohort of People Living with HIV.

Background: Anal HPV infection can cause squamous intraepithelial lesions (SILs), which are precursors of anal squamous cell carcinoma (SCC). The early detection of HPV infections and improvement of effective screening programmes are, therefore, essential to prevent progression from pre-cancerous lesions to SCC, especially in people living with HIV (PLWH), who represent a population at higher risk of HPV infection and associated lesions. Among prevention strategies, HPV vaccination is relevant too, but its efficacy in persons already infected by HPV is still debated. Methods: This is a retrospective single-center study on a cohort of PLWH who performed longitudinal screening for anal dysplasia and HPV infection. The screening included cytological and molecular analyses. Results: A total of 110 PLWH performed at least one anal HPV screening, with an overall prevalence of HPV infection of 86.4% [23.6% low risk (LR)-HPV and 62.7% high risk (HR)-HPV genotypes]. Abnormal cytology was demonstrated in 39.1% of subjects, of whom ASCUS 6.4%, LSIL 30.9% and HSIL 1.8%. In total, 80 patients (72.7%) had an available longitudinal screening. No patient developed SCC during follow-up. However, a high incidence of new cytological abnormalities and new HPV infections was observed. On the other side, clearance of some HPV genotypes was also frequent, confirming that HPV infection is a dynamic process. A CD4 cell count > 500/mmc was an independent predictor of HPV clearance. HPV vaccination was performed on 30.9% of patients. A trend toward an increased clearance of HPV genotypes included in 9-valent vaccine was observed in vaccinated patients (40.6% versus 30.8% in unvaccinated, p = 0.079). Conclusions: A high prevalence of HPV infection and SILs was observed in our cohort of PLWH. A high incidence of new HPV infections and HPV-associated lesions was also observed in the longitudinal cohort, highlighting the need of strengthening immunization programs and continuous screening for anal HPV infection. Whether HPV vaccination may be efficacious in patients already infected by HPV remains to be determined.

Comprehensive Clinicopathological Analysis of Oral Reactive Hyperplastic Lesions Diagnosed in Libyan Population: Cross-Sectional Multicentric Study

Oral reactive hyperplastic lesions (ORHLs) are non-neoplastic tumor-like hyperplasia frequently developing in the oral mucosa due to chronic inflammation caused by many low-grade irritations. They are relatively common, and their clinical appearance resembles neoplastic proliferations. This study aims to determine the prevalence and distribution of ORHLs based on WHO's head and neck tumor classification (2022) in the Libyan population over the last 20 years and compare the results with previous literature. In this retrospective study, all the records of histologically diagnosed ORHLs between 2002 and 2023 collected from the Tripoli University Hospital and Saray Salam Center in Tripoli, Libya, were reviewed. Information regarding the age at diagnosis, gender, site affection, and histopathological diagnosis was extracted and analyzed using SPSS statistical software (V.26) using the Chi-square test. ORHLs constituted 14.5% of the total diagnosed cases (335/3210) in registered oral and maxillofacial biopsies. Pyogenic granuloma (PG) was the most common type of ORHL (48%) followed by irritational fibroma (IF) (30%), and peripheral giant cell granuloma (PGCG) (8%). The peak incidence of ORHLs was in the third and fourth decades (37.6% and 32.8% retrospectively), with an overall age at onset of diagnosis (Mean ± SD 36.4±7). The relationship between the age categories and ORHLs was statistically significant (P=0.03). Female predominance was found in all lesions with a ratio (2:1). Gingiva was the most prevalent anatomical location for ORHLs, accounting for 31% of cases. There have been some similarities and inconsistencies between our findings and previous studies involving various populations. We found a clear geographic difference in the relative incidence of oral reactive lesions in each Libyan governorate. The occurrence of ORHRLs in different nations can be retrospectively evaluated to improve knowledge of ORHLs, which is critical for pathologists and oral and maxillofacial surgeons.

Поражение костей у взрослых пациентов с болезнью Гоше I типа: распространенность, клинические особенности, костно-суставные осложнения и проблемы инвалидизации

BACKGROUND. Although highly effective enzyme replacement therapy (ERT) for Gaucher disease (GD) is accessible and affordable, orthopedic issues in patients appear often to be the main factor leading to their disability. Bone lesions are essentially observed in 100 % of GD patients. The nature and severity of bone and joint changes, however, are reported to be extremely heterogeneous, whereas their incidence and clinical features have until now remained underresearched. AIM. To assess the incidence and clinical value of bone and joint lesions which complicate the course of GD type 1 with bone involvement. MATERIALS &amp; METHODS. This trial enrolled 267 GD type 1 patients aged 17–85 years (median 38 years), who were followed-up at the National Research Center for Hematology from 2004 to 2024. There were 109 men and 158 women. The analysis focused on the following MRI findings: bone marrow infiltration (BMI), Barnett-Nordin cortical index (BNI), bone deformity, osteolytic and osteonecrotic lesions, as well as orthopedic pathologies progressing to disability. RESULTS. BMI was identified in 213/267 (79.8 %) patients. Erlenmeyer flask-like femoral expansion was observed in 95 % patients (n = 254). The mean BNI was 42.9 % (the normal BNI in adult population exceeds 45 %). Low BNI values were associated with osteolytic lesions, disability, and BMI. No significant association of decreased BNI was seen with osteonecroses. The incidence of osteolytic lesions was 11.2 % (n = 30). New osteolytic lesions were reported neither in ERT nor in substrate reduction therapy recipients. Medullary osteonecrosis was detected in 206/267 (77.15 %) patients, and epiphyseal osteonecrosis was identified in 74/267 (27.72 %) patients. Along with osteonecroses, in contrast to osteolytic manifestations, new lesions (n = 8) were reported to occur under long-term (&gt; 5 years) ERT. The rate of bone fractures was 6.7 % (n = 18). In 18 patients, 64 fractures were observed at various locations. Disability associated with bone and joint complications of GD occurred in 58/267 (21.72 %) patients. After reconstructive surgery, including total articular replacement arthroplasties, 37 patients achieved complete functional recovery. CONCLUSION. Bone changes are essentially observed in all adult patients with GD type 1. However, clinical severity and disability of patients depend on secondary bone and joint complications, among them arthroses resulting from epiphyseal osteonecrosis, pathologic fractures, bone and joint infections. These complications developing on effective ERT were identified in 67/267 patients, which accounted for 25 %.

Cystic parathyroid lesion: case report of rare entity

Introduction and importance: Parathyroid cysts are rarely encountered in neck surgery and often misdiagnosed. We review the case incidence and treatment of parathyroid cystic lesions among all neck procedure in two single institutions operated on by a single surgeon. Case presentation: We report two female patients presenting with neck swallowing, dysphagia, choking and occasional dysphonia. Ultrasound US (ultrasound) imaging revealed two neck masses of 66 × 44 mm and 44 × 25 × 23 mm; serum iPTH (intact Parathyroid Hormone) levels were 238 and 699 ng/mL respectively and sestamibi scintiscan results were negative for both masses. Intra-cystic fluid evaluation of PTH showed elevated value (&gt;5000 ng/ml). Both patients underwent parathyroidectomy along with total thyroidectomy and thyroid lobectomy. Post-operatively I-PTH and serum calcium levels became normal. Final histology confirmed a benign parathyroid cystic adenoma with concomitant benign thyroid disease. Clinical discussion: Parathyroid cyst is of rare entity and a diagnostic challenge. Conclusions: This case report demonstrates that fine needle aspiration (FNA) fluid with intra-cystic parathyroid analysis shows to be fundamental and supports surgery for hyperparathyroidism resolution.

Prevalence and outcomes of nonmass lesions detected on screening breast ultrasound based on ultrasound features.

To determine how often non-mass lesions are seen in screening breast ultrasounds, and analyze their ultrasound features according to the ultrasound lexicon to find features suggestive of malignant non-mass lesions. This study is a single center retrospective study for nonmass lesions on screening breast ultrasound. Among 21,604 patients who underwent screening breast US, there were 279 patients with nonmass lesions. Of these lesions, 242 lesions were included for analysis. To distinguish between benign and malignant nonmass lesions, univariate analysis was performed on size, echogenicity, distribution, orientation, and associated ultrasound features. Additionally, Fisher's exact test was performed for mammographic density and abnormalities. 279 patients with nonmass lesions were included (mean age 53.7 ± 9.7years, all women). The incidence of nonmass lesions on screening breast ultrasound was 1.29% with positive predictive value of 5.78%. The most common malignant nonmass lesion was ductal carcinoma in situ. Nonparallel orientation (p = 0.002), echogenic rim (p = 0.005), architectural distortion (p = 0.0004), posterior shadowing (p = 0.007), vascularity (p < 0.001), and calcifications (p < 0.001) were indicators of malignant lesions. Additionally, mammographic abnormalities were significantly associated with malignant lesions (p < 0.001). The incidence of nonmass lesions on screening breast ultrasound was 1.29%, with a positive predictive value of 5.78%. Mammographic abnormalities, nonparallel orientation, architectural distortion, posterior shadowing, vascularity, and calcifications were associated with malignant nonmass lesions.

Prevalence, Incidence and Risk Factors of White Spot Lesions Associated With Orthodontic Treatment – A Systematic Review and Meta‐Analysis

ABSTRACTThe primary objective was to systematically assess the prevalence, incidence and risk factors of WSLs with orthodontic treatment. The secondary objective was to compare the prevalence of WSLs between conventional fixed appliances (CFA) and other appliances, as well as with no treatment. PubMed, Scopus, Web of Science, LILACs, Virtual Health Library and Cochrane CENTRAL were searched. Risk of bias was assessed using RoB‐2, ROBINS‐I tool and the Joanna Briggs Institute Critical Appraisal Checklist. Random‐effects meta‐analyses of pooled proportions and odds ratios (OR) with 95% confidence intervals (CIs) were conducted, followed by meta‐regressions, sensitivity analyses, and an assessment of the quality of evidence using GRADE. Trial Sequential Analysis (TSA) was performed to determine the conclusiveness of the evidence. Fifty‐seven studies involving 9101 patients (mean age of 16.4 years, 33.5% male) were included. Among orthodontic patients, the pooled prevalence of WSLs was 55.06% (95% CI: 47.7%, 63.6%: 42 studies), incidence was 34.2% (95% CI: 27.6%, 40.6%: 44 studies) and surface prevalence was 26.9% (6 studies; 95% CI: 13.8%, 39.8%). Among non‐treated patients, the pooled prevalence of WSLs was 29.1% (95% CI: 17.2%, 41.1%; 21 studies). The odds of WSLs were significantly higher, with CFA being 4.73 times greater compared to other appliances (OR = 4.7, 95% CI: 1, 19.2, p = 0.05) and seven times higher compared to no treatment (OR = 7, 95% CI: 2.6, 18.5, p = 0.001). Prevalence of WSLs increased with longer treatment duration (p &lt; 0.001), varied with ethnicity, being highest in Africans and lowest in Americans (p &lt; 0.05), and method of detection (p &lt; 00.1). TSA confirmed that CFA leads to more WSLs than other appliances or no treatment, with future studies unlikely to alter the direction of the outcomes. Orthodontic treatment increases WSL prevalence, influenced by various factors. Clinicians should carefully consider the development of WSLs during orthodontic treatment and adjust treatment plans accordingly, choose appliances wisely and monitor with effective detection tools. Since one‐third of untreated cases already have WSLs, proper documentation at treatment start is essential.Trail Registration: CRD42023478065

Environmental and management determinants of blackleg crown canker disease (Leptosphaeria maculans) of canola (Brassica napus)

AbstractBlackleg disease (Leptosphaeria maculans) impacts canola (Brassica napus) productivity worldwide, but the factors driving severity are not well defined. This study characterised blackleg disease progression from leaf lesion appearance to crown canker development. Leaf lesion severity at four crop growth stages and crown canker severity were empirically associated in crops planted at different times. The biotrophic growth rate of L. maculans in planta was determined at temperatures between 12 and 28 °C. Data from 24 Australian field experiments on spring B. napus cultivars were analysed to relate infection timing relative to crop growth stage and site conditions to crown canker severity at maturity. Despite variations in lesions across seasons and planting times, no significant relationship was found between lesion severity or incidence and crown canker severity. Crown canker severity increased significantly when younger plants were infected. The average in planta hyphal growth rate of L. maculans was 0.13 mm/°C-day. The analyses of biotrophic hyphal growth alongside the timing of infection were used to identify the onset of crown canker development. Simulations showed that thermal time and plant available water accounted for 61% and 36% of the variance in crown canker severity for moderately susceptible and moderately resistant genotypes, respectively. Blackleg crown canker severity is a nuanced interplay between time of infection relative to crop growth stage, genetic resistance, temperature, and moisture. Disease-crop models incorporating these factors could be used to explore how, for example, sowing time, level of host genetic resistance or extreme weather conditions affect disease infection and crop yield.

SYNTAX I score is associated with genetically confirmed familial hypercholesterolemia in chinese patients with coronary heart disease

BackgroundFamilial hypercholesterolemia (FH) is a genetically inherited disorder caused by monogenic mutations or polygenic deleterious variants. Patients with FH innate with significantly elevated risks for coronary heart disease (CHD). FH prevalence based on genetic testing in Chinese CHD patients is missing. Whether classical index of coronary atherosclerosis severity can be used as indicators of FH needs to be explored. To investigate the FH prevalence in Chinese CHD patients and the association of SYNTAX I score with FH genotype.MethodsThe monogenic and polygenic FH related genes were genotyped in 400 consecutively enrolled CHD patients. The clinical characteristics and SYNTAX I scores were analyzed in a retrospective nested case–control study.ResultsThe prevalence of genetically confirmed FH in our CHD cohort was 8.75%. The cLDL-C level, SYNTAX I scores and incidences of triple vessel lesions in FH patients were significantly higher, while cLDL-C and SYNTAX I scores were independent risk factors for FH. Furthermore, cLDL-C levels of polygenic FH were significantly lower than monogenic FH, while their severity of coronary atherosclerosis was comparable.ConclusionsOur study revealed that the SYNTAX I score was an independent risk factor for FH. Besides, polygenic origin of FH should be taken into consideration for CHD patients suspected of FH.Graphical

Retrospective comparative analysis of human fascioliasis versus bacterial liver abscess.

This study aimed to compare the clinical characteristics of human fascioliasis and bacterial liver abscesses to provide a reference for the early and effective differentiation of these 2 diseases to avoid misdiagnosis. We retrospectively compared the epidemiological and clinical characteristics of 95 patients with human fascioliasis and 95 with bacterial liver abscess admitted to the First Affiliated Hospital of Dali University between January 2013 and March 30, 2023. The human fascioliasis group exhibited a higher proportion of female patients and a greater frequency of abdominal pain and lesions affecting both lobes of the liver. Additionally, eosinophil count, percentage of eosinophils, red blood cells, hemoglobin, total protein, albumin, carbohydrate antigen-125 (CA-125), CA-199, and CA-724 levels were elevated compared to the bacterial liver abscess group. Conversely, the proportion of patients with diabetes, duration of hospital stay, and the incidence of lesions affecting the right lobe of the liver, cavity formation, ascites, pleural effusion, white blood cells, total bilirubin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were lower in the fascioliasis group compared to the bacterial liver abscess group. Furthermore, higher thrombin time and fibrinogen levels were observed in the fascioliasis group than in the bacterial liver abscess group (P < .05). Human fascioliasis predominantly occurs from August to November, while bacterial liver abscess exhibits a consistent incidence throughout the year. Human fascioliasis predominantly affects young women and demonstrates a seasonal pattern. It is associated with severe abdominal symptoms, widespread lesions, significantly elevated eosinophil levels, and seasonal incidence. Bacterial liver abscess predominantly affects elderly men with diabetes, and it is associated with localized lesions and severe inflammatory manifestations and occurs throughout the year.

Vertebral osteomyelitis: a comparative, single-center study in northwestern China

Background Vertebral osteomyelitis (VO) is an infection of the spine with increasing prevalence due to improved diagnostics and aging populations. Multiple pathogens, including Mycobacterium tuberculosis, Brucella spp., and pyogenic bacteria, can cause VO, making differential diagnosis complex, especially in regions with endemic brucellosis and tuberculosis. Early and accurate diagnosis is essential for appropriate treatment. Methods This was a single-center, retrospective, observational study performed between 2019 and 2022 in Kashi, Xinjiang. Results In this study, a total of 319 patients were enrolled, comprising 45.5% with tuberculous vertebral osteomyelitis (TVO; 52.4% females), 37.9% with brucellar vertebral osteomyelitis (BVO; 19.8% females), and 16.6% with pyogenic vertebral osteomyelitis (PVO; 52.8% females). Demographically, TVO had a longer mean time to diagnosis compared to BVO and PVO. BVO was more prevalent in male, and PVO patients had higher rates of spinal surgery history (45.3%) and diabetes (13.2%). Clinically, TVO patients presented with fever (72.4%), sweating (83.4%), weight loss (71.7%), and appetite loss (84.8%) more frequently, while BVO patients reported more lower back pain (86.0%). Laboratory investigations revealed significantly higher leucocyte and neutrophil levels in PVO, whereas TVO patients had elevated monocyte-to-lymphocyte and platelet-to-lymphocyte ratios. Radiologically, TVO patients exhibited a higher incidence of thoracic involvement (56.6%) and skip lesions (20%). Microbiologically, BVO and PVO had high positive culture rates (84.3 and 84.9%, respectively), with M. tuberculosis isolated from only 4.1% of TVO patients. Conclusion These findings underscore the distinct clinical, laboratory, and radiological characteristics of TVO, BVO, and PVO.

Clinical Characteristics, Cytogenetic Risks, and Prognoses of Young Multiple Myeloma Patients in the Era of Novel Therapies.

Background/Objectives: In recent years, there have been significant advances in the understanding and treatment of multiple myeloma (MM). Despite this progress, there is still limited information on the disease in patients aged 50 or younger, including the impact of young age on disease characteristics, treatment, and outcome. Methods: In this retrospective study, we analyzed 68 newly diagnosed MM patients aged ≤ 50 years (y) who had undergone at least one peripheral blood stem cell transplantation (PBSCT). Additionally, we reviewed data published during 2008-2022 and compared these to our cohort. Results: Of note, the disease characteristics in our cohort were similar to those in older patients. However, the incidence of bone lesions was higher in younger patients (84%). Moreover, 33% had LC-only MM and 7% had high-risk (del17p, t(14;16), t(4;14)) cytogenetics. Advanced ISS and R-ISS II/III were observed in 57% and 78%, respectively. Therapy was intense, with 53% of patients undergoing ≥2 SCTs. Median follow-up was 75 months, median progression-free survival was 57 months, and median overall survival (OS) was not reached. The 10-year OS rate was 72%, with only 19% succumbing to the disease. Notably, no specific therapeutic regimen or risk factors for worse outcomes were identified through uni- or bivariate analyses, even in subgroup analyses of younger patients aged ≤ 40 y. Conclusions: Our, and prior, results of young (<50 y) and very young (<40 y) MM patients underscore the need for further comprehensive studies focused on this significantly affected cohort.