Medical Archives Research Articles

Profile and Histopathological Description of Gastritis Patients

Gastritis, better known as ulcer disease, is a disorder of the abdomen that patients most often complain about and is a disease that is often found in clinics when seen from the symptoms experienced. The Indonesian Ministry of Health stated that currently, Indonesia is in fourth place as the country with the highest incidence of gastritis. Based on Basic Health Research (Riskesdas) data in 2018, gastritis is one of the 10 most common diseases in hospitalized patients in Indonesia with 30,154 cases or 4.9%. The number of gastritis cases is considered quite high because the prevalence of cases is 274,396 out of the 258,704,900 total population of Indonesia. This study aims to explore the histopathological features of the gastric mucosa and the characteristics of patients with gastritis. This study used a descriptive method with retrospective data collection from the medical record archives of the MRCCC Siloam Semanggi Hospital during the period 2022. The research sample included all m edical records of patients with gastritis who underwent an endoscopic examination. Of the 252 patients who met the inclusion criteria, 59 patients (23.4%) were diagnosed with gastritis in the age range of 41 to 50 years. More women experience gastritis than men, with 137 patients (54.4%). In terms of histopathology, 171 patients (67.9%) were diagnosed with chronic non-active gastritis. From the assessment of the corpus and antrum, it was found that 121 patients (48%) had no atrophy, 249 patients (98.8%) had no intestinal metaplasia, and 248 patients (98.4%) had no Helicobacter pylori. Therefore, it is important to carry out an early examination and endoscopic examination so that medical treatment can be carried out as soon as possible. Keywords: Stomach, Helicobacter pylori, atrophy, intestinal metaplasia

“Multi-layer” encryption of medical data in DNA for highly-secure storage

The exponential increasement and the attributes of medical data drive the requirement for secure medical data archiving. DNA data storage shows promise for storing sensitive and important data like medical records due to its high density and endurance. Nevertheless, current DNA data storage working scheme generally does not fully consider the data encryption, posing a risk of data corruption by routine DNA sequencing. Here, we designed a “multi-layer” encryption pipeline for medical data archiving. Initially, digital information was encrypted using Blowfish algorithm at information technology (IT) layer, followed by two-layer data encryption at the biotechnology (BT) layer. The first BT layer exploited the molecular weight of synthetic DNA or nucleoside to encrypt the key, while the second BT layer encrypted digital information within DNA sequences. Consequently, decryption involved layer-by-layer interpretation of data, including mass spectroscopy, sequencing, and Blowfish decryption, significantly enhancing data security. Utilizing mass spectroscopy to retrieve information allows for employment of both natural and unnatural nucleosides, as well as their synthetic oligonucleotides, for data storage, thereby considerably boosting scalability. Our work implies expanded flexibility of DNA-based data storage, highlighting the potential for leveraging various physical and chemical characteristics of DNA molecules to encode and access digital information.

Examining Sepsis Incidence, Risk Factors, and Mitigation Efforts at PKU Muhammadiyah Gamping Hospital, Yogyakarta: A Retrospective Analysis

Sepsis poses a significant challenge in healthcare settings due to its association with heightened morbidity and mortality rates, prolonged hospitalizations, and increased healthcare expenditures. This study aims to investigate the incidence of sepsis, its associated risk factors, and the efficacy of various mitigation efforts implemented at PKU Muhammadiyah Gamping Hospital in Yogyakarta. Employing a cross-sectional, analytical observational design, this study examined a sample comprising patients diagnosed with sepsis at the hospital between January 2019 and December 2022, meeting predefined inclusion and exclusion criteria. Inclusion criteria encompassed patients diagnosed with sepsis in accordance with hospital protocols and those admitted between January 2019 and December 31, 2022, while exclusion criteria included patients with incomplete bacteremia diagnoses. Consecutive sampling was utilized for sample selection, with data extracted from patient records maintained in the hospital's medical archives. This study was conducted with the approval of PKU Muhammadiyah Gamping Hospital's ethical committee (permit number: 051/KEP-PKU/III/2023). Analysis of four years' worth of data revealed a total of 210 cases of sepsis, comprising 112 male and 98 female patients.

Exploring LGR5 as a prognostic marker of extrahepatic cholangiocarcinoma: insights from expression analysis and clinical correlations.

Leucine-rich repeat-containing G protein-coupled receptor 5 (LGR5) is a cancer stem cell (CSC) marker of colorectal cancer and may be a CSC marker of other cancer types. Few studies have been conducted on LGR5 expression in extrahepatic cholangiocarcinoma (ECC). We analyzed LGR5 expression using RNAscope, a highly sensitive RNA in situ hybridization technique. Fifty-three ECCs were selected from the medical archives at Shinshu University Hospital and analyzed using a tissue microarray. LGR5 expression levels were divided into expression and no expression groups. LGR5 expression and clinicopathological characteristics were analyzed. Among 25 cases, no LGR5-positive dots were identified. Among 28 cases, some LGR5-positive dots were observed in carcinoma cells, together with a wide range of LGR5-positive cells. LGR5 expression was conspicuous in glandular duct formations. Well- to moderately differentiated types showed significantly higher LGR5 expression than the poorly differentiated type (p = 0.0268). LGR5 expression was associated with good overall survival (p = 0.0219) and good disease-free survival (DFS) (p = 0.0228). High LGR5 expression was associated with well- to moderately-differentiated types, indicating a favorable prognosis. In terms of DFS, multivariate analysis showed that high LGR5 expression was an independent favorable prognostic factor (p = 0.0397). These findings suggest that LGR5 is a promising, novel prognostic marker.

Differentiation of Post-Polio Syndrome from Prior Poliomyelitis Sequela by Assessing Paraspinal Muscle Involvement in Magnetic Resonance Imaging.

Background/Objectives: Post-polio syndrome (PPS) affects former polio patients, manifesting decades after initial infection with progressive symptoms like pain, fatigue, and muscle weakness. Diagnosis relies on the clinical criteria and exclusion of other probable causes. The purpose of this study is to determine the scope and new diagnostic value of magnetic resonance imaging (MRI) in identifying muscle involvement in PPS and distinguishing it from prior poliomyelitis (PPM). Methods: This study was approved by the Koç University Ethics Committee with Approval No. 2023.409.IRB2.090. Electronic medical archives from two academic institutions were searched for records tagged with ICD code B-91 for poliomyelitis sequalae. The resulting search query of 291 records was manually sorted for PPS and PPM, medical history, clinical examination findings, and lumbar MR images down to 32 patients. Two independent radiologists evaluated the paraspinal musculature in the MRIs using the Mercuri scale. Inter-rater agreement, comparison of the paraspinal musculatures between groups, and their relationship to leg involvement were assessed with the resulting data. Results: Inter-rater agreement was found to be almost perfect across all muscles, except for the multifidus muscle. When clinical examination findings were included for these muscles, quadratus lumborum (QL) degradation was found in both right-side (p = 0.017) and left-side (p = 0.002) leg involvement. Conclusions: QL muscle deterioration may serve as a diagnostic marker for PPS, potentially guiding lumbar pain treatment through rehabilitation.

Hidden in plain sight: the covering of patients’ eyes and a microethics of medical photography

This article uses the author’s experience of researching historical photographs of facial injury and surgical reconstruction to think through the ethics of writing about and publishing images of patients anonymised...

Highlighting the contribution of the Greek physician Theodoros Aretaios to the history of thyroidectomy.

Theodoros Aretaios (1829-1893), having pursued advanced studies at home and abroad and possessing a wide range of competences and interests, was among the first Greek physicians to produce educational treatises for both students and doctors of medicine. Among these is his medical treatise Surgery which deals with thyroid operations and goiter symptoms as well as post-operative lesions which included a record of his extensive experience, learned recommendations, deep insights, and advanced techniques. In this medical archive, which is preserved in the National Library of Greece, there is, for example, the physician's vivid description of a thyroidectomy that he performed which illustrates his expertise as a surgeon as well as the surgical knowledge of his times. Aretaios was not the first to perform this operation in Greece: he was, however, the first to document it, which he did for the benefit of his fellow Greeks and of surgeons worldwide.

MET exon 14 skipping in NSCLC: An unMET Indian need.

e13537 Background: The approval of capmatinib and tepotinib, selective MET tyrosine kinase inhibitors (TKI), has further shifted the therapeutic paradigm of advanced NSCLC. MET exon 14 skipping (MET ex14) alteration is a complex mechanism, reported in ~3-4% cases of NSCLC. Controlled trials have reported remarkable outcomes of selective MET TKIs, however real world outcomes from this part of the world are currently lacking. Methods: This is a non-interventional study reporting real world outcomes of NSCLC with MET ex14 from two apex cancer centers of India. 49 eligible patients were recovered from the electronic medical record archives. All cases with MET ex14 were included irrespective of clinicopathologic characteristics and therapy offered. Statistical analysis was performed using R studio. Results: Clinical characteristics are shown (Table). Treatment patterns were heterogeneous across therapy lines and included chemotherapy, MET TKIs and immune checkpoint inhibitors. 42/49 patients opted for treatment; rest dropped out owing to economic restraints. 1st line TKI was offered to 14 patients, and chemotherapy to 28 patients. 1st line PFS of TKI treated was 11.9 months (95%CI:5.8-17.8) vs. 5.9months (95%CI: 3.9-16.8) (p<0.002*) for the chemotherapy treated cases (HR for TKI: 0.3295 (95%CI: 0.1630 to 0.6663). Presence of TP53 co-mutation and male gender and were factors affecting 1st line PFS (p<0.06) on multivariate analysis. 2nd line treatment was opted by 13/14 patients in TKI treated group of which 5 received sequential TKI, and 8 received chemotherapy and 22/28 in chemotherapy treated group (TKI: 14, chemotherapy: 8). PFS for 2nd line TKI was 7.7 months (95%CI: 2.8-14.8) vs 4.6 months (95%CI:2.1-9.8) for chemotherapy {HR for TKI: 0.3641 (95%CI: 0.1378 to 0.9616)} (p<0.04*). The dropout rate from 1st to 2nd line was 36% and 44% in subsequent line. 28 (57%) received MET TKI at any given point in disease course. Median OS for patients treated with 1st line TKI was not reached at study end (95%CI: 9.2-NR) and was 20.7 months (95%CI:18.1-36.1) for chemotherapy (p=0.3). One year and 2 year survival rates for 1st line TKI and Chemotherapy were 86%vs 73% and 47% vs 45%, respectively. Conclusions: This is the largest cohort from India reporting real world uptake of TKI therapy in MET ex14 altered NSCLC. There is a blaring disparity with respect to accessibility of drugs, as well as prevailing socioeconomic restraints. This study clearly depicts an unmet need for more global clinical trials for rare genomic alterations as well as patient access programs in this part of the world. [Table: see text]

Popularizing Surgical Cures: Walter Dandy and the Vestibular Neurectomy for Menière's Disease at the Johns Hopkins Hospital.

To uncover the context that allowed for the vestibular neurectomy to grow in favor and practice at the Johns Hopkins Hospital in the early 20th century, and the reasons for its broad abandonment since. The Walter E. Dandy (1905-1946) and Samuel J. Crowe collections (1905-1920) at the Alan Mason Chesney Medical Archives were reviewed, as well as the Samuel J. Crowe and Stacy Guild Temporal Bone Collection. Speculation on the etiology of Menière's disease (MD) has been countless, as have the medical and surgical interventions aimed at treating it. At the Johns Hopkins Hospital, Walter Dandy popularized the neurectomy for MD and performed 692 procedures from 1924 to 1946, believing it to be a curative therapy for vertigo. When he later modified the procedure from a total cranial nerve section to a partial vestibular neurectomy preserving auditory function, surgical candidacy expanded to include nearly any patient with vestibular symptoms. After his passing, trainees' attention shifted to traumatic injuries, likely influenced by WWII. This left the procedure scarcely used until third parties rekindled interest decades later. Neurectomy as the preferential treatment for MD at the Johns Hopkins Hospital was not driven by pure scientific reasoning but was rather contingent on historical context and sponsorship by a prominent figure like Walter Dandy. Appreciation of MD's natural history has since curtailed the favorability of destructive procedures in preference for conservative management.

Nerve Epidermal Growth Factor-Like 1 Protein (NELL-1) Expression in Mercury-Related Membranous Nephropathy: Is It a True Association or a Chance Occurrence?

Neural epidermal-like growth factor-like 1 (NELL-1) is a protein kinase C binding protein expressed in osteoblasts and renal tubules. It is expressed in 5%-25% glomerular cells at the mRNA level. Membranous Nephropathy (MN) is characterized by the presence of antibodies against certain types of antigens on the glomerular basement membrane. The most common one implicated in primary MN is an antibody against PLA2R. Many newer antigens have been discovered in the recent past, which are proven to cause secondary MN, one of which is NELL-1. NELL-1 has been associated with malignancy-associated MN and also recently associated with traditional indigenous medications containing mercury. In this study, we study the expression of NELL-1 in mercury-associated MN. Records of ten cases of Mercury -associated MN were retrieved from the Institute medical archives and NELL-1 Immunohistochemistry was performed in all ten cases. NELL-1 was found to be positive in 50% of the cases of Mercury associated MN. In addition, mass spectrometric studies was performed, which revealed the common Mercuric compound associated to be 'Swaskalpa', 'Sudarshana Melugu' and 'Rasagandhi Mezhugu'. This study highlights why it is important to diagnose mercury-associated MN by a pathologist by picking up the finer histopathological clues and by using NELL-1 immunohistochemistry, especially in PLA2R-negative patients. The former is true as most of the time a history of mercuric compound intake is missed out.

French Psychiatry and Alcoholism in the 1950s and 1960s: The Paradoxes of Outpatient Care

Summary This article examines the place of alcoholic patients in French psychiatry in the 1950s and 1960s, an era of incipient psychiatric reform. Relying on medical literature, national and department archives, as well as hitherto unexploited patient files from one of the first anti-alcoholic consultations opened in the early 1950s in Paris, it shows how new therapies and drugs, such as disulfiram, revived the interest of psychiatrists for alcoholism and enabled the outpatient treatment of alcoholics. However, the study of patient trajectories reveals that ambulatory care did not substitute itself for hospitalisation. The article then analyses how the psychiatrist–patient relation was transformed in the framework of the consultation, and included new stakeholders such as social workers and family members. It finally explains why therapeutic enthusiasm gave way, at the end of the 1960s, to increasing doubts concerning the role of the psychiatrist in the cure of alcoholism.

NEUROOPHTHALMOLOGIC MANIFESTATIONS AMONG 195 PATIENTS WITH INTRACRANIAL TUMOR AT NATIONAL REFERRAL HOSPITAL

Introduction & Objective: Intracranial tumor might show neuroophthalmological manifestations. Early detection and prompt treatment could alter the visual outcome. Ophthalmologists need to be aware of neuroophthalmological features commonly found among patients with intracranial tumor. This study revealed those signs and symptoms. Methods: Study was done in tertiary referral hospital. Subjects were patients with intracranial tumor attending neuroophthalmology clinic between the specified period. It was a descriptive study using retrospective data of the patient’s initial visit to the clinic. Data was retrieved from the medical record archive and electronic health record. Results : There were 195 patients, 67.7% of them were women, with average age 43.4 years old. Half the patients arrived within 6 months after eye related symptoms occurred and the referring physicians was equal between ophthalmologists and other specialties. The most frequent symptom and sign were blurred vision and optic nerve head abnormality (atrophy, edema). Hemianopia outnumbered other patterns of visual field disturbance, yet bilateral pattern was difficult to be evaluated as most patients had either one or both eyes blind. Conclusion : Intracranial tumor was one of the diseases that could show ophthalmic signs and symptoms. Neuroophthalmological manifestations in those cases was related to the extraocular process and the relevant pathway affected by the tumor.

Evaluation of concordance between loop electrosurgical excisional procedure and cervical colposcopic biopsy results

To evaluate the results of loop electrosurgical excisional procedures (LEEP) with colposcopic biopsy results of patients who presented to our hospital for vaginal smears. The LEEP reports of patients who presented to our gynecology clinic between January 2015 and December 2020 were retrospectively evaluated. The data were obtained from electronic patient records and the department of medical pathology archives. A total of 579 patients were evaluated with a mean age of 38.05±6.17 years. Colposcopy-guided biopsy was not taken from 102 patients. The results of the remaining 477 (82.4%) patients were: no dysplasia (n=12; 2.1%), Cervical intraepithelial neoplasia-I (CIN-I) (n=99; 17.1%), CIN-II (n=111; 19.2%), CIN-III (n=248; 42.8%), and cancer (n=7; 1.2%). Completed excision was performed in 87.0% of the patients using LEEP, the lesion was positive at the surgical margins in 10.9%, and the lesion could not be completely excised in 2.1%. The complication rate after LEEP was 3.1% including pelvic pain (n=5; 0.9%) and bleeding (n=13; 2%). The histopathologic results of LEEP were: benign (n=50; 8.6%), CIN-I (n=110; 19.0%), CIN-II (n=89; 15.4%), CIN-III (n=280; 48.4%), cancer (n=7; 1.2%), and metaplasia (n=37; 6.4%). The concordance between colposcopic biopsy and LEEP results was 85.9% for CIN-I, 71.2% for CIN-II, 98.4% for CIN-III, and 85.7% for cancer diagnoses. LEEP is a simple minimally invasive method used in the treatment of CIN, with low persistence, recurrence, and complication rates and increased human papillomavirus clearance in most patients. Our results support the consistency of cervical colposcopic biopsy and LEEP results.

Ultrasound blood flow characteristics changes in fetal umbilical artery thrombosis: A retrospective analysis.

Umbilical artery thrombosis (UAT) is extremely uncommon and leads to adverse perinatal outcomes. Hypercoagulation of blood in pregnant women is suspected to be an important risk for UAT. Ultrasound is an effective way to detect thrombosis. The mother can monitor her own fetal health using ultrasound, which enables her to take preventative action in case of emergency. To investigate ultrasonic blood signal after UAT in the umbilical artery, and evaluate the relationship between hypercoagulability and UAT. We described a case of a newly formed UAT with markedly altered ultrasonic indices of umbilical artery blood flow, and retrospectively studied it with 18 UAT patients confirmed by histopathology from October 2019 and March 2023 in Xiamen Women and Children's Hospital. Patients' information was collected from medical archives, including maternal clinical data, neonatal outcomes, pathological findings and ultrasonic indices of umbilical artery blood flow, such as systolic-diastolic duration ratio (S/D), resistance index (RI), pulsatility index (PI) and peak systolic velocity (PSV). Ultrasound and coagulation indices were analyzed with matched samples t-test and Wilcoxon rank sum test using the statistical packages in R (version 4.2.1) including car (version 3.1-0) and stats (version 4.2.1), and visualized by ggplot2 package (version 3.3.6). A patient with normal findings in second and third-trimester routine ultrasound scan developed UAT with severe changes in ultrasonic indices of umbilical artery blood flow (within 2.5th of reference ranges) in a short period of time. Statistical analysis of umbilical artery blood flow ultrasound indices for 19 patients with UAT showed that the decrease in S/D, RI, and PI and increase of PSV during the disease process was greater than that of non-UAT. All 18 patients delivered in our hospital showed characteristic manifestations of UAT on histological examination after delivery, most of which (16/18) showed umbilical cord abnormalities, with 15 umbilical cord torsion and 1 pseudoknot. Coagulation parameters were not significantly changed in UAT patients compared with normal pregnancy women. Significant changes in ultrasound indicators after UAT were demonstrated. PSV can play important roles in the diagnosis of UAT. Hypercoagulability alone is not sufficient for the occurrence of UAT.

Maternal and neonatal outcomes of intrahepatic cholestasis of pregnancy after in vitro fertilization

BackgroundIntrahepatic cholestasis of pregnancy (ICP) is an idiopathic disease of pregnancy. Little is known about how it specifically affects pregnancies resulting from in vitro fertilization (IVF). Our aim is to evaluate the impact of IVF on the perinatal outcomes of ICP.MethodsA retrospective study of 242 patients with intrahepatic cholestasis of pregnancy, comprising 36 conceived through IVF and 206 spontaneous conceptions (SC), enrolled between 2019 and 2021 was carried out. Data were analyzed from the medical archives of the Huazhong University of Science and Technology, Tongji Hospital.ResultsNumerical values of transaminases (ALT, alanine aminotransferase; AST, aspartate aminotransferase) and serum total bile acid (TBA) are significantly lower in the IVF group than that in the spontaneous conceived group (p < 0.05). The incidence of gestational diabetes mellitus (GDM) was higher in the IVF group than in SC group (30.6% vs. 16%, p = 0.037). The cesarean section (CS) rates are higher in the IVF group (97.2% vs. 85.4%, p = 0.023). On the other hand, the prevalence of premature rupture of membranes (PROM) was higher in the SC group (10.7%) while none was reported in the IVF-ICP group. Other maternal comorbidities and neonatal outcomes were similar between the two groups.ConclusionICP patients who underwent IVF are more likely to suffer from GDM. Therefore, monitoring and management of blood glucose should be strengthened during pregnancy. Fortunately, IVF does not seem to worsen the progression or outlook of ICP, so sticking to standard management practices is recommended.

On Occasion of the Thirty Years of the Establishing Avicena Publisher and its Medical Journals Medical Archives and Acta Informatica Medica

Here we will focus on two of the four indexed biomedical journals that were published in Sarajevo during wartime conditions in 1992-1995. The first is the Medical Archives, which was founded in 1947 and whose last editor until 1991 was the respected Academician Mirko Grujic, and whose last edited issue remained in storage (then the printing was done on Heidelberg machines and the text was typed using lead letters) and that unprinted issue – the number one volume in 1991 never even came out. Given that the contracts with the strongest index database MEDLINE included the Contract of the Assembly of doctors of Bosnia and Herzegovina (BiH), which at that time was the owner of the journal, and the pause in printing had already been going on for two years, Medline withdrew this journal as well. Numerous correspondences with the main responsible person Mr. Sheldon Kotzin, we received an unexpected consent from the Medline database to try to fill the gap with at least a few double-issues within 6 months, and Medline will meet us and reactivate the depositing of the Medical Archive in Medline. In addition to these facts, I was reminded of the incredible activities related to the preparation and printing of 47 books and monographs out of a total of 98 in B&amp;H in the war period 1992-1995, and their list is in the attached tables. Those war publications were created in various ways. Very important collection of published monographs are printed during wartime written by very famous scientists from Golden Arabic Ages: Ibn Sina, Ibn Haitham, Ibn Rushd, Ibn Nafis, Al Biruni, Ar Razi, which has been forgotten, translated by famous professors Sakir Sikiric and Hamdija Karamehmedovic until 1962. In addition to these facts, I was reminded of the incredible activities related to the preparation and printing of 4 scientific journals out of 8 biomedicine which today indexed journals in Bosnia and Herzegovina. Very important item from wartime was recording documetary movie "Amputation or Reconstruction in Wartime Conditions" recorded by Izet Masic and Zoran Ridjanovic which made in 1994 and showen in Lisbon during MIE '94 Conefernce as one of war miracles. Finaly, during wartime in B&amp;H Avicena organized and published Proceedings of ten scientific meetings held in sieged Sarajevo and all presented papers were published and deposited in PubMed Central database. Total amount of published books and monographs during past thirty years is more than 200, and, also published papers by Avicena during 30 years in four Avicena Publisher's journals have number more than 15,000 papers writen at least by 60,000 authors, from over 50 countries from all continents, and almost a half of them are stored in most influential indexed databases. It is incredible job of one very small publisher from small countriy.

Research on the Construction of Medical Archives Information Resource Sharing Platform under the Background of Digitization

Abstract Establishing a medical archive information resource-sharing platform can effectively address issues of resource waste, unavailability, and retrieval. The article develops a medical archive information resource-sharing platform using virtualization and cloud computing technology and proposes a virtualization-based RA_WLC resource scheduling strategy to achieve real-time allocation and scheduling of system resources. Through experimental testing of the medical archive information resource-sharing platform proposed in this paper, the article concludes that two critical paths to promote the construction of the resource pool are derived from the grouping analysis of conditional variables, i.e., Combined Path I (A1): P1*P2*P3*P4*P5*~P7 (Subject*System Standard*Technology Platform* Resource*User*Non-Feedback), Combined Path II (A2): P1*P2* P3*P4*P5*P6 (subject*system standard*technology platform*resource* user*environment). The performance test of the system yields a fault tolerance rate of 0~0.01 for 2000~4000.

Normative MRI for Lumbar Spinal Canal and Vertebral Body Dimensions in a Jordanian Population Sample

Aim: To provide normal values for the lumbar spinal canal, lumbar vertebral body and dural sac dimensions and canal body ratio by MRI for a Jordanian population sample.&#x0D; Material and methods: Three well trained observers reviewed 218 lumbar MRI scans performed between 2019–2021 (1090 lumbar levels) and obtained from the central computerized medical archive of three main governmental hospitals in north, central and south Jordan. All MRIs with alignment abnormalities (scoliosis and kyphosis), canal compression, vertebral disease (including fractures) or technical artifacts were excluded. The following were measured from L1 to L5 levels: the midsagittal diameters of the spinal canal and vertebral body, axial anteroposterior (AP), and transverse diameter of the vertebral body, dural canal and dural canal area. Data on sex and age were also documented.&#x0D; Results: The studied MRI scans included 113 males (51.8%) and 105 females (48.2%). Age ranged between 23–86 years old (mean 52.23 ± 13.125). The mid sagittal mid vertebral AP diameter of the lumbar spine range was 2.8–3.1 cm. The mid sagittal spinal canal diameter range was 1.3–1.5 cm. Canal body ratio was 3.3–3.6. The AP, transverse dural sac diameter ranges were 1.2–1.4 cm and 1.5–1.9 cm, respectively. Finally, the dural sac area ranged from 331–362 mm2.&#x0D; Conclusion: The dimensions of the lumbar spinal canal, vertebral bodies, and vertebral canal ratio at all levels were documented for a Jordanian population sample. Dimensions varied according to sex and when compared with other ethnic groups (Asian and African). The findings suggest that canal stenosis criteria should take these differences into consideration.

Chemoradiotherapy treatment with gemcitabine improves renal function in locally advanced cervical cancer patients with renal dysfunction

BackgroundCervical cancer (CC) in Mexico is diagnosed mainly in locally advanced (LACC) and advanced (ACC) stages, where ureteral obstruction is more frequent. The standard treatment for this population is concurrent chemoradiotherapy (CCRT) with cisplatin, which is nephrotoxic and could lead to further deterioration of renal function in LACC patients with renal function decline. We aimed to evaluate the effect of CCRT with Gemcitabine on renal function in LACC patients. MethodsThis retrospective study included LACC patients treated with CCRT with Gemcitabine as a radiosensitizer from February 2003 to December 2018. Data were collected from medical archives and electronic records. We assessed renal function before and after CCRT treatment and analyzed the patient's response to treatment and survival. Results351 LACC patients treated were included and stratified into two groups: 198 with Glomerular Filtration Rate (GFR) ≥60ml/min (group A) and 153 with GFR<60ml/min (group B). An improvement in GFR was observed after CCRT in patients in group B, from 33 ml/min to 57.5 ml/min (p<0.001). Complete response was observed in 64.1% of patients in Group A and 43.8% in Group B (p<0.0001). Factors associated with increased risk of death included having a GFR of 15-29 ml/min (HR: 2.17; 1.08-4.35), having GFR<15 ml/min (HR: 3.08; 1.63-5.79), and receiving Boost treatment (HR: 2.09; 1.18-3.69). On the other hand, receiving brachytherapy is a positive predictor for OS (HR:0.51; 0.31-0.84). ConclusionCCRT with gemcitabine is an appropriate treatment option for patients diagnosed with LACC who present impaired renal function due to the disease's obstructive nature or other comorbidities.

Spatial distribution of histological subtypes of Meningioma: A 14-Year longitudinal study in a developing country

BackgroundMeningiomas are extra-axial tumors that arise from meningothelial cells, accounting for about one-third of primary central nervous system malignancies. While they are often classified by location and histology, the role of the molecular profile in their development and progression is significant. The topographic distribution of meningiomas has not been extensively studied, and it is unclear whether specific histological subtypes have predilection sites. Therefore, this study analyzes the preferred locations of meningiomas according to different biological characteristics and their association with different gradings. MethodsThis is a retrospective chart review of patients in tertiary institutes over 14 years. The data were retrieved from medical and pathological record archives. An association between the biological nature of tumors and the location of meningiomas was analyzed. SPSS version 25 was used to analyze the data. ResultsOut of 272 patients, the predominant location for meningioma distribution was convexity (33.5%), followed by parafalcine (12.5%). WHO Grade I meningiomas were the most common, accounting for 84.2% of all meningiomas. The transitional histological subtype is the common variant (34.6%). The distribution of the histological subtype of meningioma in relation to tentorium was statistically significant. However, that was not the case with the skull base. ConclusionThe spatial distribution of meningiomas within the brain is not uniform. The most frequent locations for meningiomas were found to be convexity and parafalcine. Transitional and fibroblastic meningiomas were the predominant subtypes.