Mild Lesions Research Articles

Serum Levels of lncRNA CCHE1 and TCF21 in Patients with Coronary Artery Disease and Their Clinical Significances.

Objective To detect serum level changes of CCHE1 and TCF21 in coronary artery disease (CAD) patients and to explore their clinical significances. Patients and Methods. A total of 150 CAD patients were divided into the mild lesion group (n = 52), moderate lesion group (n = 48), and severe lesion group (n = 50), respectively, according to the Gensini score. In addition, they were divided into single vessel lesion (n = 42), two vessel lesions (n = 49), and three vessel lesions group (n = 59), respectively. Serum levels of CCHE1 and TCF21 in CAD patients were detected by quantitative real-time polymerase chain reaction (qRT-PCR). Spearman's rank correlation was conducted to assess the relationship between levels of CCHE1 and TCF21 and severity and numbers of vessel lesions in CAD. Pearson's correlation test was used for analyzing the correlation between CCHE1 and TCF21 levels. A multivariable logistic regression test was performed to evaluate the influences of CCHE1 and TCF21 levels on CAD severity and the occurrence of cardiovascular events within 3 years of follow-up. Results Significant differences in incidences of diabetes and hypertension were identified in CAD patients divided according to CAD severity. In addition, significant differences in incidences of drinking, diabetes, and hypertension were identified in CAD patients divided according to numbers of vessel lesions. The serum level of CCHE1 was positively related to CAD severity and numbers of vessel lesions, while TCF21 displayed a negative relationship. During the 3-year follow-up, the incidence of cardiovascular events was 39.3% (59/150). CAD severity, numbers of vessel lesions, and serum levels of CCHE1 and TCF21 were independent factors influencing the occurrence of cardiovascular events in CAD patients. Conclusions The increased serum level of CCHE1 and decreased TCF21 level are closely related to CAD severity, which are able to influence the prognosis in CAD patients.

Respiratory symptoms and radiological findings in post-acute COVID-19 syndrome.

RationaleThe characteristics of patients with respiratory complaints and/or lung radiologic abnormalities after hospitalisation for coronavirus disease 2019 (COVID-19) are unknown. The objectives were to determine their characteristics and the relationships between dyspnoea, radiologic abnormalities and functional impairment.MethodsIn the COMEBAC (Consultation Multi-Expertise de Bicêtre Après COVID-19) cohort study, 478 hospital survivors were evaluated by telephone 4 months after hospital discharge, and 177 who had been hospitalised in an intensive care unit (ICU) or presented relevant symptoms underwent an ambulatory evaluation. New-onset dyspnoea and cough were evaluated, and the results of pulmonary function tests and high-resolution computed tomography of the chest were collected.ResultsAmong the 478 patients, 78 (16.3%) reported new-onset dyspnoea, and 23 (4.8%) new-onset cough. The patients with new-onset dyspnoea were younger (56.1±12.3 versus 61.9±16.6 years), had more severe COVID-19 (ICU admission 56.4% versus 24.5%) and more frequent pulmonary embolism (18.0% versus 6.8%) (all p≤0.001) than patients without dyspnoea. Among the patients reassessed at the ambulatory care visit, the prevalence of fibrotic lung lesions was 19.3%, with extent <25% in 97% of the patients. The patients with fibrotic lesions were older (61±11 versus 56±14 years, p=0.03), more frequently managed in an ICU (87.9 versus 47.4%, p<0.001), had lower total lung capacity (74.1±13.7 versus 84.9±14.8% pred, p<0.001) and diffusing capacity of the lung for carbon monoxide (DLCO) (73.3±17.9 versus 89.7±22.8% pred, p<0.001). The combination of new-onset dyspnoea, fibrotic lesions and DLCO <70% pred was observed in eight out of 478 patients.ConclusionsNew-onset dyspnoea and mild fibrotic lesions were frequent at 4 months, but the association of new-onset dyspnoea, fibrotic lesions and low DLCO was rare.

Effect of transgenic Leishmania major expressing mLLO-Bax-Smac fusion gene in the apoptosis of the infected macrophages.

Objective(s):Leishmaniasis is a complex infection against which no confirmed vaccine has been reported so far. Transgenic expression of proteins involved in macrophage apoptosis-like BAX through the parasite itself accelerates infected macrophage apoptosis and prevents Leishmania differentiation. So, in the present research, the impact of the transgenic Leishmania major including mLLO-BAX-SMAC proapoptotic proteins was assayed in macrophage apoptosis acceleration. Materials and Methods: The coding sequence mLLO-Bax-Smac was designed and integrated into the pLexyNeo2 plasmid. The designed sequence was inserted under the 18srRNA locus into the L. major genome using homologous recombination. Then, mLLO-BAX-SMAC expression was studied using the Western blot, and the transgenic parasite pathogenesis was investigated compared with wild-type L. major in vitro and also in vivo. Results:Western blot and PCR results approved mLLO-BAX-SMAC expression and proper integration of the mLLO-Bax-Smac fragment under the 18srRNA locus of L. major, respectively. The flow cytometry results revealed faster apoptosis of transgenic Leishmania-infected macrophages compared with wild-type parasite-infected macrophages. Also, the mild lesion with the less parasitic burden of the spleen was observed only in transgenic Leishmania-infected mice. The delayed progression of leishmaniasis was obtained in transgenic strain-injected mice after challenging with wild-type Leishmania. Conclusion:This study recommended transgenic L. major including mLLO-BAX-SMAC construct as a pilot model for providing a protective vaccine against leishmaniasis.

Porcine ear necrosis in weaned piglets: prevalence and impact on daily weight gain

BackgroundPorcine ear necrosis (PEN) in pigs is characterized by a blue to black discoloration of the tip or margin of the ear followed by necrosis. The present study investigated the prevalence of PEN in a Belgian pig farm with PEN problems in nursery pigs, the effect of a mycotoxin detoxifier added to the feed on PEN prevalence, and the impact of PEN on the piglets’ growth. Six consecutive batches of weaned piglets [565–751 piglets per batch, (n = 3898)] were included. For each weaning batch, the presence and severity of PEN during the nursery period (3–10 weeks of age) were recorded weekly. Average daily gain (ADG) was calculated by weighing 597 individual piglets divided over the six batches. Additionally different mycotoxins were measured in the feed using LC–MS/MS analysis, and to three randomly selected batches, a mycotoxin detoxifier (Mycofix® Plus 5E, Biomin) was added to the feed.ResultsAt the end of the nursery period, 11.0–32.0% of the piglets in each batch were affected. The prevalence increased with the number of weeks post-weaning, especially from week 4 after weaning onwards. Mild, moderate, severe and very severe lesions represented 84.6%, 14.0%, 1.3% and 0.1% of all lesions, respectively. Different mycotoxins were present in the feed, but all at low concentrations. The mean ADG (± SD) for pigs without (n = 243) and with (n = 158) lesions was 391 g (± 71 g) and 394 g (± 65 g), respectively (P > 0.05). The ADG for mildly affected (387 g ± 68 g) and moderately affected piglets (420 g ± 44 g) was not significantly different (P > 0.05). The PEN prevalence in the batches without or with the mycotoxin detoxifier was 25% and 22%, respectively (P > 0.05).ConclusionsTwenty-three percent of animals showed lesions at the end of the nursery. Affected pigs did not have a lower ADG compared to non-affected animals, which might be explained by the fact that most affected piglets only had mild lesions. The addition of a mycotoxin detoxifier did not influence the prevalence of PEN, possibly because of the low levels of mycotoxin contamination. Further research is warranted to assess the impact of more severe PEN lesions and the effect of control measures.

Disturbance in invasion? Idiopathic necrotizing hepatopancreatitis in the signal crayfish Pacifastacus leniusculus (Dana, 1852) in Croatia.

As the most successful crayfish invader and possible vector for infectious agents, signal crayfish Pacifastacus leniusculus is among the major drivers of the native crayfish species decline in Europe. We describe histopathological manifestation and frequency of newly detected idiopathic necrotizing hepatopancreatitis along the invasion range of the signal crayfish in the Korana River in Croatia. Our results show extremely high prevalence of necrotizing hepatopancreatitis (97.3%), with 58.9% of individuals displaying mild and 31.5% moderate histopathological changes in the hepatopancreas, also reflected in the lower hepatosomatic index of analysed animals. Recorded histopathological changes were more frequent in the invasion core where population density is higher. Our preliminary screening of co-occurring native narrow-clawed crayfish Pontastacus leptodactylus showed lower incidence (33.3%) and only mild hepatopancreatic lesions, but potentially highlighted the susceptibility of native crayfish populations to this disease. Pilot analyses of dissolved trace and macro elements in water, sediment fractions and crayfish hepatopancreas do not highlight alarming or unusually high concentrations of analysed elements. Hepatopancreas microbiome analysis, using 16S rRNA gene amplicon sequencing, identified taxonomic groups that should be further investigated, along with impacts of the disease on health and viability of both invasive and native crayfish populations.

Socio-demographic and Clinical Profile of Covid-19 in Children

Introduction: The corona virus disease 2019 (COVID-19) is a pandemic disease. Infection by COVID-19 in children is not so common but gradually the numbers of children affected with COVID-19 are increasing day by day. The epidemiological importance and clinical pattern in children with COVID-19 is now a challenge to be described by the clinicians. Objectives: To describe socio-demographic and clinical characteristics of COVID-19 infected children. Material and Methods: This cross sectional observational study was conducted among 58 COVID-19 children who were admitted in COVID-19 dedicated Kurmitola General Hospital (KGH), Dhaka from March 2020 to July 2020. Their signs, symptoms, sex, age distribution, laboratory results and familial contact were analyzed. Results: Among 58 most of the children (63.8%) were in school going age (5-15years). The number of female (39) was more than male (19) and female-male ratio was 1:0.48. Most of the children (75.9%) came from urban lower middle socioeconomic group. About 84.4% children were affected from family member. Among all, (8.6%) patients had no symptoms. Main symptoms of the children were cough (36.2%), only fever (22.4%), fever with cough (8.62%) and diarrhoea (5.2%). About 12.06% of the children had additional symptoms including sore throat, nasal congestion, fatigue, headache, body ache, vomiting, abdominal pain, convulsion and rash, 6.9% had respiratory distress and one child came with convulsion. About 12.1% patients showed lymphopenia, 18.9% showed leucopenia, 13.8% patient had neutrophillia. C-Reactive Protein (CRP) and serum ferritin were high in only 12.1% and 8.6% cases respectively. There were 29.3% patients who had normal Chest X-Ray and 58.6% had mild lesion, 8.6% had bilateral consolidation and 3.4% had patchy opacities. Conclusions: COVID-19 is not so common in children and usually presents with mild form or no sign symptoms clinically and by laboratory analysis. But it is noteworthy that they may play role in transmission of disease. JAFMC Bangladesh. Vol 16, No 2 (December) 2020: 72-75

Acne prevalence and characterization in adolescents.

Background. Acne vulgaris is a very common chronic disease that affects mainly adolescents and has a negative effect on their quality of life. Objective and methods. The aim of this study was to determine the prevalence of acne in adolescents, to characterize this condition and estimate its impact on adolescents’ quality of life. For this purpose, a questionnaire was distributed in 4 schools to teenagers aged 14 to 17 years in 2021. Results. A sample of 237 adolescents was analyzed. The overall prevalence of acne was 71.3%. The median age was 16 years, acne evolution was favorable in 53.3% of cases, 44.4% had permanent lesions and 75.7% experienced flare ups. Comedonal acne lesions were reported by 74.0% of adolescents and inflammatory acne was reported by 69.2%. As for severity, 27.8% had mild lesions and 12.4% had moderate lesions. We found that female gender, topical and systemic treatment, and acne duration had a statistically significant association with acne severity. There was also an association between female gender, relapses, and acne severity in the last 12 months and worse quality of life scores. Discussion. In our study, the prevalence of acne was high, comedonal and inflammatory lesions were the more frequent type of acne, and severe forms were not frequent. Several adolescents reported relapses and the quality of life was undoubtedly affected. These findings were in accordance with recent literature and strengthen the available data. The extensive characterization of this population along with the risk factors that we found to be associated with acne severity, should be taken into account when treating these adolescents.

Cause of death in adult patients with congenital heart disease: experiences of a tertiary centre

Abstract Background We are currently facing a growing and aging population of adults with complex congenital heart disease. However, long-term survival in these patients remained reduced. Purpose To identify the main causes of death and compare mortality based on the complexity of the underlying congenital heart defect. Methods Patients with at least one visit in our adult congenital heart disease (ACHD) clinic between 2010 and 2020 were reviewed. Clinical data were obtained from digital medical records. Based on the complexity of the underlying heart defect patients were classified as mild, moderate, and severe. Data about the median age at death in the general population was collected from the National Statistical Office. Survival difference between the groups was analysed using the Kaplan-Meier method along with the log rank test. Results We included 2658 patients (53% female, overall median age of 35.6 years) with severe (21.2%), moderate (46.2%), and mild (32.6%) lesions. Over the median follow-up of 8.5 years (IQR 5.2–12.2) 125 patients (4.7%) died with an incidence of 0.51 deaths/100 patient years. The median age at death was 39.1 years (severe: 37.2 years, moderate: 50.3 years, mild: 83.1 years, p&amp;lt;0.001) Heart failure was the leading cause of death (35.2%) followed by non-cardiac causes (12.8%), perioperative/periprocedural death (11.2%), arrhythmia (7.4%), sudden cardiac death (4.1%) and endocarditis (2.4%). Heart failure related death was the most likely present in severely complex lesions (mild: 2.3%, moderate: 13.6%, severe: 84.1%). Underlying CHD with the highest mortality were univentricular heart (26.3%), pulmonary atresia (24.3%), Eisenmenger syndrome (22.7%), Ebstein anomaly (15.2%), and transposition of the great arteries after Senning procedure (13.4%). Conclusions Adult patients with moderately to severely complex congenital heart disease die at a relatively young age. The highest mortality rates were observed in patients with severely complex defects, with heart failure being the most common cause of death. Funding Acknowledgement Type of funding sources: None. Kaplan-Meier survival curve

Actual Aspects of Surgical Treatment of Dupuytren's Disease (Literature Review)

Relevance. The variety of manifestations of Dupuytren's disease, caused by the degree of lesions of the palmar aponeurosis, the duration of the disease, the nature of professional activity, and concomitant pathology of patients, has led to the development of numerous surgical techniques with different levels of effectiveness in the acute and long-term periods. A wide discussion of the issues of Dupuytren's disease in the domestic and foreign periodicals, the analysis of treatment methods, complications and rehabilitation indicate the urgency of the problem and the expediency of further research.&#x0D; Objective: a retrospective analysis of the leading literary sources devoted to the surgical treatment of Dupuytren's disease; the definition of modern approaches to surgical tactics and restoration of hand function.&#x0D; Results. The analysis of literature sources showed the advantages of differentiated approaches to the surgical treatment of Dupuytren's disease, depending on the severity of the disease. With mild and moderate lesions, there is a significant increase in needle aponeurectomy. In severe forms, the segmental aponeurectomy technique is preferred over the total one. There is some discrepancy in carrying out surgical mobilization of the proximal interphalangeal joint and the need to achieve a functional position as a result of treatment. The tactics of surgical treatment and rehabilitation of Dupuytren's disease requires an individual approach, taking into account the age and severity of the disease, and tends to spread minimally invasive fasciotomy techniques.

Comparison of echocardiographic parameters of patients with COVID-19 pneumonia in hospital and three months after discharge

Abstract Background COVID-19 affects firstly the respiratory system of patients however cardiovascular system is also damaged. To study the impact of a novel coronavirus infection on the cardiovascular system, in particular on echocardiographic parameters after SARS-CoV-2 is very important. Purpose To compare echocardiographic parameters in patients with COVID-19 pneumonia in hospital and 3 months after hospital discharge. Methods A total of 106 patients with confirmed COVID-19 pneumonia were included in the period from April to July 2020 within “One-year Cardiac Follow-up of COVID-19 Pneumonia”. All patients underwent clinical examination including transthoracic echocardiography in hospital and 3 months ± 2 weeks after discharge. Mean age of patients was 47±16 years (19–84 years), mean body mass index was 28.2±5.7 kg/m2, females were 49%. During hospitalization, chest computed tomography detected mild lesions in 29.2%, moderate lesions in 31.1%, severe lesions in 27.4% and critical lesions in 5.7%. Cardiovascular pathology detected in 52% of patients. Results Three months after discharge significant dynamics of mean echocardiographic parameters was observed. Left ventricular end-diastolic, end-systolic and stroke volume decreased (113.8±26.8 vs 93.5±29.4 ml; 37.7±13.0 vs 31.3±14.2 ml; 77.2±17.8 vs 62.2±18.7 ml, respectively; all p&amp;lt;0.001). End-diastolic right ventricular outflow tract diameter, pulmonary artery trunk diameter decreased (26.0 [24.0–9.3] vs 25.0 [23.0–27.0] mm, p=0.004; 21.7±3.6 vs 18.7±2.5 mm, p&amp;lt;0.001), as well as pulmonary artery systolic pressure (28.0 [25.0–32.25] vs 21.5 [17.0–25.0] mmHg) and rate of moderate to severe tricuspid regurgitation (52.4 vs 19.8%, both p&amp;lt;0.001). Right atrium volume (42.0 [37.0–50.0] vs 31.0 [22.0–36.5] ml, p&amp;lt;0.001) and width decreased (36.1±4.6 vs 34.5±6.5 mm, p=0.023), however right atrium length increased (46.7±6.8 vs 48.6±7.1, p=0.021). Conclusions In patients after COVID-19 pneumonia echocardiography showed decrease of the load predominantly on the right heart 3 months after discharge. A subgroup analysis is planned depending on the severity of lung damage and presence of cardiovascular pathology. Funding Acknowledgement Type of funding sources: None.

Angiographic and Clinical Predictors of Mild Non-Culprit Coronary Lesion Progression in Acute ST-Elevation Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention: A Prospective Cohort Study

Abstract Aims To identify the angiographic and clinical predictors of mild non-culprit coronary lesion (NCCL) progression in acute ST-elevation myocardial Infarction (STEMI). Methods and Results The present prospective cohort study evaluated 200 patients with acute STEMI underwent primary percutaneous coronary intervention (PPCI) (either PPCI or pharmaco-invasive PCI) divided into2groups based on whether the clinically driven non culprit lesion PCI existed or not into: Control group-1: 157 patients(78.5%) with non-progressed non culprit lesion (no additional PCI to the non-culprit lesion) and Study group-2: 43 patients(21.5%) with clinically driven non culprit lesion PCI (underwent additional PCI to progressed non-culprit lesions). Our study end point was the clinically driven non culprit lesion PCI (additional PCI to progressed non-culprit lesions). Asymptomatic patients were followed up by exercise ECG at 12 months and myocardial perfusion stress testing at 24 months. Multivariate regression analysis showed that the strongest independent predictor for progression of mild NCCL was complex morphology of culprit lesion (p &amp;lt; 0.001). Finally, a receiver operating characteristic (ROC) curve was performed to assess a cutoff value for predictors for NCCL progression after PPCI in Patients with STEMI. Conclusions Our novel angiographic independent predictor was complex morphology of culprit lesion. And our novel clinical independent predictors were CRP cutoff more than 7.05mg/l, peak cardiac troponin I value cutoff more than 27.5 ng/ml, and age cutoff less than 57.5 years, could be used for early prediction of mild NCCL progression after PPCI for acute STEMI patients. This could be used for early diagnosis to avoid repeated PCI and proper management for better outcomes.

COVID-19 in pregnancy: placental pathological patterns and effect on perinatal outcome in five cases

IntroductionCOVID-19, the disease caused by the novel coronavirus SARS-CoV-2, is a severe systemic thrombotic syndrome that emerged in 2019, with an ensuing pandemic.To evaluate the impact of this disease on placental tissue and perinatal outcome, histological, immunohistochemical and ultrastructural analyses of placental tissue were performed for five cases of pregnant women with COVID-19.Case reportsAll five pregnant women in this series developed COVID-19 in late pregnancy. Two patients experienced respiratory distress, and computed tomography revealed signs of pneumonia, with bilateral involvement, multiple lobular and subsegmental areas of consolidation and ground-glass opacities.Histological studies of placental tissue revealed the presence of slight signs of maternal vascular underperfusion (MVUs) or foetal vascular underperfusion (FVUs) lesions and mild inflammatory lesions. CD15 immunoreactivity in the placental tissue was low in all cases, demonstrating that in these cases there was not severe foetal hypoxia/asphyxia risk for newborns or distal vascular immaturity.In all cases examined, ultrastructural analyses showed spherical-like coronavirus particles with an electron intermediate-density core as well as projections from the surface as spike-like structures in the syncytiotrophoblasts. At term, all of the women delivered newborns who were negative for SARS-CoV-2 by nasopharyngeal testing in their first day of life. All newborns were exclusively breastfed and were discharged on the 3rd day of life.ConclusionsIn conclusion, placental patterns in pregnancy due to COVID-19 in the late stage of gestation indicate no evidence of vertical trans-placental SARS-CoV-2 transmission or a significant impact on the perinatal outcome of newborns, in both mild and more severe cases.

CARDIOPULMONARY BYPASS RE-INSTITUTION AND INTRAOPERATIVE REVISIONS ARE ASSOCIATED WITH INCREASED PERIOPERATIVE RISK IN CONGENITAL CARDIAC SURGERY

CARDIOPULMONARY BYPASS RE-INSTITUTION AND INTRAOPERATIVE REVISIONS ARE ASSOCIATED WITH INCREASED PERIOPERATIVE RISK IN CONGENITAL CARDIAC SURGERY

Biomechanical analysis of degenerative intervertebral disc enlargement of human spine

This paper uses the MC surface rendering method to extract the three-dimensional CT images of the lumbar spine. An integrated model of L4-L5 lumbar spine of normal youth was constructed, including anterior ligament, posterior ligament, ligamentum flavum, supraspinous ligament, interspinous ligament, annulus fibrosus, nucleus pulposus and other main human spine attached soft tissues. An integrated model of different stages of degenerative disk enlargement lesions (including mild enlargement lesions, moderate enlargement lesions, severe enlargement lesions, etc.) and other finite element mechanical model was constructed; model meshing and parameterized setting of the corresponding material properties of each component was carried out; finally, the loads and boundary conditions in different directions were defined to simulate the stress and deformation under different working conditions of degenerative disk enlargement model at normal youth and different stages. By comparing the stress, deformation and other mechanical test data, the biomechanical characteristics of the lesion model was analyzed according to the relevant mechanical model parameters and evaluation system, so as to verify the correctness and effectiveness of the constructed model, and then to provide accurate mechanical model reference for disease feature recognition, reliability of diagnosis and safety during surgery.

Relationship between Histomorphological Profile and Endoscopic Pictures of Reflux Esophagitis in Adults

BackgroundEarly diagnosis of GERD is very important because chronic reflux esophagitis is a major risk factor for Barrett esophagus, which is aprecursor lesion for esophageal adenocarcinoma. The aim of this study is to determine the frequency, demographic characteristics,histomorphological profile based on Esohisto criteria and endoscopic features of reflux esophagitis in FKUI/RSCM in 2016-2018.MethodsA cross-sectional study was conducted in Anatomical Pathology Department, Cipto Mangunkusumo General Hospital from January2016 to December 2018. Assessment criteria include demographic characteristics, histomorphological profiles, and endoscopicfeatures. Histomorphological assessment of reflux esophagitis in this study used the Esohisto criteria, by assessing basal cellhyperplasia, elevated papillae, dilated intercellular spaces and intraepithelial eosinophils. Assessment of the lesion severity isclassified as normal mucosa, mild lesion and severe lesion.ResultsThere were 65 cases of reflux esophagitis in adults over a period of 3 years in the Department of Anatomical PathologyFKUI/RSCM. Reviewing demographic data in January 2016-December 2018. The assessment criteria included demographiccharacteristics, histomorphological profiles, and endoscopic features. Histomorphological assessment of reflux esophagitis in thisstudy used the Esohisto criteria, by assessing basal cell hyperplasia, elevated papillae, dilated intercellular spaces in 65 casesfound 33 cases (50.8%) in men and 32 cases (49.2%) in women, with an average sample age of 56 years. The location of the mostlesions was distal esophagus in 30 cases (46.2%). Clinical manifestations in 13 cases (20%) were esophagitis. The most commonclinical symptoms were dysphagia in 21 cases (32.3%). Most endoscopic features were laryngopharyngeal reflux in 12 cases(18.5%), followed by grade C esophagitis in 9 cases (13.8%). The lesion severity of reflux esophagitis lesions based on Esohistocriteria found 37 cases (56.9%) mild lesion followed by severe lesion as many as 28 cases (43.1%)ConclusionThe Esohisto criteria can be used to help diagnose the lesion severity of reflux esophagitis with endoscopic pictures

Prognostic Role of Chronic Rhinosinusitis in Acute Ischemic Stroke Patients Undergoing Mechanical Thrombectomy.

Background: The aim of the study was to assess the relevance of chronic rhinosinusitis (CRS) CT features to the efficacy of mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: This study included 311 patients qualified for MT in whom the CRS features were assessed based on a CT scan, according to the Lund-Mackay (L-M) score. Clinical, inflammatory parameters, patients neurological (NIHSS) and functional status (mRS), and recanalisation efficacy (TICI) were compared between patients with mild lesions (L-M score 0–3 points)-group 1, and patients with more severe lesions (L–M score 4–24)-group 2. Results: There was a significant difference in the NIHSS on day seven after stroke onset-10 points in group 1 and 14 points in group 2, p = 0.02. NIHSS ≤ 6 points on day seven was found in 41.9% of patients in group 1, and in 27.5% in group 2, p = 0.042. There were no significant differences in mRS score and in the TICI score. L-M score, lipid abnormalities and CRP were factors associated with NIHSS ≥ 7 points on day 7. Conclusions: The CT features of CRS may be used as a prognostic tool for early prognosis assessment in stroke patients.

Knowledge of prevention and treatment of human papillomavirus (HPV) infections among young men

Background: Today, human papillomavirus (HPV) infection has become the most common sexually transmitted disease worldwide. Major consequences of contracting the virus include both mild skin lesions and a range of cancers, the most frequent of which are cervical cancer, penile cancer, oral cavity cancer, throat cancer, and anal cancer, undoubtedly demonstrating its high oncogenic potential. Aim of the study: The objective of this study is to determine the level of knowledge among men aged 18–26 years with regard to HPV prevention and treatment. Materials and methods: An online survey was conducted using a questionnaire developed by the authors. The questionnaire was comprised of 16 closed-ended questions and 5 questions pertaining to demographics. Chi-squared tests or Spearman’s rank correlation coefficients were used for the statistical analysis. Results: Only 27.5% of the respondents correctly answered a question regarding the number of types of the virus, and 33% correctly determined the percentage of the cases where an active infection turns into a chronic state. However, a high level of awareness of the routes of infection was demonstrated, with more than half of the respondents (63%) answering this question correctly. Additionally, more than two-thirds (67.9%) of the men indicated correctly that one of the factors facilitating infection is a young age at the time of the first contact with the virus. Nearly all respondents (90%) indicated that using condoms is an effective form of prevention. Conclusions: The results expressly indicate an insufficient level of knowledge regarding HPV among young men. Due to the high level of sexual activity in this age group, increased education with regard to the prevention of sexually transmitted diseases is needed.

Complete Resorption of Large Cervical Disc Protrusion Compressing Spinal Cord

In this report, we describe a case of 32-year-old woman who experienced spontaneous resolution of a large herniated disc with cord compression at C5-6. While the need for a surgical procedure is commonly accepted in case of symptomatic myelopathy, the medical management of cases with no or mild symptomatic lesion may be debated [1]. The following manuscript describes a case of spontaneous regression of herniated cervical disc and suggests that, even in patient with acute cervical disc herniation accompanied with cervical myelopathy, non-surgical, conservative treatment could be an option.

Bacteriophage mediated control of necrotic enteritis caused by C. perfringens in broiler chickens.

In Egypt, little attention has been paid to the isolation and application of C. perfringens phages for treating necrotic enteritis at the farm level. This study aims to evaluate the efficiency of the podovirus C. perfringens phage in treating necrotic enteritis in broiler chickens. Accordingly, C. perfringens phage was isolated from cecal samples of apparently healthy chickens and characterized by transmission electron microscopy, thermal stability test, and pH stability test. Commercial 14-day-old Arbor Acres broiler chickens were allocated to three groups: group Ӏ received BHI broth and assigned as a negative control, group П served as a positive control group that was challenged with C. perfringens via oral gavage for four successive days, and group Ш was administrated six phage doses on several occasions after oral gavage challenge with C. perfringens. Daily clinical symptoms and mortality were recorded. At three-time intervals, necrotic enteritis lesions were scored. Cecal samples were examined for re-isolation and counting of C. perfringens. The isolated C. perfringens phage was a podovirus with an icosahedral head diameter of 78.7nm and a short non-contractile tail length of 22.2nm. It remained stable for 60min at 30°C and 50°C at pH values of 2, 4, 8, and 10. The phage-treated group (Ш) showed mild gross lesions with a lower mortality rate and reduced colony-forming units than the positive control group (П). The findings revealed that the isolated C. perfringens phage effectively treated experimental necrotic enteritis in broiler chickens.

Clinical Characteristics, Treatment Effectiveness, and Predictors of Response to Pharmacotherapeutic Interventions Among Patients with Herpetic-Related Neuralgia: A Retrospective Analysis.

BackgroundThe treatment for herpetic-related neuralgia focuses on symptom control by use of antiviral drugs, anticonvulsants, and tricyclic antidepressants. We aimed to explore the clinical characteristics associated with medication responsiveness, and to build a classifier for identification of patients who have risk of inadequate pain management.MethodsWe recruited herpetic-related neuralgia patients during a 3-year period. Patients were stratified into a medication-resistant pain (MRP) group when the pain decrease in the visual analogue scale (VAS) is < 3 points, and otherwise a medication-sensitive pain (MSP) group. Multivariate logistic regression was performed to determine the factors associated with MRP. We fitted four machine learning (ML) models, namely logistic regression, random forest, supporting vector machines (SVM), and naïve Bayes with clinical characteristics gathered at admission to identify patients with MRP.ResultsA total of 213 patients were recruited, and 132 (61.97%) patients were diagnosed with MRP. Subacute herpes zoster (HZ) (vs. acute, OR 8.95, 95% CI 3.15–29.48, p = 0.0001), severe lesion (vs. mild lesion, OR 3.84, 95% CI 1.44–10.81, p = 0.0084), depressed mood (unit increase OR 1.10, 95% CI 1.00–1.20, p = 0.0447), and hypertension (hypertension, vs. no hypertension, OR 0.36, 95% CI 0.14–0.87, p = 0.0266) were significantly associated with MRP. Among four ML models, SVM had the highest accuracy (0.917) and receiver operating characteristic-area under the curve (0.918) to discriminate MRP from MSP. Phase of disease is the most important feature when fitting ML models.ConclusionsClinical characteristics collected before treatment could be adopted to identify patients with MRP.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40122-021-00303-7.