Negative History Research Articles

Frequency Of Primigravida In Patients With Eclampsia.

Pregnancy-induced hypertension (PIH) occurs in about 5% of pregnancies and is a major cause of high perinatal and maternal morbidity and mortality. In several international studies, primigravidas were associated with a significantly higher incidence of eclampsia. The local studies so far have a small sample size and mainly focus on preeclampsia in all pregnant women. limited data is available on the frequency of eclampsia in primigravidas in our population. This study aims to determine the frequency of primigravidas in patients with eclampsia after 20 weeks of gestation. This descriptive Cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from 7/10/2020 to 7/4/2021. A total of 134 patients were observed. Diagnosis of eclampsia was based upon obstetrical history, presence of fits or coma, raised blood pressure and presence of proteinuria on urine complete examination. Immediate management included stabilizing the patient and delivery by Induction of labour or Caesarean section. The guardians of the patients explained the purpose and the benefits of the study and informed written consent was taken. : Our study shows that among 134 patients, 96 (72%) patients were in the age range of 18-27 years while 38 (28%) patients were in the age range of 28-35 years. The mean age was 30 years with SD±10.94. Eighty two (61%) patients had a POG range ≤34 weeks while 52 (39%) patients had a POG range >34 weeks. Forty-eight (36%) patients had BMI <27 Kg/m2 while 86 (64%) patients had BMI >27 Kg/m2. Fifty-six (42%) patients had a positive history of hypertension while 78(58%) patients had a negative history of hypertension. Out of 134 patients, 102(76%) were primigravidas while 32 (24%) were multigravidas. Our study concludes that the frequency of primigravidas was 76% in patients with eclampsia after 20 weeks of gestation presenting at tertiary care hospital Abbottabad.

Flouting Relevance Maxim Benefits of Hillary Clinton's President Candidate Debate on 2016

This research has an objective to analyze and reveal the benefits of flouting the relevance maxim of Hillary Clinton's speech in the 2016 USA candidate presidential debate. The data consist of the debate transcript which was taken from the Washington Post website, and a video that could be watched on YouTube. They are analyzed by confirming the relevance of semantic answers to every question within the context of speech. In the end, there are nine findings of the benefits of flouting the relevance maxim, which consists of increasing positive self-impression, avoiding giving direct agreement to a sensitive issue, closing potential negative attacks, decreasing the rival's credibility, guessing truthfulness, beating the rival's credibility, increasing effort to show positive personal credibility, telling the rival's past negative history, and proposing indirect conclusion. The findings are the implication of the complex use of verbal speech that is combined with action. The formal situation of the debate supports the maximum benefit of every flouting relevance maxim. The main conclusion of this research is that flouting the relevance maxim only sometimes negatively impacts both a speaker and an interlocutor. The impact is influenced by complex factors such as the background of the occasion, past conditions, and passion for an interaction.

Efficacy of Six Different SARS-CoV-2 Vaccines during a Six-Month Follow-Up and Five COVID-19 Waves in Brazil and Mexico.

Comparisons among the different vaccines against SARS-CoV-2 are important to understand which type of vaccine provides more protection. This study aimed to evaluate the real-life efficacy through symptomatic infection and the humoral response of six different vaccines against SARS-CoV-2-BNT162b2, mRNA-1273, ChAdOx1-S, CoronaVac, Ad26.COV2, and Ad5-nCoV. This multicentric observational longitudinal study involved hospitals from Mexico and Brazil in which volunteers who received complete vaccination schemes were followed for 210 days after the last dose. SARS-CoV-2 Spike 1-2 IgG levels were taken before receiving the first vaccine, 21 days after each dose, and the last sample at six months (+/-1 month) after the last dose. A total of 1132 individuals exposed to five COVID-19 waves were included. All vaccines induced humoral responses, and mRNA vaccines had the highest antibody levels during follow-up. At six months, there was a decline in the SARS-CoV-2 Spike 1-2 IgG antibody titers of 69.5% and 36.4% in subjects with negative and positive history of infection respectively. Infection before vaccination and after complete vaccination scheme correlated with higher antibody titers. The predictors of infection were vaccination with CoronaVac compared to BNT162b2 and ChAdOx1-S. In the presence of comorbidities such as diabetes, rheumatoid arthritis, or dyslipidemia, CoronaVac lowered the risk of infection.

Mycobacterial Spindle Cell Pseudotumor of the Nasal Cavity.

Mycobacterial spindle cell pseudotumor (MSCP) represents an uncommon tumor-like proliferation associated with nontuberculous mycobacterial infection, i.e., M. avium intracellulare, affecting primarily the lymph nodes of immunocompromised men in their 5th decade. Involvement of the nasal cavity by MSCP is exceedingly rare with only 3 well-documented examples in the literature. A 74-year-old, HIV-negative, man presented with a 0.5-cm nodule of the left nasal cavity clinically presenting as a "nasal polyp." His medical history was significant for colonic adenocarcinoma, cutaneous basal cell carcinoma, and chronic lymphocytic leukemia (CLL) transforming to B-cell prolymphocytic leukemia, responsive to chemotherapy. The patient was diagnosed with prostatic adenocarcinoma treated with radiotherapy two months before the nasal lesion was detected. No lymph node enlargement, pulmonary involvement or hepatosplenomegaly were noticed. The nasal nodule was surgically excised and histopathologically examined to rule out metastatic disease or CLL relapse. Microscopically, the lesion comprised a well-circumscribed, monotonous, spindle cell population in a vaguely storiform arrangement mixed with a heavy infiltrate of neutrophils and sparse lymphocytes. The spindle cells featured finely granular rich eosinophilic cytoplasm with rounded, oval to epithelioid, or elongated nuclei with vesicular chromatin and one or two distinct nucleoli. The lesional cells lacked overt cytologic atypia and showed occasional regular mitoses. The surface epithelium was intact or focally ulcerated. By immunohistochemistry, the spindle cell population stained strongly and diffusely for CD68 and was negative for AE1/AE3, SMA, CD34, and PSA. CD3 highlighted scattered lymphocytes. Ziehl-Neelsen stain disclosed numerous intracytoplasmic acid-fast bacilli. A diagnosis of MSCP was rendered. No recurrences were observed during a 24-month follow-up period. Although exceptionally rare, MSCP should be considered in the differential diagnosis of nodular lesions of the nasal cavity that are characterized microscopically by marked spindle cell proliferation in a vague storiform pattern, admixed with a lymphocytic or mixed inflammatory infiltrate. A negative medical history for HIV infection and medication-induced immunosuppression should not preclude a diagnosis of MSCP, particularly in extranodal sites. Once the diagnosis is established, prognosis appears to be excellent for nasal MSCP following conservative surgical excision.

Fulminant type 1 diabetes developed after influenza split vaccination.

Fulminant type 1 diabetes (FT1D) is a subtype of diabetes characterized by rapid progression of β-cell destruction, hyperglycemia, and diabetic ketoacidosis (DKA). The pathogenesis of this disease remains unclear. However, viral infections, HLA genes, and immune checkpoint inhibitor use were reportedly involved in this disease. A 51-year-old Japanese man with no chronic medical condition was admitted to our hospital with complaints of nausea and vomiting. Cough, sore throat, nasal discharge, and diarrhea were not noted. He had a medical history of at least two influenza infections. His vaccination history was notable for receiving an inactive split influenza vaccine 12 days prior to developing these symptoms. He was diagnosed with DKA associated with FT1D. His HLA class II genotypes were nonsusceptible to FT1D, and he had a negative history of immune checkpoint inhibitor use. The destruction of the pancreas by cytotoxic T cells is reported to be involved in FT1D. Inactive split influenza vaccines do not directly activate cytotoxic T cells. However, these could activate the redifferentiation of memory CD8-positive T cells into cytotoxic T cells and induce FT1D, as this patient had a history of influenza infections. Influenza split vaccination could cause fulminant type 1 diabetes (FT1D). The mechanism of influenza split vaccine-induced FT1D might be through the redifferentiation of CD8-positive memory T cells into cytotoxic T cells.

Liability for illegal execution of activities on provision of consumer credit (loans): current status and perspectives for improvement

Consumer lending services are among the most demanded in the financial market. The high socio-economic significance of the activities of entities providing consumer loans is increasing in the context of regional imbalances in the implementation of banking services and the focus of credit institutions on clients with a certain income and stable income. Solving the problems of the availability of financial services for citizens living in small settlements, as well as persons who cannot receive funds from credit institutions due to low income, negative credit history, lack of collateral, microcredit organizations increase the purchasing power of the population, maintain the standard of living socially vulnerable citizens, stimulate the country's economy, involving (through investment) low-income strata in economic processes, making tax payments. The increased requirements for professional lenders determined the expansion of the illegal financial services sector, supported by high consumer demand. In order to counteract the illegal activities of illegal creditors and protect the interests of consumers of credit services, the legislator established administrative and criminal liability.The analysis of the current norms, which provide for liability for illegal activities for the provision of consumer loans (loans), carried out in the course of the study, made it possible to identify technical and legal flaws in the content of Art. 14.56 of the Administrative Code and enshrined in 2021 Art. 171.5 of the Criminal Code.Having identified the problems arising in the implementation of Art. 14.56 of the Administrative Code in practice, the author proposes to exclude from the disposition of this norm the signs that specify the subject of an administrative offense (legal entity, individual entrepreneur). The inevitability of the liability of illegal usurers will be ensured by changing the approach to determining the moment when illegal professional activities for the provision of consumer loans (Art. 14.56 of the Administrative Code) are concluded from the date of the conclusion of the consumer loan agreement on the day the creditor submits executive documents for organizing the enforcement of court decisions on the collection of the corresponding debt.Having determined the disposition of Art. 171.5 of the Criminal Code casually, with a triple reference-blanketness, the legislator not only deviated from the rules of legal technique, but also disoriented the law enforcement officer in the content of the criminal law prohibition. The author substantiates the proposals to state Art. 171.5 of the Criminal Code in a new edition, excluding the name of the violated law and detailing the signs of the subject of the crime. As crimi-forming signs, the composition covered by Art. 171.5 of the Criminal Code, it was proposed to determine alternatively: the large size of consumer loans (loans) issued by an illegal lender (over 2 million 250 thousand rubles); administrative punishment of a person under Art. 14.56 of the Administrative Code.

Associations of neurodevelopmental risk factors with psychosis proneness: Findings from a non-clinical sample of young adults

Psychotic disorders often develop as the continuum of subclinical symptoms that include hallucination-like and delusion-like experiences, and are commonly referred to as psychotic-like experiences (PLEs). To date, a number of neurodevelopmental risk factors of psychosis have been detected, yet their mutual interplay remains unknown. Therefore, we aimed to investigate the additive association of childhood trauma history, reading disabilities and symptoms of attention-deficit/hyperactivity disorder (ADHD) with psychosis proneness. A total of 3000 young adults (58.3% females, aged 18–35 years) with a negative history of psychiatric treatment were recruited to the cross-sectional study through computer-assisted web interview. Self-reports were administered to measure childhood trauma history, ADHD symptoms and reading disabilities. Linear regression analyses revealed significant main associations of childhood trauma history and reading disabilities with higher levels of PLEs. There were no significant main associations of ADHD with the level of PLEs. However, the associations of all possible interactions between neurodevelopmental risk factors with the level of PLEs were significant. Our findings suggest that childhood trauma history and reading disabilities may additively increase a risk of psychosis. The present findings bring new implications for early intervention strategies in psychosis and posit the rationale of recording the accumulation of neurodevelopmental vulnerabilities in clinical practice.

A case series evaluation of comprehensive drug testing in the pediatric acute care setting

IntroductionDrug testing typically follows a one-size-fits-all approach that is inadequate in some clinical scenarios, such as child maltreatment, neglect, and unintentional drug exposure. Results from immunoassay-based testing, which are non-specific, insensitive, and far from comprehensive, can lead to unintended consequences for children and their families. ObjectivesThe objective of this retrospective case series study is to evaluate the utility of real-time (0–1 day) comprehensive drug testing as an alternative to immunoassay-based testing in the pediatric acute care setting. MethodsComprehensive drug testing results obtained by mass spectrometry testing and associated medical data for all pediatric cases (0–12 years) at one institution from 2019 to 2022 were included in the analysis. The final case series (n = 7) included all cases from patients <3 years with comprehensive drug testing results that were inconsistent with medication history and/or toxicology results by immunoassay. ResultsComprehensive drug testing by mass spectrometry was ordered for 174 urine and blood samples representing 97 patients (0–12 years) from 2019 to 2022. Of these, 76 cases were from patients <3 years old; results were consistent with medication history and confirmatory for immunoassay results (n = 34), consistent with medication history (n = 14), confirmatory for immunoassay results (n = 10), negative (n = 9), or medical history was incomplete (n = 2). The remaining 7 cases were included in the final case series. ConclusionsThe cases highlight the value of real-time comprehensive drug testing in acute pediatric cases. Testing results can rule out toxic exposure from the diagnostic differential when negative, and lead to appropriate medical and social interventions when positive.

Factors associated with follow-up attendance of patients with oral squamous cell carcinoma: A retrospective cohort study.

This study examined the postoperative follow-up attendance of oral squamous cell carcinoma (OSCC) patients, evaluated some of the factors associated with it, and assessed its relationship with early detection of postoperative disease progression. An exploratory retrospective cohort study of 430 OSCC patients was conducted. We examined associations of follow-up attendance within the first year after surgery with selected demographic and clinical factors, and with early detection of disease progression. The mean number of follow-up visits within the first year after surgery was 3.9 out of the 12 recommended at our center; few patients were fully adherent. Age ≥70 years, unmarried status, high education level, and negative history of surgery for premalignant or malignant lesions from oral cavity or other sites were significantly associated with lower follow-up attendance. Greater follow-up attendance was significantly associated with early detection of disease progression during the first year after surgery (p=0.025). Adherence to follow-up visits was poor. Several sociodemographic and clinical factors were related to follow-up attendance, greater follow-up attendance was significantly associated with early detection of disease progression, and these should be further explored in future research.

Diffusion tensor imaging discriminates focal cortical dysplasia from normal brain parenchyma and differentiates between focal cortical dysplasia types

ObjectivesAlthough diffusion tensor imaging (DTI) may facilitate the identification of cytoarchitectural changes associated with focal cortical dysplasia (FCD), the predominant aetiology of paediatric structural epilepsy, its potential has thus far remained unexplored in this population. Here, we investigated whether DTI indices can differentiate FCD from contralateral brain parenchyma (CBP) and whether clinical features affect these indices.MethodsIn this single-centre, retrospective study, we considered children and adolescents with FCD-associated epilepsy who underwent brain magnetic resonance (MRI), including DTI. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity, and radial diffusivity, were calculated in both FCD and CBP. The DTI indices best discriminating between FCD and CBP were subsequently used to assess the link between DTI and selected clinical and lesion-related parameters.ResultsWe enrolled 32 patients (20 male; median age at MRI 4 years), including 15 with histologically confirmed FCD. FA values were lower (p = 0.03), whereas MD values were higher in FCD than in CBP (p = 0.04). The difference in FA values between FCD and CBP was more pronounced for a positive vs. negative history of status epilepticus (p = 0.004). Among histologically confirmed cases, the difference in FA values between FCD and CBP was more pronounced for type IIb versus type I FCD (p = 0.03).ConclusionsFA and MD discriminate between FCD and CBP, while FA differentiates between FCD types. Status epilepticus increases differences in FA, potentially reflecting changes induced in the brain. Our findings support the potential of DTI to serve as a non-invasive biomarker to characterise FCD in the paediatric population.

Extracorporeal Cardiopulmonary Resuscitation—A Chance for Survival after Sudden Cardiac Arrest

Extracorporeal membrane oxygenation (ECMO) is an increasingly popular method for the treatment of patients with life-threatening conditions. The case we have described is characterized by the effectiveness of therapy despite resuscitation lasting more than one hour. A 3.5-year-old girl with a negative medical history was admitted to the Department of Cardiology due to ectopic atrial tachycardia. It was decided to perform electrical cardioversion under intravenous anaesthesia. During the induction of anaesthesia, cardiac arrest with pulseless electrical activity (PEA) occurred. Despite resuscitation, a permanent hemodynamically effective heart rhythm was not achieved. Due to prolonged resuscitation (over one hour) and persistent PEA, it was decided to use veno-arterial extracorporeal membrane oxygenation. After three days of intensive ECMO therapy, hemodynamic stabilization was achieved. The time of implementing ECMO therapy and assessment of the initial clinical status of the patient should be emphasized.

Down syndrome patients with normal hearts: are they really normal?

Even though congenital heart disease is a common finding in down syndrome (DS) patients, some of them have anatomically normal hearts. However, the term "normal" might not be suitable, as these patients usually suffer from functional cardiac dysfunction. Several research highlighted that despite the absence of anatomical heart defects, subtle cardiac function derangements are present in DS patients. We aim to assess cardiac functions by Two-dimensional echocardiography and tissue Doppler imaging (TDI) in pediatric DS patients who have anatomically normal hearts. One hundred seventy-two patients with karyotyping confirmed DS with anatomically normal hearts and 165 healthy normal control children were enrolled in the current study. Their cardiac functions were assessed using both 2-dimensional echocardiography and TDI. Both patients and controls had structurally and anatomically normal hearts. In DS patients, the right side of the heart showed a significant reduction in both systolic and diastolic functions. Systolic dysfunction was evident by significantly decreased levels of Tricuspid annular plane systolic excursion and systolic wave by TDI. Diastolic dysfunction of the right ventricle was evident by prolonged deceleration time by conventional echocardiography and a significant decrease in annular tissue doppler velocity during early diastole/late diastole ratio by TDI. The E/De ratio was significantly increased. Even with anatomically normal hearts, DS patients should undergo cardiac function assessment by echocardiography & TDI. TDI is superior to conventional echocardiography in detecting subtle cardiac dysfunction especially left ventricular diastolic dysfunction in DS patients. TDI showed a significant decrease in the early/atrial ratio of mitral valve annulus and prolongation of left ventricle isometric relaxation time in DS children. Also, the left ventricle E/De ratio was prolonged denoting elevated filling pressures and diastolic dysfunction. This indicates that the TDI has higher sensitivity to detect diastolic dysfunction than conventional Echocardiography. Biventricular TDI-derived myocardial performance index was found to be significantly increased in DS children.

Closing the window on COVID-19 case-control studies.

Closing the window on COVID-19 case-control studies.

Executive function and relation to static balance metrics in chronic mild TBI: A LIMBIC-CENC secondary analysis.

Among patients with traumatic brain injury (TBI), postural instability often persists chronically with negative consequences such as higher fall risk. One explanation may be reduced executive function (EF) required to effectively process, interpret and combine, sensory information. In other populations, a decline in higher cognitive functions are associated with a decline in walking and balance skills. Considering the link between EF decline and reduction in functional capacity, we investigated whether specific tests of executive function could predict balance function in a cohort of individuals with a history of chronic mild TBI (mTBI) and compared to individuals with a negative history of mTBI. Secondary analysis was performed on the local LIMBIC-CENC cohort (N = 338, 259 mTBI, mean 45 ± STD 10 age). Static balance was assessed with the sensory organization test (SOT). Hierarchical regression was used for each EF test outcome using the following blocks: (1) the number of TBIs sustained, age, and sex; (2) the separate Trail making test (TMT); (3) anti-saccade eye tracking items (error, latency, and accuracy); (4) Oddball distractor stimulus P300 and N200 at PZ and FZ response; and (5) Oddball target stimulus P300 and N200 at PZ and FZ response. The full model with all predictors accounted for between 15.2% and 21.5% of the variability in the balance measures. The number of TBI's) showed a negative association with the SOT2 score (p = 0.002). Additionally, longer times to complete TMT part B were shown to be related to a worse SOT1 score (p = 0.038). EEG distractors had the most influence on the SOT3 score (p = 0.019). Lastly, the SOT-composite and SOT5 scores were shown to be associated with longer inhibition latencies and errors (anti-saccade latency and error, p = 0.026 and p = 0.043 respectively). These findings show that integration and re-weighting of sensory input when vision is occluded or corrupted is most related to EF. This indicates that combat-exposed Veterans and Service Members have greater problems when they need to differentiate between cues when vision is not a reliable input. In sum, these findings suggest that EF could be important for interpreting sensory information to identify balance challenges in chronic mTBI.

Healthcare workers’ mental health and perception towards vaccination during COVID-19 pandemic in a Pediatric Cancer Hospital

The consistent increase of Coronavirus disease 2019 (COVID-19) cases parallel with the rate of deaths and the controversial response regarding the vaccines caused an increase in the burden of psychological diseases. This study aimed to evaluate the psychological condition of healthcare workers (HCWs) in a pediatric cancer hospital and to identify the knowledge, attitude, and perception (KAP) of HCWs toward COVID-19 vaccination. A cross-sectional observational study was conducted between April to May 2021. A validated, confidential survey was employed to measure the mental health of HCWs and the KAP toward COVID-19 vaccines. The total responses were 395, of which 11.4% physicians, 18.5% pharmacists, and 70.1% were nurses. Sixty-six percent of HCWs had different degrees of anxiety and depression. Nurses significantly accounted for the highest anxiety levels (P = 0.003), while the cumulative anxiety score was significantly higher in HCWs who had a positive history of COVID-19 infection (P = 0.026). Although 67.6% of HCWs believe that “vaccines are essential for us,”, the vaccination rate was 21.3%. The Factors associated with not receiving the vaccine were younger ages (P = 0.014), nurses (P = 3.6987 × 10–7), negative history of COVID-19 infection (P = 0.043) and believing that infections can happen after taking the vaccine (P = 1.5833 × 10–7). Healthcare organizations must take serious intervention to decrease the mental load on HCWs and facilitate the vaccination process.

Socio-Demographic Correlates and Patterns of Use Among Patients Visiting Addiction Services of Almadinah Specialized Psychiatric Hospital in Saudi Arabia

Background: Substance use disorders are on the increase worldwide with negative consequences on individuals, their family and the community. Our objective is to study the socio-demographic and patterns of use in those requesting addiction treatment in Addiction treatment services of Almadinah Specialist Psychiatrist Hospital (ASPH). Methods: A descriptive chart review study of 622 patients requesting treatment between the first January 2019 and 31 December 2012. Information was taken from patients’ records and if necessary, completed by a direct interview with the patient. Data collected were analysed using Statistical Package for the Social Sciences (SPSS) version 22.0. Results: The majority were male (96.6%) with a mean age of 32.1 ± 9.2 years. More than half had less than a bachelor’s degree, while 23.5% were highly educated. The majority of patients were single (70.7%), 53.1% reported difficulty keeping a job, 17.8% a high income, 90% a negative family history of substance abuse and 94.7% a negative family history of psychiatric illness. The most frequent substances used, in descendant order, were captagon (69.8%), cannabis (63%) and alcohol (30.7%). The mean age of initiation was around 21 years for the three main substances. The prevalence of co-occurring disorders was at 14%. Two thirds of patients were from the outpatient department (67.7%) and 32.2% from the emergency department (ED). Around a third of our sample visited the emergency room at least once during the month prior to their evaluation and overall, 32.3% needed hospital admission. Conclusions: The fact that 90% of our sample reported a negative history of substance abuse with about 4 out of 5 having an early age of initiation to substance use emphasizes the urgent need for psychoeducational preventive efforts on substance abuse and dependence targeting our youths and their families, in multiple areas particularly in school and neighbourhoods.

The Levels of Anti-SARS-CoV-2 Spike Protein IgG Antibodies Before and After the Third Dose of Vaccination Against COVID-19.

The COVID-19 pandemic has been going on for almost three years, and so far, many preventive and therapeutic strategies have been developed. The issue of subsequent booster vaccinations is currently being discussed. We aimed to analyze how the third dose of vaccination against COVID-19 correlates with the dynamics of IgG anti-SARS-CoV-2 spike protein antibody levels in a group of healthy people. The prospective study included 93 participants before and after a second booster of COVID-19 vaccination, from whom 4 blood samples were collected at intervals. The levels of IgG anti-SARS-CoV-2 in serum were identified using the chemiluminescent immunoassay specific for the receptor-binding domain (RBD) of the S1 protein. The analysis of the results was performed using appropriate statistical methods, considering p <0.05 as a statistically significant value. The IgG levels were significantly higher and less diverse after the same follow-up time from the second booster vaccination compared to the first booster. The antibody levels were positively correlated with female, healthcare workers, the elderly and participants with a negative COVID-19 history. Furthermore, the increase in IgG antibodies after the second booster vaccination correlated inversely with the baseline level of antibodies before the vaccination. The latest results showed that antibody levels dropped 1.5-fold after approx. 10 months from the second booster vaccination but still remained at a protective level. Booster vaccinations seem to better stimulate immune memory, and in the case of borderline IgG level induces the greatest increase in antibodies. It is worth considering the individual parameters of patients and measuring antibodies before vaccination.

Effects of subcutaneous immunotherapy in allergic rhinitis children sensitive to dust mites.

Subcutaneous immunotherapy (SCIT) is now the only treatment that can modify the natural course of allergic rhinitis (AR). However, not all children with AR benefit from SCIT. To evaluate the efficacy of SCIT in dust-mites-induced AR children and explore correlative factors predicting treatment response to SCIT. 225 children aged 4-17 years old with AR were recruited from January 2016 to September 2019, and monitored at baseline, 4, 12, and 24 months after the start of SCIT treatment. The visual-analogue-score (VAS) was used to assess the clinical symptoms. Multivariate binary logistic regression analyses and receiver operating characteristic curves were used to explore correlative factors in predicting the efficacy of SCIT. The significant declines in VAS started after 4 months of SCIT and continued to improve throughout the study compared with baseline. An increase in children's age (OR=0.688, 95%CI: 0.479-0.988) and those with allergic history (OR=0.097, 95%CI: 0.009-1.095) were negatively associated with the risk of poor efficacy. Polysensitized children were more likely to suffer poor efficacy (OR=15.511 95%CI: 1.319-182.355). The clinical response at month 4 (r=0.707) and month 12 (r=0.925) was related to that at month 24. The area under the curve (AUC) for improvement at month 4 and month 12 was 0.746 and 0.860, respectively. Our study confirmed the clinical efficacy of SCIT in AR children. Children with younger age, negative allergic history, and multiple allergens may predict a worse efficacy. The onset of action and the clinical response to SCIT in the second year can be predicted as early as by month 4.

Knowledge and awareness of colorectal cancer among the public population, Al-Ahsa, Saudi Arabia: a survey-based study

Objective: This study aimed to assess the knowledge and awareness of risk factors, manifestations, and screening methods of colorectal cancer (CRC) among the public population, Al-Ahsa, Saudi Arabia (SA). Methods: The adult population of Al-Ahsa was enrolled in this survey study with negative history of CRC. From April to May 2022, demographic data were collected on healthy individuals, including their age, gender, marital status, and educational status. The survey comprises 10 questions about colon and rectum function, incidence, risk factors, manifestations, screening modalities, and prognosis of CRC; all questions were multiple-choice, with multiple answers accepted when appropriate. Results: Three hundred and ninety-four questionnaires were completed. The total knowledge score among the study participants was 60%. Age, gender, and marital status had no statistically significant association with CRC knowledge (p-value = 0.131, p-value = 0.227, and p-value = 0.291); however, education level played a crucial role (p-value = 0.001). Conclusion: CRC knowledge was lacking, which was influenced by an individual&amp;apos;s level of education but was unrelated to age, gender, or marital status. It is recommended that SA conducts a national education campaign to enhance CRC knowledge.

BRUGADA-LIKE ECG PATTERN AND TUMORS INVOLVING RIGHT VENTRICULAR OUTFLOW TRACT - CASE SERIES AND LITERATURE REVIEW.

Mechanical heart compression, including that from mediastinal tumor, may cause Brugada-like ECG pattern. Such ECG pattern might also be observed in intracardiac tumor obstructing the right ventricular out"ow tract (RVOT). Eight cases with Brugada-like ECG and tumors involving RVOT have been described so far; 4 growing in the mediastinum (with one example of in"ammatory mass), 3 with intracardiac location, and 1 being an organized pericardial hematoma. The authors present other 3 cases of intracardiac metastatic tumors in RVOT and Brugada-like ECG pattern with coved ST-segment elevation in the right precordial leads. All patients had negative history of cardiovascular disease or familiar malignant arrhythmia occurrence. ECG were done routinely; none of the patients had chest pain or an increased level of cardiac troponins. In all patients, neoplastic disease was at advanced stage. A 76-year-old male, had a history of four neoplasms: bladder cancer was being treated with chemotherapy, while prostate, tongue, and lung cancers had been resected years ago and no signs of local relapse were found. A 78-year-old female, was diagnosed with colon cancer 1 month after an episode of venous thromboembolism. Six months after the resection of cancer, second focus of adenocarcinoma was found in the rectum. Third patient, a 65-year-old-male had undergone nephrectomy for renal cancer a year before cardiac metastasis diagnosis.