Patient Gender Research Articles

Study on medical dispute prediction model and its clinical-application effectiveness based on machine learning

BackgroundMedical dispute is a global public health issue, which has been garnering increasing attention. In this study, we used machine learning (ML) method to establish a dispute prediction model and explored the clinical-application efficiency of this model in effectively reducing the occurrence of medical disputes.MethodsRetrospective study of All disputes filed by Gansu Medical Mediation Committee from 2019 to 2021 and patients with the same hospital level as that of the dispute group and hospitalization year were randomly selected as the control group in 1:1 ratio. SPSS software was used for univariate feature selection of the 14 factors that may cause disputes, and factors with statistical differences were selected. The data were divided into training and test sets in a 7:3 ratio. Six ML models were selected, and Python was used to establish a dispute prediction model. The area under the curve (AUC) of the receiver operating characteristic curve (ROC), sensitivity, specificity, accuracy, precision, average precision (AP), and F1 score were used to characterize the fitting and accuracy of the models, while decision curve analysis (DCA) was used to evaluate their clinical utility.ResultsA total of 1189 patients in the dispute and control groups were extracted. Following 11 influencing factors were selected: the inpatient department, doctor title, patient age, patient gender, patient occupation, payment method, hospitalization days, hospitalization times, discharge method, blood transfusion volume, and hospitalization espenses. Compared to other models, the AUC (0.945, 95% CI 0.913–0.981), Sensitivity (0.887), Accuracy (0.887), AP (0.834), and F1 score (0.880) of the random forest model were higher than those of other models, while the DCA curve indicated its high clinical benefits.ConclusionsInpatient department, hospitalization expenses, and discharge type are the primary influencing factors of dispute. Random forest exhibited high dispute prediction and clinical-application value and is expected to be promoted for offline dispute prediction.

EVALUASI PENGGUNAAN TERAPI OBAT KARDIOVASKULAR PADA PASIEN HIPERTENSI YANG DIRAWAT DI RSUP DR. M. DJAMIL PADANG

Hypertension is one of the major modifiable risk factors associated with cardiovascular disease, and its prevalence and severity increase with age. The purpose of this study was to look at the description of the use of hypertension drug therapy, gender and age level of patients treated at dr. M. Djamil Padang Hospital October-December 2023 period. Data were collected retrospectively from the medical records of hypertensive patients admitted to the internal medicine ward. period October to December 2023 analyzed descriptively. Based on the results of the study of 131 hypertensive patients who were treated at DR. M.Djamil Padang Hospital in the October-December 2023 period, it was concluded that male sex patients were more than female, based on the age of patients with an age range of 56 - 65 years and the use of the most widely used antihypertensive therapy was 3 combinations.

Bariatric surgery decreases prescription drug costs for metabolic syndrome: a Canadian population-based cohort study.

Obesity is a chronic disease that is significantly linked to metabolic syndrome. Bariatric surgery is considered the most effective treatment for obesity resulting in long-term weight loss and comorbidity resolution. Prior studies have demonstrated the overall cost effectiveness of bariatric surgery; however, there is little data regarding direct pharmaceutical costs. The objective of this population-based study is to compare the cost of dispensed common prescription medications for metabolic syndrome before and after bariatric surgery. All patients that were enrolled in the Center for Metabolic and Bariatric Surgery who underwent gastric bypass or sleeve gastrectomy between 2013 and 2019 in Manitoba were included. Basic demographic information and outpatient prescription dispensation data were obtained from the Manitoba Population Research Data Repository, which is housed at the Manitoba Centre for Health Policy. Specific drug categories that were reviewed for costs 5years before and after surgery included Antihypertensives, Lipid Lowering Agents, Insulin and Non-insulin Diabetic Drugs. One thousand one hundred and eighty four patients were included in this review. Comparing the 5-yearpre- and post-surgery, there was a decrease in the overall amount of drug dispensed and the overall cost for all drug categories in the 5years following surgery. These categories included Antihypertensives ($506,268.8), Lipid Lowering Agents ($173,866.48), Insulin ($549,305.92), and Other Diabetes Drugs ($513,371.1). Additionally, older patients experienced a larger proportion of cost savings compared to younger patients, with the exception of non-insulin diabetic medications which trended to have more cost savings in the 30-49year old grouping. This is the first Canadian study to use accurate dispensing data from a provincial administrative prescription database to capture long-term cost savings for metabolic prescriptions after bariatric surgery. The results are consistent with the existing literature for prescriptions post-bariatric surgery. Future study will include subgroup analysis by patient age, gender, income quintile, and geography.

Etiological and epidemiological analysis of patella fractures: evaluation of COVID-19 pandemic and lockdown era effects

Background: Patella fractures are relatively rare, but significant public health burden with consequences ranging from skin problems to extensor mechanism deficiencies and patellofemoral arthrosis due to their significant effects on pain, functionality, and quality of life. It was aimed to present basic etiological, and epidemiological information about patella fractures and to evaluate the impact of the COVID-19 Pandemic and lockdown era period. Methods: All patellar fractures admitted to a stage-1 trauma center between 2016 and 2022 were collected retrospectively. Patient's gender, age, side, fracture classification, trauma mechanism, treatment method, admission day and season, accompanying extremity, and non-musculoskeletal/visceral pathologies were recorded and analyzed. Results: A retrospective evaluation was conducted on 304 patients, with 181 (59.5%) males and 123 (40.5%) females, with an average age of 46±19 years. Most patients were between 30-65 (51.4%) and the most common cause was simple falls (74%). Fractures mostly occurred in the winter (35.2%) and on Sundays (19.7%). 9.9% of the patients were accompanied by extremity traumas and 6.9% by non-musculoskeletal injuries. Regarding the descriptive classification, transverse, distal pole, and proximal pole; and according to the AO/OTA classification, C1 was the most common. Conclusion: The incidence of patella fractures is increasing. Non-surgical treatment is a priority, and the complication rates of surgical treatment are considerable. The study, which presents etiological and epidemiological data of level-1 trauma center patients, is a suitable sample for Türkiye. The study is unique in showing the potential effects of COVID-19 on the patient profile and treatment management of patella fractures.

Short-to-Mid-Term Outcomes of Ipsilateral Femoral Head Autograft Combined with Uncemented Total Hip Replacement for Partial Periacetabular Defects Following Tumor Resection.

Periacetabular tumors, especially in young to middle-aged patients with invasive benign tumors or low-grade malignant tumors involving type II or II + III, present significant challenges due to their rarity and the complexity of the anatomical and biomechanical structures involved. The primary difficulty lies in balancing the need to avoid unfavorable oncological outcomes while maintaining postoperative hip joint function during surgical resection. This study aimed to evaluate the effectiveness and reliability of a surgical method involving partial weight-bearing acetabular preservation combined with the use of an uncontaminated femoral head autograft to reconstruct the segmental bone defect after intra-articular resection of the tumorous joint, providing a solution that ensures both oncological safety and functional preservation of the hip joint in these patients. We conducted a retrospective study with a follow-up period of at least 36 months. From January 2010 to October 2020, we reviewed 20 cases of patients under 60 year of age with periacetabular invasive benign tumors or primary low-grade malignant tumors. All patients underwent reconstruction of the tumorous joint using autologous femoral head grafts. Data collected included patient age, gender, tumor type, preoperative and postoperative visual analog scale (VAS) scores, Musculoskeletal Tumor Society (MSTS) scores, Harris Hip Scores (HHS), patient survival rates, postoperative tumor recurrence, and surgical complications. To analyze the data, we utilized various statistical methods, including descriptive statistics to summarize patient demographics and clinical characteristics, and paired sample t-tests to compare preoperative and postoperative scores. The study included 20 patients, and a total median follow-up was 83 months. Their pathologic diagnoses comprised 13 giant cell tumors (GCTs), 5 chondrosarcomas, one chondroblastoma, and 1 leiomyosarcoma. Postoperatively, the median differences in vertical and horizontal center of rotation (COR) were 3.8 and 4.0 mm. Median limb length discrepancy (LLD) postoperatively was 5.7 mm (range, 2.3-17.8 mm). Two patients (10%) experienced delayed wound healing, resolved with antibiotics and early surgical debridement. One patient experienced dislocation 3 months postoperatively, which was promptly addressed under general anesthesia without further dislocation. Through multiplanar osteotomy with limited margins, femoral head autograft, and uncemented total hip replacement for pelvic segmental bone defects in selected patients in type II or II + III appears to be an encouraging limb-sparing surgery worthy of consideration for carefully selected patients.

Expression and Prognostic Potential of ESR1 in Breast Cancer

This study aims to explore the potential of ESR1 as a biomarker in breast cancer (BRCA) using bioinformatics analysis tools. The up-regulation of ESR1 expression in BRCA was investigated using UALCAN and GEPIA2, illustrating its role in BRCA progression. Furthermore, analyses based on various variables such as gender, age, race, and pathological stages of BRCA patients revealed a consistent up-regulation of ESR1, emphasizing its role in the development and progression of BRCA. Additionally, an analysis of ESR1 promoter methylation levels across various parameters revealed hypomethylation, affirming the inverse correlation between methylation and ESR1 expression. Prognostic analysis further indicated that overexpression of ESR1 is associated with poor overall survival, highlighting its potential as a prognostic biomarker in BRCA. Moreover, genetic mutation analysis using cBioPortal disclosed a minor role of ESR1 genetic mutations in BRCA, with only 2.5% of genetic alterations observed. The STRING and DAVID tools were utilized to conduct pathway enrichment analysis, revealing diverse biological functions of ESR1 and its 10 interconnected genes. Altogether, these results underscore the significance of understanding ESR1 up-regulation in BRCA and demonstrate its potential as a therapeutic, diagnostic, and prognostic biomarker.

Efficacy of Upper Gastrointestinal Endoscopy In Cholelithiasis Before Laparoscopic Cholecystectomy

Background: The most prevalent condition affecting the gallbladder and biliary tree is cholelithiasis. Presence of gall stones is discovered commonly during imaging tests for other pathologies. Laparoscopic cholecystectomy is a preferred modality for the treatment of gallstone disease. Objective: The primary aim of the study is to determine the efficacy of upper gastrointestinal endoscopy as a routine investigative modality in symptomatic presentation of cholelithiasis prior to laparoscopic cholecystectomy. Methods: A total 50 participants having single or multiple stones in the gall bladder found on ultrasound were included in the study. Enrolled patients underwent routine investigations. The baseline demographic details like patient name, age, gender, clinical presentation, and upper endoscopy findings were documented. The intensity of the pain was measured by visual analogue scale. Results: A total of 36% patients were in the age-group of < 30 years. The highest incidence of cholelithiasis was observed in female gender. Abdominal pain was the most common symptom. The most common upper gastrointestinal endoscopy findings were gastritis followed by gastritis erosion. A significant reduction of pain was noted in group I as compared to group II at first- and fourth-week time durations. Conclusion: Cholelithiasis has common clinical presentations in similarity to other upper gastrointestinal diseases. Upper gastrointestinal endoscopy can be recommended for patients with atypical presentation to prevent post-surgical adverse outcomes.

Instrumentation Considerations for Calcified Thyroid Cartilage during Chondrolaryngoplasty

ObjectiveChondrolaryngoplasty, also known as thyroid cartilage reduction, alleviates gender dysphoria by reducing the thyroid cartilage to conform to a patient's gender identity. Reduction of the thyroid cartilage prominence (“Adam's apple”) is often performed with a scalpel, but in cases of cartilage calcification, rongeurs or drills are utilized. This study aims to characterize the success rate with scalpel‐only excision and relate this to patient age and operative time.MethodsBilling records were screened for chondrolaryngoplasties performed between 2020 and 2023 by a single surgeon. Patient demographics, operative notes, and operation duration were recorded. Type of instrumentation was categorized as scalpel only, rongeur, or drill. All cases began with attempted scalpel excision of cartilage and were transitioned to rongeur or drill if there was calcification that prevented sharp excision. Descriptive statistics were used to describe patient and surgical factors.Results52 individuals underwent chondrolaryngoplasty: 30 cases (57.7%) had soft cartilage requiring only a blade, 22 (42.3%) required use of either drill or rongeur. The average age of these groups was 25.7 (SE 1.8) and 41.3 years (SE 2.2), respectively; this difference was statistically significant (p < 0.0001). Cases requiring a drill or rongeur lasted on average 78.5 min (SE 2.3), whereas those using only a blade were shorter at 66.8 min (SE 2.7); this difference was significant (p = 0.0017).ConclusionCartilage calcification should be expected in a significant number of chondrolaryngoplasties, and surgeons should be prepared for this scenario. The need for alternative instrumentation is higher in older individuals and may extend procedural time.Level of Evidence4 Laryngoscope, 2024

Correlation Between Sex Hormones (Testosterone and Prolactin) and Anti-ds-DNA Antibody Levels in Systemic Lupus Erythematosus Patients: A Gender-Specific Analysis of the Hormonal Influence on Immune Responses.

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that mostly affects women and has a noteworthy gender gap. Although the precise effects of sex hormones on SLE are yet unknown, they may modulate the immune response and affect the severity of the illness. Two important sex hormones that have apossible influence on autoimmune processes are prolactin and testosterone. The objective of this study was to assess the correlation between the levels of different sex hormones (testosterone and prolactin) and anti-double-stranded DNA (anti-ds-DNA) antibody levels in Sudanese anti-ds-DNA-positive SLE patients. Methodology A prospective cross-sectional study was conducted from February to July 2017 at Al-Rayan Specialized Medical Laboratory Complex and Omdurman Military Hospital, Sudan. There were 90 SLE patients who tested positive for anti-ds-DNA. Using commercial kits, serum levels of prolactin, testosterone, and anti-ds-DNA antibodies were tested from blood samples. SPSS version 21 was used for statistical analysis to find relationships between hormone levels and antibody levels. Results In this study of 90 patients with SLE, gender distribution was 14 males (16%) and 76 females (84%). The mean prolactin levels were significantly higher in males (17.99 ng/ml) compared to females (15.73 ng/ml, P < 0.001), and testosterone levels were also significantly higher in males (1.43 ng/ml) than females (0.37 ng/ml, P = 0.001). Although males had slightly higher mean levels of anti-ds-DNA antibodies (4.51) compared to females (4.08), this difference was not statistically significant. The results of correlation analyses indicated a weak and non-significant link between anti-ds-DNA antibody levels and hormone levels, with prolactin's Spearman's rho value of -0.054 (P = 0.616) and testosterone's Spearman's rho value of 0.080 (P = 0.456). Conclusion It was found that prolactin and testosterone levels differ by gender in SLE patients and that these hormones may have an impact on how the condition is managed. But the poor associations with anti-ds-DNA antibody levels suggest that further investigation is required to fully comprehend these intricate interactions.

Respiratory pathogen dynamics in community fever cases: Jiangsu Province, China (2023–2024)

BackgroundRespiratory infectious diseases have the highest incidence among infectious diseases worldwide. Currently, global monitoring of respiratory pathogens primarily focuses on influenza and coronaviruses. This study included influenza and other common respiratory pathogens to establish a local respiratory pathogen spectrum. We investigated and analyzed the co-infection patterns of these pathogens and explored the impact of lifting non-pharmaceutical interventions (NPIs) on the transmission of influenza and other respiratory pathogens. Additionally, we used a predictive model for infectious diseases, utilizing the commonly used An autoregressive comprehensive moving average model (ARIMA), which can effectively forecast disease incidence.MethodsFrom June 2023 to February 2024, we collected influenza-like illness (ILI) cases weekly from the community in Xuanwu District, Nanjing, and obtained 2046 samples. We established a spectrum of respiratory pathogens in Nanjing and analysed the age distribution and clinical symptom distribution of various pathogens. We compared age, gender, symptom counts, and viral loads between individuals with co-infections and those with single infections. An autoregressive comprehensive moving average model (ARIMA) was constructed to predict the incidence of respiratory infectious diseases.ResultsAmong 2046 samples, the total detection rate of respiratory pathogen nucleic acids was 53.37% (1092/2046), with influenza A virus 479 cases (23.41%), influenza B virus 224 cases (10.95%), and HCoV 95 cases (4.64%) being predominant. Some pathogens were statistically significant in age and number of symptoms. The positive rate of mixed infections was 6.11% (125/2046). There was no significant difference in age or number of symptoms between co-infection and simple infection. After multiple iterative analyses, an ARIMA model (0,1,4), (0,0,0) was established as the optimal model, with an R2 value of 0.930, indicating good predictive performance.ConclusionsThe spectrum of respiratory pathogens in Nanjing, Jiangsu Province, was complex in the past. The primary age groups of different viruses were different, causing various symptoms, and the co-infection of viruses did not correlate with the age and gender of patients. The ARIMA model estimated future incidence, which plateaued in subsequent months.

Implementasi Data Mining Klasifikasi Gejala Penyakit TB Menggunakan Algoritma Naive Bayes pada Studi Kasus Puskesmas Pegangsaan Dua B

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. The bacteria can enter the lungs, causing the patient to experience shortness of breath and chronic coughing. The infection process in TB progresses through three main stages: primary infection, latent infection, and active infection. During the primary infection stage, the bacteria enter the lungs through inhaled air. If the immune system successfully controls the bacteria, the infection becomes latent, where the bacteria remain inactive and cause no symptoms. However, if the immune system fails, the infection becomes active, and the bacteria attack healthy lung cells, leading to severe symptoms. Tuberculosis remains a major cause of global morbidity and mortality. According to the 2022 WHO report, Indonesia ranks second in the world with an estimated 969,000 TB cases, or 354 per 100,000 people, and a mortality rate of 144,000, or 52 per 100,000 people. This study aims to improve the accuracy of TB diagnosis through the application of the Naive Bayes algorithm, applied to patient data from the Pegangsaan Dua B Community Health Center. The dataset includes 1,527 training data and 1,029 testing data, covering attributes such as patient name, gender, age, identification number, registration date, address, diagnosis status, and diagnosis results. The results indicate that the Naive Bayes algorithm achieved an accuracy of 99.71%, showing its potential for early and accurate TB diagnosis prediction.

Frequency of KRAS and BRAF mutations in colorectal carcinoma and their association with clinical-pathological characteristics in a tertiary hospital in Kenya.

Colorectal carcinoma is a leading cause of cancer morbidity and mortality globally. Its management includes the use of targeted therapy which require assessment for biomarkers to choose eligible patients. KRAS and BRAF mutations are biomarkers predictive of response to anti-EGFR therapy. This study aimed at determining the frequency of BRAF V600E and KRAS exon 2,3,4 mutations in colorectal carcinoma patients at the Aga Khan University Hospital Nairobi, Kenya. Study participants were patients who had colectomy for colorectal carcinoma. They were identified from the laboratory information system. The patients age, gender and tumor location were determined from the medical records. The histological diagnosis, pathological tumor and nodal stage were confirmed by examining hematoxylin and eosin-stained slides prepared from the colectomy specimen. DNA was extracted from the specimens using Qiagen QIAamp DNA FFPE Tissue Kit and PCR performed using EntroGen KRAS/BRAF mutation analysis kit following manufacturer's protocol. One hundred fourteen patients were enrolled. Colorectal carcinoma was significantly more common in males than females. The mean age at diagnosis was 58 years. Majority of the tumors were in the right colon, were of pathological tumor stage T3 and had nodal involvement. Forty six percent (46%) of the cases had KRAS mutations while 5.3% had BRAF V600E mutation. KRAS mutation was associated with a high pathological tumor stage and nodal involvement. Colorectal carcinoma in our patients is more common in males and tend to occur at a younger age. The patients tend to have a high tumor pathological stage and nodal involvement at diagnosis. The high frequency of KRAS exon 2,3,4 mutation and low frequency of BRAF V600E mutations is similar to what has been reported in literature.

Family strategies for managing childhood cancer: Using traditional and complementary medicine in Southern Egypt.

The use of traditional and complementary medicine (T&CM) is common in children with cancer globally. We aimed to assess the prevalence, types, reasons, perceived effectiveness, and disclosure rate of T&CM use among children with cancer in Southern Egypt. We also investigated whether T&CM use contributed to delays in initial presentation and treatment. A cross-sectional design was utilized. Data were collected via an interviewer-administered questionnaire. Eligible children and their caregivers at the South Egypt Cancer Institute were invited to participate. Eighty-six children completed the study (response rate=86%). T&CM use was reported by 52 (60.5%) patients, with six (11.5%) experienced delayed presentation. The reasons for T&CM use were complementary for 37 (71%) and alternative for 15 (29%) of the participants. The types of T&CM used included herbal (63%), nutritional (33%), witchcraft (29%), and religious (19%) therapies. Approximately 48% of users employed multiple T&CM types. Family members recommended T&CM for 60% of the users. Most patients (65%) perceived T&CM as effective, with 71% initiating its use during the early phases of treatment. Almost all participants (98%) reported that healthcare providers did not inquire about T&CM use. T&CM usage was more prevalent among wealthier families (p=.023). There was no significant relationship between T&CM use and patient gender, diagnosis, residence, or paternal educational level. The significant utilization of T&CM among children with cancer highlights the need for healthcare providers to engage in open and early discussions with families regarding T&CM use.

Frequency, localization, and diameter of the accessory maxillary ostium and its relationship with sinus pathologies and nasal cavity variations: an anatomical study based on cone beam computed tomography.

The aim of the present study was to determine the presence, frequency, and characteristics of the accessory maxillary ostium (AMO) in a specific Turkish population using cone beam computed tomography (CBCT) and to evaluate the frequency of pathologies and anatomical variations in the nasal cavity and maxillary sinus and to assess their relationship with the AMO. This study retrospectively evaluated the presence of AMO in CBCT images of 543 patients, the patients' age, gender, and dentition status, the presence of nasal cavity variations and maxillary sinus pathologies, and their relationship to the presence of AMO. Descriptive values of the data and comparative results were included. 249 males and 294 females participated in the study. The majority of right and left sinus pathologies were irregular type mucosal thickenings (right/left; 14%, 14.9%). The majority of nasal variations were concha bullosa (right/left; 37.9%, 39.2%). There were 148 (27.3%) and 138 (25.4%) AMOs on the right and left sides, respectively, with the majority in the middle position (right/left; 21.2%/17.5%). The frequency of right and left AMOs was significantly higher in men (P = 0.019 and P = 0.020, respectively). The left AMO frequency was significantly higher in patients with left-sided sinus pathology (P = 0.003). AMO diameters were larger in men (right/left P = 0.010 and P = 0.021, respectively), and left AMO diameter was significantly larger in patients with left sinus pathology (P = 0.006). Before any surgical intervention in the maxillary sinus and osteomeatal region, the presence and location of the AMO, existing pathologies, and variations in the region should be carefully checked to avoid complications.

The Success of Treatment for Osteoarthritis with a Genicular Nerve Block is Associated with Patients’ Body Mass Index

Background: While the mainstay of treatment for severe osteoarthritis of the knee has been total knee arthroplasty, a prognostic genicular nerve block (GNB) followed by cooled radiofrequency ablation (CRFA) has been shown to provide long term relief of osteoarthritic knee pain and its disability. The goal of this study is to determine if there is a difference in the demographic makeup of those who had a successful prognostic genicular nerve block compared to those who did not. Methods: A retrospective chart review of 224 genicular nerve blocks was completed. The nerve block was considered successful if the patient reported a 50% or greater pain reduction for a week or more at follow up. Demographic cohorts that were compared include sex, age, race, and BMI. Results: Those who were categorized as non-obese, 36 out of 69 (52.2%) had unsuccessful blocks while 33 out of 69 (47.8%) in this BMI category had successful blocks. Of those who were categorized as obese, 25 out of 75 (33.3%) had unsuccessful blocks while 50 out of 75 (66.7%) in this BMI category had successful blocks. Of those who were deemed morbidly obese, 22 out of 75 (29.3%) had unsuccessful blocks while 53 out of 75 (70.7%) in this BMI category had successful blocks. These results were found to be statistically significant with a p-value of .011. Furthermore, GNB success was not found to be significantly impacted by patient age, race, or gender. Conclusions: These findings demonstrate the utility of prognostic genicular nerve blocks in all patients with osteoarthritis of the knee, but, in particular, the obese patient, who experiences a greater chance of pain relief on average.

The NF1 gene mutations and co-mutations in lung adenocarcinomas with brain metastasis.

The co-occurrence of lung adenocarcinoma and brain metastasis remains a significant cause of morbidity and mortality despite advancements in cancer treatment. The activity of neurofibromin, the product of Neurofibromatosis Type 1 gene (NF1), is crucial in regulating the RAS/MAPK pathway. The NF1 somatic mutations are significant in conditions such as melanoma, lung cancer, breast cancer, neuroblastoma, and central nervous system tumors. Therefore, this research aims to uncover the profile of NF1 mutations and co-mutations in patients with brain metastases from lung adenocarcinoma, shedding light on their role in the pathophysiology of metastatic lung cancer. In this study, a total of 131 (31 females, 90 males) patients diagnosed with metastatic lung adenocarcinoma who were examined in the Molecular Pathology Laboratory between 2019 and 2022 were retrospectively analyzed. The NF1 somatic mutations and co-mutations were evaluated using the NGS lung panel on the MiniSEQ NGS platform. The average age of the 131 patients (31 females, 90 males) retrospectively examined in the study was 62.05 years. The ages of the cases included in the study followed a normal distribution according to Kolmogorov-Smirnov test (P = 0.200). Lymph node metastasis was detected in 48 patients (36.6%), while distant organ metastasis was observed in 81 patients (61.83%). Metastases were more frequently seen in males. No statistically significant difference was found between metastases and gender (P > 0.05). Distant organ metastasis (n = 26, 19.8%) and NF1 mutations (n = 8/26, 30.77%) were most commonly observed in the brain. The most common NF1 pathogenic variants in brain metastases were c.2325 + 3A > G (p.M1205fs*12) (n = 6/26, 23.07%) and c.1400C > T (p.T4671) (n = 5/26, 19.23%). There was no statistically significant relationship observed between patients' age, gender, brain metastasis, and NF1 mutation types (respectively, P = 0.98, P = 0.63, and P = 0.87). The mutations that showed the most association with NF1 mutations in brain metastases were PTEN and TP53. Somatic NF1 mutations and co-mutations can play a critical driving force in metastatic lung adenocarcinoma and may contribute to treatment resistance. The mutational landscape of somatic NF1 mutations and co-mutations can provide new insights into the pathophysiology of metastatic lung cancer, especially those that have metastasized to the brain.

Role of Ultrasonography in the Diagnosis of Acute Appendicitis

Introduction: Acute appendicitis is still prevalent as a major surgical emergency. Due to the fast progress of the ailment, surgery is often the most sensible approach to manage it. But any surgery comes with its fair share of risk. If the diagnosis of the disease can be made more accurate prior to surgery, the error rate of negative appendectomy can be greatly reduced. Aim of the study: The aim of the study was to evaluate the role of ultrasonography in the diagnosing acute appendicitis. Methods: This prospective cross-sectional study was conducted at the Institute of Nuclear Medicine &amp; Allied Sciences (INMAS), Rangpur with Department of Surgery &amp; Department of Pathology of Rangpur Medical College Hospital, Rangpur, Bangladesh. The study duration was 02 years, from 01January 2022 to 31 December 2023. A total of 100 cases were selected from those patients were come for ultrasound examination, send from the hospital with pain in the right lower quadrant of the abdomen for the purpose of this study. Result: Among the 100 participants of the study, histopathological diagnosis showed that 86% were acute appendicitis cases and 14% had normal appendicitis. Gender or age had no significant association with histopathological diagnosis, but male prevalence was observed in the study, with a high prevalence of young adults. The original site of pain was periumbilical pain shifted to the right iliac fossa for half the participants. Pain duration was between 18-24 hours for 36% of the cases. All participants presented with pain, fever, anorexia, and nausea had a high prevalence among participants. The sensitivity and specificity of high-resolution ultra-sonogram were 84.9% and 85.7% respectively. Conclusion: Appendicitis is a disease of the young, and can occur in participants of both genders. Histopathological diagnosis has no significant association with patient age or gender. Ultra-sonogram has high sensitivity and specificity ratio in diagnosing acute appendicitis and also h

Gender bias in assessing narcissistic personality: Exploring the utility of the ICD-11 dimensional model.

Narcissistic personality disorder as captured in categorical diagnostic systems (e.g., DSM-5) emphasizes grandiose features more associated with masculine norms and under-emphasizes vulnerable features more associated with femininity. This poses significant implications in diagnostic outcome and clinical treatment in women with narcissistic preoccupations. Research finds that clinicians using the DSM-5 categorical system tend to diagnose vulnerable narcissism in women as other 'feminized' personality disorders (e.g., borderline), but no research has explored gender differences in narcissism using the new ICD-11 dimensional framework for personality disorders. This study investigated the clinical utility of the ICD-11 approach in capturing gender differences in narcissistic presentations. Adopting an online vignette-based study, mental health clinicians (N = 157; 71.3% female) completed ratings of ICD-11 personality disorder severity and trait domains for two cases reflecting 'grandiose' and 'vulnerable' narcissism in hypothetical male or female patients. The results showed that ratings of core impairments in personality functioning and overall severity were consistent irrespective of patient or clinician gender, contrasting prior research using categorical models. While some differences were observed in trait domain (e.g., negative affectivity) between patient gender, these results suggest the clinical utility of the ICD-11 model as emphasizing elements of personality functioning in the process of assessment and diagnosis, therefore potentially being less susceptible to influences of gender stereotype in aiding clinical conceptualization.

Partnership Status And Prevalence Of Mental Disorders In Women And Men With Cancer

Patients facing the diagnosis of cancer are confronted with high stress levels, which increase the risk of developing a mental disorder. Being in a relationship moderates patients' mental health and can have a risk-reducing effect. We aim to describe the influence of partnership status on the 4-week-prevalence of mental disorders in cancer patients and how it varies by gender. As part of the secondary data analysis of a multicenter cross-sectional study, 1857 patients with cancer (51,6% women, age 18-75 years, Ø age 57 years, 79,7% in a partnership) were assessed using a written questionnaire and, for the diagnosis of psychological disorders (4-week prevalence), the CIDI-O interview. Frequency calculations and binary logistic analyses were carried out. In the univariate analyses, the frequency of the presence of at least one mental disorder is significantly lower in patients who are in a relationship (25,4% vs. 35,3%, p<0,001). They are also less likely to simultaneously suffer from multiple mental disorders. These differences are also evident for individual classes of disorders. The multivariate gender-differentiated analysis confirms this trend. In addition to age and income as significant predictors, only men experience a significant protective effect of their relationship against the occurrence of a mental disorder (OR=2,5, p<0,001). There has been very limited research on the links between partnership status, gender, and mental disorders in cancer patients. The results found in our analyses should be further explored, particularly regarding the protective role of partnership against developing mental disorders. In the context of psycho-oncological care the status of living alone should be considered as a possible risk factor for developing mental disorders, especially in men.

A Comparative Ex Vivo Study on Apex Locator Precision in Mature Teeth and Immature Teeth With Divergent Canals.

This study investigates the accuracy of an apex locator in mature andimmature teeth with divergent root canals ex vivo. Fifty extracted premolar teeth were utilized for the study, with 25 mature teeth (Nolla stage 9 or 10) and 25 immature teeth (Nolla stages ≤ 8). The discrepancies between the actual length (AL) and the electronic length (EL), measured using a Bingo 1020 apex locator, were compared and analyzed. Statistical analysis included Pearson's correlation analysis, a T-test for independent samples, and multiple linear regression. Statistical significance was set at p < 0.05. The difference between AL and EL in immature teeth was significantly higher than in mature premolar teeth. Nonetheless, patient gender or jaw type (upper/lower) did not affect the accuracy of electronic apex locator (EAL) measurements. EAL readings are less accurate in immature teeth than in mature teeth. Supplementary measures, such as radiographic length determination and wet-dry paper point tests, are required to confirm theworking length for improved treatment outcomes and patient compliance.