PRESENTATION AT Research Articles

Complications related to unwitnessed magnet ingestion in paediatrics: Case series.

Foreign body inges tion is one of the mo s t common problems a mo ng chi ldren. There is a great te ndency among children between the age of six months to six years to p lace objects, such as coins, fish bone, pins, button batteri es, magnets and o th er hous ehold ite ms, in their m outh and often swa llow them. Magnet ingestion is not uncommon. Hazardous effects can occur owing to the fact that these are usually unwitnessed leading to disparity in histor y an d delayed presentation. Nowadays these m agnets are made of Neodymium which is a s trong element and can be moulded into various shapes and sizes, making them more attractive to children . Single magnet ingestion may pass with out complication, bu t multip le ingested magnets pose risk of severe complications such as obstruction, inter bowel fistulae, and perforation often requiring urgent intervention. Here, we present three cases who presented to the emergency d epartment with unusu al prese nt ation s an d ultimately under went exp loratory La parotomy with surprising intra- operative findings along with magnetic objects.

ЧУВСТВО БЕЗОПАСНОСТИ И ВОСПРИЯТИЕ БАЗОВЫХ ЭМОЦИЙ: ЭКСПЕРИМЕНТАЛЬНОЕ ИССЛЕДОВАНИЕ С ИСПОЛЬЗОВАНИЕМ МЕТОДА ОКУЛОГРАФИИ

Background. Th e relevance of the study is determined by the need to understand emotional aspects of safety and psychophysiological mechanisms underlying it, which are signifi cant for the development of resources for its self-provision. Objective. To analyze the relationship between the feeling of safety and perceived basic emotions, taking into account diff erent ways of presenting stimulus material, as well as individual and gender diff erences. Methods. Th e study implemented the oculography method (eye tracking), paired comparisons, the “EmIn” test measuring emotional intelligence, the TIPI-RU personality questionnaire, comparative and correlation analysis. Sample. Th e study involved students and staff of the Far Eastern Federal University (N = 13, mean age 26.5 years), the database included 819 measurement procedures. Results. Joy and anger are the most signifi cant emotions for a person’s sense of safety and are associated with individual and gender diff erences established during the study depending on the ways of presenting stimulus material. Th e study revealed the predominance of gaze fi xations in the subjects of both sexes on the female faces, on the emotional expressions of anger, fear (on women faces) and joy (on men faces). Correlation analysis established closer connections of the sense of safety with emotions of calmness, joy and disgust, less pronounced connections — with emotions of surprise and fear. Although when perceiving both photographs of faces and descriptions of emotions the largest number of choices were made in favor of positive emotions as the safest ones, analysis of physiological reactions revealed a predominance of gaze fi xations on the negative emotions as well. Conclusion. A person can associate with a sense of safety not only positive and neutral emotions but also the negative ones. Th e most security-threatening emotions are disgust and anger, the safest ones are joy, calmness and surprise (for women — mostly joy, for men — calmness). Compared to men, women rate sadness and disgust as safer emotions, while anger and fear — as less safe. Attribution of emotions as associated with safety is correlated with high scores on the “openness”, “emotional stability” and “emotional intelligence”. Th e results obtained contribute to the study of the emotion recognition mechanism, taking into account the ways of stimulus prese ntation, to the study of the psychophysiological aspects of the safety perception, and can be used in the development of tools for training emotional intelligence.

ОПЫТ РАЗРАБОТКИ БАЗЫ РАДИОЭКОЛОГИЧЕСКИХ ДАННЫХ ДЛЯ ОЦЕНКИ РАДИАЦИОННОЙ БЕЗОПАСНОСТИ ОКРУЖАЮЩЕЙ СРЕДЫ

A radioecological database is developed using theresults of radiation monitoring over the period from 2000 to 2019 in the areas of six reference nuclear power facilities: three nuclear power plants with different types of nuclear reactors (Novovoronezh, Leningrad, and Beloyarsk NPPs) and three combines (Priargunsky Industrial Mining and ChemicalUnion, Mining and Chemical Combine, and Mayak Production Association). The goals of creating the radioecological database are formulated. The principles implemented during its development and operation are indicated. The structure of the database and the format of data prese ntation are shown. A general description of the database is given. The availability and distribution of data over the years, various environmental objects, and technogenic radionuclides are analyzed. Examples of using the information stored in the database for assessing the environment radiati on safety based on the environmental criteria are given.

Frequency and Risk Factors of Diabetic Ketoacidosis in a Specialized Children's Hospital, Riyadh: A Cross-sectional Study.

ObjectivesDiabetic ketoacidosis (DKA) is a life-threatening complication and a leading cause of hospitalization in patients with type 1 diabetes mellitus (T1DM). We aimed to assess the risk factors of admissions of children with DKA in a specialized children’s hospital to reduce morbidity and inform appropriate prevention and intervention strategies.MethodsWe conducted a retrospective review of all DKA admissions at King Abdullah Specialized Children’s Hospital, Riyadh (March 2015–December 2017). Data were gathered from newly diagnosed patients with T1DM and known patients ≤ 14 years old with DKA criteria. The main variables were frequency, precipitating factors, and other characteristics of DKA admissions in both groups.ResultsA total of 116/562 patients with T1DM (mean age 8.9±3.0 years) had 146 DKA episodes, of which 42/116 (36.2%) were newly diagnosed. The frequency of DKA admissions were 146/562 (26.0%), of which 42/141 (29.8%) were newly diagnosed versus 104/421 (24.7%) known T1DM patients. The majority were 10–14 years old (p ≤ 0.001), and 77.8% were females. Missing insulin was the main cause of DKA (p = 0.001) among known patients with T1DM. Recurrent episodes (n = 30/146, 20.5%) occurred in 15/116 patients and were more common in children ≥ 10 years of age (p = 0.024). The mean length of stay was 2.6±2.0 days and increased with DKA severity (p = 0.008).ConclusionsMost DKA episodes were in patients with known T1DM and missing insulin was the leading cause of DKA. In addition to awareness campaigns to prevent DKA as an initial presentation, intervention strategies should also target high-risk groups of known patients of T1DM such as adolescents and patients with recurrent episodes.

Splenomegaly (SPML) in Polycythemia Vera (PV): Its Clinical Significance and Relation to Myelofibrosis and Survival

▪Introduction: SPML is considered a hallmark of PV, but its frequency, as reported in the literature, ranges from 20% to 75%. It has been assumed, without documentation, that SPML may be accompanied by symptoms and signs and may affect prognosis. Moreover, expensive radiographic tests have become mandatory in some recent phase 2 drug trials in PV (and ET) to carefully document spleen size on trial entry and its change, if any, during therapy. Because systematic studies have not been performed, we studied SPML in patients (pts) with PV at their initial diagnosis (DX) or at first presentation (PRES) at our institution, Weill Cornell Medicine (WCM), and determined its clinical significance.Methods: This single-center retrospective study was approved by the WCM institutional review board. A systematic literature search including PubMed, Embase, and Cochrane School relevant to the specific search questions was unrevealing. We used a research data repository based on an automated query system which had aggregated longitudinal clinical information pertaining to our PV patients for our analysis of spleen size (Abu-Zeinah et al. Leukemia 2021). Standardized PV diagnostic criteria were used for all pts (Silver et al. Blood 2013). As a tertiary referral center within a major metropolitan area, our PV population is composed of those diagnosed at WCM (DX) and those presenting to WCM some time after diagnosis (PRES). Degree of SPML was categorized into 3 subgroups: (1) <1 cm if the spleen was not enlarged, (2) palpable 1-5 cm, or (3) more than 5.0 cm below the left costal margin of the abdomen in the medial clavicular line in the supine or left lateral decubitus position; it was also considered enlarged after splenic ultrasound scan (US) based upon the method and verified formula of Chow KU, et al. Radiology 2016. Spleen size was correlated with age, sex, race, and ELN risk score, and symptoms including pruritus, night sweats, anorexia, abdominal discomfort and pain. Progression to myelofibrosis (MF) with myeloid metaplasia was defined per ELN/IWG-MRT criteria. Spleen measurements after progression to MF were excluded. Peripheral blood smears were routinely examined to view RBC morphology and to exclude leukoerythroblastosis. MF-free survival (MFS) and overall survival (OS) were calculated using the Kaplan-Meier log rank test among the various spleen subgroups. Multivariable survival analysis (MVA) was performed using a Cox proportional hazards model.Results: From our 470 PV dataset, 351 pts had documented spleen size at DX (165) or PRES (186). The median age for all patients was 60 years (yr), for DX 54 yr, for PRES 62 yr. The median DX ages of SPML <1 cm, 1-5 cm, and >5 cm were 56, 50, and 54 yr respectively (p=0.011). The median time between first evaluation for PV and first visit at WCM (PRES) was 2 years (range 0-30). 49% were female and 13% were non-white (Figure 1a). There was no correlation between spleen size and ELN risk scores. The linkage between SPML and symptoms will be reported. Overall survival of the three groups was similar at 12 years (Figure 1b). SPML at presentation, however, was associated with increased risk of MF (1-5cm versus 0: HR 2.56, p=0.026; >=5cm versus 0: HR 5.64, p<0.001), independent of age or disease duration in MVA.Discussion & Conclusion: Patients who had SPML > 5cm at presentation had a worse MFS than those with a lesser degree of SPML or no SPML (1-5 cm or <1 cm). For determining SPML, clinical examination and calculated US length were equally satisfactory. In the absence of clinical SPML, radiographic tests appear unnecessary. However, for SPML > 5cm, and unusual body types, more detailed radiographic studies may still be required. SPML was more common in younger patients, suggesting more aggressive disease and earlier progression to MF. ELN risk category did not correlate with SPML, suggesting an additional reason for its revision. Our PV patients with SPML > 5cm at DX or PRES did not have a decreased OS at 12 years, but did have a reduced MF-free survival. These data support the WHO mandated requirement for marrow biopsy for diagnosis of PV, especially for patients with SPML but also as a baseline requirement to establish the presence of MF less than grade 2. Patients with SPML> 5cm appear to be at high risk of MF progression and must be monitored closely for this event and treated appropriately. [Display omitted] DisclosuresSilver: Abbvie: Consultancy; PharamEssentia: Consultancy, Speakers Bureau. Scandura: CR&T (Foudation): Research Funding; European Leukemia net: Honoraria, Other: travel fees ; MPN-RF (Foundation): Research Funding; Constellation: Research Funding; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Abu-Zeinah: PharmaEssentia: Consultancy.

Clinical Prediction Score for Diagnosing Non-Diabetic Renal Disease in Patients with Type 2 Diabetes Mellitus

Background: When non-diabetic kidney disease (NDKD) is suspected, biopsy proven is used for definite diagnosis. However, there are not always easily available and may lead to cause complications. A clinical prediction score may help selecting appropriate patients for kidney biopsy. Objective: To develop a clinical prediction score for distinguishing any type of NDKD (NDKD alone or coexisting NDKD and diabetic nephropathy [DN]) and DN alone. Materials and Methods: A retrospective cohort study was conducted in type 2 diabetes mellitus (T2DM) patients with atypical features of DN, who had kidney biopsy at Thammasat University Hospital between 2011 and 2019. The present study divided patients into NDKD alone, coexisting NDKD and DN, and DN alone, confirmed by pathological diagnoses. The authors developed a clinical prediction score by weighing coefficients of predictors in a multivariable logistic model. Internal validation was performed with bootstrapping. Results: The present study included 81 patients of which 28 (34%) had NDKD alone, 15 (18%) had coexisting NDKD and DN, and 38 (41%) had DN alone. Primary membranous nephropathy, primary focal segmental glomerulosclerosis (FSGS), and secondary FSGS were prevalent in any NDKD. Absence of diabetic retinopathy (DR) showed a significant association with any NDKD (adjusted OR 3.72; 95% CI 1.28 to 10.8; p=0.02). The prediction score, AUROC of 0.75 (95% CI 0.63 to 0.86), had four predictors, duration of DM of less than 10 years, eGFR of more than 30 mL/minute/1.73 m², HbA1c of less than 8%, and absence of DR. Higher scores were associated with higher probability of NDKD. Conclusion: The present study clinical prediction score appears to be a useful tool to determine NDKD probability. T2DM patients with atypical presentation of DN with lower scores (0 to 2) may defer kidney biopsy. Keywords: Non-diabetic kidney disease; clinical prediction score; kidney biopsy; type 2 diabetes mellitus

CD19: Old allergen, new presentation: badge of honour

CD19: Old allergen, new presentation: badge of honour

Successful virtual presentations.

Successful virtual presentations.

[Guidelines for diagnosis and treatment of acute pancreatitis in China (2021)].

Acute pancreatitis is a common acute abdomen of the digestive system. In recent years,great progress has been made in the diagnosis and treatment concepts,methods and strategies of acute pancreatitis,which plays an important role in promoting the standardization of acute pancreatitis management and improving the level of patient treatment. Based on the previous guidelines and expert consensus,this guideline adopts an evidence-based and problem-oriented presentation in a way. Comprehensive analysis of the data of important domestic and foreign clinical research in the past 5 years,29 recommendations are formed after multi-disciplinary expert discussion which including diagnosis,treatments and follow-up,with the expectation of providing evidence support for clinical practice of acute pancreatitis in China.

How CFIHOS can help you recover from COVID-19

This paper is not published as no presentation was made at the APPEA 2021 Conference.

Presentations and presenters.

Presentations and presenters.

Venous sinus thrombosis in pediatrics. Case series of a tertiary hospital.

Venous sinus thrombosis (VST) is a rare entity in pediatrics, probably under-diagnosed and poten tially serious, described as a cause of stroke in childhood. To describe the clinical presenta tion, risk factors, treatment, and evolution of pediatric patients with VST. Re trospective study of patients admitted to a referral hospital, diagnosed with VST, aged between one month and seventeen years, from January 2011 to December 2019. The following data were re viewed: age at diagnosis, sex, signs and symptoms of presentation, predisposing mechanisms, study of thrombophilias, treatment and duration of treatment, follow-up protocol, long-term sequelae, and mortality. Due to their differences in clinical presentation, the sample was divided into two age groups: young children between 1 month and 5 years and older children and adolescents between 6 and 17 years. 17 patients were diagnosed with VST, 45% were women, with a median age of 4.5 years. The most frequent symptoms in older children (6-17 years old) were headache (80%) and diplopia (60%). In children under 5 years old, the most frequent clinical presentation was cerebellar ataxia (42%), asymptomatic (34%), and headache (25%). In 23.5% of the total, VST was a casual fin ding in neuroimaging. 13 patients presented relevant histories such as complicated otitis media with mastoiditis (53%), severe traumatic head injury (6%), and resection of a space-occupying lesion of the brain (6%). 23% of the cases were idiopathic and in 23% there were prothrombotic factors. The treatment of choice in all patients was low-molecular-weight heparin. During the short-term follow- up, 11.8% presented self-limited neurological symptoms. One patient presented long-term paresis of the sixth paired cranial nerve. There were no deaths or recurrences of the episode in our series. VST is a rare entity and it usually appears with signs and symptoms of intracranial hy pertension. It is a potentially serious condition and early diagnosis and treatment can help minimize long-term sequelae.

Occasional series of scientific tricks and tips: The best presentation of the meeting

Occasional series of scientific tricks and tips: The best presentation of the meeting

GARAP GENDERAN DALAM GENDING LAMPAH TIGA

 Gending lampah tiga composed by Harjasubrata in the 1950s. At the very beginning of its existence, lampah tiga composition focused and working on vocals, so gending lampah tiga has not been equipped with settled garap instruments. Most pengrawits find it hard to present gending lampah tiga, especially on ricikan gender, this is because the information about genderan lampah tiga is still limited. This article is entitled “Garap Genderan in Gending Lampah Tiga”, the problem  described in this article is how to present garap genderan in gending lampah tiga. The method that used to solve the problem in this article is to analyze and transcribe the presentation of gending lampah tiga, then interpreted.The writer hopes to provide an offer about how to interpret genderan in gending lampah tiga and to give a “little” contribution of thoughts for the development of karawitan science.

Presentation new editor: Nina Robbins

Presentation new editor: Nina Robbins

Presentation and Discussion

Presentation and Discussion

Low Serum Albumin Predicts Severe Outcomes in COVID-19 Infection: A Single-Center Retrospective Case-Control Study

Background: Coronavirus disease 2019 (COVID-19) can cause serious complications such as multiorgan failure and death which are difficult to predict. We conducted this retrospective case-control observational study with the hypothesis that low serum albumin at presentation can predict serious outcomes in COVID-19 infection. Methods: We included severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase-polymerase chain reaction (RT-PCR) confirmed, hospitalized patients from March to July 2020 in a tertiary care hospital in the USA. Patients were followed for 21 days for the development of the primary endpoint defined as the composite outcome which included acute encephalopathy, acute kidney injury, the requirement of new renal replacement therapy, acute hypercoagulability, acute circulatory failure, new-onset heart failure, acute cardiac injury, acute arrhythmia, acute respiratory distress syndrome (ARDS), high flow oxygen support, intensive care unit (ICU) stay, mechanical ventilation or death; and the secondary endpoint of death only. Univariate and multivariate logistic regression analyses were performed to study the effect of albumin level and outcomes. Results: The mean age was 56.76 years vs. 55.67 years (P = 0.68) in the normal albumin vs. the low albumin group. We noticed an inverse relationship between serum albumin at presentation and serious outcomes. The low albumin group had a higher composite outcome (93.88% vs. 6.12%, P < 0.05) and higher mortality (13.87% vs. 2.38%, P < 0.05) in comparison to the normal albumin group. The multivariate logistic regression analysis revealed higher odds of having composite outcomes with lower albumin group (odds ratio (OR) 10.88, 95% confidence interval (CI) 4.74 - 24.97, P < 0.05). In the subgroup analysis, the multivariate logistic regression analysis revealed higher odds of having composite outcomes with the very low albumin group (OR 7.94, 95% CI 1.70 - 37.14, P < 0.05). Conclusions: Low serum albumin on presentation in COVID-19 infection is associated with serious outcomes not limited to mortality. The therapeutic option of albumin infusion should be investigated. J Clin Med Res. 2021;13(5):258-267 doi: https://doi.org/10.14740/jocmr4507

Second Presentations of COVID-19 Due to Non–Variant-of-Concern Strains

Reinfection with SARS-CoV-2 is rare and primarily involves variants of concern (VOCs) with altered spike proteins that can elude antibodies. Now,

THE ROLE OF PARENTS TO ENLARGE STUDENT’S INTEREST IN LEARNING DURING THE COVID-19 PANDEMIC: A CASE STUDY IN INDONESIA

The aim of the study at determining the role of parents to enlarge student’s interest in learning during the Covid-19 pandemic. The research method uses quantitative with a case study approach in Indonesia. Collecting data using interviews, observation, and Likert scale questionnaires with descriptive data analysis. Data analysis techniques used data reduction, data presentation, and conclusions. The results show that the role of parents has a significant effect to enlarge student’s interest in learning during the covid-19.  Article visualizations:

Abstracts of the RCOG National Trainees Conference (NTC) 2021, 27-28 May 2021.

Abstracts of the RCOG National Trainees Conference (NTC) 2021, 27-28 May 2021.