PRESENTATION AT Research Articles

Quality assessment of global liver cancer screening guidelines and consensus

Objective: To systematically assess the quality of guidelines/consensus on live cancer screening globally and provide references for the formulation of evidence-based guideline on liver cancer screening in China. Methods: PubMed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, SinoMed, and other related guideline development institutions were searched to identify guidelines on live cancer screening before June 30, 2020. Two experienced reviewers screened literature and extracted data independently. The Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ) and Reporting Items for Practice Guideline in Healthcare (RIGHT) were used to evaluate the quality of guidelines. Results: A total of 19 guidelines/consensus issued between 2003 and 2019 were included in this study. The quality of these guidelines was high according to AGREE Ⅱ, nine of which were recommended as level A, and the other five were graded as level B. Each guidance scored higher in scope and purpose, stakeholder involvement, and clarity of presentation. The reporting quality of basic information with 56.1% reporting rate was the highest based on RIGHT. The reporting quality of background (37.5%) and recommendations (39.8%) were acceptable. However, evidence (35.8%), review and quality assurance (18.4%), funding and declaration and management of interests (22.4%) and other information (21.0%) still need to be improved. Conclusions: Although the quality of screening guidelines for liver cancer is acceptable, the evidence, review and quality assurance, and funding and declaration and management of interests still need to be strengthened. There is still a lack of solely evidence-based medical screening guidelines for liver cancer in China.

Profound Hypoxemia From Right Ventricular Failure Following Acute Type A Aortic Dissection

Acute aortic dissection is a catastrophic event with high mortality rate if left untreated. Complications of aortic dissection are fairly common, and some of them increase mortality rates further, necessitating early diagnosis and treatment. We present a case of Stanford type A aortic dissection with an uncommon complication of right ventricular failure, which resulted in a rare presentation of persistent hypoxemia despite intubation and maximal ventilatory support. Other common causes of hypoxemia were ruled out and this was eventually attributed to the aortic dissection and emergency surgery was arranged for the patient. Our case can help to increase the awareness of such a potential association, which should be considered in future similar clinical situations, thus minimizing any delay in management. J Med Cases. 2021;12(4):145-148 doi: https://doi.org/10.14740/jmc3652

Pediatric nasal neuroglial heterotopia: report of 13 cases

Objective: To summarize clinical features and our experience of the diagnosis and treatment of pediatric nasal neuroglial heterotopia (NGH). Methods: Clinical data of 13 nasal NGH patients in Beijing Children's Hospital from August 2014 to October 2019 were retrospectively reviewed, including 9 boys and 4 girls, aged from 1 to 38 months with median age of 5 months. Radiological workups and excision of nasal NGH under general anesthesia were performed for all patients. B ultra-sound and MRI were performed for all external and mixed lesions, while ultra-low-dose CT scan and MRI for all intranasal type. Surgical approaches were dependent on location and extent of the lesions according to radiographic workup, including extranasal or transnasal endoscopic approach. Patients were followed up regularly after operation to evaluate the effect. Initial presentation, locations, imaging findings, surgical approaches and follow-up results were analyzed through descriptive statistical method. Results: Eight nasal NGH patients presented with an internal nasal mass and nasal obstruction, which belonged to intranasal type. Three patients presented with an external nasal mass which belonged to extranasal type and 2 patients had mixed lesions. The sites included nasal dorsum (n=5), anterior to the middle turbinate (n=5) and olfactory cleft (n=3). Surgical resections were done through median rhinotomy approach (n=5) or transnasal endoscopic approach (n=8). All the operations were successful and no complication occurred. All cases were followed up from 3 to 65 months. No recurrence was encountered. Conclusions: Nasal NGH is a rare lesion with atypical clinical presentation. Preoperative imaging including CT scan and MRI is essential for evaluation of the location, extent of the disease and for making the surgical plan. Treatment requires complete surgical excision.

Once-Daily Halobetasol Propionate 0.01% Lotion for Moderate-to-Severe Plaque Psoriasis: Phase 3 Analysis of Hispanic Participants.

Background Psoriasis is a chronic, inflammatory disease that may differ in prevalence and clinical presentation among patients from various racial and ethnic groups. Two phase 3 studies demonstrated efficacy and safety of halobetasol propionate (HP) 0.01% lotion in the treatment of moderate-to-severe plaque psoriasis (NCT02514577, NCT02515097). These post hoc analyses evaluated HP 0.01% lotion in Hispanic participants. Methods Participants were randomized (2:1) to receive once-daily HP or vehicle lotion for 8 weeks, with a 4-week posttreatment follow-up. Post hoc efficacy assessments in Hispanic participants (HP, n=76; vehicle, n=43) included treatment success (g2‑grade improvement in Investigatorrs Global Assessment and score of lclearr or lalmost clearr), psoriasis signs, and affected body surface area (BSA). Treatment-emergent adverse events (TEAEs) were evaluated. Results At week 8, 38.8% of participants achieved treatment success with HP versus 10.3% on vehicle (P=0.001). HP‑treated participants achieved greater improvements in psoriasis signs, compared with vehicle (Pl0.01 all). HP group had a greater reduction in affected BSA versus vehicle (P=0.001). Treatment-related TEAEs with HP were application site infection and dermatitis (n=1 each). Conclusions Once-daily HP 0.01% lotion was associated with significant reductions in disease severity in Hispanic participants with moderate-to-severe psoriasis, with good tolerability and safety over 8 weeks. J Drugs Dermatol. 2021;20(3):252-258. doi:10.36849/JDD.2021.5698.

Opportunities and Challenges in Using Information from Zambia’s Government Monitoring and Evaluation System

To ascertain the opportunities and challenges in using information from Zambia’s whole-of-government monitoring and evaluation system (WoGM&ES) was the main aim of this research study. The study is premised on the conviction that the acquisition and use of information from M&E is what lacks in key development decision- and policy- making development processes. Thus, the Zambian government would do well to strengthen the M&E function and improve its culture of using results across the public sector. The research approach taken was investigatory and descriptive. Two analysis tools were employed for data collection, collation, discussion, drawing of conclusions and recommendations as well as presentation—a diagnostic tool and the LEADS scoring system. While Zambia’s public sector system for M&E was in place, it was found to be weak in many ways. Efforts to improve the system were acknowledged by several stakeholders but clearly, the M&E gaps still left much to be desired if the country’s use of evidence to inform development processes was to match expected local and global standards. Using results from the diagnostic checklist and the LEADS scoring system, useful insights critical to assist the Government of Zambia and other stakeholders have been identified and espoused. Thus, national and decentralised level-government structures, civil society, parliament, academia, donors and other key stakeholders have been identified to be crucial partners towards enhancing the demand and use of information from M&E within and outside government. Collaborations by these stakeholders will lead to a strengthened WoGM&ES for Zambia’s public sector.

A distinção entre abdução e inferência da melhor explicação: a abordagem de Daniel Campos

Este artigo pretende oferecer uma apresentação e análise do artigo “On the distinction between Peirce’s abduction and Lipton’s Inference to the best explanation”, de Daniel Campos. Apresentamos uma reconstrução da argumentação de Campos a favor da distinção entre abdução e inferência da melhor explicação, enfatizando a interpretação de Campos sobre inferência da melhor explicação na perspectiva de Peter Lipton. Em contraposição a Campos, que defende uma distinção parcial entre abdução e a inferência da melhor explicação, neste artigo sugerimos uma distinção completa entre as formas de raciocínio.

Elliptical shadow on the cervical spinal cord.

Chiari type 1 deformation can show progressive degenerative neurological presentation in the elderly.

CISTACEAE PLANTS OF ISRAEL AND PALESTINE. UNDER-INVESTIGATED FAMILY WITH GREAT POTENTIAL

Cistaceae plant family is one of the most under-investigated families in our region. Few plants of this family were reasonably studied, but most of them were either totally “ignored” or very limitedly published. Those that were studied reveal the richness in special natural products that have unique structures with special sub-units. Even traditional medicines worldwide made very little use of these plants, compared with other plant families that grow in Israel and Palestine. In this short review article, we will present some ethnomedicinal uses of this family's plants, along with a comprehensive literature survey of medicinal, biological and other activities published by modern research. The presentation will include tables and figures for the convenience of readers. The discussion section will focus on some of the studies about chemistry and the biochemistry of the special natural products of this family and the importance of accurate scientific reporting. To the best of our knowledge, a review article about this plant family of our region was never published and it will be a significant contribution since very few review articles about this family were published hitherto. Conclusions and future research recommendations are presented for the benefit of interested scholars.

Sarcoidosis Presenting as Cranial Multinevritis

A 29-year-old woman presented to the emergency department with red eyes and hypoacusia since the previous weeks associated with a sudden right facial palsy. Ophthalmologic examination revealed bilateral uveitis and lumbar puncture was compatible with aseptic meningitis. Thoracic computed tomography scan showed pulmonary nodules and mediastinal and hilar lymphadenopathy. Bronchoalveolar lavage revealed a CD4/CD8 ratio of 8, and lymph node biopsy confirmed non-caseating granulomas. The diagnosis of sarcoidosis with ocular, pulmonary, and neurologic involvement was made. Due to sarcoidosis severity at presentation, the patient was started on systemic steroids and methotrexate with improvement. Sarcoidosis involvement of the central nervous system is a rare condition (5-10%) but can be the first manifestation of the disease. Its presentation can be heterogeneous; therefore, symptoms are frequently devalued by patients and physicians, leading to a late diagnosis and permanent damage. Clinicians’ awareness is crucial to early diagnosis and treatment. J Med Cases. 2021;12(3):112-114 doi: https://doi.org/10.14740/jmc3635

Cerebral Air Embolism After Gastrointestinal Procedure: A Case Report and Literature Review

Esophagogastroduodenoscopy (EGD) is one of the forefronts of minimally invasive modalities with excellent safety records and tremendous capability but despite its accolades and functions, there are still very rare complications including air embolism. It is a life-threatening condition that could lead to a significant increase in morbidity and mortality. However, there are limited data for incidence of air embolism in association with gastrointestinal endoscopy. Diagnosis of air embolism after or during gastrointestinal endoscopy might be a difficult task due to overlapping presentations with anesthesia effects on the cardiopulmonary and the neurological systems, as a result, there should be increased awareness allowing clinicians to quickly rule out air embolism in patient with altered mental status or cardiopulmonary changes after or during gastrointestinal endoscopy. Herein, we report a unique case of cerebral air embolism after EGD in a 79-year-old female patient. In addition, we also performed a systematic review of cases based on PRISMA guideline, with the aim to investigate the demographics and clinical outcomes associated with this complication. This systematic review of cases hopes to increase the awareness about this rare entity. J Med Cases. 2021;12(3):119-125 doi: https://doi.org/10.14740/jmc3639

Pattern of Visual Attention according to Presentation Type of Language Information in Life Science VR Contents - Eye Tracking Study -

Pattern of Visual Attention according to Presentation Type of Language Information in Life Science VR Contents - Eye Tracking Study -

Editorial: Presentations at the 4th Workshop of the German Astrobiological Society (DAbG) on Astrobiology, 26–27 September 2019, Vienna, Austria

Editorial: Presentations at the 4th Workshop of the German Astrobiological Society (DAbG) on Astrobiology, 26–27 September 2019, Vienna, Austria

El mono filósofo. Presentación de El mono de Heidelberg, cuento de Michael von Albrecht

Michael von Albrecht, el gran catedrático emérito de Filología Latina y autor, entre otras obras pioneras, de la monumental Historia de la literatura romana, publicó en 1989 un cuento en latín con el título de De simia Heidelbergensi (El mono de Heidelberg). El objetivo de esta presentación es proporcionar al lector un breve panorama sobre esta preciada joya de la literatura neolatina y presentarle, al mismo tiempo, la actualidad que lo recorre, capaz de trascender la ficción cuentística. Michael von Albrecht, great Emeritus Professor of Latin Philology and author, among other pioneering works, of the monumental History of Roman Literature, published in 1989 a short story in Latin under the title De simia Heidelbergensi (Heidelberg's Monkey). The objective of this presentation is to provide the reader with a brief overview of this precious jewel of Neo-Latin literature and reveal, at the same time, current events that run through it, capable of transcending short story fiction.

Chalk and Talk Versus Powerpoint: Perception among Medical Students

Introduction: The emerging technologies made by day changing the techniques of teaching medicaleducation. The teaching technique has changed since the last decade from the old traditional techniqueof chalk and talk (CNT) to a newer technique of Power-point presentation (PPT) to the video classroomsconverting the whole traditional environment of the classrooms. This paper aims to access the perception ofthe medical students about these two instructional method.Materials and Method: In this study cross-sectional descriptive survey was used. Medical students wereselected through non-probability convenient sampling. The data were collected using a questionnaire-basedsurvey about their views and perception of two method of lecture delivery, viz., PPT presentation, and usinga chalkboard. For each of the two method, the students were asked to rank twelve comments on a four-pointscale: strongly agree, agree, disagree, or strongly disagree. The data was analyzed using SPSS version 16and the results expressed as proportions.Results: In our study where more than 97% of our study respondents emphasized the value of chalk andtalk and declared it as the more effective and useful teaching tool in their learning experience compared toPowerPoint (86%) and recommended it for teaching.Conclusion: Both CNT, as well as PPT, are the effective method for medical education and both can be usedin combination for the effective delivery of classroom sessions.

A Case Presentation on Acute Lymphonodular Pharyngitis with a Review

Acute lymphonodular pharyngitis is a viral infection predominantly caused by coxsackievirus and is seen in children. The infection is characterized by typical prodromal symptoms of mild fever, sore throat, difficulty in deglutition. The characteristic clinical presentation reveals multiple raised, discrete, yellowish-white non-vesicular lesions with surrounding erythematic appearance commonly seen on the roof of the posterior aspect of the oral cavity. The lesions have been identified as early as 1962, described in detail in the literature. These lesions may be common but are often overlooked due to less knowledge among the patients or rather the patients not directly reporting to the dental office. We present with a case of a five-year-old apparently healthy child with a detailed description of symptoms, clinical features, follow up, differential diagnosis and review. This article aims to bring awareness of the disease in the present form to the readers with the purpose of early detection and identification of condition for treatment. We found very less review in the literature over past years which bring us to understand that it is overlooked though it has been identified in the early years. The disease may be reported less, but it is not obsolete to be discarded.

Changes in Knowledge of Time among Gabra Miigo Pastoralists of Southern Ethiopia

ters, although coherent knowledge of ti_me representations was unequally distributed within Gabra Miigo soci ety . We discuss how knowledge of time representa tion has changed and how modemi1.ation and Islam have aiTected this knowledge. Knowledge of time representatio ns that regulate the age system has fas the influence of [slam has grown. However, time re presentati ons that serve to retain historical memories are gaining social value i_n the modern contexl. Those who are well inro rmed in such time repres entations have become experts'' and have begun to act as leaders. Gabra Miigo society . which was traditio nally acephalous, is becoming a more top-down and central­ ized socie ty.

Brachymetacarpia and brachymetatarsia: do we need to operate?

Brachymetacarpia and brachymetatarsia are rare congenital presentations denoted by shortening of metacarpals and metatarsals respectively, in which the deformity usually presents around childhood/early adolescence.The aetiology is usually congenital besides several other syndromic or endocrinologic associations.Cosmetic issues such as absence of a normal-looking knuckle while making a fist or disruption of finger-tip curvature besides functional issues are the main indications for surgical intervention in brachymetacarpia.In the foot, apart from cosmetic issues, pain due to transfer metatarsalgia as well as callosities along with toe deformities which lead to difficulty of using footwear are the main indications for intervention.Lengthening of the affected bone, either acute with grafting or gradual, is the mainstay of treatment. Gradual lengthening can be either single-stage as in callotasis, or two-stage where the primary procedure is followed by bone grafting after the length has been achieved.Adolescence, specifically between 12 and 15 years, is the preferred period for surgical intervention in these cases.Cite this article: EFORT Open Rev 2021;6:15-23. DOI: 10.1302/2058-5241.6.200087

Presentation

Presentation

COVID-19 Infection in Children and Young Adults with Chronic Kidney Disease: A Single Center Experience

Background: Coronavirus has affected millions of people worldwide and its severity is more pronounced in those with comorbidities; there is paucity of literature on its presentation and course in children and young adults suffering from chronic kidney disease (CKD). Aims: The aim of the study was to describe the clinico-epidemiological, biochemical, and radiological profile of children and young adults (up to 25 years of age) having CKD with coronavirus disease 2019 (COVID-19). Methods: This retrospective study was done at a tertiary care “dedicated COVID” hospital between May 1, 2020 and August 30, 2020. Ten children and young adults (up to 25 years of age) with underlying CKD who tested positive by reverse transcription polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 infection and were hospitalized during this period were included; their clinical presentation, outcomes, biochemical, and hematological parameters were recorded and analyzed. Results: All 10 patients (seven males and three females) were in stage 5 of CKD and were undergoing maintenance hemodialysis at admission. Fever and cough were the most common presenting symptoms of COVID-19, while anemia (100%), leukopenia (50%), lymphopenia (30%), and thrombocytopenia (30%) were the hematological findings. Radiological abnormalities on chest radiography were seen in 50% patients with a majority having bilateral lesions. The median (range) duration of hospital stay was 21.5 (10–46) days; five (50%) patients needed intensive care support and one patient required mechanical ventilation who eventually expired. Conclusion: The presenting features of COVID-19 were similar in children and young adults with underlying CKD compared to their healthy counterparts; however, the mortality rate and intensive care requirement were higher and duration of hospital stay too was longer.

Subacute invasive pulmonary aspergillosis

Subacute invasive pulmonary aspergillosis (IPA) is an indolent cavitating infectious process which can mimic other chronic lung infections such as tuberculosis. This usually occurs in mildly immunosuppressed individuals and clinically evolves over weeks to months. Radiological presentation is in the form of thick-walled cavity with or without mycetoma, fibrosis, and pleural invasion. Here, a case of subacute IPA in a middle-aged female with rheumatoid arthritis is reported, highlighting a rare radiological appearance.