Previous History Research Articles

Evaluation of an education program upon women's knowledge toward management of Breast Self – Examination(BSE)

To determine the evaluation of education program on women's knowledge regarding managing BSE. The present quasi- experimental study, Non-probability (purposive), sample consisting of (260) women who are employee, and students in both colleges (Nursing college, Medical and Health Techniques College). The sample consist of two groups, study group (130) including those in (Nursing college), and control group (130) in (Medical and Health Techniques College). A questionnaire was constructed which included, Demographic information, Reproductive information, Family history, Previous medical history, and information about women's knowledge toward management of breast self examination (BSE). Instrument validity and reliability was determined. Data were collected through the use of the questionnaire, the application of the educational program a post-test was done for the study only which use the lectures, booklets, training practice of BSE, and video film. Analysis of data was performed through the application of descriptive and inferential statistical data analysis approach. Revealed that the women in the study group had benefited from the implementation of the educational program; their knowledge regarding managing BSE was adequately improved and developed. The study illustrated significant difference between women's knowledge means in pre and post test periods regarding their managing for BSE. Implementation of proposed model of continuous medical education for women for BSE within the scope of their work.

Long-term clinical outcomes of hypofractionated stereotactic radiotherapy using the CyberKnife robotic radiosurgery system for jugular foramen schwannomas.

Jugular foramen schwannomas (JFSs) are rarely seen, benign tumors with slow growth. Today, management options for JFSs include observation, surgery, and radiation. However, the optimal treatment strategy remains controversial. Stereotactic radiosurgery serves as a minimally invasive alternative or adjuvant therapeutic regimen of microsurgery. Gamma Knife radiosurgery is suitable for patients with JFS who have small- and medium-sized tumors and normal cranial nerve (CN) function. Hypofractionated stereotactic radiotherapy (HSRT) offers a potential radiobiological advantage and may result in better preservation of normal structures compared to single-fraction stereotactic radiosurgery. The aim of the article was to review the clinical and radiographic outcomes of patients with JFS who were treated using HSRT. The authors retrospectively analyzed 74 patients with JFS who received HSRT between January 2009 and January 2020 in the authors' center. Among them, 53 patients were newly diagnosed with JFS, 19 patients had a previous history of microsurgical resection, and the other 2 patients underwent CyberKnife because of tumor recurrence after Gamma Knife radiosurgery. A total of 73 patients had preexisting CN symptoms and signs. The median tumor volume was 14.8 cm3 (range 0.5-41.2 cm3), and most of them (70.3%) were ≥ 10 cm3. The radiation dose regimen was prescribed depending on the tumor size, and more fractions were used in larger tumors. The median margin doses prescribed were 18.2 Gy/2 fractions, 21.0 Gy/3 fractions, and 21.6 Gy/4 fractions. The median follow-up was 103 months (range 18-158 months). After treatment, 42 (56.8%) patients had tumor regression, 27 (36.5%) patients had stable tumors, and 5 (6.8%) experienced tumor progression. Among them, MRI revealed that 1 patient had a complete response. Three patients received surgery at a median of 25 months because of tumor progression. One patient underwent ventriculoperitoneal shunt insertion for hydrocephalus that developed after HSRT independent of tumor progression. The 5-year progression-free survival rate was 93.2%. Preexisting cranial neuropathies improved in 46 patients, remained stable in 14, and worsened in 14. HSRT proved to be a safe and effective primary or adjuvant treatment strategy for JFSs, although 14 patients (18.9%) experienced some degree of delayed symptomatic deterioration posttreatment. This therapeutic option was demonstrated to provide both excellent tumor control and improvement in CN function.

First report of Apple bitter rot caused by Colletotrichum godetiae in Ontario.

Bitter rot is an emerging disease of apple (Malus domestica) fruit in Ontario in part due to changing weather conditions. The disease was mostly documented in warm and humid regions such as the southern USA, and Central and South America. Thirteen Ontario orchards in the fall of 2019 and 15 in 2020 were scouted for bitter rot based on their previous history of the disease. 100 fruit were collected from ten asymptomatic trees per cultivar and two susceptible cultivars, 'Empire' and 'Ambrosia' were scouted per orchard. If an orchard did not have either one of these cultivars, 'Honeycrisp' or 'Gala' were used. The fruit was stored at 4-5 oC for five months and then left at 22 oC for two weeks and assessed thereafter for bitter rot symptoms. Monoconidial cultures of Colletrotrichum spp. were established from the symptomatic fruit using potato dextrose agar media with antibiotics at 22 oC 14-hour light cycles. The fungal isolates were divided into two groups based on colony morphology observations seven days after culturing. The first group showed light grey, cottony, aerial mycelium on top and a pink to dark red color on the reverse of the plate. The second group showed light to dark grey, cottony mycelium on top and dark green colonies on the reverse of the plate. It is difficult to identify Colletrotricuhum species solely based on morphology, therefore the representative isolates from each group were used for multilocus gene sequencing and species identification. Genomic DNA was extracted using the Qiagen DNeasy Plant Mini Kit according to the manufacturer's protocols. The ITS region was amplified and sequenced using the primers ITS-1F (Grades & Bruns 1993) and ITS-4 (White et al. 1990). Primers T1 and T2 (O'Donnell & Cigelnik 1997) were used to amplify and sequence the 750 bp region of the TUB gene. Primers GDF1 and GDR1 (Guerber et. al. 2003) were used to amplify a 280 bp region of the GADPH gene. Following an NCBI nucleotide blast search, the isolates from group 1 were identified as C. fioriniae.The ITS sequences of group 2 isolates were matched 100% to the Colletotrichum godetiae type strain CBS133.44 and they were 99% matched to the closest species C. Johnstonii CBS128532. The TUB sequences matched 100% identity to 20 sequences belonging to C. godetiae, 99.59 % identity to C. godetiae type strain CBS133.44, and 97.75% to C. Johnstonii CBS128532. The GADPH sequences matched with 100% identity to C. godetiae ON241087.1 or MT816329.1 and 99-99.5% identity to the type strain CBS133.44 and 98.61-99% identity to CBS128532. Based on the blast results the group 2 isolates were identified as C. godetiae and their sequences were submitted to GenBank with ID OP702962 for ITS and OP972240 and OP972241 for GADPH and OP972242 for the TUB gene. Out of 50 isolates collected in this work, 94% belonged to group 1 and 6% belonged to group 2. Koch's postulates were performed on selected isolates by artificial inoculation of 5 healthy detached fruits of the cultivar, 'Empire.' Fruit surfaces were wiped with 70% ethanol, dried, wounded with a sterile needle, and then inoculated with a 10 µl of spore suspension containing 1x10^6 spores /ml. Inoculated fruits were incubated in a humid chamber at 22°C in dark. Symptoms started to appear at 5 days post-inoculation and looked like small brown circular lesions which developed orange spore masses as they grew into larger lesions. The non-inoculated control fruit did not develop lesions. Fungal colonies were established from the spores collected from the inoculated fruit and found to have identical morphological characteristics to the original isolates. C. godetiae has previously been reported to cause bitter rot in apples from various countries in Europe (Baroncelli et al. 2014; Munda, 2014; Wenneker et al. 2016). C. fioriniae has previously been reported as the dominant species causing bitter rot in apples although other species including C. chrysophilum and C. noveboracense have also been reported as causal agents from the Eastern USA (Khodadadi et al. 2020). To the best of our knowledge, this is the first report of Colletotrichum godetiae causing the bitter rot of apples in Ontario, Canada.

Incidence and characteristic of deep venous thrombosis in hospitalized chronic heart failure patients.

This study was conducted to investigate the incidence of deep venous thrombosis (DVT), outcomes and its characteristics in patients with chronic heart failure (CHF) in a retrospective setting. Patients died of cardiac shock or acute exacerbation of heart failure (HF), admitted to intensive care unit (ICU) due to acute exacerbation of HF, patients decided to withdraw treatment and return home due to acute exacerbation of HF. From January 2015 to June 2022, we admitted 359 patients diagnosed with CHF, and lower limb ultrasonography was performed for the examination of DVT after admission. The incidence of DVT was recorded and patients with known risk factors of VTE were identifiedand excluded after incidence of DVT was calculated. Patients' clinical data were thencollected. The occurrence of DVT was 10.0% (36/359), as calf intramuscular vein thrombosis was the main constitution (n = 28, 75%). DVT patients with other factors (carcinoma, surgery, stroke, previous history of DVT) constituted a considerable part (33.3%, 12/36). Age, history of Diabetes Mellitus (DM), levels of DDi (D-Dimer), levels of alanine transferase (ALT) and left ventricular end-diastolic diameter (LVEDd) were independent predictors or risk factors of DVT in CHF patients, while chronic kidney disease (CKD) stage 1-4, white blood cell (WBC) and direct oral anticoagulant (DOAC) were protective factors. Incidence of DVT was correlated with a poor outcome of CHF patients (Pearson Chi-Square test, Value 19.612, P < 0.001). In this retrospective study, incidence of DVT was found to be relatively high among hospitalized CHF patients, while patients with DVT was associated with a poor prognosis.

Prevalence of Urinary Tract Infection and Anemia and Their Associated Factors Among Pregnant Women

Background: Urinary tract infections (UTIs) and anemia are significant disorders that occur during pregnancy, potentially leading to severe complications. Objectives: This study explored the prevalence of urinary tract infections and anemia, along with their associated factors, among pregnant women. Methods: A cross-sectional retrospective study was conducted with 700 pregnant women attending clinics in Khash, Iran, in 2022. A self-administered questionnaire collected data on the socio-demographic and clinical factors of these women. The data were analyzed using descriptive statistics and the chi-square test in SPSS software, version 22. Multiple logistic regression models were used to calculate the adjusted odds ratio (AOR) with a 95% confidence interval (CI). Results: The prevalence rates of anemia and urinary tract infections were 63.6% (95% CI: 59.8 - 67.1) and 49% (95% CI: 45.2 - 52.7), respectively. Significant associations were observed between anemia and the number of medical care visits, smoking status, the use of iron and folic acid supplements, history of abortion, and thalassemia (P-value &lt; 0.05). Additionally, income level, previous history of urinary tract infections, education level, and syphilis were significantly associated with UTIs among pregnant women (P-value &lt; 0.05). Conclusions: The prevalence rates of anemia and UTIs among pregnant women are high. Consequently, standard antenatal care services, as recommended for the early identification of risk factors, should be emphasized by the Ministry of Health and its stakeholders to mitigate the high prevalence of anemia and UTIs during pregnancy and their associated complications.

Repositioning of herniated buccal fat pad following blunt trauma - Rare case report in pediatric patients

Herniation of the buccal fat pad in pediatric patients is a rare injury, occurring due to a breach in the buccinator muscle, often termed traumatic pseudolipoma in infants. This condition plays a crucial role in cheek contour in adults. Two case reports detailing the management of this rare injury in young children emphasize the importance of assessing mucosal perforation and considering previous trauma history for accurate diagnosis. These reports provide valuable insights for healthcare professionals, contributing to the understanding and management of uncommon medical conditions.

The impact of video gaming and playing a musical instrument on robotic surgical simulator performance - the Robotic Surgical Simulator Study (RS3)

BackgroundA personal history of video gaming has been associated with improved laparoscopic skills acquisition in some but not all studies. The impact of playing a musical instrument on laparoscopic or robotic proficiency is less investigated. MethodsThis study evaluates the impact of video gaming, playing a musical instrument, and other demographic parameters on robotic simulator proficiency in a cohort of 27 participants. Candidates performed 3 standardized exercises on a virtual reality robotic training platform, resulting in a proficiency score. After completing a detailed survey, participants repeated the standardized exercises to obtain a basic learning curve. Gaming history, playing a musical instrument, surgical experience, and demographic parameters were correlated with overall robotic proficiency and improvement during the experimental session. ResultsParticipants with previous gaming history had 33 % higher overall robotic performance scores (p = 0.02). There was no difference in performance between surgical trainees and attending physicians with high volume laparoscopic surgery experience (average of 77 laparoscopic procedures). In this small cohort, playing an instrument had no influence overall (p = 0.2), but we found a trend towards increased proficiency in those playing the piano, yielding 30 % higher scores (p = 0.14). Participants performed up to 22 % better in the second run of the "Suture Sponge" exercises (p = 0.08), indicating a steep learning curve of simulated robotic surgery. ConclusionsA history of video gaming and playing the piano is associated with improved performance on a virtual-reality robotic surgical simulator. The steep learning curve underlines the benefit of virtual robotic surgical training before performing robotic procedures on patients.

Hypercalcaemia as a suspected paraneoplastic syndrome to feline intestinal leiomyosarcoma

AbstractA 13‐year‐old, female, neutered, domestic, shorthair cat presented with a history of weight loss and vomiting. An intra‐abdominal mass was palpated during clinical examination, and total hypercalcaemia was noted on biochemistry. Imaging findings were consistent with a jejunal mass, which was surgically resected, and an end‐to‐end anastomosis was performed. No other obvious signs of metastatic disease were observed. The hypercalcaemia resolved after 14 days, and histopathology results identified a leiomyosarcoma, which was confirmed by immunohistochemistry staining. After 200 days, the patient returned with signs of hyporexia, weight loss and vomiting. Abdominal imaging evidenced a gastric wall mass and based on the previous clinical history, metastatic spread of the initial leiomyosarcoma was suspected, and the patient was euthanased. This is the first report of intestinal leiomyosarcoma associated with hypercalcaemia.

Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA)

BackgroundBoth anastomotic leak (AL) and conduit necrosis (CN) after oesophagectomy are associated with high morbidity and mortality. Therefore, the identification of preoperative, modifiable risk factors is desirable. The aim of this study was to generate a risk scoring model for AL and CN after oesophagectomy. MethodsPatients undergoing curative resection for oesophageal cancer were identified from the international Oesophagogastric Anastomosis Audit (OGAA) from April 2018–December 2018. Definitions for AL and CN were those set out by the Oesophageal Complications Consensus Group. Univariate and multivariate analyses were performed to identify risk factors for both AL and CN. A risk score was then produced for both AL and CN using the derivation set, then internally validated using the validation set. ResultsThis study included 2247 oesophagectomies across 137 hospitals in 41 countries. The AL rate was 14.2% and CN rate was 2.7%. Preoperative factors that were independent predictors of AL were cardiovascular comorbidity and chronic obstructive pulmonary disease. The risk scoring model showed insufficient predictive ability in internal validation (area under the receiver-operating-characteristic curve [AUROC] = 0.618). Preoperative factors that were independent predictors of CN were: body mass index, Eastern Cooperative Oncology Group performance status, previous myocardial infarction and smoking history. These were converted into a risk-scoring model and internally validated using the validation set with an AUROC of 0.775. ConclusionDespite a large dataset, AL proves difficult to predict using preoperative factors. The risk-scoring model for CN provides an internally validated tool to estimate a patient's risk preoperatively.

Monitoring Intra-Annual Wood Formation of Pinus nigra J.F. Arnold (Black Pine) to Understand the Fire Seasonality in Western Anatolia

Recent climate and societal changes have increased wildfire activity and prolonged the fire season in many regions of the world. The precision of fire seasonality analysis from tree-ring records can be improved by complementing the subjectively determined intra-ring position of fire scars with more precise studies of wood formation. With this aim, we monitored the wood formation dynamics of Pinus nigra J.F. Arnold (black pine) trees along a climatic gradient in western Anatolia to better understand the wood formation for the interpretation of fire seasonality. Wood microcores were collected from April to November 2021 from trees at four sites across (from north; the Black Sea climate in Bolu to the south; and the Mediterranean climate in Isparta) the areas where previous fire history reconstructions were conducted. These previous studies showed that most fires occurred during the latewood formation period. We found that matured latewood tracheids were observed between September (August) and November, thus suggesting that these fires occurred during late summer and fall. Our results show the importance of temperature and water availability for the timing of earlywood and latewood formations. These findings can be used to better inform planning activities for fire management and as a proxy to reconstruct past fire seasonality.

Long-Term Persistence of COVID-Induced Hyperglycemia: A Cohort Study.

Although the short-term mortality of patients with COVID-19 infection and hyperglycemia has been well documented, there is little available data regarding longer-term prognosis. The presence of diabetes has not only influenced disease severity but has also impacted its transmission dynamics. In this study, we followed a historical cohort of patients without previous history of diabetes who presented with moderate to severe COVID-19 and were found to have hyperglycemia (random blood glucose >140 mg/dL) at the time of admission. We evaluated the need for antidiabetic therapy in these patients at the end of 6 months and the risk factors associated with persistent hyperglycemia determined by monthly values of self-monitored blood glucose. Of the seventy participants who were followed telephonically, 54 (77%) continued to receive antidiabetic therapy or have persistent hyperglycemia (>140 mg/dL) at the end of 6 months. Persistent hyperglycemia at the end of follow-up, was found to be associated with a higher blood glucose at presentation.

The Association of Age, Parity, and History of Cesarean Section with the Occurrence of Placenta Accreta Spectrum (Pas) at H. Adam Malik Hospital in Medan 2020-2022

Background: Maternal mortality rate (MMR) is an indicator of the quality of midwifery services in a country. Postpartum hemorrhage is a serious life-threatening complication and the main cause of maternal death especially that caused by placenta accreta spectrum (PAS). This study aims to determine the relationship between age, parity, and history of cesarean section on the incidence of PAS at H. Adam Malik Hospital Medan in 2020-2022.Method: This study was an analytic-observational study with a cross-sectional design. The data used came from the medical records, including information about the population of mothers who gave birth, maternal age at delivery, parity, and previous history of cesarean section. Statistical analysis used univariate and bivariate chi-square tests.Result: The study subjects were 84 people selected by simple random sampling method. The results of the univariate analysis showed the highest frequency of age &gt;32 years, parity 3-4 times, and a history of cesarean section ≥ 2. The results of bivariate analysis showed a significant relationship between age and the incidence of PAS (p=0.016), parity and the incidence of PAS (p&lt;0.001), and a history of cesarean section and the incidence of PAS (p=0.004).Conclusion: There is a relationship between age, parity, and history of cesarean section with the incidence of PAS at H. Adam Malik Hospital Medan in 2020-2022.

Enterococcal endocarditis management and relapses.

Enterococcus faecalis is the third micro-organism causing endocarditis and is associated with a significant relapse rate. The objective of this study was to describe the management of patients with Enterococcus faecalis endocarditis (EE) and its implication for relapses. We conducted a monocentric, retrospective analysis of all patients hospitalized for EE including endocarditis or infection of cardiac implantable electronic device defined by the modified ESC 2015 Duke criteria in a referral centre in Paris, France. Between October 2016, and September 2022, 54 patients with EE were included, mostly men (n = 40, 74%) with a median age of 75 [68-80] years. A high risk for infective endocarditis (IE) was found in 42 patients (78%), including 14 (26%) previous histories of IE, and 32 (59%) histories of valvular cardiac surgery. The aortic valve was the most frequently affected (n = 36, 67%). Combination therapy was mainly amoxicillin-ceftriaxone during all the curative antibiotic therapy duration (n = 31, 57%). Surgery was indicated for 40 patients (74%), but only 27 (50%) were operated on, mainly due to their frailty. Among the 17 deaths (32%), six (11%) happened during the first hospitalization for EE. A suppressive antibiotic treatment was initiated in 15 (29%) patients, mostly because of not performing surgery. During the 6-year study period an EE relapse occurred in three (6%) patients. EE is a worrying disease associated with a high risk of relapse and significant mortality. Suppressive antibiotic therapy could be a key treatment to limit the occurrence of relapses.

Predicting the risk of pulmonary infection in patients with chronic kidney failure: A-C2GH2S risk score-a retrospective study.

The objective of this study is to investigate the associated risk factors of pulmonary infection in individuals diagnosed with chronic kidney disease (CKD). The primary goal is to develop a predictive model that can anticipate the likelihood of pulmonary infection during hospitalization among CKD patients. This retrospective cohort study was conducted at two prominent tertiary teaching hospitals. Three distinct models were formulated employing three different approaches: (1) the statistics-driven model, (2) the clinical knowledge-driven model, and (3) the decision tree model. The simplest and most efficient model was obtained by comparing their predictive power, stability, and practicability. This study involved a total of 971 patients, with 388 individuals comprising the modeling group and 583 individuals comprising the validation group. Three different models, namely Models A, B, and C, were utilized, resulting in the identification of seven, four, and eleven predictors, respectively. Ultimately, a statistical knowledge-driven model was selected, which exhibited a C-statistic of 0.891 (0.855-0.927) and a Brier score of 0.012. Furthermore, the Hosmer-Lemeshow test indicated that the model demonstrated good calibration. Additionally, Model A displayed a satisfactory C-statistic of 0.883 (0.856-0.911) during external validation. The statistical-driven model, known as the A-C2GH2S risk score (which incorporates factors such as albumin, C2 [previous COPD history, blood calcium], random venous blood glucose, H2 [hemoglobin, high-density lipoprotein], and smoking), was utilized to determine the risk score for the incidence rate of lung infection in patients with CKD. The findings revealed a gradual increase in the occurrence of pulmonary infections, ranging from 1.84% for individuals with an A-C2GH2S Risk Score ≤ 6, to 93.96% for those with an A-C2GH2S Risk Score ≥ 18.5. A predictive model comprising seven predictors was developed to forecast pulmonary infection in patients with CKD. This model is characterized by its simplicity, practicality, and it also has good specificity and sensitivity after verification.

(107) Evaluating the Impact of Prior Prostate Cancer Hormonal Therapy on Satisfaction Rates in Post Implantation of Inflatable Penile Prosthesis

Abstract Introduction Androgen deprivation therapy (ADT), a vital treatment modality for prostate cancer, effectively reduces androgens (testosterone &amp; dihydrotestosterone) through inhibiting its production or blocking its action, thereby impeding the growth and even causing shrinkage of prostate cancer cells. It has been utilized in the treatment of early-stage, recurrent, and metastatic cases of prostate cancer. Common side effects were hot flashes, fatigue, decreased bone density, mood changes, decrease libido and sexual dysfunction. Inflatable penile prosthesis (IPP) implantation has already emerged as a highly successful treatment option, garnering significant satisfaction rates among the general population with erectile dysfunction (ED) and specifically in prostate cancer patients who underwent radical prostatectomy (RP) or radiation therapy (XRT). Nevertheless, there remains a dearth of literature examining satisfaction rates specifically in patients with hormonal therapy history post-IPP implantation Objective Our study aims to comprehensively evaluate patient satisfaction rates post IPP implantation for ED, in relation to their ADT status for prostate cancer. Methods A retrospective chart review from our institutional database was conducted to identify 529 patients who underwent IPP at our institution by a single surgeon from 2017 to 2022. Eligible patients for inclusion included those with histological confirmation of prostate cancer treated by RP or XRT with or without hormonal therapy, followed by IPP implantation for ED, and had completed the 11-item Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) validated questionnaire with data available for review. All EDITS questionnaires were administered at least 6 months from operative date or later. Eligible patients were screened for placement into one of two groups depending on their ADT status. To prevent crossover confounding; patients with history of other types of hormonal therapy for non prostate cancer patients were excluded. Results A total of 96 patients were included and categorized into group 1 (ADT, n=30) and group 2 (No ADT, n=66). All patients' demographics were summarised in Table 1. The study revealed notable results regarding the impact of ADT on post IPP satisfaction rates which exhibited a significantly lower EDITS score compared to group 2 (P= 0.034) (Figure 1). Furthermore, group 1 showed no significant changes in post IPP satisfaction with relation to type of prostate cancer treatment offered. While group 2 demonstrated a significantly higher EDITS score post IPP in RP patients compared to XRT, which aligns with the reported literature. Conclusions Our initial findings suggest that despite IPP implantation for managing erectile dysfunction, which is expected to yield high satisfaction rates compared to other available treatment options, Yet the previous or ongoing history of androgen deprivation therapy continues to influence such patients' satisfaction. These observations provide valuable insights; however, further investigation on a larger scale is essential to validate these trends. Additionally, it is crucial to offer proper counseling to these patients regarding the expected outcomes to assist them in making informed decisions regarding the management of their ED. Lastly, the routine use of validated questionnaires has demonstrated significant value in quantifying device and sexual satisfaction following IPP implantation and should be considered as an integral evaluation tool Disclosure No.

Incidence of incisional hernia following liver surgery for colorectal liver metastases. Does the laparoscopic approach reduce the risk? A comparative study.

No reports to compare incisional hernia (IH) incidence between laparoscopic and open colorectal liver metastases (CRLM) resections have previously been made. This is the first comparative study. Single-center retrospective review of patients who underwent CRLM surgery between January 2011 and December 2018. IH relating to liver surgery was confirmed by computed tomography. Patients were divided into laparoscopic liver resection (LLR) and open liver resection (OLR) groups. Data collection included age, sex, presence of diabetes mellitus, steroid intake, history of previous hernia or liver resection, subcutaneous and peri-renal fat thickness, preoperative creatinine and albumin, American Society of Anesthesiologists (ASA) score, major liver resection, surgical site infection, synchronous presentation, and preoperative chemotherapy. Two hundred and forty-seven patients were included with a mean follow-up period of 41 ± 29 months (mean ± standard deviation). Eighty seven (35%) patients had LLR and 160 patients had OLR. No significant difference in the incidence of IH between LLR and OLR was found at 1 and 3 years, respectively ([10%, 19%] vs. [10%, 19%], p = 0.95). On multivariate analysis, previous hernia history (hazard ratio [HR], 2.22; 95% confidence interval [CI], 1.56-4.86) and subcutaneous fat thickness (HR, 2.22; 95% CI, 1.19-4.13) were independent risk factors. Length of hospital stay was shorter in LLR (6 ± 4 days vs. 10 ± 8 days, p < 0.001), in comparison to OLR. In CRLM, no difference in the incidence of IH between LLR and OLR was found. Previous hernia and subcutaneous fat thickness were risk factors. Further studies are needed to assess modifiable risk factors to develop IH in LLR.

Qualities of Soil Upper Layers Under Rubber Plantation and Various Previous Soil Histories in Zépréguhé (Daloa, west-central Côte d'Ivoire)

Qualities of Soil Upper Layers Under Rubber Plantation and Various Previous Soil Histories in Zépréguhé (Daloa, west-central Côte d'Ivoire)

Chronic lymphocytic leukemia/small lymphocytic lymphoma arising in the pituitary gland: illustrative case.

The authors describe a 60-year-old female who underwent a correlative examination for an accidental scalp injury, revealing a sellar mass, which was surgically excised and pathologically confirmed to be a non-Hodgkin's small B-cell lymphoma. These findings in combination with the immunophenotype led to a final diagnosis of chronic lymphocytic leukemia/small lymphocytic lymphoma. Previous studies have shown that hematological solid tumors occurring in the pituitary gland are extremely rare, and there are only approximately three other cases of living patients with similarities to this case, all of which had ambiguous expression of subsequent hematological treatment. In this case, the authors used an endoscopic approach to completely excise the tumor. Follow-up of the patient was continued after surgery, and the patient is currently receiving standardized treatment with zanubrutinib. This patient did not have any previous history of tumor, had a good postoperative recovery with a normal quality of life, and still receives hormone replacement and zanubrutinib on a standardized basis. This is a complete case that has not been previously reported and reveals the diagnostic and therapeutic process of rare diseases in the sellar area.

Children and adolescents' quality of life in repeated cross-sectional studies during the COVID-19.

During the COVID-19 pandemic, internalizing and externalizing symptoms have impacted the quality of life of children and adolescents. This cross-sectional study evaluated children's quality of life using parental reports, observing associations with mental health problems and sociodemographic variables. Some behavioral measures were linked to lower quality of life, particularly depression symptoms, relationship problems, and inattention. Multiple regression models indicated that reduced children's quality of life (R2 = 36%) was associated with higher levels of internalizing (r = -0.46) and externalizing (r = -0.23) behavioral problems and younger parents (r = -0.08). Children with previous mental disorder diagnoses had lower quality of life than those without (p < 0.001). In summary, children's quality of life during the COVID-19 pandemic was linked to current mental health, parental age, and previous history of mental disorders.

Comparative multimodal sensory testing in multifocal motor neuropathy and multifocal variant of chronic inflammatory demyelinating polyradiculoneuropathy

Comparative multimodal sensory testing in multifocal motor neuropathy and multifocal variant of chronic inflammatory demyelinating polyradiculoneuropathy