Ten-year Study Research Articles

Chyme reinfusion practices in the neonatal population.

Chyme reinfusion therapy (CRT) is a safe and effective method to improve nutritional outcomes and promote intestinal adaptation in patients with stomas. This practice involves refeeding the proximal stoma output, down the distal limb, and mimics a state of intestinal continuity; thereby promoting growth and adaption of the distal bowel. Despite its promise, CRT in neonates is a relatively underutilised practice and can be of significant value in neonates with congenital bowel anomalies or necrotising enterocolitis. We aimed to identify the frequency, methodology and adverse effects associated with CRT in our neonatal population. We aimed to identify the frequency, methodology and adverse events associated with CRT in our neonatal population. A ten-year retrospective cohort study was conducted using database searches at two major paediatric hospitals in New Zealand. All patients with suitable anatomy were identified, and data on CRT methodology and outcomes were recorded. Of the 49 eligible neonates, 23 (47%) underwent CRT. Indications for CRT included high stoma output, malnutrition with poor weight gain, and routine refeeding prior to stoma reversal. A nasogastric feeding tube was inserted into the distal limb and collected chyme was reinfused via manual bolus or automated syringe driver. The median (IQR) weight gain increased from 13.9 (3.50-22.89) to 24.37 (19.68-29.99) g/day during CRT (p = 0.04). 18 infections requiring medical intervention but unrelated to CRT occurred in 13 patients (56%). Amongst our cohort, there was a high rate of non-infectious events, including peri-stomal skin irritation (60%), stoma prolapse (43%) and stomal bleeding (26%). CRT is an underutilised method of improving nutrition in neonates with intestinal failure. Premature neonates requiring double enterostomy formation are at high risk of infectious and non-infectious complications, but few of these are related to CRT. Standardised protocols providing clear eligibility criteria and detailed methodology for CRT are required to promote uniform utilisation of this practice.

Increased ambient temperature and hyponatraemia presentations: A ten-year retrospective study at an Australian hospital.

To determine the relationship between ambient air temperature and the incidence of hyponatraemia in a heat-prone region. We conducted a retrospective study that correlated serum sodium concentrations documented at The Austin Hospital in Melbourne over ten years from January 2014 to December 2023, with publicly available temperature data from the Australian Bureau of Meteorology. Serum sodium concentrations and incidence of hyponatraemia admissions when correlated to temperature, and following heatwave events, defined as temperature above 30°C over five consecutive days. Over this period, 45718 low serum sodium results were identified from 26557 unique patients. Serum sodium concentrations in January (Australian Summer) were 0.55mmol/L lower (95% CI 0.36 to 0.77, p < 0.001) compared to September (Australian early Spring). Women had lower sodium concentrations compared to men (-0.21 mmol/L, 95% CI -0.29 to -0.12, p<0.001), as did patients older than 80 years when compared to those younger than 65 years (-0.39 mmol, 95% CI -0.50 to -0.29, p<0.001). Hospital admissions with hyponatraemia were more frequent during summer months. Profound hyponatraemia admissions (sodium ≤125 mmol/L) were more frequent following a heatwave, compared to without (7.6% vs 6.5%, p=0.04). Our study demonstrates that serum sodium concentrations are lower and profound hyponatraemia-related hospital admissions higher when ambient temperatures are warmer. This suggests that hyponatraemia is a climate associated health issue. Local public health advice for water consumption during heatwaves should consider this risk, and prompt action to limit climate change is required to mitigate this risk.

Restoration of forestry-drained boreal peatland ecosystems can effectively stop and reverse ecosystem degradation

Ecosystem restoration will increase following the ambitious international targets, which calls for a rigorous evaluation of restoration effectiveness. Here, we present results from a long-term before-after control-impact experiment on the restoration of forestry-drained boreal peatland ecosystems. Our data comprise 151 sites, representing six ecosystem types. Species-level vegetation sampling has been conducted before, two, five, and ten years after restoration. With joint species distribution modelling, we show that, on average, not restoring leads to further degradation, but restoration stops and reverses this trend. The variation in restoration outcomes largely arises from ecosystem types: restoration of nutrient-poor ecosystems has a higher probability of failure. Yet, the ten-year study period is insufficient to capture the restoration effects in slow-recovering ecosystems. Altogether, restoration can effectively halt the biodiversity loss of degraded ecosystems, although ecosystem attributes affect the outcome. This variability in outcomes underlies the need for evidence-based prioritization of restoration efforts across ecosystems.

Physical activity and persistence of supra-threshold depressive symptoms in older adults: A ten-year cohort study

Few multination-based studies have examined the longitudinal association between PA (physical activity) and persistence of supra-threshold depressive symptoms (SDS). This cohort study aimed to assess the influence of PA on persistence of SDS. Data were obtained from the Population Survey of Health, Ageing and Retirement in Europe (SHARE). The cohort was composed of individuals with SDS at baseline. Depressive symptoms were ascertained using the EURO-D scale, with a value over 4 indicatives of SDS. The study included 6,631 participants with SDS. After adjusting for nine different covariates at baseline and the changes of PA level during the follow-up period, compared to very low PA, moderately high (OR=0.82; 95 %CI: 0.69–0.98; p = 0.03), and high (OR=0.80; 95 %CI: 0.66–0.95; p = 0.01) PA levels were associated with significantly reduced persistence of depressive symptoms. In a propensity score analysis, matching low and high PA level for baseline scores of EURO-D, people with high PA levels reported a lower EURO-D of 0.53 points (p < 0.0001). In conclusion, among adults with depression, higher levels of PA were associated with a reduced persistence of depression. These real-world data complement evidence on efficacy of exercise as a treatment for depression and can inform clinical guidelines.

Ten-Year Trends in Aerial Stem Rot Management: Evaluating Copper-Based Solutions for Sustainable Potato Cultivation

Aerial stem rot (ASR) is an important disease of potato worldwide and is predominantly caused by the soft rot bacteria Pectobacterium carotovorum. It differs from black leg (caused by P. atrosepticum) as it is found later in the season after row closure. The pathogen enters through wounds in the stem and expands outward leaving a distinct black lesion. Lesions spread down the stem as opposed to black leg lesions which spread up the stem from diseased tubers. Ten years of field trials were conducted using a susceptible variety in a randomized complete block design. Treatments consisted of different formulations of copper fungicides starting at row closure and continuing on a seven-day schedule until vine kill. Disease incidence and severity was rated visually, and results were used to calculate the Relative Area Under the Disease Progress Curve (RAUDPC), showing the rate of disease progress. Results showed that the RAUDPC was consistently higher in the untreated check compared to fungicide-treated plots, suggesting these products significantly reduced both disease incidence and severity. However, while the fungicides reduced disease, this did not always translate into higher yields. Nevertheless, factorial analysis of variance of yield by treatment showed significant differences in total yields with fungicide-treated plots outperforming the untreated check with yields at least 3 tonnes/ha higher. There have been few studies on the efficacy of copper fungicides for control of ASR. The findings of this ten-year study should provide growers with the data necessary to make informed decisions on the management of ASR.

Pathology-Based Animal Cancer Registry of Abruzzo and Molise Regions (Central Italy): A Ten-Year Retrospective Study (2014-2023).

Pets have a crucial role in cancer research. Specifically, dogs and cats share the same environment as their owners and thus may serve as sentinels of naturally occurring tumors that are linked to the exposure to environmental hazards. Quantitative comparison of tumor types may reveal unusual cancer frequencies, providing directions for research and generation of hypotheses of cancer causation in a specific area and identification of risk factors. The aim of this study was to describe the data collected by the pathology-based animal cancer registry, managed by Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise (IZSAM), during 10 years of activity (2014-2023) and to assess its potential epidemiological relevance. Frequencies of tumor topography and morphology in dogs and cats were described, analyzed and compared. Proportional morbidity ratios (PMRs) were calculated, taking into consideration some potential risk factors such as species, breed, sex, diet and living environment. The database comprises 5311 tumors (n = 4719 in dogs and n = 592 in cats), with a higher prevalence in females (67.3% in dogs and 61.2% in cats). The mean age at the first diagnosis of tumors was similar between sexes and slightly lower in dogs compared to cats. PMRs highlighted certain risk and "protective" factors for the development of tumors in specific topography. The risk of developing tumors of the blood and hematopoietic system (PMR = 0.44; 95% CI: 0.21-0.94), skin and subcutaneous tissues (PMR = 0.70; 95% CI: 0.61-0.80), oral cavity and pharynx (PMR = 0.60; 95% CI: 0.24-0.89), urinary organs (PMR = 0.33; 95% CI: 0.11-0.99) and bones, joints and cartilage (PMR = 0.72; 95% CI: 0.22-0.98) was lower in non-neutered male dogs than in neutered male dogs. Non-spayed female dogs had a greater risk of developing tumors of the mammary gland (PMR = 1.75; 95% CI: 1.57-1.96), female sexual organs (PMR = 2.12; 95% CI: 1.01-4.36) and respiratory system (PMR = 2.25; 95% CI: 1.55-6.74) but less risk for cutaneous and subcutaneous tissue tumors (PMR = 0.44; 95% CI: 0.38-0.51) and blood/hematopoietic system tumors (PMR = 0.47; 95% CI: 0.26-0.85) compared to spayed female dogs. Compared with mixed breed, purebred dogs had a significantly greater risk of developing mammary gland tumors (PMR = 1.36; 95% CI: 1.20-1.54) and lower risk for respiratory (PMR = 0.15; 95% CI: 0.07-0.32), gastrointestinal (PMR = 0.63; 95% CI: 0.34-0.94) and oral (PMR = 0.59; 95% CI: 0.36-0.96) neoplasia. Non-neutered male cats had a lower risk of developing skin and subcutaneous tumors (PMR = 0.68; 95% CI: 0.50-0.92) compared with neutered cats. The risk of developing skin and subcutaneous tissues tumors was higher for dogs and cats that lived mostly outdoor (PMR dogs = 1.21; 95% CI: 1.10-1.33; PMR cats = 1.18; 95% CI: 1.08-1.47), while dogs that live mainly indoor had a greater risk to develop mammary gland tumors (PMR = 0.78; 95% CI: 0.68-0.89). Results described herein highlight the fundamental role of animal cancer registration initiatives. These efforts would contribute to the possibility of conducting multicentric collaborative studies to deepen the knowledge of the epidemiology of tumors in dogs and cats from a comparative perspective, thus fulfilling the One Health approach.

Living without pain: A 10-year study of congenital insensitivity to pain with anhidrosis.

Congenital Insensitivity to Pain with Anhidrosis (CIPA) is a rare hereditary neuropathy caused by NTRK1 gene mutations, predisposing patients to recurrent infections and chronic wounds. Long-term studies on microbial and clinical outcomes in CIPA are limited. This study presents analysis of infection patterns, antibiotic resistance, and clinical outcomes in CIPA patients. A comprehensive ten-year retrospective cohort study was conducted at Soroka University Medical Center, Beer Sheva, Israel, from January 2014 to January 2023. Electronic medical records were reviewed to identify 63 CIPA patients, all were of consanguineous Bedouin families. Data collection included demographic details, clinical presentations, genetic analysis, documentation of infections, wound sites, hospital duration, and surgical interventions. Staphylococcus aureus, notably methicillin-resistant, dominated, with Gram-negative bacteria common in lower limbs. The study noted reduced extended-spectrum beta-lactamase bacteria and linked demographic factors to infection traits, antibiotic resistance, and surgical needs. This study provides valuable insights into the clinical and microbial patterns of CIPA, highlighting dynamic shifts in microbial compositions and antibiotic resistance profiles over time. Staphylococcus aureus, and Gram-negative bacteria particularly in lower limb infections, pose significant challenges in patient management. The findings underscore the importance of tailored approaches to address evolving microbial profiles and optimize patient care in CIPA. Key Message: This is the largest cohort study on CIPA to date, highlighting the dominance of Staphylococcus aureus, including methicillin-resistant strains, and significant Gram-negative bacterial infections in lower limbs. Contribution to Literature: It draws parallels between infection dynamics in CIPA and diabetic foot ulcers, emphasizing similar challenges due to neuropathy and ischemia, enhancing understanding of infection susceptibility and management in neuropathic conditions. The findings inform clinical practices by detailing infection and resistance patterns, supporting the development of targeted treatment strategies to improve outcomes for CIPA and similar conditions.

Is Migraine Surgery Financially Viable for the Hospital and Surgeon? A Single-Surgeon, Ten-Year Study at an Academic Institution.

Data exists to demonstrate that migraine surgery is cost-effective for the long-term treatment of headaches, but no data exists regarding its financial viability for healthcare institutions. The goals of the current study are to demonstrate that (1) migraine surgery is financially viable for an academic institution with a net-positive profitability and (2) migraine surgery is a sought-after therapy that can draw patients into the healthcare system. A retrospective chart review of migraine and bilateral breast reduction (BBR) consults seen in clinic between 05/01/2011-05/30/2020 was conducted. Patient age, sex, payor information, and distance from the hospital was collected. Profit margin, percentage profit, collection percentage, and conversion rate to surgery from clinic was calculated. 407 new migraine consults and 119 new BBR consults were included from which, 150 underwent migraine surgeries and 117 underwent BBR respectively. Migraine surgery group came from a further distance for the initial consult (P-value<0.001) and for surgery (P-value<0.001). There were also more migraine surgery patients from out-of-state (P-value=0.012). Migraine clinic patients had a larger ratio of private insurers (P-value<0.001). Migraine surgery patients had a greater total charge (P-value<0.001), estimated reimbursement (P-value=0.001), and total cost (P-value<0.001). This study provides evidence that migraine surgery is financially viable for hospitals and while performing similarly to bilateral breast reduction in profit margin, it brought in more patients from outside the catchment area of our institution. These findings may encourage hospitals to recruit migraine surgeons to improve care for this underserved patient population.

Predictive value of clinico-radiological variables in the management of suspected foreign body aspiration in children: A ten-year retrospective cohort study

ABSTRACT Background: Definite history is not always present in children with foreign body aspiration (FBA), hence necessitating a high index of suspicion. Objective: To assess the predictive value of clinico-radiological variables among children presenting with features of suspected FBA and to document their course in a tertiary care teaching hospital. Materials and Methods: In this retrospective observational study, we included children aged below 15 years presenting with clinical features of suspected FBA. Data was obtained from case records. Multivariable binary logistic regression analysis (MVA) was performed to determine statistically significant predictors of FBA, and Weighted Risk Scores (WRS) were calculated to determine the significance of the model. Results: Of the 296 children included in the study and having undergone bronchoscopy, 84.5% were toddlers; 269 (90.87%) had a foreign body (FB) removed. Organic material was commonly found with 64.3% being peanut and right main bronchus, the commonest lodging site (50.6%). Of the 54 (18%) children with symptomatic but unwitnessed FBA, 45 (83.3%) had a FB retrieved. Choking with sudden onset cough, stridor, unilateral decreased breath sounds, abnormal chest radiograph, unilateral hyperinflation and mediastinal shift correlated with FBA (P &lt; 0.05). MVA confirmed statistical significance with choking with sudden onset cough to predict FBA (P = 0.024) with overall sensitivity and specificity of 60.9% and 77.8%, respectively. Total WRS with cut-off &gt;2 showed good power of discrimination with sensitivity, specificity and AUC of 60.2%, 77.8% and 0.704%, respectively. Conclusions: The proposed predictive value-based scoring system enhances accuracy in decision-making regarding bronchoscopy in children with suspected FBA.

Ten-year mortality study of dengue in Malaysia

ObjectivesUnderstanding the factors that contribute to dengue deaths is crucial for developing effective interventions and improving public health strategies. This study aims to determine the dengue mortality rate in Malaysia from 2012 to 2021. MethodsAll dengue-related death data were obtained from the Department of Statistics Malaysia and were examined from 2012 to 2021. ResultsA total of 1641 dengue-related deaths were identified. The average annual crude mortality rate was 0.5 deaths per 100,000 population, with the highest rate in 2015 at 1.1 deaths per 100,000 population. The central and southern regions had the highest age-adjusted mortality rates. Older age groups had higher mortality rates than younger individuals. ConclusionsDengue remains a significant public health challenge in Malaysia. It is essential to prioritize older individuals and urban areas in addressing this issue.

An Analysis of Emergency Surgical Outcomes for Pediatric Traumatic Brain Injury: A Ten-Year Single-Institute Retrospective Study in Taiwan.

Background and Objectives: Pediatric traumatic brain injury (pTBI) remains a major pediatric public health problem, despite well-developed injury prevention programs. The purpose of this study is to analyze the emergency surgical outcomes of pTBI in a single institute ten-year retrospective study to offer a real-world clinical result. Materials and Methods: Our institute presented a clinical retrospective, single-institute research study of 150 pediatric TBI cases that were diagnosed and underwent emergency surgical treatment from 2010 to 2019. Results: The incidence of radiological findings is detailed as follows: brain edema (30%, 45/150), followed by acute subdural hematoma (27.3%, 41/150), epidural hematoma (21.3%, 32/150), chronic subdural hemorrhage (10%, 15/150), skull fracture (6.7%, 10/150), and traumatic subarachnoid hemorrhage (4.7%, 7/150). Surgical intervention data revealed that decompressive craniectomy was still the main effective surgical method. The results showed longer hospital stays and higher morbidity rates in the brain edema, acute subdural hematoma, and chronic subdural hemorrhage groups, which were viewed as poor surgical outcome groups. Epidural hematoma, skull fracture and traumatic subarachnoid hemorrhage were categorized into good surgical outcome groups. Notably, the data revealed gross improvement in Glasgow Coma Scale/Score (GCS) evolution after surgical interventions, and the time to cranioplasty was a significant factor in the development of post-traumatic hydrocephalus (PTH). Conclusions: Our study provided real-world data for the distribution of etiology in pTBI and also categorized it into six groups, indicating disease-orientated treatment. In addition, our data supported that decompressive craniectomy (DC) remains a mainstay surgical treatment in pTBI and early cranioplasty could decrease the incidence of PTH.

You can take a person out of the military, but you can't take the military out of the person: findings from a ten-year identity study on transition from military to civilian life.

This article takes its starting point in a longitudinal interview study that began in 2013 with the aim of investigating identity reconstruction during the transition from military to civilian life. Annual follow-up interviews were conducted for 3 years, after which there was a break for 7 years until 2023 when a new interview cycle was conducted. The article presents the findings from this interview round. The purpose of the study was to describe the ways in which military identity had impacted the selves and lives of the participants. An inductive approach was employed in the analysis and an abductive approach used in the interpretative phase. The results showed, among other things, that a military identity, containing a particularly strong work ethic, had grown salient over the years. This military identity salience amplified the perception of a contrasting civilian work ethic, which generated moral frustration and even conflict. It was seen as imperative to maintain consistency between a military work ethic and the identity standard as a civilian employee rather than to modify the behavior to another standard, i.e., a civilian standard. These results were counterintuitive given the earlier interview cycles. A military work ethic was generally a powerful asset but could have negative health outcomes, manifesting as burnout. The results reflect the challenges in operating multiple identities tailored to contrasting moral regimes. Future longitudinal qualitative and quantitative research approaches to self-identity work among former service members are warranted.

The contemporary approach to chylothorax – Single-center experience with the proposal of a management algorithm

Objectives: Chylothorax is a relatively rare condition of lymphatic fluid accumulation in the thoracic cavity due to a leakage from the thoracic duct or its tributaries. Patients present with dyspnea, malnutrition, and immunosuppression. Treatment can be conservative or surgical, depending on etiology and clinical course. The optimal management algorithm for chylothorax is still controversial. Methods: This is a ten-year period retrospective study of all patients with chylothorax treated at our Department of Thoracic Surgery. Results: A total of 14 patients were identified for the study. Nine patients had chylothorax after lung or esophageal cancer surgery. Four patients had chylothorax in advanced lymphoma. One patient had chylothorax after blunt chest trauma. A conservative approach was initiated in most patients (92%), including pleural drainage, nil per mouth, total parenteral nutrition, and somatostatin 0.1 mg bid subcutaneously. Surgical treatment was indicated in patients with thoracic drain production &amp;gt;800 mL per day beyond the fifth day of treatment and those with blunt thoracic trauma. Two patients had thoracic duct ligation via right-sided thoracotomy, and five patients had video-assisted thoracoscopic thoracic duct ligation with the immediate arrest of chylous leakage. Conclusion: Chylothorax should be treated conservatively initially. Surgical treatment should not be delayed beyond the fifth day in case of failure. In our series of patients, a video-assisted thoracoscopic approach for thoracic duct ligation proved to be minimally invasive, highly efficient, and well tolerated. Therefore, it should be the preferable route of surgical treatment.

Genomic and Spatial Analysis on the Recent Transmission of Mycobacterium tuberculosis in Eastern China: A 10-Year Retrospective Population-Based Study.

Understanding the mode of Mycobacterium tuberculosis (M. tuberculosis) transmission is crucial for disease prevention and control. Compared to traditional genotyping methods, whole genome sequencing (WGS) provides higher resolution and comprehensive genetic information, enabling the tracing of infection sources and determining of transmission routes to resolve extensive tuberculosis (TB) outbreaks. We conducted a ten-year study on the transmission of M. tuberculosis in a population in eastern China. We selected Lianyungang, an eastern city in China, as the study site. Patients diagnosed with active pulmonary TB from 2011 to 2020 were enrolled as the study subjects. We isolated and sequenced 2252 M. tuberculosis. Strains with pairwise genetic distances of less than 12 single nucleotide polymorphisms were defined as genomic clusters and which were considered recent transmissions. Kernel density estimation and K-function analysis were applied to explore the spatial distribution of recently transmitted strains. After excluding non-tuberculous mycobacteria and duplicated samples, 2114 strains were included in the final analysis. These strains comprised lineage 2 (1593, 75.35%) and 4 (521, 24.65%). There were 672 clustered strains, with a recent transmission rate of 31.79%. The logistic regression model showed that the risk of recent transmission was high in students [adjusted odds ratio (aOR): 2.68, 95% confidence interval (CI): 1.63-4.49, P<0.001] and people infected with L2.2.1 strains (aOR: 1.59, 95% CI: 1.20-2.12). Higher spatial aggregation of TB transmission has been concentrated in Haizhou, Donghai, and Guanyun for the past 10 years. Three outbreaks affecting 46 patients were spatially spaced, with 11 to 23 persons each. Different groups exhibited varying geographic distances between the initial and later cases. There are areas with a high risk of transmission for M. tuberculosis in the research site, and the risk varies among different populations. Accurate prevention strategies targeted at specific regions and key populations can help curb the prevalence of TB.

The impact of community services usage on geriatric depression: a ten-year follow-up study

BackgroundThis study explores whether the impact of environmental factors (community services usage, CSU) on geriatric depression is mediated by psychological resilience and moderated by the COMT (catechol-O-methyltransferase) gene val158met polymorphism.MethodsThe data consists of 13,512 entries from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) collected in the years 2008, 2011, 2014, and 2018. The study employed a Random Intercept Cross-Lagged Panel Model (RI-CLPM) to examine the relationship between CSU and geriatric depression, including the mediating effect of psychological resilience and the moderating role of the comt gene val158met gene polymorphism in this relationship.ResultsLower CSU at earlier assessments were significantly associated with more severe geriatric depression in subsequent evaluations.Psychological resilience was found to partially mediate the relationship between CSU and depression.Differential impacts were observed among various gene genotypes; specifically, the val genotype demonstrated a significantly greater influence of CSU on subsequent psychological resilience and on subsequent depression compared to the met genotype.ConclusionEnhancement in CSU can predict subsequent geriatric depression. The relationship between the CSU and depression can be mediated by psychological resilience, with genetics modulating the pathway from CSU through psychological resilience to depression. Multidisciplinary interventions focused on enhancing community service quality, boosting psychological resilience, and mitigating depression are likely to benefit the older adults’s emotional and psychological well-being.

Oxidative balance and mental health: Exploring the link between prooxidant-antioxidant balance and depression in hypertensive and normotensive individuals, accounting for sex differences

BackgroundExisting studies have suggested a link between oxidative stress levels and depression. Additionally, factors such as gender and conditions like hypertension have been shown to influence oxidative stress. This ten-year follow-up cohort study aims to examine the association between prooxidant-antioxidant balance (PAB) and the onset of depression and its symptoms in both hypertensive and normotensive individuals, while considering gender differences. MethodsThe data for this study was obtained from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study, a cohort study conducted in eastern Iran. Serum PAB levels were measured in 1702 hypertensive and 4096 normotensive individuals aged 35 to 65 years. After ten years, the participants' depression status was evaluated using the Beck questionnaire, and depression symptoms were investigated using the BDI-II structural model, which includes somatic, affective, and cognitive symptoms. ResultThe analysis indicates that in hypertensive male participants, the highest tertile of PAB is associated with an increased risk of depression (β: 1.22, 95 % CI: −0.046, 2.485; P = 0.059) and symptoms of depression, including cognitive (β: 2.937, 95 % CI: 0.511, 5.362; P = 0.018) and somatic (β: 2.654, 95 % CI: 0.37, 4.939; P = 0.023) symptoms. However, there was no significant association between affective symptoms and PAB tertiles. Additionally, there was no significant link between depression and depressive symptoms in female hypertensive and normotensive individuals. ConclusionIn male hypertensive patients, but not in normotensive individuals of both genders and hypertensive women, depression and its associated symptoms, including somatic and cognitive symptoms, are associated with elevated levels of oxidative stress, as evidenced by higher serum PAB values. PAB is not associated with affective symptoms. Future studies should focus on the gender-specific nature of this relationship and work to clarify its underlying mechanisms.

Incidence and risk factors for acute kidney injury after traumatic hemorrhagic shock: A 10-year retrospective cohort study.

Acute kidney injury (AKI) is a common complication of traumatic hemorrhagic shock. Therisk factors for AKI aftertraumatic hemorrhagic shockremain unclear. The aim of this study was to investigate the risk factors for AKI after traumatic hemorrhagic shock. This was a ten-year retrospective cohort study of patients who experiencedtraumatic hemorrhagic shock between January 2013 and April 2023. Patient characteristics and clinical data were recorded for 417 patients. The outcome was the occurrence of AKI, defined as a serum creatinine increase of ≥ 0.3mg/dL (≥ 26.5μmol/L) within 48h, or an increase to 1.5 times the baseline, or a urine volume of <0.5mL/(kg h.). Risk factors for AKI were tested by logistic regressionmodels. The incidence of AKI after traumatic hemorrhagic shockwas 29.3% (122/417 patients). Multivariable analysis revealed that the independent risk factors for AKIincluded age (OR, 1.048; 95% CI, 1.022-1.074; p < 0.001), B-type natriuretic peptide (OR, 1.002; 95% CI, 1.000-1.004; p = 0.041), sepsis (OR, 4.536; 95% CI, 1.651-12.462; p = 0.030) and acute myocardial injury (OR, 2.745; 95% CI, 1.027-7.342; p = 0.044). Road traffic accidents (OR, 0.202; 95% CI, 0.076-0.541; p = 0.001), mean arterial pressure (OR, 0.972; 95% CI, 0.950-0.995; p = 0.017), and base excess (OR, 0.842; 95% CI, 0.764-0.929; p = 0.001) were negatively correlated with AKI. The area under the receiver operating characteristic (ROC)curvefor prediction by thismodel was 0.85(95% CI, 0.81-0.90). The incidence of AKI aftertraumatic hemorrhagic shockwas 29.3%in our series. Indicators of bloodperfusion, sepsis and acute myocardial injury may be independent risk factors for AKI aftertraumatic hemorrhagic shock. Early detection and effective intervention on these risk factors could reduce the occurrence of AKI and improve outcomes.

Rib tumors: A ten-year institutional study

Objectives The primary aim of this study was to study the demography and frequency distribution of the various rib tumors. The treatment modality offered and patient outcomes were also recorded wherever available. Material and Methods A ten year data was retrieved from the hospital registry from 2011-2021. Inclusion criteria were all patients with any tumors in the rib. Those patients who did not have a histological diagnosis and those having a chest wall mass and secondary involvement of the ribs were excluded. Results Out of 72 cases of rib tumors, 25 were diagnosed as Ewing Sarcoma, 22 Chondrosarcoma cases, 10 Multiple myeloma/plasmacytoma cases, 9 Osteosarcoma cases, rest 1 case each of Non Hodgkin Lymphoma, Brown tumor, Enchondroma, Osteochondroma, Clear cell sarcoma and metastases. Conclusion In this study the most common primary malignant tumor of the ribs in adults was Chondrosarcoma (41.1%) and in pediatric &amp; young adolescent age group (upto 18yrs) it was Ewing sarcoma (76.1%)

Management of a dentigerous cyst; a ten-year clinicopathological study

BackgroundDentigerous cysts, deemed of developmental origin, are benign odontogenic cysts characterized by a gradual growth rate. Their occurrence is twice as prevalent in men compared to women. These cysts are recognized as the most frequent developmental cysts affecting the jaws, with a typical manifestation in individuals aged 20 to 40, while infrequently identified in young children. Notably, dentigerous cysts have the potential to attain significant dimensions, resulting in painless enlargement of the jaw and subsequent deformation.ObjectivesTo assess the clinicopathological features and management of ten years of experience with dentigerous cysts.MethodsA challenging cases were reported from reviewed records of the patients who were treated by the surgical intervention of various dentigerous cysts throughout the period of ten years, 2012–2022 and only histologically confirmed cases were selected, at Ramadi Teaching Hospital in addition to Rashid, Razi, Zuhur Private Hospitals and private clinics in Iraq.Results76 patients were included in this clinicopathological research. The highest age group affected was ≤ 18 years (68.4%), 54% were male, the mandible was more affected (63.1%) than the maxilla (36.9%). Marsupialization was applied to 30.3% of the cases, while enucleation was carried out in 69.7%.ConclusionsThe significance of meticulous examination of radiographs and the consequences associated with undetected and untreated ailments is affirmed by this case study. A comprehensive understanding of oral pathology serves as a valuable resource for dentists, facilitating accurate diagnosis, appropriate referrals, and the provision of anticipatory guidance to patients striving to achieve optimal oral health across various age groups.

Extending the role of tryptase in perioperative anaphylaxis: Predicting positive results in basophil activation tests

BackgroundBasophil activation tests (BAT) are useful in identifying culprits of perioperative anaphylaxis (PA), but its utility remains limited due to technical limitations, cost and availability. Being able to prioritize patients with likely higher yields for BAT would be useful in reducing costs and manpower. ObjectiveTo investigate if tryptase levels and clinical parameters may be useful for selecting patients for BAT. MethodsWe performed a ten-year retrospective study in Hong Kong to investigate the performance of BAT associated with tryptase levels (taking during PA) and other clinical parameters. ResultsOut of 90 patients, 70 (77.8%) showed significant tryptase elevation and 37 (41.1%) had positive BAT. BAT-positive patients presented with significantly higher absolute levels (15.9 μg/L vs 9.1 μg/L, p=0.018), absolute elevation (12.8μg/L vs 7.1 μg/L, p=0.012) and fold elevation (5.6- vs 4.1-fold, p=0.014) of acute tryptase; than negative BAT patients. Among patients with positive BAT, 94.6% (35/37) demonstrated elevated acute tryptase, significantly more than the BAT-negative group (66.0%, p<0.001). In regression analysis, tryptase elevation was the sole significant factor correlated to BAT positivity (OR=10.14 [95% CI=2.15-47.85], p=0.003). Overall, elevated acute tryptase demonstrated a sensitivity of 94.7% and a negative predictive value of 90.0% in predicting positive results with BAT. ConclusionWe observed that tryptase elevation is a very sensitive predictor of BAT positivity among patients with identified culprits of PA. Acute elevation of tryptase would not only aid in confirming anaphylaxis, but may also help guide the decision towards selecting labour-intensive and costly in vitro tests such as BAT.