Ten-year Study Research Articles

EPR24-121: Trends in the Incidence and Mortality of Metastatic Epidural Spinal Cord Compression: A Ten-Year Population-Based Study.

EPR24-121: Trends in the Incidence and Mortality of Metastatic Epidural Spinal Cord Compression: A Ten-Year Population-Based Study.

Strongyloidiasis in Auckland: A ten-year retrospective study of diagnosis, treatment and outcomes of a predominantly Polynesian and Fijian migrant cohort.

Strongyloides stercoralis is not endemic in Aotearoa New Zealand (AoNZ). However, approximately one third of Auckland residents are born in endemic countries. This study aimed to describe the epidemiology and management of strongyloidiasis in Auckland, with a focus on migrants from Pacific Island Countries and Territories. This study retrospectively reviewed clinical, laboratory and pharmacy records data for all people diagnosed with strongyloidiasis in the Auckland region between July 2012 and June 2022. People with negative Strongyloides serology were included to estimate seropositivity rate by country of birth. Over ten years, 691 people were diagnosed with strongyloidiasis. Most diagnoses were made by serology alone (622, 90%). The median age was 63 years (range 15-92), 500 (72%) were male, and the majority were born in Polynesia (350, 51%), Fiji (130, 19%) or were of Pasifika ethnicity (an additional 7%). Twelve participants (1.7%) had severe strongyloidiasis at diagnosis. The total proportion treated with ivermectin was only 70% (484/691), with no differences between immunocompromised and immunocompetent participants, nor by ethnicity. The outcome of treatment (based on a combination of serology and/or eosinophilia and/or stool microscopy) could only be determined in 50% of the treated cohort. One participant failed treatment with ivermectin, experiencing recurrent strongyloidiasis, and another participant died in association with severe strongyloidiasis. The rate of 'positive' Strongyloides serology was highest among participants born in Samoa (48%), Fiji (39%), and Southeast Asian countries (34%). Strongyloidiasis was common and under-treated in Auckland during the study period. Clinicians should have a low threshold for considering strongyloidiasis in migrants from endemic countries, including Polynesia and Fiji.

Unraveling the Complexities of Substance-Induced Psychosis and its Transition to Independent Psychosis: a Ten-Year Retrospective Cohort Study

Unraveling the Complexities of Substance-Induced Psychosis and its Transition to Independent Psychosis: a Ten-Year Retrospective Cohort Study

Spatial Heterogeneity of Nontuberculous Mycobacterial Pulmonary Disease in Shanghai: Insights from a Ten-Year Population-Based Study

ObjectiveTo investigate the spatial heterogeneity of nontuberculous mycobacterial pulmonary disease (NTM-PD) in Shanghai. MethodsA population-based retrospective study was conducted using presumptive pulmonary tuberculosis surveillance data of Shanghai between 2010 and 2019. The study described the spatial distribution of NTM-PD notification rates, employing hierarchical Bayesian mapping for high-risk areas and the Getis-Ord Gi* statistic to identify hot spots and explore associated factors. ResultsOf 1652 NTM-PD cases, the most common species was Mycobacterium kansasii complex (MKC) (41.9%), followed by Mycobacterium avium complex (MAC) (27.1%) and Mycobacterium abscessus complex (MABC) (16.2%). MKC-PD patients were generally younger males with a higher incidence of pulmonary cavities, while MAC-PD patients were more often farmers or had a history of tuberculosis treatment. MKC-PD hot spots were primarily located in the areas alongside the Huangpu River, while MAC-PD hot spots were mainly in the western agricultural areas. Patients with MKC-PD and MAC-PD exhibited a higher risk of spatial clustering compared to those with MABC-PD. ConclusionsDifferent types of NTM-PD exhibit distinct patterns of spatial clustering and are associated with various factors. These findings underscore the importance of environmental and host factors in the epidemic of NTM-PD.

ОБЕСПЕЧЕНИЕ ПРОДОВОЛЬСТВЕННОЙ БЕЗОПАСНОСТИ ЗА СЧЕТ ИМПОРТОЗАМЕЩЕНИЯ МОЛОКА

The scientific article conducts a theoretical and economic study of the problems of ensuring food security through import substitution, import and export of milk. A review of the scientific literature showed the relevance of the study; many domestic and foreign scientists are directing their scientific interests to the development of an effective mechanism for ensuring the development of agricultural production sectors, and in particular the dairy product complex. In the field of interest of scientists are the problems of ensuring growth in production volumes, the prospects for reducing and completely eliminating the import of milk, as well as the possibility of increasing milk exports in certain regions. For the period from 2013 to 2022, according to official statistics, we observe an increase in milk production volumes, while in 2015 a decrease of 0.4% was detected, and in 2016 by 0.3%. Over the past three years, milk imports do not exceed 18% of the total dairy resource, which indicates food security at the level of 83%. The growth rate of milk exports significantly exceeds the growth rate of its imports; their value has crossed the mark of 114%. It was revealed that the growth of milk volumes was significantly influenced by the annual increase in cow productivity in the ten-year study period; a decrease in milk production volumes was observed in those periods when the number of animals decreased significantly. A slight decrease in milk production volumes in 2015 and 2016 did not have a detrimental effect on milk sales volumes; milk sales volumes, according to official statistics, have been trending upward over the past 10 years.

Hospital admission rates and related outcomes among adult Aboriginal australians with bronchiectasis – a ten-year retrospective cohort study

BackgroundThis study assessed hospitalisation frequency and related clinical outcomes among adult Aboriginal Australians with bronchiectasis over a ten-year study period.MethodThis retrospective study included patients aged ≥ 18 years diagnosed with bronchiectasis between 2011 and 2020 in the Top End, Northern Territory of Australia. Hospital admissions restricted to respiratory conditions (International Classification of Diseases (ICD) code J) and relevant clinical parameters were assessed and compared between those with and without hospital admissions.ResultsOf the 459 patients diagnosed to have bronchiectasis, 398 (87%) recorded at least one respiratory related (ICD-J code) hospitalisation during the 10-year window. In comparison to patients with a recorded hospitalisation against those without—hospitalised patients were older (median 57 vs 53 years), predominantly females (54 vs 46%), had lower body mass index (23 vs 26 kg/m2) and had greater concurrent presence of chronic obstructive pulmonary disease (COPD) (88 vs 47%), including demonstrating lower spirometry values (forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) (median FVC 49 vs 63% & FEV1 36 vs 55% respectively)). The total hospitalisations accounted for 3,123 admissions (median 4 per patient (IQR 2, 10)), at a median rate of 1 /year (IQR 0.5, 2.2) with a median length of 3 days (IQR 1, 6). Bronchiectasis along with COPD with lower respiratory tract infection (ICD code-J44) was the most common primary diagnosis code, accounting for 56% of presentations and 46% of days in hospital, which was also higher for patients using inhaled corticosteroids (81 vs 52%, p = 0.007). A total of 114 (29%) patients were recorded to have had an ICU admission, with a higher rate, including longer hospital stay among those patients with bronchiectasis and respiratory failure related presentations (32/35, 91%). In multivariate regression model, concurrent presence of COPD or asthma alongside bronchiectasis was associated with shorter times between subsequent hospitalisations (-423 days, p = 0.007 & -119 days, p = 0.02 respectively).ConclusionHospitalisation rates among adult Aboriginal Australians with bronchiectasis are high. Future interventions are required to explore avenues to reduce the overall morbidity associated with bronchiectasis among Aboriginal Australians.

Enterovirus and parechovirus meningoencephalitis in infants: A ten-year prospective observational study in a neonatal intensive care unit

BackgroundNon-polio enteroviruses (EV) and human parechoviruses (HPeV) are known etiological agents of meningoencephalitis in neonates. However, reports of neuroradiological findings and neurodevelopmental outcomes in this population are scarce. Objectivesto describe clinical characteristics, neuroradiological findings and, in a subset of patients, neurodevelopmental outcomes in a cohort of infants with EV or HPeV meningoencephalitis within 60 days of life. Study designclinical/laboratory data, neuroradiological findings (cranial ultrasound, cUS, brain magnetic resonance imaging, MRI), and neurodevelopmental outcomes assessed by Ages and Stages Questionnaires – third edition were prospectively collected. Resultsoverall, 32 infants with EV (21, 67.8 %) or HPeV (11, 28.2 %) meningoencephalitis were enrolled. Infants with HPeV (73 %: type 3 HPeV) presented more frequently with seizures (18.2 % vs. 0, p value=0.03), lymphopenia (1120 vs. 2170 cells/mm3, p = 0.02), focal anomalies at electroencephalography (EEG) (63.6 vs. 23.8 %, p = 0.03), and pathological findings at MRI (72.7 % vs. 15.8 %, p value=0.004) compared to those affected by EV. cUS was not significantly altered in any of the enrolled infants. All infants with EV meningoencephalitis evaluated at 12–24 months and at 30–48 months were normal. Two out of the 7 infants with HPeV meningoencephalitis showed some concerns in gross motor (1/7, 14.3 %) or in problem solving (1/7, 14.3 %) function at 30–48 months of age. ConclusionsIn our cohort, neonates infected by HPeV had more severe clinical manifestations, more alterations at brain MRI, and some signs of long-term neurodevelopmental delay. Our data highlight the heterogeneity of manifestations in infants with EV or HPeV meningoencephalitis, and the need for long-term follow-up of those infected by HPeV in the neonatal period.

Clinical and laboratory parameters associated with febrile seizure recurrence within the first 24 h: a ten-year cohort study.

We assessed clinical and laboratory parameters associated with early recurrence of febrile seizure in patients presenting at the Emergency Department with a first episode. Case series of patients admitted to the emergency department with the first episode of febrile seizure for ten consecutive years. Exclusion criteria were focal features and prolonged duration (>15 min). We included 693 patients, 284 (41%) female. Median age of 20 (IQR 15-27) months. Fifty-two (8%) patients had a recurrence within 24 h. At univariate analysis, patients with recurrent seizures had higher use of antipyretics (88% vs. 74%, P = 0.03, OR 2.6, 95% CI: 1.1-7.7), higher median maximal body temperature (39.3 °C, IQR 38.9-39.9, vs. 38.9, IQR 38.4-39.3, P < 0.001, OR 2.3, 95% CI: 1.5-2.6) and presented with a lower proportion of respiratory tract infections (54% vs. 70%, P = 0.02) compared to patients without recurrence. A maximal body temperature equal to or higher than 39 °C was associated with a higher recurrence (11% vs. 4%, P < 0.001, OR 2.9, 95% CI: 1.6-5.6). Hyponatremia was not associated with a risk of recurrence. The multivariate analysis confirmed a direct association with body temperature (OR 2.3, 95% CI: 1.5-3.7, P < 0.001), and an inverse association with respiratory tract infections (OR 0.4, 95% CI: 0.2-0.9, P = 0.01), while antipyretic use was not correlated (OR 1.9, 95% CI: 0.8-5.2, P = 0.2). High body temperature and respiratory tract infections were (directly and inversely) associated with recurrences. Consideration of these conditions might help for anticipating the probability of recurrence.

Posttraumatic glaucoma in southern China: A ten-year retrospective study.

To analyze posttraumatic glaucoma regarding its demographics, presentations, different causes, surgical modalities, and hospitalization burden among patients in southern China. This retrospective study investigated all individuals with posttraumatic glaucoma admitted to the Zhongshan Ophthalmic Center of Sun Yat-Sen University from January 2012 through December 2021. Out of 2211 cases, 64.82% had closed globe injury (CGI), 28.22% had open globe injury (OGI), and 6.96% had chemical injury (CI). The mean age of all patients was 44.45 ± 19.45 years old. Males (83.36%), rural patients (56.17%), and farmers (27.14%) predominantly had posttraumatic glaucoma. The most common external injury mechanism was blunt objects (37.82%). Compared with the other two groups, the majority of surgical modalities were cataract extraction (27.12%) in the CGI group, combined anterior-posterior surgery (34.79%) in the OGI group, and cyclocryotherapy/cyclophotoagulation (49.1%) in the CI group. The CI group had higher times of hospitalization (3.542 ± 0.242) and hospitalization duration (8.373 ± 0.743 days), whereas the OGI group had more operation expense ($ 1476.729 ± 11.047) and medical consumables expense per head ($ 962.578 ± 25.801). Blunt injury, males, adults, farmers, and rural patients were high-risk factors for posttraumatic glaucoma. Chemical-induced glaucoma management requires a longer hospitalization period, while OGI requires more medical expenditure. This knowledge provides a new reference for clinicians to accurately diagnose and intervene in posttraumatic glaucoma. It also suggests that more education and long-term surveillance are needed regarding the presence of glaucoma after ocular trauma.

Ten-year (2009–2019) epidemiological study of head and neck, salivary glands and upper aerodigestive tract cancers, and overall survival outcomes in the Northern Territory of Australia

BackgroundHead and neck, salivary glands and aerodigestive tract cancers (HNACs) rank sixth in cancer incidence in Australia, posing significant public health and economic challenges. However, data on HNACs in the...

Epidemiology of aquaporin-4-IgG-positive NMOSD in Sardinia

PurposeThe Italian Island of Sardinia (population, 1,578,146) is recognized for the high risk of multiple sclerosis (MS) but the epidemiological burden of other less common demyelinating diseases of the central nervous system (CNS), such as aquaporin-4-IgG-positive neuromyelitis optica spectrum disorder (AQP4-IgG+NMOSD), is unknown. In this study, we determined the incidence and prevalence of AQP4-IgG+NMOSD in Sardinia over a ten-year study period (2013–2022). MethodsPatients with a diagnosis of AQP4-IgG+NMOSD (per 2015 IPND diagnostic criteria) were retrospectively identified using two sources: (1) Archives of the reference and only laboratory for AQP4-IgG testing in Sardinia; and (2) medical records of the four MS units in the island. Incidence (January 2013–December 2022) and prevalence (December 31, 2022) were calculated. ResultsA total of 45 cases were included: incident, 31; prevalent, 41. The median age (range) at disease presentation was 51 (6–78) years; female/male ratio was 9:1. The crude (95 % CI) incidence and prevalence were 1.9 (1.3–2.7) per million and 2.6 (1.9–3.5) per 100,000, respectively. Prevalence increased from 2013 (1.1 per 100,000) to 2022 (2.6 per 100,000); p = 0.002. After age-standardization to the world, incidence and prevalence (95 % CI) decreased to 1.3 (0.7–2) per million and 1.8 (1.3–2.3) per 100,000, respectively. Coexisting immune-mediated disorders, mostly autoimmune thyroiditis, were reported in 50 % of patients. ConclusionsThe epidemiology of AQP4-IgG+NMOSD in Sardinia is overall in line with other Caucasian populations. The high MS risk in the island seems disease-specific and not associated with an increased risk of other CNS demyelinating disorders, confirming different pathophysiology.

Redox-associated changes in healthy individuals at risk of Alzheimer's disease. A ten-year follow-up study

Carrying an allele 4 of the apolipoprotein E (ApoE) is the best-established genetic risk factor to develop Alzheimer's disease (AD). Fifty percent of ApoE4/4 individuals develop the disease at 70 years of age. ApoE3/4 carriers have a lower risk of developing the disease, still 50% of them suffer AD at around 80 years. In a previous study we showed that healthy young individuals, who had a parent with AD and were carriers of at least one ApoE4 allele displayed reductive stress. This was evidenced as a decrease in oxidative markers, such as oxidized glutathione, p-p38, and NADP+/NADPH ratio, and an increase of antioxidant enzymes, such as glutathione peroxidase (Gpx1) and both the catalytic and regulatory subunits of glutamyl-cysteinyl (GCLM and GCLC). Moreover, we found an increase in stress-related proteins involved in tau physiopathology.Now, 10 years later, we have conducted a follow-up study measuring the same parameters in the same cohort. Our results show that reductive stress has reversed, as we could now observe an increase in lipid peroxidation and in the oxidation of glutathione along with a decrease in the expression of Gpx1 and SOD1 antioxidant enzymes in ApoE4 carriers. Furthermore, we found an increase in plasma levels of IL1β levels and in PKR (eukaryotic translation initiation factor 2 alpha kinase 2) gene expression in isolated lymphocytes.Altogether, our results suggest that, in the continuum of Alzheimer's disease, people at risk of developing the disease go through different redox phases, from stablished reductive stress to oxidative stress.

A GIS-based approach to assess the influence of the urban built environment on cardiac and respiratory outcomes in older adults

The impact of the urban built environment on cardiovascular and respiratory health has been studied extensively in children and adults. However, limited research exists on this topic in older adults. To fill this gap, we conducted a ten-year retrospective study of a cohort of elderly people living in Lausanne. We extracted cardiac and respiratory health outcomes of people living at the same address. A geographic information system (GIS) application was used to join spatial data between participant address and characteristics of the built environment (building age, building density, road density, proximity to vegetation and lake, elevation). To capture the impact of the urban landscape characteristics on the health of older people, the built environment descriptors, were considered alone and aggregated. Principal component analysis (PCA) was employed to resolve the multicollinearity among the built environment descriptors, while agglomerative hierarchical clustering was used to reveal underlying patterns and relationships within built environment variables. In addition, to better assess the effectiveness of ventilation in their homes, we characterized indoor air-associated mycobiomes in a representative sample of homes. This involved employing both culture-based methods and metabarcoding of the first internal transcribed spacer (ITS1) of the ribosomal DNA. The analysis revealed a significant association between exposure to the built environment as a whole and heart disease in the elderly. A higher prevalence was observed for the cluster of buildings near the lake/highway. The period of building construction showed an association with the prevalence of chronic lung disease and chronic cough, with a higher prevalence observed in houses built between 1975 and 2013. The contribution of indoor air pollution to worsening respiratory health was confirmed by higher Aspergillus spore loads and increased relative abundance of Gloeophyllum and Aureobasidium in indoor air, all of which were associated with respiratory outcomes. This research highlights the crucial influence of the built environment on the health status of the elderly population, with implications for targeted interventions and public health policy development.

Beyond the First Year: Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation.

Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1year. Among 1066KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0-45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections.

Analysis of characteristic and postexposure practices of occupational blood and body fluid exposures among health care workers in Chinese tertiary hospitals: a retrospective ten-year study

BackgroundOccupational blood and body fluid exposure (OBEs) is a highly concerning global health problem in health facilities. Improper or inadequate post-exposure practices increase the risk of infection with bloodborne pathogens. Understanding risk factors for OBEs and evaluating the post-exposure practices will contribute to healthcare workers’ (HCWs) well-being.MethodsThis study retrospectively synthesized and reviewed the 10-year data (from 2010 to 2020) on OBEs in a tertiary teaching hospital.ResultsA total of 519 HCWs have reported OBEs, increasing yearly from 2010 to 2020. Of these, most were nurses (247 [47.2%]), female (390 [75.1%]), at 23–27 years old (207 [39.9%]). The hepatitis B was the primary bloodborne pathogen exposed to HCWs, with 285 (54.9%) cases, internal medicine was the main exposure site (161 [31.0%]), and sharp injury was the main exposure route (439 [84.6%]). Data analysis shows that there are significant differences between exposure route, exposed pathogens, and exposure site among the different occupational categories (X2 = 14.5, 43.7, 94.3, all P < 0.001). 3.3% of HCWs did not take any post-exposure practices. For percutaneous exposure, 4.7% did not rinse the wound, 3.3% did not squeeze out the wound, and 2.3% did not disinfect the wound. In the case of mucosal exposure, 90.4% clean the exposure area immediately.ConclusionsThe data from the past decade underscores the seriousness of current situation of OBEs in Chinese tertiary hospital, particularly among young HCWs, and with hepatitis B as the predominant blood-borne pathogen. This study also identifies HCWs may take incorrect post-exposure practices. It’s crucial in the future to discuss the effectiveness of main groups targeted for focused specialty-specific guidance for the prevention of such accidents, meanwhile, to include blood-borne disease immunity testing in mandatory health check-ups. Additionally, focus on optimizing post-exposure practices, offering significant steps toward prevention of such incidents and reducing infection risks should also be considered in future studies.

Interactions between sustainable development goals at the district level in Lao PDR

Monitoring the status and evolution of Sustainable Development Goals (SDGs) is typically carried out at the national level. However, significant variation can exist within countries, and this may not be captured by aggregate statistics. Here, we develop a unique dataset representing indicators for three SDGs at a district level for Lao PDR. The indicators comprise prevalence of stunting (SDG 2, Zero hunger), poverty headcount (SDG 1, No Poverty), and share of natural area (SDG 15, Life on land) for two moments in time: 2005 and 2015. In both years, we find considerable variation among district-level outcomes for stunting and poverty. We also find that higher stunting and poverty rates are significantly correlated with higher shares of natural land in both years. This is consistent with the common perception of a trade-off between environmental outcomes and socioeconomic wellbeing. The correlation vanishes, however, when we consider changes in poverty, stunting, and natural area over the ten-year study period. This holds as well when we focus on agricultural land instead of natural areas. We observe that most regions show improvements in both stunting and poverty, albeit not always in a statistically significant sense. This points to synergistic development. Similarly, improvements in both indicators are associated with losses in natural areas in all regions, indicating a trade-off. These results suggest that both trade-offs and synergies between SDGs can arise at the district level, but that context and local conditions likely moderate the strength of these interactions. Our results highlight the importance of quantifying and monitoring sustainable development at the detailed subnational level.

The Epidemiology of Anal Human Papillomavirus (HPV) in HIV-Positive and HIV-Negative Women and Men: A Ten-Year Retrospective Observational Study in Rome (Italy).

Human papillomaviruses (HPVs) commonly infect the anogenital mucosa; most infections are transient, but a fraction of those caused by high-risk (HR) types persist and may lead to anogenital cancer. The epidemiology of HPV genotypes in anal infections in groups at different risk for anal cancer has not been well described in Italy. This retrospective study reports the results of HPV DNA testing and complete genotyping performed on anal swabs from 691 female and male patients attending proctology clinics in Rome during 2012-2021; one-third had repeated testing. Cumulative HPV positivity in 1212 anal swabs was approximately 60%, was not age related, and showed an increasing trend over the study period. HPV rates differed significantly by sex and HIV status: HIV-negative women had the lowest (43.6%) and HIV-positive men the highest (83.5%) HPV prevalence. HIV-positive men had more oncogenic HPV genotypes detected, more multiple infections, and the highest frequency of persistent infections. Two-thirds of all infections were vaccine-preventable. This study found that anal HPV infection rates are still elevated and even increasing in groups at low and high risk of developing anal cancer. Prevention programs need to be improved to reduce rates of anal infection in young women and men.

The impact of MYD88 and PIM1 in mature large B-cell non-Hodgkin lymphomas: Defining element of their evolution and prognosis.

Sequence studies of the entire exome and transcriptome of lymphoma tissues have identified MYD88 and PIM1 as involved in the development and oncogenic signaling. We aimed to determine the frequency of MYD88 and PIM1 mutations, as well as their expressions in conjunction with the clinicopathological parameters identified in mature large B-cell non-Hodgkin lymphomas. The ten-year retrospective study included 50 cases of mature large B-cell lymphoma, diagnosed at the Pathology Department of the Emergency County Hospital of Constanţa and Săcele County Hospital of Brasov. They were statistically analyzed by demographic, clinicopathological, and morphogenetic characteristics. We used a real-time polymerase chain reaction technique to identify PIM1 and MYD88 mutations as well as an immunohistochemical technique to evaluate the expressions of the 2 genes. Patients with lymphoma in the small bowel, spleen, brain, and testis had a low-performance status Eastern Cooperative Oncology Group (P = .001). The Eastern Cooperative Oncology Group performance status represented an independent risk factor predicting mortality (HR = 9.372, P < .001). An increased lactate dehydrogenase value was associated with a low survival (P = .002). The international prognostic index score represents a negative risk factor in terms of patient survival (HR = 4.654, P < .001). In cases of diffuse large B-cell lymphoma (DLBCL), immunopositivity of MYD88 is associated with non-germinal center B-cell origin (P < .001). The multivariate analysis observed the association between high lactate dehydrogenase value and the immunohistochemical expression of PIM1 or with the mutant status of the PIM1 gene representing negative prognostic factors (HR = 2.066, P = .042, respectively HR = 3.100, P = .004). In conclusion, our preliminary data suggest that the oncogenic mutations of PIM1 and MYD88 in our DLBCL cohort may improve the diagnosis and prognosis of DLBCL patients in an advanced stage.

Fertility policy changes, maternal and foetal characteristics and birth timing patterns at a tertiary referral centre in Beijing: a ten-year retrospective study

ObjectiveThis study aimed to explore the impacts of the changing national fertility policy on maternal and fetal characteristics, and birth timing patterns and provide a basis for the management of...

Histopathologic and Immunohistochemical Analysis of Neurofibromas in a North-Western Nigerian Tertiary Hospital: A Ten-Year Retrospective Study.

Neurofibromas are the most common benign nerve sheath tumours occurring as solitary sporadic tumours or multiple Syndromic tumours associated with neurofibromatosis type 1(NF1). In Nigeria and West Africa, there is a paucity of literature and studies on neurofibromas. This study aims to analyse the histopathologic and immunohistochemical patterns of neurofibromas and determine the frequency, demographic and anatomic distributions. The study was a hospital-based retrospective study, and the study population constituted all surgical specimens submitted for histological examination to the Department of Pathology between 1st January 2010 to 31st December 2019 reported as neurofibroma. Records were retrieved from the archives and subjected to histopathologic and immunohistochemical analysis following standard protocols. Collated data was analysed, slides were reviewed, and results were presented in frequency distribution tables and statistical charts. A total of 125 cases were seen constituting 8.3% of all soft tissue tumours seen. Neurofibromas were more prevalent in females with a male-to-female ratio of 1:1.15. The age ranged between 2-70 years with a mean age of 25.38 years and the highest frequency of occurrence was in the second decade of life. The most frequent anatomic site of occurrence was the head and neck region. Most of the tumours 103 (82.4%) were sporadic while 22(17.6%) were Syndromic and associated with NF1. A malignant transformation of a pre-existing neurofibroma in an NF1 patient was seen. The most common histologic variant seen was the conventional variant. Ninety percent of these tumours showed SOX10 immunopositivity, 91% showed S100 immunopositivity and 95% showed CD34 immunopositivity. Calretinin expression was low showing 16%. No hot spots labeling index seen with Ki67 antibody. Neurofibromas are more common in females in our environment and the most frequent anatomic site of involvement is the head and neck region.