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Lill Y, Cespedes WV, Benitez BK, Eckstein-Halla NC, Leitmeyer KS, Gürtler N, Stieger C, Mueller AA. Screening for congenital hearing impairment with brainstem evoked response audiometry in isolated orofacial cleft. Int J Oral Maxillofac Surg 2024; 53:376-381. [PMID: 38061954 DOI: 10.1016/j.ijom.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 04/16/2024]
Abstract
Brainstem evoked response audiometry (BERA) is the most established and recommended objective audiometric method for the clinical diagnosis of hearing impairment in high-risk infants. It is unclear whether infants with orofacial clefts meet the criteria for the high-risk group. This retrospective cohort study evaluated the need for diagnostic BERA in infants with cleft palate with or without cleft lip by assessing the predisposition to and diagnosis of congenital hearing impairment. Data from 122 patients treated at a single cleft centre were evaluated. BERA was conducted at the time of palate repair at 4-6 months of age. Clinical follow-up was analysed up to 4 years. The presence of a syndrome was examined as a risk factor for congenital hearing impairment. Among the 122 patients, four had congenital sensorineural or mixed hearing loss requiring hearing aids. All affected patients had syndromes in addition to the cleft. Most patients with elevated hearing thresholds had transient conductive hearing loss. Most suspected sensorineural hearing loss initially diagnosed was refuted. However, a higher incidence of sensorineural hearing loss was found in patients with syndromic clefts, supporting the diagnostic use of BERA with initial surgery only in patients with syndromic clefts.
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Affiliation(s)
- Y Lill
- Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
| | - W V Cespedes
- Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - B K Benitez
- Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
| | - N C Eckstein-Halla
- Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
| | - K S Leitmeyer
- Department of Otorhinolaryngology, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - N Gürtler
- Department of Otorhinolaryngology, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Otorhinolaryngology, University Children's Hospital Basel, Basel, Switzerland.
| | - C Stieger
- Department of Otorhinolaryngology, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - A A Mueller
- Oral and Craniomaxillofacial Surgery, University Hospital Basel and University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
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2
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Spytska L. Anxiety and depressive personality disorders in the modern world. Acta Psychol (Amst) 2024; 246:104285. [PMID: 38642453 DOI: 10.1016/j.actpsy.2024.104285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/22/2024] Open
Abstract
The study's significance lies in the multitude of challenges facing individuals today, such as the COVID-19 pandemic, military conflicts like the war in Ukraine, and the escalating rates of cancer morbidity and mortality. These factors contribute to the onset of anxiety and depressive disorders, disrupting various aspects of individuals' mental functioning and social interactions. Addressing these disorders effectively necessitates a comprehensive approach, combining pharmacological interventions with psychotherapeutic strategies under the guidance of specialized professionals. In this regard, the study is aimed at identifying aspects and features of the development of psychological problems and personality disorders in the modern world filled with various stressors. The leading methods of studying this problem are analysis, synthesis, induction, deduction, comparison, experiment and systematisation of approaches that will help determine a wide range of mental disorders. Theoretical methods were used to analyze the literature and summarize theoretical material on anxiety and depressive disorders. Diagnostic methods were used to assess the psychological state of the study population. The study examines significant clinical syndromes and vegetative disorders that disrupt normal lifestyle, hinder daily activities, and impede professional growth. It evaluates the roles of psychologists, psychiatrists, and social workers in assisting individuals with anxiety disorders. It outlines preventive measures for anxiety and depression, while also delving into various types of anxiety disorders. The research proposes diverse methods to prevent emotional anxiety and instability. It underscores the importance of devising novel strategies for diagnosis and therapy, emphasizing a comprehensive approach involving psychotherapeutic support, medical intervention, and adaptive behavioral techniques. The findings of the study hold both practical and theoretical significance for professionals in psychology, psychiatry, psychoanalysis, and sociology who provide support for individuals with anxiety and depressive disorders. Furthermore, the insights provided may be pertinent to researchers and scholars investigating the psychological well-being of contemporary society amidst adverse external circumstances.
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Affiliation(s)
- Liana Spytska
- Department of Psychology and Pedagogy, Kyiv International University, 03179, 49 Lvivska Str., Kyiv, Ukraine.
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Fisayo T. 'No One Is Talking About This' - rare diseases in childhood. Arch Dis Child 2024; 109:436-437. [PMID: 38041665 DOI: 10.1136/archdischild-2023-326318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 12/03/2023]
Affiliation(s)
- Temitope Fisayo
- Queen Mary University of London Blizard Institute, London, UK
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El Fakih R, Bajuaifer YS, Shah AY, Sulaiman R, Almohamady R, ELGohary G, Alothaimeen HS, Aljurf M. Paraneoplastic syndromes associated with classic Hodgkin lymphoma, a systematic literature review. Ann Hematol 2024; 103:1131-1137. [PMID: 37428199 DOI: 10.1007/s00277-023-05357-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/04/2023] [Indexed: 07/11/2023]
Abstract
PNS are uncommon manifestations of cancer. The current literature about these syndromes in the setting of cHL is disintegrated. A systematic literature review of all published literature was conducted. One hundred twenty-eight patients from 115 publications met the inclusion/exclusion criteria. Eight-five patients were of the NS subtype (66.4%). The most frequent clinical presentation of the PNS was CNS manifestation (25.8%). The majority of patients were diagnosed with the cHL and PNS simultaneously (42.2%). In 33.6% of patients, the lymphoma diagnosis preceded the PNS diagnosis. In 16.4% of patients, the PNS diagnosis preceded the lymphoma diagnosis. The presence of PNS antibodies was reported in 35 patients (27.3%). Age older than 18 was associated with higher prevalence of PNS. The CR rate of the lymphoma was 77.3%. The complete resolution rate of the PNS was 54.7%. Relapse of lymphoma was reported in 13 patients, and recurrence of the PNS upon relapse was reported in 10/13 patients.
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Affiliation(s)
- Riad El Fakih
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia.
| | - Yazeed S Bajuaifer
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
| | - Amna Yousaf Shah
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
| | - Reem Sulaiman
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
| | - Rawan Almohamady
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
| | - Ghada ELGohary
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
- Oncology Center, University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Haya S Alothaimeen
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
| | - Mahmoud Aljurf
- Oncology Center, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh, 11471, Saudi Arabia
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Ahilasamy N, Kumar RD, S S, K S, Rahiman A. Missed Maxillary Sinus Ostium Syndrome and its Management. Indian J Otolaryngol Head Neck Surg 2024; 76:2032-2034. [PMID: 38566669 PMCID: PMC10982247 DOI: 10.1007/s12070-023-04385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
The inflammatory process involving the maxillary sinus is often exacerbated by a functional obstruction due to laterally displaced uncinate process which obstructs the infundibulum and the natural ostium. Physiologically the drainage pathway may be adequate but during periods of inflammation resulting in nasal oedema, the ostium/infundibulum interface is inadequate, preventing adequate ventilation and drainage of the maxillary sinus. Incomplete removal of the uncinate process without including the natural ostium may result in failure and recurrence. This method of Middle meatal antrostomy that does not include the natural ostium of the maxillary sinus, leads to the missed ostium sequence and continued sinus disease. Here a case of missed maxillary sinus syndrome and its management is presented. A 28-year-old man with complaints of post nasal drip and Left facial pain for 4 months. 3 years prior the patient underwent functional endoscopic sinus surgery (FESS), following surgery patient had recurrent episode of sinusitis. Diagnostic nasal endoscopy revealed presence of mucopurulent discharge in left middle meatus, CT scan Paranasal sinus was suggestive of opacity in left maxillary sinuses and in left middle meatus with wide maxillary antrostomy. Revision FESS surgery was performed, where two ostia were present was converted into single wide middle meatal antrostomy using a back bitting forceps and microdebrider to avoid maxillary sinus mucus recirculation phenomenon. On follow up 1 year later, patient had no symptoms of repeated sinusitis. Missed maxillary sinus ostium syndrome has to be recognized and timely addressed by joining the natural and surgically created ostia as single wide middle meatal antrostomy window. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-023-04385-x.
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Affiliation(s)
| | - Rajendran Dinesh Kumar
- Department of ENT and Head-Neck Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka 560074 India
| | - Sowmya S
- Department of ENT and Head-Neck Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka 560074 India
| | - Srirangaprasad K
- Department of ENT and Head-Neck Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka 560074 India
| | - Asma Rahiman
- Department of ENT and Head-Neck Surgery, Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka 560074 India
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刘 学, 贾 皇, 王 丽, 王 子, 许 孟, 李 云, 王 茸. [Screening for Characteristic Genes of Different Traditional Chinese Medicine Syndromes of Psoriasis Vulgaris: A Study Based on Bioinformatics and Machine Learning]. Sichuan Da Xue Xue Bao Yi Xue Ban 2024; 55:337-345. [PMID: 38645867 PMCID: PMC11026890 DOI: 10.12182/20240360402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 04/23/2024]
Abstract
Objective To screen for the key characteristic genes of the psoriasis vulgaris (PV) patients with different Traditional Chinese Medicine (TCM) syndromes, including blood-heat syndrome (BHS), blood stasis syndrome (BSS), and blood-dryness syndrome (BDS), through bioinformatics and machine learning and to provide a scientific basis for the clinical diagnosis and treatment of PV of different TCM syndrome types. Methods The GSE192867 dataset was downloaded from Gene Expression Omnibus (GEO). The limma package was used to screen for the differentially expressed genes (DEGs) of PV, BHS, BSS, and BDS in PV patients and healthy populations. In addition, KEGG (Kyoto Encyclopedia of Genes and Genes) pathway enrichment analysis was performed. The DEGs associated with PV, BHS, BSS, and BDS were identified in the screening and were intersected separately to obtain differentially characterized genes. Out of two algorithms, the support vector machine (SVM) and random forest (RF), the one that produced the optimal performance was used to analyze the characteristic genes and the top 5 genes were identified as the key characteristic genes. The receiver operating characteristic (ROC) curves of the key characteristic genes were plotted by using the pROC package, the area under curve (AUC) was calculated, and the diagnostic performance was evaluated, accordingly. Results The numbers of DEGs associated with PV, BHS, BSS, and BDS were 7699, 7291, 7654, and 6578, respectively. KEGG enrichment analysis was focused on Janus kinase (JAK)/signal transducer and activator of transcription (STAT), cyclic adenosine monophosphate (cAMP), mitogen-activated protein kinase (MAPK), apoptosis, and other pathways. A total of 13 key characteristic genes were identified in the screening by machine learning. Among the 13 key characteristic genes, malectin (MLEC), TUB like protein 3 (TULP3), SET domain containing 9 (SETD9), nuclear envelope integral membrane protein 2 (NEMP2), and BTG anti-proliferation factor 3 (BTG3) were the key characteristic genes of BHS; phosphatase 15 (DUSP15), C1q and tumor necrosis factor related protein 7 (C1QTNF7), solute carrier family 12 member 5 (SLC12A5), tripartite motif containing 63 (TRIM63), and ubiquitin associated protein 1 like (UBAP1L) were the key characteristic genes of BSS; recombinant mouse protein (RRNAD1), GTPase-activating protein ASAP3 Protein (ASAP3), and human myomesin 2 (MYOM2) were the key characteristic genes of BDS. Moreover, all of them showed high diagnostic efficacy. Conclusion There are significant differences in the characteristic genes of different PV syndromes and they may be potential biomarkers for diagnosing TCM syndromes of PV.
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Affiliation(s)
- 学伟 刘
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 皇超 贾
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 丽云 王
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 子雯 王
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 孟月 许
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 云飞 李
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - 茸慧 王
- 河南中医药大学 (郑州 450046)Henan University of Chinese Medicine, Zhengzhou 450046, China
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7
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Stanishevskiy A, Babichev K, Svistov D, Savello A, Abramyan A, Zelenskiy B. Coexistence of moyamoya syndrome with arteriovenous malformation. Systematic review and illustrative case report. J Clin Neurosci 2024; 121:34-41. [PMID: 38354649 DOI: 10.1016/j.jocn.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/19/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
The coexistence of Moyamoya Syndrome with Arteriovenous Malformation is exceedingly rare. Here, we present the case of a 37-year-old female patient diagnosed with AVM in the right parietal lobe, accompanied by severe stenosis of the right middle cerebral artery and right anterior cerebral artery, along with moyamoya collateral induction. Our objective was to investigate the frequency and mutual influence of these conditions, and to determine a preferable treatment strategy by conducting a comprehensive review of previous case reports. We conducted a thorough search of PubMed, Scopus, and Web of Science databases, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our review encompassed 36 publications, reporting a total of 64 cases of AVM coexisting with Moyamoya Syndrome. Notably, bilateral stenosis was observed in half of the cases. Among patients with unilateral stenosis, AVM was localized in the opposite hemisphere only in 2 cases. Treatment approaches varied, with 18 cases undergoing active treatment for both stenosis and AVM, 11 cases treating stenosis prior to AVM, 5 cases addressing AVM first, and 3 cases treating both AVM and stenosis simultaneously. Embolization, either standalone or supplemented by stereotactic radiosurgery, was employed in six cases. Stereotactic radiosurgery alone was utilized in 12 cases, while 15 patients underwent surgical removal of the AVM. Our findings provide valuable insights for neurosurgeons managing patients with concurrent AVM and Moyamoya Syndrome. The variety of treatment approaches observed in the literature underscores the complexity of these cases, emphasizing the need for individualized strategies. This information may guide future systematic reviews and meta-analyses, contributing to a better understanding of the optimal management of these rare coexisting vascular pathologies.
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Affiliation(s)
- Artem Stanishevskiy
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Konstantin Babichev
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Dmitriy Svistov
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
| | - Alexander Savello
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia
| | | | - Bogdan Zelenskiy
- Department of Neurosurgery, Military Medical Academy named after S.M. Kirov, Saint-Petersburg, Russia.
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Gonzaga AKG, Costa CSDO, Morais HGDF, da Fonseca Neto B, Pinto LP, Dantas WRM, de Oliveira PT, de Melo DP. Clinical and radiographic characteristics of pycnodysostosis: A systematic review. Imaging Sci Dent 2024; 54:13-24. [PMID: 38571780 PMCID: PMC10985529 DOI: 10.5624/isd.20230191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 04/05/2024] Open
Abstract
Purpose Pycnodysostosis (PYCD), an autosomal recessive syndrome, is characterized by an imbalance in bone remodeling that produces various clinical and radiographic craniofacial manifestations. This review represents a systematic examination of these manifestations, as well as oral features associated with PYCD. Materials and Methods A systematic review was conducted across 8 databases from February to March 2023. The search strategy focused on studies reporting cases of PYCD that examined the clinical and radiographic craniofacial and oral characteristics associated with this syndrome. Results The review included 84 studies, encompassing a total of 179 cases of PYCD. More than half of the patients were female (55.3%), and the mean age was 14.7 years. Parental consanguinity was reported in 51.4% of the cases. The most common craniofacial clinical manifestation was a prominent nose, observed in 57.5% of cases. Radiographically, the most frequently reported craniofacial characteristics included the presence of an obtuse mandibular angle (84.3%) and frontal cranial bosses (82.1%). Clinical and radiographic examinations revealed oral alterations, with micrognathia present in 62.6% of patients and malocclusion in 59.2%. Among dental anomalies, tooth agenesis was the most commonly reported, affecting 15.6% of patients. Conclusion Understanding the clinical and radiographic craniofacial features of PYCD is crucial for dental professionals. This knowledge enables these clinicians to devise effective treatment plans and improve patient quality of life.
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Affiliation(s)
- Amanda Katarinny Goes Gonzaga
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Carla Samily de Oliveira Costa
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Hannah Gil de Farias Morais
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Braz da Fonseca Neto
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Leão Pereira Pinto
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Wagner Ranier Maciel Dantas
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Patricia Teixeira de Oliveira
- Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Daniela Pita de Melo
- Graduate Program in Dentistry, Department of Dentistry, State University of Paraíba, Campina Grande, PB, Brazil
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Maddhesiya J, Mohapatra B. Understanding the Genetic and Non-Genetic Interconnections in the Aetiology of Syndromic Congenital Heart Disease: An Updated Review: Part 2. Curr Cardiol Rep 2024; 26:167-178. [PMID: 38358608 DOI: 10.1007/s11886-024-02020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE OF REVIEW Approximately 30% of syndromic cases diagnosed with CHD, which lure us to further investigate the molecular and clinical challenges behind syndromic CHD (sCHD). The aetiology of sCHD in a majority of cases remains enigmatic due to involvement of multiple factors, namely genetic, epigenetic and environmental modifiable risk factors for the development of the disease. Here, we aim to update the role of genetic contributors including chromosomal abnormalities, copy number variations (CNVs) and single gene mutations in cardiac specific genes, maternal lifestyle conditions, environmental exposures and epigenetic modifiers in causing CHD in different genetic syndromes. RECENT FINDINGS The exact aetiology of sCHD is still unknown. With the advancement of next-generation technologies including WGS, WES, transcriptome, proteome and methylome study, numerous novel genes and pathways have been identified. Moreover, our recent knowledge regarding epigenetic and environmental regulation during cardiogenesis is still evolving and may solve some of the mystery behind complex sCHD. Here, we focus to understand how the complex combination of genetic, environmental and epigenetic factors interact to interfere with developmental pathways, culminating into cardiac and extracardiac defects in sCHD.
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Affiliation(s)
- Jyoti Maddhesiya
- Cytogenetics Laboratory, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Bhagyalaxmi Mohapatra
- Cytogenetics Laboratory, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India.
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Strehle EM. Freiherr von Münchhausen and the two syndromes bearing his name. Arch Dis Child 2024; 109:253-255. [PMID: 37640433 DOI: 10.1136/archdischild-2023-325915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
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11
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Gebray HM, Abeje AE, Boye AT. BRASH syndrome with a complete heart block- a case report. BMC Cardiovasc Disord 2024; 24:114. [PMID: 38373878 PMCID: PMC10877849 DOI: 10.1186/s12872-024-03782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/11/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION BRASH syndrome (Bradycardia, Renal failure, Atrioventricular (AV) nodal blocking agent, Shock and Hyperkalemia) is a recently emerging diagnosis that describes the profound bradycardia seen in patients on AV nodal blockers who present with acute kidney injury (AKI) and hyperkalemia. CASE PRESENTATION We present a case of a 68 years old female patient with past history of hypertension taking atenolol and Enalapril presented to emergency department with the complaint of loss of consciousness of 02 hours duration. She had 03 days history of fatigue, poor oral intake, decreased urine output, appetite loss, vertigo and global headache. Her vital signs were blood pressure of 60/40 mmHg, absent radial pulse and temperature of 36.4 °C. Her systemic examination was remarkable for dry buccal mucosa; apical heart rate was 22 beats per minute. Glasgow Coma Scale was 13/15. Her laboratory tests showed creatinine of 1.83 mg/dL, blood urea nitrogen of 89 mg/dL and potassium elevated to the level of 6.39 mEq/dL. ECG revealed complete heart block with a normal QT interval and T waves and no U waves with ventricular rate of 22 beats per minute. Her previous medications were discontinued and the patient was resuscitated with intravenous (IV) fluids. She was given 03 doses of 1 mg atropine every 5 minutes but there was no increment in heart rate. She was given 50% dextrose with 10 international units of regular insulin, 1 g of calcium gluconate and Intravenous perfusion of norepinephrine and dopamine. Subsequently, after 14 hours of ICU admission the patient had a cardiac arrest with asystole and resuscitation was attempted but she couldn't survive. CONCLUSION BRASH syndrome is largely an under-recognized life threatening clinical diagnosis. Physicians should have high index of suspicion for BRASH when they encounter patients with bradycardia, hyperkalemia, and renal failure, as timely diagnosis is crucial in the management.
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Park JY, Kim MS, Ryu JM. Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study. Support Care Cancer 2024; 32:149. [PMID: 38329591 DOI: 10.1007/s00520-024-08338-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation. METHODS This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA). RESULTS The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth. CONCLUSION Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.
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Affiliation(s)
- Ji Young Park
- Gastrointestinal Surgery Ward, Pusan National University Hospital, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, 599-1, Daeyeon 3 dong, Namgu, Busan, 48513, South Korea.
| | - Jung Mi Ryu
- Department of Nursing, Busan Institute of Science and Technology, Busan, South Korea
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13
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Grøvle L, Haugen AJ, Johansen M, Hasvik E. The terminologies of transient, migratory, or localized osteoporosis, and bone marrow edema syndrome: a scoping review. Osteoporos Int 2024; 35:217-226. [PMID: 37814095 PMCID: PMC10837245 DOI: 10.1007/s00198-023-06929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/21/2023] [Indexed: 10/11/2023]
Abstract
There is no formally defined terminology for the related entities transient osteoporosis of the hip (TOH), localized or regional migratory osteoporosis (RMO) and bone marrow edema syndrome (BMES). This study aimed to map the diversity and frequency of diagnostic terms and vocabulary utilized in the literature. A comprehensive search of electronic databases and reference lists was conducted. Publications that reported on patients with TOH, RMO, BMES, or related variants were eligible for inclusion. The terminologies were categorized based on the wording of the titles, abstracts, or texts. We included 561 publications, of which 423 were case reports, involving 2921 patients. Overall, TOH was the most commonly used term, occurring in 257 (45.8%). RMO was used in 34 (6.1%) and BMES in 57 (10.2%). The remaining used various combinations of transient, migratory, and regional in conjunction with either osteoporosis or bone marrow edema. Localized osteoporosis was not used. We identified three different terms related to pregnancy. In 76.3% of the publications, the terminology was related to osteoporosis and in 18.2% to bone marrow edema, although terminology did not correspond to actual findings. Bone marrow edema occurred as often as osteoporosis, and osteoporosis was generally ascertained by visual inspection of radiographs, seldom by bone densitometry. Many publications used osteoporosis-related terms without evidence that osteoporosis had been detected. The terminology of these closely related entities is confusing and unstandardized. The lack of formal definitions impedes accurate diagnosis, research on disease mechanisms, and effective treatment.
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Affiliation(s)
- Lars Grøvle
- Department of Rheumatology, Østfold Hospital Trust, Grålum, Norway.
| | | | | | - Eivind Hasvik
- Department of Physical Medicine and Rehabilitation, Østfold Hospital Trust, Grålum, Norway
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14
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Aedo Inostroza G, Pincheira Figueroa L, Aragón-Caqueo D, Loubies Muñoz R, Fuenzalida H, Sepúlveda A. [Translated article] Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment. Actas Dermo-Sifiliográficas 2024; 115:T174-T179. [PMID: 38048953 DOI: 10.1016/j.ad.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/12/2023] [Indexed: 12/06/2023] Open
Abstract
Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment.
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Affiliation(s)
- G Aedo Inostroza
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - L Pincheira Figueroa
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | | | - R Loubies Muñoz
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - H Fuenzalida
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - A Sepúlveda
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile
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15
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Aedo Inostroza G, Pincheira Figueroa L, Aragón-Caqueo D, Loubies Muñoz R, Fuenzalida H, Sepúlveda A. Reticulate Skin Lesions: Practical Color-Based Algorithm for Initial Clinical Assessment. Actas Dermosifiliogr 2024; 115:174-179. [PMID: 37276995 DOI: 10.1016/j.ad.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/28/2023] [Accepted: 03/12/2023] [Indexed: 06/07/2023] Open
Abstract
Reticular patterns are observed in a great variety of skin diseases. While these morphologic patterns are often highly distinctive, they are seldom discussed or studied in clinical contexts or recognized as a diagnostic category in their own right. Diseases presenting with reticulate skin lesions have multiple etiologies (tumors, infections, vascular disorders, inflammatory conditions, and metabolic or genetic alterations) and can range from relatively benign conditions to life-threatening ones. We review a selection of these diseases and propose a clinical diagnostic algorithm based on predominant coloring and clinical features to aid in their initial assessment.
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Affiliation(s)
- G Aedo Inostroza
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - L Pincheira Figueroa
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | | | - R Loubies Muñoz
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - H Fuenzalida
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile; Servicio de Dermatología, Hospital El Pino, Santiago, Chile
| | - A Sepúlveda
- Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile
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16
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Naseri K, Safarzadeh M, Moghaddam MR, Aramjoo H, Roshanravan B, Samarghandian S, Farkhondeh T. Protective Effect of Chrysin against Chlorpyrifos-Induced Metabolic Impairment and Pancreatitis in Male Rats. Curr Mol Pharmacol 2024; 17:e200223213784. [PMID: 36825695 DOI: 10.2174/1874467216666230220094827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 02/22/2023]
Abstract
BACKGROUND This study was performed to evaluate the protective effects of chrysin (CH) on metabolic impairment and pancreatic injury caused by sub-chronic chlorpyrifos (CPF) intoxication in male rats. METHODS Forty male Wistar rats were randomly allocated into five groups (n=8). Intraperitoneal injections of chrysin (12.5, 25 and 50 mg/kg for 45 days) and CPF (10 mg/kg for 45 days) gavage were performed. Present findings indicated that the serum levels of glucose, total cholesterol, and lowdensity lipoprotein-cholesterol, as well as body weight, were increased in the CPF-exposed group. RESULTS It was also found that CPF decreased superoxide dismutase activity as well as increased malondialdehyde and nitric oxide levels in the pancreatic tissue of exposed animals. Histopathological examination also confirmed the toxic effects of CPF on pancreatic tissue as mostly evidenced by infiltration of inflammatory cells and necrosis. CH (50 mg/kg) decreased blood glucose concentration (p < 0.05), TG (p < 0.05), and LDL-C in CPF-exposed animals. CH decreased the pancreas levels of MDA in all treated CPF-exposed groups versus the non-treated CPF-exposed group (p < 0.05, p < 0.001, p < 0.001, respectively). A significant difference was not seen in the NO and MDA levels and SOD activity between CH-treated (50 mg/kg) animals exposed to CPF and controls. A significant difference was not seen in the NO and MDA levels and SOD activity between CHtreated (50 mg/kg) animals exposed to CPF and controls. CONCLUSION A significant difference was not seen in the NO and MDA levels and SOD activity between CH-treated (50 mg/kg) animals exposed to CPF and controls. In conclusion, CH could prevent initiate and progress of CPF-induced metabolic impairment by modulating oxidative stress in pancreatic tissue as a target organ of organophosphorus pesticides.
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Affiliation(s)
- Kobra Naseri
- Department of Toxicology and Pharmacology, School of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahdieh Safarzadeh
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Mahdieh Rajabi Moghaddam
- Department of Pathology, School of Medicine, Razi Specialized Hospital, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamed Aramjoo
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Babak Roshanravan
- Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran
| | - Saeed Samarghandian
- Healthy Ageing Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Tahereh Farkhondeh
- Department of Toxicology and Pharmacology, School of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
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17
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Ebisike KJ, Iliya J, Elon WI, Alkali YS, Kelechi-Ebisike VO, Danjin M, Aliu R, Iliya A, Apollos D, Ezra D, Ozhe SI. METABOLIC SYNDROME AND ASSOCIATED RISK FACTORS AMONG SECONDARY SCHOOL ADOLESCENTS IN NORTHEAST NIGERIA. West Afr J Med 2023; 40:S45. [PMID: 38071598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Introduction Metabolic syndrome (MetS) is a cluster of risk factors that may predispose to cardiovascular diseases and type 2 diabetes mellitus. These risk factors include hypertension, central obesity, hyperglycaemia, hypertriglyceridemia and low high-density lipoprotein cholesterol (HDL-C). The presence of at least three of these risks factors defines MetS. Globally, MetS now affects children and adolescents with increasing obesity prevalence. This study determined the prevalence of MetS and associated risk factors among secondary school adolescents in Gombe Local Government Area(LGA), Northeast Nigeria. Methods A cross-sectional study; 688 participants from 12 secondary schools in Gombe LGA, Northeast Nigeria. Data were obtained using structured questionnaire. Anthropometry and blood pressure were measured. Fasting plasma glucose, serum triglyceride and HDL-C were determined. Data were analysed using SPSS version 21. Result The prevalence of MetS was 1.3%. Low serum HDL-C was the commonest risk factor. MetS was significantly higher in upper socio-economic class and private school participants. Lifestyle and family medical history were not significantly associated with MetS. Conclusion This study showed that the prevalence of metabolic syndrome was low in the overall study population but high among centrally obese adolescents. Metabolic syndrome occurred in normal weight and underweight participants. Low HDL-C was the commonest risk factor for metabolic syndrome and lifestyle and family medical history were not associated with metabolic syndrome.
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Affiliation(s)
- Kelechi Joseph Ebisike
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | - Jalo Iliya
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | - Warnow Isaac Elon
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | - Yaya Saidu Alkali
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | | | - Mela Danjin
- Department of Public Health, College of Nursing and Midwifery, Gombe, Nigeria
| | | | - Asabe Iliya
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | - Daniel Apollos
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
| | - Daniel Ezra
- Department of Paediatrics, Federal Teaching Hospital/ Gombe State University, Gombe State, Nigeria
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18
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Hp C, Harjai G, Doddawad VG, S M. Comprehensive Preventive and Therapeutic Oral Health Care: A Case Report of Mucopolysaccharidosis Type IV A in a Pediatric Patient. P R Health Sci J 2023; 42:332-334. [PMID: 38104293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Mucopolysaccharidosis (MPS) is a metabolic disorder resulting from a deficiency of lysosomal enzymes. It is an autosomal recessive disorder with similar incidences in men and women. Mucopolysaccharidosis type IV A is caused by a deficiency of N-acetylgalactosamine-6-sulfatase, which deficiency is, in turn, caused by alterations in the GALNS gene. It is marked by a short stature, a pigeon chest, frontal bossing, kyphosis, and a flat nasal bridge. Intraorally, macroglossia, hypodontia, dentinogenesis imperfecta, a broad mouth, and an anterior open bite are some of the common features. The present paper reports on a case of MPS in a 5-year-old male patient, along with providing a review of the literature and insight into the oral manifestations related to MPS IV A, also called Morquio A syndrome, and its dental treatment. It aims to highlight the clinical recommendations for oral health care in such cases during different phases of MPS IV A treatment.
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Affiliation(s)
- Chanchala Hp
- Assistant Professor, Department of Paediatric and Preventive Dentistry, JSS Dental College and Hospital, A constituent college of the JSS Academy of Higher Education & Research, Karnataka, India
| | - Gunica Harjai
- Postgraduate, Department of Paediatric and Preventive Dentistry, JSS Dental College and Hospital, A constituent college of the JSS Academy of Higher Education & Research, Karnataka, India
| | - Vidya G Doddawad
- Associate Professor, Department of Oral Pathology and Microbiology, JSS Dental College and Hospital, A constituent college of the JSS Academy of Higher Education & Research, Karnataka, India
| | - Manjual S
- Associate professor, Department of Oral and Maxillo Facial Surgery, JSS Dental College and Hospital, A constituent college of the JSS Academy of Higher Education & Research, Karnataka, India
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19
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Chew J, Chia JQ, Kyaw KK, Fu KJ, Lim C, Chua S, Tan HN. Frailty Screening and Detection of Geriatric Syndromes in Acute Inpatient Care: Impact on Hospital Length of Stay and 30-Day Readmissions. Ann Geriatr Med Res 2023; 27:315-323. [PMID: 37743682 PMCID: PMC10772326 DOI: 10.4235/agmr.23.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/09/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Frailty is prevalent in acute care and is associated with negative outcomes. While a comprehensive geriatric assessment to identify geriatric syndromes is recommended after identifying frailty, more evidence is needed to support this approach in the inpatient setting. This study examined the association between frailty and geriatric syndromes and their impact on outcomes in acutely admitted older adults. METHODS A total of 733 individuals aged ≥65 years admitted to the General Surgery Service of a tertiary hospital were assessed for frailty using the Clinical Frailty Scale (CFS) and for geriatric syndromes using routine nursing admission assessments, including cognitive impairment, falls, incontinence, malnutrition, and poor oral health. Multinomial logistic regression and Cox regression were used to evaluate the associations between frailty and geriatric syndromes and their concomitant impact on hospital length of stay (LOS) and 30-day readmissions. RESULTS Greater frailty severity was associated with an increased likelihood of geriatric syndromes. Individuals categorized as CFS 4-6 and CFS 7-8 with concomitant geriatric syndromes had 29% and 35% increased risks of a longer LOS, respectively. CFS 4-6 was significantly associated with functional decline (relative risk ratio =1.46; 95% confidence interval [CI], 1.03-2.07) and 30-day readmission (hazare ratio=1.78; 95% CI, 1.04-3.04), whereas these associations were not significant for CFS 7-8. CONCLUSION Geriatric syndromes in frail individuals can be identified from routine nursing assessments and represent a potential approach for targeted interventions following frailty identification. Tailored interventions may be necessary to achieve optimal outcomes at different stages of frailty. Further research is required to evaluate interventions for older adults with frailty in a wider hospital context.
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Affiliation(s)
- Justin Chew
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Jia Qian Chia
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
- Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore
| | - Kay Khine Kyaw
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Katrielle Joy Fu
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Celestine Lim
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Shiyun Chua
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
| | - Huei Nuo Tan
- Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore
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20
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Tüysüz B, Kasap B, Uludağ Alkaya D, Alp Ünkar Z, Köseoğlu P, Geyik F, Özer E, Önal H, Gezdirici A, Ercan O. Investigation of (Epi)genetic causes in syndromic short children born small for gestational age. Eur J Med Genet 2023; 66:104854. [PMID: 37758162 DOI: 10.1016/j.ejmg.2023.104854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/08/2023] [Accepted: 09/24/2023] [Indexed: 10/03/2023]
Abstract
Intrauterine onset syndromic short stature constitutes a group of diseases that pose challenges in differential diagnosis due to their rarity and clinical as well as molecular heterogeneity. The aim of this study was to investigate the presence of (epi)genetic causes in children born small for gestational age (SGA) and manifesting clinically undiagnosed syndromic short stature. The study group comprised twenty-nine cases selected from the syndromic SGA cohort. Various analyses were performed, including chromosomal microarray (CMA), methylation-specific-multiple ligation probe amplification for chromosomes 6,14 and 20, and whole exome sequencing (WES). Pathogenic copy number variants (CNVs) on chromosomes 2q13, 22q11.3, Xp22.33, 17q21.31, 19p13.13 and 4p16.31 causing syndromic growth disturbance were detected in six patients. Maternal uniparental disomy 14 was identified in a patient. WES was performed in the remaining 22 patients, revealing pathogenic variants in nine cases; six were monoallelic (ACAN, ARID2, NIPBL, PIK3R1, SMAD4, BRIP1), two were biallelic (BRCA2, RFWD3) and one was hemizygous (HUWE1). Seven of these were novel. Craniofacial dysmorphism, which is an important clue for the diagnosis of syndromes, was very mild in all patients. This study unveiled, for the first time, that ARID2 mutatios can cause syndromic SGA. In conclusion, a high (55.2%) diagnosis rate was achieved through the utilization of CMA, epigenetic and WES analyzes; 15 rare syndromes were defined, who were born with SGA and had atypical and/or mild dysmorphic findings. This study not only drew attention to the association of some rare syndromes with SGA, but also introduced novel genes and CNVs as potential contributors to syndromic SGA.
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Affiliation(s)
- Beyhan Tüysüz
- Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey.
| | - Büşra Kasap
- Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Dilek Uludağ Alkaya
- Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Zeynep Alp Ünkar
- Department of Neonatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Pınar Köseoğlu
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Filiz Geyik
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Emre Özer
- Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
| | - Hasan Önal
- Department of Pediatric Endocrinology, University of Health Sciences Turkey, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey
| | - Alper Gezdirici
- Department of Medical Genetic, University of Health Sciences Turkey, Başakşehir Çam ve Sakura City Hospital, Istanbul, Turkey
| | - Oya Ercan
- Department of Pediatric Endocrinology, Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty, Istanbul, Turkey
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Jelsig AM, van Overeem Hansen T, Gede LB, Qvist N, Christensen LL, Lautrup CK, Ljungmann K, Christensen LT, Rønlund K, Tørring PM, Bertelsen B, Sunde L, Karstensen JG. Whole genome sequencing and disease pattern in patients with juvenile polyposis syndrome: a nationwide study. Fam Cancer 2023; 22:429-436. [PMID: 37354305 PMCID: PMC10542306 DOI: 10.1007/s10689-023-00338-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/23/2023] [Indexed: 06/26/2023]
Abstract
Juvenile polyposis syndrome (JPS) is a hereditary hamartomatous polyposis syndrome characterized by gastrointestinal juvenile polyps and increased risk of gastrointestinal cancer. Germline pathogenic variants are detected in SMAD4 or BMPR1A, however in a significant number of patients with JPS, the etiology is unknown. From Danish registers, and genetic department and laboratories, we identified all patients in Denmark with a clinical diagnosis of JPS and/or a pathogenic variant in BMPR1A or SMAD4. In patients where no variant had been detected, we performed genetic analysis, including whole genome sequencing. We collected clinical information on all patients to investigate the phenotypic spectrum. Sixty-six patients (mean age 40 years) were included of whom the pathogenic variant was unknown in seven patients. We detected a pathogenic variant in SMAD4 or PTEN in additional three patients and thus ≈ 95% of patients had a pathogenic germline variant. Endoscopic information was available in fifty-two patients (79%) and of these 31 (60%) fulfilled the clinical criteria of JPS. In 41 patients (79%), other types of polyps than juvenile had been removed. Our results suggest that almost all patients with a clinical diagnosis of JPS has a pathogenic variant in mainly BMPR1A, SMAD4, and more rarely PTEN. However, not all patients with a pathogenic variant fulfil the clinical criteria of JPS. We also demonstrated a wide clinical spectrum, and that the histopathology of removed polyps varied.
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Affiliation(s)
- Anne Marie Jelsig
- Department of Clinical Genetics, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
| | - Thomas van Overeem Hansen
- Department of Clinical Genetics, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lene Bjerring Gede
- Department of Clinical Genetics, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Niels Qvist
- Research Unit for Surgery, Odense University Hospital, Odense, Denmark
- University of Southern Denmark, Odense, Denmark
| | | | | | - Ken Ljungmann
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | | | - Karina Rønlund
- Department of Clinical Genetics, University Hospital of Southern Denmark, Vejle Hospital, Vejle, Denmark
| | | | - Birgitte Bertelsen
- Center for Genomic Medicine, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Lone Sunde
- Department of Clinical Genetics, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - John Gásdal Karstensen
- Danish Polyposis Registry, Gastrounit, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Barakizou H. Two-year-old boy with sparse hair. Arch Dis Child Educ Pract Ed 2023; 108:359-360. [PMID: 36997305 DOI: 10.1136/archdischild-2023-325315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Hager Barakizou
- Department of Pediatrics, Military Hospital of Instruction of Tunis, Tunis, Tunisia
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Jellins T, Hill M, Prager JD, Francom CR, Chan CM, Schneider KW, Sharma A, Herrmann BW. Pediatric head and neck manifestations associated with multiple endocrine neoplasia syndromes. Int J Pediatr Otorhinolaryngol 2023; 173:111703. [PMID: 37604101 DOI: 10.1016/j.ijporl.2023.111703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/29/2023] [Accepted: 08/17/2023] [Indexed: 08/23/2023]
Abstract
INTRODUCTION Multiple endocrine neoplasia (MEN) syndromes are a group of hereditary cancer syndromes that can predispose children to endocrine neoplasms developing within the head and neck. OBJECTIVE To examine the neoplastic manifestations of MEN type 1 (MEN1) and MEN type 2 (MEN2) in the pediatric head and neck. METHODS Single-institution, retrospective review of pediatric MEN between 2005 and 2022. RESULTS Fifty-three children were genetically confirmed with MEN (15 MEN1, 34 MEN2A, and 4 MEN2B), while three patients received clinical diagnoses of MEN1. The male to female ratio was essentially equal (1.15:1), and a documented family history of cancer was present in 89% (50/56). After multidisciplinary evaluation, a familial MEN diagnosis was confirmed in 91% (51/56). The mean ages of initial presentation and surgical intervention were 8.9 years (SD 5) and 9.8 years (SD 4.8), respectively. Although patients with MEN2 received surgery earlier than patients with MEN1 (8.7 vs 12.7 years), surgical patients with MEN2 in this cohort were older relative to current American Thyroid Association (ATA) guidelines primarily due to late presentation. Thyroid malignancies were identified in 36% (9/25) of thyroidectomy specimens (21 MEN2A, 4 MEN2B), with medullary thyroid carcinoma (MTC) present in five MEN2A patients and three MEN2B patients (89%), and papillary thyroid carcinoma (PTC) present in one MEN2A patient (11%). Nearly 90% (8/9) of thyroid malignancies were occult, with some occurring earlier than predicted by current guidelines (ATA-MOD and ATA-H). Central neck dissections were performed in 24% (2 MEN1, 2 MEN2A, and 4 MEN2B), with two MEN2B (50%) demonstrating cervical lymph node (LN) metastases. Additional histopathologic findings included C-cell hyperplasia in 57% (12/21) of MEN2A thyroidectomy patients. Of the eight MEN1 parathyroidectomy patients, four demonstrated parathyroid hyperplasia and four presented with parathyroid adenoma. CONCLUSION Nearly 60% required head and neck procedures. While MEN1 guidelines were appropriate for our cohort, we identified patients with MEN2 that developed MTC earlier than expected based on current ATA guidelines, including children in categories considered lower risk. In conjunction with a multidisciplinary approach, pediatric head and neck surgeons should be aware of the potential need for earlier surgical intervention in the pediatric MEN2 population.
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Affiliation(s)
- T Jellins
- University of Colorado School of Medicine, Aurora, CO, USA
| | - M Hill
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA
| | - J D Prager
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - C R Francom
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - C M Chan
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - K W Schneider
- Department of Pediatrics, Section of Hematology, Oncology, and Bone Marrow Transplantation, University of Colorado School of Medicine, Aurora, CO, USA
| | - A Sharma
- Department of Pediatrics, Section of Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - B W Herrmann
- Department of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Pediatric Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA.
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Vorstman JAS, Scherer SW. Contemplating syndromic autism. Genet Med 2023; 25:100919. [PMID: 37330697 DOI: 10.1016/j.gim.2023.100919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 06/19/2023] Open
Affiliation(s)
- Jacob A S Vorstman
- Department of Psychiatry, Hospital for Sick Children University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Toronto, ON, Canada.
| | - Stephen W Scherer
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, ON, Canada; The Centre for Applied Genomics, Hospital for Sick Children, Toronto, ON, Canada; McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada.
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Le JP, Shashikumar SP, Malhotra A, Nemati S, Wardi G. Making the Improbable Possible: Generalizing Models Designed for a Syndrome-Based, Heterogeneous Patient Landscape. Crit Care Clin 2023; 39:751-768. [PMID: 37704338 PMCID: PMC10758922 DOI: 10.1016/j.ccc.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Syndromic conditions, such as sepsis, are commonly encountered in the intensive care unit. Although these conditions are easy for clinicians to grasp, these conditions may limit the performance of machine-learning algorithms. Individual hospital practice patterns may limit external generalizability. Data missingness is another barrier to optimal algorithm performance and various strategies exist to mitigate this. Recent advances in data science, such as transfer learning, conformal prediction, and continual learning, may improve generalizability of machine-learning algorithms in critically ill patients. Randomized trials with these approaches are indicated to demonstrate improvements in patient-centered outcomes at this point.
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Affiliation(s)
- Joshua Pei Le
- School of Medicine, University of Limerick, Castletroy, Co, Limerick V94 T9PX, Ireland
| | | | - Atul Malhotra
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA
| | - Shamim Nemati
- Division of Biomedical Informatics, University of California San Diego, San Diego, CA, USA
| | - Gabriel Wardi
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA; Department of Emergency Medicine, University of California San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA.
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Neophytou P, Artemiadis A, Hadjigeorgiou GM, Zis P. Miller Fischer syndrome after COVID-19 infection and vaccine: a systematic review. Acta Neurol Belg 2023; 123:1693-1701. [PMID: 37468803 PMCID: PMC10505097 DOI: 10.1007/s13760-023-02336-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND COVID-19 (CoranaVirus disease 2019) is an ongoing infectious disease caused by the RNA SARS-CoV-2 virus (Severe Acute Respiratory Syndrome CoronaVirus-2). The virus mainly causes respiratory symptoms, but neurological symptoms have also been reported to be part of the clinical manifestations of the disease. The aim of this study was to systematically review Miller fisher syndrome (MFS) published cases, in the context of COVID-19 infection or vaccination. METHODS A systematic literature review on Medline was performed. A total of 21 papers were included in the present review. RESULTS Twenty-two MFS cases (77% males) were identified, 14 related to COVID-19 infection and 8 to vaccination against COVID-19. The median age of the adult patients was 50 years (interquartile range 36-63 years). Sixteen patients (73%) had the classic triad of MFS (ophthalmoplegia, ataxia, areflexia), four (18%) had acute ophthalmoplegia and one other characteristic symptom and two patients (9%) had only one other characteristic symptom, but they tested positive for GQ1b antibodies. Nine (41%) patients had positive GQ1b antibodies and were classified as "definite" MFS. Albuminocytologic dissociation was found in half of the cases. The outcome was favourable in the majority of cases (86%) whereas one patient, despite the initial improvement, died because of a cardiac arrest, after cardiac arrythmia. CONCLUSIONS MFS after COVID-19 infection/vaccination was found to have the typical epidemiological characteristics of classic MFS; being rare, occurring more often after infection than vaccination, affecting mainly middle-aged males usually within 3 weeks after the event and having an excellent prognosis after treatment with IVIG or even with no treatment at all. We found no evidence that MFS after COVID-19 infection was different from MFS after COVID-19 vaccination, although the former tended to occur earlier.
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Affiliation(s)
- Panayiota Neophytou
- Medical School, University of Cyprus, Old Road Nicosia-Limmasol 215/6, 2029, Nicosia, Cyprus
| | - Artemios Artemiadis
- Medical School, University of Cyprus, Old Road Nicosia-Limmasol 215/6, 2029, Nicosia, Cyprus
| | | | - Panagiotis Zis
- Medical School, University of Cyprus, Old Road Nicosia-Limmasol 215/6, 2029, Nicosia, Cyprus.
- Medical School, National Kapodistrian University of Athens, 15772, Athens, Greece.
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27
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Yuan L, Yang R, Deng H. Auricular fistula: a review of its clinical manifestations, genetics, and treatments. J Mol Med (Berl) 2023; 101:1041-1058. [PMID: 37458758 DOI: 10.1007/s00109-023-02343-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 09/07/2023]
Abstract
Auricular fistula is a common congenital auricular malformation, characterized as a small opening in the skin and a subcutaneous cyst. It can be classified in different ways according to positions of pits and directions of fistula tracts. The term preauricular fistula and variant type of preauricular fistula (postauricular fistula) are used. Auricular fistula prevalence varies in countries and populations, and its actual prevalence is presently unknown. The most accepted and widely cited theory of auricular fistula etiopathogenesis is an incorrect or incomplete fusion of six auricular hillocks that are mesenchymal proliferations. Auricular fistula can occur either sporadically or genetically. The pattern in inherited cases is thought to be incomplete autosomal dominant, with variable expressions, reduced penetrance, and inapparent gender differences. Auricular fistula has several forms and is reported as being a component of many syndromes. In the field of genetics, currently, there is no related review to comprehensively summarize the genetic basis of auricular fistula and related disorders. This article provides a comprehensive review of auricular fistula, especially congenital preauricular fistula, which accounts for the majority of auricular fistula, by summarizing the clinical manifestations, histological and embryological development, genetics, examinations, and treatments, as well as syndromes with auricular fistula.
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Affiliation(s)
- Lamei Yuan
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Ruikang Yang
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China
- Disease Genome Research Center, Central South University, Changsha, 410013, China
| | - Hao Deng
- Health Management Center, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Center for Experimental Medicine, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
- Disease Genome Research Center, Central South University, Changsha, 410013, China.
- Department of Neurology, the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
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Gao Y, Wu Q, Xu J, Tian Q, Xie X, Du X, Bi H. Management and follow-up of uveal effusion syndrome: a case report. BMC Ophthalmol 2023; 23:355. [PMID: 37574556 PMCID: PMC10424428 DOI: 10.1186/s12886-023-03078-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND We present the management and follow-up of a case of uveal effusion syndrome (UES). CASE PRESENTATION We study the relevant recent literature reports and review the aetiology, clinical classification, pathogenesis, diagnostic characteristics, treatment methods, and prognosis of this disease. When we encounter UES patients clinically, we can classify them according to their clinical characteristics and adopt different treatment plans for different types. The retina of this patient reattached 5 months after receiving eight periocular injections of triamcinolone acetonide (TA). CONCLUSIONS For type III UES patients, local hormone therapy can be applied, and follow-up should be done to optimize the clinical outcome.
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Affiliation(s)
- Yane Gao
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Jinan, 250002, Shandong, P.R. China
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China
| | - Qiuxin Wu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China
| | - Jing Xu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China
| | - Qingmei Tian
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China
| | - Xiaofeng Xie
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China
| | - Xiujuan Du
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China.
| | - Hongsheng Bi
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Shandong Academy of Eye Disease Prevention and Therapy, Jinan, 250002, Shandong, P.R. China.
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, Shandong, China.
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29
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Ibrahim T, Ahmed AF, Nofal M, Hegazy A, Ghomrawi HMK. Metabolic syndrome and the likelihood of knee pain and functional disability: evidence from a large middle eastern population-based study. BMC Musculoskelet Disord 2023; 24:634. [PMID: 37542219 PMCID: PMC10403861 DOI: 10.1186/s12891-023-06685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 07/02/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVES Metabolic Syndrome (MetS) has been associated with knee osteoarthritis (KOA) in animal studies, but epidemiologic evidence of the association remains controversial. We investigated the association between MetS and knee pain and functional disability, the hallmarks of KOA, in a Middle Eastern population with high reported MetS rates. METHODS A population-based study of adult individuals was conducted between 01/2016 and 03/2019. Data collected included age, sex, blood pressure, body mass index (BMI), waist circumference (WC), and comprehensive metabolic panel blood tests. Knee symptoms were assessed using The Western Ontario and McMaster Arthritis index (WOMAC) The Adult Treatment Panel III criteria was applied to determine if participants had MetS. Multivariable regression was used to determine the association of MetS, and its components, with the WOMAC total and subscale scores. RESULTS Of 6,000 participants enrolled, 15.5% had MetS. The multivariate regression demonstrated that participants with MetS had significantly higher WOMAC total and subscale scores after adjusting for demographic variables; however, these associations were not significant after adjusting for BMI. Multivariate regression examining the association between MetS components and the WOMAC scores showed sex-based significant differences with WOMAC scores; however, the differences were not larger than the minimally clinical important differences. CONCLUSIONS This study demonstrated that after adjustment for BMI, neither MetS nor its individual parameters were associated with worse knee symptoms. As such, the association between MetS and worse knee symptoms requires further study.
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Affiliation(s)
- Talal Ibrahim
- Department of Surgery, Division of Orthopaedic Surgery, Sidra Medicine, Doha, Qatar
| | - Abdulaziz F Ahmed
- Department of Orthopaedic Surgery, Massachussetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Abdelsalam Hegazy
- Department of Surgery, Division of Orthopaedic Surgery, Sidra Medicine, Doha, Qatar
| | - Hassan M K Ghomrawi
- Departments of Surgery, Medicine (Rheumatology), and Pediatrics, Northwestern University Feinberg School of Medicine, 633 N St Clair, 20th Floor, Chicago, IL, 60611, USA.
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Naudhani S, Ahmad A, Khan Bazai F, Pervez MT, Zafar A, Shah SA, Raheem N, Baloch AH, Mushtaq M, Daud S. A Missense Pathogenic Variant in a Conserved Region of CNTNAP2 Is Associated with Obesity, Seizures, and Language Impairment in a Pakistani Family. Mol Syndromol 2023; 14:293-302. [PMID: 37766826 PMCID: PMC10521233 DOI: 10.1159/000529427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/24/2023] [Indexed: 09/29/2023] Open
Abstract
Introduction In a consanguineous family, seven siblings born in three sibships showed a syndromic disorder characterized by obesity, seizures, and language impairment phenotypes, which appeared at early age or developed during early childhood. Methods By whole-exome sequencing and subsequent Sanger sequencing, a novel homozygous missense variant (c.3371 T>A [p.Ile1124Asn]) in exon 20 of the CNTNAP2 gene was identified. Results The pathogenic variant in this family is located within one of the laminin G-like 4 domains of CASPR2 and may cause loss of hydrophobic interactions of CASPR2 with its partner proteins. Single nucleotide and copy number variants in this gene have previously been related to Gilles de la Tourette syndrome, cortical dysplasia-focal epilepsy syndrome, schizophrenia, Pitt-Hopkins syndrome, and autism spectrum, attention deficit hyperactivity, and obsessive compulsive disorders. Yet, few studies described patients with CNTNAP2 variants showing diet-induced obesity. Conclusion This report expands the phenotypic spectrum of this rare syndrome and provides deeper insights by documenting the clinical features and genetic findings of the patients.
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Affiliation(s)
- Sara Naudhani
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Adeel Ahmad
- Continental Medical College and Hayat Memorial Hospital, Lahore, Pakistan
| | - Fariya Khan Bazai
- Quetta Institute of Medical Sciences/Combined Military Hospital, Quetta, Pakistan
| | - Muhammad Tariq Pervez
- Department of Bioinformatics and Computational Biology, Virtual University of Pakistan, Lahore, Pakistan
| | - Azqa Zafar
- Lahore General Hospital, Lahore, Pakistan
| | - Sajjad Ali Shah
- Institute of Biotechnology and Microbiology, Bacha Khan University, Charsadda, Pakistan
| | | | - Abdul Hameed Baloch
- Department of Biotechnology, Lasbela University of Agriculture, Water and Marine Sciences (LUAWMS), Uthal, Pakistan
| | | | - Shakeela Daud
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
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Narváez-Martínez MA, Henao-Castaño ÁM. Severity classification and influencing variables of the Postintensive Care Syndrome. Enferm Intensiva (Engl Ed) 2023:S2529-9840(23)00042-3. [PMID: 37517880 DOI: 10.1016/j.enfie.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The study aims to characterise Postintensive Care Syndrome by classifying the severity of the disease and identifying the variables of influence in two highly complex intensive care units for adults in Colombia. METHODS A descriptive, cross-sectional, prospective study was carried out to characterise survivors of critical illness using the Healthy Aging Brain Care -Monitor in a sample of 135 patients. Postintensive Care Syndrome severity was classified using Gaussian Mixture Models for clustering, and the most influencing variables were identified through ordinal logistic regression. RESULTS Clustering based on Gaussian Mixture Models allowed the classification of Postintensive Care Syndrome severity into mild, moderate, and severe classes, with an Akaike Information Criterion of 308 and an area under the curve of 0.80, which indicates a good fit; Thus, the mild class was characterised by a score on the HABC-M Total scale ≤9; the moderate class for a HABC-M Total score ≥10 and ≤42 and the severe class for a HABC-M Total score ≥43. Regarding the most influencing variables, the probability of belonging to the moderate or severe classes was related to male sex (91%), APACHE II score (22.5%), age (13%), intensive care units days of stay (10.6%), the use of sedation, analgesia and neuromuscular blockers. CONCLUSION Intensive care units survivors were characterised using the Healthy Aging Brain Care-Monitor scale, which made it possible to classify Postintensive Care Syndrome through Gaussian Mixture Models clustering into mild, moderate, and severe and to identify variables that had the major influence on the presentation of Postintensive Care Syndrome.
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Affiliation(s)
- M A Narváez-Martínez
- Universidad Nacional de Colombia, Bogotá, Colombia; Fundación Cardioinfantil - Instituto de Cardiología, Bogotá, Colombia.
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Elmer S, Schmitt R, Giroud N, Meyer M. The neuroanatomical hallmarks of chronic tinnitus in comorbidity with pure-tone hearing loss. Brain Struct Funct 2023; 228:1511-1534. [PMID: 37349539 PMCID: PMC10335971 DOI: 10.1007/s00429-023-02669-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Tinnitus is one of the main hearing impairments often associated with pure-tone hearing loss, and typically manifested in the perception of phantom sounds. Nevertheless, tinnitus has traditionally been studied in isolation without necessarily considering auditory ghosting and hearing loss as part of the same syndrome. Hence, in the present neuroanatomical study, we attempted to pave the way toward a better understanding of the tinnitus syndrome, and compared two groups of almost perfectly matched individuals with (TIHL) and without (NTHL) pure-tone tinnitus, but both characterized by pure-tone hearing loss. The two groups were homogenized in terms of sample size, age, gender, handedness, education, and hearing loss. Furthermore, since the assessment of pure-tone hearing thresholds alone is not sufficient to describe the full spectrum of hearing abilities, the two groups were also harmonized for supra-threshold hearing estimates which were collected using temporal compression, frequency selectivity und speech-in-noise tasks. Regions-of-interest (ROI) analyses based on key brain structures identified in previous neuroimaging studies showed that the TIHL group exhibited increased cortical volume (CV) and surface area (CSA) of the right supramarginal gyrus and posterior planum temporale (PT) as well as CSA of the left middle-anterior part of the superior temporal sulcus (STS). The TIHL group also demonstrated larger volumes of the left amygdala and of the left head and body of the hippocampus. Notably, vertex-wise multiple linear regression analyses additionally brought to light that CSA of a specific cluster, which was located in the left middle-anterior part of the STS and overlapped with the one found to be significant in the between-group analyses, was positively associated with tinnitus distress level. Furthermore, distress also positively correlated with CSA of gray matter vertices in the right dorsal prefrontal cortex and the right posterior STS, whereas tinnitus duration was positively associated with CSA and CV of the right angular gyrus (AG) and posterior part of the STS. These results provide new insights into the critical gray matter architecture of the tinnitus syndrome matrix responsible for the emergence, maintenance and distress of auditory phantom sensations.
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Affiliation(s)
- Stefan Elmer
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
- Competence Center Language & Medicine, University of Zurich, Zurich, Switzerland
| | - Raffael Schmitt
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
| | - Nathalie Giroud
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
- Center for Neuroscience Zurich, University and ETH of Zurich, Zurich, Switzerland
- Competence Center Language & Medicine, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Department of Comparative Language Science, University of Zurich, Zurich, Switzerland
- Center for Neuroscience Zurich, University and ETH of Zurich, Zurich, Switzerland
- Center for the Interdisciplinary Study of Language Evolution (ISLE), University of Zurich, Zurich, Switzerland
- Cognitive Psychology Unit, Alpen-Adria University, Klagenfurt, Austria
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Noll R, Schaaf J, Von Wagner M, Storf H. Diagnosis Support for Rare Diseases Using Phenotypic Profiles. Stud Health Technol Inform 2023; 302:607-608. [PMID: 37203759 DOI: 10.3233/shti230216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The common occurrence of characteristic symptoms can be used to infer diagnoses. The aim of this study is to show how syndrome similarity analysis using given phenotypic profiles can help in the diagnosis of rare diseases. HPO was used to map syndromes and phenotypic profiles. The system architecture described is planned to be implemented in a clinical decision support system for unclear diseases.
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Affiliation(s)
- Richard Noll
- Goethe University Frankfurt, University Hospital Frankfurt, Institute of Medical Informatics, Frankfurt, Germany
| | - Jannik Schaaf
- Goethe University Frankfurt, University Hospital Frankfurt, Institute of Medical Informatics, Frankfurt, Germany
| | - Michael Von Wagner
- Department of Medical Information Systems and Digitalization, University Hospital Frankfurt, Frankfurt, Germany
| | - Holger Storf
- Goethe University Frankfurt, University Hospital Frankfurt, Institute of Medical Informatics, Frankfurt, Germany
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Michieletti E, Bodini FC, Morelli N, Rossi B, Bossalini M, Colombi D. Acute Budd-Chiari Syndrome with Complete Portal Vein Thrombosis Complicated by Hepato-Renal Syndrome Treated Successfully by Emergent TIPS with Rheolytic Thrombectomy. J Clin Exp Hepatol 2023; 13:549-551. [PMID: 37250886 PMCID: PMC10213869 DOI: 10.1016/j.jceh.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/12/2022] [Indexed: 11/21/2022] Open
Abstract
We described a case of a 73-year-old female admitted to the emergency department with acute hepatic and renal failure (hepato-renal syndrome, HRS) due to acute Budd-Chiari syndrome associated with complete portal vein thrombosis (BCS-PVT) for an unknown cause. Despite the initial therapy with anticoagulants, a sudden impairment of the renal function requiring hemodialysis was observed. The hepatic transplant was excluded for patient age and clinical conditions. Thus, the patient was successfully treated by emergent transjugular intrahepatic portosystemic shunt (TIPS) previous rheolytic thrombectomy of the PVT with AngioJet Ultra PE Thrombectomy System (Boston Scientific, Marlborough, MA, USA). After the procedure, the sudden resolution of the HRS was observed, and the patient is alive 13 months after hospital dismission with no TIPS dysfunction. In conclusion, emergent extended TIPS with the usage of rheolytic thrombectomy device in patient with acute BCS-PVT complicated by HRS is feasible by experienced operators and provide resolution of the HRS.
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Affiliation(s)
- Emanuele Michieletti
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
| | - Flavio C Bodini
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
- Department of Radiology, Fondazione Poliambulanza Istituto Ospedaliero, Via Leonida Bissolati, 57, Postal Code 25124, Brescia, Italy
| | - Nicola Morelli
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
| | - Beatrice Rossi
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
| | - Margherita Bossalini
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
| | - Davide Colombi
- Department of Radiological Functions, Azienda USL Piacenza, Via Taverna 49, Postal Code 29121, Piacenza, Italy
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Nugent K, Nugent R, Yang S. When should clinicians use the term syndrome? Am J Med Sci 2023; 365:475-479. [PMID: 36906228 DOI: 10.1016/j.amjms.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/24/2023] [Accepted: 03/06/2023] [Indexed: 03/11/2023]
Abstract
Medical language provides essential communication with patients and among healthcare providers. Some words appear frequently in this communication, in clinical records, and in the medical literature, and the use of these words assumes that the listener and reader understand their meaning in the context related to their current use. Words, such as syndrome, disorder, and disease, should have obvious definitions but often, in fact, have uncertain meanings. In particular, the word syndrome should imply a definite and stable association between patient characteristics that have implications for treatment, prognosis, pathogenesis, and possibly clinical studies. In many cases the strength of this association is uncertain and the use of the word represents a convenient shorthand which may or may not improve communication with patients or other clinicians. Some astute clinicians have identified associations in their clinical practices, but this is a slow haphazard process. The development of electronic medical records, internet-based communication, and advanced statistical techniques has the potential to clarify important features of syndromes. However, the recent analysis of certain subsets of patients in the ongoing COVID-19 pandemic has demonstrated that even large amounts of information and advanced statistical techniques using clustering or machine learning may not provide precise separation of patients into groups. Clinicians should use the word syndrome carefully.
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Affiliation(s)
- Kenneth Nugent
- Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States.
| | - Rebecca Nugent
- Department of Statistics and Data Science, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Shengping Yang
- Department of Biostatistics, Pennington Biomedical Research Center Baton Rouge, LA, United States
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Glinianaia SV, Rankin J, Tan J, Loane M, Garne E, Cavero-Carbonell C, de Walle HEK, Gatt M, Gissler M, Klungsøyr K, Lelong N, Neville A, Pierini A, Tucker DF, Urhoj SK, Wellesley DG, Morris JK. Ten-year survival of children with trisomy 13 or trisomy 18: a multi-registry European cohort study. Arch Dis Child 2023; 108:461-467. [PMID: 36882305 DOI: 10.1136/archdischild-2022-325068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/03/2023] [Indexed: 03/09/2023]
Abstract
OBJECTIVE To investigate the survival to 10 years of age of children with trisomy 13 (T13) and children with trisomy 18 (T18), born 1995-2014. DESIGN Population-based cohort study that linked mortality data to data on children born with T13 or T18, including translocations and mosaicisms, from 13 member registries of EUROCAT, a European network for the surveillance of congenital anomalies. SETTING 13 regions in nine Western European countries. PATIENTS 252 live births with T13 and 602 with T18. MAIN OUTCOME MEASURES Survival at 1 week, 4 weeks and 1, 5 and 10 years of age estimated by random-effects meta-analyses of registry-specific Kaplan-Meier survival estimates. RESULTS Survival estimates of children with T13 were 34% (95% CI 26% to 46%), 17% (95% CI 11% to 29%) and 11% (95% CI 6% to 18%) at 4 weeks, 1 and 10 years, respectively. The corresponding survival estimates were 38% (95% CI 31% to 45%), 13% (95% CI 10% to 17%) and 8% (95% CI 5% to 13%) for children with T18. The 10-year survival conditional on surviving to 4 weeks was 32% (95% CI 23% to 41%) and 21% (95% CI 15% to 28%) for children with T13 and T18, respectively. CONCLUSIONS This multi-registry European study found that despite extremely high neonatal mortality in children with T13 and T18, 32% and 21%, respectively, of those who survived to 4 weeks were likely to survive to age 10 years. These reliable survival estimates are useful to inform counselling of parents after prenatal diagnosis.
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Affiliation(s)
- Svetlana V Glinianaia
- Newcastle University Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Judith Rankin
- Newcastle University Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Joachim Tan
- Population Health Research Institute, St George's University of London, London, UK
| | - Maria Loane
- Centre for Maternal, Fetal and Infant Research, Faculty of Life and Health Sciences, Ulster University, Belfast, UK
| | - Ester Garne
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark
| | - Clara Cavero-Carbonell
- Rare Diseases Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO, Valencia, Spain
| | - Hermien E K de Walle
- University Medical Centre Groningen, Department of Genetics, University of Groningen, Groningen, Netherlands
| | - Miriam Gatt
- Malta Congenital Anomalies Registry, Directorate for Health Information and Research, Tal-Pietà, Malta
| | - Mika Gissler
- Department of Knowledge Brokers, Finnish Institute for Health and Welfare, Helsinki, Finland
- Academic Primary Health Care Centre, Stockholm, Region Stockholm, Sweden
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Natalie Lelong
- Université de Paris Cité, Obstetrical, Perinatal and Paediatric Epidemiology Research Team (EPOPé), CRESS, INSERM, Paris, France
| | - Amanda Neville
- IMER Registry (Emilia Romagna Registry of Birth Defects), Centre for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Emilia-Romagna, Italy
| | - Anna Pierini
- Unit of Epidemiology of Rare Diseases and Congenital Anomalies, Institute of Clinical Physiology, National Research Council, Pisa, Toscana, Italy
| | - David F Tucker
- Public Health Wales, Public Health Knowledge and Research, Swansea, Wales, UK
| | - Stine Kjaer Urhoj
- Department of Paediatrics and Adolescent Medicine, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Joan K Morris
- Population Health Research Institute, St George's University of London, London, UK
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Lysak N, Vavra AK, Ho KJ. Open aortic septectomy for complicated type B aortic dissection. J Vasc Surg Cases Innov Tech 2023; 9:101103. [PMID: 36852323 PMCID: PMC9958067 DOI: 10.1016/j.jvscit.2023.101103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 01/15/2023] Open
Abstract
Malperfusion is a complication of acute aortic dissection associated with substantially increased morbidity and mortality. Although endovascular treatment of the dissection with a stent graft to cover the intimal tear and reexpand the true lumen will often be sufficient to treat distal malperfusion, persistent or delayed malperfusion will necessitate additional interventions. Endovascular strategies to increase true lumen expansion include bare metal dissection stent placement and percutaneous fenestration. However, for patients with anatomy not amenable to an endovascular approach, alternative techniques are required. We describe two cases of complicated acute aortic dissection due to partial false lumen thrombosis treated with open aortic septectomy. Although an uncommon procedure, open septectomy can be useful for patients with malperfusion syndromes without appropriate endovascular options.
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Affiliation(s)
| | | | - Karen J. Ho
- Correspondence: Karen J. Ho, MD, Division of Vascular Surgery, Northwestern University Feinberg School of Medicine, 676 N St Clair St, Ste 650, Chicago, IL 60611
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Davies A, Davies A, Wren Y, Deacon S, Cobb A, McLean N, David D, Chummun S. Syndromes associated with Robin sequence: a national prospective cohort study. Arch Dis Child 2023; 108:42-46. [PMID: 36376018 DOI: 10.1136/archdischild-2022-324722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/26/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To determine the prevalence of syndromic Robin sequence (RS) in the UK and if this group of patients had an increased need for airway and feeding management compared with a non-syndromic RS cohort. DESIGN A prospective national multicentre study of cases submitted to the Cleft Collective cohort studies. SETTING Specialist cleft services in the UK. PATIENTS 259 participants who fulfilled the diagnosis of RS. This group was compared with 548 participants with cleft palate only (CPO). MAIN OUTCOME MEASURES The primary outcome measure was the presence of a syndrome in patients with RS and CPO. Secondary outcome measures included the use of airway and feeding adjuncts. RESULTS An associated syndrome was seen in 28% of patients with RS and 14% of patients with CPO. The most common syndrome for the RS group was Stickler syndrome (27%). Syndromic status was significantly higher among patients with RS compared with those with CPO (OR 2.36, 95% CI 1.65 to 3.39; p<0.001). Patients with syndromic RS have an increased reliance on airway adjuncts compared with the patients without syndromic RS (OR 2.02, 95% CI 1.13 to 3.64; p=0.018). There was no evidence of a difference in the use of feeding adjuncts between syndromic and non-syndromic RS groups (OR 2.43, 95% CI 0.78 to 7.58; p=0.126). CONCLUSION The presence of a syndrome has implications for management of patients with RS. Early identification of a syndrome may help prevent the consequences of a missed syndromic diagnosis. Routine ophthalmological and genetic screening for Stickler syndrome should be mandatory for all patients with RS.
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Affiliation(s)
- Alex Davies
- South West Cleft Service, University of Bristol Dental Hospital, Bristol, UK .,The Cleft Collective, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Amy Davies
- The Cleft Collective, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Yvonne Wren
- The Cleft Collective, Faculty of Medicine and Dentistry, University of Bristol, Bristol, UK
| | - Scott Deacon
- South West Cleft Service, University of Bristol Dental Hospital, Bristol, UK
| | - Alistair Cobb
- South West Cleft Service, University of Bristol Dental Hospital, Bristol, UK
| | - Neil McLean
- Craniofacial Australia, North Adelaide, South Australia, Australia
| | - David David
- Craniofacial Australia, North Adelaide, South Australia, Australia
| | - Shaheel Chummun
- South West Cleft Service, University of Bristol Dental Hospital, Bristol, UK
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Patil P, Mundada V. BCG reactivation in an infant with multisystem inflammatory syndrome in children. Arch Dis Child 2023; 108:24-25. [PMID: 35948403 DOI: 10.1136/archdischild-2022-324614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/30/2022] [Indexed: 02/04/2023]
Affiliation(s)
- Prabhakar Patil
- Paediatrics and Neonatology, Aster DM Healthcare, Dubai, UAE
| | - Vivek Mundada
- Paediatric Neurology, Aster DM Healthcare, Dubai, UAE
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Grosso D, Leiby B, Wilde L, Carabasi M, Filicko-O'Hara J, O'Hara W, Wagner JL, Mateja G, Alpdogan O, Binder A, Kasner M, Keiffer G, Klumpp T, Martinez UO, Palmisiano N, Porcu P, Gergis U, Flomenberg N. A Prospective, Randomized Trial Examining the Use of G-CSF Versus No G-CSF in Patients Post-Autologous Transplantation. Transplant Cell Ther 2022; 28:831.e1-831.e7. [PMID: 36167307 DOI: 10.1016/j.jtct.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/25/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022]
Abstract
Contemporary, prospective data regarding the impact of granulocyte-colony stimulating factor (G-CSF) on outcomes after autologous hematopoietic stem cell transplantation (Auto-HSCT) in an era when stem cell grafts are more qualitatively robust are limited. Recent retrospective analyses have not supported a beneficial effect of post-transplantation G-CSF use on major outcomes after Auto-HSCT leading to strategies to delay or eliminate the use of G-CSF altogether in this context. To test the hypothesis that the infusion of consistently higher doses of stem cells (defined as ≥4 × 106/kg) in Auto-HSCT will obviate the need for post-transplantation G-CSF. If so, the impact of withholding G-CSF will be noninferior to the use of G-CSF in terms of length of stay (LOS). The specific objectives were to conduct a prospective, randomized clinical trial primarily examining the impact of post-transplantation G-CSF on LOS, and secondarily on engraftment, infectious complications, antibiotic usage, and incidence of engraftment syndrome after Auto-HSCT in patients receiving versus not receiving G-CSF after Auto-HSCT. Patients with multiple myeloma or non-Hodgkin lymphoma (NHL) who underwent Pegfilgrastim plus Plerixafor-primed stem cell collection followed by Auto-HSCT were randomized to the G-CSF group (receive G-CSF starting at day 3 after Auto-HSCT) or the no G-CSF group (G-CSF withheld after Auto-HSCT). Seventy patients per arm were planned to demonstrate the primary endpoint of noninferiority in LOS between the G-CSF and the no G-CSF groups. Patient outcomes in the two groups were followed up and compared after Auto-HSCT, and an interim analysis for futility was planned when accrual reached 50%.The primary finding of this study was that despite only a 2-day longer median absolute neutrophil count (ANC) recovery in the no G-CSF arm (median 11 versus 13 days; P = .001), LOS was 4 days longer in patients not treated with G-CSF (median 11 days versus 15 days; P = .001). G-CSF use was associated with more robust incremental daily increases in ANC once recovered (P = .001), fewer days of febrile neutropenia (P = .001), and fewer days on antibiotics (P = .001), potentially contributing to this disproportionate finding. Inferiority in LOS in the no G-CSF group was demonstrated on the interim analysis, and the study was closed at the half-way point. There were no significant group differences in platelet recovery, documented infections, hospital readmissions, or overall survival at 1 year. Engraftment syndrome occurred in 54.3% of patients and was not related to G-CSF use. These results suggest that the increased LOS associated with the omission of G-CSF is largely due to concerns regarding the potential for infection in patients without a stable, recovered ANC in a hospital setting. Engraftment syndrome represented a significant source of febrile neutropenia further contributing to patient safety concerns and requires strategies to decrease its incidence. Infectious complications and death were not affected by the omission of G-CSF supporting a carefully monitored outpatient approach to Auto-HSCT in which white blood cell growth factor is eliminated or given as needed for documented infection. © 2023 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
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Affiliation(s)
- Dolores Grosso
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania.
| | - Benjamin Leiby
- Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lindsay Wilde
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Matthew Carabasi
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Joanne Filicko-O'Hara
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - William O'Hara
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - John L Wagner
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Gina Mateja
- Office of Clinical Research, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Onder Alpdogan
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Adam Binder
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Margaret Kasner
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Gina Keiffer
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Thomas Klumpp
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ubaldo Outschoorn Martinez
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Neil Palmisiano
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Pierluigi Porcu
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Usama Gergis
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Neal Flomenberg
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania
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Essobiyou TB, Kebalo SP, Pali E, Keheou AP, Issa M, Dosseh ED. A case of prune belly syndrome: Experience from a regional hospital in Togo. Int J Surg Case Rep 2022; 102:107812. [PMID: 36502656 PMCID: PMC9763359 DOI: 10.1016/j.ijscr.2022.107812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Prune Belly syndrome is a rare congenital condition first reported in 1939. It is a malformative disease associated with high mortality. We report a neonatal case in a regional hospital in Togo. PRESENTATION OF CASE A 4-month-old male infant was brought to the hospital by his uncle because of a "deformity of the abdomen and absence of testicles". The examination revealed hypoplasia of the abdominal wall associated with bilateral cryptorchidism. Abdominal and urinary tract ultrasound revealed a left pyelocaliceal dilatation and a right megaureter. All these data allowed the diagnosis of Prune Belly syndrome. CONCLUSION Prune Belly syndrome is a rare and complex disease with a high mortality rate.
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Affiliation(s)
| | - Sosso Piham Kebalo
- Pediatric Surgery Department, Sylvanus Olympio University Hospital Center, Lome, Togo
| | - Essomondjona Pali
- General Surgery Department, Sylvanus Olympio University Hospital Center, Lome, Togo
| | | | - Mohamed Issa
- General Surgery Department, Sylvanus Olympio University Hospital Center, Lome, Togo
| | - Ekoue David Dosseh
- General Surgery Department, Sylvanus Olympio University Hospital Center, Lome, Togo
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Williams GM, Leary S, Leadbetter S, Toms S, Mortimer G, Scorrer T, Gillespie K, Shield JPH. Establishing breast feeding in infants with Down syndrome: the FADES cohort experience. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001547. [PMID: 36645743 PMCID: PMC9660693 DOI: 10.1136/bmjpo-2022-001547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe breastfeeding prevalence and maternal experience in infants with trisomy 21. DESIGN Longitudinal cohort study. SETTING Participants from UK recruited through websites, social media and local collaborators: neonatologists, community paediatricians and research nurses. SUBJECTS Infants under the age of 8 months with Down syndrome (DS) recruited to the Feeding and Autoimmunity in Down Syndrome Evaluation Study between 1 September 2014 and 31 August 2017. Seventy participants: median age 20 weeks (IQR 13-29 weeks) at initial questionnaire. MAIN OUTCOME MEASURE Breastfeeding prevalence at 6 weeks and 6 months among infants with DS. RESULTS The prevalence of exclusive breast feeding among study participants was similar to the general population (13/61, 21% vs 23% at 6 weeks, 2/54, 4% vs 1% at 6 months). However, the prevalence of breast feeding (exclusive or combination feeding) among the study participants was higher than the general population (39/61 64% vs 55% at 6 weeks, 32/59 54% vs 34% at 6 months). CONCLUSION Although there may be challenges in establishing breast feeding in infants with DS, our data suggest that exclusive breast feeding is possible for some, and the prevalence of breast feeding is comparable to the prevalence in the general population. TRIAL REGISTRATION NUMBER ISRCTN12415856.
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Affiliation(s)
- Georgina M Williams
- NIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, UK .,Translational Health Sciences, University of Bristol, Bristol, UK.,Department of Paediatric Endocrinology, Noah's Ark Children's Hospital for Wales, Cardiff, UK
| | - Sam Leary
- NIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, UK
| | - Sofia Leadbetter
- NIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, UK
| | - Stu Toms
- NIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, UK
| | | | - Tim Scorrer
- Neonatology, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | | | - Julian P H Shield
- NIHR Bristol Biomedical Research Centre Nutrition Theme, University of Bristol, Bristol, UK
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Holland P, Wildhagen M, Istre M, Reiakvam OM, Dahl JA, Søraas A. Cri du chat syndrome patients have DNA methylation changes in genes linked to symptoms of the disease. Clin Epigenetics 2022; 14:128. [PMID: 36242045 PMCID: PMC9563797 DOI: 10.1186/s13148-022-01350-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Cri du chat (also called 5p deletion, or monosomy 5p) syndrome is a genetic disease caused by deletions of various lengths in the short (p) arm of chromosome 5. Genetic analysis and phenotyping have been used to suggest dose-sensitive genes in this region that may cause symptoms when a gene copy is lost, but the heterogeneity of symptoms for patients with similar deletions complicates the picture. The epigenetics of the syndrome has only recently been looked at with DNA methylation measurements of blood from a single patient, suggesting epigenetic changes in these patients. Here, we conduct the deepest epigenetic analysis of the syndrome to date with DNA methylation analysis of eight Cri du chat patients with sibling- and age-matched controls. Results The genome-wide patterns of DNA methylation in the blood of Cri du chat patients reveal distinct changes compared to controls. In the p-arm of chromosome 5 where patients are hemizygous, we find stronger changes in methylation of CpG sites than what is seen in the rest of the genome, but this effect is less pronounced in gene regulatory sequences. Gene set enrichment analysis using patient DNA methylation changes in gene promoters revealed enrichment of genes controlling embryonic development and genes linked to symptoms which are among the most common symptoms of Cri du chat syndrome: developmental delay and microcephaly. Importantly, this relative enrichment is not driven by changes in the methylation of genes on chromosome 5. CpG sites linked to these symptoms where Cri du chat patients have strong DNA methylation changes are enriched for binding of the polycomb EZH2 complex, H3K27me3, and H3K4me2, indicating changes to bivalent promoters, known to be central to embryonic developmental processes. Conclusions Finding DNA methylation changes in the blood of Cri du chat patients linked to the most common symptoms of the syndrome is suggestive of epigenetic changes early in embryonic development that may be contributing to the development of symptoms. However, with the present data we cannot conclude about the sequence of events between DNA methylation changes and other cellular functions—the observed differences could be directly driving epigenetic changes, a result of other epigenetic changes, or they could be a reflection of other gene regulatory changes such as changed gene expression levels. We do not know which gene(s) on the p-arm of chromosome 5 that causes epigenetic changes when hemizygous, but an important contribution from this work is making the pool of possible causative genes smaller. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-022-01350-3.
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Affiliation(s)
- Petter Holland
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Mari Wildhagen
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Mette Istre
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | | | - John Arne Dahl
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Arne Søraas
- Department of Microbiology, Oslo University Hospital, Oslo, Norway.
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Arredondo Montero J, Bronte Anaut M, López-Gutiérrez JC. Proteus Syndrome: Case Report with Anatomopathological Correlation. Fetal Pediatr Pathol 2022; 41:861-864. [PMID: 34668833 DOI: 10.1080/15513815.2021.1989097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: Proteus syndrome is characterized by a progressive segmental or patchy growth of bone, skin, adipose tissue, and central nervous system, associated with a wide range of neoplasms, pulmonary pathology, and thrombotic risk. The main histological findings are diffuse patchy overgrowth of skin and subcutaneous tissue, plantar cerebriform connective tissue nevus, and ossification defects. Case report: We present a patient that met the clinical and histological criteria necessary for the diagnosis of the disease. He required multiple surgical interventions, including amputation of the right foot. Genetic evaluation confirmed an AKT1 mutation. Discussion: CLOVES syndrome, neurofibromatosis 1 or PTEN hamartoma tumor syndrome are partially superimposable entities to Proteus syndrome and may generate diagnostic doubt. Although the clinical criteria and histologic findings are indicative, the diagnostic confirmation of this entity is genetic.
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45
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Razban M, Exadaktylos AK, Santa VD, Heymann EP. Cannabinoid hyperemesis syndrome and cannabis withdrawal syndrome: a review of the management of cannabis-related syndrome in the emergency department. Int J Emerg Med 2022; 15:45. [PMID: 36076180 PMCID: PMC9454163 DOI: 10.1186/s12245-022-00446-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/19/2022] [Indexed: 11/17/2022] Open
Abstract
Background Cannabis-related medical consultations are increasing worldwide, a non-negligible public health issue; patients presenting to acute care traditionally complain of abdominal pain and vomiting. Often recurrent, these frequent consultations add to the congestion of already chronically saturated emergency department(s) (ED). In order to curb this phenomenon, a specific approach for these patients is key, to enable appropriate treatment and long-term follow-up. Objectives This study reviews cannabinoid hyperemesis syndrome (CHS) and cannabis withdrawal syndrome (CWS), in a bid to help promote better understanding and handling of pathologies associated with chronic cannabis use. Following a literature review, we present a novel therapeutic algorithm aimed at guiding clinicians, in a bid to improve long-term outcomes and prevent recurrences. Methods Using the keywords “Cannabis,” “Hyperemesis,” “Syndrome,” “Withdrawal,” and “Emergency Medicine,” we completed a literature review of three different electronic databases (PubMed®, Google scholar®, and Cochrane®), up to November 2021. Results Although often presenting with similar symptoms such as abdominal pain and vomiting, cannabinoid hyperemesis syndrome (CHS) and cannabis withdrawal syndrome (CWS) are the result of two differing pathophysiological processes. Distinguishing between these two syndromes is essential to provide appropriate symptomatic options. Conclusion The correct identification of the underlying cannabis-related syndrome, and subsequent therapeutic choice, may help decrease ED presentations. Our study emphasizes the importance of both acute care and long-term outpatient follow-up, as key processes in cannabis-related disorder treatment.
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Affiliation(s)
- Mohammad Razban
- Department of Internal Medicine, University Hospital of Geneva, Geneva, Switzerland. .,University of Bern, Bern, Switzerland.
| | | | - Vincent Della Santa
- Department of Emergency Medicine, Cantonal Hospital of Neuchatel, Neuchatel, Switzerland
| | - Eric P Heymann
- Department of Emergency Medicine, Cantonal Hospital of Neuchatel, Neuchatel, Switzerland
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Nacer N, Fatimi N, Rkha S, Rkha S. Syndromes associated with sexually transmitted infections: Prevalence and risk factors among women of childbearing age in Morocco. Afr J Reprod Health 2022; 26:94-102. [PMID: 37585074 DOI: 10.29063/ajrh2022/v26i9.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
This research was designed to determine the prevalence and risk factors associated with syndromes of sexually transmitted infections in women of reproductive age in the province of Essaouira in Morocco. A questionnaire was distributed to 1100 women using a random sampling technique. Subsequently, a clinical and speculum examination was performed. In this study, 38.6% of the women examined had syndromes of sexually transmitted infections, of which 81.8% had a vaginal discharge. Diagnosed sexually transmitted infection syndromes have been influenced by a woman's level of education, socio-economic status, marital status, obstetric history, and whether the partner is suspected of having other sexual relations. This study revealed a high prevalence of sexually transmitted infection syndromes, and that demands more effort in diagnosis and management should be made.
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Affiliation(s)
- Nezha Nacer
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behavior / Biology/ /Faculty of Sciences Semlalia/ Cadi Ayyad University, Marrakech. Morocco
| | - Najat Fatimi
- General practitioner at the Rahal Ben Ahmed Health Center, Essaouira Health Province, Morocco
| | - Samia Rkha
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behavior / Biology/ /Faculty of Sciences Semlalia/ Cadi Ayyad University, Marrakech. Morocco
| | - Samia Rkha
- Laboratory of Pharmacology, Neurobiology, Anthropobiology, Environment and Behavior / Biology/ /Faculty of Sciences Semlalia/ Cadi Ayyad University, Marrakech. Morocco
- Higher Institute of Nursing and Health Techniques of Marrakech, Morocco
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Abstract
The aim of this report is to provide a brief review of the predisposing factors for Text Neck Syndrome, along with diagnostic and therapeutic approaches in young and adult populations. Text neck pain is a worldwide public health problem, largely reported nowadays. Currently, data have shown that the erroneous use of personal computers and cell phones might be correlated with the development of various clinical symptoms that are defined as "text neck syndrome". Modified radical changes in everyday life may ameliorate the powerful forces on the cervical spine that can lead to cervical degeneration, along with other developmental, medical, psychological, and social complications that are attributed to text neck syndrome. CONCLUSION: New technologies and the potentially harmful addiction to cell phones and computers while reading or texting are inducing an epidemic of text neck syndrome. By focusing on postural correction, both pain alleviation and a better quality of life can be achieved for the patient. The predisposing factors and therapeutic approaches for this syndrome that affects public health remain to be further elucidated.
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Affiliation(s)
- Alexandra-Regina Tsantili
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Dimosthenis Chrysikos
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Theodore Troupis
- Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Greece. ;
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Garrido-Torres N, Ruiz-Veguilla M, Alameda L, Canal-Rivero M, Ruiz MJ, Gómez-Revuelta M, Ayesa-Arriola R, Rubio-García A, Crespo-Facorro B, Vázquez-Bourgon J. Prevalence of metabolic syndrome and related factors in a large sample of antipsychotic naïve patients with first-episode psychosis: Baseline results from the PAFIP cohort. Schizophr Res 2022; 246:277-285. [PMID: 35878542 DOI: 10.1016/j.schres.2022.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 06/03/2022] [Accepted: 07/10/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Few investigations have been carried out on metabolic syndrome in antipsychotic- naïve patients with schizophrenia. METHODS Our primary objective was to compare the prevalence of Metabolic Syndrome (MetS), as defined by the National Cholesterol Education Program, Adult Treatment Panel III in 2001 (NCEP-ATP III), between a Spanish cohort of 303 drug-naïve patients with a first episode of psychosis (FEP) without any previous cardiovascular condition, and 153 healthy individuals. RESULTS Participants included 303 patients with FEP (M:F 53:46) and 153 control subjects (M:F 56:43). The mean and standard deviation ages were 31(9.38) and 29 (7.57) years in the study and control groups respectively (F = 4.09; p = 0.93). We found that the prevalence of MetS in drug-naïve patients with FEP (5.6 %) was similar to the prevalence of MetS in age-sex matched controls (5.12 %). However, 60.7 % of patients with FEP met at least one of the five MetS components, while among the control subjects only 36.5 % met at least one component. Additionally, we found that other factors not included among the operational definition of MetS, but still important in cardiovascular risk, were also altered. CONCLUSION FEP patients have a greater risk of presenting at least one altered MetS component than healthy controls which could indicate the need of development of screening methods detecting cardiovascular risk. Likewise, gender differences in metabolic components such as waist circumference, which is a predictor of cardiovascular events have been found. Similarly, research should focus on metabolic risk predictors that include not only MetS, but also specific parameters for the early psychosis population.
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Affiliation(s)
- Nathalia Garrido-Torres
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - Miguel Ruiz-Veguilla
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - Luis Alameda
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain; Service of General Psychiatry, Lausanne University Hospital (CHUV), Lausanne 1008, Switzerland; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Manuel Canal-Rivero
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain
| | - María Juncal Ruiz
- Department of Psychiatry, Sierrallana Hospital-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Torrelavega, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain
| | - Marcos Gómez-Revuelta
- Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Rosa Ayesa-Arriola
- Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Ana Rubio-García
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain
| | - Benedicto Crespo-Facorro
- Mental Health Unit, Virgen del Rocio University Hospital, Seville, Spain; Translational Psychiatry Group, Seville Biomedical Research Institute (IBiS), Seville, Spain; Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Psychiatry, University of Seville, Seville, Spain.
| | - Javier Vázquez-Bourgon
- Spanish Network for Research in Mental Health, Carlos III Institute (CIBERSAM, ISCIII), Madrid, Spain; Department of Medicine and Psychiatry, School of Medicine, University of Cantabria, Santander, Spain; Department of Psychiatry, University Hospital Marqués de Valdecilla-Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
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Yale SH, Tekiner H, Yale ES. Signs and syndromes in acute appendicitis: A pathophysiologic approach. World J Gastrointest Surg 2022; 14:727-730. [PMID: 36158282 PMCID: PMC9353750 DOI: 10.4240/wjgs.v14.i7.727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/20/2022] [Accepted: 07/06/2022] [Indexed: 02/06/2023] Open
Abstract
Physical examination signs have not been well studied, and their accuracy and reliability in diagnosis remain unknown. The few studies available are limited in that the method of performing the sign was not stated, the technique used was not standardized, and the position of the appendix was not correlated with imaging or surgical findings. Some appendiceal signs were written in a non-English language and may not have been appropriately translated (e.g., Blumberg-Shchetkin and Rovsing). In other cases, the sign described differs from the original report (e.g., Rovsing, Blumberg-Shchetkin, and Cope sign, Murphy syndrome). Because of these studies limitations, gaps remain regarding the signs’ utility in the bedside diagnosis of acute appendicitis. Based on the few studies available with these limitations in mind, the results suggest that a positive test is more likely to be found in acute appendicitis. However, a negative test does not exclude the diagnosis. Hence, these tests increase the likelihood of ruling in acute appendicitis when positive but are less helpful in ruling out disease when negative. Knowledge about the correct method of performing the sign may be a valuable adjunct to the surgeon in further increasing their pretest probability of disease. Furthermore, it may allow surgeons to study these signs further to better understand their role in clinical practice. In the interim, these signs should continue to be used as a tool to supplement the clinical diagnosis.
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Affiliation(s)
- Steven Howard Yale
- Internal Medicine, University of Central Florida, Orlando, FL 32827, United States
| | - Halil Tekiner
- Department of the History of Medicine and Ethics, Erciyes University School of Medicine, Melikgazi 38039, Kayseri, Turkey
| | - Eileen Scott Yale
- Division of General Internal Medicine, University of Florida, Gainesville, FL 32608, United States
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Kershaw M, Lok A, Robson E. Unusual case of respiratory distress in a newborn. Arch Dis Child Educ Pract Ed 2022; 108:189-190. [PMID: 35790338 DOI: 10.1136/archdischild-2022-323883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Michael Kershaw
- Neonatology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Aishin Lok
- Neonatology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Evelyn Robson
- Paediatric Respiratory Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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