Notes

Up-to-date Viewpoints on the Treatments for Relapsed along with Refractory Multiple Myeloma.
Retrospective cohort.

To radiographically evaluate Craniovertebral junction (CVJ) tuberculosis infection pathogenesis and to propose a modification to the Lifeso classification.

A cohort of patients with radiologically or microbiologically identified CVJ tuberculosis treated at a single tertiary referral center in a TB endemic area was queried for characteristics about clinical presentation, treatment, and radiographic evidence of bone destruction and abscess formation were included. Disease was classified according to the Lifeso grading system and bony lesions were classified as either type 1 (preservation of underlying structure) or type 2 (damage of underlying structure).

52 patients were identified (mean age 28.5 ± 13.4yr, 48% male; 14% with a prior history of tuberculosis). All presented with neck pain at presentation, 29% with rotatory pain, and 37% with myelopathy. Comparison by Lifeso type showed Lifeso III lesions had longer symptom durations (
= .03) and more commonly had periarticular or s of CVJ TB.Izmir is a city in Turkey where both tourists and refugees concentrate, making it home to many foreign nationals. In recent years, many refugees have tried to reach Europe via Izmir and the Aegean Sea. In this study, we examine autopsy reports on foreigners who died in Izmir between 2015 and 2020, and we compare the data with relevant international studies. This study analysed the autopsy reports of foreign nationals in Izmir, in terms of demographic data, date of death, place of death, manner of death, source of death, histopathology and toxicology results and exact cause of death. A total of 9951 autopsies were performed between 2015 and 2020 in Izmir, of which 538 (5.4%) were on foreign nationals. Of the autopsy cases in our study, 55.4% were performed on males and 44.6% were performed on females; 32.5% of the cases died between the ages of 0 and 10 years. Syrian nationals comprise 29.7% of the total cases. Of the autopsies of Syrian nationals, 80% died between the ages of 0 and 10. The cause of death was determined to be drowning in 42.4% of all cases. Information gathered from autopsies performed on foreign nationals can contribute to an understanding of the common problems of refugees, which can aid in the alleviation of some migration issues by drawing attention to the mass deaths of refugees in the Aegean Sea, the health problems experienced by children during their journey, and the deaths of refugee children.This in silico study aims to investigate flaviviruses as an environmental factor in the etiology of nonsyndromic cleft lip and/or palate (CL/P).A scoring method with 7 topics-disease, transplacental passage, tropism, cellular damage, reported case, analysis of genome similarity, and transcriptome between virus and host, was created based on literature and in silico experimentation. Viral genomes of NCBI virus were obtained and BLAST 2.12.0 was applied for the similarity analysis, adjusted to search for only human sequences related to CL/P with the statistical threshold defined for E-value ≤1.Flaviviruses with high potential to cause CL/P were serotypes 2, 3, and 4 of the Dengue virus and lineage 2 of the West Nile virus, while the Yellow Fever virus, Japanese encephalitis virus, Tick-borne encephalitis virus, and Saint Louis encephalitis virus presented with medium potential to cause CL/P. As for the Zika virus, even strains associated with microcephaly showed only medium potential.Dengue virus and West Nile virus presented with high potential to act as environmental factors in the etiology of CL/P.Learning disabilities (LD) may affect a range of academic skills but are most often observed in reading. Researchers and policymakers increasingly recommend addressing reading difficulties encountered by students with LD using evidence-based practices, or interventions validated through multiple, high-quality research studies. A valuable tool in identifying evidence-based practices is the meta-analysis, which entails statistically aggregating the results obtained through primary studies. Specific methods used in meta-analyses have the potential to influence their findings, with ramifications for research and practice. This review assessed the methodological features of the systematic reviews and analytic procedures featured in meta-analyses of reading intervention studies that included students with LD written between 2000 and 2020. selleck compound Identified articles (n = 23) suggest that meta-analyses have become more prevalent and transparent over time, notwithstanding issues related to publication bias and the opacity of coding procedures. A discussion of implications follows a description of results.We describe two poorly differentiated, non-myofibroblastic (SMA-, S100+, CD34±), spindle cell neoplasms with immunohistochemical positivity for ALK and with ALK gene rearrangements leading to PLEKHH2ALK and CLTCALK fusions, respectively. ALK protein overexpression and/or gene fusions should be evaluated in poorly differentiated spindle cell neoplasms, even when there is an absence of a myofibroblastic phenotype. A positive ALK evaluation has therapeutic implications as both tumors responded to single-agent treatment with the tyrosine kinase inhibitor crizotinib.
Arteriovenous fistulas (AVFs) are considered the first choice for venous access in end-stage renal disease patients, however, they are also known to have a high primary failure rate (early thrombosis and maturation failure). Of these, the outcome of thrombosed immature AVFs is not well known. This study aimed to investigate the outcome of AVFs with early thrombosis.

Patients who underwent AVF creation from January 2009 to December 2019 at Seoul National University Hospital or Seoul Metropolitan Government - Seoul National University Boramae Medical Center were retrospectively reviewed. Patients who received salvage operations due to early thrombosis within 30 days after access creation were analyzed.

During the study period, a total of 45 patients (radiocephalic 26; brachiocephalic 19) developed early thrombosis and underwent salvage operations. The median age of patients was 61.0 (54.5-69.5) years, and 51.1% were male. The first salvage operation was performed on the median 1.0 (0.0-4.5) day after AVF creation. The most common cause for early thrombosis was venous stenosis (64.4%) and followed by poor arterial inflow (28.9%), especially in radiocephalic AVFs. About 20 AVFs were salvaged to maturation (46.5%). Post-salvage primary patency and secondary patency at 1 year was 72.6% and 100%. In a multivariate logistic regression, significant risk factors for maturation failures were minimum venous outflow diameter ⩽2.5 mm (OR, 4.433; 95% CI, 1.039-18.921;
 = 0.044) and lower in patients with hypertension (OR, 0.064; 95% CI, 0.006-0.637;
 = 0.019).

Thrombosed immature AVFs are associated with a high failure rate after salvage operation. However, if the salvage operation is successfully performed, it is associated with an acceptable 1-year outcome.
Thrombosed immature AVFs are associated with a high failure rate after salvage operation. However, if the salvage operation is successfully performed, it is associated with an acceptable 1-year outcome.Prior research documents associations between personal network characteristics and health, but establishing causation has been a long-standing research priority. To evaluate approaches to causal inference in egocentric network data, this article uses three waves from the University of California Berkeley Social Networks Study (N = 1,159) to investigate connections between nine network variables and two global health outcomes. We compare three modeling strategies cross-sectional ordinary least squares regression, regression with lagged dependent variables (LDVs), and hybrid fixed and random effects models. Results suggest that cross-sectional and LDV models may overestimate the causal effects of networks on health because hybrid models show that network-health associations operate primarily between individuals, as opposed to network changes causing within-individual changes in health. These findings demonstrate uses of panel data that may advance scholarship on networks and health and suggest that causal effects of network support on health may be more limited than previously thought.This study was conducted in a cross-sectional correlation design to identify factors affecting the practice of COVID-19 prevention activities in patients with heart diseases. A convenience sample of 195 patients with heart diseases from one tertiary teaching hospital completed questionnaires with items from the characteristics of these participants, their knowledge, attitude, and practice related to COVID-19 prevention activities. Participants' knowledge, attitude, and practice for COVID-19 prevention were relatively high but there was a significant difference in the degree of practice of COVID-19 prevention activities according to the characteristics of the participants. The higher the level of their knowledge and the more positive their attitude, the higher their practice. Attitude and information check about COVID-19 prevention were factors that influenced the practice of COVID-19 prevention activities, with an explanatory power of 32%. This study can help motivate and actively encourage COVID-19 prevention practices.
New therapeutic approaches in neurological disorders are progressing into clinical development. Past failures in translational research have underlined the critical importance of selecting appropriate inclusion criteria and primary outcomes. Narrow inclusion criteria provide sensitivity, but increase trial duration and cost to the point of infeasibility, while broader requirements amplify confounding, increasing the risk of trial failure. This dilemma is perhaps most pronounced in spinal cord injury (SCI), but applies to all neurological disorders with low frequency and/or heterogeneous clinical manifestations.

Stratification of homogeneous patient cohorts to enable the design of clinical trials with broad inclusion criteria.

Prospectively-gathered data from patients with acute cervical SCI were analysed using an unbiased recursive partitioning conditional inference tree (URP-CTREE) approach. Performance in the 6-minute walk test at 6months after injury was classified based on standardized neurological stimates of the relative frequencies of cohorts to improve the design of clinical trials in SCI and beyond.
To describe a new technique for management of recalcitrant deep stromal keratitis using posterior lamellar keratectomy.

A 66-year-old pseudophakic male presented with deep stromal corneal infiltrates, extending from 2 to 4 o'clock in the vicinity of the limbus of the left eye, 3 months after phacoemulsification. The infiltrates failed to respond to empirical topical medications, anterior chamber wash and intrastromal injection. Posterior lamellar keratectomy was done to debulk the infectious load. In this technique the diseased posterior lamella was excised through a sclerocorneal lamellar pocket without a donor graft.

The infection subsided within 2 weeks after posterior lamellar keratectomy. Patient achieved best corrected visual acuity (BCVA) of 20/60 with complete resolution of symptoms at 2 weeks follow up. Till the last follow-up at 6 months, the patient maintained BCVA of 20/60 with no sign of recurrence or corneal decompensation at the keratectomy site.

Posterior lamellar keratectomy is a simple, effective and inexpensive technique for management of small, peripheral, deep-seated recalcitrant keratitis.
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