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Biomedicines Jan 2023The popularity of living-donor organ donation has increased recently as an alternative to deceased-organ donation due to the growing need for organs and a shortage of...
The popularity of living-donor organ donation has increased recently as an alternative to deceased-organ donation due to the growing need for organs and a shortage of deceased-donor organs. This procedure requires an in-depth health assessment of candidates, who must be in excellent physical and mental health. We present a potential living-kidney donor withdrawn from donation due to a newly diagnosed Paget's disease of bone (PDB). The patient underwent computed tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy, and bone densitometry with trabecular bone score (TBS) assessment. The sole lumbar vertebra affected by PDB was investigated comprehensively, non-invasively, quantitatively, and qualitatively.
PubMed: 36830939
DOI: 10.3390/biomedicines11020401 -
BMC Immunology Jul 2020Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased...
BACKGROUND
Primary immunodeficiences (PIDs) are a group of chronic, serious disorders in which the immune response is insufficient. In consequence, it leads to an increased susceptibility to infections. Up to date, there are about 350 different disorders classified in that group. There are also patients suffering from recurrent respiratory tract infections (RRTI), however that group doesn't present any abnormalities in terms of conducted immunological tests. Many factors, including medical, can have an impact on physical development of a child. Data such as birth weight and length, also weight, height, BMI during admission to the hospital were collected from 195 patients' medical histories from their hospitalization at Clinical Immunology and Paediatrics Ward of J. Gromkowski Hospital in Wrocław. Investigated groups included patients with PIDs, RRTI and a control group of healthy children. Our purpose was to evaluate the physical growth of children with PID and children with RRTI by assessment of their height and weight. All of parameters were evaluated using centile charts, suitable best for the Polish population.
RESULTS
The lowest mean birth weight and height was found among the PIDs patients group. Children with PIDs during hospitalization had statistically relevant lower mean weight than the control group and almost 18% of them had their height situated below 3rd percentile. The statistically relevant differences have been found between them and RRTI group in terms of weight, height and nutritional status. The statistically significant difference was detected between the nutritional status of PID and control group.
CONCLUSIONS
There is a higher percentage of PID patients with physical growth abnormalities in comparison to healthy children. Our findings indicate a need for further investigation of immune system irregularities and their influence on physical growth of children.
Topics: Adolescent; Body Height; Body Mass Index; Body Weight; Child; Child, Preschool; Chronic Disease; Female; Growth Disorders; Humans; Male; Primary Immunodeficiency Diseases; Recurrence; Respiratory Tract Infections
PubMed: 32677887
DOI: 10.1186/s12865-020-00372-x -
Journal of Diabetes Research 2021Infection in diabetic foot syndrome (DFS) represents serious medical problem, and the annual risk of DFS in diabetic patients is 2.5%. More than half of the patients... (Comparative Study)
Comparative Study
AIMS
Infection in diabetic foot syndrome (DFS) represents serious medical problem, and the annual risk of DFS in diabetic patients is 2.5%. More than half of the patients with DFS have symptoms of extremity ischemia (peripheral arterial disease (PAD)). The aim of the present study was to analyze the frequency of particular bacterial strains in people with DFS, analyze the impact of arterial ischemia on the occurrence of a given pathogen, and evaluate the antibacterial treatment based on the results of bacterial culture.
METHODS
The analysis included 844 bacterial strains obtained from 291 patients with DFS hospitalized in the Department of Angiology in years 2016-2019.
RESULTS
The most common isolates were , , , , and . Nearly 20% of the species were found to have at least one resistance mechanism. In patients with PAD, Gram-negative species were isolated more commonly than in people without PAD. The most useful drugs in DFS in hospitalized patients are penicillins with beta-lactamase inhibitors, 3rd- to 5th-generation cephalosporins (with many exceptions), carbapenems, aminoglycosides, and tigecycline.
CONCLUSIONS
Bacterial strains isolated from ischemic DFS are more resistant to commonly used antibacterial agents, i.e., penicillins (including penicillins with beta-lactamase inhibitors), cephalosporins (except for the 4 and 5 generations), glycopeptides, and linezolid. When planning treatment of hospitalized patients with DFS, the presence of ischemia in DFS should always be taken into consideration. It determines the occurrence of particular bacterial species and the choice of antibacterial agent and may determine the rate of treatment success.
Topics: Aged; Anti-Bacterial Agents; Bacteria; Diabetic Foot; Female; Humans; Ischemia; Male; Microbial Sensitivity Tests; Middle Aged; Peripheral Arterial Disease; Poland; Predictive Value of Tests; Wound Infection
PubMed: 34007849
DOI: 10.1155/2021/9947233 -
Diseases (Basel, Switzerland) Jan 2023Hypertrophic pyloric stenosis is a common cause of vomiting in the first few weeks of life, but in rare cases, it may occur in older subjects with a major risk of...
Hypertrophic pyloric stenosis is a common cause of vomiting in the first few weeks of life, but in rare cases, it may occur in older subjects with a major risk of delayed diagnosis and complications. We describe the case of a 12-year-and-8-month-old girl who presented to our department for epigastric pain, coffee-ground emesis, and melena, which arose after taking ketoprofen. An abdomen ultrasound showed thickening (1 cm) of the gastric pyloric antrum, while upper-GI endoscopy documented esophagitis and antral gastritis with a non-bleeding pyloric ulcer. During her hospital stay, she had no further episodes of vomiting and was therefore discharged with a diagnosis of "NSAIDs-induced acute upper gastrointestinal tract bleeding". After 14 days, following recurrence of abdominal pain and vomiting, she was hospitalized again. At endoscopy, pyloric sub-stenosis was found, abdominal CT showed thickening of large gastric curvature and pyloric walls, and an Rx barium study documented delayed gastric emptying. On suspicion of idiopathic hypertrophic pyloric stenosis, she underwent Heineke-Mikulicz pyloroplasty with resolution of symptoms and restoration of a regular caliber of the pylorus. Hypertrophic pyloric stenosis, although occurring rarely in older children, should be taken into account in the differential diagnosis of recurrent vomiting at any age.
PubMed: 36810533
DOI: 10.3390/diseases11010019 -
Biomedicine & Pharmacotherapy =... Nov 2021Patients with peripheral artery disease have poor prognosis despite advances in vascular surgery. Therefore, attempts have been made at using gene and cell therapy to...
INTRODUCTION
Patients with peripheral artery disease have poor prognosis despite advances in vascular surgery. Therefore, attempts have been made at using gene and cell therapy to stimulate angiogenesis in the lower limbs in patients with critical lower limb ischemia (CLI).
METHODS
The study included 30 rats divided into 3 groups. An intramuscular injection of a therapeutic gene or cells in the right hind limb was administered in each group: angiopoietin-1 (ANG1) plasmid in group 1, ANG1/vascular endothelial growth factor (ANG1/VEGF) bicistronic construct in group 2, and naked plasmid in group 3 (control). After 3 months of follow-up, tissue samples were harvested, and vessels that stained positively for CD34 cells were quantified.
RESULTS
The highest CD34+ cell count was noted in the ANG1/VEGF group (98.26 cells), followed by the ANG1 group (80.31) and control group (47.93). The CD34+ cell count was significantly higher in the ANG1/VEGF and ANG1 groups than in the control group. There was no significant difference in the CD34+ cell count between the ANG1/VEGF and ANG1 groups.
CONCLUSION
Our study confirmed that therapy with ANG1 plasmid alone or ANG1/VEGF bicistronic construct is safe and effective in a rat model. The therapy resulted in the recruitment of more CD34+ vascular endothelial cells than in the control group receiving naked plasmid.
Topics: Angiopoietin-1; Animals; Antigens, CD34; Cell Movement; Disease Models, Animal; Endothelial Progenitor Cells; Female; Gene Transfer Techniques; Genetic Therapy; Genetic Vectors; Hindlimb; Injections, Intramuscular; Ischemia; Male; Muscle, Skeletal; Neovascularization, Physiologic; Rats, Inbred BUF; Vascular Endothelial Growth Factor A; Rats
PubMed: 34649339
DOI: 10.1016/j.biopha.2021.112186 -
International Journal of Surgery Case... Feb 2021Segmental aganglionosis (the absence of ganglions) is a rare presentation of Hirschsprung's disease, whereby only limited segment/segments of aganglionic bowel is...
INTRODUCTION
Segmental aganglionosis (the absence of ganglions) is a rare presentation of Hirschsprung's disease, whereby only limited segment/segments of aganglionic bowel is interposed between segments of innervated bowel, or "skip'' area of normal innervations is present within an area of aganglionosis.
PRESENTATION OF CASE
We reported a case of a 3 day old male newborn who presented with failure to pass meconium along with progressive abdominal distension. There were skip lesions present in between. Mikulicz double barrel enterostomy was carried out, which was followed by an uneventful postoperative period. Four months later, the patient was admitted for levelling biopsies which revealed the absence of ganglions in the terminal ileum as well as in the rectosigmoid junction. But the ganglions were present in between and proximal to the terminal ileum where the previously dilated small bowel segment was resected. This presentation was contradicted the most accepted migration theory of Hirschsprung's disease.
DISCUSSION
As seen in our case, and in21 other cases published between 1954-2016, we highly recommend that leveling/mapping biopsies should definitely include the cecal pole and the small bowel segments proximal to the ileocecal valve as well as the multilevel colonic biopsies down till the rectum.
CONCLUSION
Reporting of these cases brings out interesting questions with respect to the pathogenesis and serves to highlight the existence of several variants within the spectrum of Hirschsprung's disease.
PubMed: 33485175
DOI: 10.1016/j.ijscr.2021.01.049 -
Internal Medicine (Tokyo, Japan) Sep 2021A 68-year-old man presented with a solid mass at the left renal pelvis and ureter with multiple systemic lymphadenopathies and a mass with a cavity in the right lower...
A 68-year-old man presented with a solid mass at the left renal pelvis and ureter with multiple systemic lymphadenopathies and a mass with a cavity in the right lower lobe of the lung. While a transbronchial lung biopsy revealed no malignancy, a biopsy of the renal pelvis showed marginal zone lymphoma with polyclonal IgG4-positive cells. The serum IgG4 level and presence of a bilateral orbital mass suggested Mikulicz disease. The lesions shrank following the administration of steroids. A rebiopsy confirmed lung adenocarcinoma, and its background showed IgG4-positive cells a year later. IgG4-related diseases require careful follow-up because they can be complicated by malignancy.
Topics: Adenocarcinoma of Lung; Aged; ErbB Receptors; Exons; Humans; Immunoglobulin G4-Related Disease; Lung Neoplasms; Lymphoma, B-Cell, Marginal Zone; Male; Mutation
PubMed: 33775999
DOI: 10.2169/internalmedicine.6470-20 -
Hinyokika Kiyo. Acta Urologica Japonica Nov 2021A 67-year-old female, with a past medical history of IgG4-related Mikulicz disease, was referred to our department for a periurethral mass revealed by contrast-enhanced...
A 67-year-old female, with a past medical history of IgG4-related Mikulicz disease, was referred to our department for a periurethral mass revealed by contrast-enhanced computed tomography. She presented with weak urine flow a half year before the first consultation. Magnetic resonance imaging (MRI) revealed a periurethral mass, 39×39×29 mm, extending from the bladder neck to the urethral meatus. Serum IgG4 level was elevated to 580 mg/dl. Histological examination by the transvasinal biopsy revealed a lymphocytic infiltrate with IgG4-positive plasmacytoid predominance, leading to the diagnosis of IgG4-related disease arising in the periurethra. She was treated with prednisolone for 4 months, and urinary disturbance disappeared. MRI showed that the periurethral mass decreased in size.
Topics: Aged; Biopsy; Female; Humans; Immunoglobulin G; Immunoglobulin G4-Related Disease; Magnetic Resonance Imaging; Prednisolone
PubMed: 34856791
DOI: 10.14989/ActaUrolJap_67_11_507 -
The Indian Journal of Surgery Jun 2020The earliest available evidence attributes the discovery of droplets as a mode of transmission of disease to Carl Flügge, a German bacteriologist, a contemporary of...
The earliest available evidence attributes the discovery of droplets as a mode of transmission of disease to Carl Flügge, a German bacteriologist, a contemporary of Emil Kocher, in 1897. This finding was instrumental in the development of the gauze mask introduced by Johann von Mikulicz Radecki in the same year. A surgical mask has become an indispensable tool in the armamentarium to fight the COVID 19 pandemic. Surgical masks which were once limited to the confines of healthcare setups are now donned by the members of the general public. It has become imperative that a healthcare worker selects the right kind of respiratory protective equipment to protect himself and his patients. The surgical mask has become essential, in a way, for survival.
PubMed: 32837074
DOI: 10.1007/s12262-020-02438-x -
Cancers Feb 2024The role of immune checkpoint inhibitors (ICIs; anti-PD1) in the treatment of childhood cancers is still evolving. The aim of this nationwide retrospective study was to...
BACKGROUND/AIM
The role of immune checkpoint inhibitors (ICIs; anti-PD1) in the treatment of childhood cancers is still evolving. The aim of this nationwide retrospective study was to assess the safety and effectiveness of ICIs used in a group of 42 patients, with a median age of 13.6 years, with various types of advanced malignancies treated in pediatric oncology centers in Poland between 2015 and 2023.
RESULTS
The indications for treatment with anti-PD1 were as follows: Hodgkin lymphoma (11); malignant skin melanoma (9); neuroblastoma (8); and other malignancies (14). At the end of follow-up, complete remission (CR) was observed in 37.7% (15/42) of children and disease stabilization in 9.5% (4/42), with a mean survival 3.6 (95% CI = 2.6-4.6) years. The best survival (OS = 1.0) was observed in the group of patients with Hodgkin lymphoma. For malignant melanoma of the skin, neuroblastoma, and other rare malignancies, the estimated 3-year OS values were, respectively, 0.78, 0.33, and 0.25 ( = 0.002). The best progression-free survival value (0.78) was observed in the group with malignant melanoma. Significantly better effects of immunotherapy were confirmed in patients ≥ 14 years of age and good overall performance ECOG status. Severe adverse events were observed in 30.9% (13/42) patients.
PubMed: 38473329
DOI: 10.3390/cancers16050968