Syncope Time Frames for Adverse Events after Emergency Department Presentation: An Individual Patient Data Meta-Analysis
Conclusions: The risk of death or life-threatening adverse event is rare in patients presenting syncope at the ED. The most common adverse events are brady and supraventricular arrhythmias, which occur during the first 3 days. Prolonged ECG monitoring in the ED in a short stay unit with ECG monitoring facilities may, therefore, be beneficial.PMID:34833453 | PMC:PMC8623370 | DOI:10.3390/medicina57111235 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Ludovico Furlan Lucia Trombetta Giovanni Casazza Franca Dipaola Raffaello Furlan Chiara Marta Filippo Numeroso Jordi P érez-Rodon James V Quinn Matthew J Reed Robert S Sheldon Win-Kuang Shen Benjamin C Sun Venkatesh Thiruganasambandamoorthy Andrea Ungar Source Type: research

Percutaneous Endoscopic Gastrostomy Tubes Can Be Considered Safe in Children: A Single-Center 11-Year Retrospective Analysis
Conclusions: Negative deviations of z-score body weight, body height, and body mass index could indicate the need for possible earlier placement of PEG. PEG can be considered as a safe therapeutic option in children since PEG-related complications, mostly in minor forms, were found in a small number of patients.PMID:34833454 | PMC:PMC8622246 | DOI:10.3390/medicina57111236 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Antonia Jeli čić Kadić Tea Rado šević Vanda Žitko Ranka Despot Zenon Pogoreli ć Carlos Martin Llorente Mu ñoz Edita Runji ć Tanja Kova čević Tatjana Ćatipović Ardalić Branka Poli ć Jo ško Markić Source Type: research

Management of Pulp Canal Obliteration-Systematic Review of Case Reports
Conclusions: For discolored non-symptomatic PCO teeth, external bleaching is advocated and the RCT approach should not be implemented as a preventive intervention strategy. Symptomatic PCO teeth should follow regular endodontic treatment pathways. Clinical approach of teeth with PCO should follow a decision-making algorithm incorporating clinical and radiographic signs and patient-reported symptoms.PMID:34833455 | PMC:PMC8625069 | DOI:10.3390/medicina57111237 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Alexandra Vinagre Catarina Castanheira Ana Messias Paulo J Palma Jo ão C Ramos Source Type: research

Rare Orbital Metastasis Originating from Ampullary Adenocarcinoma
CONCLUSIONS: We presented a rare case of orbital metastasis from ampullary adenocarcinoma. This should be considered in the differential diagnosis of patients with a history of ampullary adenocarcinoma who present with symptoms referring to the relevant locations.PMID:34833456 | PMC:PMC8624159 | DOI:10.3390/medicina57111238 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Yung-En Tsai Ke-Hung Chien Yao-Feng Li Shiue-Wei Lai Source Type: research

Contact Allergy Induced by Mango ( < em > Mangifera indica < /em > ): A Relevant Topic?
CONCLUSION: Mango fruit is frequently consumed, but mango induced contact dermatitis, the main hypersensitivity reaction induced by mango, is rare. Further data is necessary for a better understanding of sensitising substances and, consecutively, standardization of patch test reagents.PMID:34833457 | PMC:PMC8621529 | DOI:10.3390/medicina57111240 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Elena Camelia Berghea Mihai Craiu Selda Ali Sabina Loredana Corcea Roxana Silvia Bumbacea Source Type: research

Ebstein Anomaly and Right Aortic Arch in Patient with Charge Syndrome
Medicina (Kaunas). 2021 Nov 13;57(11):1239. doi: 10.3390/medicina57111239.ABSTRACTEbstein anomaly is a rare congenital heart disease characterized by a varying degree of anatomical and functional abnormalities of tricuspid valve and right ventricle. It often coexists with other congenital cardiac malformations. Up to 79-89% of patients with Ebstein anomaly have interatrial communication in the form of patent oval foramen or atrial septal defect and more than one-third has other types of cardiac malformations. Association between Ebstein anomaly and right aortic arch is extremely rare and only few cases have been described ...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Inguna Lubaua Madara Teraudkalna Source Type: research

A Promising Role of TGF- β Pathway in Response to Regorafenib in Metastatic Colorectal Cancer: A Case Report
Medicina (Kaunas). 2021 Nov 13;57(11):1241. doi: 10.3390/medicina57111241.ABSTRACTColorectal cancer (CRC) is one of the most common cancer types around the world. The prognosis of patients with advanced diseases is still poor in spite of currently available therapeutic options. Regorafenib is an oral tyrosine kinase inhibitor (TKI) approved to treat refractory metastatic colorectal cancer (mCRC). We investigated Somatic mutations in several genes involved in immunological response and cancer progression in both long/short responder mCRC patients who underwent third-line therapy with regorafenib to identify predictive bioma...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Simona De Summa Katia Danza Brunella Pilato Giuseppina Matera Rossella Fasano Angela Calabrese Rosanna Lacalamita Nicola Silvestris Stefania Tommasi Antonella Argentiero Oronzo Brunetti Source Type: research

The Incidence of Gastrointestinal Stromal Tumors in Obese Patients-A Large Single Center Experience
Conclusions: The incidence of GIST in our study was estimated at 0.31%. All patients had a very low-risk GIST and no recurrence until follow-up. Recent literature suggests that the risk of GIST is higher in the obese population, and therefore surgeons should be aware of the risk of incidental GIST during LSG.PMID:34833460 | PMC:PMC8623259 | DOI:10.3390/medicina57111242 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Natalia Dowgia łło-Gornowicz Klaudia Sztaba Pawe ł Lech Anna Botuli ńska Maciej Michalik Source Type: research

Effects of Mean Artery Pressure and Blood pH on Survival Rate of Patients with Acute Kidney Injury Combined with Acute Hypoxic Respiratory Failure: A Retrospective Study
Conclusions: Acute kidney injury combined with respiratory failure is associated with high mortality. High mean arterial pressure and normal blood pH might improve these outcomes. Therefore, the acid-base status and MAP should be considered when attempting to predict outcome. Moreover, the blood pressure targets for acute kidney injury in critical care should not be similar to those recommended for the general population and might prevent mortality.PMID:34833461 | PMC:PMC8623837 | DOI:10.3390/medicina57111243 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Chi-Hua Ko Ying-Wei Lan Ying-Chou Chen Tien-Tsai Cheng Shan-Fu Yu Abdulkadir Cidem Yu-Hsien Liu Chia-Wen Kuo Chih-Ching Yen Wei Chen Chuan-Mu Chen Source Type: research

Delirium and Cognitive Impairment as Predisposing Factors of COVID-19 Infection in Neuropsychiatric Patients: A Narrative Review
Medicina (Kaunas). 2021 Nov 14;57(11):1244. doi: 10.3390/medicina57111244.ABSTRACTSARS-CoV-2 neuroinvasive and neurotropic abilities may underlie delirium onset and neuropsychiatric outcomes. Only a limited number of studies have addressed the potential effect of SARS-CoV-2 infection on mental health so far. Most studies mainly reported the acute onset of mixed neuropsychiatric conditions in patients infected with SARS-CoV-2, characterized by agitated behavior, altered level of consciousness, and disorganized thinking, regardless of psychological or socioeconomic triggering factors. The present narrative review aims to ana...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Michele Fabrazzo Antonio Russo Alessio Camerlengo Claudia Tucci Mario Luciano Valeria De Santis Francesco Perris Francesco Catapano Nicola Coppola Source Type: research

Non-IgE Mediated Hypersensitivity to Food Products or Food Intolerance-Problems of Appropriate Diagnostics
Medicina (Kaunas). 2021 Nov 14;57(11):1245. doi: 10.3390/medicina57111245.ABSTRACTThe diagnosis of food intolerance is tricky due to the different etiologies of adverse reactions. There is also a lack of clear rules for interpreting alternative tests used to diagnose these problems. The analyses of IgG4 concentration in serum or cytotoxic tests became the basis of elimination diets. However, it can result in nutritional deficiencies and loss of tolerance to eliminated foods. Our study aimed to assess the necessity of food elimination in four cases with food intolerance symptoms based on alternative diagnostic tests. Four p...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Dorota Myszkowska Barbara Zapa ła Ma łgorzata Bulanda Ewa Czarnobilska Source Type: research

Immunohistochemistry Helps to Distinguish Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features/Noninvasive Encapsulated Follicular Variant of Papillary Thyroid Carcinoma with Other Follicular Thyroid Lesions
Conclusions: Our results broaden the use of IHC markers for differential diagnoses among the four groups of follicular-based lesions. In addition, the similar IHC profiles of NIFTP and NEFVPTC also suggest the original criterion of
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Hao-Wen Chuang Jyh-Seng Wang Jen-Wei Tsai Chao-Tien Hsu Kai-Jen Lin Source Type: research

Clinical Outcome of Primary Total Hip Arthroplasty in Patients with Morbid Obesity-Retrospective and Prospective Follow-Up Studies
Medicina (Kaunas). 2021 Nov 15;57(11):1247. doi: 10.3390/medicina57111247.ABSTRACTBackground and objective: There is a general clinical concern on the negative impact of obesity on surgical complications and functional outcomes. We hypothesized that the patients with morbid obesity are exceptionally prone to a significantly increased risk for surgical and short-term complications after primary total hip arthroplasty (THA). We aimed to identify the range of Body Mass Index (BMI) values of patients with a significant risk for lower functional improvement after THA. Materials and methods: In Stage 1 of the study, we conducted...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Andrey Gritsyuk Alexey Lychagin Liu Yi Nahum Rosenberg Source Type: research

Reconstruction of a Lower Polar Artery for Kidney Transplantation Using Donor Ovarian Vein: Case Report with Literature Review
Conclusions: If an inferior polar artery is severed, vascular reconstruction must be performed to preserve the function of the graft. Usually, the gonadal vein is available during donor nephrectomy; therefore, it can be explanted without additional difficulties or incisions. Although we have not reported any complications, further studies are recommended on the long-term outcomes of this alternative approach for the reconstruction of short renal arteries.PMID:34833466 | PMC:PMC8618098 | DOI:10.3390/medicina57111248 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Saul ė Bikauskaitė Kamil ė Počepavičiūtė Linas Veli čka Antanas Jankauskas Darius Trumbeckas Erika Šuopytė Source Type: research

Correlations between PNPLA3 Gene Polymorphisms and NAFLD in Type 2 Diabetic Patients
Conclusions: Our results suggest that PNPLA3 does not independently influence cardiovascular risk in patients with type 2 diabetes mellitus. The hypothesis that PNPLA3 may have a cardioprotective effect requires future confirmation.PMID:34833467 | PMC:PMC8620174 | DOI:10.3390/medicina57111249 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Oana Irina Gavril Lidia Iuliana Arhire Radu Sebastian Gavril Madalina Ioana Zota Andreea Gherasim Otilia Nita Andrei Drugescu Andrei Catalin Oprescu Irina Mihaela Esanu Florin Mitu Mariana Graur Laura Mihalache Source Type: research

Comparison of General and Spinal Anaesthesia on Systemic Inflammatory Response in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis
Conclusion: Spinal anaesthesia tended to induce a lower inflammatory response than general anaesthesia when considering CRP levels in patients undergoing TKA. However, the effects of anaesthetic techniques on the overall outcomes were not significant.PMID:34833468 | PMC:PMC8623492 | DOI:10.3390/medicina57111250 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Ha-Jung Kim Priodarshi Roychoudhury Stuti Lohia Jin-Sun Kim Hyung-Tae Kim Young-Jin Ro Won-Uk Koh Source Type: research

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo
Medicina (Kaunas). 2021 Nov 16;57(11):1251. doi: 10.3390/medicina57111251.ABSTRACTA balance within the immune system is necessary for the proper development of ovarian follicles. Numerous cytokines were detected in follicular fluid, the role of which in reproductive physiology seems crucial. They influence the development and maturation of the follicle, ovulation, and corpus luteum formation, as well as embryo implantation and maintenance of pregnancy. The analysis of follicular fluid requires its collection by puncturing of the ovary, which is usually executed in connection with various gynaecological procedures. When int...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Rafa ł Adamczak Natalia Ukleja-Soko łowska Kinga Lis Mariusz Dubiel Source Type: research

Clinical Outcomes of Chemotherapeutic Molecules as Single and Multiple Agents in Advanced Non-Small-Cell Lung Carcinoma (NSCLC) Patients
Conclusions: The findings of this review indicate that targeted therapy using specific inhibitors is now the most promising first-line anticancer treatment available in the market. However, chemotherapy is still effective in treating advanced NSCLC and is viable as a first-line treatment.PMID:34833470 | PMC:PMC8618045 | DOI:10.3390/medicina57111252 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Ting Yoon Kwan Ezharul Hoque Chowdhury Source Type: research

Prenatal Diagnosis and Outcome of Tracheal Agenesis as Part of Congenital High Airway Obstruction Syndrome. Case Presentation and Literature Review
In this study we report on a 15-week male fetus, diagnosed with hyperechogenic lungs, midline heart position and inverted diaphragm. Sonographic findings suggest congenital High Airway Obstruction Syndrome (CHAOS) An ultrasound scan and fetal MRI were not able to point out the exact obstruction level. In spite of extensive counselling, the parents opted to carry on with the pregnancy. Fetal demise was noted on a scan at 19 weeks gestation. After the elective termination of pregnancy, a post-mortem examination showed partial tracheal atresia with no other anomalies. Despite technological progress in CHAOS syndrome, a precis...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Tiberiu Georgescu Viorica Radoi Micaela Radulescu Aurora Ilian Oana Daniela Toader Lucian G Pop Nicolae Bacalbasa Source Type: research

Morphological Study of Fossa Ovalis in Formalin-Fixed Human Hearts and Its Clinical Importance
Conclusions: Knowledge of the interatrial septal anatomy becomes important for interventional cardiologists and should be documented before transeptal puncture.PMID:34833472 | PMC:PMC8619833 | DOI:10.3390/medicina57111254 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Monica Adriana Vaida Caius Glad Streian Cristina Gug Nawwaf Sebastian Damen Adelina Maria Jianu Andreea Grigori ță Laura Grigori ță Source Type: research

Effects of Female Reproductive Hormone Levels on Inadvertent Intraoperative Hypothermia during Laparoscopic Gynecologic Surgery: A Retrospective Study
This study aimed to investigate the effects of female reproductive hormones on inadvertent intraoperative hypothermia in patients who underwent laparoscopic gynecologic surgery under general anesthesia. Materials and Methods: This retrospective study included 660 menstruating and menopausal female patients aged 19-65 years. The patients were divided into two groups according to the occurrence of inadvertent intraoperative hypothermia: non-hypothermia group (N = 472) and hypothermia group (N = 188). After propensity score matching, 312 patients (N = 156 in each group) were analyzed to investigate the association between int...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Cheol Lee SeongNam Park ByoungRyun Kim Hyeonbin Yim Myeongjong Lee Juhwan Lee Hyungtae Kim Source Type: research

Bipolar Disorder and Comorbid Use of Illicit Substances
Medicina (Kaunas). 2021 Nov 17;57(11):1256. doi: 10.3390/medicina57111256.ABSTRACTSubstance use disorders (SUD) are highly prevalent in bipolar disorder (BD) and significantly affect clinical outcomes. Incidence and management of illicit drug use differ from alcohol use disorders, nicotine use of behavioral addictions. It is not yet clear why people with bipolar disorder are at higher risk of addictive disorders, but recent data suggest common neurobiological and genetic underpinnings and epigenetic alterations. In the absence of specific diagnostic instruments, the clinical interview is conducive for the diagnosis. Treati...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Ulrich W Preuss Martin Schaefer Christoph Born Heinz Grunze Source Type: research

A Portrait of Intratumoral Genomic and Transcriptomic Heterogeneity at Single-Cell Level in Colorectal Cancer
Medicina (Kaunas). 2021 Nov 17;57(11):1257. doi: 10.3390/medicina57111257.ABSTRACTIn the study of cancer, omics technologies are supporting the transition from traditional clinical approaches to precision medicine. Intra-tumoral heterogeneity (ITH) is detectable within a single tumor in which cancer cell subpopulations with different genome features coexist in a patient in different tumor areas or may evolve/differ over time. Colorectal carcinoma (CRC) is characterized by heterogeneous features involving genomic, epigenomic, and transcriptomic alterations. The study of ITH is a promising new frontier to lay the foundation ...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Andrea Angius Antonio Mario Scanu Caterina Arru Maria Rosaria Muroni Ciriaco Carru Alberto Porcu Paolo Cossu-Rocca Maria Rosaria De Miglio Source Type: research

Maternal-Fetal Outcomes in Women with Endometriosis and Shared Pathogenic Mechanisms
Medicina (Kaunas). 2021 Nov 17;57(11):1258. doi: 10.3390/medicina57111258.ABSTRACTThe connection between endometriosis and pregnancy outcomes is trending among the research topics. Until recently, endometriosis and its painful symptomatology were considered to be alleviated by pregnancy. However, these beliefs have shifted, as emerging literature has demonstrated the role of this condition in affecting pregnancy evolution. The underlying pathogenesis of endometriosis is still poorly understood, all the more when pregnancy complications are involved. Debatable opinions on endometriosis associated with obstetric complication...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Francesca Frincu Andreea Carp-Veliscu Aida Petca Dumitru-Cristinel Badiu Elvira Bratila Monica Cirstoiu Claudia Mehedintu Source Type: research

Efficacy and Safety of Sugammadex for the Reversal of Rocuronium-Induced Neuromuscular Blockade in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis
Conclusions: Sugammadex may effectively and safely reverse rocuronium-induced NMB in patients with ESRD, although the recovery to a TOF ratio of 0.9 may be prolonged compared to patients with normal renal function. Further studies are needed, considering the small number of studies included and the high heterogeneity of some of the results.PMID:34833477 | PMC:PMC8622972 | DOI:10.3390/medicina57111259 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Young-Sung Kim Byung-Gun Lim Young-Ju Won Seok-Kyeong Oh Jung-Suk Oh Soo-Ah Cho Source Type: research

Emphysema-Predominant COPD Had a Greater 5-Year Mortality and a Worse Annual Decline in Lung Function Than Airway Obstruction-Predominant COPD or Asthma at Initial Same Degree of Airflow Obstruction
Medicina (Kaunas). 2021 Nov 17;57(11):1261. doi: 10.3390/medicina57111261.ABSTRACTBackground and Objectives: We studied whether the extent of exertional oxygen desaturation and emphysema could cause greater mortality in COPD and asthma independent of airflow obstruction. Materials and Methods: We performed a 5-year longitudinal observational study in COPD and asthma patients who matched for airflow obstruction severity. All subjects performed a 6-min walk test (6MWT) and high-resolution computed tomography (HRCT) and followed spirometry and oxygen saturation (SpO2) during the 6MWT every 3-6 months. Overall survival was rec...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Chang-Wei Lin Hung-Yu Huang Fu-Tsai Chung Chun-Yu Lo Yu-Chen Huang Ting-Wen Wang Lan-Yan Yang Yu-Bin Pan Kian Fan Chung Chun-Hua Wang Source Type: research

Efficacy and Safety of Vacuum-Assisted Excision for Benign Breast Mass Lesion: A Meta-Analysis
Conclusion: VAE for benign breast lesions showed favorable outcomes with respect to complete resection and complications. This meta-analysis suggested that VAE for low-risk benign breast lesions is a reasonable option for both diagnostic and therapeutic purposes.PMID:34833479 | PMC:PMC8621526 | DOI:10.3390/medicina57111260 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Hee-Seon Yoo Wu-Seong Kang Jung-Soo Pyo Junghan Yoon Source Type: research

Complex Regional Pain Syndrome in Athletes: Scoping Review
Conclusions: Our review suggests a higher prevalence of CRPS type 1 in younger people and in lower limbs than in general population but confirms the higher prevalence in females. However, the number of studies addressing CRPS in athletes is limited, as well as the number of involved patients, considering that only few and heterogeneous case reports were published about this topic. Moreover, the high prevalence of old studies (only 5 available studies in the last 10 years) might have influenced the choice of both assessment tools and management strategies. Despite these limitations, athletes showing disproportionate pain af...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Antimo Moretti Angela Palomba Marco Paoletta Sara Liguori Giuseppe Toro Giovanni Iolascon Source Type: research

A Higher Polygenic Risk Score Is Associated with a Higher Recurrence Rate of Atrial Fibrillation in Direct Current Cardioversion-Treated Patients
Conclusions: A higher PRS is associated with increased odds of AF recurrence after treatment with DCC. PITX2 (rs2200733) is significantly associated with an increased risk of AF. The protective allele of rs11047543 (SOX5) is associated with a greater risk of AF recurrence. Further studies are needed to predict the success of rhythm control and guide patient selection towards the most efficacious treatment.PMID:34833481 | PMC:PMC8624440 | DOI:10.3390/medicina57111263 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Simon Vogel Irina Rudaka Dmitrijs Rots Jekater īna Isakova Oskars Kal ējs Krist īne Vīksne Linda Gail īte Source Type: research

Nonbacterial Thrombotic Endocarditis Associated with Acute Promyelocytic Leukemia: An Autopsy Case Report
Medicina (Kaunas). 2021 Nov 18;57(11):1264. doi: 10.3390/medicina57111264.ABSTRACTValve vegetation is one of the most fearful findings for physicians. The first diagnosis that comes to their mind is infective endocarditis (IE), but it can also be noninfective; nonbacterial thrombotic endocarditis (NBTE). NBTE can be even more challenging than IE for physicians because of the wide range of differential diagnoses such as malignancies, autoimmune disorders and human immunodeficiency virus. A 45-year-old woman presented at the emergency room with a sudden onset of dysarthria and right-sided hemiplegia. Laboratory data showed h...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Tadayuki Hashimoto Tatsuya Aoki Yoshitaka Kawabata Yoshihiro Owai Yoshikazu Matsuda Shinobu Tamura Source Type: research

Characteristics of Patients with Obstructive Sleep Apnea at High Risk for Cardiovascular Disease
Medicina (Kaunas). 2021 Nov 18;57(11):1265. doi: 10.3390/medicina57111265.ABSTRACTBackground and Objectives: To evaluate the influence of obstructive sleep apnea (OSA)-related symptoms on prevalent cardiovascular disease (CVD) in a large clinical population of patients. Materials and Methods: A total of 2127 patients (mean age 55 years, 24% women) underwent diagnostic polysomnography and were evaluated using the Epworth sleepiness scale (ESS), the Athens Insomnia Scale (AIS), and the Beck Depression Inventory (BDI). We investigated the predictive value of OSA-associated symptoms for prevalent cardiovascular disease, after ...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Izolde Bouloukaki Michail Fanaridis Georgios Stathakis Christina Ermidou Eleftherios Kallergis Violeta Moniaki Eleni Mauroudi Sophia E Schiza Source Type: research

Longitudinal Motor Functional Outcomes and Magnetic Resonance Imaging Patterns of Muscle Involvement in Upper Limbs in Duchenne Muscular Dystrophy
Conclusions: Our results confirmed that the integrated use of functional scales and imaging can help to monitor functional and MRI changes over time.PMID:34833484 | PMC:PMC8624281 | DOI:10.3390/medicina57111267 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Claudia Brogna Lara Cristiano Tommaso Verdolotti Giulia Norcia Luana Ficociello Roberta Ruiz Giorgia Coratti Lavinia Fanelli Nicola Forcina Giorgia Petracca Fabrizia Chieppa Tommaso Tartaglione Cesare Colosimo Marika Pane Eugenio Mercuri Source Type: research

A Review of Natural Products for Prevention of Acute Kidney Injury
CONCLUSIONS: in this paper, the results of studies on natural products related to AKI were found and summarized, and the mechanism by which the efficacy of AKI was demonstrated was reviewed. Many natural products show that AKI can be prevented and treated, suggesting that these natural products can help to develop new drugs. In addition, we may be helpful to elucidate additional mechanisms and meta-analysis in future natural product studies.PMID:34833485 | PMC:PMC8623373 | DOI:10.3390/medicina57111266 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Hyun Goo Kang Hyun Ki Lee Kyu Bong Cho Sang Il Park Source Type: research

Absence of Wharton's Jelly at the Abdominal Site of the Umbilical Cord Insertion. Rare Case Report and Review of the Literature
We report the fortunate case of a 29-year-old nulliparous woman, with an uncomplicated pregnancy, admitted at 39 weeks in labor where a persistently abnormal cardiotocographic trace led to delivery by cesarean section of a healthy 3500 g newborn. After delivery, a Wharton's jelly anomaly was identified at the abdominal umbilical insertion (umbilical cord vessels, approximately 1 cm in length, were completely uncovered by Wharton's jelly), which required surgical thread elective ligation. In the presence of a persistently abnormal CTG trace, in a pregnancy with no clinical settings suggestive of either chronic or acute feta...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Radu Botezatu Sandra Raduteanu Anca Marina Ciobanu Nicolae Gica Gheorghe Peltecu Anca Maria Panaitescu Source Type: research

Predictors of Clinical Course and Outcomes of Acute Diverticulitis: The Role of Age and Ethnicity
Medicina (Kaunas). 2021 Nov 19;57(11):1269. doi: 10.3390/medicina57111269.ABSTRACTBackground and Objectives: Acute diverticulitis (AD) is the leading and most burdensome complication of colonic diverticulosis. However, risk factors for its development and predictors of its course are still poorly defined. In this regard, the association of a young age with a complicated course and worse outcome are still controversial. Moreover, little research has addressed the effect of ethnicity on the course of AD. The current study aimed to evaluate the impact of these variables on AD's course and outcome in the diverse and unique eth...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Randa Taher Yael Kopelman Abdel-Rauf Zeina Amir Mari Fadi Abu Baker Source Type: research

Stable Low-Grade Degenerative Spondylolisthesis Does Not Compromise Clinical Outcome of Minimally Invasive Tubular Decompression in Patients with Spinal Stenosis
This study is a retrospective review of prospectively collected data. Ninety-six consecutive patients who underwent elective MIS lumbar decompression with a mean follow-up of 27.5 months were included in the study. The spondylolisthesis (S) group comprised 53 patients who suffered from LSS with stable degenerative spondylolisthesis, and the control (N) group included 43 patients suffering from LSS without spondylolisthesis. Outcome measures included complications and revision surgery rates. Pre- and post-operative visual analog scale (VAS) for both back and leg pain was analyzed, and the Oswestry Disability Index (ODI) was...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Morsi Khashan Khalil Salame Dror Ofir Zvi Lidar Gilad J Regev Source Type: research

Vitamin D Enhanced the Osteogenic Differentiation of Cell Spheroids Composed of Bone Marrow Stem Cells
This study aimed to analyze the effects of vitamin D on the osteogenic differentiation and mineralization of human mesenchymal stem cells. Materials and Methods: Spheroids were fabricated using human bone marrow-derived stem cells, and were cultured in the presence of vitamin D at concentrations of 0, 0.1, 1, 10, and 100 nM. Stem cell spheroids were fabricated and the morphological evaluation was conducted on days 1, 3, 7 and 14. Determination of qualitative cellular viability was performed with Live/Dead Kit assay on days 1 and 7. Quantitative cellular viability was evaluated with Cell Counting Kit-8 on days 1, 3, 7, and ...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Hyun-Jin Lee Young-Min Song Seunghoon Baek Yoon-Hee Park Jun-Beom Park Source Type: research

Clinical Effectiveness of Immune Checkpoint Inhibitors in Non-Small-Cell Lung Cancer with a Poor Performance Status
Medicina (Kaunas). 2021 Nov 19;57(11):1273. doi: 10.3390/medicina57111273.ABSTRACTImmune checkpoint inhibitors (ICIs) are standard treatments for patients with lung cancer. PD-1/PD-L1 or CTLA4 antibodies are chosen as the first-line therapy, contributing to the long-term survival and tolerability. Unlike molecular targeting agents, such as gefitinib, lung cancer patients with a poor performance status (PS) display unsatisfactory clinical improvements after ICI treatment. Several previous reports also demonstrated that the PS is identified as one of the most probable prognostic factors for predicting poor outcomes after ICI...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Kyoichi Kaira Hisao Imai Atsuto Mouri Ou Yamaguchi Hiroshi Kagamu Source Type: research

Impact of the COVID-19 Pandemic on Emergency Department Workload and Emergency Care Workers' Psychosocial Stress in the Outbreak Area
Conclusions: Different goals should be pursued by the levels and region of the emergency department to overcome the effects of the COVID-19 pandemic and promote optimal care.PMID:34833491 | PMC:PMC8618446 | DOI:10.3390/medicina57111274 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: In-Hwan Yeo Yun-Jeong Kim Jong-Kun Kim Dong-Eun Lee Jae-Young Choe Chang-Ho Kim Jung-Bae Park Kang-Suk Seo Sin-Yul Park Suk-Hee Lee Jae-Kyung Cho Sang-Hun Lee Source Type: research

The Lymphatic System in Breast Cancer: Anatomical and Molecular Approaches
Medicina (Kaunas). 2021 Nov 19;57(11):1272. doi: 10.3390/medicina57111272.ABSTRACTBreast cancer is one of the most important causes of premature mortality among women and it is one of the most frequently diagnosed tumours worldwide. For this reason, routine screening for prevention and early diagnosis is important for the quality of life of patients. Breast cancer cells can enter blood and lymphatic capillaries, then metastasizing to the regional lymph nodes in the axilla and to both visceral and non-visceral sites. Rather than at the primary site, they seem to enter the systemic circulation mainly through the sentinel lym...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Gianfranco Natale Michael E J Stouthandel Tom Van Hoof Guido Bocci Source Type: research

Clinical and Histopathological Features of Scleroderma-like Disorders: An Update
Medicina (Kaunas). 2021 Nov 20;57(11):1275. doi: 10.3390/medicina57111275.ABSTRACTScleroderma-like disorders include a set of entities involving cutis, subcutis and, sometimes, even muscular tissue, caused by several pathogenetic mechanisms responsible for different clinical-pathological pictures. The absence of antinuclear antibodies (ANA), Raynaud's phenomenon and capillaroscopic anomalies constitutes an important element of differential diagnosis with systemic sclerosis. When scleroderma can be excluded, on the basis of the main body sites, clinical evolution, any associated pathological conditions and specific histolog...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Rosario Foti Rocco De Pasquale Ylenia Dal Bosco Elisa Visalli Giorgio Amato Pietro Gangemi Riccardo Foti Alice Ramondetta Source Type: research

Acute Zonal Occult Outer Retinopathy in a Patient Suffering from Epilepsy: Five-Year Follow-Up
We report an unprecedented case of a young patient with epilepsy coexisting with acute zonal occult outer retinopathy (AZOOR), a rare white dot syndrome of unknown etiology, associated with damage to the large zones of the outer retina. Recently, it has been established that epileptic episodes contribute to an inflammatory response both in the brain and the retina. A 13-year-old male patient with epilepsy was referred by a neurologist for an ophthalmologic consultation due to a sudden deterioration of visual acuity in the left eye. The examination, with a key role of multimodal imaging including color fundus photography, f...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Izabella Karska-Basta Bo żena Romanowska-Dixon Dorota Pojda-Wilczek Alina Bakunowicz- Łazarczyk Agnieszka Kubicka-Trz ąska Karolina Gerba-G órecka Source Type: research

Fetal Surveillance in Pregnancies with Myasthenia Gravis
Medicina (Kaunas). 2021 Nov 20;57(11):1277. doi: 10.3390/medicina57111277.ABSTRACTMyasthenia gravis (MG) is an autoimmune condition, that commonly impacts adult women of reproductive age. Myasthenia gravis in pregnancy is rare, but the incidence is higher in different geographical areas. Pregnancies in mothers with MG can have an unfortunate outcome. Acetylcholine receptor antibodies may pass into the fetal circulation and can affect the fetal neuromuscular junction, generating transient MG or even fetal arthrogryposis. The 2016 and 2021 International Consensus Guidance for Management of Myasthenia Gravis issued by Myasthe...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Br îndușa Ana Cimpoca-Raptis Anca Marina Ciobanu Nicolae Gica Gheorghe Peltecu Dan Mitrea Anca Maria Panaitescu Source Type: research

Meta-Analysis of Prevalence of Depression in Dental Students during COVID-19 Pandemic
Conclusions: Our results suggest that dental students are suffering from higher levels of depression compared with the general population or other college students during the COVID-19 pandemic, with differences across regions. Measures to improve mental health and wellbeing of dental students during the pandemic are needed.PMID:34833496 | PMC:PMC8619286 | DOI:10.3390/medicina57111278 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Javier Santab árbara Naiara Ozamiz-Etxebarria Nahia Idoiaga Beatriz Olaya Juan Bueno-Novitol Source Type: research

Parvovirus B19 in Croatia: A Large-Scale Seroprevalence Study
Medicina (Kaunas). 2021 Nov 21;57(11):1279. doi: 10.3390/medicina57111279.ABSTRACTBackground and Objectives: Seroepidemiological studies indicate that parvovirus B19 circulates in all areas of the world, although with some differences. The aim of this study is to analyze the seroprevalence of parvovirus B19 in the Croatian population. Materials and Methods: From 2010 to 2021, 1538 serum samples from different populations were tested for the presence of parvovirus B19 IgM/IgG antibodies. Serological tests were performed using a commercial enzyme-linked immunosorbent assay. Results: IgG antibodies were detected in 986/64.1% ...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Tatjana Vilibic-Cavlek Irena Tabain Branko Kolaric Klara Mihulja Lana Blazevic Maja Bogdanic Dan Navolan Natasa Beader Anna Mrzljak Source Type: research

Changes in the Plasma Apurinic/Apyrimidinic Endonuclease 1/Redox Factor-1(APE1/Ref-1) Level during Cancer Surgery: An Observational Study
Conclusions: The plasma APE1/Ref-1 level increased during surgery with more severe lymph node invasion, but there were no significant differences according to the anesthetics used.PMID:34833498 | PMC:PMC8623191 | DOI:10.3390/medicina57111280 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Yumin Jo Yeojung Kim Eunhye Park Yuran Lee Jiyeon Kim Minwoong Kang Jaesung Lim Insang Song Chaeseong Lim Byeonghwa Jeon Source Type: research

The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis and GRADE Assessment
Conclusions: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants.PMID:34833499 | PMC:PMC8619455 | DOI:10.3390/medicina57111281 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Nanthida Phattraprayoon Teerapat Ungtrakul Wimonchat Tangamornsuksan Source Type: research

Classification and Morphometric Features of Pterion in Thai Population with Potential Sex Prediction
Conclusions: Further studies are needed to explore the use of machine learning in anatomical studies and morphometry-based sex and age estimation. Thorough understanding of the anatomy of the pterion is clinically useful when planning pterional craniotomy, particularly when the position of the pterion may change with age.PMID:34833500 | PMC:PMC8618372 | DOI:10.3390/medicina57111282 (Source: Medicina (Kaunas))
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Nongnut Uabundit Arada Chaiyamoon Sitthichai Iamsaard Laphatrada Yurasakpong Chanin Nantasenamat Athikhun Suwannakhan Nichapa Phunchago Source Type: research

Minimally Invasive Approaching in Hip Surgery-An Anatomical Investigation of 20 Specimens
Medicina (Kaunas). 2021 Nov 22;57(11):1283. doi: 10.3390/medicina57111283.ABSTRACTBackground and objectives: Based on the preparation of 20 formalin-fixed anatomical cadavers, the feasibility of the anterior, minimally invasive approach to the hip joint was investigated in each side of the body. The hypothesis of the study was that the Lateral Femoral Cutaneous Nerve can be spared under the use of this approach. Materials and Methods: The anterior approach to the hip was performed via an incision of 8 cm. The position of the nerve was noticed in relation to the skin incision, and the distance was measured in millimeters. T...
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Clemens Schopper Hannes Traxler Bernhard Schauer G ünter Hipmair Tobias Gotterbarm Matthias Luger Source Type: research

Hyperbaric Oxygen Therapy with Iloprost Improves Digit Salvage in Severe Frostbite Compared to Iloprost Alone
The objective was to assess the efficacy of HBO + iloprost among patients with severe frostbite. Materials and Methods: We conducted a multicenter prospective single-arm study from 2013 to 2019. All patients received early HBO in addition to standard care with iloprost. Outcomes were compared to a historical cohort in which all patients received iloprost alone between 2000 and 2012. Inclusion criteria were stage 3 or 4 frostbite and initiation of medical care
Source: Medicina (Kaunas) - November 27, 2021 Category: Universities & Medical Training Authors: Marie-Anne Magnan Ang èle Gayet-Ageron Pierre Louge Frederic Champly Thierry Joffre Christian Lovis Rodrigue Pignel Source Type: research