Life-Threatening Esophageal Variceal Hemorrhage in a 7-Year-Old Boy with Massive Portal Vein Enlargement Due to Congenital Arterioportal Fistula.

BACKGROUND Arterioportal fistulas (APFs) are abnormal connections between the arterial and portal venous systems, leading to portal hypertension (PH) and symptoms such as gastrointestinal bleeding, splenomegaly, and hepatic pain. Symptoms typically appear by the age of 2 years in about 75% of cases. CASE REPORT A 7-year-old boy with an asymptomatic APF developed life-threatening complications following a Clostridium difficile infection.

Multiomics integration and machine learning reveal prognostic programmed cell death signatures in gastric cancer.

Gastric cancer (GC) is characterized by notable heterogeneity and the impact of molecular subtypes on treatment and prognosis. The role of programmed cell death (PCD) in cellular processes is critical, yet its specific function in GC is underexplored. This study applied multiomics approaches, integrating transcriptomic, epigenetic, and somatic mutation data, with consensus clustering algorithms to classify GC molecular subtypes and assess their biological and immunological features.

Hemoglobin decrease predicts untoward outcomes better than severity of anemia.

Patients with gastrointestinal bleeding (GIB) exhibit varying tolerances to acute blood loss. We aimed to investigate the effect of relative Hb decrease (ΔHb%) on GIB outcomes. Participants enrolled in the Hungarian GIB Registry between 2019 and 2022 were analyzed.

Effects of moderate intensity exercise on liver metabolism in mice based on multi-omics analysis.

Physical exercise is beneficial to keep physical and mental health. The molecular mechanisms underlying exercise are still worth exploring. The healthy adult mice after six weeks of moderate-intensity exercise (experimental group) and sedentary mice (control group) were used to perform transcriptomic, proteomic, lactylation modification, and metabolomics analysis.

The complex anatomy of the bronchial arteries: a meta-analysis with potential implications for thoracic surgery and hemoptysis treatment.

The present meta-analysis aimed to provide the most detailed and comprehensive anatomical description of bronchial arteries (BAs) using data available in the literature. Adequate knowledge of the normal anatomy and morphological variations of BAs can be clinically significant; for example, this approach can prevent potential risks while undertaking bronchial artery embolization (BAE) procedures and, ultimately, lead to better patient outcomes. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, and the Cochrane Library were searched.

Development and implementation of a 3d-HDR brachytherapy program for cervical cancer in a sub-Saharan African centre.

Background: Cervical cancer is the second most common cancer among women in Nigeria where, the gap between need for, and access to, radiation therapy including brachytherapy is significant. This report documents the implementation of the first three-dimensional high-dose-rate (3D-HDR) brachytherapy service for cervical cancer in Nigeria.

Purpose: This report details the steps taken to implement the 3D-HDR brachytherapy program, the challenges faced, and the adaptive strategies employed to overcome them.

Mucoepidermoid Carcinoma: Enhancing Diagnostic Accuracy and Treatment Strategy through Machine Learning Models and Web-Based Prognostic Tool.

Background: Oral cancer, particularly mucoepidermoid carcinoma (MEC), presents diagnostic challenges due to its histological diversity and rarity. This study aimed to develop machine learning (ML) models to predict survival outcomes for MEC patients and pioneer a clinically accessible prognostic tool.

Methods: Using the SEER database (2000-2020), we constructed predictive models with five ML algorithms: Random Forest Classifier (RFC), Gradient Boosting Classifier (GBC), Logistic Regression (LR), K-Nearest Neighbors (KNN), and Multilayer Perceptron (MLP).

Repair of Cleft Palate in Adult Patients; Impact of Speech Therapy Following Surgical Intervention in Africa.

Cleft lip and palate anomalies constitute both aesthetic and functional impairments for affected individuals. While an individual with an unrepaired cleft palate may adjust somewhat to the associated feeding challenges as he or she gets older, the consequent speech impairment is amenable primarily to surgery. It is pertinent to assess how well speech function is restored in individuals with cleft after surgical repairs.

Disrupted methionine cycle triggers muscle atrophy in cancer cachexia through epigenetic regulation of REDD1.

The essential amino acid methionine plays a pivotal role in one-carbon metabolism, facilitating the production of S-adenosylmethionine (SAM), a critical supplier for DNA methylation and thereby a modulator of gene expression. Here, we report that the methionine cycle is disrupted in skeletal muscle during cancer cachexia, leading to endoplasmic reticulum stress and DNA hypomethylation-induced expression of the DNA damage inducible transcript 4 (Ddit4) gene, encoding the regulated in development and DNA damage response 1 (REDD1) protein. Targeting DNA methylation by depletion or pharmacological inhibition of DNA methyltransferase 3A (DNMT3A) exacerbates cachexia, while restoring DNMT3A expression or REDD1 knockout alleviates cancer cachexia-induced skeletal muscle atrophy in mice.

Cuproptosis: A new mechanism for anti-tumour therapy.

As an indispensable trace metal element in the organism, copper acts as a key catalytic cofactor in a wide range of biological processes. Copper homeostasis disorders can be caused by either copper excess or deficiency, and copper homeostasis disorders will affect the normal physiological functions of cells and induce cell death through a variety of mechanisms, such as the emerging cuproptosis model. The imbalance of copper homeostasis will lead to the occurrence of cancer, and copper is a key factor in cell signalling, so copper is involved in the development of cancer by promoting cell proliferation, angiogenesis and metastasis, etc.

Assessing the Reliability of YouTube Content for Plastic Surgery Patient Information in Africa With the Modified DISCERN and JAMA Scores.

Introduction: YouTube has become a popular source of health information, including plastic surgery. Given the platform's wide reach and potential influence on patient decisions, this study aimed to assess the quality of information available on YouTube for African audiences seeking plastic surgery procedures.

Methods: This cross-sectional study extracted data from YouTube videos on plastic surgery relevant to Africa.

Allogenic faecal microbiota transplantation for antibiotic-associated diarrhoea in critically ill patients (FEBATRICE)-Study protocol for a multi-centre randomised controlled trial (phase II).

Background: Exposure of critically ill patients to antibiotics lead to intestinal dysbiosis, which often manifests as antibiotic-associated diarrhoea. Faecal microbiota transplantation restores gut microbiota and may lead to faster resolution of diarrhoea.

Methods: Into this prospective, multi-centre, randomized controlled trial we will enrol 36 critically ill patients with antibiotic-associated diarrhoea.

Prognostic and functional role of the nuclear export receptor 1 (XPO1) in gastrointestinal cancers: a potential novel target?

In the last decades the survival of metastatic gastrointestinal (GI) cancer patients could have been significantly extended due to the introduction of targeted- and immunotherapy. However, only the minority of patients will experience long-lasting survival. Hence, novel therapeutics are clearly necessary for GI cancer patients.

Echocardiographic Changes in Dogs with Stage B2 Myxomatous Mitral Valve Disease Treated with Pimobendan Monotherapy.

The present study aimed to evaluate the effects of chronic pimobendan monotherapy on cardiac size in dogs with stage B2 myxomatous mitral valve disease (MMVD). Data from 31 dogs diagnosed with MMVD and cardiomegaly (LA/Ao ≥ 1.6 and LVIDdn ≥ 1.

Dermoscopy of Scabies: Utility of Polarised and Ultraviolet-Induced Fluorescence Examination in Fair and Dark Skin.

Introduction: Ultraviolet-based dermoscopy may support the recognition of scabies, yet neither accuracy analyses nor data on skin of colour are available. The aim of this multicentric observational retrospective was to investigate the diagnostic accuracy of polarised and ultraviolet-induced fluorescence (UVF) dermoscopic examination in both fair and dark skin, also assessing possible differences according to the skin tone.

Methods: Consecutive patients with a diagnosis of scabies were eligible.

Clinical outcomes and complications of retained biliary stents during the COVID-19 pandemic: a case series.

Biliary stents are widely used following endoscopic management of choledocholithiasis. Removal is recommended within 3-6 months to prevent complications. This study analyzed cases of retained biliary stents managed at our institution.

Quality of pediatric trauma care: development of an age-adjusted TRISS model and survival benchmarking in a major trauma center.

Background: Pediatric trauma is a major global health concern, accounting for a substantial proportion of deaths and disease burden from age 5 onwards. Effective triage and management are essential in pediatric trauma care, and prediction models such as the Trauma Injury Severity Score (TRISS) play a crucial role in estimating survival probability and guiding quality improvement. However, TRISS does not account for age-specific factors in pediatric populations, limiting its applicability to younger patients.

Etiologic Pattern, Severity, and Outcome of Pericardial Effusion Among Children Seen Over Ten Years at a Tertiary Hospital in Sokoto, Northwest Nigeria.

Introduction: Pericardial effusion (PE) is an abnormal accumulation of fluid in the pericardial space, which, if severe, is associated with high mortality. The causes are diverse, including infective and non-infective. Few studies have looked at the spectrum of severity and causes in Northern Nigeria.

Thyroid Functions and Cognitive Decline in the Elderly.

Background The maintenance of cognitive health depends on thyroid hormones, and it is becoming more widely acknowledged that thyroid hormone issues may be a factor in cognitive decline in the aged. Objective This study aimed to investigate the association between thyroid hormone levels and cognitive decline among elderly individuals, considering the influence of age-related factors and comorbidities. Methodology Over the course of two years, 218 adults 60 years of age and older with clinically diagnosed hypothyroidism or subclinical thyroid disease were included in a prospective observational research.

Impact of schistosomiasis infection on maternal and neonatal outcomes in pregnancy: a prospective cohort study in Nigeria.

Background: Schistosomiasis, a neglected tropical disease, affects approximately 40 million women of reproductive age contributing to preventable anaemia during pregnancy, intrauterine growth retardation and low birth weight. In spite of the high prevalence rate of this disease among school aged children in Abakaliki, no study in Abakaliki has looked at the burden of Schistosomal infection in pregnancy with a view to determining maternal and neonatal outcomes.

Objective: To determine the association between schistosomal infection and maternal anemia, low birth weight, and other neonatal outcomes in Abakaliki.

Thoracic and abdominal diagnostic imaging findings in dogs diagnosed with immune-mediated polyarthritis: 71 cases (2011-2023).

Objectives: To describe thoracic and abdominal imaging findings in dogs with immune-mediated polyarthritis and to evaluate their impact on the decision to commence immunosuppressive therapy.

Materials And Methods: Retrospective case series describing imaging findings in dogs with immune-mediated polyarthritis across modalities, including thoracic radiographs, abdominal ultrasound, computed tomography, and where available, echocardiography. Additionally, two internal medicine clinicians reviewed the signalment, clinical signs, clinicopathological findings and diagnostic imaging results on two separate occasions, reaching a consensus for each dog on whether immunosuppression would be their treatment of choice or whether their recommendations would be altered by the results of diagnostic imaging.

Accuracy and precision of 3 multidose vial tracking methods to inform controlled drug tracking in practice.

Objective: To evaluate the precision and accuracy of 3 common methods (method 1, actual draws of the volume remaining; method 2, weight tracking of the volume remaining and/or the volume removed; and method 3, discrepancy percentage at the end of each vial) for monitoring volumes in vials of injectable controlled drugs.

Methods: For methods 1 and 2, doses were drawn from a vial containing a known amount of sterile water. For method 1, after each dose was removed, the remaining quantity of liquid was withdrawn, measured, and reinjected into the vial.

Single oral dose of gabapentin reduces vigilance and increases play behavior without changing mobility in New Zealand white rabbits (Oryctolagus cuniculus).

Objective: To evaluate rabbit behavioral responses and activity after gabapentin administration.

Methods: In this study, 5 intact female and 3 intact male New Zealand white rabbits aged 8 to 12 months were administered a single oral 25-mg/kg dose of gabapentin. This study was conducted from December 2020 to February 2021.

Prevalence and trends of pregnancy-related acute kidney injury in sub-Saharan Africa: a systematic review and meta-analysis.

Background: Pregnancy-Related Acute Kidney Injury (PRAKI) is an important contributor to maternal-fetal morbidity and mortality. The burden of PRAKI in sub-Saharan Africa is not well documented. We conducted a systematic literature review and meta-analysis to estimate the prevalence of PRAKI in sub-Saharan Africa.

Practical recommendations for therapy and monitoring of mogamulizumab patients in Germany.

Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of the heterogeneous group of cutaneous T-cell lymphomas (CTCL). With the expansion of the biologic treatment landscape, new treatment options have become available in recent years, most notably the C-C chemokine receptor 4 (CCR4)-directed monoclonal antibody mogamulizumab. Based on the phase III pivotal trial, mogamulizumab is recommended by the German S2k guidelines for the second-line treatment of stage IB and above SS and MF, after at least one prior systemic therapy.