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Parvovirus B19 (B19V) is a significant pathogen responsible for a wide range of clinical manifestations, particularly in children and pregnant women. While B19V is most commonly recognized as the cause of Fifth disease, a mild erythematous illness in children, its clinical impact extends far beyond this condition. B19V can lead to severe complications, including transient aplastic crisis in individuals with chronic hemolytic anemias, arthralgia, and more severe joint diseases. During pregnancy, B19V infection poses serious risks, such as spontaneous abortion, non-immune hydrops fetalis, and fetal anemia, particularly when infection occurs between 9 and 20 weeks of gestation. Moreover, B19V is associated with a variety of organ system involvements, including cardiac, neurological, hepatic, and renal complications. These manifestations can range from mild to life-threatening, necessitating a broad spectrum of therapeutic approaches, including symptomatic care, immunoglobulins, corticosteroids, and supportive therapies. Despite the significant clinical burden posed by B19V, no specific antiviral treatment or vaccine is currently available, making early recognition and prompt management crucial for improving patient outcomes. This review provides a comprehensive overview of the diverse clinical presentations of B19V infection, with a focus on pediatric and pregnancy-related complications. It underscores the need for ongoing research into targeted therapies and highlights the importance of vigilant clinical management to mitigate the severe consequences of this pervasive virus. [ABSTRACT FROM AUTHOR]

A 51-year-old female sanitation worker in China developed bilateral neuroretinitis due to scrub typhus. Initially diagnosed with ‘scrub typhus infected pneumonia’, her symptoms subsided within seven days of chloramphenicol treatment. However, two weeks later, she experienced acute bilateral vision loss. Fundoscopy revealed swollen optic discs, exudates, and a small macular pigment epithelial detachment. Diagnosed with scrub typhus-related neuroretinitis, her vision improved after methylprednisolone treatment. This represents the first reported case of such in southern China, suggesting a delayed immune response to scrub typhus. Early diagnosis and proper treatment are crucial for vision prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Oral vesiculobullous diseases (VBD) consist of disorders which result in blister formation. VBDs are considered to be a multifactorial disease process. Corticosteroids and immunomodulating drugs are used for disease management. Methods: The research team assessed peer-reviewed journal articles related to the dietary details of oral lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris. The articles included in this study comprised literature reviews, randomized controlled trials, case studies, and systematic reviews published in the last 26 years (1997-2023). Results: The literature review revealed the promising role that nutrition plays in the management of VBD. Avoiding triggering food and maintaining a well-nourished diet can decrease the symptoms noted during active episodes of VBDs. Oral hygiene maintenance decreases the presence of infection which is beneficial to the recovery process. Conclusion: Studies have shown that the addition of essential vitamins, minerals, and supplements to the diet can aid in the management of VBDs, however, further research is needed. Practical Implications: Dental providers can use this guide as a way to educate patients on the dietary adjustments needed after the diagnosis of one of the vesiculobullous disorders. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has resulted in devastating medical and economic consequences worldwide over the past 3 years. As the pandemic enters a new stage, it is essential to consider the potential impact on rare diseases such as Guillain–Barre syndrome (GBS), which has been intimately associated with COVID-19 since the first COVID-19-related GBS case was reported in January 2020. There are notable differences between COVID-19-related GBS and GBS without COVID-19 in terms of diagnostic types and clinical manifestations. Furthermore, with the widespread administration of COVID-19 vaccines, there have been reports of GBS occurring shortly after vaccination, which requires close attention despite its rarity. This review also explores the vaccines associated with heightened GBS risks, offering insights that may guide vaccination policies and clinical practice. To provide a visual summary of these findings, we have included a graphical abstract. This article will discuss the characteristic manifestations of GBS patients after being positive for the novel coronavirus and the safety of several COVID-19 vaccines. Firstly, this article comprehensively expounds and discusses the epidemiological aspects of novel coronavirus–related GBS. For example, from the perspective of the same population, the expected incidence of GBS in the COVID-19-positive population (persons/100,000 persons/ year) is about 43 times that of the COVID-19-negative population, and the incidence of GBS is significantly increased. Secondly, the clinical characteristics of COVID-19-negative GBS patients and SARS-CoV-2-GBS (SC2-GBS) patients were summarized and compared. Thirdly, this article reviews GBS cases in the current adverse events after COVID-19 vaccination and analyzes and discusses from multiple perspectives, such as the incidence of GBS events, the age proportion of patients, and the interval of onset [ABSTRACT FROM AUTHOR]

Background: This study investigated the factors influencing the prognosis of children with steroid-resistant nephrotic syndrome (SRNS) in patients from the Guangxi region. Methods: We retrospectively analyzed clinical and pathological data of 279 patients with SRNS from six tertiary hospitals in Guangxi. Clinical data were compared between initial (I-SRNS) and secondary (S-SRNS) steroid resistance subgroups and Cox regression analysis was used to determine risk factors for chronic kidney disease (CKD) and CKD stage 5 (CKD5) in patients with SRNS. Results: The median age of onset was 54 months. Thirty-three patients had extra-kidney manifestations. Fifty-two, 24, 57, 33, and 41 patients had hypertension, acute kidney injury, vitamin D deficiency, high intraocular pressure, and dwarfism, respectively. One hundred eighty-two and 92 patients had I-SRNS and S-SRNS, respectively. There were significant differences in sex, ethnicity, family history, incidence of hematuria, clinical classification, efficacy of immune agents, and prognosis between groups (P < 0.05). Among the 279 cases of SRNS, 239 had normal kidney function, 37 developed CKD, and 16 had CKD5. An increase in serum creatinine level (HR = 1.003) was significantly associated with CKD in children with SRNS, and effective immunosuppressant therapy decreased the CKD risk (HR = 0.168). Patients with increased serum creatinine levels (HR = 1.003) and acute kidney injury (HR = 4.829) were more likely to progress to CKD5. Conclusions: Children with S-SRNS showed a higher response to immunosuppressants than those with I-SRNS. Effective immunosuppressant therapy was found to protect against CKD, whereas increased acute kidney injury was an independent risk factor for CKD5. [ABSTRACT FROM AUTHOR]

Background: To analyze the clinical manifestations, endoscopic features, pathological features, endoscopic resection, and prognosis of esophageal granular cell tumors (GCTs). Methods: The present study retrospectively analyzed and followed up the clinical data of 62 patients diagnosed with esophageal GCTs who underwent endoscopic resection at Zhongshan Hospital of Fudan University between July 2007 and March 2022. The clinicopathological features, endoscopic diagnosis, and treatment experience of esophageal GCT patients were summarized. Results: Among the 62 patients with esophageal GCT, there were 34 males and 28 females, with an average age of 49.3 ± 11.7 years. Only 11 patients had symptoms, such as epigastric discomfort, regurgitation or dysphagia. One patient had multiple lesions, and the rest had single lesions, totaling 63 lesions. Most lesions (53/63) were located in the median and lower esophagus, the diameters ranged from 3 to 22 mm. The endoscopic morphology of the GCTs was molar, flat, hemispherical, or irregular submucosal protuberance. Endoscopic ultrasound (EUS) was performed in 38 cases, most cases (31/38) were hypoechoic, and 32 cases were appeared as homogeneous lesions. There were no complications during or after the endoscopic operations, and the en bloc resection rate was 100%. The negative rate of microscopic incisional margin was 63.5% (40/63). No patients developed recurrence during the follow-up period. The follow-up duration was 21–197 months (100.5 months for average). Conclusion: Esophageal GCT is a rare disease with no obvious symptoms and a good prognosis. Endoscopic resection is a safe and effective method of diagnosis and treatment for esophageal GCTs. A microscopic positive tumor margin may not increase the rate of recurrence. [ABSTRACT FROM AUTHOR]

Abstract Parvovirus B19 (B19V) is a significant pathogen responsible for a wide range of clinical manifestations, particularly in children and pregnant women. While B19V is most commonly recognized as the cause of Fifth disease, a mild erythematous illness in children, its clinical impact extends far beyond this condition. B19V can lead to severe complications, including transient aplastic crisis in individuals with chronic hemolytic anemias, arthralgia, and more severe joint diseases. During pregnancy, B19V infection poses serious risks, such as spontaneous abortion, non-immune hydrops fetalis, and fetal anemia, particularly when infection occurs between 9 and 20 weeks of gestation. Moreover, B19V is associated with a variety of organ system involvements, including cardiac, neurological, hepatic, and renal complications. These manifestations can range from mild to life-threatening, necessitating a broad spectrum of therapeutic approaches, including symptomatic care, immunoglobulins, corticosteroids, and supportive therapies. Despite the significant clinical burden posed by B19V, no specific antiviral treatment or vaccine is currently available, making early recognition and prompt management crucial for improving patient outcomes. This review provides a comprehensive overview of the diverse clinical presentations of B19V infection, with a focus on pediatric and pregnancy-related complications. It underscores the need for ongoing research into targeted therapies and highlights the importance of vigilant clinical management to mitigate the severe consequences of this pervasive virus.

Background: Cardiogenic stroke is associated with substantial morbidity and mortality, necessitating a better understanding of its clinical characteristics for improved patient outcomes. This study aimed to identify clinical characteristics influencing short-term functional prognosis in patients with cardiogenic stroke. Methods: The study prospectively enrolled 212 patients with cardiogenic stroke, collecting their clinical data and laboratory results. The modified Rankin Scale score at 90 days was used to define functional prognosis, with patients having a good prognosis (modified Rankin Scale ≤2; n = 164) or poor prognosis (modified Rankin Scale ≥3; n = 48). Results: The poor prognosis group had higher rates of total anterior circulation infarcts (12.5% vs 0.0%; P < .001) and posterior circulation infarction (50.0% vs 38.4%; P < .001) compared with the good prognosis group. Lesion characteristics differed significantly, with the poor prognosis group exhibiting more large-area lesions (39.6% vs 18.9%; P < .001) and multiple confluent lesions (56.3% vs 24.4%; P < .001). Admission-based National Institute of Health Stroke Scale scores were higher in the poor prognosis group (median [IQR], 12 [8-18] vs 5 [4-7]; P

Non-specific orbital inflammation (NSOI) is a non-infectious orbital inflammation. Although it is often considered the most common diagnosis in orbital biopsies, it is an exclusionary diagnosis that requires ruling out systemic disease or other possible causes. Its characteristics include acute orbital signs and symptoms, including pain, proptosis, periorbital edema, chemosis, diplopia, and visual impairment. The clinical manifestations and histological findings of NSOI are heterogeneous, without specific diagnostic criteria or treatment guidelines, which poses significant challenges for diagnosis and treatment. This guideline provides a detailed description of the definition, classification, diagnosis, and treatment of NSOI.

Abstract Background To analyze the clinical manifestations, endoscopic features, pathological features, endoscopic resection, and prognosis of esophageal granular cell tumors (GCTs). Methods The present study retrospectively analyzed and followed up the clinical data of 62 patients diagnosed with esophageal GCTs who underwent endoscopic resection at Zhongshan Hospital of Fudan University between July 2007 and March 2022. The clinicopathological features, endoscopic diagnosis, and treatment experience of esophageal GCT patients were summarized. Results Among the 62 patients with esophageal GCT, there were 34 males and 28 females, with an average age of 49.3 ± 11.7 years. Only 11 patients had symptoms, such as epigastric discomfort, regurgitation or dysphagia. One patient had multiple lesions, and the rest had single lesions, totaling 63 lesions. Most lesions (53/63) were located in the median and lower esophagus, the diameters ranged from 3 to 22 mm. The endoscopic morphology of the GCTs was molar, flat, hemispherical, or irregular submucosal protuberance. Endoscopic ultrasound (EUS) was performed in 38 cases, most cases (31/38) were hypoechoic, and 32 cases were appeared as homogeneous lesions. There were no complications during or after the endoscopic operations, and the en bloc resection rate was 100%. The negative rate of microscopic incisional margin was 63.5% (40/63). No patients developed recurrence during the follow-up period. The follow-up duration was 21–197 months (100.5 months for average). Conclusion Esophageal GCT is a rare disease with no obvious symptoms and a good prognosis. Endoscopic resection is a safe and effective method of diagnosis and treatment for esophageal GCTs. A microscopic positive tumor margin may not increase the rate of recurrence.

Abstract Background This study investigated the factors influencing the prognosis of children with steroid-resistant nephrotic syndrome (SRNS) in patients from the Guangxi region. Methods We retrospectively analyzed clinical and pathological data of 279 patients with SRNS from six tertiary hospitals in Guangxi. Clinical data were compared between initial (I-SRNS) and secondary (S-SRNS) steroid resistance subgroups and Cox regression analysis was used to determine risk factors for chronic kidney disease (CKD) and CKD stage 5 (CKD5) in patients with SRNS. Results The median age of onset was 54 months. Thirty-three patients had extra-kidney manifestations. Fifty-two, 24, 57, 33, and 41 patients had hypertension, acute kidney injury, vitamin D deficiency, high intraocular pressure, and dwarfism, respectively. One hundred eighty-two and 92 patients had I-SRNS and S-SRNS, respectively. There were significant differences in sex, ethnicity, family history, incidence of hematuria, clinical classification, efficacy of immune agents, and prognosis between groups (P

Background/purpose: Erythema multiforme (EM) is considered a hypersensitivity reaction associated with drugs and infections, and remains underestimated due to the lack of precise classification and diagnostic criteria. The aim of this study was to evaluate the triggering factors and clinical manifestations of EM and to present our experience in the diagnosis and management of this disorder. Materials and methods: All patient records were reviewed, and records of patients admitted, diagnosed, and treated with EM were retrieved. Data on age, gender, medical history, triggering factor(s), clinical form, mucosal/cutaneous involvement, affected oral site(s), recurrence, and treatment were collected. The data were analyzed statistically at a significance level set at P < 0.05. Results: A total of 36 EM patients were studied. The triggering factor was identified as infection in 25 %, drugs in 16.7 %, infections and drugs in 41.7 %, and none in 16.7 % of the 36 EM patients. EM minor was diagnosed in 77.8 % of the patients. Labial mucosa (86.1 %) was the most commonly affected oral site. Most patients were treated with topical steroids (25 %). No significant differences were detected between demographic and clinical characteristics with regards to gender, triggering factor, and the number of affected oral sites (P > 0.05). Conclusion: The results of this study, based on the data from 36 EM patients with oral involvement treated at our clinic, can guide dentists in this regard and may be considered as an epidemiological source for the region.

Aims: The sensitivity and specificity of electrodiagnostic parameters in diagnosing carpal tunnel syndrome (CTS) have been reported differently, and this study aims to address this gap. Methods: This case-control study was conducted on 57 cases with CTS and 58 controls without complaints, such as pain or paresthesia on the median nerve. The main assessed electrodiagnostic parameters were terminal latency index (TLI), residual latency (RL), median ulnar F-wave latency difference (FdifMU), and median sensory latency-ulnar motor latency difference (MSUMLD). Results: The mean age in cases and controls were 50.7 years (SD 9.9) and 47.9 years (SD 12.1), respectively. The CTS severity was mild in 20 patients (34.4%), moderate in 19 patients (32.8%), and severe in 19 patients (32.8%). The sensitivity and specificity of the electrodiagnostic parameters in diagnosing CTS were as follows: TLI 75.4% and 87.8%; RL 85.9% and 82.5%; FdifMU 87.9% and 82.9%; and MSUMLD 94.8% and 60.0%, respectively. Conclusion: Our findings indicated that electrodiagnostic parameters are significantly associated with the clinical manifestation of CTS, and are associated with high diagnostic accuracy in CTS diagnosis. However, further studies are required to highlight the role of electrodiagnostic parameters and their combination in CTS detection. Cite this article: Bone Jt Open 2024;5(10):898–903.

Lei Zhang,&ast; Peng Sun,&ast; Xin Liu, Ya Yang, Ruo-Nan Sun, Xu-Dong Wang Department of Emergency Medicine, Aerospace Center Hospital, Beijing, 100049, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xu-Dong Wang, Department of Emergency Medicine, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, Beijing, 100049, People’s Republic of China, Tel +86 01059975120, Email wxundong@126.comObjective: We aimed to analyze the clinical characteristics and prognostic factors of patients with severe hyperkalemia in the emergency department.Methods: This retrospective cohort study included adult patients diagnosed with severe hyperkalemia who sought medical care at the emergency department of Aerospace Center Hospital between January 2018 and May 2022. Clinical data, including demographics, comorbidities, laboratory findings, and outcomes, were systematically collected. Patients were categorized into survival and deceased groups based on in-hospital mortality. Comparative analysis between these groups identified significant differences, highlighting key clinically covariates. Binary logistic regression was employed to determine the primary factors influencing patient outcomes.Results: Of 90 patients diagnosed with severe hyperkalemia, 64 were in the survival group, and 26 in the deceased group. Binary logistic regression identified several significant predictors of mortality, including higher APACHE II scores (odds ratio [OR] 1.41, P = 0.02), widened QRS wave on electrocardiogram (ECG) (OR 79.39, P = 0.04), and elevated serum potassium levels (OR 1.3, P = 0.04). In contrast, emergency blood purification was associated with a reduced mortality rate (OR 0.29, P = 0.03).Conclusion: Key risk factors for mortality in patients with severe hyperkalemia include widened QRS wave on ECG, elevated APACHE II score, and high serum potassium level. Timely correction of hyperkalemia through emergency blood purification significantly improves patient outcomes.Keywords: clinical manifestation, prognosis, risk factors, severe hyperkalemia, treatment

Abstract Background Alagille syndrome (ALGS) is a multisystem genetic disorder frequently characterized by hepatic manifestations. This study analyzed the clinical, pathological, and molecular genetic features of ALGS to improve the efficiency of clinical diagnosis. Methods We retrospectively analyzed the clinical manifestations, pathological examination findings, and genetic testing results of 17 children diagnosed with ALGS based on the revised criteria and hospitalized at our center from January 2012 to January 2022. Results The clinical manifestations are as follows: Cholestasis (16/17, 94%), characteristic facies (15/17, 88%), heart disease (12/16, 75%), butterfly vertebrae (12/17, 71%) and posterior embryotoxon (7/12, 58%). Among the 15 patients who underwent liver pathology examination, 13 (87%) were found to have varying degrees of bile duct paucity. Genetic testing was performed on 15 children, and pathogenic variants of the jagged canonical Notch ligand 1 (JAG1) gene were identified in 13 individuals, including 4 novel variants. No pathogenic variant in the notch homolog 2 (NOTCH2) gene were identified, and 2 children exhibited none of the aforementioned gene pathogenic variants. The median follow-up duration was 7 years. Of the remaining 15 patients (excluding 2 lost to follow-up), 11 remained stable, 4 deteriorated, and no patient died during the follow-up period. Conclusions Among children diagnosed with ALGS, cholestasis stands as the most common feature. To minimize the risk of misdiagnosis, genetic testing should be performed on children exhibiting cholestasis, followed by the application of the revised diagnostic criteria for ALGS. While pharmacological therapy has shown effectiveness for ALGS patients, liver transplantation may be considered in instances of severe pruritus.

Abstract Purpose To evaluate the therapeutic efficacy of intravenous amoxicillin clavulanate potassium combined with nebulized budesonide and ambroxol hydrochloride in pediatric community-acquired pneumonia (CAP) and its impact across various microbial strains and clinical symptoms. The primary objective of this study is to evaluate the efficacy of intravenous amoxicillin-clavulanate combined with nebulized budesonide and ambroxol hydrochloride in the treatment of pediatric community-acquired pneumonia (CAP), and to analyze their impact on different microbial strains and clinical symptoms. Secondary objectives include assessing the treatment's effect on the improvement of clinical symptoms, hospital stay duration, and the levels of inflammatory markers. Design Prospective, single-center study. Methods Fifty-six children with CAP, aged under 6 years, from Affiliated Maternity and Child Health Care Hospital of Nantong University were included. Patients were treated with conventional therapy and the study medication. Clinical characteristics, microbiological data, symptom improvement, and hospitalization times were analyzed. Findings Young children, particularly under 1 year, exhibited a higher incidence of multiple microbial infections and severe clinical manifestations. Treatment with budesonide and ambroxol hydrochloride led to significant clinical improvement across all age groups, with notable efficacy against various pathogens. Conclusions Nebulized budesonide and ambroxol hydrochloride are effective in treating pediatric CAP, offering a promising therapeutic option, particularly for young children with severe presentations.

Erythema multiforme (EM) is considered a hypersensitivity reaction associated with drugs and infections, and remains underestimated due to the lack of precise classification and diagnostic criteria. The aim of this study was to evaluate the triggering factors and clinical manifestations of EM and to present our experience in the diagnosis and management of this disorder. All patient records were reviewed, and records of patients admitted, diagnosed, and treated with EM were retrieved. Data on age, gender, medical history, triggering factor(s), clinical form, mucosal/cutaneous involvement, affected oral site(s), recurrence, and treatment were collected. The data were analyzed statistically at a significance level set at P < 0.05. A total of 36 EM patients were studied. The triggering factor was identified as infection in 25 %, drugs in 16.7 %, infections and drugs in 41.7 %, and none in 16.7 % of the 36 EM patients. EM minor was diagnosed in 77.8 % of the patients. Labial mucosa (86.1 %) was the most commonly affected oral site. Most patients were treated with topical steroids (25 %). No significant differences were detected between demographic and clinical characteristics with regards to gender, triggering factor, and the number of affected oral sites (P > 0.05). The results of this study, based on the data from 36 EM patients with oral involvement treated at our clinic, can guide dentists in this regard and may be considered as an epidemiological source for the region. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the therapeutic efficacy of intravenous amoxicillin clavulanate potassium combined with nebulized budesonide and ambroxol hydrochloride in pediatric community-acquired pneumonia (CAP) and its impact across various microbial strains and clinical symptoms. The primary objective of this study is to evaluate the efficacy of intravenous amoxicillin-clavulanate combined with nebulized budesonide and ambroxol hydrochloride in the treatment of pediatric community-acquired pneumonia (CAP), and to analyze their impact on different microbial strains and clinical symptoms. Secondary objectives include assessing the treatment's effect on the improvement of clinical symptoms, hospital stay duration, and the levels of inflammatory markers. Design: Prospective, single-center study. Methods: Fifty-six children with CAP, aged under 6 years, from Affiliated Maternity and Child Health Care Hospital of Nantong University were included. Patients were treated with conventional therapy and the study medication. Clinical characteristics, microbiological data, symptom improvement, and hospitalization times were analyzed. Findings: Young children, particularly under 1 year, exhibited a higher incidence of multiple microbial infections and severe clinical manifestations. Treatment with budesonide and ambroxol hydrochloride led to significant clinical improvement across all age groups, with notable efficacy against various pathogens. Conclusions: Nebulized budesonide and ambroxol hydrochloride are effective in treating pediatric CAP, offering a promising therapeutic option, particularly for young children with severe presentations. [ABSTRACT FROM AUTHOR]

Objectives: Behçet's syndrome (BS) is a rare disease of unknown etiology, with limited reports especially in pediatric BS. The clinical characteristics and phenotypes of pediatric BS as a highly heterogeneous variable vessel vasculitis were investigated in this study. Methods: A cross-sectional study was conducted to compare clinical variables and descriptive characteristics of BS by age of onset and gender. Cluster analysis was then performed to identify the phenotypes of pediatric BS. Results: A total of 2082 BS patients were included in this study, 1834 adults and 248 children. Compared with adult-onset BS, pediatric BS had a higher incidence of folliculitis [relative risks (RR) and 95% confidence interval (CI) 1.3 (1.0–1.5)], uveitis of the left eye [RR and 95% CI 2.3 (1.0–5.0)], intestinal ulcer complications [RR and 95% CI 2.1 (1.1–4.2)], pericarditis [RR and 95% CI 2.5 (1.0–6.2)], and psychiatric disorders [RR and 95% CI 2.8(1.0–7.9)], while the incidence of thrombocytopenia was lower [RR 0.2 (0.1–1.0)]. Among pediatric BS, females had more genital ulcers, while males were more likely to have skin lesions, panuveitis, vascular involvement, venous lesions, cardiac involvement, and aortic aneurysms. Cluster analysis classified pediatric BS into five clusters (C1–C5): C1 (n = 61, 24.6%) showed gastrointestinal (GI) involvement; C2 (n = 44, 17.7%) was the central nervous system (CNS) type where 23 cases overlapped joint involvement; in C3 (n = 35, 14.1%), all patients presented with arthritis or arthralgia; all patients in C4 (n = 29, 11.7%) manifested ocular involvement, with a few patients overlapping with GI involvement or joint damage; C5 (n = 79, 31.9%) was the mucocutaneous type, presenting both oral ulcers, genital ulcers, and skin lesions. Conclusions: The clinical features of pediatric and adult BS differ significantly. Male and female pediatric BS also have a distinct demography. Five phenotypes including GI, CNS, joint, ocular, and mucocutaneous types were identified for pediatric BS. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and objectiveNeurobrucellosis is a rare neurological disorder characterized by diverse clinical manifestations. Although several relevant cases were reported, our understanding of this disorder is limited. In this study, we presented the clinical and imaging characteristics of four cases of neurobrucellosis.MethodsFour patients with neurobrucellosis were diagnosed and treated in the West China Hospital of Sichuan University and Chengdu Shangjin Nanfu Hospital, from January 2020 to September 2023. Data on demographics, clinical phenotypes and symptoms, cerebrospinal fluid investigations, radiological investigations, and therapies were collected and reviewed. This study was approved by and conducted in accordance with the recommendations of West China Hospital’s ethics -.1clinical manifestations of neurobrucellosis in these patients included meningitis, meningoencephalitis, encephalitis, cranial neuropathy, intracranial hypertension, radiculitis, peripheral neuropathy, myelitis, and other psychiatric symptoms. Brucella species were isolated from blood or cerebrospinal fluid (CSF) in four patients; three patients had elevated CSF protein levels, and two had elevated CSF leukocyte counts. All four patients had abnormal imaging findings, including meningeal signs, abnormal cortex and subcortical white matter signals, and signal abnormalities in the vertebral body and spinal cord. All patients were treated with rifampicin (450 mg once daily) and minocycline (100 mg twice daily) for at least 12 weeks, and their clinical symptoms showed significant improvements.ConclusionThis report reviews four cases of neurobrucellosis. All four patients had headache, fever, seizure, cranial nerve damage, low back pain, along with imaging abnormalities, and were successfully treated with antibiotics. The symptoms of neurobrucellosis can be insidious, mild, and non-specific, characterized by various clinical manifestations and atypical imaging findings. This complexity increases the risk of misdiagnosis and missed diagnosis; thus, careful identification, extended treatment, and close follow-up are required.

BackgroundTropical Candida spondylitis is an uncommon cause of lower back pain in patients, especially in non-tropical areas or in patients not at risk of immunocompromise.Case presentationA 65-year-old woman presented with a six-month history of poorly managed low back pain, now accompanied by numbness and pain in both lower extremities. Her medical history was significant for tertiary hypertension. Inflammatory markers were mildly elevated. MRI fluid sequences revealed lamellar enhancement of the L4-5 vertebral bodies, narrowing of the intervertebral space, peripheral soft tissue edema, and spinal canal compression. After 3 weeks of empirical anti-tuberculosis therapy, the patient’s symptoms did not improve, prompting posterior lesion debridement and autologous iliac bone grafting with pedicle screw fixation. Postoperatively, disc tissue cultures and next-generation sequencing (NGS) identified Candida tropicalis. The patient was subsequently treated with a six-week course of voriconazole, resulting in symptomatic improvement, with no recurrence observed during follow-up.ConclusionThe imaging and clinical presentation of Candida tropicalis spondylitis can closely mimic that of tuberculous spondylitis, particularly in patients without clear risk factors for immune compromise. This overlap in presentation often complicates the differential diagnosis, leading to potential delays in appropriate treatment.

Exacerbated by the rise of global warming due to climate change, as well as ease of international travel and mass migration, the dengue virus infection remains of particular economic and global concern. Of note, the emergence of the first case of dengue viral infection occurred in Saudi Arabia in the 1990s, and since then there has been a steady rise in the number of cases. Moreover, the arrival of imported dengue virus variants poses a significant challenge to dengue fever surveillance and control efforts within the region, especially as Saudi Arabia attracts millions of religious pilgrims throughout the year. Herein, we discuss the epidemiology of dengue viral infection in Saudi Arabia, dengue fever biology and clinical manifestation. Current management strategies, amongst other factors influencing dengue fever in Saudi Arabia are also deliberated upon. Future ongoing research and consistent monitoring of both established and emerging dengue viral strains within Saudi Arabia are needed, given the lack of current comprehensive studies.

Kounis syndrome is an acute coronary syndrome triggered by allergic mediators that induce coronary vasoconstriction and thrombosis, leading to further myocardial damage and anaphylactic shock. Kounis syndrome is also a rare but severe adverse reaction to the COVID-19 vaccine, a phenomenon that underscores the importance of collecting and analyzing similar cases to improve treatment and prognosis. Through comprehensive searches of the Web of Science, Embase, and PubMed databases, this study aimed to gather detailed patient data on patients who developed Kounis syndrome after receiving the COVID-19 vaccine and to further investigate the possible underlying mechanisms using currently available studies. A total of 15 patients (8 females, 7 males) were found. We analyzed comprehensive patient data, including demographics, vaccination details, time of onset of illness after vaccination, clinical manifestations, treatment and outcomes, duration of illness, and relevant examination results. Analysis of these data combined with known allergy-related mechanisms indicated that, regardless of the vaccine type, the first dose of the vaccine was more likely to cause Kounis syndrome than subsequent doses. Therefore, early diagnosis and clinical symptomatic treatment are particularly crucial for managing the severity of Kounis syndrome and preventing further cardiac complications. Additionally, when an unusual and severe allergic reaction occurs within a few hours after vaccination, it is important to closely monitor the development of cardiac-related symptoms and prepare clinically for the potential onset of Kounis syndrome.

Background Oral vesiculobullous diseases (VBD) consist of disorders which result in blister formation. VBDs are considered to be a multifactorial disease process. Corticosteroids and immunomodulating drugs are used for disease management.Methods The research team assessed peer-reviewed journal articles related to the dietary details of oral lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris. The articles included in this study comprised literature reviews, randomized controlled trials, case studies, and systematic reviews published in the last 26 years (1997-2023).Results The literature review revealed the promising role that nutrition plays in the management of VBD. Avoiding triggering food and maintaining a well-nourished diet can decrease the symptoms noted during active episodes of VBDs. Oral hygiene maintenance decreases the presence of infection which is beneficial to the recovery process.Conclusion Studies have shown that the addition of essential vitamins, minerals, and supplements to the diet can aid in the management of VBDs, however, further research is needed.Practical Implications Dental providers can use this guide as a way to educate patients on the dietary adjustments needed after the diagnosis of one of the vesiculobullous disorders.

Background: We investigated the clinical manifestation and severity of COVID-19 infection represented as a composite outcome (hospital or ICU admission, or in-hospital death) among infected fully vaccinated HCWs, the RT-PCR test Ct value (Cycle Threshold) of positive fully vaccinated HCWs, and we measure the interval from the second vaccine to acquiring the infection. Methods: A multicenter retrospective cohort study was conducted in different regions at (16) Ministry of Defense Health Services (MODHS) hospitals. Data were restricted to fully vaccinated (minimum of 2 doses) HCWs who had a confirmed positive PCR test and employed in MODHS hospitals from August 2021 to March 2022. Results: A total of 45862 HCWs were vaccinated as of Aug 2021. Of these 1253 participants met the selection criteria and were included in the study. The average age of infected HCWs was 35.27 years (SD = ± 8.10) of which 57% were females. The HCWs were employed as doctors (24%), nurses (33%), and other (43%). The most administered vaccine type was mRNA (44%) followed by Adenovirus Viral Vector (39%) and mixed vaccine (17%). The incidence of COVID-19 vaccine breakthrough (BT) infection among HCWs was observed at 2.73% (m-RNA 3.19%, Viral Vector 2.83% and mixed 1.87%). Conclusion: the overall COVID-19 (BT) infection incidence proportion was (2.73%), with the Mixed vaccine group showing the lowest (BT) incidence proportion (1.87%). The most commonly reported symptoms among (BT) infections were cough (51%), sore throat (51%), fever (47%), headache (31%), and runny nose (23%), with overall (6%) asymptomatic (BT) infections. We had (1%) hospital admissions, Zero ICU admission, and Zero deaths. our finding may indicate that infection affecting fully vaccinated patients were less severe and mostly affected the upper respiratory tract.

Dengue, a mosquito-borne viral infection, is rapidly increasing worldwide and affects over half of the world’s population in at-risk areas. Factors such as globalization, urbanization, and climate change have fueled its rapid geographical expansion. Although no indigenous dengue cases have been identified in Korea, the number of imported dengue cases has increased from travel to endemic regions. In Korea, dengue diagnosis relies mainly on detecting antidengue antibodies or viral nucleic acids using real-time polymerase chain reaction. Although specific antiviral treatments for dengue are currently unavailable, promising progress has been made in developing antiviral agents that target viral replication. Single-dose tetravalent live-attenuated dengue vaccine candidates are currently being evaluated for their safety and efficacy. Innovative vector control methods, including Wolbachia-infected and genetically modified species of Aedes mosquitos, have demonstrated promising results. Owing to the limited therapeutic options, vector control strategies remain a primary focus for preventing transmission, alongside ongoing research on antiviral drugs and vaccine development. This review provides insight into dengue fever transmission, clinical manifestations, and diagnosis. Additionally, it covers current global control measures, emerging treatment options, and the status of vaccines in development.

Ling Zhang,1,2 Ronghua Liu,1,2 Shuangmei Ye,1,2 Mingfu Wu,1,2 Rong Liu1,2 1Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China; 2National Clinical Research Center for Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of ChinaCorrespondence: Mingfu Wu; Rong Liu, Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Anv, Wuhan, Hubei, 430030, People’s Republic of China, Email wu_mingfu@tjh.tjmu.edu.cn; liurongdoctor@tjh.tjmu.edu.cnPurpose: To recommend the classification of unilateral genital tract obstruction with ipsilateral renal anomaly (UGTOIRA) syndrome into five types based on the site of obstruction, and to analyze the clinical manifestations and precise diagnosis of the syndrome.Methods: The data, including demographic characteristics, symptoms, and precise diagnoses from 59 patients over the last decade, were retrospectively analyzed. Data analysis was conducted using the statistical software package SPSS 26.0.Results: All 59 patients diagnosed with UGTOIRA syndrome were classified into five types based on the site of obstruction: Type I (vaginal obstruction) (45, 76.3%), Type II (cervicovaginal obstruction) (7, 11.9%), Type III (cervical obstruction) (3, 5.1%), Type IV (unilateral partial cervical aplasia) (3, 5.1%), and Type V (Unilateral isthmus atresia) (1, 1.7%). Of these cases, there were 34 cases (57.6%) with communication and 25 cases (42.4%) without communication between the left and right genital tracts. The chief complaints included dysmenorrhea alone in 28 cases (47.5%), dysmenorrhea accompanied by blood dripping after menstruation in 12 cases (20.3%), blood dripping after menstruation alone in 14 cases (23.7%), purulent vaginal secretions in one case (1.7%), vaginal pain in one case (1.7%), irregular menstruation in one case (l.7%), and infertility in two cases (3.4%). The precise diagnostic criteria include the affected side, abnormalities in the kidney and ureter, the site of obstruction, the location of blood accumulation, the size of the ipsilateral genital tract, whether there is communication and its site, the type based on the site of obstruction, and the presence and type of complications.Conclusion: This classification of UGTOIRA syndrome encompasses the anatomical features of all cases reported in our study. Only by fully understanding the anatomical characteristics of this syndrome and identifying its clinical manifestations can clinicians make precise diagnoses as early as possible and provide individualized management.Keywords: uterine malformation, cervical malformation, vaginal malformation, classification, clinical manifestation, diagnosis

Introduction: Juvenile-onset systemic lupus erythematosus (jSLE) is a rare chronic autoimmune disease with multisystemic involvement that can cause significant damage, disability and death. jSLE has a more severe disease presentation than lupus in adults, with a higher incidence of major organ involvement. Aim of the study is to determine the presenting clinical and laboratory characteristics of jSLE patients and to compare symptoms at disease onset from our cohort through a review of the literature. Materials and methods: rretrospective review of medical records encompassing all juvenile systemic lupus erythematosus (jSLE) patients treated in department from July 2007 to July 2024. Upon disease presentation, we abstracted array of clinical and laboratory indices: constitutional symptoms, skin and mucosal changes, arthritis, renal and CNS involvement, CRP, ESR, WBC, platelet count, DCT, ANA, anti-DsDNA, anti-Sm, antiphospholipid antibodies, C3, C4, and RF. Results:. Nineteen children (15 girls and 4 boys) were diagnosed with jSLE. The mean age was 11 years. Arthralgia was the most common complaint (78%), followed by fever, (47%). The most common clinical manifestation was arthritis (62%), followed by renal disease (68%), leukopenia (57%), oral ulcers and thrombocytopenia (42%), malar rash (31%), serositis (21%), and CNS symptoms (16%). Four patients (21%) had stage 2 nephritis, one had stage 3 nephritis, and three (16%) had stage 4 nephritis. All exhibited elevated ESR and positive ANA. Majority of patients had elevated anti-DsDNA (83%), anti-Sm (52%), antiphospholipid antibodies(62%), and anti-ribonucleoprotein antibodies in 9 patients (47%). Low C3 levels were observed in 14 patients (73%) and low C4 levels in 17 patients (88%). Conclusion: (jSLE) is a challenging disease in terms of both diagnosis and treatment. Any case of fever of unknown origin, particularly when accompanied by joint pain, should prompt an evaluation for jSLE. In our cohort, the most common presenting symptoms were fever, arthritis, and arthralgia. [ABSTRACT FROM AUTHOR]

Objective: This study compared the clinical presentations and disease severity between influenza A and B (FLUA and FLUB). Materials and Methods: The study included children hospitalized with virologically confirmed influenza between 2010 and 2020. The severity of the disease was evaluated based on admission to the pediatric intensive care unit (PICU), mechanical ventilation requirement, length of hospital stay, length of stay in the PICU, and death. Influenza viruses were compared within predefined age groups (0-2, 3-9, and 10-18 years) and in all age groups. Results: Of 343 patients, FLUA and FLUB were detected in 75.8% and 24.2% of children, respectively. FLUB was associated with a higher incidence of headache and abdominal pain (P < .001 and P = .01). Children with FLUB were prescribed antibiotics and antivirals 0.56 and 0.58- fold fewer than those with FLUA. Headache and abdominal pain rates were higher in patients between 3 and 9 years with FLUB. Children between 0 and 2 years with FLUA were more frequently admitted to the PICU than those with FLUB (23.6% vs. 4.0%; P < .004). Eight patients with FLUA died, while only 1 with FLUB died (P = .69). Conclusion: The clinical presentation of FLUA and FLUB appeared similar, except for headache and abdominal pain, which were more prevalent in older patients with FLUB. Our study revealed that children between 0 and 2 years with FLUA were at a significantly higher risk for admission to the PICU. As a result, greater attention and awareness should be paid to children under 2 years old with FLUA. [ABSTRACT FROM AUTHOR]

Background: Normocalcemic primary hyperparathyroidism (nPHPT) is a condition characterized by persistently high levels of parathyroid hormone (PTH) and normal serum calcium levels in the absence of other causes for secondary hyperparathyroidism. The aim of the present study was to assess the clinical presentation and the biochemical characteristics in patients with nPHPT and to compare them with those in patients with hypercalcemic PHPT (hPHPT). Materials and methods: The study included 316 patients (277 women and 39 men, average age 58.7 ± 12.1) diagnosed with PHPT. Total serum calcium, inorganic phosphates (PO4), PTH, urinary Ca (uCa), albumin, creatinine, 25(OH)D and bone markers (b-CTX and ALP) were examined in all of them. BMD of the lumbar spine (LS), distal third of the radius (DR), femoral neck (FN) and total proximal femur (TF) were measured by a dual-energy X-ray absorptiometry (DXA). The patients were divided into two groups according to albumin-corrected calcium (Ca) level – with hPHPT (Ca>2.62 mmol/L) and with nPHPT (Ca 2.12–2.62 mmol/l), without other causes for secondary hyperparathyroidism. Results: The frequency of nPHPT was 15.2%. Normocalcemic patients had lower levels of PTH, higher PO4 and 25(OH)D, and smaller parathyroid adenomas. No significant difference in the frequency of osteoporosis, low-energy fractures, nephrolithiasis and gastrointestinal disorders was found between nPHPT and hPHPT. There was no difference in BMD between the two groups. Conclusion: The patients with nPHPT show a more favorable biochemical profile compared to those with hPHPT. Nevertheless, clinical manifestations and complications are similar, without a significant difference in the frequency of osteoporosis, nephrolithiasis, gastrointestinal disorders and low-energy fractures. [ABSTRACT FROM AUTHOR]

Introduction: Accurate identification of the etiology of orthopedic infection is very important for correct and timely clinical management, but it has been poorly studied. In the current study we explored the association of multiple bacterial pathogens with orthopedic infection. Methods: Hospitalized orthopedic patients were enrolled in a rural hospital in Qingdao, China. Wound or exudate swab samples were collected and tested for twelve bacterial pathogens with both culture and multiplex real time PCR. Results and discussion: A total of 349 hospitalized orthopedic patients were enrolled including 193 cases presenting infection manifestations upon admission and 156 with no sign of infection. Orthopedic infection patients were mainly male (72.5%) with more lengthy hospital stay (median 15 days). At least one pathogen was detected in 42.5% (82/193) of patients with infection while 7.1% (11/156) in the patients without infection (P < 0.001). S. aureus was the most prevalent causative pathogen (15.5%). Quantity dependent pathogen association with infection was observed, particularly for P. aeruginosa and K. pneumoniae, possibly indicating subclinical infection. Most of the patients with detected pathogens had a previous history of orthopedic surgery (odds ratio 2.8, P = 0.038). Pathogen specific clinical manifestations were characterized. Multiplex qPCR, because of its high sensitivity, superior specificity, and powerful quantification could be utilized in combination with culture to guide antimicrobial therapy and track the progression of orthopedic infection during treatment. [ABSTRACT FROM AUTHOR]

Elevated immunoglobulin E (IgE) levels are commonly associated with allergies. However, high IgE levels are also found in several other infectious and non-infectious disorders. Elevated IgE levels typically suggest allergies, eczema, or recurrent skin infections. Hyperimmunoglobulin E (hyper-IgE) levels typically reflect a monogenic atopic condition or inborn immune defects with an atopic phenotype. The aim of our research is to investigate and observe the clinical characteristics of children with increased IgE levels who have previously manifested infectious diseases. Furthermore, the retrospective study considers other factors, such as demographic characteristics (sex, area/environment, and age), and their effect on IgE serum levels. To answer this question, we conducted a one-year hospital-based retrospective study that included 200 hospitalized children who had at least two viral or bacterial infections in the six months preceding hospitalization. Measurements of IgE and allergen panels (respiratory and digestive) using blood samples revealed that individuals who tested positive for the body's synthesis of hyper-IgE were not observably allergic to any potential allergens despite having higher total serum IgE. According to the results, there was a strong correlation between elevated IgE serum levels and a history of infectious diseases among the patients. [ABSTRACT FROM AUTHOR]

A twig-like middle cerebral artery (MCA) is an uncommon lesion in which a plexiform network of small vessels replaces the M1 segment of the MCA. Currently, we have insufficient information for twig-like MCAs. Therefore, a review of the literature using PubMed was conducted. In this review of twig-like MCAs, the following were discussed: the definition, pathogenesis, hemodynamics, associated aneurysm, clinical manifestations, imaging examinations, therapeutic strategies, therapeutic complications and prognosis. In addition, we proposed a reasonable grading system for twig-like MCAs, which is significant. For a twig-like MCA, the pathogenesis is unclear, and congenital and acquired factors can be involved. A twig-like MCA disturbed cerebral hemodynamics. An associated aneurysm can occur in patients with twig-like MCAs. Twig-like MCAs can present subclinically and without clinical symptoms, hemorrhage, or ischemic strokes. Of all the available imaging examinations, digital subtracted angiography is the gold standard. When treating a twig-like MCA, it is feasible to target the associated aneurysm, and extracranial-intracranial bypass can be effective in reducing the risk of strokes, but more evidence is needed. Now, the decision to perform surgery for twig-like MCAs should be made on a case-by-case basis. [ABSTRACT FROM AUTHOR]

Retinitis pigmentosa (RP) is a heterogeneous inherited retinal disorder. Mutations in KIZ cause autosomal recessive (AR) RP. We aimed to characterize the genotype, expression pattern, and phenotype in a large cohort of KIZ cases. Sanger and whole exome sequencing were used to identify the KIZ variants. Medical records were reviewed and analyzed. Thirty-one patients with biallelic KIZ mutations were identified: 28 homozygous for c.226C>T (p.R76*), 2 compound heterozygous for p.R76* and c.3G>A (p.M1?), and one homozygous for c.247C>T (p.R83*). c.226C>T is a founder mutation among patients of Jewish descent. The clinical parameters were less severe in KIZ compared to DHDDS and FAM161A cases. RT-PCR analysis in fibroblast cells revealed the presence of four different transcripts in both WT and mutant samples with a lower percentage of the WT transcript in patients. Sequence analysis identified an exonic sequence enhancer (ESE) that includes the c.226 position which is affected by the mutation. KIZ mutations are an uncommon cause of IRD worldwide but are not rare among Ashkenazi Jews. Our data indicate that p.R76* affect an ESE which in turn results in the pronounced skipping of exon 3. Therefore, RNA-based therapies might show low efficacy since the mutant transcripts are spliced. [ABSTRACT FROM AUTHOR]

We investigated the clinical manifestation and severity of COVID-19 infection represented as a composite outcome (hospital or ICU admission, or in-hospital death) among infected fully vaccinated HCWs, the RT-PCR test Ct value (Cycle Threshold) of positive fully vaccinated HCWs, and we measure the interval from the second vaccine to acquiring the infection. A multicenter retrospective cohort study was conducted in different regions at (16) Ministry of Defense Health Services (MODHS) hospitals. Data were restricted to fully vaccinated (minimum of 2 doses) HCWs who had a confirmed positive PCR test and employed in MODHS hospitals from August 2021 to March 2022. A total of 45862 HCWs were vaccinated as of Aug 2021. Of these 1253 participants met the selection criteria and were included in the study. The average age of infected HCWs was 35.27 years (SD = ± 8.10) of which 57% were females. The HCWs were employed as doctors (24%), nurses (33%), and other (43%). The most administered vaccine type was mRNA (44%) followed by Adenovirus Viral Vector (39%) and mixed vaccine (17%). The incidence of COVID-19 vaccine breakthrough (BT) infection among HCWs was observed at 2.73% (m-RNA 3.19%, Viral Vector 2.83% and mixed 1.87%). the overall COVID-19 (BT) infection incidence proportion was (2.73%), with the Mixed vaccine group showing the lowest (BT) incidence proportion (1.87%). The most commonly reported symptoms among (BT) infections were cough (51%), sore throat (51%), fever (47%), headache (31%), and runny nose (23%), with overall (6%) asymptomatic (BT) infections. We had (1%) hospital admissions, Zero ICU admission, and Zero deaths. our finding may indicate that infection affecting fully vaccinated patients were less severe and mostly affected the upper respiratory tract. [ABSTRACT FROM AUTHOR]

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Nasal glial heterotopia (NGH), formerly known as nasal glioma, is a rare congenital developmental abnormality. A two-year-old female infant with intranasal NGH was admitted to Affiliated Hospital of Yangzhou University in 2023. The patient treated in the Department of Otorhinolaryngology Head and Neck Surgery in our hospital due to bilateral runny nose. Finding a nasal space occupying lesion in the left nasal cavity, she was hospitalized as “nasal space occupying lesion (left)”. Consequently, she underwent surgical treatment after completing the relevant examinations. The postoperative pathological examination results showed it was glioma, and then she was diagnosed with intranasal type of nasal glial heterotopia finally. After half a year of postoperative follow-up, there was no recurrence and complications such as meningitis and cerebrospinal fluid rhinorrhea. The incidence of NGH is very low, and it is easy to miss diagnosis. For congenital nasal midline tumors in children, NGH should be considered when CT results suggest the tumor is not communicated with the skull, which has a good prognosis after surgical treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT To analyze the characteristics of Mycoplasma pneumoniae as well as macrolide antibiotic resistance through whole-genome sequencing and comparative genomics. Thirteen clinical strains isolated from 2003 to 2019 were selected, 10 of which were resistant to erythromycin (MIC >64 µg/mL), including 8 P1-type I and 2 P1-type II. Three were sensitive (

BackgroundFetus-in-fetu (FIF) represents an exceedingly rare disease, characterized as an encapsulated and pedunculated vertebrate neoplasm, typically lacking cerebral tissue. The prevalence shows no gender preference. Notably, FIF can cause compressive damage to adjacent organs and tissues, potentially impeding the host's development and maturation.Case presentationA four-month-old male infant was identified, during pregnancy, to have a left-sided pelvic mass on ultrasound. Subsequent evaluations suggested the mass could be a FIF, exhibiting active movement. Surgical exploration revealed that the mass's left boundary was connected to the left spermatic cord and vas deferens. Pathological analysis post-surgery showed the absence of testicular tissue, but the presence of skin tissue, cartilage-like structures, and gastrointestinal elements. Additionally, localized tissue resembling vertebrae confirmed the diagnosis of testicular FIF.ConclusionAn intraperitoneal testicular FIF is extremely rare, with its cause still unknown. This groundbreaking report details the diagnosis and management of such a case. Following a FIF diagnosis, prompt surgical removal is crucial, along with regular follow-up using ultrasound and tumor markers.

Background and objective: The current COVID-19 pandemic has become a main health threat worldwide and concerns have been raised regarding the effect of the Covid-19 infection on the wellbeing of pregnant women and their unborn baby. This study aimed to determine the clinical manifestations in addition to maternal and perinatal outcomes in pregnant women with confirmed COVID-19. Methods: A cross sectional study conducted in the Maternity Teaching Hospital and some private obstetric clinics in Erbil city/Kurdistan region, Iraq. The study started from the 1st April 2020 until the end of April of 2021. Seventy-one women who represent all infectedwithCOVID-19 during that period during pregnancy who were 16 years old or more were included in the study. Swabs were taken from nasopharynx by citoswab were diagnosed by quantitative real-time polymerase chain (qRT-PCR) at central laboratory of Erbil city/Iraq. The data were collected through direct interview with the patients using a special questionnaire, prepared for this purpose. Results: More than half (53.5%) of participants were 25-34 years old, 80.3% of women were housewives and 29.6% of them were illiterate. The majority (87.3%) of women did not have chronic illnesses and 43.7% of them were in second trimester during COVID-19 infection. The following symptoms were reported: fever (91.5%), cough (80.3%), headache (77.5%), weakness (73.2%), loss of smell (69%), aguesia (67.6%), sore throat (66.2%), arthralgia and myalgia (64.8%), flu like illness (62%), dyspnea (39.4 %), and diarrhea and/or vomiting (26.8%). The majority (84.51%) of women did notreport any fetal complications or none has happened and 1.4% of the fetuses suffered from fetal distress and FGR. Caesarean section was the commonest mode of delivery. A significant statistical association was found between age group and fetal complications suggesting that fetal complications increased with becoming older. Conclusion: Manifestations such as fever, sore throat, cough, headache, fatigue, loss of smell and taste, arthralgia and myalgia were commonly observed in Covid-19 pregnant patients. Cough was still the highest reported symptom followed by weakness and dyspnea even six months post Covid-19 infection. Adverse maternal and neonatal outcomes were observed in pregnant patients infected with Covid-19.