Reports

10 pages, 414 KiB

Open AccessArticle

Association between Thyroid Profile Levels and Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Retrospective Study

by Yu-Shan Hsieh, Ting-Teng Yang, Chung-Huei Hsu and Yan-Yu Lin

Reports 2024, 7(3), 78; https://doi.org/10.3390/reports7030078 - 16 Sep 2024

Abstract

Background: Thyroid cancer is the most common endocrine carcinoma, accounting for 3.26% of all cancers. The most histologically, well-differentiated thyroid cancer is papillary thyroid carcinoma (PTC). Although PTC is regarded as an indolent tumor, a portion of the cancer cells metastasize to lymph [...] Read more.

Background: Thyroid cancer is the most common endocrine carcinoma, accounting for 3.26% of all cancers. The most histologically, well-differentiated thyroid cancer is papillary thyroid carcinoma (PTC). Although PTC is regarded as an indolent tumor, a portion of the cancer cells metastasize to lymph nodes around the thyroid gland. Lymph node metastasis (LNM) is a critical risk factor for tumor recurrence in PTC, which strongly affects disease prognosis and the quality of life. Methods: This study aims to examine how differences in the level of the thyroid profile and other risk factors may influence LNM incidence in patients with PTC in Taiwan. We carried out a single-center retrospective study. These PTC patients were retrospectively reviewed by the Department of Endocrinology from 2016 to 2019. A total of 165 patients were included in our research. Results: The findings revealed a close relationship with the level of free thyroxine (FT4), the level of the thyroid-stimulating hormone (TSH), and lymph node metastases. The correlation in terms of FT4 (p = 0.005) and TSH (p = 0.417) with LNM was found as a result of the univariate regression analysis. In the multiple regression analysis, the findings revealed a close relationship between LNM, FT4 (p < 0.001), and TSH (p = 0.008). Conclusions: Although the predictability of the TSH should be examined further, the association between LNM and FT4 or TSH should not be ignored. The results could help guide decision-making and patient counseling, using the level of serum FT4 or the TSH as a possible predictive factor of the LNM in PTC. Full article

(This article belongs to the Section Endocrinology/Metabolism)

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12 pages, 1258 KiB

Open AccessArticle

Cancer Stem Cell Marker CD147 Expression in Erosive Oral Lichen Planus Compared to Moderately and Severely Dysplastic Leukoplakia

by Vasileios Zisis, Nikolaos Nikitas Giannakopoulos, Athanasios Poulopoulos, Marc Schmitter and Dimitrios Andreadis

Reports 2024, 7(3), 77; https://doi.org/10.3390/reports7030077 - 15 Sep 2024

Abstract

Oral lichen planus is a frequent, chronic autoimmune disease that affects the oral mucosa and is characterized as an oral potentially malignant disorder. The aim of our study is to examine the presence of CSCs bearing CD147 (a marker related to local inflammation [...] Read more.

Oral lichen planus is a frequent, chronic autoimmune disease that affects the oral mucosa and is characterized as an oral potentially malignant disorder. The aim of our study is to examine the presence of CSCs bearing CD147 (a marker related to local inflammation and associated with various cancers) through immunohistochemistry in oral lichen planus (OLP) compared to oral leukoplakia (OL) and healthy tissues. These findings could contribute to clinical practice by providing a marker for the prognostic assessment of OLP lesions with regards to their potentially malignant nature. The study sample consisted of paraffin-embedded oral mucosa specimens from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece during the period 2009–2019. The study sample contained 24 cases of OLP (14 erosive and 10 reticular) and 30 cases of oral leukoplakia, which were compared to 5 normal oral epithelium samples derived from healthy epithelium adjacent to fibromas from other cases. Cell membrane staining of CD147 was observed mostly in the basal and parabasal cell layer. The statistically significantly higher expression of CD147 in the erosive lichen planus subgroup than in the moderately and severely dysplastic leukoplakia subgroup (p = 0.01) constituted the most important finding of this study. The characteristic expression of CD147 in erosive OLP suggests the presence of epithelial cells with CSC characteristics, but its lower expression in oral leukoplakias suggests a more intense relation of the CD147 marker with inflammation rather than with oral dysplastic progression. Full article

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9 pages, 574 KiB

Open AccessArticle

Prevalence of Cardiotoxicity Secondary to Trastuzumab in Patients with HER-2-Positive Breast Cancer in Southeast Mexico

by Luz I. Pascual-Mathey, Midory I. Velez-Figueroa, Joel J. Díaz-Vallejo, Gustavo Mendez-Hirata and Gustavo F. Mendez-Machado

Reports 2024, 7(3), 76; https://doi.org/10.3390/reports7030076 - 14 Sep 2024

Abstract

In Mexico, breast cancer (BC) is the principal cause of death in women over 30 years old, with an annual mortality rate of 14.61 deaths per a 100,000 population. Chemotherapy, in combination with trastuzumab (TTZ), improves the survival of cancer patients; however, cardiotoxicity [...] Read more.

In Mexico, breast cancer (BC) is the principal cause of death in women over 30 years old, with an annual mortality rate of 14.61 deaths per a 100,000 population. Chemotherapy, in combination with trastuzumab (TTZ), improves the survival of cancer patients; however, cardiotoxicity (CT) is the principal consequence. CT prevalence occurs between 10% and 30% of patients; however, there are no data about the prevalence of CT in the Mexican population. This study aims to establish the prevalence of CT in patients treated with anti-HER-2 therapy among BC women in southeast Mexico. A retrospective cross-sectional study was carried out from January 2015 to July 2019. The records of 46 patients diagnosed with HER-2-positive BC who attended the Mexican Social Security Institute in the Ambulatory Care Medicine Unit were analyzed. The diagnostic criterion for CT was a decrease in LVEF > 10% from baseline or a final LVEF < 53%. CT prevalence was observed in 19 (41.3%) of women with cancer, with an average decrease in LVEF of 13%. In the population, we found an association between weight, surface area, and the loading dose of TTZ with CT. Nutritional follow-up and the administration of cardioprotective drugs are necessary to recover LVEF and avoid cardiovascular failure in women with BC and survivors. Full article

(This article belongs to the Section Oncology)

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7 pages, 1922 KiB

Open AccessCase Report

Three-Layer Reconstruction of a Full-Thickness Nasal Alar Defect after Basal-Cell Carcinoma Removal

by Kostadin Gigov, Ivan Ginev, Ivaylo Minev and Petra Kavradzhieva

Reports 2024, 7(3), 75; https://doi.org/10.3390/reports7030075 - 9 Sep 2024

Abstract

Restoring the integrity of the external nose presents a complex surgical challenge due to its three-dimensional structure and subunit divisions. The most frequent causes of nasal defects include basal or squamous cell carcinoma, animal bites and trauma. The reconstruction approach varies depending on [...] Read more.

Restoring the integrity of the external nose presents a complex surgical challenge due to its three-dimensional structure and subunit divisions. The most frequent causes of nasal defects include basal or squamous cell carcinoma, animal bites and trauma. The reconstruction approach varies depending on factors such as the defect’s size, the affected subunit of the nose, the condition and quality of the surrounding tissues and the surgeon’s expertise. Commonly employed surgical techniques for nasal reconstruction include the forehead flap, nasolabial flap, Rieger flap, bilobed flap, and free autologous skin graft. We present a clinical case of a patient with a full-thickness nasal alar defect who underwent three-layer reconstruction with a combination of an inverted skin flap- for the internal lining, a conchal graft to substitute the missing alar cartilage and a forehead flap for external coverage. One of the challenges of nasal reconstruction surgery is to restore a full-thickness defect, especially the internal nasal lining. We offer a different perspective on this problem, showcasing considerable advantages, as there are limited literature data on this method. Full article

(This article belongs to the Section Surgery)

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15 pages, 1361 KiB

Open AccessArticle

The Relationship between Proinflammatory Molecules and PD-L1 in Patients with Obesity Who Underwent Gastric Sleeve Surgery—A Pilot Study

by Ciprian Cucoreanu, Ximena Maria Muresan, Adrian-Bogdan Tigu, Madalina Nistor, Radu-Cristian Moldovan, Ioana-Ecaterina Pralea, Maria Iacobescu, Cristina-Adela Iuga, Catalin Constantinescu, George-Calin Dindelegan and Constatin Ciuce

Reports 2024, 7(3), 74; https://doi.org/10.3390/reports7030074 - 3 Sep 2024

Abstract

In the last few decades, obesity played a pivotal role by having a high impact on global economic and health systems due to its associated diseases, with cardiovascular, respiratory, musculoskeletal, oncological, mental, and social implications. One of the most incriminated physiopathological mechanisms in [...] Read more.

In the last few decades, obesity played a pivotal role by having a high impact on global economic and health systems due to its associated diseases, with cardiovascular, respiratory, musculoskeletal, oncological, mental, and social implications. One of the most incriminated physiopathological mechanisms in obesity is chronic inflammation. The primary goal of this pilot study was to determine the molecular aspects of inflammation among patients with obesity compared to participants with a normal BMI (≤25 kg/m²), as well as within a smaller subset of obese individuals who have been evaluated three months following sleeve gastrectomy. The research employs conventional blood tests and plasma measurements of particular molecules, such as proinflammatory cytokines and proteins that play critical roles in immune and inflammatory regulation. The results revealed a promising kinetic effect after bariatric surgery on IL-18, MCP-1, and PD-L1 molecules. The proinflammatory makers IL-18 (p = 0.006) and MCP-1 (p = 0.035) were elevated in the obese group compared to the control, while the follow-up group displayed lower levels of these molecules. Commonly investigated in oncology related studies, PD-L1 was recently linked to adipose tissue gain and its associated inflammatory effect. Until now, there is no clinical evidence for the relationship between circulating PD-L1 and proinflammatory markers derived from low-grade inflammation of the adipose tissue. The circulating PD-L1 levels were significantly lowered in the obese group compared to the control (p = 0.049), and after sleeve gastrectomy, the PD-L1 level increased. The present study is the first investigating this type of crosstalk and its potential involvement in bariatric patient management. Full article

(This article belongs to the Section Endocrinology/Metabolism)

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8 pages, 6002 KiB

Open AccessCase Report

Wandering Spleen Complicated by Thrombocytopenia, Acute Appendicitis, and Sepsis: A Case Report and Literature Review

by Sri Inggriani, Callistus Bruce Henfry Sulay and Gilbert Sterling Octavius

Reports 2024, 7(3), 73; https://doi.org/10.3390/reports7030073 - 2 Sep 2024

Abstract

Wandering spleen (WS) is a rare condition often linked with torsion or infarction, but its association with Bochdalek hernia, acute appendicitis, and thrombocytopenia is exceptionally rare. We present a case of a nine-year-old girl who was admitted with acute abdominal pain, later diagnosed [...] Read more.

Wandering spleen (WS) is a rare condition often linked with torsion or infarction, but its association with Bochdalek hernia, acute appendicitis, and thrombocytopenia is exceptionally rare. We present a case of a nine-year-old girl who was admitted with acute abdominal pain, later diagnosed with WS, Bochdalek hernia, and acute appendicitis. A literature search was performed on PubMed and Google Scholar on 30 May 2024 with keywords including “Wandering spleen” and (“Bochdalek Hernia” OR “Sepsis” OR “Acute Appendicitis” OR “Thrombocytopenia”). The management was complicated by severe thrombocytopenia and post-operative sepsis, with Klebsiella pneumoniae as the causative agent. Imaging revealed an abnormally located spleen and significant splenic enlargement over time. The patient’s condition was managed non-operatively concerning the WS, avoiding splenectomy due to the risks of post-splenectomy sepsis. Instead, laparotomy was performed to address the appendicitis and diaphragmatic hernia. The patient experienced post-operative complications, including a seizure and persistent fever, which resolved with appropriate antibiotic therapy. This case underscores the complexity of managing WS with concurrent severe conditions, highlighting the importance of individualised treatment strategies. It also emphasises the need for further studies to explore optimal treatment modalities for such rare and complex presentations. This case serves as an educational example in clinical settings, demonstrating the challenges and considerations when treating multiple rare pathologies simultaneously. Full article

(This article belongs to the Section Surgery)

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7 pages, 2020 KiB

Open AccessCase Report

Life-Threatening Hypokalemic Paralysis and Prevention of Severe Rebound Hyperkalemia in a Female with Barium Poisoning: A Rare Case Report

by Ting-Wei Liao, Ruei-Lin Wang, Szu-Chi Chen, Ya-Chieh Chang, Wen-Fang Chiang and Po-Jen Hsiao

Reports 2024, 7(3), 72; https://doi.org/10.3390/reports7030072 - 28 Aug 2024

Abstract

Hypokalemic paralysis is a clinical syndrome characterized by acute flaccid paralysis with concomitant hypokalemia. Complications, such as acute respiratory failure and cardiac arrhythmias, can be fatal. If treated appropriately, the patient can recover without any sequelae. We present a rare case of life-threatening [...] Read more.

Hypokalemic paralysis is a clinical syndrome characterized by acute flaccid paralysis with concomitant hypokalemia. Complications, such as acute respiratory failure and cardiac arrhythmias, can be fatal. If treated appropriately, the patient can recover without any sequelae. We present a rare case of life-threatening hypokalemic paralysis following the ingestion of an unknown substance. At presentation, her serum potassium concentration was 1.9 mmol/L. A review of the patient’s history confirmed the ingestion of barium chloride. She was diagnosed with acute barium poisoning characterized by high serum and urine barium levels. Aggressive potassium repletion was administered intravenously and orally. Her serum potassium concentration dropped to 1.5 mmol/L and peaked at 5.4 mmol/L following treatment. The patient achieved a complete recovery and was discharged without sequelae. Barium can competitively block the potassium inward rectifier channels and interfere with the efflux of intracellular potassium, leading to severe hypokalemia. Our report illustrates a rare presentation of acute barium intoxication and a differential diagnosis indicating hypokalemic paralysis. We also discuss the pathophysiological features and compare the clinical findings with cases of rebound hyperkalemia. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

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12 pages, 2138 KiB

Open AccessArticle

Assessing the Methylation Status of Two Potential Key Factors Involved in Cervical Oncogenesis

by Alina Fudulu, Marinela Bostan, Iulia Virginia Iancu, Adriana Pleșa, Adrian Albulescu, Irina Liviana Stoian, Demetra Gabriela Socolov, Gabriela Anton and Anca Botezatu

Reports 2024, 7(3), 71; https://doi.org/10.3390/reports7030071 - 18 Aug 2024

Abstract

(1) Background: Cervical cancer, caused mainly by high-risk Human Papillomavirus (hrHPV), is a significant global health issue. While a Pap smear remains a reliable method for early detection, identifying new biomarkers to stratify the risk is crucial. For this purpose, extensive research has [...] Read more.

(1) Background: Cervical cancer, caused mainly by high-risk Human Papillomavirus (hrHPV), is a significant global health issue. While a Pap smear remains a reliable method for early detection, identifying new biomarkers to stratify the risk is crucial. For this purpose, extensive research has been conducted on detecting DNA methylation. (2) Methods: This cross-sectional study aimed to assess the expression levels of EIF4G3 and SF3B1 in precursor lesions and cervical tumor tissues through qRT-PCR and evaluate the methylation status of their promoters through bisulfite conversion. (3) Results: Both genes showed similar mRNA expression patterns, with the highest levels observed in squamous cell carcinoma (SCC) samples (p < 0.0001). Additionally, methylation analysis indicated increased percentages in the control group for both factors. Notably, the expression levels of both genes were inversely correlated with promoter methylation (EIF4G3—p = 0.0016; SF3B1—p < 0.0001). (4) Conclusions: Regarding the methylation pattern for both genes, we observe a decreasing trend from NILM to SCC patients. Therefore, we concluded that the decrease in methylation at the promoter level for both genes could be an indicator of abnormal cytology. Full article

(This article belongs to the Topic Cancer Stem Cells, DNA Methylation and DNA Sequences: Their Diagnostic and Therapeutical Applications)

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7 pages, 2290 KiB

Open AccessCase Report

Is Minimal Change Disease Associated with Prostate Cancer or Is Age Just a Number?

by Patrícia Kleinová, Matej Vnučák, Karol Graňák, Monika Beliančinová, Tímea Blichová and Ivana Dedinská

Reports 2024, 7(3), 70; https://doi.org/10.3390/reports7030070 - 13 Aug 2024

Abstract

Background: Prostate cancer is the most common malignancy in men. Secondary nephrotic syndrome, a feature of paraneoplastic syndrome, occurs in 11% of cases and is mainly caused by membranous glomerulopathy. The association between minimal change disease and prostate cancer is rare. Only one [...] Read more.

Background: Prostate cancer is the most common malignancy in men. Secondary nephrotic syndrome, a feature of paraneoplastic syndrome, occurs in 11% of cases and is mainly caused by membranous glomerulopathy. The association between minimal change disease and prostate cancer is rare. Only one cause has been described in the available literature. Case presentation: We present the case of a 77-year-old patient who was admitted to our department with stage 3 acute kidney injury and with nephrotic syndrome with anasarca (creatinine: 168 µmol/L, eGFR: 33 mL/min/1.73 m², albumin: 18.5 g/L, total cholesterol: 6.86 mmol/L, urine albumin creatinine ratio: 812.7 mg/mmol). In the differential diagnosis of nephrotic syndrome, looking for a secondary cause is essential, so the parainfectious causes of nephrotic syndrome were excluded. An elevated prostate-specific antigen (10.69 ng/L) was found when screening for oncological causes, and prostate adenocarcinoma was identified on biopsy. A renal biopsy was then performed with a finding of minimal change disease. Despite the generally accepted guidelines of prostate carcinoma in that stage and age of the patient being watchful waiting, antiandrogen therapy was started with the cooperation of a urologist. There was a significant improvement in renal parameters in the patient (creatinine: 87 µmol/L, eGFR: 73 mL/min/1.73 m², albumin: 33.4 g/L, urine albumin creatinine ratio: 27.6 mg/mmol). Conclusion: This case shows the importance of multidisciplinary cooperation in the treatment of secondary causes of nephrotic syndrome. In the case of proven paraneoplastic syndrome, it is necessary to start treating the malignancy; however, in general, a conservative approach without treatment is recommended. Full article

(This article belongs to the Section Nephrology/Urology)

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9 pages, 9789 KiB

Open AccessCase Report

CPR-Induced Life-Threatening Hemothorax in a Rescue PCI Patient: Case Report and Brief Challenges of Regional Centers

by Vaikunthan Thanabalasingam, Clement Tan, Chaminda Sella Kapu, Mark Daniel Higgins and Zhihua Zhang

Reports 2024, 7(3), 69; https://doi.org/10.3390/reports7030069 - 12 Aug 2024

Abstract

Background: Cardiopulmonary resuscitation (CPR) is performed in cardiac arrests. There exist life support guidelines for individuals in performing effective CPR. CPR-related bleeding and hemothoraces are rare. Intercostal artery rupture leading up to shock and respiratory compromise in such situations is rare. Here, we [...] Read more.

Background: Cardiopulmonary resuscitation (CPR) is performed in cardiac arrests. There exist life support guidelines for individuals in performing effective CPR. CPR-related bleeding and hemothoraces are rare. Intercostal artery rupture leading up to shock and respiratory compromise in such situations is rare. Here, we present a unique case with a management dilemma while discussing challenges and guidance to regional centers. Case presentation: A 49-year-old Caucasian male experienced an out-of-hospital cardiac arrest which required bystander cardiopulmonary resuscitation from a colleague prior to commencement of lysis protocol at the local hospital. Transfer was later arranged to the nearest cardiac catheterization laboratory where a rescue percutaneous coronary intervention was performed in the left anterior descending artery that required strict dual antiplatelet use. Beneath the shroud of these events was a life-threatening right-sided hemothorax from rupture of intercostal arteries that occurred during initial resuscitation. Astute recognition of this post-percutaneous coronary intervention resulted in eventual transfer of the patient to a tertiary center where the source and the collection of the bleed was addressed. The patient’s took a great trajectory to improvement. Conclusions: A regional center poses many challenges and limitations. Massive bleeding from intercostal arteries leading to hemorrhagic shock and respiratory compromise from an expanding hemothorax post-CPR is rare. Post-percutaneous coronary intervention use of dual antiplatelets posed a management dilemma that prompted assistance from tertiary counterparts. Clinicians should be astute and quick in assessing and providing care. Full article

(This article belongs to the Section Cardiology/Cardiovascular Medicine)

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11 pages, 4542 KiB

Open AccessCase Report

Severe Bushmaster Snakebite Envenoming: Case Report and Overview

by Allan Quadros Garcês-Filho, Humberto H. M. Santos, Thays K. P. P. Aguiar, Dafnin L. S. Ramos, Luis E. B. Galan, Domingos S. M. Dantas, Felipe A. Cerni, Roberto C. Carbonell and Manuela B. Pucca

Reports 2024, 7(3), 68; https://doi.org/10.3390/reports7030068 - 7 Aug 2024

Abstract

Unlike the well-documented bothropic and crotalid snakebites in Brazil, lachetic envenomings (i.e., triggered by the bushmaster snake) are rare and present significant diagnostic challenges. This case describes a severe envenoming induced by a Lachesis muta snake in a 26-year-old Brazilian man who was [...] Read more.

Unlike the well-documented bothropic and crotalid snakebites in Brazil, lachetic envenomings (i.e., triggered by the bushmaster snake) are rare and present significant diagnostic challenges. This case describes a severe envenoming induced by a Lachesis muta snake in a 26-year-old Brazilian man who was bitten near a forest in November 2022. Characteristic symptoms such as sweating and bradycardia pointed towards lachetic envenoming, but initial misdiagnosis as a bothropic bite resulted in a delay in appropriate antivenom therapy. Despite later receiving the correct treatment, the severity of the envenoming necessitated the amputation of a finger and triggered a severe infection. This report highlights the challenges of diagnosing and treating Lachesis spp. bites due to their rarity. Moreover, an overview of lachetic-induced signs and symptoms was explored. This study emphasizes that further reports are warranted to improve understanding of Lachesis muta envenoming and to optimize treatment strategies. Full article

(This article belongs to the Special Issue Venomous Encounters: Reports on Diagnoses, Management, Therapy, and Outcomes of Venomous Animal-Induced Envenomations)

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13 pages, 259 KiB

Open AccessArticle

Psychological and Psychiatric Characteristics of People with Keratoconus

by Szymon Florek, Piotr Gościniewicz, Magdalena Suszka, Ewa Mrukwa-Kominek and Robert Pudlo

Reports 2024, 7(3), 67; https://doi.org/10.3390/reports7030067 - 3 Aug 2024

Abstract

Background and Objectives: There are many reports in the literature on the co-occurrence of somatic diseases and psychiatric disorders. Relatively few have addressed the co-occurrence of corneal cone with anxiety, depression, or personality disorders. Materials and Methods: 99 patients with keratoconus [...] Read more.

Background and Objectives: There are many reports in the literature on the co-occurrence of somatic diseases and psychiatric disorders. Relatively few have addressed the co-occurrence of corneal cone with anxiety, depression, or personality disorders. Materials and Methods: 99 patients with keratoconus (study group) and 92 patients without keratoconus (control group) participated in the entire study, which was conducted in 2015 and 2020–2023. The Hamilton Depression Rating Scale (HDRS) and Beck’s Depression Inventory (BDI) were used to assess depressive symptoms, the State-Trait Anxiety Inventory (STAI) to assess anxiety symptoms, and the DSM-IV Personality Disorder Inventory (IBZO-DSM-IV) to identify personality disorders. Results: In the study group, the severity of depressive and anxiety symptoms correlated with all types of personality disorders. In the control group, these symptoms did not correlate with antisocial and narcissistic personalities. In the comparative analysis, there were more patients with antisocial, schizotypal, obsessive compulsive, schizoid, paranoid, and dependent personality traits in the study group. Conclusions: Patients with keratoconus have increased expressions of antisocial personality traits, but no differences in anxiety and depression symptoms were evident. Further research is needed among patients diagnosed with keratoconus in the short term. Full article

(This article belongs to the Section Mental Health)

15 pages, 1650 KiB

Open AccessArticle

Plasma CXCL4–DNA/RNA Complexes and Anti-CXCL4 Antibodies Modulation in an SSc Cohort under Iloprost Treatment

by Anna Mennella, Katia Stefanantoni, Raffaella Palazzo, Giuseppe Ocone, Immacolata Pietraforte, Simona Truglia, Ilaria Bisconti, Alba Pisacreta, Valeria Riccieri, Roberto Lande and Loredana Frasca

Reports 2024, 7(3), 66; https://doi.org/10.3390/reports7030066 - 2 Aug 2024

Abstract

Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular and immunity alterations and skin/internal organ fibrosis. Aberrant levels of plasma CXCL4, CXCL4–RNA/DNA complexes, type I IFN (IFN-I) and anti-CXCL4 antibodies characterize SSc. These parameters influence each other: CXCL4–self-DNA/RNA complexes are triggers [...] Read more.

Background: Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular and immunity alterations and skin/internal organ fibrosis. Aberrant levels of plasma CXCL4, CXCL4–RNA/DNA complexes, type I IFN (IFN-I) and anti-CXCL4 antibodies characterize SSc. These parameters influence each other: CXCL4–self-DNA/RNA complexes are triggers of IFN-I in plasmacytoid dendritic cells (pDCs), and anti-CXCL4 autoantibodies amplify this effect. Here, we assess the modulation over time of plasma CXCL4 and the related parameters of CXCL4–DNA/RNA complexes, anti-CXCL4 antibodies, IFN-α and TNF-α in an SSc cohort under the synthetic analogue of prostacyclin PGI2 (iloprost) treatment to address contribution of these parameters to pathogenesis and their role as biomarkers. Methods: We analyzed immunological parameters at baseline (T0) and after 3 (T3) and 6 (T6) months in 30 SSc patients. Responders were the patients that lowered their disease activity parameters after six months of treatment. Results: Anti-CXCL4 autoantibodies correlated with both IFN-α and TNF-α levels in SSc plasma. Responders significantly down-regulated serum IFN-α. In seven patients with a shorter disease duration, improvement coincides with a decrease in plasma IFN-α, CXCL4 and TNF-α. Iloprost efficiently blocks pDCs IFN-α production induced by CXCL4–DNA/RNA complexes in vitro. Conclusions: The data suggest a possible role of iloprost as a disease-modifying drug, mainly accompanied by down-regulation of plasma IFN-I levels. Since CXCL4, IFN-I and TNF-α down-modulation was evident and significant in improving SSc patients with a shorter disease duration, these results warrant future investigations on the early use of iloprost to slow SSc progression. Full article

(This article belongs to the Section Allergy/Immunology)

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6 pages, 580 KiB

Open AccessCase Report

Social Isolation as a Precipitating Factor for Charles Bonnet Syndrome in a Patient with Mild Visual Deterioration

by Shriya Prakash Bhat, Abeezar Shipchandler and Chris Tokunaga

Reports 2024, 7(3), 65; https://doi.org/10.3390/reports7030065 - 2 Aug 2024

Abstract

Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in individuals with acute vision loss, typically affecting older adults. Most CBS cases are observed in patients with sudden severe visual impairment; however, there are limited reports of CBS occurring in individuals with [...] Read more.

Charles Bonnet Syndrome (CBS) is characterized by complex visual hallucinations in individuals with acute vision loss, typically affecting older adults. Most CBS cases are observed in patients with sudden severe visual impairment; however, there are limited reports of CBS occurring in individuals with mild visual deterioration, particularly when confounded by sensory deprivation and social isolation. Here, we report a case of CBS in a female in her early 80s, who experienced vivid visual hallucinations during a period of prolonged social isolation following a hip surgery. Although symptomatology initially presented as delirium and psychosis, the diagnosis of CBS was confirmed after a neuropsychiatric evaluation and ophthalmologic exam, which showed mild deterioration in the patient’s macular degeneration, combined with a social history of reduced independence and increased isolation. The case highlights the lesser-known role of sudden lifestyle changes and reduced cognitive engagement in CBS development in cases of mild visual impairment. It also suggests that cognitive and social stimulation may play a crucial role in CBS management, which has limited reports in the current literature. Full article

(This article belongs to the Section Mental Health)

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11 pages, 1381 KiB

Open AccessArticle

Is It Necessary to Add the Feedback Insufflation Time in Manikins? A Simulation Pilot Study

by Luis Castro-Alonso, Eloy Carracedo-Rodríguez, Martín Otero-Agra, Sheila Vázquez-Álvarez, Roberto Barcala-Furelos and María Fernández-Méndez

Reports 2024, 7(3), 64; https://doi.org/10.3390/reports7030064 - 1 Aug 2024

Abstract

(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample [...] Read more.

(1) Objective: This study aimed to assess the evolution of the quality of ventilations of a group of rescuers after two training sessions by taking into account inspiration times. (2) Materials and Methods: A pilot simulation study was carried out with a sample of 10 lifeguard students. Two training sessions were held three weeks apart, in which CPR skills were trained by means of feedback tools. Participants performed three tests in pairs on a ResusciAnne QCPR^® manikin connected to SkillReporter QCPR software, namely one pre-training test and one test after each training session. CPR was performed in pairs for two minutes and began with five rescue breaths. (3) Results: One training session was enough to improve chest compression quality (T0: 48%; IQR 17–77/T1: 83%; IQR 59–88; p = 0.022/T2: 79%; IQR 64–92; p = 0.002). The quality of the ventilations increased progressively in each training session without reaching high-quality results (T0: 0%; IQR 0–0/T2: 15%; IQR 8–27; p = 0.011). (4) Conclusion: A two-session training program focused on inspiratory times achieved significant improvements in the quality of bag-mask ventilations performed by lifeguard students. Training focused on the insufflation time of ventilations and not only on the volume seems to be an important factor in improving the quality of ventilations. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

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6 pages, 2340 KiB

Open AccessCase Report

Multimodal Management of a Descending Aorta Injury with Penetrating Chest Trauma: A Case Report

by Giuseppe Sena, Paolo Perri, Paolo Piro, Francesco Zinno, Daniela Mazzuca, Davide Costa and Raffaele Serra

Reports 2024, 7(3), 63; https://doi.org/10.3390/reports7030063 - 1 Aug 2024

Abstract

A penetrating thoracic aorta injury (PTAI) is a life-threatening condition with significant morbidity and mortality, often resulting from several traumatic mechanisms. Among these, gunshot wounds leading to aortic injury are exceedingly rare and pose unique challenges in terms of diagnosis, management, and surgical [...] Read more.

A penetrating thoracic aorta injury (PTAI) is a life-threatening condition with significant morbidity and mortality, often resulting from several traumatic mechanisms. Among these, gunshot wounds leading to aortic injury are exceedingly rare and pose unique challenges in terms of diagnosis, management, and surgical intervention. We present a case of a 47-year-old male victim of a gunshot wound resulting in penetrating chest trauma and a descending thoracic aorta injury. This report outlines the sequential management involving thoracic endovascular aortic repair (TEVAR), followed by surgical intervention for hematoma drainage and foreign body removal, highlighting the interdisciplinary approach required in managing complex cardiothoracic injuries. Full article

(This article belongs to the Section Critical Care/Emergency Medicine/Pulmonary)

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10 pages, 30058 KiB

Open AccessCase Report

Optimization of Collagen Scaffold with Cultured Autologous Chondrocytes for Osteochondritis Dissecans of the Knee: A Case Report

by Nicolas Valladares, Gibran J. Jacobo-Jimenez, Nathaniel Lara-Palazuelos and Maria G. Zavala-Cerna

Reports 2024, 7(3), 62; https://doi.org/10.3390/reports7030062 - 30 Jul 2024

Abstract

The treatment of osteochondritis dissecans of the knee has always been a challenge for orthopedic surgeons. We present a case report of a 38-year-old male with severe right knee pain after suffering from an indirect trauma and axial rotation of the knee, limiting [...] Read more.

The treatment of osteochondritis dissecans of the knee has always been a challenge for orthopedic surgeons. We present a case report of a 38-year-old male with severe right knee pain after suffering from an indirect trauma and axial rotation of the knee, limiting knee functionality and impeding his ability to walk, with a diagnosis of osteochondritis dissecans in the trochlea of the knee, who underwent arthroscopic treatment with matrix-induced autologous chondrocyte implantation (MACI). After the surgery, a physical therapy protocol for MACI was implemented, and magnetic resonance images with cartilage mapping were used to evaluate the recovery of the lesion. A total recovery was observed and evaluated with the modified Cincinnati knee rating system (mCKRS). A discussion is provided with evidence and general recommendations for the use of MACI in the treatment of adult OCD of the knee as a possible alternative to conventional treatments. Our case shows a rapid improvement in pain and functionality 2 months after surgery that progressed to full recovery within 6 months. Full article

(This article belongs to the Special Issue Orthopedic and Trauma Surgery: Clinical Research and Case Reports)

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11 pages, 958 KiB

Open AccessArticle

Association of SARS-CoV-2 Seropositivity with Persistent Immune Activation in HIV/Tuberculosis Co-Infected Patients

by Ashwini Shete, Manisha Ghate, Hiroko Iwasaki-Hozumi, Sandip Patil, Pallavi Shidhaye, Takashi Matsuba, Gaowa Bai, Pratiksha Pharande and Toshio Hattori

Reports 2024, 7(3), 61; https://doi.org/10.3390/reports7030061 - 29 Jul 2024

Abstract

We asked if SARS-CoV-2 seropositivity in HIV/TB co-infected patients plays a role in precipitating active tuberculosis in HIV-infected individuals and alters inflammatory status. A prospective study was conducted on HIV/TB co-infected patients presenting with pulmonary (n = 20) or extrapulmonary (n [...] Read more.

We asked if SARS-CoV-2 seropositivity in HIV/TB co-infected patients plays a role in precipitating active tuberculosis in HIV-infected individuals and alters inflammatory status. A prospective study was conducted on HIV/TB co-infected patients presenting with pulmonary (n = 20) or extrapulmonary (n = 12) tuberculosis. Abbott SARS-CoV-2 IgG kits assessed the presence of anti-nucleoprotein antibodies. Inflammatory markers viz. osteopontin, total and full-length galectin-9, and C-reactive protein were tested at baseline and the end of antituberculosis treatment. The inflammatory score (INS) was assessed based on the percentage of reduction in the inflammatory markers’ levels at the end of the treatment. Anti-SARS-CoV-2 antibodies were detected in five male patients diagnosed with pulmonary (n = 2) and extrapulmonary (n = 3) TB. None of them reported symptomatic COVID-19. Inflammatory marker levels did not differ significantly at baseline compared to those in seronegative patients. However, the INS correlated negatively with SARS-CoV-2 seropositivity (r = −0.386, p = 0.039), indicating persistently raised inflammatory markers in these patients at the end of the treatment compared to seronegative individuals. Among the four markers studied, total galectin-9 levels failed to decrease significantly in these patients (p = 0.030). The majority of HIV/TB co-infected patients enrolled in our study (84.5%) were SARS-CoV-2-seronegative, indicating that SARS-CoV-2 infection might not have played a role in precipitating TB reactivation. Full article

(This article belongs to the Special Issue Acute and Persistent Viral Infection Diseases)

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12 pages, 1819 KiB

Open AccessArticle

Diagnosis of Relapse of Colorectal Adenocarcinoma through CEA Fluctuation

by Zsolt Fekete, Patricia Ignat, Laura Gligor, Nicolae Todor, Alina-Simona Muntean, Alexandra Gherman and Dan Eniu

Reports 2024, 7(3), 60; https://doi.org/10.3390/reports7030060 - 27 Jul 2024

Abstract

Carcinoembryonic antigen(CEA) is a routine marker employed for follow-up of colorectal tumors. We aimed to determine whether a CEA increase within the normal range can be linked to a risk of recurrence. From the period of 2006–2013 we selected 78 consecutive patients with [...] Read more.

Carcinoembryonic antigen(CEA) is a routine marker employed for follow-up of colorectal tumors. We aimed to determine whether a CEA increase within the normal range can be linked to a risk of recurrence. From the period of 2006–2013 we selected 78 consecutive patients with colorectal cancer, who underwent curative surgery with or without neo-/adjuvant chemo- or radiotherapy and had proper follow-up procedures. For analyzing CEA fluctuation, we used the smallest value of the CEA during follow-up as the reference. With the aid of a Chi-squared test, we have chosen the value of 1.1 ng/mL for significant CEA fluctuation. A total of 43.6% of patients had fluctuations in CEA of at least 1.1 ng/mL, with or without increases above 5 ng/mL. From these, in 79.4% of patients, the increases in CEA were explained either by recurrence (44.1%), adjuvant chemotherapy (20.6%) or benign pathology (14.7%). In 23% of the recurrences, a CEA increase of at least 1.1 ng/mL, but below 5 ng/mL, preceded the clinical relapse by a median of 8 months. Our conclusion is that an increase in CEA levels by at least 1.1 ng/mL within the normal range after curative treatment for colorectal cancer may serve as an early indicator of relapse or could be associated with other pathological conditions. Full article

(This article belongs to the Collection Clinical Research in Oncology)

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