Onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus

Objective. To analyze the onco-epidemiological features of head and neck tumors within the competence of the otorhinolaryngological service across the regions of the Republic of Belarus.Materials and methods. The material for the study was data on 21,533 cases of malignant neoplasms of the head and neck (including laryngeal tumors) registered in the Belarusian Cancer Registry from 2009 to 2018.Results. Significant changes have occurred in the structure of the incidence of head and neck malignant neoplasms over the past decade. The leading positions are occupied by such tumors of visual localization as cancer of the oropharynx (14.9 %), the floor of the oral cavity (12.4 %), tonsils (11.4 %) and tongue (excluding the root of the tongue) (11.4 %), which are available for diagnosis during routine clinical examination.Conclusion. The analysis of newly diagnosed cases of malignant neoplasms depending on the localization has showed that regardless of the availability of otorhinolaryngologists and staffing levels, patients with primary manifestations of the tumor process are not timely referred to the health experts for morphological verification, which requires further organizational decisions on patient referral at different levels of health care and defining the role and scope of responsibility of subject-matter primary care specialists.

Ultrasound Is Not Useful in Monitoring Lipedematous Alopecia: A Clinical, Trichoscopic, Histologic, and Ultrasound Analysis of 2 Cases

<b><i>Introduction:</i></b> Lipedematous scalp (LS) is a rare condition characterized by thickened adipose tissue in the subcutaneous layer of the scalp resulting in a soft, spongy, or thick consistency of the scalp. When associated with hair loss, this condition is called lipedematous alopecia (LA). Various imaging modalities have been used to diagnose LS and LA along with histopathology. <b><i>Case Presentation:</i></b> We present 2 cases of LS: a 56-year-old female with a 1-year history of hair thinning, pain, and tenderness at the vertex scalp and a 60-year-old female with a 5-year history of lichen planopilaris presenting with a 1-year history of itching and soreness on the crown of her head. Ultrasound (US) was used for diagnosis, treatment response surveillance, routine clinical examination, and symptom assessment. Follow-up US revealed no improvement in scalp thickness in either case despite symptom improvement and visual improvement in hair growth. <b><i>Discussion/Conclusion:</i></b> US has been reported as a helpful tool in the diagnosis of LS; however, treatment response was better approximated by hair growth and symptom alleviation. We found that once the diagnosis with made with US, clinical monitoring is adequate as symptom improvement and hair growth may not correlate with a change in scalp thickness.

Developing Fine-Grained Actigraphies for Rheumatoid Arthritis Patients from a Single Accelerometer Using Machine Learning

In addition to routine clinical examination, unobtrusive and physical monitoring of Rheumatoid Arthritis (RA) patients provides an important source of information to enable understanding the impact of the disease on quality of life. Besides an increase in sedentary behaviour, pain in RA can negatively impact simple physical activities such as getting out of bed and standing up from a chair. The objective of this work is to develop a method that can generate fine-grained actigraphies to capture the impact of the disease on the daily activities of patients. A processing methodology is presented to automatically tag activity accelerometer data from a cohort of moderate-to-severe RA patients. A study of procesing methods based on machine learning and deep learning is provided. Thirty subjects, 10 RA patients and 20 healthy control subjects, were recruited in the study. A single tri-axial accelerometer was attached to the position of the fifth lumbar vertebra (L5) of each subject with a tag prediction granularity of 3 s. The proposed method is capable of handling unbalanced datasets from tagged data while accounting for long-duration activities such as sitting and lying, as well as short transitions such as sit-to-stand or lying-to-sit. The methodology also includes a novel mechanism for automatically applying a threshold to predictions by their confidence levels, in addition to a logical filter to correct for infeasible sequences of activities. Performance tests showed that the method was able to achieve around 95% accuracy and 81% F-score. The produced actigraphies can be helpful to generate objective RA disease-specific markers of patient mobility in-between clinical site visits.

The association between erosive tooth wear and diet, hygiene habits and health awareness in adolescents aged 15 in Poland

Purpose The aim of the study was to assess the prevalence of erosive tooth wear (ETW) and risk indicators in the population of adolescents aged 15 in Poland. Methods Erosive tooth wear in 2639 participants was determined by calibrated examiners according to the BEWE scoring system, and the prevalence of risk factors was assessed on the basis of a survey. Results Erosive tooth wear was reported in 24.3% of participants. Initial loss of surface (BEWE 1) was the predominant finding, observed in 21.3% of participants. Hard tissue loss (BEWE 2 and 3) occurred very rarely, only in 3% of participants. Acidic diet, masculine gender and lower socio-economic status were associated with higher prevalence and severity of erosive lesions in the examined population. Conclusion Two modifiable factors—acidic diet and low health awareness—were found to be highly unsatisfactory in the adolescents aged 15 in Poland. Accordingly, to prevent the deterioration of the functionality and aesthetics of the teeth in young people, certain measures, such as routine clinical examination, education, dietary consulting and prophylaxis, should be implemented as early as possible, focusing predominantly on families with lower socio-economic status.

Histopathological Study of Placenta in COVID-19 Positive Mothers in a Tertiary Care Hospital, South Kerala

BACKGROUND The coronavirus disease 2019 (Covid-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), is a global public health emergency. Data on the effect of coronavirus disease 2019 in pregnancy is limited to few case series. The purpose of this study was to describe the histopathological findings in the placentas of women with Covid-19 during pregnancy. METHODS Pregnant women with Covid-19 who delivered between August 1, 2020 and May 10, 2021, at Government Medical College, Trivandrum were considered for the study. Handling of specimens were carried out using Indian council of medical research (ICMR) guidelines for Covid-19 specimens. Placentas underwent routine clinical examination and processing. Clinical information was retrieved from the medical records. Histological examination was performed and features classified into maternal vascular malperfusion (MVM) and fetal vascular malperfusion (FVM). RESULTS 50 placentas from patients with severe acute respiratory syndrome coronavirus 2 were examined [33 patients delivered at term, 12 patients were preterm, 4 cases were intrauterine fetal demise and 1 case was medical termination of pregnancy (MTP)]. Patients with risk factors for maternal and fetal vascular malperfusion were excluded. 8 cases showed features of maternal vascular malperfusion and 11 cases showed features of fetal vascular malperfusion. Among intra uterine fetal death (IUFD) cases, 2 cases showed features of vascular malperfusion, 7 cases showed low grade acute inflammatory pathology which needs further studies with a greater number of cases to establish relationship with Covid-19 virus. CONCLUSIONS Covid-19 placentas showed increased rates of maternal and fetal vascular malperfusion. These changes may reflect a hypercoagulable state influencing placental pathology and hence an increased antenatal surveillance for women diagnosed with SARS–CoV-2 infection may be warranted. Further studies with control groups are necessary to determine the reproducibility and significance of these initial findings. KEYWORDS Covid-19, Pregnancy, Maternal Vascular Malperfusion, Fetal Vascular Malperfusion.

Dermatomal Somatosensory Evoked Potentials And Cortical Somatosensory Evoked Potentials Assessment In Congenital Scoliosis

Background: The aim of this study was to assess the value of dermatomal somatosensory evoked potentials (DSEPs) and cortical somatosensory evoked potentials (SSEPs) in monitoring spinal cord function for patients with congenital scoliosis (CS). Methods: This study retrospectively analyzed the neurophysiological signals recorded in 62 patients from our orthopedic department who underwent MRI, CT and a specialist physical examination by a surgeon to confirm the diagnosis of CS. To observe the incidence of abnormal DSEPs and SSEPs in CS patients and to analyze the difference in sensitivity and reliability between the two in the examination of scoliosis patients. Results: All patients were evaluated with total spine magnetic resonance imaging (MRI). Only 23 patients (37.09%) showed intradural lesions in the MRI findings. Abnormal waveforms were observed in the DSEPs of 60 patients (96.8%) , 25 of which (40.3%) had abnormal waveforms in the tibial SSEPs, and the difference was statistically significant (P＜0.05). Of the 10 patients with clinical symptoms, 2 (20%) had abnormal tibial SSEPs waveforms , and 23 (44.2%) of 52 patients without clinical symptoms had abnormal tibial SSEPs waveforms. DSEPs are more sensitive to microscopic posterior column dysfunction in patients with CS that cannot be detected by either imaging or routine clinical examination. Conclusion: DSEPs provide evidence for the type of neurophysiological dysfunction in patients with congenital scoliosis. Preoperative DSEPs assessment is recommended as a baseline examination for intraoperative monitoring and comparison with the postoperative situation. DSEPs recording complements the information obtained from routine clinical and radiological evaluation.

Cognitive Functions Assessment in Psoriasis Patients: A cross sectional study in University Hospital

Background: Psoriasis is not merely an inflammatory skin disease but is commonly associated with systemic inflammation causing medical and psychiatric comorbidities. Methods: One hundred psoriasis patients and 80 age and sex-matched controls were recruited, dermatological and psychiatric assessments were done, psoriasis severity was assessed using the psoriasis area and severity index (PASI) score. Montreal Cognitive Assessment-Basic (MoCA-B) evaluated the different cognitive domains and screened for any possible MCI. Results: Cognitive functions were significantly worse in patients than in the healthy controls for the total score of MOCA-B (p <0.001), abstraction (p <0.001), delayed recall (p <0.001), visuospatial abilities (p= 0.013), naming (p=0.029) and attention (p <0.001). MCI was detected by the Arabic version of MoCA-B with a cut-off score of 21/22, and it was more in the psoriasis group (16 %) than in the controls (4%). No correlations were observed between disease characteristics (Psoriasis duration in months, PASI, BSA %) and the MoCA scores in psoriasis patients. Conclusion: Psoriasis patients showed worse cognitive impairment when compared to the controls regardless of the psoriasis severity. Thus, the routine clinical examination of psoriasis patients should include administering a brief cognitive screening tool to reach the best management.

Diagnostic prediction models of stratifying chronic heart failure patients based on the underlying disease

Aim. To develop classification criteria for stratifying congestive heart failure (CHF) patients based on the underlying disease.Methods. 61 patients with CHF were recruited in a study. All patients were assigned to three groups according to the underlying disease: patients with coronary artery disease (CAD) (n = 29), patients with arterial hypertension (AH) (n = 19), and those present with dilated cardiomyopathy (DCM) (n = 13). Patients underwent routine clinical examination. Biochemical and inflammatory markers (IL-6, its soluble receptor sIL-6R, and sgp130) were measured in all patients. The Mann-Whitney U test, the Kruskal-Wallis H test, the Pearson χ2 test, and Fischer exact test were used to analyze the selected variables. Discriminant analysis was used for generating prediction models. The quality of the models was evaluated with the ROC analysis.Results. Statistically significant variables identified by the pairwise comparison of patients with CAD and AH, CAD and DCM, AH and DCM were included in the discriminant analysis along with clinically valid parameters. Clinical prediction models of stratifying patients to different etiological groups were based on these parameters. The optimal cut-off values were determined for each model. The area under the ROC curve (AUC) was used to evaluate the quality of the model. The AUC value for CAD and AH groups was 1, for AH and DCM - 72±0.024, and for CAD and DCM - 0.907±0.053.Conclusion. Diagnostic prediction models were developed using the discriminant analysis. These models allow stratifying CHF patients according to the underlying disease (CAD, AH, and DCM). The ROC curves have confirmed the good classifying quality of the models.

Imaging Method for Osteosarcoma Diagnosis and Clinical Staging Information Optimization

In order to better assist clinicians in the diagnosis and treatment of osteosarcoma, and our understanding of the advantages and disadvantages of different examination techniques of DR, CT and MRI, this article collects the pathological diagnosis of the PACS Medical system of Liaocheng People’s Hospital 2015 to 2018. 130 patients with osteosarcoma and imaging examination data, retrospectively analyzed the diagnostic and clinical staging information contained in DR, CT and MRI examination data of osteosarcoma patients, and detected the diagnosis and clinical staging information of osteosarcoma by comparing various examination methods ability to obtain the optimal imaging examination method that can provide complete diagnosis and clinical staging information of osteosarcoma, and is recommended as a routine clinical examination program. Finally, we conclude that: DR, CT, and MRI examinations have no significant differences in the detection capacity of osteosarcoma bone destruction, periosteal response, and periosteal triangle; MRI has less ability to detect tumor bone than DR and CT; DR has soft tissue. The ability to detect masses is inferior to CT and MRI. Among the single DR, CT or MRI examinations, CT examinations have the best comprehensive detection ability for all imaging diagnostic signs of osteosarcoma. MR examination has the best comprehensive display of clinical staging information such as infiltration range and infiltration boundary of osteosarcoma. Combined DR, CT, and MRI examinations are optimized imaging procedures that provide complete osteosarcoma diagnosis and clinical staging information.