Efficacy of Combination Therapies for Autoimmune Hepatitis: A Systematic Review and Meta-Analysis.

Autoimmune hepatitis (AIH) is a hepatocellular disorder thought to be caused by an immune system that cannot tolerate autoantigens specific to hepatocytes. This study aims to evaluate the efficacy of using corticosteroids (prednisolone and azathioprine) as a combination therapy in treating AIH. This study aims to synthesize and analyze existing evidence to inform clinical practices concerning the overall clinical efficacy of this treatment approach in managing AIH. A comprehensive search was conducted across multiple online databases and search engines, including PubMed, Google Scholar, ScienceDirect, Medline, and Embase. RevMan 5.4 software was used for meta-analysis, with forest plots created for each outcome. Thirteen studies were included in this systematic review and meta-analysis. The results indicate that the combination of prednisolone and azathioprine for treating AIH leads to less recurrence and better disease control.

A Systematic Review and Meta-Analysis of Endoscopic Surveillance Studies for Detecting Dysplasia in Patients With Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD)is an extremely common gastrointestinal disorder that can give rise to dysplasia and colorectal cancer (CRC). There are various diagnostic methods but endoscopy has proved to be the best in the diagnosis, monitoring, and treatment of IBD. The objective of this review is to evaluate the efficacy of endoscopy in detecting patients with IBD. A structured search strategy on PubMed, Science Direct, and Google Scholar was used, as well as formal inclusion or exclusion, data extraction, validity assessment, and meta-analysis. RevMan 5.4 (Review Manager (RevMan) (Computer program). Version 5.4. The Cochrane Collaboration, 2020) was used for the meta-analysis, and forest plots were generated for each outcome separately. All of these studies are prospective cohorts and 11 of these are randomized controlled trials (RCTs). In IBD, both chromoendoscopy and white light endoscopy are useful in detecting dysplasia and neoplastic lesions. Furthermore, narrow-band imaging is a less time-consuming option for endoscopic surveillance. The meta-analysis also showed that chromoendoscopy is superior to other methods.

Effect of hormonal therapy on 18F-fluciclovine PET/CT in the detection of prostate cancer recurrence, localization of metastatic disease, and correlation with prostate-specific antigen.

INTRODUCTION: 18F-Fluciclovine, is a positron emission tomography (PET) radiotracer approved for the localization of sites of prostate cancer recurrence in men with a rising prostate-specific antigen (PSA) after definitive treatment. To explore the impact of androgen deprivation therapy (ADT) on the performance of 18F-fluciclovine, we conducted a retrospective analysis to compare the 18F-fluciclovine PET/CT positivity rate in patients receiving ADT at the time of the scan with the rate achieved in patients not receiving ADT. METHODS: A retrospective review of data from patients who underwent 18F-fluciclovine PET/CT for biochemical recurrence of prostate cancer between December 2016 to March 2020 was performed. The cohort was divided into an ADT group (patient reportedly on ADT) and a non-ADT group (not currently receiving ADT). Patients with unknown ADT status or undetectable/unknown PSA were excluded. For each group, the number of positive 18F-fluciclovine PET/CT scans (positivity rate) was evaluated for the whole body, prostate/bed, and extraprostatic regions and rates were correlated with PSA. The Fisher's Exact test was applied to establish the significance between the ADT and non-ADT positivity groups. Mantel-Haenszel trend test was performed to assess linearity between the positivity rate and PSA level. RESULTS: In 320 patients, the status of ADT was known. At the time of the 18F-fluciclovine scan, 68/320 (21%) patients were on ADT, while 252/320 (79%) were not. The median Gleason score was 8 (range of 6-10) in the ADT group vs. 7 (range of 6-10) in the non-ADT group (P < 0.001). Overall, positivity rates demonstrated no statistical significance between the ADT and non-ADT groups; Positivity rates (ADT vs. non-ADT) were 82% (56/68) vs. 82% (206/252) for the whole body, 57% (39/68) vs. 60% (152/252) for prostate/bed, and 60% (41/68) vs. 53% (133/252) for extraprostatic regions (P > 0.05). A positive linear correlation was noted between PSA and each group's positivity rate (P < 0.01). However, no significant difference was observed between ADT and non-ADT groups at different PSA levels (P > 0.05). CONCLUSIONS: Detection of prostate cancer recurrence with 18F-fluciclovine PET/CT is not significantly influenced by ADT, suggesting that localization of disease in patients with detectable PSA who are receiving ADT is feasible with 18F-fluciclovine.

Internal Jugular Vein Phlebectasia in a Child: A Case Report.

Neck swellings that appear on straining, crying, and Valsalva maneuver are usually suggestive of laryngocele. Phlebectasia of jugular veins can cause a similar sign but is rare compared to laryngocele. Jugular vein phlebectasia (JVP) is of unknown etiology and is caused by vein dilatation without tortuosity, which is rare in children. It transiently appears during straining as a soft cystic neck mass. Such cases are frequently misdiagnosed or managed inappropriately due to their rarity. We report a case of a four-year-old boy with right internal JVP and right hydrocele.

Maximum power extraction under different vector-control schemes and grid-synchronization strategy of a wind-driven Brushless Doubly-Fed Reluctance Generator.

This paper proposes an advanced strategy to synchronize the wind-driven Brushless Doubly-Fed Reluctance Generator (BDFRG) to the grid-side terminals. The proposed strategy depends mainly upon determining the electrical angle of the grid voltage, θv and using the same transformation matrix of both the power winding and grid sides to ensure that the generated power-winding voltage has the same phase-sequence of the grid-side voltage. On the other hand, the paper proposes a vector-control (power-winding flux orientation) technique for maximum wind-power extraction under two schemes summarized as; unity power-factor operation and minimum converter-current. Moreover, a soft-starting method is suggested to avoid the employed converter over-current. The first control scheme is achieved by adjusting the command power-winding reactive power at zero for a unity power-factor operation. However, the second scheme depends on setting the command d-axis control-winding current at zero to maximize the ratio of the generator electromagnetic-torque per the converter current. This enables the system to get a certain command torque under minimum converter current. A sample of the obtained simulation and experimental results is presented to check the effectiveness of the proposed control strategies.