Relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during the COVID-19 pandemic.

AIM: The study aimed to determine the relationship between supportive care needs with coronavirus anxiety and death anxiety of women with gynecologic cancer during COVID-19. METHODS: The population of the study was women with gynecologic cancer who received chemotherapy in a university hospital. The study sample was calculated using G*Power 3.1.9.4 analysis program and completed with 64 patients who agreed to participate and met the research criteria. The personal information form, supportive care needs survey-short form (SCNS-SF29Tr ), coronavirus anxiety scale (CAS), and death anxiety scale (DAS) were used for data collection. RESULTS: The participants' SCNS-SF29Tr mean score was 105.7 ± 17.26, CAS mean score was 11.19 ± 3.96, and DAS mean score was 40.13 ± 15.5. There was a positive, very high-level correlation between the health system and information and psychological needs subscales of SCNS-SF29Tr and CAS (r = 0.809, r = 0.878, respectively; p < 0.05). In addition, a high-level relationship was found between the daily life subscale of SCNS-SF29Tr and CAS (r = 0.674; p < 0.001). A positive low-level relationship was determined between the health system and information, daily life, and psychological needs (except for the sexuality) subscales of SCNS-SF29Tr and DAS (r = 0.357, r = 0.252, r = 0.353 respectively; p < 0.05). CONCLUSION: Gynecologic cancer participants had unmet supportive care needs in all subscales except for the sexuality. The participants had higher supportive care needs, high-level coronavirus anxiety, and medium-level death anxiety. In addition, the participants' all supportive care needs have increased as their coronavirus anxiety levels have increased. The participants' supportive care needs have increased, except for sexuality, as their death anxiety levels have increased.

Predicting miscarriage using systemic immune-inflammation index.

AIM: To evaluate the clinical significance of the systemic immune-inflammation index (SII) for patients who had miscarriages. MATERIALS: The retrospective study included 709 pregnant women who had a miscarriage (nonviable intrauterine pregnancy up to 20 weeks of gestation) and 676 women who carried a viable intrauterine pregnancy up to 20 weeks of gestation-serving as the control group. The study and the control group were compared in terms of demographic characteristics, laboratory test results, and SII values. Furthermore, laboratory test results and SII values were compared between patients in the study group and the control group with a history of genital bleeding (threatened abortion). RESULTS: The mean gestational week of pregnancy was 9.5 ± 3 for the control group and 8.3 ± 2.5 for the study group (p = 0.150). The SII values were higher in the study group than in the control group (p = 0.030). In all participants with a clinical history of genital bleeding, the leukocyte count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), and SII values were higher in the miscarriage group than the group with viable fetus (p = 0.031, p = 0.003, p = 0.002, p < 0.001). Based on a receiver operating characteristic (ROC) curve analysis, the SII cutoff value for miscarriage was 883.95 (109 /L) (62.6% sensitivity, 62% specificity) in patients with a clinical history of threatened abortion. CONCLUSION: High SII values in early pregnancy may be used as an additional marker for the prediction of miscarriage, in pregnant women with threatened abortion. Further prediction models including maternal risk factors and multiple markers may be more valuable for clinical practice.

Argininosuccinate lyase in enterocytes protects from development of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC), the most common neonatal gastrointestinal emergency, results in significant mortality and morbidity, yet its pathogenesis remains unclear. Argininosuccinate lyase (ASL) is the only enzyme in mammals that is capable of synthesizing arginine. Arginine has several homeostatic roles in the gut and its deficiency has been associated with NEC. Because enterocytes are the primary sites of arginine synthesis in neonatal mammals, we evaluated the consequences of disruption of arginine synthesis in the enterocytes on the pathogenesis of NEC. We devised a novel approach to study the role of enterocyte-derived ASL in NEC by generating and characterizing a mouse model with enterocyte-specific deletion of Asl (Asl(flox/flox); VillinCre(tg/+), or CKO). We hypothesized that the presence of ASL in a cell-specific manner in the enterocytes is protective in the pathogenesis of NEC. Loss of ASL in enterocytes resulted in an increased incidence of NEC that was associated with a proinflammatory state and increased enterocyte apoptosis. Knockdown of ASL in intestinal epithelial cell lines resulted in decreased migration in response to lipopolysaccharide. Our results show that enterocyte-derived ASL has a protective role in NEC.

Next-generation sequencing for disorders of low and high bone mineral density.

UNLABELLED: To achieve an efficient molecular diagnosis of osteogenesis imperfecta (OI), Ehlers-Danlos syndrome (EDS), and osteopetrosis (OPT), we designed a next-generation sequencing (NGS) platform to sequence 34 genes. We validated this platform on known cases and have successfully identified the causative mutation in most patients without a prior molecular diagnosis. INTRODUCTION: Osteogenesis imperfecta, Ehlers-Danlos syndrome, and osteopetrosis are collectively common inherited skeletal diseases. Evaluation of subjects with these conditions often includes molecular testing which has important counseling and therapeutic and sometimes legal implications. Since several different genes have been implicated in these conditions, Sanger sequencing of each gene can be a prohibitively expensive and time-consuming way to reach a molecular diagnosis. METHODS: In order to circumvent these problems, we have designed and tested a NGS platform that would allow simultaneous sequencing on a single diagnostic platform of different genes implicated in OI, OPT, EDS, and other inherited conditions, leading to low or high bone mineral density. We used a liquid-phase probe library that captures 602 exons (~100 kb) of 34 selected genes and have applied it to test clinical samples from patients with bone disorders. RESULTS: NGS of the captured exons by Illumina HiSeq 2000 resulted in an average coverage of over 900X. The platform was successfully validated by identifying mutations in six patients with known mutations. Moreover, in four patients with OI or OPT without a prior molecular diagnosis, the assay was able to detect the causative mutations. CONCLUSIONS: In conclusion, our NGS panel provides a fast and accurate method to arrive at a molecular diagnosis in most patients with inherited high or low bone mineral density disorders.

Femoral hernias in children at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

OBJECTIVE: To ascertain the diagnostic accuracy and outcome of surgical treatment in Nigerian children referred for paediatric surgical opinion at the Olabisi Onabanjo University Teaching Hospital, Sagamu, South-west Nigeria. DESIGN: A retrospective review of our practice experience over a 15-year period; between January, 1989 and December, 2003. SETTING: The Olabisi Onabanjo University Teaching Hospital (OOUTH), serves as a referral centre for other government and private hospitals in and around the Ogun State, South-west Nigeria. The OOUTH, though a tertiary medical centre also receives patients who present directly at the General Out-Patient Clinics and the Emergency Units of the hospital. The catchment population is estimated at 7.5 million. SUBJECTS: The medical records of all patients under 14 years of age with a final diagnosis of femoral hernia who presented between January, 1989 and December, 2003 were reviewed. METHODS: The age, sex, mode of presentation, findings at surgery, procedure performed, immediate post-operative and 12 months follow-up details were recorded. RESULTS: Seven of 1,213 (0.58%) patients with groin hernias within the study period had femoral hernias; four (57%) were girls and three (43%) were boys. Age range was 3 to 9 years. The mode of presentation in all the children was recurrent lump in the groin. Five patients (71%) had right sided lump while the lump was on the left side in two of the patients. The duration of symptoms ranged from two years to eight years. The provisional diagnosis by the referring general practitioners and paediatricians were incorrect in all seven patients. Five patients (71 %) were correctly diagnosed preoperatively by the attending surgeon while two were thought to be inguinal hernias. CONCLUSION: The diagnosis of femoral hernia remains a challenging problem in childhood because of its rarity and similar clinical presentation as inguinal hernia.

Clinical characteristics and outcome of management of Fournier's gangrene at the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.

BACKGROUND: Fournier's gangrene (FG) though a rare condition can be associated with significant mortality. There are few reports in our environment documenting the outcome of management of the condition. The aim of the following study was to describe the clinical characteristics and outcome of management of patients with FG in a tertiary hospital in Southwest Nigeria. PATIENTS AND METHODS: The clinical records of patients who presented with FG at a tertriary hospital over a 5 year period were reviewed. RESULTS: A total of 11 cases were reviewed and all patients were male. The scrotum alone was the most common site of involvement (54.5%). Late presentation was common with 9.6 days (range 1-21 days) being the average duration between the onset of symptoms and presentation at the hospital. Most of the patients (63.6%) did not have any identifiable systemic predisposing factor. There was no mortality or testicular loss recorded. CONCLUSION: Patients with FG still present late in our environment. However, appropriate aggressive treatment can help ameliorate the associated mortality and morbidity even in a resource poor setting.

Cephalhematoma causing severe anemia in the newborn: report of 2 cases.

This report describes two newborns with massive Cephalhematoma leading to marked blood loss and severe anemia. The hematocrits were 19% and 13% respectively. The babies were managed with blood transfusion, phototherapy, antibiotics and dexamethasone.