First incidence of extrarenal wilms tumor within the spinal canal in the adult population: a novel case report and literature review.

BACKGROUND: Wilms tumor (WT), also known as nephroblastoma, is rare in adults, accounting for merely 3% of all nephroblastomas or 0.2 cases per million individuals. Extrarenal Wilms tumor (ERWT) emerges outside the renal boundaries and comprises 0.5 to 1% of all WT cases, with even rarer incidences in adults. Oncogenic mutations associated with ectopic nephrogenic rests (NR) may contribute to ERWT development. Diagnosis involves surgical resection and pathology examination. Due to scarce cases, adults often rely on pediatric guidelines. We thoroughly searched PubMed, Scopus, and Web of Science databases to establish our case's uniqueness. To the best of our knowledge, this is the first documented incidence of extrarenal Wilms tumor within the spinal canal in the adult population. CASE PRESENTATION: A 22-year-old woman with a history of congenital lipo-myelomeningocele surgery as an infant presented with a 6-month history of back pain. This pain gradually resulted in limb weakness, paraparesis, and loss of bladder and bowel control. An MRI showed a 6 × 5 × 3 cm spinal canal mass at the L4-S1 level. Consequently, a laminectomy was performed at the L4-L5 level to remove the intramedullary tumor. Post-surgery histopathology and immunohistochemistry confirmed the tumor as ERWT with favorable histology without any teratomatous component. CONCLUSION: This report underscores the rarity of extrarenal Wilms tumor (ERWT) in adults, challenging conventional assumptions about its typical age of occurrence. It emphasizes the importance of clinical awareness regarding such uncommon cases. Moreover, the co-occurrence of spinal ERWTs and a history of spinal anomalies warrants further investigation.

Calorie restriction and calorie-restriction mimetics activate chaperone-mediated autophagy.

Chaperone-mediated autophagy (CMA) is part of the mammalian cellular proteostasis network that ensures protein quality control, maintenance of proteome homeostasis, and proteome changes required for the adaptation to stress. Loss of proteostasis is one of the hallmarks of aging. CMA decreases with age in multiple rodent tissues and human cell types. A decrease in lysosomal levels of the lysosome-associated membrane protein type 2A (LAMP2A), the CMA receptor, has been identified as a main reason for declined CMA in aging. Here, we report constitutive activation of CMA with calorie restriction (CR), an intervention that extends healthspan, in old rodent livers and in an in vitro model of CR with cultured fibroblasts. We found that CR-mediated upregulation of CMA is due to improved stability of LAMP2A at the lysosome membrane. We also explore the translational value of our observations using calorie-restriction mimetics (CRMs), pharmacologically active substances that reproduce the biochemical and functional effects of CR. We show that acute treatment of old mice with CRMs also robustly activates CMA in several tissues and that this activation is required for the higher resistance to lipid dietary challenges conferred by treatment with CRMs. We conclude that part of the beneficial effects associated with CR/CRMs could be a consequence of the constitutive activation of CMA mediated by these interventions.

Giant pedunculated hepatic hemangioma accompanied by a 10-year history of taking oral contraceptive: A case report and literature review.

Key Clinical Message: Giant pedunculated hepatic hemangiomas, mostly seen in women, are considered a rare type of giant hepatic hemangioma, with challenging diagnosis. Unlike other types of liver hemangiomas, they can manifest different kinds of symptoms, and are prone to life-threatening manifestations like rupture or torsion. Abstract: Hemangioma is the most common benign liver primary tumor. Hepatic hemangioma >4 cm (some studies suggest >10 cm) is referred to as a giant hemangioma. Although hepatic hemangioma does not manifest symptoms in most cases, a giant hepatic hemangioma can manifest different kinds of symptoms. Giant pedunculated hepatic hemangiomas are considered a rare type of giant hepatic hemangioma, with challenging diagnosis, as the thin pedicle could be hard to be detected on imaging. A 41-year-old woman was admitted to our hospital, with dull discomfort of the right upper quadrant and epigastric region and early satiety for the past 7 months, with the history of taking oral contraceptive (OCP) for 10 years. Ultrasound and computed tomography revealed a 130 × 124 × 76 mm solid mass, with central cystic lesion, located in the midline of the epigastric region, attaching to the inferior surface of the third segment of the left lobe of the liver. Due to the potential risk for torsion, and rupture of the hemangioma, the management of the patient proceeded to surgical excision. Pathological examination of the specimen confirmed the diagnosis of hepatic hemangioma. Giant pedunculated hepatic hemangioma is a rare benign tumor. It demonstrates higher incidence rate in women, as some hemangiomas have estrogen receptors, and estrogen can lead to endothelial cell proliferation and organization in vascular structure. Most hemangiomas do not express any symptoms; therefore, no treatment is needed except for the patients who manifest symptoms, or in giant pedunculated hemangiomas, as they are prone to rupture or torsion. In this review most cases were female, and most of them presented with abdominal pain, in most cases the tumor located in the left lobe of the liver. Almost all the reviewed cases underwent surgery. Giant hepatic hemangioma is a differential diagnosis of palpable mass, or other symptoms of the right upper quadrant, and epigastric region specially in women taking OCP. Imaging is needed to rule out these tumors, and most often, pedunculated hemangioma is harder to be defined on imaging. It requires surgery because of the risk of acute problems, such as torsion and rupture.

Determination of Element Concentration of Brewed Tea Consumed in Iran Using ICP-OES: A Risk Assessment Study.

Tea is a popular drink enjoyed by many people around the world. However, it is important to note that impurities and contaminants in tea can potentially threaten human health when consumed. The main objective of this research is to assess the concentration of 16 trace elements (As, Fe, Al, Co, B, Li, Cd, Ba, Pb, Cr, Zn, Hg, Ni, Mn, Sb, and Sn) present in different types brewed of tea by using the ICP-OES (the inductively coupled plasma optical emission spectrometer) device, and the human health risks related to its use were evaluated. In this study, manganese (Mn) indicated the highest mean concentration in black (917.64 µg/kg) and green tea (912.89 µg/kg), respectively. Our study showed that the highest mean concentration of element boron (B) was (44.36 µg/kg) in Stachys lavandulifolia brewed tea. Among different packaging, tea bag samples had the highest concentration of Mn (1025.65 µg/kg) and aluminum (Al) (396.63 µg/kg). However, those unpacked posed the lowest content of Mn (188.13 µg/kg) and Al (100.47 µg/kg). The lead (Pb), mercury (Hg), and cadmium (Cd) concentrations in all samples were lower than the maximum limit of the Iranian standard and the WHO. In general, the amount of tea metal in Iranian samples was higher than in imported samples. Also, increasing the brewing time (10 min) can be effective in the solubility and extraction of metals such as B, Hg, cobalt (Co), iron (Fe), and lithium (Li). Further, the correlation between the amount of metals and type in tea samples was evaluated with principal component analysis. Based on the conducted non-carcinogenic risk assessment by the Monte Carlo simulation, the hazard index (HI), due to ingestion of heavy metals via tea in the 5-min brewing of tea, was 7.39E - 03 and 2.09E - 03, and in the 10-min brewing of tea, it was 3.20E - 02 and 9.07E - 03 for children and adults, respectively. Therefore, there was no significant non-carcinogenic risk from tea consumption.

Implementation of hazard analysis and critical control point (HACCP) in yogurt production.

This study aimed to review hazard analysis and critical control points (HACCP) in the dairy industry for the production of yogurt. The food safety management system (FSMS) was implemented over the last several decades with several amendments. The need for practical and proactive procedures in the dairy industry was identified so that HACCP implementation could ensure that consumers would always have safe food. The concept of HACCP is a systemic and science-based method that can result in safe dairy products such as yogurt based on the complete analysis of manufacturing processes, recognition of hazards potentially present at all stages of production, and risk prevention. In yogurt production, raw milk receipt, pasteurization, packaging, and storage are the steps most susceptible to contamination and were considered critical control points. Further steps also need to be implemented to achieve other related control measures, and these will be discussed.

Deep Plasma Proteome Profiling by Modulating Single Nanoparticle Protein Corona with Small Molecules.

The protein corona, a dynamic biomolecular layer that forms on nanoparticle (NP) surfaces upon exposure to biological fluids is emerging as a valuable diagnostic tool for improving plasma proteome coverage analyzed by liquid chromatography-mass spectrometry (LC-MS/MS). Here, we show that spiking small molecules, including metabolites, lipids, vitamins, and nutrients, into plasma can induce diverse protein corona patterns on otherwise identical NPs, significantly enhancing the depth of plasma proteome profiling. The protein coronas on polystyrene NPs when exposed to plasma treated with an array of small molecules (n=10) allowed for detection of 1793 proteins marking an 8.25-fold increase in the number of quantified proteins compared to plasma alone (218 proteins) and a 2.63-fold increase relative to the untreated protein corona (681 proteins). Furthermore, we discovered that adding 1000 µg/ml phosphatidylcholine could singularly increase the number of unique proteins within the protein corona (897 proteins). This specific concentration of phosphatidylcholine selectively depleted the four most abundant plasma proteins, including albumin, thus reducing concentration dynamic range of plasma proteome and boosting LC-MS/MS sensitivity for detection of proteins with lower abundance. By employing an optimized data-independent acquisition (DIA) approach, the inclusion of phosphatidylcholine led to the detection of 1436 proteins in plasma. This significant achievement is made utilizing only a single NP type and one small molecule to analyze a single plasma sample, setting a new standard in proteomic depth of the plasma sample. Given the critical role of plasma proteomics in biomarker discovery and disease monitoring, we anticipate widespread adoption of this methodology for identification and clinical translation of proteomic biomarkers into FDA approved diagnostics.

A uniform data processing pipeline enables harmonized nanoparticle protein corona analysis across proteomics core facilities.

Protein corona, a layer of biomolecules primarily comprising proteins, forms dynamically on nanoparticles in biological fluids and is crucial for predicting nanomedicine safety and efficacy. The protein composition of the corona layer is typically analyzed using liquid chromatography-mass spectrometry (LC-MS/MS). Our recent study, involving identical samples analyzed by 17 proteomics facilities, highlighted significant data variability, with only 1.8% of proteins consistently identified across these centers. Here, we implement an aggregated database search unifying parameters such as variable modifications, enzyme specificity, number of allowed missed cleavages and a stringent 1% false discovery rate at the protein and peptide levels. Such uniform search dramatically harmonizes the proteomics data, increasing the reproducibility and the percentage of consistency-identified unique proteins across distinct cores. Specifically, out of the 717 quantified proteins, 253 (35.3%) are shared among the top 5 facilities (and 16.2% among top 11 facilities). Furthermore, we note that reduction and alkylation are important steps in protein corona sample processing and as expected, omitting these steps reduces the number of total quantified peptides by around 20%. These findings underscore the need for standardized procedures in protein corona analysis, which is vital for advancing clinical applications of nanoscale biotechnologies.

Improving performance, reproduction, and immunity in laying Japanese quail with algal derivatives.

We investigated the effect of the Persian Gulf algae derivatives, namely phycocyanin (PC) and fucoidan (FUC), on the performance, reproductive traits, and immune responses of laying Japanese quails. A completely randomized design was used to distribute 250 six-wk-old Japanese quails with an average body weight of 215 ± 10 g into 5 treatments, 5 replicates, and 10 birds in each replicate over a 5-wk period. Unlike the control groups, the treatment groups received drinking water supplemented with PC and FUC at concentrations of 20 or 40 mg/L, denoted as PC20, PC40, FUC20, and FUC40, respectively, while all birds were provided with identical feed. Supplemental algal derivatives notably improved hen day egg production (HDEP), egg mass, and feed conversion ratio (FCR) compared to the control group (P < 0.01). Incorporating PC and FUC had no significant effect on the weight of males' testes or the weight and length of hens' oviducts. Additionally, the experimental treatments had no impact on the chicks' hatching weight. The supplementation of PC and FUC resulted in increased fertility (P = 0.038) and hatchability (P < 0.001) rates, with the exception of fertility in the PC40 group. The effect of the experimental treatments on immune responses was largely not statistically significant, except in the case of ND. Specifically, the experimental treatments resulted in increased (P = 0.033) antibody titers against ND when compared to the control group, with the exception of FUC20. Supplemental algal derivatives significantly (P < 0.01) reduced total cholesterol, creatinine, and triglycerides (except in the case of PC20). Overall, these findings underscore the potential of algal derivatives to enhance quail performance, reproductive traits, and immune responses.

Massive Solubility Changes in Neuronal Proteins upon Simulated Traumatic Brain Injury Reveal the Role of Shockwaves in Irreversible Damage.

We investigated the immediate molecular consequences of traumatic brain injuries (TBIs) using a novel proteomics approach. We simulated TBIs using an innovative laboratory apparatus that employed a 5.1 kg dummy head that held neuronal cells and generated a ≤4000 g-force acceleration upon impact. A Proteome Integral Solubility Alteration (PISA) assay was then employed to monitor protein solubility changes in a system-wide manner. Dynamic impacts led to both a reduction in neuron viability and massive solubility changes in the proteome. The affected proteins mapped not only to the expected pathways, such as those of cell adhesion, collagen, and laminin structures, as well as the response to stress, but also to other dense protein networks, such as immune response, complement, and coagulation cascades. The cellular effects were found to be mainly due to the shockwave rather than the g-force acceleration. Soft materials could reduce the impact's severity only until they were fully compressed. This study shows a way of developing a proteome-based meter for measuring irreversible shockwave-induced cell damage and provides a resource for identifying protein biomarkers of TBIs and potential drug targets for the development of products aimed at primary prevention and intervention.

A large population-based study on the prevalence of electrocardiographic abnormalities: A result of Mashhad stroke and heart atherosclerotic disorder cohort study.

BACKGROUND: Twelve-lead electrocardiogram (ECG) is a common and inexpensive tool for the diagnostic workup of patients with suspected cardiovascular disease, both in clinical and epidemiological settings. The present study was designed to evaluate ECG abnormalities in Mashhad population. METHODS: ECGs were taken as part of MASHAD cohort study (phase1) and were coded according to the Minnesota coding criteria. Data were analyzed using SPSS. RESULTS: Total 9035 ECGs were available for final analysis including 3615 (40.0%) male and 5420 (60.0%) female. Among ECG abnormalities precordial Q wave, major T-wave abnormalities, inferior Q wave, sinus bradycardia, and left axis deviation were the most prevalent abnormalities. The frequency of precordial and inferior Q wave, inferior QS pattern, major and minor ST abnormalities, major and minor T abnormalities, Wolff-Parkinson-White and Brugada pattern, sinus bradycardia, sinus tachycardia, left axis deviation, ST elevation, and tall T wave were significantly different between two genders. Moreover, the frequency of Q wave in precordial and aVL leads, QS pattern in precordial and inferior leads, major and minor T-wave abnormalities, Wolff-Parkinson-White, atrial fibrillation, sinus bradycardia, left axis deviation, and ST elevation were significantly different in different age groups. A comparison of the heart rate, P-wave duration, and QRS duration between men and women indicated that there was a significant difference. CONCLUSIONS: Our finding indicated that the prevalence ECG abnormalities are different between men and women and also it varied in different age groups.

Correction: Jafari et al. Modeling Thermal Developmental Trajectories and Thermal Requirements of the Ladybird Stethorus gilvifrons. Insects 2023, 14, 11.

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Comparative evaluation of fracture resistance and failure modes in endodontically treated molars restored with zirconia endocrown and onlays.

INTRODUCTION: Developments in dental materials, CAD/CAM technologies and adhesive dentistry have improved the application of conservative restorations such as endocrowns and onlays. Among ceramics, zirconia has properties such as high strength, transformation toughening, chemical and structural durability, and biocompatibility, which enable zirconia to be used in the posterior area. AIM: This study is a comparative evaluation of fracture resistance and failure modes in endodontically treated molars restored with zirconia endocrown and onlays. MATERIALS AND METHODS: This study was performed on 20 human mandibular first molars with similar dimensions. After root canal treatment, the samples were divided into two groups: endocrowns and onlays (n=10). Restorations were made using a CAD-CAM milling machine with zirconia CAD blocks and, after cementation, subjected to 10,000 thermocycling and 500,000 fatigue cycle procedures, respectively. Each specimen was placed on a Universal Testing Machine and subjected to axial compressive force applied at a crosshead speed of 0.5 mm/min. The mean loads of failure of each group were statistically compared using the Student t-test. Chi-square tests were used to compare frequencies of failure modes among groups. RESULTS: Fracture resistance showed a statistically significant difference between endocrown (5374.6810±670.03445 N) and onlay (3312.5000±804.01428 N) (p<0.001). No statistically significant difference was detected in the distribution of failure types among the groups (p>0.05). CONCLUSIONS: The fracture resistance of endocrown is substantially higher than that of onlay, and failure type does not differ in both restorations. Zirconia is a reliable material to use in conservative restorations.

Probiotics for glycemic and lipid profile control of the pre-diabetic patients: a randomized, double-blinded, placebo-controlled clinical trial study.

BACKGROUND: Pre-diabetes is a condition in which blood glucose levels are high but not as high as in diabetic patients. However, it can lead to diabetes, making it a serious global health issue. Previous studies have shown that the gut microbiome can affect insulin sensitivity and improve glucose management, which can reduce or delay the progression of pre-diabetes to type 2 diabetes mellitus. This study was designed to investigate the effects of probiotics on glycemic and lipid profile control in pre-diabetic patients. METHODS: This randomized, double-blinded clinical trial was conducted on 70 pre-diabetic patients at the Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran. Participants were divided into two groups, both of which received lifestyle modification training. One of the groups also received 500 mg/day probiotic capsules for three months, while the other group received a placebo. Before and after the three-month period, systolic and diastolic blood pressure, serum insulin level, hemoglobin A1c (HbA1c), fasting blood sugar (FBS), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) were measured and compared using statistical tests to examine the effect of probiotics. RESULTS: A total of 70 individuals participated in the trial, including 50 women (71.4%) and 20 men (28.6%), with an average age of 43.53 ± 8.54 years. At the end of the trial, the mean weight (P < 0.001), FBS (P < 0.001), HbA1c (P = 0.035), TG (P = 0.004), and LDL (P = 0.016) were significantly reduced in the intervention group, while their insulin level (P = 0.041) and HDL (P = 0.001) were significantly increased. However, mean systolic (P = 0.459) and diastolic blood pressure (P = 0.961) and insulin resistance (P = 0.235) did not show any significant difference in the intervention group from the beginning of the study. CONCLUSION: Our study showed that probiotic administration is effective in improving the glucose and lipid profile of pre-diabetic patients. However, it was not significantly different from the placebo.

The effect of periodate oxidation of basil seed gum and its addition on protein binding.

This study attempted to determine the best point of basil seed oxidation by applying response surface methodology (RSM) with 3 factors of temperature (35-45 °C), pH (3-7) as well as time (3-7 h), at 3 levels. The produced dialdehyde basil seed gum (DBSG) was collected and its physicochemical properties were determined. Fitting of quadratic, linear polynomial equations was subsequently done by considering the insignificant lack of fit, as well as highly considerable R2, in order to probe the probable relationship existing between these considered variables as well as the obtained responses. So the considered optimal related test conditions, which included pH = 3, T = 45 °C as well as Time = 3 h, were specified to produce the highest percentage of aldehyde (DBSG32), optimal (DBSG34) and the (DBSG74) samples with the highest viscosity. The results obtained by FTIR and aldehyde content determination provided the indication that dialdehyde groups were formed in a way that was in equilibrium with the considered the hemiacetal form which was dominant. Furthermore, AFM investigation related to the considered DBSG34 sample displayed over-oxidation as well as depolymerization; this might be due to the enhanced hydrophobic qualities, as well as the decreased viscosity. While the DBSG34 sample had the most dialdehyde factor group with a particular tendency for the combination having the proteins' amino group, DBSG32 and DBSG74 samples could be desirable for industrial uses owing to no overoxidation.

Thermal Oviposition Performance of the Ladybird Stethorus gilvifrons Preying on Two-Spotted Spider Mites.

The ladybird, Stethorus gilvifrons (Mulsant) (Coleoptera: Coccinellidae), is an important predator of two-spotted spider mites, Tetranychus urticae Koch (Acari: Tetranychidae), in southeastern Europe and western and southwestern Asia, such as Iran, India, and Turkey. To enhance forecasting the occurrence and performance of this predator in natural control and improve its usage in biological control, we evaluated and compared four non-linear oviposition models, i.e., Enkegaard, Analytis, Bieri-1, and Bieri-2. The models were validated by using data of age-specific fecundity of female S. gilvifrons at six constant temperatures (15, 20, 25, 27, 30, and 34 °C). All four models provided good fit quality to age-dependent oviposition at 15 to 30 °C (R2 0.67 to 0.94; R2adj 0.63 to 0.94) but had a poor fit at 34 °C (R2 0.33 to 0.40; R2adj 0.17 to 0.34). Within temperatures, the best performing models were Bieri-1 (R2), Bieri-2 (R2adj), and Analytis (RSS) at 15 °C, Bieri-1 at 27 °C, and Analytis at 20, 25, and 30 °C. Analytis was the best suited model across the wide temperature range tested (from 15 to 30 °C). The models presented here allow for prediction of the population dynamics of S. gilvifrons in field and greenhouse crops in temperate and subtropical climates.

Ultrasound features of pregnancy-associated breast cancer: A retrospective observational analysis.

Pregnancy-associated breast cancer (PABC) is a poor prognosis in women, and the mortality rate is higher in this subgroup of patients than in non-PABC. This study aims to assess clinicopathological and ultrasound features of patients with PABC. Of 75 patients with breast cancer, 31 cases were in lactating, or pregnancy phase and 44 patients had no recent history of pregnancy/lactation at the time of cancer detection. The available pathological characteristics and ultrasound findings of the PABC and non-PABC groups were compared. The analysis of ultrasound findings demonstrated that the percentages of antiparallel orientation (p = 0.04) and heterogeneous internal echo pattern (p = 0.002) were higher in the PABC group. The final Breast Imaging Reporting and Data System (BI-RADS) assessment in the two groups was significantly different (p = 0.008). In this study, most PABCs were BI-RADS 4c or 5; compared with age-matched non-PABC cases. There were significant differences in ER (p = 0.03), receptor groups (p = 0.007), and tumor grade (p = 0.02) in PABC compared to non-PABC group. To conclude, radiologists should be careful about ultrasound findings of PABC and recommend core needle biopsy in suspected cases.

Laboratory and field efficacy of terpene combinations (carvacrol, thymol and menthol) against the poultry red mite (Dermanyssus gallinae).

In this study, we evaluated the efficacy of combinations of the terpenes carvacrol, thymol, and menthol on Dermanyssus gallinae under in vitro (direct contact and vapour efficacy assays) and in-use conditions. Combinations investigated in vitro included carvacrol-menthol, thymol-menthol, carvacrol-thymol, and carvacrol-thymol-menthol. Results from contact efficacy studies showed that carvacrol-thymol-menthol was the most efficacious compared to the other combinations (P < 0.05), killing 100 % of the mites when at a concentration of 0.5 µg/mL. Thymol-menthol showed the weakest acaricidal activity with an approximate 80 % mortality rate at a concentration of 2 µg/mL. Based on the results of the vapour efficacy assay, all tested combinations appear to exert their acaricidal efficacy not only through direct contact, but also by fumigant action. A subsequent in-field efficacy investigation in a cage system laying farm was carried out to confirm the miticidal activity of the carvacrol-thymol-menthol combination. A formulation based on the triple combination of carvacrol-thymol-menthol diluted 1:40 in water was sprayed, with 1-week interval, in an 8000-laying hen farm, in presence of hens. The number of mites were counted by monitoring traps for 21 days through the study. The number of mites in the treated group decreased until day 5 after the first spray, but increased on days 5 and 7. However, after the second spray on day 7, the number of mites showed a significant decrease on day 10. This terpene-based combination which showed promising in vitro and in field miticidal activity can be a step forward in greening the future of pest management, also producing residue-free eggs.

Is there a relationship between assisted reproductive technology and maternal outcomes? A systematic review of cohort studies.

Background: Pregnancy with assisted reproductive technology (ART) is accompanied by fetal and maternal outcomes. Objective: This systematic review aimed to assess the relationship between ART and maternal outcomes. Materials and Methods: In this systematic review, the electronic databases, including PubMed, MEDLINE, Web of Science, Scopus, Science Direct, Cochrane Library, Google Scholar, Magiran, Irandoc, and Scientific Information Database were searched for maternal outcomes reported from 2010-2021. The Newcastle-Ottawa Scale for cohort studies was used to assess the methodological quality of studies. Results: A total of 3362 studies were identified by searching the databases. After screening abstracts and full-text reviews, 19 studies assessing the singleton pregnancy-related complications of in vitro fertilization/intracytoplasmic sperm injection were included in the study. The results demonstrated that singleton pregnancies conceived through ART had higher risks of pregnancy-related complications and adverse maternal outcomes, such as vaginal bleeding, cesarean section, hypertension induced by pregnancy, pre-eclampsia, placenta previa, and premature membrane rupture than those conceived naturally. Conclusion: In conclusion, an increased risk of adverse obstetric outcomes was observed in singleton pregnancies conceived by ART. Therefore, obstetricians should consider these pregnancies as high-risk cases and should pay special attention to their pregnancy process.

Clinical Manifestations Laboratory Tests Abdominal Ultrasonic Findings and In-hospital Prognosis of COVID-19 in 185 Pediatric Cases in a Tertiary Center.

BACKGROUND: Despite the COVID-19 pandemic, there is little information about the different clinical aspects of COVID-19 in children. In this study, we assessed the clinical manifestations, outcome, ultrasound, and laboratory findings of pediatric COVID-19. METHODS: This retrospective study was conducted on 185 children with definitive diagnosis of COVID-19 between 2021 and 2022. The patients' information was retrieved from hospital records. RESULTS: The average age of the patients was 5.18 ± 4.55 years, and 61.1% were male. The most frequent clinical manifestation was fever (81.1%) followed by cough (31.9%), vomiting (20.0%), and diarrhea (20.0%). Mesenteric lymphadenitis was common on ultrasound and found in 60% of cases. In-hospital death was identified in 3.8% of cases. The mean length of hospital stay was 8.5 days. Mandating intensive care unit (ICU) stay was found in 19.5% and 5.9% of cases were intubated. Acute respiratory distress syndrome (ARDS), lower arterial oxygen saturation, higher white blood cell (WBC) count, and higher C-reactive protein (CRP) were the main determinants of death. Lower age, respiratory distress, early onset of clinical manifestations, lower arterial oxygen saturation, lower serum hemoglobin (Hb) level, and higher CRP level could predict requiring ICU admission. CONCLUSION: We recommend close monitoring on CRP, serum Hb level, WBC count, and arterial level of oxygenation as clinical indicators for potential progression to critical illness and severe disease. Mesenteric lymphadenitis is a common sonographic finding in pediatric COVID-19 which can cause abdominal pain. Ultrasound is helpful to avoid unnecessary surgical interventions in COVID-19.