Map-Like Magnetic Resonance Imaging Changes in HIV-Positive Patient with Multiple Osteonecrosis: A Case Report.

Background: Osteonecrosis is a common complication, particularly in HIV-infected patients undergoing long-term glucocorticoid therapy. This case report aims to highlight the unique "map-like" magnetic resonance imaging (MRI) changes observed in an HIV-positive patient with multiple osteonecrosis due to glucocorticoid overdose, emphasizing the importance of recognizing and managing this complication in this high-risk population. Case Presentation: A 29-year-old HIV-positive male patient developed extensive multi-joint osteonecrosis involving 7 joint sites (right shoulder, bilateral hips, bilateral knees, and bilateral ankles) after 6 months of high-dose glucocorticoid treatment for an opportunistic pneumonia associated with his HIV status. The patient required prolonged glucocorticoid therapy to manage the severe lung infection. MRI revealed characteristic "map-like" changes, with the osteonecrotic areas distributed in a linear, clustered, or map-like pattern. To alleviate his condition and improve joint function, the patient underwent a customized treatment plan, including total hip replacement for the left hip, core decompression surgery for the right hip. Following surgical intervention, the patient experienced reduced joint pain and improved joint mobility. Conclusion: This case underscores the potential risk of extensive multi-joint osteonecrosis in HIV-positive patients receiving long-term high-dose glucocorticoids, with the "map-like" MRI changes being a distinctive imaging feature. It emphasizes the importance of close monitoring and timely implementation of effective interventions in this high-risk population. Notably, core decompression surgery can improve local blood circulation, slow disease progression, and serve as an effective minimally invasive treatment option for early-stage osteonecrotic lesions.

Multisite Pain and Intensity were Associated with History Fall among Older Adults: A Cross-Sectional Study.

Purpose: This study examined the independent associations among multisite pain, pain intensity, and the risk of falls, including a history of falls in the previous 12 months and frequent falls (≥ two falls vs one or two falls) among community-dwelling older adults. Methods: A cross-sectional design from Wave 2 of the National Social Life, Health, and Aging Project was used. Data on pain intensity and location (45 sites) over the past 4 weeks were collected. Multisite pain was categorized into four groups: none, one, two, and three or more sites. The main outcomes of falls were a history of falls and frequent falls. The covariates included age, sex, race, body mass index, education, medications, and comorbidities. Results: Among 3,196 participants in Wave 2, 2,697 were included because of missing key variables related to pain and fall history. The prevalence of falls and frequent falls were 30.3% (n = 817) and 12.6% (n = 339), respectively. Multisite pain at ≥ three sites (odds ratio (OR) 2.04, confidence interval (CI) [1.62, 2.57]; p < 0.001) and two sites (OR 1.72, 95% CI [1.30, 2.27]; p < 0.001) was significantly associated with an increased risk of falls. An increase in pain intensity was significantly associated with an increased risk of fall (OR 1.28, 95% CI [1.15, 1.44], p < 0.001), independent of multisite pain. Multisite pain at ≥3 sites (OR 2.19, 95% CI [1.56, 3.07], p < 0.001) and 2 sites (OR 1.54, 95% CI [1.01, 2.34], p = 0.045) was associated with an increased risk of frequent falls. An increase in pain intensity was associated with risk of frequent falls (OR 1.64, 95% CI [1.40, 1.91], p < 0.001), independent of multisite pain. Conclusion: Multisite pain and pain intensity were associated with a history of falls and frequent falls among older adults, emphasizing the need for routine pain evaluation to develop fall prevention strategies in this population.

Multi-region calcium imaging in freely behaving mice with ultra-compact head-mounted fluorescence microscopes.

To investigate the circuit-level neural mechanisms of behavior, simultaneous imaging of neuronal activity in multiple cortical and subcortical regions is highly desired. Miniature head-mounted microscopes offer the capability of calcium imaging in freely behaving animals. However, implanting multiple microscopes on a mouse brain remains challenging due to space constraints and the cumbersome weight of the equipment. Here, we present TINIscope, a Tightly Integrated Neuronal Imaging microscope optimized for electronic and opto-mechanical design. With its compact and lightweight design of 0.43 g, TINIscope enables unprecedented simultaneous imaging of behavior-relevant activity in up to four brain regions in mice. Proof-of-concept experiments with TINIscope recorded over 1000 neurons in four hippocampal subregions and revealed concurrent activity patterns spanning across these regions. Moreover, we explored potential multi-modal experimental designs by integrating additional modules for optogenetics, electrical stimulation or local field potential recordings. Overall, TINIscope represents a timely and indispensable tool for studying the brain-wide interregional coordination that underlies unrestrained behaviors.

Intron-Dependent or Independent Pseudouridylation of Precursor tRNA Containing Atypical Introns in Cyanidioschyzon merolae.

Eukaryotic precursor tRNAs (pre-tRNAs) often have an intron between positions 37 and 38 of the anticodon loop. However, atypical introns are found in some eukaryotes and archaea. In an early-diverged red alga Cyanidioschyzon merolae, the tRNAIle(UAU) gene contains three intron coding regions, located in the D-, anticodon, and T-arms. In this study, we focused on the relationship between the intron removal and formation of pseudouridine (Ψ), one of the most universally modified nucleosides. It had been reported that yeast Pus1 is a multiple-site-specific enzyme that synthesizes Ψ34 and Ψ36 in tRNAIle(UAU) in an intron-dependent manner. Unexpectedly, our biochemical experiments showed that the C. merolae ortholog of Pus1 pseudouridylated an intronless tRNAIle(UAU) and that the modification position was determined to be 55 which is the target of Pus4 but not Pus1 in yeast. Furthermore, unlike yeast Pus1, cmPus1 mediates Ψ modification at positions 34, 36, and/or 55 only in some specific intron-containing pre-tRNAIle(UAU) variants. cmPus4 was confirmed to be a single-site-specific enzyme that only converts U55 to Ψ, in a similar manner to yeast Pus4. cmPus4 did not catalyze the pseudouridine formation in pre-tRNAs containing an intron in the T-arm.

An Unusual Presentation of Extramedullary Relapse Following Blinatumomab in Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia.

In adult patients, extramedullary relapse (EMR) in B-acute lymphoblastic leukemia (B-ALL) has a pejorative prognosis, especially after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Blinatumomab, a bispecific CD3/CD19 antibody, is approved for relapsed/refractory acute lymphoblastic leukemia (ALL) and has proven its efficacy with good complete response (CR) rates and molecular responses in several trials. Unusual sites of relapse following treatment with blinatumomab for ALL are rarely reported. We describe the case of a 23-year-old male with B-ALL characterized as Philadelphia chromosome-positive without extramedullary lesions at diagnosis. He benefited from a matched-related donor allo-HSCT at first remission. A relapse in the bone marrow and central nervous system was diagnosed four months later. A treatment with blinatumomab was initiated with the obtention of CR after one cycle. During the third cycle of blinatumomab, multiple sites of EMR occurred initially with a painless swelling appearing in the areolas and the nipples, followed by bilateral testicular hypertrophy and moderate paraplegia. A diagnosis of leukemic infiltration on the areola-nipple complex was made by cytological analysis of the fine-needle aspiration of the left areola. The analysis of bone marrow was normal, but molecular BCR-ABL was positive. Systemic chemotherapy with hyper-CVAD (cyclophosphamide, vincristine, doxorubicin, and dexamethasone) and cycles of blinatumomab with nilotinib was initiated in association with intrathecal chemotherapy and whole-brain radiation therapy. Clinical, molecular, and central nervous remissions were obtained. We report this case to describe multiple sites of EMR of B-ALL with atypical breast infiltration in an adult male patient following treatment with blinatumomab.

Multi-site infection by methicillin-resistant Staphylococcus aureus in a six-year old girl: a case report.

BACKGROUND: Community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen that leads to severe outcomes, especially in pediatric patients with multiple sites infection. CASE PRESENTATION: We report a case of multiple sites and life-threatening infection caused by CA-MRSA in a 6-year-old girl who manifested sepsis, myelitis, purulent arthritis, purulent meningitis, hydropericardium, pneumonia, and empyema. The girl exhibited good response to the combination therapy of linezolid and rifampicin after treatment failure of vancomycin with maximum dose due to its serum concentration unable to reach therapeutic goal. We performed pleural effusion and hydropericardium effusion drainage and treated left lower limb infection using interdisciplinary approaches. CONCLUSION: This case highlights the need to be aware of CA-MRSA infection, which requires accurate diagnosis, identification of infected sites, appropriate antibiotic treatment, and surgical debridement.

[An investigation of musculoskeletal disorders at multiple sites and related influencing factors among workers in an automobile assembly shop].

Objective: To investigate the current status of work-related musculoskeletal disorders (WMSDs) in automobile assembly workers, as well as the distribution of WMSDs at multiple sites and related influencing factors. Methods: From March to July 2019, cluster sampling was performed to select 663 male automobile assembly workers as respondents, and the musculoskeletal injury questionnaire was used to investigate their general status and working condition. A multinomial logistic regression analysis was used to analyze the influencing factors for WMSDs at multiple sites. Results: The detection rate of WMSDs within the past 7 days was 37.9% (251/663) among the automobile assembly workers, and the detection rate of WMSDs within the past 1 year was 51.9% (344/663) . Of all workers, 13.6% (90/663) had WMSDs involving only 1 site, while 38.3% (254/663) had WMSDs involving 2 or more sites. The multinomial logistic regression analysis showed that frequent turns during work was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites (odds ratio [OR]=1.65, 2.47, and 3.65, respectively) . Repeated action of lower extremities and ankles was a risk factor for WMSDs involving 4-6 and 7-9 sites (OR=2.15 and 2.98, respectively) . Working in an uncomfortable position was a risk factor for WMSDs involving 1-3, 4-6, and 7-9 sites (OR=1.95, 2.67, and 3.04, respectively) . Prolonged standing during work was a risk factor for WMSDs involving 1-3 and 4-6 sites (OR= 1.87 and 1.79, respectively) . Working overtime was a risk factor for WMSDs involving 7-9 sites (OR=5.48) . Adequate time for rest was a protective factor against WMSDs involving 1-3 and 4-6 sites (OR=0.50 and 0.31, respectively) . Conclusion: There is a high detection rate of WMSDs in automobile assembly workers, and WMSDs at multiple sites are more common than WMSDs at a single site. Poor position and organizational management factors are risk factors for occupational WMSDs at multiple sites.

Partial-Single-Atom, Partial-Nanoparticle Composites Enhance Water Dissociation for Hydrogen Evolution.

The development of an efficient electrocatalyst toward the hydrogen evolution reaction (HER) is of significant importance in transforming renewable electricity to pure and clean hydrogen by water splitting. However, the construction of an active electrocatalyst with multiple sites that can promote the dissociation of water molecules still remains a great challenge. Herein, a partial-single-atom, partial-nanoparticle composite consisting of nanosized ruthenium (Ru) nanoparticles (NPs) and individual Ru atoms as an energy-efficient HER catalyst in alkaline medium is reported. The formation of this unique composite mainly results from the dispersion of Ru NPs to small-size NPs and single atoms (SAs) on the Fe/N codoped carbon (Fe-N-C) substrate due to the thermodynamic stability. The optimal catalyst exhibits an outstanding HER activity with an ultralow overpotential (9 mV) at 10 mA cm-2 (η 10), a high turnover frequency (8.9 H2 s-1 at 50 mV overpotential), and nearly 100% Faraday efficiency, outperforming the state-of-the-art commercial Pt/C and other reported HER electrocatalysts in alkaline condition. Both experimental and theoretical calculations reveal that the coexistence of Ru NPs and SAs can improve the hydride coupling and water dissociation kinetics, thus synergistically enhancing alkaline hydrogen evolution performance.

Sources, variability and parameterizations of intra-city factors obtained from dispersion-normalized multi-time resolution factor analyses of PM2.5 in an urban environment.

Ambient fine particulate matter (PM2.5) data of similar continuously monitored species at two air monitoring sites with different characteristics within the City of Toronto were used to gauge the intra-city variations in the PM composition over a largely concurrent period spanning two years. One location was <8 m from the side of a major highway while the other was an urban background location. For the first time, multi-time resolution factor analysis was applied to dispersion-normalized concentrations to identify and quantify source contributions while reducing the influence of local meteorology. These factors were particulate sulphate (pSO4), particulate nitrate (pNO3), secondary organic aerosols (SOA), crustal matter (CrM) that were common to both sites, a hydrocarbon-like organic matter (HOM) exclusive to the urban background site, three black carbon related factors (BC, BC-HOM at the highway site, and a brown carbon rich factor (BC-BrC) at the urban background site), biomass burning organic matter (BBOM) and brake dust (BD) factors exclusive to the highway site. The PM2.5 composition was different between these two locations, over only a 10 km distance. The sum of SOA, pSO4 and pNO3 at the urban background site averaged 57% of the PM2.5 mass while the same species represented 43% of the average PM2.5 mass at the highway site. Local or site-specific factors may be of greater interest for control policy design. Thus, regression analyses with potential explanatory, site-specific variables were performed for results from the highway site. Three model approaches were explored: multiple linear regression (MLR), regression with a generalized reduced gradient (GRG) algorithm, and a generalized additive model (GAM). GAM gave the largest fraction of variance for the locally-found factors at the highway site. Heavy-duty vehicles were most important for explaining the black carbon (BC and BC-HOM) factors. Light-duty vehicles were dominant for the brake dust (BD) factor. The auxiliary modelling for the local factors showed that the traffic-related factors likely originated along the main roadways at their respective sites while the more regional factors, - pSO4, pNO3, SOA, - had sources that were both regional and local in origin and with contributions that varied seasonally. These results will be useful in understanding ambient particulate matter sources on a city scale that will support air quality management planning.

Correlation analysis of earthquake impacts on a nuclear power plant cluster in Fujian province, China.

The construction of nuclear power plants in China has proceeded rapidly in recent years, and a nuclear power plant cluster is present in the coastal area of Fujian Province. Considering the lessons of the Fukushima Daiichi nuclear power plant accident, we applied the Monte Carlo approach to calculate the correlation characteristics of earthquake impacts on the nuclear power plant cluster and to assess the seismic hazards at multiple sites. Based on the seismic source zone model, seismicity model and ground-motion prediction model of the Seismic Ground Motion Parameters Zonation Map of China, many earthquake scenarios were sampled, and the possibility of multiple sites experiencing ground motions that exceed critical values at the same time were obtained. The results show that the correlation between nuclear power plants Fuqing (C) and Putian (D) is the largest and that they have a slight probability of exceeding their respective design criteria at the same time. The correlation of earthquake impacts on nuclear power plants Ningde (A) and Xiapu (B) is also high, but the probability that they simultaneously exceed their respective design criteria is very low. This study can provide a reference for the site selection of nuclear power plants.

Likelihood Ratio Test Method for Multiple Medical Devices Comparison Using Multiple-Site Data with Continuous Outcomes.

BACKGROUND: With a record number of medical devices approved or cleared, it is important to understand the performance of devices once they are on the market. Using data from multiple medical devices and multiple sites, the problem of interest in this article is to detect if a device is a signal; that is, if a device performs significantly different from other devices of the same class, when the outcome of interest is a continuous variable. METHODS: We develop a normal likelihood ratio test (LRT) method, henceforth referred to as normal-LRT, by incorporating sample size information into the methodological framework, to detect device signals using multi-site and multi-device data. RESULTS: It is shown via extensive simulation that the proposed method controls the type-I error and false discovery rate (FDR), while having good power and sensitivity. This method is applied to a hypothetical case study, in which 6 medical devices of the same class are compared. DISCUSSION: The normal-LRT method can be considered as a tool for device signal detection using data from multi-site and multi-device when the outcome of interest is a continuous measurement.

Women's multisite microbial modulation during pregnancy.

The composition of female microbiome varies with age, physiological and socio-behavior conditions. Also, changes in microbiome composition are observed as pregnancy progresses, especially in the vaginal site. Together with the physiological adaptations of gestation, changes in microbiome composition seem to be fundamental for proper fetal development. This study aimed at simultaneously evaluating the vaginal, gut, and oral microbiome of healthy pregnant women, and comparing it with those observed in healthy non-pregnant women of reproductive age. In a cross-sectional study, vaginal, oral and gut samples were collected from 42 pregnant and 18 non-pregnant women, and the microbiome composition was evaluated by 16S rRNA sequencing, using Illumina platform. In the pregnant group, we observed a positive correlation between Eubacterium and Akkermansia in the gut samples; between Eubacterium and Ruminococcus in the vaginal samples; and between Streptococcus and Gemella in the oral samples. Notwithstanding, we observed a negative correlation between Lactobacillus and Atopobium and between Lactobacillus and Gardnerella in vaginal microbiome. Prevotella was the only genus found in all three sites studied; however, there was no signal of bacterial influence between sites during pregnancy. These results suggest that in addition to hormonal and immunological variations during healthy pregnancy, the female body also undergoes microbiome modulation in multiple sites in order to maintain an eubiotic status.

Cross-sectional area reference values for sonography of nerves in the upper extremities.

INTRODUCTION: Detailed morphological features of the peripheral nerves could improve the diagnostic sensitivity in some polyneuropathies. In this study we aimed to establish multiple-site, cross-sectional area (CSA) reference values for peripheral nerves of upper extremities in a healthy Chinese population. METHODS: One hundred eleven healthy subjects, 15 to 70 years of age, were prospectively recruited. CSA at predetermined sites of the median, ulnar, radial nerves, and brachial plexus was measured bilaterally. Ten consecutive sites were studied along the median/ulnar nerves. RESULTS: The CSA at ten sites of the median nerve ranged from 5.59 ± 0.89 to 8.43 ± 1.30 mm2 , and for the ulnar nerve from 2.94 ± 0.57 to 5.63 ± 1.08 mm2 . Both age and gender correlated with nerve CSA at most sites. DISCUSSION: CSA was not uniform along the length of the median and ulnar nerves. The multiple-site reference values could be helpful for investigating polyneuropathies in the Asian population.

Investigation and research of nurses'willingness and cognition on multiple-sites practice in Shenyang city / 中国实用护理杂志

Objective To Investigate the willingness of nurses on multiple-sites practice in Shenyang city and their motivations and concerns on multiple-sites practice, and to provide reference for the implementation of nurses' multiple-sites practice policy. Methods A convenient sampling method was used to conduct a questionnaire survey of 845 registered nurses in Shenyang city. Results 82.13％(694/845) nurses indicated that they were in favor of nurses on multiple-sites practice, and 79.05％(668/845) nurses expressed their willingness to engage in multiple-sites practice. The differences in the age, job title, working hours, monthly income of nurses and whether specialist nurses were statistically different from their willingness to multiple-sites practice (χ2=10.73-96.40, all P<0.01), and whether Chinese medicine nurse (χ2=6.42, P<0.05) was also different in their willingness to multiple-sites practice. Raising their own economic income and worrying about their overworked workload were the biggest drivers (89.37％,597/668) and concerns of nurses practicing multiple points respectively(88.14％,156/177). 82.04％(548/668) and 70.21％(496/668) of nurses believed that multi-practice practice was conducive to improve their self-worth and enhance nursing work skills. The lack of protection of rights and security (70.01％, 124/177) and the unclear medical risk of practice (53.12％, 94/177) were important factors restricting nurses′ multi-practice practice. In addition, nurses believed that the state should improve relevant laws and regulations (83.31％, 704/845) and protect the legal rights of nurses (88.64％, 745/845). Conclusions Nurses are generally optimistic about multiple-sites practice. Under the premise of sufficient energy and perfect legal protection, nurses multiple-sites practice is a practical and effective measure, which can increase the economic and social value of nurses, and at the same time classify the country′s practice. The medical treatment system provides protection of medical resources.

Insights and analysis on nurse's multiple-sites practice / 中华护理杂志

The nurse's multiple-sites practice is currently being implemented,but there are debates regarding advantages and disadvantages.This review analyzed the background and advantages of the nurse's multiple-sites practice,and its main obstacles encountered in China,and put forward our opinions and suggestions about nurse's multiple-sites practice connecting with the practical situation.

Cognitive analysis on nurses' multiple-sites practice from nurse groups / 中华护理杂志

Objective To investigate the cognition of nurse groups toward nurses' dual practice,and to analyze nurses' tendency to pursuc dual practice and its influencing factors.Methods A questionnaire survey was conducted,and 1010 registered nurses were recruited using stratified sampling method.Results Most (76.4％) nurses agreed with nurses' dual practice.The willingness about nurses' dual practice was significantly different(P=0.022,P=0.008) due to different age and length of service.The top three benefits of nurses' dual practice were to increase reasonable salary of nurses,improve quality of nursing care in community institutions for the aged and increase the utilization of health care resource.As for the disadvantages,disrupting the medical and nursing order,increasing difficulties of management and government's supervision,increasing medical risks.Nurses believed that the main obstacles for nurses' dual practice were the unclear medical risks and the unprotected nurses' interests.Conclusion The nurse groups had a positive and optimistic attitude towards nurses' dual practice.In the case that the government implements relevant laws and regulations,and the interests of nurses are well-guaranteed,nurses' dual practice is a good measure that can improve nurses' work motivation.

Investigation of nurses' attitude and willingness on multiple-sites practice in China / 中华护理杂志

Objective To understand attitude and willingness of nurses on multiple-sites practice in China,and to explore promoters and inhibitors as well as influencing factors of multiple-sites practice.Methods A questionnaire survey was conducted and 113 839 nurses were recruited from 31 provinces,autonomous regions and municipalities.Results Among 113 839 respondents,90343(79.36％) expressed supports for multiple-sites practice,88 571(77.81％) were willing to practice in multiple sites.The biggest promoter and inhibitor for nurses to practice in multiple-sites were increasing personal income and already existing heavy workloads.Totally 86 990(79.29％) nurses thought relevant laws or regulations should be launched in China to ensure implementation of multiple-sites practice.In addition,nurses with senior professional title,with higher educational level,aged 31 to 45 years,holding specialist practice license were more willing to practice in multiple sites (P＜0.01).Conclusion Nurses had a positive attitude towards multiple-sites practice.Policy-makers should sort out and amend the present laws and regulations,and guide excellent nursing talents including specialist nurses,to realize reasonable allocation of nursing resources through multiple-sites practice.

Investigation of nurses' attitude and willingness on multiple-sites practice in China / 中华护理杂志

Objective To understand attitude and willingness of nurses on multiple-sites practice in China,and to explore promoters and inhibitors as well as influencing factors of multiple-sites practice.Methods A questionnaire survey was conducted and 113 839 nurses were recruited from 31 provinces,autonomous regions and municipalities.Results Among 113 839 respondents,90343(79.36％) expressed supports for multiple-sites practice,88 571(77.81％) were willing to practice in multiple sites.The biggest promoter and inhibitor for nurses to practice in multiple-sites were increasing personal income and already existing heavy workloads.Totally 86 990(79.29％) nurses thought relevant laws or regulations should be launched in China to ensure implementation of multiple-sites practice.In addition,nurses with senior professional title,with higher educational level,aged 31 to 45 years,holding specialist practice license were more willing to practice in multiple sites (P＜0.01).Conclusion Nurses had a positive attitude towards multiple-sites practice.Policy-makers should sort out and amend the present laws and regulations,and guide excellent nursing talents including specialist nurses,to realize reasonable allocation of nursing resources through multiple-sites practice.

Malignant mesothelioma with fungating masses and multiple sites involvement.

Malignant mesothelioma (MM) is a rare tumor associated with asbestos exposure. It typically presents as thickening or nodularity of the pleura, although it can also originate from other sites consisting of mesothelia and have manifestations other than thickening or nodularity. Several studies have implied that these different manifestations are associated with a different tumor biology. We report the case of a 54-year-old man with multiple fungating masses diagnosed as MM on histological examination.

Risk factors of keloids in Syrians.

BACKGROUND: Keloid is a benign fibrous growth, which presents in scar tissue of predisposed individuals. It is a result of irregular wound healing, but the exact mechanism is unknown. However, several factors may play a role in keloid formation. To date, there are no studies of keloids in Syria, and limited studies on Caucasians, so we have investigated the risk factors of keloids in Syrians (Caucasians), and this is the main objective of this study. METHODS: Diagnosis of keloids was clinically made after an interview and physical examination. We did a histopathological study in case the physical examination was unclear. The following information was taken for each patient; sex, Blood groups (ABO\Rh), cause of scarring, anatomical sites, age of onset, number of injured sites (single\multiple) and family history. RESULTS: We have studied the clinical characteristics of 259 patients with keloids,130 (50.2 %) females and 129 (49.8 %) males. There were 209 (80.7 %) patients with keloids in a single anatomical site compared to 50 (19.3 %) patients with 130 keloids in multiple anatomical sites, 253 (97.68 %) patients with keloids caused by a single cause for each patient compared to 6 (2.32 %) patients with keloids caused by two different causes for each patient. Keloids could follow any form of skin injury, but burn was the most common (28.68 %). Also, keloids could develop at any anatomical sites, but upper limb (20 %) followed by sternum (19.17 %) was the most common. Over half of the patients developed keloids in the 11-30 age range. 19.3 % (50/259) of patients had family history, 76 % (38/50) of them had keloids located in the same anatomical sites of relative, also, 66 % (33\50) of them had keloids caused by the same cause. The following information was found to be statistically significant; people with blood group A (p = 0.01) compared with other blood groups, spontaneous keloids in patients with blood group A (p = 0.01), acne in males (p = 0.0008) compared to females, acne in someone who has a previous acne keloid (p = 0.0002), burn in someone who has a previous burn keloid (p = 0.029), family history, especially for spontaneous (p = 0.005), presternal (p = 0.039) and shoulder (p = 0.008) keloids, people in second and third decades (p = 0.02) (p = 0.01) respectively. CONCLUSION: Age of onset, sex, cause of scarring, blood groups, anatomical site, presence of family history and the number of site (multiple\single) were significant in keloid formation in Syrians.