Frontiers in Medicine最新文献

{"title":"Preoperative bimodal imaging evaluation in finding histological correlations of in situ, superficial spreading and nodular melanoma","authors":"Mircea Negruțiu, S. Dănescu, Theodor Popa, Liliana Rogojan, Ș. Vesa, A. Baican","doi":"10.3389/fmed.2024.1436078","DOIUrl":"https://doi.org/10.3389/fmed.2024.1436078","url":null,"abstract":"The aim of this study is to correlate the diagnostic criteria described in dermoscopy, ultrasonography (US), and histology of the most common types of cutaneous melanoma (CM).We conducted a prospective study including 40 CM cases, which were analyzed by dermoscopy using the Delta 30 dermatoscope and Vidix 4.0 videodermoscope, by ultrasound (US) using a high-resolution 20 MHz linear probe, along with histopathological analysis.The study involved 40 patients with histopathologically confirmed CM, comprising 10 nodular melanomas (NM), 21 superficial spreading melanomas (SSM), and nine in situ melanomas (MIS). US measurements of tumor thickness exhibited strong correlations with the histopathological Breslow index (BI), particularly in the NM and SSM groups. A notable correlation was observed between the presence of ulceration in histopathology and ultrasonography. Dermoscopic analysis revealed significant associations between specific features and CM types. For instance, the presence of an atypical network, irregular globules, irregular dots, prominent skin margins, angulated lines/polygons, dotted and short linear vessels, and negative network correlated with a median BI ≤ 0.5 mm. Conversely, the presence of blue–white veil, atypical vessels, blue–black color, and milky red color were associated with a median BI ≥ 2.3 mm. Furthermore, regression observed in histopathology correlated with regression identified in dermoscopy, we also found statistical correlations between the presence of vascularization at US with the high Clark level, and the presence of prominent skin markings at dermoscopy. The presence of histopathological regression was more frequently associated with tumors that had precise margins, absent vascularization and with those that did not have ulceration on US. The high mitotic rate was associated with tumors that presented imprecise margins, increased vascularization and US detectable ulceration.Innovative CM diagnosis using non-invasive methods like dermoscopy and ultrasound may enhance accuracy and treatment guidance by assessing lesion characteristics.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"35 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141924816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neutrophil-lymphocyte ratio predict outcome of upper gastrointestinal bleeding in emergency","authors":"Xinyi Chen, Xinqun Li, Guangju Zhao, Wen Xu","doi":"10.3389/fmed.2024.1366715","DOIUrl":"https://doi.org/10.3389/fmed.2024.1366715","url":null,"abstract":"The neutrophil-lymphocyte ratio (NLR) is a simple marker of systemic inflammatory responses. The present study aims to evaluate the prognostic significance of the NLR on admission day in predicting outcomes for patients with upper gastrointestinal bleeding (UGIB), which is a prevalent medical emergency.726 patients who were admitted to our clinic between January 2019 and December 2022 diagnosed with UGIB, and who underwent necessary examinations, were included in the study. The patients’ Glasgow-Blatchford Score (GBS), Full Rockall Score (FRS), and NLR levels were calculated at the first admission. Outcomes were defined as in-hospital mortality, need for blood transfusion, surgical treatment and endoscopic therapy. Patients were categorized into four groups using NLR quartile levels to compare their clinical characteristics, Glasgow Blatchford Score, Full Rockall Score levels, and prognosis. Secondary, we modified FRS and GBS by adding NLR, respectively. We used area under the receiver operating characteristic curve (AUROC) to assess the accuracy of risk prediction for NLR, NLR-GBS, and NLR-FRS improved models.Of 726 patients, 6% died in hospital, 23.9% received endoscopic interventon, 4.8% received surgical treatment, and 46.4% received transfusion therapy. Multifactorial logistic regression showed that a high level of NLR was a risk factor for death in patients with UGIB (p = 0.028). NLR, GBS, FRS, NLR-GBS, and NLR-FRS have sufficient accuracy in predicting inpatient mortality, endoscopic treatment, and transfusion treatment, and the differences are statistically significant (p < 0.05). In the comprehensive prediction of adverse outcomes, NLR-GBS has the highest AUROC, and in predicting inpatient mortality, NLR-FRS has the highest AUROC.For UGIB patients, a high NLR was strongly associated with high risk UGIB. Combined testing with the GBS and FRS can achieve good predictive results, which is valuable in guiding the pre-screening and triage of emergency nursing care and clinical treatment to ensure that patients receive rapid and effective treatment and improve the quality of care.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"27 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causality between various cytokines and asthma: a bidirectional two-sample Mendelian randomization analysis","authors":"Yansen Zheng, Qi Chen, Xiaqing Shi, Lei Lei, Donglin Wang","doi":"10.3389/fmed.2024.1447673","DOIUrl":"https://doi.org/10.3389/fmed.2024.1447673","url":null,"abstract":"Many studies have shown that cytokines play an important role in the pathogenesis of asthma, but their biological effects on asthma remain unclear. The Mendelian randomization (MR) method was used to evaluate the causal relationship between various cytokines [such as interleukins (ILs), interferons (IFNs), tumor necrosis factors (TNFs), colony-stimulating factors (CSFs), transforming growth factor (TGF), etc.,] and asthma.In this study, inverse variance weighting was used to evaluate the causal relationship between asthma and cytokines. In addition, the reliability of the results is ensured by multiple methods such as MR-Egger, weighted median, MR-Raps, MR-Presso, and RadialMR, as well as sensitivity analysis.The results showed that none of the 11 cytokines was associated with the risk of asthma. In contrast, asthma can increase levels of IL-5 [odds ratio (OR) = 1.112, 95% confidence interval (CI): 1.009–1.224, P = 0.032] and IL-9 (OR = 1.111, 95% CI: 1.013–1.219, P = 0.025).Genetically predicted asthma was positively associated with elevated levels of IL-5 and IL-9, indicating the downstream effects of IL-5 and IL-9 on asthma. Medical treatments can thus be designed to target IL-5 and IL-9 to prevent asthma exacerbations.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"6 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of adenomyosis according to revised definitions of morphological uterus sonographic assessment features","authors":"O. Yavuz, A. Akdöner, Mehmet Eyüphan Özgozen, Begüm Ertan, Sefa Kurt, E. Ulukus, Mehmet Güney","doi":"10.3389/fmed.2024.1387515","DOIUrl":"https://doi.org/10.3389/fmed.2024.1387515","url":null,"abstract":"This study aimed to predict the diagnosis of adenomyosis by revised definitions of morphological uterus sonographic assessment (MUSA) features in individuals who had hysterectomy.This was retrospective cohort research conducted at a tertiary facility. Between January 2022 and January 2023, 196 individuals who had hysterectomy were analyzed in the research. The revised definitions of MUSA features of the adenomyosis approach were used to record the direct and indirect results of the sonography. The cases were classified as Group 1 (adenomyosis; n = 40, 20.4%) and Group 2 (control; n = 156, 79.6%) according to histopathology reports.Hyperechogenic islands and echogenic subendometrial buds and lines were the most predictive direct features (p = 0.02). Globular uterus and irregular junctional zone were the most predictive indirect features (p = 0.04; p = 0.03, respectively). Among all indirect features, the globular uterus was the most predictive (p = 0.02). Total feature >4 was determined as the significant cutoff value to predict adenomyosis (p < 0.001).This study shows that combinations with a total number of features >4 can be practically used in the evaluation of adenomyosis using the revised definitions of MUSA features.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"109 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141926638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive analysis on the safety of two biologics dupilumab and omalizumab","authors":"Yu Xiao, Wanying Yang, Muyang Wang","doi":"10.3389/fmed.2024.1435370","DOIUrl":"https://doi.org/10.3389/fmed.2024.1435370","url":null,"abstract":"Dupilumab was approved for the treatment of several dermatologic immune-mediated inflammatory diseases, such as atopic dermatitis and bullous pemphigoid; whereas omalizumab is the first biological agent which was approved to treat chronic spontaneous urticaria. None of the published meta-analyses has provided the sufficient data regarding the safety of these two biologics, especially regarding their potential serious adverse events (SAEs). The aim of this study was, to comprehensively evaluate the safety of the two biologics dupilumab and omalizumab. In this study, we included 32 randomized trials, and performed meta-analyses on 113 types of SAEs regarding dupilumab and 61 types of SAEs regarding omalizumab. We identified that: (1) use of dupilumab was significantly associated with the lower incidence of atopic dermatitis, while use of omalizumab was significantly associated with the lower incidence of asthma; and (2) use of dupilumab was not significantly associated with the incidences of 112 other kinds of SAEs including various infectious diseases, while use of omalizumab was not significantly associated with the incidences of 60 other kinds of SAEs including various infectious diseases. This meta-analysis for the first time assessed the association between use of dupilumab or omalizumab and incidences of various SAEs, and identified that neither dupilumab use nor omalizumab use was associated with the increased risks of any SAEs including various infectious diseases. These findings further confirm the general safety of the two biologics dupilumab and omalizumab. This informs clinicians that there is no need to worry too much about the safety issues of these two biologics.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"50 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium fluctuation as a parameter in predicting mortality in general hospitalized patients","authors":"Siyu Liang, Lize Sun, Yuelun Zhang, Qi Zhang, Nan Jiang, Huijuan Zhu, Shi Chen, Hui Pan","doi":"10.3389/fmed.2024.1399638","DOIUrl":"https://doi.org/10.3389/fmed.2024.1399638","url":null,"abstract":"Dysnatremia is the most common electrolyte disorder in hospitalized patients. Sodium fluctuation level may be a better parameter in dysnatremia management. We aimed to examine the association between sodium fluctuation level during hospitalization and mortality and to evaluate its value in predicting poor prognosis among general hospitalized patients.Data were collected from patients admitted to Peking Union Medical College Hospital. The generalized estimated equation (GEE) was used to examine the relationship between sodium fluctuation level and mortality. Receiver-operating characteristic (ROC) curve analysis was performed to calculate the optimal cutoff value and the area under the ROC curve (AUC).Sodium fluctuation level showed a dose-dependent association with increased mortality in general hospitalized patients. After adjusting age, sex, length of hospital stay, and Charlson comorbidity index, the ORs of group G2 to G6 were 5.92 (95% CI 5.16–6.79), 26.45 (95% CI 22.68–30.86), 50.71 (95% CI 41.78–61.55), 104.38 (95% CI 81.57–133.58), and 157.64 (95% CI 112.83–220.24), respectively, p trend <0.001. Both normonatremia and dysnatremia patients on admission had the dose-dependent associations similar to general hospitalized patients. The AUC of sodium fluctuation level was 0.868 (95% CI 0.859–0.877) in general hospitalized patients, with an optimal cutoff point of 7.5 mmol/L, a sensitivity of 76.5% and a specificity of 84.2%.We determined that sodium fluctuation level had a dose-dependent association with increased mortality in general hospitalized patients. Sodium fluctuation level could be used to develop a single parameter system in predicting mortality in general hospitalized patients with acceptable accuracy, sensitivity, and specificity.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"13 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141640370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report and literature review: Laparoscopic extended right hemicolectomy for a 55-year-old patient with idiopathic mesenteric phlebosclerosis","authors":"Siyu Liu, Yujun Tong, Ruizi Shi, Xintao Zeng, Hua Luo, Pei Yang, Xianfu Cai, Decai Wang, Huiwen Luo, Jianjun Wang","doi":"10.3389/fmed.2024.1382475","DOIUrl":"https://doi.org/10.3389/fmed.2024.1382475","url":null,"abstract":"Idiopathic mesenteric phlebosclerosis (IMP) is an extremely rare disease with an unclear pathogenesis and risk factors. The clinical manifestations of IMP are mostly non-specific, mainly consisting of digestive symptoms such as abdominal pain, bloating and diarrhea. The diagnosis of IMP mainly relies on abdominal computed tomography (CT) and colonoscopy. Pathological changes associated with IMP often involve fibrous degeneration of the venous wall, which results in the thickening of the colonic wall and longitudinal calcification of the mesenteric arteries. Currently, there is no standard treatment protocol for IMP, and nonsurgical treatment is the mainstay of most medical centers. In this study, we reported a case of a 55-year-old female patient with IMP whose main clinical presentation was recurrent abdominal pain. The patient’s initial diagnosis was considered an incomplete intestinal obstruction and received non-surgical treatments; however, the efficacy of the treatment was unsatisfactory. After completing abdominal CT and colonoscopy, we excluded common diseases of the digestive system (e.g., tumors, Crohn’s disease), and finally considered that this patient had a high likelihood of IMP. This patient eventually underwent laparoscopic enlarged right hemicolectomy due to recurrent symptoms and poor outcomes of non-surgical treatment. Postoperative pathological results confirmed the diagnosis of IMP. During the follow-up period, the patient recovered well without recurrence of IMP. Furthermore, we have reviewed the literature related to IMP and summarized the etiology, risk factors, diagnostic methods, treatment options and prognosis of IMP.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"59 50","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141644162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and imaging features of pulmonary mixed squamous cell and glandular papilloma: a case report and literature review","authors":"Xianwen Hu, Wei Zhao, Fangming Li, Pan Wang, Jiong Cai","doi":"10.3389/fmed.2024.1437597","DOIUrl":"https://doi.org/10.3389/fmed.2024.1437597","url":null,"abstract":"Pulmonary mixed squamous cell and glandular papilloma (MSGP) is a rare benign lung tumor with both squamous and glandular epithelial components. Reports on primary lung MSGP are few, and the aim of this study is to describe the imaging, including computed tomography (CT) and positron emission tomography (PET) findings, and histopathological characteristics of a case of MSGP in our hospital. A 53-year-old woman with no smoking history who underwent a chest CT scan revealed a nodule in the upper lobe of the left lung. The solid nodule showed no lobulation or spiculation but demonstrated significant enhancement on contrast-enhanced CT and increased fluorine-18 fluorodeoxyglucose (18F-FDG) uptake on PET. Moreover, a literature review identified 19 cases of lung MSGPs involving imaging findings, including CT and/or PET imaging. Except for one patient with a ground glass nodule, the rest were solid and ranged in size from 0.7 to 8.2 cm, which can present as a mildly to significantly increased 18F-FDG uptake on PET. MSGP is a rare benign tumor entity, and understanding its imaging findings and pathological immunohistochemical characteristics will help to improve the accurate diagnosis of MSGP so as to avoid unnecessary lobectomy and mediastinal lymph node dissection.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"72 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141642978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chromoblastomycosis caused by Alternaria infectoria, concurrent with myiasis, in a recipient of a kidney transplant: a compelling case report","authors":"Hamidreza Mahmoudi, Zahra Ramezanalipour, Mahmoud Khansari, Eelco F J Meijer, Shahram Mahmoudi, Bram Spruijtenburg, Abbas Rahimi Foroushani, Mohsen Gramishoar, Hasti Kamali Sarvestani","doi":"10.3389/fmed.2024.1396224","DOIUrl":"https://doi.org/10.3389/fmed.2024.1396224","url":null,"abstract":"Neglected tropical diseases (NTDs) pose a significant threat to the health of millions of people worldwide, particularly in impoverished populations in tropical and subtropical regions. The World Health Organization (WHO) considers certain fungal infections, such as chromoblastomycosis, as NTDs. Chromoblastomycosis is a chronic fungal infection affecting the skin and subcutaneous tissue, primarily found in tropical and subtropical regions of Latin America, Africa, and Asia. This case report presents a 46-year-old female patient with chromoblastomycosis who had a history of renal transplantation and was receiving immunosuppressive therapy. The patient exhibited dark, verrucous, and ulcerative lesions on the legs, and the diagnosis was confirmed through the microscopic examination of skin scrapings by observing medlar bodies. Two sequential fungal tissue cultures and ITS sequencing verified the presence of Alternaria infectoria, not formerly described in chromoblastomycosis. Moreover, observation of fly larvae in the lesions verified the diagnosis of myiasis. Treatment with voriconazole and terbinafine resulted in complete resolution of the lesions after 5 months. This case emphasizes the importance of considering chromoblastomycosis in individuals with occupational exposure in tropical areas, as well as the challenges associated with its diagnosis, coinfections, and treatment.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"7 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrauterine leiomyomas in uncommon locations: two case reports and literature review","authors":"O. Yavuz, Ali Hakan Kula, Zeynep Bayramoğlu, Nur Yağ mur Aydin, Kadir Alper Mankan, A. Akdöner","doi":"10.3389/fmed.2024.1408247","DOIUrl":"https://doi.org/10.3389/fmed.2024.1408247","url":null,"abstract":"This study aims to provide an overview of the diagnosis, treatment, and follow-up management of vulvar and vaginal leiomyomas through the presentation of two rare cases.Detailed clinical presentations, surgical procedures, histopathological examinations, and follow-up outcomes of two cases of vulvar and vaginal leiomyomas are described. Relevant literature is also reviewed to contextualize the findings.Both patients underwent successful surgical excision of the leiomyomas with no perioperative or postoperative complications. Histopathological examinations confirmed the diagnosis of leiomyoma based on characteristic microscopic features and immunohistochemical analyses.Vulvar and vaginal leiomyomas are rare benign tumors that require careful evaluation for accurate diagnosis and appropriate management. Surgical excision remains the primary treatment modality, and long-term follow-up is essential for monitoring recurrence and ensuring favorable outcomes.","PeriodicalId":502302,"journal":{"name":"Frontiers in Medicine","volume":"9 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}