Successful treatment of massive thrombosis in different locations with prolonged thrombolytic therapy: A life-saving intervention

Venous thrombosis is recognized as one of the most important complications of nephrotic syndrome (NS). In patients with NS, venous thrombosis may develop in the renal veins, the deep veins of the lower limb, and the inferior vena cava. Here, we describe a case report of an NS patient with multiple venous thrombosis in the right renal vein, the left iliac vein, the vena cava inferior, the right atrium, and the pulmonary arteries. Moreover, we describe the successful treatment of multiple venous thrombosis with prolonged thrombolytic treatment in spite of an increased risk of bleeding due to renal biopsy.     

IMMUNOGENICITY OF HEPATITIS A VACCINE IN CHILDREN WITH CANCER

This study evaluated the immuned response of the hepatitis A vaccine in children with cancer who were receiving chemotherapy. Twenty-eight patients with lymphomas or solid tumors and who had negative serology for hepatitis A were enrolled. The median age was 4.7 years (range 2–16). The patients received 1440 IU hepatitis A vaccine at 0 and 6 months. Seroconversion rates at the first and seventh months were 60% (n = 17/28 patients) and 89% (n = 24/27 patients). No adverse effects were observed. The hepatitis A vaccine was found to be effective and safe in children with cancer.     

PRIMARY SPINAL EPIDURAL EXTRAOSSEOUS EWING'S SARCOMA MIMICKING A SPINAL ABSCESS

Ewing's sarcoma is one of the most common malignant tumors of the skeletal system in children and young adults. It most frequently stems from the long bones of the extremities. However, though uncommon, extraosseous localization can be seen. Epidural extraosseous presentations are extremely rare. In this case, the authors report on the long-term follow-up of a patient with this well-demonstrated, but uncommon localization, and the initial unique presentation of the patient, which clinically and radiologically mimicked a cervical abscess.     

Assessment of Ventricular Functions by Tissue Doppler Echocardiography in Children with Asthma

Patients with asthma develop pulmonary hypertension due to recurrent hypoxia and chronic inflammation, leading to right heart enlargement with ventricular hypertrophy. Patients with severe asthma can experience cor pulmonale later in life, but little is known about ventricular function during the early stages of the disease. This study aimed to investigate ventricular functions in asymptomatic children with asthma as detected by conventional echocardiography and tissue Doppler echocardiography (TDE). Fifty-one pediatric patients (mean age 10.4 ± 2.2 years) with asthma and 46 age- and sex-matched healthy children (mean age 10.9 ± 2.4 years) were studied. All subjects were examined by conventional echocardiography and TDE, and they had pulmonary function tests on spirometry. The right-ventricular (RV) wall was statistically (p = 0.01) thicker among asthmatic patients (4.7 ± 1.5 mm) compared with healthy children (3.6 ± 0.4 mm). However, conventional pulsed-Doppler indices of both ventricles did not differ significantly between asthmatic patients and healthy children (p > 0.05). The results of TDE examining RV diastolic function showed that annular peak velocity during early diastole (E′), annular peak velocity during late diastole (A′) (16.4 ± 1.8 and 5.1 ± 1.4 cm/s, respectively), E′/A′ ratio (3.2 ± 0.7), isovolumetric relaxation time (67.7 ± 10.2 ms) and myocardial performance index (48.1 % ± 7.0 %) of the lateral tricuspid annulus among asthmatic patients differed significantly (p = 0.01) from those of healthy children (13.2 ± 2.3, 8.2 ± 2.0 cm/s, 1.6 ± 0.5, 46.2 ± 8.7 ms, and 42.0 % ± 5.7 %, respectively). Only peak expiratory flow (PEF) rate from the pulmonary function tests was negatively correlated with the E′/A′ ratio of the tricuspid annulus (r = ?0.38, p = 0.01). This study showed that although the findings of clinical and conventional echocardiography were apparently normal in children with asthma, TDE showed subclinical dysfunction of the right ventricle, which is negatively correlated with PEF. These findings signify the diagnostic value of TDE in the early detection and monitoring of such deleterious effects among asthmatic patients.     

The association between trans fatty acids,infertility and fetal life: a review

Trans fatty acids (TFAs) are thought to affect reproductive health by causing adverse effects on sperm morphology and ovum quality as a result of changing membrane lipid composition which, in turn, leads to impairment in metabolic pathways. This literature review examines the evidence for the effects of dietary TFAs on male and female infertility. Studies conducted between 2007 and 2017 on the effect of dietary TFAs on human reproductive health and fetal life have been included. They indicate that TFA intakes are inversely proportional to sperm concentration and total sperm count and exhibit a positive correlation with asthenospermia, as well as an adverse association on sperm concentration and semen quality. In the female TFAs intakes are associated with an increase in the risk of ovulatory infertility, adversely affect the length of gestation leading to fetal developmental defects and fetal loss. The findings suggest that high TFA intake (more than 1% of energy consumption) constitute a risk factor for infertility in both sexes.