Management of a locally invasive Central Giant Cell Granuloma (CGCG) of mandible: Report of an extraordinary large case

Central Giant Cell Granuloma (CGCG) is a benign tumour of the jaws. The site most frequently involved is the anterior part of mandible, especially in females under 30 years of age. The traditional treatment of CGCG is curettage. Resection is indicated in locally aggressive cases.This report presents the management of a massive CGCG in a 13-year-old girl with its non-surgical and surgical treatments. The non-surgical treatment with corticosteroid therapy was difficult and unsuccessful. Surgical treatment was performed successfully and at 2-year follow-up showed no recurrence of the lesion.     

Comparison of elective lumbar discectomy outcomes between civilians and military personnel

Objective: To determine the results of discectomy surgery for lumbar disc herniation in military personnel and compare it with civilians. Design: A cross-sectional study. Place and Duration: This study was conducted in Neurosurgery Department and Trauma Research Center, Baqiyatallah Medical Sciences University, Tehran, Iran, from February to October 2006. Patients and Methods: One-hundred and seventeen military patients (54 subjects as combat forces and 63 as office personnel) and 115 civilians, who underwent discectomy surgery were included. In a mean duration of 50.8 months, the ability to return to full duty and resolution of complaints were assessed and satisfaction was measured using a Visual Analog Scale. Results: Inability to return to previous duty was significantly higher in military personnel compared to civilians (p = 0.002); and in combat forces compared to office personnel (p < 0.001). The mean (SD) satisfaction was 80.09 (17.8) and 79.32 (9.8) percent in civilian and military personnel, respectively; p = 0.02. However, this difference was not seen in military subgroup forces. Military personnel had less complaints after surgery, 32.1% comparing to 42.7% in civilians; but the difference was not statistically significant. Likewise, fewer complaints were observed in combat forces comparing with office forces; 37% vs. 47.6% (p>0.05). Conclusion: Surgical intervention had relatively poor outcomes in military personnel, specifically in combat forces. Prevention of injury to back region should be considered in military training programs and in case of presence of disc herniation related symptoms, efforts should be made to save patients' effective function by conservation and medical therapies.     

Rosai‐Dorfman disease presenting with solitary liver mass without lymphadenopathy: A case report

Rosai‐Dorfman disease (RDD), as a lymphoproliferative disorder with unknown etiology, is commonly identified with systemic clinical manifestations in various organs. In this case study, RDD occurrence was reported with an exceedingly liver mass.     

Design and usability evaluation of a mobile-based-self-management application for caregivers of children with severe burns

Paediatric burns are a major public health issue because of long-term physical, psychological and social consequences and the high cost of treatment. The aim of this study was to design and evaluate a mobile-based self-management application for caregivers of children with severe burns. A participatory design technique was employed to develop the Burn application, which included three main phases: the determination of application requirements, the design and evaluation of the low-fidelity prototype, and the design and evaluation of the high-fidelity prototypes. In the first phase, application requirements were determined via validated paper questionnaires using the Delphi technique. In the second step, a low-fidelity prototype was prepared using conceptual models and evaluated through a focus group with specialists. Seven specialists reviewed the application and evaluated how this prototype meets functional requirements and objectives. The third phase was performed in three stages. First, the high-fidelity prototype was designed and developed by the JAVA programming language. Second, a cognitive walk-through was carried out to show how users can interact with the mobile application and how it works. Third, this program was installed on the mobile phones of 28 caregivers of burned children, eight IT experts, and two general surgeries, and the prototype's usability was evaluated. In the present study, most caregivers of children with burns stated that after discharge, they face problems regarding infection control and wound care (4.07) and how to perform physical activity (4.12). User registration, educational materials, caregiver-clinician communication, chat box, and appointment booking, safe login were the most important characteristic of the Burn application. Mean usability evaluation scores were in the range of 7.92 ± 0.238 to 8.10 ± 0.103, which is considered at a “good” level. From the Burn program design experience, it can be concluded that co-design with health care specialists can significantly support and meet the specialists' and patients' needs and ensure the program's usefulness. In addition, application evaluation by users involved and not involved in the application design process can help enhance usability.     

The expression of miR-181b,CYLD, CBX-7, BCL2, and p53 in osteosarcoma patients and correlation with clinicopathological factors

Osteosarcoma is a common human malignancy with a high mortality rate worldwide. Recent studies have been focused on understanding the involvement of microRNA (miRNAs) in the pathogenesis of osteosarcoma. Therefore, the present study aimed to measure the expression levels of miR-181a, cylindromatosis (CYLD), chromo box homolog 7 (CBX7), B-cell lymphoma 2 (BCL2), and tumor protein p53 in tumor tissue and adjacent normal tissues in patients with osteosarcoma and its relationship with clinicopathological factors. The expression levels of miR-181a, CYLD, CBX7, BCL2, and p53 were measured in 60 patients with osteosarcoma using quantitative real-time polymerase chain reaction. Finally, we compared the relationship between these gene levels and clinicopathological factors in tumor and healthy tissues. Our results showed that the expression levels of miR-181a, BCL2, and p53 were significantly higher in osteosarcoma tissue in comparison with normal tissues (p < .05). On the contrary, CYLD and CBX7 were downregulated in osteosarcoma tumor tissues compared to adjacent healthy tissues (p < .05). In addition, the expression levels of miR-181a in tumor tissues were strongly correlated with patients' age, tumor size, clinical stage, cancer grade, and lymph node metastasis (p < .05). Our findings highlight new insights into understanding the role of miR-181a in the pathogenesis of osteosarcoma. However, further studies are needed to elucidate miRNA as therapeutic targets for osteosarcoma.     

The effect of late-onset CMV infection on the outcome of renal allograft considering initial graft function

Background

Delayed graft function (DGF) increases the renal allograft failure risk. Late-onset Cytomegalovirus (CMV) infection's effect on the association between DGF and allograft failure has not been determined.

Methods

In this retrospective cohort, we included all renal allograft recipients at London Health Sciences Centre from January 1, 2014 to December 30, 2017, and continued clinical follow-up until February 28, 2020. We determined whether late-onset CMV infection affects the association between DGF and allograft failure in stratified and Cox proportional hazard analyses.

Results

Of 384 patients (median age [interquartile range]: 55 [43.3–63]; 38.7% female), 57 recipients (14.8%) were diagnosed with DGF. Patients with DGF were at a greater risk of CMV infection than patients without DGF (22.8% vs. 11.3%, p = .017). Late-onset CMV infection (odds ratio [OR]: 4.7, 95% CI: 2.07–10.68) and rejection (OR: 9.59, 95% CI: 4.15–22.16) significantly increased the risk of allograft failure in recipients with DGF. Patients with DGF had a significantly greater risk of graft failure than those without DGF (17.5% vs. 6.1%, p = .007). In the adjusted Cox hazard model, CMV infection significantly increased the risk of allograft failure (aHR: 3.19, 95% CI: 1.49–6.84).

Conclusion

Late-onset CMV infection considerably increased the risk of graft failure in patients with DGF. A hybrid preventive model including prophylaxis followed by CMV-specific cell-mediated immunity monitoring may decrease the risk of allograft failure in recipients with DGF.

     

Isolated psoas abscess caused by Mycobacterium tuberculosis: A rare case report

Psoas tuberculosis abscess is very rarely detected primarily without an adjacent vertebral cold abscess. Early diagnosis prevents unnecessary operations and life‐threatening complications.     

Economic evaluation of next-generation sequencing techniques in diagnosis of genetic disorders: A systematic review

In recent years, massively parallel sequencing or next generation sequencing (NGS) has considerably changed both the research and diagnostic fields, and rapid developments have led to the combination of NGS techniques in clinical practice, ease of analysis, and detection of genetic mutations. This article aimed at reviewing the economic evaluation studies of the NGS techniques in the diagnosis of genetic diseases. In this systematic review, scientific databases (PubMed, EMBASE, Web of Science, Cochrane, Scopus, and CEA registry) were searched from 2005 to 2022 to identify the related literature on the economic evaluation of NGS techniques in the diagnosis of genetic diseases. Full-text reviews and data extraction were all performed by two independent researchers. The quality of all the articles included in this study was evaluated using the Checklist of Quality of Health Economic Studies (QHES). Out of 20 521 screened abstracts, 36 studies met the inclusion criteria. The mean score of the QHES checklist for the studies was 0.78 (high quality). Seventeen studies were conducted based on modeling. Cost-effectiveness analysis, cost-utility analysis, and cost-minimization analysis were done in 26 studies, 13 studies, and 1 study, respectively. Based on the available evidence and findings, exome sequencing, which is one of the NGS techniques, could have the potential to be used as a cost-effective genomic test to diagnose children with suspected genetic diseases. The results of the present study support the cost-effectiveness of exome sequencing in diagnosing suspected genetic disorders. However, the use of exome sequencing as a first- or second-line diagnostic test is still controversial. Most studies have been conducted in high-income countries, and research on the cost-effectiveness of NGS methods is recommended in low- and middle-income countries.