Nonalcoholic fatty liver disease prevalence in an Italian cohort of patients with hidradenitis suppurativa: A multi-center retrospective analysis

BACKGROUND Nonalcoholic fatty liver disease(NAFLD) includes two distinct conditions, with different histologic features and prognosis: non-alcoholic fatty liver(NAFL) and non-alcoholic steatohepatitis(NASH). Furthermore, NASH is the more aggressive necro-inflammatory form, which may accumulate fibrosis and result in End stage liver disease(ESLD). NAFLD is also linked to systemic inflammatory conditions such as psoriasis. NAFLD is currently the most common cause of ESLD in Western countries, becoming a serious public health concern.Hidradenitis suppurativa(HS) is a systemic inflammatory/autoinflammatory disease of the terminal follicular epithelium of the apocrine gland with a prevalence of 0.05% to 4.10%. Due to its systemic inflammatory behavior several comorbidities were recently associated, however liver ones were scarcely assessed.AIM To evaluate the prevalence and characteristics of NASH/NAFL in HS patients.METHODS This retrospective study is a sub-analysis of a larger study carried out in 4 Italian dermatological centers. In this cohort, there were 83 patients: 51 patients with HS only, 20 patients with HS/NAFL and 12 with HS/NASH.RESULTS Inflammatory comorbidities were present in 3.9% of HS only patients, 25% of HS/NAFL patients and 58.3% of HS/NASH patients(P < 0.001). Similarly, mean Autoinflammatory Disease Damage Index(ADDI) was significantly higher among patients with HS/NASH(5.3 ± 2.2, P < 0.001) compared to patients with HS/NAFL or HS only(2.8 ± 1.6 and 2.6 ± 1.4 respectively). Furthermore, ADDI correlates with IHS4 in HS, HS/NAFL and HS/NASH. Diabetic patients have higher Hurley score than not diabetic ones. Ultrasound examination was significantly different in the three groups.CONCLUSION HS patients displayed a high prevalence of NASH/NAFLD and ultrasound examination should be particularly addressed to patients that display high ADDI scores.

Radiological clinical trials: Proposal of a problem-finding questionnaire to improve study success

AIM To develop a survey to help define the main problems in radiological clinical trials. METHODS Since 2006, we have managed seven different radiological clinical trials recruiting patients in academic and non-academic centres. We developed a preliminary questionnaire using a four-round Delphi approach to identify problems occurring in radiological clinical trials run at our centre. We investigated the recruitment experience, involvement of all multi-disciplinary team members and main obstacles to completing the projects. A final round of Delphi processes elucidated solutions to the identified problems.RESULTS Among 19/20(95%) respondents, 10(53%) were young physicians(under 35 years old), and the respondents included non-faculty members, fellows, residents, and undergraduate students. Ninety-four percent(18/19) of respondents showed interest in conducting clinical trials. On a scale of 1 to 10, the problems with higher/worse scores(8-9) were related to technical or communication problems. The most frequent problems across all studies were technical problems related to clinical trial equipment, insufficient willingness to participate, obstacles to understanding the design of electronic-case report form and extra work.CONCLUSION The developed questionnaire identified the main recurring problems in radiological clinical trials as perceived by endusers and helped define possible solutions that are mostly related to having dedicated clinical trial research staff.

The Acute Effects of Aerobic Dance Exercise with and without Face Mask Use on Attention, Perceived Exertion and Mood States

The present study aimed to determine the effect of wearing a face mask during aerobic dance exercise on cognitive function,more specifically on attention,as well as on perceived exertion and mood states.Thirteen healthy college students(9 males and 4 females:mean age=17.5 years,height=1.72 m,weight=71.00 kg)volunteered to participate in this study.They were randomized to perform aerobic dance exercise while wearing a cloth face mask or no mask or a control condition(sitting on a comfortable chair and reading information about the health benefits of aerobic dance exercise)on three separate occasions(with at least one week of interval).Rate of perceived exertion(RPE),the Brunel Mood Scale(BRUMS)and d2 Attention assessment were assessed before and immediately after each condition.The results demonstrated higher concentration performance for the aerobic dance exercise without face mask than the control condition(p=0.05).Post RPE and BRUMS fatigue subscale values were significantly higher in the aerobic dance exercise with face mask as compared to the aerobic dance exercise without face mask and control condition(all,p<0.05).BRUMS vigor subscale value significantly differed across conditions(F=113.84,p<0.001,ES=0.86)and was significantly higher in the aerobic dance exercise group without face mask as compared to the aerobic dance exercise with face mask and the control conditions(both,p<0.001).This study suggests that face mask use during aerobic dance exercise with moderate intensity did not affect attention.Practitioners,students and athletes should avoid wearing face mask while practicing physical activity or aerobic dance exercise with moderate intensity to improve its acute effect on cognitive function.

Understanding the impact of HIV on mpox transmission in the MSM population: A mathematical modeling study

The recent mpox outbreak(in 2022e2023)has different clinical and epidemiological features compared with previous outbreaks of the disease.During this outbreak,sexual contact was believed to be the primary transmission route of the disease.In addition,the community of men having sex with men(MSM)was disproportionately affected by the outbreak.This population is also disproportionately affected by HIV infection.Given that both diseases can be transmitted sexually,the endemicity of HIV,and the high sexual behavior associated with the MSM community,it is essential to understand the effect of the two diseases spreading simultaneously in an MSM population.Particularly,we aim to understand the potential effects of HIV on an mpox outbreak in the MSM population.We develop a mechanistic mathematical model of HIV and mpox co-infection.Our model incorporates the dynamics of both diseases and considers HIV treatment with antiretroviral therapy(ART).In addition,we consider a potential scenario where HIV infection increases susceptibility to mpox,and investigate the potential impact of this mechanism on mpox dynamics.Our analysis shows that HIV can facilitate the spread of mpox in an MSM population,and that HIV treatment with ART may not be sufficient to control the spread of mpox in the population.However,we showed that a moderate use of condoms or reduction in sexual contact in the population combined with ART is beneficial in controlling mpox transmission.Based on our analysis,it is evident that effective control of HIV,specifically through substantial ART use,moderate condom compliance,and reduction in sexual contact,is imperative for curtailing the transmission of mpox in an MSM population and mitigating the compounding impact of these intertwined epidemics.

Traumatic peroneal split lesion with retinaculum avulsion:Diagnosis and post-operative multymodality imaging

Tears of peroneus brevis tendon represent a cause of underdiagnosed lateral ankle pain and instability. The typical clinical presentation is retro-malleolar pain, in some cases associated with palpable swelling around the fibular malleolus, pain during activities and difficulty in walking. We present a case of peroneus brevis split lesion with superior peroneal retinaculum avulsion in a young athlete who referred to the emergency ward of our hospital for left ankle pain after an inversion injury. An early diagnosis allowed treating the injury and promptly resuming sport activity, after rehabilitation training. Surgical reconstruction key-points and postsurgical follow-up were also discussed. A late diagnosis would have caused a symptomatology worsening and an increased recovery time.

Imaging in multiple myeloma: Computed tomography or magnetic resonance imaging?

Multiple myeloma(MM)is the second most common type of hematological disease with its incidence rising in the elderly.In MM,the extent of the bone disease increases both morbidity and mortality.The detection of lytic bone lesions on imaging,especially computerized tomography(CT)and magnetic resonance imaging(MRI)is crucial to separate asymptomatic from symptomatic MM patients even when no clinical symptoms are present.Although radiology is essential in the staging and management of patients with MM there is still high variability in the choice between MRI and CT.In addition,there is still suboptimal agreement among readers.The potential of medical imaging in MM is largely under-evaluated:artificial intelligence,radiomics and new quantitative methods to report CT and MRI will improve imaging usage.

PSMA PET/CT in the low-to intermediate-risk prostate cancer:when and why?

Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) represents a significant advancement in the imaging of prostate cancer (PCa), yet its application in low- and intermediate-risk cases continues to be a topic of active discussion. This article delves into the nuanced role of PSMA PET/CT, critically analyzing its strengths and limitations in these specific risk categories. For patients with low-risk PCa, PSMA PET/CT demonstrates limited effectiveness in routine staging due to its minimal tracer uptake in low-grade tumors. However, its ability to differentiate between low- and high-grade tumors suggests a promising role in active surveillance, offering a potential noninvasive method for monitoring disease progression and aiding in treatment decision-making. In the intermediate-risk PCa setting, the high specificity of PSMA PET/CT in nodal staging makes it a valuable asset for precise surgical and radiation therapy planning. The article underscores the necessity for further research to fully realize the potential of PSMA PET/CT in PCa management, particularly in developing more personalized treatment approaches in these clinical scenarios.

Assessing Ebola-related web search behaviour: insights and implications from an analytical study of Google Trends-based query volumes

Background:The 2014 Ebola epidemic in West Africa has attracted public interest worldwide,leading to millions of Ebola-related Internet searches being performed during the period of the epidemic.This study aimed to evaluate and interpret Google search queries for terms related to the Ebola outbreak both at the global level and in all countries where primary cases of Ebola occurred.The study also endeavoured to look at the correlation between the number of overall and weekly web searches and the number of overall and weekly new cases of Ebola.Methods:Google Trends(GT)was used to explore Internet activity related to Ebola.The study period was from 29 December 2013 to 14 June 2015.Pearson’s correlation was performed to correlate Ebola-related relative search volumes(RSVs)with the number of weekly and overall Ebola cases.Multivariate regression was performed using Ebola-related RSV as a dependent variable,and the overall number of Ebola cases and the Human Development Index were used as predictor variables.Results:The greatest RSV was registered in the three West African countries mainly affected by the Ebola epidemic.The queries varied in the different countries.Both quantitative and qualitative differences between the affected African countries and other Western countries with primary cases were noted,in relation to the different flux volumes and different time courses.In the affected African countries,web query search volumes were mostly concentrated in the capital areas.However,in Western countries,web queries were uniformly distributed over the national territory.In terms of the three countries mainly affected by the Ebola epidemic,the correlation between the number of new weekly cases of Ebola and the weekly GT index varied from weak to moderate.The correlation between the number of Ebola cases registered in all countries during the study period and the GT index was very high.Conclusion:Google Trends showed a coarse-grained nature,strongly correlating with global epidemiological data,but was weaker at country level,as it was prone to distortions induced by unbalanced media coverage and the digital divide.Global and local health agencies could usefully exploit GT data to identify disease-related information needs and plan proper communication strategies,particularly in the case of health-threatening events.

Prevalence of hepatitis C virus among street children in Iran

Background:Street children are forced to spend a lot of time away from their homes and some of them do not have homes at all,due to economic and family problems,which makes them exposed to many health problems,such as the hepatitis C virus(HCV)infection.Iran,like many other countries in the world,experiences the burden of street children,however,the rate of HCV among street children is virtually unknown.This study aimed to determine the prevalence of HCV among street children in Iran.Main body:This systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.The study protocol of this review was registered in PROSPERO under identification term CRD42018082336.A comprehensive literature search was conducted to identify published studies reporting on the prevalence of HCV among street children in Iran.Several international scholarly databases,including Web of Science,PubMed^(■)/MEDLINE^(■),Embase,Scopus®,Google Scholar and Directory of Open Access Journals,as well as Iranian databases such as MagIran and Barakathns were searched.Studies published between 1988 and December 2017 with any of the following keywords were selected:(street OR homeless OR labour)AND(children OR child OR infant)AND(hepatitis C OR hepatitis C virus OR HCV OR viral hepatitis OR hepatitis OR hepacivirus)AND Iran.Moreover,a grey literature search was performed in order to obtain other potentially relevant studies.The search was carried out without any language restrictions.Four studies,surveying a total of 1691 street children,conducted between 2006 and 2017 were found to be eligible for inclusion in the review and therefore analysed.Three studies were conducted in Tehran and one in Isfahan.The prevalence of HCV among street children in Iran was found to be high,at 2.4%(95%CI:1.8-3.3).Conclusions:Since the prevalence of HCV among street children in Iran is quite high,health decision-and policy-makers should pay more attention to street children and widen support channels,both social and economic.Further studies should be conducted among street children in different cities of Iran to add to the knowledge base of HCV among street children in the country.The health system should provide facilities for street children to be screened to quickly diagnose illnesses and prevent them from developing complications.