Hopperstrand2357

Coronavirus disease 2019 (COVID-19) is a novel emerging disease and a major risk factor for postoperative complications, especially in thoracic surgery. However, it is unclear how previous COVID-19 infection may affect perioperative management of lung resection patients. A 70-year-old woman visited her primary doctor complaining of chest pain. Chest computed tomography (CT) revealed three abnormal nodules in the right upper and middle lung lobes and synchronous triple primary cancer was suspected. Before we could assess the patient for surgery, she developed a persistent fever. A second chest CT scan revealed newly emerged subpleural ground-glass opacities (GGO) in the right lung. The patient was diagnosed with COVID-19 pneumonia and hospitalized. She was treated for COVID-19 (Clinical Trial jRCTs031200196) and discharged in a satisfactory condition 10 days later. A right upper and middle bilobectomy was performed 60 days after the patient's initial COVID-19 diagnosis without any complications. Histopathological examination of the nodules identified synchronous triple primary lung cancer. The subpleural right upper and middle lung lobe tissue showed peribronchial lymphocyte infiltration and interstitial thickening. However, immunohistochemical staining for the SARS-CoV-2 antigen and PCR testing for SARS-CoV-2 were both negative. In this case, bilobectomy for triple primary lung cancer was performed safely after COVID-19 pneumonia. Further studies are needed to establish a safe and appropriate perioperative management system for thoracic surgery in patients recovering from COVID-19 pneumonia.[This corrects the article DOI 10.21037/acr.2019.05.08.].

Maisonneuve fractures are most commonly characterised by a specific pattern with a medial malleolar fracture or deltoid ligament rupture, a disruption of the ankle syndesmosis ligaments and a fracture of the proximal fibula.

We hereby describe for the first time two cases of conservative therapy of Maisonneuve fracture with intact medial structures and with associated posterior malleolus fracture. Patients were assessed with ankle radiographs and magnetic resonance imaging (MRI). The distal fibula was anatomically positioned in its notch and the deltoid ligament and interosseous membrane (IOM) were intact. In addition, the posterior malleolus fracture was not associated with talar subluxation or articular impaction, and the mortise remained anatomically positioned on the initial radiographs. Based on clinical and imaging evaluations, the decision was made to follow conservative treatment. Follow-up showed stability criteria on standing radiographs, and their evolution was clinically uneventful with a goodour two cases are, moreover, in favor of an early weight-bearing protocol.COVID-19 is a respiratory viral illness that can have life threatening complications. While the short-term sequela of COVID-19, including cytokine storm, is relatively well known, the long-term complications of COVID-19 infection on the immune system is still unknown. There have been some reported cases of autoimmune disease development after COVID-19 infection. We present a patient with a history of COVID-19 infection one month prior who presented with non-specific symptoms including fatigue, malaise, bilateral lower extremity swelling and shortness of breath. His laboratory evaluation and physical exam showed him to be in acute renal failure. Further workup and kidney biopsy results confirmed systemic lupus erythematosus (SLE). Our patient needed treatment with plasmapheresis and immunosuppressants, and subsequently had significant improvement in his symptoms. We discuss the current 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR) diagnostic criteria for SLE and describe plausible mechanisms of COVID-19 induced lupus such as B-cell activation by the virus. We also explore the role of interferons in the potential development of autoimmune diseases after COVID-19 infection and highlight the need for further research in the area.Intragastric balloon (IGB) is a widely used, minimal invasive treatment for obesity. The IGB reduce gastric capacity and enhance feeling of fullness, thereby inducing weight loss. A rare, but severe complication to IGB treatment is gastric perforation. We present a rare case of gastric perforation, occurring shortly after a second IGB treatment. The patient was first treated with an Orbera® IGB for 12 months, exceeding the recommended treatment period of 6 months. Upon removal, esophagitis and gastritis was found. Therefore, insertion of the second IGB was postponed. After only 9 treatment-free days, a new endoscopy revealed a macroscopical normal gastric mucosa, and the second Orbera® IGB was inserted. The day after the insertion the patient was admitted to the hospital, due to extensive vomiting and mild epigastric pain. Three days after the insertion a gastric perforation was found. The patient underwent endoscopic removal of the IGB and laparoscopic suture of the perforation. The postoperative course was complicated due to recurrent multiple intra abdominal abscesses, treated with antibiotics, drainage and abscess puncture on several occasions. We suggest that patients should be carefully evaluated before IGB treatments are repeated, especially when gastritis is present. If the gastric mucosa is affected, sufficient time to let it heal is needed. The recommended treatment period should not be exceeded, and perforation should always be suspected as a differential diagnosis when patients present with abdominal symptoms after IGB insertion.

The COVID-19 pandemic has caused disruptions to the functioning of societies and their health systems. Prior to the pandemic, health systems in low- and middle-income countries (LMIC) were particularly stretched and vulnerable. The International Society of Global Health (ISoGH) sought to systematically identify priorities for health research that would have the potential to reduce the impact of the COVID-19 pandemic in LMICs.

The Child Health and Nutrition Research Initiative (CHNRI) method was used to identify COVID-19-related research priorities. All ISoGH members were invited to participate. Seventy-nine experts in clinical, translational, and population research contributed 192 research questions for consideration. Fifty-two experts then scored those questions based on five pre-defined criteria that were selected for this exercise 1) feasibility and answerability; 2) potential for burden reduction; 3) potential for a paradigm shift; 4) potential for translation and implementation; and 5) impact on equ services in LMICs. ISoGH calls on the funders of health research in LMICs to consider the urgency and priority of this research during the COVID-19 pandemic and support studies that could make a positive difference for the populations of LMICs.The development of nanoparticles (NPs) with potential therapeutic uses represents an area of vast interest in the scientific community during the last years. Recently, the pandemic caused by COVID-19 motivated a race for vaccines creation to overcome the crisis generated. This is a good demonstration that nanotechnology will most likely be the basis of future immunotherapy. Moreover, the number of publications based on nanosystems has significantly increased in recent years and it is expected that most of these developments can go on to experimentation in clinical stages soon. The therapeutic use of NPs to combat different diseases such as cancer, allergies or autoimmune diseases will depend on their characteristics, their targets, and the transported molecules. This review presents an in-depth analysis of recent advances that have been developed in order to obtain novel nanoparticulate based tools for the treatment of allergies, autoimmune diseases and for their use in vaccines. Moreover, it is highlighted that by providing targeted delivery an increase in the potential of vaccines to induce an immune response is expected in the future. Definitively, the here gathered analysis is a good demonstration that nanotechnology will be the basis of future immunotherapy.[This corrects the article DOI 10.1016/j.crmeth.2021.100062.].The primary objective of the FDA-led Sequencing and Quality Control Phase 2 (SEQC2) project is to develop standard analysis protocols and quality control metrics for use in DNA testing to enhance scientific research and precision medicine. This study reports a targeted next-generation sequencing (NGS) method that will enable more accurate detection of actionable mutations in circulating tumor DNA (ctDNA) clinical specimens. To accomplish this, a synthetic internal standard spike-in was designed for each actionable mutation target, suitable for use in NGS following hybrid capture enrichment and unique molecular index (UMI) or non-UMI library preparation. When mixed with contrived ctDNA reference samples, internal standards enabled calculation of technical error rate, limit of blank, and limit of detection for each variant at each nucleotide position in each sample. True-positive mutations with variant allele fraction too low for detection by current practice were detected with this method, thereby increasing sensitivity.Lactate metabolism has been shown to have increasingly important implications in cellular functions as well as in the development and pathophysiology of disease. The various roles as a signaling molecule and metabolite have led to interest in establishing a new method to detect lactate changes in live cells. Here we report our development of a genetically encoded metabolic indicator specifically for probing lactate (GEM-IL) based on superfolder fluorescent proteins and mutagenesis. With improvements in its design, specificity, and sensitivity, GEM-IL allows new applications compared with the previous lactate indicators, Laconic and Green Lindoblum. We demonstrate the functionality of GEM-IL to detect differences in lactate changes in human oncogenic neural progenitor cells and mouse primary ventricular myocytes. The development and application of GEM-IL show promise for enhancing our understanding of lactate dynamics and roles.Deciphering the spatial composition of cells in tissues is essential for detailed understanding of biological processes in health and disease. Recent technological advances enabled the assessment of the enormous complexity of tissue-derived parameters by highly multiplexed tissue imaging (HMTI), but elaborate machinery and data analyses are required. This severely limits broad applicability of HMTI. Here we demonstrate for the first time the application of ChipCytometry technology, which has unique features for widespread use, on formalin-fixed paraffin-embedded samples, the most commonly used storage technique of clinically relevant patient specimens worldwide. The excellent staining quality permits workflows for automated quantification of signal intensities, which we further optimized to compensate signal spillover from neighboring cells. In combination with the high number of validated markers, the reported platform can be used from unbiased analyses of tissue composition to detection of phenotypically complex rare cells, and can be easily implemented in both routine research and clinical pathology.