Acute invasive fungal rhinosinusitis in post-COVID-19 patients in Vietnam.

BACKGROUND: Acute invasive fungal rhinosinusitis (AIFR) is a potentially lethal infection commonly found in immunocompromised patients. It is considered the most aggressive subtype of fungal sinusitis and can lead to severe morbidity and mortality. There was a significant increase in the incidence of AIFR in post-COVID-19 patients compared to AIFR cases before the COVID-19 pandemic. This study aimed to describe the clinical presentation of AIFR associated with COVID-19 illness. METHODS: A retrospective study included 22 patients diagnosed with AIFR with a recent COVID-19 infection. RESULTS: The most frequent disease associated with AIFR was diabetes mellitus (95.5%). The mycological analysis identified infection caused by Aspergillus species in 72.7% of patients. Along with stabilizing hemodynamic parameters and controlling any comorbidities, all patients in the present study underwent combined surgical debridement followed by antifungal medications. The overall survival rate was 72.7%. The chance of developing a fatal outcome was significantly higher if meningitis presented initially (odds ratio 35.63, p < 0.05). CONCLUSION: The presence of meningitis upon initial diagnosis is related to a significantly higher chance of developing a fatal outcome and should be considered, especially in AIFR patients previously treated for COVID-19 infections. Early diagnosis, early use of antifungal agents, aggressive surgical debridement, and control of comorbid conditions remain crucial in managing AIFR.

A Two-Flap Combination for Auricular Elevation in Microtia Reconstruction.

BACKGROUND: The aims of this study were to describe and evaluate the effectiveness of combined flaps, a modification of the Nagata technique, for providing a reasonable projection for reconstructed auricles. METHODS: The authors modified the Nagata method for covering the cartilage block by introducing a new combined flap technique, including the temporoparietal skin flap and retroauricular flap. The authors compared the shape, size, and position of the reconstructed ear to the opposite ear, and we evaluated postoperative complications and patient satisfaction levels. They verified the effectiveness of the combined flap by assessing flap necrosis, skin color, thickness, hair in the auricular area, and scars. RESULTS: A total of 38 consecutive patients (39 ears) with microtia, aged 6 to 34 years, underwent reconstruction using the modified method and were followed up for 33.6 months on average. The reconstructed auricle's shape was well defined, with 41.0% having good and 15.4% having excellent results. Most cases achieved good and acceptable levels in size, position, medial longitudinal axis angle, and auriculocephalic angles, and 79.9% of patients/their families were satisfied. The authors observed no cases of flap necrosis or hypertrophic scarring, and there were low rates of flap complications, such as unmatched skin color (7.7%), unacceptable thickness (5.1%), or hair and stretch marks (10.3%). CONCLUSIONS: The modified method's reconstructed ear achieved stable projection, symmetric appearance, and obvious anatomical landmarks with high patient satisfaction. The combined flap method showed certain advantages: high survival rate, less skin contrast, no hypertrophic scars, and fewer complications. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Machine Learning-Based Prediction of Drug-Drug Interactions for Histamine Antagonist Using Hybrid Chemical Features.

The requesting of detailed information on new drugs including drug-drug interactions or targets is often unavailable and resource-intensive in assessing adverse drug events. To shorten the common evaluation process of drug-drug interactions, we present a machine learning framework-HAINI to predict DDI types for histamine antagonist drugs using simplified molecular-input line-entry systems (SMILES) combined with interaction features based on CYP450 group as inputs. The data used in our research consisted of approved drugs of histamine antagonists that are connected to 26,344 DDI pairs from the DrugBank database. Various classification algorithms such as Naive Bayes, Decision Tree, Random Forest, Logistic Regression, and XGBoost were used with 5-fold cross-validation to approach a large-scale DDIs prediction among histamine antagonist drugs. The prediction performance shows that our model outperformed previously published works on DDI prediction with the best precision of 0.788, a recall of 0.921, and an F1-score of 0.838 among 19 given DDIs types. An important finding of the study is that our prediction is based solely on the SMILES and CYP450 and thus can be applied at the early stage of drug development.

Partial Decellularized Scaffold Combined with Autologous Nasal Epithelial Cell Sheet for Tracheal Tissue Engineering.

Decellularization has emerged as a potential solution for tracheal replacement. As a fully decellularized graft failed to achieve its purposes, the de-epithelialization partial decellularization protocol appeared to be a promising approach for fabricating scaffolds with preserved mechanical properties and few immune rejection responses after transplantation. Nevertheless, a lack of appropriate concurrent epithelialization treatment can lead to luminal stenosis of the transplant and impede its eventual success. To improve re-epithelialization, autologous nasal epithelial cell sheets generated by our cell sheet engineering platform were utilized in this study under an in vivo rabbit model. The newly created cell sheets have an intact and transplantable appearance, with their specific characteristics of airway epithelial origin being highly expressed upon histological and immunohistochemical analysis. Subsequently, those cell sheets were incorporated with a partially decellularized tracheal graft for autograft transplantation under tracheal partial resection models. The preliminary results two months post operation demonstrated that the transplanted patches appeared to be wholly integrated into the host trachea with adequate healing of the luminal surface, which was confirmed via endoscopic and histologic evaluations. The satisfactory result of this hybrid scaffold protocol could serve as a potential solution for tracheal reconstructions in the future.

A portable surface-enhanced Raman scattering sensor integrated with a lab-on-a-chip for field analysis.

An integrated real-time sensing system that uses a portable Raman spectrometer and a micropillar array chip has been developed for field analysis. The problem of poor detection sensitivity, caused by miniaturization in the portable Raman spectrometer, was overcome by using the surface-enhanced Raman scattering (SERS) technique. The problem of poor reproducibility in the SERS detection, caused by different particle sizes and inhomogeneous degrees of aggregation, was also overcome by using continuous flow and homogeneous mixing between the analytes and nanocolloidal silver in a micropillar array microfluidic chip. Two hazardous materials, dipicolinic acid and malachite green, were quantitatively analysed using our integrated portable Raman sensor system. The observed limit of detection was estimated to be 200 ppb and 500 ppb, respectively. Our proposed analytical method, using a micropillar array PDMS chip and a portable SERS system, offers a rapid and reproducible trace detection capability for hazardous materials in the field.