Chronic Form Research Articles

Chronic kidney disease in patients with chronic heart failure infected with human immunodeficiency virus

Chronic kidney disease (CKD) is the most common manifestation of target organ damage in chronic heart failure (CHF). The aim of the study was to determine the risk factors associated with the course of CKD in patients with CHF infected with the human immunodeficiency virus (HIV). According to the results obtained, the prevalence of CKD among HIV-infected patients with CHF is 58.82%, which is 4 times more common than in patients with HIV infection without CHF. The dependence of glomerular filtration rate (GFR) on three main factors that reflect damage to the heart muscle – blood plasma NT-proBNP concentration, left ventricular ejection fraction (LVEF%) and left ventricular myocardial mass index (LVMI) was proved, which together, being included in the regression model, determine 42.2% of the variance of GFR values and are decisive in the development of CKD in patients with CHF on the background of HIV infection. The concentration of NT-proBNP in the blood plasma of patients with CHF equal to or greater than 683.65 pg/ml can be considered as a diagnostic criterion for the development of CKD in HIV-infected people with a sensitivity of the method of 75.0% and a specificity of 75.4%, respectively. In addition, risk factors for the development of CKD in patients with CHF and HIV infection are smoking, alcohol and drug use, a history of chronic and acute forms of coronary artery disease, atrial fibrillation, ventricular arrhythmias, diabetes mellitus, chronic viral hepatitis C, anemia and thrombocytopenia. Patients with CHF and CKD have a more rigid arterial wall – there is a significant excess of the stiffness indices of the aorta and peripheral arteries. Long-term use of antiplatelet agents, NRTIs, NNRTIs, and protease PIs may aggravate the course of CHF in HIV-infected people with CKD manifestations.

The many faces of pediatric urticaria.

Urticaria is a common disease that can affect individuals of all age groups, with approximately one-quarter of the population experiencing it at least once in their lifetime. Lesions characterized by erythema and itchy hives can appear anywhere on the body. These can vary in size ranging from millimeters to centimeters, and typically clear within 24 h. About 40% of patients with urticaria have accompanying angioedema, which involves localized deep tissue swelling. Urticaria usually occurs spontaneously and is classified into acute and chronic forms, with the latter referring to a condition that lasts for more than 6 weeks. The prevalence of chronic urticaria in the general population ranges from 0.5% to 5%, and it can either be inducible or spontaneous. The most common form of pediatric urticaria is acute and is usually self-limiting. However, a broad differential diagnosis should be considered in children with urticaria, particularly if they also have accompanying systemic complaints. Differential diagnoses of pediatric urticaria include chronic spontaneous urticaria, chronic inducible urticaria, serum sickness-like reaction, urticarial vasculitis, and mast cell disorders. Conditions that can mimic urticaria, including but not limited to cryopyrinopathies, hyper IgD syndrome, Periodic Fever, Aphthous Stomatitis, Pharyngitis and Adenitis (PFAPA), Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPs), and Schnitzler syndrome should also be considered. The many faces of pediatric urticaria can be both easy and confusing. A pragmatic approach relies on clinical foresight and understanding the various forms of urticaria and their potential mimickers. This approach can pave the way for an accurate and optimized diagnostic approach in children with urticaria.

Clinical staging across eating disorders: a scoping review protocol

IntroductionClinical staging models in psychiatry assert that there are earlier, less severe or more malleable forms of illness that are distinguishable from later, more chronic forms of illness, and that...

Sistemik inflamatuar yanıt indeksin(SIRI) kronik total oklüzyon öngörülmesinde rolü: yararlı mı değil mi?

Aim: Inflammation is very important in the pathogenesis of atherosclerosis and CAD. Chronic total occlusion (CTO) is a chronic form of CAD and is common in patients with severe CAD. The aim of this study was to determine the association of the systemic inflammatory response index (SIRI), a marker of inflammation, with CTO. 
 
 Materials and Methods: Our study was retrospective and included 100 CAD patients with CTO and 100 CAD patients without CTO. SIRI was compared between the two groups.
 
 Results: Among the basic clinical and laboratory characteristics of the patients, age, white blood cell, and neutrophil counts were statistically higher in the CTO group (p=0.044, p=0.044, p=0.036, respectively). SIRI parameters were similar between the groups, and no statistical difference was observed (p=0.111). According to the ROC analysis, the optimum cut-off value for SIRI was >1040 (sensitivity 70.0% and specificity 44.0%).
 
 Conclusion: SIRI is not a useful predictor for the detection of CTO.

Urine retention-From the symptom to the structure

Urinary retention describes the inability to urinate. Based on the symptoms and the amount of the initial residual urine formation, a differentiation can be made between acute and chronic forms. The cause can be a subvesical obstruction or a bladder atony. In addition to emergency treatment in the form of initial relief of the strain on the bladder by insertion of a catheter, the indication for a definitive treatment with a clarification of the question whether an acute or chronic event is present is also important. Although the selection of the catheter is subject to few criteria, the further structured approach is complex. Both decision trees are presented in this article.

Alveolitis as a result of dust chlorine exposure

Hypersensitivity pneumonia of the lung, also called "extrinsic allergic alveolitis" or "hypersensitivity pneumonitis", is a condition in which the lung tissue becomes inflamed for reasons other than microbial causes. There may be many different reasons. Among the most common reasons were bird feeding, agricultural works and air conditioners. There are acute, subacute or chronic (slowly progressing) forms. Acute and subacute forms may recur, while the chronic form progresses and causes permanent and irreversible damage such as fibrosis and emphysema. Bird proteins, mammalian proteins, fungi, bacterial proteins and small molecular weight chemicals are generally blamed for the formation of the disease. Sometimes the causative agent may not be identified. In this case, we aimed to present a patient who applied to our clinic due to complaints of sudden respiratory distress, rapid fatigue and cough as a result of dust chlorine exposure, and was diagnosed with alveolitis, hospitalized and followed up.

Treatment algorithm for chronic vertebrogenic back pain: the role of chondroprotectors

Back pain constitutes one of the major medico-social problems of healthcare. The development of a unified approach to the diagnosis and treatment of back pain is hindered since it is difficult to assess the various approaches to its treatment, especially its chronic forms. Yet recent data witnessing the important role of the neuroinflammatory process in the pathogenesis of the degenerative forms of discopathy suggest that the traditional treatment approach, which includes physical therapy exercises and non-steroidal anti-inflammatory drugs and myorelaxants, could be enhanced by using drugs characterized by slow structure-modifying action on the structure of the cartilaginous tissue of intervertebral discs and joints. Given the intelligent use of manual therapy, needle reflex therapy, kinesiotherapy, as well as modification of psychosocial factors that pre-determine the yellow flag phenomenon, the application of sustained-release symptomatic drugs increases the efficacy of therapy and prevents subsequent pain episodes. As of today, a placebo-controlled study has proven the action of Alflutop, which can be administered both intramuscularly and paravertebrally. This approach not only improves the patients’ condition but also reduces the burden associated with chronic back pain problems for the society.

Concept of Leucorrhoea & its Understanding in the Light of Unani Medicine

Leucorrhea or vaginal discharge is a common symptom among females. It is a complaint with which each women suffers atleast once in a lifetime. It is a frequent gynecological complaint that accounts for more than 1/4th gynaec visit to gynecologist. It is typically whitish, yellowish, or greenish vaginal discharge in females that may be natural or an infection symptom. It is almost mucus discharge which exhibits vaginal epithelial cell exfoliation due to the influence of estrogen on the vaginal mucosa. The cause of discharge may be physiological, pathological & inflammatory. If, it is not treated in initial stage then it may convert into chronic form and leads to Pelvic inflammatory disease (PID). According to Unani concept Sailan-ur- Rahem is a chronic inflammatory disease & it is due to derangement in quality and quantity of Humors (Akhlat), especially Phlegm (Balgham) and because of accumulation of excessive morbid material (Mawad-e-Fasida) in the uterus due to weaken repulsive power (Zoaf-e-quwat-e-dafea).The main aim of the study is to spread knowledge of Leucorrhoea described in Traditional Unani system of Medicine and its treatment with the available single and compound formulations widely used in Unani Medicine with minimal side effects.

Clinical Outcomes of Patients with Chronic Neuropathic Form of Gaucher Disease in the Spanish Real-World Setting: A Retrospective Study.

This was a retrospective, multicenter study that aimed to report the characteristics of type 3 Gaucher disease (GD3) patients in Spain, including the genotype, phenotype, therapeutic options, and treatment responses. A total of 19 patients with GD3 from 10 Spanish hospitals were enrolled in the study (14 men, 5 women). The median age at disease onset and diagnosis was 1 and 1.2 years, respectively, and the mean age at follow-up completion was 12.37 years (range: 1-25 years). Most patients exhibited splenomegaly (18/19) and hepatomegaly (17/19) at the time of diagnosis. The most frequent neurological abnormalities at onset were psychomotor retardation (14/19) and extrinsic muscle disorders (11/19), including oculomotor apraxia, supranuclear palsy, and strabismus. The L444P (c.1448T>C) allele was predominant, with the L444P (c.1448T>C) homozygous genotype mainly associated with visceral manifestations like hepatosplenomegaly, anemia, and thrombocytopenia. All patients received enzyme replacement therapy (ERT); other treatments included miglustat and the chaperone (ambroxol). Visceral manifestations, including hepatosplenomegaly and hematological and bone manifestations, were mostly controlled with ERT, except for kyphosis. The data from this study may help to increase the evidence base on this rare disease and contribute to improving the clinical management of GD3 patients.

Banff 2022 pancreas transplantation multidisciplinary report: Refinement of guidelines for T cell–mediated rejection, antibody-mediated rejection and islet pathology. Assessment of duodenal cuff biopsies and noninvasive diagnostic methods

The Banff pancreas working schema for diagnosis and grading of rejection is widely used for treatment guidance and risk stratification in centers that perform pancreas allograft biopsies. Since the last update, various studies have provided additional insight regarding the application of the schema and enhanced our understanding of additional clinicopathologic entities. This update aims to clarify terminology and lesion description for T cell–mediated and antibody-mediated allograft rejections, in both active and chronic forms. In addition, morphologic and immunohistochemical tools are described to help distinguish rejection from nonrejection pathologies. For the first time, a clinicopathologic approach to islet pathology in the early and late posttransplant periods is discussed. This update also includes a discussion and recommendations on the utilization of endoscopic duodenal donor cuff biopsies as surrogates for pancreas biopsies in various clinical settings. Finally, an analysis and recommendations on the use of donor-derived cell-free DNA for monitoring pancreas graft recipients are provided. This multidisciplinary effort assesses the current role of pancreas allograft biopsies and offers practical guidelines that can be helpful to pancreas transplant practitioners as well as experienced pathologists and pathologists in training.

Long-term success after catheter ablation of atrial fibrillation

Ablation is an established treatment option for atrial fibrillation (AF) and is associated with convincing success rates and areasonable safety profile. Ablation strategies going beyond pulmonary vein isolation in patients with chronic forms of AF are less well established and reproducible. Especially in patients with progressed AF forms multiple ablation procedures might be mandatory to achieve reasonable clinical success. An early ablation strategy might stop or prolong the progress from paroxysmal to persistent AF. In addition, ablation is more effective than drug-based treatment and comparably safe. Long-term success rates after asingle and after multiple ablation procedures in paroxysmal AF are reported with 60-70% and up to 80%, while success rates in persistent or long-standing persistent AF are less favorable (single procedure 40-50%, multiple procedures 70%). However, currently non-recurrence of AF is the most established but potentially not the best endpoint. The burden of AF after ablation as assessed by novel monitoring modalities might gain further clinical importance.

Clinical Aspects of Mandibular Osteitis at the Sominé Dolo Hospital in Mopti (Mali) from 2017-2022

Infectious osteitis is often of dental origin and is caused by negligent or desocialized patients. Its chronic form is a public health problem due to its health and economic consequences. The objective of this work was to describe the clinical aspects of mandibular osteitis at the Sominé Dolo hospital in Mopti, Mali. From 2017 – 2022, we conducted a descriptive cross-sectional study on cases of mandibular osteitis who were seen in maxillofacial surgery consultations at the Sominé Dolo hospital in Mopti. This hospital is located in Sevaré and is the largest reference center in the 5th region of Mali. All patients were questioned and examined by a maxillofacial surgeon and additional examinations were carried out (BCN, blood sugar, serum creatinine, transaminases, SRV, TPHA/VDRL, mandibular radiography). During the study period, 47 cases of mandibular osteitis were included out of a total of 710 patients seen in maxillofacial surgery consultations, representing a hospital frequency of 6.6%. The ages of the patients ranged between 5 and 70 years with an average age of 17 years. The gender is divided into 25 men (53.2%) and 22 women (46.8%), i.e. a sex ratio of 1.1. The consultation time before 6 months was 71.5%, it was 11.9% between 6 and 12 months and 16.6% after 12 months. The osteitic lesions were located: the left horizontal branch (42.5%), the right horizontal branch (25.5%), pan-mandibular (14.3%), the left ascending branch (10.6%), the right ascending ramus (10.6%) and the mandibular symphysis (2.4%). The osteitis of our patients was of origin: post-traumatic (6.3%), periodontal (4.3%), dental (89.4%). Traditional treatment was done by 36.1% of our patients before the medical consultation. Regarding treatment: five patients were treated medically (10.6%) and 42 were operated on (89.3%). Knowledge of this condition allows early treatment, which obviously avoids complications sometimes responsible for aesthetic and functional after-effects that are difficult ....

Effectiveness of Surgical Treatment Acute Hematogenic Osteomyelitis Children in the Complex With Ozone Therapy and Lymphogenic Technology

The results of operative treatment of acute hematogenous osteomyelitis in 96 children aged from 3 to 12 years are presented. The control group consisted of 52 patients who had traditional surgical treatment and 44 children who were operated according to the developed method in combination with ozone therapy and the use of lymphogenous technology. Transition to the chronic form in the control group was 13.4%, and in the primary group 6.8%.

Modeling Multiple Sclerosis in the Two Sexes: MOG35-55-Induced Experimental Autoimmune Encephalomyelitis.

Multiple Sclerosis (MS) is a chronic autoimmune inflammatory disease affecting the central nervous system (CNS). It is characterized by different prevalence in the sexes, affecting more women than men, and different outcomes, showing more aggressive forms in men than in women. Furthermore, MS is highly heterogeneous in terms of clinical aspects, radiological, and pathological features. Thus, it is necessary to take advantage of experimental animal models that allow the investigation of as many aspects of the pathology as possible. Experimental autoimmune encephalomyelitis (EAE) represents one of the most used models of MS in mice, modeling different disease features, from the activation of the immune system to CNS damage. Here we describe a protocol for the induction of EAE in both male and female C57BL/6J mice using myelin oligodendrocyte glycoprotein peptide 35-55 (MOG35-55) immunization, which leads to the development of a chronic form of the disease. We also report the evaluation of the daily clinical score and motor performance of these mice for 28 days post immunization (28 dpi). Lastly, we illustrate some basic histological analysis at the CNS level, focusing on the spinal cord as the primary site of disease-induced damage.

LEVELS OF IL-4 AND Γ- INTERFERON IN CHILDREN’S BLOOD SERUM AS PREDICTORS OF ASTHMA FORMATION

Introduction. The prevalence of asthma continues to increase every year. Asthma is the leading chronic disease. Infl ammation,both acute and chronic, is closely related to the action of cytokines (pro- and anti-infl ammatory). T-helper 2 lymphocytesrelease IL-4, which triggers the production of immunoglobulin E (IgE) antibodies, which set the stage for allergy and activateinfl ammatory cells. The regulators of this process are T helper-1 lymphocytes, which produce cytokines (IFN-gamma) thatsuppress Th-2 activity. Disturbances in the ratio of Th-1/Th-2 lymphocyte clones are a subject of debate in the early detectionof asthma and the prediction of the development of this disease.The aim of the study was to evaluate the levels of IL-4 and γ-interferon in the blood serum of children with transient wheezeand asthma..Material and methods. 121 children were included in the study. The patients were divided into groups: group 1 – childrenwith transient wheezing (TW) (n = 81), group 2 – children with doctor- diagnosed asthma (DDA) (n = 15), group 3 – healthychildren (n = 25).IL-4 and γ-interferon in blood serum were analyzed by ELISA using commercial kits (human IL-4 and human γ-interferon“Vector Best- Ukraine”). Data were analyzed using Statsoft Statistica version 8 (Tulsa, OK) and the MedCalc version 17.2statistical program.The planned clinical trials were conducted after obtaining the approval of the local ethics committee (date: February 1, 2015;number: 2015/01) and were conducted in accordance with the principles of the Declaration of Helsinki, as amended in October 2013.This article was conducted within the framework of the Department of Pediatrics No. 2 of Kharkiv National MedicalUniversity «Medical and biological aspects of adaptation of children with somatic pathology to modern conditions. Predictionof asthma control in children taking into account infl ammatory markers and the state of the airway barrier of the lungs» (stateregistration number 0120U102471).Results. It was found that in children of the fi rst and second groups, in the midst of clinical manifestations of wheezing, IL-4levels signifi cantly increased and serum γ-interferon levels decreased. The highest levels of IL-4 and the lowest levels of serumγ-interferon were found in patients with DDA.Serum levels of IL-4 above 15.33 pg/mL and γ-interferon below 98.62 pg/mL in children with wheezing episodes may beconsidered as a possible indicator of asthma development.Conclusions. Serum IL-4 and γ-interferon are involved in the regulation of allergic infl ammatory processes in the body.A statistically signifi cant increase in IL-4 levels and a decrease in γ-interferon levels in the blood serum of patients with asthmais likely to indicate the development of a chronic form of infl ammation.

Chronic Vasomotor Allergic Rhinitis

In recent years, there has been a significant increase in the prevalence of diseases of the nose and paranasal sinuses (NPS). Inflammatory diseases of the nasal mucosa (rhinitis) are accompanied by difficulty in nasal breathing and nasal discharge. Chronic forms of rhinitis affect 10–20% of the population, and in epidemiological studies, 40% of respondents report symptoms of rhinitis. In this article, specific aspects of chronic vasomotor allergic rhinitis and treatment methods are considered

Awareness and knowledge of female genital schistosomiasis in a population with high endemicity: a cross-sectional study in Madagascar.

Female genital schistosomiasis (FGS) is a neglected disease with long-term physical and psychosocial consequences, affecting approximately 50 million women worldwide and generally representing an unmet medical need on a global scale. FGS is the chronic manifestation of a persistent infection with Schistosoma haematobium. FGS services are not routinely offered in endemic settings with a small percentage of women at risk receiving adequate care. Madagascar has over 60% prevalence of FGS and no guidelines for the management of the disease. This study aimed to determine FGS knowledge among women and health care workers (HCWs) in a highly endemic area of Madagascar. A convenience sampling strategy was used for this cross-sectional study. Descriptive statistics including proportions and 95% confidence intervals (CI) were calculated, reporting socio-demographic characteristics of the population. Knowledge sources were evaluated descriptively. Binary Poisson regression with robust standard errors was performed; crude (CPR) and adjusted prevalence ratio (APR) with 95% CIs were calculated. A total of 783 participants were included in the study. Among women, 11.3% (n = 78) were aware of FGS while among the HCWs 53.8% (n = 50) were aware of FGS. The highest level of knowledge was observed among women in an urban setting [24%, (n = 31)] and among those with a university education/vocational training [23% (n = 13)]. A lower APR of FGS knowledge was observed in peri-urban [APR 0.25 (95% CI: 0.15; 0.45)] and rural [APR 0.37 (95% CI 0.22; 0.63)] settings in comparison to the urban setting. Most HCWs reported other HCWs [40% (n = 20)] while women mainly reported their family [32% (n = 25)] as being their main source of information in the 6 months prior to the survey. Our study shows limited awareness and knowledge of FGS among population groups in the highly endemic Boeny region of Madagascar. With this study we contribute to identifying an important health gap in Madagascar, which relates to a disease that can silently affect millions of women worldwide. In alignment with the targets of the NTD roadmap, addressing schistosomiasis requires a paradigm shift for its control and management including a greater focus on chronic forms of the disease.

Coenurus Cerebralis Associated Pathological Findings In Goats: Research Communication

Coenurosis, which is also known as gid is a stage, which causes infection especially in goats, sheeps and sometimes also in human. This is the intermediate stage of the tapeworm of carnivores, known as Taenia multiceps. Blood, CSF, brain and cyst samples of total 30 (N=30) were obtained from the affected goats.CBC, serum biochemistry, PCR, cytology and histopathology was performed. The data about owner, management and conditions were recorded. Chi-square test and Independent t-test was used for analysis.Statistical analysis was performed on Statistical Package for the Social Sciences (IBM SPSS version 25) software. This study done yield data about the status of acute and chronic form of Coenurosis cerebralis in goats population of district Lahore and its cytological effects and histopathological lesion,as well as, its hematological effects and molecular characterization.The study findings helped in designing some strict measures for minimizing economic losses in livestock industry of Pakistan.

Haemato-biochemical characterization of equine piroplasmosis asymptomatic carriers and seropositive, real-time PCR negative horses

Equine piroplasmosis (EP) is caused by Theileria equi and Babesia caballi, transmitted by tick vectors. Horses can suffer an acute, subacute, and chronic forms of the disease, with clinical signs such as poor performance, fever, pale mucosal membranes, and jaundice. The diagnosis of EP subclinical cases is complex due to the sensitivity of real-time PCR and the limited parasite load in some carriers, making it challenging to differentiate them from seropositive, PCR negative (S+PCR-) individuals. This study aimed to describe haematological and biochemical changes in asymptomatic EP carriers, EP S+PCR- horses and control horses (EP seronegative and PCR negative). It also investigated potential haemato-biochemical markers to aid in distinguishing true EP carriers alongside molecular and serological tests. A comprehensive haematology and biochemistry profile was conducted on 410 sera and EDTA blood samples, comprising 130 EP positives by real-time PCR and competitive ELISA (cELISA) (carriers), 130 EP negatives by real-time PCR but positive to cELISA (S+PCR-) and 150 EP negative horses to real-time PCR and c-ELISA (controls). Our study confirmed that a haematological and biochemistry profile could help to differentiate between EP carriers/S+PCR- from healthy horses. Carriers and S+PCR- horses showed significant increases in the white blood cell count (WBC), high total proteins (TP) and total globulins (GLOB) concentration, and liver function markers compared to controls. Additionally, the evaluation of uric acid (UA) suggested oxidative stress in carrier horses. However, no useful haemato-biochemical diagnostic markers were identified to aid the challenging differentiation of EP carriers and S+PCR- horses, highlighting the need for improvement in molecular/serological diagnosis for these horses.

Contagious caprine pleuropneumonia: A review of the global situation with a special reference to Oman

Contagious caprine pleuropneumonia (CCPP) is a severe infectious disease caused by Mycoplasma capricolum subsp. capripneumoniae (Mccp) and infects goats, sheep, and wild ruminants. CCPP is characterized by high morbidity and mortality rates reaching up to (100% and 80%), respectively. The disease affects goat farming around the globe in more than 30 countries, particularly in Asia, the Middle East, and Africa. CCPP is manifested in peracute, acute, or chronic forms. The general characteristic clinical signs of the disease are rapid, painful, and labored respiration, dyspnea, nasal discharge, coughing, hyperthermia (41°C), anorexia, emaciation, and abnormal posture. Lesions induced by CCPP are restricted to the pleural cavity in the form of unilateral serofibrinous, pleuropneumonia, accumulation of fluid in the chest cavity, lung congestion, hepatization, formation of adhesion to the pleural coastal, and swollen mediastinal and bronchial lymph nodes. Disease diagnosis encompasses a range of methods, including bacterial culture, isolation, and identification, pathological, serological, and molecular tests. The present review provides an overview of the historical perspective, epidemiological factors, and recommended diagnostic and control strategies for CCPP in Oman.