Classification Of Disorders Research Articles

From compulsivity to compulsion: the neural basis of compulsive disorders.

Compulsive behaviour, an apparently irrational perseveration in often maladaptive acts, is a potential transdiagnostic symptom of several neuropsychiatric disorders, including obsessive-compulsive disorder and addiction, and may reflect the severe manifestation of a dimensional trait termed compulsivity. In this Review, we examine the psychological basis of compulsions and compulsivity and their underlying neural circuitry using evidence from human neuroimaging and animal models. Several main elements of this circuitry are identified, focused on fronto-striatal systems implicated in goal-directed behaviour and habits. These systems include the orbitofrontal, prefrontal, anterior cingulate and insular cortices and their connections with the basal ganglia as well as sensoriomotor and parietal cortices and cerebellum. We also consider the implications for future classification of impulsive-compulsive disorders and their treatment.

Classifications of cutaneous lymphomas and lymphoproliferative disorders: An update from the EORTC cutaneous lymphoma histopathology group.

The classification of primary cutaneous lymphomas and lymphoproliferative disorders (LPD) is continuously evolving by integrating novel clinical, pathological and molecular data. Recently two new classifications for haematological malignancies including entities of cutaneous lymphomas were proposed: the 5th edition of the WHO classification of haematolymphoid tumours and the International Consensus Classification (ICC) of mature lymphoid neoplasms. This article provides an overview of the changes introduced in these two classifications compared to the previous WHO classification. The main changes shared by both classifications include the downgrading of CD8+ acral T-cell lymphoma to CD8+ acral T-cell LPD, and the recognition of entities that were previously categorized as provisional and have now been designated as definite types including primary cutaneous small or medium CD4+ T-cell LPD, primary cutaneous gamma/delta T-cell lymphoma, primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma, Epstein-Barr virus-positive mucocutaneous ulcer. Both classifications consider primary cutaneous marginal zone B-cell clonal neoplasm as an indolent disease but use a different terminology: primary cutaneous marginal zone lymphoma (WHO) and primary cutaneous marginal zone LPD (ICC). The 5th WHO classification further introduces and provides essential and desirable diagnostic criteria for each disease type and includes chapters on reactive B- or T-cell rich lymphoid proliferations formerly referred as cutaneous pseudolymphomas, as well as histiocyte and CD8 T-cell rich LPD in patients with inborn error of immunity. As already emphasized in previous lymphoma classifications, the importance of integrating clinical, histological, phenotypic and molecular features remains the crucial conceptual base for defining cutaneous (and extracutaneous) lymphomas.

A Fine-Tuned CatBoost-Based Speech Disorder Detection Model

The classification of speech disorders (SDs) is crucial for treating children with speech impairment (SI). An automated SD classification can assist speech therapists in rendering services to children with SI in rural areas. Automated techniques for detecting SDs provide objective assessments of speech attributes, including articulation, fluency, and prosody. Clinical examinations and quantitative assessments provide an in-depth understanding of the patient’s speaking abilities and limitations. Existing deep learning (DL) models for SD detection often lack generalization across diverse populations and speech variations, leading to suboptimal performance when applied to individuals with different linguistic backgrounds or dialects. This study introduces a DL-based model for classifying normal and abnormal speeches using voice samples. To overcome the overfitting and bias, the authors construct convolutional neural network models with the weights of MobileNet V3 and EfficientNet B7 models for feature extraction (FE). To improve performance, they integrate the squeeze and excitation block with the MobileNet V3-based FE model. Similarly, the EfficientNet B7-model-based FE is improved using the structure pruning technique. The enhanced CatBoost model differentiates the normal and abnormal speeches using the extracted features. The experimental analysis is performed using the public dataset that contains 4620 utterances of healthy children and 2178 utterances of children with SI. The comparative study reveals the exceptional performance of the proposed SD classification model. The model outperforms the current SD classification models. It can be employed in clinical settings to support speech therapists. Substantial training with diverse voice samples can improve the generalizability of the proposed model.

The awareness of behavioral addictions in general practitioners- An epidemiological report

IntroductionAlthough the research on behavioral addictions (BAs) is continuously developing, the awareness about this category of disorders and their important negative consequences still remains a problem for many physicians. This phenomenon is associated with delayed diagnosis and treatment initiation, lack of valid epidemiological data about these pathologies, and overall lower quality of life in these patients.ObjectivesThe main objective of this study was to explore the awareness of GPs on the general diagnosis criteria of BAs.MethodsAn online questionnaire addressed to general practitioners (GPs) investigated the level of their knowledge regarding the main criteria for diagnosis in five more commonly reported BAs, i.e., gambling disorder, problematic Internet use, cell phone addiction, food addiction, and shopping addiction. The questionnaire included 50 items and required 20-25 minutes to complete. The answers were anonymized.ResultsAnswers from 12 GPs were analyzed, with an 80% completion rate. Gambling disorder was the only diagnosis recognized by all the respondents, followed by shopping addiction (50%) and abusive Internet use (33.3%). Lack of time to screen for these disorders was the most frequently invoked reason for not including instruments dedicated to BAs in the regular visits to the GPs. The Internet was admitted by all the respondents as their source of information about BAs.ConclusionsThere is an acute need to improve the knowledge of GPs about the existence and consequences of BAs in order to increase the probability of early detection and treatment initiation for these patients. It is expected that Internet-based campaigns for increasing GPs will benefit BAs patients in the long term.Disclosure of InterestNone Declared

Феномен некорригируемых ложных умозаключений в современных психиатрических классификациях

The article analyzes the phenomenon of uncorrectable false conclusions and its representation in modern psychiatric classifications (ICD-11 and DSM 5). Attention is drawn to the tendency to confuse the concepts of delusional, overvalued, dominant and obsessive ideas. In particular, we are talking about hypochondria, dysmorphic disorder, pathological preoccupation with one’s own smell and pathological hoarding (hording) “with a decrease or absence of criticality”, which are presented not under the heading of chronic delusional disorders, but under the heading of obsessive-compulsive disorders. The paradox is that the lack of criticality, the conviction of the correctness of one’s own false judgments and their incorrigibility are traditionally considered as criteria for delusional ideas. On the other hand, the fact is analyzed that outside psychiatric classifications there are phenomena that are clinically similar to delusional ones, but in fact are not delusional ones. Analysis of the phenomenon of uncorrectable false conclusions and the attitude towards it as a psychopathological syndrome shows the ambiguity of psychiatrists' views on this problem. Some of these phenomena (hypochondria, preoccupation with one’s own smell, dysmorphia) have found their place in modern classifications of mental and behavioral disorders, others (racism, anti-semitism, homophobia, transphobia) turned out to be outside the group of chronic delusional disorders and continue to be considered non-psychopathological. It is argued that the process of attitude towards this problem is significantly influenced by society, which puts pressure on the psychiatric community and dictates the development of diagnostic criteria based on sociocultural, rather than medical factors.

How good is the clinical diagnosis in schizophrenia? Reliability and validity

AbstractSeveral changes to the classification of mental disorders have been made during the past half century to increase the reliability, clinical use and validity of the diagnostic classification. Despite the high expansion of knowledge about mental disorders, understanding of their components and processes still requires fine-tuning. This symposium identifies key issues on different classification systems with different purposes relevant to understanding and classifying mental disorders. We discuss how key issues such as ICD-11, RDoC or Biomarkers correspond or diverge because of their different purposes, and constituencies. Although these approaches have varying degrees of overlap and distinguishing features, they share the goal of reducing the burden of suffering due to mental disorder.Disclosure of InterestNone Declared

The Prevalence of Hyperuricemia and the Association Between Hyperuricemia and Age in Patients with Psychiatric Disorders to a General Hospital: A Cross-Section Study.

In clinical work, it has been found that the prevalence of hyperuricemia (HUA) is significantly higher in younger patients with psychiatric disorders, but there are few studies in this area. The present study aims to evaluate the prevalence of HUA and the relationship between the HUA and age in hospitalized patients with psychiatric disorders in the real world, and to provide a theoretical basis for clinical staff to pay attention to the metabolic indicators of younger patients and for future related studies. This is a cross-sectional evaluation of a cohort of 1761 patients with psychiatric disorders of hospitalized. The categories of disorders designed for study included: Depression, Bipolar disorder, Schizophrenia, Anxiety, Obsessive-Compulsive disorder, Acute and transient psychotic disorder, Dissociative(conversion) disorders, Conduct disorders and Tic disorders. In addition, based on age, the participants are stratified into three groups. The authors used Kruskal-Wallis tests, chi-square tests, and multiple linear logistic regression to verify the relationship between HUA and age among hospitalized patients with psychiatric disorders. Overall, the estimated prevalence of HUA was 35.4%. The prevalence of HUA was significantly higher in individuals with 17 years and under compared to those with 45 years and above (P < 0.001). After adjusting for confounders, the prevalence of HUA remained higher at 17 years and under than at 45 years and above. Bipolar disorder can lead to an increased prevalence of HUA (P<0.05). The prevalence of HUA was higher in hospitalized patients with psychiatric disorders, and the prevalence was inversely proportional to age.

Achieving functional remission in schizophrenia: a pilot study

IntroductionMany patients with schizophrenia are unable to achieve adequate levels of psychosocial functioning and quality of life despite of the remission of illness symptoms. According to previous reports, only one-third of patients with symptomatic remission reach functional remission. While current pharmacotherapy options seem to be relatively effective for different symptoms of schizophrenia (e.g. positive symptoms), more specific psychosocial interventions that could enable functional remission are yet to be developed.ObjectivesOur objective is to investigate differences in psychopathology, quality of life, functioning, and achieving functional remission before and after specific group treatments developed in our clinic.Methods We will conduct a prospective study including a consecutive cohort of female patients older than 18 years of age, which fulfilled the criteria for schizophrenia and schizoaffective disorder according to the International Classification of Disorders, 10th revision. Exclusion criteria are intellectual disabilities, mental disorders due to known physiological or neurological conditions, lactation or pregnancy, treatment with medications that can provoke psychosis, alcoholism, and other addictions. Patients will be recruited after finished hospital treatment or during individual outpatient controls. The Recovery Helm will be used at the beginning of the treatment, to make individual treatment plan and include patients in specific programs including day hospital treatment and/or outpatient group programs: psychoeducation, relaxation, metacognitive training, and social skills training. Besides collecting sociodemographic data, pre- and post-treatment assessment will include the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Quality of Life Scale (QLS), and the “Functional Remission of General Schizophrenia” (FROGS) scale.ResultsWe will analyze the changes in psychopathology levels, quality of life, functioning, and achieving functional remission between the two assessment points, taking into account different treatment possibilities.ConclusionsEvaluation of current available programs can help with recognition of specific needs of patients with schizophrenia and provide guidelines for further development of treatment programs that could be helpful in achieving functional remission.Disclosure of InterestNone Declared

Prevalence and impact of comorbid mental disorders in hospitalized patients with obstructive sleep apnea: a protocol for a nationwide retrospective study

Introduction Obstructive sleep apnea (OSA) is a common sleep disorder in the adult population, often associated with an increased prevalence of comorbid conditions such as obesity and diabetes, but also several mental disorders that have been independently associated with worse hospitalization outcomes in a variety of situations. However, and despite such associations, there is a relative dearth of studies exploring comorbid psychopathology beyond depression and anxiety, and no studies seem to address the impact of comorbid mental disorders on the hospitalization outcomes of patients with OSA.ObjectivesThis study aims to characterize and compare mental comorbidities among hospitalization episodes of adult patients with and without OSA held in mainland Portugal, regardless of the primary cause of admission, and to analyze the impact of such comorbidities on hospitalization outcomes.MethodsAn observational retrospective study will be conducted using an administrative database comprising de-identified routinely collected discharge data from all Portuguese mainland public hospitals. Inpatient episodes spanning from 2008 to 2015 will be categorized into two groups according to the presence of an OSA code (ICD-9-CM codes 780.51, 780.53, 780.57, 327.20 and 327.23). For both groups, mental disorders will be identified according to categories 650 to 670 of the Clinical Classifications Software (CCS) for ICD-9-CM. Descriptive, univariate, and multivariate analyses will be performed. Study reporting will comply with the RECORD statement guidelines.Results Out of 6,072,538 sampled episodes, 57,301 have an OSA code. Prevalence of any comorbid mental disorder is 30.4% in the OSA group, and 19.3% in the non-OSA group. For both groups, sociodemographic, administrative, and clinical variables will be characterized and compared, as well as the prevalence of each mental disorder category, yearly hospitalization trends, and most common primary diagnoses. Hospitalization outcomes, including length of stay, in-hospital mortality, and readmissions, will be compared taking into consideration the presence of CCS categories of mental disorders.ConclusionsWe expect to improve the understanding of the prevalence of mental comorbidities among hospitalized patients with OSA, including understudied mental disorders, and to elucidate their impact on relevant hospitalization outcomes, thus highlighting the need to recognize and treat this common association to achieve optimal outcomes.Disclosure of InterestNone Declared

ChatGPT accurately performs genetic counseling for gynecologic cancers

ObjectiveArtificial Intelligence (AI) systems such as ChatGPT can take medical examinations and counsel patients regarding medical diagnosis. We aim to quantify the accuracy of the ChatGPT V3.4 in answering commonly asked questions pertaining to genetic testing and counseling for gynecologic cancers. MethodsForty questions were formulated in conjunction with gynecologic oncologists and adapted from professional society guidelines and ChatGPT version 3.5 was queried, the version that is readily available to the public. The two categories of questions were genetic counseling guidelines and questions pertaining to specific genetic disorders. The answers were scored by two attending Gynecologic Oncologists according to the following scale: 1) correct and comprehensive, 2) correct but not comprehensive, 3) some correct, some incorrect, and 4) completely incorrect. Scoring discrepancies were resolved by additional third reviewer. The proportion of responses earning each score were calculated overall and within each question category. ResultsChatGPT provided correct and comprehensive answers to 33/40 (82.5%) questions, correct but not comprehensive answers to 6/40 (15%) questions, partially incorrect answers to 1/40 (2.5%) questions, and completely incorrect answers to 0/40 (0%) questions. The genetic counseling category of questions had the highest proportion of answers that were both correct and comprehensive with ChatGPT answering all 20/20 questions with 100% accuracy and were comprehensive in responses. ChatGPT performed equally in the specific genetic disorders category, with 88.2% (15/17) and 66.6% (2/3) correct and comprehensive answers to questions pertaining to hereditary breast and ovarian cancer and Lynch syndrome questions respectively. ConclusionChatGPT accurately answers questions about genetic syndromes, genetic testing, and counseling in majority of the studied questions. These data suggest this powerful tool can be utilized as a patient resource for genetic counseling questions, though more data input from gynecologic oncologists would be needed to educate patients on genetic syndromes.

Body dysmorphia in a 23 year old patient with obsessive compulsive disorder: a case report

IntroductionBody dysmorphic disorder (BDD) was considered an anxiety disorder in the DSM-IV, but in the DSM-V was added to the obsessive-compulsive and related disorders category. BDD is a psychiatric disorder characterised by an excessive, persistent, and distressful preoccupation with a perceived defect in appearance. These perceived defects are slight and are unnoticed by others. People with BDD usually have poor insight and are preoccupied with a perceived physical defect which causes them to check on it repeatedly. This leads to an impairment in psychosocial functioning, depression, and an increase in suicide risk.ObjectivesReview how dismorphophobia (BDD) and obsessive compulsive syndrome intersect, the differences they present in symptomatology, prevalence and treatment.MethodsPresentation of a patient’s case and review of existing literature, in regards to body dysmorphic syndrome and its similarities and differences with respect to obsessive compulsive syndrome.ResultsThere are common features between both disorders, which are genetic overlap, physical past traumatic events, sex ratio, trait of perfectionism and body image disturbance.Studies have found the prevalence of BDD in patients with OCD in a large patient sample was 8.7% to 15% compared to 3% in non-OCD.The risk of comorbidity of OCD-BDD is three times higher in samples with a primary diagnosis of BDD compared to those with a primary diagnosis of OCD with 27.5% and 10.4%, respectively.BDD as well as OCD must be managed with pharmacological and psychotherapy treatment. A selective serotonin reuptake inhibitor is the recommended first-line medication for BDD, even if appearance beliefs are delusional in nature. Serotonin reuptake inhibitor (SRI) doses and trial durations are similar to those used for OCD; higher doses and a longer treatment trial are recommended than those typically used for depression and most other disorders. Cognitive-behavioral therapy that is specifically tailored to BDD is the psychosocial treatment of choice. Simply treating BDD as if it were OCD is not recommended.ConclusionsThere are limitations included a restricted number of studies overall, an absence of studies comparing biological parameters, and the frequent inclusion of participants with comorbid body dysmorphic disorder and obsessive-compulsive disorder. The current nosological status of body dysmorphic disorder is somewhat tenuous and requires further investigation, with particular focus on dimensional, biological and aetiological elements.Disclosure of InterestNone Declared

Manifestations of antisocial behavior in older adults: A review of current literature

IntroductionAntisocial behavior in older adults is a problem for their relatives and health care providers Antisocial behavior may present differently in the older population which makes it more difficult to diagnose adequately and apply therapeutic interventions. This literature review provides an overview of diverse conceptualizations of antisocial behavior in older adults and the way it affects recognizability of diagnostic categories and the applicability of interventions.ObjectivesTo gain insight into the various manifestations of antisocial behavior in older adults.MethodsA systematic review design was performed. In this review, an extensive manual and electronic literature search was conducted for papers published from 1980 to 2023. For this purpose we used the electronic databases PubMed and Embase. The review will include empirical and quantitative studies of older adults with antisocial behavior.ResultsThe results from the literature indicate that antisocial behavior does probably not decrease with age nor the burden on their social environment. Rather, the manifestations of antisocial behavior change as this population ages. Personality disorders are determined by several dimensional trait domains. The domains which are highly predictive for antisocial behavior include antagonism and disinhibition.ConclusionsThese findings challenge the notion of antisocial behavior decreasing with age. This review underscores the need to shift from traditional personality disorder categories to a dimensional trait perspective. Therefore, specific interventions are needed for older adults.Disclosure of InterestNone Declared

Efficiency of William’s versus McKenzie’s therapy for patients diagnosed with low back pain

From the category of musculoskeletal disorders, lumbar pathology registered a 50% increase between 1990 and 2019, directly correlated with an age decrease for the onset of symptoms among patients diagnosed with lumbar pain. Consequently, we are witnessing a younger population experiencing lumbar pain and at times, functional disability. According to statistical analysis, the economic impact of low back pain (LBP) in highly industrialized countries produces costs of up to 134 billion dollars annually. In this context, the appropriate therapeutic approach of LBP becomes a factor of major interest. This review uses 137 primary articles and specialized literature published between 2010-2022. Article selection was based on keywords and focused on comparing the effectiveness of William's and McKenzie's exercises. As the two rehabilitation programs are founded on different principles - William's therapy emphasizes flexion exercises while McKenzie's therapy focuses on extension exercises - patient assessment was conducted using evaluation scales. The evaluation employed the Visual Analogue Scale (VAS), the Oswestry Low Back Pain Disability Index (OSLBPDI), and the Short Form 36 (SF 36). The comparative analysis revealed modified scale scores following completion of the therapeutic protocol: 50-65% reduction in pain, 10-40 % increase in flexibility, and significant improvement in mental state. Based on these findings, an advancement in the patient’s condition can be observed for both William’s and McKenzie protocols. Nonetheless, the reviewed articles underscore the importance of selecting and adapting the therapeutic approach to the characteristics of lumbar pain.

Ant Colony and Whale Optimization Algorithms Aided by Neural Networks for Optimum Skin Lesion Diagnosis: A Thorough Review

The adoption of deep learning (DL) and machine learning (ML) has surged in recent years because of their imperative practicalities in different disciplines. Among these feasible workabilities are the noteworthy contributions of ML and DL, especially ant colony optimization (ACO) and whale optimization algorithm (WOA) ameliorated with neural networks (NNs) to identify specific categories of skin lesion disorders (SLD) precisely, supporting even high-experienced healthcare providers (HCPs) in performing flexible medical diagnoses, since historical patient databases would not necessarily help diagnose other patient situations. Unfortunately, there is a shortage of rich investigations respecting the contributory influences of ACO and WOA in the SLD classification, owing to the recent adoption of ML and DL in the medical field. Accordingly, a comprehensive review is conducted to shed light on relevant ACO and WOA functionalities for enhanced SLD identification. It is hoped, relying on the overview findings, that clinical practitioners and low-experienced or talented HCPs could benefit in categorizing the most proper therapeutical procedures for their patients by referring to a collection of abundant practicalities of those two models in the medical context, particularly (a) time, cost, and effort savings, and (b) upgraded accuracy, reliability, and performance compared with manual medical inspection mechanisms that repeatedly fail to correctly diagnose all patients.

Диагностическая классификация нарушений психического здоровья и развития у детей от рождения до 5 лет в практической работе психологов

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;Data collection requires a structure and a consistent algorithm to create a common language for the team of professionals and to support the development of support programs. Work on the approbation of the possibilities of using the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-5) in the comprehensive assessment of the development and condition of the child and his/her immediate environment was carried out.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;Over a 12-month period, 48 families with children aged from one month to 4 years 10 months were referred to the Child and Family Mental Health Center &amp;ldquo;Opening Doors&amp;rdquo;. Expert assessment was conducted using DC:0-5 and the following methods: observation, assessment of child and close adult relationships; assessment of the emotional state and behavior of adults.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;The possibilities of using the DC:0-5 tool were demonstrated on the example of one case from the practice of the center&amp;rsquo;s specialists: a structured diagnostic report, written in a common language for the team of specialists, included a description of the assessment results in accordance with the algorithm of data collection and structuring of information: cultural aspects; conditions and factors of the child&amp;rsquo;s physical health; psychosocial and environmental stress factors; developmental competencies and the context of the child&amp;rsquo;s relationships with close adults. Biological and social risk and protective factors are identified. Risk factors on the part of the adult can be: a suppressed emotional state, difficulties in recognizing the emotional needs and signals of the child and an inappropriate response to them; on the part of the child &amp;mdash; a restraint of activity and emotions. In the conclusion, the opinions of specialists about the possibility of clinical disorders in the child are given.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions.&amp;nbsp;&lt;/strong&gt;The data obtained with the use of DC:0-5 allows us to formulate the directions of the individual program of support for the child and family fully and clearly. At the next stage of work it is planned to continue the analysis, systematization and description of cases of classification application with the generalization of results.&lt;/p&gt;

Порушення менструального циклу в жінок репродуктивного віку: сучасний погляд на проблему (огляд літератури)

Menstrual health, as a component of reproductive health - a state of complete physical, mental and social well-being, and not just the absence of diseases, is an integral part of improving the health of women around the world, achieving the goals of sustainable development of society and realizing gender equality and human rights. Aim of the study is to analyze data on the problem of menstrual cycle disorders in women of reproductive age, modern classifications of menstrual cycle disorders, and also to propose an option for correcting these disorders. Preserving menstrual health is inextricably linked to the possibility of access to appropriate medical services and resources, including timely diagnosis of menstrual cycle disorders, their treatment and prevention. The article presents modern data on the nomenclature, definition of the norm and pathology of the menstrual cycle, classification systems of its violations. The expediency and application of the complex herbal preparation Normomens® is a highly effective alternative therapy for menstrual cycle disorders, PMS symptoms, dysmenorrhea, fibrocystic disease of the mammary glands, infertility and hyperproliferative processes of the pelvic organs in women of reproductive age. No conflict of interests was declared by the authors.

МАГНИТНО-РЕЗОНАНСНАЯ ТОМОГРАФИЯ ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА ПРИ ДИАГНОСТИКЕ ПАРАФУНКЦИЙ ЗУБОЧЕЛЮСТНОЙ СИСТЕМЫ С ПОМОЩЬЮ ЦИФРОВОГО АППАРАТА T-SCAN

Parafunctions of the dental system occupy a special position among dental diseases, due to the complexity of their diagnosis, treatment, complex and varied clinical picture. Methods for screening and monitoring patients with parafunctions remain an urgent scientific and practical task. Most often, this manifests itself unconsciously in the form of daytime or nighttime bruxism or clenching. Parafunction is one of the etiological factors of pain dysfunction of the temporomandibular joint. In the diagnosis of structural changes in the temporomandibular joint, the “gold” standard is magnetic resonance imaging. Due to the high contrast of soft tissues, magnetic resonance imaging is a method for diagnosing structural changes in the tissues of the temporomandibular joint and allows the most accurate, highly informative and quick assessment of the condition and function of intra- and extra-articular elements. In daily practice, dentists need simple and practical methods for diagnosing and parafunctional activity. Digital dentistry provides opportunities for assessing occlusal contacts. T-scan is one of the most functional digital devices. The purpose of the study was to increase the efficiency of providing dental care to patients with parafunctions by identifying the severity of bruxism and clenching using the T-scan apparatus and magnetic resonance imaging. The study involved functional analysis using a digital T-scan device and magnetic resonance imaging. The results of the study, in patients with parafunctions, the average areas of wear facets were identified for each degree of severity for each side of the dentition. The values of occlusal parameters of the left side in patients in the group with bruxism and clenching prevail over the values of the right side of the dentition. With mild severity, there was a normal position of the articular disc and a small ventral displacement with reposition according to the Wilkes classification of internal disorders of the temporomandibular joint. With moderate severity, a small ventral displacement with and without reposition was noted. In severe cases, there was a small ventral displacement without reposition, a complete ventral displacement of the articular disc with and without reposition. Thus, it has been proven that diagnostics using digital analysis, assessing the severity of parafunctional activity and magnetic resonance data selects the necessary tactics for the treatment and prevention of dysfunctional conditions of the dental system. This technique allows for screening and monitoring of patients with bruxism and clenching.

Sexological Diagnosis: Methodology of Diagnosis and Classification of Sexual Disorders in Men

The lecture presented a methodology for assessing sexual health and staging sexological diagnosis. Based on the assessment of the vast clinical material (23 601 married/partner couples and 4113 male patients without a partner, aged 16 to 85, who sought help on their own or on the referral of other doctors to the Kyiv Center for Family Planning, Sexology and Reproductive Health for the period from 1996 to 2019) the main clinical forms of sexual disharmony and sexual dysfunction in men are presented, as well as the frequency of certain forms and their etiopathogenetic study. It also gives examples of sexological diagnoses and methods of statistical encryption according to ICD-10.

Clinical experiences of guided tapering of antipsychotics for patients with schizophrenia– a case series

Background80% of patients value information on treatment options as an important part of recovery, further patients with a history of psychotic episodes feel excluded from decision making about their antipsychotic treatment, and on top of that, mental health staff is prone to be reluctant to support shared decision making and medication tapering for patients with schizophrenia. This case series aims to demonstrate the tapering of antipsychotic medication and how guided tapering affects the patient’s feeling of autonomy and psychiatric rehabilitation.Case presentationWe present six patients diagnosed with schizophrenia (International Classification of Mental and Behavioral Disorders– 10th Edition codes F20.0–5, F20.7–9) who underwent professionally guided tapering in our clinic. The clinic aims to guide the patients to identify the lowest possible dose of antipsychotic medication in a safe setting to minimise the risk of severe relapse. Two patients completely discontinued their antipsychotic medication, two suffered a relapse during tapering, one chose to stop the tapering at a low dose, and one patient with treatment resistant schizophrenia, which is still tapering down.ConclusionsReducing the antipsychotic dose increased emotional awareness in some patients (n = 4) helping them to develop better strategies to handle stress and increased feelings of recovery. Patients felt a greater sense of autonomy and empowerment during the tapering process, even when discontinuation was not possible. Increased awareness in patients and early intervention during relapse may prevent severe relapse.Impact and implicationsSome patients with schizophrenia might be over medicated, leading to unwanted side effects and the wish to reduce their medication. The patients in our study illustrate how guided tapering of antipsychotic medication done jointly with the patient can lead to improved emotional awareness and the development of effective symptom management strategies. This may in turn lead to a greater sense of empowerment and identity and give life more meaning, supporting the experience of personal recovery.

World Health Organization and International Consensus Classification of eosinophilic disorders: 2024 update on diagnosis, risk stratification, and management.

The eosinophilias encompass a broad range of non-hematologic (secondary or reactive) and hematologic (primary or clonal) disorders with the potential for end-organ damage. Hypereosinophilia (HE) has generally been defined as a peripheral blood eosinophil count greater than 1.5 × 109/L, and may be associated with tissue damage. After the exclusion of secondary causes of eosinophilia, diagnostic evaluation of primary eosinophilias relies on a combination of various tests. They include morphologic review of the blood and marrow, standard cytogenetics, fluorescence in situ hybridization, molecular testing and flow immunophenotyping to detect histopathologic or clonal evidence for an acute or chronic hematolymphoid neoplasm. Disease prognosis relies on identifying the subtype of eosinophilia. After evaluation of secondary causes of eosinophilia, the 2022 World Health Organization and International Consensus Classification endorse a semi-molecular classification scheme of disease subtypes. This includes the major category "myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions" (MLN-eo-TK), and the MPN subtype, "chronic eosinophilic leukemia" (CEL). Lymphocyte-variant HE is an aberrant T-cell clone-driven reactive eosinophila, and idiopathic hypereosinophilic syndrome (HES) is a diagnosis of exclusion. The goal of therapy is to mitigate eosinophil-mediated organ damage. For patients with milder forms of eosinophilia (e.g., <1.5 × 109/L) without symptoms or signs of organ involvement, a watch and wait approach with close follow-up may be undertaken. Identification of rearranged PDGFRA or PDGFRB is critical because of the exquisite responsiveness of these diseases to imatinib. Pemigatinib was recently approved for patients with relapsed or refractory FGFR1-rearranged neoplasms. Corticosteroids are first-line therapy for patients with lymphocyte-variant HE and HES. Hydroxyurea and interferon-α have demonstrated efficacy as initial treatment and in steroid-refractory cases of HES. Mepolizumab, an interleukin-5 (IL-5) antagonist monoclonal antibody, is approved by the U.S Food and Drug Administration for patients with idiopathic HES. Cytotoxic chemotherapy agents, and hematopoietic stem cell transplantation have been used for aggressive forms of HES and CEL, with outcomes reported for limited numbers of patients. Targeted therapies such as the IL-5 receptor antibody benralizumab, IL-5 monoclonal antibody depemokimab, and various tyrosine kinase inhibitors for MLN-eo-TK, are under active investigation.