Symptoms Research Articles

ANALISIS KALIUM PADA KEMATIAN AKIBAT RACUN IKAN: LAPORAN KASUS DAN TINJAUAN LITERATUR (POTASSIUM ANALYSIS IN FISH POISON MORTALITY: A CASE REPORT AND LITERATURE REVIEW)

Murder by poison has emerged in recent years as a legal issue that significantly impacts social life. Potassium cyanide is one type of poison that reacts very quickly. This compound will paralyse the oxygen transport system and, in higher doses, can weaken the heartbeat and stop electrical activity in the brain. This literature study was conducted based on a literature review by reviewing several related literatures that aim to analyse the crime case due to fish poison containing Potassium cyanide. The results of this literature review and case analysis show that the crime of using Potassium cyanide is complex and horrific, requiring a multidisciplinary approach to understand it. Cyanide poisoning can cause intracellular hypoxic disorders with symptoms of breathlessness. Less than one minute causes anxiety, headache, dizziness, and can even reduce the level of consciousness, seizures, and coma. From the three cases mentioned, forensic analysis of fish poison containing potassium cyanide in murder victims is an important step in a multidisciplinary approach that includes determining the cause of death, reconstructing events before death based on the victim's clinical symptoms, and providing scientific evidence to support legal justice.

PCR-Based Evaluation of Viral Load Reduction in Adenoviral Conjunctivitis: A Comparative Study of Ganciclovir and Povidone-Iodine

ABSTRACT Purpose To evaluate the efficacy of topical ganciclovir (GCV), povidone-iodine (PVP-I), and their combination with loteprednol etabonate (LE) in reducing viral load and improving clinical outcomes in adenoviral conjunctivitis. Methods This single-centered, controlled study enrolled patients diagnosed with adenoviral conjunctivitis, confirmed by the Rapid Pathogen Screening Adeno-Detector Plus test. Participants were assigned to five treatment groups: artificial tears (AT) as the control group, and the treatment groups included PVP-I, GCV, PVP-I/LE, and GCV/LE. Treatment efficacy was assessed by viral load, clinical sign and symptom scores, and complications (subepithelial infiltrates and pseudomembranes). The early phase encompassed days 0–7, and the late phase covered days 8–14. Results Seventy-five eyes were included. Adenovirus type 8 was the most common pathogen (95%). At baseline, clinical signs and symptoms were similar among groups (p > 0.05), but viral loads differed significantly (p = 0.036). The greatest reduction in viral load in the early phase was observed in the PVP-I group (p < 0.05). The fastest improvement of the clinical signs and symptoms was observed in the PVP-I/LE and the GCV/LE group (p < 0.05). Subepithelial infiltrates were significantly less frequent in the PVP-I/LE group (p = 0.014). Conclusions The combination of PVP-I/LE effectively reduced viral load and improved clinical outcomes in adenoviral conjunctivitis. PVP-I significantly decreased viral load in the early phase, while PVP-I/LE and GCV/LE combinations led to faster clinical improvement. Subepithelial infiltrates were significantly lower in the PVP-I/LE group, suggesting this combination may help prevent complications and offer an effective treatment option.

Kidney transplant program in Irkutsk Region

Introduction. Kidney transplantation (KT) is often considered the best option for renal replacement therapy (RRT), significantly improving patient outcomes. Post-transplant, life expectancy doubles, and mortality decreases more than 4-fold compared to other RRT modalities. This article presents KT outcomes in Irkutsk Region from 2018 to 2023. All procedures were performed at a single center – the Irkutsk Regional Clinical Hospital.Objective: to analyze the immediate and long-term outcomes of KT in Irkutsk Region.Material and methods. A retrospective analysis was conducted on the treatment outcomes of 125 patients with kidney failure (KF). Among them, 74 were men with a median age of 42 (35–49) years, and 51 were women with a median age of 46 (37–55) years. The median transplant waitlist time was 15.5 (range: 6–32) months. The leading cause of KF was chronic glomerulonephritis, observed in 60 patients (48%). There were no HLA matches in 36 patients (28.8%), while 38 patients (30.4%) had one match. Arterial anastomosis was primarily performed end-to-end with the external iliac artery in 121 cases (96.8%), while in 3 cases (2.4%), the internal iliac artery was used due to external iliac artery spasm. Cold ischemia time was 222 minutes (range: 162–360), and warm ischemia time was 39 minutes (range: 30–46).Results. Length of hospital stay was 16 (range: 13–25) bed days. Primary renal function was achieved in 95 patients (77%), while 25 patients (20%) experienced delayed graft function. Blood tacrolimus reached target levels by postoperative days 9–12. Creatinine level at discharge was 120 μmol/L (range: 97–165). Surgical complications occurred in 24 patients (19.2%), while urinary tract infections were observed in 36 patients (28.8%), with 17 cases (13.6%) presenting clinical symptoms. Immunosuppressive therapy was initiated in 124 patients (99.2%) using a standard triple-drug regimen (calcineurin inhibitors, mycophenolates, and glucocorticoids). One patient (0.8%) succumbed to complications from COVID-19. One-year graft survival was 94.1%.Conclusion. The immediate outcomes align with national averages. There is a consistent upward trend in the number of kidney transplants performed. Further development of the regional transplant program will enhance access to this high-tech medical service, meeting the needs of the local population.

The effectiveness of neuromuscula electrical stimulation therapy combined with swallowing exercises for patients with dysphagia following traumatic brain injury

Introduction: Dysphagia is a common complication following traumatic brain injury (TBI). Early detection and treatment of dysphagia are essential. Swallowing exercises combined with neuromuscular electrical stimulation (NMES) are used in TBI patients with dysphagia. This study aims to evaluate the effectiveness of swallowing exercises combined with NMES in patients with dysphagia due to TBI. Methods: This study is a pre- and post-intervention study on a series of first-time TBI cases with dysphagia. A total of 30 TBI patients with dysphagia were randomly selected. The patient group received treatment with swallowing exercises combined with NMES for 15 days. Demographic characteristics, time since TBI, incidence of post-TBI pneumonia, clinical symptoms of dysphagia, and GUSS scores were recorded on day 1 and day 15 post-treatment. Results: After the intervention period, the clinical symptoms of dysphagia in the patient group showed significant improvement, with a decrease in the percentage of dysphagia symptoms after 15 days. Before treatment, patients presented moderate (46.7%) to mild dysphagia (53.3%), with no patients experiencing severe dysphagia. Following treatment, the levels of dysphagia and risk of aspiration decreased, reflected by moderate dysphagia at 33.3% and mild dysphagia at 40%. Conclusion: Swallowing exercises combined with NMES are a safe and effective treatment method for patients with dysphagia following traumatic brain injury.

A complicated case of cutaneous necrotizing vasculitis associated with monoclonal gammopathy. Case report

Diagnosing diseases related to monoclonal gammopathy (MG) with clinical significance is challenging. In real-world practice, proving the connection between organ damage and paraprotein or plasma cell dyscrasia is difficult or even impossible. Only an atypical course of the disease and non-compliance with the established criteria may suggest the contribution of plasma cell neoplasia in pathogenesis. Rheumatic diseases associated with monoclonal secretion do not belong to MG with clinical significance. Therefore, in the absence of hematological malignancy, clone reduction therapy is not indicated. We present the first clinical case of a patient with cutaneous necrotizing vasculitis and MG, who received clone reduction therapy with no hematological malignancy. The rationale for the choice of such treatment approach was the atypical course of vasculitis, as well as the unstable effect after methylprednisolone therapy. Therapy with lenalidomide, cyclophosphamide, and dexamethasone was highly effective; the regression of clinical symptoms was associated with a decrease in paraprotein to trace amounts. However, the lack of evidence of the relationship of vasculitis with plasma cell dyscrasia does not support considering the described case as one of the forms of MG with clinical significance. Further observation and resumption of monoclonal secretion, coinciding with the recurrence of vasculitis, may additionally support the relationship between these two conditions. This case was discussed at the Council of Experts with hematologists, rheumatologists, and pathologists.

Radiotherapy for human T-cell leukemia virus type 1-associated adult T-cell leukemia/lymphoma.

Adult T-cell lymphoma/leukemia (ATL) is an aggressively malignant peripheral T-cell neoplasm. Only a few studies have reported the use of radiotherapy (RT) for ATL. Therefore, the aim of this study was to clarify the efficacy of RT for ATL. We retrospectively reviewed 90 courses of RT administered to 19 consecutive ATL patients between 2008 and 2023. The subtypes included lymphoma (n = 8), acute (n = 7), smoldering (n = 3) and unknown (n = 1). Ninety lesions (cutaneous = 72, extranodal = 10, nodal = 8) were treated at a mean dose of 39.1Gy/3.2Gy (range, 24-60Gy). Administration of RT for ATL lesions resulted in a combined complete response and partial response rate of 92%. At a mean of 47.5months of follow-up (range, 0-102months), local recurrence was not observed in 98.9% of the courses. A treatment response in terms of clinical symptoms was observed in 92% of the courses. The median survival time was 918days. No acute grade ≥3 toxicity or any late toxicity was noted. In conclusion, RT was confirmed to be effective and safe for the treatment of local ATL lesions.

The T1 mapping and T2 mapping of lateral pterygoid muscle: a quantitative analysis in patients with acute and chronic temporomandibular joint disorders.

The study aimed to quantitatively assess the signal changes in the lateral pterygoid muscle (LPM) of patients with acute and chronic temporomandibular joint disorders (TMD) using T1 mapping and T2 mapping techniques, and to explore the correlation between these changes and clinical symptoms. Fifty-five acute TMD patients, 121 chronic TMD patients, and 19 normal controls (NC) were enrolled in this prospective study. T1 mapping and T2 mapping sequences were acquired to obtain T1 and T2 values of the superior heads of the lateral pterygoid muscle (SHLP) and inferior heads of the lateral pterygoid muscle (IHLP). According to the position of the TMD, acute and chronic TMD patients were further divided into two subgroups, which were the normal position group (TMD-NP) and the anterior disc displacement group (TMD-ADD). Chronic TMD patients exhibited significantly lower T1 mapping values in both SHLP and IHLP compared to NC and acute TMD patients (p < 0.05). Conversely, acute TMD-ADD patients showed significantly higher T2 mapping values in SHLP and IHLP compared to acute TMD-NP and NC (p < 0.05). Positive correlation was observed between T2 mapping values and numerical rating scale (NRS) scores for pain in both acute and chronic TMD patients (p < 0.05). Chronic TMD may be associated with fat infiltration in the LPM, while acute TMD-ADD may present with inflammatory edema. The strong correlation between T2 mapping values and pain scores underscores the clinical utility of these techniques in assessing TMD severity and monitoring treatment responses. Question Are there differences in T1 and T2 mapping signals of the LPMs between patients with acute and chronic TMD? Findings Chronic TMD patients had lower T1 mapping values, and cut TMD-ADD patients had higher T2 mapping values than acute TMD-NP and NC. Clinical relevance By providing quantitative measures of muscle signal changes, T1 mapping and T2 mapping may help clinicians differentiate between acute and chronic TMD, assess the severity of muscle involvement, and guide treatment decisions.

The Clinical Significance of Non-Criteria Antiphospholipid Antibodies in Atypical Antiphospholipid Syndrome.

To analyse the correlation between non-criteria antiphospholipid antibodies (non-criteria aPLs) and clinical symptoms (recurrent miscarriage) in patients with seronegative antiphospholipid syndrome (SNAPS).Methods:Ninety-four SNAPS patients who were treated in the First Affiliated Hospital of Soochow University from May 2022 to May 2024 were included. Chemiluminescence immunoassay was used to detect anti-β2 glycoprotein I antibody (aβ2GPI), anti-cardiolipin antibody (aCL), and lupus anticoagulant. ELISA was used to detect the levels of anti-annexin A5 (ANXA5), anti-phosphatidylethanolamine antibody (aPE), anti-prothrombin IgG antibody (aPT IgG), anti-prothrombin IgM antibody (aPT IgM), anti-phosphatidylserine/prothrombin IgG antibody (aPS/PT IgG), and anti-phosphatidylserine/prothrombin IgM antibody (aPS/PT IgM). The correlation between non-criteria antiphospholipid antibodies and clinical events was analysed. Compared with the non-criteria antibody-negative group, the positive group had a higher rate of positive antinuclear antibodies (p < 0.05). The proportion of recurrent miscarriage in the positive non-criteria antibody group was significantly higher than in the negative group (p = 0.002). Compared with the negative group, patients with positive anti-annexin A5 antibody and aPT IgM were more likely to have recurrent miscarriage (p < 0.05). Compared with the aPE-negative group, those with aPE-positive were more likely to experience early miscarriage (p = 0.039). Both aPT IgM subtype (p = 0.004) and ANXA5 (p = 0.013) antibodies were the risk factors for recurrent miscarriage. Patients with positive ANXA5, aPT IgG, and aPT/PS IgM antibodies showed a significant decrease in antibody titers after treatment (p < 0.05). Detection of non-criteria aPLs contributes to improving the diagnosis of SNAPS, assessing its development trends, and intervening promptly to prevent recurrent miscarriage.

Hematopoietic Stem Cell Transplantation in an International Cohort of Colony Stimulating Factor-1 Receptor (CSF1R)-Related Disorder.

Colony stimulating factor-1 receptor (CSF1R)-related disorder (CSF1R-RD) is an autosomal dominant, rapidly progressive, demyelinating disease leading to death usually within a few years. Because of the central role of CSF1R in microglia functions, allogeneic hematopoietic stem cell transplantation (HSCT) has been suggested as a therapy for CSF1R-RD. To report multicenter clinical (Expanded Disability Scoring Scale [EDSS]), neurocognitive), neuroimaging (Sundal score), and biological (neurofilament light chain [NfL]) outcomes after HSCT in CSF1R-RD. We report an international cohort of 17 adult patients (8 females/9 males, 43.3 ± 9.4 years) who were treated in seven transplant centers. Patients were evaluated for a median of 2.5 years post-HSCT, including one patient with follow-up of 8 years. We also report neurological outcomes of the first child transplanted to date with biallelic CSF1R variants. In the first 6 months post-HSCT, 2 patients died from early complications of myeloablative transplantation, and clinical and radiological severity scores worsened in most surviving adult patients. At 12 months post-HSCT, most patients completely stabilized or improved in certain clinical domains. Radiological scores fully stabilized or slightly improved in all but one of the patients. Plasma/serum NfL sharply decreased in most patients after transplantation. Notably, 7/8 adult patients who received a reduced-intensity conditioning regimen displayed similar neurological outcomes as patients who underwent myeloablative transplantation. After an initial clinical and radiological deterioration in the first 6 months post-transplantation, HSCT can halt disease progression in patients with CSF1R-RD, regardless of their presenting clinical symptoms. The possibility of reduced conditioning regimens in CSF1R-RD opens the way to treat older patients. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Clinical Evidence on the Health Benefits and Safety of Probiotic Lacticaseibacillus rhamnosus: A Systematic Review.

In recent years, the health benefits of probiotics have received increasing attention. As one of the most common probiotics, the health efficacy and safety of Lacticaseibacillus rhamnosus (L. rhamnosus) have become the research focus. For this reason, the review aimed to comprehensively evaluate the impact of L. rhamnosus on human health and various diseases. PubMed, Embase, Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) investigating the effect of L. rhamnosus and multiple diseases. A digital search was conducted following systematic review guidelines, and 51 studies met inclusion criteria from a total of 1595 articles. The results of this review indicate that L. rhamnosus provides potential health benefits in various diseases. For example, studies have shown that it may alleviate clinical symptoms of atopic dermatitis in children, modulate gut microbiota to improve symptoms in patients with irritable bowel syndrome (IBS), and potentially reduce the incidence of gestational diabetes mellitus. L. rhamnosus is generally considered safe for healthy individuals, with no serious adverse events commonly reported in the general population. However, occasional adverse effects have been documented in special populations such as critically ill patients, pregnant women, and infants, and caution is advised when used in these groups. Future studies investigating the health benefits of L. rhamnosus still need to design more comprehensive RCTs and expand the sample size to better study the impact of L. rhamnosus on various diseases.

West Nile Virus Antibody Prevalence in Horses During the 2023 Outbreak in Tunisia, North Africa.

A total of 20 horses belonging to the Pasteur Institute of Tunis used for the production of therapeutic serum antiscorpion venom were tested for the presence of antibodies anti-West Nile virus (WNV) during the 2023 outbreak of West Nile disease that affected humans and horses in Tunisia. Of the 20 samples tested in November 2023 by enzyme-linked immuno-sorbent assay (ELISA), five were positive, leading to a seroprevalence of 25%. Since the number of horses is not substantial, all samples were tested also by virus microneutralization test (MNT) using the Tunisian strain of WNV lineage 1 isolated in 2014 from a pool of field-collected Culex pipiens from Central Tunisia. WNV-neutralizing antibodies were detected in two horses, yielding a seroprevalence of 10%. Of the five horses tested positive by ELISA, only two were positive by MNT. The follow-up of the serological analysis performed in December 2023 and January 2024 did not show any seroconversion in the remaining horses. No clinical cases were reported during the investigation. While molecular blood analysis failed to detect viral RNA, MNT-based seroprevalence provided strong evidence of the circulation of WNV during this outbreak. Taking into account that humans and horses share similar clinical symptoms and antibody responses following WNV infection, equid surveillance could provide an accurate and timely detection of WNV outbreaks.

Stage-specific computational mechanisms of working memory deficits in first-episode and chronic schizophrenia.

Stage-specific computational mechanisms of working memory deficits in first-episode and chronic schizophrenia.

Improving meningitis surveillance and diagnosis with machine learning: Insights from São Paulo

IntroductionMeningitis, an inflammatory condition of the membranes surrounding the brain and spinal cord, can be caused by various agents. Bacterial meningitis is particularly severe due to its high morbidity and mortality rates. This study aims to develop machine learning (ML) models to classify the aetiology of bacterial meningitis using data from the Notifiable Diseases Information System (SINAN) in São Paulo State, Brazil.MethodsData were collected from the SINAN database, including sociodemographic variables, clinical symptoms, and cerebrospinal fluid (CSF) analyses. Five ML models Random Forest, LightGBM, XGBoost, CatBoost, and AdaBoost were applied to classify meningitis cases into bacterial, fungal, viral, and other types. Models were evaluated using metrics such as AUC-ROC, accuracy, precision, recall, F1-score, and MCC.ResultsThe CatBoost model demonstrated superior performance, achieving an AUC-ROC of 0.95 for binary classification (bacterial vs. non-bacterial) and 0.85 for multiclass classification (Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae). XGBoost and LightGBM also showed promising results with AUC-ROC scores of 0.94 and 0.92, respectively, for binary classification. The CatBoost model exhibited high sensitivity and reasonable specificity, highlighting its applicability in the rapid and accurate diagnosis of meningitis. SHAP analysis identified variables such as leukocyte count and the presence of petechiae as influential predictors in the models.ConclusionML algorithms, particularly CatBoost, XGBoost, and LightGBM, proved highly effective in the differential diagnosis of meningitis, offering a valuable tool for the rapid identification of meningitis types and bacterial serogroups. These techniques can be integrated into public health protocols to improve meningitis outbreak responses and optimize patient treatment.

FREQUENCY OF DIFFERENT PRESENTATIONS IN MYOCARDIAL INFARCTION PATIENTS WITH AND WITHOUT DIABETES

Background: Myocardial infarction (MI) presents with a spectrum of symptoms, and diabetic patients often exhibit atypical or less pronounced presentations, which may delay diagnosis and treatment. Understanding the variation in symptomatology between diabetic and non-diabetic patients is essential for timely intervention. Objective: To determine the frequency of various clinical presentations of myocardial infarction and compare symptom patterns between diabetic and non-diabetic patients. Study Design: Cross-sectional observational study. Setting: Cardiology Department, Rehman Medical Institute, Peshawar. Duration of Study: From February 23, 2025, to May 23, 2025. Methods: A total of 164 patients (both diabetic and non-diabetic), aged 35 to 90 years, and diagnosed with MI were included. Clinical symptoms such as chest pain, arm pain, epigastric pain, jaw pain, nausea/vomiting, anxiety, and cold sweats were recorded and compared between the diabetic and non-diabetic groups. Data were analysed using descriptive statistics and Chi-square tests, with a p-value &lt;0.05 considered statistically significant. Results: The mean age of participants was 65.7 ± 16.47 years, with males comprising 56.7% of the cohort. Chest pain was the most commonly reported symptom (72%). Diabetic patients had a significantly higher frequency of epigastric pain (16.5%, p = 0.03), anxiety (32.9%, p = 0.01), and cold sweats (43.0%, p = 0.04) compared to non-diabetics. Other symptoms, such as arm pain, jaw pain, and nausea/vomiting, showed no statistically significant differences between the two groups. Conclusion: Chest pain remains the predominant presenting symptom in both diabetic and non-diabetic MI patients. However, diabetic patients are more likely to present with atypical symptoms such as epigastric pain, anxiety, and cold sweats. These findings underscore the need for heightened clinical suspicion and broader diagnostic criteria when assessing diabetic patients for MI.

Derivation and Validation of a COPD-specific Pulmonary Embolism Diagnostic Strategy.

Diagnosing pulmonary embolism (PE) in patients with chronic obstructive pulmonary disease (COPD) exacerbation is challenging due to similarities in clinical symptoms. The aim of this study was to evaluate predictors of PE and to derive and validate a COPD-specific PE diagnostic strategy.A post-hoc analysis of the PEP trial, a prospective multicenter study of patients with COPD hospitalized with acutely worsening respiratory symptoms, was conducted. The outcome predicted was PE at admission. Univariable and multivariable analyses were conducted to evaluate predictors of PE. Receiver operating characteristic curves were computed to determine the most discriminant D-dimer cut-offs. The COPD-specific PE diagnostic strategy was externally validated in the independent SLICE trial cohort.A total of 734 patients were included. At admission, the prevalence of PE and/or proximal deep venous thrombosis (DVT) was 6.5% (95%CI 5.0-8.6%). A COPD-specific PE diagnostic strategy consisting of a 3-item score (type of COPD exacerbation, alternative diagnosis less likely than PE, and clinical signs of DVT) combined with D-dimer at specific cut-offs (1,000 μg/L if 0 score item and 500 μg/L if 1 or 2 score items) was derived. The overall diagnostic failure rate was 0.9% (95%CI 0.4-1.9%) and 392 patients (53.4%) would need imaging to rule out PE. The external validation showed comparable results.A COPD-specific PE diagnostic strategy was derived specifically for patients with COPD and acutely worsening respiratory symptoms. Further prospective validation of this diagnostic algorithm is needed prior to integrating it in clinical practice.

Unmasking the Hidden Tumours: Clinical and Pathological Insights into Appendicular Neoplasms

Appendicular neoplasms, although rare, represent a diverse group of tumours arising from the appendix, including adenocarcinomas, carcinoid tumours, and mucinous neoplasms. This review aims to synthesize current knowledge on the epidemiology, diagnostic approaches, and treatment options for appendicular neoplasms. We conducted a comprehensive literature search across multiple databases, identifying key studies that elucidate the incidence, clinical presentation, and histopathological characteristics of these tumours. The epidemiological data highlight a slight male predominance and variability in incidence across different populations. Clinical symptoms often mimic acute appendicitis, leading to potential diagnostic challenges. Advanced imaging techniques, including ultrasound and computed tomography, play a critical role in diagnosis, often supplemented by histological analysis. Treatment typically involves surgical resection, with chemotherapy considered for advanced or high-grade tumours. Prognosis varies significantly depending on tumour type and stage at diagnosis, underscoring the need for early detection and tailored management strategies. This review identifies critical gaps in the literature and suggests directions for future research to enhance understanding and treatment of appendicular neoplasms.

Unveiling anomalies in visual processing regions in obsessive-compulsive disorder: evidence from gray matter volume and functional connectivity analyses.

Obsessive-compulsive disorder (OCD) is a prevalent neurological condition characterized by recurring obsessive thoughts and compulsive behaviors. The underlying mechanisms of the disorder remain poorly understood due to its considerable heterogeneity. Given the extensive brain impairments observed in OCD, this study aimed to investigate gray matter volume and functional connectivity in individuals with OCD using a multimodal neuroimaging approach, while also exploring the relationship between these neural changes and clinical symptom severity. Structural and resting-state functional magnetic resonance imaging data were collected from 56 OCD patients and 41 healthy controls. Voxel-based morphometry analysis was employed to identify gray matter volume differences between the patient and control groups. Compared to healthy controls, patients exhibited reduced gray matter volume in visual processing regions, including the cuneus, left calcarine, and middle occipital gyrus. Furthermore, whole-brain functional connectivity analysis was conducted on these regions with abnormal gray matter volume, showing increased connectivity between the visual processing areas and subcortical and prefrontal regions. Additionally, gray matter volume reductions in the left calcarine and middle temporal gyrus were significantly correlated with higher scores on the Yale-Brown Obsessive Compulsive Scale, suggesting a link between visual processing abnormalities and the severity of clinical symptoms. These findings highlight structural and functional alterations in visual-related brain regions as key contributors to the pathophysiology of OCD, providing valuable insights into its neural basis and potential avenues for therapeutic intervention.

A Case Control Study Examining the Patterns and Predictors of Referral to Cancer Rehabilitation at Canada's Largest Comprehensive Cancer Centre

ABSTRACTBackgroundCancer rehabilitation has become increasingly relevant as the number of cancer survivors grows, coupled with the high‐documented rates of adverse effects and related disability. Cancer rehabilitation can reduce functional limitations among cancer survivors and enhance their well‐being. However, only a small proportion of individuals are referred to rehabilitation services. To identify and address disparities and foster access, it is essential to develop a better understanding of the factors that drive referral to cancer rehabilitation services.MethodsThe purpose of this study was to: (1) describe the sociodemographic and clinical characteristics and symptom burden of patients who were referred to the Princess Margaret Cancer Rehabilitation and Survivorship (CRS) Program between 2017 and 2019 and (2) Compare these variables between patients who were referred to CRS (n = 2783) and matched cases who were not referred over this period (n = 18,434). A retrospective secondary analysis of data extracted from the Princess Margaret (PM) Cancer Registry, electronic patient records, and patient‐reported outcome data (PROMs) (including ESAS‐r and ECOG status) was performed. Summary statistics were used to describe the patients referred to the CRS program. Multivariable logistic regression modelling was used to identify factors associated with likelihood of referral.ResultsMost referred patients were female (74%), English speakers (93%) and half lived within 15 km of the referred hospital. The most common reasons for referral were musculoskeletal impairment (26%) and lymphedema (25.4%). Many patients (45%) had multiple reasons for referral. Several key predictors of referral were identified including closer distance to hospital, lower age (< 65 years), cancer site, and completion of PROMs. For those who completed PROMs, patient reported function status and pain scores were related to referral.ConclusionThe findings can be helpful in optimizing the referral processes and addressing disparities regarding access to cancer rehabilitation. Solutions are likely multifaceted including health care provider and patient education and systemic changes to address barriers.

The role of cholecalciferol deficiency in the development of dermatoses in geriatric patients

Background. Dermatological pathology, which includes a wide range of nosologies, is a common problem in geriatric patients. Currently, more and more attention is being paid to the importance of cholecalciferol deficiency in the pathogenesis of dermatoses, especially among the elderly. Vitamin D3 is known for its ability to modulate immune responses and perform many functions at the cellular level, including influencing the proliferation and differentiation of keratinocytes. Given the inevitable age-related changes in vitamin D3 metabolism and the increasing prevalence of dermatoses among geriatric patients, the present study aims to analyze the role of cholecalciferol deficiency on the course of dermatoses in this category of people. Aim. The aim of the study was to evaluate the role of cholecalciferol deficiency in the development of dermatological pathology and effectiveness its order in complex therapy in geriatric patients. Materials and methods. A prospective cohort study of 100 geriatric patients aged 67 to 95 years with verified skin diseases (chronic eczema, allergic dermatitis, microbial eczema, intertriginal dermatitis) was conducted. A Visually analog pruritus scale and the EASI index (Eczema Area and Severity Index) were used to assess the condition of patients at the entrance to the study. At the initiation stage of therapy, all patients underwent an analysis of serum cholecalciferol levels, according to which a vitamin-containing drug was prescribed. The assessment of the clinical effect and effectiveness of treatment was analyzed by the dynamics of the severity of clinical and subjective symptoms of Visually analog pruritus scale and EASI dermatoses after 2, 4, 12 weeks of therapy. Results. In the course of the study, it was found that: 100% of geriatric patients with dermatoses had a pronounced deficiency of serum vitamin D3 levels; evaluation of therapy for various dermatoses has demonstrated an improvement in clinical conditions in patients receiving vitamin D3 in addition to the main treatment Conclusion. The results of the study allowed us to establish: vitamin D3 deficiency is a common problem in geriatric patients with dermatoses, which can worsen the manifestation of diseases; recommendations to normalize vitamin D3 levels may be critical to maintaining dermatological health and overall well-being in geriatric patients.

PediMS: A Pediatric Multiple Sclerosis Lesion Segmentation Dataset

Multiple Sclerosis (MS) is a chronic autoimmune disease that primarily affects the central nervous system and is predominantly diagnosed in adults, making pediatric cases rare and underrepresented in medical research. This paper introduces the first publicly available MRI dataset specifically dedicated to pediatric multiple sclerosis lesion segmentation. The dataset comprises longitudinal MRI scans from 9 pediatric patients, each with between one and six timepoints, with a total of 28 MRI scans. It includes T1-weighted (MPRAGE), T2-weighted, and FLAIR sequences. Additionally, it provides clinical data and initial symptoms for each patient, offering valuable insights into disease progression. Lesion segmentation was performed by senior experts, ensuring high-quality annotations. To demonstrate the dataset’s reliability and utility, we evaluated two deep learning models, achieving competitive segmentation performance. This dataset aims to advance research in pediatric MS, improve lesion segmentation models, and contribute to federated learning approaches.