Common Pathology Research Articles

Red eye : common ocular pathologies in outpatient care

Red eye is a common condition characterized by eye redness, often accompanied by itching, burning, pain, or discharge. This condition can be caused by a multitude of factors, ranging from minor irritations to severe infections. Red eyes are a frequent complaint in outpatient practice. Only a small percentage of patients with red eyes require urgent ophthalmological referral and treatment, while the vast majority can be managed by a general practitioner.

A IMPORTÂNCIA DOS RECURSOS FISIOTERAPÊUTICOS PARA CRIANÇAS E ADOLESCENTES COM ESCOLIOSE IDIOPÁTICA

Idiopathic scoliosis is the most common pathology in adolescents and children, prevailing in 80% of scoliosis cases. Physiotherapy treatment serves to prevent and improve pain and quality of life by improving muscle strengthening, mobility and range of motion in the spine. This article carries out a systematic review of articles published between 2015 and 2024, using the Ânima University (RUNA), SciELO and LILACS databases. It presents some case studies and randomized clinical trials investigating the application of Global Postural Reeducation (GPR) and Pilates methods in reducing the curvature of scoliosis in children and adolescents. A total of 15 studies were selected, but of these, 5 were excluded, leaving 10 scientific productions that were consistent with the objectives of the study. The results indicated a significant reduction in curvature in both methods.

Use of Postoperative Radiotherapy and Multiple Adjuvant Treatments After Surgical Removal of a Giant Retroauricular Keloid ina Pediatric Patient.

The use of postoperative radiotherapy (PORT) for the treatment of keloids in the pediatric population is rare, despite being a common pathology at this age. Recurrences after surgery are very common. The absence of a standardized protocol for the management of recurrent keloids further complicates therapeutic decision-making. Here, we present a clinical case involving a recurrent giant retroauricular keloid in a pediatric patient, demonstrating a satisfactory response to a comprehensive approach involving surgery, PORT, and periodic injections of 5-fluorouracil with corticosteroid. We believe that reporting this case adds value as a potential therapeutic option in the absence of established protocols for recurrent keloids in pediatric patients.

What is the spectrum of kidney pathology associated with COVID-19?

Kidney involvement occurs in almost one third of patients hospitalised with coronavirus disease 2019 (COVID-19) and is associated with increased disease severity. This review aims to outline the spectrum of kidney pathology involved in COVID-19. Literature was reviewed systematically on the databases Medline OVID and Scopus in search of case reports, case series, cohort studies and autopsy studies of patients with COVID-19 who underwent kidney biopsies. Studies were published between August 2020 and November 2021. Fourteen studies consisting of 159 patients were included in this review. Acute tubular necrosis is the most common pathology followed by collapsing glomerulopathy, occurring in 40.1% and 28.9% of patients respectively. Of the 46 patients with collapsing glomerulopathy, 44 were of African descent with high-risk apolipoprotein L1 genotypes. Less common glomerular diseases include membranous nephropathy, secondary focal segmental glomerulosclerosis, minimal change disease and primary focal segmental glomerulosclerosis occurring in 5%, 4.4%, 3.1% and 2.5% of patients respectively. Glomerulonephritis occurred in a minority of patients. Direct viral infection has not been found as a definitive aetiology. Acute kidney injury occurs frequently in hospitalised COVID-19 patients and is associated with increased morbidity and mortality. The mechanisms underpinning acute kidney injury are multifactorial. Acute tubular necrosis is the most common. Collapsing glomerulopathy is the most common glomerular injury and is strongly linked to apolipoprotein L1 genotypes. Improved understanding of COVID-19-related kidney pathologies can guide treatment to improve patient outcomes and reduce progression of chronic kidney disease. The longitudinal impact of COVID-19-related kidney disease requires further research.

Göç Olgusunun Göçmen Bireyler Üzerindeki Ruh Sağlığına Etkisi

Migration is a complex structure that has existed throughout human history of individuals and units. There are different types of migration. Internal migration means displacement within the borders of the country. Emigration means leaving the regions they belong to for certain reasons. Brain drain, on the other hand, occurs when people who have developed their own personality are academically educated elsewhere due to the country's conditions. As a result of this move, immigrant individuals are affected by spiritual and emotional changes. The psychological effects of immigration on immigrants are known. Immigrant individuals may experience difficulties in three different categories: before migration, during migration and after migration. As a result of research on common pathologies seen in immigrants, post-traumatic stress disorder, anxiety disorders, self-alienation, schizophrenia, somatization disorder, and increased psychotic features have been expressed. It is known that the life disruption of immigrants has also been reduced. There are definitions of these immigrant types, as well as the psychological transitions of immigrant individuals and the common problem seen in immigrants. Literature research is included in their content. It can be stated that the results of the research showing that migration disrupts the daily life of the students and that psychological problems arise in their lives in a negative way can be expressed. Keywords: Types of migration, migrants, psychology, mental health, trauma.

Segmentation of periapical lesions with automatic deep learning on panoramic radiographs: an artificial intelligence study

Periapical periodontitis may manifest as a radiographic lesion radiographically. Periapical lesions are amongst the most common dental pathologies that present as periapical radiolucencies on panoramic radiographs. The objective of this research is to assess the diagnostic accuracy of an artificial intelligence (AI) model based on U²-Net architecture in the detection of periapical lesions on dental panoramic radiographs and to determine whether they can be useful in aiding clinicians with diagnosis of periapical lesions and improving their clinical workflow. 400 panoramic radiographs that included at least one periapical radiolucency were selected retrospectively. 780 periapical radiolucencies in these anonymized radiographs were manually labeled by two independent examiners. These radiographs were later used to train the AI model based on U²-Net architecture trained using a deep supervision algorithm. An AI model based on the U²-Net architecture was implemented. The model achieved a dice score of 0.8 on the validation set and precision, recall, and F1-score of 0.82, 0.77, and 0.8 respectively on the test set. This study has shown that an AI model based on U²-Net architecture can accurately diagnose periapical lesions on panoramic radiographs. The research provides evidence that AI-based models have promising applications as adjunct tools for dentists in diagnosing periapical radiolucencies and procedure planning. Further studies with larger data sets would be required to improve the diagnostic accuracy of AI-based detection models.

Limited Availability and Readability of Spanish Language Patient Educational Material: A Review of the Nation's Top Children's Hospitals.

Cleft lip with or without cleft palate (CL/P) is a common congenital facial pathology that occurs at higher incidences in Hispanic communities. The authors analyzed the availability and readability of Spanish-written patient education materials (PEMs) on CL/P from top-ranking U.S. children's hospitals to determine the presence of health literacy barriers. Availability of PEM was evaluated by 2 methods: (1) Google search and (2) evaluation of the official hospital websites. For each institution, a Google search was conducted using the phrase, "labio leporino y/o paladar hendido (translation: CL/P) + (hospital name)." In addition, each hospital website was assessed for Spanish PEM availability. Spanish PEMs were then categorized by whether they had been generated by an automated translation function or if they were independently written Spanish text. English PEM readability was assessed using the Simple Measure of Gobbledygook (SMOG). Spanish PEM readability was assessed using spanish orthgraphic length (Spanish Orthographic Length), the SMOG converted for the Spanish language. Unpaired 2-tailed t tests were used to compare readability. Of a total of 85 pediatric hospitals, 28 (37.3%) had Spanish PEM. Five (6.7%) hospitals created their own Spanish-language document. The average spanish orthgraphic length reading level was 9.49 compared with an average SMOG of 11.38 (P < 0.001). Institutions that did not provide Spanish PEM in any format had a significantly higher SMOG for English PEM of 12.13 compared with 11.38 of those that had SMOG with English PEM (P = 0.04). Health literacy barriers not only exist for Spanish PEM but also for English PEM, indicating an opportunity to improve communication.

PATOLOGIAS EM PAVIMENTOS FLEXÍVEIS: TRECHO AVENIDA TORQUATO TAPAJÓS COM AVENIDA CONSTANTINO NERY NA CIDADE DE MANAUS - AM

This study aimed to conduct a case analysis through the evaluation and assessment of pathologies in flexible pavements at a stretch of Avenida Torquato Tapajós with Avenida Constantino Nery, in the city of Manaus - AM. The research sought to identify the causes and origins of these pathologies, relating solutions to each diagnosed situation based on theses, articles, and consulted literature. The main objective of this article is to analyze the most common pathologies in flexible pavements. The research is justified by the need to assess the maintenance of damages and pathologies in pavements, a constant factor in the infrastructure sector that incurs high costs and requires thorough analysis to determine the procedures to be adopted. The method used was a descriptive qualitative exploratory study, grounded in existing literature and field documentation. Based on the analysis of the pathologies, the necessary maintenance methods were defined in accordance with federal regulations and current standards in Brazil. The results revealed different classifications of pathological manifestations in flexible pavements. It was found that the traffic anticipated for the road project does not align with its actual usage, contributing to the noticeable occurrence of cracks in the analyzed roadway. Implementing best practices can mitigate the negative impacts of these pathologies, ensuring the longevity of pavements and the safety of users. Adherence to established guidelines is crucial to ensure that flexible pavements meet required standards, avoiding future problems arising from inadequate interventions. With the increasing digitization in the construction sector, the integration of new technologies becomes increasingly viable for managing pathologies in flexible pavements in heavily trafficked highway segments.

Contralateral Sublaminar Approach in Lumbar Spine With Unilateral Biportal Endoscopy

Unilateral biportal endoscopy (UBE) can be used to treat common lumbar pathologies, such as synovial facet cysts, foraminal disc herniations, and foraminal stenosis via a contralateral sublaminar approach. Due to the ultra-minimally invasive technique, UBE can reduce damage to anatomical structures, thereby reducing postoperative pain and allowing faster recovery. The patient is placed prone on a Wilson frame or bolsters. Fluoroscopy is used to identify the midline and medial pedicle line in the anterior-posterior projection. Spinal needles can aid to identifying portals’ trajectory in the lateral fluoroscopic projection. The procedure is performed via 2 separate portal incisions. The endoscope is introduced through the viewing portal and the surgical instruments through the working portal. Soft tissue dissector is used to create a working area over the spinous process-lamina junction. Bony shaving and drilling start at the target area and continue medially underneath the base of the spinous process until the midline and contralateral ligamentum flavum are identified. Contralateral ligamentum flavum is excised, exposing thecontralateral thecal sac, traversing nerve root, and lateral recess. The contralateral disc space, annulus, and superior articulating process are then identified and the offending pathology can be addressed under direct visualization. Meticulous hemostasis and close attention to outflow should be maintained to reduce the risk of complications. The steps of this procedure closely resemble those of traditional microscopic “over-the-top” techniques, including the surgical instruments used through the working portal. In this video, authors present the surgical technique of the contralateral sublaminar approach in the lumbar spine with UBE.

Chitinase 3-like 1 overexpression aggravates hypoxia-reoxygenation injury in IEC-6 cells by inhibiting the PI3K/AKT signalling pathway.

Intestinal ischaemia-reperfusion (I/R) is a common clinical pathology with high incidence and mortality rates. However, the mechanisms underlying intestinal I/R injury remain unclear. In this study, we investigated the role and mechanism of chitinase 3-like 1 (CHI3L1) during intestinal I/R injury. Therefore, we analysed the expression levels of CHI3L1 in the intestinal tissue of an intestinal I/R rat model and explored its effects and mechanism in a hypoxia-reoxygenation (H/R) IEC-6 cell model. We found that intestinal I/R injury elevated CHI3L1 levels in the serum, ileum and duodenum, whereas H/R enhanced CHI3L1 expression in IEC-6 cells. The H/R-induced inhibition of proliferation and apoptosis was alleviated by CHI3L1 knockdown and aggravated by CHI3L1 overexpression. In addition, CHI3L1 knockdown alleviated, and CHI3L1 overexpression aggravated, the H/R-induced inflammatory response and oxidative stress. Mechanistically, CHI3L1 overexpression weakened the activation of the phosphoinositide 3-kinase (PI3K)/AKT pathway, suppressed the nuclear translocation of Nrf2, and promoted the nuclear translocation of nuclear factor κB (NF-κB). Moreover, CHI3L1 knockdown had the opposite effect on the PI3K/AKT pathway, Nrf2, and NF-κB. Moreover, the PI3K inhibitor LY294002 blocked the effect of CHI3L1 knockdown on the H/R-induced inhibition of proliferation, apoptosis, inflammatory response and oxidative stress. In conclusion, CHI3L1 expression was induced during intestinal I/R and H/R injury in IEC-6 cells, and CHI3L1 overexpression aggravated H/R injury in IEC-6 cells by inhibiting the PI3K/AKT signalling pathway. Therefore, CHI3L1 may be an effective target for controlling intestinal I/R injury.

Giant Epididymal Cyst in the Right Testicle: Case Report and Literature Review.

Introduction: Cystic intratesticular lesions can occur in the second and fourth decades of life and are typically identified via ultrasound. Testicular cysts, usually under 2 cm, result from epididymal-lymphatic obstruction or hormonal changes. Larger lesions with sperm and lymphocytes are spermatoceles. Epididymal cysts are asymptomatic but can cause discomfort or pain, sometimes requiring surgery. Clinical case: A 38-year-old male with no chronic diseases presented with a giant tumor in the right testicle, experiencing pain and hypersensitivity. Physical examination and ultrasound revealed an irregular, painful testicular tumor and a right epididymal cyst. A right epididymal tumor excision was performed successfully. Discussion: Testicular cysts are benign and represent 20-40% of benign testicular tumors. They may arise due to idiopathic, infectious, or traumatic causes with no established risk factors. Diagnosis is often incidental and involves physical examination and imaging techniques like ultrasound. Management is conservative for asymptomatic cases, while symptomatic cases may require surgical intervention that involves careful separation of the cyst from the adhered area. Conclusion: An epididymal cyst is a common pathology in males worldwide, occupying up to 40% of the masses in the testes at the time of a urological assessment. It is a collection at the testicular level of hyaline content and usually measures &lt; 2 cm. They are generally asymptomatic, but when their size exceeds 2 cm or causes symptomatology, it is important to know the therapeutic options that can be offered to patients. In the case of our patient, as it is an epididymal cyst with a diameter of 5 cm and with additional symptomatology, the ideal management was surgical resection, showing adequate evolution in the postoperative follow-up.

Natural language processing realises the potential of electronic health records: identifying risk factors for disease progression and major adverse limb events in intermittent claudication

Abstract Background/Introduction Peripheral Arterial Disease (PAD) is a common pathology, affecting 4.5% of the UK population. Symptomatic PAD manifests as intermittent claudication (IC). Predictors of IC progression to Chronic-Limb-Threatening Ischaemia (CLTI) and complications including Major Adverse Limb Events (MALE), such as smoking history and diabetes, have been described previously in resource-intensive cohort studies. Novel Natural Language Processing (NLP) approaches transform routinely collected, unstructured health records into datasets for real-world analysis of PAD. Purpose This study leverages NLP based interrogation of electronic health records to efficiently identify risk factors for disease progression and MALE in patients presenting with IC. Methods A retrospective cohort study of patients with PAD at a large, tertiary vascular referral centre identified using the SNOMED terms of IC in the Medcat-NLP-AI toolkit. Demographics, Index of Multiple Deprivation (IMD), and indicators of disease progression, and revascularisation and amputation (MALE) were analysed using Kaplan-Meier survival and Cox Proportional-Hazards analysis. Results 5,027 patients (Mean age 73.7(61.8-85.6), Males 66.1% (n=2,781) were identified. Self-reported population ethnicity was 4.72% Asian, 15.5% Black, 79.7% White. All-cause mortality was 19.5% (n=979) after 10 years of follow-up, with 5.85% of patients progressing to CLTI (n=294). 2.32% of Asian patients, 5.78% of Black patients and 5.04% of White patients progressed to CLTI, respectively. 5.09% of Asian patients, 8.99% of Black patients, and 7.36% of White patients underwent amputation. Multivariate analysis of risk factors for progression to CLTI, demonstrated that diabetes (HR 2.36, 95%CI: 1.22 - 4.48, p = .01) and smoking history (HR 1.76, 95%CI: 1.19 - 2.59, p = .004) independently predicted progression. No risk factors for MALE reached significance. Conclusions Diabetes and smoking behaviour are well-described in the literature as risk factors for progression to CLTI. This study demonstrates the utility of NLP as a resource efficient, validated, methodological tool. Disparities in MALE may exist between patients within a universal healthcare system, although our sample size was insufficient to demonstrate statistical significance. A larger, multicentre analysis is warranted. NLP represents a valuable tool for efficiently identifying and analysing risk factors for PAD progression and holds potential to refine management algorithms.KM curves of CLTI-free survival (DM)

Impact and determinants of depression in cardiac hospitalized patients

Abstract Depression increases cardiovascular risk and involves worse clinical outcomes. Little attention is paid to it in hospitalized patients. We studied prevalence and determinants of depression in this group, in order to select patients for further specific management. Methods Consecutive patients admitted to Cardiology wards were included. Cardiovascular risk factors, clinical and psychosocial data were collected. Self perceived mental and physical health quality were assesed by 12-item Short Form survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) questionnaires were administered. Statistical analysis was performed using Spearman´s correlation, Mann-Whitney and Fisher tests, and Mantel-Cox, linear and logistic regression analyses. Results 170 consecutive patients, median age 74.5 (67.2-81.1), 59.4% male, were included. Most common pathologies were heart failure (44.7%) and coronary syndroms (28.8%). According to HADS results, depression was probable (score &amp;gt;10) in 10%, and at least possible (score &amp;gt; 8) in 27.1%. Both increased duration of hospitalization (Median 14 vs 7 days;p=0.016 and 11 vs 7 days;p=0.005 respectively). Anxiety was present in 16.5 % for probable case and 34.1% for possible case, with no significant change in median duration of hospitalization. 22.9% of patients were under antidepressant treatment, and 24% under anxiolytics, but they were added to treatment only in 1% and 7% respectively. No other not pharmacological measure was initiated. Self perceived mental health was diminished in probable depression (mean difference 14.9%;95%IC 9.7-20.2;p&amp;lt;0.001). Self perceived physical health was also lower (mean difference 6.4%;95%CI:1.1-11.8;p=0.016). Patients with depression were a mean of 5.6 years older (95%CI 1.4-9.8;p=0.032). Less than primary education (OR 5.69 (p 0.021), and Previous hospital admission OR 3.2 (1.0-10.3;p=0.034) increased the risk of depression in univariate analysis. By multivariate analysis, determinants of depression were anxiety (OR 22.5;95%CI 5.9-85.6;p&amp;lt;0.0001), need for surgery (OR 12.3;95%IC 2.1-73.2;p=0.009), need for intensive care unit surveillance (OR 4.2;95%CI 1.1-15.8;p=0.039), and age (OR 1.1;95%IC 1.0-1.2;p=0.001. AUC was 0.89;95%CI 0.81-0.96;p&amp;lt;0.0001. There was no difference in civil status, gender, income level, living accompanied, number of comorbidities, cardiovascular risk factor or reason for hospital admission. Conclusions Depression was prevalent in our hospitalized cardiac patients,in spite of previous pharmacological treatment. It prolongs duration of stay and impacts negatively in self perceived mental and physical health. Risk is increased in older people requiring intensive care surveillance or surgery, and specially by anxiety. These patients could benefit from a preventive multifactorial approach. Attention should also be paid to patients with a previous hospitalization and low educational level.ROC curve for multivariate model

Preliminary findings of the TB-HEART Study: prevalence of cardiac pathology among newly diagnosed patients with tuberculosis with and without HIV in Zambia

Abstract Background Cardiovascular diseases (CVD) burden is rapidly increasing in sub-Saharan Africa (SSA) where tuberculosis and HIV prevalence remain high.(1-3) Recent data suggest pulmonary tuberculosis (PTB) is associated with increased CVD morbidity.(4) However, the mechanisms of cardiac injury remain poorly understood. Purpose The TB-HEART study is a cross-sectional and natural history study consecutively recruiting participants with newly-diagnosed PTB, living with and without HIV in Zambia. The primary outcome is the burden of cardiac pathology in PTB patients with and without HIV. Methods Participants with bacteriologically-proven PTB, consecutively recruited from an outpatient settings in Zambia, undergo detailed clinical and functional assessments including point-of-care and standard two-dimensional (2D) echocardiography. Participants are reviewed at completion of TB treatment when all assessments are repeated. The target sample size is 250 participants with PTB, with and without HIV, matched 2: 1 to participants without PTB, stratified by HIV. Results Since 1 November 2023, we have recruited 73 participants with a mean age of 35.3±10.9 years of whom 51/73 (69.9%) are male and 19/73 (23.5%) are living with HIV. Baseline characteristics including cardiovascular risk factors, TB symptoms, anthropometry and clinical and functional observations at presentation, stratified by HIV status, are summarised in Table 1. We detected significant cardiac pathology (defined as left ventricular ejection fraction (LVEF) &amp;lt;51% and/or pericardial effusion &amp;gt;2cm in depth) in 8/65 (12.3%) participants for whom 2D-echocardiography had been completed. Median LVEF was 61.2% (IQR 57.7-67.8). LVEF was normal in 59/65 (91%); mildly abnormal in 5/65 (7.7%); and moderately abnormal in 1/65 (1.5%) participants, respectively. Pericardial effusion &amp;gt;0.5cm was detected in 16/65 (24.6% ) participants and maximum effusion depth was &amp;gt;2cm in 2/16 (3.1%), 1-2cm in 12/16 (75%) and &amp;lt;1cm in 2/16 (12.5%). 2D-echocardiography findings, stratified by HIV-status, are described in Table 2 alongside two echocardiography stills of typical pericardial effusion findings in one participant. Conclusions Our preliminary results demonstrate a higher than expected prevalence of cardiac pathology among participants with PTB with and without HIV, which ranges from 1-7% in autopsy studies and case series.(5-7) The most common cardiac pathology was pericardial effusion. Further analyses will include cardiac biomarkers; repeat clinical and echocardiographic assessments at TB treatment completion; and comparator data, to determine associations between prevalent cardiac pathology and PTB controlling for HIV and TB status, respectively. This may have important implications for clinical practice to prevent complications such as constrictive pericarditis; and policy design to better integrate TB and HIV patient services with preventative care to reduce future CVD risk.Table 1 - Baseline characteristicsFigure 1 and Table 2

Clinical characteristics and outcomes of patients presenting with acute coronary syndromes and suspected plaque erosion

Abstract Background Plaque erosion (PE) is the second most common pathology of acute coronary events after plaque rupture. PE is characterized by endothelial denudation and formation of neutrophil extracellular traps. Patients with PE may have a different prognosis as compared to those with plaque rupture. Specific clinical and laboratory predictors were validated to suspect PE among acute coronary syndrome (ACS) patients. Purpose The objectives of this study were to compare both clinical and laboratory findings, and outcomes of ACS patients with high probability of PE and those with less likely PE. Methods Six hundred ninety-six ACS patients were divided into two groups (suspected PE vs less likely PE) based on 5 reported predictors of PE. The predictors were: age &amp;lt;68, anterior ischemia, no diabetes mellitus, hemoglobin &amp;gt;15 g/dL and normal renal function (eGFR&amp;gt; 60 ml/min) as assessed at hospital admission. Patients with 4 or 5 of these 5 predictors were included in the suspected PE group, while patients with 0 or 1 entered less likely PE group. Baseline clinical features and laboratory analyses at hospital admission were compared between the two groups. Major adverse cardiac events (MACE), defined as death from any cause, non-fatal myocardial infarction or unplanned revascularization, were compared between the two groups at 20 months after hospital discharge. Results Among 696 patients, 283 (41%) composed the suspected PE group, while 413 (59%) entered into less likely PE group. The suspected PE group had a higher prevalence of current smokers and had a higher BMI. They showed higher values of both LDL cholesterol and triglycerides, while C-reactive protein and fibrinogen levels were significantly lower. The suspected PE group showed a higher frequency of single vessel disease (Table). The suspected PE group showed a significantly lower rate of MACEs at 20 months (7.4% vs 28.8%, p=0.0001) as well as death from any cause was significantly lower (2.1% vs 24.9%, p=0.0001). The median time from the index ACS episode to recurrent myocardial infarction or unplanned coronary revascularization tended to be longer in the suspected PE group as compared to the less likely PE group (15 months [9-20] vs 9 months [6-13], p=0.062) (Figure). Conclusions In a cohort of ACS population, the suspected PE group showed distinctive clinical characteristics with less coronary plaque burden and low grade of systemic inflammation. The suspected PE group had a better prognosis at 20-month follow-up time with a significantly lower rate of death from any cause, and non-fatal coronary events tended to occur later.Table.Baseline characteristicsFigure.Non fatal coronary events

Acute Ear, Nose and Throat Pain in Children in Brazzaville

Objective: To evaluate the intensity of acute pain associated with ENT conditions during consultations and the effectiveness of the analgesic prescribed. Patients and Methods: We conducted a prospective, experimental, randomised, double-blind study in the ENT CCF department of the CHUB. The study took place over a period of 9 months (01 March to 30 November 2021) and involved only children aged 2-12 years presenting with an acute ENT complaint and having been treated in the ENT consultation department of the CHUB. Paracetamol and ibuprofen were administered after pain assessment. Results: During the study period, 60 patients presented with acute ENT complaints and were managed on an outpatient basis. The mean age was 7.7 +/- 31 years, with extremes ranging from 2 to 12 years. Tekes were the most represented ethnic group at 58.4%. Schoolchildren represented the most common school level. Acute pain affected patients' life activities. Acute pharyngitis was the most common pathology. Acute ENT pain. Paracetamol and ibuprofen were the molecules most frequently used, and pain was virtually absent on the 3rd day of use (96.7% and 75% respectively for paracetamol and ibuprofen). Conclusion : Acute pain in children is often underestimated or sometimes inadequately treated.

Mechanisms of Bioactive Lipids to Modulate Master Regulators of Lipid Homeostasis and Inflammation in Metabolic Syndrome.

Metabolic Syndrome (MetS) refers to the co-occurrence of a constellation of metabolic diseases in the same individual, such as abdominal/visceral obesity, insulin resistance or diabetes, alterations in the lipid profile (dyslipidemias), and/or hypertension, which promotes the development of other cardiometabolic and hepatic diseases. Dyslipidemia and metabolic dysfunction- associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), are common MetS pathologies closely related to lipid metabolism. Alterations in the metabolism of proteins, carbohydrates, and lipids, caused by an excessive intake of nutrients and abnormal accumulation of body fat, which promotes chronic low-grade inflammation, are pivotal aspects of MetS development. To avoid damage caused by lipid overaccumulation, the transcription factors responsible for regulating lipid homeostasis and inflammation (named in this work master regulators) must modify their regular activity; however, the high adiposity established for long periods causes the appearance of insulin resistance (the MetS triggering factor most widely accepted in the literature). Fortunately, scientific evidence suggests that the abnormal activity of these regulators can be conveniently modulated by distinct species of bioactive lipids, among which unsaturated fatty acids stand out, offering new alternatives for treating MetS. Therefore, this work aims to provide a general overview of scientific evidence that supports the mechanisms of action and the effective modulation by bioactive lipids of some master lipid-metabolism-and-inflammation regulators in diverse aspects of MetS.

Adults with congenital heart disease: what every cardiologist should know about their care.

As patients with congenital heart disease (CHD) continue to enjoy longer lives, non-congenital cardiologists and other healthcare professionals are increasingly encountering them in their practice and are challenged by their specific needs. Most under- and post-graduate medical training tends to overlook this common pathology, resulting in insufficient awareness of post-repair or post-palliation residual lesions and sequelae from previous interventions. In a strive towards improving the quality of care for this ever-growing cardiovascular patient cohort, it is prudent to outline the areas of concern and specific management needs pertaining to adult patients with CHD and share it with non-CHD professionals. The purpose of this paper is to offer essential guidance to physicians, including cardiologists, when they encounter a patient with CHD in a non-congenital healthcare setting.

Metabolic and lifestyle factors accelerate disease onset and alter gut microbiome in inflammatory non-communicable diseases.

Biomedical and lifestyle factors in Western populations have significantly shifted in recent decades, influencing public health and contributing to the increasing prevalence of non-communicable diseases (NCDs) that share inflammation as common pathology. We investigated the relationship between these factors and 11 NCDs in the cross-sectional FoCus cohort (n = 1220), using logistic regression models. Associations with age-at-disease-onset were specifically analyzed for type 2 diabetes (T2D, low-grade chronic inflammation) and inflammatory bowel disease (IBD, high-grade chronic inflammation) in disease-specific cohorts (FoCus-T2D, n = 514; IBD-KC, n = 1110). Important factors for disease risk were identified using Cox-PH-regression models and time-to-event analysis. We further explored the interaction between identified risk factors and gut microbiome composition using linear models. Lifestyle factors were clearly linked to disease phenotypes, particularly in T2D and IBD. Still, some factors affected only the age-at-onset, but not disease prevalence. High-quality nutrition significantly delayed onset for both IBD and T2D (IBD: HR = 0.81 [0.66; 0.98]; T2D: HR = 0.45 [0.28; 0.72]). Smoking accelerated T2D onset (HR = 1.82 [1.25; 2.65]) but delayed onset in ulcerative colitis (UC: HR = 0.47 [0.28; 0.79]). Higher microbiota diversity delayed IBD onset (Shannon: HR = 0.58 [0.49; 0.71]) but had no effect on T2D. The abundance of specific microbial genera was strongly associated with various biomedical and lifestyle factors in T2D and IBD. In unaffected controls, these effects were smaller or reversed, potentially indicating a greater susceptibility of the gut microbiome to negative influences in T2D and IBD. The dual insights into age-at-disease-onset and gut microbiota composition in disease emphasize the role of certain biomedical and lifestyle factors, e.g., nutrition quality, in disease prevention and management. Understanding these relationships provides a foundation for developing targeted strategies to mitigate the impact of metabolic and inflammatory diseases through lifestyle modifications and gut health management.

Diagnostic considerations and orthodontic treatment approaches of adolescents with the dentoalveolar form of class II malocclusion

Relevance. Class II malocclusion (distal occlusion) is a common pathology of the maxillofacial region in the sagittal plane and is one of the most prevalent malocclusions. Studies confirm that Class II malocclusion in adolescents exhibits significant variability, prompting the development of various treatment approaches using both removable and fixed orthodontic appliances. The challenges of adolescence include concurrent physiological and psychological changes, which can complicate the treatment process.Purpose. To enhance the effectiveness of orthodontic treatment for patients with the dentoalveolar form of Class II malocclusion by utilizing the Rotation-Torque Index (RTI).Material and methods. A study was conducted on 49 residents of St. Petersburg with physiological occlusion types, who were included in the control group. The main group comprised 95 adolescents (aged 12-18) with the dentoalveolar form of Class II malocclusion classified into three levels of severity, based on the proposed working prognostic classification.Results. A new method was developed to calculate a coefficient that describes the relationship between the position of the upper and lower jaws and the torque of the central incisors. This coefficient helps predict treatment outcomes and guides the selection of the optimal treatment strategy. The Rotation-Torque Index (RTI) was introduced to quantify the relationship between the position of the jaws in the skull (SNA, SNB) and the inclination of the central incisors of the upper jaw relative to the nasal line (NL) and those of the lower jaw relative to the mandibular line (ML).Conclusions. Based on the Rotation-Torque Index (RTI), a working prognostic classification and treatment strategies for patients with the dentoalveolar form of Class II malocclusion were proposed.