Early Symptoms Research Articles

Mapping the diagnostic odyssey of congenital disorders of glycosylation (CDG): insights from the community

BackgroundCongenital disorders of glycosylation (CDG) are a group of rare metabolic diseases with heterogeneous presentations, leading to substantial diagnostic challenges, which are poorly understood. Therefore, this study aims to elucidate this diagnostic journey by examining families’ and professionals’ experiences.Results and discussionA questionnaire was designed for CDG families and professionals, garnering 160 and 35 responses, respectively. Analysis revealed the lack of seizures as a distinctive feature between PMM2-CDG (11.2%) with Other CDG (57.7%) at symptom onset. Hypotonia and developmental disability were prevalent symptoms across all studied CDG. Feeding problems were identified as an early onset symptom in PMM2-CDG (Cramer’s V (V) = 0.30, False Discovery Rate (FDR) = 3.8 × 10− 9), and hypotonia in all studied CDG (V = 0.34, FDR = 7.0 × 10− 3). The average time to diagnosis has decreased in recent years (now ~ 3.9 years), due to advancements namely the increased use of whole genome and exome sequencing. However, misdiagnoses remain prevalent (PMM2-CDG – 44.9%, non-PMM2-CDG – 64.8%). To address these challenges, we propose adapting medical training to increase awareness of CDG and other rare diseases, ongoing education for physicians, the development of educational resources for relevant medical units, and empowerment of families through patient organizations and support networks.ConclusionThis study emphasizes the crucial role of community-centered research, and the insights families can offer to enhance CDG management. By pinpointing existing gaps and needs, our findings can inform targeted interventions and support systems to improve the lives of those impacted by CDG.

Impaired striatal glutathione-ascorbate metabolism induces transient dopamine increase and motor dysfunction.

Identifying initial triggering events in neurodegenerative disorders is critical to developing preventive therapies. In Huntington's disease (HD), hyperdopaminergia-probably triggered by the dysfunction of the most affected neurons, indirect pathway spiny projection neurons (iSPNs)-is believed to induce hyperkinesia, an early stage HD symptom. However, how this change arises and contributes to HD pathogenesis is unclear. Here, we demonstrate that genetic disruption of iSPNs function by Ntrk2/Trkb deletion in mice results in increased striatal dopamine and midbrain dopaminergic neurons, preceding hyperkinetic dysfunction. Transcriptomic analysis of iSPNs at the pre-symptomatic stage showed de-regulation of metabolic pathways, including upregulation of Gsto2, encoding glutathione S-transferase omega-2 (GSTO2). Selectively reducing Gsto2 in iSPNs in vivo effectively prevented dopaminergic dysfunction and halted the onset and progression of hyperkinetic symptoms. This study uncovers a functional link between altered iSPN BDNF-TrkB signalling, glutathione-ascorbate metabolism and hyperdopaminergic state, underscoring the vital role of GSTO2 in maintaining dopamine balance.

Prediction of mental health risk in adolescents via a smartphone app: a feasibility pilot study

Abstract Background The prevalence of mental health problems in adolescents is a global public health concern. Machine learning (ML) can analyse multidimensional data collected by phone sensors (passive tracking) and symptom self-reporting (active tracking) to model and predict mental health states. However, research in adolescents is lacking. This study investigated the feasibility of using ML to predict mental health in a non-clinical population of adolescents from active and passive data collected through the Mindcraft mobile app. Methods We recruited 103 secondary students (aged 14-18) who first completed the Strengths and Difficulties Questionnaire (SDQ) and then used the Mindcraft app for two weeks. The app integrates sensor data (location, steps, noise, light, battery, app usage) and self-reports. We extracted 85 sensor-based features and 19 from questionnaires to develop a gradient-boosted ensemble ML model. This model identifies students with abnormal SDQ scores and was evaluated using leave-one-out cross-validation. Results All students completed the active questionnaires; 67 also provided passive sensor data. 31 had abnormal SDQ scores. Using passive data, the ML model reached a balanced accuracy of 0.64 and an AUC score of 0.57. Incorporating both data types improved accuracy to 0.67 and AUC to 0.70. Feature importance scores showed step count and questionnaire on racing thoughts and hopefulness as most significant. Conclusions Our findings affirm the potential of integrating passive and active data collection to monitor mental health in real-world settings. Our ML model demonstrated moderate accuracy in predicting adolescents’ mental health risk measured with a behavioural screening questionnaire. This study will guide the development of a ML-driven, personalised mobile intervention for early symptom detection and mental health self-management, which might constitute an innovative and scalable tool for mental health prevention and intervention in adolescents. Key messages • This study shows the feasibility of using active and passive data to predict mental health risk in adolescents. • This study informs the development of a personalised machine learning-driven mobile intervention.

Adiponectin and Endothelin-1 are Correlated with the Development of Normal-tension Glaucoma in Metabolic Syndrome Patients

BACKGROUND: Glaucoma can lead to irreversible blindness, but normotension glaucoma (NTG) often shows no early symptoms. However, to date, there is limited knowledge regarding the potential parameters for early detection. Therefore, in this study, various metabolic parameters and biomarkers which may contribute to NTG in metabolic syndrome (MetS) patients were evaluated.METHODS: A retrospective cross-sectional study was conducted in the National Cardiac Center Harapan Kita Hospital. Mets were confirmed following the IDF criteria. NTG was determined based on normal intraocular pressure (IOP) with a mean defect (MD) of the visual field, thinning of the retinal nerve fiber layer (RNFL), and enlargement of cup disc ratio (CDR) by ocular coherence tomography (OCT). Metabolic parameters results of waist circumference (WC), body weight, body height, body mass index (BMI), blood pressures, HbA1c, fasting blood glucose (FBG), lipid profiles; and biomarkers including thiobarbituric acid reactive substance (TBARS) and ferric reducing antioxidant power (FRAP), leptin, adiponectin, high-sensitivity C-reactive protein (hs-CRP), and endothelin-1 (ET-1) were analyzed. Statistical analysis was performed using comparative and correlative tests.RESULTS: From 29 subjects, 19 subjects (65.5%) were included in the NTG group and 10 subjects (34.5%) were included in the non-NTG group. In the NTG group, we found significant correlation between MD with systolic blood pressure (p=0.035); CDR with ET-1 (p=0.049); and CDR with adiponectin (p=0.010). The non-NTG group had a significant correlation between MD with BMI (p=0.043); CDR with LDL (p=0.042); and CDR with TG (p=0.031).CONCLUSION: There are correlation between adiponectin and ET-1 with NTG in MetS patients. Therefore, they might be considered as potential early detectors for NTG in MetS patients.KEYWORDS: normal tension glaucoma, metabolic syndrome, biomarker, endothelin-1, adiponectin

The Mediating Role of Social Interactions and Early Psychopathological Symptoms in the Relationship Between Empathy and Prosociality in Young Children with ASD and Neurotypical Peers.

This study examined the relationship between empathy, prosocial behaviour, social interactions and early psychopathological symptoms (internalising and externalising behaviours) in children with autism spectrum disorder (ASD) and typically developing (TD) children. A total of 506 parents of children aged 18-48 months participated in this study. The parents of 92 children with ASD and 414 neurotypical children completed the Empathy Questionnaire, the Child Prosocial Behaviour Questionnaire, and the Emotional and Social Development Questionnaire. The results confirmed the direct relationship between empathy and prosocial behaviour in both groups. However, the findings showed a different pattern of the indirect relationship between empathy and prosociality through the social dimensions in the children with ASD compared to their typically developing peers. In the children with ASD, there was only one significant indirect path from empathy to prosocial behaviour - through internalising behaviours (anxiety). Anxiety also played a moderating role in this relationship. The higher the anxiety, the stronger the relationship between empathy and prosociality. In the neurotypical group, social interactions were a significant mediator, strengthening the relationship between empathy and prosocial behaviour. Externalising behaviours weakened this relationship. Intergroup and gender differences were also examined. These findings may have practical implications for social skills training programmes based on behavioural interventions by highlighting the importance of prosocial behaviour for social interaction and protection against psychopathological problems in children with autism and typically developing children.

A Prospective Cohort Study on Metamorphosis of Peptic Ulcer Dynamics: Insights into High Risk Paramedical Students Transformed Knowledge, Lifestyle and Symptoms Pattern

Background: This study explores the epidemiology of Peptic Ulcer Disease (PUD) among resident students in Komarapalayam, India, with the aim of increasing awareness, identifying influential lifestyle factors, and assessing intervention effectiveness. Methods: A comprehensive nine-month prospective cohort study involving 404 paramedical students aged 17-28 was rigorously conducted. Data collection included a meticulously validated questionnaire, high-risk subgroup identification, and the implementation of educational interventions. Statistical analyses maintained a significance threshold at p ≤ 0.05. Results: The study findings revealed a striking contrast. While the actual incidence of Peptic Ulcer Disease was lower than anticipated, the prevalence of prodromal symptoms was surprisingly high. This underscores the critical need for early symptom identification. Tailored educational interventions exhibited great promise in improving PUD comprehension. Lifestyle choices played a substantial role in susceptibility, with hostellers experiencing the highest PUD prevalence at 10.3%— the efficacy of symptom-based assessments extended beyond healthcare domains. Conclusion: This investigation underscores the urgency of early symptom recognition, personalized education, and proactive health-oriented choices to mitigate the onset of Peptic Ulcer Disease. It highlights the merit of symptom- based assessments and emphasizes the essential role of health education within tertiary institutions. This research catalyzes future initiatives aimed at enhancing the well-being of students in the context of Peptic Ulcer Disease.

Research and implementation of intelligent diagnostic system for temporomandibular joint disorder

Temporomandibular joint disorder (TMD) is a common oral and maxillofacial disease, which is difficult to detect due to its subtle early symptoms. In this study, a TMD intelligent diagnostic system implemented on edge computing devices was proposed, which can achieve rapid detection of TMD in clinical diagnosis and facilitate its early-stage clinical intervention. The proposed system first automatically segments the important components of the temporomandibular joint, followed by quantitative measurement of the joint gap area, and finally predicts the existence of TMD according to the measurements. In terms of segmentation, this study employs semi-supervised learning to achieve the accurate segmentation of temporomandibular joint, with an average Dice coefficient (DC) of 0.846. A 3D region extraction algorithm for the temporomandibular joint gap area is also developed, based on which an automatic TMD diagnosis model is proposed, with an accuracy of 83.87%. In summary, the intelligent TMD diagnosis system developed in this paper can be deployed at edge computing devices within a local area network, which is able to achieve rapid detecting and intelligent diagnosis of TMD with privacy guarantee.

Intratumoral microbiota: a new force in the development and treatment of esophageal cancer.

Esophageal cancer (EC) ranks among the most prevalent cancers worldwide, with a particularly high incidence in the Asian population. Due to the inconspicuous nature of early symptoms, patients with esophageal cancer are typically diagnosed in the middle to late stages, resulting in suboptimal overall treatment outcomes. Consequently, there is an urgent need to explore and refine therapeutic strategies. Microorganisms have been identified in numerous tumor tissues, including EC, and these microorganisms are referred to as the intratumoral microbiome. Intratumoral microbiota and their metabolic byproducts can influence the progression and treatment of esophageal cancer through various mechanisms, such as modulating tumor cell metabolism and local immune responses. Therefore, the intratumoral microbiota may potentially serve as a target for the treatment of esophageal cancer. This review delineates the composition, origin, and diagnostic significance of intratumoral microbiota in esophageal cancer tissue, and discusses the mechanisms by which intratumoral microbiota contribute to the onset of esophageal cancer. In addition, the impact of intratumoral microbiota on the treatment of esophageal cancer and its intervention measures are also addressed.

COMMUNITY EMPOWERMENT IN THE SADARI PROGRAM (BREAST SELF-EXAMINATION)

Background: Cancer is currently one of the leading causes of death worldwide. One of the most common cancers and with the highest incidence is breast cancer. There are still many PKK Mojosongo Jebres Surakarta mothers who are not aware of the importance of early breast examination. This Breast Self-Examination (BSE) has been proven to be culturally acceptable, religiously friendly, and inexpensive. BSE is one way of action to find early symptoms of breast cancer that can be detected by mothers themselves, does not require experts to find breast cancer early, and is part of prevention efforts. Objective: This community service is to improve BSE knowledge and skills through community empowerment which will have an impact on increasing awareness and efforts to prevent breast cancer in Mojosongo. Methods: This activity begins with a regional visit to find out the existing problems, and a meeting with the PKK Chairperson to coordinate the implementation, the sampling technique uses a total sampling of all PKK mothers totaling 50 people who are given education and practice on how to do self-examination at home. Results: Community service can improve the ability of PKK mothers to do BSE independently. Conclusion: SADARI Education and Training improves the ability of knowledge and skills independently and has a positive impact on maternal health. The Recommendations, need to encourage and follow up on education and training on SADARI examinations by adding periodic follow-up sessions, this is done so that knowledge and practice of SADARI continue to be implemented.

Reduction in the olfactory ability in aging Mitf mutant mice without evidence of neurodegeneration

Age-related decline occurs in most brain structures and sensory systems. An illustrative case is olfaction. The olfactory bulb (OB) undergoes deterioration with age, resulting in reduced olfactory ability. A decline in olfaction is also associated with early symptoms of neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). However, the underlying reasons are unclear. The microphthalmia-associated transcription factor (MITF) is expressed in the projection neurons (PNs) of the OB–the mitral and tufted (M/T) cells. Primary M/T cells from Mitf mutant mice show hyperactivity, potentially attributed to the reduced expression of a key potassium channel subunit, Kcnd3/Kv4.3. This influences intrinsic plasticity, an essential mechanism involving the non-synaptic regulation of neuronal activity. As neuronal hyperactivity often precedes neurodegenerative conditions, the current study aimed to determine whether the absence of Mitf causes degenerative effects during aging. Aged Mitf mutant mice showed reduced olfactory ability without inflammation. However, an increase in the expression of potassium channel subunit genes in the OBs of aged Mitfmi-vga9/mi-vga9 mice suggests that during aging, compensatory mechanisms lead to stabilization.

Unveiling the microRNA landscape in pancreatic ductal adenocarcinoma patients and cancer cell models

BackgroundPancreatic ductal adenocarcinoma (PDAC) poses a significant challenge due to late-stage diagnoses resulting from nonspecific early symptoms and the absence of early diagnostic biomarkers. MicroRNAs (miRNAs) play a crucial role in regulating diverse biological processes, and their abnormal expression is observed in various diseases, including cancer. Cancer stem cells (CSCs) are thought to act as a driving force in PDAC spread and recurrence. In pursuing the goal of unravelling the complexities of PDAC and its underlying molecular mechanisms, our study aimed to identify PDAC-associated miRNAs and relate them to disease progression, focusing on their involvement in various PDAC stages in patients and in reliable in vitro models, including pancreatic CSC (PaCSC) models.MethodsThe miRNA profiling datasets of serum and solid biopsies of PDAC patients deposited in GEO DataSets were analyzed by REML-based meta-analysis. The panel was then investigated by Real Time PCR in serum and solid biopsies of 37 PDAC patients enrolled in the study, as well as on BxPC-3 and AsPC-1 PDAC cell lines. We extended our focus towards a possible role of PDAC-associated miRNAs in the CSC phenotype, by inducing CSC-enriched pancreatospheres from BxPC-3 and AsPC-1 PDAC cell lines and performed differential miRNA expression analysis between PaCSCs and monolayer-grown PDAC cell lines.ResultsMeta-analysis showed differentially expressed miRNAs in blood samples and cancerous tissues of PDAC patients, allowing the identification of a panel of 9 PDAC-associated miRNAs. The results emerging from our patients fully confirmed the meta-analysis for the majority of miRNAs under investigation. In vitro tasks confirmed the aberrant expression of the panel of PDAC-associated miRNAs, with a dramatic dysregulation in PaCSC models. Notably, PaCSCs have shown significant overexpression of miR-4486, miR-216a-5p, and miR-216b-5p compared to PDAC cell lines, suggesting the recruitment of such miRNAs in stemness-related molecular mechanisms. Globally, our results showed a dual behaviour of miR-216a-5p and miR-216b-5p in PDAC while miR-4486, miR-361-3p, miR-125a-5p, miR-320d expression changes during the disease suggest they could promote PDAC initiation and progression.ConclusionsThis study contributed to an enhanced comprehension of the role of miRNAs in the development and progression of PDAC, shedding new light on the miRNA landscape in PDAC and its intricate interplay with CSCs, and providing specific insights useful in the development of miRNA-based diagnostic biomarkers and therapeutic targets.

Factors influencing delayed cancer health seeking in Meghalaya, Northeast India: A qualitative study

Background & objectives India accounts for about seven per cent of the global cancer burden with the highest cancer incidence reported from the North-Eastern Region (NER), including Meghalaya. Despite this, there is paucity of published studies on health seeking behaviour for cancer in the NER. To address this gap, this study used a qualitative approach to document patient, caregiver and provider perspectives to understand the factors influencing healthcare seeking for cancers in Meghalaya. Methods In-depth interviews were undertaken with 37 individuals diagnosed with one of the top five cancers in Meghalaya, namely, oesophageal, breast, oral, cervical and lung cancer. They were identified from the State referral cancer hospital. Twelve caregivers and five healthcare providers were also interviewed. All interviews were conducted in the local language using semi-structured interview guides. Transcripts were translated to English, coded, categorized and analyzed using thematic framework content analysis approach. Results A key factor influencing delayed cancer treatment in Meghalaya included misconceptions regarding the causes of cancer and cultural concepts such as bih and skai (Khasi language), i.e. notions of a figurative ‘poison’ or ill intent that makes one susceptible to illness. A general reluctance to discuss cancer diagnoses, perceived stigma, apprehension of treatment methods influenced their decision. Other factors included negligence and misinterpretation of early symptoms of cancer, self-management, preference for traditional medicines, financial constraints and health system-related factors. Interpretation & conclusions This study underscores the importance of addressing barriers to cancer diagnosis and treatment in indigenous populations in northeast India, advocating for culturally appropriate messaging, capacity building for healthcare workers, integration of traditional healers, and community involvement to enhance early healthcare seeking and improve outcomes.

An efficient enhanced stacked auto encoder assisted optimized deep neural network for forecasting Dry Eye Disease

Meibomian Gland Dysfunction (MGD) and Dry Eye Disease (DED) comprise two of the most significant eye diseases, impacting millions of sufferers worldwide. Several etiological factors influence the early symptoms of DED. Early diagnosis and treatment of erectile dysfunction may significantly improve the Quality of Life (QoL) for people. The current study introduces the ESAE-ODNN, an improved stacked autoencoder-aided optimised deep neural network, as a new way to predict DED using feature selection (FS), feature extraction (FE), and classification. The approach described here is novel because it merges chaotic maps into FS, employs SLSTM-STSA for improved classification accuracy (CA), and optimizes with the adaptive quantum rotation of the Enhanced Quantum Bacterial Foraging Optimisation Algorithm (EQBFOA). The present study enhances prediction functions by extracting MGD-related features and complicated relationships from the DED dataset. To ensure essential feature identification, the ESAE minimizes irrelevant and redundant features. To predict the DED, the ESAE first applies FE and then implements an ODNN classifier. This method fine-tunes the ODNN framework to enhance the effectiveness of the classification. The proposed ESAE-ODNN classification system efficiently assists in the early diagnosis of DED. Combining advanced Deep Learning (DL) methods with optimization can help us understand MGD features better and sort the data with the best accuracy (96.34%). The experimental evaluation with relevant performance metrics indicates that the proposed method is efficient in diverse aspects: accurate identification, reduced complexity, and fine-tuned performance. The ESAE-ODNN’s robustness in handling intricate feature indications and high-dimensional data outperforms the existing state-of-the-art techniques.

Non epileptiform abnormal neurologic signs in newborns following in-utero psychotropic medication exposure.

Post natal adaptation syndrome is well reported but early presentation of neurological symptoms severe enough to warrant detailed neurological work up is rare. Our aim was to evaluate and describe abnormal early neurological symptoms in infants following in-utero exposure to a varying combination of selective serotonin uptake inhibitor medication and other psychotropic medications, with negative seizure work-up. Descriptive case series of infant exposed to selective serotonin uptake inhibitor medication and other psychotropic medications, presenting with early neurologic signs and symptoms within the first 24 hours of life concerning for seizures, who underwent an extensive neurologic evaluation. Five infants met criteria. Infant #1 : 39-weeks gestational age (GA), with escitalopram, clonazepam, gabapentin, methadone exposure, presented with generalized hypertonia and intermittent back-arching. #2 : 40-weeks GA with escitalopram and hydroxyzine exposure, with bilateral arm stiffening and sucking mouth movements. #3 : 34-weeks GA with fluoxetine, quetiapine and clonazepam exposure, presented with decerebrate posturing. #4 : 38-weeks GA with fluoxetine, clonazepam, clonidine, quetiapine and gabapentin exposure, presented with asynchronous tremoring of all extremities. #5 : 35-weeks GA with citalopram, quetiapine exposure, presented with increased tone and posturing of upper extremities. Electroencephalogram was negative for seizures in all infants. In-utero exposure to selective serotonin uptake inhibitor medication, especially in combination with other psychotropic medications, may be associated with significant abnormal neurological symptoms, which may not represent true seizures.

Advanced Imaging for Localized Prostate Cancer

Background/Objectives: Prostate cancer is a prevalent malignancy often presenting without early symptoms. Advanced imaging technologies have revolutionized its diagnosis and management. This review discusses the principles, benefits, and clinical applications of multiparametric magnetic resonance imaging (mpMRI), micro-ultrasound (microUS), and prostate-specific membrane antigen positron emission tomography–computed tomography (PSMA PET/CT) in localized prostate cancer. Methods: We conducted a comprehensive literature review of recent studies and guidelines on mpMRI, microUS, and PSMA PET/CT in prostate cancer diagnosis, focusing on their applications in biopsy-naïve patients, those with previous negative biopsies, and patients under active surveillance. Results: MpMRI has demonstrated high sensitivity and negative predictive value in detecting clinically significant prostate cancer (csPCa). MicroUS, a newer technology, has shown promising results in early studies, with sensitivity and specificity comparable to mpMRI. PSMA PET/CT has emerged as a highly sensitive and specific imaging modality, particularly valuable for staging and detecting metastatic disease. All three technologies have been incorporated into urologic practice for prostate cancer diagnosis and management, with each offering unique advantages in different clinical scenarios. Conclusions: Advanced imaging techniques, including mpMRI, microUS, and PSMA PET/CT, have significantly improved the accuracy of prostate cancer diagnosis, staging, and management. These technologies enable more precise targeting of suspicious lesions during biopsy and therapy planning. However, further research, especially randomized controlled trials, is needed to fully establish the optimal use and inclusion of these imaging modalities in various stages of prostate cancer care.

Visually Asymptomatic Leaf Loss in Xylella fastidiosa-Infected Blueberry Plants.

Xylella fastidiosa (Xf), a gram-negative bacterium, is a notorious, world-wide plant pathogen with an extended latent period that presents a challenge for early disease detection and control interventions. We used thermal imaging of tissue-cultured, experimentally Xf-infected blueberry plants to identify visually pre-symptomatic leaves and compared the minimum force required to dislodge symptomatic leaves from infected plants to leaves on uninfected (control) blueberry plants. For two different blueberry cultivars and one pathogenic isolate of X. fastidiosa, we found no statistical difference between the mean downward force for leaf dislodgement, regardless of symptom category, on Xf-infected blueberry plants. That force was about 50% to 30% of the mean force to remove leaves from uninfected blueberry plants depending on the cultivar. These results indicate that visually pre-symptomatic leaves may be just as readily lost under field conditions as visually symptomatic leaves, both of which are important for early disease detection. Second, some thermally symptomatic and visually symptomatic leaves appeared to self-prune (abscise) and this may be an unrecognized early symptom of Xf-caused disease in blueberries. Last, it is possible that the self-pruning of visually asymptomatic leaves may occur in other agriculturally and culturally important plants infected by X. fastidiosa, but this remains an unrecognized early disease symptom.

Cinnamon potential in alleviating early postmenopause symptoms: a randomized clinical trial

Abstract Objective Menopause is a substantial physical, mental, and emotional transition in a woman's life. Most women suffer symptoms during menopause, impacting their quality of life for a decade or more. This study aimed to determine the effect of cinnamon on the severity of postmenopause symptoms. Methods A randomized, triple-blind, parallel clinical trial was conducted on 60 postmenopausal women in the health centers of Hamadan, Iran. The study included women aged 45 to 60 years who were 1 to 3 years after their last menstrual period. The participants were assigned to two groups using a permuted block randomization method. The intervention group received a daily dose of one cinnamon capsule (1 g) for 2 months, whereas the control group received a placebo. The participants, researchers, and statistical analysts were all blinded. The study measured the severity of menopause symptoms using the Menopause Rating Scale before and 2 months later. Data were analyzed using Stata-13 software. Results Data from 59 individuals were analyzed. The analyses were adjusted for baseline Menopause Rating Scale scores. After the intervention, the severity of menopause symptoms was lower in the intervention group (13.95 ± 4.16) compared to the control group (16.64 ± 4.16) (P = 0.01), with an effect size of 0.65 (95% CI, 0.12-1.17). Additionally, the intervention group had lower scores for psychological symptoms compared to the control group (P = 0.006), with an effect size of 0.74 (95% CI, 0.21-1.27). Conclusions The consumption of cinnamon in postmenopausal women has been found to improve the severity of menopause symptoms, with a particular emphasis on the psychological domain.

High levels of autotaxin and lysophosphatidic acid predict poor outcome in treatment of resectable gastric carcinoma

BackgroundAlthough early-stage gastric cancer is a candidate for curative surgical resection, the absence of specific early symptoms results in a late diagnosis and consequently most patients present advanced or metastatic disease. Identifying noveland tumor-specific biomarkers is needed to increase early detection and match patients to the appropriate treatment. The present study focused on the possible prognostic role of Ectonucleotide Pyrophosphatase/Phosphodiesterase 2 (ENPP2)/Autotaxin (ATX) and lysophosphatidic acid (LPA) in Gastro-Esophageal Adenocarcinoma (GEA). High levels of ATX/LPA are associated with several malignancies including gastrointestinal tumors. MethodsUsing a bioinformatics analysis, the incidence of ENPP2 mutations together with its expression in the tumor tissues and the correlation between the presence of mutations and the survival rate were examined in databases of GEA patients. Furthermore, circulating levels of ATX and LPA were studied retrospectively and longitudinally both in patients receiving frontal surgery and in patients receiving preoperative chemotherapy. ResultsOverall findings suggested that although ENPP2 mutations occur at low incidence, their presence was associated with a particular poor Overall Survival (OS). Furthermore, removal of the tumour by surgery resulted in a decrease in serum ATX and LPA levels within five days, regardless of any previous chemotherapy. Basal circulating ATX were associated with the aggressive diffuse GEA and could be considered of negative prognostic value, mainly in combination models with circulating Carcino-Embryonic Antigen (CEA). ConclusionsBased on these observations, clinical trials with ATX-targeted drugs and standard chemotherapy regimens may benefit from selecting GEA patients based on their levels of ATX, LPA and CEA.

Characterizing the Patterns of Cervical Cancer Symptom Recognition, Symptom Response, and Associated Factors Among Patients Treated in a Teaching Hospital in Ghana.

Cervical cancer is a major global health issue and ranks as the second leading cause of cancer-related deaths among women in Ghana. This study aimed to explore and characterize the patterns of symptom recognition associated with cervical cancer and the symptom responses among women in Ghana. A descriptive qualitative design utilizing 20 individual semistructured interview sessions was used. The study was conducted in one of Ghana's major cancer treatment centers. Data were collected using face-to-face interviews. The data were analyzed using NVivo 12 and presented as themes and subthemes. Data analysis revealed 2 main themes: barriers to symptom recognition and response and facilitators of early symptom recognition and symptom response. Barriers included deficient knowledge about cervical symptoms, spiritual attributions of symptoms, preference for herbal remedies for symptoms, misdiagnosis, and seeking help through multiple facility visits. Facilitating factors of symptom response include perceived severity/identification of additional symptoms, quick referrals with some navigation within the healthcare system, and advice from women's microcommunity. The study emphasizes the need for continuous educational efforts on cervical cancer and its symptoms. Healthcare providers, patients, and the public have a part to play in the awareness and early detection of cervical cancer. Initiatives that educate women about the early symptoms of cervical cancer and the importance of screening can help with early recognition. Educating communities about cervical cancer empowers individuals to take charge of their health and encourages supportive environments for women to seek care.

Comparative analysis of post-procedural symptom patterns after intragastric balloon and endoscopic sleeve gastroplasty

Aim: Endoscopic bariatric and metabolic therapies (EBMTs) offer minimally invasive approaches for obesity management, with intragastric balloon (IGB) and endoscopic sleeve gastroplasty (ESG) being amongst the most prominent interventions. While both are effective, their comparative impact on post-procedural gastric symptoms remains underexplored. Methods: Single-center retrospective study was designed to evaluate the incidence of post-procedure symptoms in patients undergoing IGB and ESG. Incidence and severity of gastric symptoms were assessed using visual analog scales at various time points. Weight outcomes and medication usage were also recorded. Changes at different time points (baseline, one and four months) were compared by means of Mann-Whitney U Test. Bivariate correlations were carried out through Pearson correlation. Results: Thirty patients undergoing IGB placement and 13 patients undergoing ESG were included in the analysis. ESG group showed a significant reduction in BMI at four months compared to IGB (32.2 ± 4.2 vs . 34.4 ± 5.3, P = 0.05). ESG demonstrated significantly lower rates of post-procedural gastric symptoms compared to IGB, including nausea, regurgitation, vomiting, and abdominal cramps and greater satiety (P < 0.001) in the early postoperative period. Medication usage differed between groups, with higher usage of antispasmodics and antiemetics among IGB patients during the first week (P < 0.001). Symptom severity correlated with the need for antiemetics and antispasmodics. Conclusion: This study provides insights into the management of gastric symptoms following two prominent EBMTs. While both endoscopic interventions offer viable options for obesity management, ESG emerges as a favorable choice due to its significantly lower incidence of early post-procedural gastric symptoms. Further research is warranted to refine symptom management strategies and elucidate differences in symptom profiles between IGB and ESG procedures, ultimately aiming to optimize treatment efficacy and patient satisfaction in the field of endoscopic obesity interventions.