Epidemiological Issues Research Articles

Stability and Bifurcation Analysis of a Symmetric Fractional-Order Epidemic Mathematical Model with Time Delay and Non-Monotonic Incidence Rates for Two Viral Strains

This study investigates a symmetric fractional-order epidemic model with time delays and non-monotonic incidence rates, considering two viral strains. By confirming the existence, uniqueness, and boundedness of the system’s solutions, the research ensures the model’s well-posedness, guaranteeing its mathematical soundness and practical relevance. The study calculates and evaluates the equilibrium points and the basic reproduction numbers R01 and R02 to understand the dynamic behavior of the model under different parameter settings. Through the application of the Lyapunov method, the research examines the asymptotic global stability of the system, determining whether it will converge to a particular equilibrium state over time. Furthermore, Hopf bifurcation theory is employed to investigate potential periodic solutions and bifurcation scenarios, highlighting how the system might shift from stability to periodic oscillations under certain conditions. By utilizing the Adams-Bashforth-Moulton numerical simulation method, the theoretical results are validated, reinforcing the conclusions and demonstrating the model’s applicability in real-world contexts. It emphasizes the importance of fractional-order models in addressing epidemiological issues related to time delays (τ), individual heterogeneity (m, k), and memory effects (θ), offering greater accuracy compared with traditional integer-order models. In summary, this research provides a theoretical foundation and practical insights, enhancing the understanding and management of epidemic dynamics through fractional-order epidemic models.

Преконцептивное облучение матерей: Риск фетоинфантильных потерь

Safety of female personnel exposed to occupational radiation is still a topical issue of radiation epidemiology. Mayak Production Association is the first Russian atomic enterprise and women made a quarter of its personnel. Fetal and infant losses (FILs) that include stillbirths and infant mortality could be used as an important criterion for assessing the effects of maternal preconception (prior to conception) exposure. The aim of this study was to assess FILs risk among the offspring of female Mayak PA workers exposed to occupational preconception external gamma-radiation. A retrospective analysis was performed among 15307 children born in 1949–1973; mothers of 4880 of them were Mayak PA workers. FILs were analyzed taking into account sex of the offspring, period of their birth, nosologies, parental age, and dose categories of preconception exposure. Methods of non-parametrical statistics were used and calculation of relative risk was performed with 95 % confidence interval. In general, fetal and infant losses demonstrated no statistical differences, 44.5 for 103 in the main group, 38.7 for 103 in the reference group, χ2 =2.79, p = 0.95. A statistically significant increase of FILs, stillbirths and infantile mortality was detected among the offspring with only their mothers working at Mayak PA. Dynamics analysis established the period from 1949 to 1953, in which FILs, stillbirths and infantile mortality were higher among the offspring of exposed mothers. Statistically significant differences in the FILs structure were obtained for fetal death that was more often registered in the main group, 3.48 vs 1.34 for 103, χ2 = 7.54, p = 0.006. FILs risk among mothers working at Mayak PA aged under 20 was statistically significantly higher for girls, 2.42 (1.25–4.67), and for both sexes, 2.16 (1.37–3.4). FILs were associated with the dose range of preconception external gamma-radiation of mothers from 0.16 mGy to 3006 mGy. The study also established certain categories of preconception exposure of the ovaries with significantly higher stillbirth risk in the main group as opposed to the reference one.

Preconception maternal exposure: Risk of fetal and infant losses

Safety of female personnel exposed to occupational radiation is still a topical issue of radiation epidemiology. Mayak Production Association is the first Russian atomic enterprise and women made a quarter of its personnel. Fetal and infant losses (FILs) that include stillbirths and infant mortality could be used as an important criterion for assessing the effects of maternal preconception (prior to conception) exposure. The aim of this study was to assess FILs risk among the offspring of female Mayak PA workers exposed to occupational preconception external gamma-radiation. A retrospective analysis was performed among 15307 children born in 1949–1973; mothers of 4880 of them were Mayak PA workers. FILs were analyzed taking into account sex of the offspring, period of their birth, nosologies, parental age, and dose categories of preconception exposure. Methods of non-parametrical statistics were used and calculation of relative risk was performed with 95 % confidence interval. In general, fetal and infant losses demonstrated no statistical differences, 44.5 for 103 in the main group, 38.7 for 103 in the reference group, χ2 =2.79, p = 0.95. A statistically significant increase of FILs, stillbirths and infantile mortality was detected among the offspring with only their mothers working at Mayak PA. Dynamics analysis established the period from 1949 to 1953, in which FILs, stillbirths and infantile mortality were higher among the offspring of exposed mothers. Statistically significant differences in the FILs structure were obtained for fetal death that was more often registered in the main group, 3.48 vs 1.34 for 103, χ2 = 7.54, p = 0.006. FILs risk among mothers working at Mayak PA aged under 20 was statistically significantly higher for girls, 2.42 (1.25–4.67), and for both sexes, 2.16 (1.37–3.4). FILs were associated with the dose range of preconception external gamma-radiation of mothers from 0.16 mGy to 3006 mGy. The study also established certain categories of preconception exposure of the ovaries with significantly higher stillbirth risk in the main group as opposed to the reference one.

Post-stroke pain syndrome: clinical, pathophysiological characteristics and modern rehabilitation management

Background. Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. The article highlights the issues of epidemiology, pathogenesis, methods of clinical assessment and risk factors for the development of post-stroke pain. A review of the literature on the most common post-stroke pain syndromes including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain, shoulder pain, pain associated with spasticity and headache is presented. Modern management of the pain is analyzed.Conclusion. In the best interests of optimizing the rehabilitation of a stroke patient, improving his quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, detail the presence and characteristics of pain, and also be aware of options for correcting post-stroke pain syndromes.

Neurovascular Manifestations of Sickle Cell Disease

Sickle cell disease (SCD) is a hereditary blood disorder characterized by abnormal hemoglobin, leading to the sickle shape of red blood cells. It has several vascular complications and the cerebrovascular ones are among the most frequent and severe both in children and in adults. This review summarizes the main neurovascular manifestations of SCD, including acute stroke, silent cerebral infarction, large-vessel diseases (moyamoya arteriopathy and aneurysms), and brain bleeding. Both epidemiology, pathophysiology, and treatment issues are addressed and prevention of cerebrovascular events, including silent cerebral infarctions, is particularly relevant in SCD patients, being associated to poor functional outcome and cognitive complaints. Transfusions and hydroxyurea are the main available therapy at the moment, but contraindications, availability, and complications might prevent their long term use, particularly in low-income countries. The role of transcranial Doppler in monitoring the patients (mainly children) is analyzed and a practical approach has been selected in order to give the main messages from the current literature for a better management of SCD patients.

EPIDEMIOLOGY OF PROSTHETIC DENTISTRY IN THE ORTHOPEDIC DENTISTRY CLINIC

Introduction. The urgent task of orthopedic dentistry is the timely and optimal restoration of masticatory efficiency. Removable prosthetics remains one of the most popular methods of dental prosthetics. At the same time, removable prosthetics is associated with a number of clinical complications. An analysis of modern available domestic and foreign sources of literature on the epidemiology of prosthetic stomatitis, as well as the potential role of removable prostheses in the development of this disease, was carried out. Aim. To present the collected updated information from the current available systematic literature on the epidemiology of denture stomatitis, as well as the potential role of removable dentures in the development of the disease and make it accessible to orthopedic dentists. Materials and methods. A literature search was conducted using the electronic database PubMed to find studies related to the epidemiology and etiology of prosthetic stomatitis. The search period covered the period from January 2012 to December 2022, and 53 sources of literature were analysed. Results. A selection of 19 scientific articles was formed as a result of the conducted search and selection of scientific works that most closely corresponded to the set goal of the research. It was established that the prevalence of prosthetic stomatitis varies depending on a certain number of factors. According to the results of research by various authors, this disease affects from 20% to 80% of patients who use removable dentures. Variability of the prevalence of prosthetic stomatitis depends significantly on the age of the patient, gender, type of prosthesis, general health and oral hygiene of people using these structures. Analysis of data from an epidemiological study shows that the prevalence of prosthetic stomatitis among users of removable dentures varies from 20% to 80%. It is possible that the spread of stomatitis prevalence rates was influenced by conducting the study among various samples of the population. In general, the incidence of prosthetic stomatitis was higher among women and the elderly in the studies reviewed. Conclusions. The analysis of available sources of literature on the issue of epidemiology of prosthetic stomatitis allows to systematize the available modern developments, conduct their detailed analysis and make the obtained data available to practicing orthopedic dentists. The perspective of research consists in the detailed study of etiological factors contributing to the development of prosthetic stomatitis in patients with removable prostheses.

Intra-Abdominal Hypertension and Abdominal Compartment Syndrome. Literature Review

Intra-abdominal hypertension and abdominal compartment syndrome remain a challenging problem in abdominal surgery. Due to various etiological factors leading to increased intra-abdominal pressure (inflammatory, destructive processes, trauma, sepsis, postoperative complications, etc.), and the negative impact of increased IBP on the functions of the gastrointestinal, respiratory, cardiovascular systems, kidneys, central nervous system, timely diagnosis and treatment play an important role. Gradually elevated intra-abdominal pressure can cause persistent organ dysfunction and be potentially fatal. To date, the pathophysiological mechanisms, methods for determining intra-abdominal pressure, the frequency of its measurement, and methods of conservative and surgical treatment have been studied in sufficient detail. The paper presents a literature review on the problem of intra-abdominal hypertension and abdominal compartment syndrome. The study considers issues of epidemiology, mortality rates, methods for measuring intra-abdominal pressure, including advanced innovative technologies. The authors present the basics of clinical diagnosis, the significance and informativity of additional biochemical blood tests, radiation methods, mainly computed tomography, and ultrasound examination. Advanced methods of conservative treatment are considered, which, when used early, significantly minimize target organ damage, organ dysfunction, and indications for emergency decompressive laparotomy. Finally, recommendations are given for the postoperative management of patients with an “open” abdomen, and for the optimal timing of laparostoma closure.

NEW POSSIBILITIES OF MODERN RADIOLOGY DIAGNOSIS OF HEPATOCELLULAR CARCINOMA: A LITERATURE REVIEW

Relevance: Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumor (80-90%), ranks 6th among malignant neoplasms and is the 3rd leading cause of cancer mortality worldwide. Despite advances in locoregional therapy, targeted therapy, and immunotherapy, the median survival for advanced HCC does not exceed 2 years, and the 5-year survival rate is 18%. Diagnosis of the tumor at an early stage allows for resection and liver transplantation, which can increase the 5-year survival rate by 1.5-2 times. The options for biopsy are limited by sensitivity and potential complications for the patient. In most cases, HCC can be detected by non-invasive radiology. The study aimed to evaluate the effectiveness of modern methods of radiological diagnosis of HCC. Methods: This literature review included published articles and studies on the capacity of modern methods of radiological diagnosis of hepatocellular carcinoma. Data were found in PubMed, BMC Medicine, and Google Scientific using the keywords ‘hepatocellular carcinoma,’ ‘ultrasound examination,’ ‘computed tomography,’ ‘magnetic resonance imaging,’ and ‘radiomics.’ A total of 123 publications were found; 49 sources were included in this review. Results: The review article addresses current issues of HCC epidemiology, genetics, etiology, and radiology diagnosis. Updated data on the efficacy of CEUS and MFI, LDCT and DECT, and a-MRI are presented. The prospects of MRI-radiomics, which solves the problem of subjectivity in radiology and offers new possibilities in the non-invasive diagnosis of HCC, are described. The study of the possibilities of radiology methods in the diagnosis of HCC continues. Conclusion: CEUS is highly effective for imaging tumor vascularization. LDCT is superior to ultrasound in sensitivity and specificity. A shortened MRI protocol delivers better results than an ultrasound as a screening tool for high-risk groups. MRI-radiomics can determine the tumor histological classification and radiogenomics, predict recurrence after surgical resection, and evaluate measurement methodology and response to transarterial chemoembolization and systemic therapy.

Pandemic Governance: Responses for COVID-19 Management of Zamboanga City

The challenges brought by pandemic governance include the efficient management of socioeconomic, political, and health issues. In today's sociodemographic and globalized environment, a rational and scientific approach to pandemic governance and public health policy formulation necessitates a combination of science, culture, and people. Effective pandemic governance requires an approach that is adaptive, and lesson based. In instances when faith in governmental institutions and political leadership are crucial, knowledge of the public health system, epidemiology, and socio-political issues is also important. Effective pandemic governance can impact COVID-19 management outcomes. This study looks into the Zamboanga City's COVID-19 management responses. It examines the effectiveness of the measures implemented by Zamboanga City in the critical areas specified for the management of the COVID-19 epidemic. This study employs a descriptive-qualitative method using secondary data analysis and interview guide. This study demonstrates that Zamboanga City's approaches to the management of the COVID-19 pandemic are effective in thirteen (13) assessment categories. This study also reveals flaws in the application of countermeasures against the spread of the COVID-19 virus. Thus, there is a need to improve responses on the part of political leaders by designing, integrating, and implementing sound governance strategies in the fight against COVID-19 pandemic.

Hepatocardial relationships in non-alcoholic fatty liver disease: issues of epidemiology, diagnosis, prognosis

World statistics indicate a steady increase in the prevalence of non-alcoholic fatty liver disease, which correlates with the pandemics of obesity and diabetes, which are quite common in Russia. The commonality of cardiometabolic risk factors, the high global prevalence of non-alcoholic fatty liver disease and atherosclerotic cardiovascular diseases generates the interest of researchers in studying hepatocardial relationships. Currently, non-alcoholic fatty liver disease is positioned as a hepatic manifestation of a multisystem disorder, heterogeneous in underlying causes, manifestations, course and outcomes. The purpose of this review was to analyze hepatocardial relationships based on publications. 76 sources on the epidemiology of non-alcoholic fatty liver disease, published from 2011–2023 in journals indexed in Pubmed and eLibrary, were analyzed. Age and gender aspects of the development of non-alcoholic fatty liver disease were considered. The pathogenetic mechanisms of hepatocardial relationships, which were closely related to systemic inflammation, insulin resistance, metabolic syndrome and its components, were highlighted. The criteria and methods for diagnosing non-alcoholic fatty liver disease and metabolic-associated liver disease were outlined. Recent studies demonstrated the presence of hepatocardial connections, characterized by an increased risk of developing atherosclerosis, cardiomyopathy and rhythm disturbances, changes in the structural and functional parameters and geometry of the heart, as well as diastolic dysfunction, which may precede and/or contribute to the development of chronic heart failure in patients with non-alcoholic fatty liver disease. The article presents data on non-alcoholic fatty liver disease as a new factor associated with the development of adverse cardiovascular events to a greater extent than the outcome of liver diseases themselves, which confirms the need for primary and secondary prevention of cardiovascular diseases in this cohort of patients.

Blood and sputum microbiota composition in Afghan immigrants and Iranian subjects with pulmonary tuberculosis.

TB infection is one of the most challengeable epidemiological issues. Complex interactions between microbiota and TB infection have been demonstrated. Alteration in microbial population during TB infection may act as a useful biomarker. The present study examined the microbiota patterns of blood and sputum samples collected from Afghan immigrants and Iranian patients with active TB. Sixty active pulmonary TB patients were enrolled in the study. Blood and sputum samples were collected. To detect phylum bacterial composition in the blood and sputum samples, bacterial 16S rRNA quantification by Real-Time qPCR was performed. A significant decrease in Bacteroidetes in Iranian sputum and blood samples of Afghan immigrants and Iranian TB active subjects were seen. While, sputum samples of Afghan immigrants showed no significant differences in Bacteroidetes abundance among TB active and control. Firmicutes were also presented no significant difference between sputum samples of the two races. Actinobacteria showed a significant increase in Iranian and Afghan sputum samples while this phylum showed no significant abundance in Iranian and Afghan TB positive blood samples. Proteobacteria also showed an increase in sputum and blood samples of the two races. An imbalance in Bacteroidetes and Firmicutes abundance may cause an alteration in the microbiota composition, resulting in dysregulated immune responses and resulting in the augmentation of opportunistic pathogens during TB infection, notably Proteobacteria and Actinobacteria. Evaluation of human microbiota under different conditions of TB infection can be critical to a deeper understanding of the disease control.

Pathogenicity islands in bacteria of upper respiratory tract infection

Children's upper respiratory tract infections (URTIs)—infections of the upper respiratory tract without symptoms of pneumonia—represent a significant socioeconomic and epidemiological issue. The study of microbial pathogenicity, which is a complex multifactorial process complicated by the coordinated activity of genetic regions linked to virulence and resistance determinants, has accelerated due to increased awareness of infectious diseases in humans caused by microbial pathogens. Pathogenicity islands and resistance islands are essential to the evolution of pathogens and seem to work in tandem during the bacterial infection process. While pathogenicity islands encourage the development of illness, Additionally, pathogenicity islands are part of a vast array of genomic islands that play a vital role in the transmission of bacterial genes. They encode essential characteristics such as virulence, antibiotic resistance, and other supplementary functions.

Research trends in alopecia areata: a cross-sectional bibliometric analysis of the top cited studies.

In the field of alopecia areata research, various focuses including risk factors, epidemiology, molecular pathways, and treatment were constantly improving. However, to date, a bibliometric analysis summarizing the research trend is not available to date. The main objective of this study was to provide researchers with an overview of the research trend on alopecia areata in the past two decades. In Web of Science database, screening and extraction of studies related to alopecia areata has been performed. Within studies related to alopecia areata, the most cited 100 studies were appraised and the information of articles, including the citation amounts, keywords and publication types, was extracted for analyses. On average, each study in the top 100 list was cited 104.72 times. Within the top 100 list, the most focused fields were on the management of alopecia areata (34%), molecular mechanisms (28%) and epidemiological issues (23%). Approximately one third of the management-associated studies focused on Janus kinase (JAK) inhibitors (10 studies) and 5 studies focused on the efficacy of corticosteroids for alopecia areata. According to the results of the keyword analysis, JAK inhibitors had become the most mentioned keywords in the field of alopecia areata research since 2016. The top 100 most referenced papers in the field of alopecia areata mostly focused on essential aspects such as treatment options, pathogenesis, risk factors, and comorbidities. The results of the current study could be considered a potential resource for future research and patient care information.

IgM nephropathy on the background of Hodgkin's lymphoma: clinical case and literature review

IgM nephropathy, although a rare and controversial disease, attracts the attention of both morphologists and clinicians. The issues of etiopathogenesis, epidemiology and treatment of this pathology are currently insufficiently studied. A variety of morphological manifestations under light microscopy make immunofluorescence examination crucial for diagnosis. Although IgM nephropathy shares clinical and morphological features with minimal change disease and focal segmental glomerulosclerosis, it has its own characteristics that not all scientists recognize as sufficient to classify it as a separate nosological form. It is necessary to coordinate morphological criteria for the diagnosis of IgM nephropathy. Clarifying the pathogenetic mechanisms of the development of this disease will help determine the place of IgM nephropathy among primary glomerulopathies. A rare case of association of IgM nephropathy and Hodgkin's lymphoma is presented.

The phenomenon of attachment and feeding of unfed ticks (Ixodoidea) on fed and feeding specimens of the same or different species: biological and epidemiological issues

Hyperparasitism, characterized by attachment and feeding of unfed ticks on engorged or feeding specimens of the same species (tick-to-tick attachment and feeding) has been extensively documented in laboratory colonies of ticks of the Ixodoidea superfamily. Existing literature generally assumes that hyperparasitism operates similarly across tick species in both main families, Argasidae and Ixodidae. However, a closer examination of the available data reveals distinct biological mechanisms underlying this phenomenon in different groups. In argasid ticks, hyperparasitism in laboratory colonies primarily involves unfed specimens stealing blood from their fed relatives, especially under stress of starvation or overcrowding. It remains uncertain whether this behavior of argasid ticks occurs under field conditions. If it does happen naturally, it may have originated as a consequence of the nidicolous lifestyle exhibited by soft ticks. In Ixodes ticks (Ixodinae or Prostriata), hyperparasitism of males on unfed or feeding females appears to be a side-effect in the male attempts to copulate while hyperparasitism in Amblyomminae (Metastriata) ticks is likely an aberration in feeding. This difference between Argasidae and Ixodidae may stem from independent adaptation to blood-feeding within the two Ixodoidea families. Experimental evidence of pathogen transmission between aggressor and victim during hyperparasitic feeding has only been demonstrated under laboratory conditions specifically in Ornithodoros species (Argasidae). The practical importance of this route of pathogen transmission is still unclear. Although there is an assumption in the literature that hyperparasitic pathogen transmission occurs in the taiga tick Ixodes persulcatus, it is important to know that no current data is available to support this presumption.

The Role of Olorofim in the Treatment of Filamentous Fungal Infections: A Review of In Vitro and In Vivo Studies.

Invasive fungal infections have recently been recognized by the WHO as a major health, epidemiological, and economic issue. Their high mortality rates and the emergence of drug resistance have driven the development of new molecules, including olorofim, an antifungal belonging to a new family of compounds, the orotomides. A review was conducted on the PubMed database and the ClinicalTrials.gov website to summarize the microbiological profile of olorofim and its role in the treatment of filamentous fungal infections. Twenty-four articles were included from the search and divided into two groups: an "in vitro" group focusing on minimum inhibitory concentration (MIC) results for various fungi and an "in vivo" group evaluating the pharmacokinetics (PK), pharmacodynamics (PD), efficacy, and tolerability of olorofim in animal models of fungal infection and in humans. Olorofim demonstrated in vitro and in vivo activity against numerous filamentous fungi, including azole-resistant Aspergillus fumigatus, various dermatophytes, and endemic and dimorphic fungi. in vitro results showed higher MICs for certain Fusarium species and dematiaceous fungi Alternaria alternata and Exophiala dermatitidis; further in vivo studies are needed. Published PK-PD data in humans are limited. The results of the ongoing phase III clinical trial are eagerly awaited to evaluate olorofim's clinical impact.

Ретиноваскулиты: этиология, патогенез, клинические проявления. Сообщение 1

This article highlights the issues of epidemiology, etiology, classification, etiology, pathogenesis and clinical manifestations of retinovasculitis, which is an inflammatory lesion of the walls of retinal vessels with secondary involvement of surrounding tissues in the process. The most complete clinical classification was proposed by E.I. Ustinova. In most cases, retinovasculitis develops against the background of a systemic disease of various etiologies. If the etiology remains unclear, such retinovasculitis is called idiopathic. The pathogenesis of retinovasculitis development has not yet been fully established. Clinical manifestations have both common features and the peculiarities depending on the etiology. As a rule, the onset is asymptomatic or almost imperceptible. Ophthalmoscopy most often reveals vascular lesions in the form of a violation of their caliber and course, perivascular infiltrates, «cotton» exudates. Key words: uveitis, retinovasculitis, damage of retinal vessels

Diagnosis and Intensive Care in Children’s Diabetic Acidosis: an Interdisciplinary Viewpoint

Diabetic ketoacidosis (DKA) is the main cause of death and disability in children with type I diabetes mellitus (T1DM). Children’s mortality from T1DM reaches 1% in developed countries and 13% in developing countries. The main cause of death in DKA is cerebral edema, clinical manifestations of which develop in 0.5–0.9% of children with DKA, while mortality riches 24%.Objective. Developing recommendations to prevent life-threatening complications of children with DKA using analysis of literature data and consolidated opinion of experts on the issues of intensive care in children with T1DM.Materials and methods. We analyzed and discussed studies in diagnosis and treatment of DKA in children with type 1 diabetes and 1200 literature sources since January 1970, published in Russian peer-reviewed scientific journals and international publications presented in the online repository Medline (Pubmed). The search for publications was carried out using the keywords: «children», «DKA», «DM1», «dehydration», «cerebral edema».Results. We considered issues of epidemiology, pathogenesis, clinical manifestations, diagnosis, intensive care for DKA, as well as clinical and diagnosis, treatment, prevention of cerebral edema issues in children. Limitations of the study were the small number of modern studies with a high level of evidence (randomized controlled trials, meta-analyses) over the past 5 years on DKA in children.Conclusion. Taking into account the national and international experience, joint recommendations on a consensus format were developed and formulated for the diagnosis of DKA, its leading complications and treatment recommendations for children with T1DM and DKA. Timely and accurate diagnosis of DKA, intensive therapy options based on proven therapeutic efficacy, laboratory and clinical monitoring are warranted to interrupt the DKA pathogenesis, prevent the development of life-threatening conditions, and improve treatment outcomes for children with DKA.

Lumbosacral transitional vertebrae in children and adolescents (literature review, illustrated with clinical observations)

Introduction An analysis of the medical literature devoted to various aspects of transitional lumbosacral vertebrae shows that there are very few publications covering the course of this disease in the pediatric and adolescent population.Aim To study the issues of epidemiology, diagnosis, treatment and prevention of transitional lumbosacral vertebrae in paediatric and adolescent patients based on the analysis of current medical literature and illustrate the material with our own clinical observations.Material and methods To analyze the literature on the topic, 75 papers published between 1984 and 2023 were selected. Among them, there were 7 (9.3 %) domestic literary sources, 68 (90.7 %) were foreign. In the process of searching for scientific articles, the resources of the electronic databases of current medical information PubMed and CyberLeninka were used.Results and discussion The incidence of transitional vertebrae in children and adolescents is 16.8 % of clinical observations, as reported. In the structure of the transitional vertebrae in children, type II of the disease predominates according to the classification Castellvi et al (1984), 43.2 % of cases. The main clinical symptom of the pathology is pain of lumbosacral location, the intensity of which on the visual analog scale in children corresponds to an average of 3.0 points. In adult patients with similar pathology, the average pain intensity measured with the same scale is 7.5 points. The most informative method for diagnosing the disease is computed tomography, which allows obtaining both 3D images and sections at the level of pseudarthrosis between the enlarged transverse process (or processes) of the suprasacral vertebra and the wing of the sacrum. To relieve pain in children with transitional vertebrae, both conservative and surgical methods are used. The most commonly used procedure is pseudarthrectomy. The study of long-term results one year after the intervention allowed us to record the absence of pain in children who underwent surgery. Prevention measures for transitional lumbosacral vertebrae have not been developed.Conclusion The analysis of the published literature shows that transitional vertebrae are a frequently diagnosed pathology in children and adolescents. Current methods of imaging are able to accurately detect not only the presence of the disease, but also to differentiate its type. The main clinical symptom of transitional vertebrae is pain in the lumbosacral spine which is difficult to relieve with conservative therapy. Pseudarthrectomy is the most frequent surgical method of treatment in children and adolescents that provides stable relief of vertebrogenic pain syndrome. Measures for specific prevention of the disease have not been developed.

Algae in Recreational Waters: An Overview within a One Health Perspective

Recreational water activities are widely recognized to have a positive impact on our physical and mental well-being. However, recreational water sources and their management are also a risk factor for human health due to different agents, including the overgrowth of cyanobacteria and algae. The presence of cyanobacteria and algae in recreational waters represents a One Health threat because of their potential release and the overuse of biocides. These organisms have the potential to metabolize organic matter and produce thermophilic and thermotolerant toxins. Moreover, different species of algae are involved in biofilm formation processes, thus impacting water quality and safety and also posing risks to the environment and animal and human health. Different species of algae participate in biofilm formation and have an impact on managing water and equipment maintenance. By searching literature databases, e.g., PubMed, we reviewed the state of the art, providing basic definitions, taxonomy, and epidemiological or medical issues related to the recreational uses of water. Methods of treatments and monitoring were summarized, considering both traditional and innovative strategies. Public health and surveillance approaches focus on the detection of toxins, the formation of biofilms, and the understanding of the benthonic and planktonic components as part of the larger microbial biodiversity. The review process allowed us to acknowledge that this is the first comprehensive overview of algae in recreational waters carried out within a wider One Health outlook.