Etiological Factors Research Articles

Some aspects of clinical trial of the drug “Vetmicoderm”

Our aim was to conduct some clinical trials of the drug «Vetmikoderm» and compare its effectiveness with the well-known agent «Triosan». Clinical trials to determine the therapeutic effectiveness of the drug «Vetmikoderm» were carried out at the veterinary clinic «BEST» (Zaporizhzhia) on two groups of dogs, formed by gradual recruitment (based on the owners' referral to the clinic). To determine the etiological factors contributing to the development of dermatosis, we conducted a study of skin microflora. The sensitivity of microorganisms and fungi to the action of the «Vetmikoderm» preparation was determined by the disc-diffusion method. In the process of diagnostic research, including microbiological studies, it was established that conditionally pathogenic microflora from affected areas of dogs' skin was represented by both microorganisms and fungi. At the same time, fungi prevailed in the microbiocenosis of the selected skin samples. It is worth noting that «Vetmikoderm» has a better fungicidal effect, while «Triosan» is evidently more effective in treating dermatoses with predominantly microbial contamination. It has been proven that the combined use of both drugs has a better influence on the recovery process in animals.

APPLICATION OF BOTULINUM TOXIN IN CONSERVATIVE TREATMENT OF MASTICATORY MUSCLES DYSFUNCTION

The purpose of this paper is to describe the application of the botulinum toxin in diseases of the temporomandibular system of a muscular type such as masticatory hypertrophy, spasm, bruxism, and tension headaches of idiopathic etiology. The masticatory system is a complex apparatus with great adaptive capacity. Still, when that capacity is exceeded, functional disorders occur followed by a series of symptoms that depend on individual, local, and systemic etiological factors. Occlusal trauma exceeding the physiological limits of the teeth, periodontium, and TMJ leads to a series of functional disorders. Temporomandibular dysfunctions (TMD) are used to describe a large, heterogeneous group of diseases of the temporomandibular joint (TMJ) and its adjacent tissues and organs. Botulinum toxin type A, hemagglutinin complex with 500 IU (DISPORT Ipsen Biopharm, UK) was used for the therapy of muscle disorders like bruxism or night teeth clenching in female patient 26 years old. Depending on the dose that was applied to the targeted muscle, a complete or partial reduction in contraction occurs with reduced function and weakening of the muscle. Two weeks after applying the neuromodulator, the patient reported a reduction in pain and episodes of teeth grinding and clenching. Bilateral hypotrophy of left and right masseter muscles was noticeable after 2 months. We concluded that botulinum toxin could be used as an effective treatment for reducing nocturnal bruxism and myofascial pain in patients with bruxism.

Development and validation of a structured questionnaire to assess the Knowledge, Attitude and Practice (KAP) regarding the effect of yoga on periodontal health among Indian adults.

Background Periodontal disease is a chronic inflammatory disease of structures surrounding the teeth. Its etiology is multifactorial. The primary etiological factor is the microbial component; the other factors are systemic, behavioral, environmental, and psychological. Conventional management includes routine periodontal therapy involving prophylactic and surgical management. In developing countries like India, complementary medicine and alternative medicines like yoga are gaining popularity for improving systemic health. Hence this pilot study was designed to assess the psychometric properties of a structured questionnaire that can assess knowledge, attitude, and practice (KAP) regarding the impact of yoga on oral and periodontal health in Indian population. Methods The KAP questionnaire was developed (Stage One) using a deductive approach, and a psychometric evaluation of the questionnaire was performed to evaluate it’s reliability and validity (Stage Two). Initial content validation and test re-test reliability were assessed using kappa statistics with binary responses. An intraclass correlation coefficient (ICC) was used to assess the questions in the practice and attitude category with categorical variables. Further assessment of psychometric properties of the questionnaire was done using item response theory. The developed questionnaire had four principal sections: demography of participants; knowledge regarding yoga and oral health; attitude towards yoga and oral health; and practice towards implementing yoga for oral health. Results The ICC for all the assessed questions was greater than 0.60 suggesting satisfactory stability. Internal consistency measured using Cronbach’s alpha for knowledge, attitude, and practice items were reported to be 0.632, 0.923, and 0.591 respectively and that of the KAP total was 0.632. Conclusions The findings of this study showed that the questionnaire had an acceptable psychometric property for measuring KAP regarding yoga and it’s role in oral and periodontal health among Indian adults. The analysis of participant responses revealed that they had a medium level of knowledge regarding yoga and periodontal disease.

NOSOLOGICAL FEATURES OF INFECTIOUS ABORTIONS IN COWS

Providing the country's population with high-quality products is a priority task of modern animal husbandry. However, there are a number of problems in the industry that prevent obtaining quality products of animal origin in the required volume. The intensification of dairy farming and the increase in milk productivity of cows is often accompanied by a metabolic disorder, which reduces the body's resistance, contributing to the development of immune-deficiencies, which increase the susceptibility of animals to infectious diseases, some of which have an abortive form of manifestation and, accordingly, the consequence is a lack of offspring and potential income due to abortions. Abortion in cows should be considered not only as a gynecological problem, but also as an economic one, because animal husbandry accounts for more than 38% in the structure of gross agricultural products of the country and the lack of keeping of young animals significantly affects the development of the livestock industry. This publication is devoted to the results of the nosological profile of infectious abortions in cows on the territory of Ukraine, among which 64% of cases are infectious agents - 41.4% of bacterial origin and 22.6% of viral origin. The most frequent factors of bacterial etiology of abortions in cows are leptospira, coxiella, salmonella, mycoplasma, campylobacter, chlamydia, toxoplasma and listeria, and the most common viral ones are flavo-virus, gamma-herpesvirus and alpha-herpesvirus.

A prospective study on the causes of hyperbilirubinemia and its clinical markers in term and near-term newborns admitted to a tertiary care hospital in Patna, India

This study aimed to investigate the root causes, prognostic factors, and therapeutic strategies for neonatal hyperbilirubinemia among term and near-term infants admitted to the Neonatal Intensive Care Unit (NICU) at IGIMS, Patna. Furthermore, the research aimed to analyze the clinical progression of these infants throughout their NICU stay.Conducted within the NICU at IGIMS, Patna, Bihar, this study encompassed term and late preterm infants admitted with serum bilirubin levels exceeding 12 mg/dl. The primary focus was on identifying risk factors, etiological factors, and the clinical profile of these infants during their NICU tenure.The study examined birth weight distribution and concurrent medical conditions. Parameters included the initiation of phototherapy based on bilirubin levels and treatment methodologies. Out of the 210 infants studied, 27.14% and 47.62% weighed between 2001 and 2500 grams. The most prevalent causes were physiological (129 cases), fetal prematurity (30 cases), birth asphyxia (7 cases), and prolonged labor (18 cases). Idiopathic causes were observed in 28 instances, ABO incompatibility in 7 cases, and Rh incompatibility in 7 cases. G6PD deficiency was identified once. At the commencement of phototherapy, 19.52% had bilirubin levels between 12 and 15 mg/dl, 58.57% between 15.1 and 18 mg/dl, 11.91% above 20 mg/dl, and 10% between 18.1 and 20 mg/dl.Physiological causes emerged as the most frequent contributors to neonatal hyperbilirubinemia, followed by septicemia and idiopathic factors. Infrequent causes included blood group incompatibility. Phototherapy was established as a cost-effective and efficient method for reducing bilirubin levels in neonatal jaundice. Exchange transfusion proved to be a safe therapeutic measure in cases of severe hyperbilirubinemia. Blood group incompatibility was the main determinant requiring exchange transfusion.

Tracheomalacia in patients undergoing thyroid surgery—What is the true estimate: A systematic review and meta‐analysis

AbstractObjectivesTracheomalacia is defined as the weakening of the tracheal rings secondary to long‐standing compression or inherent structural weakness, leading to stridor and airway compromise. The common etiological factor of tracheomalacia includes compression of the tracheal framework due to a large multinodular goiter. There are various management techniques described in the literature to manage a patient with tracheomalacia including tracheostomy, tracheal stenting, and tracheopexy. However, the evidence of tracheomalacia in the literature is conflicting. Therefore, a systematic review was conducted to estimate the incidence of tracheomalacia after thyroidectomy.MethodsThe systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A literature search was performed on PubMed, Web of Science, Cochrane library, and Elton B. Stephens Co. cumulative index to nursing and allied health literature plus to determine the incidence of tracheomalacia among patients undergoing thyroidectomy up till October 2021. The eligibility was assessed by two independent authors. A quality assessment of individual studies was performed using the National Institute of Health quality assessment tool. Outcomes were double data extracted and were analyzed using OpenMeta.ResultsThe online search retrieved 214 papers, out of which 17 studies were included that fulfilled the eligibility criteria. The number of patients included in the systematic review who underwent thyroidectomy was 1108. The mean age was 55.8 ± 7.7 years, ranging from 48 to 75 years. Tracheomalacia was reported in 146 patients (1.4%). Sternotomy was performed in 102 patients to approach the goiters with retrosternal extension. The most common intervention to manage tracheomalacia was tracheostomy or prolonged intubation.ConclusionsTracheomalacia is a rare complication. In cases where tracheomalacia is encountered, common methods of management include tracheostomy or prolonged endotracheal intubation. Prospective, long‐term studies are required to accurately assess its true incidence and associated factors.

An Updated Review on the Diaphragmatic Hernia in Bovines

Diaphragmatic hernia is a common surgical condition in buffaloes but is occasionally recorded in cattle. A high hospital occurrence of diaphragmatic hernia in buffaloes raises a concern and a thought on the aetiology, as it affects the socio-economic status of the farmer. Scientific literature published to date could not establish any definitive aetiology of diaphragmatic hernia in bovines. However, it is also definitive that diaphragmatic hernia is not a congenital condition as the symptoms start appearing not before one year of age. Some anatomical factors listed specifically for buffaloes may also add to the aetiology other than the foreign body, advanced stage of pregnancy, or recent calving. Being a slow-progressing and non-infectious condition, early diagnostic and prognostic factors based on clinical, imaging and haemato-biochemical parameters and the selection of cases for surgical intervention are important. The article reviews the literature, when it was first time diagnosed, its global incidence, etiological factors and advancement in the diagnostic modalities, anaesthetic and surgical treatment methods, productive and reproductive outcomes and future directions.

Idiopathic toe walking: What’s New? An Integrative Review

Objective: Consolidate the current knowledge on idiopathic toe walking, provide a critical overview, and identify areas for potential future research. Methods: An electronic search was conducted in the following databases up to June 2023: MEDLINE, EBSCO, Embase, CINAHL Plus, and PubMed. The PICO framework was employed to define search terms. Results: Despite considerable methodological heterogeneity among studies, a stronger inclination was found to investigate etiological and prognostic factors. There is a trend for a higher prevalence in boys with a positive family history. Novel classifications have been proposed to improve differential diagnosis. Among conservative treatment options, there is stronger evidence for gait improvement using serial casting followed by orthoses. Severe cases may benefit from surgical zone III gastrocsoleus lengthening. Conclusion: Further studies with standardized methodologies are required to clarify questions about this condition’s etiology, classification, and treatment. Nonetheless, there is a higher level of evidence supporting conservative treatments with serial casting and orthoses and zone III gastrocsoleus lengthening for severe cases in the second decade of life. Level of evidence II; Diagnostic studies. Keywords: Walking; Equinus Deformity; Foot;

Comprehensive Analysis of Gallstone Composition and Association with Risk Factors in Bangladesh: Insights into the burden and outlook for prevention and management.

Gallstone is as ancient as human civilization. It has been found in the gallbladders of Egyptian mummies, dating back to 1000 BC. Gallstone is one of the diseases prevalent in developed nations but it is less prevalent in the developing populations that still consume traditional diets. Gallstones are formed in the gallbladder, from the constituents of bile cholesterol and calcium bilirubinate are the main chemical compounds present in gallstones and their precipitation in bile is induced by multiple aetiological factors. The prevalence and the chemical composition of gallstones vary from population to population. This indicates the involvement of multiple risk factors in the pathogenesis of gallstones. Therefore investigation of the chemical composition of gallstones is primarily important to recognize the correlation with the risk factors for gallstones disease in a community. J Shaheed Suhrawardy Med Coll 2022; 14(2): 3-10

Evaluation of Alterations That May Occur on Root Surfaces after Root Planing Procedures with a Scanning Electron Microscope

Background: The aim of root debridement procedures in non-surgical periodontal treatment is the elimination of etiologic factors that cause periodontal disease, as well as the removal of cement affected by the disease. However, root debridement procedures for the treatment of periodontal diseases produce root surface irregularities that can adversely affect the healing of periodontal tissues. The objective of the present study is to evaluate the surface texture of a root after instrumentation, including an ultrasonic instrument, a Gracey curette, or a double Gracey curette. Methods: A total of 26 single-rooted teeth were used in this study; two specimens were used as controls, and the remaining 24 specimens were equally divided into three groups. Specimens from each group were then subjected to root planing using one of the following instruments: (1) an ultrasonic instrument; (2) a Gracey curette; or (3) a double Gracey curette. The control group was treated with no instrumentation. The extracted teeth were analyzed under a scanning electron microscope and graded in terms of the “roughness and loss of tooth substance index” and the “exposed dentin tubule index.” The SPSS (Statistical Package for Social Sciences) V.21 program was used to conduct a statistical analysis of the data obtained in this study. While evaluating the data, in addition to descriptive statistical methods (mean and standard deviation), a one-way analysis of variance (one-way ANOVA) was carried out to compare the quantitative data and evaluate normally distributed parameters between groups, while a post hoc multiple comparison test was carried out for subgroup comparisons. Results: There was no statistically significant difference between the roughness and material loss on the root surfaces in the samples treated with the ultrasonic instrument or the Gracey curette, and no exposed dentine tubules were observed. Meanwhile, it was observed that the double Gracey curette caused more roughness and material loss on the root surface, and exposed dentine tubules were observed in some samples. The time required for treatment using a double Gracey curette was significantly shorter than that required with the Gracey curette and ultrasonic instruments. Conclusions: The double Gracey curettes produced a relatively rougher root surface than the Gracey curettes or the ultrasonic instrument.

Rare heterozygous genetic variants of NRXN and NLGN gene families involved in synaptic function and their association with neurodevelopmental disorders.

The interaction of neurexins (NRXNs) in the presynaptic membrane with postsynaptic cell adhesion molecules called neuroligins (NLGNs) is critical for this synaptic function. Impaired synaptic functions are emphasized in neurodevelopmental disorders to uncover etiological factors. We evaluated variants in NRXN and NLGN genes encoding molecules located directly at the synapse in patients with neuropsychiatric disorders using clinical exome sequencing and chromosomal microarray. We presented detailed clinical findings of cases carrying heterozygous NRXN1 (c.190C>T, c.1679C>T and two copy number variations [CNVs]), NRXN2 (c.808dup, c.1901G>T), NRXN3 (c.3889C>T), and NLGN1 (c.269C>G, c.473T>A) gene variants. In addition, three novel variants were identified in the NRXN1 (c.1679C>T), NRXN3 [c.3889C>T (p.Pro1297Ser)], and NLGN1 [c.473T>A (p.Ile158Lys)] genes. We emphasize the clinical findings of CNVs of the NRXN1 gene causing a more severe clinical presentation than single nucleotide variants of the NRXN1 gene in this study. We detected an NRXN2 gene variant (c.808dup) with low allelic frequency in two unrelated cases with the same diagnosis. We emphasize the importance of this variant for future studies. We suggest that NRXN2, NRXN3, and NLGN1 genes, which are less frequently reported than NRXN1 gene variants, may also be associated with neurodevelopmental disorders.

DNT cells mediate resistance to CAR-T cells therapy in a pediatric patient with relapsed and refractory B-ALL.

Chimeric antigen receptor T (CAR-T) cells therapy is a milestone achievement in the immunotherapy of relapsed and refractory (R/R) B cell acute lymphoblastic leukemia (B-ALL). However, some patients treated with CAR-T cells do not achieve complete remission, the mechanisms of which have not been elucidated. In the present study, we report a 9-year-old pediatric patient with refractory B-ALL received a triple infusion of autologous CD19 CAR-T cells therapy after the second relapse. CAR-T cells expanded in the peripheral blood and bone marrow. However, the patient did not achieve complete remission, indicating a lack of response to CAR-T cells therapy. Analysis of etiological factors revealed that the number of CD4 and CD8 double-negative T (DNT) cells was significantly upregulated in the peripheral blood, bone marrow, and autologous CAR-T cells products. In conclusiont,these findings indicate that DNT cells mediated resistance to CAR-T cells therapy in this pediatric patient with R/R B-ALL.

ПРОБЛЕМА ОЖИРЕНИЯ У ДЕТЕЙ И ПОДРОСТКОВ

Currently, the problem of obesity and overweight in children and adolescents is a serious public threat, the prevalence of which continues to grow rapidly in many countries around the world. The occurrence of obesity depends on a combination of various and dangerous etiological factors. Obesity and overweight have many pathogenetic links that cause adverse and dangerous health effects, significantly impair the quality of life and reducing its duration. High prevalence, life-threatening consequences, unsuccessful therapy, large financial costs and social discrimination put obesity and overweight in a special place among modern problems of medicine and healthcare. This study is devoted to the study of etiology, pathogenesis and influence of overweight on human health, evaluating the outcomes in clinical studies of obesity in children and adolescents. The study of the problem of obesity in children and adolescents should be aimed at identifying the relationship between various components of pathogenesis and the development of adverse consequences of obesity, taking into account the role of etiology – genetic and environmental factors. It is necessary to systematically approach the treatment of obesity and its complications, taking into account the multifactorial etiology and pathogenesis of this condition. Such tactics will help to find potential targets for obesity therapy, individual approaches in the diagnosis, treatment and prevention of this disease, which is crucial in the fight against this global epidemic.

Predicting in-hospital mortality in infective endocarditis: insights from complete blood count parameters and NT-proBNP

Abstract Funding Acknowledgements None. Introduction Infective endocarditis (IE) is a rare condition with an increasing incidence rate and complexity of cases over the last few years, accompanied by a high mortality rate ranging from 18% to 25%. Recent studies have shown the utility of new outcome predictors based on complete blood count (CBC), such as red blood cell distribution width (RDW) and neutrophils/lymphocytes ratio (NLR). Drawing retrospectively from an 8-year experience, we provide a perspective from a tertiary center on predictors of in-hospital mortality based on basic laboratory test results in patients with valve-related IE. Purpose The aim of the study was to assess the clinical accuracy of CBC-based parameters as in-hospital mortality predictors. Methods From a tertiary center database (serving a stable population of 2.5 million citizens), we selected all patients hospitalized due to valve-related infective endocarditis between 2015 and 2022. We analyzed clinical data (including sex, age, IE localization, and etiological factors, number of cases, management and mortality), laboratory test results at admission (including CBC parameters, C-reactive protein - CRP, procalcitonin - PCT, N-terminal prohormone of brain natriuretic peptide - NT-proBNP, estimated glomerular filtration rate - eGFR, Creatinine - Crea, urea - UR). For three NT-proBNP, NLR, and RDW we provided a further analysis to compare their clinical accuracy. Univariable logistic regression was used to assess the impact of specific factors on mortality. To determine the optimal cutoff values for predicting mortality, we analyzed the area under the curve (AUC) from receiver operating characteristic (ROC) curves and used Youden's index. P-values < 0.05 were considered statistically significant. Results A total of 194 consecutive patients with confirmed IE were included in the study, the majority of whom were men (75.3%) with an overall median age of 62 years. The overall mortality rate was 27.8%. The most common localization was left-sided IE (92.3%). In 39.7% of cases, the etiological factor was unidentified, while Staphylococcus spp. were the most common bacteria among the identified cases. We identified significant impacts on mortality in most of the analyzed laboratory tests (RDW, platelet count, hemoglobin, NLR, PCT, NT-proBNP, eGFR, Crea, UR). Results showed that for every 1000pg/ml of NT-proBNP the risk of in-hospital death increases by 6%. ROC analysis was performed for the three parameters (RDW, NLR, and NT-proBNP), and each parameter showed an acceptable area under the curve - AUC (RDW: 0.69; NLR: 0.62; NT-proBNP: 0.78). Although we found the highest AUC for NT-proBNP (p<0.001). Conclusions Although CBC parameters are easy to assess and useful in predicting in-hospital death in IE, the accuracy of NT-proBNP is higher. The management of IE cases requires a complex approach, and NT-proBNP, which also reflects the clinical state of patients, still remains a more useful tool.In-hospital deaths ROC analysis

MICROFLORA OF THE UROGENITAL TRACT IN ACUTE PURULENTINFLAMMATORY DISEASES OF THE URINARY SYSTEM AS A PREREQUISITE OF ABDOMINAL SEPSIS

The aim – to ascertain the etiological role of various taxonomic groups of autochthonousand allochthonous microorganisms in the origin of acute purulent- inflammatory diseasesof the urinary system as a prerequisite of abdominal sepsis.Materials and methods. The study covers 145 patients with acute purulent- inflammatorydiseases of the urinary system. When studying the microbiota of the urinary system,standard microbiological methods were used, the number of colony- forming units(CFU) was counted, determining the population level of each species or group of themicroorganisms, the obtained numerical values were converted into a decimal logarithm(lg CFU). The etiopathogenetic value of individual representatives of the microbiotawas assessed by the constancy index, frequency and significance indicators, as well asthe coefficient of quantitative dominance of each type of microorganisms, and otherindicators (Margalef index, Berger- Parker dominance index).Results. Acute purulent- inflammatory diseases of the urinary system are polyetiologicaldiseases caused by microorganisms belonging to different taxonomic groups. The leadingrole belongs to opportunistic Escherichia, to a lesser extent enteropathogenic E.coli,as well as conditionally pathogenic Staphylococci, in addition to that only in a small(13.48 %) number of patients it was not possible to isolate and identify the pathogens.Associations of pathogens were often encountered, which testifies to the need of developingan antimicrobial effect on etiological factors. Conclusions. Acute purulent- inflammatory diseases of the urinary system arecharacterized by polyetiological factors, a variety of pathogens with the dominant roleof Escherichia coli and Staphylococci. The identified pathogens create the potentialfor translocation and formation, under certain conditions, of abdominal sepsis in thiscontingent of patients.

Differences in clinical features according to survival and gender in patients admitted for cardiac arrest

Abstract Funding Acknowledgements None. Introduction Cardiac arrest (CA) is a condition with poor vital and neurological prognosis. Although there are widely known clinical features modifying prognosis –such as time to return of spontaneous circulation (ROSC) and neuron-specific enolase values-, there is uncertainty around whether gender, ischemic etiology or classic cardiovascular risk factors may influence in the management and prognosis. Purpose The aim of this study was to analyze the differences in baseline characteristics and management between survivors and non survivors, among patients admitted for CA in an Intensive Cardiac Care Unit. Methods A prospective unicentric registry was performed from January 2010 to December 2021, including all consecutive cardiac arrest patients admitted to an intensive cardiac care unit of a university hospital. Patients were classified into survivors –to hospital discharge- and non-survivors –deceased during hospital admission, irrespective of time of death. Univariate analysis were performed using Chi-square and Student t tests, and logistic regression was used for a multivariate analysis to compare both groups. Results A total of 324 patients were included, mean age 59.7 (DE 12.2) years, 17.9% were women. In-hospital mortality was 42% (136 patients) and 188 patients survived to hospital discharge. Survivors were significantly younger (mean of 57,37 vs 62,98 years) and had less prevalence of diabetes (17 vs 33%) and previous myocardial infarction (15 vs 25%) than non-survivors. Among survivors, there was a higher prevalence of in-hospital CA (26,6 vs 12,5%), CA due to acute coronary syndrome (68,62 vs 57,78%) and shockable first rhythm (90,43 vs 72,06%). They also had shorter ROSC (mean 22,13 vs 34,25 minutes) and no flow times (mean 2,54 vs 5,67 minutes). Gender, arterial hypertension, dyslipidemia and smoking habit did not modify prognosis. When comparing genders, women had significantly less prevalence of smoking habit and previous ischemic heart disease, their time to ROSC was lower and they received less coronary angiographies than men. The multivariate analysis showed significant in-hospital mortality risk increase with age (OR 1,04 per year), ROSC (OR 1,04 per minute) and no-flow (OR 1,09 per minute) times, out of hospital CA (OR 2,26) and non shockable rhythm. Conclusions In a consecutive cohort of 324 patients admitted after cardiac arrest, survivors were significantly younger, and had less prevalence of diabetes mellitus and previous myocardial infarction. In-hospital arrest, shockable rhythm, and shorter ROSC and no-flow times were associated with better survival. No differences in survival were found between genders, although women had significantly shorter resuscitation times.Univariate analysisMultivariate analysis

Tracing Geographic and Molecular Footprints of Copepod Crustaceans Causing Multifocal Purple Spots Syndrome in the Caribbean Sea Fan Gorgonia ventalina

The recent rise in ocean temperatures, accompanied by other environmental changes, has notably increased the occurrence and spread of diseases in Octocorallia, many species of which are integral to shallow tropical and subtropical coral reef ecosystems. This study focuses on the understanding of these diseases, which has been largely limited to symptomatic descriptions, with clear etiological factors identified in only a fraction of cases. A key example is the multifocal purple spots syndrome (MFPS) affecting the common Caribbean octocoral sea fan Gorgonia ventalina, linked to the gall-forming copepods of the genus Sphaerippe, a member of the widespread family, Lamippidae. The specialized nature of these copepods as endoparasites in octocorals suggests the potential for the discovery of similar diseases across this host spectrum. Our investigation employed four molecular markers to study disease hotspots in Saint Eustatius, Curaçao, northwest and southwest Cuba, and Bonaire. This led to the discovery of a group of copepod species in these varied Caribbean locations. Importantly, these species are morphologically indistinguishable through traditional methods, challenging established taxonomic approaches. The observed diversity of symbionts, despite the host species’ genetic uniformity, is likely due to variations in larval dispersal mechanisms. Our phylogenetic analyses confirmed that the Lamippidae copepods belong to the order, Poecilostomatoida (Copepoda), and revealed their sister group relationship with the Anchimolgidae, Rhynchomolgidae, and Xarifiidae clades, known for their symbiotic relationships with scleractinian corals. These results add to our understanding of the evolutionary and ecological interactions of copepods and their hosts, and the diseases that they cause, and are important data in a changing climate.

Use of gabapentin for neuropathic pain therapy: A view from perspective of evidence-based medicine

The aim of the study was to analyze the literature sources for pharmacodynamic and pharmacokinetic features of gabapentin, providing its use in patients with neuropathic pain, as well as a comparative evaluation of its efficacy and safety when used in different doses.Materials and methods. PubMed, Google Scholar, EMBASE, ResearchGate scientific information network and elibrary.ru databases were used as search resources. The keywords used for the search were “gabapentin”, “mechanism of action”, “gabapentin targets”, “gabapentin pharmacodynamics”, “pharmacokinetics”, “pharmacokinetic parameters”, “neuropathic pain”, and “randomized clinical trials”. The depth of the search was 26 years (from 1998 to 2024). This review resulted in 87 literature sources.Results. Neuropathic pain (NeP) is one of the most common types of chronic pain, characterized by a high prevalence among people of the working age. Effective pharmacotherapy aimed at eliminating the pain syndrome is a key tool for improving the quality of life and preserving the work capacity of patients. Heterogeneity of etiologic factors involved in the genesis of NeP indicates the need to use drugs the analgesic effect of which is based on weakening the transmission of pain impulses in the CNS. In clinical trials, gabapentin has demonstrated efficacy in reducing the severity of pain in patients with postherpetic NeP, painful diabetic neuropathy and many other conditions accompanied by NeP. The dose of gabapentin 300 mg/day is the initial dose in the therapy of NeP and requires a further slow titration depending on the patient’s response to therapy and tolerability of the drug, especially in elderly and senile patients, as well as in patients with an impaired renal function. According to the published data, the most pronounced analgesic effect is achieved in the patients against the background of the gabapentin administration at a dose of 3600 mg/day.Conclusion. Gabapentin is the drug of choice in the management of patients with NeP of different etiology and intensity. A satisfactory safety profile and pharmacodynamic effects make gabapentin possible, despite the long history of its use, to remain a relevant drug used by a wide range of physicians, specialties, for pharmacotherapy of NeP patients.

Practitioner Review: Assessment and treatment of body dysmorphic disorder in young people.

Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under-recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long-term consequences and treatment.

Association of Risk Factors with Female Pattern Hair Loss

Introduction: Female Pattern Hair Loss (FPHL) is one of the main causes of hair loss in adult women and has a major impact on individual’s quality of life. It evolves from the progressive miniaturization of follicles that lead to a subsequent decrease of the hair density, leading to a non-scarring diffuse alopecia. In spite of the high frequency of the disease and the relevance of its psychological impact, its pathogenesis is not yet fully understood, being influenced by genetic, hormonal, and environmental factors. Objective: To evaluate etiological factors associated with female pattern hair loss. Materials & Methods: This was a hospital-based case control study, conducted in the Department of Dermatology & Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March, 2021 to August, 2022. In this study, total 100 females aged 18 to 45 years were enrolled. Among them, 30 females had history of hair loss >6 months, presented to outpatient department, BSMMU were included as case & 70 healthy females who had no history of hair loss included as control according to inclusion & exclusion criteria. Diagnosis of FPHL was made clinically & Ludwig classifications were used to assess the degree of hair loss. Information on possible risk factors for FPHL was collected using a questionnaire interview. Result: The mean age of the patients with FPHL was 41.0±7.77 years with majority belongs to >40 years of age group & their mean duration of hair loss was 26.3±12.0 months. Among the patients of FPHL, 36.7% had history of inadequate intake of iron containing food, 66.7% had family history of alopecia, 36.7% had history of increased bleeding during their menstruation, 20.0% had multiple (>3) childbirth & 23.3% had hypertension. About 86.7% patients with FPHL had low serum ferritin (<30ng/ml) with mean serum ferritin level was 20.25±16.07ng/ml and 66.7% patients of FPHL had low Hb (<12 µg/l) with mean Hb was 11.47±1.52 µg/l. In the multivariate logistic regression analysis significant association found with FPHL were age (OR 2.013, 95% CI 0.672-3.714), family history of alopecia (OR1.231, 95% CI 0.162-1.991) and lower serum ferritin level (OR1.090, 95% CI 1.043-1.139). Conclusion: Age, family history of alopecia, lower serum ferritin may be implicated as risk factors for female pattern hair loss. Medicine Today 2023 Vol.36 (1): 7-11