Functional Disorders Research Articles

Perspectives on the diagnosis and management of functional cognitive disorder: An international Delphi study.

Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions. International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter-rater agreement analyses were undertaken. Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%-88% of the FCD diagnoses were attributed to non-neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%-92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD. Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence-based interventions.

Delivering a Specialised Best Practice Service for People with Functional Neurological Disorder: An Australian Qualitative Descriptive Study

Specialised functional neurological disorder (FND) clinics are emerging as the preferred way of providing best practice care to people with FND. However, questions remain around optimal care pathways, service provision, and resources. This study aimed to identify (1) service characteristics of Australian FND models of care; (2) barriers and enablers to implementing a specialised FND service; and (3) enablers and barriers to providing best practice management for people living with FND. Clinicians were recruited from Australian public and private healthcare organisations identified as leading best practice for adults with FND. Clinicians completed a structured interview via phone. A descriptive content analysis was used. Five out of 12 healthcare organisations interviewed had a specialised multidisciplinary FND service. All specialised FND services were outpatient programs, but the structure and referral pathways varied. Barriers identified by organisations with an FND service included “funding” and “staff and service fragility,” while enablers included “engaging stakeholders” and having a clear “service driver.” “Diagnosis delay” and “insufficient access to staff” were identified as barriers to implementing best practice by organisations without a specialised FND service. Despite specialised clinics being recognised as a practical way to deliver care to people with FND, only a few services operate in Australia. Timely and educated diagnosis and access to an interdisciplinary team consisting of neurology, physiotherapy, and psychology are central pillars for FND services. Further work to establish clinically and economically effective delivery models is required to facilitate the provision of best practice care for people living with FND.

A Study of Outcome of Detethering in Delayed Presentation of Tethered Cord Syndrome

Abstract Introduction Tethered cord syndrome (TCS) is a stretch-induced functional disorder associated with tethering of caudal spinal cord to dura mater with inelastic tissue, limiting its movement. It not only manifests in childhood but also noted in adults. Here, we studied the role of detethering on delayed presentation of TCS. Material and Methods All patients of symptomatic TCS from January 2011 to December 2019 were included. Preoperative evaluation was done through X-ray; ultrasonography kidney, ureter, urinary bladder; magnetic resonance imaging spine and brain; and urodynamic studies. Detethering was done and associated pathology was excised. Preoperative and postoperative comparison was done through Necker functional score using chi-squared system. Results Age range was 8 to 30 years with mean age of 13.8 years. Most common presentation was urological manifestations in ∼61.1% of cases followed by pain in 41.6%, sensory deficits in 38.8%, asymmetric weakness in 30.5%, orthopaedic and trophic ulcers in 22.2% each, and bowel abnormalities in 13.8% of cases. Mean duration of symptoms was 5.52 years. Improvement in urological manifestations was in 71.4% patients, pain in 80%, sensory dysfunctions in 71.4%, bowel dysfunctions in 80%, motor weakness in 90.9%, and trophic ulcer in 100% patients. On comparison, chi-squared value was 25.9993 and p-value was 0.000032, which was significant (&lt;0.05). Conclusion Detethering in early ages is already proven with good results. In our study, detethering showed statistically significant improvement even in delayed presentation. So, authors recommend to surgically interfere by detethering, even if tethering is detected late with significant deficits.

Do occupational therapy and/or physiotherapy interventions improve activity and participation function for children and adolescents with functional neurological disorder? A systematic review

Background/Aims Functional neurological disorder is increasingly common in paediatric neurological practice, yet the role and scope for occupational therapy and physiotherapy intervention remains unclear. The aim of this systematic review was to evaluate if occupational therapy and/or physiotherapy interventions improve activity and participation for children and adolescents with functional neurological disorder compared to usual care. Methods CINAHL, Embase and Medline were searched until May 2023. Eligibility criteria were applied by two reviewers independently. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Data were synthesised narratively and the certainty of evidence assessed using a Grading of Recommendations, Assessment, Development and Evaluation approach. Results A total of eight non-randomised studies (n=451 participants, mean age 13.2 years) were selected. There was very low certainty evidence that for approximately three in four participants, inpatient or outpatient multidisciplinary programmes involving physiotherapy and/or occupational therapy led to recovery at the end of the programme, with recovery and school attendance retained at 12 months. Two studies provided very low certainty evidence that two in three participants attending multidisciplinary programmes were independent on all Pediatric Functional Independence Measure items at programme discharge. Conclusions: There is insufficient evidence to suggest routine occupational therapy and/or physiotherapy interventions improve activity and participation function for children and adolescents with functional neurological disorder compared to usual care. Implications for practice The implications for clinical practice for allied health professionals are ambiguous because of the low-quality of the available evidence. Until further research is conducted to support clinical practice, clinicians must rely on the combination of their clinical expertise and the best available evidence to guide practice.

Impact of Coronavirus disease 2019 pandemic in children with functional abdominal pain disorders: Data from long-term follow-up.

We aimed to compare symptom frequency and severity in children with functional abdominal pain disorders (FAPDs) and to evaluate anxiety, quality of life (QoL) and global health during Coronavirus disease 2019 (COVID-19) related quarantine and after 17 months. Children diagnosed with FAPDs between October 2019 and February 2020 at 5 different centers were enrolled and prospectively interviewed during the COVID-19 quarantine and 17 months later when schools, hospital services, and routine activities had re-opened to the public. The patients were asked to complete the Rome IV questionnaire, the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) Generic Core Scale, the Patient-Reported Outcomes Measurement Information System (PROMIS) anxiety and global health questionnaires. Data about COVID-19 infection and its clinical outcome were also collected. Ninety-nine out of 180 (55%) children completed the follow-up. The number of patients reporting a worsening of their symptoms was significantly higher at follow-up when compared to the quarantine period (24/99 [24.2%] vs. 12/99 [12.1%]; p = 0.04). The PedsQL 4.0 subtotal score at follow-up significantly decreased at 17 months of follow-up (65.57 [0-100]) when compared to the quarantine (71 [0-100], p = 0.03). Emotional functioning was the most significantly reduced (Follow-up: 64.7 [0-100] vs. Quarantine: 75 [0-100]; p = 0.006). We did not identify significant differences in symptoms and QoL between COVID-19 infected children and the remaining cohort at the two time points. An improvement of symptoms and QoL was observed during the quarantine, followed by a worsening at-follow-up. These findings reinforce the hypothesis that the nest effect overweighted COVID-19 fears during the quarantine and highlight the importance of psychological factors in symptom exacerbation.

Palm oil as part of a high-fat diet: advances and challenges, or possible risks of pathology?

Nutritional status disorders have the most significant impact on the development of cardiovascular and oncologic diseases; therefore, the interest in the study of palm oil as among the leading components of nutrition has been increasing. The data examined in this review were sourced from the Scopus, SCIE (Web of Science), PubMed and PubMed Central, MEDLINE, CAPlus/SciFinder, and Embase databases; experts in the field; bibliographies; and abstracts from review analyses from the past 15 years. This review summarizes recent research data focusing on the quantitative and qualitative composition of nutrition of modern humans; concepts of the relationship between high-fat diets and disorders of insulin functioning and transport and metabolism of fatty acids; analyses of data regarding the palmitic acid (16:0) to oleic acid (18:1) ratio; and the effect of diet based on palm oil consumption on cardiovascular risk factors and lipid and lipoprotein levels. Several studies suggest a potential vector contributing to the transmission of maternal, high-fat-diet-induced, addictive-like behaviors and obesogenic phenotypes across generations. The relationship between cholesterol accumulation in lysosomes that may lead to lysosome dysfunction and inhibition of the autophagy process is analyzed, as is the progression of inflammatory diseases, atherosclerosis, nonalcoholic liver inflammation, and obesity with associated complications. Data are discussed from analyses of differences between rodent models and human population studies in the investigated different effects of palm oil consumption as a high-fat diet component. A conclusion is reached that the results cannot be generalized in human population studies because no similar effects were observed. Although there are numerous published reports, more studies are necessary to elucidate the complex regulatory mechanisms in digestive and nutrition processes, because there are great differences in lipoprotein profiles between rodents and humans, which makes it difficult to reproduce the pathology of many diseases caused by different types of the high-fat diet.

Exploring intricate connectivity patterns for cognitive functioning and neurological disorders: incorporating frequency-domain NC method into fMRI analysis.

This study extends the application of the frequency-domain new causality method to functional magnetic resonance imaging analysis. Strong causality, weak causality, balanced causality, cyclic causality, and transitivity causality were constructed to simulate varying degrees of causal associations among multivariate functional-magnetic-resonance-imaging blood-oxygen-level-dependent signals. Data from 1,252 groups of individuals with different degrees of cognitive impairment were collected. The frequency-domain new causality method was employed to construct directed efficient connectivity networks of the brain, analyze the statistical characteristics of topological variations in brain regions related to cognitive impairment, and utilize these characteristics as features for training a deep learning model. The results demonstrated that the frequency-domain new causality method accurately detected causal associations among simulated signals of different degrees. The deep learning tests also confirmed the superior performance of new causality, surpassing the other three methods in terms of accuracy, precision, and recall rates. Furthermore, consistent significant differences were observed in the brain efficiency networks, where several subregions defined by the multimodal parcellation method of Human Connectome Project simultaneously appeared in the topological statistical results of different patient groups. This suggests a significant association between these fine-grained cortical subregions, driven by multimodal data segmentation, and human cognitive function, making them potential biomarkers for further analysis of Alzheimer's disease.

РАЗРАБОТКА НОВОЙ КОНСТРУКЦИИ АРМИРОВАННОЙ ОККЛЮЗИОННОЙ ШИНЫ С ПАРАМЕТРИЗОВАННЫМ КАРКАСОМ НА ОСНОВЕ МЕДИЦИНСКИХ И ИНЖЕНЕРНЫХ ЦИФРОВЫХ ТЕХНОЛОГИЙ

Subject. Today, the use of splint therapy is an essential part of specialized dental treatment, since in recent years the number of patients with dysfunctional conditions of the dentofacial apparatus, has increased significantly. In addition, according to recent research, the use of occlusal splints as part of complex therapy is effective in the treatment of neurological diseases, such as bruxism, chronic tension-type headache, and neuromuscular syndrome. Traditionally used designs of occlusal splints have some disadvantages, such as fragility of use, insufficient rigidity, and the impossibility of relining if the patient's dental status changes. The article provides a description and clinical and laboratory stages of manufacturing the developed new design of an occlusal splint reinforced with a titanium frame. Objectives. Increasing the effectiveness of treatment of patients with functional disorders of the dentofacial system through the development and implementation of a new prosthetic construction – a combined occlusal splint with a titanium frame, using modern intellectual and medical 3D technologies. Materials and methods. Titanium alloy (Rematitan®) was chosen as the material for the frame of the occlusal splint. Manufacturing method implies the use of additive technologies, in particular, 3D-printing for obtaining a high-precision structure with a minimum cross-sectional thickness. Hot-curing acrylic plastic was used to cover the parameterized frame; it is also possible to use a light-curing composite. Results. During the study, the expediency of introducing a reinforcing component in the form of a metal frame into the construction of the occlusal splint was determined. A new design of a combined occlusal splint and a method for its manufacture were developed. Conclusion. By reinforcing the occlusal splint with a titanium frame, high structural strength, durability of use, maintainability or relocation if necessary are ensured; at the same time, due to 3D-printing, the frame has a minimal cross-sectional thickness, which practically does not affect the thickness of the structure as a whole.

АНАЛИЗ ОБЪЕМОВ СТОМАТОЛОГИЧЕСКОЙ ОРТОПЕДИЧЕСКОЙ ПОМОЩИ ПАЦИЕНТАМ В СИСТЕМЕ ПЛАТНЫХ МЕДИЦИНСКИХ УСЛУГ

The article is devoted to the analysis of the volume of dental orthopedic care for patients in the system of paid medical services in a multidisciplinary medical organization. Various epidemiological surveys conducted abroad and in our country have revealed an unsatisfactory condition of the organs and tissues of the mouth in the majority of the Russian population. Among dental pathology, tooth loss with subsequent functional disorders occupies a significant place [2–4]. One of the important indicators of dental health of the adult population, characterizing the level of dental care, is to ensure the need for prosthetics. According to WHO, the main causes of missing teeth are periodontitis and caries. Periodontitis is noted in 75–80% of the population, of which 90% are elderly and senile people. According to A. K. Kuryanov and L. N. Babenko (1988), 75% of 1,000 examined at the age of 60 needed dental prosthetics, and complete loss of teeth in the jaw was detected in 225 cases [1]. An analysis of the volume of dental orthopedic care for patients in the provision of paid medical services in orthopedic dentistry showed that for 5 years, among all manufactured orthopedic structures, removable plate prostheses with partial absence of teeth accounted for the largest volume, single crowns in second place, removable plate prostheses in the third place with complete absence of teeth. For each type of orthopedic structures manufactured, there is a growth trend from 2018 to 2022. There was a slight decrease in the volume of orthopedic dental care in 2020, due to the unfavorable epidemiological situation in the country at that time.

Experimental evidence for a robust, transdiagnostic marker in functional disorders: Erroneous sensorimotor processing in functional dizziness and functional movement disorder

ObjectiveRecent neuroscientific models suggest that functional bodily symptoms can be attributed to perceptual dysregulation in the central nervous system. Evidence for this hypothesis comes from patients with functional dizziness, who exhibit marked sensorimotor processing deficits during eye-head movement planning and execution. Similar findings in eye-head movement planning in patients with irritable bowel syndrome confirmed that these sensorimotor processing deficits represent a shared, transdiagnostic mechanism. We now examine whether erroneous sensorimotor processing is also at play in functional movement disorder. MethodsWe measured head movements of 10 patients with functional movement disorder (F44.4, ICD-10), 10 patients with functional dizziness (F45.8, ICD-10), and (respectively) 10 healthy controls during an eye-head experiment, where participants performed large gaze shifts under normal, increased, and again normal head moment of inertia. Head oscillations at the end of the gaze shift served as a well-established marker for sensorimotor processing problems. We calculated Bayesian statistics for comparison. ResultsPatients with functional movement disorder (Bayes Factor (BF)10 = 5.36, BFincl = 11.16; substantial to strong evidence) as well as patients with functional dizziness (BF10 = 2.27, BFincl = 3.56; anecdotal to substantial evidence) showed increased head oscillations compared to healthy controls, indicating marked deficits in planning and executing movement. ConclusionWe replicate earlier experimental findings on erroneous sensorimotor processing in patients with functional dizziness, and show that patients with functional movement disorder show a similar impairment of sensorimotor processing during large gaze shifts. This provides an objectively measurable, transdiagnostic marker for functional disorders, highlighting important implications for diagnosis, treatment, and de-stigmatization.

Assessment of serum osteopontin, osteoprotegerin and bone-specific alp as markers of bone turnover in patients with disorders of thyroid function in Ile-Ife, Nigeria

Assessment of serum osteopontin, osteoprotegerin and bone-specific alp as markers of bone turnover in patients with disorders of thyroid function in Ile-Ife, Nigeria

Generalized Camera-Based Infant Sleep-Wake Monitoring in NICUs: A Multi-Center Clinical Trial.

The infant sleep-wake behavior is an essential indicator of physiological and neurological system maturity, the circadian transition of which is important for evaluating the recovery of preterm infants from inadequate physiological function and cognitive disorders. Recently, camera-based infant sleep-wake monitoring has been investigated, but the challenges of generalization caused by variance in infants and clinical environments are not addressed for this application. In this paper, we conducted a multi-center clinical trial at four hospitals to improve the generalization of camera-based infant sleep-wake monitoring. Using the face videos of 64 term and 39 preterm infants recorded in NICUs, we proposed a novel sleep-wake classification strategy, called consistent deep representation constraint (CDRC), that forces the convolutional neural network (CNN) to make consistent predictions for the samples from different conditions but with the same label, to address the variances caused by infants and environments. The clinical validation shows that by using CDRC, all CNN backbones obtain over 85% accuracy, sensitivity, and specificity in both the cross-age and cross-environment experiments, improving the ones without CDRC by almost 15% in all metrics. This demonstrates that by improving the consistency of the deep representation of samples with the same state, we can significantly improve the generalization of infant sleep-wake classification.

Factors associated with having previously received a diagnosis of fibromyalgia, chronic fatigue syndrome and irritable bowel syndrome: A cross sectional DanFunD study

ObjectivesFibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome are highly prevalent conditions and part of the functional somatic syndromes (FSS) diagnosis, that are classified under the unifying umbrella term functional somatic disorder (FSD). Multiple factors are associated with FSD symptom development; However, few studies have explored these associations in relation to the diagnosis status. This study aims to examine associations with a previously received FSS diagnosis from a physician in participants fulfilling the FSD diagnostic criteria in a population-based sample. MethodsThis research employs a comprehensive observational approach using a cross sectional design with data from the DanFunD part two cohort. Information about received FSS diagnoses was obtained from self-reported questionnaires. Participants fulfilling the FSD diagnostic criteria were identified with both self-reported questionnaires and diagnostic interviews. Validated questionnaires were used to assess the examined factors. Results1704 cases fulfilled the diagnostic criteria for an FSD according to questionnaires or interviews in the DanFunD study. In participants fulfilling the diagnostic criteria, having previously received an FSS diagnosis by a physician was strongly associated with female sex, negative illness perceptions and poor health-related quality of life for questionnaire and interview-based diagnoses. Less consistent associations were observed for lower socioeconomic status, anxiety, and adverse life events. ConclusionPreviously received FSS diagnoses showed associations with multiple factors with a particular strong association with female sex and poor health related quality of life.

Mimickers of autoimmune encephalitis: a literature review.

Autoimmune encephalitis (AIE) is a rapid, progressive neurological disorder characterized by nervous system inflammation. While the Graus criteria are the best known criteria for AIE diagnosis, other differential diagnoses meeting the Graus criteria must be considered before management. This narrative review discusses the most common etiologies that resemble AIE. We suggest routine exclusion of mimickers meeting the Graus criteria before confirming an AIE diagnosis. We reviewed 28 studies including 356 patients. The main initial diagnosis was AIE, then paraneoplastic limbic encephalitis and anti-N-methyl-D-aspartate receptor encephalitis. Only 194 patients met the possible Graus criteria. The most frequent conditions among the total population were dementia, other neurodegenerative diseases, and psychiatric and functional neurological disorders. AIE is often misdiagnosed, leading to unnecessary treatment. Despite publication of the Graus criteria, medical cases mimicking this condition are being published. Many neurological diseases entering the differential diagnosis of AIE could be excluded through a detailed history, neurological examination, laboratory analysis, and other investigations, including cerebrospinal fluid and brain magnetic resonance imaging. However, some differential diagnoses complied with the possible Graus criteria, with some having concurrent antineuronal antibodies, which were considered true mimickers. AIE diagnosis suspicion is primarily clinical, but a definitive diagnosis requires various diagnostic tools.

High Prevalence and Risk Factors of Functional Gastrointestinal Disorders Among University Students in South Korea

High Prevalence and Risk Factors of Functional Gastrointestinal Disorders Among University Students in South Korea

The Relationship Between Potassium And Ureum Levels Of New Drugs In Drug Resistant Tuberculosis Patients

The use of new types of drugs in RO TB patients will cause disturbances in the body's electrolytes, especially potassium levels, as well as disturbances in urea levels caused by the excretion of urea that is retained in the body. Continuous increases in urea in the body result in the kidneys not being able to work optimally. The aim of this study was to determine the relationship between potassium levels and urea levels on new types of drugs in RO TB patients. The research method used is analytical observational with a cross sectional approach. This research was conducted on 16 February – 16 March 2023 with research subjects being RO TB patients who received treatment with a new type of drug at the Lung Hospital dr. Ario Wirawan Salatiga as many as 21 respondents using a sampling technique that is the total population. Potassium levels were measured using the ISE (Ion Selective Electrode) method and urea levels used the enzymatic UV test method. The data was then processed using the Shapiro-Wilk normality test, then continued with prerequisite tests (crosstab test and homogeneity test) then continued with hypothesis testing, because my data scale was ratio and nominal, the alternative test used was the Chi-Square Test. The equipment test results obtained a homogeneity test with a P value of 0.698 and 0.610 (0.05), meaning the data was homogeneous. The test results for the relationship between potassium and urea levels on new types of drugs for RO TB patients were Chi-Square hypothesis test results with a P value of 0.152 and 0.384 ( 0.05) means there is no relationship between potassium levels and urea levels on new types of drugs in RO TB patients. The results show that the TB drugs bedaquiline and delamanid do not cause kidney function disorders so that RO TB patients can consume these TB drugs regularly.

Relative Frequency of Gastrointestinal Functional Disorders in Patients with Inflammatory Bowel Disease Based on Rome IV: A Case-Control Study

Relative Frequency of Gastrointestinal Functional Disorders in Patients with Inflammatory Bowel Disease Based on Rome IV: A Case-Control Study

Low preoperative serum uric acid is associated with early acute kidney injury after living donor liver transplantation.

Liver transplantation is treatment option for patients with end-stage liver disease and hepatocellular carcinoma. Renal function deterioration significantly impacts the survival rates of liver recipients, and serum uric acid (SUA) is associated with both acute and chronic renal function disorders. Thus, our study aimed to assess the relationship and predictive value of preoperative SUA level and postoperative acute kidney injury (AKI) in living donor liver transplantation (LDLT). We conducted a prospective observational study on 87 patients undergoing LDLT. Blood samples were collected immediately before LDLT, and renal function status was followed up for 3 consecutive days postoperatively. Low SUA levels (cutoff value 4.15 mg/dL) were associated with a high risk of early posttransplantation AKI. The area under the curve was 0.73 (sensitivity, 79.2%; specificity, 59.4%). Although not statistically significant, there were no deaths in the non-AKI group but two in the early AKI group secondary to liver graft dysfunction in addition to early AKI within the first month after LDLT. AKI after liver transplantation may lead to a deterioration of patient status and increased mortality rates. We determined low preoperative SUA levels as a possible risk factor for early postoperative AKI.

The Presence of Ganglionic Acetylcholine Receptor Antibodies in Sera from Patients with Functional Gastrointestinal Disorders: A Preliminary Study.

Functional gastrointestinal disorders (FGIDs), including functional dyspepsia (FD) and irritable bowel syndrome (IBS), are characterized by chronic and recurrent gastrointestinal symptoms. Clinically, FD and IBS often resemble gastrointestinal dysmotility caused by autoimmune autonomic neuropathy. We examined the seropositive frequency of autoantibodies against ganglionic nicotinic acetylcholine receptors (gnAChRs) in patients presenting with FGIDs. To elucidate the seropositivity of gnAChR antibodies and the clinical features of seropositive FD and IBS. We measured autoantibodies against the gnAChR α3 and β4subunits using luciferase immunoprecipitation systems. Serum samples from patients with any autonomic symptoms were obtained from hospitals in Japan between January 2012 and August 2018 (1787 serum samples of 1381 patients). We selected FD and IBS patients and compared the clinical characteristics and prevalence of autonomic symptoms between those with seropositive and seronegative IBS and FD. Nine IBS and two FD cases (one comorbid case with IBS) were found. We found four patients (36.4%) in whom gnAChR antibodies were positive in these eleven patients. Sicca symptoms were observed in three of four cases (75%) of seropositive FGID compared with zero of seven cases (0%) of seronegative FGID. We found patients with gnAChR antibodies in FD and IBS patients. These data will be valuable for elucidating the pathophysiology of these FGIDs and developing new treatment strategies.

Pathogenetic strategies for addressing periodontal morphological and functional disorders in plaque-induced gingivitis

Relevance. Plaque-induced gingivitis represents the initial phase of periodontal diseases and a significant medical and social challenge within global healthcare frameworks, particularly prevalent among younger people.Demographics. This prevalence arises from its multifactorial etiology, complex developmental mechanisms, and notable pathogenetic features, most evidently microcirculatory disruptions leading to tissue hypoxia. Addressing these pathological conditions requires the development of novel diagnostic methodologies and therapeutic interventions to prevent further complications.Materials and methods. The study encompassed 54 subjects with an average age of 22.5 ± 1.7 years. The control group included 34 participants (GroupI), and the comparison group 20 participants (Group II). Group II received vacuum laser therapy in conjunction with Mexidol-based dressings, noted for their antihypoxant and antioxidant properties.Results. Evaluations conducted post-treatment indicated enhancements in both arterial and venous capillary functions. Amid the antioxidant and antihypoxant treatment regimen, capillary diameters were reduced to match those observed in the control group.Conclusion. Regimen implemented in this study was clinically and functionally effective in a combined treatment protocol involving vacuum laser therapy on periodontal tissues of plaque-induced gingivitis patients. This regimen is recommendable as a corrective measure for microcirculatory disturbances within the scope of managing inflammatory periodontal diseases.