Functional Disorders Research Articles

Knowledge and personal hygiene behavior during menstruation among adolescent girls in various regions: A literature review

Personal hygiene is still a public health issue in Indonesia. Menstrual hygiene is the management of hygiene and health when women experience menstruation as part of a personal hygiene care routine with the concept of clean. Personal hygiene during menstruation plays an important role in a person's health status in avoiding functional disorders of the reproductive organs. Knowledge in Indonesia states that poor personal hygiene behavior during menstruation of adolescent girls is a major concern because it has a health impact. The method used was literature review by searching articles through Google Scholar and Pubmed databases. Selection stages were carried out to obtain articles that met the inclusion and exclusion criteria, and 6 articles were obtained that could be analyzed. The results showed that knowledge has a significant role in determining menstrual hygiene behavior in adolescent girls, there are also differences in knowledge and behavior when performing personal hygiene behavior during menstruation in urban and rural areas. To improve knowledge and behavior of personal hygiene during menstruation, especially in various regions, it can be done with various strategies such as promotion, education, collaboration, improving service quality, and increasing accessibility.

A global neuronal workspace model of functional neurological disorders.

We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.

Infant formulas for the treatment of functional gastrointestinal disorders: A position paper of the ESPGHAN Nutrition Committee.

Functional gastrointestinal disorders (FGID), such as infant regurgitation, infant colic, and functional constipation, are common and typically physiological phenomena during the early months of an infant's life and account for frequent consultations with pediatricians. Various infant formulas are marketed for their management and are frequently given by parents to infants before a medical consultation. However, the evidence supporting their effectiveness is limited and some have altered nutritional compositions when compared to standard formulas. Thus, these products should only be used under medical supervision and upon medical advice. Marketing and over-the-counter sales do not ensure proper medical guidance and supervision. The aim of this position paper is to review the current evidence regarding the safety and efficacy of formulas specifically formulated for addressing regurgitation, colic, and constipation, recognized as FGID. The objective is to provide guidance for clinical management based on the highest quality of available evidence. A wide search using Pubmed, MEDLINE, EMBASE and Cochrane Database of Systematic Reviews was performed including the MESH terms infant formula, colic, constipation, regurgitation, reflux, palmitate, lactase, lactose, magnesium, hydrolyzed protein, prebiotics or probiotics. 752 papers were identified and screened. Finally, 72 papers were included in the paper. In the absence of evidence, recommendations reflect the authors' combined expert opinion. Final consensus was obtained by multiple e-mail exchange and meetings of the Nutrition Committee. (1) For breastfed infants experiencing FGID such as regurgitation, colic, or constipation, transitioning from breastfeeding to commercial formulas is not recommended. (2) In general, whether an infant is breastfed or formula-fed, it's crucial to reassure parents that FGIDs are normal and typically do not necessitate treatment or change to a special formula. (3) Thickened formulas, often termed anti-reflux formulas, may be considered in specific cases of regurgitation. (4) The usage of specialized formulas for infants with colic is not advised due to a lack of clinical evidence. (5) In the case of constipation in infants, the use of formulas enriched with high β-palmitate and increased magnesium content may be considered to soften the stool. Generally, there is limited evidence supporting the use of specialized formulas for FGID. Breastfeeding should never be discontinued in favor of formula feeding.

STRUCTURE AND CHARACTERISTICS OF THE FIRST MODULE IN THE EDUCATIONAL COMPONENT “INDIVIDUAL RESEARCH WORK” FOR EDUCATIONAL PROFESSIONAL PROGRAM “MEDICINE”

The proportion of skills, abilities, and competencies pertaining to the scientific method of understanding reality—comprising principles, rules, norms, and methodologies for acquiring and organizing new knowledge about both objective and subjective realities—represents the scientific aptitude within the educational framework. A robust scientific aptitude within the educational process is a vital prerequisite for students in specific fields of study (specializations) to receive education of requisite quality. The Department of Pathophysiology at Poltava State Medical University is actively engaged in not only fundamental medical and preclinical research but also in ongoing scientific and methodological endeavors aimed at enhancing the educational process departmentally and university-wide. The educational component ‘Individual Research Work” within the educational professional program “Medicine”, developed by the departmental faculty, serves to elevate educational standards by augmenting the scientific aptitude within the educational process. This study aimed to analyze and delineate the structure of the initial module within the educational component “Individual Research Work” of the educational and professional program “Medicine”. In preparing the manuscript of the article, the authors employed several general theoretical research methods, including analysis, synthesis, comparison of concepts, abstraction, and generalization. Module No. 1, titled “Modeling of Typical Pathological Processes in Various Organs and Systems”, within the educational component “Individual Research Work”, spans 120 hours and is structured as follows: 8 lecture hours, 32 hours of practical classes, and 80 hours designated for independent study of module topics. The thematic plan encompasses the exploration of the following topics: 1. Modelling inflammatory processes in various organs; 2. Modelling disturbances in the cell cycle (hypo- and hyperbiotic processes); 3. Modelling systemic metabolic disorders; 4. Modelling functional disorders across various organs and systems. The ultimate outcome of Module No. 1 entails students selecting a topic and experimental model conducive to their research pursuit. The structure and content of this initial module within the educational component “Individual Research Work”, developed by the Department of Pathophysiology at Poltava State Medical University, align with the standards of contemporary higher medical education. The study, along with its inaugural module, is poised to enhance the quality of education for aspiring individuals enrolled in the educational and professional program “Medicine”.

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.

Predictive Processing and the Pathophysiology of Functional Neurological Disorder.

The contemporary neuroscience understanding of the brain as an active inference organ supports that our conscious experiences, including sensorimotor perceptions, depend on the integration of probabilistic predictions with incoming sensory input across hierarchically organized levels. As in other systems, these complex processes are prone to error under certain circumstances, which may lead to alterations in their outcomes (i.e., variations in sensations and movements). Such variations are an important aspect of functional neurological disorder, a complex disorder at the interface of brain-mind-body interactions. Thus, predictive processing frameworks offer fundamental mechanistic insights into the pathophysiology of functional neurological disorder. In recent years, many of the aspects relevant to the neurobiology of functional neurological disorder - e.g., aberrant motor and sensory processes, symptom expectation, self-agency, and illness beliefs, as well as interoception, allostasis, and emotion - have been investigated through the lens of predictive processing frameworks. Here, we provide an overview of the current state of research on predictive processing and the pathophysiology of functional neurological disorder.

Remote family education and support program for parents of patients with adolescent and early adulthood eating disorders based on interpersonal psychotherapy: study protocol for a pilot randomized controlled trial.

In cases of adolescent and early adulthood eating disorders, despite the importance of the patients' relationship with their parents, conflict and confusion frequently occur among them. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. We developed a remote family education and support program exclusively for parents of patients with eating disorders, based on the principle of IPT. The use of IPT is expected to reduce conflicts in the patient-parent relationship. Consequently, parents will be better able to listen to patients, and patients will be better able to express their thoughts and desires. In this study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication in their home based on active listening skills of parents of patients with adolescent and early adulthood eating disorders. Participants will be parents of patients aged 12-29years with adolescent and early adulthood eating disorders. Individually randomized, parallel-group trial design will be employed. Seventy participants will be allocated to one of two treatment conditions: (1) remote family education and support program (four, 150min weekly group sessions) for parents plus treatment-as-usual for patients (consultation by physicians or no treatment), or (2) waiting for the control condition (parents will wait to start the program for 8weeks) plus treatment-as-usual for patients. The primary outcome measure will be parents' active listening ability as measured by the Active Listening Attitude Scale at 8weeks after randomization. Additionally, perception of social support (Social Provision Scale-10 item), loneliness (UCLA Loneliness Scale), mental health status (K6), family function (Family Assessment Device), and parent-evaluated eating disorder symptoms (Anorectic Behavior Observation Scale) will be assessed. Data from the intention-to-treat sample will be analyzed 8weeks after randomization. This is the first study to evaluate the effectiveness of a family education and support program for parents of patients with adolescent and early adulthood eating disorders based on IPT. If this type of intervention is effective, although indirect, it could be a new support method for this patient population. Clinical Trials. gov ID NCT05840614.

Brain functional networks and psychiatric disorders.

Brain functional networks and psychiatric disorders.

Natural History and Outcomes of Individuals with Functional Bowel Disorder: a 9-year Population-based Longitudinal Study.

Long-term studies characterizing the natural history of functional bowel disorder (FBD) from community-based settings and exploring association with psychological factors are sparse. We aimed to evaluate the evolution of symptoms, health outcomes, and association of FBD with psychological disorders in Chinese population. Individuals identified from random sampling of residents of Hangzhou, China participated in a baseline survey in January of 2010. Follow-up phone survey was conducted in December of 2018. FBD was diagnosed based on Rome III criteria. Among 452 individuals (mean age 44.6±15.3 years, 174 (38%) male) who completed the study, the prevalence of FBD was 36.3% (95%CI 32.6-40.0%) at enrollment and 36.1% (95%CI 32.3-39.8%) at follow-up survey (p=0.94). However, 214 (47%) individuals had interval change in diagnosis. Although no difference in incidence of organic disease or death was observed, a higher proportion of patients with FBD (16/164, 9.8% vs. 9/288, 3.1%; p=0.003) compared to those without FBD received non-cancer-related abdominal and/or pelvic surgery during follow-up. FBD was associated with anxiety and/or depression at initial (AOR=1.7, 95%CI 1.7-2.7, p=0.02) and follow-up (AOR=8.0, 95%CI 3.2-20.0, p<0.001) surveys. Diagnosis of FBD at baseline was associated with new-onset anxiety and/or depression at follow-up (OR=3.2, 95%CI 1.2-8.3, p=0.01). Although the prevalence of FBD remained stable, transformation of symptoms was common over time. Patients with FBD may have increased risk of receiving non-cancer related abdominal and/or pelvic surgery. FBD symptoms at baseline increased the risk of new-onset anxiety and/or depression by 3.2-fold over the next 9 years.

Evaluation of the Knowledge and behavior of Indonesian Mothers About Infantile Colic

Introduction: Infantile colic is a functional gastrointestinal disorder (GSCF) found in 20-30% of infants aged 5 months which is characterized by recurrent prolonged periods of infant irritability, fussing, or crying without obvious cause and cannot be prevented or resolved by parents. Infantile colic is often associated with higher mothers depression and lower quality of life. Mothers' knowledge and behavior of infantile colic varies greatly. This research to investigate the knowledge and behavior of Indonesian mothers regarding infantile colic and related factorMethods: A cross-sectional analytic observational study with the target of 100 mothers with babies aged 0-12 months was performed using an electronic questionnaire in Google forms. The questionnaire consists of multiple-choice questions regarding the mothers' knowledge and behavioral to infantile colic.Results: As many as 82% of mothers understand that infantile colic as recurrent prolonged periods of crying that occur without obvious cause and cannot be prevented or resolved by parents, however only 12% of mothers know that most infantile colic will disappear by the age of 5 months. Forty percent mothers had babies with infantile colic; 97.5% of them were worried about their baby's condition and 7.5% of the mothers gave them medication. There was no significant difference between mothers' age and number of children with inadequate mother-infant interaction (P = 0.770 and P = 0.647)Conclusion: The knowledge and behavior of mothers in Indonesia regarding infantile colic is quite good, however parental reassurance still needs to be improved, especially to reduce maternal anxiety.

FOLATES–RELATED AND BONE MARROW DISORDERS PROMOTE ATRIAL CARDIOMYOPATHY INPATIENTS AFFECTED BY PAROXYSMAL ATRIAL FIBRILLATION VIA BOTH EPCS AND ENDOTHELIAL DYSFUNCTION

Abstract Background Atrial Cardiomyopathy (AC) has been recently postulated to explain those embolic strokes not due to atrial fibrillation (AF) and paradoxical embolism. Pathogenic mechanisms underlying AC are still largely unknown. Folate cycle disorders (FD) are a yet underrated pro–thrombotic dysmetabolism. FD could hinder both endothelial and circulating endothelial progenitor cell (EPCs) functioning, therefore providing one–shot explanation to both atrial fibrosis and endothelial dysfunction (ED). Purpose This study aims to enquire for the hypothesis that: 1) atrial fibrosis (AFib) would relate to FD (intended as both: a)MTHFR C677T inherited mutations and b)bone–marrow function disorders, here referring to erythropoiesis diversions) and 2) AF patients would show dysfunctional EPCs. Methods We studied 59 consecutive patients admitted to the cardiology Unit of the General Hospital“F.Miulli”, with preserved EF, subjected to AF ablation. AFib was quantified in term of percentage of bipolar peak–to–peak voltage points below 0,5mV with respect to the wholeness of picked points. Blood count cell was evaluated at the admission. MTHFR C677T genotypes and serum folate were assessed. EPCs isolation and characterization were performed by cytometry analysis (CD45, CD34, CD133, VEGFR2 and KDR). EPCs functional wound healing assay was performed to determine the percentage of EPCs able to "fix the wound” and compared with matched–controls. Results Baseline characteristics did not differ between Sample and Control groups (Fig. 1 – Left Table). % of Afib significantly differs between C677T MTHFR homozigosis patients (n=15) with respect to non–C677TMTHFR homozygosis patients (n=44) (Fig.1 – Right graph. – p &amp;lt; 0,02). Once univariate analysis was performed, subsequent multivariate analysis highlight highest fit, once merged RBC, RDW–SD and folates values were inputed (Fig.2 – superior graph. – R2=0,39;p=0,0001). Either RBC, RDW–SD and folates coefficient reached significance (p &amp;lt; 0,0001; p &amp;lt; 0,01; p &amp;lt; 0,05 respectively). Number of EPCs signifi cantly differs between AF patients and matched controls (Fig 2 – inferior graph. –p &amp;lt; 0,001). Conclusions Our findings support the hypothesis that genetically determined folates dysmetabolism (MTHFR dysfunction) promotes AFib via a complex cardiac–bone marrow networking involving circulatingEPCs and unraveled by erythropoiesis diversions. Such results suggest a pathogenic role of folate cycle disorders in the AC development.

Stroke Mimics in Children With Moyamoya Arteriopathy

BACKGROUND Comorbid conditions may result in symptoms that mimic stroke in children with moyamoya arteriopathy. Health care usage for stroke mimics is not well characterized. METHODS Consecutive children (aged &lt;18 years) with moyamoya syndrome or disease treated at a single center (2007–2021) were identified from a registry. Data including documentation of headache, anxiety, and functional neurologic disorders were retrospectively abstracted using standardized forms. Encounters were attributed to the comorbid condition when (1) related symptoms led to the visit; (2) the condition was documented as the visit diagnosis; and (3) in the absence of stroke, transient ischemic attack, or seizure. RESULTS We identified 32 children (63% female) with symptomatic moyamoya arteriopathy diagnosed via imaging at a median age of 7.5 years (range, 0.7–17) years, all treated with revascularization surgery. During follow‐up (median, 6.7 years after diagnosis [interquartile range, 4.0–8.3]), 81% of patients reported headache, 53% reported anxiety, 19% reported panic attacks, and 6% developed a functional neurologic disorder. Both patients with functional neurologic disorder also had migraines and anxiety. In 10 patients (31% of the cohort), a stroke mimic led to 33 emergency department encounters and 9 hospital admissions; 9 received head imaging (magnetic resonance imaging, computed tomography, or computed tomographic angiography) as part of the workup. CONCLUSION Headaches, anxiety, and functional neurologic disorders may mimic stroke symptoms in children with moyamoya arteriopathy, leading to significant health care usage. While providers should remain vigilant for stroke, early recognition of stroke mimics should promote interventions to address comorbid conditions.

Gastrointestinal adverse reaction to food (GARF) and endoscopic confocal laser endomicroscopy (eCLE).

Gastrointestinal adverse reaction to food (GARF) is reported frequently in the general population and even more in patients with disorders of the gut brain axis. However, there is a significant difference between self-reported and objective proven GARF. The aim of the study was to characterize a mucosal correlate of GARF by endoscopic confocal laser endomicroscopy (eCLE) with duodenal food challenge (DFC). In an observational and proof of concept study we evaluated 71 patients with disorders of the gut brain axis without (group I, n=19) and with (group II, n=52) GARF by eCLE and DFC. Spontaneous and food induced transfer of fluorescein into duodenal lumen was detected 10 minutes following intravenously application of fluorescein and 10 minutes after DFC. According to Rom IV, the patients (group I/II) could be classified as irritable bowel syndrome (IBS) 32%/31%, functional abdominal pain without changes in bowel movement 47 %/48 %, functional abdominal bloating/distension 0 %/10 %, functional diarrhea 5 %/ 2 %, and unspecified functional bowel disorder 16 %/10 %, respectively. 21 %/27 % of the patients responded with a fluorescein leakage into the duodenal lumen before and 74 %/69 % following to DFC. Frequency rank order of food components that induced a response were soy (55.5 %/60 %), wheat (60 %/45.5 %), egg (35.7 %/8.3), milk (30 %/18.2 %) and yeast (10 %/6.6 %), respectively. Histology of duodenal biopsies, number, form and distribution of intraepithelial lymphocytes and mucosal mast cells as well as mast cell function were normal. Overall, 14 %/79 % reported main symptom benefit following a food exclusion therapy according to eCLE and DFC that was significant different between the groups. The results of our study indicate that eCLE with DFC is a technique to clinically evaluate patients with disorders of the gut brain axis and GARF resulting in a high proportion of patients reporting symptom benefit upon food exclusion dietary advice focussed on the results of eCLE.

Thalamic Nucleus Reuniens Glutamatergic Neurons Mediate Colorectal Visceral Pain in Mice via 5-HT2B Receptors.

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and visceral hypersensitivity. Reducing visceral hypersensitivity is the key to effectively relieving abdominal pain in IBS. Increasing evidence has confirmed that the thalamic nucleus reuniens (Re) and 5-hydroxytryptamine (5-HT) neurotransmitter system play an important role in the development of colorectal visceral pain, whereas the exact mechanisms remain largely unclear. In this study, we found that high expression of the 5-HT2B receptors in the Re glutamatergic neurons promoted colorectal visceral pain. Specifically, we found that neonatal maternal deprivation (NMD) mice exhibited visceral hyperalgesia and enhanced spontaneous synaptic transmission in the Re brain region. Colorectal distension (CRD) stimulation induced a large amount of c-Fos expression in the Re brain region of NMD mice, predominantly in glutamatergic neurons. Furthermore, optogenetic manipulation of glutamatergic neuronal activity in the Re altered colorectal visceral pain responses in CON and NMD mice. In addition, we demonstrated that 5-HT2B receptor expression on the Re glutamatergic neurons was upregulated and ultimately promoted colorectal visceral pain in NMD mice. These findings suggest a critical role of the 5HT2B receptors on the Re glutamatergic neurons in the regulation of colorectal visceral pain.

Rapid biotransformation of STW 5 constituents by human gut microbiome from IBS- and non-IBS donors.

STW 5 is an herbal medicinal product with proven clinical efficacy in the treatment of functional gastrointestinal disorders, like functional dyspepsia and irritable bowel syndrome (IBS). The effects of STW 5 on fecal microbial communities and metabolite production effects have been studied in an experimental model with fecal samples from individuals with and without IBS. While only minor taxonomic disparities were noted between IBS- and non-IBS samples and upon treatment with STW 5, rapid metabolic turnover of STW 5 components into specific degradation products with reported anti-inflammatory, cytoprotective, or spasmolytic activities was observed, which may be relevant for the pharmacological activity of STW 5.

The effectiveness of exergames intervention on motor memory and inhibitory control of children with executive function disorders: A randomized control trial

The present study was conducted with the aim of investigating the effect of exergames in improving the motor memory and inhibitory control of children with executive functions disorder. Children, selected by simple random method were divided into two groups: experimental (n = 16) and control (n = 16). Circle drawing task, and The Serial Reaction Time Task were used to collect and analyze data. The current study is a randomized control trial (RCT) type of research with a two-group pretest, post-test, and follow up –test design in terms of the purpose of applied research and the method of data collection. T-test results for the differences in post- test mean scores between the two groups in motor memory and inhibitory control showed that the treatment group outperformed the control group. There were statistical differences between pre and post measures in favor of post test, and between pre and follow up measures in favor of follow up test, but no statistical differences between post and follow up test. This study demonstrates that it is possible to enhance motor memory and inhibitory control of children with executive functions disorder using exergames intervention.

Analysis of the quality of surgical care for patients with consequences of gunshot combat wounds of the maxillofacial area

One of the most pressing problems of maxillofacial surgery (MFS) is the provision of specialized medical care to the wounded and injured in combat conditions. Even more complex tasks are reconstructive surgical treatment at the stages of evacuation and the most complete rehabilitation of patients with the consequences of combat injuries to the maxillofacial area (MFA). Gunshot combat wounds of the MFA are characterized by severe anatomical and functional disorders, they can manifest themselves as significant defects and severe deformations, which in turn leads to an increase in sanitary losses of army personnel, disability of young and middle (working) age patients, a decrease in the quality of their life, long-term and expensive treatment that requires special knowledge and manual skills from specialists. All this determines not only the medical, but also the socio-economic significance of the topic of this study.Objective. Present an analysis of the quality of surgical care provided to patients with consequences of gunshot combat wounds of the MFA.Methods. The study was carried out by specialists from the State Budgetary Healthcare Institution «Maxillofacial Hospital for War Veterans» of the Moscow Department of Health, under the guidance of the chief, PhD, professor, main specialist in MFS – V.A. Belchenko, for the period from October 2022 to July 2023. Diagnosis, planning and surgical treatment of adult patients with the consequences of gunshot combat wounds of the MFA were carried out at the stages of treatment and evacuation measures. A sample of medical documentation was made, the data obtained was processed by the generally accepted statistical method. The results were analyzed and compared with data from similar studies.Results. The study group included 55 males, aged from 23 to 56 years, the average age of the patients was 36.16±7.79 years. We divided the studied patients into subgroups according to the conditional zones of damage to the MFA: 1st – upper zone of the face (n=3, 5.45%), 2nd – middle zone of the face (n=28; 50.91%), 3rd – lower zone of the face ( n=32; 58.18%). The number of patients with isolated injuries is 18.18% (n=10); with multiple – 81.81% (n=45); with combined – 72.72% (n=40). The article presents the characteristics of patients with the pathology under study, discusses some features of diagnosis and planning, discusses tactics and problems associated with the surgical stage of treatment, as well as further rehabilitation measures.Conclusion. Despite the emergence of new medical equipment, equipment for diagnostics, planning and solving complex problems of surgical intervention, there is a clear need for training specialists, developing and improving the applied medical recommendations, with a clear indication of the method of choosing tactics and methods of surgical treatment. Medical care for adult patients with the consequences of gunshot combat wounds of the MFA must be comprehensive and carried out on the basis of specialized centers, and must include both surgical and orthopedic components, which will minimize the number of errors and complications, increase the effectiveness of treatment and, as a result, make rehabilitation as complete as possible.

A retrospective study of the relationship between the presence of complaints and the identified pathological changes in the temporomandibular joint

Introduction. In the practice of an orthodontist, diseases of the temporomandibular joint (TMJ) are an urgent problem due to their widespread, diverse clinical manifestations.Goal. To study the relationship between the identified anatomical and functional disorders of the TMJ, as risk factors for complications during orthodontic treatment, and the presence of characteristic complaints in the structure of pathological changes in the TMJ.Materials and methods. According to the type of organization and the ratio of data collection time, the scientific study belonged to a longitudinal retrospective study, according to the type of observation: case-control. A retrospective analysis of 102 outpatient medical records of patients who sought medical help from an orthodontist at a dental clinic was carried out. The criterion for inclusion in the study was the presence of a newly diagnosed disease of the temporomandibular joint, mandatory radiological diagnostic methods. Magnetic resonance imaging (MRI) of the TMJ in the patient who sought medical help was used as a radiation diagnosis. As part of the scientific study, the structure of pathological changes in the TMJ was analyzed, the relationship between the presence of complaints and the revealed pathology was studied.Results. The analysis of the data showed that the MR examination of the TMJ reveals pathological changes in patients who sought orthodontic care, both with complaints and with an asymptomatic course of diseases. Data analysis did not show a statistically significant relationship between the presence of complaints and the revealed pathology in the case of degenerative (χ2 = 0.123; p &gt; 0.05), inflammatory changes in the TMJ (χ2 = 0.123; p &gt; 0.05) and pathological disorders of the masticatory muscles (F = 0.704; p &gt; 0.05). The relationship is statistically significant, but weak for ventral dislocation without reposition (p &lt; 0.05; φ = 0.107) and the dorsal arrangement of the disc (p &lt; 0.05; φ = 0.101). In the case of ventral dislocation of the articular disc with the reposition, the relationship is statistically significant, of medium strength (p &lt; 0.05; φ = 0.284).Conclusions. The results of a retrospective analysis of medical documentation confirm the need for instrumental research methods for all patients, regardless of whether they have any complaints at the stage of determining the optimal tactics of orthodontic intervention to obtain diagnostic information on the state of the TMJ in order to prevent the risks of complications during orthodontic treatment.

High Prevalence of Psychological Comorbidities and Functional Neurological Symptoms in Women With Urinary Retention.

Chronic idiopathic urinary retention (CIUR) in young women is poorly understood and a probable etiology is established only in around 40%, most commonly a primary disorder of external urethral sphincter relaxation, sometimes referred to as Fowler's syndrome. A high prevalence of psychological and functional comorbidities is reported, however these have been poorly characterized. Women consecutively referred for the assessment and management of CIUR were evaluated cross-sectionally for 13 psychological/behavioral domains using a structured clinical interview: depression, anxiety, post-traumatic stress disorder (PTSD), other psychiatric history, functional neurological disorder, other functional syndromes, childhood and adult trauma, personality disorder, and self-harm (ever/current). A total of 91 women (mean age [SD]: 34 [11] years) were evaluated. Women with Fowler's syndrome (n = 69) were younger (mean age [SD]: 32 [9] vs 40 [13] years) than women without Fowler's syndrome and reported shorter mean duration of urinary symptoms (mean [SD]: 5 [6] vs 10 [9]). A high prevalence of psychiatric and psychological comorbidities was reported (97%) including current depression (77%), current anxiety (78%), and PTSD (32%). A high prevalence of functional neurological disorder (56%) and other functional symptoms (65%) was also reported. Self-harm was reported in (14%) and personality disorder in 16%. Childhood trauma was reported in 35% of women. Young women with CIUR report a high burden of psychiatric disorders, affective symptoms, trauma, PTSD, self-harm, and functional neurological disorder, particularly in those with Fowler's syndrome. These factors can undermine the engagement with health care professionals and affect management and should therefore be addressed during the urological assessment.

Personality and psychopathological characteristics in functional movement disorders.

Aim of the present study was to assess personality and psychopathological characteristics in patients with functional movement disorders (FMDs) compared to patients with other neurological disorders (OND). In this cross-sectional study, patients affected by clinically established FMDs and OND who attended the Neurologic Unit of the University-Hospital "Policlinico-San Marco" of Catania from the 1st of December 2021 to the 1st of June 2023 were enrolled. Personality characteristics were assessed with the Rorschach test coded according to Exner's comprehensive system and the Structured Clinical Interview for DSM-5 (SCID-II). Thirty-one patients with FMDs (27 women; age 40.2±15.5 years; education 11.7±3.2 years; disease duration 2.3±2.5 years) and 24 patients affected by OND (18 women; age 35.8±16.3 years; education 11.9±2.9 years; disease duration 3.4±2.8 years) were enrolled. At the Rorschach, FMDs presented a significantly higher frequency of Popular (P) and sum of all Human content codes (SumH>5) responses and avoidant coping than OND. FMDs presented "conformity behaviors", excessive interest in others than usual a maladaptive avoidant style of coping and a difficulty in verbalizing emotional distress. These psychopathological characteristics may favor the occurrence of FMDs.