Functional Disorders Research Articles

Dynamics of endothelial function in patients with arterial hypertension with different cardiovascular risk against the background of antihypertensive therapy

The aim of the work was to investigate the dynamics of endothelial markers in patients with arterial hypertension with different cardiovascular risk under the influence of the prescribed treatment during a year of observation. The first group (with a moderate risk of cardiovascular events) included 48 patients with arterial hypertension (AH). The second group consisted of 54 patients with hypertension and a high risk of cardiovascular events, namely type 2 diabetes. Each group of patients was randomized into two subgroups by blood pressure (BP) medication. In patients of subgroup 1a (n=29) and subgroup 2a (n=35) – the main subgroups – the therapy necessarily included the angiotensin II receptor antagonist losartan potas­sium in a dosage of 50-150 mg/day, depending on the blood pressure level. Patients of subgroup 1b (n=19) and subgroup 2b (n=19) – comparison subgroups were treated with antihypertensive drugs of other first-line groups according to the data of the unified clinical protocol for the treatment of hypertension. According to the ROC analysis, it was determined that the dynamics of endothelin-1 (ET-1) indicators after 9 and 12 months of therapy (a decrease of 12% or more from the initial level) can predict the normalization of indicators of the coagulation and anticoagulation systems with indicators of sensitivity and specificity – 85% (95% CI 62.1-96.6%) and 92.9% (95% CI 76.5-98.9%), respectively. A decrease in the level of Willebrand factor (fV) by 23% or more due to such a treatment time can be used as a prognostic sign in determining the regression of endothelial dysfunction with sensitivity – 75% (95% CI 50.9-91.2%), specificity – 100% (95% CI 87.5-100%). According to the given data, both in the group with moderate and with high cardiovascular risk, there is a relationship between endothelial dysfunction (ED) and the duration of hypertension, indicators of the lipid spectrum and abdominal obesity – factors that increase the viscous resistance of the blood circulation, as well as platelet hyperactivity in the bloodstream. We have also established that according to the dynamics of ET-1 indicators after 9 and 12 months of therapy (decrease by 27% or more from the initial level), it is possible to predict the normalization of indicators of the coagulation and anticoagulation systems with indicators of sensitivity – 81.8% (95% CI 59.7-94.7%), specificity – 90.6% (95% CI 75-97.9%). A decrease in the level of fV by 24.5% or more after a year of treatment can be used as a prognostic sign in determining the regression of endothelial dysfunction with sensitivity – 68.2% (95% CI 45.1-86.1%), specificity – 71.9% (95% CI 53.3-86.2%). The obtained results testify to the dominant role of type 2 diabetes as a factor in platelet disorders of hemostasis. Taking into account the positive dynamics of the above-mentioned markers of ED during the year of treatment, their relationship with the reduction of blood pressure, indicators of the lipid spectrum and abdominal obesity, it should be noted the positive effect of angiotensin II receptor blockers (BRA II) as endothelioprotective drugs. Considering the irrefutable literary data about the absence of thrombomodulin in the blood stream, even its insignificant appearance indicates the presence of endothelial dysfunction. Determining the state and dynamics of changes in endothelial function under the influence of prescribed therapy will make it possible to improve the diagnosis of endothelial function disorders and increase the effectiveness of treatment of patients with hypertension and various cardiovascular risks.

EXPERIENCE OF CLINICAL AND RADIOGRAPHIC CORRELATION IN PATIENTS WITH PAIN SYNDROME OF TMJ DYSFUNCTION IN ATRICULATION-OCCLUSIVE DISORDERS

This article examines the imaging anatomy of the temporomandibular joint (TMJ), describes the technique of calculating the gaps between the fossa and the head, their comparison based on TMJ computed tomography (CT) data, and their comparison with clinical signs of TMJ dysfunction. The aim was to determine CT diagnostic criteria for persistent functional displacement of the lower jaw in patients with TMJ functional disorders in occlusal-articulation disorders at the stage of orthopedic treatment planning. Research materials and methods. A clinical and radiological examination of 150 patients with functional disorders of the masticatory apparatus and occlusal disorders, who were included in the experimental group, and 30 practically healthy persons – the control group, was carried out. The results. The presence of a pain syndrome was primarily determined - 60 patients (40.00%) complained of pain in the TMJ area, masticatory muscles or headache, and in 19 (31.67%) of them, complaints of pain bothered more than half year TMJ pain was found in 30 (20.00%) patients, in masticatory muscles in 43 (28.67%), headache in 47 (31.33%). Hypertonus of the masticatory muscles was established - 94 - 62.67% with their hypertrophy - 46 - 30.67%, both unilateral and bilateral, which were observed simultaneously with the parafunction of the masticatory muscles (34 - 22.67%). Palpatory functional stable displacement of the lower jaw was determined in 135 (90.00%) patients of the research group, in 57 (42.22%) of them significant pain syndrome was present in 46 (80.70%). At the same time, deviation or deflexion was established in 74 (49.33%) patients of the experimental group, restriction of mouth opening in 52 (32.67%) patients; crunching and clicking in the TMJ - 112- 74.67%. The presence of bilateral posterior displacement of the heads of the lower jaw was established in 103 (68.67%) patients with TMJ dysfunction, of which 42 (40.77%) came to the doctor with complaints of orofacial pain, and in 22 (14.67%) significant displacement, 17 (77.27%) of them had a pain syndrome; unilateral posterior displacement of the heads of the lower jaw in 32 (21.33%) patients with TMJ dysfunction, 16 (50.00%) of them have a pain syndrome, and 11 of them have a significant displacement; in 16 (10.67%) one-sided posterior displacement with simultaneous anterior displacement in the contralateral joint was established with a subjective assessment of the absence of pain syndrome. Presence of a significant displacement in at least one joint was established in 72 (48.00%) patients with TMJ dysfunction, 63 (87.50%) of them had a pain syndrome. Conclusions. CT enables a comprehensive assessment of bone structures and their connection in the TMJ and is a valuable tool for planning orthopedic treatment and evaluating its effectiveness in dynamics.

Estimates of multidimensional poverty and its determinants among older people in rural China: evidence from a multicenter cross-sectional survey

BackgroundIn 2020, China declared that the absolute poverty in the country had been eradicated, but older people in rural areas are deprived in multiple domains. Poverty is multidimensional and involves deprivations in health, social welfare, living standards, and income. This study focused on assessing the poverty status of rural older persons and providing a basis for decision-making at all levels of government in China.MethodsA multicenter cross-sectional survey was conducted in four rural areas of China. Individuals aged 60 years and older were selected through stratified sampling. People with aphasia and severe cognitive impairment were excluded. An electronic questionnaire was used to collect older people’s information, including basic demographics, major illnesses, disabilities, chronic diseases, functional disorders, and ability to perform activities of daily living. It also asked about the medical, financial, and social security assistance that respondents received, food and clothing standards, safe housing, clean energy, safe drinking water, and reliable electricity. Specific questions were asked regarding income sufficiency, financial support from children, and pension income. Multidimensional poverty measurements were used to compare regional disparities and indicators differences. Logistic regression was used to identify the risk factors influencing poverty.ResultsA total of 1272 older people were analyzed. Of them, 704 (55.35%) were women and 652 (51.26%) were aged between 60 and 69 years. The most frequently mentioned causes of poverty were illness, a lack of employment, inadequate technology, and poor transportation. We found that as multidimensional poverty indicators increased (from 6 to 10), the number of poor older people decreased (from 1218 to 437), as did the poverty incidence (from 95.75 to 34.36%) and multifaceted poverty index (from 53.41 to 25.06%). Xuanwei had the highest incidence of poverty (66.61%) and multidimensional poverty index (0.66) among the four provinces studied. Regarding the contribution of indicators, financial alleviation made the greatest contribution to multidimensional poverty among rural older adults (up to 70.51%). Age, marital status, education level, awareness of poverty alleviation policies, and region were significant predictors of multidimensional poverty among older rural residents(P < 0.05).ConclusionsChina’s subsidy system and financial support must be enhanced. Particular attention should be given to the re-education of rural older individuals, basic vocational education should be strengthened in rural areas, and social participation should be encouraged.

Impact of proprioceptive cervical dizziness in chronic neck pain syndromes on gait and stance during active head-turn challenges.

An earlier observational study described selected patients with acute neck pain syndrome, who experienced short bursts of cervical vertigo elicited by rapid head movements. The current study on a larger cohort of 20 patients with chronic or frequently recurring neck pain syndrome and age-matched controls focused on two major questions: (1) Can head movements in subjects with exacerbations of neck pain and restrictions of neck mobility also elicit bursts of vertigo? (2) What is the impact on postural balance measured by analysis of body sway and locomotion? A detailed questionnaire was applied, posture and gait were evaluated by use of instrumented posturography-and gait analysis with and without slow or rapid horizontal head rotations in the yaw plane with and without sight/visual input. All patients reported some or frequent episodes of dizziness in the range of seconds only elicited by rapid, not by slow head movements. Postural sway in patients was unremarkable in undisturbed conditions without head movements, but specifically increased by rapid but not slow head turns. The latter is best explained by the lack of continuous control of velocity and amplitude of saccadic head movements. Gait analysis revealed a slowed and cautious gait pattern already at undisturbed condition that was even exaggerated during rapid head turns. These observations demonstrate that chronic or recurrent neck pain is associated with episodic experiences of dizziness and above results in both chronic and episodic alterations of stance and gait that resemble those described for patients with phobic postural vertigo/persistent postural perceptual dizziness, a functional gait disorder.

Risk factors for acute kidney injury in children with critical illness

Background Acute kidney injury (AKI) is an acute functional kidney disorder that increases morbidity and mortality in children. The mortality rate for critically ill patients accompanied by AKI is quite high and is influenced by the degree of AKI, the severity of the disease, and organ function disorders. Understanding the risk factors of developing AKI in children with critical illness can help prevent AKI. Objective To determine the risk factors for AKI in children with critical illness. Methods This retrospective cohort study included 255 children aged 1 month to 18 years admitted at the pediatric intensive care unit (PICU) of dr. Zainoel Abidin Regional Public Hospital, Banda Aceh, Aceh, from January to December 2022 using medical record data. Bivariate and multivariate analyses were performed. Results Acute kidney injury occurred in 68 (26.7%) patients. Based on pRIFLE criteria, 34 (50%) patients had AKI in the failure stage. Risk factors for AKI in children with critical illness were in descending order of RR: sepsis (RR 14.3; 95%CI 11.68 to 18.66; P=0.000), mechanical ventilation (RR 12.13; 95%CI 8.75 to 15.98; P=0.000), respiratory disorders (RR 2.51; 95%CI 2.06 to 4.02; P=0.003), congenital heart disease (RR 2.08; 95%CI 2.00 to 3.05; P=0.004), CNS disorders (RR 1.24; 95%CI 1.02 to 2.49; P=0.048), nephrotoxic drug use (RR 1.41; 95%CI 1.24 to 3.08; P=0.000), and age 1 month to 5 years (RR 0.072; 95%CI 0.16 to 0.32; P=0.010). Conclusion Sepsis is a risk factor for AKI in children with critical illness, followed by mechanical ventilation use, respiratory disorders, nephrotoxic drug use. Age &lt;5 years is a protective factor.

Using Network Analysis to Examine the Brain Regions Connectivity of Functional Neurological Disorder Patient and Healthy Participant

Introduction: Functional neurological disorder (FND) is one of the most common causes of neuropathy, However, its cause continues to be mysterious. Understanding the underlying mechanisms of that is crucial for treatment strategies. The study was conducted on brain images resting state fMRI taken from two volunteers (functional neurological disorder patient and healthy subject)who had the same characteristics. Methods: We fitted Gaussian Graphical Models to a single subject data using a network approach. Results: Based on the results of the networks, the number of significant edges was more in the left hemisphere in the patient, but in the healthy person, the number of these non-zero edges was more in the right hemisphere. Both the networks related to the healthy person and the patient had high density. Therefore, it indicated that the regions considered by these 2 people were strongly related to each other. The results showed the existence of more links and positive relationships between the regions, most of which showed a strong relationship. Among these connections, there were also negative connections. The networks of the healthy participant with almost symmetrical structures and the patient with Functional neurological disorder showed different characteristics, including asymmetry between the hemispheres. Conclusion: this study is the first to demonstrate that the brain regions of both functional neurological disorder patient and healthy participant can be conceptualized as networks. The findings of this study add to a growing body of literature that functional neurological disorder patient brain regions can be analyzed using network approaches.

Sirtuins and mechanisms of diabetic lung damage: a scientific discussion. A review

Induced tissue damage in target organs (kidneys, heart, eyes, liver, skin, nervous system) significantly contributes to the morbidity and mortality of patients from diabetes mellitus (DM). In recent decades, the question has been actively discussed: should the lungs be regarded as a target organ for diabetes? The c collected data demonstrate histological and functional lung disorders in DM patients. This suggests that the lungs are a target organ for diabetes. It is known that sirtuins regulate a number of physiological processes and affect obesity, insulin resistance, type 2 DM, heart disease and aging. In this review, we have tried to summarize the knowledge about the contribution of sirtuins to cellular regulation and the formation of pulmonary disease in patients with type 2 DM.

Selected Blood Biochemical Parameters after Right and Left Nephrectomy in Clinical Practice

Introduction. Radical nephrectomy is considered as a common operation associated with significant changes in the topography of the upper abdominal cavity which appear in the postoperative period. Analysis of the literature fails to provide sufficient information about functional changes in the parenchymatous abdominal organs that occur after nephrectomy. Aim. To investigate a number of liver and pancreatic enzymes in the blood of patients at the pre­ and post­ operative stages of the radical nephrectomy. Materials and methods. The study involved a retrospective analysis of medical records of 111 patients after radical nephrectomy. The patients underwent biochemical examination at the pre­operative stage, on day 1, and day 7 after the operation: ALT, AST, amylase, diastase. The examination was performed by means of biochemistry analyzers Bio Systems BA 400 and Beckman Coulter AU 480. Statistical data processing was carried out using Statistica 10.0. Results. The analysis of the obtained materials shows that the level of liver and pancreatic enzymes increases after radical nephrectomy. A side of the operation was revealed significant: left­sided nephrectomy leads to an increase in the level of blood amylase and diastase, right­sided nephrectomy results in an increase in the level of ALT and AST. No dependence on the sex of patients was determined. No increase in the level of the studied enzymes was found in a number of patients in the postoperative period; however, almost half of patients were detected with a significant, 1.5–2 times and higher, increase in the level of enzymes, thus requiring special control and correction. The maximum level of ALT reached 245 U/L (norm 0–35 U/L), the maximum level of AST comprised 184 IU/L (norm 0–35 IU/L). Discussion. The obtained results indicate the interrelation of functional disorders of the liver and pancreas and changes in their topography after radical nephrectomy. Conclusion. Radical nephrectomy is associated with significant functional disorders of the liver and pancreas depending on the side of the operation: the level of blood amylase and diastase increases after left nephrectomy, the level of ALT and AST grows after right nephrectomy. The level of enzymes exceeds the norm by 1.5–2 times in almost half of patients.

Psychopathology and the Validity of Gastrointestinal Symptom Reporting as Revealed Through Cluster Analyses of MMPI-2-RF Results.

Psychological state, self-reported gut symptoms, and somatic complaints are recognized relationships that can impact health assessment and subsequent treatment. To investigate the impact of psychological state and personality on symptom self-reporting and somatization. Sixty-two (62) participants from the Hunter region of NSW (Australia) undertook a survey of health and lifestyle along with an MMPI-2-RF assessment of personality, psychopathology, and test-taking attitude. Participants also completed the Rome Criteria to assess functional gastrointestinal disorders (FGIDs). To assist the interpretation of MMPI-2-RF results, clustering was applied to identify similar responses and sub-cohort profiles of reporting. Cluster analysis revealed four sub-cohorts, stratified by psychopathology, gut-related symptoms, and the validity of self-reported somatic complaints. Sample clustering identified one sub-cohort defined by high rates of negative affectivity and suicidal ideation. Apart from these differences, clusters were uniform for age, sex, smoking, mental health diagnoses, as well as for gut-related conditions. Results provide further evidence of the interaction of the gut-brain axis and its relationship to serious mental health conditions. It also points to the need to assess the veracity of self-reported symptomatology that may be both pathognomonic for psychopathology but might also be a consequence of gut dysbiosis. Clustering assisted these investigations by defining distinct sub-cohorts based on participant MMPI-2-RF responses.

Functional neurological disorder in pregnancy, labour and the postpartum period: systematic review.

Functional neurological disorder (FND) most often presents in women of childbearing age, but little is known about its course and outcomes during pregnancy, labour and postpartum (the perinatal period). We searched MEDLINE, PsycInfo and Embase combining search terms for FND and the perinatal period. We extracted data on patient demographics, subtype of FND, timing of symptom onset, comorbidities, medications, type of delivery, investigations, treatment, pregnancy outcomes and FND symptoms at follow-up. We included 36 studies (34 case reports and 2 case series) describing 43 patients. Six subtypes of FND were identified: functional (dissociative) seizures, motor weakness, movement disorder, dissociative amnesia, speech disorders and visual symptoms. New onset of perinatal FND was more common in the third trimester and onwards. Some women with functional seizures were exposed to unnecessary anti-seizure prescriptions and intensive care admissions. Prospective studies are urgently needed to explore how FND interacts with women's health in the perinatal period.

Mitochondrial dysfunction in patients with respiratory diseases

The aim of this scientific literature review was to find new solutions to urgent problems of treating respiratory diseases and reducing the associated temporary loss of ability to work and disability. The article presents the results of the analysis of 62 scientific papers published over 23 years (2001 – 2023) on mitochondrial dysfunction (MD), new methods of its diagnosis, and ways of its correction in respiratory diseases. Disorder of the energy function of mitochondria has been identified as an urgent scientific problem of respiratory medicine. It is noted that new methods of pathogenetic therapy for common and currently difficult-to-treat diseases are being developed to solve this problem. The key section of the review is devoted to the results of studies of mitochondrial dysfunction in patients with asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, and pulmonary hypertension.Conclusion. The article assesses MD diagnostic methods that are potentially applicable in real clinical practice. The results of studying the electric potential of the inner mitochondrial membrane, accumulation of active forms of oxygen, production of adenosine triphosphate in blood cells, alveocytes and epithelium of the respiratory tract, as well as bronchial smooth muscle cells, endothelium and vascular smooth muscle cells in the pulmonary artery system, determination of mitochondrial DNA in biological environments are compared. Proposed methods for the correction of MD syndrome in the clinical picture of respiratory diseases are briefly covered.

Relationships among Dioxin-like Mitochondria Inhibitor Substances (MIS)-Mediated Mitochondria Dysfunction, Obesity, and Lung Function in a Korean Cohort.

Mitochondrial dysfunction is closely linked to obesity and diabetes, with declining lung function in aging increasing diabetes risk, potentially due to elevated serum levels of dioxin-like mitochondria inhibitor substances (MIS) from prolonged exposure to environmental pollutants. However, the mechanisms connecting MIS, mitochondria, lung function, and metabolic disorder remain unclear. In this study, we analyzed data from 1371 adults aged 40-69 years in the 2008 Korean Genome Epidemiologic Study (KoGES) Ansung cohort. We indirectly estimated dioxin-like MIS levels by measuring intracellular ATP (MISATP) and reactive oxygen species (MISROS) in cultured cells treated with the serum of participants. Using correlation analysis and structural equation modeling (SEM), we explored the relationships among MIS, mitochondrial function, body mass index (BMI), and lung function (FEV1 and FVC). Our findings revealed that MISATP was associated with BMI in females and with FVC in males, while MISROS correlated with both BMI and FVC in males, not in females. Significant associations between BMI and FVC were found in the highest MIS subgroup in both sexes. SEM analyses demonstrated that MIS negatively influenced mitochondrial function, which in turn affected BMI and lung function. Age-related declines in lung function were also linked to mitochondrial dysfunction. This study underscores the potential of MIS assays as alternatives for assessing mitochondrial function and highlights the importance of mitochondrial health in metabolic disorders and lung function.

Informative value of diagnostic imaging methods in the detection of subepithelial formations of the stomach: a clinical case

INTRODUCTION: Subepithelial formations (SubEO) of the upper gastrointestinal tract (GI tract) are asymptomatic in most cases, and are a diagnostic finding in routine studies. Given the risk of malignancy of some SubEO, the question of treatment tactics remains relevant today: observation or surgical intervention.PURPOSE: To demonstrate diagnostic capabilities at the outpatient stage when choosing observational tactics in a patient with SubEO.MATERIALS AND METHODS: A dynamic observation of a 68-year-old woman with a randomly identified SubEO was demonstrated. The patient has been observed by a gastroenterologist since 2005 with a diagnosis of functional disorder of the gallbladder and sphincter of Oddi. In August 2022, when contacting the clinic with complaints of epigastric pain and heartburn, the following studies were performed: gastroscopy (FGDS), endoscopic ultrasound (EUS) with fine needle puncture, transabdominal ultrasound (TAUZI), computed tomography (CT) of the abdominal cavity, during which a submucosal formation of the stomach was diagnosed. The picture is more consistent with a gastrointestinal stromal tumor (GISO). Given the small size of the formation, the surveillance tactic was chosen. At the time of 12.2023, according to the results of control studies of the SubEO without dynamics.RESULTS: The follow-up period was 17 months, the results of the control studies justified the wait-and-see tactics and allowed avoiding unjustified surgical interventions and intraoperative complications.CONCLUSION: The combined use of TAUZI with endoscopy contributes to a better differential diagnosis and the choice of adequate treatment tactics.

Relationships between emotional states, bipolar disorder, and gastrointestinal disorders: A two-sample Mendelian randomization study

BackgroundFunctional gastrointestinal symptoms are frequently observed in patients with bipolar affective disorder, but the causal relationship between these conditions remains unclear. To establish causality, this study utilized Mendelian randomization (MR) with data from large-scale genomic research. The investigation aimed to elucidate the relationship between emotional states, bipolar disorder, and functional gastrointestinal disorders (FGIDs). MethodsSummary statistics from GWAS were utilized for mood swings (UK biobank, N = 451,619), irritable mood (UK biobank, N = 373,733), bipolar disorder (UK biobank, N = 352,006),functional dyspepsia (FinnGen biobank, N = 194,071), and irritable bowel syndrome (UK biobank, N = 486,601). All GWAS summary statistics were derived from individuals of European ancestry. The primary analysis employed the inverse variance-weighted method for Mendelian randomization (MR). Additionally, we conducted tests for heterogeneity and pleiotropy to ensure the robustness of our results. ResultsA suggestive positive causal relationship was identified between mood swings-related conditions and IBS using the inverse variance-weighted (IVW) method [mood swings-IBS: OR/95%CI: 3.221(2.417,4.294), P(1.42E−15); irritable mood-IBS: OR/95%CI: 1.881(1.615,2.191), P(4.56E−16); bipolar disorder-IBS: OR/95%CI: 1.003(1.001,1.006), P(0.009)]. For functional dyspepsia, a suggestive positive causal relationship was observed with mood swings [mood swings-FD: OR/95%CI: 2.827(1.124,7.109), P(0.027)]. In the reverse analysis, causal relationship was observed between IBS and emotional states [IBS and mood swings: OR/95%CI: 1.030(1.021,1.040), P(1.10E−10); IBS and irritable mood: OR/95%CI: 1.064(1.041,1.087), P(2.58E−08)]. ConclusionsMood swings, irritable mood, and bipolar disorder were associated with an increased risk of functional gastrointestinal disorders (FGIDs). Additionally, reverse analysis revealed a causal relationship between irritable bowel syndrome (IBS) and both mood swings and irritable mood. These findings suggest that targeted emotional interventions may be beneficial for patients with FGIDs. Further research is warranted to explore the relationship between mood instability-related disorders and FGIDs, particularly IBS.

Effects of morroniside isolated from Cornus officinalis fruits on functional gastrointestinal disorders and gastric ulcer in mice

The dried fruits of Cornus officinalis (Cornaceae) are used in Kampo medicine (e.g. Hachimigan and Goshajinkigan) to treat senile osteoporosis, diabetes, gastric atony, frequent urination, and diarrhea/constipation associated with aging. The present study investigated the effects of a C. officinalis fruit extract and morroniside, an iridoid compound from isolated these fruits, on the reduction in gastric emptying small intestinal motility caused by 5-hydroxytryptamine (5-HT) and 1-(3-chlorophenyl) biguanide (5-HT3 receptor agonist), and gastric ulcers induced by 150 or 75 mM HCl/90 % EtOH (HCl-EtOH) and/or 5-HT in mice. C. officinalis extract (500 mg/kg) and morroniside (20 and 50 mg/kg) suppressed the reduction in gastric emptying induced by 5-HT- and 5-HT3 agonist. C. officinalis extract, morroniside and 5-HT3 receptor antagonist (ramosetron) attenuated 5-HT-induced diarrhea. Furthermore, morroniside (20 and 50 mg/kg) prevented EtOH/HCl-induced gastric ulcers and those caused by 5-HT. Morroniside (20 and 50 mg/kg) attenuated elevations in the plasma levels of corticosterone, corticotropin-releasing factor (CRF), and adrenocorticotropic hormone (ACTH) in 75 mM HCl/90 % EtOH- and 5-HT-treated mice. The results obtained herein suggest the potential of morroniside as an effective treatment for irritable bowel syndrome, such as diarrhea and functional dyspepsia (reductions in gastric emptying and small intestinal motility), caused by 5-HT. The present study suggests a role for morroniside in the regulation of elevations in CRF, ACTH, and corticosterone levels through hypothalamic-pituitary-adrenal axis activity induced by stress loading, such as a 5-HT treatment and/or HCl/EtOH stimulation.

The Neuroconnective Endophenotype, A New Approach Toward Typing Functional Neurological Disorder: A Case-Control Study.

Functional neurological disorder (FND) is a core neuropsychiatric condition that includes both physical and mental symptoms. Recently, a validated clinical phenotype termed neuroconnective endophenotype (NEP), which includes several physical and psychological characteristics together with joint hypermobility (hypermobility spectrum disorders), was found at a significantly higher frequency among patients with anxiety. The purpose of the present study was to examine the presence of the NEP among patients with FND. The authors conducted a multicenter case-control study comprising 27 FND patients and 27 healthy control participants (matched by sex and age) ages 13 to 58 years. Eight questionnaires were administered. Proportional differences were examined with Student's t tests, one-way analyses of variance, and chi-square tests. Differences between FND patients and control participants were observed. FND patients had higher sensory sensitivity, increased prevalence of hypermobility features (including relevant physical signs and symptoms), greater frequency of polarized behaviors, a greater number of both psychiatric and physical comorbidities, and an increase in the characteristics and sensations typical of anxiety. Particularly striking was the presence of the hypermobility spectrum in more than 75% of FND patients compared with 15% among control participants. FND patients presented higher scores in all five dimensions included in the NEP. Thus, this phenotype, solidifying the original association between anxiety and the hypermobility spectrum, could help to identify an FND subtype when evaluating and managing FND patients, because it provides a new global view of patients' physical and mental symptoms.

Relationship between voice impairment and stress coping styles in professionally active teachers.

The cause of voice problems in teachers are excessive voice strain, improper voice emission, and wrong emotional responses to occupational stress. The aim of the study was to analyze the relationship between subjective voice assessment of professionally active teachers treated for voice disorders and their stress-coping styles. The study included 174 female teachers participating in a 24-day voice rehabilitation program at a sanatorium hospital. The Voice Handicap Index (VHI) self-assessment questionnaire was used to subjectively assess voice impairment. The Coping Inventory for Stressful Situations (CISS) questionnaire was used to assess coping styles. The VHI and CISS questionnaires were administered to the teachers at the beginning of the rehabilitation stay. Emotion-focused coping was shown to be associated with the subjective assessment of voice dysfunction as assessed by the VHI questionnaire for the total score and all of its dimensions (p = 0.04). In addition to proper voice emission, the prevention and rehabilitation of occupational voice disorders in teachers should also include stress management techniques, as this can help reduce the incidence of functional voice disorders in this occupational group.

The Effectiveness of Brief Multidisciplinary Outpatient Treatment for Functional Neurological Disorder: A Pilot Study

Background: Functional neurological disorder (FND) is a common, costly, and debilitating condition with a guarded prognosis. Limited evidence supports providers about which treatment approaches to undertake. Evidence-based care for FND is urgently needed to improve patient outcomes. The objective of this study was to evaluate functional and psychological outcomes associated with a novel outpatient multidisciplinary treatment program for adults with FND. Methods: Participants included 18 sequentially referred adults who attended the five-day FND treatment program, including those who completed ( N = 13) and who were available for follow-up at six months ( N = 9). Intervention included assessment and up to five consecutive days of treatment including two group-administered psychoeducation sessions. Primary measures included the Timed Up and Go (TUG), the EQ-5D-5L index score, and the visual analogue scale (VAS), and the Canadian Occupational Performance Measure (COPM). Secondary outcomes included Battery for Health Improvement-2 (BHI-2) Depression and Anxiety subscales. Results: Significant improvement observed on COPM performance and COPM satisfaction; EQ-5D-5L index (as well as VAS) and TUG (p = &lt; 0.05) immediately following five-day treatment. Improvement was gained at six months for BHI-2 Depression and Anxiety, and maintained for COPM performance, COPM satisfaction, EQ-5D-5L index, EQ-5D-5L VAS, and TUG. Conclusions: The findings of this preliminary work suggest that multidisciplinary treatment for FND has a positive impact on psychological and physical outcomes with results sustained up to six months.

Oral State and Salivary Cortisol in Multiple Sclerosis Patients.

Background: MS patients experience gradual and progressive functional limitation, bulbar symptoms, cognitive dysfunction, and psychiatric disorders that can impinge on oral status. This study aimed to investigate the oral state, oral hygiene habits, and salivary cortisol levels in patients with relapsing-remitting multiple sclerosis (RRMS) compared to healthy controls. It also evaluated systemic parameters: disease duration, type of Disease Modifying Therapy (DMT), disability score, professional activity, and smoking in the study group. Methods: This study included 101 patients (71 women and 30 men, aged 16-71 years) and 51 healthy volunteers (36 women and 15 men, aged 28-82 years). The oral examination assessed the number of teeth, type and number of dental fillings and prosthetic restoration, oral hygiene state, and salivary cortisol. Results: It was found that MS patients had significantly more professional activity, swallowing problems, pronunciation issues, dry mouth, and taste disturbances than the control group. They brushed their teeth twice daily significantly less often. The API was higher, while the SBI was lower in MS patients. Disease duration positively correlated with age and number of missing teeth. The Expanded Disability Status Scale positively correlated with age, disease duration, number of missing teeth, number of composite fillings, and right and left-hand Nine Hole Peg test scores, and negatively correlated with the Sulcus Bleeding Index. Salivary cortisol levels did not differ between groups and correlated only with the disability scale. Conclusions: MS patients require ongoing dental care and preventive measures to manage both general and oral health symptoms effectively.

CRISPR-Cas9 guided RNA-based model for the silencing of spinal bulbar muscular atrophy: A functional genetic disorder.

This study explores a novel therapeutic approach for spinal bulbar muscular atrophy (SBMA), a neurodegenerative disorder caused by a mutation in the Androgen Receptor (AR) gene. The aim is to investigate the potential of CRISPR-Cas9 technology in targeting the mutant AR gene to inhibit its production. The objectives include assessing the accuracy and efficacy of CRISPR-Cas9 guided RNAs in silencing the mutant gene and evaluating the feasibility of this approach as a treatment for SBMA. Computational and in-silico approaches are used to evaluate the feasibility of using CRISPR-Cas9 technology for treating SBMA. Computational analysis is used to design CRISPR-Cas9 guided RNAs targeting the mutant AR gene, assessing their on-target and off-target scores, GC content, and structural accuracy. In-silico simulations predict the potential therapeutic outcomes of the CRISPR-Cas9 approach in an artificial environment. Three guided RNA (gRNA) sequences were designed using the CHOPCHOP tool, targeting specific regions of the AR gene with high efficiency and 100% match. These gRNAs demonstrated effective targeting with minimal off-target scores and optimal GC content. Additionally, lentiCRISPR v2 plasmids were designed for the delivery of CRISPR materials, enabling high-efficiency multiplex genome editing of the AR gene. Thermodynamic ensemble predictions indicated favorable secondary structure stability of the designed gRNAs, further supporting their suitability for gene editing. The evaluation of designed gRNAs confirmed their strong binding ability to the target sequences, validating their potential as effective tools for genome editing. The study highlights the potential of CRISPR-Cas9 technology for targeting the Androgen Receptor gene associated with spinal bulbar muscular atrophy (SBMA). The findings support the feasibility of this approach for gene editing and suggest further exploration in preclinical and clinical settings. Recommendations include continued research to optimize CRISPR-Cas9 delivery methods and enhance specificity for therapeutic applications in SBMA.