Control Group Of Healthy Subjects Research Articles

Жалобы на когнитивные нарушения при унилатеральной компрессии височной доли

<p>Awareness of cognitive deficits, as a rule, occurs in the form of «memory complaints». Spontaneous narration of problems reveals their semantic hierarchy and can be a model for generating a spontaneous flow of thoughts and memories with the activity of the default brain network. The objective of the study was to study the nature of spontaneously expressed complaints about memory by patients with mild compression of the temporal regions of the resting network of the brain. The study was conducted in a homogeneous clinical group of 48 patients with extracerebral benign neoplasms located in close proximity to the medio-basal parts of the left (25 people) or right (28 people) temporal lobe. The tumor compresses these parts, but does not infiltrate the brain substance. With left-sided compression, complaints about verbal processes dominated, and their quantitative predominance over similar complaints was recorded in the group with right-sided compression and in the control group of healthy subjects (24 people). The severity of cognitive complaints with left-sided exposure to the brain revealed a negative correlation with experimental indicators of the success of spatial distribution of attention and simultaneous perception. With right-sided compression, spontaneously generated cognitive complaints revealed a dependence on the number of recognition errors in the AVP test, but this dependence was paradoxical: the worse this memory indicator was, the fewer cognitive complaints patients presented. The phenomenology of neural network compression makes it possible to register hemispheric specificity in spontaneously generated thoughts and memories.</p>

Treatment Outcomes in Patients with Muscular Temporomandibular Joint Disorders: A Prospective Case-Control Study.

Muscular temporomandibular joint disorders (M-TMDs) encompass a wide range of painful muscular conditions, which can provoke functional limitation and severely affect quality of life. The aim of the present study was to assess the treatment outcomes in patients affected by M-TMDs in terms of pain scores assessed with pressure pain threshold (PPT). The levels of depression, anxiety, and the Oral Health Impact Profile were also assessed and compared to healthy controls. Patients with a clinical diagnosis of M-TMDs and a control group of healthy subjects were enrolled. At baseline, OHIP-14, PHQ-9, and GAD-7 were administered. PPT was registered at the level of masseter and temporalis muscles. The patients affected by M-TMDs were then treated with oral splints and physio-kinesiotherapy following a standardized treatment protocol. At the 6-month follow-up of M-TMD-affected patients, PPT was registered, and the questionnaires were re-administered to evaluate treatment outcomes. In total, sixty patients and sixty controls were enrolled. The treatment of M-TMDs produced a significant improvement in PPT at the level of the masseter muscle. OHIP-14 at baseline in the M-TMD group was significantly higher compared to the control group (p < 0.05). At the 6-month follow-up, a significant reduction in OHIP-14 scores was registered, although with higher scores compared to the control group (p < 0.05). PHQ-9 was significantly higher at baseline in the M-TMD group (p < 0.05) and decreased to values comparable to the control group after treatment. GAD-7 presented statistically significant differences between the control group and M-TMD patients at baseline (p < 0.05) and between pre- and post-treatment in the M-TMD group. Following treatment, the GAD-7 scores were comparable to the control group. The symptom burden associated with M-TMDs negatively affects quality of life, with higher oral health impairment and a tendency towards depression and anxiety compared to healthy subjects. Following treatment, an improvement in both PPT and quality of life was observed.

Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy.

The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction.

Emotion recognition in amyotrophic lateral sclerosis in a dynamic environment

ObjectiveThe aim of our study was to measure the ability of ALS patients to process dynamic facial expressions as compared to a control group of healthy subjects and to correlate this ability in ALS patients with neuropsychological, clinical and neurological measures of the disease. MethodsSixty-three ALS patients and 47 healthy controls were recruited. All the ALS patients also underwent i) the Geneva Emotion Recognition Test (GERT) in which ten actors express 14 types of dynamic emotions in brief video clips with audio, ii) the Edimburgh Cognitive and Behavioral ALS Screen (ECAS) test; iii) the ALS Functional Rating Scale Revised (ALSFRS-R) and iv) the Medical Research Council (MRC) for the evaluation of muscle strength. All the healthy subjects enrolled in the study underwent the GERT. ResultsThe recognition of irritation and pleasure was significantly different between ALS patients and the control group. The amusement, despair, irritation, joy, sadness and surprise had been falsely recognized differently between the two groups. Specific ALS cognitive impairment was associated with bulbar-onset phenotype (OR = 14,3889; 95%CI = 3,96-52,16). No association was observed between false emotion recognition and cognitive impairment (F(1,60)=,56,971, p=,45,333). The number of categorical errors was significantly higher in the ALS patients than in the control group (27,66 ± 7,28 vs 17,72 ± 5,29; t = 8723; p = 0.001). ConclusionsALS patients show deficits in the dynamic processing of a wide range of emotions. These deficits are not necessarily associated with a decline in higher cognitive functions: this could therefore lead to an underestimation of the phenomenon.

Retinal arterial–venous pulse delay: a new specific marker for a carotid–cavernous fistula

PurposeThe purpose of the study was to describe ocular blood flow changes in eyes affected by a carotid–cavernous fistula (CCF) using laser speckle flowgraphy. We hypothesized that imaging blood flow velocity waveforms in the retinal arterioles and venules simultaneously would reveal specific characteristics of an arteriovenous (AV) connection.DesignThe study was an observational case series, with a retrospective case–control analysis.MethodsFive patients with a CCF underwent measurement of ocular blood flow using laser speckle flowgraphy. The blood flow was compared retrospectively between a control group of healthy subjects (n = 32) and patients with an elevated intraocular pressure or venous outflow impairment without an AV fistula (n = 40). The outcomes were derived from the arteriole and venule blood flow velocity waveforms, including an A–V phase delay and flow pulsatility.ResultsThe presence of an active CCF was associated with an increased delay in the peak velocity measured in the retinal venule (10.7% ± 2.2% of the cardiac cycle duration) compared with unaffected fellow eyes (1.8% ± 0.2%; p = 0.05) or control eyes of normal subjects (2.7% ± 0.3%; p = 0.02). This delay disappeared after fistula thrombosis and was not present in eyes with a central retinal vein occlusion (CRVO), glaucoma, non-arteritic anterior ischemic optic neuropathy (NAION), or papilledema. The venule blood flow velocity decreased during systole (and in some cases momentarily stopped), leading to a delayed pulse with a greater amplitude in the venules than in fellow eyes and normal controls after normalizing to the arteriole amplitude (1.71 ± 0.3 vs 0.54 ± 0.03 vs 0.59 ± 0.02; p = 8.0E-12). This specific AV delay could also be identified in a scanning laser ophthalmoscope (SLO; SPECTRALIS®) video.ConclusionLaser speckle flowgraphy reveals dynamic retinal vascular changes in eyes affected by a CCF, which are not present in healthy controls or patients with other eye conditions, and which reverses with treatment.

Lipid Profile Paradox: Investigating Improved Lipid Levels in Diabetic Mellitus Patients with Foot Ulcer Infections—A Prospective Descriptive Study

Type 2 diabetes mellitus (DM) is a chronic metabolic disorder posing multifaceted challenges to global public health. Among its numerous complications, infected diabetic foot ulcers (IDFUs) represent a particularly debilitating consequence. Beyond cardiovascular implications, there is an emerging understanding of the interconnectedness among IDFUs, neuropathy, atherosclerosis, and dyslipidemia. IDFUs, peripheral neuropathy, and atherosclerosis share common risk factors and mechanistic pathways. The primary objective of this study was to characterize the lipid profiles in DM patients with IDFUs, comparing them with DM patients without foot ulcers, and with a control group of healthy subjects. The secondary objectives included evaluating apolipoprotein E (ApoE) levels across these study groups and comparing lipid profiles within IDFU subgroups. A total of 160 patients were assessed for this study. After applying exclusion criteria, 140 participants were included, divided into three groups: Group IDFU (80 patients with IDFUs), Group DM (32 patients with DM but no foot ulcers), and Group Controls (28 healthy controls). Compared to Group DM, Group IDFU demonstrated lower levels of high-density lipoprotein cholesterol (HDL-C) (30.9 ± 12.6 mg/dL vs. 40.8 ± 16.6 mg/dL, p = 0.002), but improved levels of ApoE (160.9 ± 68.4 mg/dL vs. 197.2 ± 69.6 mg/dL, p = 0.01), triglycerides (TG) (126.9 ± 56.2 mg/dL vs. 165.8 ± 79.0 mg/dL, p = 0.004), low-density lipoprotein cholesterol (LDL-C) (84.2 ± 32.3 mg/dL vs. 92.3 ± 39.3 mg/dL, p = 0.1), and total cholesterol (133.6 ± 43 mg/dL vs. 164.6 ± 44.4 mg/dL, p = 0.002). The IDFU patients exhibit improved lipid profiles, excepting HDL-C, which is unusual because IDFU follows complications related to dyslipidemia for DM patients. Anemia, impaired renal function, and elevated TG levels were identified as biomarkers for mortality among patients with IDFUs. The data suggest that a lower level of HDL-C and an improved lipid profile may indicate a systemic end-stage disease manifestation in DM patients with IDFUs.

Toll-like receptor 4 and cytotoxic T cells CD8+ are prognostic markers in type 1 Diabetes Mellitus

Objective: To determine the correlation between toll-like receptor 4 and cytotoxic T cells in patients with type-1diabetes mellitus.Method: The cross-sectional, case control study was conducted at Al-Manatharah Hospital in the Al-Najaf province ofIraq from June 2021 to December 2021, and comprised patients of either gender aged 20-69 years having type-1diabetes mellitus in group A, and healthy subjects in control group B. From all the subjects, 4ml blood was collectedby vein puncture. Fasting blood glucose and lipid profile were estimated using a precipitant kit. Also measured weretoll-like receptor 4 and cytotoxic T cell levels using an enzyme-linked immunosorbent assay kit. Data was also notedon age, gender and body mass index. Data was analysed using SPSS version 23Results: Of the 100 subjects, 60(60%) were cases; 30(50%) males and as many females with mean age 59.21±18.092years. The remaining 40(40%) were controls; 20(50%) males and as many females with mean age 42.076±11.019 years.BMI values were not significantly different between the groups (p&gt;0.05), and all lipid profile values were significantlyhigher in group A compared to group B (p&lt;0.05) except high-density lipoprotein which was higher in group Bcompared to group A (p&lt;0.05). Group A patients had significantly higher levels of toll-like receptor 4 and cytotoxicT cell than group B subjects (p&lt;0.05).Conclusion: A significant relationship was found between type-1 diabetes and higher levels of toll-like receptor 4 andcytotoxic T cells.Keywords: Diabetes mellitus, Toll-like receptor 4, Cytotoxic T cells, CD8.

Brain positron emission tomography in idiopathic normal-pressure hydrocephalus: new 18F-fluorodeoxyglucose pattern in a long-known syndrome.

Patients with idiopathic normal-pressure hydrocephalus (iNPH) can show a global reduction in cerebral glucose metabolism at [18F]Fluorodeoxyglucose (FDG) PET. The presence of caudate hypometabolism has been identified as a potential biomarker in iNPH, yet there is limited evidence of hypermetabolic findings in patients with iNPH so far. We retrieved retrospectively patients with iNPH and normal cognitive assessment, evaluated before surgery undergoing brain [18F]FDG-PET. The 18F-FDG-PET brain scans were compared to those of a control group of healthy subjects, matched for age and sex, by statistical parametric mapping (SPM) to identify areas of relative hypo- and hypermetabolism. Furthermore, the existence of a correlation between areas of hypo- and hypermetabolism in the patient group was tested. Seven iNPH patients (mean age 74 ± 6 years) were found in the hospital database. SPM group analysis revealed clusters of significant hypometabolism (P = 0.001) in the iNPH group in the dorsal striatum, involving caudate and putamen bilaterally. Clusters of significant hypermetabolism (P = 0.001) were revealed in the bilateral superior and precentral frontal gyrus (BA 4, 6). A significant inverse correlation between striatal hypometabolism and bilateral superior and precentral frontal gyrus hypermetabolism was revealed (P < 0.001 corrected for multiple comparisons). In this cohort, patients with iNPH showed subcortical hypometabolism, including bilateral dorsal striatum. To the best of our knowledge, this is the first report demonstrating a hypermetabolic pattern in the primary motor and premotor areas, and showing an inverse correlation between the striatum and motor cortex in patients with iNPH.

Effect Of Urinary Kidney Injury Molecule-1 Levels On Short-Term Prognosis Of Chronic Heart Failure.

To explore the influential elements of urinary kidney injury molecule-1 levels in chronic heart failure, and to judge its ability to predict 90-day rehospitalisation. The cross-sectional case-control study was conducted from November 2020 to April 2021, at Hanzhong Central Hospital, China, and comprised adult patients having chronic heart failure with normal renal function in group A and healthy subjects in control group B. Patients in group A received anti-heart failure therapy for 1 week in hospital and were followed up for 90 days after discharge. Blood pressure (BP), kidney injury molecule-1, creatinine and serum pro- B-type natriuretic peptide levels were evaluated at baseline and 1 week after treatment in group A, while the samples were collected only at baseline in the control group B. Data was analysed using SPSS 22. Of the 102 subjects, 68(66.6%) were in group A; 44(64.7%) males and 24 (35.3%) females with mean age 62.38±9.51 years. The remaining 34(33.3%) subjects were in group B; 21(61.7%) males and 13(38.2%) females with mean age vs. 58.82±8.11 years. The urinary kidney injury molecule-1 level in group A was essentially on the increase compared to group B (p<0.05). After 1 week of treatment, the kidney injury molecule-1 level decreased compared to the baseline value in group A (p<0.05). Diastolic blood pressure and pro-B-type natriuretic peptide were the determinants of urinary kidney injury molecule-1 level, and urinary kidney injury molecule-1 level before discharge was significantly associated with rehospitalisation within 90 days (p<0.05). Urinary kidney injury molecule-1 level before discharge was a significant predictor of rehospitalisation within 90 days, and diastolic blood pressure and pro-B-type natriuretic peptide levels were the influencing factors of urinary kidney injury molecule-1. Also, urinary kidney injury molecule-1 levels were significantly raised in chronic heart failure.

Employment status among individuals afflicted by acquired brain injury: exploring economic consequences for both the affected person and their family (Situación laboral en personas con lesión cerebral adquirida: estudio sobre el impacto económico individual y familiar)

ABSTRACT Background: Acquired Brain Injuries (ABI) are conditions that can result in decreased workforce engagement and economic earnings. This research study aims to explore the impact of ABIs on employability, and their potential to reduce individual and family income. Method: Using data from the II National Survey on Disability, a cohort of 9,835 individuals aged 18 to 65 was chosen. Subsequently, a sample of 110 ABI-affected individuals was selected, employing propensity score matching to ensure equivalence with a control group of healthy subjects (n = 110). Results: The study found that the presence of ABI and disability decreases the likelihood of employment and labour force engagement. These differences persist even after accounting for covariate effects. However, no conclusive predictive association was established regarding individual and family income levels, despite observed disparities across the analysed groups. Discussion: The obtained findings can contribute to raising awareness regarding the general employment situation of individuals with ABI, and facilitate policy-making in the context of inclusion and vocational rehabilitation initiatives.

The impact of glaucomatous disease on lifestyle and healthy aging. Association between structural visual and auditory functional changes in glaucoma

Abstract: In the last decade, it was concluded that glaucomatous optic neuropathy is part of the neurodegenerative diseases in which destructive neuronal lesions are located not only in the structure of the retina, but they are also present at the level of the central visual and nervous pathways. The purpose of this study was to evaluate the degree of involvement of the auditory system in patients with Primitive Open Angle Glaucoma (POAG), the structural changes in the optic nerve, and to establish correlation between the hearing loss and structural changes in the optic nerve. Material and methods: It is a prospective, cross-sectional study on 32 eyes of 16 subjects with POAG in a study group and 24 eyes of 12 healthy subjects in control group, with a mean age of 62 years in both groups. Both groups underwent ophthalmological, audiological and brain magnetic resonance imaging (MRI) evaluation. Results: In the Study group patients, compared to the Control group, the average levels of the left Pure-tone audiometry (PTA), the cup/disc (C/D) area in both eyes, and the C/D ratio in both eyes are increased. Conclusions: Patients with POAG show changes in audiometry test in correlation with ophthalmological parameters demonstrating that the auditory system can be affected in glaucoma.

Gene expression of Interleukin-10 and Foxp3 as critical biomarkers in rheumatoid arthritis patients

Introduction and Aim: Forkhead box P3 (FOXP3) and interleukin-10 (IL-10) are the key regulators controlling the activity of Treg cells, which are crucial for maintaining immune tolerance and reducing autoimmune reactions. The objective of this study was to investigate the potential utility of elevated levels of FOXP3 and IL-10 gene expression as a diagnostic indicator in patients with rheumatoid arthritis (RA). Materials and Methods: The study used quantitative polymerase chain reaction (qPCR) to examine the expression levels of FOXP3 and IL-10 transcripts in whole blood samples from Iraqi patients with rheumatoid arthritis. A group of healthy control subjects were also included in the study. Results: In blood samples taken from Iraqi patients diagnosed with rheumatoid arthritis, a statistically significant decrease (P 0.01) in the expression levels of the FOXP3 gene and a statistically significant elevation (P 0.01) of IL-10 expression were seen in contrast to the healthy control group. Conclusion: Rheumatoid arthritis patients in Iraq may benefit from FOXP3 and IL-10 gene expression tests. IL-10 and FOXP3 overexpression promotes T cell and immune system immunoreactivity.

Flow Dynamic Pattern in Liver and Renal Transplantation under Exercise Prescription Program.

Cardiovascular diseases in the context of renal and liver transplants remain the leading cause of morbidity and mortality. Physical exercise at a moderate intensity is allowed to contrast the risk profile. Echocardiographic evaluation is essential to stratifying potential cardiotoxicity by the standard and, more recently, the deformation and dynamic study of the intracardiac vortex. This study aims to investigate the vortex echo parameters of solid-organ-transplanted subjects who are physically active compared to a control group of healthy subjects. A group of 33 transplanted subjects (16 kidneys and 17 livers) was studied via a transthoracic echocardiography exam, comprehending the myocardial deformation parameters of global longitudinal strain (GLS), twisting of the left ventricle (LV) chamber, and HyperDoppler image acquisition. The subjects enrolled in this study were 50 in total: there were 33 transplanted and 17 healthy subjects. The transplanted subjects presented higher values of interventricular septum in diastole (IVSd p = 0.001), posterior wall diastolic (PWd p = 0.05), and left ventricle mass index (LVMI p = 0.029); ejection fraction (EF) was found to be higher in athletes (p < 0.001). Transplanted subjects presented mild diastolic dysfunction, emerging only from septal E values (p = 0.001). The 4DStrain (p = 0.018) and GLS2c (p = 0.017) were significantly better in the athletes. All of the geometrical and energetical vortex data were in the normal range and no significant differences were found. An interesting positive correlation was evident for the diastolic parameter, particularly the E/A ratio (p = 0.023) and E' septal value (p = 0.049), along with the vorticity fluctuation. This behavior was present for all subjects, particularly those that were transplanted (p = 0.005). In the vortex investigation, especially in cases of normal EF, the positive correlation of some diastolic parameters with the flow dynamic patterns corroborates this hypothesis. The HyperDoppler analysis could be helpful to detecting potential damage earlier in the diastolic time before a systolic deficiency.

Common and Distinct Functional Connectivity of the Orbitofrontal Cortex in Depression and Schizophrenia.

Schizophrenia and depression are psychiatric disorders with overlapping clinical and biological features. This study aimed to identify common and distinct neuropathological mechanisms in schizophrenia and depression patients using resting-state functional magnetic resonance imaging (fMRI). The study included 28 patients with depression (DEP), 29 patients with schizophrenia (SCH), and 30 healthy control subjects (HC). Intrinsic connectivity contrast (ICC) was used to identify functional connectivity (FC) changes at the whole-brain level, and significant ICC differences were found in the bilateral orbitofrontal cortex (OFC) across all three groups. Further seed-based FC analysis indicated that compared to the DEP and HC groups, the FC between bilateral OFC and medial prefrontal cortex (MPFC), right anterior insula, and right middle frontal gyrus were significantly lower in the SCH group. Additionally, the FC between right OFC and left thalamus was decreased in both patient groups compared to the HC group. Correlation analysis showed that the FC between OFC and MPFC was positively correlated with cognitive function in the SCH group. These findings suggest that OFC connectivity plays a critical role in the pathophysiology of schizophrenia and depression and may provide new insights into the potential neural mechanisms underlying these two disorders.

1306-P: Body-Worn Motion Sensors Detect Gait Deficits in People with Impaired Fasting Glucose Who Have Normal 400-Meter Walk Time

Background: Gait is increasingly recognized as a marker of general health status. Abnormal gait characteristics have been observed in people with diabetes, but it is unclear if subtle changes in specific gait characteristics can be found in people with impaired fasting glucose (IFG), who are not yet classified as diabetic (prediabetic). Aim: The aim of this study was to investigate if digital gait measures discriminate people with IFG from healthy control subjects (HC) who have a normal 400-meter walk time. Methods: One-hundred and eight people with IFG (mean age: 71.20 years) and 63 healthy control participants (mean age: 70.40 years) wore 6 inertial sensors (Opals by APDM, a Clario Company) while performing a 400-meter fast walk test. In total, 56 measures were derived from the 400-meter walk test, including time to complete the test. Analysis of Covariance (ANCOVA) was used to investigate the differences between the prediabetic and healthy control groups while adjusting for body mass index (BMI) as a covariate. Results: After controlling for BMI as a covariate, 9 out of 55 gait measures were significantly different (p&amp;lt;10-4) between IFG and HC groups. Step duration, cadence, and turn velocity were the most discriminative measures. In contrast, there was no significant difference between groups for stopwatch timed for 400-meter walk test. Conclusion: Specific gait measures using body-worn sensors could be abnormal in people with IFG, even when stop watch time for the 400-meter walk test is normal. Thus, digital gait measures show promise to be used as endpoints for clinical trials in people with prediabetes. Disclosure V.V.Shah: Employee; APDM Wearable Technologies, A Clario Company. P.Carlson-kuhta: None. K.Sowalsky: Employee; Clario. M.Mancini: Consultant; Clario. F.B.Horak: Employee; APDM Precision Motion, division of Clario. Funding National Institutes of Health (5IK2CX000729-05)

Transforming growth factor-b1 and soluble co-inhibitory immune checkpoints as putative drivers of immune suppression in advanced basal cell carcinoma.

9567 Background: BCC rarely metastasizes and the mortality rate is low; however, the disease is associated with substantial morbidity. Transforming growth factor-b1 (TGF-b1) is a key player in cell proliferation, differentiation, apoptosis, and immune regulation. TGF-b1 is associated with immunosuppression and resistance to immunotherapeutic drugs. Immune checkpoint proteins (ICMs) maintain self-tolerance and modulate the immune responses of effector cells. The current study compared the levels and possible associations between systemic soluble ICMs (sICMs) and a group of humoral modulators of immune suppressor cells in a cohort of patients with advanced basal cell carcinoma (BCC, n = 40) and a group of healthy control subjects (n = 20). Methods: We measured sICMs and immunosuppressive humoral modulators by using multiplex bead array or ELISA procedures, with plasma as the matrix. The sICMs comprised seven co-inhibitory (CTLA-4, BTLA, LAG-3, PD-1, PDL-1, PDL-2, and TIM-3) and eight co-stimulatory (CD27, CD28, CD40, CD80, CD86, GITR, GITRL, and ICOS) proteins, as well as the two dual-active sICPs, HVEM and TLR2. The seven humoral modulators of immunosuppressor cells included arginase 1, fibroblast activation protein (FAP), RANTES (Regulated upon Activation Normal T Cell Expressed and Presumably Secreted) also known as CCL5, interleukin-10 (IL-10), TGF-b1, and the M2-type macrophage biomarkers, soluble CD163 (sCD163) and sCD206. Ethics approval was granted by The Research Ethics Committee, Faculty of Health Sciences, University of Pretoria (Ethics Committee Approval Numbers 356/2020. Results: The plasma levels of six co-inhibitory sICPs, sCTLA-4, sLAG-3, sPD-1, sPD-L1, and sTIM-3 and sPD-L2 were significantly elevated in the cohort of BCC patients ( p&lt; 0.001- p&lt; 0.00001), while that of sBTLA was significantly decreased ( p&lt; 0.006). Of the co-stimulatory sICPs, sCD27 was significantly increased ( p &lt;0.0002) in the cohort of BCC patients, with the levels of the others essentially comparable with those of the control patients; of the dual active sICPs, sHVEM, sTLR2 was significantly elevated ( p&lt; 0.00001) and TLR2 comparable with the control group. Although the plasma levels of the seven modulators of immune suppressor function were not significantly different between the BCC and control groups, correlation heat maps revealed selective, strong associations of TGF-b1 with seven co-stimulatory (z = 0.618468-0.768131) and 4 co-inhibitory (z = 0.674040-0.808365) sICPs, as well as with sTLR2 (z = 0.696431). Conclusions: Notwithstanding the association of BCC with selective elevations in the levels of a large group of co-inhibitory sICPs, our novel findings also imply the probable involvement of TGF-b1 in driving immunosuppression in this malignancy, possibly via activation of regulatory T cells.

Evaluation of Omega-3 Effect as Adjuvant Therapy to Methotrexate on Alkaline Phosphatase Level in Iraqi Patients with Active Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a common inflammatory disease associated with many extraarticularfeatures. The aim: of the current study is to assess the influence of omega-3 fatty acids(EPA, DHA) on serum alkaline phosphatase in patients with active RA. A single blinded placebocontrolled clinical trial with 12 weeks follow up period at which 50 patients with active RAusing methotrexate were randomized into 2 groups to receive either omega-3 (1000 mg) capsulethree times daily or capsules prefilled with glucose as placebo and were evaluated at zero time(baseline) and after 12 weeks for alkaline phosphatase level in serum. In addition to twenty fivehealthy subjects as control group. The age of RA patients in omega-3 group ranged from 25-80years (50.36±2.46), whereas the age of RA patients in placebo group ranged from 35-68 years(50.08±1.84 ), while the age of apparently healthy subjects in control group where ranged from40-60 years (94.20±1.12). The RA disease activity was measured using disease activity score of28 joints(DAS28-ESR) and clinical disease activity index (CDAI). After 12 weeks of startingadjuvant treatment with either omega-3 or placebo, the results showed that there were nosignificant difference between the effect of omega- 3 and placebo on alkaline phosphatase level.In Conclusion, omega-3 significantly decreased alkaline phosphatase level in patient with activerheumatoid arthritis

Dysregulation of systemic soluble immune checkpoints in early breast cancer is attenuated following administration of neoadjuvant chemotherapy and is associated with recovery of CD27, CD28, CD40, CD80, ICOS and GITR and substantially increased levels of PD-L1, LAG-3 and TIM-3.

Neoadjuvant chemotherapy (NAC) may alter the immune landscape of patients with early breast cancer (BC), potentially setting the scene for more effective implementation of checkpoint-targeted immunotherapy. This issue has been investigated in the current study in which alterations in the plasma concentrations of 16 soluble co-stimulatory and co-inhibitory, immune checkpoints were measured sequentially in a cohort of newly diagnosed, early BC patients (n=72), pre-treatment, post-NAC and post-surgery using a Multiplex® bead array platform. Relative to a group of healthy control subjects (n=45), the median pre-treatment levels of five co-stimulatory (CD27, CD40, GITRL, ICOS, GITR) and three co-inhibitory (TIM-3, CTLA-4, PD-L1) soluble checkpoints were significantly lower in the BC patients vs. controls (p<0.021-p<0.0001; and p<0.008-p<0.00001, respectively). Following NAC, the plasma levels of six soluble co-stimulatory checkpoints (CD28, CD40, ICOS, CD27, CD80, GITR), all involved in activation of CD8+ cytotoxic T cells, were significantly increased (p<0.04-p<0.00001), comparable with control values and remained at these levels post-surgery. Of the soluble co-inhibitory checkpoints, three (LAG-3, PD-L1, TIM-3) increased significantly post-NAC, reaching levels significantly greater than those of the control group. PD-1 remained unchanged, while BTLA and CTLA-4 decreased significantly (p<0.03 and p<0.00001, respectively). Normalization of soluble co-stimulatory immune checkpoints is seemingly indicative of reversal of systemic immune dysregulation following administration of NAC in early BC, while recovery of immune homeostasis may explain the increased levels of several negative checkpoint proteins, albeit with the exceptions of CTLA-4 and PD-1. Although a pathological complete response (pCR) was documented in 61% of patients (mostly triple-negative BC), surprisingly, none of the soluble immune checkpoints correlated with the pCR, either pre-treatment or post-NAC. Nevertheless, in the case of the co-stimulatory ICMs, these novel findings are indicative of the immune-restorative potential of NAC in early BC, while in the case of the co-inhibitory ICMs, elevated levels of soluble PD-L1, LAG-3 and TIM-3 post-NAC underscore the augmentative immunotherapeutic promise of targeting these molecules, either individually or in combination, as a strategy, which may contribute to the improved management of early BC.

Altered Ankle Muscle Activation at 2-Year Post Achilles Tendon Repair: An Age, Gender, and Activity Level-Matched Comparison With Healthy Subjects.

The study purpose was to compare the ankle muscle activation and dynamic ankle joint stability of subjects who underwent endoscopy-assisted Achilles tendon repair (ATR; at ≥ 2y postsurgery) with age, gender, and activity level-matched healthy control group subjects. Prospective, cross-sectional study. All functional tests were performed on the involved ankle of the ATR group, and at the matched side of healthy age, gender, and activity-level control group subjects. Fifteen men in each group were evaluated for medial and lateral gastrocnemius, soleus, tibialis anterior, and peroneus longus muscle activation during modified star excursion balance test and heel-rise test performance. The weight-bearing lunge test (ankle dorsiflexion) and heel-rise test distance (ankle plantar flexion) also determined weight-bearing, active ankle mobility magnitudes. The Achilles Tendon Total Rupture Score and Foot and Ankle Outcome Score provided patient-reported outcome perceptions specific to Achilles tendon rupture and comprehensive foot and ankle symptoms and function, respectively. Medial (P = .005) and lateral (P = .012) gastrocnemius displayed greater activation amplitudes in the ATR group during the star excursion balance test, and peroneus longus displayed greater activation amplitudes during the heel-rise test (P = .006). The star excursion balance test reach distance was comparable between groups. Active weight-bearing ankle plantar flexion (heel-rise test) and dorsiflexion (weight-bearing lunge test) mobility magnitudes were lower in the ATR group. Subjects who underwent endoscopy-assisted percutaneous ATR had reduced active weight-bearing ankle dorsiflexion and plantar flexion mobility magnitudes and greater gastrocnemius and peroneus longus neuromuscular activation when performing the same tasks as healthy control group subjects. As surgical approaches evolve to less invasive, soft tissue preserving methods with less tissue morbidity and faster healing, rehabilitation approaches may likewise need to evolve. Level III.

The pittsburg sleep quality index in asthmatic patients: A case-control study

Introduction: Sleep disturbances are common in asthmatic patients. The purpose of this study was to evaluate sleep quality in asthmatic patients in local setting. Materials and methods: In the present case-conrol study, sleep quality of asthma patients was assessed using Pittsburgh Sleep Quality Index (PSQI), in 76 clinically stable asthmatic patients at the outpatient clinic compared to 76 healthy subjects in control group. Poor sleep quality is classified as PSQI score more than 5. Results: Mean PSQI score in patients was significanly higher than the control group. The number and percent of cases with poor sleep quality and all subdomains of PSQI score were statistically more than control group. Conclusion: According to the results of the present study, sleep quality of the majority of asthma patients was not desirable. It is necessary for policy makers and health managers as well as physicians to focus on this aspect of the patients’ health as well. It is recommended to have sleep health consultation in pulmonary clinic.