Higher Incidence In Females Research Articles

Emerging therapies and innovations in vitiligo management: a comprehensive review.

Vitiligo is a common skin disorder where melanocytes, the cells that produce skin pigment, are destroyed by the immune system, leading to white patches on the skin and mucous membranes. This condition affects 0.4% to 2.0% of the global population, with a higher prevalence in females and often beginning in childhood. In India, about 1% of the population is affected, particularly in northern regions, with a higher incidence in females and links to other autoimmune diseases. This review examines recent progress in understanding vitiligo and its treatment. It focuses on the genetic, autoimmune, and environmental factors involved in the disease and highlights new therapies, such as targeted molecular treatments and advanced repigmentation methods. Current research shows that oxidative stress and genetic predispositions contribute to the autoimmune destruction of melanocytes. Novel drug delivery systems, including liposomes, nanoemulsions, and nanostructured lipid carriers, have improved treatment effectiveness. Clinical trials are exploring new treatments like Ruxolitinib cream and melanocyte transplantation, while teledermatology is becoming useful for managing patients. Vitiligo also poses a significant economic burden due to its impact on patients' quality of life. Continued research is essential to develop better, more accessible treatments and reduce the economic impact of vitiligo.

Association between body mass index and urinary tract infections: A cross-sectional investigation of the PERSIAN Guilan cohort study.

There is a relationship between excess body weight and the risk of a number of infectious diseases, including urinary tract infections (UTIs). This study aimed to investigate the correlation between body mass index (BMI) and UTIs among Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan Cohort Study (PGCS) population. This cross-sectional study was conducted on 10,520 individuals aged 35-70 years from PGCS. The demographical data and clinical characteristics of the participants were recorded. Microscopic examination of the urine samples was performed to detect the presence of bacteria or white blood cells (WBC) as indicators of infection. UTI was defined as the presence of bacteria in the urine (Few, moderate, and many) and a value of ≥10 WBC/high power field (HPF) by light microscopy. The prevalence of UTIs in this study was 8.8%, with a higher incidence in females compared to males (12.2% vs. 4.7%, p<0.001). Among participants, the prevalence of UTIs across different weight categories was as follows: underweight/normal weight, 7.1%; overweight, 8.1%; and obesity, 10.9%. According to the unadjusted model, subjects with obesity were at significantly higher odds for UTIs than subjects with underweight/normal BMI (OR=1.62, 95% CI: 1.35-1.93, p<0.001). However, this association was no longer significant after adjusting for demographic and clinical variables. The findings of this study provide evidence supporting a higher prevalence of UTIs among individuals with obesity.

INTEGRATED CARE FOR URETEROCELE PROLAPSE

Ureteroceles are rare congenital anomalies, occurring in about 1 in 4000 individuals, with a higher incidence in females, particularly those with a duplex renal system. The etiology and clinical presentation of ureteroceles vary, often complicating diagnosis and management. Common symptoms include antenatal hydronephrosis, vesicoureteral reflux (VUR), and recurrent urinary tract infections (UTIs). In cases of ectopic ureteroceles, there is a risk of significant complications, such as hypertension and renal failure, requiring timely and precise intervention. Diagnostic methods include sonography and voiding cystourethrography (VCUG), while management approaches range from minimally invasive endoscopic incisions to more complex excision and reimplantation procedures, depending on the severity. We report the case of a 1.5-month-old female infant, born via LSCS, presenting with fever and a rapidly enlarging reddish mass descending from the urethra. Initially the size of a peanut, it grew to the size of a lemon, accompanied by symptoms of straining during urination and defecation. While prenatal scans showed hydro-ureteronephrosis, postnatal imaging appeared normal until the mass emerged. Clinical suspicion of a ureterocele was confirmed through imaging studies. This case highlights the unpredictable nature of ureteroceles, emphasizing the importance of prenatal and postnatal screening. Treatment strategies must be individualized, considering the rapid progression of the condition. While endoscopic incision is favored for its minimally invasive approach, reconstructive surgery may be necessary if complications such as reflux or a duplex renal system are present. Early detection remains key to preventing long-term morbidity and improving outcomes in infants with ureteroceles.

Risk of anxiety-related sleep disorder in nursing students

Introduction: Anxiety affects 29% of the world's population, with higher incidence in females (77%) and this begins before the age of 18 years. Academic pressure aggravates anxiety and can lead to severe or serious mental health problems. Objective: To correlate anxiety and sleep disorders in university students. Methods: This quantitative, descriptive, cross-sectional study seeks to test hypotheses about anxiety and sleep disorders in 100 nursing students of the Technical University of Ambato through surveys, analyzing data in SPSS and Excel. Results: 85% of the students experience severe levels of anxiety, which can negatively affect their sleep quality and general well-being. Conclusion: Anxiety in university students, especially in health areas, can lead to more serious mental health problems and affect their academic performance and clinical skills. Implementing psychological support and stress management programs is essential to improve their well-being and academic performance.

Post-Traumatic Trigeminal Neuropathic Pain: A Narrative Review of Understanding, Management, and Prognosis.

This study provides an updated overview of the clinical characteristics of post-traumatic trigeminal neuropathic pain (PTNP) resulting from dental procedures or facial trauma, addressing its etiology, prevalence, evaluation, management, and prognosis. PTNP arises from injury to the trigeminal nerve, which governs sensory and motor functions in the maxillofacial region. The prevalence and characteristics of PTNP vary considerably across studies, with a reported prevalence ranging from 1.55% to 13%. The predominant causative factors are dental procedures, particularly third molar removal and implant placement. While gender distribution varies, a trend towards higher incidence in females is observed, particularly within the 40-60-year age group. Anatomically, the mandibular nerve is frequently involved. PTNP presents with a spectrum of symptoms ranging from tingling sensations to severe pain. Diagnostic challenges arise due to the lack of standardized criteria and potential overlap with focal neuralgia, necessitating comprehensive evaluation. Misdiagnosis can lead to prolonged patient suffering and unnecessary interventions. Successful management hinges on prompt diagnosis and interdisciplinary collaboration, with early intervention crucial in mitigating progression to chronic pain. Although nerve recovery post-trauma is challenging, preventive measures through accurate evaluation and treatment are paramount. Management strategies for PTNP include non-invasive and surgical interventions, with non-invasive approaches encompassing systemic and local pharmacological management. This narrative review aims to enhance uniformity in PTNP evaluation and treatment approaches, ultimately improving patient care and outcomes.

Gender disparities in incidence of psychological disorder among patients with breast cancer: A national cohort study.

e23285 Background: Male breast cancer (MBC) is rare. The features of MBC shares similar characteristics with female breast cancer, often resembling postmenopausal breast cancer. However, there are notable differences between male and female breast cancer, especially regarding gender and age, which can have distinct psychological impacts on male patients. In this study, we investigated whether the psychological distress experienced upon a diagnosis of breast cancer differs according to gender. Methods: Data were obtained from the National Health Insurance claims database of the Health Insurance Review and Assessment Service in South Korea. This study focused on the three most common psychological disorders: sleep disorders, anxiety disorders, and depression. Diagnosis confirmation relied on diagnostic codes based on the International Code of Disease, 10th revision, alongside breast cancer diagnoses. Propensity score matching was used in a 1:5 ratio, and adjustment variables included age, endocrine therapy, chemotherapy, HER2-targeted treatment, and Charlson Comorbidity Index score. Results: After excluding patients with previous psychological disorder, there were a total of 75,936 patients, and 281 (0.4%) male patients. Male patients were diagnosed at an older age, had a higher prevalence of hormone receptor-positive status, higher comorbidities, and lower rates of anxiety disorders, while sleep disorders and depressive disorders showed similar incidences. The Cox proportional hazard regression model exhibited that being female was a risk factor for anxiety disorder (after matching, multivariable, HR 1.498, 95% CI 1.057-2.123, p = 0.023). However, gender did not significantly influence the development of sleep or depressive disorders, despite these conditions typically having a higher incidence in females. During the acute phase shortly after diagnosis, women tend to have more distress, as seen on the cumulative incidence curves. Conclusions: MBC patients experienced similar levels of psychological distress related to sleep and depression disorders as female patients. These results suggested that both genders require an equal support system and psychological care to maintain mental well-being after a breast cancer diagnosis.

In-utero and newborn factors and thyroid cancer incidence in adult women in the Sister Study cohort.

10560 Background: Thyroid cancer ranks as the fifth most common cancer in women globally, with 90% of cases classified as differentiated thyroid cancer (DTC). Currently, thyroid cancer etiology remains largely unknown, with childhood exposure to ionizing radiation and obesity among the few established modifiable risk factors. Considering that DTC is diagnosed at relatively younger ages compared to many other cancers, with higher incidence in females versus males, the current study aimed to investigate in-utero and newborn exposures in relation to adult female DTC incidence. Methods: From the Sister Study, a cohort of sisters of women with breast cancer living in the U.S. (including Puerto Rico), we included 47810 women who were cancer-free at baseline (2003–2009). At baseline, participants provided information on their birth and newborn characteristics, and characteristics of their parents before and during pregnancy. Using Cox proportional hazards regression models, we assessed the association between in-utero and newborn factors and self-reported DTC incidence during follow-up. The models were adjusted for attained age (timescale), race/ethnicity, BMI, smoking status, personal history of benign thyroid disease, educational level, household annual income, and Area Deprivation Index. Results: The median age at baseline of the study population was 55.4 (interquartile range [IQR]: 48.9-62.1). During follow-up (median: 13.1 years, IQR: 11.5-15), 233 women were diagnosed with DTC, with medical records available for 72% of cases. Factors associated with a higher incidence of DTC included gestational hypertension or hypertension-related disorders (15 exposed cases, HR= 1.87, 95%CI 1.10-3.16), and higher birth weight (for every additional kilogram HR=1.13, 95%CI 1.00-1.27). The HR for maternal pre-pregnancy or gestational diabetes was 2.33 (5 exposed cases, 95%CI 0.96-5.67). Conversely, being born at least two weeks before the due date was associated with a lower incidence (6 exposed cases, HR=0.35, 95%CI 0.15-0.79). These associations remained consistent when restricting to advanced-stage and large-sized DTCs. We observed no associations for participants’ birth order, time since last pregnancy of the participants' mother, multiple versus singleton birth, ever having been breastfed, parental smoking during pregnancy or age at delivery, maternal morning sickness, or paternal diabetes. Conclusions: In this study, maternal diabetes, maternal hypertension, and birth weight were associated with higher female DTC incidence while being born at least two weeks before the due date was associated with lower DTC incidence. These findings provide evidence that in-utero and newborn exposures may have a long-term influence on thyroid cancer development.

Refractive Errors of School Children from Economically Disadvantaged Areas in Northwest México.

Background: Refractive errors, including myopia, hyperopia, and astigmatism, are the leading causes of visual impairment in school-aged children and can significantly impact their academic performance and quality of life. This study aimed to assess the prevalence of refractive errors among school children from economically disadvantaged areas in Northwest México, using a consistent methodology to facilitate comparison with global data. Methods: We adopted the Refractive Error Study in Children (RESC) protocol by the World Health Organization to examine the prevalence of myopia, hyperopia, and astigmatism. The study comprised a systematic sampling of children aged 6 to 18 years from diverse schools in Northwest México. Trained optometrists conducted visual acuity testing and autorefraction, while ophthalmologists performed cycloplegic refraction to ensure accuracy. Results: The study found a myopia (SE ≤-1.50 D at least one eye) prevalence of 14.55% (95% CI: 13.27-15.91), with a higher incidence in females (6.92%) compared to males (6.00%) in at least one eye. Hyperopia (SE ≥ +1.00 D at least one eye) was less common, at 3.23% (95% CI: 2.61-3.95), with a slightly higher occurrence in males in at least one eye. Astigmatism (Cylinder ≥ 0.75 D at least one eye) was present in 18.63% (95% CI: 17.21-20.12) of the students in at least one eye, with no significant difference between genders. These findings are consistent with other studies in regions such as Puerto Rico and Iran, indicating widespread refractive error issues among schoolchildren. Conclusions: The high prevalence of refractive errors, particularly myopia and astigmatism, highlights the critical need for regular vision screenings in schools and the implementation of public health interventions to provide corrective eyewear. Our study confirms the importance of utilizing standardized methodologies like the RESC protocol to compare refractive error prevalence across different geographical and socio-economic contexts, thereby informing global public health strategies.

#2146 Gender difference in hospital-acute kidney injury epidemiology and outcome: not just a matter of sex

Abstract Background and Aims Hospital Acute kidney injury (H-AKI) is a complex entity associated with an increased risk of complications and mortality. Its occurrence and outcome are influenced by several patient and organizational-related factors. Due to the biological and genetic differences, sex may greatly influence the kidney function. However, the impact of sex on H-AKI risk and related consequences is still unclear. This retrospective study aimed to assess H-AKI epidemiology and outcomes in a large cohort of hospitalized patients, with a focus on the association with patients' sex. Method From adult patients admitted to two large University Hospitals in Italy between 2016 and 2019, we collected clinical data, serum creatinine (sCr), comorbidities and primary diagnoses as codified in the hospital discharge form (HDF), and data on discharge, length of hospital stay (LOS), and death. Patients with Chronic kidney disease (CKD) stage 5 reported on HDF were excluded. We defined and graded AKI according to the KDIGO criteria, by comparing the peak sCr to the lowest sCr during hospitalization under the assumption that the lowest sCr would represent baseline kidney function. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration creatinine-based equation. Results We analyzed 87,087 patients, with an average age of 69.2 ± 17.7 years of whom 43467 (49.9%) were males and 43620 females (50.1%). Female patients were older than males (69.9 ± 16.5 vs 68.5 ± 18.9 years, p &amp;lt; 0.001), had less prevalence of diabetes mellitus (DM) [3797 (8.7%) vs 4695 (11.8%), p &amp;lt; 0.001] and CKD [2609 (6%) vs 3340 (7.7%), p = 0.001] and higher prevalence of heart failure (HF) [4083 (9.3%) vs 3729 (8.6%), p &amp;lt; 0.001]. Admission eGFR was lower in females than males [82.6 (54.5-99.1) vs 84.2 (57.8-99.0) ml/min, p &amp;lt; 0.001] (see Fig. 1). Overall, 17946 patients (20.6%) developed H-AKI, with a higher incidence in females (21.4% vs. 19.8%, p = 0.000). Females with H-AKI were older and exhibited more heart failure, while males presented more acute myocardial ischemia and sepsis. The male/female ratio varied across AKI severity, with stage 3 AKI more frequent in males. AKI awareness, as evaluated by comparing the incidence of AKI diagnosed according to the sCr changes with AKI diagnoses codified on HDF, showed a higher rate of undetection in females. Moreover, when we stratified our cohort according to the age quartiles, we observed that for each AKI stage in the 1st age quartile H-AKI incidence was higher in males, in the second quartile there was no difference between male and female patients, while in the last quartiles, AKI incidence was higher in females (Fig. 2). This tendency was also confirmed by Kaplan-Meier analysis. However, when we separately analyzed the risk of developing AKI in the different quartiles with multivariate logistic regression analysis we found that while in the youngest quartiles the risk of developing AKI was not correlated with sex, in the elderly, female sex was an independent risk factor for developing AKI (3rd quartile OR 1.30, IC 1.21-1.39; 4th quartile OR 1.46 IC 1.38-1.59, adjusted for age, DM, HF, CKD, admission to ICU, sCr, LOS). The analysis of outcomes among AKI patients (Fig. 3) showed that mortality was the same for the youngest patients, while it was higher in male patients for the 3rd and 4th age quartile. A similar trend was found for ICU admission and LOS. Conclusion Sex emerges as a significant determinant of H-AKI development. However, the relationship between sex and H-AKI is not linear. Indeed, AKI incidence, severity, and outcomes vary between males and females across different age groups, probably reflecting the modifications of health status occurring during a lifetime. Consideration of gender differences is crucial in studying AKI to ensure accurate and equitable diagnosis and management.

Lichen Sclerosus-Incidence and Comorbidity: A Nationwide Swedish Register Study.

Background: Data on the incidence and comorbidity of Lichen sclerosus (LS), based on validated nationwide population-based registries, remains scarce. Objective: To explore the incidence and association of comorbidities with LS in Sweden, emphasizing its potential links to malignancies and autoimmune disorders. Methods: A population-based retrospective open cohort study was conducted using the National Patient Register to identify all individuals diagnosed with LS (ICD-10 code L90.0) from 1 January 2001 to 1 January 2021. The study included 154,424 LS patients and a sex and age matched control group of 463,273 individuals to assess the incidence and odds ratios for various cancers and premalignant conditions. Results: The incidence of LS in Sweden was 80.9 per 100,000 person per year, with higher incidence in females (114.4) than in males (47.2). LS patients showed an increased odds ratio for vulvar cancer (OR = 8.3; 95% CI = 7.5-9.0), penile cancer (OR = 8.9; 95% CI = 7.3-11.0), prostate cancer (OR = 1.2; 95% CI = 1.1-1.2), testicular cancer (OR = 1.4; 95% CI = 1.1-1.7), bladder cancer (OR = 1.1; 95% CI = 1.1-1.2), breast cancer (OR = 1.4; 95% CI = 1.3-1.4), leukoplakia of the vulva (OR = 253.5; 95% CI = 221.9-289.6), and leukoplakia of the penis (OR = 5.1; 95% CI = 4.9-5.4). Conclusions: This study underscores the significantly increased association of various cancers and premalignant conditions in LS patients, highlighting the critical need for efficacious treatment and diligent follow-up. The association between LS and autoimmune diseases further necessitates comprehensive investigation to understand the underlying mechanisms and clinical management implications. Future research is essential to confirm these findings and elucidate the role of LS in cancer development.

Clinical characteristics analysis of pediatric spinal cord injury without radiological abnormality in China: a retrospective study

PurposeThis study aims to analyze the clinical characteristics of Chinese children with spinal cord injury (SCI) without radiographic abnormality (SCIWORA) and explore their contributing factors and mechanisms of occurrence.MethodsA retrospective analysis was conducted on the clinical data of pediatric patients diagnosed with SCIWORA from January 2005 to May 2020. Epidemiological, etiological, mechanistic, therapeutic, and outcome aspects were analyzed.ResultsA total of 47 patients with SCIWORA were included in this study, comprising 16 males and 31 females. The age range was 4 to 12 years, with an average age of 7.49 ± 2.04 years, and 70% of the patients were below eight. Sports-related injuries constituted 66%, with 70% attributed to dance backbend practice. Thoracic segment injuries accounted for 77%. In the American Spinal Injury Association (ASIA) classification, the combined proportion of A and B grades accounted for 88%. Conservative treatment was chosen by 98% of the patients, with muscle atrophy, spinal scoliosis, hip joint abnormalities, and urinary system infections being the most common complications.ConclusionSCIWORA in Chinese children is more prevalent in those under eight years old, with a higher incidence in females than males. Thoracic spinal cord injuries are predominant, dance backbend as a primary contributing factor, and the social environment of “neijuan” is a critical potential inducing factor. Furthermore, the initial severity of the injury plays a decisive role in determining the prognosis of SCIWORA.

Incidence and outcomes of emergency department patients requiring emergency general surgery: a 5-year retrospective cohort study.

Patients undergoing emergency general surgery are at high risk of complications and death. Our objectives were to estimate the incidence of emergency general surgery in a Swiss University Hospital, to describe the characteristics and outcomes of patients undergoing such procedures, and to study the impact of age on clinical outcomes. This was a retrospective cohort study of adult patients who visited the emergency department (ED) of Geneva University Hospitals between January 2015 and December 2019. Routinely collected data were extracted from electronic medical records. The primary outcome was the incidence of emergency general surgery among patients visiting the emergency department, defined as general surgery within three days of emergency department admission. We also assessed demographic characteristics, mortality, intensive care unit admission and patient disposition. Multivariable log-binomial regression was used to study the associations of age with intensive care unit (ICU) admission, one-year mortality and dependence at discharge. Age was modelled as a continuous variable using restricted cubic splines and we compared older patients (75thpercentile) with younger patients (25thpercentile). Between January 2015 and December 2019, a total of 310,914 emergency department visits met our inclusion criteria. Among them, 3592 patients underwent emergency general surgery within 3 days of emergency department admission, yielding an annual incidence of 116 events per 10,000 emergency department visits (95% CI: 112-119), with a higher incidence in females and young patients. Overall, 5.3% of patients were admitted to ICU, 7.8% were dependent on rehabilitation or assisted living at discharge and 4.8% were dead after one year. Older patients had a higher risk of ICU admission (adjusted risk ratio (aRR) 2.9 [1.5-5.4]), dependence at discharge (aRR 15.3 [5.5-42.4]) and one-year mortality (aRR 5.4 [2.2-13.4]). Emergency department visits resulting in emergency general surgery are frequent, but their incidence decreases with patient age. Mortality, ICU admission and dependence at discharge following emergency general surgery are more frequent in older patients. Taking into account the increased risk for older patients, a shared process is appropriate for making more informed decisions about their options for care.

The Association between Gender, Personal Hygiene Indicators, and Occupancy Density with the Incidence of Pediculosis Capitis at Madrasah Tsanawiyah Pondok Pesantren (Ponpes) Nurus Sunnah Semarang

Background: Pediculosis capitis is one of the neglected tropical diseases (NTDs) caused by Pediculus humanus capitis, an obligate ectoparasite that lives parasitically on human skin. This disease is most common in women, in people with poor personal hygiene, and in densely populated areas. Boarding schools are densely populated and pose a risk for transmission of pediculosis capitis due to the many interactions among residents. Purpose: This study aims to investigate the association between gender, personal hygiene indicators, and occupancy density with the incidence of pediculosis capitis at Madrasah Tsanawiyah Pondok Pesantren Nurus Sunnah Semarang. Methods: In this cross-sectional observational study, all the junior high school students at Ponpes Nurus Sunnah were included in a total of 49 subjects. The data were collected by filling out questionnaires, doing a direct examination of the hair, and counting the measurements of the room area. Data analysis was performed using SPSS 23.0 for Windows. Result: Pediculosis capitis infestation was found among 13 (26.5%) students, with a higher incidence in females (46.4%) than males (0%), in respondents with the habit of combing hair using a personal comb (37.1%), and in non-densely populated areas (58.8%). There was an association between gender (p=0.000), the habit of combing hair using a personal comb (p=0.006), and occupancy density (p=0.000) and the incidence of pediculosis capitis. Conclusion: Gender, the habit of combing hair using a personal comb, and occupancy density are associated with the incidence of pediculosis capitis...

Frequency of Neck Pain and Associated Disability in Medical Students

Background: Musculoskeletal disorders, particularly neck pain, have been increasingly documented among medical students due to their rigorous academic and clinical training demands. The impact of neck pain can lead to significant disability, affecting academic performance and quality of life. Prior studies have demonstrated varying prevalence across different geographies, indicating a need for further localized research. Objective: This study aimed to assess the prevalence of neck pain and its associated disability using the neck disability index among students of Akhtar Saeed Medical College and to compare these findings with global data. Methods: A cross-sectional descriptive study design was employed, involving 150 students from various medical programs. Data collection was conducted via a structured questionnaire including the Neck Pain Disability Index and the Visual Analog Scale for pain intensity. Ethical approval was obtained in line with the Helsinki Declaration. The sample size was determined statistically, and the collected data were analyzed using SPSS version 24.0. Statistical tests including independent t-tests and Chi-square tests were utilized to discern the significance of associations, with a p-value of less than 0.05 considered statistically significant. Results: Participants had an average age of 22.74±2.04 years, with a gender distribution of 58.7% female and 41.3% male. The mean score for neck pain disability was higher in females (21.33±6.45) compared to males (20.76±5.11), albeit non-significantly (p=0.562). The prevalence of neck pain in our sample (58.7%) was higher than in similar cohorts from Brazil (8.23%), Thailand (22.3%), and China (33.8%), yet comparable to Pakistan (44.8%), Australia (52.8%), and Central Saudi Arabia (54%). Approximately 22.7% of students reported neck pain that interfered with their normal activities. Conclusion: Neck pain was found to be prevalent among the medical student population, with a higher incidence in females. The study underscores the association between neck pain and disability, suggesting the need for preventive measures and interventions within the medical academic setting.

Anatomical variations of the atlas arches: prevalence assessment, systematic review and proposition for an updated classification system.

This study focuses on the atlas, a pivotal component of the craniovertebral junction, bridging the cranium and spinal column. Notably, variations in its arches are documented globally, necessitating a thorough assessment and categorization due to their significant implications in clinical, diagnostic, functional, and therapeutic contexts. The primary objective is to ascertain the frequency of these anatomical deviations in the atlas arches among a Colombian cohort using cone-beam computed tomography (CBCT). Employing a descriptive, cross-sectional approach, this research scrutinizes the structural intricacies of the atlas arches in CBCT scans. Analytical parameters included sex distribution and the nature of anatomical deviations as per Currarino's classification. Statistical analyses were conducted to identify significant differences, including descriptive statistics and Chi-square tests. A systematic review of the literature was conducted in order to enhance the current Currarino's classification. The study examined 839 CBCT images, with a nearly equal sex distribution (49.7% female, 50.3% male). Anatomical variations were identified in 26 instances (3%), displaying a higher incidence in females (X2 [(1, N = 839) = 4.0933, p = 0.0430]). The most prevalent variation was Type A (2.5%), followed by Type B (0.4%), and Type G (0.2%) without documenting any other variation. The systematic review yielded 7 studies. A novel classification system for these variations is proposed, considering global prevalence data in the cervical region. The study highlights a statistically significant predominance of Type A variations in the female subset. Given the critical nature of the craniovertebral junction and supporting evidence, it recommends an amendment to Currarino's classification to better reflect these clinical observations. A thorough study of anatomical variations of the upper cervical spine is relevant as they can impact important functional aspects such as mobility as well as stability. Considering the intricate anatomy of this area and the pivotal function of the atlas, accurately categorizing the variations of its arches is crucial for clinical practice. This classification aids in diagnosis, surgical planning, preventing iatrogenic incidents, and designing rehabilitation strategies.

Potential Alzheimer’s early biomarkers in a transgenic rat model and benefits of diazoxide/dibenzoylmethane co-treatment on spatial memory and AD-pathology

Alzheimer’s disease (AD) is the major form of dementia prevalent in older adults and with a high incidence in females. Identification of early biomarkers is essential for preventive intervention to delay its progression. Furthermore, due to its multifactorial nature, a multi-target approach could be therapeutically beneficial. Our studies included 4- (pre-pathology) and 11-month (mild-pathology) TgF344-AD rats, a transgenic Alzheimer’s model that exhibits age-dependent AD progression. We identified two potential early biomarker genes for AD, early growth response 2 (EGR2) and histone 1H2AA (HIST1H2AA), in the hippocampus of 4-month females. Out of 17,168 genes analyzed by RNA sequencing, expression of these two genes was significantly altered in 4-month TgF344-AD rats compared to wild-type littermates. We also evaluated co-treatment with diazoxide (DZ), a potassium channel activator, and dibenzoylmethane (DIB), which inhibits eIF2α-P activity, on TgF344-AD and wild-type rats. DZ/DIB-treatment mitigated spatial memory deficits and buildup of hippocampal Aβ plaques and tau PHF in 11-month TgF344-AD rats but had no effect on wild-type littermates. To our knowledge, this preclinical study is the first to report EGR2 and HIST1H2AA as potential AD biomarkers in females, and the benefits of DZ/DIB-treatment in AD. Evaluations across multiple AD-related models is warranted to corroborate our findings.

567 - Prognostic factors in pediatric patients with vitiligo

Abstract Introduction Vitiligo is a pigmentary disorder, and its prevalence reaches 2.16% in children.(1) Childhood vitiligo differs from adult vitiligo in clinical characteristics such as higher incidence in females, higher prevalence of segmental presentation and lower association with autoimmune disorders. (2) The course of vitiligo is unpredictable, the disease may regress, stabilize, progress and exacerbate. (3) Few studies of the course of vitiligo have been published. Objectives The aim of this study was to identify the clinical characteristics associated with the progression of vitiligo in children and adolescents and also to describe the epidemiological profile in our patients. Methods We analyzed the clinical records of a cohort of pediatric patients with vitiligo attended at Centro Dermatológico Dr. Ladislao de la Pascua in Mexico City. Vitiligo diagnosis was defined clinically and to classify patients with NSV we used the revised classification of the Vitiligo Global Issues Consensus Conference. The outcome was the progression of vitiligo, and it was defined as an increase in the extent of the disease at the last visit of follow-up of the patient. We extracted the following data: age at onset, presence of halo nevus, Koebner phenomenon, familial medical history of vitiligo, presence of autoimmune and thyroid disorders. The Koebner phenomenon was considered if lesions were present in areas of friction or if the parents reported their occurrence at sites of previous trauma. Statistical analysis was performed using software SPSS v.25. To calculate the follow-up time we calculate the number of days between the last visit to the first visit of the participant to the center. We define four states according to the clinical course of vitiligo: stable, partial remission, complete remission and progressión. Stable means that the affected body surface area (BSA) did not change over the time, partial remission that the BSA decreased, complete remission means a BSA equal to zero and progression an increase in the involved BSA. We made a survival analysis using Kaplan Meier curves. Results Of the 679 participants, 50.2% (341) were males and 49.8% (338) females, giving a male-to-female ratio of 1:1. The average age of onset was 8.6 years (SD 4.4 years). Non-segmental vitiligo (NSV) was more common (55.5%) than segmental vitiligo (44.5). Koebner’s phenomenon was observed in 22.5% of patients and halo nevus was diagnosed in 5% of them. Only 4.1% (28) of the patients had family history of vitiligo; 0.9% had thyroid disorders and 0.3% had been diagnosed with an autoimmune disorder. The mean time of follow up was 11 months. The clinical course of the patients was: stable 44.3%, partial remission 38.7%, complete remission 4.9% and progression in 12.1%. The median time to progression of vitiligo was 71 months equivalent to 5.9 years (95%CI 58.72-83.29 months). The mean time to progression for non-segmental vitiligo was 54.94 months vs. 61.94 patients with segmental vitiligo (p=0.087). Time to progression was different in patients with another skin disease 68.37 months vs. 54.53 months (p=0.015). There were no differences in time to progression for the following variables: treatment, age of onset, gender, family history, Koebner phenomenon, halo nevus and autoimmune disorders. Conclusions In our population childhood vitiligo has a slow progression rate and a low prevalence of family history and Koebner's phenomenon compared to other Latin American populations. (4) The ratio of non-segmental to segmental vitiligo and female to male were lower than other countries. (5) Studies with longer follow-up periods are needed to assess progression in vitiligo.

Evaluation of Claw Lesions in Beef Cattle Slaughtered in Northern Portugal: A Preliminary Study

Claw diseases have a profound impact on cattle welfare, affecting behaviors such as grazing, rumination, rest, decubitus, and water consumption. This study aimed to assess the prevalence of claw lesions and classify them according to the ICAR Claw Health Atlas (International Committee of Animal Recording) in two slaughterhouses. The influence of claw lesions on carcass weight, classification, and fat deposition was also examined. Involving 343 crossbreed cattle from 103 different extensive or semi-intensive farms, this study found an animal prevalence of claw disorders at 65.8%, with a higher incidence in females (n = 207, 60.35%) compared to males (n = 136, 39.65%). Despite the observed prevalence, claw lesions were not influenced by age or sex (p &gt; 0.05). The main claw lesions identified, including heel horn erosion, double sole, and asymmetric claw, were consistent with the cattle management practices in the study area. These cattle were raised in small, rustic premises with uneven floors, utilizing a mix of manure and plant material as bedding and lacking access to pasture. Also, no negative economic impact was detected concerning carcass weight, classification, or fat deposition. Consequently, it was concluded that the presence of claw lesions in beef cattle raised under the characteristic management of this geographical area does not adversely affect animal health or farm economics.

Characteristics of Functional Hyperthermia Detected in an Outpatient Clinic for Fever of Unknown Origin

Background: Functional hyperthermia (FH) is characterized by hyperthermia resulting from sympathetic hyperactivity rather than inflammation, and it is frequently overlooked by medical practitioners due to the absence of abnormalities in a medical examination. Although FH is an important differential diagnosis for fever of unknown origin (FUO), the literature on FUO cases in Japan lacks information on FH. In this study, we aimed to uncover the population of FH patients hidden in FUO cases. Methods: An outpatient clinic for FUO was established at Okayama University Hospital, and 132 patients were examined during the period from May 2019 to February 2022. Results: A diagnosis of FH was made in 31.1% of the FUO cases, and FH predominantly affected individuals in their third and fourth decades of life with a higher incidence in females (68.3%). The frequency of a history of psychiatric illness was higher in patients with FH than in patients with other febrile illnesses. Although the C-reactive protein (CRP) is generally negative in FH cases, some obese patients, with a body mass index ≥ 25 had slightly elevated levels of CRP but were diagnosed with FH. Conclusions: The results showed the importance of identifying FH when encountering patients with FUO without any organic etiology.

Differences in the Incidence of Hypotension and Hypertension between Sexes during Non-Cardiac Surgery: A Systematic Review and Meta-Analysis.

Background: Major determinants of blood pressure (BP) include sex and age. In youth, females have lower BP than males, yet in advanced age, more pronounced BP increases result in higher average BPs in females over 65. This hypothesis-generating study explored whether age-related BP divergence impacts the incidence of sex-specific intraoperative hypotension (IOH) or hypertension. Methods: We systematically searched PubMed and Embase databases for studies reporting intraoperative BP in males and females in non-cardiac surgery. We analyzed between-sex differences in the incidence of IOH and intraoperative hypertension (primary endpoint). Results: Among 793 identified studies, 14 were included in this meta-analysis, comprising 1,110,636 patients (56% female). While sex was not associated with IOH overall (females: OR 1.10, 95%CI [0.98-1.23], I2 = 99%), a subset of studies with an average age ≥65 years showed increased exposure to IOH in females (OR 1.17, 95%CI [1.01-1.35], I2 = 94%). One study reported sex-specific differences in intraoperative hypertension, with a higher incidence in females (31% vs. 28%). Conclusions: While sex-specific reporting on intraoperative BP was limited, IOH did not differ between sexes. However, an exploratory subgroup analysis offers the hypothesis that females of advanced age may face an increased risk of IOH, warranting further investigation.