Hyperactivity Syndrome Research Articles

Role of stereotactic radiosurgery for intracranial epidermoid tumors: a systematic review to assess its safety, efficacy, and complication profile.

Even a gross total resection of a benign epidermoid tumor (ET) carries a high risk of recurrence. The management strategy mostly involves redo surgical excision but at a significant cost of morbidity and mortality. The role of adjuvant radiation therapies in this scenario is still undefined. To evaluate the feasibility, safety, efficacy, and complication profile of radiosurgery as a standalone or adjuvant therapy for intracranial epidermoid in the published literature. Following PRISMA guidelines, a comprehensive search of the databases PubMed, Embase, Scopus, and Web of Science in published English language was conducted. We included studies with radiosurgery for benign ET and in patients with malignant transformation of ET (MTET). All studies were evaluated for tumor characteristics, pattern of treatment, dosimetric profile, outcome, and complications. We included all studies with at least one outcome of interest i.e. local control (LC); progression-free survival (PFS); symptomatic toxicity; disease progression; retreatment; and overall survival (OS); and cause-specific mortality. The search revealed 403 articles, of which 6 and 8 studies with patients of benign ET and MTET respectively were included. 25 (65.7%) patients received primary SRS. 27 patients presented with hyperactive cranial nerve syndromes; 77.7% gained complete improvement. The overall median age was 46.7 years (22-67) and the median tumor volume ranged from 0.38 to 6.2cc in benign ET. Volumetric reduction was seen in 6 cases; progression was seen in 2 cases while ET remained stable in the rest. Mean follow-up duration ranged from 33.7to60 months, and no recurrence was reported at thelatest follow-up in any case of benign ET. 9.5% ofpatients suffered from transient cranial nerve deficits with no prolonged adverse radiation effect. OS in theMTET group was 6to60 months following GKRS with 50% ofpatients alive at thelatest follow-up. SRS may be a promising treatment option for a conventionally benign and radioresistant ET making a meaningful change in the natural history of the disease. It is avaluable adjuvant technique in patients with MTET.

Danggui Liuhuang Decoction Ameliorates Endothelial Dysfunction by Inhibiting the JAK2/STAT3 Mediated Inflammation

Ethnopharmacological relevanceVascular endothelial dysfunction (VED) is recognized as a key triggering diabetic vascular complications. Danggui Liuhuang Decoction (DGLHD) has shown potential in mitigating these complications. However, the clinical efficacy of DGLHD in enhancing endothelial function, as well as the molecular mechanisms underlying its alleviation of Type 2 Diabetes-Related Vascular Endothelial Dysfunction (T2DM-VED), remains insufficiently understood. Aim of the studyThis study aims to validate the therapeutic efficacy of DGLHD in ameliorating T2DM-VED through clinical research. Furthermore it seeks to analyze the pharmacodynamic basis and molecular mechanisms of DGLHD, elucidating the biological processes through which DGLHD alleviates VED in type 2 diabetes mellitus (T2DM). Materials and methodsPatients diagnosed with "Yin deficiency with hyperactive fire syndrome", who are at a high risk for atherosclerotic cardiovascular disease (ASCVD) associated with T2DM, were recruited for this study. The effect of DGLHD on vascular endothelial function in T2DM was assessed by measuring the levels of pro-inflammatory factors through enzyme-linked immunosorbent assay (ELISA) and flow-mediated dilation (FMD). The primary components of DGLHD were analyzed using the UHPLC-Q-Exactive Orbitrap system. Potential therapeutic targets of DGLHD were predicted using network pharmacology and molecular docking analysis. To validate the mechanism of DGLHD on T2DM-VED, endothelial injury and inflammation cell models were established using human umbilical vein endothelial cells (HUVECs). A mouse model of diabetic endothelial injury was also developed to observe the effects of DGLHD on pro-inflammatory factors and vascular endothelial factors were observed through immunohistochemistry. Additionally, the effects on the JAK2/STAT3 signaling pathway were observed through Western blot experiments. ResultsDGLHD was found to contain 201 active components. Network pharmacology analysis indicated that the treatment of T2DM-VED with DGLHD is associated with modulation of the JAK2/STAT3 signaling pathway. Molecular docking analysis demonstrated that small molecules in DGLHD interact with JAK2 and STAT3. Our clinical study demonstrated that DGLHD significantly reduces the levels of pro-inflammatory factors and improves FMD readings in diabetic patients, thereby alleviating T2DM-VED. DGLHD was shown to inhibit the phosphorylation of JAK2 and STAT3, which blocks the JAK2/STAT3 signaling pathway transmission, reducing the release of pro-inflammatory and vascular endothelial growth factors, and preventing the inflammatory response in vivo and in vitro. ConclusionThis study demonstrates the potential efficacy of DGLHD in improving endothelial function in T2DM patients at high risk for ASCVD. By inhibiting the JAK2/STAT3 signaling pathway, DGLHD effectively reduces the release of pro-inflammatory factors and vascular endothelial growth factors, alleviating VED.

The Use of Botulinum Toxin Type A and the Occurrence of Anaphylaxis: A Descriptive Analysis of Data from the European Spontaneous Reporting System.

Botulinum toxin type A (BTA) is a protein produced by Clostridium botulinum bacteria. It is the most widely used among botulinum toxin types, and it is recommended for the treatment of many clinical conditions, including muscle hyperactivity syndromes and for esthetic indications too. BTA is generally considered safe, and the most reported adverse events (AEs) include eyelids ptosis, immunogenicity, neuromuscular disorders and hypersensitivity reactions. In addition, serious idiosyncratic AEs, such as anaphylactic shock, have been highlighted. Taking into account that BTA skin toxicity has been already investigated recently by our research group and that, in many cases, the BTA-induced skin toxicity represents a symptom of an hypersensitivity reaction, the aim of the present study was to better characterize cases of anaphylaxis occurring after intramuscular administration of BTA by analyzing Individual Case Safety Reports (ICSRs) sent to the EudraVigilance database. A total of 86 ICSRs, covering 449 Preferred Terms, reporting BTA as suspected drug and "anaphylactic reaction," "anaphylactic shock," "anaphylactoid reaction" or "anaphylactoid shock" as ADR were suitable for our analysis. The majority of patients who experienced BTA-induced anaphylaxis were female (89.5%) and mostly belonged to the age group 18-64years. The most common outcome was "recovered/resolved," while the seriousness criteria was mostly reported as "caused/prolonged hospitalization." Our results showed that anaphylactic reactions may occur after esthetic use of BTA; thus, a close monitoring before, during and after BTA intramuscular injection is highly recommended in order to prevent the occurrence of this event and ensure an appropriate management of the patients receiving this drug. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Tackling Neuroinflammation in Cognitive Disorders with Single-targeted and Multi-targeted Histamine H3 Receptor Modulators.

Neuroinflammation is a process involved in a variety of central nervous system (CNS) diseases and is being increasingly recognized as a key mediator of cognitive impairments. Neuroinflammatory responses including glial activation, increased production of proinflammatory cytokines, and aberrant neuronal signaling, contribute to cognitive dysfunctions. Histamine is a key peripheral inflammatory mediator, but plays an important role in neuroinflammatory processes as well. The unique localization of histamine H3 receptor (H3R) in the CNS along with the modulation of the release of other neurotransmitters via its action on heteroreceptors on non-histaminergic neurons have led to the development of several H3R ligands for various brain diseases. H3R antagonists/ inverse agonists have revealed potential to treat diverse neuroinflammatory CNS disorders, including neurodegenerative diseases, attention-deficit hyperactivity syndrome and schizophrenia. In this mini review, we provide a brief overview on the crucial involvement of the histaminergic transmission in the neuroinflammatory processes underlying these cognitive disorders, with a special focus on H3R involvement. The anti-neuroinflammatory potential of single-targeted and multi-targeted H3R antagonists/inverse agonists for the treatment of these conditions is discussed here.

Heart Rate Variability and Cerebral Autoregulation in Patients with Traumatic Brain Injury with Paroxysmal Sympathetic Hyperactivity Syndrome.

Severe traumatic brain injury (TBI) can lead to transient changes in autonomic nervous system (ANS) functioning and development of paroxysmal sympathetic hyperactivity (PSH) syndrome. Clinical manifestation of ANS disorders may be obscured by therapeutic interventions in TBI. This study aims to analyze ANS metrics and cerebral autoregulation in patients with PSH syndrome to determine their significance in early prognostication. This single-center retrospective study investigated the relationship between changes in ANS metrics, cerebral autoregulation, and PSH syndrome. Arterial blood pressure and intracranial pressure signals were monitored for 5 days post TBI. ANS metrics included time and frequency domain heart rate variability (HRV) metrics. Cerebral autoregulation was assessed using the pressure reactivity index. Sixty-six patients with severe TBI (median age 33 [interquartile range 26-50] years) were analyzed, and PSH was confirmed in nine cases. Impairment of cerebral autoregulation was observed in 67% of patients with PSH and 72% without the syndrome. Patients with PSH had higher HRV in the low-frequency range (LF; 253 ± 178 vs. 176 ± 227 ms2; p = 0.035) and lower heart rates (HRs; 70 ± 7 vs. 78 ± 19 bpm; p = 0.027) compared to those without PSH. A receiver operating characteristic curve analysis indicated that HR (area under the curve(AUC) = 0.73, p = 0.006) and HRV in the LF (AUC = 0.70, p = 0.009) are moderate predictors of PSH. In the multiple logistic regression model for PSH, diffuse axonal trauma (odds ratio(OR) = 10.82, 95% confidence interval(CI) = 1.70-68.98, p = 0.012) and HR (OR =0.91, 95% CI 0.84-0.98, p = 0.021) were significant factors. Elevated HRV in the LF and decreased HR may serve as early predictors of PSH syndrome development, particularly in patients with diffuse axonal trauma. Further research is needed to investigate the utility of the cerebral autoregulation-ANS relationship in PSH prognostication.

Paroxysmal sympathetic hyperactivity syndrome after recurrent stroke: A case report

Paroxysmal sympathetic hyperactivity (PSH) is a state of autonomic dysfunction characterized by symptoms such as tachypnea, tachycardia, hypertension, hyperthermia, sweating, and dystonia. It can occur after traumatic brain injury, hypoxic-ischemic encephalopathy, and diseases such as stroke. Hypoxia, extensive axonal damage, and young age are believed to predispose to the development of PSH. These patients may be diagnosed with pulmonary embolism, septicemia, or epileptic seizures. Delays in diagnosis prolong hospital stay. Here, we present an 81-year-old man who developed PSH after a recurrent stroke and our management.

Paroxysmal Sympathetic Hyperactivity Syndrome in the Setting of Fat Emboli Syndrome Secondary to Polytrauma

Paroxysmal sympathetic hyperactivity (PSH) syndrome is a potentially life-threatening complication after traumatic brain injuries that results from a massive release of catecholamines in the brain. Fat embolism syndrome (FES) is a complication of long bone fractures that results in cerebral or pulmonary fat emboli. We describe PSH in the setting of cerebral FES in an adolescent female following polytrauma secondary to a motor vehicle collision to highlight the importance of rapid diagnosis and treatment of this rare complication.

Medication rules of Chinese herbs in treatment of H-type hypertension based on data mining

Based on the R language data mining technology, the medication rules of traditional Chinese medicine(TCM) in the treatment of H-type hypertension were discussed, and the basis and new ideas for the treatment of H-type hypertension with TCM were provided. CNKI, Wanfang, VIP, and SinoMed were searched to collect clinical studies on the treatment of H-type hypertension with TCM. The data were screened, and Excel was used to build a database. Rstudio was used to carry out drug efficacy classification, four Qi and five flavors, meridian homing, frequency of use, correlation, association rules, and clustering analyses of drugs and explore the medication rules of TCM. 191 TCM prescriptions were obtained, and the main syndromes were phlegm-dampness accumulation syndrome, phlegm and blood stasis syndrome, and Yin deficiency and Yang hyperactivity syndrome. A total of 169 kinds of TCM were used, and the frequency was 1 875 times. Among them, the drugs whose single use frequency was more than 20 times were high-frequency medicines, 26 kinds in total. They were Gestrodiae Rhizoma, Poria, Pinelliae Rhizoma, Achyranthis Bidenthis Radix, Glycyrrhizae Radix et Rhizoma, etc. The efficacy of high-frequency medicines was mainly classified as tonic medicines, blood-activating and stasis-removing medicines, liver-relieving wind medicines, and damp-clearing medicines. The four Qi of the drug were mainly warm and flat, and the five flavors were mainly sweet and bitter. The liver meridian and spleen meridian were the main meridians. The association rule analysis obtained a total of 14 groups of commonly used drug combinations, and the correlation analysis obtained 20 drug combinations with a high correlation coefficient. A total of six drug combinations were obtained by cluster analysis. Eight groups of drug pairs were obtained by association rule analysis on H-type hypertension with phlegm-dampness accumulation syndrome. Seven drug combinations with high correlation coefficients were obtained by correlation analysis, and three drug prescriptions were obtained by cluster analysis. The pathological factors of H-type hypertension are mainly phlegm, stasis, and deficiency. The disease site is in the liver, involving the spleen, lungs, and other viscera. The commonly used drugs are Gestrodiae Rhizoma, Poria, Pinelliae Rhizoma, Achyranthis Bidenthis Radix, etc. Banxia Baizhu Tianma Decoction, Tianma Gouteng Decoction, and Buyang Huanwu Decoction are commonly used prescriptions. The medication rules shown in this study can provide certain ideas for the clinical treatment of H-type hypertension with TCM.

Mechanism and functional substances of Saiga antelope horn in treating hypertension with liver-yang hyperactivity syndrome explored using network pharmacology and metabolomics

Ethnopharmacological relevanceSaiga antelope horn (SAH) is a traditional Chinese medicine for treating hypertension with liver-yang hyperactivity syndrome (Gan-Yang-Shang-Kang, GYSK), that has a long history of clinical application and precise efficacy, but its mechanism and functional substances are still unknown. Based on the demand for alternative research on the rare and endangered SAH, the group designed and carried out the following studies. Aim of the studyThe purpose of this research was to demonstrate the functional substances and mechanisms of SAH in the treatment of GYSK hypertension. Materials and methodsThe GYSK-SHR model was constructed by administering a decoction of aconite to spontaneously hypertensive rats (SHRs). Blood pressure (BP), behavioural tests related to GYSK, and pathological changes in the kidneys, heart and aorta were measured to investigate the effects of SAH on GYSK-SHRs. Proteomic analysis was used to identify the keratins and peptides of SAH. Moreover, network pharmacology and plasma metabolomics studies were carried out to reveal the mechanisms by which functional peptides in SAH regulate GYSK-hypertension. ResultsSAH has a significant antihypertensive effect on GYSK hypertensive animals. It has also been proven to be effective in protecting the function and structural integrity of the kidneys, heart and aorta. Moreover, SAH improved the abnormalities of 31 plasma biomarkers in rats. By constructing a “biomarker-target-peptide” network, 10 functional peptides and two key targets were screened for antihypertensive effects of SAH. The results indicated that SAH may exert a therapeutic effect by re-establishing the imbalance of renin-angiotensin (RAS) system. ConclusionsFunctional peptides from keratin contained in SAH are the main material basis for the treatment of GYSK-hypertension and exhibited the protective effect on the GYSK-SHR model through the RAS system.

Protective Effect of Prunella vulgaris L. Whole Plant or Spicas Water Extracts on Hyperthyroidism with Liver-yang Hyperactivity Syndrome

Background: Prunella vulgaris L. (Lamiaceae) is a perennial medicinal plant commonly used to treat thyroid dysfunction, infectious hepatitis, and mastitis in north-east Asia and Europe. In China, there has been a historical change in the medicinal use of P. vulgaris from the use of whole plants to the use of the spicas. Purpose: This study aimed to evaluate the protective effects of whole plant P. vulgaris water extracts and spicas on hyperthyroidism with liver-yang hyperactivity syndrome and to preliminarily explain the mechanism of action of these water extracts. Methods: Rats were induced with aconite decoction and levothyroxine and treated with P. vulgaris whole plant and spicas water extract for 28 days at the same time. Body weight, food intake, and rectal temperature were monitored. The serum thyroid function indicators thyroid stimulating hormone (TSH), thyroid hormone-free triiodothyronine (FT3) and free thyroxine (FT4), liver function index alanine aminotransferase (ALT) and aspartate aminotransferase (AST), oxidative damage index malondialdehyde (MDA), and superoxide dismutase (SOD) were detected. Liver and thyroid tissues were taken for sectioning and observation. The liver inflammatory factors human tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were detected by immunohistochemistry, and the expression levels of the apoptotic proteins caspase-3 and B-cell lymphoma-2 (Bcl-2) were detected. Results: Both P. vulgaris whole plant and spica water extract groups exhibited markedly reduced FT3 and FT4 contents, increased the TSH content, and decreased ALT and AST activities. Furthermore, these agents improve thyroid and liver lesion tissue; reduce MDA content; increase SOD activity; reduce IL-6, TNF-α, and caspase-3 expression; and increase Bcl-2 expression. Conclusion: The whole plant and spicas water extracts of P. vulgaris have obvious protective effects on hyperthyroidism and hyperactivity in liver yang, and the protective effect of the water extract of spicas is greater than that of the whole plant water extract.

Clinical experience of Tianxiong Granules in treatment of hypertension based on treatment principle of supressing Yang and promoting blood circulation

Hypertension is the most common chronic disease in clinics and has become the most common risk factor for cardiovascular diseases. Because of its high incidence rate, disability rate, and mortality, it has attracted worldwide attention. Despite continuous progress in modern medicine in the treatment of hypertension with new antihypertensive drugs such as Zilebesiran, a nucleic acid drug that acts on microRNA, direct renin inhibitors, and renal sympathetic blockade, the control rate is still not ideal. How to effectively prevent and control hypertension has become one of the urgent clinical challenges to be solved. Traditional Chinese medicine(TCM) has a long record of treating hypertension and has accumulated rich experience, including theoretical understanding, effective single medicine, compound medicine, traditional Chinese patent medicines, and classic famous prescriptions. In TCM, hypertension belongs to the categories of diseases such as dizziness and headache. Previous literature and clinical studies have found that hypertension has key pathogenesis such as fire syndrome, fluid syndrome, deficiency syndrome, and blood stasis syndrome. Among them, the hyperactivity of liver Yang is closely related to blood pressure fluctuations, blood pressure variability, inflammation, and sympathetic activity stimulation. Internal obstruction by blood stasis is closely related to the damage of target organs such as the heart, brain, and kidneys in hypertension. Therefore, the two key pathogenesis of liver yang hyperactivity and internal obstruction by blood stasis run through the entire process of hypertension. Previous studies have found that the effective empirical formula Tianxiong Granules, based on the principles of suppressing Yang and promoting blood circulation, originated from the classic formula Xiongqiong Tianma Pills in Yu Yao Yuan Fang. It is composed of Gastrodiae Rhizoma, Chuanxiong Rhizoma, Puerariae Lobatae Radix, Achyranthis Bidentatae Radix, and Cyathulae Radix and has significant therapeutic effects in the treatment of hypertension. The clinical indications include headache, dizziness, bloating, strong neck, and weak waist and legs. At the same time, it may be accompanied by poor speech, thirst, normal or loose stools, soreness in the waist and legs, lower limb pain, muscle and pulse spasm, menstrual and abdominal pain, dark red tongue, strong pulse strings, or straight and long pulse strings that pass through the mouth of an inch. In the combination rule, it can be used according to the different pathogenesis stages of hypertension patients. In the fire syndrome stage, it is often combined with Tianma Gouteng Decoction and Chaihu Jia Longgu Muli Decoction. In the fluid syndrome stage, it is often combined with Banxia Baizhu Tianma Decoction. In the deficiency syndrome stage, it is often combined with Liuwei Dihuang Pills and Shenqi Pills. In terms of dosage, it is important to focus on the main symptoms and adjust the dosage of key drugs based on blood pressure values. Some drugs can be used in sufficient quantities. By analyzing the compatibility of Tianxiong Granules, clinical application indications, combined formula experience, and dosage application experience, we provide effective treatment methods and more options for TCM to treat hypertension with Yang hyperactivity and blood stasis syndrome.

UNDERSTANDING THE EMOTIONAL IMPACT OF ADHD IN PRIMARY SCHOOL STUDENTS

Today, a remarkable place in society is occupied by children who need special conditions of education and their inclusion in schools, which determines the peculiarities of the organization of education. In all historical eras, the development system of special education has been connected with the socio-economic structure of the country, the state's value system and society, and the state's policy towards children who have developmental problems.
 The article highlights children with special educational needs, especially children with attention deficit and hyperactive behavior syndrome. Children with attention deficit and hyperactivity disorder are included in the inclusive education system, and the organization of their educational activities, their inclusion in schools is considered an important and primary issue. To organize the effective teaching of hyperactive children, it is necessary to study the features of the emotional sphere of these children, which will make it possible to identify their strengths, highlight their problems, and accordingly organize their education more effectively, as well as interpersonal interactions with classmates in public schools. At present, the syndrome of attention deficit and hyperactivity is the subject of study of many psychologists, because the features of the emotional sphere of these children are not so well studied.

Professor Qiao Shuzhen's Medication Experience in the Treatment of Vertigo with Liver-Yang Hyperactivity Syndrome

Professor Qiao Shuzhen's Medication Experience in the Treatment of Vertigo with Liver-Yang Hyperactivity Syndrome

A digital solution for determining the severity of paroxysmal sympathetic hyperactivity syndrome in patients with brain injury

Paroxysmal sympathetic hyperactivity syndrome is a frequent complication of acute severe brain injury, so with severe traumatic brain injury, it develops in 30 % of patients. Despite a large number of publications, the issues of diagnosis, prevention and treatment of this syndrome remain unresolved. To date, the assessment of the syndrome of paroxysmal sympathetic hyperactivity takes, with proper training of the doctor, from 8 to 15 minutes, taking into account the calculation of points using a calculator. With the digitalization of this process, a single assessment will take about 2–3 minutes to enter the indicators. In this case, the calculation will occur automatically. Subsequently, when using «wearable gadgets for measurement», the process of filling in indicators can also occur automatically. The application allows to register and store basic data about users who can have three roles: patients, specialist doctors, administrators. The creation of a database of patients with sympathetic hyperactivity syndrome will significantly improve diagnostic methods and assess the adequacy of therapy. Medical data is only useful if it can be turned into meaningful information. This requires high-quality data sets, uninterrupted communication between IT systems, and standard data formats that can be processed by humans and machines.

Nano-level assay of attention-deficit/hyperactivity disorder medicament, atomoxetine by molecular-size-based resonance rayleigh scattering strategy. Employment in content uniformity, dosage form, and plasma analysis

The psychoanaleptic medication atomoxetine (ATX) is prescribed to cure attention-deficit hyperactivity syndrome. ATX works by selective prevention of norepinephrine reuptake. It acts by raising the brain’s natural level of norepinephrine, which is necessary for behavior regulation. In this study, a sensitive and practical experimental method was employed to analyze the presence of ATX. The approach utilized a green chemistry-compatible technique, known as a one-pot experiment. The main principle behind this method was the use of molecular-size-dependant resonance Rayleigh scattering (RRS) phenomenon, which occurred due to the interaction between the dual complex of Cilefa Pink B and ATX. When ATX medication and Cilefa Pink B were combined in an acidic environment, they formed an association complex, leading to an amplification of the RRS signal. This amplification directly correlated with the concentration of ATX, specifically within the range of 40-1250 ng/mL. The RRS signal was monitored at a wavelength of 352 nm. The sensitivity of the method was demonstrated by the determination of the limit of detection (LOD) at 12.9 ng/mL and the limit of quantitation (LOQ) at 39.2 ng/mL. The variables of the method were thoroughly investigated and optimized. To ensure the reliability of the method, it was validated according to the International Council for Harmonisation (ICH) guidelines. Furthermore, the method was successfully applied to analyze ATX in its prescribed dosage form. The achievement of using the established resonance Rayleigh scattering (RRS) technology to analyze the target drug in plasma and ensure content uniformity was a remarkable feat.

Skin Toxicities Associated with Botulin Toxin Injection for Aesthetic Procedures: Data from the European Spontaneous Reporting System.

Botulinum toxin is a protein deriving from the bacteria Clostridium botulinum and it is widely used for the treatment of a variety of muscle hyperactivity syndromes and for cosmetic indications. Having a long-lasting effect, Botulinum toxin type A (BTA) is one of the most botulin toxin products used. Even if BTA has shown benefits in reducing the vertical lines between the eyebrows, Adverse Drug Reactions (ADRs) have been experienced as well, of which the most common ones are headache and drooping eyelids. In addition, since other local and systemic risks have been identified, a non-interventional post-authorization safety study (PASS) has been started. The aim of the present study was to report cases of skin toxicity associated with this drug, considering Individual Case Safety Reports (ICSRs) existing on the Eudravigilance website. Among 1464 ICSRs sent to the EV database, 718 ICSRs, including 5154 PTs, reported BTA as a suspected drug associated with cutaneous toxicity. The majority of patients experiencing BTA-induced skin toxicity were female (92.1%) belonging mostly to the age group of 18-64 years. The most serious criteria, when reported, were "Other Medically Important Condition" and "Caused/prolonged hospitalization", although the outcome was mainly reported as "Unknown". The most reported PTs, related to skin disorders, were: "Erythema", "Rash", "Pruritus", "Urticaria", "Swelling face", "Brow ptosis", "Eyelid ptosis", "Injection site pain", and "Angioedema". Considering that in most ICSRs, ADRs related to skin disorders were symptoms of hypersensitivity reactions which in some conditions could be life-threatening, further studies are required to better define the safety profile of BTA used for aesthetic procedures.

Coherent analysis in electroencephalography. Experience in the use of coherent analysis in the assessment of disorders of human mental functions in practical electroencephalography. (Lecture three)

It is discussed what actually useful coherent analysis can give in solving the problem of assessing the system- functional organization of cortical rhythms, which underlies the clinical interpretation of quantitative indicators of intracerebral connections. The authors emphasized. That in the basis of the assessment of disorders of the mental function of the brain according to EEG data, one should look for signs of dissociation of the level of wakefulness in non-sleeping people. It is necessary to look for features of the electroencephalographic picture, which can be considered as neurophysiological neurotic patterns and, most importantly, an assessment of the state of the systemic- functional organization of the cortical rhythm, interpreted as a state of hypofrontality. The authors took the path of visual illustration using examples of specific patients with various pathological states of brain function. The features of changes in coherence indices in patients with hyperactivity syndrome, in violation of the function of attention, with mental retardation, in vegetative- vascular dystonia are given. The authors cite the observation of a child with sensorineural hearing loss from birth and connect the fact of a decrease in the level of intertemporal relations, not with the underlying disease, but with the lack of oral speech skills. The paper emphasizes that hypersynchronization of the alpha rhythm is quite pathognomonic to the state of increased anxiety. The authors explain in detail under what states of mental dysfunction the values of the average coherence are more informative, and in which the values of the dominant frequency. In conclusion, the authors complain about the unsatisfactory software capabilities of mathematical processing in some EEG computer systems, so neurophysiologists have unequal opportunities.

CHALLENGES IN DIFFERENTIAL DIAGNOSIS OF COELIAC DISEASE AND GLUTEN INTOLERANCE IN CHILDREN

CHALLENGES IN DIFFERENTIAL DIAGNOSIS OF COELIAC DISEASE AND GLUTEN INTOLERANCE IN CHILDREN

Hyperkinetic disorder and attention deficiency and hyperactivity syndrome in adults

Introduction. Hyperkinetic disorder (HR) and attention-deficit/hyperactivity disorder (ADHD) are traditionally regarded as a pathology of childhood, but the frequency of its detection among the adult population is high. GR and ADHD has a significant impact on professional, educational activities and social and domestic relationships.The purpose of the work was to systematize the current data in the field of research on hyperkinetic disorder and attention deficit hyperactivity disorder in adults.Materials and methods Full-text publications of metaanalyses from 2017 to 2022 were searched in the PubMed electronic search engine for full-text keyword matches. The criterion for not including a publication in this review was a study conducted on a sample of individuals under 18 years of age. A total of 154 unique references were checked, of which 70 articles were included in the review.Results and discussion. ADHD is a polyethiological disorder. ADHD symptoms can be associated with other pathological conditions, which can influence the pathogenetic and clinical picture. A number of authors consider ADHD symptoms in terms of adaptation to the modern information environment. Positive aspects of ADHD are pointed out: the ability to be creative, the ability to find non-standard, original solutions, an increased capacity for empathy. In a number of modern works, persons with ADHD have an increased ability to “hyperfocus” on activities relevant to the individual, although not all researchers adhere to this opinion.Conclusion. The clinical essence of ADHD is its dysontogenetic nature. The range of etiological factors, both external and internal, that can lead to the development of ADHD symptoms is quite wide, and the likelihood of comorbid conditions is extremely high. Not all of the classifications and diagnostic criteria aimed at identifying ADHD symptoms in individuals under 18 years of age can be applied to adult patients, which shifts the epidemiological indicators toward a reduction of the disorder in the adult population.

A novel spectrophotometric approach relies on a charge transfer complex between atomoxetine with quinone-based π-acceptor. Application to content uniformity test

Atomoxetine (ATO) belongs to psychoanaleptic drugs and is utilized in attention-deficit hyperactivity syndrome treatment. In this study, two facile and selective approaches are implemented for the spectrophotometric analysis of atomoxetine. The two approaches rely on charge transfer formed between ATO base (n-donor) with p-chloranil and 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ; π-acceptor). The generated complexes exhibit absorption intensity maxima at 550 and 460 nm in acetonitrile for p-chloranil and DDQ in the order. Under the optimum reaction condition, Beer’s law was followed for p-chloranil and DDQ at concentrations of 30–320 and 10–80 µg mL− 1, respectively. The ICH guidelines were followed for work validation, and the outcomes were excellent and satisfactory. The assessment of ATO in pharmaceutical capsules using the suggested procedures was successful, and the results were contrasted with those obtained using a different published method to show accuracy and precision. Additionally, the two methods were used to assess the homogeneity of ATO content in the commercialized capsule.