Incidence Of Syndrome Research Articles

Association of Sleep Disturbances With Prevalent and Incident Motoric Cognitive Risk Syndrome in Community-Residing Older Adults.

There is growing evidence that sleep disturbances are associated with cognitive impairment risk, but their association with the incidence of motoric cognitive risk syndrome (MCR)-a predementia syndrome characterized by slow gait speed and cognitive complaints-is unknown. We aimed to examine the association of sleep disturbances, overall and specific subtypes, with (1) incident and (2) prevalent MCR in older adults. Community-residing adults aged 65 years and older without dementia were recruited from population lists and included in Central Control of Mobility and Aging, a prospective cohort study, in Albert Einstein College of Medicine, Bronx, NY. We included participants with available data for MCR and Pittsburgh Sleep Quality Index (PSQI). MCR was defined as cognitive complaints reported on standardized questionnaires and slow gait speed as recorded on an electronic treadmill and was adjudicated at baseline and annual follow-up visits. Participants were divided into "good" sleepers (≤5) and "poor" sleepers (>5) based on an established PSQI cut score. Among participants without MCR at baseline, Cox proportional hazard models adjusted for (1) age, sex, and education and (2) further for comorbidity index, Geriatric Depression Scale score, and global cognitive score were used to examine the association of baseline sleep disturbances with MCR incidence. Association between poor sleep quality and prevalent MCR at baseline in the overall population was explored using multivariate logistic regression analysis. 445 participants were included (56.9% women, mean age: 75.9 years [75.3; 76.5]). In MCR-free participants at baseline (n = 403), 36 developed incident MCR over a mean follow-up of 2.9 years. Poor sleepers had a higher risk of incident MCR (HR = 2.7 [1.2; 5.2]) compared with good sleepers, but this association was not significant after adjustment for depressive symptoms (adjusted hazard ratio [aHR] = 1.6 [0.7-3.4]). Among the 7 PSQI components, only sleep-related daytime dysfunction (excessive sleepiness and lower enthusiasm) showed a significant risk of MCR in fully adjusted models (aHR = 3.3 [1.5-7.4]). Prevalent MCR was not associated with poor sleep quality (OR [95% CI] = 1.1 [0.5-2.3]). Overall poor sleep quality was associated with incident MCR, but not with prevalent MCR. Specifically, older adults with sleep-related daytime dysfunction are at increased risk of developing MCR. Further studies are needed to validate mechanisms of this relationship.

Quantitative Analysis of the Carpal Tunnel and Its Inner Structures in Primates.

To explore the anatomical factors potentially involved in the high incidence of carpal tunnel syndrome in humans, we have quantified the anatomical variations of the carpal tunnel and its inner structures in humans, non-hominoid primates (monkeys), and hominoid primates (apes). In specimens of six humans, eight monkeys, and three apes, we assessed the size of the carpal tunnel, the tendons of the digit flexor muscles, and the median nerve. We compared the size of the carpal tunnel normalized by the wrist size, and the size of the median nerve and the tendons of the digit flexors normalized by the size of the carpal tunnel. Differences between humans and monkeys were calculated using the T test or Mann-Whitney U test, as appropriate. Data on the apes were not included in the statistical analyses due to the small sample size. The normalized size of the carpal tunnel was similar in all specimens. The normalized size of the tendons of the digit flexors was smaller in humans, while that of the median nerve was significantly larger. The median nerve was also larger in apes than in monkeys. The relatively larger median nerve observed in humans could suggest a greater vulnerability of the nerve to compression, which could predispose humans to carpal tunnel syndrome. However, the tendons of the digit flexor muscles were smaller in humans, and moreover, the proportional size of the median nerve was similar in apes, leading us to suggest that the factors predisposing humans to carpal tunnel syndrome must be sought beyond anatomical features and may be more closely related to functional or personal parameters.

The impact of sleep deprivation on the occurrence of acute coronary syndrome depending on obesity status

Objective: To determine how sleep insufficiency affects the occurrence of acute coronary syndrome in the presence of obesity. Method: The observational study was conducted in South Korea on the basis of data collected by a cohort study conducted from January 2001 to December 2020, and comprised adults of either gender aged 40-69 years. During the 20-year period, 9 follow-up surveys were conducted at two-year intervals. Those with sleep <7 hours were in the insufficient sleep group A, and those with >7 hours of sleep were in the sufficient sleep group B. The main exposure variable was sleeping insufficiency, and the dependent variable was the occurrence of acute coronary syndrome. The hazard ratio between sleep insufficiency and obesity was identified, and the risk with respect to obesity was worked out. Finally, the joint effect of sleep insufficiency and obesity on the occurrence of acute coronary syndrome was determined. Data was analysed using SAS 9.4. Results: Of the 3,698 subjects, 2,411(65.2%) were in group A; 1,234(51.2%) females and 1,177(48.8%) males with mean age 50.4+/-7.55 years, and 1,287(34.8%) subjects were in group B; 747(58%) males and 540(42%) females with mean age 50.4+/-7.41 years. There were 1,637(44.3%) obese subjects; in group A 1,097(45.5%) and in group B 540(42%). Overall, 127(3.4%) subjects developed acute coronary syndrome; in group A 85(3.5%) and in group B 42(3.3%). Incidence of acute coronary syndrome was no significantly associated with sleep sufficiency and obesity status (p>0.05). The risk of developing acute coronary syndrome was significantly higher in obese individuals having sleep insufficiency compared to non-obese individuals without sleep insufficiency (hazard ratio: 1.54, 95% confidence interval: 1.03-2.62). Conclusion: There was a significant combined effect of obesity and sleep insufficiency on the occurrence of acute coronary syndrome. Key Words: Acute coronary syndrome, Obesity, Sleep insufficiency.

Effects of Fermented Kimchi Consumption on Anthropometric and Blood Cardiometabolic Indicators: A Systematic Review and Meta-Analysis of Intervention Studies and Prospective Cohort Studies.

Increasing global kimchi consumption has prompted interest in its health impact. However, comprehensive reviews of the influence of kimchi on cardiometabolic risk factors, especially meta-analyses, remain limited. This review assessed the impact of fermented kimchi consumption on cardiometabolic risk factors by systematically reviewing human intervention and prospective cohort studies, and conducting a meta-analysis of intervention studies. A literature search of PubMed, EMBASE, Scopus, Web of Science, RISS, KISS, and ScienceON databases was conducted through April 30, 2024. The inclusion criteria encompassed studies that examined the effects of fermented kimchi, without any added ingredients or lactic acid bacteria, on health outcomes, including anthropometric measures, blood pressure, cardiometabolic and glycemic indicators, inflammatory cytokines, and the incidence of related chronic diseases. Data extraction and quality evaluation were conducted independently by 3 researchers. Pooled effect sizes were calculated as weighted mean differences (WMDs) with 95% CIs employing random-effects models. Five intervention studies (205 participants) and 4 prospective cohort studies (42 455 participants) were selected. A meta-analysis of the intervention studies revealed a significant reduction in fasting blood glucose (WMD: -1.93 mg/dL; 95% CI: -3.82, -0.03; I2 = 17.4%) following the consumption of fermented kimchi. After excluding studies that contributed to increased heterogeneity, significant inverse associations were observed between fermented kimchi consumption and triglycerides (WMD: -28.9 mg/dL; 95% CI: -53.2, -4.5; I2 = 0.0%), systolic blood pressure (WMD: -3.48 mmHg; 95% CI: -5.95, -1.01, I2 = 0.0%), and diastolic blood pressure (WMD: -2.68 mmHg; 95% CI: -4.75, -0.62; I2 = 0.0%). Prospective cohort studies linked higher kimchi intake with a lower incidence of cancer and metabolic syndrome and an increased likelihood of achieving normal body weight. This review supports beneficial effects of fermented kimchi on cardiometabolic health. However, due to the limited number of studies, these findings should be interpreted cautiously, highlighting the need for further research in diverse populations. PROSPERO registration No. CRD42024532020.

Prevalence of Burnout Syndrome Among Medical Students

Background: The mental health of medical students is a matter of concern due to the heavy study load that begins with the bachelor’s degree program, progresses through the professional phase, and continues into the internship period. Approximately 49% of medical students in the USA and between 28%-61% in Australia experience burnout. Potential factors such as responsibilities for completing assignments, parental expectations, efforts to maintain grades, and academic competition can lead to burnout syndrome. If individuals are unable to adapt to and manage prolonged stress, it can result in maladaptive behavior.Aims: The purpose of this research was to assess the prevalence and severity of burnout syndrome among medical students at the University of Muhammadiyah Semarang.Methods: A descriptive analysis was conducted using primary data collected through the Maslach Burnout Syndrome Inventory. A total sampling technique was used with respondents from the medical professional study program during the 2022-2023 academic year. Those with psychiatric disorders, consuming sedatives, or absent during the study period were excluded.Results: Out of 135 participants, the incidence of burnout syndrome showed that 77.0% experienced low emotional exhaustion, 11.9% moderate, and 11.1% high. Depersonalization cases were 80.7% low, 9.6% moderate, and 9.6% high. Personal accomplishment was reported as 37.0% low, 17.0% moderate, and 45.9% high.Conclusion: The incidence of burnout syndrome among the respondents predominantly featured low in emotional exhaustion and depersonalization, and high personal achievement. Keywords: burnout syndrome, depersonalization, emotional exhaustion, medical student, personal accomplishment

Hubungan Antara Sindrom Nefrotik Resisten Steroid Dengan Gangguan Pertumbuhan Pada Anak

Background: The incidence of nephrotic syndrome is increasing and has been reported to be the second most common disease found in pediatric nephrology. Most children with nephrotic syndrome tend to be picky eaters and have poor appetite due to malabsorption due to intestinal edema and abdominal pain, combined with enteropathic protein loss which can further impair nutrition. In addition, corticosteroid treatment in patients with nephrotic syndrome also has an important role in growth disorders in children that can have a long-term effect and reduce their quality of life if not detected and not intervened early. Aims : to identify the association between steroid-sensitive nephrotic syndrome and growth retardation in children Methods: This study used a cross-sectional study. The calculation of the sample size used the unpaired categorical analytic formula and purposive sampling method in taking the sample size. The research subjects in this study was 50 patients with nephrotic syndrome. Data analysis was performed using non-parametric statistics testing, Chi-square. Results: The results of the Chi Square test showed a significant value or p value = 0.248 (p> 0.05, so it can be concluded that there is no relationship between steroid-resistant nephrotic syndrome (SNRS) and growth retardation in children. Odds Ratio in this study is 1.962. Conclusion: There is no significant association between steroid resistant nephrotic syndrome and growth disorders in children. Keywords: Nephrotic Syndrome, Growth Retardation

Curation and reporting of pathogenic genome-wide copy-number variants in a prenatal cell-free DNA screen.

Advances in fetal fraction amplification in prenatal cell-free DNA screening now allow for high-resolution detection of copy-number variants (CNVs). However, approaches to interpreting CNVs as part of a primary screen are still evolving and require consensus. Here, we present a conservative, patient-centered framework for reporting fetal CNVs. Syndromes described in the literature were evaluated for inclusion based on a definable minimal critical region, disease severity, penetrance, and age of onset. The reporting framework required that a CNV overlap a defined minimal critical region and/or that it be ≥5 Mb and contain at least 1 OMIM disease-associated gene. This framework was then applied to CNVs identified from a cohort of 313,544 prenatal cfDNA screening patient samples. Patient-friendly terminology describing syndrome phenotypes was developed by scientists with training in genetic counseling. 65 syndromes met criteria for inclusion and represented the second most common class of CNVs in a retrospective cohort, more so than an established panel of microdeletions (1p36, 4p, 5p, 15q11.2-q13, and 22q11.2). Frequencies were concordant with reported syndrome incidence rates. The most common CNVs were those ≥5 Mb encompassing an OMIM disease gene(s). This framework for genome-wide fetal-CNV reporting carefully prioritizes findings with the potential to affect reproductive decision making.

Incidence of post-intensive care syndrome among patients admitted to post-ICU multidisciplinary consultations: the retrospective observational PICS-MIR study

To determine the prevalence of functional, respiratory and renal impairments and of post-intensive-care-syndrome (PICS) among patients who had attended a post-ICU multidisciplinary consultation (post-ICU-MC) around 3 months after ICU discharge, we performed a retrospective, monocentric observational study, at Clermont Ferrand University hospital, France. We included patients who had attended a post-ICU-MC. Their characteristics during ICU stay and at the post-ICU-MC were collected. Functional status was assessed by the 6-min-walking test, handgrip test and peak inspiratory pressure, respiratory function by exploratory functional outcomes, mental status by SF-36 score, and quality of life by SF-36 score and European Quality of Life 5 Dimensions questionnaire. Overall, we enrolled 67 patients, of whom 70%, 74%, and 68% had functional, respiratory, and renal impairments, respectively, at the post-ICU-MC. Additionally, 40%, 28%, 19%, and 2.5% had three, two, one, and none of these impairments, respectively. All patients experienced mental disorders and a decline in quality of life. Functional impairment correlated with frailty score and sex, and respiratory function with age. To conclude, the prevalence of PICS in our cohort was high, as was that of functional, respiratory and renal failure.

Combined lifestyle factors and metabolic syndrome risk: a systematic review and meta-analysis.

The metabolic syndrome is a complex condition influenced by many factors including lifestyle. Recently, more and more studies explored the relationships between combined lifestyle factors (often measured as lifestyle scores/indices) and metabolic syndrome due to the co-occurrence of these factors. These scores/indices considered potential interactions among lifestyle factors, offering a more comprehensive understanding of their relationship with metabolic syndrome. However, no review/meta-analysis has been conducted to summarize existing evidence. Thus, this study aimed to synthesize the associations between lifestyle scores/indices and metabolic syndrome in cross-sectional and cohort studies. A literature search was performed in Embase and Medline. Multivariable-adjusted estimates were synthesized using random-effects models. In research where higher scores indicated better health, we used original estimates directly. In studies where higher scores denoted poorer health, we first calculated the coefficients and standard errors based on original estimates. Afterward, we reversed coefficients' directions and recalculated new estimates. Thus, the pooled estimates compared the healthiest with the least-healthy lifestyles (the highest vs. lowest scores/indices). Subgroup analyses were conducted based on study design, region, baseline time, baseline age, sex, health status, metabolic syndrome diagnosis, and lifestyles' number. Sensitivity analyses were performed by including only high-quality studies and employing leave-one-out analyses. Nineteen studies from 16 publications were included. Physical activity, diet, and smoking were the top three included lifestyle factors. Compared to participants with the least-healthy lifestyles, those with the healthiest lifestyles had a 43% lower metabolic syndrome risk (95% confidence interval = 0.41-0.73). In subgroup analyses, healthy lifestyle scores/indices were inversely associated with both metabolic syndrome prevalence in cross-sectional studies (Odds ratio = 0.62; 95% confidence interval = 0.51-0.73) and metabolic syndrome incidence in cohort studies (Odds ratio = 0.40; 95% confidence interval = 0.11-0.68). The inverse association was consistent in other subgroup and sensitivity analyses. Adherence to a healthy lifestyle pattern was beneficial to metabolic syndrome prevention.

Clinical and angiographic characteristics of patients with familial hypercholesterolemia presenting with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Familial hypercholesterolemia (FH) is a world public health problem that enhances the risk of premature coronary artery disease (CAD) with a high incidence of acute coronary syndrome. This study aimed to evaluate the clinical and angiographic characteristics of the patients with and without FH who had ST-elevation myocardial infarction (STEMI). It included 690 patients who presented with the first attack of STEMI and underwent primary percutaneous coronary interventions (PPCI). The patients were analyzed to diagnose FH according to the Dutch Lipid Clinic Network (DLCN) criteria. All angiograms were analyzed for the number of diseased vessels, Syntax score, thrombus burden grade, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade. The majority of patients were male (72.6%) with a mean age of 54 ± 12 years. Based on DLCN criteria, they were classified into unlikely/possible FH (86.1%) and probable/definite FH (13.9%) groups. Probable/definite FH patients were significantly younger, and higher incidence of males < 55 years compared with unlikely/possible FH patients (p < 0.001 for each). Moreover, probable/definite FH patients had a higher frequency of three-vessel disease (p = 0.007) and Syntax score (p < 0.001) with a moderate positive correlation with the DLCN score (r = 0.592, p < 0.001). Furthermore, probable/definite FH patients showed a higher thrombus burden and final TIMI slow/no-reflow when compared to the unlikely/possible FH patients (p = 0.006 and p = 0.027, respectively). Patients with probable/definite FH and LDL-C level were independent predictors of high thrombus burden besides males < 55 years, and the number of diseased vessels. In conclusion, STEMI patients with FH were younger males and associated with severe CAD with frequent multivessel CAD, high anatomical complexity of CAD, and frequent high thrombus burden. Furthermore, FH was one of the predictors of high thrombus burden.

Early Endocrine and Metabolic Complications in Childhood Cancer Survivors—Experience from a Tertiary Care Pediatric Oncology Center in South India

Background Endocrine abnormalities and metabolic complications remain one of the common late effects after cancer therapy in children. Data on the incidence and pattern of complications would help to guide appropriate monitoring and treatment of childhood cancer survivors. Methods, Aims, and Objectives Purpose of study is to determine endocrine and metabolic effects in childhood cancer survivors including both hematological malignancies and solid tumors due to cancer per se and treatment-related, including different chemotherapeutic agents and radiotherapy. Results Among 97 participants, 84 children (84.5%) had at least one endocrine or metabolic complication; 41 children (42.3%) had more than two endocrine/metabolic complications. Common endocrine complications included precocious puberty (6.2%), short stature (6.2%), and hypothyroidism (5.1%). Among metabolic complications, dyslipidemia was the highest with an incidence of 68%, followed by fasting hyperinsulinism (32%), diastolic hypertension (18.6%), systolic hypertension (11.3%), obesity (8.8%), and metabolic syndrome (8.2%) and impaired fasting glucose (4.1%).Among endocrine complications, there was a significant increase in incidence of hypothyroidism among children receiving radiotherapy (odds ratio [OR]: 7.13, 95% confidence interval [CI]: 1.1–46.2), and among metabolic complications, a significant increase in incidence of metabolic syndrome in children treated with L-asparaginase compared with those not treated with L-asparaginase was observed (OR: 5.61, 95% CI: 1.07–29.5). There was no significant difference between incidence of observed endocrine and metabolic complications based on type of tumor, gender, and puberty status of study participants. Conclusion This study suggests that there is significant incidence of endocrine and metabolic complications in childhood cancer survivors, hence timely and appropriate recognition of these complications by appropriate screening recommendations and pursuing further endocrine evaluation rationally is needed.

The Effect of Adjuvant Therapy on Metabolic Syndrome in Schizophrenia Patients at Madani Hospital

Background: Schizophrenia is a mental disorder that impacts behavior, emotions, and communication. In recent years, atypical antipsychotics have been increasingly prescribed because they significantly reduce both positive and negative symptoms. However, the long-term effects of atypical can cause metabolic syndrome. Additional therapy is provided to maximize the primary therapy and reduce the side effects. Method: This study used a quasi-experimental design with a single-blind, pretest-posttest approach. Patients who had been using atypical antipsychotics, either monotherapy or combination therapy, for more than 3 were examined pretest to determine metabolic syndrome levels. Group A received adjuvant therapy, while Group B did not receive adjuvant therapy. Based on this data, an analysis of the reduction in metabolic syndrome categories was conducted. Result: The percentage of schizophrenia patients by gender was dominated by males (60%). By age, the majority were adults (87%). In Group A, the incidence of metabolic syndrome decreased from 53% in the pretest to 40% in the posttest after being given vitamin A, B, and folic acid therapy. The most commonly used other medication was THP (38%). Conclusion: The administration of adjuvant therapy with vitamins A, B, E, and folic acid can reduce the value of one or two of the five metabolic syndrome criteria for schizophrenia patients (p = 0.052) compared to the group of patients who did not receive vitamins A, B, E, and folic acid adjuvant therapy. Future research should use a longer duration to observe the effects of vitamins A, B, E, and folic acid and evaluate their therapeutic doses. Additionally, it should narrow down the criteria for medication use, focusing solely on the atypical antipsychotic’s clozapine or olanzapine.

Asymmetry of the Frontal Aslant Tract and Development of Supplementary Motor Area Syndrome.

Background/Objectives: The purpose of this study was to investigate preoperative interhemispheric differences of the FAT in relation to the onset of postoperative SMA syndrome. Methods: This was a single-center retrospective analysis of patients who underwent surgical resection of diffuse gliomas involving the SMA between 2018 and 2022. Inclusion criteria were availability of preoperative and postoperative Magnetic Resonance Imaging, no previous surgery, and no neurological deficits at presentation. Diffusion-weighted data were processed by spherical deconvolution (SD) and diffusion tensor imaging tractography algorithms, and TrackVis was used to dissect the FAT of both hemispheres. The FAT data were analyzed for correlation with postoperative SMA syndrome onset. Results:N = 25 cases were included in the study, among which n = 23 had preoperative bilaterally identifiable FAT by SD. N = 12 developed an SMA syndrome, 6 demonstrated a motor-only syndrome, 4 had a verbal-only syndrome, and 2 had mixed verbal and motor features. The SMA syndrome incidence was significantly more frequent in lower-grade gliomas (p = 0.005). On the tumor side, the FAT identified by SD was smaller than the contralateral (mean volume 6.53 cm3 and 13.33 cm3, respectively, p < 0.001). In the 6 cases that developed a verbal SMA syndrome, a normalized FAT volume asymmetry (FAT-VA) demonstrated an asymmetry shifted towards the non-dominant side (mean FAT-VA = -0.68), while the cases with no postoperative verbal impairment had opposite asymmetry towards the dominant side (mean FAT-VA = 0.42, p = 0.010). Conclusions: Preoperative interhemispheric FAT volume asymmetry estimated according to functional dominance can predict postoperative onset of verbal SMA syndrome, with proportionally smaller FAT on the affected dominant hemisphere.

Incidence of Neuroleptic Malignant Syndrome During Antipsychotic Treatment in Children and Youth: A National Cohort Study.

Objective: The incidence of neuroleptic malignant syndrome (NMS), a rare, potentially fatal adverse effect of antipsychotics, among children and youth is unknown. This cohort study estimated NMS incidence in antipsychotic users age 5-24 years and described its variation according to patient and antipsychotic characteristics. Methods: We used national Medicaid data (2004-2013) to identify patients beginning antipsychotic treatment and calculated the incidence of NMS during antipsychotic current use. Adjusted hazard ratios (HRs) assessed the independent contribution of patient and antipsychotic characteristics to NMS risk. Results: The 1,032,084 patients had 131 NMS cases during 1,472,558 person-years of antipsychotic current use, or 8.9 per 100,000 person-years. The following five factors independently predicted increased incidence: age 18-24 years (HR [95% CI] = 2.45 [1.65-3.63]), schizophrenia spectrum and other psychotic disorders (HR = 5.86 [3.16-10.88]), neurodevelopmental disorders (HR = 7.11 [4.02-12.56]), antipsychotic dose >200mg chlorpromazine-equivalents (HR = 1.71 [1.15-2.54]), and first-generation antipsychotics (HR = 4.32 [2.74-6.82]). NMS incidence per 100,000 person-years increased from 1.8 (1.1-3.0) for those with none of these factors to 198.1 (132.8-295.6) for those with 4 or 5 factors. Findings were essentially unchanged in sensitivity analyses that restricted the study data to second-generation antipsychotics, children age 5-17 years, and the 5 most recent calendar years. Conclusion: In children and youth treated with antipsychotics, five factors independently identified patients with increased NMS incidence: age 18-24 years, schizophrenia spectrum and other psychotic disorders, neurodevelopmental disorders, first-generation drugs, and antipsychotic doses greater than 200 mg chlorpromazine-equivalents. Patients with 4 or 5 of these factors had more than 100 times the incidence of those with none. These findings could improve early identification of children and youth with elevated NMS risk, potentially leading to earlier detection and improved outcomes.

Surgical anatomy of the carotid sympathetic plexus in endoscopic endonasal approaches: strategies for preventing Horner syndrome.

Endoscopic endonasal approaches (EEAs) specifically for procedures involving manipulation of the internal carotid artery (ICA), such as the transcavernous and translacerum approaches, confer a potential risk of carotid sympathetic plexus injury, potentially leading to postganglionic Horner syndrome. The primary aim of this study was to delineate the surgical anatomy of the carotid sympathetic plexus from an endoscopic endonasal perspective, offering insights to facilitate intraoperative anatomical identification and injury prevention. A comprehensive dissection was conducted on 20 silicone-injected, lightly embalmed postmortem human heads. The segments, patterns, and surgical landmarks of the carotid sympathetic plexus were investigated in a stepwise manner. In addition, 3 illustrative cases highlighting the involvement of the carotid sympathetic plexus in EEAs are included to contextualize the anatomical findings. The carotid sympathetic plexus can be categorized into 3 segments: 1) the cavernous sinus (CS) segment, beginning at the upper surface of the petrolingual ligament and ascending anterosuperiorly along the inferior compartment of the CS (mean ± SD length 5 ± 0.5 mm); 2) the lacerum segment, starting at the exit of the petrous carotid canal and ascending laterally and vertically to the upper surface of the petrolingual ligament (mean ± SD length 10 ± 1 mm); and 3) the petrous segment, originating at the external opening of the carotid canal and terminating at the foramen lacerum (mean ± SD length 18 ± 1 mm). Two primary morphological patterns of the sympathetic plexus at the CS and lacerum segments were identified: a plexus-like pattern in 12 (30%) hemispheres, and a nerve-like pattern that was subcategorized as double (18 [45%] hemispheres) or single (10 [25%] hemispheres) trunks. Surgical strategies emphasize the importance of recognizing key landmarks when approaching the carotid sympathetic plexus, including the pterygosphenoidal triangle, lingual process, petrolingual ligament, lateral parasellar ligament, and abducens nerve. This article provides a comprehensive anatomical description of the carotid sympathetic plexus in EEAs, highlighting key anatomical segments and patterns for intraoperative identification. A better understanding of anatomical landmarks for the carotid sympathetic plexus could help reduce the incidence of postganglionic Horner syndrome, augmenting the safety and efficacy of endoscopic endonasal transcavernous surgery.

Clinical manifestations, treatment and prognosis of juvenile idiopathic arthritis with pulmonary involvement in China: a single centre study.

In recent years, the distinct clinical presentations and elevated mortality rates of various subtypes of juvenile idiopathic arthritis (JIA) with pulmonary involvement have garnered significant attention. This study aimed to elucidate the clinical characteristics of pulmonary involvement in patients with JIA to improve clinicians' knowledge. This single-centre retrospective study analysed the baseline data, treatment options, follow-up of sixty patients of JIA with pulmonary involvement in China. Patients with interstitial lung disease (ILD) were further classified in accordance with the 2013 American Thoracic Society/European Respiratory Society International multidisciplinary consensus on idiopathic interstitial pneumonia. Sixty patients (5.03%) with JIA were complicated with pulmonary involvement. The highest subtype was systemic JIA (sJIA, 63.3%), followed by rheumatoid factor (RF)-positive polyarthritis (pJIA, 25.0%). The incidence of macrophage activation syndrome (MAS) was 21.6%. The most common diagnosis was ILD (90%). Respiratory symptoms/signs were initially experienced by 61.7% of the patients, and respiratory support was required by 21.7%. High-resolution CT classification of sJIA revealed non-specific interstitial pneumonia (NSIP) and organising pneumonia. High-resolution CT classification of pJIA was NSIP and usually interstitial pneumonia (UIP). Patients were treated with NSAIDs, along with glucocorticoids, DMARDs, and biological agents. The survival rates after 1 and 5 years were approximately 93.3% and 90.0%, respectively. Patients with JIA with pulmonary involvement present with early onset, high mortality rate. JIA patients should undergo physical examination thoroughly and high-resolution CT scans, lung function tests for evaluating and monitoring the occurrence and development of pulmonary involvement in early stages to improve prognosis.

Residual popliteal vein thrombosis after endovascular treatment of mixed-type lower extremity deep vein thrombosis is relevant to post-thrombotic syndrome

ObjectivePatients with mixed-type lower extremity deep vein thrombosis (LEDVT) have a higher incidence of post-thrombotic syndrome (PTS) following endovascular treatment (EVT). This study aimed to identify risk factors associated with PTS in these patients post-EVT. MethodsThis retrospective study included patients diagnosed with acute mixed-type LEDVT who underwent EVT between January 2020 and December 2022. Patient assessments were conducted using ultrasound and the Villalta scale. Baseline characteristics, management details, and follow-up findings were compared between patients who developed PTS and those who did not at six months after EVT. Cox regression and nomogram analyses were performed to identify risk factors associated with the development of PTS. ResultsThe study enrolled 118 patients, of which 103 completed the follow-up. Among them, 24.3% developed post-thrombotic syndrome (PTS) within six months. Significant differences between the PTS and non-PTS groups were found concerning residual thrombosis in the popliteal, common femoral, and femoral veins. Multivariate Cox regression analysis indicated that residual popliteal vein thrombosis (RPVT) (HR 4.93, 95% CI 1.61-15.11) and preoperative iliac vein stenosis (HR 3.21, 95% CI 1.11-9.33) were significant risk factors for PTS. Additionally, subgroup analysis for preoperative iliac vein stenosis and sensitivity analysis confirmed that RPVT remained a risk factor for PTS (HR 4.48, 95% CI 1.27-15.84). ConclusionOur study demonstrated a positive association between residual popliteal vein thrombosis (RPVT) and PTS in patients with extensive mixed-type LEDVT after EVT. These findings suggest that intensive monitoring and aggressive therapeutic interventions may be required for patients with RPVT to reduce the risk of PTS.

NEONATAL OUTCOMES IN INFANTS OF DIABETIC MOTHERS: FOCUS ON HYPOGLYCEMIA, RESPIRATORY DISTRESS SYNDROME AND MACROSOMIA

Background: Infants of diabetic mothers (IDMs) face heightened risks of various neonatal complications. This study evaluates the incidence of specific complications-macrosomia, hypoglycaemia, and neonatal respiratory distress syndrome (NRDS)-in this population. Methods: A cross-sectional observational study was conducted over 1.5 years at a tertiary hospital in Mumbai. We reviewed the medical records of infants born to mothers with diabetes (both pregestational and gestational). Data on the incidence of macrosomia (birth weight &gt;4000 grams), hypoglycaemia (blood glucose &lt;40 mg/dL), and NRDS (diagnosed based on clinical and radiographic criteria) were collected. Results: Among the 50 infants studied, 8% were diagnosed with macrosomia, 46% experienced hypoglycaemia, and 20% developed NRDS. The frequency of these complications was significantly higher in IDMs compared to the general neonatal population. Conclusion: This study reveals a high incidence of macrosomia, hypoglycaemia, and NRDS in IDMs, emphasizing the need for regular antenatal follow-up and strict glycaemic control throughout pregnancy. Enhanced monitoring and management strategies are essential to mitigate these risks and improve neonatal health outcomes.

Influenza and non-influenza ARVI in children. A relationship between cytokine profile, parameters of the “lipid peroxidation – antioxidant defense system” as well as clinical and laboratory indicators

Influenza and acute respiratory viral infections (ARVI) impose a substantial damage to the population health in the Russian Federation due to their seasonal circulation and predominantly affect young children. A very few data on the cytokine profile, the nonspecific LPO — AOD system and their relationships with clinical characteristics in such diseases in preschool children are available. The aim of this study was to assess the cytokine profile, LPO — AOD system parameters and their relationship with the clinical and laboratory characteristics of diseases in preschool children with influenza and other ARVI. 86 preschool children (3–6 years old) were examined: with an established diagnosis of influenza (n = 31), non-influenza ARVI (n = 28), apparently healthy children (control group (n = 27). All pediatric samples were analyzed by enzyme-linked immunosorbent assay assessing blood serum concentrations of C-reactive protein and cytokines IL-1β, IL-4, IL-6, IL-8, TNFα, IFNα, IFNγ. Spectrophotometric, fluorometric and enzyme immunoassay methods to assess the state of the “LPO — AOD” system were used. In the group of children with influenza vs other ARVI, a higher incidence of intoxication syndrome was revealed. Cytokine profile in children from both clinical groups compared with control cohort was featured with higher indicators of both pro-inflammatory and anti-inflammatory origin. Children with non-influenza ARVI, had increased magnitude of LPO final products in the nonspecific LPO — AOD system along with lowered concentration of fat-soluble vitamins, general antioxidant activity, GSH level, and SOD activity. In the group with influenza, the level of primary and final lipid peroxidation products was increased, whereas that of for retinol,α-tocopherol, and total antioxidant activity was decreased paralleled with higher GSSG and SOD levels. Numerous correlations were noted in the group of children with ARVI: IL-1β/ketones, IL-6/ketones, IL-8/ketones, TNFα/ketones, IL-4/ketones, IFNg/shortness of breath, IFNα/cough, double bonds/fever, double bonds/AST, SO/intoxication, retinol/fever, GSSG/cough. The influenza group differed in the following relationships: IL-4/ketones, IL-4/fever, IFNα/ketones, CDs/AST. It can be concluded that in preschool children with ARVI and influenza, changes in the cytokine profile are accompanied by increased pro- and anti-inflammatory cytokine levels, increased intensity of lipid peroxidation reactions along with reduced magnitude of antioxidant factors. In the group with ARVI, there was a relationship between the final toxic products of lipid peroxidation — Schiff bases — and the intoxication index, as well as the presence of protective mechanisms in the form of connections between interferons and disease clinical manifestations. The group with influenza was distinguished by the presence of protective relations, which may have a beneficial effect in the context of developing pathological process. The data obtained will help expand the understanding of the pathogenetic mechanisms related to immune reactivity and nonspecific lipid peroxidation reactions in preschool patients and formulate appropriate measures for correction.

Metabolic syndrome in patients who have been subjected to isolation security measures and treated with atypical antipsychotics.

The main aim of the study was to assess the incidence of metabolic syndrome and its individual components in patients subject to a confinement measure, treated with antipsychotics in mono - or polytherapy. Additional objectives included the analysis of associations between the occurrence of metabolic syndrome and patients' age, psychiatric diagnosis, overweight or obesity, and the presence of addictions to psychoactive substances. The study involved 61 patients of the Department of Forensic Psychiatry, including 9 women and 52 men, subject to a confinement measure from September 2019 to August 2021. All parameters of metabolic syndrome and BMI were measured twice, at the beginning of the stay at the Department and after six months of treatment with atypical antipsychotics. Appropriate statistical comparative analyses were then performed. There was no relationship between the occurrence of metabolic syndrome and the age of the subjects, medical diagnosis, addiction to psychoactive substances, including smoking. It has not been confirmed that the chronic use of atypical antipsychotics with parallel prophylactic and health-promoting effects in conditions of confinement leads to the development of metabolic syndrome and worsens its symptoms, apart from a marked increase in waist circumference and an increase in BMI. Systematic measurements of BMI and waist circumference during treatment with atypical antipsychotics may be accurate tools in assessing the risk of metabolic syndrome. Long-term confinement hospitalizations should include psychoeducational nterventions aimed at minimizing metabolic complications of pharmacotherapy.