Internal Organ Systems Research Articles

Brain, heart and lung weight in landrace pigs and their association with biochemical indicators

The genesis of internal organ systems is determined by a spectrum of various factors and characterizes the growth rate of animals, their constitution, resistance to diseases and the ability of animals to adapt to environmental conditions. An assessment of the absolute weight of the lungs, brain and heart of Landrace pigs of Irish selection was carried out. At the early stages of the technological cycle, a representative group of pigs was formed, taking into account their origin, sex, age, and live weight. The total number of animals was 12. The fattening of the animals took place in a large pig-breeding farm in the Altai Territory, where standard living conditions were provided according to the standards of meat fattening of animals. Vaccination of animals was carried out in accordance with the preventive plan, and systematic veterinary control was provided. At the end of the technological cycle, when the live weight reached 100 kg, slaughter was carried out on the basis of the current technological instructions. The absolute mass of organs without surrounding structures was determined by weighing on scales with a high accuracy class. The obtained data were evaluated using Microsoft Office Excel and the R programming language in the data analysis environment RStudio version 2022.07.2+576 (RStudio, PBC). Visual assessment showed the absence of pathoanatomic changes in organs. In all cases, based on the ShapiroWilk test, a normal distribution was established. In pigs, the median absolute lung weight was 447.8 g, brain – 81.6 g, for the heart – 33.8 g; 95% confidence interval for the lungs – 245,56 525,85 g, for the brain 45,33–98,42 g, for the heart – 190,21–404,49 g. The article provides indicators of variability of the trait in question. The interbreed differentiation of pigs by lung and heart weight has been established.

Advances in wearable electronics for monitoring human organs: Bridging external and internal health assessments

Devices used for diagnosing disease are often large, expensive, and require operation by trained professionals, which can result in delayed diagnosis and missed opportunities for timely treatment. However, wearable devices are being recognized as a new approach to overcoming these difficulties, as they are small, affordable, and easy to use. Recent advancements in wearable technology have made monitoring information possible from the surface of organs like the skin and eyes, enabling accurate diagnosis of the user's internal status. In this review, we categorize the body's organs into external (e.g., eyes, oral cavity, neck, and skin) and internal (e.g., heart, brain, lung, stomach, and bladder) organ systems and introduce recent developments in the materials and designs of wearable electronics, including electrochemical and electrophysiological sensors applied to each organ system. Further, we explore recent innovations in wearable electronics for monitoring of deep internal organs, such as the heart, brain, and nervous system, using ultrasound, electrical impedance tomography, and temporal interference stimulation. The review also addresses the current challenges in wearable technology and explores future directions to enhance the effectiveness and applicability of these devices in medical diagnostics. This paper establishes a framework for correlating the design and functionality of wearable electronics with the physiological characteristics and requirements of various organ systems.

Komplikasi Sindrom Stevens-Johnson (SSJ) dan Nekrolisis Epidermal Toksik (NET)

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions with severe skin involvement; may affect many internal organ systems with significant psychosocial complications. Several studies have documented physical complications associated with Stevens-Johnson syndrome and toxic epidermal necrolysis (TEN). SJS/TEN patients require multidisciplinary care to deal with psychological complications and reduced quality of life.

KIDNEYS INVOLVEMENT INTO THE THYROID GLAND BURNING PATHOGENETIC MECHANISMS

Background. Burn injuries considered to be the most common and severe diseases in people, positioned second place after traffic injuries. The thyroid gland, taking into account the wide range of thyroid hormones physiological activity, its structural and functional organization and morpho-functional features as well as large-scale duplicative mechanisms of regulatory feedback, is one of the first which receives the alterative thermal influence. Thyroid gland and other organs of the body dysfunction or pathological dysregulation occurs as a result of thermal exposure “triggers” systemic dysfunctions via the “vicious circle” and positive feedback mechanisms and systemic-antisystemic regulation which cannot be ignored by the majority of internal organs and organ systems resulting ion their functional disorders. We decided to test the assumptions regarding the kidneys participation in thyroid burning pathological process manifestation.
 Aim: to investigate the changes in lipid peroxidation and antioxidant defense in erythrocytes and kidney tissue and to investigate the kidneys functional activity throughout the thyroid gland thermal.
 Materials and methods. The malondialdehyde concentration and antioxidant enzymes activity - glutathione, catalase, superoxide dismutase and glutathione peroxidase - were determined in white Wistar rats’ erythrocytes and kidney homogenate 1, 3, 7, 14, 21, and 30 days after the thyroid gland burning. Diuresis was calculated in rats during induced water diuresis and both the protein and creatinine content in urine was determined during the indicated periods after thyroid gland burning
 Results. The significant accumulation of lipoperoxidation intermediate products and the antioxidant enzymes activity suppression in erythrocytes and in the kidney parenchyma are registered in rats during the post-burn period. The postburn period course is characterized by diuresis decrease. The urine protein level increased and the rate of protein excretion also increased in conditions of thyroid gland burning
 Conclusion. Significant accumulation of lipoperoxidation intermediate products and the antioxidant enzymes activity suppression in erythrocytes and in the liver parenchyma is recorded in thyroid gland burning dynamics which we consider as evidence of erythrocytes and kidney involvement in the specified pathological process mediation. The expressed renal dysfunction develops with thyroid gland thermal damage which is manifested by kidneys both excretory and filtering functions impairment. The data obtained we consider as the experimental background for kidney involvement into the thyroid gland burning pathogenetic mechanisms and the pathological dysregulation of organs and organ systems formation in these pathological conditions.

Population-level antagonism between FGF and BMP signaling steers mesoderm differentiation in embryonic stem cells.

The mesodermal precursor populations for different internal organ systems are specified during gastrulation by the combined activity of extracellular signaling systems such as BMP, Wnt, Nodal, and FGF. The BMP, Wnt and Nodal signaling requirements for the differentiation of specific mesoderm subtypes in mammals have been mapped in detail, but how FGF shapes mesodermal cell type diversity is not precisely known. It is also not clear how FGF signaling integrates with the activity of other signaling systems involved in mesoderm differentiation. Here, we address these questions by analyzing the effects of targeted signaling manipulations in differentiating stem cell populations with single cell resolution. We identify opposing functions of BMP and FGF, and map FGF-dependent and -independent mesodermal lineages. Stimulation with exogenous FGF boosts the expression of endogenous Fgfs while repressing Bmp ligand genes. This positive autoregulation of FGF signaling, coupled to the repression of BMP signaling, may contribute to the specification of reproducible and coherent cohorts of cells with the same identity via a community effect, both in the embryo and in synthetic embryo-like systems.

Implementing Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome management system by hospital pharmacists in Samutsakhon Hospital, Thailand.

To study the process of implementing the DRESS management system by pharmacists and its results, during 2016-2020. Operational Research, starting from the process of implementing the DRESS management system by the pharmacy department of Samutsakhon Hospital and reporting the results to the Pharmacy and Therapeutic Committee in patients diagnosed with DRESS according to the RegiSCAR criteria, collecting data from an electronic medical records database. The main DRESS management system implementation process is: 1) listing the High alert drugs which may cause an adverse reaction and preparation of pharmacists in DRESS; 2) Using RegiSCAR for patient assessment; 3) Suggesting a genotyping test before the patient receives the drug, starting with carbamazepine and allopurinol; 4) Using a Computerized Decision Support System (CDSS) to facilitate the screening alert. 5) Proposing to the Pharmacy and Therapeutic Committee for approval on gene testing. As a result, a total of 184 patients were sent for genotyping testing, and 92 of the drug allergy genes were identified, making the prevention or monitoring of patients more effectively. 31 patients were diagnosed with DRESS, and 54.84% were male. The 4 drug items with the highest incidence were phenytoin 28.95%, nevirapine 10.53%, rifampicin 7.89%, and pyrazinamide 7.89%. Clinical symptoms were rash 100.00%, fever 90.32%, lymphadenopathy 6.45%, at least one dysfunction in the internal organ system 74.19%, liver dysfunction 80.65%, and eosinophilia 58.65%. Phenytoin had a statistically significant induced eosinophil (p=0.044), which could be used as a factor in the CDSS drug surveillance. Even DRESS is a rare adverse drug reaction symptom but causes life-threatening. Continuous system management by pharmacists is significant with a huge effect. In the drug items, the highest incidence was phenytoin. Implementing a system to monitor patients' drug use, could reduce DRESS, and prevent the recurrence of drug allergies.

Bio Nanotube Its Application in Vaccination and Cancer Therapy

Microfluidic activities predominate all processing of metal, polymers, Artificial Internal Organ (AIO), Regenerative medicine and Biological systems. Microfluidic system is also used in RT-PCR (Real Time Polymerase Chain Reaction) automatic to use reverse transcriptase, to design C-(Cloned)- DNA to initiate, DNA-DNA or DNA-RNA hybridization to detect/separate corona infected person from non-infected one. BNT (bionano tube) of Escherichia coli was made by isolated fimbriae (pili) of hybrid, genetically engineered) E. coli K-12 C600, Yale USA strain. BNT is made by isolated fimbriae (pili), growing in outermost surface antigen of E. coli and are differentiated by O: K:H: If BNT are immobilized by cancer drugs they could pursue bidirectional AAIR to prevent benign tumor to malignant. This is possible, because GE E. coli is made by the cloning of isolated tumor genes. BNT, if made GE hybrid E. coli, particularly by cancer isolated gene, fimbriae of GE E. coli would response humoral antibodies against that specific cancer cell. Similarly, it would response the AAIR against opportunistic microbial infections. The slow movements of DNA were essential during reverse transcriptase, involved in polymerase chain reaction. Micro fluidic transport supports RT-PCR. Reverse transcriptase enzyme reactions, molecules, convert DNA to RNA, to detect corona/viral m-RNA. The m-RNA moves from spike proteins, to lung alveoli cells by fusion of spike proteins, help to transcribe, translate and multiply corona viral particles and to spread corona. Virulence and pathogens are determined by the adhering nature of microbes and also cancer cells. They are all being characterized by innate immunity, varied from individual to individual and community to community. ETEC (Enterotoxignic-(O8 :) EPEC (Enter pathogenic-, (O26:) and UTI (Urinary Tract Infective) (O25: O:11) Escherichia coli carry plasmids, during their infective/virulent phase. These plasmids were identified in AGE (Agarose Gel Electrophoresis). MRHU (D-mannose Resistant haemagglutination of Human Erythrocytes) plasmids determines the adhering nature of microbes. The HA tests in vitro, virulence test (+/-) vivo in Balb/C mice and plasmid test in AGE established the relations of AAIR All Balb/ C mice vivo phenotypic expressions were made intraperitoneal inoculum. The virulence/adherence / pathogenic E. coli as ETEC, EPEC/UTI were used to design AAIR.

The role of periodontal pathology and oral cavity condition in the occurrence of general somatic diseases

The aim of the study is a review of modern national and foreign literature on the influence of the oral cavity state and the pathology of periodontal tissues, in particular generalized periodontitis, on the occurrence and severity of the course of internal organ and body system diseases. Inflammatory-dystrophic periodontal diseases lead to an increase in the level of chronic inflammatory agents due to the systemic spread of inflammatory mediators released during local tissue destruction, as well as the systemic spread of pathogenic microorganisms, which contributes to the development of cardiovascular diseases, atherosclerosis, pathological processes in the gastrointestinal tract, complicates the course of diabetes mellitus and respiratory diseases in patients with periodontal diseases. That is why the study on pathogenetic interrelations between periodontal diseases and comorbid conditions is an urgent problem of modern dentistry. Conclusions. Given that certain extraoral pathologies arise as a result of damage by disseminated periodontopathogens, it is possible to provide new therapeutic opportunities to reduce the risk of developing comorbid conditions etiopathogenetically associated with generalized periodontitis. The data of clinical and experimental studies that are presented in this literature review definitely show the need for timely treatment of periodontal diseases, which provides not only the health of the oral cavity, but also prevents the occurrence of general somatic diseases.

Pulling back the curtain: live imaging adult disease processes

Zebrafish (Danio rerio) have become an important model system to study a wide variety of disease processes. Ample molecular and genetic tools, alongside live imaging that is facilitated by the optical transparency of the larvae, have enabled significant insight into in vivo dynamics. However, Danio rerio does not maintain its transparency after larval stages; therefore, internal organ systems, later-onset diseases and the neuronal basis of complex behaviors, such as courtship, become largely inaccessible to imaging. To circumvent this issue, Danionella cerebrum, a close relative of D. rerio that is smaller and remains essentially transparent in adulthood, has been recently employed as a model for neuroscience and behavior studies. Importantly, although molecular genetic methods had been successfully used with D. cerebrum, longitudinal studies, including timelapse imaging of adults over extended periods of time, have not yet been described in D. cerebrum.To this end, Pui-Yin Lam set out to develop reliable, long-term imaging methodology for adult D. cerebrum. Building from methods recently developed to enable long-term imaging of adult D. rerio, the author designed imaging chamber systems to house intubated D. cerebrum for imaging on either upright or inverted microscopes. With a particular interest in immune responses in the brain, the author generated new transgenic D. cerebrum lines to label macrophages and microglia [Tg(mpeg1:Dendra2)] and endothelial cells [Tg(kdrl:mCherry-CAAX)], using constructs originally generated for use in D. rerio. The author then went on to establish two experimental paradigms for brain injury in D. cerebrum: stab wound and laser-induced intracerebral hemorrhage to mimic this form of stroke. Macrophage and microglia behaviors were imaged under baseline conditions and after injury and, by using endothelial structures for orientation and registration, the same position in the brain was imaged repeatedly over the course of several days. In this way, immune cell response and resolution specifically around the injury site was visualized.Together, this work demonstrates the feasibility of long-term, repeated imaging of adult D. cerebrum. With these new transgenic tools, D. cerebrum is poised to be a valuable model for brain injury and intracerebral hemorrhage. More broadly, the author has demonstrated the practicality of D. cerebrum for studying the immune response in living adult tissue during wound healing, repair and regeneration processes. Therefore, the tools developed here might impact research into many additional disease processes and organ systems beyond the brain.

Formation of Coelomic Cavities during Abbreviated Development of the Brittle Star Ophioplocus esmarki.

AbstractIn brittle stars, the coelomic cavities that form during embryogenesis contribute to most of the internal organ systems of the juvenile. In the ancestral mode of development, the coelomic cavities begin with bilateral symmetry and play a minor role in the function of the ophiopluteus larva. However, the coelomic cavities undergo extensive changes during metamorphosis to set up the body systems of the juvenile brittle star. Many lineages of brittle stars have evolved life histories without the ophiopluteus larva. The non-feeding vitellaria larva has rapid development of juvenile structures. This work demonstrates the modifications to the origin and early development of the coelomic cavities in a vitellaria larva. Much of the archenteron forms an unpaired axocoel, hydrocoel, and somatocoel. The posterior-most portion of the archenteron forms the rudiment of the juvenile stomach. The right somatocoel and a portion of the left somatocoel form as invaginations of the lateral ectoderm. Later morphogenesis of the axocoel, the hydrocoel, and the two somatocoels is similar to what has been shown for brittle stars with an ophiopluteus larva. Confocal microscopy and three-dimensional modeling were used to show new details for the later morphogenesis of the coelomic cavities. The stone canal originates as an outgrowth of the hydrocoel between lobes 4 and 5. The hydrocoel lobes have minimal migration after they meet to complete the ring canal. The right somatocoel contributes to a component of the axial complex and perihemal system. A detailed description is given for how the left somatocoel contributes to multiple organ systems.

A typical presentation of moxifloxacin-induced DRESS syndrome with pulmonary involvement: a case report and review of the literature

BackgroundDrug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a kind of hypersensitivity drug reaction involving the skin and multiple internal organ systems. Moxifloxacin has rarely been reported to be a drug that is associated with DRESS syndrome. Lungs are less frequently involved in DRESS syndrome, but their involvements may herald more serious clinical processes. We present a rare typical case of moxifloxacin-induced DRESS syndrome with lungs involved. Valuable clinical data such as changes in the pulmonary imaging and pulmonary function tests was recorded. This case is important for the differential diagnosis of DRESS syndrome with lungs involved by providing clinical manifestations, CT imaging, pulmonary function tests, and biopsy pathological characteristics. The changes in pulmonary imaging and pulmonary function tests may help us understand the mechanism of DRESS syndrome further.Case presentationWe report a case of a 47-year-old woman who was treated with oral moxifloxacin for community-acquired pneumonia. The patient subsequently developed a cough, fever, liver injury, skin rash, hematologic abnormalities, and shortness of breath (SOB) followed by pharyngeal herpes and peripheral neuritis. These symptoms, clinical lab index, and CT scan of the lungs improved after the withdrawal of moxifloxacin. The probability of moxifloxacin-induced DRESS syndrome was rated as “Definite”, with 7 scores graded by RegiSCAR. A literature search was also performed with “fluoroquinolones,” “moxifloxacin,” “ciprofloxacin,” “levofloxacin,” “delafloxacin,” and “DRESS” or “drug-induced hypersensitivity syndrome (DIHS)” as the keywords that were put into PubMed. The overall pulmonary involvement was approximately 9.1% (1/11). It is a rare reported case of DRESS syndrome with pulmonary involvement induced by moxifloxacin. We summarized detailed clinical data, including pulmonary imaging and pulmonary function changes.ConclusionThis is a rare reported case of DRESS syndrome with pulmonary involvement induced by moxifloxacin. Prompt recognition and correct diagnosis can promote appropriate treatment and accelerate recovery. This case is important for us as a reference in the differential diagnosis of DRESS syndrome and helps us further understand the mechanism of DRESS syndrome.

A Rare Case of Drug-induced Vasculitis in Out-patient Department

Drug-induced vasculitis can be defined as inflammation of blood vessels triggered by a spectrum of drugs. It presents not only with a localized skin rash but also may involve the internal organ systems, including the gastrointestinal tract, kidneys, lungs, central nervous system, and joints. Here, we report the case of a 60-year-old woman who developed purpuric pruritic rashes on bilateral lower limbs and buttocks after the ingestion of sulphasalazine. The patient took the prescribed regimen for 14 days while experiencing an adverse drug reaction. At the follow-up visit, the patient was admitted and treated with methylprednisolone monotherapy with 32 mg/day for the first 3 days and after that, methylprednisolone 16 mg for the next 3 days. The rashes resolved after 6 days. Clinicians should ascertain the patient knowledge of how and when to obtain urgent care as the patient may experience ill effects after taking prescribed treatment. Timely advice may save patients’ costs of admission and treatment to manage adverse events.

Dermatologic Manifestations of Systemic Diseases in Childhood

Dermatologic Manifestations of Systemic Diseases in Childhood

A practical approach to the evaluation and management of gastrointestinal symptoms in patients with systemic sclerosis.

The gastrointestinal (GI) tract is the most commonly affected internal organ system in systemic sclerosis (SSc). SSc may lead to impaired function in any region of the GI tract, from the esophagus to the anorectum, which causes significant morbidity as well as mortality in patient subsets. Given the low prevalence of SSc in the community, many rheumatologists may not have a systematic framework for diagnosing or treating the GI complaints in this disease. These practice recommendations aim to summarize and consolidate the current guidelines from the fields of gastroenterology and rheumatology and establish a symptom-based framework for diagnosis and management based on available evidence in the literature. Subject areas that are in need of additional research are also identified.

Breath Biopsy and Discovery of Exclusive Volatile Organic Compounds for Diagnosis of Infectious Diseases.

Exhaled breath contains thousand metabolites and volatile organic compounds (VOCs) that originated from both respiratory tract and internal organ systems and their microbiomes. Commensal and pathogenic bacteria and virus of microbiomes are capable of producing VOCs of different chemical classes, and some of them may serve as biomarkers for installation and progression of various common human diseases. Here we describe qualitative and quantitative methods for measuring VOC fingerprints generated by cellular and microbial metabolic and pathologic pathways. We describe different chemical classes of VOCs and their role in the host cell-microbial interactions and their impact on infection disease pathology. We also update on recent progress on VOC signatures emitted by isolated bacterial species and microbiomes, and VOCs identified in exhaled breath of patients with respiratory tract and gastrointestinal diseases, and inflammatory syndromes, including the acute respiratory distress syndrome and sepsis. The VOC curated databases and instrumentations have been developed through statistically robust breathomic research in large patient populations. Scientists have now the opportunity to find potential biomarkers for both triage and diagnosis of particular human disease.

Clinical Impact of Inherited and Acquired Genetic Variants in Mastocytosis.

Mastocytosis is a rare and complex disease characterized by expansion of clonal mast cells (MC) in skin and/or various internal organ systems. Involvement of internal organs leads to the diagnosis of systemic mastocytosis (SM). The WHO classification divides SM into indolent SM, smoldering SM and advanced SM variants, including SM with an associated hematologic neoplasm, aggressive SM, and MC leukemia. Historically, genetic analysis of individuals with pure cutaneous mastocytosis (CM) and SM have focused primarily on cohort studies of inherited single nucleotide variants and acquired pathogenic variants. The most prevalent pathogenic variant (mutation) in patients with SM is KIT p.D816V, which is detectable in most adult patients. Other somatic mutations have also been identified—especially in advanced SM—in TET2, SRSF2, ASXL1, RUNX1, CBL and JAK2, and shown to impact clinical and cellular phenotypes. Although only small patient cohorts have been analyzed, disease associations have also been identified in several germline variants within genes encoding certain cytokines or their receptors (IL13, IL6, IL6R, IL31, IL4R) and toll-like receptors. More recently, an increased prevalence of hereditary alpha-tryptasemia (HαT) caused by increased TPSAB1 copy number encoding alpha-tryptase has been described in patients with SM. Whereas HαT is found in 3–6% of general Western populations, it is identified in up to 17% of patients with SM. In the current manuscript we review the prevalence, functional role and clinical impact of various germline and somatic genetic variants in patients with mastocytosis.

Ethnic influence on the phenotype of French patients with systemic sclerosis.

Systemic sclerosis (SSc) is a rare multisystem autoimmune disorder. It has a worldwide distribution but geographical and ethnic influences are poorly known. The aim of the study was to compare demographic characteristics and frequency of internal organ system involvement of Black SSc patients to those of White SSc patients in France. Patient population included 425 SSc patients recruited at Cochin Hospital in Internal medicine and Rheumatology departments. Data were collected at the baseline visit, each Black patient was matched with 2 to 3 White controls from the same department. One hundred and five Black patients and 320 White were included. Demographic comparison highlighted an older age for the White patients (48.66±14.87 vs 39.56±10.79, P<0.0001). Phenotypic comparison showed more severe skin involvement for Black patients: they had more often diffuse skin involvement than White patients (69.2% vs. 44.7%, P<0.0001) with a higher baseline modifiedRodnan skin score (15.8 vs. 11.3, P<0.001). Comparisons also showed more active ulcers (46.5% vs. 21.6%, P<0.001) and more common interstitial lung disease (73.7% vs. 43%, P<0.0001) for Black patients. Auto-antibody testing showed that White patients were more likely to harbor anti-centromere antibodies (ACA) (26.6% vs. 9%, P<0.001) whereas Black patients were more likely to have anti-U1RNP antibody (24.6% vs. 6.2%, P<0.0001). In this population recruited in a disease referral center, Black patients had more severe skin and lung involvements with lower prevalence of ACA as compared to White patients, supporting a more severe phenotype.

The incidence of, and relationship between, distal limb and facial asymmetry, and performance in the event horse

Identification of influential conformational traits is an important aspect in choosing the most appropriate horse for a specific discipline with regards to both performance potential and career longevity. Symmetry of bilateral traits, both functional and non-functional, demonstrates the ability of an individual to display their genotypic quality through their phenotype. External trait symmetry has been linked to effective functioning and health of a number of internal organ systems. The identification of a relationship between bilateral trait symmetry and performance in the equine athlete could highlight important conformational indicators of potential future performance. Using Invicta metric callipers and a tape measure, direct measurements of 15 bilateral traits, functional (limb) and non-functional (facial), were obtained from 18 advanced event horses (AdE) and 15 event horses proven incapable of reaching advanced level (NIE). Tests of difference were performed to determine differences in asymmetry between the two populations for individual traits and for identification of the mean total asymmetry (MTA) of the two populations. The AdE group demonstrated statistically lower asymmetry for a number of functional (metacarpal length and width, P≤0.05; fore proximal phalanx length, P≤0.05) and non-functional (nostril length, P≤0.001; pinna length, P≤0.05) traits. Furthermore, the AdE group demonstrated significantly lower MTA (P≤0.001) than the NIE. Where significance was not identified, all but one functional trait still demonstrated a trend for lower asymmetry in the AdE group. From the results, it is suggested that asymmetry levels have future potential to be used as an indicator of performance potential. The size of the mean asymmetry values being considered, further imply that the differences between the performance of the two groups cannot be as a result of limb biomechanics alone and that other more intricate biological disruptions, for example neurological development, may also be reflected by the trait asymmetries.

PUK27 THE ECONOMIC IMPACT OF DIGITAL HEALTH INTERVENTIONS IN THE MANAGEMENT OF TYPE 2 DIABETES: A SYSTEMATIC REVIEW

The rising prevalence of Type 2 Diabetes Mellitus (T2DM) is placing economic pressure on global healthcare systems. Poor glycaemic control over prolonged periods can lead to chronic complications of nervous, vascular and internal organ systems. Digital health interventions (DHIs) such as mobile technologies and web-based platforms that facilitate patient-directed behavioural changes have been linked with improved health. There has been limited implementation of DHIs on a large scale, with the paucity of cost-effectiveness data being listed as a major barrier. Here, we perform a literature review to identify existing cost-effectiveness evidence for DHIs in T2DM and explore gaps in research. Systematic searches of Medline and Embase were conducted to identify economic evaluations from the last five years. Cost-effectiveness data for IT-based communications and mobile devices in those diagnosed with T2DM was analysed. Of 556 records, five studies were included. Overall, it was reported that telemonitoring using smart phone apps, Bluetooth monitors and other online platforms is a cost-effective approach to managing T2DM. Integration of a telemedicine app across the EU5 resulted in up to €57.8 million cost-savings in healthcare resource utilisation, with DHI use also demonstrating lower healthcare costs, compared with standard care (mean $3,781 vs $4,662 per patient; p <.001) in an Australian population. A cost-effectiveness acceptability curve for a web-based intervention presented an 87% probability of cost-effectiveness at £20,000/QALY willingness-to-pay (WTP) threshold in England while a Mexican study deemed a technology-enhanced programme highly cost-effective, reporting an ICER of just $4,299/QALY, compared to standard care. Our findings favour a larger scale uptake of DHIs for T2DM management and represent wider economic benefits for DHI use across numerous therapeutic areas. Economic factors from the perspective of all stakeholders, including providers, payers and patients must be considered so future health policies and business models are well informed.

The role of pre-gravida preparation in the successful development of pregnancy

An integrated approach of pre-gravida training plays an important role in the preservation of the reproductive health of the nation. Due to the multi-stage organization, young families can go to outpatient clinics early, before the expected pregnancy, in order to undergo the necessary clinical and laboratory examinations, to rule out potential risk for miscarriage, to obtain the necessary recommendations for the use of vitamin and mineral complexes or the need to use progesteronecontaining medications, to acquire awareness of the management of pregnancy in the early stages. All those measures will signifi cantly reduce the percentage of births of children with congenital malformations of internal organs and organ systems. An integrated approach is not only the interaction of all parts of obstetric and gynecological care, but also cooperation with specialists of related disciplines.