Level Of Impairment Research Articles

Clinical Presentation of Ischaemic and Haemorrhagic Stroke and Its Relation to Lipid Profile

Introduction: Stroke is a major health hazard in both developed and developing countries. Dyslipidaemia is one of the important risk factors for stroke. The purpose of the present study was to identify clinical presentations of both ischaemic and haemorrhagic stroke, and to find out correlation between stroke and lipid profile. Methods: The observational study was conducted in the Department of Medicine at Sher-e-Bangla Medical College Hospital, Barishal from April to September 2013 for a period of 6 months. All the stroke patients over 20 years of age of both sexes were selected as study population. After admission at the hospital, history was taken from the patients or the attendants. The clinical presentation was recorded in a pre designed data collection sheet. Fasting lipid profile was measured in every stroke patient. Results: Total 100 stroke patients were enrolled for this study, of them 36 were haemorrhagic and 64 were ischaemic stroke patients. The mean ± SD of age were 63.945 ± 8.84 and 62.26 ± 14.40 in haemorrhagic and ischaemic stroke patients respectively (p>0.05). Among both haemorrhagic and ischaemic stroke patients maximum 61.1% and 60.9% used to have sedentary work. Impaired level of consciousness was more common among the haemorrhagic stroke patients (91.7%) than ischaemic stroke patients (57.8%) group and the association is statistically significant (p=0.001). Limb weakness was the commonest presentation in both haemorrhagic (91.7%) and ischaemic (87.5%) stroke patients. The mean ± SD of total cholesterol was 173.47 ± 61.96 and 178.22 ± 54.79 in haemorrhagic stroke and ischaemic stroke patients respectively (p<0.05). Conclusion: Older age, male sex, sedentary work and dyslipidaemia were susceptible to be affected in stroke. Among lipoproteins, elevated total cholesterols, triglycerides and LDL showed strong correlation with both ischaemic and haemorrhagic strokes. J MEDICINE 2024; 25: 24-28

Utility of Structured Oculomotor, Balance, and Exercise Testing in Civilian Adults With Mild Traumatic Brain Injury.

Assessments of oculomotor, balance, and exercise function detect different responses to mild traumatic brain injury in sports-related mild traumatic brain injury. These assessments are understudied in the adult community mild traumatic brain injury population. We evaluated level 1 trauma center patients with nonsports-related mild traumatic brain injury on oculomotor functioning (near point of convergence and accommodation), balance (Balance Error Scoring System), and exercise tolerance (Buffalo Concussion Treadmill Test). A prospective, cohort study of adults with mild traumatic brain injury ( n = 36) were assessed at 1 wk and 1-mo post-mild traumatic brain injury ( n = 26) using near point of convergence, near point of accommodation, Balance Error Scoring System, Buffalo Concussion Treadmill Test, and the Rivermead Post Concussion Symptoms Questionnaire. Prevalence of test impairment and association between performance and mild traumatic brain injury-related symptom burden (Rivermead Post Concussion Symptoms Questionnaire scores) were characterized. Participants demonstrated varying levels of impairment (e.g., 33.3% oculomotor, 44.1% balance, and 55.6% exercise impairment at 1 wk). Participants displayed diverse impairment profiles across assessments. We observed medium-to-large correlations between poorer near point of convergence and Buffalo Concussion Treadmill Test performance and greater mild traumatic brain injury symptom burden. Clinical examinations of oculomotor function, balance, and exercise adopted from sports-related concussion assessments detect impairment in adult community members with mild traumatic brain injury. While findings warrant larger-scale replication, they imply that incorporating these simple, structured examinations into the assessment of mild traumatic brain injury may facilitate more personalized management strategies.

Variation in macroinvertebrate assemblages and water quality as a test for different levels of ecological impairment across an Ethiopian highland river system

ABSTRACT The Ethiopian highlands is an area under high anthropogenic pressure. Despite being a hotspot for freshwater biodiversity, the ecological status of local rivers is not monitored. Physicochemical and nutrient water quality parameters and macroinvertebrate assemblages were sampled monthly from the Megech River and its tributaries from January to March 2021. Sampling locations were designated as either upstream or downstream of the Gondar City urban area. We tested for temporal (monthly) and spatial (location, river) variation in water quality and spatial (location, river) variation in macroinvertebrate assemblage structure to examine which water quality parameters were most associated with patterns in macroinvertebrate assemblages. Water quality varied significantly between locations and months but not between rivers. Water quality differences were particularly driven by higher nutrient, salinity, dissolved solids, and conductivity levels downstream, and higher pH and dissolved oxygen levels upstream. Despite the more abundant and diverse macroinvertebrate assemblages downstream, biotic index scores generally indicated slightly increased ecological impairment downstream. A clear spatial pattern emerged in macroinvertebrate assemblages between locations; we detected a significant difference between rivers, with pairwise differences between sampling locations, particularly due to high dissimilarity between the upstream and downstream locations of the Angereb, Shinta, and Qeha rivers. BIO-ENV Pearson correlations indicated that variation in macroinvertebrate assemblages were mostly explained by dissolved oxygen, salinity, and nutrient parameters including nitrate, ammonium, and sulphate. Our findings confirm the need for more rigorous monitoring of Ethiopian highland rivers and improved management of nutrient inputs.

Enhancing prompt perception in dementia: a comparative study of mixed reality cue modalities.

Dementia impacts millions worldwide and is challenging individuals' ability to engage in daily activities. Active living is crucial in mitigating dementia's neurodegenerative effects, yet people with dementia often struggle to initiate and complete tasks independently. Technologies offer promising solutions to engage people with dementia in activities of active living and improving their quality of life through prompting and cueing. It is anticipated that developments in sensor and wearable technologies will result in mixed reality technology becoming more accessible in everyday homes, making them more deployable. The possibility of mixed reality technologies to be programmed for different applications, and to adapt them to different levels of impairments, behaviours and contexts, will make them more scalable. The study aimed to develop a better understanding of modalities of prompts that people with dementia perceive successfully and correctly in mixed reality environments. It investigated interactions of people with dementia with different types of visual (graphics, animation, etc.) and sound (human voice, tones, etc.) prompts in mixed reality technologies. We used the Research through Design (RtD) method in this study. This paper describes the findings from the user research carried out in the study. We conducted observation studies with twenty-two people with dementia playing games on off-the-shelf mixed reality technologies, including both Augmented Reality (HoloLens, ArKit on iPhone) and Augmented Virtuality (Xbox Kinect and Osmo) technologies. The interactions with the technologies during the gameplay were video recorded for thematic analysis in Noldus Observer XT (version 16.0) for successful and correct perception of prompts. A comparison of the probability estimates of correct perception of the prompts by people with dementia suggests that human voice, graphic symbols and text are the most prominently perceived modalities of prompts. Feedback prompts for every action performed by people with dementia on the technology are critical for successful perception and should always be provided in the design. The study has resulted in recommendations and guidelines for designers to design prompts for people with dementia in mixed-reality environments. The work lays the foundation for considering mixed reality technologies as assistive tools for people with dementia, fostering discussions on their accessibility and inclusive design in technology development.

Developing a new questionnaire of positive contributions to Chinese families by children with autism spectrum disorder.

A literature review of both Eastern and Western literature regarding families of children with autism spectrum disorder (ASD) revealed limited empirical research that examines ASD in China. Furthermore, most research in this area comes from a deficit model and there is a lack of research that comes from a strengths background. No previous study in China has looked at the positive contributions of children with ASD to their families. The present study came from a strengths-based perspective and aimed to develop a new questionnaire to evaluate the positive contributions made to families by children who have ASD in China and are raised by their respective families. It considered the severity level of the children's disorder and the impact this had on the parents. Besides examining the children's impairment levels, the study also examined positive contributions and their relationship with socio-demographic elements such as family income and employment status of the parents, which also seem to be related to the positive contributions experienced by the parents. First, based on the literature review, an initial qualitative interview protocol was developed and administered to 10 parents of children with ASD. Then, based on the analyses of the interviews, a quantitative questionnaire was developed to assess the positive contributions of children with ASD to their families. The questionnaire was then administered to 156 parents of children with ASD. The internal structure of the questionnaire was analyzed by factor analysis. The questionnaire's reliability and validity were also examined. The data were then analyzed with multiple correlation comparisons and an independent sample T-test. Six factors emerged for families of children with ASD. The results showed that the cumulative explanatory variance of the six dimensions of the questionnaire was 65.42%. The Cronbach's coefficient of each dimension was between 0.7 and 0.9, and the combined Cronbach's coefficient of the total questionnaire was 0.945. This study found that the overall average positive contribution to families by children with ASD was 3.32, which is at a medium level, and all six dimensions were at a medium-to-high level. This study also found that the family's monthly income contributed to the overall positive contribution, intimacy and happiness, and gaining more special knowledge through experience dimensions. Furthermore, it was found that moderate severity of ASD, high income, and parental employment were all associated with more positive contributions. This new questionnaire appears to have good reliability and validity and seems suitable for assessing the positive contributions to families by children with ASD in China. The present study may be helpful for the parents of children with ASD and will likely help them focus on the strengths of their children rather than their shortcomings. The study might also benefit counselors and researchers who would be able to use the new questionnaire to evaluate the positive contributions made to families by children who have ASD.

NEUROTROPIC PROPERTIES OF RETROVIRUSES IN THE CONTEXT OF ANXIETY-DEPRESSIVE AND COGNITIVE DISORDERS IN HIV-POSITIVE PATIENTS

The aim: a comprehensive assessment and comparison of the prevalence of undiagnosed anxiety-depressive and cognitive symptoms in HIV-positive individuals at different stages of the disease who have been undergoing treatment for an extended period. Materials and methods According to the criteria of the scientific project, 71 HIV-positive individuals undergoing outpatient treatment with a compensated condition were involved. To explore dependencies on clinical stages (ClSt) of HIV infection and search for gender differences, the study was divided into 2 stages, respectively. The research included the collection of epidemiological and clinical-anamnestic data, as well as laboratory studies. Clinical-psychopathological and psychometric methods were used. Inclusion criteria for the study were HIV-positive status, receiving ART for more than 6 months, adulthood, and voluntary consent to participate. The obtained information was statistically processed by mathematical methods of statistics, using ANOVA criteria, Student's t-test, etc. Elements of neurocognitive and anxiety-depressive symptomatology were considered, utilizing GAD-7, HADS, and MMSE scales. Results: In patients of different groups in the first stage of the study, a gradually increasing level of anxiety and cognitive impairments was identified, depending on the stage of HIV infection. In the second stage of the study, gender and stage-related differences in anxiety and cognitive disorders were found in patients of all groups. Conclusions. Individuals in the first clinical stage (I ClSt) exhibited the least anxiety-depressive and cognitive disorders, indicating emotional and cognitive stability at this stage of HIV infection. HIV-infected individuals in the second and third clinical stages (II and III ClSt) demonstrated a progressive tendency toward anxious and depressive disorders, indicating a stage-dependent relationship to the progression of the disease. Patients in the fourth clinical stage (IV ClSt) showed the most pronounced anxious, depressive, and cognitive symptoms, which may be associated with the duration of the illness and antiretroviral therapy (ART). Research results in the female group (Group A1) suggest their lower susceptibility to disorders compared to males (Group A2) in the early stages of HIV infection. In the later stages (III-IV), it was found that women had pronounced anxious and depressive disorders (Group B1), while men exhibited signs of cognitive and depressive disorders (Group B2).

The unmet need for mental health support among persons with disabilities in Somalia: Principal correlates and barriers to access.

Disability and mental ill-health may be especially prevalent in Somalia, largely due to a protracted armed conflict and its consequent humanitarian crises. Little, if any, research to date, however, has simultaneously explored disability- and mental health-related factors in the Somali context. Using both descriptive and regression analytical techniques, we aimed to determine how increasing levels of functional impairment reported across different disability domains (i.e., visual, hearing and cognition), number of concomitant disabilities, and other empirically supported variables (such as employment and sex) are associated with the likelihood of self-identifying the need for mental health support among a sample (N=1,355) of Somalis with disabilities, as well as identify the common barriers to such support. Despite most participants self-identifying a need for mental health support, only 15% were able to access it, with the most common barriers being the cost of services and the unavailability of local services. Being female, married, and having increasing levels of functional difficulty in the cognitive, mobility and self-care domains of disability were each significantly associated with an increased likelihood of the self-identified need for mental health support. This study's findings highlight potential points of prioritisation for mental health policy and programming in Somalia. A Somali version of this abstract can be found in the SupplementaryMaterial.

COVID-19 pandemic and its impact on the quality of life of MBBS students – A cross-sectional study

Background: Coronavirus disease 2019 (COVID-19) is considered an additional source of stress to the general population and especially to medical students. Medical students are known to have higher levels of psychological impairment in the form of depression, anxiety, and stress. This study assesses the impact of the COVID-19 pandemic and the quality of life of MBBS students, including their E-leaning experience. Aims and Objectives: The aim of this study was to study the effect of the COVID-19 pandemic on the quality of life of MBBS students including E-leaning experience. Materials and Methods: It is a cross-sectional survey, conducted on 343 MBBS students during second wave, at Kurnool Medical College. The survey involved a questionnaire that was distributed as an online version (Google Forms) to the medical students. Data were analyzed using SPSS software. Results: The majority of the students were from the age group of 20 years (37.3%) with female predominance (53.9%). Second-year MBBS students were in majority (n = 48.4%) are most of them were unmarried (n = 98.5%). Quality of health, life, energy, sleep, self-contentment, and study potential along with future career plans was determined. E-learning was determined by various aspects such as device, internet connection and quality, data sharing, and proficiency. Conclusion: Student recognized a significant disruption to their medical education, shared a desire to continue with in-person rotations, and were willing to accept the risk of infection with COVID-19. They feel more secure with vaccination of self. Our novel results provide a solid foundation to help shape medical student roles in the clinical environment during this pandemic and future outbreaks.

Design, Development, and Functional Validation of a 3D-Printed Passive Upper Limb Exoskeleton.

Motor disability in children is evident in diagnoses such as cerebral palsy, muscular dystrophy, multiple sclerosis, or spinal muscular atrophy, among others, due to altered movement and postural patterns. This becomes more evident as the child grows and can be treated with physical therapy. The effectiveness of early interventions in facilitating an improvement in daily life activities varies depending on the child's condition. In this context, the use of exoskeletons has emerged in recent years as a valuable resource for conducting more efficient therapy processes. This work describes the design (both structural and functional) and preliminary usability and functional validation of a 3D-printed passive upper limb exoskeleton. The goal is to provide clinicians with an efficient, low-cost device that is both easy to manufacture and assemble and, in a gamified environment, serves as an assistive device to physical therapy. The device features 5 degrees of freedom, enabling both a pro-gravity and an anti-gravity mode, controlled by a series of elastic bands. This gives rise to a dual operating mode, offering assistance or resistance to different arm, forearm, and shoulder-dependent movements. Usability validation conducted by exoskeleton users showed average results in all aspects rated above 3.8 out of 5, which implies levels of satisfaction between "quite satisfied" and "very satisfied". The analysis of metrics recorded during therapy, such as the Hand Path Ratio and Success Rate (capturing user movements using an inertial sensor in the gamified environment), as well as the range of motion, reveals quantifiable improvements which can be attributed to the use of the exoskeleton: the Hand Path Ratio tended to approach 1 throughout sessions in almost all the users, the Success Rate remained stable (as users consistently were capable of completing the assigned tasks), and the range of motion showed that all patients achieved improvements of more than 10 degrees in some of the tested movements). These functional validation processes involved the participation of 7 children with varying levels of upper limb neuro-motor impairments.

Independência funcional, aspectos clínicos e fatores sociodemográficos em pacientes na fase aguda do Acidente Vascular Cerebral: uma análise de associação

ABSTRACT Purpose To analyze the association of functional independence with clinical aspects of neurological impairment, the location and extent of neuronal damage and sociodemographic factors in patients in the acute phase of stroke. Methods Analytical cross-sectional study in 90 adult and older patients affected by ischemic stroke, admitted to the hospital within 24 hours of the vascular event. Sociodemographic factors and clinical aspects data were collected from electronic medical records and/or interviews in order to depict the patients'profile, Oxfordshire Community Stroke Project, Alberta Stroke Programme Early CT Score, National Institute of Health Stroke Scale, and Functional Independence Measure. Results Neurological impairment, according to the National Institute of Health Stroke Scale, was associated with functioning in the first 24 hours after the stroke. Furthermore, the presence of arterial hypertension, age, inactive work, smoking and extent of neuronal damage were associated with functional dependence, but did not remain in the final model of this study. Conclusion Functional dependence is associated with arterial hypertension, age, inactive work, smoking, extent of neuronal damage, and degree of neurological impairment in the first 24 hours after the vascular event. Furthermore, a higher level of neurological impairment was independently associated with increased levels of functional dependence.

Secrecy Performance Analysis of Energy Harvesting Untrusted Relay Networks with Hardware Impairments

In this work, we focus on the issue of secure communication in energy harvesting untrusted relay networks taking into account the impact of hardware impairments, where an energy‐constrained relay, powered by received radio frequency signals, attempts to decode sensitive data from the source without authorization. To achieve secure communication, we employ destination‐assisted jamming to prevent the untrusted relay from decoding sensitive data while serving as a useful energy source. We derive the interception probability (IP), connection outage probability (COP), and effective secrecy throughput (EST) in closed form for time switching relaying (TSR) strategy. Subsequently, we conduct an asymptotic analysis in the high signal‐to‐noise ratio (SNR) regime to provide practical insights into how various system parameters affect security, reliability, and efficiency, including time switching factor and the level of hardware impairments. Our findings demonstrate that the presence of hardware impairments improves security performance but compromises reliability performance, which does more harm than good.

The ganglion cell complex thickness and visual function in leber hereditary optic neuropathy

Purpose: To evaluate the ganglion cell complex (GCC) thickness using the Iowa Reference Segmentation Algorithm in individuals with chronic Leber hereditary optic neuropathy (LHON) and to assess its relation to visual acuity, visual field sensitivity, and Estermann score.Methods: In this study, a total of 17 patients (34 eyes) aged 16–72 with chronic LHON were enrolled. Visual acuity, visual fields, and Optic coherence tomography (OCT) were performed. Visual fields was evaluated with Estermann and a custom central 30‐degree test, both performed monocularly with the Octopus 900 Haag‐Streit Diagnostics. OCT imaging was performed using a Canon OCT HS‐100 to measure the retinal ganglion cell complex (GCC) thickness. The raw OCT images were exported to IOWA Reference Algorithm and the GCC segmentation was rechecked and manually recorrected if needed. The thickness obtained from the Iowa Reference Algorithms was analysed and compared against the automated segmentation provided by the OCT's inbuilt segmentation algorithm. The correlation between the GCC thickness from 9 ETDRS sectors and the visual function were analysed.Results: On average the automated segmentation overestimated GCC thickness by 23.8 μm for all sectors. Macular central GCC correlated significantly with both visual field sensitivity and Estermann points missed (r = −0.486 and −0.396 respectively). Macular middle sector GCC thickness correlated significantly with visual acuity and visual field sensitivity (r = −0.586 and −0.396 respectively). GCC thickness in outer macular sector correlated significantly only with visual acuity (r = −0.471).Conclusions: In patients with chronic LHON, GCC thickness in central and middle sectors of macula correlates well with the visual function. OCT imaging and precise ganglion cell thickness evaluations in the macula can provide useful information about the structural damage and level of visual impairment in chronic LHON patients.

Psychiatric Manifestations Caused by Mycoplasma pneumoniae Encephalitis Mimicking Autoimmune Encephalitis

AbstractA significant etiological factor for upper respiratory tract infections and community-acquired pneumonia is Mycoplasma pneumoniae. The incidence of extrapulmonary neurological problems in infected patients has been shown to range from 0.1 to 7%, often manifesting within a timeframe of 2 to 14 days following the onset of respiratory symptoms. Acute disseminated encephalomyelitis, Guillain–Barré syndrome, and transverse myelitis are among the immune-mediated illnesses encompassed under the syndrome. A 3-year-old male child exhibited symptoms of acute encephalopathy and behavioral disruption subsequent to an infection caused by M. pneumoniae. He presented with irritability, sleep disturbance, slurred speech, increased appetite, episodes of unresponsiveness, moving in circles, staring, and laughing episodes lasting for up to 15 to 30 minutes over a week. He lost his previous toilet training. Abnormal jerks were noted while awake and asleep. Symptoms were preceded by exposure to vague febrile illness 3 weeks prior to presentation. The patient's brain magnetic resonance imaging was normal. Electroencephalography showed a slow background with no epileptiform discharges. Cerebrospinal fluid analysis and polymerase chain reaction for viruses were negative. The workup for autoimmune encephalitis was negative. Mycoplasma serology IgM was detected. Marked improvement was noted after methylprednisolone pulse therapy, intravenous immunoglobulin, valproic acid, and azithromycin. In conclusion, our report serves as a reminder that M. pneumoniae infection is a possible cause of encephalopathy and behavioral disturbance in children. Early recognition and promotion of immunomodulatory and antimicrobial treatment can prevent the affected child from experiencing different levels of long-lasting impairments in cognitive, physical, or visual abilities.

Interference-assisted energy harvesting short packet communications with hardware impairments

Radio frequency energy harvesting offers a promising solution to provide low power Internet of Things (IoT) devices with convenient and perpetual energy supply. In this work, we investigate the reliable performance of an energy-constrained transmitter communicating with a receiver over Nakagami-m channel, where the effects of transceiver hardware impairments and finite blocklength coding are jointly considered. Specifically, the communication link between the transmitter and receiver operates within the coverage of an existing wireless system, with radio frequency signal from the existing system serving as an energy signal for the transmitter while acting as an interference signal for the receiver. By utilizing the finite-blocklength information theory, we first derive average block error rate (BLER) and asymptotic average BLER in closed-form expressions, which enable us to quantify the extent of reliability loss. Then, we analyze effective throughput of the system, and determine the optimal blocklength that maximizes the effective throughput. Computer simulations are employed to validate the accuracy of our analytical findings, demonstrating the presence of an outage threshold solely due to hardware impairments. Furthermore, if transmission rate exceeds the outage threshold defined by the level of hardware impairments, reliable communication within the system under consideration cannot be achieved, regardless of the transmit signal-to-noise ratio (SNR).

The antioxidant betulinic acid enhances porcine oocyte maturation through Nrf2/Keap1 signaling pathway modulation.

During in vitro maturation, excess levels of reactive oxygen species (ROS) are a major cause of developmental defects in embryos. Betulinic acid (BA) is a naturally produced antioxidant in white birch bark. Recent studies have shown that BA exhibits antioxidant properties in various cells through the activation of antioxidant genes. Therefore, we investigated the effect of BA treatment on porcine oocytes and its underlying mechanism during oocyte maturation. Treatment with 0.1 μM BA significantly increased the proportion of MII oocytes compared with controls, and BA-treated oocytes had significantly higher development rates, trophectoderm cell numbers, and cell survival rates than controls. These results demonstrate that BA treatment improved the developmental competence of oocytes. Following BA treatment, oocytes exhibited reduced ROS levels and elevated glutathione (GSH) levels, accompanied by the enhanced expression of antioxidant genes, compared with control oocytes. To evaluate the antioxidant effects of BA, oocytes were exposed to H2O2, a potent ROS activator. Impaired nuclear maturation, ROS levels, and GSH levels induced in oocytes by H2O2 exposure was restored by BA treatment. As these antioxidant genes are regulated by the Nrf2/Keap1 signaling pathway, which is involved in antioxidant responses, we applied the Nrf2 inhibitor brusatol to investigate the effects of BA on this pathway. The negative effects of brusatol on meiotic maturation and oocyte quality, including levels of ROS, GSH, and antioxidant-related gene expression, were mitigated by BA treatment. Our results suggested that BA plays an effective role as an antioxidant in porcine oocyte maturation through adjusting the Nrf2/Keap1 signaling pathway. This finding provides valuable insights into the mechanisms governing oocyte maturation and embryonic development.

Specific Immunological Investigation in the Management of Patients with Spine and Joint Pathology

Abstract Objective: The immunological investigation is used for the improvement of the quality of the treatment of various diseases. The aim of the study was to estimate the significance of specific immunological methods in the management of inflammatory diseases. Materials and Methods: Determination of the level of autoimmune lymphocytotoxic and granulocytotoxic antibodies (ALA and AGA) and reaction of inhibition of leukocyte migration were used for investigation of persons with orthopedic, metabolic, and lung pathology. Results: The study showed increased serum levels of ALA and AGA, decreased nonspecific LIF production and increased level of LIF in the presence of own serum, increased leukocyte migration to synovial membrane, bone, cartilage, Candida lusitaniae, Staphylococcus epidermidis, Staphylococcus aureus in persons with periprosthetic infection.. Decreased leukocyte migration to the antigens of S. aureus, Streptococcus pyogenes, Escherichia coli, and Pseudomonas aeruginosa and connective tissue antigens was determined in persons with inflammatory diseases of bones. Increased ALA, reduced LIF, and leukocyte migration enhancement to synovial membrane were revealed in impaired glucose metabolism. The persons with anemia were characterized by increased ALA, sensitization to bone and cartilage, Staphylococcus, and humoral sensitization to E. coli. Increased serum levels of ALA, AGA, decreased level of nonspecific LIF production and sensitization to connective tissue, Streptococcus and E. coli were determined in persons with impaired cholesterol level. Chronic obstructive pulmonary disease patients were characterized by sensitivity to S. aureus, P. aeruginosa, and humoral sensitization to the lung tissue. Conclusions: Inflammatory diseases are characterized by specific signs of immunological status and require definition of individual tactics of the treatment.

Effect of regular physical activity and lifestyle changes on insulin resistance in patients after kidney transplantation.

Insulin resistance (IR) is the most significant risk factor for post-transplant diabetes mellitus (PTDM). This study aimed to determine the effects of regular physical activity on IR and PTDM in patients after kidney transplantation (KT). The study group (n = 22) participated in aerobic or combined sports (aerobic and anaerobic). Monitoring was provided by asports tracker (Xiaomi Mi Band 4, compatible with the Mi Fit mobile application). Waist circumference was significantly lower (p = 0.0437, p= 0.0372), graft function was better (p= 0.0036, p= 0.0137), fasting blood glucose was lower (p = 0.0016, p= 0.0003), C-peptide level was lower (p = 0.0447, p= 0014) in the 3rd and 6th months of monitoring, and low-density lipoprotein was lower at 6months (p = 0.0444) in the observed group than in the control group. IR was significantly lower at 6 months (p = 0.0202), and fasting blood glucose was significantly lower at 3 and 6 months (p = 0.0227) in the observed group. We confirmed the significant effect of regular physical activity on preventing the development of IR and impaired fasting glucose levels in patients after KT (Tab. 1, Fig. 4, Ref. 27). Text in PDF www.elis.sk Keywords: kidney transplantation, insulin resistance, physical activity.

Quality of Life After Early Clot Removal for Acute Iliofemoral Deep Vein Thrombosis

To evaluate patient reported outcome measures after early clot removal for acute deep vein thrombosis (DVT), using the Chronic Venous Disease Quality of Life Questionnaire (CIVIQ-20) and the Short Form Health Survey (SF-36). Cross sectional design. Patients who underwent early clot removal between June 2012 and November 2021 were asked to complete the two questionnaires once. Lower CIVIQ-20 and higher SF-36 scores indicate better quality of life (QoL). Primary endpoints were the median scores. The one sample Wilcoxon signed rank test was used to compare SF-36 physical and mental component summary (PCS and MCS) to the normative and CIVIQ-20 to the minimum. Secondary, non-parametric independent t test or Fisher's exact test examined how age, sex, body mass index, stent placement, re-intervention, and time of questionnaire completion related to QoL. Multivariable linear regression tested whether various variables were associated with QoL. The response rate was 73.5% (n= 39). Median time of questionnaire completion was 1.8 years (interquartile range [IQR] 3.1) after clot removal. The median CIVIQ-20 of 29.0 (IQR 28.0) was slightly higher than the minimum value 20.0 (p < .001). The median PCS (50.5, IQR 16.6) and median MCS (50.2, IQR 14.2) did not differ from the normative of 50.0. However, wide IQRs indicated impairments for a subgroup of patients. None of the tested variables affected QoL except for the finding that re-interventions had a significantly negative impact on the SF-36 MCS (standardised β coefficient of-0.4, p= .030). Overall patient reported outcome measures were satisfactory after early clot removal, but impaired physical and mental functioning levels were present in a subgroup of patients. Re-interventions were found to have a negative impact on mental QoL. This finding was independent of time that had passed between the procedure and questionnaire completion. This study emphasises that mental functioning deserves attention, besides the widely recognised physical consequences after invasive acute iliofemoral DVT treatment.

Knee osteoarthritis patients assessed during walking for ankle inversion movement discrimination sensitivity.

Background: Knee osteoarthritis (KOA) is a common musculoskeletal condition that affects dynamic balance control and increases the risk of falling during walking. However, the mechanisms underlying this are still unclear. Diminished ankle proprioception during walking has been found to be related to fear of falling in older adults, with a gender difference in incidence of falling. This study aimed to determine 1) whether ankle inversion proprioceptive acuity during walking is impaired in patients with KOA; and 2) whether there is any difference between genders. Methods: Thirty-two patients with KOA (F:M = 17:15, Median age = 52.5, BMI = 22.3 ± 3.0) and 34 healthy controls without KOA (HC) (F:M = 17:17; median age = 49.0, BMI = 22.5 ± 2.7) were recruited. In patients with KOA, ankle inversion proprioceptive acuity was measured on the affected side using the ankle inversion discrimination apparatus for walking (AIDAW), whilst HC were assessed on a randomly selected side. Two-way (2*2) analysis of variance (ANOVA) was performed to determine the main effects and interaction between gender and KOA condition. Results: Two-way ANOVA showed a significant KOA main effect (F = 26.6, p < 0.001, ƞp 2 = 0.3) whereby AIDAW scores during walking for individuals with KOA were significantly lower than those without KOA (KOA vs. HC: 0.746 ± 0.057 vs. 0.807 ± 0.035). There was neither a gender main effect nor interaction (both p > 0.05). Conclusion: Individuals with KOA demonstrated lower ankle proprioception scores during walking compared to their healthy counterparts, with a similar level of impairment in ankle proprioceptive acuity between male and female patients. A low score may contribute to an increased risk of falling in the KOA population. The current findings suggest the need for global concern about lower limb proprioception in the clinical management of KOA.

Downsides to the empathic brain? A review of neural correlates of empathy in major depressive disorder.

Empathy as one of the basic prerequisites for successful social interactions seems to be aberrant in individuals with major depressive disorder (MDD). Although understanding empathic impairments in MDD is crucial considering the frequently reported social skill deficits in patients, the current state of research is still inconclusive, pointing to both elevated and impaired levels of empathy. In this review, we extend previous reports of MDD-related aberrations in self-reported and behavioral empathy by shedding light on the neural correlates of empathy in MDD. Study findings indicate a complex and potentially state-dependent association, comprising both elevated and lower neural activity in empathy-related brain regions such as the inferior frontal gyri, bilateral anterior insulae, and cingulate areas. Predominantly, lower activity in these areas seems to be induced by antidepressant treatment or remission, with accompanying behavioral results indicating a reduced negativity-bias in empathic processing compared to acute states of MDD. We propose a preliminary model of empathy development throughout the course of the disorder, comprising initially elevated levels of empathy and a somewhat detached and lower empathic responding during the further progression of the disorder or post-treatment. The seemingly multifaceted nature of the association between empathy and MDD requires further exploration in future multimodal and longitudinal studies. The study of neural correlates of empathy in MDD should prospectively be enlarged by including further socio-affective and -cognitive capacities in MDD and related mental disorders.