Major Symptoms Research Articles

"Diagnosed with New Health": Social Security Policy Recommendations for People with Cycstic Fibrosis in Ohio Transitioning to a Longer Lifespan

Cystic fibrosis (CF) is a chronic, progressive, genetic, and life-limiting lung disease that impacts approximately 105,000 individuals globally, including 40,000 individuals in the United States. In 2019, a revolutionary new drug, elexacaftor/ivacaftor/tezacaftor (ETI), was approved to manage some of the major symptoms of CF and dramatically increase the lifespan of people with cystic fibrosis (pwCF). Many individuals with CF cannot work full time and require Medicaid, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), and other financial assistance programs to pay for treatments and medical expenses. Yet in recent years, pwCF who are on ETI have been increasingly losing benefits. A possible explanation for this is the effectiveness of ETI in improving lung function, creating the perception that pwCF are no longer disabled by their condition. Even with this “miracle" drug, pwCF continue to experience significant complications and vulnerabilities to their physical and mental health as well as limitations on daily living and employment. The compounded vulnerabilities these individuals experience leave them without a safety net. Social Security policies for pwCF require revisions to prevent further biopsychosocial damage to this population. Two policies will be recommended: leniency in redetermination, and CF education for those who make determination decisions.

Efficacy of Yashtimadhu Ghritha Tarpana in Computer Vision Syndrome

Computer Vision Syndrome is the name given to eye problems caused by prolonged computer use including: Eye irritation (Dry eyes, itchy eyes, red eyes) Blurred vision, Headache. As we enter the 21st century, the growing use of Video Display Terminal (VDT) like Computer, Tablet, Smart phones etc. in the home and office brings with it an increase in health risks, especially for the eyes. One eye problem, called Computer Vision Syndrome (CVS), is afflicting more and more people who find themselves constantly in front of Video Display Terminal. Symptoms of Computer Vision Syndrome include Headache, Blurred vision, Burning sensation, Fatigue, Dry eyes, Irritated eyes, Double vision, and Difficulty re-focusing the eyes. These symptoms can be further aggravated by improper lighting conditions and air moving fast the eyes. Dry eye is a major symptom that is targeted in the therapy of computer vision syndrome. Acharya Susrutha mentioned Tarpanam, Putapakam, Sekam, Acshyothanam, Anjana the Kriya Kalpas for Netra Rogas. Tarpana is indicated when the eyes are fatigue inactive, Sushka (dry), Ruksha (rough), injured, patients of Vata and Pitta vitiation, when there is squint, loss of lashes, clouded vision, difficulty in opening the eyes etc. conditions, Tarpana should be done to the patients.

Efficacy and safety of tegoprazan in the treatment of gastroesophageal reflux disease: A protocol for meta-analysis and systematic review.

The incidence of gastroesophageal reflux disease (GERD) is increasing year by year, the clinical manifestations are complex and diverse, and the adverse effects of long-term use of proton pump inhibitors and gastrointestinal motility drugs have been of great concern in recent years. The effectiveness of tegoprazan in the treatment of GERD is still controversial. This protocol describes a systematic review and meta-analysis to evaluate the efficacy and safety of tegoprazan in the treatment of gastroesophageal reflux disease. PubMed, Embase, Cochrane Library and Web of Science will be searched from the database inception to 1 March 2023. All randomized controlled trials related to tegoprazan for GERD will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be complete resolution of major symptoms, complete resolution of heartburn, proportion of heartburn-free days, chronic cough, hoarseness, and adverse events. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The results of this study will provide reliable evidence to evaluate the efficacy and safety of tegoprazan in the treatment of GERD and help patients, physicians and clinical investigators choose the most appropriate treatment.

Comparative analysis of symptom burdens and influential factors among diverse terminally-ill patients.

The suffering experienced by terminally-ill patients encompasses physiological, psychosocial and spiritual dimensions. While previous studies have investigated symptom burden intensity for specific disease groups, such as cancer or heart failure patients, a research gap exists in understanding major distressing symptoms among diverse terminally-ill patients. This study assessed symptom burden intensity and explored its influential factors among diverse patient disease groups. This cross-sectional study utilized the baseline Integrated Palliative care Outcome Scale (IPOS) assessment data. The study participants were terminally-ill patients enrolled in an end-of-life care (EoLC) intervention in Hong Kong. Statistical methods including relative importance index (RII), one-way analysis of variance (ANOVA), and generalized linear regression (GLR) were employed. Final sample consisted of 1,549 terminally-ill patients (mean age =77.4 years, SD =11.6). The five top-rated distressing symptoms among these patients, revealed by the RII analysis, were poor mobility (RII =64.4%), family anxiety (RII =63.5%), sharing feelings with family/friends (RII =61.4%), weakness/lack of energy (RII =58.1%), and hardly feeling at peace (RII =50.7%). One-way ANOVA showed significant differences among the eight disease groups in perceived physical and emotional symptom burden intensity (P<0.05). Analysis of RII symptom scores for each disease group revealed that poor mobility was rated as the most distressing symptom (RII =85.1-62.9%) by patients with motor neurone disease, Parkinson's disease, heart failure, dementia, end-stage renal disease and other serious diseases (including stroke, hematological disease, multiple sclerosis and liver diseases). Perceived family anxiety (RII =66.1%) and shortness of breath (RII =63.8%) were the most distressing symptoms for cancer patients and those with chronic obstructive pulmonary disease, respectively. GLR analysis showed that illness type is the most significant factor influencing the perceived burden intensity in terms of the IPOS total and subscale scores of physical symptoms, emotional symptoms and communication/practical issues. Demographic characteristics such as age, gender, marital status and co-residing status were also identified as influential factors of various symptom categories. However, patients' educational level and relationship with primary caregiver did not significantly influence any perceived symptom burden. This study provides valuable insights into the symptom burdens experienced by diverse patient disease groups at end-stage of life. The findings highlight the major distressing symptoms of poor mobility, family anxiety, and shortness of breath. Addressing these symptoms is crucial in improving the quality of care for terminally-ill patients. Furthermore, the study identifies influential factors that can affect the perceived intensity of symptom burden, primarily the main type of terminal illness and patient's age. Tailored care support and improved clinical care should be implemented, particularly for high-risk groups such as patients with non-cancer terminal illnesses and older aged patients. These findings contribute to existing literature and emphasize the need for comprehensive and individualized care in EoLC.

Effect of Lee Silverman Voice Treatment® BIG on the major motor symptoms in patients with moderate Parkinson’s disease: an observational study

Effect of Lee Silverman Voice Treatment® BIG on the major motor symptoms in patients with moderate Parkinson’s disease: an observational study

Clinicopathologic Analysis of Malabsorption Syndrome in a Tertiary Care Center in South India

ABSTRACT Background: Malabsorption syndrome is an umbrella term for manifestations consisting of diarrhea, steatorrhea, malnutrition, unexplained weight loss, persistent or recurrent abdominal pain, and anemia. Celiac disease and Tropical sprue remain the two important causes among many more. Materials and Methods: The objectives of this study were to assess the spectrum of histological features of malabsorption at a tertiary care center and to correlate the clinical, endoscopic, and histological features between the various etiologies. Biopsy specimens of 547 subjects formed the sample for this institutional-based, retrospective research. All subjects who had a clinical diagnosis of malabsorption and underwent subsequent endoscopic evaluation along with biopsy were considered. The hematoxylin and eosin-stained sections were analyzed for villous architecture and intraepithelial lymphocytes (IELs). The histopathological findings were further correlated with the endoscopic findings. Data thus obtained were statistically analyzed using Microsoft Excel for Windows (2010). Results: The mean age of the subjects was 46.65 ± 17.31 years and with 330 males (60.33%) and 217 female (39.63%) subjects. Chronic diarrhea was the major presenting symptom in 95% of the subjects (n = 520). Normal villous architecture was noted in 68.19%, while the remaining cases showed varying degrees of atrophy ranging from mild in 27.61% (n = 151) to moderate in 2.56% (n = 14) to severe in 1.65% (n = 9). IELs were noted in 70.78% of cases. Conclusion: Histopathological findings, when analyzed, showed intraepithelial lymphocytosis as the major diagnosis in 34.19% of cases (n = 187), followed by tropical sprue in 19.56% (n = 107) cases. The pathology was nonspecific in about 13.89% (n = 76).

EXERCISE TRAINING IMPROVES GASTROINTESTINAL SYMPTOMS IN PEOPLE WITH A DISORDER OF THE GUT BRAIN INTERACTION (DGBI): SYSTEMIC REVIEW AND META-ANALYSIS

INTRODUCTION &amp; AIMS Approximately 40% of the global population has criteria that meets at least one Disorder of the Gut-Brain Interaction (DGBI). DGBIs are characterised by the absence of structural abnormalities, with chronic symptoms, such as pain, altered bowel movements, and nausea. Current therapy options focus on treating the major symptoms, which can involve pharmacological and lifestyle advice (diet, exercise, and stress management). The aim of this study was to conduct a systematic review and meta-analysis investigating the efficacy of exercise for improving gastrointestinal symptoms in people with a DGBI. METHODS A search of relevant databases was completed in February 2023, for randomised controlled trials that applied an exercise intervention in people with DGBI. Comparator groups included usual care, pharmacological therapy, or diet advice. A pairwise random-effects meta-analysis estimated the standardised mean difference (SMD) (Hedges’ g) between exercise and comparator groups for changes in gastrointestinal symptoms. Risk of bias was analysed using the Cochrane Risk of Bias tool. RESULTS Ten studies published between 2004–2023 were included. Participants (n=653) were mostly female 77.6%. Eight studies included participants with irritable bowel syndrome and two included individuals with functional dyspepsia. Exercise interventions lasted an average duration of 8 weeks. The modes included yoga (n=5), low intensity (n=1) and moderate intensity aerobic exercise (n=4). Studies ranged from low to high-risk bias. Meta-analysis showed exercise interventions improved gastrointestinal symptoms (SMD=1.2, 95% CI 0.5 to 1.8; p&amp;lt;0.001). The effect was moderated by the intensity of exercise with moderate intensity aerobic exercise having a significant impact (SMD=1.6, 1.2 to 2.0; p&amp;lt;0.001) not evident with yoga and low intensity exercise interventions (SMD=0.9, -0.01 to 1.7; p=0.053). CONCLUSION Exercise interventions in people with DGBIs improve gastrointestinal symptoms. Moderate intensity aerobic exercise is more efficacious than yoga and lower intensity exercise.

Thoracal meningioma and neurological status recovery 6 months postoperative: A case report

Introduction: Meningioma is the most common intradural tumor of the spinal cord in adults. Spinal meningioma arises from slow-growing arachnoid cap cells, which are generally located intradural extramedullary and grow laterally into the subarachnoid space to stretch the surrounding arachnoid. Local pain is usually the first major symptom. However, the majority of cases are diagnosed after the onset of neurological deficits or impaired walking. Case Presentation: Woman, 46 years old, with back pain radiating to both legs in the last 2 years before surgery. At 16 months before surgery, she had paralysis of both legs with bowel and bladder incontinence. Preoperative physical examination shows no muscle contraction on both lower extremities, with hypoesthesia in the Thoracal 2 dermatome. MRI examination shows intradural extramedullary mass at the level of the 2nd thoracal that compresses the entire spinal canal. Laminectomy surgery on thoracal 2 and tumor resection in toto were performed. Surgical resection showed a tumor mass of 2x1,2x1cm with a thick, spongy, brownish-yellow consistency. Histopathological examination shows psammomatous type meningioma, WHO Grade 1. The patient was discharged postoperatively with palpable muscle contractions on both legs, accompanied by no sensory abnormalities. Evaluation 1 month postoperatively, the patient was able to voluntarily move the lower extremities accompanied by the return of ability to micturate and defecate. Examination at 6 months postoperatively, the patient was able to walk without assistance and no other neurological deficit was found. Conclusion: Tumor resection remains as treatment of choice for spinal meningioma regardless of neurological deficit onset and histological type of tumor.

Oral health vulnerability and its associated risk factors among tribal elderly people in Bangladesh: a primary pilot initiative of national oral health survey

Background Tribal elderly is a vulnerable population due to their geographic location and lack of access to healthcare services including poor oral health. As the primary initiative for representative ethnic oral health survey for elderly, this pilot study aims to assess the oral health status of tribal elderly in Bangladesh and identify the associated risk factors. Methods This cross-sectional pilot survey was conducted among 280 tribal elderlies aged 60 years and above residing in the main tribal residing region in Bangladesh. The data was collected through cluster sampling methods using a semi-structured questionnaire and oral examination. Different statistical tools including frequency distribution, Chi-square association test and multivariable logistic regression model were performed in data analysis. Results The results showed that 25.35% of the tribal elderly had high DMFT score, indicating poor oral health. Respondents’ age, sex, marital status, occupational status, sweet eater, tobacco, and alcohol consumption were significantly associated with oral health. The major oral clinical sign and symptoms were dental carries, teeth sensitivity, loose teeth, broken teeth, calculus and staining in teeth, tongue pain and bad breath. The logistic regression analysis suggested that elderly aged 80 and above had 3.33 times more, males were 4.6 time less, tobacco user (smoked/smokeless) were 2.03 times more and alcohol consumers were 6.83 times more likely to experienced poor oral health condition than their counterparts. Conclusions Elderly individuals were found to be more likely to suffer from poor oral health condition than younger individuals, and certain lifestyle factors such as tobacco and alcohol consumption, meal frequency, and sweet consumption can further increase the risk of poor oral health condition. The findings can be a primary initiative for further investigation on the nationally representative oral health survey among ethnic elderly.

Routine follow-up imaging is not necessary in uneventful early recovery after distal radius fractures treated with volar locking plate in working-aged patients: A retrospective single-center cohort study.

The purpose of our study was to evaluate whether routine follow-up radiographs after distal radius fracture (DRF) treated with volar locking plate (VLP) influenced clinical decision-making and treatment in working-aged patients (18-65 years). We evaluated the possible correlation between clinical status and problems with follow-up radiographs and analyzed the overall reoperation rate. The study population of this retrospective cohort study consisted of working-aged (18-65 years) patients with DRF who were treated with VLP between January 2010 and December 2020. Baseline data, follow-up visits, and radiographs were collected. Radiographs were classified as either routinely assigned or according to clinical findings. Patients were divided into four groups based on abnormal radiographic findings or major symptoms leading to reoperation. Patients also received patient-rated wrist evaluation (PRWE) questionnaire, which were analyzed. A total of 861 patients were included in this study. Routine follow-up radiographs were available for 844 (98%) patients. In 7.0% of patients, 6-week radiographs led to a change of standard treatment protocol, most commonly additional imaging and/or clinical follow-up. Nine (1.1%) patients underwent an urgent reoperation, and 15 (1.8%) patients underwent reoperation later in the follow-up period. All these patients were exceptionally painful/symptomatic. In addition, 33 (3.9%) patients who underwent additional imaging and follow-up after abnormal radiograph, but did not undergo reoperation, were asymptomatic or suffered only mild pain. A total of 89 (10.5%) patients had reoperation for any reason during the follow-up period. Routine follow-up radiographs after the treatment of DRF with VLP in the working-aged population rarely leads to changes in treatment strategy or reoperation in asymptomatic patients suggesting that it would be safe and cost-effective to reduce routine follow-up radiographs and focus instead on those patients with moderate-to-severe symptoms.

Endothelin-1-mediated Brainstem Glial Activation Produces Asthmatic Airway Vagal Hypertonia Via Enhanced ATP-P2X4 Receptor Signaling in Sprague-Dawley Rats.

The occurrence of major asthma symptoms is largely attributed to airway vagal hypertonia, of which the central mechanisms remain unclear. This study tests the hypotheses that endothelin-1-mediated brainstem glial activation produces asthmatic airway vagal hypertonia via enhanced action of adenosine 5'-triphosphate on neuronal purinergic P2X4 receptors. A rat model of asthma was prepared using ovalbumin. Airway vagal tone was evaluated by the recurrent laryngeal discharge and plethysmographic measurement of pulmonary function. The changes in the brainstem were examined using ELISA, Western blot, luciferin-luciferase, quantitative reverse transcription-polymerase chain reaction, enzyme activity assay and immunofluorescent staining, respectively. The results showed that in the medulla of rats, endothelin receptor type B and P2X4 receptors were primarily expressed in astrocytes and neurons, respectively, and both of which, along with endothelin-1 content, were significantly increased after ovalbumin sensitization. Ovalbumin sensitization significantly increased recurrent laryngeal discharge, which was blocked by acute intracisternal injection of P2X4 receptor antagonist 5-BDBD, knockdown of brainstem P2X4 receptors, and chronic intraperitoneal injection of endothelin receptor type B antagonist BQ788, respectively. Ovalbumin sensitization activated microglia and astrocytes and significantly decreased ecto-5'-nucleotidase activity in the medulla, and all of which, together with the increase of medullary P2X4 receptor expression and decrease of pulmonary function, were reversed by chronic BQ788 treatment. These results demonstrated that in rats, allergic airway challenge activates both microglia and astrocytes in the medulla via enhanced endothelin-1/endothelin receptor type B signaling, which subsequently causes airway vagal hypertonia via augmented adenosine 5'-triphosphate/P2X4 receptor signaling in central neurons of airway vagal reflex.

Evaluation and Comparison of Therapeutic Efficacy of Various Hormonal Protocols in Anoestrus Buffalo Heifers of Semi-Arid Region

To assess and compare different hormonal protocols' treatment efficacy in anoestrus buffalo heifers in a semi-arid region. Forty buffalo heifers with a history of anoestrus were chosen randomly from the semi-arid region of Banaskanth and divided into four equal groups.Group-I: Heatsynch protocol (n = 10), Group-II Ovsynch protocol (n = 10), Group-III Doublesynch protocol (n = 10) and Group-IV Control (n = 10) are followed by artificial insemination at a predetermined period in treated buffalo heifers and insemination during spontaneous estrus in group-IV buffalo heifers. In Groups I, II, and III, the corresponding percentages of estrus induction were 90, 80, and 80 percent. Major symptoms such as edoema, erythema, dampness of vulva and estrus mucus secretion were present during the expression of estrus. Fifty percent of the buffalo heifers in Group IV displayed estrus at varying intervals. After three consecution services, Group II had the highest overall fertility rate (50%) followed by Group III (40%), Group I (30%), and Group IV (30%). In true anoestrus buffalo heifers, the Heatsynch, Ovsynch, and Doublesynch procedure can be applied with success to induce estrus. Buffalo heifers that follow the Ovsynch protocol may have a higher conception rate.

Patient awareness of the association between periodontal and systemic diseases in an academic setting.

Periodontal diseases (PD) have been increasingly associated with several systemic conditions such as cardiovascular disease (CVD), diabetes mellitus (DM), rheumatoid arthritis (RA), and Alzheimer's disease (AD). This study aimed to gain insight into patients' awareness of the association between PD and systemic diseases. A survey was developed to analyze patient awareness of the association between PD and systemic diseases. Descriptive and categorical variables were summarized with counts and percentages. Chi-squared tests were used to evaluate differences between variables. A linear logistical regression model was used to assess the simultaneous, independent association between each variable. Data from 161 completed surveys were analyzed. The majority of the participants (61.49%) reported awareness of symptoms of PD, but only 36.36% identified all its major symptoms. Individuals reporting awareness of the association between PD and systemic diseases was 48.4%, 31.7%, 14.9%, and 9.9% for CVD, DM, RA, and AD, respectively. Patients aged ≥51 years and males were more aware of the association between PD and CVD. Increased awareness of an association between PD and DM was observed among patients who had a higher frequency of dental visits and those with a self-reported history of DM. This study provides insight that, even with the vast amount of scientific knowledge on the inter-relationships that exist between PD and systemic diseases, most patients are still unaware of these associations. This research identified that improvement of health literacy surrounding PD, their symptoms, and their association with systemic diseases may be warranted.

Establishment of an intragastric surgical model using C57BL/6 mice to study the vaccine efficacy of OMV-based immunogens against Helicobacter pylori.

Chronic gastritis is one of the major symptoms of gastro-duodenal disorders typically induced by Helicobacter pylori (H. pylori). To date, no suitable model is available to study pathophysiology and therapeutic measures accurately. Here, we have presented a successful surgical infection model of H. pylori-induced gastritis in C57BL/6 mice that resembles features similar to human infection. The proposed model does not require any preparatory treatment other than surgical intervention. C57BL/6 mice were injected with wild-type SS1 (Sydney strain 1, reference strain) directly into the stomach. Seven days post infection, infected animals showed alterations in cytokine responses along with inflammatory cell infiltration in the lamina propria, depicting a prominent inflammatory response due to infection. To understand the immunogenicity and protective efficacy, the mice were immunized with outer membrane vesicles (OMVs) isolated from an indigenous strain with putative virulence factors of H. pylori [A61C (1), cag+/vacA s1m1]. In contrast to the non-immunized cohort, the OMV-immunized cohort showed a gradual increase in serum immunoglobulin(s) levels on the 35th day after the first immunization. This conferred protective immunity against subsequent challenge with the reference strain (SS1). Direct inoculation of H. pylori into the stomach influenced infection in a short time and, more importantly, in a dose-dependent manner, indicating the usefulness of the developed model for pathophysiology, therapeutic and prophylactic studies.

Traditional healers' perception on scabies causation and management in Ghana.

Scabies is an underdiagnosed skin infestation caused by the Sarcoptes scabiei mite. The infection causes severe itching and a skin rash but can be effectively treated using topical or systemic drugs. Scabies outbreaks are commonly reported in resource-poor countries, including Ghana. Traditional healers play an important role in primary care in rural areas. The role of these traditional healers in the management of scabies has so far not been explored. The aim of this study was therefore to investigate the perceptions of traditional healers regarding the causation and management of scabies. A phenomenological qualitative approach was employed. Traditional healers in the Asante Akim North and Central districts in Ghana were approached with an interview request. Using a semi-structured interview protocol, 15 traditional healers were interviewed. The results were coded and analysed, after which seven themes were extrapolated. Scabies infections were frequently reported by traditional healers. Itching and skin rash were unanimously regarded as the major symptoms of scabies. The majority acknowledged the infectious nature of scabies, but no participant reported the causative organism. A dichotomous disease classification was noted, consisting of 'natural' and 'spiritual' variants each with a unique disease profile and management requirements, as reported by the traditional healers. All but two traditional healers reported to treat scabies using almost exclusively herbs and spiritual rituals. The majority of traditional healers were open to collaboration with allopathic healthcare providers. Collaboration could broaden the primary care network in rural areas, but mistrust and lack of transparency form potential barriers to collaboration. We, therefore, emphasise the need for additional efforts to investigate strategies for future collaboration.

MiR-574-5p activates human TLR8 to promote autoimmune signaling and lupus

Endosomal single-stranded RNA-sensing Toll-like receptor-7/8 (TLR7/8) plays a pivotal role in inflammation and immune responses and autoimmune diseases. However, the mechanisms underlying the initiation of the TLR7/8-mediated autoimmune signaling remain to be fully elucidated. Here, we demonstrate that miR-574-5p is aberrantly upregulated in tissues of lupus prone mice and in the plasma of lupus patients, with its expression levels correlating with the disease activity. miR-574-5p binds to and activates human hTLR8 or its murine ortholog mTlr7 to elicit a series of MyD88-dependent immune and inflammatory responses. These responses include the overproduction of cytokines and interferons, the activation of STAT1 signaling and B lymphocytes, and the production of autoantigens. In a transgenic mouse model, the induction of miR-574-5p overexpression is associated with increased secretion of antinuclear and anti-dsDNA antibodies, increased IgG and C3 deposit in the kidney, elevated expression of inflammatory genes in the spleen. In lupus-prone mice, lentivirus-mediated silencing of miR-574-5p significantly ameliorates major symptoms associated with lupus and lupus nephritis. Collectively, these results suggest that the miR-574-5p-hTLR8/mTlr7 signaling is an important axis of immune and inflammatory responses, contributing significantly to the development of lupus and lupus nephritis.

Chromatographic Methods for the Analysis of the Antipsychotic Drug Clozapine and Its Major Metabolites: A Review.

Clozapine (CLZ), a second-generation antipsychotic, can effectively reduce schizophrenia, bipolar disorder and major depression symptoms. This review provides an overview of all reported chromatographic methods (62 references) for the quantification of CLZ and its two main metabolites, norclozapine and clozapine N-oxide in pharmaceutical formulations, biological matrices and environmental samples.

Pain Management Strategies in Osteoarthritis.

Pain is the major symptom of osteoarthritis (OA) and is an important factor in strategies to manage this disease. However, the current standard of care does not provide satisfactory pain relief for many patients. The pathophysiology of OA is complex, and its presentation as a clinical syndrome is associated with the pathologies of multiple joint tissues. Treatment options are generally classified as pharmacologic, nonpharmacologic, surgical, and complementary and/or alternative, typically used in combination to achieve optimal results. The goals of treatment are the alleviation of symptoms and improvement in functional status. Several studies are exploring various directions for OA pain management, including tissue regeneration techniques, personalized medicine, and targeted drug therapies. The aim of the present narrative review is to extensively describe all the treatments available in the current practice, further describing the most important innovative therapies. Advancements in understanding the molecular and genetic aspects of osteoarthritis may lead to more effective and tailored treatment approaches in the future.

Association of depressive symptom severity and suicidal ideation with health-related quality of life among stroke survivors, NHANES 2005-2018

Stroke, a critical health issue in the US, not only has physical repercussions but also potentially affects the health-related quality of life (HRQoL) through neuropsychiatric outcomes like depressive symptoms and suicidal thoughts. This study utilized a nationally representative sample of 1302 US stroke survivors (age ≥ 20) from the US National Health and Nutrition Examination Survey (2005–2018) to assessed relationships between QoL via the CDC HRQOL-4 and evaluated depressive symptoms and suicidal ideation using the Patient Health Questionnaire-9 (PHQ-9). Participants (mean age: 64.4; 56.0 % female) showed that 40.7 % had at least mild depressive symptoms, and 18.8 % exhibited major depressive symptoms. Suicidal ideation was reported by 8.1 %. After sociodemographic and health condition adjustments, mild and major depressive symptoms, along with suicidal ideation, were associated with poorer general health status and more physically and mentally unhealthy days and activity limitation days. A dose-response relationship between PHQ-9 scores and HRQoL outcomes was evident (All P for trend <0.001). Stroke survivors with suicidal ideation also experienced more physically and mentally unhealthy days and activity limitation days. Depressive symptoms and suicidal ideation are associated with reduced HRQoL among US stroke survivors, underscoring the importance of thorough neuropsychiatric evaluations and interventions to bolster stroke survivors' well-being.

Implications of cyberbullying in major depressive symptoms development in young people between 15 and 29 years of age in Chile

To evaluate the relationship between cyberbullying and major depressive symptoms in young Chileans between 15 and 29 years. Survey through the StatKnows platform. Sampling was probabilistic and stratified with allocation proportional to the size of biphasic selection. The sample and the data were accessed virtually, respecting the bioethical standards of research with humans. At all ages studied, the probability of experiencing depressive symptoms increases as levels of cyber aggression do, especially in the group between 19 and 24 years. The results reflect various factors of emerging adulthood that make this group more vulnerable, emphasizing the importance of studying the phenomenon at non-school ages since this form of aggression is not exclusive to adolescence, and neither are its effects on mental health.