Mucous Membrane Research Articles

Deep Learning Model for Cosmetic Gel Classification Based on a Short-Time Fourier Transform and Spectrogram.

Cosmetics and topical medications, such as gels, foams, creams, and lotions, are viscoelastic substances that are applied to the skin or mucous membranes. The human perception of these materials is complex and involves multiple sensory modalities. Traditional panel-based sensory evaluations have limitations due to individual differences in sensory receptors and factors such as age, race, and gender. Therefore, this study proposes a deep-learning-based method for systematically analyzing and effectively identifying the physical properties of cosmetic gels. Time-series friction signals generated by rubbing the gels were measured. These signals were preprocessed through short-time Fourier transform (STFT) and continuous wavelet transform (CWT), respectively, and the frequency factors that change over time were distinguished and analyzed. The deep learning model employed a ResNet-based convolution neural network (CNN) structure with optimization achieved through a learning rate scheduler. The optimized STFT-based 2D CNN model outperforms the CWT-based 2D and 1D CNN models. The optimized STFT-based 2D CNN model also demonstrated robustness and reliability through k-fold cross-validation. This study suggests the potential for an innovative approach to replace traditional expert panel evaluations and objectively assess the user experience of cosmetics.

The pathological function of neutrophils in pemphigoid diseases

Abstract Pemphigoid diseases (PDs) are a group of autoimmune blistering diseases, including bullous pemphigoid, epidermolysis bullosa acquisita, mucous membrane pemphigoid, linear immunoglobulin A disease, and other rare variants. These diseases are characterized by the presence of autoantibodies that target proteins at the dermal-epidermal junction, resulting in the formation of tense blisters and erosions on the skin and/or mucosa. The current therapeutic approaches, such as systemic corticosteroid, are associated with significant adverse effects, highlighting that safer and more effective treatment options are an urgent clinical need. To address this unmet need, a comprehensive understanding of the detailed mechanisms underlying PDs is essential. Based on their histopathological infiltration in pemphigoid lesions, neutrophils have long been implicated as major contributors to the initiation and progression of the diseases. Numerous in vivo and in vitro studies have investigated the role of neutrophils in the pemphigoid pathology, revealing various pathological mechanisms induced by these cells, including the release of neutrophil elastase and matrix metalloproteinase-9, as well as the formation of neutrophil extracellular traps. The present review provides a comprehensive summary and critical evaluation of the current understanding regarding the role of neutrophils in PDs. In addition, it discusses the potential of targeting neutrophil-associated pathways as a novel therapeutic approach for the diseases.

Choroidal thickness and retinal vascular changes in patients with lichen planus: an inflammatory disease beyond the skin.

Lichen planus (LP) is a common inflammatory condition of unknown etiology that commonly affects the skin and mucous membranes. Optical coherence tomography angiography (OCTA) is a noninvasive technique for identifying early retinal vascular impairment in systemic disease without clinical damage by imaging deep and superficial capillary networks. To assess the impacts of LP on the choroid and assess vascular changes in retinal capillary density using OCTA. This single-center prospective case-control study included 30 therapeutic-naïve LP patients and 30 age and sex-matched healthy individuals. All study subjects underwent a complete ophthalmological examination, including best-corrected visual acuity (BCVA) measurement using a Snellen chart, slit-lamp biomicroscopy, intraocular pressure (IOP) measurement, and fundus examination. They were then examined using spectral domain OCT and choroidal thickness was measured. The vessel density of the superficial and deep capillary networks was measured and assessed using OCTA. Patients had significantly thicker choroidal and retinal thickness than controls, with subfoveal, nasal, and temporal areas showing a significant difference. A significantly higher vascular density in the superficial capillary plexus, particularly in the nasal perifoveal area, was found compared to the control group. Significantly, higher vascular density in the deep capillary plexus in the parafoveal area compared to controls was reported. Significant correlations were found between visual acuity and IOP, and age, duration of disease, and severity of disease. This study is the first to reveal that LP patients exhibit choroidal changes and retinal vascular alterations compared to healthy controls.

The use of an innovative technique for perforations of the mucous membrane of the maxillary sinus during the sinus lift operation

Introduction. To date, according to WHO, the number of people with a complete absence of teeth is greater than 8% of all the people worldwide. Loss of teeth due to complications of caries treatment, chronic periodontitis and trauma leads to atrophy of the alveolar ridge and that of soft tissues in this area, which in turn complicates the rehabilitation of the patients. According to the literature, in the first year after tooth extraction, the volume of the bone tissue of the alveolar ridge decreases by 40–60%, which greatly complicates the subsequent orthopedic rehabilitation of the patients. Currently, the «gold standard» for increasing the volume of the bone tissue of the alveolar ridge of the upper jaw in the distal section is the sinus lift operation. However, according to the literature, when sinus lift operation is performed, Schneider’s membrane perforation occurs in 7–23% of cases, which in terms, leads to the inability to complete the operation and complications in cases with total perforations of membrane.Purpose of the study. To evaluate the complex rehabilitation of patients with partial secondary absence of teeth and severe atrophy in the lateral sections of upper jaw using the «envelope technique» during open sinus lifting.Materials and methods. In 2020–2022, during a clinical study at the clinic of the Department of maxillofacial and plastic surgery of the Moscow State Medical University named after A.I. Evdokimov, 54 patients who had a history of PPI interventions in the ENT department were treated. All patients underwent bilateral open sinus lifting using enamel matrix proteins or the «envelope technique» for perforation of the Schneider membrane. After 9–12 months, a comprehensive rehabilitation of patients based on dental implants was carried out.Results. The number of extensive (total) perforations of the Schneider membrane in the study group of patients was 50%. As a result of the use of the patented «envelope technique» with the use of enamel matrix proteins, no postoperative complications were observed in patients with total perforation of the Schneider membrane. Taking into account the planned orthopedic design, 292 dental implants were installed in all patients.Conclusion. The method is effective and safe, allowing to rehabilitate patients with missing teeth and severe atrophy in the lateral part of the upper jaw, in case of intraoperative total perforation of the Schneiderian membrane.

Anomalies of the Mesenchyme (Meninges and Skull)—Defects of Neural Tube Closure: Cephalocele and Other Calvarial and Skull Base Defects; Intracranial Lipomas; Arachnoid Cysts; Nonsyndromic and Syndromic Craniosynostoses

AbstractWithin the embryonic head, a layer of mesenchyme envelops the brain beneath the surface ectoderm. This cranial mesenchyme is responsible for the formation of the meninges, the calvaria (upper portion of the skull), and the scalp's dermis. Irregular development of these structures, particularly the meninges and the calvaria, is associated with notable congenital defects in humans, such as defects in neural tube closure. Anencephaly is the most common neural tube defect (NTD) and one of the most severe malformations of the central nervous system; it consists in the complete or partial absence of the brain, associated with the absence of the bones of the cranial vault. Iniencephaly is an uncommon congenital NTD characterized by abnormalities in the occipital region, including rachischisis of the cervicothoracic spine and a fixed retroflexion deformity of the head. Unlike anencephaly, in iniencephaly, there is a skull cavity and a normal-looking skin that entirely covers the head and the medullary retroflex area. Cephaloceles are congenital abnormalities distinguished by the protrusion of meninges and/or brain tissue through a naturally occurring defect in the skull bone. This anomaly is typically covered by skin or mucous membrane. Intracranial lipoma is a relatively uncommon and generally benign tumor that occurs in an abnormal location within the brain; it probably represents a disturbance of the differentiation of the primordial meninges: for unknown causes, the meningeal mesenchyme can differentiate into adipose tissue. Arachnoid cysts are sacs filled with cerebrospinal fluid (CSF) situated between the brain or spinal cord and the arachnoid membrane. Typically, these cysts originate within CSF cisterns and gradually expand their boundaries. Craniosynostosis is the early fusion of one or more cranial sutures. It can occur spontaneously, be associated with a syndrome, or have a familial connection. It can involve one or multiple cranial sutures. Pfeiffer's, Crouzon's, and Apert's syndromes are among the more prevalent syndromic craniosynostoses.

Idiopathic Immune Mediated Haemolytic Anaemia (IMHA) in a 2.5-Month-old Puppy: A Case Report

Background: A 2.5-month-old puppy was presented to the Veterinary Clinical Complex of the College of Veterinary Sciences and AH, Jalukie, Nagaland with a complaint of emesis for one week, inappetence, icterus of the lower abdominal area and other visible mucous membrane. Detailed clinical history was collected and clinical examination was conducted. Methods: 4 ml blood peripheral blood was collected from the cephalic vein in the Lev-Lock blood clot activator vacutainer to harvest serum for biochemical analysis. Another 2 ml of whole blood was also collected in Lev-Lock K3 EDTA vacutainer for complete blood count, blood smear examination for blood parasites, morphological changes in the RBC and IDEXX SNAP 4Dx Plus test kit was also used for diagnosis of the blood parasites test. Result: Peripheral blood smear examination and IDEXX SNAP 4Dx Plus test were found to be negative for blood parasites, but spherocytosis could be observed in the blood smears. A complete blood count (CBC) examination revealed severe anaemia of macrocytic normochromic type, neutrophilic leucocytosis and thrombocytopenia. Serum biochemistry revealed a decrease in blood urea nitrogen (BUN) and creatinine with normal alanine transaminase (ALT). Treatment with whole blood transfusion, corticosteroid and other supportive therapy was successful in this case. Based on the clinical presentation, laboratory findings and its response to the treatment with prednisolone, it was diagnosed as an idiopathic immune-mediated haemolytic anaemia (IMHA) with an extravascular mechanism of haemolysis. A follow-up review after 1 year and 4 months post-treatment reported that the dog was still alive and healthy.

Inhibition of interferon gamma impairs induction of experimental epidermolysis bullosa acquisita.

Epidermolysis bullosa acquisita (EBA) is a muco-cutaneous autoimmune disease characterized and caused by autoantibodies targeting type VII collagen (COL7). The treatment of EBA is notoriously difficult, with a median time to remission of 9 months. In preclinical EBA models, we previously discovered that depletion of regulatory T cells (Treg) enhances autoantibody-induced, neutrophil-mediated inflammation and blistering. Increased EBA severity in Treg-depleted mice was accompanied by an increased cutaneous expression of interferon gamma (IFN-γ). The functional relevance of IFN-γ in EBA pathogenesis had been unknown. Given that emapalumab, an anti-IFN-γ antibody, is approved for primary hemophagocytic lymphohistiocytosis patients, we sought to assess the therapeutic potential of IFN-γ inhibition in EBA. Specifically, we evaluated if IFN-γ inhibition has modulatory effects on skin inflammation in a pre-clinical EBA model, based on the transfer of COL7 antibodies into mice. Compared to isotype control antibody, anti-IFN-γ treatment significantly reduced clinical disease manifestation in experimental EBA. Clinical improvement was associated with a reduced dermal infiltrate, especially Ly6G+ neutrophils. On the molecular level, we noted few changes. Apart from reduced CXCL1 serum concentrations, which has been demonstrated to promote skin inflammation in EBA, the expression of cytokines was unaltered in the serum and skin following IFN-γ blockade. This validates IFN-γ as a potential therapeutic target in EBA, and possibly other diseases with a similar pathogenesis, such as bullous pemphigoid and mucous membrane pemphigoid.

Genetic characterization and clinicopathological features of <em>Escherichia coli</em> in neonatal septicemic calves

Due to severe diarrhea associated with calf scour and septicemia, colibacillosis is one of the leading causes of neonatal mortality in calves. This study investigated the clinical and hematological manifestations as well as the genetic composition of Shiga toxin-producing E. coli (STEC) strains in septicemic neonatal calves. In this study, 47 fecal specimens were collected from diarrheic calves aged between one and three weeks on dairy farms that are unorganized around Basra, Iraq, while twenty age-matched calves were tested as controls. Of the 47 tested samples, 28 fecal samples were tentatively identified as STEC, with a prevalence of 60%. STEC-affected calves had variable rectal temperatures ranging from subnormal to fever, tachycardia, hyperpnea, diarrhea, partial or complete cessation of suckling, mucous membrane congestion, depression, incoordination and rough hair coat conditions. Significant changes were observed in the hemogram and the leukogram during the analysis of blood samples from calves with diarrhea. Molecular analysis of fecal samples demonstrated that local STEC isolates are more closely related to other strains obtained from both human and animal samples worldwide. Based on the results of the current study, we can conclude that the septicemic calves were likely infected by human or environmental resources and could play a major role in further spreading STEC infection.

OHIP-14 Scores in Patients with Sjögren's Syndrome Compared to Sicca Syndrome: A Systematic Review with Meta-Analysis.

Primary Sjögren's syndrome (pSS) is a chronic autoimmune disorder characterized by dryness of mucous membranes, predominantly the eyes and mouth, following glandular tissue substitution. The onset of oral dryness constitutes a significant source of discomfort that negatively affects overall quality of life. This systematic review aimed at investigating the differences in Oral Health Impact Profile-14 (OHIP-14) questionnaire scores in patients diagnosed with Sjögren's syndrome compared to sicca syndrome, to assess the influence of the two conditions on oral health. Study Design. A systematic electronic and manual search was performed up to December 2023 for studies reporting OHIP-14 questionnaire scores in pSS patients versus sicca syndrome. Two authors independently reviewed, selected, and extracted the data. The outcome was the assessment of OHIP-14 scores in studies comparing pSS- and sicca syndrome-affected patients. Meta-analysis was conducted on available quantitative data. Literature search retrieved 30 articles, and 3 articles met the criteria for inclusion in the review. Meta-analysis revealed significantly higher scores in patients with sicca syndrome compared to pSS, although salivary flow was markedly reduced in pSS. While offering supplementary information to standard tests and supporting the assessment of pSS and sicca syndrome patients, further validation is necessary to establish OHIP-14 validity in determining the impact of pSS and sicca syndrome on patients' quality of life.

The titers of antinuclear antibodies are associated with the degree of inflammation and organ damage in Primary Sjögren's Syndrome

Primary Sjögren’s Syndrome (pSS) falls within the category of connective tissue diseases, characterized by the presence of autoantibodies such as antinuclear antibodies (ANA). However, according to the classification criteria for pSS, some patients may exhibit a negative result for autoantibodies. Patients with a negative result for autoantibodies may lack typical features of connective tissue diseases, and the immunological state as well as the extent of organ involvement and damage may differ from those with positive autoantibodies. This study aims to compare the clinical phenotypes of patients with positive and negative autoantibodies, providing insights for disease classification and treatment selection for clinicians. Patients with pSS were grouped based on the presence and titers of their autoantibodies. Subsequently, differences in organ damage and laboratory indicators were compared between these groups, aiming to analyze the value of autoantibody titers in assessing the condition of pSS. (1) Patients with positive ANA exhibited elevated levels of inflammatory indicators, including ESR, IgG levels, lip gland biopsy pathology grade, and overall organ involvement, in comparison with patients with negative ANA (P < 0.05). Furthermore, ANA-positivity correlated with a higher occurrence of multi-organ damage, particularly affecting the skin, mucous membranes, and the hematological system (P < 0.05). (2) As ANA titers increased, patients demonstrated elevated levels of IgG and an escalation in organ involvement (P < 0.05). (3) Patients in the positive autoantibody group (positive for antinuclear antibodies, anti-SSA, or anti-SSB antibodies) had higher IgG levels compared to the negative group (P < 0.05). (4) Patients with positive anti-SSA and anti-SSB antibodies exhibited higher levels of inflammatory indicators and IgG compared to other patients (P < 0.05); however, no significant differences were observed in terms of organ involvement and organ damage. Patients with positive ANA in pSS typically exhibit higher levels of inflammation and an increased likelihood of experiencing multi-organ damage. Furthermore, as the ANA titers increase, both inflammation levels and the risk of multi-organ damage also escalate. Additionally, the presence of anti-SSA and anti-SSB antibodies may contribute to an elevated risk of increased inflammation levels, but does not increase the risk of organ damage.

Understanding the treatment modalities of Pemphigus Vulgaris (Agnivisarpa) through the lens of Ayurveda - A Single Case Study

Pemphigus is a disease that causes blisters and sore on the skin or mucous membrane. The blisters rupture easily, leaving open sores, which may ooze and become infected. Agnivisarpa can be compared to pemphigus vulgaris due to its resemblance in sign and symptoms. The disease needs early and proper treatment to prevent further morbidity and mortality. Being an autoimmune disorder physician generally use corticosteroids and immunosuppressive drugs here an attempt is made to study in detail about pemphigus vulgaris and its understanding though Ayurveda. A case report of 47year old male patient with clinical presentation of fluid filled blisters burning and pain along with hyperpigmentation received systemic medication in modern medicine without an adequate response. Samshodhan coupled with Samshamana medication are the cornerstones for Visarpa. Hence in this study, Virechana Karma once in a week for 2 month. After that Raktamokshana (After completion of 3 sitting of Virechana Karma) followed by 3 months of Samshamana medicine. At the conclusion of treatment, a skin lesion assessment was performed.

A review for non-antibiotic treatment of Helicobacter pylori: new insight.

Gastric ulcers and gastric cancer are brought on by the Helicobacter pylori bacteria, which colonizes under the stomach mucous membrane. Different medication regimens are used to remove it, but the illness returns and becomes more resistant, which lowers the treatment rates. Additionally, this bacterium now exhibits a skyrocketing level of multi-drug resistance, necessitating recurrent therapeutic treatments. The negative effects of synthetic medications in comparison to conventional therapies are another significant factor in favor of non-pharmacological therapy. The most significant side effects of popular anti-gastric ulcer medications include nausea, vomiting, and diarrhea. Stomach ulcers have previously been treated with herbal remedies and complementary treatments like probiotics. When probiotics are ingested, the host experiences several advantages that may be brought about by altering the bacterial flora in the digestive system. Additionally, stronger-acting chemical compounds and plant extracts can be employed to treat patients. In this article, we look at the substances and medications that are utilized in place of synthetic stomach ulcer-curing treatments.

Identification of the immune repertoire of γδ T-cell receptors in psoriasis.

The γδ Tcells are a subpopulation of Tcells that are abundantly found in the skin and mucous membranes. Their reactivity to self-antigens and ability to secrete various cytokines make them a key component in psoriasis development. Although the correlation between the immune repertoire (IR) of γδ T-cell receptors and the occurrence and severity of psoriasis remains incompletely explored, high-throughput sequencing of γδ Tcells has led to a deeper understanding of IR in psoriasis. This study investigated the differences between γδ Tcells in patients with psoriasis and healthy controls. The γδ Tcells were identified via immunofluorescence staining and a correlation analysis was performed according to the psoriasis area and severity index (PASI) scores. The IR sequencing method was used to detect IR in the γδ T-cell receptors. The findings demonstrated more skin γδ Tcells in patients with psoriasis, which were positively correlated with the PASI score. There were subtle differences in most variable (V), diversity (D) and joining (J) gene segments and VJ/VDJ combination segments between patients with psoriasis and healthy controls. However, a higher diversity of complementarity-determining region 3 (CDR3) was observed in patients with psoriasis. In summary, the IR of skin γδ Tcells was significantly altered in patients with psoriasis, and the diversity in the cell's CDR3 population is a promising biomarker for assessment of psoriasis severity.

Evaluation of intralesional 5-fluorouracil versus intralesional interferon alpha in treatment of warts

Background: Warts are non-malignant growth of the skin and mucous membranes resulting from infection with human papillomavirus (HPV). It can significantly impact the quality of life for patients and elicit feeling of embarrassment. Aim and objectives: A comparative analysis of the efficacy of intralesional 5-FU and intralesional interferon alpha among distinct groups of patients diagnosed with warts. Patients and methods: This is a cohort of sixty individuals diagnosed with warts were selected from the period of early April 2022 to the end of April 2023. Results: There was a statistically significant difference (P-value=0.005) seen between the two groups, namely group A and group B, in relation to the final response. In group A (5-Fluorouracil)), complete clearance was achieved by 23 patients (76.7%), with 7 patients (23.3%) showing partial response. No instances of resistance were observed in this group. Conversely, in group B (Interferon alpha), only 11 patients (36.7%) attained complete clearance, while 16 patients (53.3%) exhibited partial response, and resistance was evident in 3 cases (10%). Conclusion: Intralesional 5-Fluorouracil (5-FU) is highly effective, cheaper, and easily available in treating warts. The combination of the both treatments may deliver a greater benefit to patients with resistant warts.

Systemic Anti-Inflammatory Agents in the Prevention of Chemoradiation-Induced Mucositis: A Review of Randomised Controlled Trials.

Mucositis is a pathological condition characterised by inflammation and ulceration of the mucous membranes lining the alimentary canal, particularly in the mouth (oral mucositis) and the gastrointestinal tract. It is a common side effect of cancer treatments, including chemotherapy and radiotherapy, and it is sometimes responsible for treatment interruptions. Preventing mucositis throughout the alimentary tract is therefore crucial. However, current interventions mainly target either oral or gastrointestinal side effects. This review aimed to investigate the use of systemically administered anti-inflammatory agents to prevent mucositis in cancer patients undergoing cancer treatment. PubMed, Ovid, Scopus, Web of Science, WHO ICTRP and ClinicalTrials.gov were screened to identify eligible randomised controlled trials (RCTs). The published literature on anti-inflammatory agents provides mixed evidence regarding the degree of efficacy in preventing/reducing the severity of mucositis in most anticancer treatments; however, sample size continued to be a significant limitation, alongside others discussed. Our review yielded a list of several anti-inflammatory agents that exhibit potential mucositis-preventive effects in cancer patients undergoing cancer treatment, which can be used to inform clinical practice.

Clinical Association of Lupus Erythematosus with Patients of Vitiligo: A Case Control Study

Background: Vitiligo is an idiopathic acquired depigmentary skin/ mucous membrane disorder. Lupus erythematosus and vitiligo are diseases of autoimmune origin. A genetic explanation for the association between lupus erythematosus and vitiligo has recently been attempted. Objective: To find out the association of lupus Erythematosus in patients of vitiligo. Methods: This case control study was carried out in the department of Dermatology &amp; Venereology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of January 2023 to December 2023. A total of 180 patients with and without vitiligo from both genders and different ages for case and control groups were included in the study based on inclusion and exclusion criteria. Patients were divided into two groups, 90 patients with vitiligo as cases and 90 patients without vitiligo (healthy subjects) as controls. Wood’s lamp examination was performed for diagnosis of vitiligo. LE was diagnosed based on ACR criteria and laboratory test including Complete blood count, Urinalysis, ANA, anti-ds DNA, VDRL and Skin biopsy. Patients with lupus erythematosus and patients without lupus erythematosus were considered as group I and group II respectively. Results: In this study, the mean age was found 41.7±12.8 years in case group (Vitiligo) and 42.1±13.6 years in control group (Healthy subjects).More than half (51.1%) of the patients were female in case group and 41(45.6%) in control group. There was no significant difference was found regarding age, sex, anemia, leucopenia, thrombocytopenia, proteinuria, ANA and anti ds-DNA. Family history of vitiligo was significantly higher in vitiligo patients than healthy patients (26.7% vs 12.2%). The majority 45(50.0%) presented with generalize followed by 21(23.3) acrofacial, 13(14.4%) focal, 10(11.1%) segmental and 1(1.1%) mucosal of vitiligo. Lupus erythematosus was higher in vitiligo patients than healthy patients (4.4% vs 1.1%) but the difference was not statistically significant between the two groups (p=0.184). Conclusions: This study concluded that family history of vitiligo was significantly higher in vitiligo patients than healthy patients. Lupus erythematosus was higher in vitiligo patients than healthy patients, but not statistically significant. J Rang Med Col. March 2024; Vol. 9, No. 1: 33-38

Leptospirosis in a mixed breed female dog (Canis familiaris)

The present study aimed to report a clinical case of leptospirosis diagnosed in a mixed breed dog where treatment was chosen without hospitalization. Leptospirosis is an infectious and contagious zoonotic disease caused by the spirochete of the genus Leptospira spp. All pathogenic lineages belong to a single species, Leptospira interrogans. This microorganism can affect both humans and animals, be they domestic, wild or production. Dogs and cats are susceptible, but felines have greater resistance to leptospirosis. Synanthropic rodents in large urban centers or rural areas constitute a major problem, as they end up transmitting it to domestic and stray animals. Animals become infected and end up eliminating spirochetes into the environment through contaminated urine, since leptospirosis has a predilection for the renal tubules. Transmission can be direct through contaminated urine, venereal secretions, placental transfer, bite wounds or ingestion of contaminated tissues. Leptospira can enter the body through intact oral, nasal or ocular mucous membranes, or through skin that is damaged or macerated by moisture. Indirect transmission occurs through contact with contaminated water, soil and food sources. In Brazil, where many locations lack a garbage collection system and sewage disposal is precarious, the tropical climate favors rain during summer, all increasing the role of rodents as vectors of this zoonosis due to flooding. The canine mentioned in this study did not have their vaccination protocol up to date, lived in a place with the presence of rodents, and was diagnosed positive for L. interrogans serovars Bratislava, Pomona and Copenhageni by the microscopic agglutination test (MAT), considered the gold standard. The changes in the blood count were limited to normocytic normochromic anemia and hyperproteinemia. No noteworthy changes were observed in the white blood cell count and, in the biochemical tests, liver and kidney changes consistent with the pathology were evident. The therapeutic protocol chosen was antibiotic therapy and supportive therapy, both carried out at the guardian's home, and the prognosis was favorable. Preventive vaccination measures according to the challenge faced in the environment, rodent control and also public policies regarding basic sanitation are important in preventing in zoonosis.

Vitiligo Causes and Treatment: A Review

Vitiligo is a chronic autoimmune disorder characterized by patches of skin losing pigment due to the destruction of melanocytes, the cells responsible for producing pigment. The condition can affect people of all ages and ethnicities, with symptoms including milky-white patches on the skin, premature graying of hair, and color loss in mucous membranes like the mouth or nose. Among the main causes of vitiligo are; Autoimmune Response: Vitiligo is primarily an autoimmune disease where the immune system mistakenly attacks melanocytes, leading to depigmentation. Factors like family history, genetic predisposition, and immune system disorders contribute to its development, Triggers: Events such as sunburn, emotional distress, or exposure to certain chemicals can trigger or exacerbate vitiligo. The treatment options are; Medications: Treatments include light therapy (phototherapy), oral medications like psoralen combined with UVA light (PUVA), and depigmentation therapy using monobenzone to match skin tones Surgery: Surgical options are available for some cases of vitiligo and Psychological Support: Counseling and mental health services can help individuals cope with the emotional impact of vitiligo, in conclusion, v is a multifaceted skin condition lacking a conclusive remedy, many types of vitiligo, but the most common one is Non-segmental Vitiligo (NSV), honmental and genetic are the most important causes of vitiligo. Important symptoms of vitiligo are; depigmented patches, hair discoloration, sensitivity to sunlight, treatment of vitiligo have many approach, among them are; topical Corticosteroids, phototherapy and Cosmetic Camouflage.

АНАЛИЗ КЛИНИЧЕСКОГО СЛУЧАЯ ВУЛЬГАРНОЙ ПУЗЫРЧАТКИ, АССОЦИИРОВАННОЙ С ХРОНИЧЕСКОЙ ВЭБ-ИНФЕКЦИЕЙ (ГЛОССИТА, ОБУСЛОВЛЕННОГО ВЭБ)

Background. One of the autoimmune diseases is pemphigus, a chronic malignantly occurring autoimmune dermatosis accompanied by the development of blisters on the skin and mucous membranes. Isolated lesions of the SOPR occur in 10–20% of cases, complicating differential diagnosis. Numerous studies have proven the role of herpes virus infection as an aggravating factor in the course of true acantholytic pemphigus. The aim of the study was to determine the features of the clinical course of vulgar pemphigus against the background of reactivation of chronic EBV infection (glossitis caused by EBV). The clinical case of a patient with a diagnosis of “Vulgar pemphigus. Glossitis caused by the Epstein-Barr virus”. The anamnesis of the disease was carefully collected, a clinical and laboratory examination was performed with a cytological examination of a smear taken from a LITTER, a general blood test with an expanded leukocyte formula, C-reactive protein. In order to diagnose the viral load, PCR diagnostics was performed on the DNA of the herpes virus 1, 2, 4, 5 types in saliva, on the DNA of EBV in the blood, quantitatively. Specific antibodies of Ig classes M and G to EBV were determined by the ELISA method. Results. Due to the lifelong persistence of EBV in the structures of the oral cavity, its reactivation leads not only to chronic pastoral infection and the local development of the corresponding glossitis, but also, first of all, to a decrease in the level of local immunity. This fact aggravates the course of pemphigus, shortens the period of absence of relapse. The appointment of antiviral therapy at the first visit allowed to stabilize the symptoms caused by EBV, which led to positive dynamics in the course of pemphigus against the background of average dosages of prednisone in a shorter time. Conclusions. With clinical and laboratory confirmation of chronic EBV infection (glossitis caused by EBV), it is recommended to include antiviral and immunocorrective drugs, systemically and topically, in the complex treatment of pemphigus erythematosus.

ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ АУТОФЛУОРЕСЦЕНТНОЙ СТОМАТОСКОПИИ КАК ОСНОВНОГО МЕТОДА РАННЕЙ ДИАГНОСТИКИ ПРЕДРАКОВЫХ ЗАБОЛЕВАНИЙ СЛИЗИСТОЙ ОБОЛОЧКИ РТА (ОБЗОР ЛИТЕРАТУРЫ)

Importance Currently, the prevalence of various diseases of the oral mucosa in the world has increased significantly (from 15.2% to 49.1%). Oncological pathology should be attributed to a separate group of diseases. In order to actively identify precancerous processes of the oral cavity, along with traditional methods of examination of the maxillofacial region, oncoscreening of the mucous membrane and organs of the oral cavity is mandatory. One of the possible methods of oncoscreening is autofluorescence stomatoscopy. Objectives To clarify the effectiveness of autofluorescence stomatoscopy as the main method of early diagnosis of precancerous diseases of the oral mucosa, its advantages and disadvantages. Methods In the process of investigating the effectiveness of autofluorescence stomatoscopy, methods of qualitative analysis and synthesis of available scientific literature on autofluorescence stomatoscopy were used. Conclusions It is concluded that the use of autofluorescence stomatoscopy for the early diagnosis of precancerous diseases of the oral mucosa remains controversial. Some clinicians believe that the introduction of autofluorescence stomatoscopy into the practice of a dentist as an additional method of oncoscreening of the oral mucosa is not only relevant, but also necessary; and the analysis of the light glow corresponds to the results of a biopsy. However, other researchers have concluded that the AFS-method will not replace the gold standard of histological examination, due to the low specificity of the method, the study can lead to overdiagnosis, and it can only be used by experienced clinicians to find the boundaries of precancerous lesions of the oral cavity for taking a biopsy in an altered mucous membrane.