Normal Status Research Articles

Bil holovy: klasyfikatsiia; diahnostyka; pryntsypy likuvannia (ohliad literatury; opys klinichnoho vypadku)

Introduction. Headache (cephalgia) is one of the most common neurological disorders and is among the 20 most disabling diseases in the world. Most cases of headaches are benign, while others require constant monitoring and treatment, and some are life-threatening. For individuals with a history of headaches, the physician should determine whether headache belongs to a well-known primary headache disorder, is an exacerbation of primary headache disorder induced by another medical condition, or a new secondary headache. The aim of the study is to conduct an analysis of a vascular events in a patient with secondary headache, who was diagnosed in the Neurology Department in 2023. Materials and methods. Systematic and comparative analysis, biblio-semantic method used for the interpretation of the obtained results were supplemented with a survey of literature including 18 articles published in the international renowned sources. Results. Secondary cephalgias are those in which the headache is a symptom of another disorder recognized as a potential underlying cause. Secondary headache occurs much less often than primary one, but it can encompass life-threatening pathology. A clinician should be able to distinguish between primary and secondary headaches, elaborating a specific diagnosis for each particular patient with a headache. For this purpose doctor should know the criteria for each type of headache and be capable to recognize "red flags" of secondary headache. The paper contains thorough analysis of the basic principles of diagnosis and diagnostic criteria of all known forms of cephalgia, as well as European principles of management of patients with the most common forms of headache disorders for general practitioners. Scaffolding of the article is consistent with International Classification of Headache Disorders, third revision (ICHD-3), developed by the International Headache Society in 2018, which currently is the main tool for diagnosing different forms headache disorders. The most important aspect in the diagnosis of different forms of cephalgia is patients history and medical examination. Primary headache is not a diagnosis of exclusion, but rather is based on clinical findings obtained during examination. The presence of atypical signs or "red flags" should raise concern about secondary headache. Conclusions. Many types of primary headaches can be diagnosed based on a thorough history and physical examination without use of additional examination methods. Neuroimaging is not necessary if the patient has migraines or other primary headaches with normal neurological status and the absence of the "red flags" or signs of secondary headache. The SNOOP mnemonic method is useful tool for ensuring that "red flags" are not missed. In case the "red flags", signs of secondary headache are detected, neuroimaging or other additional diagnostic tests should be used, out of which the preference should be given to the MRI of the brain. Keywords: primary and secondary headache, subarachnoid stroke, diagnosis, treatment.

Diagnostic Value of Trabecular Bone Score in Osteoporosis

Background: Osteoporosis is a common chronic disease that can cause fractures and other complications. Early diagnosis and prompt treatment of this disease can reduce the risk of fracture. The trabecular bone score (TBS) is a valuable tool for evaluating bone microarchitecture in patients with osteoporosis. Objectives: The present study aimed to evaluate the association of TBS score with bone mineral density (BMD) as the gold standard in patients with osteoporosis. Patients and Methods: This cross-sectional study was performed on 254 patients admitted to Resalat Hospital in Tehran, Iran. The BMD and TBS were concurrently evaluated, and TBS validity for osteoporosis diagnosis was assessed based on BMD as the gold standard. The agreement between TBS and BMD results was measured using the kappa statistic. All analyses were performed in MedCalc version 18.11.3.8 and SPSS version 18, and the level of statistical significance was set at < 0.05. Results: In this study, the majority of the patients were female (88.2%) and younger than 65 years (63.0%). Osteopenia and osteoporosis were diagnosed in 42.1% and 18.9% of the patients, respectively. The sensitivity of TBS for diagnosing osteoporosis versus osteopenia and osteopenia versus a normal status was higher in patients aged ≥ 65 years compared to those aged < 65 years (63.33% vs. 27.78% and 86.66% vs. 63.63%, respectively). Overall, TBS demonstrated a high diagnostic ability for differentiating osteoporosis versus normal BMD (AUC = 0.911, P < 0.001). Conclusion: Based on the findings, TBS alone is not sufficient for diagnosing osteoporosis and cannot replace BMD. Therefore, a combination of BMD and TBS techniques can be the best approach for diagnosing osteoporosis, especially in patients aged ≥ 65 years.

Improvement in neck ultrasound report quality following the implementation of European Thyroid Association guidelines for postoperative cervical ultrasound for thyroid cancer follow-up, a prospective population study.

The aim of this study was to prospectively evaluate the quality of postoperative neck ultrasound (POU) for thyroid cancer patients after implementing European Thyroid Association (ETA) guideline-based POU assessment. Our analysis involved 672 differentiated thyroid cancer patients. POU report quality was compared between the implementation radiology group (IRG), which implemented ETA guideline-based assessment in 2018, and all non-implementation radiology groups (NIRG). Differences in POU quality were evaluated before and after the implementation of guideline-based assessment. Additionally, we evaluated the ability of serum thyroglobulin (Tg) level <0.2 ng/mL or between 0.21 and 0.99 ng/mL and normal POU lesion status at 1-year follow-up to predict the absence of persistent disease or relapse at 3-year follow-up. IRG had significantly higher mean utility scores for POU reports of abnormal thyroid bed nodules compared to NIRG (P < 0.001). IRG's POU reports for suspicious nodules and lymph nodes were considered sufficient in 94% and 85% of cases, respectively, compared to 45% and 68% for NIRG. For patients with normal US lesion status and Tg <0.2 ng/mL or Tg 0.21-0.99 ng/mL at 1-year follow-up, the negative predictive values were 96% for both. Implementation of 2013 ETA POU-reporting guidelines allowed for the provision of high-quality POU reports, which may lead to increased accuracy in assessing the response to treatment and in estimating the risk of recurrence of thyroid cancer and likely reduce unnecessary repeat POU or FNA.

Effect of viral eradication with direct-acting antiviral agents on iron parameters in patients with chronic hepatitis c and hyperferritinemia.

Patients with chronic hepatitis C are at increased risk for hyperferritinemia (HF). Abnormalities of serum iron parameters are frequently observed in patients with chronic hepatitis C (CHC). About a third of patients have increased iron parameters. Recently, studies on the effect of direct-acting antiviral agents (DAAs) in HCV eradication in patients with increased serum iron has been published, demonstrating the restoration of normal iron status. The aim of this study was to evaluate the effect of viral eradication with DDAs in patients with CHC and HF. Retrospective study conducted from January 2018 to December 2020 including patients treated with DAAs for HCV. Pre-treatment (PreT) and post-treatment (PostT) serum ferritin values were evaluated in all patients. Inclusion criteria: Pret HF (>400 μg/L); CHC patients treated with DAA achieving sustained viral response (SVR). Exclusion criteria: No PreT or PostT HF available; no SVR; lost patients. From 621 patients treated with DAAs for CHC, 77 presented HF (12.40%), and 74 were included in the study. Fifty nine were men (79.73%) with a mean age 58.33, SD 8.68; PreT mean ferritin: 893.20 (SD 1037.09); PostT: 264.17 (SD 161.33); PreT mean transferrin saturation: 40.96 (SD 15.71); PostT: 29.82 (SD 11.17); PreT mean serum iron 152.32 (SD 62.07), PostT: 109.32 (SD 39.49). When we compared PreT and PostT iron parameters, significant statistical differences were present considering ferritin (p = 0.0000), transferrin saturation (p = 0.0000), and iron (p = 0.0002) determinations. SVR after DAAs for CHC induces a statistically significant reduction on iron parameters.

Factors Associated with Diet Quality during COVID-19 Pandemic among Undergraduate Students in Universiti Putra Malaysia

Introduction: The COVID-19 preventive and restriction measures may disrupt an individual’s daily diet quality, potentially leading to obesity and other non-communicable diseases. This study aims to assess and determine factors associated with diet quality during the COVID-19 pandemic among undergraduate students at Universiti Putra Malaysia. Methods: 130 eligible undergraduate students, who participated in this cross-sectional study were assessed using Global Physical Activity Questionnaire (GPAQ), Depression, Anxiety, Stress Scale (DASS-21), and Rapid Eating Assessment for Participants short version (REAP-S). Self-reported sociodemographic characteristics, body weight status, and nutrition knowledge were evaluated. Statistical analysis was conducted using IBM SPSS 26.0 and p&lt;0.05 was denoted as statistically significant. Results: Most of the respondents were female (76.2%), aged between 20-22 years old (64.6%), Bumiputera (80.0%), funded by loan or scholarship (73.1%), low socioeconomic status (60.0%), residing in the family household (57.7%), consumed home-cooked meals (58.5%), and used the e-hailing food services for 0-3 days/week (63.1%). There was an equal distribution in the year and program of study in every selected faculty. Most were having normal BMI status (54.6%), good nutrition knowledge (66.9%), sedentary (48.5%), less severe mental health status (85.4%), and good diet quality (62.3%). Nonetheless, throughout the study, only the anxiety subscale was associated with diet quality (r= -0.20, p&lt;0.05). Conclusion: Perceived anxiety may lead to poor diet quality. Future studies could determine the food environment and food security faced by the students as these factors vary among individuals. It is also recommended to measure diet quality differences before, during, or after the pandemic.

Iron supplements in pregnant women with normal iron status: A systematic review and meta-analysis.

Effects of daily iron supplementation in iron replete pregnancy are unclear. This systematic review aimed to assess benefits and harms of oral iron supplements in pregnant women without anemia and iron deficiency. We predefined and registered a protocol in PROSPERO (CRD42020186210) and performed the review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched for randomized clinical trials (RCTs) and observational studies comparing daily oral iron supplementation with no iron supplements in non-anemic iron replete pregnant women. Searches were conducted in MEDLINE (by PubMed), EMBASE (by OVID), Cochrane Library, and ClinicalTrials.gov from inception to September 2022 without language restrictions. Two authors independently screened records, extracted data, and assessed risk of bias using the revised Cochrane risk of bias tool (RoB2). One author read full-texts, assessed certainty of evidence by GRADE and conducted meta-analyses using a random-effects model. Primary outcomes included iron deficiency anemia, iron deficiency, hemoglobin >130 g/L, elevated iron status, small for gestational age newborns, low birthweight newborns, preterm birth, and congenital anomalies. Eight RCTs (2822 women) but no observational studies were eligible for inclusion. Daily oral iron supplementation in pregnancy probably reduces iron deficiency anemia at term (risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.38-0.70; 4 RCTs, 1670 women; I2 = 13%; moderate-certainty evidence) and the incidence of low birthweight babies (RR: 0.30, 95% CI: 0.13-0.68; 2 RCTs, 361 infants; I2 = 0%; moderate-certainty evidence). In addition, it may reduce iron deficiency at term (RR: 0.74, 95% CI: 0.60-0.92; 4 RCTs, 1663 women; I2 = 58%; low-certainty evidence) and the incidence of small for gestational age babies (RR: 0.39, 95% CI: 0.17-0.86; 1 RCT, 213 infants; I2 not estimable; low-certainty evidence). Daily iron supplementation in iron replete non-anemic pregnant women probably reduces the risk of maternal iron deficiency anemia at term and low birthweight.

Development of a novel 12-point grading system for evaluating epidural spinal cord compression and its clinical implications

BACKGROUND CONTEXTThe assessment of epidural spinal cord compression (ESCC) plays a crucial role in clinical decision-making, yet the current grading system lacks reliability and requires improvements. PURPOSEThe study aims to develop a reliable grading system for evaluating ESCC and to investigate its association with the neurological status of patients. STUDY DESIGN/SETTINGA prospective cohort study. PATIENT SAMPLEA total of 330 patients with metastatic spinal disease were included in the study. OUTCOME MEASURESThe main outcome was the neurological status evaluated using the American Spinal Injury Association (ASIA) scale. METHODSWe proposed a novel grading system, called the 12-point ESCC grading system, to evaluate ESCC based on findings from spinal magnetic resonance imaging (MRI). This new grading system consists of 12 grades, ranging from Grade 0 to 3, with higher grades indicating more severe ESCC. The detailed information about the sagittal image of the spine and the severity of spinal cord swelling was considered in this new grading system. The Spearman correlation analysis and logistic regression analysis were employed to investigate the correlation between the previous 6-point grading system and ASIA, as well as between the new 12-point ESCC grading system and ASIA. The prediction effectiveness was evaluated using the area under curve (AUC) analysis. RESULTSPatients with higher grades in the 12-point ESCC grading system exhibited a higher likelihood of experiencing a worse neurological condition. Specifically, patients with grades 2a to 2d and 3a to 3d according to the new 12-point ESCC grading system were significantly associated with more complete paralysis (p<.001) compared with patients with grade 0. The Spearman correlation coefficient was 0.729 between the previous 6-point ESCC grading system and ASIS and 0.750 between the new 12-point ESCC grading system and ASIS. When categorizing ASIS into complete paralysis and other neurological statuses, the 6-point ESCC score yielded an AUC of 0.820, which increased to 0.860 with the new 12-point ESCC grading system. Furthermore, when ASIS was divided into normal and abnormal neurological statuses, the AUC increased from 0.889 to 0.906. Additionally, spinal cord swelling was significantly associated with more complete paralysis (p<.001) and abnormal neurological status (p<.001) based on the new 12-point ESCC grading system. CONCLUSIONSThe new 12-point ESCC grading system provides more detailed information and further improves the prediction effectiveness for evaluating neurological status compared with the previous 6-point ESCC grading system. In the new 12-point ESCC grading system, higher grades or the presence of spinal cord swelling are indicative of a worse neurological condition.

POOR COGNITIVE RESERVE STATUS AS PREDICTORS OF MEMORY IMPAIRMENT AMONG ELDERLY

Background: Cognitive impairment in the elderly population is commonly associated with age-associated neurodegenerative processes in the brain. The integrity of the cognitive reserve status may be an important factor that can compensate this age-associated neurodegenerative processes. Objective: To investigate the predictor role of poor cognitive reserve status on memory impairment among elderly subpopulation in Mataram, West Nusa Tenggara. Methods: This cross-sectional study involved elderly subjects recruited at Panti Jompo Tresna Werdha Puspa Karma. Data collected included age, gender, hypertension, diabetes, cognitive reserve status (years of education, leisure activity, occupation, and exercise), and memory status. Memory status obtained based on scores of 3 neuropsychological tests (wordlist memory task, recall, and recognition tests). Subjects with normal memory status had normal scores on at least 2 of the 3 neuropsychological tests. Multivariate regression analysis was performed to examine the role of cognitive reserve as a predictor of memory impairment in subjects. Results: In Model 1 of multivariate regression analysis, the main predictors for memory impairment in elderly subjects are shorter years of education (odds ratio: 13.1; 95% confidence interval: 1.8 – 95.0) and absence of leisure activity (odds ratio: 5.9; 1.2 – 28.8). In model 2, the main predictors for memory impairment are consistently shorter years of education (OR: 11.0; 95% CI: 1.4 – 84.0) and absence of leisure activity (OR: 5.3; 95% CI: 1.0 – 27.7). Conclusion: Shorter years of education and the absence of leisure activity were predictors for memory impairment in the subpopulation of the elderly in Mataram, West Nusa Tenggara.

A Review: The Use of In Ovo Feeding in Various Types of Poultry

In ovo feeding is one way to increase poultry productivity by providing additional nutrition during the incubation period and can increase embryo growth. Many implementations of in-ovo feeding techniques have been carried out on various types of poultry, but a summary of the use of in-ovo feeding on various types of poultry has never been reported, therefore this study was conducted. This review article aims to determine the use of in-ovo feeding in various types of poultry. This study was conducted based on literature studies by analyzing secondary data and synthesizing research from various data sources originating from nationally accredited journals and reputable international journals that discuss the use of in-ovo feeding in various types of poultry. The study shows that the implementations of in-ovo feeding for various types of poultry have been mostly applied to broiler chickens and native chickens, but only a few in geese, ducks, and quails. In-ovo feeding has several advantages for enhancing nutrition and health, including preserving normal physiological status and preventing disease, so that poultry productivity can be increased.

Immunohistochemical markers of the activity of apoptosis and proliferation in women with adenomyosis who had papillary thyroid carcinoma

Research objectives: to evaluate the activity of apoptosis and proliferation mechanisms of eutopic endometrium in patients with adenomyosis who had a history of papillary thyroid carcinoma (PTC).Materials and methods. 63 women of reproductive age were examined: group I – 31 patients with adenomyosis and PTC in history, group II – 32 patients with adenomyosis and normal thyroid status. The intensity of pelvic pain was assessed using a visual analog scale in all women. The material for morphological research was obtained with Pipelle biopsy of the endometrium in the secretory phase of the menstrual cycle. A morphological study was performed on 30 biopsies of eutopic endometrium (15 samples from patients of group I and 15 samples from patients of group II). An immunohistochemical study was performed using monoclonal antibodies to cell-specific markers Bcl-2 (DAKO, clone 124) and Ki-67 (DAKO, clone MIB-1).Results. High expression of Bcl-2 was detected in the endometrial glandular epithelial cells (EGECs) in 70% and 62.5% of samples in group I and II respectively (р &gt; 0.05), the number of Bcl-2-positive cells was significantly higher in samples from group I (80.0 ± 13.1% versus 60.0 ± 15.2% in group І and ІІ respectively, р &lt; 0.05). In endometrial stromal cells (ESCs) high expression of Bcl-2 was detected in 90% and 100% of samples from group I and II respectively (р &gt; 0.05), no significant difference in the number of positive cells was found between groups (18.9 ± 12.2% and 12.6 ± 9.1% in group І and ІІ respectively, р &gt; 0.05). Expression of Ki-67 was detected in the EGECs in 70% and 62.5% (р &gt; 0.05) of samples in group І and ІІ respectively and in the ESCs in 100% of samples from groups I and II respectively. The immunocytochemical Ki-67 labelling index was much more prominent in group I (45.0 ± 11.4% versus 25.8 ± 16.7% EGECs (р &lt; 0.05); 26.5 ± 10.2% versus 16.3 ± 8.9% ESCs (р &lt; 0.05) for group I and II respectively).Conclusions. Altered proliferation of the eutopic endometrium with marked resistance to apoptosis was found in reproductive aged female with adenomyosis and PTC in history, that is can be considered as a marker of the aggressiveness of the disease course in this cohort of patients.

Role of computed tomography in glenohumeral joint deformity following obstetric brachial plexus injury: Proposed radiological classification

Objective: The study aimed to study the usefulness of computed tomography (CT) in the measurement of glenoid version angle, humeral head dislocation, or subluxation and to propose a grading system for the severity of glenohumeral deformity following OBPI. Material and Methods: A prospective study conducted over a period of 3 years. The study group includes 21 children below the age of 12 years presenting with posterior dislocation of the shoulder, with prior history of OBPI. CT of both shoulders was done using a 128-slice CT scanner. The children were assessed clinically by a Modified Mallet Scale and graded by Waters classification. Results: We graded the severity of deformity on the affected side according to Waters et al. The difference between affected and normal shoulder glenoscapular angle (GSA), percentage of humeral head anterior to the scapular line (PHH), scapular height, and scapular width was statistically significant (P &lt; 0.05). We propose grading for severity and assessed joint stability based on the CT parameters. GSA and PHH show a statistically significant difference between the three grades (P &lt; 0.05). We also confirm that the higher the grade of the deformity, the more difficult the shoulder movements leading to worse scores on the Modified Mallet Scale. Conclusion: CT scan identifies glenohumeral deformities such as increased glenoid retroversion, posterior dislocation of the humeral head, smaller humeral head size, and smaller size of the scapula as deviations from normal status and helps in radiological grading.

Immunoregulatory effects of Huaier (Trametes robiniophila Murr) and relevant clinical applications.

Huaier (Trametes robiniophila Murr) is a medicinal fungus of traditional Chinese medicine with more than 1000 years of history of clinical application. Its remarkable anticancer activities has led to its application in treating diverse malignancies. In recent years, the immunomodulatory effects of Huaier have been uncovered and proved to be beneficial in a plethora of immune-related diseases including cancer, nephropathy, asthma, etc. In this review, we comprehensively summarized the active components of Huaier, its regulatory activities on multifaceted aspects of the immune system, its application in various clinical settings as well as toxicologic evidence. Based on currently available literature, Huaier possesses broad-spectrum regulatory activities on various components of the innate and adaptive immune system, including macrophages, dendritic cells, natural killer cells, T and B lymphocytes, etc. Versatile immunologic reactions are under the regulation of Huaier from expression of damage-associated molecular patterns, immune cell activation and maturation to cell proliferation, differentiation, antibody production, expression of cytokines and chemokines and terminal intracellular signal transduction. Moreover, some modulatory activities of Huaier might be context-dependent, typically promoting the restoration toward normal physiological status. With excellent efficacy and minimal side effects, we foresee more extensive application of Huaier for treating immune-related disorders.

Vitamin D status & associations with inflammation in older adults.

Research studies have observed associations of vitamin D with inflammation but data in representative older adult studies is lacking. We aimed to investigate the association of C-reactive protein (CRP) with vitamin D status in a representative sample of the older Irish population. The concentrations of 25-hydroxyvitamin D (25(OH)D) and CRP was measured in 5,381 community dwelling Irish adults aged ≥50 years from the Irish Longitudinal Study on Ageing (TILDA). Demographic, health and lifestyle variables were assessed by questionnaire and categorical proportions of CRP were generated by vitamin D status and age. Multi-nominal logistic regression was used to investigate the association of 25(OH)D and CRP status. The prevalence (mean; 95% confidence interval (95% CI)) of normal CRP status (0-5 mg/dL) was 83.9% (82.6-85.0%), elevated status (5-10 mg/dL) 11.0% (9.9-12.0%) and high status (>10 mg/dL) was 5.1% (4.5-5.8%). Mean (95% CI) CRP concentrations were lower in those with normal vs. deficient 25(OH)D status (2.02 mg/dL (1.95-2.08) vs. 2.60 mg/dL (2.41-2.82); p<0.0001). In a logistic regression analysis, those with insufficient or sufficient 25(OH)D status were less likely to have a high CRP status compared to those with deficient 25(OH)D status (insufficient: coefficient (CE) -0.732, 95% CI -1.12-0.33, p<0.0001; sufficient: CE -0.599, 95% CI -0.95-0.24, p = 0.001). In conclusion older adults with deficient vitamin D status had higher levels of inflammation as measured by CRP. Given that inflammation is an important pathological driver of chronic diseases of ageing, and that emerging evidence suggests that vitamin D therapy can reduce inflammation in some disease settings, optimising vitamin D status could represent an effective low risk/low-cost pathway to modulate inflammation in community dwelling older adults.

Importance of Srotas - An overview

Ayurveda has its own holistic approach to understand the Purush Sharir by different theories like Srotas, In Ayurvedic classics the term Srotas is used as all the macro and micro channels and pathways operating in the living organism. The concept of Srotas is unique contribution in the understanding of anatomy of human body. There is a description of Srotas by 13 Acharya Charak and 11 pairs of Srotas by Acharya Sushrut. Srotasas are the micro channels of the body which provide platform for activities of Tridosh, Dhatu, Oja, Agni etc. Acharyas also describe the anatomical origin of Srotas (Moola Sthana), its anatomy (shape), Dushti causes &amp; Dusthi Lakshans (etiology &amp; sign symptoms). The anatomical and physiological perspective of Srotas play vital role towards the normal health status of an individual since disturbed anatomical positioning and improper physiological functioning of Srotas can leads many health issues.

Gender features of left ventricular myocardial remodeling in patients with arterial hypertension and anxiety and depressive disorders and possibilities of complex antihypertensive and psychocorrective pharmacotherapy

Relevance. Anxiety-depressive disorders are a frequent companion of arterial hypertension (AH). It is known about the deterioration of the prognosis in patients with a combination of these conditions. At the same time, it is unclear whether complex antihypertensive therapy (AHT) with the inclusion of an antidepressant will improve the control of hypertension, slow down target organ damage, and whether it will be equally effective in men and women.The aim of the study – identify gender characteristics of the structural and functional state of the myocardium of the left ventricle (LV) and the effect of antihypertensive therapy with and without the inclusion of an antidepressant on left ventricular myocardial remodeling in patients with AH and ADD, taking into account the gender of the patient.Materials and methods. The study included 182 patients: 62 with AH (32 men and 30 women) and 120 – with AH and anxiety-depressive disorders (30 men – group 1, 30 women – group 2). Patients with AH and anxiety-depressive disorders were randomized into 2 subgroups (A and B). Patients of subgroup A received a fixed combination of an angiotensin II receptor blocker and a diuretic, a beta-blocker and an antidepressant, patients of subgroup B received similar antihypertensive therapy without including an antidepressant. All patients at inclusion in the study and after 24 weeks underwent a general clinical examination, office measurement of blood pressure (also after 4,8,12 weeks), 24-hour blood pressure monitoring, echocardiography, testing on the HADS, CES-D scales, and a psychiatrist's consultation.Results. Men and women with AH and anxiety-depressive disorders, the negative changes in the main parameters of the LV structural and functional state were more significant than in patients with a normal psychoemotional status. At the same time, in women with anxiety-depressive disorders, LV hypertrophy (LVH) was more pronounced than in men. Target levels of blood pressure were achieved faster in the groups treated with antidepressant, however, intergroup differences reached the level of statistical significance only in women. Complex pharmacotherapy led to a more significant improvement in LV structural and functional state than traditional AHT, especially in women. The use of an antidepressant led to a reduction in anxiety and depressive symptoms, which was not observed in patients only with AHT groups.Conclusions. Patients with AH and anxiety-depressive disorders develop more pronounced remodeling of the LV myocardium than patients with AH with a normal psychoemotional status, especially in women. The combined use of sertraline and antihypertensive drugs contributes to a more rapid achievement target levels of blood pressure, a significant improvement in LV structural and functional state, which is more pronounced in women than in men. It is also important to normalize the psycho-emotional status against the background of an integrated approach to the pharmacotherapy of patients with AH and anxiety-depressive disorders.

Diagnosis of Photokeratitis by Tear Ferning Using a Novel Set of SK Grading Criteria in a UVB-Induced Mouse Model.

Current ocular surface diagnostic methods may not totally meet and implement the clinical demands for early and precise treatments. The tear ferning (TF) test has been known as a quick, simple, and inexpensive procedure. This study aimed to validate the TF test as an alternative method for early determination of photokeratitis status. The tear sample was collected from the UVB-induced photokeratitis eyes and processed for TF formation. The TF patterns were graded by both the Masmali and a Sophie-Kevin (SK) grading criteria, a new set of criteria modified from the Masmali grading, for differential diagnoses. In addition, the TF test results were correlated with three clinical ocular surface indicators, including tear volume (TV), tear film break-up time (TBUT), and cornea staining, to evaluate the diagnostic capacity. Differential diagnosis between the normal and the photokeratitis status was achieved by the TF test. The SK grading reflected earlier photokeratitis status than the Masmali grading criteria. The TF results were strongly correlated with the three clinical ocular surface indicators, particularly for the TBUT and cornea staining. The TF test was proven to have a capacity to distinguish photokeratitis from the normal status at an early stage by using the SK grading criteria. It is therefore potentially useful for photokeratitis diagnosis in the clinical settings. The TF test may fulfill the demands of precise and early diagnosis to facilitate in time the intervention for photokeratitis.

BDNF and Cognitive Function in Chilean Schizophrenic Patients

Despite cognitive symptoms being very important in schizophrenia, not every schizophrenic patient has a significant cognitive deficit. The molecular mechanisms underlying the different degrees of cognitive functioning in schizophrenic patients are not sufficiently understood. We studied the relation between brain-derived neurotrophic factor (BDNF) and cognitive functioning in two groups of schizophrenic patients with different cognitive statuses. According to the Montreal Cognitive Assessment (MoCA) results, the schizophrenic patients were classified into two subgroups: normal cognition (26 or more) and cognitive deficit (25 or less). We measured their plasma BDNF levels using ELISAs. The statistical analyses were performed using Spearman’s Rho and Kruskal–Wallis tests. We found a statistically significant positive correlation between the plasma BDNF levels and MoCA score (p = 0.04) in the subgroup of schizophrenic patients with a cognitive deficit (n = 29). However, this correlation was not observed in the patients with normal cognition (n = 11) and was not observed in the total patient group (n = 40). These results support a significant role for BDNF in the cognitive functioning of schizophrenics with some degree of cognitive deficit, but suggest that BDNF may not be crucial in patients with a normal cognitive status. These findings provide information about the molecular basis underlying cognitive deficits in this illness.

Modifications in cellular viability, DNA damage and stress responses inflicted in cancer cells by copper-64 ions.

Due to combined therapeutical emissions, a high linear energy transfer Auger-electrons with the longer ranged β- particles, 64Cu-based radiopharmaceuticals raise particular theragnostic interest in cancer, by joined therapeutic and real-time PET imaging properties. The in vitro study aimed to investigate the biological and molecular background of 64CuCl2 therapy by analyzing the damages and stress responses inflicted in various human normal and tumor cell lines. Colon (HT29 and HCT116) and prostate carcinoma (DU145) cell lines, as well as human normal BJ fibroblasts, were treated up to 72 h with 2-40 MBq/mL 64CuCl2. Radioisotope uptake and retention were assessed, and cell viability/death, DNA damage, oxidative stress, and the expression of 84 stress genes were investigated at various time points after [64Cu]CuCl2 addition. All the investigated cells incorporated 64Cu ions similarly, independent of their tumoral or normal status, but their fate after exposure to [64Cu]CuCl2 was cell-dependent. The most striking cytotoxic effects of the radioisotope were registered in colon carcinoma HCT116 cells, for which a substantial decrease in the number of metabolically active cells, and an increased DNA damage and oxidative stress were registered. The stress gene expression study highlighted the activation of both death and repair mechanisms in these cells, related to extrinsic apoptosis, necrosis/necroptosis or autophagy, and cell cycle arrest, nucleotide excision repair, antioxidant, and hypoxic responses, respectively. The in vitro study indicated that 40 MBq/mL [64Cu]CuCl2 delivers a therapeutic effect in human colon carcinoma, but its use is limited by harmful, yet lower effects on normal fibroblasts. The exposure of tumor cells to 20 MBq/mL [64Cu]CuCl2, might be used for a softer approach aiming for a lower radiotoxicity in normal fibroblasts as compared to tumor cells. This radioactive concentration was able to induce a persistent decrease in the number of metabolically active cells, accompanied by DNA damage and oxidative stress, associated with significant changes in stress gene expression in HCT116 colon cancer cells.

REVIEW ARTICLE ON MADHUR AVASTHAPAKA

In biology, human is known as consumers. It means that a human has to ingest all nutrients, minerals, vitamins, and water for his survival. You are not what you eat, you are what you digest and absorb. In practice, it is seen that food is not propagated further, if it is not digested well, in the normal status of the digestive tract. This condition could probably not indicate physiology. Avasthapaka gives a general view of Ayurveda about digestive stages. Ayurvedic classics explain the whole process of digestion that starts from the intake of food and takes place in three stages called avasthapaka, these are Madhur avasthapaka, Amala avasthapaka, and katu avasthapaka. Avasthapaka is observed during the action of Jatharagni and Bhutagni. It shows the effect for a short duration and can be directly perceived by physical symptoms in the body. A study of each stage is necessary as each stage is said to nourish one Dosha. Since every Dosha is responsible for controlling the entire physiology of living being, it is really worth going through the details of Avasthapaka. Clinical effects of Avasthapaka like when a person is suffering from Kaphaja swasa, accentuation of his(asthma) disease is an outward expression of first avasthapaka as dosha kapha gets accentuated in this stage and worsens the condition of the patient. Any kind of chance in avasthapaka can lead to pathogenesis with particular signs and symptoms.

Biological Embedding of Social Determinants of Health in Early Life and Across Generations

Population health disparities represent one of the most significant public health challenges. These disparities are evident from the earliest stages of life onwards, persist across the life span, are perpetuated across generations, and are strongly influenced by social and environmental factors. Chronic stress and stress-related biobehavioral processes are discussed as one of the major effectors of the causal pathways linking upstream social determinants with health and health disparities. It is evident that the effects of stress exposure can persist over long periods of time, even across the lifespan, and particularly so if exposure occurs during sensitive developmental windows such as the intrauterine period. In this symposium, presenters will address key questions and knowledge gaps regarding biological embedding of social disadvantage and the role of stress in this context, particularly during pregnancy and early life. Tom O’Connor will present data from the ECHO-UPSIDE cohort, a longitudinal pregnancy cohort study of a socio-economically and racially/ethnically diverse sample at elevated psychosocial risk but normal medical risk status. Results indicate that maternal pre-pregnancy adversity in early childhood is associated with prenatal behavioral and physical health markers, including depressive and anxiety symptoms, stress, body mass index (BMI), sleep disturbance, and diet, as well as maternal-fetal-placental biological markers that predict child health outcomes. Laura Scholaske will present results of a multi-site prospective pregnancy study conducted in Germany that includes people of Turkish origin that are among the biggest migrant groups in Germany. Results of the study suggest that pregnant women of Turkish origin exhibit higher psychological stress levels and alterations in stress-related biological systems (i.e., elevated inflammatory levels, blunted cortisol awakening response and flatter diurnal cortisol slope) compared to non-migrant pregnant women. Shannin N. Moody will address the effects of policing inequities that are one of the most harmful sources of systemic racism perpetuated against Black Americans. In three separate studies, she tested how unjust police encounter biologically “get under the skin” in Black youth from infancy to emerging adulthood. Rates of neighborhood stop-and-frisk were associated with shorter telomeres in infants. Children whose mothers experienced unfair treatment from police showed, during the TSST, blunted cortisol stress reactivity, slower cortisol recovery, and altered cortisol-testosterone coupling. Adolescents who experienced police encounters had higher waking cortisol as emerging adults. Taken together, the studies point so some of the potential pathways through which social determinants of health may propagate and transmit persisting health disparities. Elisabeth Shirtcliff will lead a discussion on the potential implications for early prevention and targeted intervention strategies to prevent or reverse biological embedding of social disadvantage in at risk individuals.