Onset Of Period Research Articles

Cohen syndrome: Can early-onset recurrent infections and hypotonia provide early diagnosis and intervention for intellectual disability?

Cohen syndrome is a rare disease associated with neurodevelopmental disorders, especially intellectual disability (ID), neutropenia and recurrent infections are consistently reported in cases. Neutropenia is an important part of the syndrome, as well as ID. Homozygous variants in the VPS13B gene, located on chromosome 8q22 and containing 62 exons, have been found to cause Cohen syndrome. Cohen syndrome is commonly diagnosed when dysmorphological findings and developmental delay become more apparent. However, the identification of some findings with increasing age has caused the diagnosis of Cohen syndrome to be delayed. Cases diagnosed with ID were evaluated using whole-exome sequencing/clinical exome sequencing method. Family segregation analysis was performed using Sanger sequencing. We presented the clinical and genetic findings of three cases diagnosed with Cohen syndrome and their parents in detail. In this study, we presented the occurrence of symptoms in different age groups, and the prognosis of three cases carrying the VPS13B gene variants, including three different variant types: missense, frameshift and nonsense. Although our cases had different variant types, they shared important similarities on the onset period and prognosis of the symptoms. All cases presented hypotonia, difficulties in swallowing, recurrent respiratory tract infections, neutropenia, delay in motor development, ID and hyperactivity. Our cases did not have a diagnosis of autism spectrum disorder. All cases had increased willingness to engage in social communication. We emphasize the importance of early-onset recurrent infections and hypotonia for early diagnosis and preventive genetic counselling in Cohen syndrome.

A Case-control Study on the Correlation between Serum Bilirubin Levels and Various Types of Appendicitis

Background Acute appendicitis is one of the most common types of surgical emergencies. Among laboratory factors, hyperbilirubinemia has recently been identified as a strong predictor of preoperative perforation and gangrene. Aim This study aimed to investigate the correlation between serum bilirubin levels and types of appendicitis. Methods This case-control study was conducted in 2022 using the convenience sampling method on 100 patients who were referred to the emergency department of Imam Khomeini Hospital in Jiroft with abdominal pain. These patients were diagnosed with appendicitis based on the initial clinical examinations. The white blood cells and total bilirubin levels were measured for all the patients. Intraoperative macroscopic findings were recorded by the surgeon, and the pathological results of the specimen were reported. Data was analyzed using SPSS 24, including descriptive and inferential statistics at the significance level of P<0.05. Results Among 100 patients aged between 28.5±14.8, 48% were men, and the rest were women. There was a significant difference between the mean of bilirubin levels in patients with complicated and uncomplicated appendicitis (P <0.01). The results of logistic regression analysis showed that the period of onset of symptoms to hospitalization, leukocytosis level, and preoperative total bilirubin level were significant variables for diagnosing complicated appendicitis (P<0.05). Conclusion In this study, we found that patients with complicated appendicitis had higher total bilirubin levels than patients with uncomplicated appendicitis. Therefore, patients with hyperbilirubinemia and clinical symptoms of appendicitis should be considered as more probable cases of perforation than those with normal bilirubin levels.

Analysis of clinical features and outcomes in patients with ocular myasthenia gravis according to anti-acetylcholine receptor antibody-seropositivity.

To comparatively analyze the clinical characteristics of patients with ocular myasthenia gravis (OMG) referred to an ophthalmology clinic, according to anti-acetylcholine receptor antibody (AchR Ab)-seropositivity. Retrospective Cohort Study. Medical records of patients with OMG who presented to a tertiary eye care center between 2003 and 2020 were retrospectively reviewed. Demographics, ophthalmologic characteristics, response to medical treatment, presence of autoimmune thyroid disease and thyroid autoantibody were compared between the AchR Ab seropositive and seronegative groups. A total of 130 patients with OMG were identified; among them, 46 patients (35.4%) had autoantibody against acetylcholine receptors. The mean age at symptom onset was 42.4 ± 18.9 years. There were no differences in mean age at symptom onset, gender ratio, and mean follow-up period between patients with seropositive and seronegative OMG. Graves ophthalmopathy was significantly more frequent in seronegative patients (p = 0.04), while thymic disease (p < 0.01) was more frequent in seropositive patients (p < 0.01). Among patients with seropositive OMG, 52.3% showed a good response to medical treatment, while only 31.4% of the seronegative patients were classified as good responders (p = 0.01). Thyroid dysfunction was found in 27.4% patients with OMG and the proportion of thyroid dysfunction was not different according to anti-acetylcholine receptor antibody-seropositivity. Seropositivity to acetylcholine receptor antibody is associated with a better response to medical treatment and lower risk of concomitant autoimmune thyroid disease in patients with OMG.

Evaluation of thiopyrano[2,3-d]thiazole derivatives as potential anticonvulsant agents.

Anticonvulsant drug discovery has achieved significant progress; however, pharmacotherapy of epilepsy continues to be a challenge for modern medicine and pharmacy. To expand the chemical space of heterocycles as potential antiepileptic agents, herein we report on the synthesis and evaluation of anticonvulsant properties of a series of thiopyrano[2,3-d]thiazoles. The studied heterocycles are characterized by satisfactory drug-likeness and pharmacokinetics properties, calculated in silico using SwissADME. The anticonvulsant activity of thiopyrano[2,3-d]thiazole derivatives was evaluated in vivo using the subcutaneous pentylenetetrazole test. Three hits, that is, compounds 12, 14, and 16, that caused a pronounced anticonvulsant effect were identified. Derivatives 12, 14, and 16 positively affected the latent period of onset of clonic seizures, number of seizures, mortality rate, and duration of the seizure period of animals under experimental conditions. The anticonvulsant properties of compound 14 were equivalent to the effect of the reference drug, sodium valproate. All hit compounds are characterized by satisfying toxicity properties in the human lymphocytes and HEK293 cell line. The most active hit 14 possesses a potential affinity with the GABAA receptor in the molecular docking study and forms a stable complex in the molecular dynamics experiments equal to diazepam. Preliminary SAR results were obtained and discussed based on screening data.

The role of air–sea heat flux for marine heatwaves in the Mediterranean Sea

Abstract. Recent studies have significantly contributed to understanding physical mechanisms associated with the occurrence of marine heatwaves (MHWs). Building upon prior research, this study investigates the relative role of air–sea heat exchange and oceanic processes during the onset and decline phases of surface MHWs in the Mediterranean Sea based on a joint analysis of remote sensing data and reanalysis outputs over the period 1993–2022. Results show that air–sea heat flux is the major driver in 44 % of the onset and only 17 % of the declining MHW phases. Thus, these findings suggest that oceanic processes play a key role in driving sea surface temperature (SST) anomalies during MHWs, particularly during declines. The role of surface flux becomes more important during warmer months and onset periods. Spatially, the heat flux contribution is greater in the Adriatic and Aegean sub-basins, where it becomes the major driver of most onset phases. Latent heat emerges as the most significant heat flux component in forming the SST evolution across all seasons. Onset and decline phases lasting less than 5 d experience a weaker contribution of heat flux compared to longer phases (lasting 5–10 or more than 10 d). Moreover, an inverse relationship between MHW severity and the contribution of heat flux is observed. At the subsurface, mixed layer shoaling is found over the entire duration of most MHWs, particularly for those of shorter duration. Therefore, the surface cooling right after the peak day is likely not associated with vertical mixing in such cases. These findings suggest that other oceanic processes, potentially horizontal advection, have a key role in modulating SST at the beginning of most MHW declines. In turn, further dissipation of heat is commonly driven by vertical mixing, as indicated by a significant mixed layer deepening after the MHW end day in most cases. This study emphasizes the need to consider subsurface information for future studies of MHWs and highlights the importance of accounting for limitations associated with the definitions employed for MHW phases.

Rising out-of-hospital mortality in Canada during 2020‒2022: A striking impact observed among young adults.

Out-of-hospital mortality rates surged during the early COVID-19 pandemic. While expecting a return to pre-pandemic levels, the evolving patterns of out-of-hospital mortality in Canada remain uncertain. We investigated whether these rates returned to pre-pandemic levels. This retrospective study, employing linked administrative data, analyzed out-of-hospital mortality trends among adult residents in Ontario, Alberta, and Nova Scotia. Interrupted time series analysis assessed trends in age- and sex-standardized rates/100,000/quarter during pre-pandemic (April 2014-March 2020) and pandemic periods (April 2020-March 2022), while considering April to June 2020 as the pandemic onset period. Crude mortality rates were also examined, stratified by sex and age groups. Pre-pandemic, Ontario's standardized out-of-hospital mortality rates were rising, while Alberta's and Nova Scotia's remained stable. At the pandemic onset, all provinces experienced significant increases in standardized out-of-hospital mortality rates/100,000 (Ontario: β 14.6, 95% CI [3.97, 25.22]; Alberta: 21.3, 95% CI [9.26, 33.34]; Nova Scotia: 10.5, 95% CI [1.06, 19.88]). During the pandemic, standardized out-of-hospital mortality rates/100,000/quarter remained above pre-pandemic levels, with no significant departure from the increased pandemic onset levels (Ontario: - 1.6, 95% CI [- 3.63, 0.52]; Alberta: 0.45, 95% CI [- 1.47, 2.36]; Nova Scotia: - 0.06, 95% CI [- 2.18, 2.06]). Crude out-of-hospital mortality rates increased most prominently among individuals aged 18 to 45 in Alberta and Ontario, and among males across all provinces. The sustained increase in out-of-hospital mortality, observed from the pandemic's onset, spanning more than 2years, potentially suggests its persistent direct and indirect effects on population health in Canada.

Impact of Bacille Calmette-Guérin vaccination on the therapeutic schedule of infantile epileptic spasms syndrome: A 25-year Japanese single-center survey

Adrenocorticotropic hormone (ACTH) therapy is effective for infantile epileptic spasms syndrome (IESS) but can induce immunosuppression. In Japan, Bacille Calmette-Guérin (BCG) vaccination, modified in 2013 to reduce osteitis/osteomyelitis risk, coincides with the peak onset age of IESS. This raises concerns about infection risks when administering ACTH therapy post-vaccination. To evaluate the impact of BCG vaccination timing on treatment decisions, we retrospectively reviewed the medical records of 86 IESS patients at our hospital (1996–2020). Infants who received ACTH therapy within eight weeks of BCG vaccination experienced no serious adverse events. Four patients deferred or opted out of ACTH therapy, with seizure remission taking 2–15 weeks. The overlap between IESS onset and BCG vaccination period presents clinical challenges in determining the appropriate timing for ACTH therapy. Further epidemiological and immunological research is needed to clarify the relationship between ACTH therapy and BCG-associated adverse events and to optimize treatment strategies and vaccination schedules.

Impact of Covid-19 pandemic on HIV testing, recent infections and annualized incidence among cisgender men who have sex with men and transgender women in Brazil

Background: The Covid-19 pandemic had great impact on HIV care and prevention worldwide, including in Brazil. We compared HIV testing, recent infection, and annualized incidence according to Covid-19 pandemic period among men who have sex with men (MSM) and transgender women (TGW). Setting: HIV/STI testing, prevention and treatment referral service in Rio de Janeiro, Brazil Methods: We used Maxim HIV-1 Limiting Antigen Avidity EIA as part of recent infection testing algorithm to identify recent HIV infections and estimate annualized HIV incidences in pre- (March/2018-February/2020) and post-Covid-19 pandemic onset period (March/2020-January 2022). Multivariable logistic regression model assessed factors associated with recent HIV infection. Results: Among 4590 MSM and TGW, 593 (12.9%) tested positive for HIV and 119 (2.6%) were identified as having recent infection. Percentage of recent HIV infection did not differ between Covid-19 periods. Overall annualized HIV incidence rates were 6.0% (95%CI:4.2-7.7) and 6.6% (95%CI:4.3-9.0) in pre- and post-Covid-19 periods, respectively. During the post-Covid-19 period, higher incidence rates were observed among TGW (8.4%[95%CI:2.9-13.9]), those aged 18-24 years (7.8%[ 95%CI:4.0-11.7]), Black race (7.9%[95%CI:3.8-12.0]), and with &lt;12 years of schooling (7.8%[95%CI:4.8-10.8]). Incidence rates were significantly higher in the post-Covid-19 period for those aged&gt;30 years and TGW, and lower for those with more years of schooling. Conclusion: HIV incidence estimates remain high among MSM and TGW in Brazil, especially among the most vulnerable. The consequences of the Covid-19 pandemic on the HIV epidemic will likely persist and contribute to worsening HIV outcomes.

Six-year (2016-2022) longitudinal patterns of mental health service utilization rates among children developmentally vulnerable in kindergarten and the COVID-19 pandemic disruption.

In the context of the COVID-19 pandemic, it becomes important to comprehend service utilization patterns and evaluate disparities in mental health-related service access among children. This study uses administrative health records to investigate the association between early developmental vulnerability and healthcare utilization among children in Alberta, Canada from 2016 to 2022. Children who participated in the 2016 Early Development Instrument (EDI) assessment and were covered by public Alberta health insurance were included (N = 23 494). Linear regression models were employed to investigate the association between service utilization and vulnerability and biological sex. Separate models were used to assess vulnerability specific to each developmental domain and vulnerability across multiple domains. The service utilization was compared between pre- and post-pandemic onset periods. The analysis reveals a significant decrease in all health services utilization from 2016 to 2019, followed by an increase until 2022. Vulnerable children had, on average, more events than non-vulnerable children. There was a consistent linear increase in mental health-related utilization from 2016 to 2022, with male children consistently experiencing higher utilization rates than females, particularly among vulnerable children. Specifically, there was a consistent linear increase in the utilization of anxiety-related services by children from 2016 to 2022, with females having, on average, 25 more events than males. The utilization of ADHD-related services showed different patterns for each group, with vulnerable male children having more utilization than their peers. Utilizing population-wide data, our study reveals sex specific developmental vulnerabilities and its impact on children's mental health service utilization during the COVID-19 pandemic, contributing to the existing literature. With data from kindergarten, we emphasize the need for early and targeted intervention strategies, especially for at-risk children, offering a path to reduce the burden of childhood mental health disorders.

Balancing constraints and requirements in an application process

ObjectiveAdolescence is a vulnerable period for onset of depression. Socioeconomic deprivation may elevate the risk of depression. We explored the risk of depression in early adulthood in relation to deprivation during adolescence. Approach97,561 individuals aged 10-14 years were grouped at baseline (2010) using small-area indicator of area-level deprivation (measured in quintiles) and linked with yearly antidepressant prescriptions (2010–2021). A logistic random-intercept multilevel model estimated the longitudinal trajectory of yearly antidepressant prescriptions (2010-2021) between deprivation quintiles in 2010, adjusting for sex and age at baseline. ResultsIn 2010, the marginal probability of receiving antidepressants for an average young person differed little between those living in the most (0.0028: 95%CI=0.0025,0.0032) and least (0.0027: 0.0023,0.0032) deprived areas (p=0.75). By 2021, the marginal probability had increased more for those who lived in the most deprived areas in 2010 (0.191: 0.187,0.195) compared to those who lived in the least deprived areas in 2010 (0.140: 0.135,0.145)(p&lt;0.001). Estimated antidepressant prescriptions were higher in females compared to males (Odds Ratio[OR]=3.15: 3.00,3.29) and increased per year of age at baseline (OR=1.26: 1.24,1.28). ConclusionsGrowing up in more socially deprived areas is associated with an increase in antidepressant prescription risk during early adulthood. Improvements in administrative data access and linkage are needed to further explore these findings. ImplicationsPolicy makers and data custodians should recognise the potential for administrative data in identifying social disadvantage and associated vulnerabilities in the general population, and take steps to make this data accessible to the research community.

Effect of Flowering Period on Drone Reproductive Parameters (Apis mellifera L.).

Insufficient protein intake during the larval phase of drones affects the development of reproductive organs and spermatogenesis. The aim of the study was to evaluate the effect of the flowering-scarcity and flowering-onset periods on the eversion of the copulatory apparatus, ejaculation, and sperm quality of drones (Apis mellifera L.). To stimulate the laying of drone eggs during the flowering-scarcity period, 1 L of sugar syrup was supplied weekly to the hives, along with a protein supplement made of 20% pollen and 80% brewer's yeast. During the periods of flowering scarcity and the onset of flowering, 800 drones were collected (200 per month). At the onset of flowering, 270 drones showed eversion of the copulatory apparatus, of which 162 ejaculated, compared to the flowering-scarcity period, where 112 drones showed eversion of the copulatory apparatus and 39 drones ejaculated. During the period of flowering onset, sperm parameters such as volume, concentration, motility, viability, acrosome integrity, and mitochondrial activity were higher compared to the period of flowering scarcity. In conclusion, we observed a greater number of drones with eversion of the copulatory apparatus and ejaculation, as well as better sperm quality with the drones bred during the period of flowering onset. These differences indicate that the flowering-scarcity period significantly impacts the reproductive parameters of drones.

The effect of age on heart rate variability indices during and following high-intensity continuous exercise in masters and young cyclists.

This study compared heart rate variability (HRV) parameters of cardiovascular autonomic regulation between well-trained masters and young cyclists at rest, during and following a continuous cycle (CTS) protocol. Ten masters (age = 56 ± 5years) and eight young (age = 26 ± 3years) cyclists completed a 100min experimental protocol consisting of a 60min CTS cycling bout at 95% of Ventilatory Threshold 2 followed by 40min of supine recovery. Beat-to-beat heart rate was measured continuously, and HRV parameters analysed at standardised 5min intervals during rest, exercise and recovery. The root mean square of the successive differences (RMSSD), low-frequency power and high-frequency power parameters were corrected by division of the R-R interval (time domain), or R-R interval squared (frequency domain). Further, the RMSSD and RMSSD:RR for successive 60-s R-R intervals at the onset (0-10min) and offset (60-70min) of CTS exercise were analysed over 10-min periods. The natural logarithm (Ln) of skewed parameters was taken for analysis. Significant interaction effects (P < 0.05) for 5min segments were found for (LnRMSSD, LnRMSSD:RR, LnHF and LnHF:RR2. Masters cyclists demonstrated lower values of parasympathetic activity at rest and during recovery (15-20min and 35-40min) compared to younger cyclists. However, similar HRV responses were observed during exercise, including throughout the acute onset and offset periods (P > 0.05). This data shows that cardiac autonomic regulation during, or immediately following CTS exercise may not be influenced by age, but masters athletes may exhibit a lower baseline for parasympathetic activity.

Motion sickness and visual impairment

Motion sickness (MS) is caused by exposure to unfamiliar movements. The theory is that MS is due to a conflict between information perceived by the vestibular, visual, and somatosensory systems. This study examines the role of vision in MS by comparing MS susceptibility among individuals with varying degrees of visual impairments to sighted individuals. We hypothesized that subjects with no perception of light would be less susceptible to MS than less impaired subjects, who would themselves be less susceptible than sighted subjects. To address these, the Motion Sickness Susceptibility Questionnaire (MSSQ1) was administered to 340 subjects (170 visually impaired paired with 170 sighted subjects) to assess their susceptibility to various modes of transport under real conditions. Visually impaired subjects were divided into subgroups according to the presence (partially sighted) or absence (totally blind) of light perception, as well as the period of onset of impairment (congenital or acquired). Totally blind individuals are significantly less susceptible to MS than partially sighted (p = 0.001), and sighted (p < 0.001) subjects, with no difference between partially sighted and sighted subjects (p = 0.526). Additionally, acquired totally blind subjects are less susceptible to MS than congenitally blind subjects (p = 0.038). Thus, despite a lower susceptibility totally blind subjects may still be susceptible to MS. The absence of vision reduces MS susceptibility but does not completely prevent it. This suggests that vision is more a mediator, than an essential condition for MS appearance.

Aмпелографска характеристика на интродуцирани в България десертни сортове лози

A brief ampelographic characteristic of the introduced table grapevine cultivars from P. R. China - Kyoho, Shennong Jinhuanghou, Bixiang Wuhe, and Hanxiangmi was done. According to the period of onset of consumptive ripeness of the grapes, under the specific soil-climatic conditions, the Hanxiangmi cultivar belongs to the group of „very early ripening“ cultivars (beginning of August), and the rest to the group of „early ripening“ (the second half of August). The studied cultivars are distinguished by good adaptive potential and manage to fully develop their qualities in the study area. They are characterized by high fertility and yield, large and attractive clusters, very large berries, and high quality and high transportability of the grapes. They have increased resistance to downy mildew (Plasmopara viticola) and low winter temperatures. The seedless cultivar Hanxiangmi has a very high and relatively constant fertility over the years, with a high proportion of fruit shoots developed from additional and dormant buds.

Seizure onset and offset pattern determine the entrainment of the cortex and substantia nigra in the nonhuman primate model of focal temporal lobe seizures.

Temporal lobe epilepsy (TLE) is the most common form of drug-resistant epilepsy. A major focus of human and animal studies on TLE network has been the limbic circuit. However, there is also evidence suggesting an active role of the basal ganglia in the propagation and control of temporal lobe seizures. Here, we characterize the involvement of the substantia nigra (SN) and somatosensory cortex (SI) during temporal lobe (TL) seizures induced by penicillin injection in the hippocampus (HPC) of two nonhuman primates. The seizure onset and offset patterns were manually classified and spectral power and coherence were calculated. We then compared the 3-second segments recorded in pre-ictal, onset, offset and post-ictal periods based on the seizure onset and offset patterns. Our results demonstrated an involvement of the SN and SI dependent on the seizure onset and offset pattern. We found that low amplitude fast activity (LAF) and high amplitude slow activity (HAS) onset patterns were associated with an increase in activity of the SN while the change in activity was limited to LAF seizures in the SI. However, the increase in HPC/SN coherence was specific to the farther-spreading LAF onset pattern. As for the role of the SN in seizure cessation, we observed that the coherence between the HPC/SN was reduced during burst suppression (BS) compared to other termination phases. Additionally, we found that this coherence returned to normal levels after the seizure ended, with no significant difference in post-ictal periods among the three types of seizure offsets. This study constitutes the first demonstration of TL seizures entraining the SN in the primate brain. Moreover, these findings provide evidence that this entrainment is dependent on the onset and offset pattern and support the hypothesis that the SN might play a role in the maintenance and termination of some specific temporal lobe seizure.

Introduction of varieties of чубушник (Philadelphus L.) selected by N.K. Vekhov in the Stavropol Botanical Garden

To create sustainable and long-lasting landscape gardening, gardeners need a wide range of ornamental plants, among which considerable importance is given to Philadelphus L. For recreational development of territories and enrichment of the assortment of ornamental plants in the zone of insufficient moisture, varieties with good xerothermal characteristics, high decorative qualities and adaptive capabilities are proposed.The biological and decorative features of seven varieties Philadelphus L. in the soil and climatic conditions of the Stavropol upland have been studied. Earlier and later periods of vegetation onset in different years are highlighted. The dates of the beginning and end of flowering have been set. The average duration of flowering was 18–23 days, the maximum was 25 days, the minimum was 16 days. The analysis of habitual indicators is carried out, the characteristic of the crown shape is given. The study of phytoentomological resistance has shown high resistance of these varieties to diseases and pests in local soil and climatic conditions. According to the results of the introduction variety study, seven varieties of Philadelphus L. with high decorative qualities and resistance to a complex of adverse environmental factors were proposed for mass use in decorative gardening in the Stavropol territory.

Application study on the prevention and treatment of spleen aminopeptide oral solution on seasonal allergic rhinitis

Methods: A total of 392 patients with seasonal allergic rhinitis were selected from the population of the epidemiological investigation project of allergic diseases in Hohhot, Inner Mongolia. The project was led by Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, and assisted by Hohhot First Hospital from April to May 2023. The patients were randomly divided into a spleen aminopeptide group (296 cases) and control group (96 cases) at a ratio of 3∶1, and the enrollment period was from June 1 to 14, 2023. The treatment group was treated with spleen aminopeptide oral solution for 12 weeks starting from 4-6 weeks (±7 days) before the pollen dispersal period, while the control group was treated with a simulated agent of spleen aminopeptide oral solution. Both the treatment group and the control group were treated with oral antihistamines and/or nasal glucocorticoids as needed during the pollen dispersal period. Evaluate the therapeutic effect by comparing the symptom scores, drug scores and quality of life scores of the two groups, and detect the expression levels of cytokines in serum. Symptom scores, quality of life scores, drug scores and laboratory results were compared by independent sample t test/Kruskal-Wallis test and χ2 test/Fisher's exact test. Results: Compared with the control group, spleen aminopeptide treatment for 12 weeks significantly improved symptoms of nasal congestion [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=6.308, P<0.05], nasal itching [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=4.966, P<0.05], sneezing [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=5.245, P<0.05], runny nose [M(Q1,Q3):2(1, 2) vs. 2(1, 3), H=5.41, P<0.05] and tearing [M(Q1,Q3):1(0, 2) vs. 1(0, 3), H=4.664, P<0.05]. At 12 weeks of treatment, the scores of nasal symptoms and ocular symptoms in control group and experimental group were significantly increased compared with baseline (P<0.05). In experimental group, nasal congestion [M(Q1,Q3):1(0, 1) vs. 1(0, 2), H=4.042, P<0.05], eye itching/foreign body sensation/redness symptom scores [M(Q1,Q3):1(0, 2) vs. 1(0, 2), H=5.302, P<0.05] and total scores [M(Q1,Q3):4(-1, 9) vs. 5(0, 12.5), H=3.958, P<0.05] were significantly increased. The antihistamine drug score of the splenic peptide treatment group at 6 weeks were lower than that of the control group (H=4.232, P<0.05). After 12 weeks of treatment, the antihistamine drug score [M(Q1,Q3):10(0, 24) vs. 19(2, 36.5), H=6.67, P<0.05] and the total drug score [M(Q1,Q3):28.5(5, 77.5) vs. 46(6, 155.5), H=3.995, P<0.05] were significantly lower than those of the control group. The serum IL-17A levels of the treatment group were significantly lower than those of the control group after 6 weeks (0.7±1.77 vs. 0.85±1.67,H=10.08, P<0.05) and 12 weeks (0.81±1.63 vs. 0.94±1.73,H=5.196, P<0.05) of splenic aminopeptide treatment. Conclusions: Early treatment with spleen aminopeptide oral solution can significantly improve nasal and ocular symptoms of patients with seasonal allergic rhinitis, reduce the use of drugs during the onset period, and improve the quality of life. It may exert an immunomodulatory effect by reducing the expression level of IL-17A in the serum of patients. Objects: To conduct a study on the prevention and treatment of seasonal allergic rhinitis in Hohhot, Inner Mongolia, evaluate the preventive and therapeutic effects of spleen aminopeptide oral solution on seasonal allergic rhinitis, and explore its related mechanisms.

Birth outcomes in pregnant women with gestational diabetes mellitus

From the perspective of modern obstetrics, gestational diabetes mellitus (GDM) is considered an epidemic of the 21st century. It can complicate the course of pregnancy at any week of gestation. The purpose of the work was to determine the influence of the gestational age of GDM onset on birth outcomes in pregnant women. Materials and methods: During the study, a retrospective analysis of 362 individual records of pregnant and postpartum women was carried out. Results: Earlier onset of GDM is significantly more often associated with the development of symphysitis in the mother, with fetal growth retardation and the need to use insulin therapy to correct hyperglycemia. Conclusions: Regardless of the period of onset of GDM, pregnant women constitute a risk group for obstetric and perinatal complications.

Early Childhood Onset Vanishing White Matter Disease with Multiple Cranial Nerve Enhancement: A New Consensus Criteria?

Vanishing White Matter Disease (VWM), also known as Childhood Ataxia with Central Nervous System Hypomyelination (CACH), although a rare neurological condition, is a prevalent hereditary leukoencephalopathy with a characteristic phenotype of gradual neurologic deterioration with ataxia being a prominent feature. It is characterized by a wide range of onset, from antenatal and infantile periods to early childhood and later adulthood periods. The early childhood form is considered the prevailing form, characterized by a preceding phase of normal development until the second or 3rd year of life, followed by progressive neurologic deterioration, accentuated by certain stressors, such as infections or minor trauma. Diagnosis is achieved based on the clinical pretext combined with distinctive MRI brain features, confirmed by DNA analysis detection of elf2B mutation. Our case is a healthy 18-month-old male who after a preceding upper respiratory tract infection, developed an ataxic gait, encephalopathy, and recurrent generalized seizures. Physical assessment revealed signs of generalized spasticity and hyperreflexia. Neuroimaging revealed diffuse symmetric supratentorial and infratentorial diffuse white matter hypomyelination. Interestingly, there was notable enhancement of the 3rd and 5th cranial nerves. Differential diagnosis included acute demyelinating leukoencephalopathies; and neuromatobolic disorders with acute presentations (including leukodystrophies, hypomyelinating disorders, and mitochondrial encephalopathies). In the early course of his management, he received immunomodulatory therapy in the form of pulse steroids, intravenous immunoglobulins, and oral tapering course of steroids. He had limited response to these interventions. Whole exome sequencing yielded a homozygous mutation in EIF2B3, confirming the diagnosis of VWMD/CACH. The presence of enhancing cranial neuropathies represent an atypical phenotype reported in other case reports and should alert the physician to avoid unnecessary intervention with immunosuppressive therapies.

Delayed epistaxis after endoscopic transnasal pituitary tumor resection: clinical characteristics, risk factors, treatment and prevention

BackgroundDelayed epistaxis after endoscopic transnasal pituitary tumor resection (ETPTR) is a critical complication, tending to cause aspiration or hemorrhagic shock. This study assessed clinical characteristics, risk factors, and provide treatment and prevention advice of this complication.MethodsThis was a retrospective monocentric analysis of 862 patients who underwent ETPTR. Statistical analyses of clinical data revealed the incidence, sources and onset time of delayed epistaxis. Univariate analysis and binary logistic regression were used to identify risk factors.ResultsThe incidence of delayed epistaxis was 2.78% (24/862), with an average onset time of 20.71 ± 7.39 days. The bleeding sources were: posterior nasal septal artery branch of sphenopalatine artery (12/24), multiple inflammatory mucosae (8/24), sphenopalatine artery trunk (3/24) and sphenoid sinus bone (1/24). Univariate analysis and binary logistic regression analysis confirmed that hypertension, nasal septum deviation, chronic rhinosinusitis and growth hormone pituitary tumor subtype were independent risk factors for delayed epistaxis. Sex, age, history of diabetes, tumor size, tumor invasion and operation time were not associated with delayed epistaxis. All patients with delayed epistaxis were successfully managed through endoscopic transnasal hemostasis without recurrence.ConclusionsDelayed epistaxis after ETPTR tends to have specific onset periods and risk factors. Prevention of these characteristics may reduce the occurrence of delayed epistaxis. Endoscopic transnasal hemostasis is recommended as the preferred treatment for delayed epistaxis.