Symptoms In Patients Research Articles

Mood symptoms, cognitive function, and changes of brain hemodynamics in patients with COVID-19: A functional near-infrared spectroscopy study

BACKGROUND Many patients with coronavirus disease 2019 (COVID-19) may experience emotional issues and cognitive impairment. However, it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms. It remains unclear whether anxiety and depression are caused by stressors or viral infection. AIM To use functional near-infrared spectroscopy (fNIRS) to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms (mainly depression and anxiety), to investigate whether COVID-19 causes these changes by affecting brain function. METHODS A total of 58 subjects, comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited. Then cortical activation during the performance of the verbal fluency test (VFT) and brain connectivity during the resting state (rs) were evaluated by 53-channel fNIRS. For the COVID-19-infected group, Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess the emotional state before fNIRS measures. RESULTS For the rs, compared to the uninfected group, the infected group exhibited lower rs functional connectivity (FC) in the dorsolateral prefrontal cortex (DLPFC), which was correlated with both the PHQ score and GAD score. During the VFT, the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right. Besides, the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group. CONCLUSION There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups, which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms. In addition, the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety, which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety, rather than depression or anxiety alone. Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits, which also provide insights into the future treatment and prognosis of individuals with COVID-19.

Treatment of refractory thoracolumbar spine infection by thirteen times of vacuum sealing drainage: A case report

BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage (VSD) surgeries were treated. CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility, including five performed under local anesthesia and eight performed under general anesthesia. The source of the ailment was ultimately identified as Enterobacter cloacae . After the last procedure, the patient's symptoms were alleviated, and the recovery process was satisfactory. Three months post-operation, the Japanese Orthopaedic Association scores had improved to 100%. Imageological examination revealed a satisfactory position of internal fixation, and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results. CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection, providing an alternative to traditional surgery.

Clozapine-induced obsessive-compulsive symptoms in schizophrenia: Clinical and cognitive determinants of dysfunctional checking.

Obsessive-compulsive symptoms (OCS) emerge in a significant proportion of clozapine-treated schizophrenia patients, affecting social functioning and increasing depressive symptoms. This study investigates the underexplored cognitive mechanisms of clozapine-induced OCS, particularly focusing on dysfunctional checking behavior. Clinical and cognitive profiles of OCS and their relationship to dysfunctional checking were investigated using a novel checking paradigm (image verification task or IVT) in four groups: clozapine-treated schizophrenia patients with clozapine-induced OCS (SCZ-OCS, n = 21) and without (SCZ-only, n = 15), patients with obsessive-compulsive disorder (OCD, n = 32) and IQ-matched healthy volunteers (HV, n = 30). Only SCZ-OCS patients showed a distinctive pattern of dysfunctional checking on the IVT. Compared with SCZ-OCS, SCZ-only patients exhibited functional checking while having equivalent deficits in executive cognition, clozapine dose, and treatment duration, though with less severe positive and depressive symptoms. In SCZ-OCS, dysfunctional checking was positively correlated with clozapine dose and working memory performance. By contrast, OCD patients' checking was positively related to intolerance of uncertainty. Checking in the OCD and SCZ-OCS groups was positively correlated with YBOCS-compulsion. This study is the first to compare the distinct cognitive and clinical profiles of SCZ-OCS, SCZ-only, and OCD, with a focus on checking behavior, a major symptom in clozapine-treated patients. We introduced a novel and sensitive measure for checking, which showed dysfunctional checking only in SCZ-OCS patients treated with clozapine. These findings indicate that a subset of patients with schizophrenia with more severe positive symptoms and cognitive deficits are especially susceptible to OCD symptoms when treated with clozapine.

Analysis on the efficacy and safety of transvenous lead extraction in the treatment of patients with cardiac lead perforation

To investigate the efficacy and safety of transvenous lead removal (TLR) in the treatment of patients with cardiac lead perforation. The case data of 82 patients who underwent TLR for lead perforation at Peking University People's Hospital from January 2014 to June 2024 were retrospectively analyzed. The patients' age was (68.0±12.6) years, with 38 males and 44 females. Clinical symptoms of patients with lead perforation, characteristics of the perforated leads, operation success rate, complication incidence, tools used in TLR, and follow-up situation were analyzed. Clinical symptoms related to lead perforation were present in 80.5% (66/82) of patients, with chest pain being the most common [57.3%(47/82)]. Among the perforated leads, 6.1%(5/82) penetrated outside the pericardium, 58.5%(48/82) were delayed perforations, 65.9%(54/82) were active fixation leads, 78.0%(64/82) of the perforation sites were at the right ventricular apex, and 76.8%(63/82) had abnormal programmed lead parameters. The diagnosis of all lead perforations was confirmed by imaging examinations. Eight high-risk patients received percutaneous dry pericardiocentesis before surgery. Eighty-two patients underwent TRL surgery successfully, and no major complications occurred. Among the perforated leads, 57.3% (47/82) of the perforated leads were successfully removed manually. New leads were implanted in 91.5% (75/82) of patients during the same operation. Follow-up was conducted until August 2024, with a total follow-up duration of (5.1 ± 2.7) years. During the follow-up period, a total of 7 patients reached the end events, including 5 deaths and 2 patients who underwent TLR again. In experienced centers, TLR is a safe and effective treatment approach for cardiac implantable electronic devices lead perforation. Prophylactic dry pericardiocentesis can be used as an unconventional option.

Lebrikizumab Improved Skin Signs, Quality of Life, and Showed High Levels of Patient Satisfaction in Adult and Adolescent Patients with Moderate-to-Severe Atopic Dermatitis and Skin of Color

Introduction: Lebrikizumab improved signs and symptoms in patients with skin of color (SoC) and moderate-to-severe atopic dermatitis (AD) after 16 weeks of treatment in ADmirable (NCT05372419), an open-label, Phase 3b clinical trial. Here we report 16-week quality of life (QoL) response and patient satisfaction results in this underrepresented patient population, as well as skin response and QoL response achieved for patients mostly/completely satisfied with treatment. Methods: At baseline and Week 2, patients received 500-mg lebrikizumab loading doses followed by 250-mg every 2 weeks through Week 16. Concomitant topical therapy was allowed. Patients receiving protocol-defined rescue therapy were discontinued. Key eligibility criteria included: ≥12 years of age, self-reported race other than White, Fitzpatrick Phototype IV-VI, and moderate-to-severe AD. Skin response was assessed using Eczema Area and Severity Index (EASI) and QoL response was assessed using Dermatology Life Quality Index (DLQI). Patients reported satisfaction on the treatment’s ability to treat their AD by responding not satisfied, slightly satisfied, somewhat satisfied, mostly satisfied, or completely satisfied. Endpoints are summarized as observed data. The analysis was descriptive based on all observed data. Results: At baseline, patients (N=90) had a mean (standard deviation [SD]) EASI of 26.4 (12.2), and n=77 had DLQI of 13.2 (7.4). Patients self-reported their race as Black/African American (77.8%), Asian (11.1%), American Indian/Alaskan Native (6.7%), and Native Hawaiian or Other Pacific Islander (4.4%). Patients had Fitzpatrick Phototypes of IV (43.3%), V (24.4%), and VI (32.2%). At Week 16, 71.7% (43/60) of patients achieved ≥4-point improvement from baseline in DLQI, 57.4% (39/68) achieved DLQI ≤5, and 29.4% (20/68) achieved DLQI 0,1. The mean percentage improvement in DLQI from baseline to Week 16 was 52.7% (n=66). In total, 62.8% (49/78) of patients were mostly/completely satisfied with treatment, while 37.2% (29/78) were somewhat, slightly or not satisfied. Of these 29 patients, 6 (7.7%) were not satisfied with treatment. For EASI 75 Week 16-responders, 74.1% (40/54) were mostly/completely satisfied with treatment and 71.4% (25/35) of EASI 90 responders were mostly/completely satisfied. In terms of QoL, 69.8% (30/43) of patients who achieved ≥4-point improvement from baseline in DLQI were mostly/completely satisfied with treatment, 76.9% (30/39) of DLQI ≤5 responders and 85.0% (17/20) of DLQI 0,1 responders were mostly/completely satisfied. Conclusion: Lebrikizumab treatment showed improved QoL and high rates of patient-reported treatment satisfaction in SoC patients with moderate-to-severe AD. Patients treated with lebrikizumab who achieved high rates of skin clearance and QoL improvements reported the highest levels of treatment satisfaction.

Developing a machine learning-based predictive model for the analgesic effectiveness of transdermal fentanyl in cancer patients: an interpretable approach.

Cancer-related pain is a common and distressing symptom in patients with malignant tumors, significantly affecting quality of life. Transdermal fentanyl is a convenient opioid option for patients with intestinal obstruction or difficulty swallowing; however, some patients do not experience adequate pain relief. Predicting transdermal fentanyl analgesic effectiveness is crucial to optimize pain management. This study aimed to develop a predictive model for transdermal fentanyl effectiveness in cancer patients. Clinical data from adult cancer pain patients at Chongqing University Cancer Hospital were analyzed (January 2020-December 2022). Logistic regression and feature selection were applied, followed by developing nine predictive models using Logistic Regression, Random Forest (RF), and Extreme Gradient Boosting. The receiver operating characteristic (ROC) curves, the Youden index, and the Brier score were used to evaluate the performance of the model. Cross-validation and SHapley Additive exPlanations (SHAP) analysis were used for validation and feature interpretation. Among 151 patients, 27.2% reported ineffectiveness of transdermal fentanyl. Logistic regression identified key factors of NRS, transdermal fentanyl dosage, BMI2, and ALT. Among the nine models, RF Model 8 exhibited the best performance, achieving a ROC-AUC of 0.984 (95% CI: [0.968, 0.999]). This performance was further validated by the confusion matrix metrics and visualization results. The SHAP analysis highlighted lower doses, NRS, and ALT as predictors of transdermal fentanyl ineffectiveness. The Random Forest model offers a valuable tool for predicting the effectiveness of transdermal fentanyl in cancer pain patients, supporting the refined assessment and management of pain.

Effect of Group Rumination-Focused Cognitive Behavior Therapy on Depressive Symptoms in People With Schizophrenia: A Randomized Controlled Trial.

Prolonged depressive symptoms in individuals with schizophrenia not only diminish their quality of life but also significantly increase their risk of suicide. This, in turn, may lead to a lower average life expectancy among people with schizophrenia compared to the general population. This study was designed to examine the effectiveness of rumination-focused cognitive behavior therapy (RFCBT) on depressive symptoms in individuals with schizophrenia. This study was conducted between July 2019 and March 2020. Seventy-seven participants, all of whom had been diagnosed with schizophrenia, were randomly divided into the experimental group (n = 38) and control group (n = 39). The experimental group underwent a 12-week, six-session RFCBT regimen, whereas the control group received six sessions of psychosocial education. Outcomes were measured using the Beck Depression Inventory-II and the revised short form of the Chinese Response Style Questionnaire at three time points: baseline, postintervention, and at the 3-month follow-up. Statistical analyses were conducted using chi-square tests, independent t tests, and generalized estimating equations, with the generalized estimating equations model assessing between-group differences over time after adjusting for 13 covariates. No effect on depressive symptoms was observed immediately following RFCBT. However, at the 3-month follow-up, the mean Beck Depression Inventory-II score had reduced significantly in the experimental group (from 17.24 to 15.56) and increased in the control group (from 17.59 to 23.03; p = .016). Chinese Response Style Questionnaire-10 scores, which are used to represent ruminative responses, did not differ significantly between the groups at any of the three time points. These findings offer compelling preliminary evidence in support of RFCBT as a potentially effective treatment strategy for alleviating depressive symptoms in patients with schizophrenia. The efficacy of RFCBT was demonstrated in terms of preventing the exacerbation of depressive symptoms. The findings have notable implications for clinicians, researchers, and policymakers with regard to developing more effective treatment strategies and enhancing outcomes for individuals with schizophrenia.

The effects of exercise interventions on depressive symptoms in stroke patients: a systematic review and meta-analysis

The effects of exercise interventions on depressive symptoms in stroke patients: a systematic review and meta-analysis

Role of DPP-4 and NPY Family Peptides in Gastrointestinal Symptoms Associated with Obesity and Type 2 Diabetes Mellitus

Background and Objectives: Neuropeptide Y (NPY) family peptides and dipeptidyl peptidase-4 (DPP-4) are involved in gastrointestinal regulation and may contribute to obesity and type 2 diabetes mellitus (T2DM) pathophysiology. This study investigates their expression in jejunal muscular tissue and associations with gastrointestinal symptoms in patients with obesity, with (OB+/DM+) and without T2DM (OB+/DM−). Materials and Methods: This cross-sectional study includes forty-four patients undergoing laparoscopic Roux-en-Y gastric bypass divided based on T2DM status. Gastrointestinal symptoms were assessed using the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire, and jejunal tissue samples were analyzed for DPP-4, NPY, peptide YY (PYY), and pancreatic polypeptide (PP) mRNA and protein levels. Results: DPP-4, NPY, PYY, and PP gene expression in jejunal muscular tissue was similar between groups. In the OB+/DM+ group, PP protein was higher, while DPP-4 and PYY were lower compared to the OB+/DM− group. Significant positive correlations between DPP-4 and NPY, PYY, and PP were found in the OB+/DM− group, while only DPP-4 and PYY correlated in the OB+/DM+ group. Gastrointestinal symptoms in the OB+/DM− group showed positive correlations with PP (abdominal pain), DPP-4 (indigestion), and NPY (constipation). Conclusions: The study demonstrates significant differences in DPP-4, PYY, and PP protein expression between patients with obesity, with or without T2DM. Peptide correlations with gastrointestinal symptoms in non-diabetic patients suggest distinct regulatory mechanisms, warranting further research.

Prevalence and Impact of Gastrointestinal Symptoms in Patients with Chronic Low Back Pain -Systematic Review

Introduction: Low back pain encompasses a variety of pain categories (e.g., nociceptive, neuropathic, neoplastic, or non-specific) that commonly overlap. Recent research suggests a link between gastrointestinal (GI) symptoms and musculoskeletal pain, specifically CLBP. However, the prevalence and nature of GI symptoms in CLBP patients are little characterized. Objectives: This study examines the prevalence, severity, and impact of gastrointestinal symptoms among patients with chronic low back pain. Methods: A complete search was undertaken across numerous databases, including PubMed, PEDro, and The Cochrane Database, until August 2024. The search yielded 4,065 results, with four research selected for qualitative and quantitative synthesis. Results The searches retrieved 47 records, of which were selected for full-text screening. four reviews were included. The findings say that gastrointestinal (GI) symptoms in the chronic stage of low back pain. It occurs due to a convergence of viscerosomatic pathways and dysfunction in trunk muscles, which leads to reduced gastrointestinal motility. Conclusions There is strong evidence indicating a connection between gastrointestinal (GI) symptoms and chronic lower back pain (CLBP. The results of this suggested study could aid physiotherapists in managing low back pain patients with GI discomfort. GI symptoms as part of CLBP therapy may improve patients' physical functioning and quality of life.

The Role of Purinergic Mechanisms in the Excitability of Trigeminal Afferents of Rats with Prenatal Hyperhomocysteinemia

Elevated levels of homocysteine in the blood plasma (hyperhomocysteinemia, HHCY) positively correlate with migraine symptoms in patients. Experimental studies show a higher sensitivity of rats with prenatal HHCY (pHHCY) to migraine symptoms like allodynia, photophobia, anxiety, and a higher excitability of meningeal trigeminal afferents. In the present study, the roles of purinergic mechanisms in the homocysteine-induced hyperexcitability of the trigeminal ganglion (TG) system using electrophysiological recordings from the trigeminal nerve, Ca2+ imaging of cells isolated from TG, and mast cell staining in meninges were investigated. Experiments were performed using rats with pHHCY born from females fed with a high-methionine-containing diet before and during pregnancy. Firstly, we found that lower concentrations of 4-aminopyridine, a K+-channel blocker, were able to induce an increase in the nociceptive activity of trigeminal afferents, supporting the hypothesis of the higher excitability of the trigeminal nerve of rats with pHHCY. Trigeminal afferents of rats with pHHCY were more sensitive to the exogenous application of the nonspecific agonist of purinergic ATP receptors. In neurons and satellite glial cells of TG of rats with pHHCY ATP, ADP (an agonist of metabotropic P2Y receptors) and BzATP (an agonist of ionotropic P2X with especially high potency for the P2X7 receptor) induced larger Ca2+ transients. The incubation of TG neurons in homocysteine for 24 h increased the ratio of neurons responding simultaneously to ATP and capsaicin. Moreover, rats with pHHCY exhibit a higher rate of degranulation of mast cells and increased response to the agonist of the P2X7 receptor BzATP application. In addition, higher levels of calcitonin gene-related peptide (CGRP) were found in rats with pHHCY. Our results suggest that chronic elevated levels of homocysteine induce the upregulation of ionotropic or metabotropic ATP receptors in neurons, satellite glial cells, and mast cells, which further provide inflammatory conditions and the sensitization of peripheral afferents underlying pain.

ASSOCIATION BETWEEN DEPRESSION SYMPTOMS AND CORONARY ARTERY DISEASE IN PATIENT UNDERGOING ANGIOGRAPHY.

Background: Depression is increasingly recognized as a significant factor influencing the prognosis of coronary artery disease (CAD). Despite its prevalence, depressive symptoms remain underdiagnosed and undertreated in CAD patients, impacting disease progression and outcomes. This study aims to determine the association between depressive symptoms and CAD severity in patients undergoing coronary angiography. Objective: To assess the prevalence and severity of depressive symptoms in CAD patients and compare them with non-CAD individuals. Methods: A case-control study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi, including 64 participants (32 CAD cases and 32 controls). Depressive symptoms were evaluated using the validated Patient Health Questionnaire-9 (PHQ-9). CAD was diagnosed through coronary angiography, defining significant disease as ≥70% stenosis in at least one major coronary artery. Sociodemographic and clinical variables were recorded. Statistical analyses, including an independent t-test for PHQ-9 scores and a chi-square test for categorical variables, were performed using SPSS version 23, considering p<0.05 as statistically significant. Results: The prevalence of depressive symptoms was significantly higher in CAD patients (84.4%) compared to controls (9.4%) (p<0.001). The mean PHQ-9 score in cases was 13.4 ± 3.2, significantly higher than in controls (6.6 ± 2.6) (p<0.001). Factors such as unemployment, urban residence, smoking, hypertension, diabetes, and dyslipidemia were more common in CAD patients. Conclusion: A strong association exists between depressive symptoms and CAD, highlighting the need for routine depression screening and integrated management strategies in cardiovascular care. Addressing depression as a modifiable risk factor may improve clinical outcomes and overall well-being in CAD patients.

Family-Based Treatment for Primary Care: An Observational Study of a Community Sample of Youth With Restrictive Eating Disorders.

To examine the outcomes of a clinical sample of young patients with restrictive eating disorders who received Family-Based Treatment for Primary Care (FBT-PC). Participants were 134 youth (mean age = 15.7 years) and their caregiver(s). Participants and caregivers completed measures of eating disorder symptomatology, quality of life, and caregiver self-efficacy. Of the 134 patients who received at least one session of FBT-PC, 55.9% completed treatment, 20.1% were followed until they began a higher level of care, and 23.8% were non-completers. Weekly measures for the full sample were evaluated using intention-to-treat analyses. Patient-reported scores on the ED-15 improved by -0.1 (SE = 0.02, F(1,133)=26.4, p < 0.0001) per week, and caregivers' ratings of patient symptoms also improved by 0.85 (SE = 0.2, F(1,133)=13.1, p = 0.0003) per week. Patient's BMI percentile increased by 1.25 points per week (SE = 0.14, F(1,133) = 83.9, p < 0.0001). For patients who completed FBT-PC, eating disorder symptoms, per patient- (M = -1.43, p < 0.0001) and caregiver-report (M = -1.33 p < 0.0001) decreased significantly from baseline to end of treatment. Patient's quality of life increased significantly from baseline to end of treatment (M = 21.6, p < 0.0001) and caregivers showed significant increases in self-efficacy (M = 3.41, p < 0.0001, d = 0.856). At the end of treatment, 62.5% of patients with complete data met criteria for full research remission, and 44.6% met criteria for full clinical remission. Findings provide preliminary support for FBT-PC as an effective treatment for youth with restrictive eating disorders. Additional research is needed to replicate these findings in other primary care settings and to understand the durability of treatment effects.

Buttock pain in lumbar disc herniation: clinical characteristics, risk factors, and surgical outcomes.

Buttock pain is a common symptom in patients with lumbar degenerative disorders. While the nature of buttock pain remains unclear, clinicians consider it as either nociceptive back pain or radicular leg pain. Some have proposed that buttock pain may be a mixed symptom of radicular pain and referred pain, although buttock pain in spine practice is less studied. This study aimed to determine the occurrence rate, clinical characteristics, risk factors, and surgical outcomes of buttock pain in patients with lumbar disc herniation (LDH). A prospective study was performed on patients with single-level LDH who underwent endoscopic discectomy at the authors' hospital between 2020 and 2023. Back pain, buttock pain (the region between the iliac crest and buttock crease), and leg pain were measured using the numeric rating scale (NRS) before and after surgery. On MRI, degenerative findings, including disc degeneration, Modic changes, and endplate defects, were assessed. The location of the hernia was recorded, and disc herniation was classified as contained or uncontained. The presence or absence of annulus rupture was further examined with endoscopy. The associations of buttock pain with MRI and endoscopic findings, back pain, and leg pain were examined. During the defined period, a study was conducted on 321 patients with single-level LDH. Buttock pain presented in 242 (75.4%) patients. Buttock pain was a common symptom for L3-4, L4-5, and L5-S1 LDH. Buttock pain was more common in patients with contained LDH than in those with uncontained LDH (85.8% vs 69.7%, p = 0.001). Furthermore, buttock pain was more common in LDH patients with an intact annulus compared with those patients with a ruptured annulus (86.7% vs 68.7%, p < 0.001), as assessed using endoscopy. Compared with baseline, buttock pain quickly improved on the 2nd day after surgery (NRS score 5.44 ± 2.07 vs 0.84 ± 1.27, p < 0.001). At the 1-year follow-up, buttock pain had resolved in 91.2% of cases and improved in the remaining 8.8% of patients, although they still had some residual buttock pain. Buttock pain is a common symptom in patients with L3-S1 LDH. Buttock pain is not related to back pain and radiating leg pain and thus should be considered as an independent symptom in LDH. Similar to radiating leg pain, buttock pain can be effectively treated with endoscopic discectomy.

Acid reflux medication use among adults with depressive symptoms.

Acid reflux medication use among adults with depressive symptoms.

Atypical pathogen community-acquired pneumonia: an analysis of clinical characteristics, drug treatment, and prognosis in the related patients.

Serious respiratory infections can occur in both in-hospital and out-of-hospital settings. These infections are known as community-acquired pneumonias (CAPs). Streptococcus pneumoniae and other microorganisms commonly cause atypical pneumonia. This study examined the clinical features, medication therapy, and prognosis of 85 cases of community-acquired pneumonia (CAP) caused by Mycoplasma pneumoniae (MPP) and Chlamydia psittaci(C. psittaci)neumoniae (CPP). A retrospective analysis was conducted at Shaoxing People's Hospital from July 2021 to August 2024, using targeted next-generation sequencing (tNGS) of bronchoalveolar lavage fluid (BALF). Patients were classified into the MPP group (54 patients) and the CPP group (31 patients). Compared with the control group, the CPP group had a significantly lower proportion of patients with a contact history of poultry and birds, a shorter length of hospital stay, and a lower percentage of severe pneumonia cases. The MPP group demonstrated higher incidences of cough and sputum production; conversely, the occurrences of fever, fatigue, diminished appetite, and generalised myalgia were comparatively lower. The MPP group exhibited markedly diminished levels of neutrophils, C-reactive protein, procalcitonin, erythrocyte sedimentation rate, heparin-binding protein, alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, direct bilirubin, pH, lactic acid, and D-dimer compared with the CPP group. In contrast, the MPP group had a markedly higher lymphocyte count, platelet count, albumin levels, as well as higher concentrations of blood sodium and blood chloride. The drug treatment regimens differed between the two groups, resulting in one unfavourable outcome within the MPP group. In summary, fatigue, fever, and reduced appetite are more prominent symptoms in patients with CPP, whereas cough and sputum production are the primary manifestations of MPP. Pleural effusion is more prevalent in patients with CPP, Additionally, these patients also have increased inflammatory responses and decreased immune function.

Gut Microbiome dysbiosis and immune activation correlate with somatic and neuropsychiatric symptoms in COVID-19 patients

BackgroundInfection with SARS-CoV-2, the virus responsible for COVID-19, can lead to a range of physical symptoms and mental health challenges, including stress, anxiety, and depression. These effects are particularly pronounced in hospitalized patients, likely due to the virus’s direct and indirect impact on the nervous system. Gut dysbiosis, an imbalance in the gut microbiome, has been implicated in immune dysfunction and chronic inflammation in COVID-19 patients. However, the interactions between gut microbiome composition and the physical and mental symptoms of COVID-19 remain incompletely understood.MethodsWe investigated the association between physical and mental symptoms, cytokine profiles, and gut microbiota composition in 124 hospitalized COVID-19 patients. We collected data on demographics, COVID-19 severity, and mental health indicators (stress, anxiety, and depression). Gut microbiome profiling was performed using full-length 16 S rRNA gene sequencing to evaluate microbial diversity and composition.ResultsCOVID-19 severity was categorized as low (27.4%), moderate (29.8%), or critical (42.8%). Common symptoms included fever (66.1%) and cough (55.6%), while somatic symptoms (27.3%), anxiety (27.3%), depressive symptoms (39%), and stress (80.5%) were frequently self-reported. Elevated interleukin-6 levels in severe cases highlighted systemic inflammation, reduced gut bacterial diversity, particularly among women and obese patients, correlated with higher disease severity. Notably, the genus Mitsuokella was associated with increased physical symptoms and mental distress, while Granulicatella was linked to critical illness.ConclusionsOur findings reveal significant associations between mental health status, systemic inflammation, and gut dysbiosis in hospitalized COVID-19 patients. These results indicate the potential for microbiome-targeted therapies to mitigate psychological and physical complications and improve recovery outcomes in this population.

Beyond the surface: understanding psychiatric disorders in individuals with spinal cord injury- a narrative exploration.

Spinal Cord Injury (SCI) presents a life-threatening condition that compromises the spinal cord's integrity. Among the complications affecting SCI patients are psychiatric disorders, whose causal mechanisms remain elusive. These disorders are often attributed to multifactorial aspects, encompassing physiological, neurobiological, psychological, and social factors. In the context of SCI patients, we are interested in identifying the specific factors that contribute to the development of psychiatric disorders in this population, emphasizing the critical need for prevention strategies and comprehensive therapeutic management, ultimately aiming to improve the affected patients' quality of life. The process of searching and selecting information was performed between August and December of 2023, utilizing PubMed, ResearchGate, and NCBI as the requisite databases for this review. To ensure precise information retrieval, keywords were strategically employed, focusing on publications spanning from 1985 to the present. MeSH terms, including spinal cord injury, acute spinal cord injury, psychiatric disorders, neuropsychiatry, cognitive impairment, and chronic pain, were applied. A total of 127 articles were identified through electronic searches, and 55 of these were chosen for inclusion in this review. The consulted studies encompassed various types, such as meta-analyses, systematic reviews, animal model experiments, and others. Various factors contributing to the onset of psychiatric disorders in patients with SCI were proposed, all grounded in evidence: neurobiological pathology; cognitive impairment; the impact of systemic diseases on psychological well-being; and, lastly, the correlation between chronic pain and diminished daily functionality, experiences widely encountered by SCI patients. The diagnosis of psychiatric disorders remains largely clinical and syndromic, with unclear causal mechanisms. Understanding psychiatric symptoms in SCI patients requires further investigation. Key contributing factors include neurobiological pathology linked to SCI, cognitive impairment, systemic and organ-specific diseases, and chronic pain associated with reduced functionality. We emphasize the importance of therapeutic and rehabilitative measures that address both physical and psychological health to improve overall quality of life.

Understanding Personalized Dynamics in Eating Disorders: A Dynamic Time Warp Analysis.

To enhance our understanding of the processes of change and the interaction of symptoms, we applied a relatively novel method known as Dynamic Time Warp to data from low-threshold internet-based interventions directed at decreasing eating disorder (ED) symptoms and increasing help-seeking. Utilizing data from the Featback study, we examined how various factors such as ED psychopathology, binge eating, vomiting, laxative use, BMI, anxiety, depression, self-efficacy, social support, well-being, and health-related quality of life interplayed over a period of 14 months among 355 individuals at six different time points. Moreover, we explored which symptoms exerted a significant temporal relationship on others (with high out-strength) and which were most affected by other symptoms (with high in-strength). The sample included participants with different types of ED symptoms and high levels of severity. On a group level, we identified four dimensions with similar within-person trajectories: (1) Depression, anxiety, ED psychopathology, health-related quality of life, and self-rated health; (2) binge eating and vomiting; (3) self-efficacy and social support; (4) BMI, well-being, and laxative use. Directed analyses revealed that social support and anxiety had the highest significant out-strength (i.e., temporal lead), indicating their changes preceded those of other factors, while laxative use and well-being were among those that mostly lagged behind those of other items (with significant in-strength). Depressive and anxiety symptom severity were strongly connected to ED severity. Social support may be an important factor to address first as it may drive other factors and symptoms in patients with EDs.

The impact of a heat therapy intervention on pain and fibromyalgia symptoms in patients with fibromyalgia: a pilot study

The impact of a heat therapy intervention on pain and fibromyalgia symptoms in patients with fibromyalgia: a pilot study