Periods Of Remission Research Articles

Trunk control in and out of an episode of recurrent low back pain in young adults during the Balance-Dexterity Task.

We investigated motor control strategies utilized by individuals with recurrent low back pain (rLBP) during active pain and remission periods as well as by back-healthy controls using the Balance-Dexterity Task. Nineteen young adults with rLBP were tested first when they were in pain and then again in symptom remission, and 19 matched controls were also tested. Trunk kinematic coupling and muscle co-activation were examined while participants performed the task by standing on one leg while compressing a spring with a maximum consistent force with the other leg. We found a decreased bilateral external oblique co-activation during the spring condition of the task compared to the stable block condition in people with rLBP compared to back healthy individuals. There was also reduced trunk coupling during the spring condition of the task compared to the stable block condition in both the rLBP active and remission groups, but no group difference between rLBP and back-healthy individuals. When individuals were in active pain, they exhibited more co-activation than when they were in remission, but the co-activation during active pain was not greater than in back-healthy individuals.

Etiopathogenetic features of recurrent aphthous stomatitis: modern approaches to prevention and treatment

Recurrent aphthous stomatitis (RAS) is an inflammatory disease of the oral mucosa, which has a chronic course with periods of remission and exacerbations. RAS requires adequate diagnosis for the purposes of properly treating. The study on RAS remains relevant over many years and continues to be a priority in modern dentistry. The aim of the work is to analyze the information in the professional literature on pathogenetic variants of RAS and approaches to its treatment and prevention. Despite the variety of studies, the etiology and pathogenesis of the disease remain the subject of numerous discussions. This article provides a review of current research on the main etiopathogenetic mechanisms of the disease development and progression, specifies current recommendations for therapeutic approaches to treatment and prevention. Conclusions. To date, there is no definitive therapeutic tactic for recurrent aphthous stomatitis, so it is advisable to systematize and study methods for the prevention and treatment of this pathology, including pain relief, acceleration of ulcer healing and reduction of its episode frequency and severity. Considering the etiopathogenetic variant of the disease development (metabolic disorders, stress, allergies, etc.), preventive measures should be comprehensive and include oral hygiene, a sparing diet, multivitamin and micro-, macroelement complexes, etc.

Cytotoxic T cell subsets in peripheral blood and cerebrospinal fluid from patients with multiple sclerosis

Using multicolor flow cytometry, the main cytotoxic T lymphocytes (Tcyt) subsets were identified, based on the expression of CD45RA and CD62L in paired samples of peripheral blood and cerebrospinal fluid from the patients during the relapse (n = 32) and remission (n = 20) of multiple sclerosis (MS), as well as in the peripheral blood samples of healthy volunteers (n = 51). During the relapse of MS, we have observed a decreased relative number of CD3+CD4+ cells and CD4/CD8 ratio in cerebrospinal liquor. In peripheral blood taken from the relapsed MS patients, we have found significant correlations between EDSS score and absolute counts (r = -0,430, p = 0.014), and with relative numbers of CD45RA+CD62L+Tcyt (r = -0,502, p = 0.003). In remission state of MS, the relative numbers of blood CD45RA-CD62L-Tcyt cells exhibited a significant decrease (p = 0.005) to 8.70% (6.51-11.63) against control group with 12.18% (10.38-15.24), although it did not significantly differ (p = 0.114) from the relapsed patients with 11.31% (8.28-13.90). Studies of liquor samples have shown that, during MS relapse, the percentage of CD45RA-CD62L-Tcyt was increased (p = 0.027) up to 8.16% (6.40-11.40), while in remission state these cells comprised only 6.49% (4.51-8.39) from the total CD3+ cell number. During relapse of MS, some positive correlations were revealed between the relative number of nave, CM, EM and TEMRA Tcyt from liquor, and the percentages, as well as contents of similar T cell subsets in peripheral blood samples. The inverse relationship between the level of EM Tcyt from liquor and peripheral blood naive cells showed the close relationship between these two Tcyt subsets and clinical manifestations of MS (i.e., scores of EDSS scale). During the remission period, most of these correlations are disrupted. Further investigations of cytotoxic T cells dynamics in peripheral blood and cerebrospinal fluid will help to approach the understanding of MS pathogenesis by revealing novel markers for the clinical prognosis in this disorder.

Life satisfaction, generalized sense of self-efficacy and acceptance of illness in rheumatoid arthritis patients depending on age and severity of the disease.

Rheumatoid arthritis (RA) is a chronic autoimmune condition characterized by periods of exacerbation (physical limitations, depressed mood, depressive states and decreased life satisfaction) and remission (hope of health improvement). Our objective was to present social functioning of RA patients taking into consideration their age and employing selected determinants: satisfaction with life, generalized sense of self-efficacy and acceptance of illness. Standardized tools were employed: the Satisfaction with Life Scale, Generalized Self Efficacy Scale and Acceptance of Illness Scale. The study group included 46 RA patients aged 18-45 years and 54 RA patients aged over 60 years. The control group consisted of 24 non-RA subjects in every group. Rheumatoid arthritis patients in the period of disease exacerbation reported low and moderate levels of satisfaction with life, in the patients in remission period the score was moderate, while the control group subjects described their level of satisfaction with life as high and moderate. The level of acceptance of illness was described by the RA patients in the period of disease exacerbation as 20.4/40 points; the patients in remission defined their level of acceptance of illness as 29.38/40 points. The patients with RA exacerbation showed a low sense of self-efficacy, yet a large group of such patients also presented high self-efficacy levels and the majority of the RA subjects in remission reported a high sense of self-efficacy. In the RA patients, satisfaction with life, generalized sense of self-efficacy and acceptance of illness were closely related and affected their general psychosocial functioning.

Possibilities of treatment by radiofrequency denervation in coxarthrosis of various stages

The scientific review presents the treatment of coxarthrosis of various stages by the radiofrequency denervations technique. Full-text articles were searched in open electronic databases PubMed, eLibrary, CyberLeninka for the maximum possible time interval for the time interval from 1990 to 2023. Fifteen scientific articles were selected, in which 302 patients were treated with 489 radiofrequency denervations of the hip joint. The authors provide information about the state of the problem with special attention to the characteristics of various denervation protocols and justification of the choice of target points for exposure from the standpoint of anatomy and innervation of the hip joint. RCD is a modern, interventional, and effective solution to the main symptom, which is pain, according to numerous studies. The introduction of targeted effects on the articular branches of the locking and femoral nerves by radiofrequency denervation into the work of a practitioner can increase the period of remission of exacerbation of coxarthrosis and shorten the period of disability with a high level of intervention safety for the patient. Conducting further research on the role of radiofrequency denervation in coxarthrosis is critical.

Intensive Counseling of Smokers for Nicotine Addiction Cessation and Health Benefits of Smoking Cessation

Abstract Smoking is a chronic disease with a recurring character, one of the oldest habits on the globe but also a problem of modern society, which kills more than 8 million people each year. More than 50% of those deaths are the result of direct tobacco use, while around 1.2 million are the result of non-smokers being exposed to second-hand smoke(1). Nicotine addiction must be seen as a chronic disease, with numerous periods of relapse and remission, and is mandatory that the clinician must treat it properly. Smoking cessation is of critical importance to public health, various studies indicate that smoking is a major risk factor for a variety of serious health conditions, including cancer, heart disease, stroke, and chronic obstructive pulmonary disease (COPD). The risk of developing these conditions is directly related to the amount and the duration of smoking and is higher for those who start smoking at a younger age. While counseling is likely to be successful in helping individuals quit smoking, there are also other methods to reach the goal, including medication, nicotine replacement therapy, and lifestyle changes. However, these methods may not be as effective as counseling in helping individuals quit smoking. Otherwise, other methods, such as reducing the amount of smoking or switching to a less harmful form of tobacco, may reduce the risk of developing some of the conditions associated with smoking, but they do not reduce the risk to the same level as quitting smoking.

Models of activity in the narratives of people with schizophrenia.

This article presents an analysis of the narratives of people with schizophrenia from the perspective of descriptions of activities. The goal is to look for changes in activity models under the influence of a psychotic crisis experience. Three fragments of auto-narratives concerning periods: prior to illness, during illness and during remission periods, were compared. These were created after psychotic crisis. The narratives of 26 people with schizophrenia about their lives and self-perception during the aforementioned periods made up the research material. Linguistics textual analysis was conducted, distinguishing the determinants of six selected models of activity relating to sense of agency and intentionality of action. Frequency analysis and multivariable methods were applied to compare the relative frequency of their occurrence in narratives. Descriptions of activities during the illness are more strongly saturated with models of an extrinsic control site, impersonal control over action, avoidance, individual actions, states in comparison to the remission period, and in particular, descriptions of activity prior to the illness. The results of analysis of schizophrenia patients' narratives indicate a decreased sense of agency related to experiencing states of disorder (subjectively defined). This motivational deficit also concerns remission periods after the active phase of the illness, though to a lesser extent. Analysis of motivational models reveals differences of descriptions of own activity, indicating alterations in auto-narration and narrative identity under the influence of a psychotic crisis in a retrospective approach. These changes pertain to deep layers hidden in the relationship between the form of the narrative and its content. They indicate other images of oneself (self-positions or self-narrative voices) as a healthy, sick and in remission person - especially in terms of the perception of their own agency.

BH10 Granulomatous scarring alopecia associated with rheumatoid arthritis: a case report with distinct folliculocentric granulomas histologically mimicking granulomatous alopecia areata

Abstract A 54-year-old woman presented with an 8-month history of a superficial erythematous skin lesion on the lower quadrant of her left breast and scarring hair loss in the vertex confirmed by diffuse central alopecia with erythema and tufted hairs. She also reported an 8-year history of seropositive rheumatoid arthritis and a history of breast cancer that was treated by surgery, followed by radiotherapy and tamoxifen. On histological examination, punch biopsy of the scalp showed a distinct folliculocentric pattern of multi­nucleated giant cells associated with a dense lymphocytic infiltrate in the hair follicular isthmic and infundibular areas extending into the subcutis, with some hair follicular tufting. Immunohistochemistry confirmed the T-cell nature of the lymphocytes. Punch biopsy of the breast showed noncaseating granulomas in the upper and lower dermis. This folliculocentric pattern was well demarcated and not associated with a granulomatous reaction to other skin adnexa. The interfollicular areas were relatively spared. There were no significant lymphocyte epidermotropism, Pautrier microabscesses or atypical lymphocytes. The differential diagnosis of the scalp included granulomatous folliculotropic mycosis fungoides; however, in our case, there was association with longstanding rheumatoid arthritis. Other differential diagnoses included granulomatous drug reaction and chronic infections such as mycobacteria and fungi. A very similar folliculocentric pattern has been described in only a handful of extremely rare cases of granulomatous alopecia areata (Wilk M, Zelger BG, Zelger B. Granulomatous alopecia areata. J Cutan Pathol 2014; 41:329–31); however, the granulomas are mainly in the hair bulb and spare the higher section of the hair follicle. The lesion in the breast was an area of previous radiotherapy for breast cancer. Other working diagnoses of the breast lesion included interstitial granulomatous dermatitis and palisading and neutrophilic dermatitis. Treatment consisted of potent topical and systemic steroids, immunosuppression, phototherapy and tumour necrosis factor-α inhibitors. Spontaneous resolution, periods of flares and remission, and treatment-resistant forms have been described. We have reported a case of scarring alopecia with a distinct pattern of folliculocentric noncaseating granulomas associated with granulomatous dermatitis in the breast as a cutaneous manifestation of rheumatoid arthritis. This hair loss is a result of an autoimmune-mediated reaction to the skin and hair follicles. Although folliculocentric noncaseating granulomas have been described in the hair bulb in very rare case reports of granulomatous alopecia areata, this pattern of folliculocentric isthmic and infundibular granulomas has not been clearly described before and needs to be better studied. Early diagnosis by skin biopsy is needed to start treatment in order to avoid permanent scarring hair loss.

Is transition between subtypes of pemphigus possible? A series of pemphigus vulgaris patients showing the transition to pemphigus foliaceus

BackgroundPemphigus vulgaris (PV) and pemphigus foliaceus (PF) are subtypes of pemphigus with distinct clinical and laboratory features. The transition between these two subtypes has rarely been reported previously. MethodsThe data of PV patients who exhibited clinical and immunoserological transition to PF during the follow-up period were retrospectively evaluated regarding their demographical, clinical, and laboratory characteristics. ResultsAmong 453 patients diagnosed with PV, 13 (2.9%) patients exhibited clinical and immunoserological transition from PV to PF. The mean age of PV patients at the time of diagnosis was 39.8 ± 14.7 (19‒62) years and 7 (53.8%) of them were female. These patients showed clinical and immunoserological transition from PV to PF after a period ranging from 4 months to 13 years (mean 36.2 ± 41 months). In addition to typical clinical features of PF, all patients had positive anti-desmoglein-1 and negative anti-desmoglein-3 antibody levels after the clinical transition had occurred without any mucosal involvement. During a mean 7.8 ± 5.8 (2‒21) years of follow-up period after the transition from PV to PF, only one female patient had experienced a re-transition to PV characterized by a relapse of disease involving mucosal surfaces with positive anti-desmoglein-3 antibody levels following a 5-year period of remission period without treatment. Study limitationsSingle-center study with a retrospective study design. ConclusionOur series is the largest group of patients reported to show the transition from PV to PF to date with a long follow-up period. The reason behind the disappearance of anti-desmoglein-3 antibodies and the pathogenesis of this phenomenon is not yet elucidated.

Index Evaluation of Clinical Efficacy of Immunomodulatory and Osteotropic Therapy for Chronic Generalized Periodontitis of Varying Severity: A Prospective Cohort Study

Background. The significant prevalence of chronic generalized periodontitis, the severity of its course, the increase in the number of complicated forms and short-term remissions cause a constant search for new methods and means of its treatment. When choosing the most effective methods of therapy, specialists mostly prefer a complex effect on the main pathogenetic links of the disease, while often losing sight of the body's own defenses, especially in terms of pharmacotherapeutic support and immunity strengthening. This study presents the results of a study of the clinical efficacy of the treatment of chronic generalized periodontitis by means of the developed therapy complex, including the use of immunomodulatory and osteotropic drugs.Objective — to study clinical efficacy of the developed complex immunomodulatory and osteotropic treatment for chronic generalized periodontitis.Methods. A prospective cohort study was conducted in 154 patients aged 20 to 75 with periodontitis of varying severity. Conventional examination of patients was carried out in specialized dental clinics DentoProma (Krasnodar) and Dentalife (Stavropol) based at the Dentistry Department, Stavropol State Medical University (Russia). The study period was 24 months. The patients were divided into a main group of 118 participants and a control group of 36 participants. The comprehensive treatment plan, prescribed to all patients, included proper oral hygiene education, individual and professional dental hygiene, topical anti-inflammatory agents, Vector therapy, open flap debridement, flap surgery, relevant splinting prosthetics (if necessary). The authors developed a comprehensive therapy, which included administration of the immunomodulatory agent Hepon (Immapharma Company, Russia), glucosamine hydrochloride and chondroitin sulfate sodium. All patients of the main and control groups were additionally ranked into subgroups depending on the severity of diagnosed periodontitis: slight (subgroup 1), moderate (subgroup 2) and severe (subgroup 3). The major focus of the study was to establish efficacy of the developed therapy which was defined by the degree of resolution of the inflammatory process and increase in the period of remission. Reflecting the presence and degree of inflammation, dental plaque index and oral hygiene status were considered to be the target indicators. Analysis and statistical processing of the obtained data were carried out using Microsoft Excel (Microsoft, USA).Results. The analysis of the data revealed that the immediate clinical results of the developed complex therapy both in the main group and in the control group were approximately identical. According to the follow-up data obtained one month after the treatment, additional prescription of complex osteotropic treatment to the patients with chronic generalized periodontitis contributed to rapid resolution of infection in the gingival tissues and provided stable treatment results.Conclusion. Introduction of the complex clinical and hygienic treatment promoted resolution of the inflammatory process in the gingival tissues of all patients who received immunomodulatory and osteotropic therapy.

Progressive Calcification of Supraspinatus Tendon in Patients With Calcific Tendinitis: Two Case Reports

Background. Calcific tendinitis (CT) is a common disease characterized by the presence of calcific deposits in the tendons of the rotator cuff. CT has a wave-like course, and the formed calcification tends to be resorbed. The lysis of the calcium deposits is characterized by a strong pain syndrome, and the site of the calcification is replaced by collagen.
 The aim to demonstrate clinical observations in which the deposited calcification in the rotator cuff did not resorb but increased over time.
 Cases presentation. We report on two rare clinical cases of an increase in calcification of the rotator cuff in patients aged 51 and 50 years old. Calcific tendinitis occurred with periods of remission and exacerbation. During exacerbations, conservative treatment was carried out, including courses of massage, physiotherapy, and pain relief therapy. In one case, a single injection of a hormonal drug was performed. Control X-rays and MRI during one of the exacerbations showed an increase in the size of the calcifications. Due to the lack of effect from conservative treatment and the detected increase in calcifications, a decision was made to perform surgical treatment. Arthroscopic removal of calcifications with re-fixation of the supraspinatus tendon and elimination of internal damage was performed on both patients. Good results were noted on the follow-up examination according to the ASES orthopedic score, as well as clinical examination data.
 Conclusion. The presented case reports illustrate the possible increase in calcification, unlike the standard course of the disease, in which the calcification is resorbed. Further study of this pathology is necessary to establish the causes and mechanisms of calcification increase over time and its dependence on the phase of the disease.

COULD IT BE BEHÇET'S DISEASE? PHYSICIANS IN PRIMARY HEALTHCARE ARE THE FIRST TO RESPOND

Behçet's disease is a chronic relapsing vasculitis with complex immunopathogenesis that can affect multiple organs, although mucocutaneous lesions are predominantly observed. Diagnosis of Behçet's disease is challenging and relies on clinical manifestations as no specific laboratory test is available. A positive Pathergy test should raise suspicion of Behçet's disease. The authors present a clinical case of a 22-year-old woman who presented with intermittent fever, weight loss, odynophagia, dysphagia, left knee arthritis, and multiple painful oral-genital aphthosis. The patient received treatment with benzydamine hydrochloride mouthwash, lidocaine on ulcers, antibiotics, and non-steroidal anti-inflammatory drugs, but the healing process was slow, and a new disease attack occurred two months later. The Pathergy test was performed and found to be positive, prompting consultation with an immunologist and gynecologist. The patient was administered Colchicine (1.5 mg/day), which resulted in decreased symptoms, albeit with a slow healing process. During the 6-month follow-up period, the disease attack was followed by a period of remission. The evidence base for the treatment of Behçet's disease is limited, and current options include symptomatic, non-biological, and biological immunosuppressive drugs to reduce clinical manifestations. A thorough evaluation and education in primary healthcare settings are crucial to facilitate timely multidisciplinary referrals for effective management of Behçet's disease.

Effects of Hemogram Parameters on Remission Durations in Self-Limited Epilepsy with Centrotemporal Spikes

AbstractThe hemogram parameters have been extensively discussed in numerous diseases, including epilepsy, for their diagnostic and prognostic values. We aimed to investigate the impact of hemogram parameters, namely, the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) at the time of the first seizure on the remission durations of the patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). This retrospective study was conducted on patients with SeLECTS with a minimum follow-up of 2 years. We assessed the hemogram parameters obtained from the venous blood samples collected from the patients upon admission. The duration of remission was categorized into two groups for further data analysis: those with a remission period less than 2 years and those with a remission period of more than 2 years. This study involved 122 patients with SeLECTS, of which 85% (n = 102) had remission durations of ≤2 years. The analysis revealed that patients with remission durations exceeding 2 years had a significantly higher median leukocyte (p = 0.009), neutrophil (p < 0.001), and platelet (p < 0.001) counts. Additionally, higher levels of NLR and PLR were observed in patients with longer-term remission (p < 0.001). However, there were no significant differences between the two groups in terms of lymphocyte count, monocyte count, mean platelet volume, or LMR. Leukocyte, neutrophil, platelet, NLR, and PLR counts have shown potential as predictive indicators of remission times in patients with SeLECTS. Neurologists can potentially find value in these easily accessible parameters when evaluating the future trajectory of patients with SeLECTS.

Idiopathic pulmonary hemosiderosis as an occupational disease: a clinical case

BACKGROUND. Idiopathic pulmonary hemosiderosis (IPH) in adults is a rare pathology of unknown etiology. We did not find information about IPH in adults with occupational hazards in the available literary sources, which makes this work relevant.
 OBJECTIVE. To analyze the peculiarities of the IPH course in a patient with 23 years’ experience as a gas-electric welder at factories by our own clinical observation.
 RESULTS AND DISCUSSION. Changes in the form of heterogeneous pneumatization of the lung parenchyma due to the increased interstitial component were determined on the computer tomography of the chest cavity (CT of the chest cavity) 1.5 years before the patient’s visit, but no additional examination was prescribed, and only the diagnosis “Chronic obstructive pulmonary disease” (COPD) was made. Negative dynamics due to the increase of miliary nodular dissemination of the lungs was revealed on the CT scan of the chest after 1.5 years. IPH was already detected pathohistologically after videothoracoscopy of the right lung with biopsy. Shortness of breath and cough increased in the patient, but apart from treatment aimed at COPD treating, no other therapy was prescribed (this therapy did not have a positive effect). The patient underwent a comprehensive immunological examination: the indicators of the anti-neutrophil cytoplasmic antibodies (ANCA) profile and the complex immunological blood test were within the normal range, which ruled out pulmonary vasculitis and an immune-mediated process. Considering the positive Quantiferon test, the patient was examined and the tuberculosis was excluded. Patient have not been suffered from hemoptysis and anemia from the moment of detection of the first changes on the CT scan of chest up to the present time. Due to treatment, the clinical and radiological stabilization of the process was determined after 4 months: the clinical symptoms of the disease decreased; small nodular shadows with areas of fibrosis, which are characteristic of the period of remission, were determined on the CT scan of the chest.
 CONCLUSIONS. IPH course features in a patient with a professional route are: a long period of development with COPD manifestations (without effect of therapy), absence of hemoptysis and anemia, normal indicators of the ANCA profile and complex immunological examination, a positive Quantiferon test. Corticosteroid therapy in high doses has a positive effect, which is manifested in the clinical and radiological stabilization of the process. The mechanism of IPH development may have been a toxic mechanism (23 years of work experience as a gas-electric welder at factories). Timely detection of IPH and timely prescribed corticosteroid therapy will prevent the progression of the process and the development of complications, as well as reduce mortality from this disease. Patients with IPH should be under dynamic observation due to timely evaluation of CT-dynamics of the process in the lungs and correction of the dose of corticosteroids.

Crohn's disease: Why the ileum?

Crohn's disease (CD) is an inflammatory bowel disease characterized by immune-mediated flares affecting any region of the intestine alternating with remission periods. In CD, the ileum is frequently affected and about one third of patients presents with a pure ileal type. Moreover, the ileal type of CD presents epidemiological specificities like a younger age at onset and often a strong link with smoking and genetic susceptibility genes. Most of these genes are associated with Paneth cell dysfunction, a cell type found in the intestinal crypts of the ileum. Besides, a Western-type diet is associated in epidemiological studies with CD onset and increasing evidence shows that diet can modulate the composition of bile acids and gut microbiota, which in turn modulates the susceptibility of the ileum to inflammation. Thus, the interplay between environmental factors and the histological and anatomical features of the ileum is thought to explain the specific transcriptome profile observed in CD ileitis. Indeed, both immune response and cellular healing processes harbour differences between ileal and non-ileal CD. Taken together, these findings advocate for a dedicated therapeutic approach to managing ileal CD. Currently, interventional pharmacological studies have failed to clearly demonstrate distinct response profiles according to disease site. However, the high rate of stricturing disease in ileal CD requires the identification of new therapeutic targets to significantly change the natural history of this debilitating disease.

Virological and Pathological Diagnosis of Canine Oral Papillomavirus in Dogs and Evaluation of Treatment Applications

Background: The canine oral papillomavirus (CoPV) is the cause of oral papillomatosis in all dogs. The purpose of this study is to compare two treatment methods after virological and pathological diagnosis of oral papillomas. Methods: Blood samples were collected from 50 owned and stray dogs of various breeds. The presence of CoPV antigen (Ag) in the blood samples investigated. Tissue samples from the papilloma mass were collected for auto vaccination and histopathological examination. CoPV (Ag) was found in the blood of dogs with papilloma lesions who were randomly divided and treated into two groups. While group 1 receives autologous vaccines and immune-supportive ZylexisTM, Group 2 receives PAPILENDTM® cream, immune-boosting ZylexisTM and premix powder (vitamin E, zinc, selenium, copper). Result: The dogs have an average age of 31.9+7.4 months. CoPV (Ag) was detected in half of all dogs with papilloma lesions. The histopathological examination typically revealed an increased epidermal layer. In the treatment of group 1, the mean remission period was 21-30 days. This period was determined to be 15-30 days in 15 animals from the second treatment group. Lesions were successfully treated in all dogs with CoPV (Ag) in both groups. The combination of PAPILENDTM® cream, immune-supportive ZylexisTM and premix powder was found to shorten the disease remission period caused by CoPV oral lesions.

Role of abbreviated non-contrast-enhanced MR-enterography in the evaluation of Crohn's disease activity and complications as an alternative for full protocol contrast-enhanced study: A systematic review and meta-analysis.

Crohn's disease (CD) is a chronic disorder that often starts at a young age and involves periods of remission and relapse. Prompt diagnosis of relapses through screening is crucial due to the potential morbid complications of untreated active inflammation. Magnetic resonance enterography (MRE) is a noninvasive technique to screen for active inflammation. The standard protocol involves intravenous injection of contrast agents with potential side effects. Some abbreviated non-contrast-enhanced MRE protocols are proposed as alternatives for conventional MRE to identify active inflammation. Currently, there is controversy regarding the applicability and accuracy of these protocols. This study aims to describe and compare these protocols and evaluate their accuracy in detecting active inflammation and CD complications. Results from a systematic search of three databases in August 2022 were queried and screened by abstract and full text. Eligible studies were qualitatively and quantitatively analyzed by diagnostic test accuracy meta-analysis. 59 studies entered the systematic review, and 37 were eligible for meta-analysis. Diffusion-weighted imaging (DWI) and fast T2-weighted (T2w) sequences were most frequently used in abbreviated protocols and showed non-inferior accuracy compared to the full protocol in detecting active inflammation. ADC and qualitative DWI had pooled sensitivity of 90% (CI: 82-95%) and 89% (CI:82-93%) and pooled specificity of 94% (CI: 88-97%) and 89% (CI: 79-94%), respectively for detecting active inflammation. Moreover, T2w and combined T2w+DWI sequences had pooled sensitivity of 80% (CI: 64-90%) and 76% (CI: 61-86%) and pooled specificity of 90% (CI: 80-95%) and 87% (CI: 74 - 94%), respectively. Unenhanced protocols show relatively poor diagnostic accuracy in detecting penetrating complications of CD. Magnetization transfer imaging (MTI) has demonstrated excellent accuracy in detecting fibrosis. High heterogeneity was observed in all subgroups, and accuracy was reported to be highly operator dependent in most studies. An abbreviated protocol consisting of DWI and fast T2w imaging can potentially replace the full protocol MRE. Full protocol MRE will still have its role in identifying penetrating complications. MTI should be indicated in case of suspected fibrostenotic disease.

ФИЗИЧЕСКОЕ И ДВИГАТЕЛЬНОЕ РАЗВИТИЕ ДЕТЕЙ, ЛЕЧИВШИХСЯ ОТ ОНКОЛОГИЧЕСКИХ ЗАБОЛЕВАНИЙ, КАК ФАКТОР, ВЛИЯЮЩИЙ НА СВЯЗАННОЕ СО ЗДОРОВЬЕМ КАЧЕСТВО ЖИЗНИ

Article represents the results of the research undertaken to prove the relationship between the physical conditions of patients treated for oncological diseases (OD) and the decrease in their health-related quality of life (HRQOL). Materials and methods used: 1564 children aged 6 to 18 y/o who have undergone rehabilitation at the “Russkoye pole” Clinical Rehabilitation Research Center for patients in remission with the National Scientific and Practical Center for Pediatric Hematology, Oncology and Immunology named after Dmitry Rogachev located in Grishenki village, Chekhovsky District, Moscow Oblast, Russia, after the complex treatment for OD from 2018 to 2021 participated in the research, of which 864 boys and 700 girls. The average age of the patients was 10.6+/-3.4 y/o, the average remission period was 5.4+/-2.7 years. The comparison group consisted of healthy siblings aged 6 to 18 y/o who stayed at the same facility and during the same period, a total of 238, of which 111 boys and 127 girls. The average age of the examined siblings was 10.2+/-2.4 y/o. The indicators of physical condition were tested as follows: anthropometry, strength endurance of muscles, tolerance to physical loads, development of motor skills. The PedsQL questionnaire was used for the HRQOL assessment. In order to build the mathematical models and to evaluate the statistically significant influence of factors, the classical linear regression models were used. The analysis of the relationship between groups of variables was carried out with the canonical correlation analysis. Comparison of children treated for OD and healthy children was carried out using the Welch's t-test. Results: all of the HRQOL indicators in all gender and age subgroups in children with OD were statistically significantly lower compared to healthy siblings. The most significant differences were obtained in the scale of physical functioning (p=0.001). A direct moderate relationship was found between HRQOL and a factor indicator for the physical condition (rcc=0.53), a direct moderate-weak relationship with a generalized measure of strength endurance (rcc=0.315) and a direct moderate relationship with motor skills (rcc=0.5). It was also found that a lag in the formation of basic motor skills had the greatest negative impact on the HRQOL of children treated for OD. Conclusion: the results of the research do confirm the role of physical condition in improving the patients’ quality of life. Continued research would allow developing a new tool for assessment of the effectiveness of physical rehabilitation for patients in this category.

The Role of Genetic and Epigenetic Regulation in Intestinal Fibrosis in Inflammatory Bowel Disease: A Descending Process or a Programmed Consequence?

Inflammatory bowel diseases (IBDs) are a group of chronic diseases characterized by recurring periods of exacerbation and remission. Fibrosis of the intestine is one of the most common complications of IBD. Based on current analyses, it is evident that genetic factors and mechanisms, as well as epigenetic factors, play a role in the induction and progression of intestinal fibrosis in IBD. Key genetic factors and mechanisms that appear to be significant include NOD2, TGF-β, TLRs, Il23R, and ATG16L1. Deoxyribonucleic acid (DNA) methylation, histone modification, and ribonucleic acid (RNA) interference are the primary epigenetic mechanisms. Genetic and epigenetic mechanisms, which seem to be important in the pathophysiology and progression of IBD, may potentially be used in targeted therapy in the future. Therefore, the aim of this study was to gather and discuss selected mechanisms and genetic factors, as well as epigenetic factors.

Theory of the remission process of schizophrenia (Nakai).

Hisao Nakai (1934-2022) surprised many experts with his prolific publication of papers ranging from meticulous therapeutic engagement and observations to original research. The "theory of the remission process of schizophrenia" is a representative example of Nakai's research and theories. The significance of Nakai's theory of the remission process is that it let the world know about the existence of schizophrenia's remission process, which had not been previously recognised. Additionally, Nakai's discovery of the "critical period" was significant and his detailed description of the same, which marks the beginning of the remission process, is widely considered to be fundamental. Nakai closely followed common phenomena that appeared accidentally, and he plotted the reactions of the autonomic nervous system, patient's dream content, and drawing content on a chart to show, for the first time, the clear emergence of a "critical period," and demonstrated the crucial role of the remission process. Nakai explained how the process progresses sequentially from the "critical period" to the "early remission period" and the "late remission period." He identified many specific indicators and discovered a great significance in innovative therapeutic engagement in each of these periods. Nakai's findings are supported by meticulous clinical observations and are free from simplifications that stem from simple theorization. In particular, close observation of the remission process was conducted with full engagement and concern of the therapist, without which, the remission process would not have been visible.