Prevalent Clinical Symptoms Research Articles

Clinical characteristics and outcomes of cerebral venous sinus thrombosis in patients with antiphospholipid syndrome.

Cerebral venous sinus thrombosis (CVST) is a rare but serious manifestation of venous thrombosis in patients with antiphospholipid syndrome (APS). This study investigated the risk factors, clinical characteristics and prognosis of CVST in APS patients. This retrospective cohort study included all thrombotic APS (tAPS) patients from Peking Union Medical College Hospital (PUMCH) from April 2005 to August 2023. Demographic characteristics, laboratory data and thrombotic risk factors were compared between tAPS-CVST group and tAPS-non-CVST group. Kaplan-Meier survival analysis was utilized to compare the recanalization rate and the recurrence rate. A total of 453 APS patients were enrolled, and 40 (8.8%) APS patients were with CVST. The median age of the APS-CVST patients was 27 (21.25, 32.75) years, and 72.5% were females. In 50% of these patients, CVST was the initial symptom of APS, with headache being the most prevalent clinical symptom (95%). Involvement of more than two venous sinuses were observed in 79.5% of patients, with the transverse sinus (79.5%) and sigmoid sinus (74.4%) being the most commonly affected sites. Oral contraceptives, intracranial infections and malignancy were identified as risk factors of APS-CVST. There were no statistically significant differences in baseline characteristics or the distribution of antiphospholipid antibodies profiles between the two groups. After a median follow-up of 24 (12, 52) months, 21 patients (52.5%) experienced recanalization, and 13 patients (32.5%) had a thrombotic recurrence. Survival analysis indicated that adequate anticoagulant therapy significantly contributed to recanalization (HR 6.27, 95% CI 2.616-15.02, P = 0.003), while continuous anticoagulant therapy was highly effective in reducing the recurrence of thrombotic events (HR 0.14, 95% CI 0.0447-0.4328, P = 0.0007). CVST should be considered in APS patients who experience sudden onset headaches, particularly those with thrombotic risk factors, such as the use of oral contraceptives, intracranial infections and malignancy. Continuous and adequate anticoagulant therapy is pivotal and beneficial for achieving recanalization and prevention of recurrence. Key Points • The prevalence of CVST in patients with APS may be underestimated. • APS-CVST is associated with special risk factors, including pregnancy, intracranial infection, oral contraceptives and tumors. • Long-term and adequate anticoagulation therapy can increase the vascular recanalization rate and reduce thrombosis recurrence.

Clinical Predilection Features of Middle Ear Adenomatous Neuroendocrine Tumors: A Review of 10 Patients and a Special Case Is Attached.

Introduction: Middle ear adenomatous neuroendocrine tumors (MEANTs) are rare middle ear lesions characterized by nonspecific symptoms, signs, and imaging findings. Diagnosis typically relies on postoperative pathological assessment. This study investigated the diagnostic utility of the predilection sites and clinical characteristics of MEANTs. Methods: A retrospective analysis was conducted on clinical data from 10 patients with histologically confirmed MEANTs, admitted to Eye & ENT Hospital of Fudan University between March 2016 and March 2023. Results: The median age of the patients at diagnosis was 39.3 years. Hearing loss (n = 8) and ear pain (n = 6) were the most prevalent clinical symptoms in the patients diagnosed with MEANTs. Endoscopic examination revealed diverse symptoms, predominantly presenting as non-pulsatile masses with distinct boundaries and quasi-circular shapes within the external auditory canal, often accompanied by abundant blood vessels (n = 4). Tumors were typically confined to the middle/lower tympanic chambers or eustachian tube and were frequently associated with tympanic sclerosis, particularly around the pharyngeal tube (n = 3). Pathologically, MEANTs exhibited CD56 positivity or weak positivity, along with positive staining for CKpan and Syn, negativity for S100, and Ki67 ≤3%. Personalized surgical interventions were chosen by all the patients based on lesion severity, with no subsequent radiotherapy or chemotherapy administered postoperatively. No tumor progression was noted during the postoperative follow-up. In addition, a noteworthy case was presented in which MEANT initially manifested in the middle or lower tympanic cavity and eustachian tubes. Over 2 years, the tumor progressively grew, invading the middle tympanum and surrounding ossicles, ultimately achieving complete resection with no recurrence observed during subsequent follow-up. Conclusions: A possible diagnosis of middle ear adenoma should be considered when encountering non-pulsatile tumors with clearly demarcated inner boundaries within the external auditory canal accompanied by abundant quasi-circular vessels and the presence of new bone or neoplasm at the pharyngeal tympanic canal orifice observed during preoperative examinations or surgical procedures.

Outcomes of Patients with End-Stage Renal Disease Hospitalized with COVID-19 in Ahvaz Razi Hospital from February 2020 to May 2021

Background: End-stage renal disease patients on maintenance hemodialysis (ESRD-HD) are at very high risk for COVID-19 infections due to their older age and comorbidities such as diabetes and hypertension. Objectives: This study aimed to investigate the outcomes of COVID-19 in ESRD-HD patients. Methods: This was a retrospective study conducted on ESRD-HD patients aged 18 years and older who were referred to Razi Hospitals in Ahvaz from February 2020 to May 2021 for hemodialysis and diagnosed with COVID-19. Patient information was extracted retrospectively from their medical records. Results: A total of 180 patients were examined. The average age of the patients was 61.5 years, and 118 (65.6%) were men. The most common underlying condition was hypertension (81.1%). The most prevalent clinical symptom was shortness of breath (70.6%), followed by cough (47.8%). Seventy-five patients (41.66%) were admitted to the intensive care unit (ICU), with an average stay of 5 days. Hypertension and ischemic heart disease were significantly more common among patients admitted to the ICU (P = 0.008 and 0.015, respectively). In-hospital mortality was 32.8%. Advanced age, fever, shortness of breath, cough, and the need for a ventilator were significant predictors of mortality in hospitalized ESRD patients with COVID-19 (P = 0.016, 0.033, 0.001, 0.012, and 0.011, respectively). Conclusions: Our study demonstrated that ESRD-HD patients with COVID-19 are at high risk for ICU admission and mortality. Advanced age and clinical symptoms such as fever, shortness of breath, cough, and the need for a ventilator significantly predict in-hospital mortality in these patients.

Understanding Factors That Cause Benign Paroxysmal Positional Vertigo, Ménière Disease, and Vestibular Neuritis: A Two-Sample Mendelian Randomization Study.

Vertigo is a prevalent clinical symptom, frequently associated with benign paroxysmal positional vertigo (BPPV), Ménière disease (MD), and vestibular neuritis (VN), which are three common peripheral vestibular disorders. However, there is a relative lack of research in epidemiology and etiology, with some existing studies presenting discrepancies in their conclusions. We conducted a two-sample Mendelian randomization (MR) analysis to explore potential risk and protective factors for these three peripheral vestibular disorders. Based on genome-wide association studies, we executed a univariable MR to investigate the potential associations between 38 phenotypes and MD, BPPV, and VN. We used the inverse variance weighted method as the primary MR result and conducted multiple sensitivity analyses. We used false discovery rate (FDR) correction to control for type I errors. For findings that were significant in the univariable MR, a multivariable MR analysis was implemented to ascertain direct effects. In addition, we replicated analyses of significant results from the univariable MR to enhance the robustness of our analyses. For BPPV, both alcohol consumption (odds ratio [OR] = 0.57, 95% confidence interval [CI] = 0.43 to 0.76, FDR Q = 0.004) and educational attainment (OR = 0.77, 95% CI = 0.68 to 0.88, FDR Q = 0.003) were found to decrease the risk. The genetic prediction analysis identified major depression (OR = 1.75, 95% CI = 1.28 to 2.39, FDR Q = 0.008) and anxiety (OR = 5.25, 95% CI = 1.79 to 15.42, FDR Q = 0.036) increased the risk of MD. However, the impact of major depression on MD could be influenced by potential horizontal pleiotropy. Systolic blood pressures (OR = 1.03, 95% CI = 1.02 to 1.04, FDR Q = 4.00 × 10 -7 ) and diastolic blood pressures (OR = 1.05, 95% CI = 1.03 to 1.07, FDR Q = 2.83 × 10 -6 ) were associated with an increased risk of VN, whereas high-density lipoprotein (OR = 0.77, 95% CI = 0.67 to 0.89, FDR Q = 0.009) and urate (OR = 0.75, 95% CI = 0.63 to 0.91, FDR Q = 0.041) reduces the risk of VN. Only the relationship between urate and VN was not replicated in the replication analysis. Multivariable MR showed that the protective effect of education on BPPV was independent of Townsend deprivation index. The protective effect of high-density lipoprotein against VN was independent of triglycerides and apolipoprotein A1. The risk impacts of systolic and diastolic blood pressures on VN exhibited collinearity, but both are independent of chronic kidney disease and estimated glomerular filtration rate. The impacts of anxiety and severe depression on MD demonstrated collinearity. Our study identified the risk association between systolic and diastolic blood pressure with VN and the protective influence of high-density lipoprotein on VN, which may support the vascular hypothesis underlying VN. Furthermore, we observed an elevated risk of MD associated with anxiety. The potential protective effects of education and alcohol consumption on BPPV need further exploration in subsequent studies to elucidate specific mechanistic pathways. In summary, our MR study offers novel insights into the etiology of three peripheral vestibular diseases from a genetic epidemiological standpoint.

Clinical and radiological features of a cluster of immunocompetent adolescents with varicella pneumonia: a descriptive study.

Varicella pneumonia is one of the most common and severe complications of chickenpox infection. This study aimed to describe the clinical and radiological features of varicella pneumonia in a cluster of immunocompetent adolescents. A retrospective analysis was conducted on a cohort of adolescent patients diagnosed with varicella pneumonia at Wuhan Jinyintan Hospital between February 2023 and May 2023. The clinical and imaging data were collected and analyzed. A total of 116 patients were divided into two groups by the absence (group 1, n=57) or presence (group 2, n=59) of lower respiratory symptoms for data comparison. Among 116 patients (median age, 16 years; 60 males), rash (100%) was the most prevalent clinical symptom. The most common respiratory symptom and sign were fever (42.2%) and coarse breath sounds (41.4%). Chest computed tomography (CT) performed within five days of symptoms onset revealed multiple (89.7%), peripheral (51.7%), and ill-defined (73.3%) lung nodules in most patients, which gradually improved 6-10 days after symptom onset. Group 2 had higher levels of interleukin-6 (P<0.001), C-reactive protein (P=0.02), serum amyloid-A protein (P=0.002), longer hospital stays (P=0.04), more involved lung lobes (P=0.02), and a higher incidence of multiple nodules (P=0.043) than those of group 1. In immunocompetent adolescents, clustered varicella pneumonia often presents as mild and more uniform in clinical and radiological presentations than sporadic cases. The most common CT findings were multiple pulmonary nodules. Patients with lower respiratory symptoms exhibited more severe clinical and radiological manifestations. Generally, it is not recommended that patients undergo frequent CT scans in a short period.

Analysis of traditional Chinese medicine syndrome elements and clinical symptoms in prediabetes: A systematic review.

Prediabetes mellitus (PDM) and impaired glucose regulation precedes diabetes and serve as early warning signals. A 2018 Chinese epidemiological survey reported prediabetes at 25.5% prevalence and type 2 diabetes at 10.8%, respectively. Untreated carries one-third of the risk of diabetes progression. This study aimed to understand traditional Chinese medicine syndromes in PDM to guide clinical practice and diabetes prevention. We systematically searched the Chinese and English literature in PubMed, EMBASE, Sinomed, CNKI, VIP, Wanfang until March 31, 2023. We manually explored the Chinese prediabetes literature, trial registrations, and references, adhering to predefined criteria. The results were independently summarized by 2 researchers. Statistical analysis was performed using EXCEL, IBM SPSS 27.0, and IBM SPSS Modeler 18.0, with data mining techniques including association and cluster analysis. Analysis of 23 clinical trials (8943 patients) identified phlegm dampness syndrome as predominant, with qi deficiency, dampness, and phlegm as the principal pathogenic elements. Spleen syndrome elements dominated, with a priori correlation analysis favoring spleen dampness. The prevalent PDM clinical symptoms include amnesia, mental fatigue, limb fatigue, dizziness, and lumbar discomfort. Prediabetes is strongly associated with spleen dampness, highlighting its role. Common traditional Chinese medicine syndrome elements include qi deficiency, phlegm, and dampness. Clinical diagnosis and treatment should prioritize syndrome differentiation and emphasize spleen-focused approaches. Although limited research exists on prediabetes syndromes, further exploration of PDM and spleen dampness is crucial.

Recent Progress in Poly (Lactic-co-Glycolic Acid)-Based Biodegradable Drug Delivery Carriers for Pain Management

Pain, a prevalent clinical symptom, significantly demands attention in the current public health system due to its profound impact on patients’ quality of life, daily activities, and economic circumstances. Despite being a pervasive issue, many forms of pain remain ineffectively addressed, hence posing an enormous burden on patients. Pharmaceutical treatments, the first-line approach for various forms of pain, continue to face considerable challenges due to their limited efficacy, lack of long-lasting effects, and adverse side effects. In recent years, the rapid advancements in science and technology, especially the incorporation of micro and nano technologies across various domains, have accelerated the development of novel therapeutics. This review underscores the merits and drawbacks of different pharmacological strategies for pain management. It focuses on the research progress and applications of poly (lactic-co-glycolic acid)(PLGA) as drug delivery carriers, elucidating their potential therapeutic influence over pain management. The review concludes with a thorough summary of current research outcomes and limitations, a discussion of potential clinical transformations, and projections for future pain management research and effective care strategies.

From Genotype to Phenotype of Polish Patients with Pitt-Hopkins Syndrome concerning the Quality of Life and Family Functioning.

Background: Pitt-Hopkins syndrome (PTHS) is a rare genetic disorder affecting psychomotor, social, and intellectual development, caused by a mutation in the TCF4 gene. The study aims to gather the phenotype and genotype data of PTHS patients from Poland and to assess the quality of life (QoL) and the impact of the disorders on the family. Methods: Eight families with PTHS participated in the study. To obtain data, the following standardized questionnaires were used: Questionnaire on Clinical Problems (QCP), the PedsQL™ Family Impact Module, and the QL-Disability Questionnaire. Additionally, a retrospective analysis of clinical examination, genetic consult, medical history, and genotype of each individual was performed. Results: All of the examined children exhibited a mutation in the TCF4 gene and typical features of PTHS. The most prevalent clinical symptoms in the study group included typical PTHS appearance, intellectual disability (n = 5; as the rest of the patients were too young to be assessed), abnormal speech development (n = 8), reduced pain response (n = 7), constipation (n = 7), drooling (n = 7), cold extremities (n = 7), and disturbances in sensory integration processes (n = 7). The QL-Disability Questionnaire revealed a total QoL score of 67.7/100 for children with PTHS, while the QoL for their families in the PedsQL Family Impact Module was 53.82/100. The highest-rated domain was cognitive functioning (Median (Me) = 67.50; Standard Deviation (SD) = 21.95), while the lowest was daily activities (Me = 25.00; SD = 29.86). Conclusions: The study allowed the collection of data on the phenotype and genotype of children with PTHS living in Poland. Overall, our study showed that the QoL of children with PTHS is impaired.

Maxillofacial infections of dental origin

Aim: to evaluate the occurrence of maxillofacial infection cases, which were treated at local hospital, identifying the main risk factors that determine the need for hospitalization of patients and the factors associated with staying length. Methods: A retrospective review of 191 records of patients with maxillofacial infection of odontogenic origin was performed, statistically evaluated by frequency and percentage of involvement, p values (based on the chi-square test) and odds ratio with a 95% confidence interval. A p-value &lt;0.05 was considered statistically significant. Results: Among all the 191 patients, 31 had some harmful habits, such as smokers (13%) and alcoholics (1%). In addition, 39 patients reported some general health problem, such as systemic arterial hypertension (8.3%), depression (6.8%), diabetes (3.6%) and some immunosuppression (1.57%). Involvement of infection in deep facial spaces was present, with 119 patients presenting a deeper infection (62.3%) and 72 patients a superficial infection (37.7%). The most prevalent clinical signs and symptoms in the initial evaluation were pain (91.1%) and edema (90.1%), followed by erythema/hyperemia (44.5%), trismus (37.7%), abscess (30.9%), cellulitis (27.7%), f istula (16.8%), fever (16.8%), dysphagia (11%), dehydration (9.9%), odynophagia (7.9% ) and dyspnea (3.7%). Pulp necrosis was considered a risk factor for treatment in a hospital environment (0.032) and root canal treatment decreases the risk of hospitalization (p=0.002). Considering the evaluated patients, 146 (76.4%) were admitted and 45 (37.7%) were not admitted for hospitalization after initial clinical evaluation. Conclusion: there is a high occurrence of maxillofacial infection cases of dental origin, considering that involvement of infection in deeper facial spaces, as well as presence of pain, edema, erythema/hyperemia, trismus, abscess, cellulitis and pulp necrosis, represent the main risk factors for hospitalization and staying length.

Skin characterization of diabetes mellitus revealed by polarization-sensitive optical coherence tomography imaging.

Diabetes can lead to the glycation of proteins and dysfunction of skin collagen. Skin lesions are a prevalent clinical symptom of diabetes mellitus (DM). Early diagnosis and assessing the efficacy of treatment for DM are crucial for patient health management. However, performing a non-invasive skin assessment in the early stages of DM is challenging. By using the polarization-sensitive optical coherent tomography (PS-OCT) imaging technique, it is possible to noninvasively assess the skin changes caused by diabetes. The PS-OCT was used to monitor the polarization characteristics of mouse skin at different stages of diabetes. Based on a multi-layered adhesive tape model, we found that the polarization characteristics (retardation, optic axis, and polarization uniformity) were sensitive to the microstructure changes in the samples. Through this method, we observed significant changes in the polarization states of the skin as diabetes progressed. This was in line with the detected microstructure changes in skin collagen fibers using scanning electron microscopy. This study presents a highly useful approach for non-invasive skin assessment of diabetes.

Colonoscopic Findings in Patients with Rectal Bleeding Suspected to Have Internal Hemorrhoids: A Cohort Study

Introduction Rectal bleeding is a prevalent clinical symptom associated with various anorectal pathology. Colonoscopy is a valuable diagnostic and therapeutic tool for a wide range of colorectal diseases. The objective of this study was to identify potential alternative diagnoses for hematochezia observed during colonoscopy, which initially appeared to be caused by hemorrhoids. Methods A retrospective study was conducted on a total of 80 consecutive patients who had been clinically diagnosed with rectal bleeding. The patients underwent a digital rectal examination, and then they were prepared for a total colonoscopy. Biopsies were taken from patients who had abnormal findings and sent for histopathological examination. Results A total ileo-colonoscopy was performed on 80 patients presenting with rectal bleeding. The male-to-female ratio was 1.05:1, with a mean age of 45.40±15.54 years old. About 56.3% of the patients had only hemorrhoids, while other findings were observed in 43.7% of the cases. The other findings were anal fissures, proctitis, colitis, solitary rectal ulcer, colorectal carcinoma, diverticula, or polyps. Conclusion Rectal bleeding can stem from various causes, among them hemorrhoids. Thus, colonoscopy stands as an essential diagnostic tool for accurately identifying the causes of the condition.

Clinical presentation and outcome of invasive mould disease in paediatric patients with acute lymphoblastic leukaemia

BackgroundChildhood acute lymphoblastic leukaemia (ALL) cure rates have improved, but invasive mould disease (IMD) remains a life-threatening complication. Here, we evaluate the epidemiology, clinical presentation, treatment and outcome of IMD in paediatric patients with ALL. MethodsPatients (1–18 years) treated according to the Dutch Childhood Oncology Group (DCOG) ALL-11 protocol from 2012–2021 were analysed for probable and proven IMD. Data was extracted from the Dutch national registry and the electronic health care system. ResultsAmong 643 patients with ALL, 47 (7.3%) were diagnosed with a probable (n = 29) or proven (n = 18) IMD. Aspergillosis was diagnosed in 42 (89%) patients. Forty-one episodes (87%) occurred during the induction (n = 20) and first consolidation (n = 21) course. The median age at ALL diagnosis was 5 years [IQR 3–10] in the overall group versus 14 years [IQR 7–16] in the IMD group. Two-third of the patients did not receive mould-active prophylaxis. The most prevalent clinical symptoms at presentation were persistent fever and respiratory symptoms. The lungs were the most common site of infection with involvement in 44 (94%) patients, followed by the CNS in 16 (34%) patients. The 6-week and 12-week mortality rate after IMD diagnosis was 10.6% and 14.9%, respectively. Discussion and conclusionIn our paediatric cohort a notable incidence of probable and proven IMD was observed during the early stages of treatment. Remarkable is the high frequency of CNS involvement. These findings highlight the importance of effective prophylactic strategies and warrant early brain imaging.

Oral Candidiasis Review: Pathogenesis, Clinical Presentation, And Treatment Strategies

The candidiasis is an opportunistic infection commonly affecting the oral cavity. The most prevalent clinical symptoms of candidiasis seen in medical and dental practice is oral candidiasis. People who are extremely young, elderly, or already ill are more likely to develop the illness. The present review summarize classification, pathophysiology, laboratory diagnosis and treatment and management of oral candidiasis. Additionally, medicinal herbs and nutraceuticals can be explored as a safe, accessible, and cost-effective therapy option for oral candidiasis.

Cytomegalovirus Pneumonia in Inflammatory Bowel Disease: Literature Review and Clinical Recommendations.

The objective was to elucidate the correlation between CMVP and immunosuppressive therapy in IBD patients, we hope this review could expand on the significance of CMV as an opportunistic pathogen and the potential impact on morbidity and mortality in IBD patients. Records and clinical trajectories linked to CMVP in IBD patients were extracted from the PubMed database, irrespective of language barriers. The reference lists incorporated in these studies were manually inspected. Conclusions were generated using straightforward descriptive analysis. In total, 18 IBD patients, including Crohn's disease (CD, 67%) and Ulcerative Colitis (UC, 33%), affected by CMVP were identified from 17 published articles. A minority of these patients (17%) exhibited active disease, whereas the majority (83%) presented with quiescent disease. Fever (100%) and dyspnea (44%) emerged as the most prevalent clinical symptoms. All the patients had undergone immunosuppressive therapy. A significant proportion, up to 89%, had received thiopurine treatment prior to the CMVP diagnosis. Interestingly, none of the patients were subjected to biological therapy. Half of the patients manifested with Hemophagocytic Lymphohistiocytosis (HLH). Almost all patients (94%) were administered antiviral treatment and a substantial 83% experienced full recovery. Immunosuppressive agents were either tapered or discontinued altogether. A subset of patients, 17%, suffered fatal outcomes. Our findings underscore the need for heightened suspicion of CMVP in IBD patients who exhibit symptoms such as fever and dyspnea. During the COVID-19 pandemic, CMVP should be considered a potential differential diagnosis. It was observed that CMVP primarily transpires during CD remission. Azathioprine emerged as the predominant immunosuppressant linked to CMV reactivation. The prompt application of effective antiviral therapy can substantially enhance patient outcomes. CMV vaccine might serve as a viable prevention strategy.

Diseases of the Entero-Mammary Circle: A New Clinical Entity

Background: Gastrointestinal malabsorption of proteins from the diet of the mother can induce diseases in breast fed infants. The malfunction of the gastrointestinal tract (GI) of the mother is the basic process causing this disease. This new entity is under the scope of “diseases of the entero-mammary circle” (DEMC). Proteins different from homologues proteins of the breast milk, present in breast milk offered to the infant develops food allergy with clinical manifestation in different organs of the newborn and infant. Here we describe the most relevant clinical symptoms associated to this new entity the DEMC. Methods: From January 2015 to January 2021, 100 charts from infants, age 0 to 6 months, were randomly selected from our clinic of Pediatric Gastroenterology and Food Allergy at Santa Casa da Misericordia do Rio de Janeiro, Rio de Janeiro, Brazil. The inclusion criteria were: 1) To be exclusively breast fed since birth and 2) Diagnosis of food allergy through strict diet to the mother without cow's milk, egg, soy and wheat protein and subsequent oral challenge with ingestion of the seafood by the mothers and recurrence of gastrointestinal, respiratory or dermal symptoms by oral challenge positive. The exclusion criteria were the use of other any food besides the breast milk. Results: The onset of symptoms in the patients studied starts early in life. In the GI system the prevalent clinical symptoms were blood in stool, gastro-esophageal reflux, abdominal distention, abdominal pain, diarrhea, constipation, bulky stools, flatus and vomiting, colic’s and nauseas and hiccups. In the respiratory system of the patients, the clinical disturbance was snoring and rhinitis, sinusitis, excess of mucus, chronic cough, and asthma. In the skin system, was prevalent the pallor, atopic eczema, eczema of folds, erythema of the cheeks, per oral erythema and seborrheic dermatitis. Related to the central nervous system we found sleep disorder, insomnia, irritability, and lethargy. Conclusion: The present study was developed to explore the broad spectrum of the DEMC, presented as different clinical pictures in infants, exclusively breast fed, compromising all systems such the GI tract, the skin, the respiratory system, and the central nervous system.

VARIANT ANATOMY IN MR VENOGRAPHY OF BRAIN

Introduction:Identifying the variations in cerebral dural venous sinus anatomy on magnetic resonance (MR) venography is important for the adequate diagnosis of cerebral venous sinus thrombosis (CVST). There is limited documentation available on gender differences in cerebral dural venous sinus anatomical variants. Aims and Objectives:This study aimed to investigate gender-related variations as well as the typical variance of the cerebral venous system anatomy in asymptomatic individuals as shown by MR venography (3D). Material and Methods:This Hospital-based retrospective study was carried out over 24 months from December 2020 to November 2022 at the Department of Radiodiagnosis, Narayana medical college, Nellore. The study was done on 100 patients. All patients underwent 3D MR Venography on 3.0 Tesla (GE DISCOVERY 750W) MRI machine. Results: 1. Headache was the most prevalent clinical symptom for an MR venography (81%). 2. The most frequent anatomical variant was hypoplastic left transverse sinus (27%). 3. Males had a greater likelihood than females to have a hypoplastic left transverse sinus (12 versus 11). 4. Hypoplastic anterior one-third SSS was the most prevalent anatomical variant of the superior sagittal sinus (SSS). Conclusion:In the current research, the most frequent structural variant was found to be hypoplastic left transverse sinus, which was more prevalent in males than females. Other dural venous sinus structural differences did not show a significant difference between genders.

A systematic review of auricular therapy for poststroke cognitive impairment and dementia: A protocol for systematic review and meta-analysis.

Post-stroke cognitive impairment and dementia (PSCID) is the main source of morbidity and mortality after stroke worldwide. It is one consequence of ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Cognitive impairment and dementia after the clinical stroke may contribute to the clinical expression of PSCID, which are prevalent clinical symptoms, especially in the elderly. Current problems in the field of PSCID are related to a lack of harmonization of the classification and definition, deficiency of well-defined diagnosis, deficiency of standardized and objective treatment plans, etc. Auricular therapy can effectively improve the symptoms of patients with PSCID. However, there has been no systematic review of auricular therapy for PSCID. This study aimed to evaluate the efficacy and safety of auricular therapy in patients with PSCID. Before December 2022, a systematic literature search was conducted using the following databases: PubMed, Embase, SinoMed (previously called the Chinese Biomedical Database), Web of Science, Chinese National Knowledge Infrastructure, and Wanfang Database. Review Manager software (version 5.3) will be used for statistical analysis; otherwise, descriptive analysis or subgroup analysis will be conducted. The quality of evidence for outcomes will be assessed with the Grading of Recommendations Assessment, Development and Evaluation approach. This meta-analysis further confirmed the beneficial effects of auricular therapy in patients with PSCID. This study investigated the efficacy and safety of auricular therapy in patients with PSCID, providing clinicians and patients with additional options for this disease.

Sonic Hedgehog Signaling Pathway: ARole inPain Processing.

Pain, as one of the most prevalent clinical symptoms, is a complex physiological and psychological activity. Long-term severe pain can become unbearable to the body. However, existing treatments do not provide satisfactory results. Therefore, new mechanisms and therapeutic targets need to be urgently explored for pain management. The Sonic hedgehog (Shh) signaling pathway is crucial in embryonic development, cell differentiation and proliferation, and nervous system regulation. Here, we review the recent studies on the Shh signaling pathway and its action in multiple pain-related diseases. The Shh signaling pathway is dysregulated under various pain conditions, such as pancreatic cancer pain, bone cancer pain, chronic post-thoracotomy pain, pain caused by degenerative lumbar disc disease, and toothache. Further studies on the Shh signaling pathway may provide new therapeutic options for pain patients.

СИМПТОМАТИКА И КЛИНИЧЕСКИЕ ДАННЫЕ ВНЕБОЛЬНИЧНОЙ ПНЕВМОНИИ У ДЕТЕЙ

The study aims to identify the main symptoms and features of the clinical manifestations of community-acquired pneumonia in relation to age in 652 hospitalized children with community-acquired pneumonia confirmed by X-ray in 2014–2019. Coughing (100 %), fever &gt; 37.5 °С (45.3 %), tachycardia (66.8 %), and tachypnea (18 %) were the most prevalent clinical symptoms in children aged 1 to 14. Rapid breathing in children with acute respiratory symptoms, such as wheezing with rale and retraction, is the most significant clinical marker associated with pneumonia. It is statistically significantly associated with hypoxemia, as well as severe hypoxemia (SpO2 &lt; 92 %), which is the most common in children under the age of six.

Phylogenetic analysis of pathogenic Candida spp. in domestic pigeons.

The current study was conducted to survey the prevalence of pigeon candidiasis in diseased pigeons suspected to candidiasis by isolation, microscopic examination, and polymerase chain reaction (PCR) method and to characterize Candida spp. phylogenetically. For this purpose, samples were obtained from 100 suspected pigeons from September 2018 to February 2019 in Ahvaz, Iran. Cloacal and oropharyngeal swab samples were collected from each diseased pigeon with diarrhea resistant to the antibiotics, crop stasis, white diphtheritic membrane in the mouth, regurgitation, and vomiting. Sabouraud dextrose agar was used as a culture medium. Selected colonies were stained with lactophenol cotton blue stain. In the culture and direct microscopic observation, 19.00% of birds were suspected to candidiasis. Twenty-two isolates were identified. All 22 isolates were confirmed as Candida spp. By PCR method. The PCR test confirmed the presence of Candida spp. in 19.00% of pigeons. Based on the sequencing results of some PCR products, the isolates belonged to Candida albicans and Candida glabrata. The results revealed a 99.78% accordance when compared with other sequences of C. albicans which were formerly deposited in GenBank® from Colombia, Indonesia, China, and Sudan. The results revealed a 99.54% accordance when compared with other sequences of C. glabrata which were formerly deposited in GenBank® from the Netherlands and Spain. The symptoms such as diarrhea resistant to antibiotics, crop stasis, white diphtheritic membrane in the mouth, regurgitation, and vomiting were the most prevalent clinical symptoms in positive pigeons.