Previous Symptoms Research Articles

Scots Pines With Tolerance to Melampsora pinitorqua and Diplodia sapinea Show Distinct Metabolic Profiles.

Diplodia sapinea causes Diplodia tip blight (DTB) and is recognised as an opportunistic necrotrophic pathogen affecting conifers. While DTB is associated with abiotic stress, the impact of biotic stress in the host on D. sapinea's lifestyle shift is unknown. Observed co-occurrences of D. sapinea and Melampsora pinitorqua, causing pine twisting rust on Scots pine (Pinus sylvestris), instigated an investigation into their interaction with and influence on the defence mechanisms of the host. We hypothesised that M. pinitorqua infections predispose the trees to D. sapinea by stressing the host and altering the shoot metabolites. Pines in a plantation were sampled over time to study pathogen biomass and host metabolites. Symptoms of both pathogens were consistent over years, and the preceding season's symptoms affected the metabolic profiles pre-infection and M. pinitorqua's proliferation. Symptoms of M. pinitorqua altered shoot metabolites more than fungal biomass, with co-symptomatic trees exhibiting elevated M. pinitorqua biomass. Specific phenolic compounds had a strong positive association with the shoot symptom × D. sapinea interaction. D. sapinea's biomass presymptoms was independent of previous disease symptoms and infection by M. pinitorqua. Some trees showed disease tolerance, with delayed rust infections and minimal DTB symptoms. Further investigations on this trait are needed.

Mpox outbreak in a cluster of hospitals at Riyadh, Saudi Arabia 2022-2023: clinical presentation, risk factors, and preventive measures.

This study investigated the Mpox outbreak that occurred in a health cluster of three hospitals in Riyadh, Saudi Arabia, involving 97 patients diagnosed between May and December 2023. Among them, 48% were Saudi nationals, 94% were men, and 73% were under 35 years old. While sexual activity was a potential transmission mode, only 38% of patients reported it. All patients were presented with skin lesions and common symptoms like fever, headaches, and itching, with two being HIV positive. Genotyping revealed all samples were from subclade IIb (West Africa clade). Unlike previous outbreaks, rashes and systemic symptoms emerged simultaneously without a prodromal phase. Stringent infection control measures kept healthcare workers safe, although underreporting of sexual behavior may limit the study's findings. This highlights the need for Mpox consideration in young individuals with skin lesions.

Partnership quality and maternal depressive symptoms in the transition to parenthood: a prospective cohort study

BackgroundPregnancy and childbirth are critical life events which lead to significant changes in family structures and roles, thus having a substantial impact on partner relationship and maternal wellbeing. A dysfunctional partnership during this critical time of life has been associated with maternal depressiveness. However, sub-components of partnership quality and the causal relation with maternal symptoms of depression in the perinatal period have been sparsely studied so far. The current study aims to longitudinally assess the course of relationship quality and its sub-components from pregnancy to postpartum and to test a potential causal association with maternal symptoms of depression in the perinatal period.MethodsDiffering from previous studies, partnership quality and symptoms of depression have been assessed prospectively and longitudinally from an early stage of pregnancy (second trimester) until six months postpartum. Cross-lagged panel models were applied to investigate a potential causal relationship between partnership quality and maternal depressive symptoms.ResultsRelationship quality decreased significantly during the transition to parenthood (p < .05) with the steepest decline referring to tenderness (p < .001). We also found a substantial association of relationship quality and maternal depressiveness, but no indication for a clear causal direction of this association.ConclusionsOur results suggest that relationship quality and maternal depressiveness are substantially related in the perinatal period, thus pointing to the need of early prevention and intervention programs for peripartum women and their partners to prevent adverse outcome for the couple and the family.

Salvage reirradiation for recurrent glioblastoma: a retrospective case series analysis.

To assess the clinical outcome of patients with recurrent glioblastoma treated with salvage reirradiation. Between 2005 and 2022, data from adult patients with glioblastoma treated with surgery and radio-chemotherapy Stupp regimen who developed a local in-field relapse and received stereotactic radiotherapy (SRT) were retrospectively reviewed. The study population included 44 patients with recurrent glioblastoma (median of 9.5 months after the first radiotherapy). Reirradiation alone was given to 47.7% of patients. The median maximum diameter of the recurrence was 13.5 mm. The most common SRT regimen (52.3%) was 35 Gy in 10 fractions. Acute toxicity was mild, with transient worsening of previous neurological symptoms in only 15% of patients. After a median follow-up of 15 months, 40% presented radiological response, but a remarkable number of early distant progressions were recorded (32.5%). The median time to progression was 4.8 months, being the dose, the scheme, the size of the recurrence or the strategy (exclusive RT vs. combined) unrelated factors. The median overall survival (OS) was 14.9 months. Karnofsky index < 70 and the size of the recurrence (maximum diameter < 25 mm) were significant factors associated with OS. Radiological changes after reirradiation were commonly seen (> 50% of patients) hindering the response assessment. Reirradiation is a feasible and safe therapeutic option to treat localized glioblastoma recurrences, able to control the disease for a few months in selected patients, especially those with good functional status and small lesions. Hypofractionated schemes provided a suitable toxicity profile. Radiological changes were common.

False HbA1c value due to a rare variant of hemoglobin Petie Salpetriere coinherited with alpha thalassemia

Abstract Objectives To describe a variant hemoglobin that interferes with HbA1c analysis by cation exchange HPLC. Case presentation A 78 years-old Spanish male patient visited the Internal Medicine Clinic for a routine check-up, with HbA1c included to screen for diabetes. He had suffered hypertension and dyslipidemia, and the patient had no previous symptoms suggestive of diabetes such as hyperglycemia, weight loss, polydipsia, polyuria or tiredness. Diabetes screening by HbA1c measurement was assessed using cation exchange HPLC and an immunoassay point-of-care analyzer. Routine hemoglobinopathy screening was performed including CBC, HbF and HbA2 measurement by cation exchange HPLC and capillary electrophoresis (CE). Further variant characterization was undertaken by DNA sequencing. Discordant HbA1c results were obtained for our subject, with elevated HbA1c of 52 mmol/mol measured by cation exchange HPLC and a normal level of 34 mmol/mol by immunoassay. Abnormal HbA1c peak shape prompted hemoglobinopathy screening to investigate potential variant interference. A globin gene analysis was performed, and the results showed a variant hemoglobin named ‘Hb Petie Salpetriere’. This variant arises from a Val → Phe substitution due to a mutation of c.103G&gt;T of the beta-globin gene [BETA34 (B16) Val&gt;Phe; HBB:c.103G&gt;T]. Conclusions This is the first reported case involving the Hb Petie Salpetriere variant in a Spanish patient. The present results show that the Hb Petie Salpetriere variant can affect the results of HbA1c analysis through ion-exchange HPLC, but not that obtained from the latex agglutination immunoassay. Only ion-exchange HPLC suggested the presence of the Hb variant in this case, suggesting that a careful review of the resulting chromatogram might reveal a potential variant.

History of symptoms consistent with REM sleep behavior disorder in a population with Parkinson's Disease

REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.

Fallo de medro: no siempre acierta, pero sí alerta

&lt;/jats:p&gt; &lt;/jats:abstract&gt; &lt;publication_date media_type='online'&gt; &lt;month&gt;09&lt;/month&gt; &lt;day&gt;10&lt;/day&gt; &lt;year&gt;2024&lt;/year&gt; &lt;/publication_date&gt; &lt;doi_data&gt; &lt;doi&gt;10.60147/0ee7e710&lt;/doi&gt; &lt;resource&gt;https://pap.es/articulo/14232/fallo-de-medro-no-siempre-acierta-pero-si-alerta&lt;/resource&gt; &lt;/doi_data&gt; &lt;/journal_article&gt; &lt;!-- ============== --&gt;&lt;journal_article publication_type='full_text'&gt; &lt;titles&gt;&lt;title&gt;Profile of the limping child &lt;/title&gt;&lt;original_language_title&gt;Perfil del paciente con claudicación de la marcha &lt;/original_language_title&gt; &lt;/titles&gt; &lt;contributors&gt; &lt;person_name sequence='first' contributor_role='author'&gt; &lt;given_name&gt;Verónica&lt;/given_name&gt; &lt;surname&gt;Gimeno-Hernández &lt;/surname&gt; &lt;/person_name&gt;&lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;Álvaro &lt;/given_name&gt; &lt;surname&gt;García&lt;/surname&gt; &lt;/person_name&gt;&lt;person_name sequence='additional' contributor_role='author'&gt; &lt;given_name&gt;Marisol &lt;/given_name&gt; &lt;surname&gt;Camacho&lt;/surname&gt; &lt;/person_name&gt;&lt;/contributors&gt; &lt;jats:abstract xml:lang='en'&gt; &lt;jats:p&gt;Introduction: lameness is a frequent reason for primary care and emergency department visits. Material and methods: observational, longitudinal, retrospective study in patients who presented with lameness to the emergency department of a tertiary care hospital between 2019-2022. Patients were included by systematic random sampling. The study variables were: age, sex, time from onset, associated symptoms, history of trauma, personal and family history, source of referral (provider vs self), examination findings, diagnostic tests and results, treatment, diagnosis in emergency department, final diagnosis, aetiological group and discharge destination. Results: 321 patients, 65.1% male, with a mean age of 5.5 ± 3.4 years. Sixty percent sought care within 24 hours of onset and 81.6% were self-referred. Diagnostic tests were ordered in 87.5% (X-rays in 55.7%). The most common aetiology was inflammatory (29%), chiefly on account of transient synovitis (24%). We found an association between provider referral and a higher priority in triage (p=0.03), the use of ultrasound (p=0.009) and referral to outpatient specialists (p=0.003). The mean age of patients with abnormal sonographic findings (5.65 years) was higher compared to patients with normal results (3.84 years). There were also mean differences in the ages of the different aetiological groups (p=0.000) and in the different diagnoses made in the emergency department (p=0.002). We found an association between the presence of previous symptoms and the aetiological group (p=0.000) and between the time elapsed from onset to the visit and the aetiological group (p=0.002), interconsultation with traumatology (p=0.000) and destination after discharge (p =0.000). Conclusions: most causes of lameness are banal, but a high index of suspicion should be maintained for less frequent alternative diagnosis that may have more serious repercussions, such as JIA.

Sex-based disparities in dopamine agonist response in patients with restless legs syndrome.

This study aimed to investigate sex-related differences in the response to ropinirole and pramipexole in patients with restless legs syndrome (RLS). By analysing clinical parameters and polysomnographic (PSG) findings, we sought to elucidate the potential factors related to sex disparities modulating treatment responses and sleep quality in RLS. A total of 41 drug-free patients with RLS, aged ≥18 years, underwent two consecutive nocturnal PSG recordings, without medication at baseline; before the second night, 26 patients received an oral dose of 0.25 mg pramipexole whereas 15 received 0.5 mg ropinirole. After each PSG recording, patients self-evaluated the severity of their previous night symptoms by means of an ad hoc visual analogue scale (VAS). At baseline, sleep efficiency and percentage of Stage N2 tended to be higher in females while wakefulness after sleep onset was significantly higher in males. After treatment, total leg movements during sleep (LMS), periodic LMS (PLMS), and periodicity indexes were significantly lower in females than in males. The VAS score was lower after treatment in all patients, without differences between the two sexes. This study demonstrates a higher acute responsiveness of PLMS to dopamine agonists (pramipexole and ropinirole) in females than in males with RLS. These findings might be explained by differential sex-related expression of dopamine receptors, especially D3, within the central nervous system. In addition, our findings provide translational hints toward a better tailored and sex-specific approach to the treatment of RLS associated with PLMS, with dopamine agonist possibly associated with a better outcome in females than in males.

How a population-based cohort of men estimate lifetime risk of prostate cancer in a survey before entering a prostate cancer screening trial in Sweden?

ObjectivesInvestigating men’s perceived lifetime risk of prostate cancer.DesignSurvey-based study to men invited for prostate-specific antigen (PSA) screening in the GÖTEBORG-2 trial between September 2015 and June 2020.Setting38 775 men in...

Physical inactivity and sedentary behavior in individuals with stable COPD non-infected by SARS-CoV-2 during the COVID-19 pandemic

Objective: to identify factors associated to sedentary behavior and physical inactivity in individuals with stable chronic obstructive pulmonary disease (COPD) non-infected by SARS-CoV-2 during the COVID-19 pandemic, and to identify possible favorable conditions during social isolation in individuals who performed pulmonary rehabilitation in the pre-pandemic period. Method: time/day in sedentary activities and moderate/vigorous physical activities (SA and MVPA, respectively), history of previous rehabilitation, laboural activity, symptoms, insecurity and quality of life (Medical Outcomes Study 36-item Short-Form Health Survey [SF-36]) were assessed during strict social isolation due to the COVID-19 pandemic. Individuals were classified as sedentary if presenting time/day in SA &gt;8.5 h/day and physically inactive if presenting time/day in MVPA &lt;150 min/week. Result: The sample consisted of 33 individuals (69±7 years; 20 male). Regarding the SF-36, non-sedentary individuals presented better functional capacity than sedentary individuals (65 [38-73] vs. 33 [20-63] points; p=0.01) whereas physically active individuals presented better physical and social function than physically inactive individuals (100 [100-100] vs. 50 [25-100] points, p=0.049; and 100 [100-100] vs. 75 [69-100] points, p=0.022, respectively). Having a professional activity and working outside were associated with non-sedentary behavior (X2=5.93; p=0.025 and X2=7.03; p=0.009, respectively). Having undergone rehabilitation previously to the pandemic was associated with less insecurity to walk outside (X2=4.95; p=0.034) and better perception of symptoms’ worsening (X2=5.46; p=0.033). Conclusion: non-sedentarism was associated with functional capacity and laboural activity; active lifestyle was associated with physical and social function; and previous rehabilitation was associated with better symptoms’ recognition and less insecurity.

Computer-aided detection of tuberculosis from chest radiographs in a tuberculosis prevalence survey in South Africa: external validation and modelled impacts of commercially available artificial intelligence software

Computer-aided detection (CAD) can help identify people with active tuberculosis left undetected. However, few studies have compared the performance of commercially available CAD products for screening in high tuberculosis and high HIV settings, and there is poor understanding of threshold selection across products in different populations. We aimed to compare CAD products' performance, with further analyses on subgroup performance and threshold selection. We evaluated 12 CAD products on a case-control sample of participants from a South African tuberculosis prevalence survey. Only those with microbiological test results were eligible. The primary outcome was comparing products' accuracy using the area under the receiver operating characteristic curve (AUC) against microbiological evidence. Threshold analyses were performed based on pre-defined criteria and across all thresholds. We conducted subgroup analyses including age, gender, HIV status, previous tuberculosis history, symptoms presence, and current smoking status. Of the 774 people included, 516 were bacteriologically negative and 258 were bacteriologically positive. Diverse accuracy was noted: Lunit and Nexus had AUCs near 0·9, followed by qXR, JF CXR-2, InferRead, Xvision, and ChestEye (AUCs 0·8-0·9). XrayAME, RADIFY, and TiSepX-TB had AUC under 0·8. Thresholds varied notably across these products and different versions of the same products. Certain products (Lunit, Nexus, JF CXR-2, and qXR) maintained high sensitivity (>90%) across a wide threshold range while reducing the number of individuals requiring confirmatory diagnostic testing. All products generally performed worst in older individuals, people with previous tuberculosis, and people with HIV. Variations in thresholds, sensitivity, and specificity existed across groups and settings. Several previously unevaluated products performed similarly to those evaluated by WHO. Thresholds differed across products and demographic subgroups. The rapid emergence of products and versions necessitates a global strategy to validate new versions and software to support CAD product and threshold selections. Government of Canada.

Effectiveness of internet-delivered psychological treatments for children and adolescents with anxiety and/or depressive disorders: Systematic review and network meta-analysis

BackgroundAnxiety and depression symptomatology has increased in the child and adolescent population. Internet-delivered psychological treatments (IDPT) can help to reduce this symptomatology, attending to the largest possible population. AimTo conduct a systematic review and network meta-analysis of IDPT to reduce anxiety and depression symptoms in children and adolescents. MethodsThe search for studies was conducted in SCOPUS, PsycINFO, PSICODOC, PsycARTICLES and Medline, between 2000 and 2022, in December 2022. Studies were selected if they were conducted with a sample of children and/or adolescents with previous symptoms of anxiety and depression, had applied IDPT, and included at least two comparative groups with pretest-posttest measures. Network meta-analyses were separately performed for anxiety and depression outcomes. Publication bias was analyzed using Egger's test and funnel plots, and mixed-effects meta-regression models were applied to account for heterogeneity. Results37 studies were included in the meta-analysis, providing a total of 74 comparative groups. IDPT exhibited low-to-moderate, statistically significant average effect sizes when compared to both inactive and active controls. No statistical significance was found when IDPT was compared with other types of interventions. DiscussionIDPT is recommended to reduce anxiety and depression symptomatology in children and adolescents, but more studies are needed which compare treatments with other types of interventions, such as face-to-face therapy.

INCIDENCE, DEMOGRAPHICS, CHARACTERISTICS, AND MANAGEMENT OF ACUTE ACHILLES TENDON RUPTURE

IntroductionAchilles tendon rupture (ATR) account for 10.7% of all tendon and ligament injuries and causes lasting muscular deficits and have a profound impact on patients’ quality of life1,2. The incidence, characteristics and management of ATR in the United Kingdom is poorly understood.MethodData was collected prospectively from University Hospitals of Leicester Emergency Department (ED) between January 2016 and December 2020 and analysed retrospectively. The medical records were reviewed to determine management protocols (surgical/non-surgical) and limited mobilisation (VACOped™ boot) duration. Leicestershire population data was taken from Leicestershire County Council demography report.Findings277 individuals were diagnosed with an ATR during the 4-year period. The mean (SD) annual incidence was 56 (±6) ATR. An incidence rate of 8.02 per 100,000 people per annum. The average characteristics of those experiencing an ATR is male (78.3%), 46.8yrs old (±14.4), body mass index 29.1 (±6.3). Median (IQR) number of comorbidities 1 (2) and duration to present to ED was 0 days (1). The main mechanism of rupture was sporting activity (62.1%).97.4% were non-surgically managed using a limited mobilisation boot (VACOped). The boot was worn for an average of 62.6 days (±8.9). 94 participants provided pre-ATR Achilles symptoms data. 16% (n=15/94) of participants reported a previous contralateral ATR. 7.4% reported a re-rupture (n=7/94). 15.4% (n=14/91) reported an Achilles tendinopathy on the ipsilateral side prior to ATR. 7.7% (n=7/91) reported bilateral Achilles tendinopathy and 1.1% (n=1/91) reported contralateral Achilles tendinopathy prior to ATR.ConclusionThe incidence of ATR is 8.02 cases per 100,000 people per annum. This is the first UK data on ATR incidence. Most ATR were managed non-surgically in this cohort. The majority of ruptures occurred during sporting activity. Those that had previous Achilles symptoms (24.2%) indicate tendons are not always asymptomatic prior to ATR.

Long-term complications in acute porphyria.

New treatment options and low attack-related mortality have changed the life expectancy of patients with acute porphyria (AP) to that of the general population. Clinicians should therefore be aware of the long-term complications of AP, which typically include chronic neuropathy and encephalopathy, high blood pressure and porphyria-associated kidney disease. Patients have an increased risk of primary liver cancer (PLC), but no increased risk of non-hepatic cancers. Chronic pain occurs in patients with recurrent attacks, combined with chronic fatigue and nausea, leading to poor quality of life. Patients with sporadic attacks may also have chronic symptoms, which should be distinguished from mild recurrent attacks and treated appropriately. Sequels of acute polyneuropathy after an attack should be distinguished from ongoing chronic polyneuropathy, as the management is different. Overestimation of chronic neuropathy or encephalopathy caused by AP should be avoided, and other causes should be treated accordingly. Prevention of recurrent attacks is the best strategy for managing chronic comorbidities and should be actively accomplished. Hormonal interventions in female patients, or in severe cases, prophylactic givosiran or haematin, may be helpful before liver transplantation to prevent recurrent attacks. Regular monitoring can be personalised according to the patient's age, comorbidities and AP activity. Blood pressure, renal function and cardiovascular risk factors should be monitored annually in patients with previous symptoms. Appropriate medication and lifestyle management, including nutrition and hydration, are necessary to prevent complications. As PLC is common, especially in patients with acute intermittent porphyria, bi-annual surveillance after the age of 50 is important.

Prevalence and Risk Factors of Multitype Post-COVID Pain in a Cohort of Previously Hospitalized COVID-19 Survivors: A Danish Cross-Sectional Survey

This population-based study investigated the prevalence of de novo, multitype, post-coronavirus disease (COVID) pain and its associated risk factors in previously hospitalized coronavirus disease 2019 (COVID-19) survivors. The nationwide, cross-sectional study included a cohort of Danish residents previously hospitalized due to severe acute respiratory syndrome coronavirus-2 infection between March 2020 and December 2021. Demographic data, preexisting medical comorbidities, previous pain-related symptoms, medication use for pain management, pain intensity (4-point scale), and development of de novo, multitype, post-COVID pain were collected by a self-reported survey distributed via e-Boks (a secured national digital mail system used in Denmark to provide public information to residents). The sample comprised 4,712 previously hospitalized COVID-19 survivors (48.6% women, mean age: 60.1 ± 15.6 years). At the time of the study (21 ± 6 months after hospitalization), 18.0% (847) reported the presence of de novo, multitype, post-COVID pain, and 38.6% of any pain. A multivariate analysis revealed that female sex (Odds Ratio (OR) 1.711, 95% Confidence Interval (CI) 1.444–2.023), higher body mass index (OR 1.032, 95% CI 1.019–1.045), intensive care unit admission (OR 1.597, 95% CI 1.324–1.926), previous history of whiplash (OR 2.471, 95% CI 1.004–6.081), anxiety (OR 3.626, 95% CI 1.335–9.708), and younger age (OR .982, 95% CI .976–.987) were factors associated with development of de novo, multitype, post-COVID pain. High income (OR .635, 95% CI .494–.817) and high educational level (OR .774, 95% CI .609–.984) were protective factors. In conclusion, multitype pain as a de novo post-COVID symptom was present in 18.0% of previously hospitalized COVID-19 survivors more than 1 year after hospital discharge and as such can be considered as adding to the global burden of chronic pain. PerspectiveThe study investigates the prevalence of de novo, multitype, post-COVID pain in previously hospitalized COVID-19 survivors. This article presents potential risk factors associated with developing new pain symptoms. The results will contribute to understanding the possibility of predicting postinfectious pain from COVID-19 for future analysis.

THE PERINATAL ANXIETY SCREENING SCALE (PASS) ASSESSMENT OF HIGHRISK PREGNANT WOMEN

Background: Psychological changes in pregnant women can be caused by hormonal imbalances. Imbalance can give rise to an anxiety response caused by conditions within oneself and the environment. Excessive anxiety can stimulate uterine contractions which can lead to pathological risks in the pregnancy. The aim of this research is to determine the anxiety and psychological domains of high-risk pregnant women. Method: The research design was descriptive research with a sample size of 30 pregnant women who had a history of high risk in Batu Kute village, Narmada subdistrict using cluster sampling technique. The instrument used was the PASS (perinatal anxiety screening scale) questionnaire. Result: The research results obtained were that most pregnant women experienced anxiety on a mild - moderate scale with a percentage of 70% experienced by mothers in the first and third trimesters of pregnancy. is in the domain category of excessive worry and specific fear as much as 57% and anxiety and active adjustment as much as 23.3%. The level of anxiety of pregnant women in the first trimester is due to the adaptation process to changes in a woman and will increasingly increase in the third trimester of pregnancy leading up to delivery. Conclusion: Anxiety conditions with or without previous symptoms will increase in high-risk third trimester mothers because they feel anxious about the condition of themselves and their fetus. If not treated, it will pose a risk to the mother, fetus and the birth process that will occur.

Imaging and molecular features of adenomyosis after menopause

ObjectivesTo explore the imaging features and the molecular characterization of adenomyosis after menopause. Study designAn observational cross-sectional study was performed in a group of postmenopausal patients undergoing a transvaginal ultrasound (TVUS) (n = 468). Among those presenting the US criteria for adenomyosis, also confirmed by magnetic resonance imaging (MRI), previous menstrual symptoms, gynecological and obstetric history were reviewed. In a subgroup undergoing hysterectomy, uterine specimens were analyzed by histology and expression of genes implicated in the epithelial-mesenchymal transition, inflammation and fibrosis, including the sphingosine-1-phosphate (S1P) pathway, was evaluated and compared to matched non-menopausal adenomyosis specimens. Main outcome measuresDirect and indirect US features of adenomyosis according to Morphological Uterus Sonographic Assessment at TVUS. Molecular characterization of postmenopausal versus pre-menopausal adenomyosis samples. ResultsAccording to TVUS and MRI, adenomyosis was identified in 49 patients (10.4 %). On US, diffuse adenomyosis was the most common phenotype, whereas internal adenomyosis with diffuse pattern and asymmetric type was the most prevalent on MRI. Molecular analysis showed that adenomyosis lesions express markers of epithelial-mesenchymal transition, inflammation and fibrosis also in postmenopausal women. By comparing the results with those from pre-menopausal samples, the expression of α smooth muscle actin (αSMA), a marker of fibrosis, was significantly greater after menopause, and altered S1P catabolism and signaling were observed. ConclusionsAdenomyosis may be identified in postmenopausal women by imaging, either TVUS or MRI, and fibrosis is one of the key features on molecular analysis.

A Retrospective Analysis: Investigating Factors Linked to High Lung-RADS Scores in a Nonsmoking, Non-Family History Population.

Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency's low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20-80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.

Addressing negative symptoms of schizophrenia in a Psychosis Day Hospital: a case report

IntroductionNegative symptoms are present in more than two thirds of schizophrenic patients throughout the evolution of the disorder. These include symptoms related to reduced motivation or pleasure, such as avolition, anhedonia and asociality, and reduced expressivity, including alogia and blunted affect.We present the case of a 24-year-old man who was admitted to our Psychosis Day Hospital after several psychotic episodes, presenting with prominent negative symptomatology that was imbued with mystical delusional beliefs.Objectives1)To describe the clinical particularities of this case, focusing on the improvement of negative symptoms during the course of treatment at our Day Hospital.2)To review the available evidence regarding the pharmacological and psychotherapeutic management of negative symptoms of schizophrenia. MethodsA review of the patient’s clinical history and complementary tests were carried out. Likewise, we reviewed the available literature in relation to the management of negative symptoms of schizophrenia in an ambulatory setting.ResultsThe patient was admitted to our Day Hospital after four psychiatric hospitalizations due to mystical delusions, ideas of grandiosity and hyper-spirituality, along with prominent negative symptoms at the moment of inclusion at our centre, including social withdrawal, diminished affective response, lack of interest in the academic sphere and poor social drive. Although previous positive symptoms were present in a lesser degree, the patient interpreted the presence of the negative symptoms described above as a “punishment” or “test” from spiritual creatures.Management of negative symptoms represents a major unmet need in schizophrenia. Modest effect size evidence for pharmacological approaches favours the use of antipsychotic in monotherapy and augmentation of antipsychotic treatment with other agents, such as antidepressants. Scarce evidence regarding psychotherapeutic approaches to these symptoms points to the use of cognitive behaviour therapy and social skills training.Conclusions-Clinical identification and characterization of negative symptoms is crucial when treating patients with schizophrenia, as these are associated with important disability and poorer functional outcomes.-Differentiation of primary and secondary negative symptoms is a key aspect in the evaluation and management of schizophrenic patients.-This case outlines the coexistence of positive and negative symptoms, and illustrates the challenges in the pharmacological and psychotherapeutic management of these symptoms at a Psychosis Day Hospital.Disclosure of InterestNone Declared

Prevalence of SARS-CoV-2-specific antibodies in a sample of the Lithuanian population-based study in Spring 2023

ObjectivesDespite positive trends in SARS-CoV-2 epidemiology, seroprevalence surveys remain an important tool for estimating the magnitude of the COVID-19 pandemic. This study aimed to investigate the prevalence of IgG antibodies against SARS-CoV-2 nucleocapsid (N) and spike (S) proteins in a sample of the Lithuanian population (N = 517) and evaluate how the pattern of seropositivity correlates with the levels of SARS-CoV-2 infection and vaccination. MethodsStudy participants (aged 18–88 years) filled in the questionnaire self-reporting their demographic-social variables, health status, and SARS-CoV-2-related status. The anti-S and anti-N IgG levels were estimated using a microarray ELISA test. ResultsAfter several pandemic waves and vaccination campaign, the seroprevalence of SARS-CoV-2-specific IgG in the analyzed sample was 97.87 % by March–May 2023. We determined the 96.91 % prevalence of anti-S and 58.03 % prevalence of anti-N IgG. The majority of study participants (71.18 %) had hybrid immunity induced by vaccination and SARS-CoV-2 infection. 20.3 % of study participants were anti-N IgG positive without reporting any previous symptoms or a positive SARS-CoV-2 test. A decline of anti-N IgG positivity within 9 months after infection was observed. ConclusionsThis study demonstrates high total seroprevalence in March–May 2023 in all age groups indicating a widely established humoral immunity against SARS-CoV-2 in Lithuania.