Recovery Of Disorders Research Articles

PERSPECTIVES FOR THE USE OF PLANT RAW MATERIALS OF THE CLOVER MEADOW (TRIFOLIUM PRATENSE L.) IN PHARMACY

Background. The creation and registration of original medicines based on plant raw materials are becoming promising areas in pharmaceutical practice. Clover meadow (Trifolium pratense L.) has been used in folk medicine for a long time, due to the content of many biologically active substances with Therapeutic properties. It grows over large areas; extracts are easy to obtain from plant raw materials and have a certain economic attractiveness. In this regard, compounds extracted from meadow clover can be considered as potential precursors for the development of new promising pharmaceuticals. Aim. Carrying out a narrative review on the Perspectives of the use of biologically active substances extracted from the plant raw materials of meadow clover in pharmaceutical practice. Material and methods. The scientific publications of the PubMed biomedical research database are analyzed. Results. Meadow clover (Trifolium pratense L.) is a widespread perennial herbaceous plant belonging to the pharmacopoeia group. Extracts obtained from plant raw materials have a wide range of biological activity. The largest proportion of them are isoflavones, flavonoids, saponins, clovamides and phenolic acids. Isoflavones have a phytoestrogenic effect, and in this regard, they are successfully used in the treatment of diseases of the reproductive system. In addition, their anti-inflammatory, reparative properties have been proven; they can be used for the prevention and recovery of metabolic disorders. Flavonoids, saponins, clovamides and phenolic acids have antioxidant and antiplatelet effects. Conclusion. Among biologically active substances extracted from meadow clover, the greatest use in pharmacological practice was noted for isoflavones. At the same time, there are a few other potentially effective compounds with known medicinal properties. Their further study is required in order to create new original medicines

Towards Transforming Neurorehabilitation: The Impact of Artificial Intelligence on Diagnosis and Treatment of Neurological Disorders.

Background and Objectives: Neurological disorders like stroke, spinal cord injury (SCI), and Parkinson's disease (PD) significantly affect global health, requiring accurate diagnosis and long-term neurorehabilitation. Artificial intelligence (AI), such as machine learning (ML), may enhance early diagnosis, personalize treatment, and optimize rehabilitation through predictive analytics, robotic systems, and brain-computer interfaces, improving outcomes for patients. This systematic review examines how AI and ML systems influence diagnosis and treatment in neurorehabilitation among neurological disorders. Materials and Methods: Studies were identified from an online search of PubMed, Web of Science, and Scopus databases with a search time range from 2014 to 2024. This review has been registered on Open OSF (n) EH9PT. Results: Recent advancements in AI and ML are revolutionizing motor rehabilitation and diagnosis for conditions like stroke, SCI, and PD, offering new opportunities for personalized care and improved outcomes. These technologies enhance clinical assessments, therapy personalization, and remote monitoring, providing more precise interventions and better long-term management. Conclusions: AI is revolutionizing neurorehabilitation, offering personalized, data-driven treatments that enhance recovery in neurological disorders. Future efforts should focus on large-scale validation, ethical considerations, and expanding access to advanced, home-based care.

Treatment Targets and Strategies for Eating Disorders Recovery: A Delphi Consensus With Lived Experience, Carers, Researchers, and Clinicians.

Long-term recovery rates following eating disorders (EDs) treatment remain low. This might be partly due to a lack of agreement between key stakeholder groups, including people with lived experience, carers, clinicians, and researchers, regarding optimal therapeutic targets and strategies. We aimed to reach a consensus across these diverse groups on the most valued treatment targets and strategies for fostering ED recovery. We used the Delphi method with two phases: (i) Survey development and (ii) Expert rating. The survey development phase included the design of an initial set of items through scoping review and feedback from a committee of 14 experts. During the survey rating, we engaged a larger panel of 185 experts who comprised the stakeholder groups: Individuals with lived ED experience (n = 49), carers (n = 44), researchers (n = 46), and clinicians (n = 46). Thirty-one targets and 29 strategies reached consensus (> 70% agreement over three rounds). Psychological-emotional-social targets including quality of life, sense of purpose, and emotion regulation, along with ED behaviors, reached the highest agreement (> 90%). Strategies reflecting an individualized approach to treatment (i.e., considering diversity, assessing comorbidities, and enhancing rapport) achieved the highest agreement (> 90%). Responses across groups were similar, except researchers leaning more towards consideration of weight- and eating-related targets. Holistic targets and individualized therapeutic strategies have consistent support from the different stakeholder groups involved in ED treatment. The agreed set of targets/strategies may be used, in triangulation with other sources of evidence, to design and evaluate coproduced and personalized interventions.

Identifying factors strongest associated with clinical, societal and personal recovery in people with psychosis with a long duration of illness

IntroductionMost studies on recovery of psychotic disorders focus on first-episode populations using premorbid and baseline data to predict recovery. However, many patients experience a long duration of illness and many factors are dynamic and change during life. AimsTo investigate factors strongest associated with clinical, societal and personal recovery, and recovery change scores in people with a long duration of illness using current data measured at the same assessment. MethodsLeast absolute shrinkage and selection operator regression analyses with cross-validation were used to identify the correlates of (changes in) clinical (N = 1054), societal (N = 1145) and personal recovery (N = 1187) in people with psychotic disorders. Subsequently, the identified associated factors were included in separate linear regression models, examining the associative strength of the identified variables and overall fit of the models. ResultsBetter clinical recovery was associated with better societal and personal recovery, experiencing fewer problems with daily functioning and social relations. Participants had a better societal recovery when they were employed, had fewer problems in daily life, less negative symptoms, had a life partner and better clinical recovery. Personal recovery was associated with greater satisfaction with life in general, no depressive mood and increased clinical recovery. Change scores were small with minimal fluctuation and no significant associations with change scores were detected. ConclusionsRecovery domains strongly influence each other in people with a long illness duration of psychosis and should therefore have an equally important focus during treatment.

Running toward substance use recovery: Does delay discounting mediate the relationship between physical activity and quality of life?

BackgroundRecovery from substance use disorders is multifactorial with psychosocial functioning, such as quality of life (QOL), playing a particularly important role. Delay discounting, the degree to which individuals devaluate a reinforcer as a function of the delay to its receipt, is associated with QOL. Moreover, evidence shows that physical activity may decrease delay discounting rates. The present study aims to examine associations among physical activity, delay discounting, and QOL, and investigate the mediating role of delay discounting in the relationship between physical activity and QOL domains. MethodsData was collected from the International Quit & Recovery Registry (IQRR), and comprised of 267 participants (67% women) who reported being in recovery from substance use disorders. Participants completed the Health Behaviors Questionnaire (physical activity was measured using the fitness domain), a delay discounting minute task (higher delay discounting rates indicate a preference for smaller, sooner rewards), the World Health Organization QOL questionnaire, as well as demographics and substance use disorders-related questions. Multivariate linear regression was used to test associations between physical activity with delay discounting, and physical activity with each QOL domain. Mediation analyses were conducted to evaluate the mediating role of delay discounting in the relationship between physical activity and QOL domain. ResultsHigher levels of physical activity were associated with greater valuation of the future (lower delay discounting rates; p < .001) and higher levels of physical (p < .001), and environmental (p = .001) QOL. Delay discounting mediated the relationship between physical activity and physical (p = .004), and environmental (p < .001) QOL. ConclusionPhysical activity can be an important tool in the treatment and recovery of substance use disorders, as it is associated with future-oriented choices, which in turn contributes to improving the QOL of those individuals.

Association of total bilirubin and prognosis in disorders of consciousness

Accurate prediction of the recovery of Disorders of Consciousness (DoC) is of paramount significance for clinicians and families. Serum total bilirubin (TBIL) formed by activation of heme oxygenase 2, is associated with incidence and prognosis of cardiovascular and cerebrovascular diseases. However, studies that based TBIL and DoC are limited. The study attempted to examine the association between serum TBIL levels and prognosis in patients with DoC. One hundred and sixty-eight patients with DoC in the Second hospital of Shandong University from June 2021 to June 2023 were recruited. The clinical characteristics and venous blood samples were collected within 24 h after admission. The diagnosis of DoC was determined by two skilled investigators employing various behavioral evaluations along the coma recovery scale-revised (CRS-R) and the investigators conducted follow-up assessments of diagnosis at 1, 3, and 6 months after admission. For statistical analysis, we categorized patients with an improvement in clinical diagnosis from study entry as having a “good outcome”. In total, 139 individuals enrolled in the study. The median TBIL level was 8.2 μmol/L. Good recovery of DoC at 1, 3, and 6 months occurred in 25 (18.0%), 41 (29.5%), and 56 (40.3%) patients, respectively. After full adjustment, a significant association was found between TBIL levels and the prognosis of DoC at 1, 3, and 6 months. When TBIL levels were analyzed as categorical variables, an increasing trend in the tertiles of TBIL levels demonstrated a significant positive association with the recovery of DoC at 1, 3, and 6 months. Stratified analysis revealed that the association between serum TBIL levels and the recovery of DoC remained consistent across different sub-populations. A high serum TBIL level is associated with an improved likelihood of recovery of DoC. Additional research is required to elucidate the underlying pathophysiological causal association between TBIL levels and DoC.

Assessment of olfactory and gustatory functions in COVID-19 patients

BackgroundOlfactory and gustatory disorders are common problems encountered during the COVID-19 pandemic with a significant impact on the patient’s quality of life: The aim of this study was to assess the olfactory and gustatory functions in COVID-19 patients with correlation between them and clinical and laboratory markers. This was a cross-sectional study conducted on 63 subjects recruited from the COVID-19 clinics at Police Authority and Menoufia University hospitals. The patients were assessed using history taking, anterior rhinoscopy, endoscopic examination, computed tomography, and polymerase chain reaction (PCR) test. Olfactory functions were assessed using the alcohol threshold test. Gustatory functions were assessed using the three-drop method. The olfactory and gustatory functions were correlated with age, gender, and laboratory parameters. Also, the recovery of smell and taste disorders was correlated with our assessed laboratory markers.ResultsThe prevalence of olfactory dysfunction among study participants was 41 patients (65%) of the participants including 12 patients (19.1%) having mild hyposmia, 10 patients (15.8%) having moderate hyposmia, 9 patients (14.3%) having severe hyposmia, and 10 patients (15.8%) having complete anosmia. The prevalence of gustatory dysfunction among study participants was 24 patients (38.1%). Age, gender, and laboratory parameters did not show any statistically significant difference between those who experienced olfactory dysfunction or gustatory dysfunction and those who did not. However, there was a significant positive correlation between the total leucocytic count, serum level of CRP, and serum level of D-dimer and the degree of olfactory dysfunction (0.049, 0.03, and 0.02, respectively). There was a nonsignificant correlation between recovery of olfactory and gustatory dysfunction and laboratory markers.ConclusionOlfactory and gustatory dysfunction are established clinical presentations among COVID-19-positive patients. The laboratory markers had no correlation with the incidence of these dysfunctions or their recovery. However, TLC, serum CRP, and serum D-dimer had a significant positive correlation with the severity of olfactory dysfunction.

L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review.

L-carnitine (LC), a vital nutritional supplement, plays a crucial role in myocardial health and exhibits significant cardioprotective effects. LC, being the principal constituent of clinical-grade supplements, finds extensive application in the recovery and treatment of diverse cardiovascular and cerebrovascular disorders. However, controversies persist regarding the utilization of LC in nervous system diseases, with varying effects observed across numerous mental and neurological disorders. This article primarily aims to gather and analyze database information to comprehensively summarize the therapeutic potential of LC in patients suffering from nervous system diseases while providing valuable references for further research. A comprehensive search was conducted in PubMed, Web Of Science, Embase, Ovid Medline, Cochrane Library and Clinicaltrials.gov databases. The literature pertaining to the impact of LC supplementation on neurological or psychiatric disorders in patients was reviewed up until November 2023. No language or temporal restrictions were imposed on the search. A total of 1479 articles were retrieved, and after the removal of duplicates through both automated and manual exclusion processes, 962 articles remained. Subsequently, a meticulous re-screening led to the identification of 60 relevant articles. Among these, there were 12 publications focusing on hepatic encephalopathy (HE), while neurodegenerative diseases (NDs) and peripheral nervous system diseases (PNSDs) were represented by 9 and 6 articles, respectively. Additionally, stroke was addressed in five publications, whereas Raynaud's syndrome (RS) and cognitive disorder (CD) each had three dedicated studies. Furthermore, migraine, depression, and amyotrophic lateral sclerosis (ALS) each accounted for two publications. Lastly, one article was found for other symptoms under investigation. In summary, LC has demonstrated favorable therapeutic effects in the management of HE, Alzheimer's disease (AD), carpal tunnel syndrome (CTS), CD, migraine, neurofibromatosis (NF), PNSDs, RS, and stroke. However, its efficacy appears to be relatively limited in conditions such as ALS, ataxia, attention deficit hyperactivity disorder (ADHD), depression, chronic fatigue syndrome (CFS), Down syndrome (DS), and sciatica.

Metacognition as a Transdiagnostic Determinant of Recovery in Schizotypy and Schizophrenia Spectrum Disorders.

The term schizotypy refers to the latent personality organization that is thought to underpin the liability to develop schizophrenia and associated disorders. Metacognition, or the ability to understand and form increasingly complex and integrated ideas of oneself, others, and one's community, has been proposed to be an important transdiagnostic construct across schizophrenia spectrum disorders and a range of both clinical and non-clinical manifestations of schizotypy. In this paper, we review evidence that deficits in metacognition are present in individuals with relatively high levels of schizotypy and that these deficits are related to symptomology, function, and quality of life. We address the idea that decrements in metacognition may also contribute to the progression from schizotypy to more severe manifestations, while the amelioration of these deficits may enhance aspects of recovery, including the ability to form an integrated sense of self, others, and the wider world. We also review the following two recovery-oriented psychotherapies that target metacognition to promote recovery in individuals with clinical manifestations of schizotypy: Evolutionary Systems Therapy for Schizotypy (ESTS) and Metacognitive Reflection and Insight Therapy (MERIT).

Making meaning of one's own life story in words and images: A narrative case report of personal recovery from personality disorder through the interventions "An Empowering Story" and art therapy.

Understanding and processing life experiences are essential in the treatment of personality disorders to promote personal recovery and psychological wellbeing. In this qualitative case report, drafted in co-creation between the client, clinical psychologist, and art therapist, individual treatment consisted of two psychotherapeutic interventions, "An Empowering Story" and life-story-focused art therapy, in 12 parallel sessions for 24 weeks. Hilda, 68 years of age, had been diagnosed with an unspecified personality disorder and various traits of borderline personality disorder. She experienced emotional exhaustion following long-term mental health problems rooted in a traumatic early childhood. This affected her ability to manage her emotions and social relations, resulting in the sense that her life had no meaning. Hilda was invited to reconstruct her life experiences, divided into the past, turning point, and present/future, in a written and a painted life story. This allowed for the integration of traumatic as well as positive memories, enhanced self-compassion, and meaning making. She developed self-reflection and integration of internal conflicts leading to a better emotional balance and self-understanding. Art therapy emphasizes bottom-up regulatory processes, while narrative psychology supports top-down regulatory processes. The combined approach effectively integrated bottom-up, experiential, sensory experiences with top-down, cognitive emotion-regulation processes. The results suggest that psychotherapeutic interventions involving a multi-pronged, complementary, and thus more holistic approach can support personal recovery in personality disorders.

(257) Prostate w-point orgasm decrypted W

Abstract Introduction Erectile dysfunction is a common disease, accounting for about 50% of adult males. No matter oral“Viagra” or surgical treatment, there are unsatisfactory, especially in the middle-aged and elderly men, there is no way, there are widowed and disabled groups. Only rely on ejaculation to get pleasure, will lose at least a third of the sex life. Prostate disease accounts for about 25 percent of the sexual dysfunction. Therefore, through the clinical observation of more than 50,000 patients, the author has improved the Prostate massage method and explored the effectiveness of diagnosis, treatment and rehabilitation not only for prostate diseases, but also for prostate diseases, a new model of male sexual pleasure-the w-spot massage technique-has also been found. 50%, 25%, 5-W. Objective To investigate a convenient and effective prostate W-spot orgasm. W. Methods 200 cases were randomly selected from prostate disease recovered patients aged 40–60 years. They were divided into two groups, an observational one and a control one with a ratio of 1:1, the experimental group used the prostate W-spot massage (massage path resembles the letter W, hence the name) method, the control used the conventional prostate P massage method (P is the initials of Prostate, no specific positioning). After 1 or 2 courses of the treatment, the efficiency was investigated by questionnaires and interviews were conducted to compare the advantages and disadvantages (W and P were substituted throughout the text).200, 40–60, W (W)P (P Prostate) 1–2 (WP). Results 91% effective rate for W and 73% effective rate for P.W 91% P 73%. Conclusions 1. W is better than P. 2. A certain duration of W-spot massage can help excrete prostate fluid, prevent or relieve prostatitis, facilitate the recovery of prostate disorders and timely detect the prostate tumors. 3. The W-spot massage path coincides with the intersection of multiple meridian paths in Chinese medicine, especially the Ren and Du meridians which intersect here. Massage can smooth and refresh Blood and Qi according to Chinese medicine theory. 4. Prostate W-spot massage is another way of sexual pleasure for non-heterosexual interpersonal sexual relations men, gay men and those who have erectile dysfunction. It may also be conducive to the rehabilitation of certain erectile dysfunction. The prostate massage path can directly stimulate the ejaculatory ducts, producing an experience similar to that of an ejaculatory orgasm. However, its pleasurable physiological mechanism is unrelated to penile erection or stimulation, thus without an “off period” for prostate orgasm. 1. WP, 2.W, 3. 4.W, 5.W. Disclosure No.

Changes in Psychological Profile and Cognitive Function in Patients with Arterial Hypertension Who Have Suffered From COVID-19 Under the Influence of Treatment

Today, the issue of treatment and rehabilitation of patients with COVID-19 is extremely relevant. A disease that has shaken the medical community, even after the patient recovers, can have serious consequences for health in the future. The greatest concern in the post-covid period is caused by rather serious and long-term complications (especially in patients who have experienced a severe form of COVID-19), which include: cardiovascular (damage to the heart muscle, exacerbation and progression of hypertension), respiratory, neurological (disturbance of sensation taste and smell, sleep disorders), psychological (depression, anxiety, mood swings) outcomes. In the modern population, there is an increased level of cognitive disorders. They have multifactorial nature, in particular, one of such pathogenetic factors is arterial hypertension (AH) and its complications, the frequency of post-stroke cognitive impairment from mild to severe grade reaches 60% during the first year. On the other hand, according to observations, treatment of AH can reduce the risk of dementia development. The results of the data analysis showed a higher prevalence of cognitive impairment in patients with AH in the post-epidemic period than in patients with elevated blood pressure (BP) who did not suffer from COVID-19. The objective: to analyze the frequency of anxiety-depressive disorders and cognitive function in patients with medically controlled AH who experienced COVID-19, and to evaluate the effectiveness of additional use of a combination of L-carnitine, L-arginine and coenzyme Q10 in the post-covid period. Materials and methods. 53 patients (24 women and 29 men) with a diagnosis of AH who treated with drug antihypertensive therapy and who recovered from COVID-19, were included in a prospective single-center study. Questionnaires (MMSE, SSS-8, PHQ-9) were chosen to assess anxiety-depressive disorders and cognitive function. The study participants were divided into two groups that did not differ in age and gender. In the first group standard treatment was added with a combination of L-arginine, L-carnitine and coenzyme Q10, the patients in the second group received standard therapy. Results. An additional effect on improved BP control only when used drug therapy in a complex with a combination of L-arginine, L-carnitine and coenzyme Q10 was determined, as well as a positive effect on improved the clinical condition of patients with AH, restoration of the psychological state after a recovery from respiratory infection SARS-COV- 2. Conclusions. The patients with AH who have suffered from COVID-19 often have psychological changes and impaired cognitive function under the conditions of medical BP control. The use of a combination of L-arginine, L-carnitine and coenzyme Q10 as part of complex therapy contributed to a more effective recovery of psychological and cognitive disorders, improvement of the subjective condition of patients due to the additional positive effect on the control of BP and heart rate.

Does amantadine improve cognitive recovery in severe disorders of consciousness after aneurysmal subarachnoid hemorrhage? A double-blind placebo‐controlled study

BackgroundSevere disorders of consciousness (sDoC) are a common sequela of aneurysmal subarachnoid hemorrhages (aSAH), and amantadine has been used to improve cognitive recovery after traumatic brain injury. ObjectiveThis study evaluated the effect of amantadine treatment on consciousness in patients with sDoC secondary to aSAH. MethodsThis double-center, randomized, prospective, cohort study included patients ≥ 18 years old with sDoC after aSAH from February 2020 to September 2023. Individual patient data of patients were pooled to determine the effect of amantadine, in comparison to placebo. The primary outcomes at 3 and 6 months after the ictus were evaluated using the modified Rankin scale (mRS) and Glasgow outcome scale (GOS). In addition to all-cause mortality, secondary endpoints were assessed weekly during intervention by scores on Rappaport's Disability Rating Scale (RDRS) and Coma Recovery Scale-Revised (CRSR). ResultsOverall, 37 patients with sDoC and initial Glasgow Coma Scale (GCS) varying between 3 and 11 were recruited and randomized to amantadine (test group, n = 20) or placebo (control group, n = 17). The average age was 59.5 years (28 to 81 year-old), 24 (65%) were women, and the mean GCS at the beginning of intervention was 7.1. Most patients evolved to vasospasm (81%), with ischemia in 73% of them. The intervention was started between 30 to 180 days after the ictus, and administered for 6 weeks, with progressively higher doses. Neither epidemiological characteristics nor considerations regarding the treatment of the aneurysm and its complications differed between both arms. Overall mortality was 10.8% (4 deaths). During the study, four patients had potential adverse drug effects: two presented seizures, one had paralytic ileus, and another evolved with tachycardia; the medication was not suspended, only the dose was not increased. At data opening, 2 were taking amantadine and 2 placebo. ConclusionDespite some good results associated with amantadine in the literature, this study did not find statistically significant positive effects in cognitive recovery in patients with delayed post-aSAH sDoC. Further large randomized clinical trials in patients’ subgroups are needed to better define its effectiveness and clarify any therapeutic window where it can be advantageous.

Prognosis and enhancement of recovery in disorders of consciousness.

Disorders of consciousness after severe brain injury encompass conditions of coma, vegetative state/unresponsive wakefulness syndrome, and minimally conscious state. DoC clinical presentation pose perplexing challenges to medical professionals, researchers, and families alike. The outcome is uncertain in the first weeks to months after a brain injury, with families and medical providers often making important decisions that require certainty. Prognostication for individuals with these conditions has been the subject of intense scientific investigation that continues to strive for valid prognostic indicators and algorithms for predicting recovery of consciousness. This manuscript aims to provide an overview of the current clinical landscape surrounding prognosis and optimizing recovery in DoC and the current and future research that could improve prognostic accuracy after severe brain injury. Improved understanding of these factors will aid healthcare professionals in providing optimal care, fostering hope, and advocating for ethical practices in the management of individuals with DoC.

Topological Hydrogels for Long-Term Brain Signal Monitoring, Neuromodulation, and Stroke Treatment.

Stroke is the primary cause of disability without effective rehabilitation methods. Emerging brain-machine interfaces offer promise for regulating brain neural circuits and promoting the recovery of brain function disorders. Implantable probes play key roles in brain-machine interfaces, which are subject to two irreconcilable tradeoffs between conductivity and modulus match/transparency. In this work, mechanically interlocked polyrotaxane is incorporated into topological hydrogels to solve the two tradeoffs at the molecular level through the pulley effect of polyrotaxane. The unique performance of the topological hydrogels enables them to acquire brain neural information and conduct neuromodulation. The probe is capable of continuously recording local field potentials for eight weeks. Optogenetic neuromodulation in the primary motor cortex to regulate brain neural circuits and control limb behavior is realized using the probe. Most importantly, optogenetic neuromodulation is conducted using the probe, which effectively reduces the infarct regions of the brain tissue and promotes locomotor function recovery. This work exhibits a significant scientific advancement in the design concept of neural probes for developing brain-machine interfaces and seeking brain disease therapies.

Insomnia and the incidence, recurrence and persistence of common mental disorders: Sex-differences in the general population

Insomnia is common throughout the population and thought to be a risk factor for mental disorders. We assessed the association of insomnia symptoms with incidence, recurrence and persistence of mood, anxiety and substance use disorders. In 4007 participants (55 % women, mean age 51.0 ± 12.3) of the population-based Netherlands Mental Health Survey and Incidence Study (NEMESIS), having insomnia symptoms increased the odds of developing, recurring and persisting mood disorders, mostly in men. Insomnia only associated with recurring anxiety disorders, particularly in women, and not with substance use disorders. Treating insomnia may aid recovery and prevention of mental disorders, particularly mood disorders.

In Utero Cell Treatment of Hemophilia A Mice via Human Amniotic Fluid Mesenchymal Stromal Cell Engraftment.

Hemophilia is a genetic disorder linked to the sex chromosomes, resulting in impaired blood clotting due to insufficient intrinsic coagulation factors. There are approximately one million individuals worldwide with hemophilia, with hemophilia A being the most prevalent form. The current treatment for hemophilia A involves the administration of clotting factor VIII (FVIII) through regular and costly injections, which only provide temporary relief and pose inconveniences to patients. In utero transplantation (IUT) is an innovative method for addressing genetic disorders, taking advantage of the underdeveloped immune system of the fetus. This allows mesenchymal stromal cells to play a role in fetal development and potentially correct genetic abnormalities. The objective of this study was to assess the potential recovery of coagulation disorders in FVIII knockout hemophilia A mice through the administration of human amniotic fluid mesenchymal stromal cells (hAFMSCs) via IUT at the D14.5 fetal stage. The findings revealed that the transplanted human cells exhibited fusion with the recipient liver, with a ratio of approximately one human cell per 10,000 mouse cells and produced human FVIII protein in the livers of IUT-treated mice. Hemophilia A pups born to IUT recipients demonstrated substantial improvement in their coagulation issues from birth throughout the growth period of up to 12 weeks of age. Moreover, FVIII activity reached its peak at 6 weeks of age, while the levels of FVIII inhibitors remained relatively low during the 12-week testing period in mice with hemophilia. In conclusion, the results indicated that prenatal intrahepatic therapy using hAFMSCs has the potential to improve clotting issues in FVIII knockout mice, suggesting it as a potential clinical treatment for individuals with hemophilia A.

Cognitive recovery in psychiatric disorders: transdiagnostic interdisciplinary intervention in a high intensity partial psychiatric in-patient unit

Aim: The present study aims to analyze the impact on cognitive recovery of an interdisciplinary treatment for acute and severe psychiatric patients. Methods: The present research is a naturalistic observational study of 130 adults (mean age of 47.68 years, 68% women). Clinical severity was assessed using Brief Psychiatry Rating Scale (BPRS), Montgomery-Asberg Depression Rating Scale (MADRS), and Hamilton Anxiety Rating Scale (HARS). Functional performance was evaluated using the Functioning Assessment Short Test (FAST), and cognitive impairment by applying the Montreal Cognitive Assessment (MoCA). Patients were clustered into four diagnostic groups (non-affective psychosis, bipolar, depressive, and personality disorders) and had individualized psychopharmacological treatment. They receive a transdiagnostic group program including several interventions that have shown evidence of beneficial effects over the different cognitive domains impaired in mental illness (attention, speed of processing, memory, working memory, reasoning, and problem-solving), as well as social cognition domains (emotion processing and social skills), in combination with psychoeducation and some strategies oriented to achieve healthy lifestyle routines (balanced diet, physical exercise, sleep hygiene, and smoking and alcohol cessation). Results: All clinical scales scores were improved after the end of treatment compared with those achieved at admission (BPRS, MADRS, and HARS scores below the cut-off point for establishing a case diagnosis). MoCA scores improved after the end of treatment concerning admission, both in the total score and in the differentiated cognitive domains, excluding orientation, which remained unchanged in the whole of the sample studied. No statistical significance was found in any comparisons between different diagnostic groups. No correlation between MoCA scores and BPRS, MADRS, or HARS scores at admission or discharge was found. Conclusions: These results show that the interdisciplinary therapeutic intervention can be effective for recovering cognitive impairment associated with mental disorders, irrespective of the diagnosis.

Behavioral Effects of Repetitive Transcranial Magnetic Stimulation in Disorders of Consciousness: A Systematic Review and Meta-Analysis.

Traumatic brain injury, cardiac arrest, intracerebral hemorrhage, and ischemic stroke may cause disorders of consciousness (DoC). Repetitive transcranial magnetic stimulation (rTMS) has been used to promote the recovery of disorders of consciousness (DoC) patients. In this meta-analysis, we examined whether rTMS can relieve DoC patient symptoms. We searched through journal articles indexed in PubMed, the Web of Science, Embase, Scopus, and the Cochrane Library until 20 April 2023. We assessed whether studies used rTMS as an intervention and reported the pre- and post-rTMS coma recovery scale-revised (CRS-R) scores. A total of 207 patients from seven trials were included. rTMS significantly improved the recovery degree of patients; the weighted mean difference (WMD) of the change in the CRS-R score was 1.89 (95% confidence interval (CI): 1.39-2.39; p < 0.00001) in comparison with controls. The subgroup analysis showed a significant improvement in CRS-R scores in rTMS over the dorsolateral prefrontal cortex (WMD = 2.24; 95% CI: 1.55-2.92; p < 0.00001; I2 = 31%) and the primary motor cortex (WMD = 1.63; 95% CI: 0.69-2.57; p = 0.0007; I2 = 14%). Twenty-hertz rTMS significantly improved CRS-R scores in patients with DoC (WMD = 1.61; 95% CI: 0.39-2.83; p = 0.010; I2 = 31%). Furthermore, CRS-R scores in rTMS over 20 sessions significantly improved (WMD = 1.75; 95% CI: 0.95-2.55; p < 0.0001; I2 = 12%). rTMS improved the symptoms of DoC patients; however, the available evidence remains limited and inadequate.

Selective interventional therapy and exercise therapy for non-specific low back pain

Introduction. Conservative treatment of non-specific low back pain (NSLBP) is not always effective. While the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants is currently a recognized criterion standard in the NSLBP treatment, the use of interventional therapy needs further clarification, and its use in combination with exercise therapy is not sufficiently covered. Aim. To evaluate the effectiveness of selective interventional therapy in combination with individual exercise therapy in patients with NSLBP. Materials and methods. A randomized controlled trial included 124 patients with NSLBP, aged 46.2±10.1 years, with a disease duration from 1 to 12 years. In the main group (n=102), selective interventional therapy with individual exercise therapy was used. The patients of the control group (n=22) were treated in accordance with the standard of medical care for NSLBP. The efficacy of treatment was evaluated using the developed quantitative assessment of biomechanical disorders of the spine. Results. The study showed that selective interventional therapy in combination with exercise therapy in patients with non-specific low back pain has an effect on various links in the pathogenesis of this disease. After the course of treatment, there was a significant decrease in biomechanical disorders (p&lt;0.001), as well as in the intensity of pain according to VAS both after treatment and during catamnestic examination (p&lt;0.001). Moreover, the highest rates were detected with discogenic pain syndrome, and the lowest rates - with spondyloarthrosis. Conclusion. Selective interventional therapy in combination with individual exercise therapy in patients with NSLBP contributes to the rapid recovery of biomechanical disorders in the spine and stable long-term remission.