Clinical Signs Research Articles

Clinical and radiological characteristics of odontogenic orbital cellulitis

PurposeTo assess the radiological features and clinical outcomes of odontogenic orbital cellulitis.MethodMulti-centre retrospective study of odontogenic orbital cellulitis. Primary outcomes assessed were causal organism(s), clinical signs, radiological findings, management and visual outcomes.ResultsFour patients with odontogenic orbital cellulitis were identified for inclusion. There was an equal proportion of men and women with a mean age of 43 years (range 25–56 years). All patients presented with an orbital compartment syndrome, with visual acuity of counting fingers (n = 1, 25%), hand movements (n = 1, 25%) and no perception of light (n = 2, 50%). The organisms implicated were Streptococcus milleri (n = 3, 75%) and Streptococcus constellatus (n = 1, 25%). MRI findings showed a subperiosteal abscess was present in all cases, which was characterised radiologically as a T1-hyperintense, T2 minimally hyperintense collection with restricted diffusion and a low apparent diffusion coefficient signal. Final visual acuity ranged from 6/6 to no light perception. One patient required an orbital exenteration due to extensive necrosis with sepsis and systemic deterioration.ConclusionsOdontogenic orbital cellulitis carries a serious risk of vision loss with a propensity to present with an orbital compartment syndrome secondary to Streptococcus species. Outcomes were highly variable, with two cases progressing to blindness of which one required an orbital exenteration.

Peracute Enterotoxemia in Saanen and Alpine Goat Herd

Background: Enterotoxemia" or "overeating disease" is considered a common and often fatal disease affecting the economy of small ruminant breeding systems. This study presents findings on the occurrence of a peracute form of enterotoxemia in a herd of Saanen and Alpine, including an examination of the clinical signs, post-mortem findings, and methods for diagnosis. examination of the clinical signs, post-mortem findings, and methods for diagnosis. Methods: In a herd of goats a distressing situation occurred where the goats displayed signs (Sudden death and high fever) of peracute enterotoxemia (125 kids). It is noteworthy that these goats had previously been vaccinated against enterotoxemia. The onset of the condition seemed to be linked to three instances of interruption and reconnection of concentrate feed. To obtain a definitive diagnosis, the findings from postmortem examinations and ELISA were utilized. Results: In total, 60 Alpine and 65 Saanen succumbed to this peracute form. These losses occurred over three days but were successfully stopped by re-vaccination after two days. Clinical signs, postmortem observations, bacterial analysis, and ELISA results all provided confirmation of enterotoxemia. Notable findings included high fever (90%), duodenum hyperemia (89%), pulmonary edema (82%), convulsions (43%), and hemorrhage in the pericardium and endocardium (58%). Conclusion: Frequent and consecutive changes in goats' diet or discontinuation of concentrate supply by breeders can disrupt the vaccine-induced immune barrier, increasing the likelihood of enterotoxemia, and leading to casualties and economic losses. Consistent and stable nutrition practices are essential for maintaining vaccination efficacy and preventing enterotoxemia in goats, particularly kids.

Investigation into the Effects of Allergen Exposure and Topical Vinegar and Water Spray on Skin Barrier Parameters in Atopic Dogs

Increased skin pH and transepidermal water loss (TEWL) are documented in atopic people and dogs but no study has investigated how these parameters change during an allergy flare. Our primary aim was to challenge atopic beagles to dust mites and measure pH and TEWL during a flare of atopic dermatitis and correlate these parameters to clinical signs. A secondary aim was to evaluate in a randomized placebo-controlled study whether the daily application of 50/50 vinegar spray improves clinical signs and affects skin parameters despite the allergen challenge. Fifteen atopic dogs were challenged epicutaneously twice weekly for 2 weeks with allergen application on the inguinal and medial thigh areas. The severity of dermatitis was scored daily (CADESI-03). TEWL and pH were measured daily on the inguinal and medial thigh areas. A repeated measures ANOVA showed the significant effect of time, with increased pH (p < 0.0001), TEWL (p < 0.0001), and CADESI (p < 0.0001) during allergen challenge. Significant positive correlations were found between CADESI and pH (r = 0.3556; p < 0.0001), CADESI and TEWL (r = 0.36; p < 0.0001), and pH and TEWL (r = 0.45; p < 0.0001). Daily application of 50/50 vinegar did not improve dermatitis, pH, and TEWL compared to the control treatment. It can be concluded that both pH and TEWL are markers of disease severity in canine atopic dermatitis.

Hot topic: Epidemiological and clinical aspects of highly pathogenic avian influenza H5N1 in dairy cattle

On March 24, 2024, the US Department of Agriculture (USDA) confirmed the first case of highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b in dairy cattle. Following this initial detection, the virus was found to have spread to other species, including humans. Since then, at least 192 dairy herds across 13 states have tested positive for the virus. The emergence of HPAI H5N1 in dairy cattle poses a serious threat to the dairy industry, requiring an approach that integrates human, animal, and environmental health. Enhancing biosecurity, improving surveillance, and advancing research are critical to managing this challenge. Swift adaptation is needed to protect both public health and dairy production. Through this work, we discuss the epidemiological and clinical aspects of HPAI H5N1 in cattle by reviewing the spatiotemporal situation of the disease across the United States, the clinical signs and testing leading to a confirmed case, and the surveillance and control measures implemented at the national and state levels. Further, considering pathogenesis and risk factors, we discuss surveillance and control measures to implement within herds, and note areas where research is needed to understand how to control this emerging disease.

Social perceptions of childhood diarrhea in Lubumbashi, Democratic Republic of the Congo: A qualitative study

Introduction: Infantile diarrhea remains a public health problem in the Democratic Republic of the Congo, where infant mortality linked to this disease remains high despite the proven efficacy of oral rehydration therapy. This study aims to understand the social perceptions of childhood diarrhea among mothers in Lubumbashi, by examining how they diagnose and treat the disease through both popular and biomedical representations.Material and methods: The study was conducted in Lubumbashi, the capital of Haut-Katanga in the DRC, utilizing a qualitative methodology that involved semi-structured interviews with 32 randomly chosen mothers. Selection criteria encompassed the number of children, educational level, religion, and age range (18 to 60). Information was gathered through documents and interviews conducted in Swahili, subsequently translated into French, and analyzed utilizing Jean-Blaise Grize’s ‘natural logic’ to grasp social representations.Results: The study revealed that the majority of mothers associated diarrhea with physical signs such as dehydration, watery stools, depressed fontanel, and sunken eyes. Several mothers attributed the diarrhea to cultural causes, such as the consumption of certain foods by pregnant women (e.g. “kabambale”) or the practice of breastfeeding by pregnant mothers. Local diseases such as “lukunga” and “kilonda ntumbo” are considered to be specific forms of diarrhea in popular culture. Treatments include traditional remedies such as ash applications and sitz baths.Conclusion: Perceptions of childhood diarrhea in Lubumbashi reflect a tension between cultural beliefs and biomedical knowledge, where rehydration is often neglected. The study recommends raising community awareness of the effectiveness of ORT while respecting local beliefs.

Evidence of altered Redox Homeostasis in Trichothiodystrophy

Trichothiodystrophy (TTD) is a rare hereditary disease whose prominent feature is brittle hair. Additional clinical signs are physical and neurodevelopmental abnormalities and in about half of the cases hypersensitivity to UV radiation. Although the mutations involved in this condition have been characterized, the correlation between the molecular defects and the plethora of clinical symptoms is not well understood. Recently the presence of a redox unbalance in TTD has been suggested although not clear evidences have been reported on this aspect. Therefore, in the present study, we evaluated the redox status of fibroblasts isolated from a TTD patient. In addition, to understand the ability of TTD cells to respond to oxidative insults, the cells were challenged with H2O2 and mitochondrial O2- and mitochondrial membrane potential were measured in different oxidative conditions. In addition, NRF2/BACH protein levels were also analysed in response to H2O2. The results suggested an aberrant mitochondrial response to oxidative stimuli, an increased baseline oxidative stress status in TTD and an altered NRF2/BACH level. This study emphasises that altered redox homeostasis might play a role in TTD pathogenesis and mitochondria functionality could represent an alternative therapeutic target for this condition to improve patients clinical features.

Role of Embolic Protection in Percutaneous Coronary Intervention without Saphenous Venous graft lesions in ST-elevation myocardial infarction - a systematic review and meta-analysis.

Embolic protection devices are catheter-based devices that can be used to capture atherosclerotic remnants released during percutaneous coronary intervention (PCI). We aim to study the efficacy and safety of EPDs in PCIs without saphenous vein grafts (SVG) in ST-elevation myocardial infarction(STEMI). 3 electronic databases of MEDLINE, Web of Science, and Embase were searched from inception to Apr 10, 2024, to identify relevant randomized controlled trials (RCTs) that compared outcomes of patients subjected to EPD during PCI with control group where EPDs were not utilized. The primary outcome was 30-day all-cause mortality. Secondary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE) at 30 days, post-PCI Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow attainment, ST-segment resolution at 90 minutes post-procedure and post-procedure angiographically detectable signs of distal embolization. The effect estimates of outcomes were assessed using risk ratio (RR) with a 95% confidence interval (CI). Random-effects meta-analysis was conducted using the restricted maximum likelihood method given the inter-study variance was inevitable. We included 3 RCTs enrolling 741 patients (age 61.6 ± 12.15 years, 22% females) undergoing PCI without SVG lesions. As opposed to the control group, the use of EPD did not yield a significant effect on all-cause mortality (RR, 0.76; 95% CI, 0.31-1.86; I2 = 0%), MACCE (RR, 0.66; 95% CI, 0.34-1.27; I2 = 0%), post-PCI TIMI 3 flow (RR, 1.18; 95% CI, 0.86-1.62; I2 = 77%) and ST segment resolution at 90 minutes post-procedure (RR, 1.05; 95% CI, 0.90-1.22; I2 = 0%). However, EPD significantly decreased angiographically detectable signs of distal embolization (RR, 0.60; 95% CI, 0.36 to 0.99; I2 = 0%). EPD significantly reduced angiographically detectable signs of distal embolization in PCI without SVG lesions in STEMI, though there were no clinical signs of improved flow or mortality. Further trials are necessary to thoroughly evaluate the potential benefits and requirements of EPD usage in such procedures.

A case of invasive aspergillus niger spondylodiscitis with epidural abscess following COVID-19 infection in an immunocompromised host with literature review

Introduction and importance: Aspergillosis is defined as an opportunistic infection which may spread hematogenously. COVID-19 infection has not been reported as a direct cause or risk factor. Its treatment (e.g., corticosteroids) significantly increases the risk for invasive infections. Respiratory system remains the main target and the Aspergillus fumigatus is the most responsible subtype. Other species like Aspergillus (A) flavus, A. niger and A. nidulans follow in frequency. Other included sites are the skeletal muscular system and the entire spine leading to spondylodiscitis. Only a total of 118 cases of Aspergillus spondylodiscitis have been reported in the literature and only 21 cases reporting spinal epidural abscess were identified. Case presentation: The authors report a new rare case of invasive A. Niger spondylodiscitis with epidural and iliopsoas abscesses in a 63-year-old North African female patient with history of coronavirus infection (COVID-19) treated with high doses of corticosteroids. The patient had favorable medical and radiological outcomes after 6 months of antibiotic and antifungal therapy. Clinical Discussion: Fungal spondylodiscitis is a rare pathology that may be lethal. Immunosuppression plays a determining role. Discovertebral contamination results from hematogenous dissemination, found in the majority of cases in adults. The main symptom is segmental spinal pain with inflammatory pattern most often predominating in the thoracolumbar spine. Clinical signs of spinal cord compression such as paresthesias, radiculalgia, paraplegia can sometimes be associated. Diagnosis of such spondylodiscitis is based on cultures and/or histology, whereas in most cases it was made by MRI. Epidural abscess remains a rare entity. The authors will explore the current literature in more detail to dissect and explain this rare entity. Conclusion: Aspergillus spondylodiscitis remains a rare and very demanding clinical entity. Early diagnosis and well-targeted medical treatment seem the ideal solution given that this type of infection has a poor prognosis.

CARD8 polymorphisms among bacterial meningitis patients in North-West Ethiopia

BackgroundThe severity of infectious disease outcomes is dependent on the virulence factors of the pathogen and the host immune response. CARD8 is a major regulator of the innate immune proinflammatory response and has been suggested to modulate the host response to common inflammatory diseases. In the present study, the C10X genetic polymorphism in the CARD8 gene was investigated in relation to bacterial meningitis.MethodsA total of 400 clinically suspected meningitis patients hospitalized at the University of Gondar Hospital were enrolled in the study. Cerebrospinal fluid (CSF) and blood samples were collected for laboratory investigations. The collected CSF was cultured, and all the results obtained from the culture were confirmed using direct RT‒PCR. Genotyping of whole-blood samples was performed using a TaqMan assay. The results were compared with apparently healthy controls and with PCR-negative meningitis suspected patients.ResultsOf the included patients, 57% were men and the most common clinical signs and symptoms were fever (81%), headache (80%), neck stiffness (76%), nausea (68%), and vomiting (67%). Microbiology culture identified 7 patients with bacterial meningitis caused by Neisseria meningitidis (n = 4) and Streptococcus pneumoniae (n = 3). The RT-PCR revealed 39 positive samples for N. meningitidis (n = 10) and S. pneumoniae (n = 29). A total of 332 whole-blood samples were genotyped with the following results: 151 (45.5%) C10X heterozygotes, 59 (17.7%) C10X homozygotes and 122 (36.7%) wild genotypes. The polymorphic gene carriers among laboratory confirmed, clinically diagnosed meningitis and healthy controls were 23(46%), 246(40%), and 1526(39%), respectively with OR = 1.27 (0.7–2.3) and OR = 1.34 (0.76–2.4). The presence of the C10X polymorphism in the CARD8 gene was more prevalent in suspected meningitis patients than in healthy controls (OR 1.2; 1.00-1.5). Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease. The presence of viable or active bacterial infection was found to be associated with the presence of heterozygous C10X carriers.ConclusionsA greater proportion of C10X in the CARD8 gene in confirmed bacterial meningitis patients and clinically diagnosed meningitis patients than in healthy controls. Homozygote C10X polymorphic gene carriers were more susceptible to infectious disease than heterozygote gene carriers and healthy controls.

Dedicator of cytokinesis 8 (DOCK8) mutation impairs the differentiation of helper T cells by regulating the glycolytic pathway of CD4+ T cells.

Dedicator of cytokinesis 8 (DOCK8) deficiency is a primary immunodeficiency disease caused by mutations in exon 45 of the DOCK8 gene. The clinical signs primarily consist of increased serum IgE levels, eczema, repeated skin infections, allergies, and upper respiratory tract infections. Using CRISPR/Cas9 technology, we generated a DOCK8 exon 45 mutation in mice, mirroring the mutation found in patients. The results indicated that DOCK8 mutation impairs peripheral T cell homeostasis, disrupts regulatory T cells (Tregs) development, increases ICOS expression in Tregs within peripheral lymph nodes (pLn), and promotes Th17 cell differentiation within the spleen and pLn. Upon virus infection, DOCK8 mutation CD4+ T cells have a Th2 effector fate. RNA-bulk sequencing data revealed alternations in the mTOR pathway of DOCK8 mutant CD4+ T cells. We observed that DOCK8 mutation upregulates the glycolysis levels in CD4+ T cells, which is related to the Akt/mTOR/S6/HIF-1α pathway. In summary, our research elucidates that DOCK8 regulates the differentiation of helper T cells by modulating the glycolytic pathway in CD4+ T cells, thereby advancing the comprehension and offering potential treatment of diseases in DOCK8-deficient patients.

Dictyocaulosis in cattle: Retrospective analysis of 20 outbreaks in Central Argentina

Bovine lungworms (Dictyocaulus viviparus) are nematodes which cause a respiratory disease known as verminous bronchitis or pneumonia. In this paper, we describe 20 outbreaks of bovine dictyocaulosis recorded between 2000 and 2023 in Central Argentina. Outbreaks occurred more frequently during the autumn-winter season (from April to August) and affected cattle under 1 year old in beef production systems. An average morbidity and mortality of 26.22 % and 8.44 % were registered, respectively. The main clinical signs observed were respiratory distress (coughing, tachypnea, dyspnea, and nasal discharge), weight loss, weakness, decubitus, and diarrhea. Necropsies were performed in thirty-one calves, heifers, and steers. Gross findings included diffuse interstitial or multifocal pneumonia, with marbled appearance intermingling atelectasis and red-gray firm areas of consolidation, and subpleural and interlobular emphysema and edema. Microscopically, lungs were characterized by abundant edema and mixed intra-alveolar multifocal to coalescent infiltrate. Frequently, adult worms and/or larvae were spotted in the bronchi or alveoli, respectively. Some cases exhibited proliferation of type 2 pneumocytes and hyaline membranes covering the alveolar septa. Co-infections with gastrointestinal nematodes were frequently found in fecal samples. Given the perspective of anthelmintic resistance and future changes in environmental conditions due to climate change, integrated parasitic control strategies are mandatory and should be tailored to each production system. The information gathered in this research provides an overview of lungworm infections in livestock production systems from Central Argentina and could be useful for surveilling, monitoring and designing strategic interventions for the control of this important parasitic disease in the region.

Fumaric acid per se and in combination with methotrexate arrests inflammation via moderating inflammatory and oxidative stress biomarkers in arthritic rats

Objective: Fumaric acid is a dicarboxylic acid that belongs to the phenolic class enriched in fruits and vegetables that are traditionally used for the treatment of various ailments. The research was planned to find out the anti-inflammatory and anti-arthritic activities of fumaric acid using in-vitro and in-vivo assays. Moreover, safety study was also done. Materials and methods: The 0.1 ml complete Freund’s adjuvant was injected in left hind paw in all Wistar rats except normal rats at day 1 to induced arthritis. The treatment with fumaric acid at 10, 20, 40, and fumaric acid 40 mg/kg together with methotrexate (MTX) was administered to immunized rats at 8th day via oral gavage and continued till 28th day though, MTX was administered as standard control. Results: The fumaric acid notably (p < 0.0001) lessened the paw edema and arthritic scoring, reinstated body and immune organ weight, and oxidation status in treated rats. Fumaric acid notably restored altered C-reactive protein, rheumatoid factor, liver function tests, ESR, WBCs, RBCs and Hb levels in treated rats. The fumaric acid in combination noticeably (p < 0.01–0.0001) suppressed the expression of TNF- α, IL-6, IL-1β, NF-kβ, and COX-2, and over expressed IL-4, and IL-10 in contrast to other treated groups. Fumaric acid had presented a dose-dependent antioxidant, anti-inflammatory and anti-arthritic activities while notable activity exhibited by fumaric acid in combination with MTX. The fumaric acid exhibited non-significant clinical signs of toxicity and mortality in acute toxicity study. The LD50 was more than 2000 mg/kg. Conclusion: Fumaric acid in combination can be used as disease-modifying anti-rheumatic drug but it will need extensive pre-clinical and clinical studies.

Demographic and Clinical Features of Visceral Leishmaniasis in Chad: A Prospective Cross-Sectional Survey.

Visceral leishmaniasis (VL), caused by the protozoan Leishmania donovani complex, is endemic in many parts of the world. Little known in Chad, VL has been recently documented from previously nonendemic areas. We report an epidemiological investigation of VL in the Léré district hospital in southwestern Chad. After informed consent, 40 VL patients were enrolled in the study. Diagnosis made using the formalin serological test was confirmed by polymerase chain reaction on blood samples. Clinical parameters were obtained from the physician or nurse caregiver, and from patients. Of a total of 40 serology positive patients, L. donovani DNA was found in 33 (82.5%), with 55% being male patients. The most affected age groups were 15-29 (47.5%) and 0-14 (32.5%) years. Fever, weight loss, and pallor were frequent symptoms. Notably, splenomegaly and hepatomegaly were uncommon clinical signs. Common comorbidities included malaria (25%) and hepatitis B (15%), followed by gastric ulcer (10%) and tuberculosis (7.5%). These comorbidities were concurrent with VL and were diagnosed microscopically in blood and serum for malaria and tuberculosis, respectively, and by the rapid diagnostic test using serum for hepatitis B and gastric ulcer. Thirty-five percent of cases were treated with meglumine antimoniate, and three patients (7.5%), all with comorbidities, died. Sixty percent of patients lived close to the main town. Our data demonstrate that VL is endemic in the health district of Léré. Improving health education regarding L. donovani infection in endemic areas of Chad and providing training of health workers on early detection and management of VL are needed to help save lives.

Risk Factors for COVID-19 Mortality in Epidemic Treatment Centers: A Case-Control Study from Decentralized Regions of Senegal

Introduction: The COVID-19 pandemic is an emerging viral zoonosis caused by SARS-CoV2. It is responsible for a systemic infection in humans, primarily respiratory. In Senegal, the Thiès Region confirmed its first case on March 14, 2020. The second epidemic wave occurring in 2021 was marked by high fatality, justifying our study on the factors associated with deaths among COVID-19 patients hospitalized at the Epidemic Treatment Centers (CTE) of the Regional Health Directorate of Thiès (Senegal). Patients and Methods: Unmatched case-control study, 1 case to 2 controls, relating to COVID-19 deaths recorded in the Thiès Regional Health Directorate from January 1 to December 31, 2021. All patients who tested positive for COVID-19 (PCR/Antigenic test) hospitalized in CTEs were included. All confirmed COVID-19 patients who died were referred to as “cases,” and all recovered patients as “controls.” The sampling of deaths was exhaustive, standardized sociodemographic, clinical, therapeutic and evolutionary data collected from patient files after a pilot trial with quality control. The data was entered on kobo collect and analyzed on Epi info7. Quantitative variables (mean, standard deviation) and qualitative variables (proportions. Measures: odds ratio, chi2 or Fisher exact test, significance threshold set at p&lt;0.05) were used. Results: A total of 348 patients were recruited in this study including 116 deaths and 232 recovered, the average age was 68.9 years +/- 14.24 for the deceased patients compared to 61.5 +/- 14.24 for the recovered, with male predominance in both groups. The most common clinical signs (cases/controls) were dyspnea (98.3/84.49%), fever (71.5/68.1%), asthenia (57.8/65.4%). and cough (52.6/58.1%). Complications were dominated by acute respiratory distress (87.9/3.8%), (11.2%/0.4%) and pulmonary embolism (03.5/0%). The factors associated with deaths found after multivariate analysis by logistic regression were male sex (OR: 4.11, 95% CI : 1.45 – 11.61 and p = 0.0076), patients aged over 60 years (OR=1.77, 95% CI: 1.0018-3.1438, p=0.049), complications such as stroke (OR=31.00; 95% CI: 5.69-168.73 and p=0 .0001), shock (OR22.61; 95% CI: 1.44-353.67 and p=0.026) and acute respiratory distress syndrome (OR: 204.09 95% CI : 70.44-591.30 and p = 0.000). Conclusion: The factors associated with COVID-19 deaths in the CTEs of Thiès Region are age, male gender, the presence of complications; stroke in particular, the state of Shock and ARDS.

Evaluation of the clinical features of an outpatient cohort with Marfan syndrome

Marfan syndrome is a connective tissue disease with autosomal dominant inheritance and variable clinical presentation. The main clinical manifestations recognition could contribute to early diagnosis and cardiovascular complication prevention. We aimed to evaluate the clinical profile of a Marfan syndrome outpatient cohort. MethodsRetrospective cross-sectional study was carried out with outpatients over 12 years of age whose electronic medical records contained the clinical information and complementary exams necessary for study inclusion. Data were analyzed using descriptive statistics and comparisons were performed using student's t-test and chi-square or Fisher's exact test. P-values<0.05 were considered statistically significant. Results75 patients (29.5 ± 13.4 years) were included and 43(57 %) were female. Positive family history for the syndrome was observed in 55(73 %) patients and ectopia lentis in 37(49 %). Positive systemic score (≥7) was identified in 60(80 %) individuals and the most frequent score components were: skin striae in 64(85 %), scoliosis in 59(79 %), wrist and thumb sign in 45(60 %), moderate or severe myopia in 43(57 %) and plain flat foot in 40(53 %). Cardiovascular symptoms occurred in 17(23 %) patients: dyspnea in 10(13 %) and palpitations in 6(8 %). Mitral valve prolapse was observed in 32(43 %) participants and aortic root dilation (z-score ≥ 2) in 53(71 %), without significant difference between the groups with or without these alterations concerning sex, age, or symptom presence. ConclusionClinical profile of a Marfan syndrome outpatient cohort includes adolescents and young adults, most without cardiovascular symptoms and with a high incidence of skeletal, ophthalmological, and cardiovascular involvement. Recognizing these clinical signs could contribute to early disease diagnosis in the general population.

A convolutional neural network model detecting lasting behavioral changes in mice with kanamycin-induced unilateral inner ear dysfunction

In acute aminoglycoside ototoxicity of the unilateral inner ear, physical abnormalities, such as nystagmus and postural alteration, are relieved within a few days by neural compensation. To examine exploratory behavior over an extended period, behaviors of freely moving mice after unilateral kanamycin injection into the inner ear were recorded in a home cage environment. The tail was excluded from deep learning-mediated object detection because of its delayed movement relative to the body. All detection results were confirmed using a convolutional neural network classification model. In kanamycin-injected mice, the total distance moved in 15 min increased on postoperative day 3. Furthermore, injured mice turned more frequently toward the healthy side up to 17 days after the surgery. This tendency resulted in increased clockwise movements in home cage recordings. Moreover, tail suspension and twisting toward the healthy side induced a physical sign for up to 14 days after the injury; the mice rapidly rotated with dorsal bending. Our analysis strategy employing deep learning helps to evaluate neuronal compensatory processes for an extended period and is useful for assessing the efficacy of therapeutic interventions.

Female hyperandrogenism

Hyperandrogenism in women is a clinical syndrome resulting from an excess of circulating androgens in the blood. They can be produced either in the ovary or the adrenal gland. The clinical manifestations are highly variable. Patients present characteristic physical signs (alopecia, hirsutism, acne) as well as menstrual cycle irregularities. The most common cause of hyperandrogenism in women of childbearing age is polycystic ovary syndrome. There are specific criteria to establish a clear diagnosis of this syndrome. Nevertheless, in the presence of hyperandrogenism, a differential diagnosis must be made among other possible causes, such as congenital adrenal hyperplasia, use of drugs (anabolic agents), or the presence of androgen-secreting tumors. The specific treatment of this disease is usually chronic and aimed at controlling secondary symptoms of the disease, attempting to improve patients’ quality of life.

AI-Driven Realtime Monitoring of Early Indicators for Ichthyophthirius multifiliis Infection of Rainbow Trout.

A novel video-based real-time system based on AI (artificial intelligence) was developed to detect clinical signs in fish exposed to pathogens. We selected a White Spot Disease model involving rainbow trout as the experimental animal and the parasitic ciliate Ichthyophthirius multifiliis as a pathogen. We compared two identical fish tank systems: one tank was infected by co-habitation, whereas the other tank was kept non-infected (sham infection). The two fish tanks were separately video monitored (full top and side view) during the course of infection, during which fish were removed whenever they developed clinical signs (direct visual inspection by the observer). Image analysis (object detection, classification and tracking) was used to track behavioural changes in fish (in every recorded video frame), focusing on movement patterns and spatial localisation. Initially, the two fish groups (infected and non-infected) exhibited similar behaviour and non-infected fish did not change behaviour during the 15 d observation period (from 5 d before infection until 10 dpi). At 4, 7, 8, 9 and 10 dpi some infected fish showed clinical signs (equilibrium disturbance, gasping and lethargy) and were removed from the experiment. Anorexia occurred from 5 dpi and a gradual progression of gasping behaviour was noted, whereas the frequency of fish flashing (rubbing/scratching against objects) was low. Equilibrium disturbances and the development of white spots in the skin appeared to be a much later (8-10 dpi at this temperature) indicator of infection. The video analysis showed a general distribution of non-infected fish in all parts of the fish tank during the entire experiment, whereas infected fish already at 4-5 dpi moved towards higher water currents in the top and bottom positions. This change of fish positioning within the tank appeared as a promising early indicator of infection. The study suggests that continuous monitoring of fish behaviour using AI can potentially optimise the timing of humane endpoints, indicate disease signs earlier and thereby improve animal welfare in both animal experimentation and in aquaculture settings.

Evaluating the Femoral Atherosclerotic Plaque in Psoriasis Patients and Controls: A Case-Control Study

Background Psoriasis is a chronic inflammatory disease that can affect the skin or the cardiovascular system. The presence of femoral atherosclerotic plaque could be a promising sign in predicting cardiovascular risk for these patients. Objective The study aims to evaluate the prevalence of femoral atherosclerotic plaque between psoriasis and control individuals. Methods This case-control study involved 40 patients diagnosed with vulgaris psoriasis and 40 non-psoriasis individuals matched by age group and gender. We used clinical signs and symptoms to diagnose psoriasis and evaluated the disease’s severity using the Psoriasis Area and Severity Index (PASI). The atherosclerotic plaque on the femoral artery was detected using Doppler ultrasound to measure the femoral artery intima-media thickness (fIMT). Data were analyzed by SPSS 25. Results Male patients accounted for the proportion of 72.5%. In the psoriatic group, the mean value of PASI was 12.91 ± 6.73 (points). The proportion of femoral atherosclerotic plaque was significantly higher in the psoriasis compared to the controls (32.5% vs 10%; P = 0.014). Some factors associated with the femoral atherosclerotic plaque include age, smoking, and hypertension ( P &lt; 0.05). Hypertension was an independent risk factor for femoral atherosclerotic after regression analysis. Conclusion Femoral atherosclerotic plaque is higher in psoriasis patients. This result emphasizes the need to screen for cardiovascular comorbidities in these patients.

Relationship between Lipid and Blood Glucose Levels with Stroke Risk in Dupak Surabaya

Background: Stroke is a syndrome characterized by rapidly developing symptoms and/or clinical signs in the form of focal or global brain functional disorders lasting more than 24 hours which are not caused by causes other than vascular. Stroke is the number one cause of disability and the main cause of death in Indonesia (19.42% of total deaths). Dyslipidemia and diabetes mellitus are two-fold risk factors for stroke.This research is to determine the relationship between lipids and blood glucose and a high risk of stroke. Methods: This research uses descriptive analytical methods with a cross sectional approach. The population is residents in Dupak Surabaya. The sampling method is random sampling technique. The total research sample was 53 participants. The statistical test used is Chi Square. Result: Statistical results show that there is no relationship between high cholesterol levels and the risk of stroke and there is a relationship between high triglyceride and blood sugar levels and the risk of stroke.Conclusion:This research concluded that there was a significant relationship between high levels of triglycerides and blood glucose and the risk of stroke and there was no significant relationship between high cholesterol levels and the risk of stroke. This lack of significant association could be due to the heterogeneous population and the presence of previous anti-cholesterol medication.