Significant Pathology Research Articles

Ultrasound signs of fetal chromosomal abnormalities at 11–14 weeks of pregnancy and its value in the era of modern genetic testing

A steady increase in average maternity age at the time of first childbirth lead to a higher risk of fetal chromosomal abnormalities. The Order No. 1130n of the Ministry of Health of the Russian Federation establish the screening protocol at 11–14 weeks of gestation with assessing the followed criteria of fetal chromosomal pathology: the nuchal translucency thickness, nasal bone measurement, ductus venosus pulsatility index, tricuspid regurgitation, and heart rate. The value of non-invasive prenatal testing (NIPT) in the early prenatal diagnosis of the most common chromosomal abnormalities, as the trisomies 21, 18, 13, and monosomy X is also increasing. Additionally, numerous other fetal karyotype abnormalities can also be suspected at 11–14 weeks of gestation by revealing a number of other ultrasound signs. The article presents the literature review on additional ultrasound signs of various, both more and less common, chromosomal abnormalities. Pathological signs, abnormalities of fetal anatomy and extrafetal structures in the first trimester, which could be used as additional ultrasound signs of chromosomal pathology of various organs and systems (central nervous system and head, heart and blood vessels, urinary system, abdominal organs, fetal skeleton, as well as the placenta, umbilical cord, amniotic membranes) are described in the article. Despite the use of NIPT, including its extended panels, there remains a need to use ultrasound to detect the signs of rarer, but no less significant chromosomal pathologies, such as triploidies, mosaic trisomies, rare autosomal trisomies, duplications, and deletions.

The relationship between renal and retinal parameters in uncomplicated hypertension in middle-aged people

Background. Controlled arterial hypertension (HTN) does not mean complete regression of preclinical target organ damage. Objective. To study the relationship between indicators characterizing the structural and functional state of the kidneys and retina in middle-aged patients with uncomplicated HTN, receiving combination antihypertensive therapy (AHT) and having office systolic (SBP) and diastolic (DBP) blood pressure levels < 140 and < 90 mmHg. Design and methods. We examined 87 patients (65 males and 22 females, average age 50,5 ± 4,87 years) with stage I and II HTN without clinically significant concomitant pathology taking double combined AHT (group average office level of SBP and DBP 134 ± 12,3 and 84 ± 14,5 mmHg, respectively). For at least the previous 12 months, patients had regularly received voluntary dual combination AHT based on pharmacological blockade of the renin-angiotensin-aldosterone system. HTN patients underwent a comprehensive assessment of the structural and functional state of the kidneys and fundus of the eye. To assess the relationships between biomarkers of kidney and retinal damage in the examined individuals within the entire set of studied parameters, correlation analysis and comparative analysis of the same quantitative (renal or retinal) indicators were used in subgroups of individuals divided according to a conditionally selected qualitative characteristic corresponding to the norm or deviation from the norm (value central retinal arterial equivalent (CRAE ≥ or < 145 μm), central retinal venous equivalent (CRVE ≥ or < 227 μm), albumin-creatinine ratio (ACR ≥ or < 10 mg/g), foveal avascular zone area (FAZ ≥ or < 0,36 mm²). Statistical processing of data was carried out using the Basic Statistics / Tables modules of the application package Statistica for Windows (version 12). The relationship between quantitative renal and retinal indicators was studied using the Pearson r correlation coefficient. Comparative analysis of quantitative parameters within the examined group, conditionally subdivided according to a certain qualitative criterion, was performed using the nonparametric Mann-Whitney U-test. Results. CRVE values directly correlated with ACR (r = 0,30; p = 0,037), FAZ area — with ACR (r = 0,40; p = 0,005), subfoveal choroidal thickness (SCT) — with estimated glomerular filtration rate (eGFR) (r = 0,45; p = 0,001); CRAE values inversely correlated with serum urea (r = –0,34; p = 0,019), SCT — with serum creatinine (r = –0,36; p = 0,011). Patients with ACR ≥ 10 mg/g compared with patients with ACR < 10 mg/g were characterized by significantly lower values of the retinal arteriovenous ratio (0,646 ± 0,09 and 0,689 ± 0,08, respectively, p = 0,016). Patients with FAZ area ≥ 0,36 mm² compared with those with FAZ area < 0,36 mm² had higher proteinuria values (0,101 ± 0,13 and 0,075 ± 0,14 mg/g, respectively, p = 0,01). Conclusions. Middle-aged patients with uncomplicated HTN without clinically significant concomitant pathology, receiving double combined AHT, demonstrate significant associations of indicators characterizing the structural and functional state of the kidneys and retinal microcirculation in terms of their preclinical damage.

Phage Display's Prospects for Early Diagnosis of Prostate Cancer.

Prostate cancer (PC) is the second most diagnosed cancer among men. It was observed that early diagnosis of disease is highly beneficial for the survival of cancer patients. Therefore, the extension and increasing quality of life of PC patients can be achieved by broadening the cancer screening programs that are aimed at the identification of cancer manifestation in patients at earlier stages, before they demonstrate well-understood signs of the disease. Therefore, there is an urgent need for standard, sensitive, robust, and commonly available screening and diagnosis tools for the identification of early signs of cancer pathologies. In this respect, the "Holy Grail" of cancer researchers and bioengineers for decades has been molecular sensing probes that would allow for the diagnosis, prognosis, and monitoring of cancer diseases via their interaction with cell-secreted and cell-associated PC biomarkers, e.g., PSA and PSMA, respectively. At present, most PSA tests are performed at centralized laboratories using high-throughput total PSA immune analyzers, which are suitable for dedicated laboratories and are not readily available for broad health screenings. Therefore, the current trend in the detection of PC is the development of portable biosensors for mobile laboratories and individual use. Phage display, since its conception by George Smith in 1985, has emerged as a premier tool in molecular biology with widespread application. This review describes the role of the molecular evolution and phage display paradigm in revolutionizing the methods for the early diagnosis and monitoring of PC.

A case of polymelia in the Black-headed Gull Chroicocephalus ridibundus

Polymelia is a malformation consisting of the presence of supernumerary limbs. Although relatively common in farm animals and anurans, it is quite rare in wild vertebrates and, especially, birds. I describe here the case of a Black-headed Gull Chroicocephalus ridibundus seen in Barcelona (Catalonia, NE Spain) in January and February 2023 that had an atrophic leg originating from the distal posteromedial part of its right tibiotarsus. It was a healthy-looking bird, apparently in its second winter, and showed normal behaviour with no visible signs of any other pathology or malfunction. We are only aware of one previous case of polymelia in gulls and this is the first time it has been reported in a Black-headed Gull. It is also good example of survival in a bird affected by polymelia.

Synthesis and Characterization of Short α and β-Mixed Peptides with Excellent Anti-Lipase Activities.

Obesity is a source of significant pathologies and deadly diseases, including heart disease, diabetes, and cancer. One of the most intriguing strategies in the hunt for new anti-obesity medications is the inhibition of pancreatic lipase (PL). This study presents a novel application of short α and β-mixed peptides as pancreatic lipase inhibitors. These peptides were synthesized in the solution phase and characterized using FTIR and 1H-NMR. L-proline is present in a high percentage of natural anti-lipase peptides and was used as a β-amino acid in this study to enhance anti-lipase activity and proteolytic stability. Moreover, L-α-proline was converted to β-amino acid derivatives using the Arndt-Eistert method with the advantage of stereo control at the α-carbon. The synthesized peptides with anti-lipase activity are N-Boc-β-Pro-Gly-OBz (93%), N-Boc-O-Bz-Tyr-β-Pro-β-Pro-Gly-OBz (92%), N-Boc-O-Bz-Tyr-β-Pro-COOH (91%), N-Boc-Phe-β-Pro-OCH3 (90%), and N-Boc-O-Bz-Tyr-β-Pro-OCH3 (89%). These peptides may function as lead molecules for further modification to more significant molecules, which can help control obesity.

Dapagliflozin improves podocytes injury in diabetic nephropathy via regulating cholesterol balance through KLF5 targeting the ABCA1 signalling pathway

Diabetic nephropathy (DN), one of the more prevalent microvascular complications in patients diagnosed with diabetes mellitus, is attributed as the main cause of end-stage renal disease (ESRD). Lipotoxicity in podocytes caused by hyperglycemia has been recognised as a significant pathology change, resulting in the deterioration of the glomerular filtration barrier. Research has demonstrated how dapagliflozin, a kind of SGLT2i, exhibits a multifaceted and powerful protective effect in DN, entirely independent of the hypoglycemic effect, with the specific mechanism verified. In this present study, we found that dapagliflozin has the potential to alleviate apoptosis and restore cytoskeleton triggered by high glucose (HG) in vivo and in vitro. We also discovered that dapagliflozin could mitigate podocyte cholesterol accumulation by restoring the expression of ABCA1, which is the key pathway for cholesterol outflows. This research also mechanistically demonstrates that the protective effect of dapagliflozin can be mediated by KLF-5, which is the upstream transcription factor of ABCA1. Taken together, our data suggest that dapagliflozin offers significant potential in alleviating podocyte injury and cholesterol accumulation triggered by high glucose. In terms of the mechanism, we herein reveal that dapagliflozin could accelerate cholesterol efflux by restoring the expression of ABCA1, which is directly regulated by KLF-5.

A non-human primate model for human norovirus infection.

Norovirus infection can cause gastrointestinal disease in humans. Development of therapies and vaccines against norovirus have been limited by the lack of a suitable and reliable animal model. Here we established rhesus macaques as an animal model for human norovirus infection. We show that rhesus macaques are susceptible to oral infection with human noroviruses from two different genogroups. Variation in duration of virus shedding (days to weeks) between animals, evolution of the virus over the time of infection, induction of virus-specific adaptive immune responses, susceptibility to reinfection and preferential replication of norovirus in the jejunum of rhesus macaques was similar to infection reported in humans. We found minor pathological signs and changes in epithelial cell surface glycosylation patterns in the small intestine during infection. Detection of viral protein and RNA in intestinal biopsies confirmed the presence of the virus in chromogranin A-expressing epithelial cells, as it does in humans. Thus, rhesus macaques are a promising non-human primate model to evaluate vaccines and therapeutics against norovirus disease.

NONINVASIVE DIAGNOSTICS OF EXTRACRANIAL ARTERIES TORTUOSITY

Deformations of carotid artery – deviation, tortuosity, coiling, hold the 2nd placeamong other carotid pathologies. They are the cause of 10-17% of cerebrovasculardisorders. It should also be noted that this pathology is common for a relatively youngage. It is considered that in the elderly carotid deformation is an acquired lesion mostcommonly seen in patients suffering from arteriosclerosis and hypertension, while inchildren and younger patients, the kinks and coils are congenital. For diagnostics ofdeformations of magistral arteries, highly efficient non-invasive methods are applied:ultrasound duplex-scanning, MR angiography, and multi-slice CT angiography. We havestudied deformations of magistral carotid and vertebral arteries in cases of isolatedatherosclerosis, isolated arterial hypertension, and a combination of atherosclerosisand hypertension. Out of 205 patients we diagnosed deformations of carotid arteriesin 93 (30%) cases, and deformations of vertebral arteries in 64 (21%) cases. Bilateraldeformation of carotid arteries was diagnosed in 43 (17%) cases. C- or S-shaped deformationsin 55 (81%) cases were located in proximal or medial parts of CCA or ICA. 76%of patients with this pathology had arterial hypertension. In the case of C- or S-typedeformation rate amounted to 30%, in the case of coiling increase of flow it reached50%, and in the case of kinking – exceeded 60%. In the case of C- or S-type elongation,flow volume (Q) is practically within the normal range - 488±38 ml/min. In the case ofspiral shape elongation, it showed the tendency of decrease -402±22 ml/min, which ismore obvious in the case of kinking - 332±22 ml/min. The frequency of elongations ispractically the same in the case of isolated atherosclerosis or hypertension, however,in the case of their combination the frequency increases. In order to study the impactof the deformation of magistral arteries on intracranial hemodynamics, we examined84 patients without any hemodynamically significant atherosclerotic pathology of carotids.We found a total of 91 elongations: In the case of C- or S-shaped deformation,flow parameters remain within the normal range, as in the case of spiral elongation orcoiling. In the case of kinking, there is an obvious tendency for a decrease in flow rate – the average flow rate is 20% below the normal value. Our data correspond to similar data of other authors, who revealed the tendency of a 20-35% decrease of flow rate in the ipsilateral middle cerebral artery, in case of significant tortuosity or kinking of the carotid artery.

Personality Disorder Symptoms in Intermittent Explosive Disorder: A Latent Class Analysis.

Intermittent explosive disorder (IED) is characterized by recurrent reactive aggression. IED is associated with significant personality pathology that is suggestive of higher levels of general personality disorder (PD). However, little is known about how personality factors impact the severity and presentation of IED. The present study employed a latent class analysis to assess for distinct PD symptom classes within IED and to evaluate whether these classes differed in terms of severity and behavioral presentation. Statistical and clinical indicators revealed a four-class model, with latent classes distinguished primarily on general levels of PD symptoms (low, moderate, high). However, the two moderate PD symptom classes were distinguished from other classes on avoidant PD. In addition, classes differed in terms of severity and presentation, suggesting important implications for both general PD and avoidant PD comorbidity within IED. Results provide further insight into the heterogeneity within IED and suggest a more nuanced approach in treating this serious condition.

Clinical value of serum DJ-1 in lung adenocarcinoma.

DJ-1 is an oncoprotein secreted by cancer cells. However, the physiological and pathological significance of DJ-1 secretion is not clearly understood. This study investigated the clinical value of serum DJ-1 in lung adenocarcinoma (LUAD). The study involved 224 LUAD patients, 110 patients with benign pulmonary disease and 100 healthy controls from the First Affiliated Hospital of Nanjing Medical University. We detected the expression of DJ-1 in lung cell lines in vitro. Meanwhile, serum concentrations of DJ-1, carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and cytokeratin 19 fragment (CYFRA21-1) were measured. The diagnostic performance of LUAD was obtained using receiver operating characteristic (ROC) curves. Kaplan-Meier, univariate and multivariate Cox regression analyses were performed for progression-free survival (PFS). DJ-1 was highly expressed in LUAD cell lines. Serum DJ-1 levels were significantly higher in the LUAD group compared to the benign pulmonary disease group (5.04 vs. 3.66 ng/mL, P<0.001) and healthy controls (5.04 vs. 3.51 ng/mL, P<0.001). DJ-1 levels were associated with gender (P=0.002), smoking history (P=0.042) and lymph node metastasis (P=0.040). ROC curve analysis of DJ-1 revealed an area under the curve (AUC) of 0.758 (95% CI [0.714-0.803], P<0.001) with a sensitivity of 63.8% and specificity of 78.6% at a cutoff value of 4.62 ng/mL for the detection of LUAD. Univariate and multivariate analyses confirmed that the preoperative serum DJ-1 level, tumor stage and smoking history were independent prognostic factors of PFS. Our study is the first to explore the clinical value of serum DJ-1 in LUAD comprehensively. Serum DJ-1 could be a potential diagnostic and prognostic biomarker for LUAD.

Effects of prazosin treatment on liver enzymes are moderated by alcohol withdrawal symptoms in individuals with alcohol use disorder.

Alcohol use disorder (AUD) is associated with significant liver pathology marked by elevated liver enzymes. Prazosin, an alpha1-noradrenergic antagonist significantly improves alcohol drinking outcomes in individuals with alcohol withdrawal symptoms (AW), but effects on liver enzymes are unknown. We assessed the effects of prazosin treatment on the liver enzymes alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyltransferase (GGT) in individuals with AUD. Participants (N=100) with AUD were enrolled in a 12-week randomized controlled trial and received either placebo or 16 mg/day of prazosin. Whole blood was drawn from 92 participants to measure liver enzyme levels every 4 weeks, and severity of AW was assessed weekly. Analysis predicting liver function outcomes used linear mixed effects models. Controlling for alcohol consumption, a significant AW × treatment effect was seen for ALT (p < 0.05), AST (p < 0.05) and GGT (p < 0.01). Additionally, AST (b = 0.2, p < 0.01), ALT (b = 0.2, p < 0.05), and GGT (b = 0.3, p < 0.01) were elevated in individuals with higher AW in the placebo but not in the prazosin group (AST: p > 0.66; ALT: p > 0.65). Only in the prazosin group were lower GGT levels associated with higher withdrawal severity (b = -0.16, p < 0.05). We found an interaction of alcohol withdrawal symptoms and prazosin treatment on liver enzyme levels, which were not influenced by week in the trial or the amount of alcohol consumed. Together, these findings suggest that prazosin treatment reduces liver enzymes over the course of AUD treatment among individuals with significant AW, though replication to establish clinical utility is needed.

Managing risk and resilience in autonomous and intelligent systems: Exploring safety in the development, deployment, and use of artificial intelligence in healthcare.

Autonomous and intelligent systems (AIS) are being developed and deployed across a wide range of sectors and encompass a variety of technologies designed to engage in different forms of independent reasoning and self-directed behavior. These technologies may bring considerable benefits to society but also pose a range of risk management challenges, particularly when deployed in safety-critical sectors where complex interactions between human, social, and technical processes underpin safety and resilience. Healthcare is one safety-critical sector at the forefront of efforts to develop and deploy intelligent technologies, such as through artificial intelligence (AI) systems intended to automate key aspects of healthcare tasks such as reading medical images to identify signs of pathology. This article develops a qualitative analysis of the sociotechnical sources of risk and resilience associated with the development, deployment, and use of AI in healthcare, drawing on 40 in-depth interviews with participants involved in the development, management, and regulation of AI. Qualitative template analysis is used to examine sociotechnical sources of risk and resilience, drawing on and elaborating Macrae's (2022, Risk Analysis, 42(9), 1999-2025) SOTEC framework that integrates structural, organizational, technological, epistemic, and cultural sources of risk in AIS. This analysis explores an array of sociotechnical sources of risk associated with the development, deployment, and use of AI in healthcare and identifies an array of sociotechnical patterns of resilience that may counter those risks. In doing so, the SOTEC framework is elaborated and translated to define key sources of both risk and resilience in AIS.

Rising Lysophosphatidylcholine Levels Post-Hepatitis C Clearance.

Hepatitis C virus (HCV) infection alters lysophosphatidylcholine (LPC) metabolism, enhancing viral infectivity and replication. Direct-acting antivirals (DAAs) effectively treat HCV and rapidly normalize serum cholesterol. In serum, LPC species are primarily albumin-bound but are also present in lipoprotein particles. This study aims to assess the impact of HCV eradication on serum LPC species levels in patients infected with HCV. Therefore, 12 different LPC species were measured by electrospray ionization tandem mass spectrometry (ESI-MS/MS) in the sera of 178 patients with chronic HCV infections at baseline, and in 176 of these patients after therapy with DAAs. All LPC species increased at 4 and 12 weeks post-initiation of DAA therapy. The serum profiles of the LPC species were similar before and after the viral cure. Patients with HCV and liver cirrhosis exhibited lower serum levels of all LPC species, except LPC 16:1, both before and after DAA treatment. Percentages of LPC 18:1 (relative to the total LPC level) were higher, and % LPC 22:5 and 22:6 were lower in cirrhotic compared to non-cirrhotic patients at baseline and at the end of therapy. LPC species levels inversely correlated with the model of end-stage liver disease score and directly with baseline and post-therapy albumin levels. Receiver operating characteristic curve analysis indicated an area under the curve of 0.773 and 0.720 for % LPC 18:1 (relative to total LPC levels) for classifying fibrosis at baseline and post-therapy, respectively. In summary, HCV elimination was found to increase all LPC species and elevated LPC 18:1 relative to total LPC levels may have pathological significance in HCV-related liver cirrhosis.

Nonneoplastic pathology of the appendix: A review article, based on the recent literature.

The appendix, although considered a vestigial organ, is of considerable clinical importance because acute appendicitis is a common medical problem. There are also other disease processes involving the appendix. The appendix is among the first specimens that the pathologist (and surgeon) cuts one's teeth on. Thus, there may be a tendency to underestimate the clinically and prognostically significant appendiceal pathologies. We provide a vade mecum of the pathologic features of a wide range of nonneoplastic appendiceal pathologies, with an emphasis on developing a practical approach to grossing, microscopy, and reporting-all with clinical and therapeutic implications. Much of this is based on literature on MEDLINE with reference to years 2008 to 2023, as well as on personal experiences and interpretations. The appendix can harbor a myriad of nonneoplastic pathologies, including infections, inflammations of varying etiologies (including interval appendectomy), endometriosis, diverticulosis, and so on. Chronic appendicitis, Crohn disease, and clinical audit are recurring themes while COVID-19 is a new entity. Most importantly, all pathologists should appreciate that the appendix is not as "routine" a specimen as one would want to believe.

Radiological Findings in Patients Presenting with Brief Resolved Unexplained Events (BRUEs)

Background/Hypothesis: Brief resolved unexplained events (BRUEs) are events in infants characterized by cyanosis, abnormal breathing, abnormal tone, and altered responsiveness. Practice guidelines define high-risk and low-risk BRUEs and do not recommend imaging in low-risk patients. We evaluated imaging in these patients and hypothesized that high-risk patients would have more imaging studies and abnormalities.&#x0D; Methods: Using the radiology information system, a retrospective review was performed between 2016-2022 for patients &lt;1 year presenting with BRUE. Defined search terms were used to identify imaging within one week of presentation. Patients were evaluated for clinical presentation, medical history, physical examination, imaging studies ordered, and final diagnoses.&#x0D; Results: 126 patients were identified. 113 patients (46 female; 93 high-risk), between 3 and 355 days old (average age 97 days), met inclusion criteria. Imaging included chest radiographs (99), head CTs (24), brain MRIs (19), skeletal surveys (16), and others (22). There was no difference in the number of imaging studies obtained between these groups (p=0.423, Mann-Whitney U test). However, a greater proportion of high-risk patients had imaging abnormalities (p=0.023, Fisher’s exact test). Only 1/20 (5%) low-risk patients had abnormal imaging (PCR proven viral bronchiolitis). 26/93 (28%) high-risk patients had abnormal findings, most commonly on chestradiographs (15), brain MRIs (9), head CTs (4), and skeletal surveys (3). 18/26 high-risk patients had imaging abnormalities leading to a diagnosis other than BRUE (viral bronchiolitis, bronchopulmonary dysplasia, nonaccidental trauma, perinatal HSV infection, ventricular septal defect, double aortic arch, intestinal malrotation, and neurofibromatosis). Overall, 7/93 (7.5%) high-risk BRUE patients had significant pathology.&#x0D; Conclusion: High-risk patients were more likely to have an imaging abnormality compared to low-risk patients, which is consistent with current imaging recommendations given only one low-risk imaging abnormality. Interestingly, 7.5% of the high-risk patients had significant pathology diagnosed by imaging.

Individual age determination based on computed tomography knee analysis using artificial neural networks and computer vision: Preliminary results

BACKGROUND: Currently, studies have focused on the modernization of existing methods of forensic age assessment (bone and skeletal) through the active use of modern methods of medical imaging (e.g., computed tomography) and artificial intelligence for their analysis. This approach enables the creation of new methods for assessing biological age, which is characterized by increased accuracy and reproducibility.&#x0D; AIM: To develop and test an algorithm for predicting the biological age of an individual based on computed tomography analysis of the knee joint using artificial neural networks and computer vision.&#x0D; MATERIALS AND METHODS: This observational retrospective transverse (one time) study analyzed computed tomography scans (334) of the knee joint performed in the Departments of Radiation Diagnostics of the Priorov Central Institute for Trauma and Orthopedics, Vreden National Medical Center for Traumatology and Orthopedics, between 2018 and 2021. The study enrolled persons of both sexes aged 13–45 years. Cases of developmental abnormalities, knee injuries, signs of general connective tissue pathology were excluded. Research methods include the use of intelligent information technologies (a formalized set of mathematical and software solutions).&#x0D; RESULTS: Based on the experiments conducted, an algorithm for assessing age according to the computed tomography scans of the knee joint has been developed. The main components of the developed system are as follows: a preprocessing module, an intelligent computing core, a data analysis module, a three-dimensional reconstruction module, a property extraction module, and a final age assessment module. The essence of the proposed method is the simultaneous use of artificial neural networks and clearly formalized mathematical procedures for calculating the properties of the epiphyseal line. To obtain the results and conduct primary experimental studies that confirmed the feasibility, correctness, and operability of the method, software using the YOLOv5 neural network was developed. The result of the error matrix analysis after training shows a probability of correct recognition of the order of 80%. Verification of experimental studies was performed on 46 cases. At present, the age estimation error is approximately 1 year for children and adolescents.&#x0D; CONCLUSIONS: The experimental results have confirmed the adequacy of the age estimates obtained to the actual age of the individual and, consequently, the applicability of the proposed method in forensic medical institutions. The proposed method is currently implemented as a set of software components with subsequent manual integration of automatically calculated data. The plan was to supplement the database of computed tomography images to increase the training sample and the accuracy of age prediction.

Real or MADE-up: Investigating Mask-Associated Dry Eye (MADE) as an emerging syndrome.

Mask-Associated Dry Eye (MADE) has emerged as a consequence of widespread face mask usage during the Covid-19 pandemic. This review critically assesses the available evidence. A comprehensive search on PUBMED and EMBASE was conducted to identify studies on MADE, which were then categorized based on their design. A total of 26 studies were critically appraised, with the majority exhibiting poor study design quality. Investigating the impact of mask use on ocular surface irritation faced challenges due to global mask mandates, pandemic-related behavioural changes, and a lack of validated methods to measure the response to mask wear. Among the 15 studies, 12 reported a statistically significant reduction in TBUT associated with mask wear; however, the median decrease of 1.3 s was considered clinically insignificant. Results from Schirmer's test in 8 studies varied, with 5 studies reporting a decrease, contradicting the hypothesis of misdirected airflow. Out of 7 studies on corneal and conjunctival staining, 6 indicated a worsening associated with mask wear. Five studies investigatingOSDI scores reported an increase following mask wear, but 3 studies repeated the survey too soon. Limited evidence suggests that masks may cause mild ocular surface irritation, but the quality and certainty of this evidence remain low. Methodological limitations were prevalent across the majority of studies, and the observed changes were minimal. Therefore, it is unlikely that significant ocular surface pathology will develop in the majority of mask wearers. Currently, there is insufficient data to support the establishment of a new syndrome.

Современные подходы к диагностике и восстановительному лечению синдрома позвоночной артерии с помощью остеопатических методов

The article presents the results of a study of the effectiveness of osteopathic treatment of young women aged 18-45 with vertebral artery syndrome. The study involved more than 100 women. Patients with signs of psychiatric pathology and organic brain diseases were excluded. Laser Doppler flowmetry of blood microcirculation was chosen as a method of the evidence-based control. The main group was exposed to osteopathic and conservative treatment while the comparison group (control group) was treated by the generally accepted methods. It was found out from to the study results that osteopathic treatment significantly improved the quality of life including reduction in complaints of fatigue, tinnitus, dizziness and absence of complaints of headache and pain in the cervical region. No changes were registered in the control group during the same examination periods.

Classification and prognostic factors of patients with cervical spondylotic myelopathy after surgical treatment: a cluster analysis

Identifying potential prognostic factors of CSM patients could improve doctors’ clinical decision-making ability. The study retrospectively collected the baseline data of population characteristics, clinical symptoms, physical examination, neurological function and quality of life scores of patients with CSM based on the clinical big data research platform. The modified Japanese Orthopedic Association (mJOA) score and SF-36 score from the short-term follow-up data were entered into the cluster analysis to characterize postoperative residual symptoms and quality of life. Four clusters were yielded representing different patterns of residual symptoms and quality of patients’ life. Patients in cluster 2 (mJOA RR 55.8%) and cluster 4 (mJOA RR 55.8%) were substantially improved and had better quality of life. The influencing factors for the better prognosis of patients in cluster 2 were young age (50.1 ± 11.8), low incidence of disabling claudication (5.0%) and pathological signs (63.0%), and good preoperative SF36-physiological function score (73.1 ± 24.0) and mJOA socre (13.7 ± 2.8); and in cluster 4 the main influencing factor was low incidence of neck and shoulder pain (11.7%). We preliminarily verified the reliability of the clustering results with the long-term follow-up data and identified the preoperative features that were helpful to predict the prognosis of the patients. This study provided reference and research basis for further study with a larger sample data, extracting more patient features, selecting more follow-up nodes, and improving clustering algorithm.

SUBCHONDRAL MICROCHANNEL NETWORK CHANGES IN EARLY OSTEOARTHRITIS

Articular cartilage (AC) and subchondral bone (SB) are intimately intertwined, forming a complex unit called the AC-SB interface. Our recent studies have shown that cartilage and bone marrow are connected by a three-dimensional network of microchannels (i.e. cartilage-bone marrow microchannel connector; CMMC), which differ microarchitecturally in number, size and morphology depending on the maturation stage of the bone and the region of the joint. However, the pathological significance of CMMC is largely unknown. Here, we quantitatively assessed how CMMC microarchitecture relates to cartilage condition and regional differences in early idiopathic osteoarthritis (OA).Two groups of cadaveric female human femoral heads (intact cartilage vs early cartilage lesions) were identified and biopsy-based high-resolution micro-CT imaging was used. Subchondral bone (SB) thickness, CMMC number, maximum and minimum CMMC size, and CMMC morphology were quantified and compared between the two groups. The effect of joint region and cartilage condition on each dependent variable was examined.The number and morphology of CMMCs were influenced by the region of the joint, but not by the cartilage condition. On the other hand, the minimum and maximum CMMC size was modified by both joint location and cartilage condition. The smallest CMMCs were consistently found in the load bearing region (LBR) of the joint. Compared to healthy subjects, the size of the microchannels was increased in early OA, most notably in the non-load bearing region (NLBR) and the peripheral rim (PR) of the femoral head. In addition, subchondral bone thinning was observed in early OA as a localized event associated with areas of partial chondral defect.Our data suggest an enlargement of the SB microchannel network and a collective structural deterioration of the SB in early idiopathic OA.