Significant Pathology Research Articles

Abnormal Pathology Following Vaginal Hysterectomy for Pelvic Organ Prolapse Repair.

Objective: Uterine-sparing surgery for pelvic organ prolapse (POP) repair has shown good results, but the potential negative implications of leaving the uterus in place are yet to be fully defined. We aimed to assess the risk of unanticipated abnormal gynecological pathology at the time of reconstructive pelvic surgery. Methods: A retrospective consecutive case series including women who underwent vaginal hysterectomy for POP repair at a tertiary medical center in 2006-2020. All patients were offered a free Pap smear test at the age of 65 years as part of a national screening program. Transvaginal ultrasound was routinely performed preoperatively. Standard 3 pedicle hysterectomy was performed with/without bilateral salpingo-oophorectomy (BSO). Results: The study comprised 462 women of mean age 63 ± 9.3 years without previous known malignant or premalignant pathology. Benign pathology was observed in 286 patients (61.9%). Endometrial malignancy was found in three patients (0.7%) and significant premalignant pathology in 15 patients (3.2%), including cervical intraepithelial neoplasia stage 2-3 in seven patients (1.5%) and complex hyperplasia with atypia in eight patients (1.7%). All these pathologies were found in postmenopausal women. None had preoperative clinical symptoms or endometrial thickness of ≥5 mm on preoperative ultrasound. In the 35 patients after BSO, adnexal findings were normal (77.2%) or benign (22.8%). Conclusions: Premenopausal women with uterovaginal prolapse and normal preoperative evaluation have a minimal risk of significant abnormal uterine pathology. In postmenopausal women, the risk of unanticipated malignant uterine pathology is 0.7% and 3.2% for significant premalignancy.

Activation of feedforward wiring in adult hippocampal neurons by the basic-helix-loop-helix transcription factor Ascl4.

Although evidence indicates that the adult brain retains a considerable capacity for circuit formation, adult wiring has not been broadly considered and remains poorly understood. In this study, we investigate wiring activation in adult neurons. We show that the basic-helix-loop-helix transcription factor Ascl4 can induce wiring in different types of hippocampal neurons of adult mice. The new axons are mainly feedforward and reconfigure synaptic weights in the circuit. Mice with the Ascl4-induced circuits do not display signs of pathology and solve spatial problems equally well as controls. Our results demonstrate reprogrammed connectivity by a single transcriptional factor and provide insights into the regulation of brain wiring in adults.

Evaluation of Prognostic Scores in Patients with Head Trauma in the Emergency Department

Background: The aim of this study was to investigate the effectiveness of Glasgow coma scale (GCS), GCS-motor component (mGCS), and FOUR (Full Outline of Un-responsiveness) Scores in predicting the prognosis of patients who presented to the emergency department with head trauma. Methods: In this prospective cross-sectional study, was obtained to collected data of patients with head trauma, who presented to the emergency department. Participants’ demographic data, medical history, GCS, FOUR scores, the duration of emergency department stays, as well as 24-hour, 7-day, and 28-day mortality rates were recorded on the case report forms. Results: Data from 302 patients were used to develop a risk score for detecting significant brain pathology via computed tomography (CT) scans. The regression model, incorporating total GCS and sex-based variables, explained 22.5% of variance and accurately classified 91.1% of cases. The model's area under the curve for detecting significant pathology via CT was 0.714. Conclusion: GCS, mGCS, and FOUR scores did not achieve the necessary the diagnostic performance benchmark to be used alone to predict or exclude clinically significant brain injury in patients with head trauma.

Case Report: Pendular Nystagmus Presenting in Usher Syndrome Type I.

We describe a 42-year-old patient with reported "shaking" vision referred due to concerns of possible vestibular system dysfunction. The patient has known history of Usher syndrome type I, bilateral cochlear implants, and severe vision impairment. This case describes an unusual nystagmus previously only reported in individuals with central demyelinating disorders, significant light deprivation, or in congenital / early-onset visual pathway impairment. Case study. Retrospective chart review of vestibular function. Vestibular function was likely absent in this case. There was no evidence of vestibular (jerk) nystagmus for sinusoidal harmonic acceleration stimuli or repeatable responses for cervical vestibular evoked myogenic potentials. Significant pendular low amplitude high frequency oscillations of approximately 6 Hz were present for horizontal and vertical tracings throughout testing. Nystagmus may not always be associated with vestibular system impairment. In this case, the patient's reported "shaking" vision was attributed to pendular low amplitude high frequency nystagmus and hypothesized to relate to long-standing significant vision impairment. This presentation is unusual in adults and has historically been associated with individuals with significant central pathology or in those with long duration light deprivation.

Development of a biodegradable polymer-based implant to release dual drugs for post-operative management of cataract surgery.

Cataract surgery is followed by post-operative eye drops for a duration of 4-6 weeks. The multitude of ocular barriers, coupled with the discomfort experienced by both the patient and their relatives in frequently administering eye drops, significantly undermines patient compliance, ultimately impeding the recovery of the patient. This study aimed to design and develop an ocular drug delivery system as an effort to achieve a drop-free post-operative care after cataract surgery. An implant was prepared containing a biodegradable polymer Poly-lactic-co-glycolic acid (PLGA), Dexamethasone (DEX) as an anti-inflammatory drug, and Moxifloxacin(MOX) as an antibiotic. Implant characterization and drug loading analysis were conducted. In vitro drug release profile showed that the release of the two drugs are correlated with the clinical prescription for post operative eye drops. In vivo study was conducted on New Zealand albino rabbits where one eye underwent cataract surgery, and the drug delivery implant was inserted into the capsular bag after placement of the synthetic intraocular lens (IOL). Borderline increase in the intraocular pressure (IOP) was noted in the test sample group. Slit-lamp observations revealed no significant anterior chamber reaction in all study groups. Histopathology study of the operated eye revealed no significant pathology in the test samples. This work aims at developing the intra ocular drug delivery implant which will replace the post-operative eye drops and help the patient with the post-operative hassle of eye drops.

HaNDL Syndrome: The Innocent Lymphocytic Pleocytosis.

HaNDL syndrome is a transient and rare condition that presents with neurological deficit and headache accompanied by lymphocytosis on cerebrospinal fluid (CSF) analysis. It is usually characterized by spontaneous recovery without neurological sequelae. This is a benign condition, which has not yet been adequately defined and includes many diseases in the differential diagnosis. We indicated 2 different cases that applied with acute neurological findings. Two patients who were admitted to our hospital with transient neurological deficits and headaches were evaluated. There was no significant pathology in cranial imaging and EEG reports. Lymphocytic pleocytosis was observed in CSF. Patients were followed up with attacks but were discharged without deficits. We diagnosed the patients with HaNDL syndrome with clinical features, imaging, and laboratory findings. HaNDL is an underdiagnosed syndrome and it should be considered especially for young patients with headaches is prominent without a risk factor for ischemia, recurrent episodes with neurological symptoms, CSF pleocytosis, and normal imaging findings.Therefore, we wanted to raise awareness for the existence of this rare disease which is a waste of time by performing unnecessary tests and therapies during the diagnosis period.

Elucidation of the Molecular Signal Linking Psychological Trauma to T-lymphocyte Inflammation

Post-traumatic stress disorder (PTSD) is a psychiatric disorder that not only exhibits significant behavioral pathology, but also increases the likelihood of comorbid inflammatory conditions such as autoimmune and cardiovascular diseases. While PTSD patients experience heightened systemic inflammation, the exact link between psychological trauma and immune dysregulation remains to be elucidated. Our group has recapitulated the psychological trauma-induced inflammatory phenotype in a pre-clinical murine model of PTSD known as repeated social defeat stress (RSDS). Importantly, a key site of this inflammation appears to originate from T-lymphocytes in the spleen, and targeted splenic nerve denervation was able to completely prevent splenic T-lymphocyte inflammation after RSDS (p<0.0001). This critical observation suggests the T-lymphocyte response to psychological trauma is neural derived as opposed to circulating, therefore, we began systematic investigation into possible neural-derived signals that may lead to enhanced T-lymphocyte inflammation. To investigate whether the signal involves the T-cell receptor (TCR), we utilized OT-I and OT-II mice that possess non-mouse antigen-restricted TCRs. RSDS induced T-lymphocyte inflammation in these mice similar to wild-type, therefore, suggesting the signal is not antigenic in nature (p>0.05). Next, we examined the role of norepinephrine and adrenergic signaling using both pharmacological blockade and genetic knockouts of both alpha and beta adrenergic receptors, but this too was insuffcient to reverse the RSDS-induced T-lymphocyte inflammation (p>0.05). Following this, we examined the role of damage associated molecular patterns (DAMPs) by pharmacological blockade of the toll-like receptor 4 (TLR4), yet again, this intervention did not attenuate T-lymphocyte inflammation after RSDS (p>0.05). Last, our data suggests interleukin 6 (IL-6) is upregulated early after psychological trauma; therefore, we examined the role for cytokine-induced T-lymphocyte inflammation. Using anti-IL-6 antibodies during RSDS, T-lymphocyte inflammation appeared blunted compared to wild-type animals (p<0.05). Moreover, T-lymphocytes treated with only IL-6 expressed similar inflammation gene profiles as those from RSDS animals (p<0.05). Taken together, our data suggest IL-6 may be the T-lymphocyte inflammation-inducing signal, but additional studies are warranted to understand the exact source of IL-6 and mechanisms underlying IL-6’s ability to drive T-lymphocyte inflammation. R01HL158521. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Normative contact mechanics of the ankle Joint: Quantitative assessment utilizing bilateral weightbearing CT

Alterations in ankle’s articular contact mechanics serve as one of the fundamental causes of significant pathology. Nevertheless, computationally intensive algorithms and lack of bilateral weightbearing imaging have rendered it difficult to investigate the normative articular contact stress and side-to-side differences. The aims of our study were two-fold: 1) to determine and quantify the presence of side-to-side contact differences in healthy ankles and 2) to establish normative ranges for articular ankle contact parameters. In this retrospective comparative study, 50 subjects with healthy ankles on bilateral weight-bearing CT were confirmed eligible. Segmentation into 3D bony models was performed semi-automatically, and individualized cartilage layers were modelled based on a previously validated methodology. Contact mechanics were evaluated by using the mean and maximum contact stress of the tibiotalar articulation. Absolute and percentage reference range values were determined for the side-to-side difference. Amongst a cohort of individuals devoid of ankle pathology, mean side-to-side variation in these measurements was < 12 %, while respective differences of > 17 % talar peak stress and > 31 % talar mean stress indicate abnormality. No significant differences were found between laterality in any of the evaluated contact parameters. Understanding these values may promote a more accurate assessment of ankle joint biomechanics when distinguishing acceptable versus pathological contact mechanics in clinical practice.

Literature Study : Histopathology Analysis of Rabies Disease (2014 - 2022)

Background: Rabies is a contagious and zoonotic disease caused by Lyssavirus, a neurotropic, negative-sense, single-stranded RNA virus. Rabies infects most mammals through the transmission of saliva from a rabid animal that enters the body of a healthy animal through an open wound, bite, scratch, or direct contact. A post-mortem diagnosis and evaluation are crucial for establishing regional statistical data in order to design a robust strategy for combating rabies. Histopathology has long been known to be an invaluable source of information regarding the destructive impact of rabies in nervous tissue. In addition to other ante-mortem evaluations, a correlation between clinical signs, gross pathological findings, and histopathological findings must be established to achieve the maximum target of combating rabies. Purpose: This study aims to analyze and compare gross pathological findings and histopathological findings in the literature published between 2014 and 2022. Methods: A comparison between gross pathological findings and histopathological findings was conducted on case studies from 2014 to 2022. Anamnesis and clinical signs were obtained as supporting data. The findings were presented as percentage to identify the predominant pathological signs. Results: A review of four case studies revealed that paralysis, hyperesthesia, gait abnormality, and muscle tremor were the most commonly observed signs (50%). Only two case studies revealed gross pathological findings, including meningeal congestion and cerebellar hemorrhage. Eight studies identified the intracytoplasmic negri body in Purkinje cells as the most commonly observed histopathological finding (100%). Conclusion: The primary clinical signs and gross pathological findings associated with rabies are typically regarded as non-specific. Histopathology revealed the intracytoplasmic Negri body in Purkinje cells as the most commonly observed finding (100%).

Interaksi Parasosial Penggemar Nike Ardilla yang tergabung Dalam “Nike Ardilla Fans Club”

This research aims to explore parasocial interactions between fans and public figures who have died, with a focus on the extraordinary phenomenon related to the persistence of the influence of these figures even after they have died. The research method used is a qualitative approach with case studies. The research results showed that the majority of informants showed characteristics of parasocial interactions, such as Imaginary Friendship, Search for Friendship, Empathy towards Idols, and Reality of Relationships. In the context of the parasocial level of interaction, most of the informants experienced Entertainment Social Value and Intense Personal Feelings, while none showed signs of Borderline Pathological Tendencies. This indicates that the parasocial interactions that occur are still within normal limits. The conclusion is that parasocial interactions between fans and public figures who are no longer alive can take place with high intensity, even though the figure has died. Despite this, the majority of fans remained within normal limits in their interactions, without showing any worrying pathological signs. Keywords: Parasocial Interaction, Nike Ardilla Fans Club, Public Figures

Immunohistochemical evaluation of tumor hypoxia and angiogenesis: Pathological significance and prognostic role in head and neck squamous cell carcinomas

Objectives: Tumor hypoxia and angiogenesis have been implicated in therapeutic resistance of head and neck squamous cell carcinomas (HNSCCs). Immunohistochemical evaluation of hypoxia-inducible factor-1 alpha (HIF-1 α), a hypoxia transcription factor, and vascular endothelial growth factor (VEGF), a hypoxia-responsive pro-angiogenic factor, can be exploited for prognostication and guiding treatment intensification or de-escalation decisions in HNSCC patients. The purpose of the study is to evaluate the immunohistochemical expression patterns of HIF-1 α and VEGF and the microvessel density (MVD) for angiogenesis in HNSCC and assess their pathological significance and prognostic role. Materials and Methods: In this cross-sectional study, immunohistochemical expression of HIF-1 α, VEGF, and MVD through Cluster of Differentiation (CD31) was evaluated in paraffin-embedded tumor resection tissue of 44 patients with HNSCC. Associations among HIF-1 α, VEGF, and MVD with clinicopathological variables were assessed. Statistical Analysis: For assessment of association between HIF-1α, VEGF and MVD by CD 31 immunohistochemical markers and other clinicopathological variables Pearson’s chi-square test and Fisher’s exact tests were used. Analysis of survival was done using Kaplan-Meier statistics. Also, the univariate and multivariate analysis were performed using the Cox proportional hazard regression model for the calculation of hazard ratios. Results: Nuclear expression of HIF-1 α showed significant association with MVD (P = 0.007) and cytoplasmic expression of HIF-1 α with histologic grade (P = 0.03). Overexpression of HIF-1 α was more frequent in T3/T4 stage. In addition to cytoplasmic staining, VEGF showed a unique nuclear expression pattern in four cases of advanced disease with nodal metastasis. Logistic regression analysis showed tumors with nuclear overexpression of HIF-1 α to have increased MVD (P = 0.05), and tumors with higher MVD to have a presence of lymphovascular invasion (P = 0.014). Multivariate analysis showed HIF-1 α nuclear overexpression to be significantly associated with decreased survival of patients (P = 0.05). Conclusions: Immunohistochemical overexpression of HIF-1 α and MVD quantification can serve as cost-effective tools for prognostication and treatment modification of HNSCC patients in resourcelimited settings.

Mitochondrial sites of contact with the nucleus.

Membrane contact sites (MCS) between mitochondria and the nucleus have been recently described. Termed nucleus associated mitochondria (NAM), they prime the expression of genes required for cellular resistance to stressors, thus offering a tethering mechanism for homeostatic communication. Here, we discuss the composition of NAM and their physiological and pathological significance.

Leukocyte-Platelet-Rich Fibrin in Bone Regeneration after Periapical Surgery: A 30-Month Follow-Up Clinical Report

Aim and background: Periapical lesions, which occur due to the infection and necrosis of dental pulp, are a significant dental pathology that poses risks to oral and systemic health. These lesions often require interventions such as root canal treatment or periapical surgery. Recent research has focused on the effectiveness of biocompatible materials, including mineral trioxide aggregate, bioceramics, and leukocyte-platelet-rich fibrin (L’PRF), in improving healing outcomes. This report presents the application of leukocyte-platelet-rich fibrin (L’PRF) derived from the patient’s autologous blood to enhance bone healing. Case description: A 61-year-old woman with well-controlled hypertension and good oral hygiene visited the dental clinic due to a painless swelling near her upper left central incisor. After examination, it was determined that she had a periapical granuloma. The patient underwent successful root canal retreatment and apical surgery, during which leukocyte-platelet-rich fibrin was applied. After 30 months, she experienced significant improvement with no symptoms and substantial bone regeneration. Conclusion: Clinical evidence and this case study indicate that leukocyte-platelet-rich fibrin (L’PRF) may enhance healing post periapical surgery. Further research, including more extensive and longer-term randomized trials, must confirm L’PRF’s effectiveness and refine treatment protocols. Clinical significance: L’PRF enhances bone healing post periapical surgery. Clinicians should consider integrating L’PRF in periapical surgeries, ensure diligent follow-up, and inform patients of its long-term advantages. Further randomized trials are needed to refine L’PRF clinical guidelines.

Detection Rate of Helicobacter Pylori Infection and Atrophic Gastritis Using Serological Markers “GastroPanel®” Among Employees of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation

Aim: to evaluate, using the “GastroPanel®”, the frequency of detection of H. pylori infection and associated gastric diseases among doctors and medical staff of the National Medical Research Radiological Centre of the Ministry of Health of the Russian Federation, Moscow.Materials and methods. Employees of three branches of the National Medical Research Radiological Centre (n = 434, mean age — 48.5 ± 0.6 years) were examined using laboratory tests “GastroPanel®” (Biohit Oyj, Finland). The test results make it possible to identify infection of the stomach with H. pylori, hypo- and hyperacid conditions, as well as atrophic gastritis of the antrum and body of the stomach, as its precancerous conditions. Esophagogastroduodenoscopy (EGDS) for suspected atrophic gastritis was performed with an Olympus GIF-HQ190 video endoscope (Japan) in a narrow-spectrum mode with close focus (NBI Dual Focus).Results. The absence of pathological signs detected by “GastroPanel®” was established in 23.3 % of cases, hyperacid state — in 18.4 %, and hypoacid state — in 5.2 %. These disorders are classified as functional. Consequently, the conditional norm in total was identified in 46.9 % of observations. An increased level of antibodies to H. pylori was found in 43.3 % of those examined. Atrophic gastritis in the body of the stomach according to the results of the “GastroPanel®” was detected in 4.8 % of cases (median age — 59 years), in the antrum (or increased secretion of hydrochloric acid) — also in 4.8 % of cases (median age — 52 years). Within two months after laboratory diagnostics, EGDS was performed for 10 out of 15 patients examined at the P. Hertsen Moscow Oncology Research Institute in whom, based on the results of the “GastroPanel®”, the presence of atrophic gastritis in the antrum (or increased secretion of hydrochloric acid) was suspected. In 6 out of 10 cases, atrophic gastritis of the antrum was confirmed (in two of them, the atrophy extended to the body of the stomach and was assessed as severe). Of the 11 people with the “GastroPanel®” conclusion “Atrophic gastritis of the body of the stomach,” an endoscopic examination was carried out in 7 persons, and in all these cases the diagnosis was confirmed, and in two people the conclusion was made of severe atrophic pangastritis.Conclusion. “GastroPanel®” confirmed its high significance in identifying H. pylori infection and precancerous atrophic changes in the gastric mucosa. Regarding the occupational risks of infection among medical workers, we consider it advisable to conduct such screening without selecting an asymptomatic population.

Non-obvious and obvious signs of the thoracic spine pathology: a clinical study

Background The thoracic spine pathology can lead to severe disability and discomfort.This study aims to identify determinant characteristics in patients with thoracic spine pathologies who present with non-regional complaints such as lumbar/cervical pain and others.Methods A prospective observational descriptive study was conducted at Basrah Teaching Hospital from March 2020 to December 2021, enrolling 114 patients categorized into two groups. Group A included patients with thoracic spine pathology and thoracic pain, while Group B consisted of patients with thoracic spine pathology and non-local symptoms (such as lower lumbar pain, pain in extremities, etc.). Comprehensive clinical evaluations were performed using a specially designed questionnaire.Results The majority of patients were in the 60-79 age group, with females comprising 55 % in Group A and 60 % in Group B. Smoking was observed in 28.98 % of Group A and 26.66 % of Group B. Symptomatic patients with solitary back pain commonly exhibited dorsal root compression symptoms (49.27 %), lower limb weakness (18.84 %), and sphincter dysfunction (7.24 %). Patients with thoracic plus lower and/or neck pain frequently reported paraesthesia (42.22 %) and cervical root symptoms (48.38 %). Kyphotic deformity was present in 20.28 % of Group A and 11.11 % of Group B, while tenderness was observed in 23.18 % of Group A and 13.33 % of Group B. Plain radiograph changes, including disk space narrowing (44.44 %), subchondral sclerosis (29.63 %), curve alterations (29.63 %), and facet arthropathy (25.9 %), were more prevalent in those with symptomatic thoracic back pain (Group A).Conclusion Non-local symptoms in thoracic spine pathologies are common, with complicated and multi-site low back pain being more prevalent than isolated back or thoracic pain. Elderly individuals, females, obesity, and comorbidities appear to be predictive risk factors for low back pain development. Paraesthesia emerges as the most common neurological manifestation, while kyphosis and scoliosis are primary presentations of thoracic pathologies. Multi-modalities of imaging, including plain radiographs, MRI, CT scan, and DEXA scan, can aid in detecting back pathologies. The mainstay of managing symptomatic thoracic pathologies is surgical intervention.

Epidemiological and clinical aspects of HFRS in the territory of the Voronezh region

At this time, hemorrhagic fever with renal syndrome remains one of the most common infectious diseases in the Russian Federation. An active natural focus of HFRS is the Voronezh region, where the natural reservoir of hantaviruses and the source of infection for people are wild rodents — bank vole, field mouse, and gray vole. The highest incidence rates of HFRS in the Voronezh region were recorded in 2019, significantly exceeding the rates of other years. The article presents data on the features of the epidemiology of HFRS and analyzes in detail the characteristic clinical manifestations of the disease. Important epidemiological aspects of hantavirus infection in the Voronezh region are the summer-autumn seasonality, the predominance in the structure of sick young men of working age living within the city. The pronounced summer-autumn seasonality of HFRS is due to contacts of patients with natural objects in both foci of infection. The clinical picture revealed a cyclical course of the disease, prolonged febrile-intoxication syndrome, enlarged liver and spleen, hemorrhagic syndrome, signs of renal pathology, thrombocytopenia. At the initial stage of the disease, typical manifestations of infection — symptoms of kidney damage, hemorrhagic manifestations, ophthalmological complaints, dry mouth and thirst — are rare or not clearly expressed. The studied features of the epidemiological aspects and clinical manifestations of HFRS in the Voronezh region are of great practical importance for differential diagnosis and early diagnosis at the prehospital stage for the purpose of timely hospitalization of the patient.

Operative techniques in otolaryngology: Head and neck surgery. Geisinger Medical Center experience for whole mount laryngectomy specimen

The American Cancer Society estimates approximately 12,380 new cases of laryngeal cancer (0.7% of all cases) with approximately 3820 people dying from the disease. There is 3.86:1 male to female ratio and represent third most prevalent upper aerodigestive tract site, following the oral and pharyngeal regions. Typically affects patients in the fifth decade of life. Accurate diagnosis and management are crucial for patient survival. This study examines the pathological features of laryngectomy specimens and their significance in the diagnosis and management of laryngeal cancer. Our institution's intraoperative evaluation of margins and surgical procedures for laryngeal cancer treatment are also discussed. The study found that gross pathology and histomorphology of laryngeal specimens after laryngectomy are the most accurate methods for determining the extent of tumor involvement. The majority of our procedures involve total or partial laryngectomy. The significance of surgical pathology in the diagnosis and management of laryngeal cancer is highlighted in this article.

Imaging Outcomes of Emergency MR Imaging in Dizziness and Vertigo: A Retrospective Cohort Study.

Patients exhibiting acute dizziness or vertigo often represent a diagnostic challenge, and many undergo neuroimaging for stroke detection. We aimed to demonstrate the imaging outcomes of first-line emergency MR imaging among patients with acute dizziness or vertigo and to determine the clinical risk factors for stroke and other acute pathology. This retrospective study included consecutive patients with acute dizziness or vertigo referred for emergency MR imaging in a tertiary hospital during 5 years. We recorded and analyzed patient characteristics, relevant clinical information, and imaging outcomes. Risk score models were derived to predict which patients were more likely to present with positive MR imaging findings. A total of 1169 patients were included. Acute stroke was found in 17%; other clinically significant pathology, in 8% of patients. In 75% of the patients, emergency MR imaging showed no significant abnormalities. Risk factors for acute stroke included older age, male sex, and a prevalence of cardiovascular risk factors and neurologic signs. Isolated dizziness had no discriminative power on imaging outcomes, and 14% of these patients showed acute stroke. Risk scores had only moderate performance in predicting acute ischemic stroke (receiver operating characteristic area under curve = 0.75) or any significant pathology (receiver operating characteristic area under curve = 0.70). Acute dizziness and vertigo remain challenging even when emergency MR imaging is readily available. One in 4 patients had acute pathology on MR imaging. Predictors for acute pathology (older age, male sex, cardiovascular risk factors, and neurologic signs) may aid in patient selection for MR imaging, optimizing the yield and clinical impact of emergency neuroimaging. Low diagnostic yields of CT and internal acoustic canal MR imaging may offer an opportunity to reduce health care expenditures in the future.

The utilization of kallistatin as a novel biomarker for the determining of serum in diagnosing liver diseases of animals

Kallistatin is a novel biomarker, a plasma protein produced by the liver, utilized for diagnosing liver diseases in both humans and animals. The indicator can serve as a diagnostic indicator for assessing the extent of liver cell damage and as a marker for chronic liver diseases. The level of kallistatin decreases significantly in cirrhosis and is directly related to the biochemical indices of blood. Furthermore, the lower the level of kallistatin, the more pronounced the degree of liver cell damage. However, this indicator has not been sufficiently investigated in laboratory diagnosis, particularly its relationship to liver disease. Further research is needed to elucidate its diagnostic potential and clinical significance in liver pathology. In addition, for animals with chronic liver disease, it has been found that kallistatin can serve as a useful and reliable diagnostic indicator of liver health, particularly in cases of cirrhosis.

SOME FEATURES OF CELLULAR ENERGY SUPPLY OF THE BODY IN PREMATURE INFANTS WITH SEVERE FORMS OF PERINATAL PATHOLOGY

The nature of postnatal adaptation of newborns, their further growth, development, health status and quality of life largelydepend on the well-being of intrauterine development and maturity at birth. Premature birth under hypoxia causes signifi cant metabolic disorders in the body, is accompanied by a high risk of severe organ dysfunction, which requires in-depth research to clarify the features of intracellular metabolism in order to further improve methods of diagnosis and treatment of newborns with various forms of perinatal pathology.Aim of the research. To study the trends of changes in energy metabolism in premature infants with severe forms of perinatal pathology to investigate the possibility of using them as additional criteria of hypoxic damage to the body in conditions of morphological and functional immaturity.Materials and methods. Clinical and laboratory examinations were performed on 68 newborns with severe forms of perinatal pathology at the gestational age of 32 to 34 weeks; the comparison group consisted of 27 conditionally healthy newborns at the gestational age of 34 to 37 weeks. Inclusion criteria for the main study group: gestational age at birth from 32 to 34 weeks, clinical signs of severe perinatal pathology. Exclusion criteria: gestational age at birth &lt; 32 and ≥ 37 weeks, diagnosed congenital malformations and septic conditions. The list of diseases was determined according to the International Classifi cation of Diseases, X Revision. The following blood serum laboratory parameters were studied: lactate level, glycerol-3-phosphate dehydrogenase (GPDH) (EC 1.1.99.5), succinate dehydrogenase (SDH), NADH dehydrogenase (NADH) (EC 1.6.5.3); the electron transport chain coeffi cient (ETC) was calculated. Laboratory studies were performed using micromethods. The study was conducted in accordance with the provisions of GCP (1996), the Convention of the Council of Europe on Human Rights and Biomedicine (April 4, 1997), the Declaration of Helsinki of the World Medical Association (1964-2008), Order of the Ministry of Health of Ukraine No. 690 dated September 23, 2009 (as amended by Order of the Ministry of Health of Ukraine No. 523 dated July 12, 2012). Protocol of scientifi c research of the Biomedical Ethics Committee of BSMU dated September 12, 2015. Informed written consent was obtained from the parents of the patients before the study with an explanationof the purpose, objectives and methods of laboratory testing. Statistical processing of the results was performed using STATISTICA software (StatSoft Inc., USA, version 10). Comparison of quantitative indicators with normal distribution was performed using Student’s t-test, and the probability of diff erences was considered statistically signifi cant at p&lt;0.05. The complex of studies was conducted within the framework of the planned research topics of the Department of Pediatrics, Neonatology and Perinatal Medicine of the Bukovinian State Medical University: «Improvement of the areas of prognosis, diagnostics and treatment of perinatal pathology in newborns and infants, optimization of the schemes of catamenial observation and rehabilitation» (State registration No. 0115U002768, term of execution 01.2015-12.2019) and «Chronobiological and adaptive aspects and features of vegetative regulation in pathological conditions in children of diff erent age groups» (State registration No. 0122U002245, term of execution 01.2020-12.2024).Results. In newborns of the main group, in comparison with the control group, a signifi cant decrease in GFDH and SDHwas found, which indicates a signifi cant impairment of the activity of enzymes of the respiratory chain and explains the lack of oxygen absorption in the body at the cellular and tissue level, causing the severity of the condition of newborns. Determination of the level of GPDH and SDH in the dynamics of observation in children showed some improvement in these indicators. In the severe condition of newborns, a signifi cant increase in the NADPH index was found, with a further probable increase in its level in the dynamics of observation. Calculations of ETC coeffi cient in cord blood showed a signifi cant decrease of this indicator in comparison with the control group. The identifi ed disorders of intracellular energy metabolism under hypoxia indicate the expediency of conducting comprehensive scientifi c research to study the possibilities of appropriate pharmacological correction to improve the eff ectiveness of treatment of severe forms of perinatal pathology in premature infants.Conclusions: 1. The results of the study revealed a signifi cant decrease in GPDH and SDH at elevated levels of NADPH andETC coeffi cient, which confi rms the presence of signifi cant disturbances in intracellular energy metabolism and mitochondrial oxidation processes. 2. Timely detection of metabolic disorders with the determination of mitochondrial oxidation, in particular energy metabolism, is an important area for improving diagnostic measures in severe forms of perinatal pathology in preterm infants with hypoxic damage to the body in the pathogenesis.