Somatic Syndromes Research Articles

Network structure of functional somatic symptoms

ObjectiveThe overlap among functional somatic syndromes (FSS) is substantial, which is why various empirical attempts at an improved understanding of related symptoms have been undertaken. Network analyses are particularly valuable from a clinical point of view, since they focus on the extent to which symptoms expression is co-dependent. The aim of this study was to provide the first estimation of the network structure of symptoms in 17 FSS. MethodsN = 3054 young adults participated in an online survey. The Questionnaire on Functional Somatic Syndromes (FSSQ) was used to diagnose FSS and to assess related symptoms. The Patient Health Questionnaire (PHQ-9) was used to assess (comorbid) depression. Various R packages were used for network analysis, which yielded correlations between symptoms (edges), symptom groups (communities), and measures of centrality for individual symptoms (e.g., node strength). ResultsThe final network had a relatively small number of edges, with small (46.5 %) or small- to medium-sized (47.1 %) correlations. Ten communities were identified: and cognitive problems/fatigue/depression, sensory problems, facial pain, head/neck/upper back pain, dizziness/nausea, throat pain/problems with swallowing, chest pain, widespread pain, abdominal pain/problems with digestion, and genital pain. The highest node strength in the network was found for the symptoms “tired”, “down, depressed, or hopeless”, and “tired after minimal exertion”. ConclusionsThe network analyses pointed to ten distinct groups of moderately associated symptoms in individuals with FSS. Fatigue and depression emerged as important symptoms connecting groups. Future studies should test whether (transdiagnostic) interventions specifically targeting these symptoms are particularly potent in alleviating FSS.

Bidirectional associations between the development of somatic syndromes and long COVID: A cross-sectional analysis

ABSTRACT Objective To examine the association between somatic syndromes and long COVID through a pre-registered cross-sectional survey. Methods United States adults (N = 2872) participated in an online survey detailing health history, including somatic syndrome and long COVID status. Multivariable logistic regression models were used to examine pre-COVID-19 somatic syndromes as a predictor of long COVID, as well as long COVID as a predictor of post-COVID-19 somatic syndromes. Results Of the 2872 participants, 562 (19.6%) developed long COVID, and 949 (33.0%) reported a prior somatic syndrome. Participants were on average 41.3 years (SD = 18.5), female (51.7%), White (87.7%), and non-Hispanic or Latino/a/x (84.1%). Having a pre-COVID-19 somatic syndrome increased the adjusted odds of long COVID by nearly three times (aOR = 2.80, 95% CI [2.25, 3.49], p < 0.001). Each additional somatic syndrome was significantly associated with increased adjusted odds of long COVID (aOR = 1.61, 95% CI [1.48, 1.76], p < 0.001). Long COVID was significantly associated with the adjusted odds of a post-infection somatic syndrome (aOR = 10.90, 95% CI [8.38, 14.17], p < 0.001). Conclusion Somatic syndromes and long COVID were associated with each other.

Trauma-Based Sexually Dimorphic Changes in the Connectome and Its Association with Central Sensitization Syndromes—A Systematic Review

Background/Objectives: Chronic pain syndromes pose a significant global health challenge to patients and physicians with a complex relationship of biological and psychosocial factors that are only partly understood. Emerging research suggests an association between prenatal and childhood adversity and the development of somatic syndromes, particularly in females. This study aims to explore the relationship between sexual dimorphic epigenetic changes in the connectome and prenatal and early life adversity (ELA). Methods: A review of the existing literature was conducted, examining studies utilizing MRI to identify critical periods of environmental influence on neural phenotypes. Results: The findings indicate a significant association between prenatal and childhood adversity and the emergence of central sensitization syndromes, particularly among females. Notably, alterations in grey matter volume and neural connectivity patterns were observed, suggesting that early adverse experiences can influence pain signaling mechanisms. Conclusions: Understanding the role of sex differences in brain circuitry is crucial for developing personalized pain management strategies. This study highlights the importance of considering both biological and psychosocial factors in addressing chronic pain, as interventions based predominantly on male subjects may be less effective for females. Further research is warranted to explore these differences and refine therapeutic approaches.

Lifestyle factors as predictors of incident functional somatic disorder. Five-year follow-up of The DanFunD study.

To assess whether lifestyle factors, including sleep pattern, are predictors for the development of functional somatic disorder (FSD). A population-based prospective cohort of 9656 men and women aged 18-76 years was established in 2011-2015 and invited for re-examination in 2017-2020, when 5738 participated. Median follow-up period was 65 months. Participants filled in validated questionnaires on lifestyle, sleep pattern and various delimitations of FSD, which were operationalized using two different approaches: bodily distress syndrome (BDS) and functional somatic syndromes (FSS) (i.e. chronic fatigue, chronic widespread pain (CWP), irritable bowel, and multiple chemical sensitivity (MCS)). Baseline lifestyle and sleep pattern in relation to incidence of BDS and FSS (chronic fatigue, CWP, irritable bowel, MCS) was analysed by logistic regressions, adjusted for age, sex and subjective social status. Inferior sleep quality at baseline predicted both incidence of BDS and all FSS delimitations except MCS. Smoking, alcohol intake, and low physical activity, but not diet, were predictors for the development of BDS. No uniform pattern was observed for the FSS. Smoking predicted development of chronic fatigue, CWP and irritable bowel, but not MCS. Alcohol and food quality only influenced the development of chronic fatigue whereas low physical activity only influenced the development of chronic fatigue and CWP. Lifestyle factors and sleep pattern seem to be predictors for some delimitations of FSD, but the importance of the various lifestyle factors is different for the different delimitations. The study shows the importance of analysing the various FSSs separately.

Fluctuation of functional somatic disorders in a population-based cohort. The DanFunD study.

Evidence of incidence of functional somatic disorders (FSD) is hampered by unclear delimitations of the conditions and little is known about the possible interchangeability between syndromes. Further, knowledge on remission and persistence of FSD in the general population is limited. We aimed to assess the natural course of various FSD over 5 years in the general population. A follow-up study (Danish Study of Functional Disorders-DanFunD) was conducted in a random sample of the general population comprising 5,738 participants aged 18-76 years at baseline. Both at baseline and five-year follow-up, participants filled in validated questionnaires on symptoms to delimitate two approaches of FSD, the bodily distress syndrome (BDS) and four functional somatic syndromes (FSS): irritable bowel (IB), chronic fatigue (CF), chronic widespread pain (CWP), and multiple chemical sensitivity (MCS). Both BDS and FSS showed a five-year incidence around 11%. Incidence of the individual FSS varied from 0.8% (MCS) to 5.7% (CF). BDS and FSS showed a remission proportion close to 50%. We found a high degree of interchangeability between each FSS varying from 15.0% to 23.4%. We identified a marked fluctuation pattern of FSD during a five-year period, with a high degree of interchangeability between each FSS. The study stresses the importance of large population-based cohorts with transparent delimitation of FSD in future research to understand these complex conditions.

Features of Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic mutation syndrome associated with the c.121A&amp;gt;C, p.(Met41Leu) UBA1 genetic variant: A systematic review

Abstract Introduction/Objective Vacuoles, E1 enzyme, X-linked, autoinflammatory, and somatic mutation (VEXAS) syndrome was first described in 2020. VEXAS is driven by a mutation in the UBA1 gene on hematopoietic progenitor cells that encodes the E1 ubiquitin-activating protein. Loss of this protein leads to various inflammatory clinical presentations ranging from dermatological, pulmonary, rheumatologic and hematologic. Many UBA1 variants have been identified. We did a systematic review focusing on a particular UBA1 variant gene mutation underlying this disease process. Methods/Case Report Databases were searched for articles discussing VEXAS syndrome until April 2024. Only case reports and case series in the English language were included. Data on patient demographics, clinical presentation, laboratory values, bone marrow findings, dermatologic presentation and skin biopsy findings were extracted. Results (if a Case Study enter NA) 332 articles discussing VEXAS syndrome were retrieved, of which 115 were case reports or case series. These were screened for patients carrying a p.Met41Leu UBA1 gene mutation and only the 25 patients with this genetic variant were ultimately included in our study. The average age was 68 years (59-81 years). 24/25 (96%) patients reported dermatologic symptoms ranging from erythema to urticarial eruptions to erythema multiforme. Fever was the second most common presenting complaint (76%) followed by arthritis (68%), chondritis (36%) and thromboembolic disease (28%). Macrocytic anemia was a common laboratory finding (65%). MDS was seen in 52% of the patients. All patients had hematopoietic progenitor cells with vacuoles. Sweet’s syndrome was the most common initial diagnosis (52%) as skin biopsies in most patients showed dermal edema and neutrophilic dermatoses/infiltration. Conclusion The c.121A&amp;gt;C, p.(Met41Leu) UBA1 variant is frequently related to cutaneous manifestations. In patients with clinical features of an inflammatory disorder with dermatological and hematologic abnormalities, testing for the p.Met41Leu UBA1 mutation might lead to an earlier diagnosis and prompt initiation of effective treatment.

Urticarial vasculitis

Purpose of review Urticarial vasculitis is a rare condition manifesting with a variety of clinical presentations ranging from skin limited lesions to life-threatening systemic illnesses. This review aims to highlight the recent findings on the etiology, diagnostic modalities, and therapeutic strategies and course of urticarial vasculitis. Recent findings In addition to well established triggers, urticarial vasculitis (UV) cases associated with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) disease and COVID-19 vaccines, vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome, and adenosine deaminase (ADA) deficiency have been reported. A clinical-dermoscopic model for differentiating urticarial vasculitis has been developed with purpuric patches and globules favoring UV diagnosis and thus diminishing the need for histopathology. The efficacy of treatment modalities has been reviewed, and antihistamines, systemic corticosteroids, omalizumab, cyclophosphamide, tocilizumab, anti-interleukin (IL)-1 agents, and rituximab were shown to have the highest success rates. Regarding the durability of remission, rituximab, dapsone, and MMF were related to long-lasting treatment free responses. The course of hypocomplementemic urticarial vasculitis was investigated in an epidemiological study, revealing 5- and 10-year survival rates of 92% and 83%, respectively. Chronic obstructive pulmonary disease, septicemia, and end-stage renal disease were identified as causes of mortality. Summary With the aid of dermoscopy, a noninvasive tool, differentiation from chronic spontaneous urticaria can be made, and the need for histopathological examination can be diminished. Although clear definitions and consensus criteria for performing disease severity are lacking, careful screening is needed to tailor the treatment on an individual basis. Emerging infections like SARS-CoV 2, vaccines, and autoinflammatory disorders like VEXAS syndrome and ADA deficiency are new associations. The optimal use of well established agents like systemic corticosteroids and immunomodulators are mainstay treatment modalities, whereas IL-1 inhibitors, omalizumab, rituximab and Janus Kinase inhibitors may represent viable alternatives in selected cases.

Accelerating depression intervention: identifying critical psychological factors using MCDM-MOORA technique for early therapy initiation

BackgroundA thorough psychosocial assessment is time-consuming, often requiring multiple sessions to uncover the psychological factors contributing to mental illness, such as depression. The duration varies depending on the severity of the patient’s condition and how effectively the psychotherapist can establish rapport. However, prolonged assessment periods pose a significant risk of patient deterioration.MethodsThe comprehensive psychosocial intervention, led by the Multi-Criteria Decision-Making (MCDM) approach utilizing the Multi-Objective Optimization by Ratio Analysis (MOORA) method, played a pivotal role in identifying the key psychological factors contributing to the depression of the client among the 21 factors specified by BDI-II analysis.ResultsThe integration of the MOORA strategy compared to traditional psychotherapy on 254 samples demonstrates a Jaccard similarity coefficient of 0.8, with a minimum error margin of 7% (vulnerability index = 0.57), indicating a significant agreement between the two approaches, both converging towards a similar solution. For patients with extreme depression, the number of sessions reduced from 18 ± 2 to 11 ± 2, showing a 33–35% reduction (χ2 = 6.94, p = 0.008). Severe depression patients experienced a reduction from 14 ± 2 to 8 ± 1 sessions i.e., 34–39% reduction (χ2 = 8.32, p = 0.004). Moderate depression patients saw sessions drop from 9 ± 1 to 5 ± 1, i.e., 37–43% reduction (χ2 = 0.29, p = 0.001). The accuracy for detecting dominant psychological factors improved to 82.88% for extreme, 86.74% for severe, and 90.34% for moderate depression, respectively. ConclusionThe implementation of MOORA facilitated the identification and prioritization of key psychosocial intervention strategies, making the process significantly faster compared to traditional methods. This acceleration greatly enhanced the precision and efficacy of the work. Additionally, critical vulnerable factors were identified through ordered statistics and correlation analysis [Pearson (r) = 0.8929 and Spearman’s rank (ρ) = 0.7551] on the Beck Depression Inventory-II model. These findings were supported by other MCDM schemes such as EDAS and TOPSIS, demonstrating high stability and robustness in dynamic decision-making environments, maintaining consistency across scenarios adapted by different psychotherapists. Overall, the combined application of MCDM (MOORA) and targeted psychological interventions yielded substantial positive outcomes in enhancing the well-being of individuals with psychological illnesses, such as depression, cognitive, affective, and somatic syndromes.

Efficacy and safety of targeted therapies in VEXAS syndrome: retrospective study from the FRENVEX

ObjectivesVacuoles, E1 enzyme, X-linked, autoinflammatory and somatic (VEXAS) syndrome is an adult-onset autoinflammatory disease associated with somatic ubiquitin-like modifier-activating enzyme 1 (UBA1) mutations. We aimed to evaluate the efficacy and...

Low remission rates and high incidence of adverse events in a prospective VEXAS syndrome registry.

We aimed to gather real-world clinical evidence of detailed disease activity, treatments, remission rates, and adverse events (AEs) associated with vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome in a prospective study. Patients in Japan suspected of having VEXAS syndrome were enrolled in a registry study. A novel disease activity measure (VEXASCAF) assessing 11 symptoms associated with VEXAS syndrome was evaluated at enrolment and after 3 months. AEs, survival, CRP levels, and treatments were also recorded at enrolment and 3 months after enrolment. All exons of UBA1 were sequenced using a next-generation sequencer to determine the variant allele frequencies of pathogenic variants in the peripheral blood of all patients. Of the 55 registered patients, 30 patients were confirmed to have pathogenic variants of UBA1. All patients were male, with a median age of 73.5 years. VEXASCAF and CRP levels decreased significantly at 3 months post-enrolment, but the oral prednisolone dose did not change. Only two patients achieved complete remission according to FRENVEX at 3 months after enrolment. During the observation period of 6 months, 28 AEs were observed, including 3 deaths, 4 malignancies from two cases, 2 thromboses, and 13 infections (including 4 mycobacterial infections). Inflammation of the lung and cervical region (i.e. parotid and submandibular gland swelling, tonsillitis, cervical swelling, and pain) were the most common AEs. Patients with VEXAS syndrome required high-dose glucocorticoids to achieve remission, and complications-such as malignancy, thrombosis, and infection-occurred frequently within a short observation period.

Correlating plasma protein profiles with symptomatology and treatment response in acute phase and early remission of major depressive disorder.

This study aimed to explore the relationship between plasma proteome and the clinical features of Major Depressive Disorder (MDD) during treatment of acute episode. In this longitudinal observational study, 26 patients hospitalized for moderate to severe MDD were analyzed. The study utilized Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS) alongside clinical metrics, including symptomatology derived from the Montgomery-Åsberg Depression Rating Scale (MADRS). Plasma protein analysis was conducted at the onset of acute depression and 6 weeks into treatment. Analytical methods comprised of Linear Models for Microarray Data (LIMMA), Weighted Correlation Network Analysis (WGCNA), Generalized Linear Models, Random Forests, and The Database for Annotation, Visualization and Integrated Discovery (DAVID). Five distinct plasma protein modules were identified, correlating with specific biological processes, and uniquely associated with symptom presentation, the disorder's trajectory, and treatment response. A module rich in proteins related to adaptive immunity was correlated with the manifestation of somatic syndrome, treatment response, and inversely associated with achieving remission. A module associated with cell adhesion was linked to affective symptoms and avolition, and played a role in the initial episodes and treatment response. Another module, characterized by proteins involved in blood coagulation and lipid transport, exhibited negative correlations with a variety of MDD symptoms and was predominantly associated with the manifestation of psychotic symptoms. This research points to a complex interplay between the plasma proteome and MDD's clinical presentation, suggesting that somatic, affective, and psychotic symptoms may represent distinct endophenotypic manifestations of MDD. These insights hold potential for advancing targeted therapeutic strategies and diagnostic tools. The study's limited sample size and its naturalistic design, encompassing diverse treatment modalities, present methodological constraints. Furthermore, the analysis focused on peripheral blood proteins, with potential implications for interpretability.

Effects of xylazine on naloxone-precipitated fentanyl withdrawal in male and female rats

PurposeThe combination of fentanyl and xylazine (i.e., “tranq-dope”) was recently declared an emerging national health threat in the United States. Given the recency of this development, very little is known regarding the behavioral pharmacology of fentanyl-xylazine combinations. The purpose of this study was to characterize the somatic and affective withdrawal symptoms of this drug combination. MethodsMale and female Long Evans rats were given twice daily (08:00 and 20:00) subcutaneous injections of fentanyl, xylazine, or combined fentanyl-xylazine for five days. On the sixth (testing) day, rats were given a final injection at 08:00. Four hours later, rats were injected intraperitoneally with either saline or a naloxone challenge before behavioral observation. Somatic withdrawal was examined using the Gellert-Holtzman scale and anxiety-like behavior was examined using the elevated plus maze. ResultsNaloxone administration did not induce somatic or affective symptoms in rats treated with fentanyl alone, a low dose of xylazine alone, or a high dose of xylazine alone. Naloxone induced somatic but not affective withdrawal symptoms in rats treated with both fentanyl and xylazine. ConclusionChronic co-exposure to fentanyl and xylazine produces an opioid-like somatic withdrawal syndrome at doses that are not apparent with either drug alone. These results corroborate clinical reports that xylazine worsens fentanyl withdrawal and suggest that novel interventions may be required to treat withdrawal from fentanyl-xylazine combinations in humans.

Somatic cough syndrome as an unaddressed diagnosis in the COVID-19 era: Long COVID or somatic coughing?

Somatic cough syndrome as an unaddressed diagnosis in the COVID-19 era: Long COVID or somatic coughing?

Approaches for the diagnosis and treatment of VEXAS syndrome: the importance of clinical suspicion and the use of methotrexate.

Vacuoles, E1-enzyme, X-linked, Autoinflammatory, Somatic (VEXAS) syndrome is caused by mutations in the UBA1 gene in myeloid precursors, leading to systemic inflammatory manifestations. We present the case of a 75-year-old man presenting with fever, panniculitis, and macrocytic anemia testing repeatedly negative for UBA1 mutations in peripheral blood samples, but ultimately found positive on bone marrow mononuclear cell DNA. The man has been successfully treated with prednisone and methotrexate.

Internalizing problems can differ in boys and girls since early childhood: Findings from the Child Behavioral Checklist 1.5-5 (CBCL 1.5-5).

Globally, internalizing problems disproportionately affect females in adolescence and adulthood, with limited research at earlier ages due to a focus on disruptive behaviors. Our study addresses this gap by exploring the structure of internalizing problems and gender differences in Brazilian preschoolers. We analyzed data from the Child Behavioral Checklist 1.5-5 in the Preschool Mental Health Study, involving 1,292 children aged 4 to 5 in Embu das Artes, São Paulo, Brazil. Confirmatory factor analysis and mean comparisons explored internalizing problems and gender variations. A two-factor model best fit both internalizing and externalizing problems.The hierarchical model with four factors (Emotionally Reactive, Anxiety/Depression, Somatic Complaints, and Withdrawn) best fit internalizing problems, achieving partial invariance between boys and girls. Boys scored higher in Withdrawn Syndrome, while girls scored higher in Somatic Complaints Syndrome. Preschoolers' internalizing problems warrant attention beyond their link to externalizing problems. While the overall construct is similar in boys and girls, divergent syndrome scores indicate potential distinct risk patterns requiring further exploration.

Comparison of the symptom networks of long-COVID and chronic fatigue syndrome: From modularity to connectionism.

The objective was to compare the symptom networks of long-COVID and chronic fatigue syndrome (CFS) in conjunction with other theoretically relevant diagnoses in order to provide insight into the etiology of medically unexplained symptoms (MUS). This was a cross-sectional comparison of questionnaire items between six groups identified by clinical diagnosis. All participants completed a 65-item psychological and somatic symptom questionnaire (GSQ065). Diagnostically labelled groups were long-COVID (N = 107), CFS (N = 254), irritable bowel syndrome (IBS, N = 369), fibromyalgia (N = 1,127), severe asthma (N = 100) and healthy group (N = 207). The 22 symptoms that best discriminated between the six groups were selected for network analysis. Connectivity, fragmentation and number of symptom clusters (statistically related symptoms) were assessed. Compared to long-COVID, the symptom networks of CFS, IBS and fibromyalgia had significantly lower connectivity, greater fragmentation and more symptom clusters. The number of clusters varied between 9 for CFS and 3 for severe asthma, and the content of clusters varied across all groups. Of the 33 symptom clusters identified over the six groups 30 clusters were unique. Although the symptom networks of long-COVID and CFS differ, the variation of cluster content across the six groups is inconsistent with a modular causal structure but consistent with a connectionist (network, parallel distributed processing) biological basis of MUS. A connectionist structure would explain why symptoms overlap and merge between different functional somatic syndromes, the failure to discover a biological diagnostic test and how psychological and behavioral interventions are therapeutic.

The role of stressful traumatic events, personality traits and psychiatric disorders in the formation of chronic pain syndromes

BACKGROUND: Chronic pain syndrome is a highly prevalent condition that negatively affects the ability to work and quality of life, as well as worsening the prognosis of the disease and increasing the risk of early death. One of the most important scientific and practical medical tasks is the identification of risk factors for the transition of acute pain to chronic pain, which in the future will allow to develop mechanisms for preventing the development of chronic pain. It has been established that various psychological and psychopathological factors, in particular, personality traits and mental disorders, psychotraumatic events, make a significant contribution to the perpetuation of pain, but these data require clarification. AIM: To determine the contribution of stressful events, personality profile and comorbid psychiatric disorders to the formation of chronic pain syndromes. MATERIALS AND METHODS: The study included 105 patients aged 18 to 70 years with unexplained somatic or neurological pain syndrome that existed for more than 6 months and served as a reason for hospitalization. All patients underwent clinical-anamnestic and psychometric examination, statistical processing of the results was performed using SPSS Statistics v22. RESULTS: In the course of the study, 4 groups of patients with psychiatric disorders comorbid with chronic pain were formed: 1 — chronic pain within the framework of prolonged reaction to stress\exhaustion disorder, 42 observations (12 men, 30 women); 2 — chronic pain within the framework of prolonged masked depressive episodes, 41 observations (6 men, 35 women); 3 — chronic pain as part of hypochondriacal spectrum disorders (limited hypochondria), 15 observations (8 men, 7 women); 4 — chronic pain as part of constitutional anomalies with a tendency to experience pain (pain prone personality), 7 observations (5 men, 2 women). CONCLUSION: A significant association of chronic pain syndromes with stressful events has been established.

Human papillomavirus (HPV) vaccination in Japan.

To review the status of human papillomavirus (HPV) vaccination in Japan from inception to the present, focusing on past and current challenges. Published articles and website content related to HPV vaccination were reviewed. The Ministry of Health, Labor and Welfare suspended proactive recommendations for HPV vaccination in June 2013 following repeated media reports of girls experiencing adverse events, including chronic pain and walking disturbances, after receiving the HPV vaccine. Despite later recognition of these symptoms as a functional somatic syndrome, HPV vaccine coverage of target girls aged 12 to 16 years in the National Immunization Program (NIP) rapidly decreased to near zero. This suspension of the proactive HPV vaccination recommendation ceased in fiscal year (f-year) 2022, initiating a 3-year catch-up free HPV vaccination period from April 2022 to March 2025 for women born from f-years 1997 to 2005. These drastic changes were driven by established evidence of the effectiveness and safety of HPV vaccines reported from both Japan and other countries, and a nine-valent HPV vaccine has been included in the NIP since f-year 2023. However, the estimated HPV vaccination rate in the NIP remains low at ≤30%. To regain high coverage of HPV vaccination in Japan, it is essential that government, industry, and academic society work together to raise awareness and educate Japanese people about cervical cancer prevention and HPV-related diseases.

Вплив стресу на стан м’язової системи пацієнтів з ушкодженнями опорно-рухового апарату

The article examines the impact of stress and psychological disorders in the context of military actions in Ukraine on the human muscular system, as well as their effect on the physical condition of patients with injuries and disorders of the musculoskeletal system. It also explores how stress and psychological disorders in wartime conditions contribute to the spread of pathological pain sensations and the occurrence of muscle spasms. A brief historical overview is provided, and scientific publications on the use of various methods in treating different pathologies, including pain syndromes caused by musculoskeletal muscle spasms, are analyzed. The article discusses types of somatic muscle spasms and pain syndromes, as well as mechanisms of local physiological influences and methods of psychological correction for conditions that cause pain and spasms in muscles, fascia, and joints. The positive impact of physiological procedures combined with psychological correction on pain associated with stressful situations and psychological disorders in people who have experienced moral humiliation and physical abuse during wartime and occupation is demonstrated. Various manifestations of stress and their effects on the functioning of muscles, fascia, and joints in individuals who are currently experiencing or have experienced military actions are described. Additionally, the article examines how psychological disorders resulting from military actions in Ukraine affect patients with musculoskeletal injuries. Methods proposed by modern rehabilitation therapy to alleviate and improve the condition of such patients are presented. These methods, such as various types of massage, heat treatments, taping, and psychological correction, are considered techniques for relieving pain that can be used both simultaneously and sequentially, without causing negative side effects during therapy and requiring minimal effort. It is established that the consequences of chronic stress and prolonged experiences of anxiety, nervousness, and panic attacks cause significant harm to the health of adults and children. The accumulated stress over the long period of war causes varying degrees of harm to each individual, with chronic forms of internal organ diseases and inflammatory processes becoming more pronounced. However, the primary target of chronic stress is the muscles. Only a comprehensive approach to this problem is an important factor in overcoming the consequences. Key words: stress, psychological disorders, human muscular system, musculoskeletal system, military actions

Pulmonary manifestations of VEXAS syndrome with acute interstitial pneumonia and diffuse alveolar hemorrhage: a case report and literature review

Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome is an emerging adult-onset systemic autoinflammatory disorder affecting multiple organ systems. While lung involvement is common in this syndrome, literature regarding specific patterns is sparse. In this report, we present a case description of a patient with VEXAS syndrome who presented at the emergency department on two separate occasions with acute interstitial pneumonia (AIP) and diffuse alveolar hemorrhage (DAH). A literature review with a comparison of our observed findings to the general findings of VEXAS syndrome, AIP, and DAH is provided. This report underscores the rarity of specific pulmonary manifestations associated with VEXAS syndrome, contributing valuable insight to the limited literature available on this topic.