Remission Stage Research Articles

GC-MS with Headspace Extraction for Non-Invasive Diagnostics of IBD Dynamics in a Model of DSS-Induced Colitis in Rats.

Inflammatory bowel diseases are extremely common throughout the world. However, in most cases, it is asymptomatic at the initial stage. Therefore, it is important to develop non-invasive diagnostic methods that allow identification of the IBD risks in a timely manner. It is well known that gastrointestinal microbiota secrete volatile compounds (VOCs) and their composition may change in IBD. We propose a non-invasive method to identify the dynamics of IBD development in the acute and remission stage at the level of VOCs in model of dextran sulfate sodium (DSS) with chemically induced colitis measured by headspace GC/MS (HS GC/MS). Methods: VOCs profile was identified using a headspace GC/MS (HS GC/MS). GC/MS data were processed using MetaboAnalyst 5.0 and GraphPad Prism 8.0.1 software. The disease activity index (DAI) and histological method were used to assess intestinal inflammation. The peak of intestinal inflammation activity was reached on day 7, according to the disease activity index. Histological examination data showed changes in the intestine due to different stages of inflammation. As the acute inflammation stage was reached, the metabolomic profile also underwent changes, especially at the short-fatty acids level. A higher relative amounts of acetic acid (p value < 0.025) and lower relative amounts of propanoic acid (p value < 0.0005), butanoic acid (p value < 0.005) and phenol 4-methyl- (p value = 0.053) were observed in DSS7 group on day 7 compared to the control group. In remission stage, disease activity indexes decreased, and the histological picture also improved. But metabolome changes continued despite the withdrawal of the DSS examination. A lower relative amounts of propanoic acid (p value < 0.025), butanoic acid (p value < 0.0005), pentanoic acid (p value < 0.0005), and a significant de-crease of hexanoic acid (p value < 0.0005) relative amounts were observed in the DSS14 group compared to the control group on day 14. A model of DSS-induced colitis in rats was successfully implemented for metabolomic assessment of different stages of inflammation. We demonstrated that the ratios of volatile compounds change in response to DSS before the appearance of standard signs of inflammation, determined by DAI and histological examination. Changes in the volatile metabolome persisted even after visual intestine repair and it confirms the high sensitivity of the microbiota to the damaging effects of DSS. The use of HS GC/MS may be an important addition to existing methods for assessing inflammation at early stages.

Interferon Regulatory Factor 5 Gene Polymorphisms and mRNA Expression Levels Are Associated with Neuromyelitis Optica Spectrum Disorder.

Interferon regulatory factor 5 (IRF5) is a critical transcription factor in the toll-like receptor signaling pathway. It is associated with autoimmune disorders, such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel disease. However, the relationship between the functional single nucleotide polymorphisms (SNPs) of IRF5 and its mRNA expression level in patients with neuromyelitis optica spectrum disorder remains unclear. The present study aimed to investigate the relationship between polymorphisms and mRNA expression levels of the IRF5 gene with the incidence of neuromyelitis optica spectrum disorder (NMOSD) in northern Chinese Han people. Two loci of the IRF5 gene (rs2004640 and rs2280714) of 164 patients with NMOSD and 269 healthy subjects were genotyped using the multiple SNaPshot technique. The frequencies of alleles, genotypes, and haplotypes were compared. Stratified analysis was performed according to age, sex, AQP4 status, onset age, and Expanded Disability Status Scale (EDSS) score. The IRF5 mRNA levels in peripheral blood mononuclear cells (PBMCs) of 64 NMOSD patients (32 patients in the acute stage and 32 patients in the remission stage) and 35 healthy subjects were detected by real-time PCR. The association of SNP polymorphisms with the mRNA expression level was determined by nonparametric tests. Allele and genotype frequency distributions of rs2004640 showed significant differences between both groups. Compared to healthy controls, the frequency of rs2004640 T allele markedly increased in patients (OR = 1.51, 95% CI = 1.09-2.08, P = 0.005). Minor allele T and GT genotype of rs2004640 that significantly increases the risk of NMOSD were discovered using genetic inheritance models (codominant, dominant, and overdominant) and haplotype analyses. Subsequent haplotype analyses revealed that the major haplotype "T-A" containing the risk alleles (the SNP sequence of the alleles was rs2004640 and rs2280714) had adverse effects on NMOSD. Based on the stratification analysis according to the EDSS score, the GT genotype frequency in the EDSS ≥ 4 group (38.2%) was markedly lower than that in the EDSS < 4 group (61.8%) (OR = 0.32, 95% CI = 0.15-0.68, P = 0.0054), with a significant difference. The IRF5 mRNA expression level was increased in NMOSD patients compared to that in normal subjects. IRF5 gene polymorphisms may be tightly associated with the genesis and progression of NMOSD in northern Chinese Han people. IRF5 mRNA expression was increased in patients with NMOSD and significantly increased in patients with acute phase. Perhaps IRF5 expression levels can be used as a predictor of disease activity in the future.

Orodental manifestations of Noonan syndrome: a clinical case study

Relevance. Mutations in the PTPN11 gene, a hallmark of Noonan syndrome, disrupt the normal development of connective tissue structure, resulting in a range of manifestations, including orodental abnormalities.Clinical case description. This article presents a medical record of a 14-year-old patient diagnosed with Noonan syndrome who sought medical assistance due to exacerbated chronic generalized periodontitis. The authors implemented a two-stage treatment approach, resulting in satisfactory outcomes. They identified concurrent orodental symptoms and conducted analyses of orthopantomography and bone densitometry for both jaws. A personalized treatment schedule was devised, emphasizing the necessity for the patient's chronic periodontitis to be in a state of remission and the utilization of sedation for effective management. Following the implementation of a planned series of therapeutic interventions during the remission stage, including professional oral care, teeth splinting with orthodontic retainers, nonsurgical root debridement, and mandibular labial frenuloplasty, quarterly follow-up assessments were chosen as the preferred monitoring method.Conclusion. Patients with hereditary pathologies, such as Noonan syndrome, often exhibit significant orodental manifestations. Addressing such conditions necessitates specific treatment techniques that integrate a comprehensive approach, timely diagnostics, and collaboration between general practitioners and dentists. Given the unique needs of these patients, it is essential to develop personalized treatment protocols tailored to their individual requirements, including the duration and efficacy of chosen treatments, as well as considerations for anesthesia or sedation care.

Urokinase prophylactic anticoagulation in children with nephrotic syndrome: a multicenter retrospective cohort study

ObjectiveTo analyze the clinical effect of urokinase on the prevention of thrombosis in children with primary nephrotic syndrome.MethodsA total of 370 children diagnosed with primary nephrotic syndrome (PNS) in the Children’s Hospital of Soochow University and Zibo Maternal and Child Health Hospital from January 2018 to December 2022 were selected as the research objects. The patients were divided into a urokinase adjuvant therapy group and non-urokinase adjuvant therapy group according to the application of drugs. The clinical data of the children were collected, including sex, age, drug application, bleeding during treatment, and telephone follow-up, to record whether thromboembolism occurred in the acute stage and remission stage. The clinical pattern of PNS, renal biopsy, histopathological type, and related laboratory indexes before and after treatment were recorded.ResultsA total of 313 patients were treated with urokinase and 57 patients were not. More thrombotic events was observed in non-urokinase group compared to the urokinase group(2 versus 0 episodes, p = 0.02). The thrombotic events observed included one patient had pulmonary embolism combined with right ventricular thrombosis, and another had intracranial venous thrombosis. More minor bleeding events occurred in urokinase group compared to the non-urokinase group(7 versus 1 episodes, p = 1.0). No major bleeding events occurred in either group.ConclusionThe rational prophylactic use of urokinase anticoagulation in children with PNS can prevent the formation of thromboembolism and has good safety.

Extracorporeal membrane oxygenation in long-term COVID-19 with severe neutropenia and thrombocytopenia after allogeneic hematopoietic stem cell transplantation: a case report

BackgroundHematopoietic stem cell transplantation (HSCT) was associated with potentially life-threatening complications. Among patients supported by extracorporeal membrane oxygenation (ECMO), those who underwent HSCT had a worse prognosis than those who did not. Advances in HSCT and critical care management have improved the prognosis of ECMO-supported HSCT patients.CaseThe patient in the remission stage of lymphoma after 22 months of allogeneic hematopoietic stem cell transplantation, suffered from ARDS, severe neutropenia, thrombocytopenia, and long-term COVID-19. We evaluated the benefits and risks of ECMO for the patient, including the possibility of being free from ECMO, the status of malignancy, the interval from HSCT to ARDS, the function of the graft, the amount of organ failure, and the comorbidities. ECMO was ultimately used to save his life.ConclusionsWe did not advocate for the general use of ECMO in HSCT patients and we believed that highly selected patients, with well-controlled tumors, few comorbidities, and fewer risk factors for death, tended to benefit from ECMO with well ICU management.

A study on the role of serum uric acid in differentiating acute inflammatory demyelinating polyneuropathy from acute-onset chronic inflammatory demyelinating polyneuropathy.

Clinical symptoms and laboratory indices for acute inflammatory demyelinating polyneuropathy (AIDP), a variant of Guillain-Barré syndrome, and acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP) were analyzed to identify factors that could contribute to early differential diagnosis. A retrospective chart review was performed on 44 AIDP and 44 A-CIDP patients looking for any demographic characteristics, clinical manifestations or laboratory parameters that might differentiate AIDP from acutely presenting CIDP. In Guillain-Barré syndrome patients (N = 63), 69.84% (N = 44) were classified as having AIDP, 19.05% (N = 12) were found to have acute motor axonal neuropathy, 6.35% (N = 4) were found to have acute motor and sensory axonal neuropathy, and 4.76% (N = 3) were found to have Miller Fisher syndrome. Serum uric acid (UA) was higher in A-CIDP patients (329.55 ± 72.23 μmol/L) than in AIDP patients (221.08 ± 71.32 μmol/L) (p = 0.000). Receiver operating characteristic analyses indicated that the optimal UA cutoff was 283.50 μmol/L. Above this level, patients were more likely to present A-CIDP than AIDP (specificity 81.80%, sensitivity 81.80%). During the follow-up process, serum samples were effectively collected from 19 AIDP patients during the rehabilitation phase and 28 A-CIDP patients during the remission stage, and it was found that UA levels were significantly increased in A-CIDP (remission) (298.9 ± 90.39 μmol/L) compared with AIDP (rehabilitation) (220.1 ± 108.2 μmol/L, p = 0.009). These results suggest that serum UA level can help to differentiate AIDP from A-CIDP with high specificity and sensitivity, which is helpful for early diagnosis and guidance of treatment.

Detection of serum interleukin-18 level and neutrophil/lymphocyte ratio in patients with antineutrophil cytoplasmic antibody-associated vasculitis and its clinical significance.

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of autoimmune diseases. This study aimed to investigate the clinical significance of changes in interleukin-18 (IL-18) and neutrophil/lymphocyte ratio (NLR) in the pathogenesis of AAV and the impact of NLR on the prognosis of patients. The clinical data of 52 AAV patients (AAV group) who met the conditions of hospitalization, 30 patients with mild mesangial proliferative glomerulonephritis (disease controls), and 30 healthy volunteers (normal controls) in Nephrology Department of Liuzhou People's Hospital from May 2020 to August 2022 were selected. A total of 52 AAV patients were divided into active phase (>15 points) and remission phase (≤15 points) based on the Birmingham vasculitis activity score (BVAS). Serum IL-18 level was detected by enzyme-linked immunosorbent assay in three groups. Pearson product moment correlation analysis was performed to investigate the correlation between serum IL-18 levels and clinical laboratory indicators, and receiver operating characteristic (ROC) curve analysis was performed on serum IL-18, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) levels, and NLR in AAV patients. The levels of serum creatinine, parathyroid hormone, β2-microglobulin (β2-MG), ESR, CRP, and IL-18 in active stage of AAV were significantly higher than those in remission stage of AAV. Moreover, the serum IL-18 level of active AAV patients was significantly higher than that of disease control group (P < 0.05). The levels of eGFR, hemoglobin, and complement C3 were significantly lower than those during the remission (P < 0.05). Pearson product moment correlation analysis showed that serum IL-18 level in AAV patients was positively correlated with BVAS score and ESR level. The area under the curve of serum IL-18, NLR, CRP, ESR levels evaluated by ROC curve was 0.921, 0.899, 0.83, and 0.75, respectively. Kaplan-Meier survival curve showed that the cumulative survival rate of patients in low NLR group was significantly higher than that in high NLR group (68.36 vs 42.89%), with significant difference (Log-Rank = 6.745, P = 0.025 < 0.05). IL-18 may be adopted as one of the important biological markers to judge the disease of AAV, and the cumulative survival rate of patients with high NLR is low, which may be applied as an indicator to evaluate the poor prognosis of patients with AAV.

Frailty of the.

Vestibular frailty and presbyvestibulopathy, including benign paroxysmal positional vertigo (BPPV), can cause dizziness among elderly patients. Vestibular frailty and presbyvestibulopathy may contribute to the onset of the vicious circle of falling-bone fracture-prolonged bedridden status-senile dementia. Treatment interventions for vestibular frailty and presbyvestibulopathy should be based on vestibular rehabilitation rather than vestibular implantation or regeneration. In acute BPPV, the otolith repositioning maneuver can be used to return otolithic debris to the utricle. At the chronic remission stage, there are nutritional guidelines for improving bone density in otolith organs and rehabilitation guidelines for activating otolith organs to prevent exfoliation. Moreover, sleeping in the head-up position can prevent free-floating debris from entering the semicircular canal. Throughout their old age, the psychiatric care/support is also indispensable to keep their initiative against vestibular frailty.

P152 Longitudinal immune profiling of peripheral blood in patients with Ulcerative Colitis

Abstract Background Recent literature has established the communication and mutual influence between the gut and the brain, referred to as the gut-brain axis. While inflammatory bowel disease (IBD) poses a risk for neuroinflammation and brain dysfunction, the molecular mechanisms are not fully understood. This study aims to investigate longitudinal changes during Ulcerative Colitis (UC), focusing first on the characterization of peripheral immune cell subsets, circulating cytokines, and extracellular vesicles (EVs). Methods In our study, we examined 19 UC patients in both active (mean age in years: 45,63) and remission phases (mean age in years: 46,16). A gastroenterologist at the Gastroenterology Department from the Otto-von-Guericke University in Magdeburg, Germany assessed all participants, categorizing them into stages using Mayo scoring and calprotectin levels. We analysed peripheral whole blood and plasma samples using different flow cytometry-based approaches. Results Our findings indicate an upregulation of the neutrophil (CD16+, CD15+) numbers during the active stage followed by a significant reduction during remission, indicating an increase in innate inflammation as a first line of defence and a balanced state during remission. Classical (CD14+, CD16-) monocytes were decreased, along with similar results in the intermediate (CD14+, CD16+) subset. Nonclassical monocytes (CD14+, CD16++) increased from the active to the remission stage. Surface expression of activation marker CCR2 was downregulated for all monocyte subsets, whereas CX3CR1 was upregulated specifically in intermediate monocytes during remission. Compared to the active stage peripheral dendritic cell (CD14-, CD16-) numbers increase during remission suggesting less colonic infiltration. Peripheral regulatory T cells (Tregs) (CD127 low/-, CD25+), which are important for the reestablishment of homeostasis are upregulated during remission. Characterization of cytokine levels in plasma revealed an upregulation of the proinflammatory milieu during the active stage, especially with elevated IL-18 and TGF- β1 levels. Finally, those changes were accompanied by alterations of the surface markers expressed by isolated circulating EVs. Conclusion Our initial results indicate the feasibility of evaluating the gut-brain axis through liquid biopsy. We unravel the composition of the peripheral inflammatory milieu during the active phase. Currently we are focusing on the assessment of the CNS-derived metabolites and their bidirectional communication with the gastrointestinal system.

EEG features in young female patients with depressive states at different stages of endogenous mental diseases

To search for neurophysiological correlates of the characteristics of the brain functional state in patients with endogenous depression with an ultra-high risk of developing psychosis in comparison with EEG parameters of patients without symptoms of a risk of developing psychosis and patients who have suffered psychotic episode. The study included 92 female patients, aged 16-26 years, at the stage of remission, divided into three groups: with depression without symptoms of ultra-high risk of developing psychosis (group 1, n=42), with depression and attenuated psychotic symptoms, but without a history of a psychotic episode (group 2, n=32) and with depression that developed after experiencing a psychotic episode (group 3, n=18). In all patients, pre-treatment multichannel background EEG was recorded with spectral power analysis in narrow frequency sub-bands. According to EEG data, the functional state of the cerebral cortex of patients in group 1 at the stage of remission was approaching normal. The EEG of group 2 and group 3 differed from the EEG of group 1 by significantly lower values of EEG spectral power in the alpha3 sub-band (11-13 Hz) in the occipital leads and a significantly increased content of theta1 (4-6 Hz) activity in the central-parietal areas. Such EEG frequency structure of patients in groups 2 and 3 reflects a reduced functional state of associative areas, and may also indicate dysfunction of the frontal parts of the cerebral cortex. These EEG features of patients in groups 2 and 3 are consistent with a significantly greater severity of their positive and negative symptoms on SAPS and SANS compared to group 1. In patients with depression at the stage of remission who have symptoms of an ultra-high risk of developing psychosis and in those who have suffered a psychotic episode, a reduced functional state of the associative and frontal areas of the cerebral cortex is noted, which may underlie the characteristics of their clinical condition.

Life meanings and values of drug addicts with different durations of remission as components of the psychology of sustainable behavior

The relevance of this study lies in the fact that it draws attention to some factors of successful recovery of drug addicts, those resources that help to maintain stable remission, namely the peculiarities of the value-sense sphere of addictive personality both at the initial stages of recovery and in stable remission. The aim of the study is to investigate the value-sense sphere of drug addicts with different durations of remission in the determination of possible positive changes.The object of the study was 150 drug addicts at different stages of remission. As psychological tools we used the test of life-meaning orientations, adapted by D. A. Leontiev, “Methodology for the study of the system of life meanings” developed by V. Y. Kotlyakov; the method “Value orientations” (M. Rokich). The average data were compared using the Kruskal-Wallis H-criterion. Significant differences in the peculiarities of the value-sense sphere of drug addicts at different stages of remission were revealed. The revealed features should be taken into account when conducting psychological and preventive measures among persons with addictive behavior.

Analysis of Peripheral Blood T Lymphocyte Subsets in Multiple Myeloma Patients.

The aim of this study was to investigate the changes of T lymphocyte subsets (Th1, Th2, Tc1, Tc2, and Th17) and memory T lymphocyte subsets (Tcm and Tem) in patients with multiple myeloma (MM) at different stages of the disease. In total, 25 newly diagnosed patients with MM were selected as the study subjects and 30 healthy people were selected as the control group. The subsets of T lymphocytes such as Th1, Th2, Tc1, Tc2, Th17, Tcm, and Tem in the peripheral blood were detected by flow cytometry at the time of initial diagnosis, infection, and remission. Th1, Tem, and Tcm cells in MM patients showed a significant decrease compared to the control group. Th2 and Th17 cells in MM patients showed a significant increase compared to the control group. Total Th1 cells and memory Th1 cells in MM patients with bacterial infection were significantly higher than at initial diagnosis (p < 0.05). The Tcm of Th2 cells in the remission stage were significantly higher than those in MM patients with no remission. MM patients have decreased Th1 cells and increased Th2 and Th17 cells. The changes in memory Th1 cells were related to bacterial infection in MM patients. The increase of Tcm of Th2 cells may be associated with disease remission. The balance of T lymphocyte subsets plays an important role in the pathogenic course of MM.

Evaluation of the beneficial effects of a GABA-based product containing Melissa officinalis on post-inflammatory irritable bowel syndrome: a preclinical study.

Visceral pain represents the most common digestive issue, frequently resulting from long-term inflammation, such as inflammatory bowel diseases. The lack of effective drugs prompted search of new therapeutic approaches. In this regard, gamma-aminobutyric acid (GABA) and Melissa officinalis (Mo) appear as excellent candidates as they were recognized to have several positive effects on the digestive system. The aim of this research was to evaluate the effects of a compound containing GABA and Mo (GABA-Mo 5:1) in inflammation-induced intestinal damage and visceral pain. Colitis was induced in rats by intrarectal 2,4-dinitrobenzenesulfonic acid (DNBS) administration. DNBS-treated animals received GABA-Mo (80mg/kg BID), starting 3days before DNBS administration, until 14days after colitis induction (preventive protocol), or starting 7days after DNBS until day 21 (curative protocol). Visceral pain was assessed by measuring the viscero-motor response (VMR) and the abdominal withdrawal reflex (AWR) to colorectal distension on day 7, 14 (both protocols) and 21 (curative protocol) after DNBS administration. In the preventive protocol, GABA-Mo reduced AWR at day 14 but had no effect on VMR. In the spinal cord, treatment with GABA-Mo significantly prevented microglia reactivity (Iba-1 positive cells). In the colon, the supplement significantly decreased malondialdehyde (MDA, index of oxidative stress) and IL-1β levels and counteracted the decreased expression of claudin-1. Moreover, GABA-Mo normalized the increased levels of plasma lipopolysaccharide binding protein (LBP, index of altered intestinal permeability). In the curative protocol, GABA-Mo significantly counteracted visceral hypersensitivity persistence in DNBS-treated animals (day 14 and 21). In the spinal cord, GABA-Mo significantly reduced GFAP positive cell density (astrocytes). Histological evaluations highlighted a mild but significant effect of GABA-Mo in promoting healing from DNBS-induced colon damage. Colonic MDA and myeloperoxidase (index of leukocyte infiltration) levels were reduced, while the decreased colonic claudin-1 expression was normalized. In addition, the increased levels of plasma LBP were normalized by GABA-Mo administration. In conclusion GABA-Mo, particularly in the curative protocol, was able to reduce visceral pain and intestinal inflammation, likely through a reinforcement of intestinal barrier integrity, thus representing a suitable approach for the management of abdominal pain, especially in the remission stages of colitis.

Study of the Effect of Cadmium Chloride on Some Marker Liver Enzymes of Experimental Animals

Introduction. Cadmium (Cd) is one of the most powerful and dangerous pollutants. Cd exposure is associated with multiple organ damage in both animals and humans. The mechanism of Cd toxicity is the disruption of the body’s antioxidant system (AOS), which leads to transformation of the functional integrity of the liver. The extent of target organ damage can be examined by measuring concentrations of key indicators of hepatocellular injury. The purpose of the work is to evaluate changes in the activity of enzyme markers of hepatotoxicity in the blood serum of laboratory animals after oral exposure to an aqueous solution of cadmium chloride (CdCl2) under the conditions of a subchronic experimental model with a period of remission. Materials and methods. The study was conducted on 40 white outbred rats. Animals of three experimental groups were intragastrically administered a pollutant in various dosages for 3 months. The duration of the remission stage was 1 month. The activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) was determined in the blood serum of animals. Results. When CdCl2 was administered to animals at a dose of 1 μg/kg, an increase in AST activity was observed by 45.9% relative to the control (p=0.006). An increase in the concentration of ALT and LDH is shown. A dose-dependent decrease in the level of alkaline phosphatase was revealed in three groups of animals by 24.7%, 37.5% and 55.4%, respectively (p=0.002). The noted trends indicate pathological processes occurring in hepatocytes. Conclusion. In the course of this study, it was found that under the conditions of a subchronic model of the experiment with a period of remission, cadmium, having a pronounced hepatoxic effect, induces liver damage in experimental animals.

Analysis of Bone Mineral Density, Bone Tissue Quality Index (TBS) and Salt Transport in Patients with Nephrolithiasis

The objective: to determine the bone mineral density (BMD), bone tissue quality index (TBS) and to analyze the salt transport in patients with and without urolithiasis. Materials and methods. For qualitatively assess of crystalluria, a study of salt transport was conducted. Evaluation of the structural and functional state of bone tissue was performed on the basis of the Ukrainian Osteoporosis Center of the State University “Institute of Gerontology named after D. F. Chebotareva of National Academy of Sciences of Ukraine” by X-ray absorptiometry of the “Hologic Discovery” apparatus. 80 persons (15 men and 65 women) were included in the study, the average age of the patients was 58 years. Study participants were divided into two groups depending on the presence of urolithiasis. I group (n=32) included patients without urolithiasis with somatic diseases in the remission stage, who had no signs of exclusion criteria. Osteoporosis was diagnosed in 9 (28.1%) women of this group. Patients with urolithiasis were included in the II group (n=48). Osteoporosis was diagnosed in 18 (37.5%) women and 3 (6.25%) men in this group. Results. It was established that 21 (26.2%) patients had BMD within the normal range, 29 (36.3%) patients had BMD abnormalities within the limits of osteopenia, and 30 (37.6%) patients had osteoporosis, namely: 27 (33.8%) women and 3 (3.8%) men. Analysis of BMD status demonstrated that normal densitometric values were comparable in both groups (31.2% without urolithiasis and 22.9% patients with nephrolithiasis; p&gt;0.05). The incidence of osteopenia in patients with urolithiasis (33.3%) and without urolithiasis (40.7%) and the number of cases of detected osteoporosis also did not significantly differ (43.8% and 28.1%, respectively; p&gt;0.05). During X-ray absorptiometry it was found that the TBS bone quality index was significantly lower in patients with urolithiasis (p&lt;0.05). A comparative analysis of salt transport demonstrated that blood uric acid levels in patients with urolithiasis were significantly higher (p=0.02) than those in patients without nephrolithiasis. Conclusions. The results of the study indicate the need for ultrasound examination of the kidneys and salt transport when checking BMD in patients at risk of osteoporosis for early diagnosis of nephrolithiasis and correction of crystalluria. Since a decrease in TBS even with a normal BMD is also an increased risk factor for bone fractures, its timely identification and correction are extremely important in patients with nephrolithiasis. The obtained data indicate the need to conduct a correlational analysis of risk factors in the group of patients with nephrolithiasis, in particular, the influence of the state of the bone system, the TBS indicator and crystalluria.

Tożsamość narracyjna osób z chorobą nowotworową

Research about health loss shows that the way we experience critical moments and build a new identity are important in giving meaning to disease. It allow to integrate the experience of illness into the whole of life. The aim of the research was to analyze the narrative identity reflected in the life history and to explore the factors contributing to the differences in the formed narratives. A research question was: what narrative about one’s life does a person with an oncological disease create? The Polish adaptation of Dan McAdams’ life story interview was used. The study was conducted in group of four people with cancer remission. The research material was subjected to McAdams’ proposed sequence and consistency analysis. Elements of hermeneutic analysis were also used. The patients identity is coherent and mature, their narrative include the time from childhood to the present. Narratives differ in the degree of paying attention on the description of emotional experiences, the level of detail and the way of moving to the next stages of the story. Patient include the disease in their narratives, doing so in an individual way. However, it is possible to distinguish two ways of storytelling. One of them is the location of the disease in the broader background of the life situation, the other – recognizing the disease as the main moment in a given part of the story, constituting its title. It seems interesting to perform comparative research in a group of people, who are during diagnosis of cancer and relate them to the results of people in remission stage.

Cross-sectional network analysis of plasma proteins/metabolites correlated with pathogenesis and therapeutic response in acute promyelocytic leukemia.

The treatment of PML/RARA+ acute promyelocytic leukemia (APL) with all-trans-retinoic acid and arsenic trioxide (ATRA/ATO) has been recognized as a model for translational medicine research. Though an altered microenvironment is a general cancer hallmark, how APL blasts shape their plasma composition is poorly understood. Here, we reported a cross-sectional correlation network to interpret multilayered datasets on clinical parameters, proteomes, and metabolomes of paired plasma samples from patients with APL before or after ATRA/ATO induction therapy. Our study revealed the two prominent features of the APL plasma, suggesting a possible involvement of APL blasts in modulating plasma composition. One was characterized by altered secretory protein and metabolite profiles correlating with heightened proliferation and energy consumption in APL blasts, and the other featured APL plasma-enriched proteins or enzymes catalyzing plasma-altered metabolites that were potential trans-regulatory targets of PML/RARA. Furthermore, results indicated heightened interferon-gamma signaling characterizing a tumor-suppressing function of the immune system at the first hematological complete remission stage, which likely resulted from therapy-induced cell death or senescence and ensuing supraphysiological levels of intracellular proteins. Overall, our work sheds new light on the pathophysiology and treatment of APL and provides an information-rich reference data cohort for the exploratory and translational study of leukemia microenvironment.

Effects of Vitamin D3 level on the gene expression of Immune checkpoint Cytotoxic T-lymphocytes antigen-4 in Iraqi patients with rheumatoid arthritis

Background: Rheumatoid arthritis is chronic autoimmune inflammatory disease that affects synovium, rheumatoid arthritis. Antigen presentation cells (APCs) link B7-1 and B7-2 with cytotoxic T-lymphocyte related protein-4 (CTLA-4), the member of the immunoglobulin superfamily, that causes T-regulatory cells to cause APCs to produce an inhibitory signal to autoreactive T cells (Treg). This study looked at the effects of vitamin D3(Vit-D3) on the expression of the CTLA-4 gene in whole blood taken from RA patients.Methods: The case control study was conducted on 100RA patients acute and remission stages of the disease depending on DAS-28 and CDAI with respect to the level of vitamin D3. The cases and samples were obtained from Baghdad Teaching Hospital, Baghdad, Iraq from Jun 2022 to January 2023. In addition,45 healthy subjects were enrolled in this study. Standardized gene expression at a level of a reference gene (GAPDH) and enumerated by the ∆Ct-value and fold change (2-∆∆Ct) method using qPCR. The ESR was measured in all subjects and serum CTLA-4, anti-cyclic citrullinated peptide (ACCP), RF was measured using ELISA techniques. The D3 level was assessed using immunofluorescent technique.Results: Significantly increased ESR and serum CTLA-4 levels, ACCP, CRP, RF in RA patients compared to controls (p≤0.05), respectively. The vitamin D3 was significantly reduced in acute cases and substantial raised in remission case compared to the controls (p≤0.05) fold change of gene expression was dramatically elevated in patients excepts in acute male cases compared to 1. There was a significant positive correlation between vitamin D3 and CTLA-4 expression.Conclusion: The current study showed that Vit-D3 up-regulates CTLA-4 gene expression as the defensive mechanism in contradiction of a severity of a disease and possible therapeutic targets through the action of Treg population and immunotolerance.

An Intensive time series investigation of the relationships across eating disorder-specific fear responses and behavior urges in partially remitted anorexia nervosa

Anorexia nervosa (AN) is a serious and persistent psychiatric illness. Many individuals with AN cycle between stages of remission (i.e., relapse), with research documenting that cognitive remission generally lags behind nutritional/weight restoration. Yet, little is known about which mechanisms promote movement from partial remission in AN (defined as nutritional, but not cognitive, recovery) to full remission. Fear-based processes, including avoidance and approach behaviors, likely contribute to the persistence of cognitive-behavioral AN symptoms after nutritional restoration. The current study used intensive longitudinal data to characterize these processes during partial remission (N = 41 participants with partially remitted AN; 4306 total observations). We aimed to a) characterize frequency of fear-based processes in real-time, b) investigate associations across fear-based processes and behavioral urges, and c) test if real-time associations among symptoms differed across commonly feared stimuli (e.g., food, social situations). On average, participants endorsed moderate fear and avoidance, with weight-gain fears rated higher than other feared stimuli. Momentary fear, avoidance, approach, and distress were all positively associated with AN behavior urges at one time-point and prospectively. Central symptoms and symptom connections differed across models with different feared stimuli. These findings provide empirical support for the theorized fear-avoidance-urge cycle in AN, which may contribute to the persistence of eating pathology during partial remission. Fear approach may be associated with temporary increases in urges, which should be considered during treatment. Future research should explore these associations in large, heterogeneous samples, and test the effectiveness of exposure-based interventions during partial remission.

Label-free microfluidic chip for segregation and recovery of circulating leukemia cells: clinical applications in acute myeloid leukemia.

We present a label-free microfluidic chip for the segregation of circulating leukemia cells (CLCs) from blood samples, with a focus on its clinical applications in Acute Myeloid Leukemia (AML). The microfluidic chip achieved an approximate capture efficiency of 92%. The study analyzed a comprehensive set of 66 blood specimens from AML patients in different disease stages, including newly diagnosed and relapsing cases, patients in complete remission, and those in partial remission. The results showed a significant difference in CLC counts between active disease stages and remission stages (p < 0.0001), with a proposed threshold of 5 CLCs to differentiate between the two. The microfluidic chip exhibited a sensitivity of 95.4% and specificity of 100% in predicting disease recurrence. Additionally, the captured CLCs were subjected to downstream molecular analysis using droplet digital PCR, allowing for the identification of genetic mutations associated with AML. Comparative analysis with bone marrow aspirate processing by FACS demonstrated the reliability and accuracy of the microfluidic chip in tracking disease burden, with highly agreement results obtained between the two methods. The non-invasive nature of the microfluidic chip and its ability to provide real-time insights into disease progression make it a promising tool for the proactive monitoring and personalized patient care of AML.