Stress Factors Research Articles

Investigating the role of psychosocial stress factors in back pain patients

Abstract Background In 2022, 27.35 million people in Germany were diagnosed with back pain. This results in a 1-year prevalence of 32.64 percent of the population and 96,8 million days of incapacity to work. Moreover, patients with back pain often suffer from additional mental disorders (e.g. anxiety, depression). This study investigated the influence of other health-related factors such as psychosocial stress in these patients. Methods A randomized controlled study was conducted with 297 gainfully employed participants in a rural rehabilitation center in Germany Bad Zwischenahn who received a 4-week multimodal pain therapy. 150 participants were allocated to the intervention (IG) who received an additional 12-month relapse prevention treatment while 147 were allocated to the control group (CG) who received no such additional treatment. Data was obtained via questionnaire (three measurement points) and claims data. Among other health-related outcomes, the number of sick days was examined. A 10-item subscale of the Patient Health Questionnaire (PHQ) was included to measure common psychosocial stress factors. Results The evaluation of the PHQ (summary) scores revealed a mild stress level at all three dates. Of the ten psychosocial stress factors surveyed, the highest level was reported in the IG and CG on the scale “Worrying about health”. The IG improved significantly (p = .017) compared to the CG after one year reporting decreased health worries. Further analyses carried out by analysis of variance (ANOVA) showed that health worries are significantly associated to a higher number of sick days in the IG (p = .002) and CG (p = .010). Conclusions With regard to psychosocial stressors, the participants were primarily affected by health worries. The results indicate that health concerns are the primary psychosocial stress factor associated with back pain and should be taken into account in the treatment of back pain. Key messages • A 12-month relapse prevention treatment significantly reduced the psychosocial stress experienced by people with back pain after their rehabilitation treatment. • Concerning psychosocial stress factors, the participants of both groups were primarily affected by health worries.

Genetic loci associated with sorghum drought tolerance in multiple environments and their sensitivity to environmental covariables.

Climate change can limit yields of naturally resilient crops, like sorghum, challenging global food security. Agriculture under an erratic climate requires tapping into a reservoir of flexible adaptive loci that can lead to lasting yield stability under multiple abiotic stress conditions. Domesticated in the hot and dry regions of Africa, sorghum is considered a harsh crop, which is adapted to important stress factors closely related to climate change. To investigate the genetic basis of drought stress adaptation in sorghum, we used a multi-environment multi-locus genome-wide association study (MEML-GWAS) in a subset of a diverse sorghum association panel (SAP) phenotyped for performance both under well-watered and water stress conditions. We selected environments in Brazil that foreshadow agriculture where both drought and temperature stresses coincide as in many tropical agricultural frontiers. Drought reduced average grain yield (Gy) by up to 50% and also affected flowering time (Ft) and plant height (Ph). We found 15 markers associated with Gy on all sorghum chromosomes except for chromosomes 7 and 9, in addition to loci associated with phenology traits. Loci associated with Gy strongly interacted with the environment in a complex way, while loci associated with phenology traits were less affected by G × E. Studying environmental covariables potentially underpinning G × E, increases in relative humidity and evapotranspiration favored and disfavored grain yield, respectively. High temperatures influenced G × E and reduced sorghum yields, with a ~ 100kgha-1 average decrease in grain yield for each unit increase in maximum temperature between 29 and 38°C. Extreme G × E for sorghum stress resilience poses an additional challenge to breed crops for moving, erratic weather conditions.

Effect of Short-Term Restraint Stress on the Expression of Genes Associated with the Response to Oxidative Stress in the Hypothalamus of Hypertensive ISIAH and Normotensive WAG Rats

Normotensive and hypertensive organisms respond differently to stress factors; however, the features of the central molecular genetic mechanisms underlying the reaction of the hypertensive organism to stress have not been fully established. In this study, we examined the transcriptome profiles of the hypothalamus of hypertensive ISIAH rats, modeling a stress-sensitive form of arterial hypertension, and normotensive WAG rats at rest and after exposure to a single short-term restraint stress. It was shown that oxidative phosphorylation is the most significantly enriched process among metabolic changes in the hypothalamus of rats of both strains when exposed to a single short-term restraint stress. The analysis revealed DEGs representing both a common response to oxidative stress for both rat strains and a strain-specific response to oxidative stress for hypertensive ISIAH rats. Among the genes of the common response to oxidative stress, the most significant changes in the transcription level were observed in Nos1, Ppargc1a, Abcc1, Srxn1, Cryab, Hspb1, and Fosl1, among which Abcc1 and Nos1 are associated with hypertension, and Fosl1 and Ppargc1a encode transcription factors. The response to oxidative stress specific to hypertensive rats is associated with the activation of the Fos gene. The DEG’s promoter region enrichment analysis allowed us to hypothesize that the response to oxidative stress may be mediated by the participation of the transcription factor CREB1 (Cyclic AMP-responsive element-binding protein 1) and the glucocorticoid receptor (NR3C1) under restraint stress in the hypothalamus of both rat strains. The results of the study revealed common and strain-specific features in the molecular mechanisms associated with oxidative phosphorylation and oxidative stress response in the hypothalamus of hypertensive ISIAH and normotensive WAG rats following a single short-term restraint stress. The obtained results expand the understanding of the most significant molecular targets for further research aimed at developing new therapeutic strategies for the prevention of the consequences of acute emotional stress, taking into account the hypertensive state of the patient.

Renal Inflammation, Oxidative Stress, and Metabolic Abnormalities During the Initial Stages of Hypertension in Spontaneously Hypertensive Rats.

Background: Hypertension is a major cause of mortality worldwide. The kidneys play a crucial role in regulating blood pressure and fluid volume. The relationship between the kidneys and hypertension is complex, involving factors such as the renin-angiotensin system, oxidative stress, and inflammation. This study aims to assess the levels of inflammatory markers, oxidative stress, and metabolic factors in the kidneys, focusing on their potential role in early renal damage and their association with the development of hypertension. Methods: This study was designed to compare the levels of selected inflammatory markers, e.g., interleukins, tumor necrosis factor-α (TNF-α), transforming growth factor, and serine/threonine-protein (mTOR); oxidative stress markers such as malondialdehyde, sulfhydryl group, and glucose (GLC); and metabolic markers among other enzymes, such as alanine transaminase (ALT), aspartate transaminase (AST), hexokinase II (HK-II), and hypoxia-inducible factor-1α (HIF-1α), as well as creatinine in the kidneys of spontaneously hypertensive rats (SHR/NCrl, n = 12) and Wistar Kyoto rats (WKY/NCrl, n = 12). Both juvenile (5 weeks old) and maturing (10 weeks old) specimens were examined using spectrophotometric methods, e.g., ELISA. Results: Juvenile SHRs exhibited reduced renal levels of all studied cytokines and chemokines, with lower oxidative stress and deficits in the mTOR and HK-II levels compared to the age-matched WKYs. Maturing SHRs showed increased renal levels of interleukin-1β (IL-1β), IL-6, IL-18, and TNF-α, alongside elevated carbonyl stress and increased HIF-1α as opposed to their control peers. The levels of all other studied markers were normalized in these animals, except for ALT (increased), ALP, and GLC (both reduced). Conclusions: This study underscores the significant impact of inflammatory, oxidative stress, and metabolic marker changes on renal function. Juvenile SHRs display lower marker levels, indicating an immature immune response and potential subclinical kidney damage that may contribute to hypertension development. In contrast, mature SHRs exhibit chronic inflammation, oxidative dysregulation, and metabolic disturbances, suggesting cellular damage. These changes create a feedback loop that worsens kidney function and accelerates hypertension progression, highlighting the kidneys' crucial role in both initiating and exacerbating this condition.

Vitamin C improved anxiety and depression like behavior induced by chronic unpredictable mild stress in adolescent rats by influencing on oxidative stress balance, neurotransmitter systems, and inflammatory response

ABSTRACT Objectives: Stress is an adaptive response to different events in daily life that could strain physically, emotionally, or psychologically. Adolescence is an important developmental period due to physical, psychological, and social maturation. The aim of our study is to state whether chronic unpredictable mild stress (CUMS) during adolescence in male rats can cause anxiety and depression in adulthood and whether vitamin C (Vit C) can prevent this problem or not. Methods: For this purpose, we performed behavioral tests, including open field test, elevated plus maze, and forced swimming test. In addition, we investigated the metabolism of serotonin, the level of inflammation, oxidative stress and brain-derived neurotrophic factor (BDNF) in the brain cortex tissue of animals. Results: Results indicated that CUMS exacerbates mood-related behaviors by affecting the brain oxidative stress balance, inflammatory response, and serotonin metabolism. Moreover, we found that CUMS-Vit C co-treatment could significantly reverse CUMS-induced complications by restoration of the mentioned biochemical parameters. Discussion: Taken together, we would like to suggest the use of Vit C supplementation as a safe, inexpensive, and effective strategy for the management of CUMS.

Relationships between work-family conflict, infertility-related stress, resilience and social support in patients undergoing infertility treatment

ABSTRACT Fertility treatments can be physically and psychologically exhausting for those who do it due to high expectations and possible frustration with the negative results. Moreover, it demands time and high financial investment, which are sometimes stressful factors for the working patient. Two aspects that can ease this context are resilience and social support. The present article aims to investigate the levels of work-family conflict in individuals undergoing infertility treatment and their associations with stress, resilience, and social support. The survey of 242 patients addressed sociodemographic data, Infertility-Related Stress Scale-Brazil (IRSS-BP), Connor-Davidson Resilience Scale 10 (CD-RISC 10), Perceived Social Support Scale (PSSS), and Work-Family Conflict Scale. Data were analyzed using R (4.3.2). Findings suggest that the level of Work-Family Conflict is higher in men (p = 0.020). The scale is also positively associated with Infertility Stress and negatively correlated with Resilience and Social Support.

Physiological and transcriptomic analysis reveals the coating of microcapsules embedded with bacteria can enhance wheat salt tolerance

Salt stress is one of the most important abiotic stress factors limiting crop production. Therefore, improving the stress resistance of seeds is very important for crop growth. Our previous studies have shown that using microcapsules encapsulating bacteria (Pontibacter actiniarum DSM 19842) as seed coating for wheat can alleviate salt stress. In this study, the genes and pathways involved in the response of wheat to salt stress were researched further. The results showed that compared with the control, the coating can improve osmotic stress and decrease oxidative damage by increasing the content of proline (29.1%), the activity of superoxide dismutase (SOD) (94.2%), peroxidase (POD) (45.7%) and catalase (CAT) (3.3%), reducing the content of hydrogen peroxide (H2O2) (39.8%) and malondialdehyde (MDA) (45.9%). In addition, ribonucleic acid (RNA) sequencing data showed that 7628 differentially expressed genes (DEGs) were identified, and 4426 DEGs up-regulated, 3202 down-regulated in the coated treatment. Many DEGs related to antioxidant enzymes were up-regulated, indicating that coating can promote the expression of antioxidant enzyme-related genes and alleviate oxidative damage under salt stress. The differential gene expression analysis demonstrated up-regulation of 27 genes and down-regulation of 20 genes. Transcription factor families, mostly belonging to bHLH, MYB, B3, NAC, and WRKY. Overall, this seed coating can promote the development of sustainable agriculture in saline soil.

Molar Incisor Hypomineralization: Etiology, Correlation with Tooth Number Anomalies and Implications for Comprehensive Management Strategies in Children from Transylvania.

This study investigates the etiology of enamel developmental defects, specifically Molar Incisor Hypomineralization (MIH), and explores correlations between MIH and dental anomalies such as hypodontia to improve interdisciplinary restorative and orthodontic treatments. Additionally, it assesses the influence of stress factors on the development of enamel defects. Conducted from July to September 2024, this study involved 57 patients aged 6 to 11 from an urban setting, divided into two groups: 32 with MIH and 25 controls, selected based on criteria of mixed dentition without systemic pathology or chronic medication. Clinical evaluations, including intraoral photographs and panoramic radiographs, were performed alongside a detailed questionnaire addressed to the mothers covering prenatal, perinatal, and postnatal factors. The average age of children with MIH was 7.5 years, in contrast to 7.04 years in the control group (p = 0.17). Significant differences were noted in maternal age, with MIH mothers older (35.56 years) than controls (29.36, p = 0.0001). The prevalence of MIH was higher in boys (66.7%) compared to girls (38.1%, p = 0.036). Factors such as prolonged labor, medication during birth, and early postnatal medication were significantly linked to MIH. The study shows a strong correlation with hypodontia, with a significantly higher incidence of tooth number anomalies (p = 0.009) in the study group. Overall, the study emphasizes the association of MIH with various maternal and birth-related factors and with hypodontia, highlighting the need for a comprehensive, multidisciplinary approach to diagnosis and treatment. Further research is recommended to investigate the relationship between stress factors and MIH.

Perspectives of Families with Seriously ill Children and Adolescents in Lower Saxony: Focus on Care and Support - An Analysis of the Current Situation and Possible Support Services

The care of children and adolescents in need of care at home is exacerbated by the shortage of skilled workers in the care sector, which leads to bottlenecks in care and presents caring families with major challenges. The implementation of new care approaches in existing structures in the healthcare system is proving to be a key development task in order to provide targeted support for affected families in the future. Qualitative explorative interview study to record the perspective of families with (seriously) ill children and adolescents on the current care situation and possible helpful support services. The sampling was criteria-driven and the analysis and evaluation was content-analytical. Respondents were given a short questionnaire to record socio-demographic characteristics. In particular, the transmission of the diagnosis, the everyday challenges and the impact on quality of life were named as stress factors by n=10 participating parents. Improved access to information, voluntary structures and central contact points as well as digital services were named as key development needs. The interviews from real life and needs-oriented perspective show that there is a need to expand low-threshold care coordination services, strengthen voluntary structures and use telemedical services. Meeting these needs should enable access to specialized treatment and helpful services, especially in rural areas.

Unmet Needs in Spondyloarthritis: Pathogenesis, Clinical Trial Design, and Nonpharmacologic Therapy.

A program focused on pathogenesis, clinical trial design, and nonpharmacologic mind-body therapy for of spondyloarthritis (SpA) was presented at the Spondylitis Association of America Unmet Needs Conference IV. SpA pathogenesis is incompletely understood but involves a complex set of drivers, including genetics, biomechanical stress, and microbial factors. Affected tissues may include axial and peripheral joints, entheses, skin, uvea, and intestines. The specific role of key cytokines like interleukin (IL)-23, IL-17, and tumor necrosis factor in the phases of this inflammatory process remains unclear. New insights into pathogenesis will continue to generate targets for novel therapeutics. How to optimally evaluate those therapeutics in clinical trials, and for the various manifestations of SpA, remains less clear. Future trials need better generalizability, robust subgroup analyses to assess differential responses for distinct disease manifestations, a focus on comparative efficacy, and outcomes relevant to the clinician and the patient. Additionally, study designs need to leverage available technology to facilitate subject participation in trials. In view of the interplay between biologic, physical, and psychological aspects of disease, there is increasing attention to nonpharmacologic agents, with the aim of maximizing long-term health-related quality of life through the control of symptoms and inflammation. Recent studies provide encouraging evidence that mind-body interventions such as tai chi, qigong, yoga, and meditation have benefits for patients with SpA, particularly those with pain. The advances in our understanding of pathogenesis, novel therapeutics, and nonpharmacologic interventions have revolutionized the management of SpA, but numerous questions around optimal management remain.

Assessment of morphophysiological parameters of resistance of various varieties of winter rye to chloride salinity in laboratory conditions

Determining the tolerance of cultivated plants to salts is considered important and necessary in breeding practice in areas with primary and secondary soil salinization. This article examines the effect of salinity (NaCl) in laboratory conditions on the growth and development of plants of three varieties of winter rye (Chusovaya, Yantarnaya, Alisa) and the effectiveness of early diagnosis on resistance to the stress factor. The purpose of the study was to determine the resistance of winter rye varieties to chloride salinity based on the variability of morphophysiological characteristics under simulated conditions. Based on the identified differences in indicators characterizing the growth processes of plants in vegetation vessels in the control and on the substrate with NaCl, the varieties according to resistance to salt stress are distributed in the following order: Chusovaya, Yantarnaya, Alisa. The data obtained indicate the specificity of the response of varieties to a stress factor. It is shown that for a more objective characterization of genotypes for salt tolerance, a comprehensive study of traits (seed germination, morphometric parameters of shoots and roots, chlorophyll content in leaves, plant biomass) is necessary. The results of the study can be used in the selection of initial forms for the selection of winter rye, as well as in the cultivation of the studied varieties in different agro-ecological conditions.

Vertical Response of Stress Transmission Through Sand–Tire Mixture Under Impact

This study evaluates the vertical stress transmission through a sand–tire mixture layer under impact, focusing on this innovative blended material that can impact underground structures such as tunnels or pipelines. By conducting consolidated undrained triaxial tests, the friction angle (φ) of the sand–tire mixture was determined, ranging from 29° for pure tire to 41° for pure sand. The vertical stress factor (α), representing the ratio of response load to applied load, was found to decrease significantly with increased tire content, with a reduction of up to 50% for mixtures containing 20% tire. Additionally, the vertical stress response decreased from 35 kPa for pure sand to as low as 15 kPa for mixtures with a high tire content under a consistent applied load of 65 kPa. This study not only presents a methodological advancement in analyzing sand–tire mixtures under dynamic loads but also suggests a sustainable approach to utilizing waste tire material in civil engineering projects, thereby contributing to environmental conservation and improved material performance in geotechnical applications.

Exploring the Impact of Resistance Training at Moderate Altitude on Metabolic Cytokines in Humans: Implications for Adipose Tissue Dynamics.

Hypobaric hypoxia (HH) limits oxygen supply to tissues and increases metabolic demands, especially during exercise. We studied the influence of HH exposure on the subcutaneous adipose tissue (SAT) thickness and circulating metabolic-related cytokines levels after a resistance training (RT) program. Twenty trained men participated in a traditional hypertrophy RT for 8 weeks (three sessions/week) under intermittent terrestrial HH (2320 m) or normoxia (N, 690 m) conditions. Before, at week 6, and after the RT, SAT, and vastus lateralis (VL) muscle thickness were measured by ultrasound. Blood samples were taken to analyse serum cytokines (IL-6, IL-15, irisin, and myostatin) by multiplex immunoassay. Our findings revealed a moderate reduction in IL-6 and irisin in HH following the RT (ES < -0.64; p < 0.05). Additionally, RT in HH promoted serum IL-15 release (ES = 0.890; p = 0.062), which exhibited a trivial inverse association with the reductions observed on SAT (-17.69%; p < 0.001) compared with N. RT in HH explained ~50% of SAT variance (p < 0.001). These results highlight the benefit of stressor factors linked to RT in HH on SAT through the modulation of serum metabolic cytokine profiles, suggesting a potential effect on overall body composition.

Interaction Between Peroxisome Proliferator-Activated Receptors and Cannabidiol in the Gut of Chickens Applied to Different Challenge Conditions.

Peroxisome proliferator-activated receptors (PPARs) are important targets for cannabidiol (CBD), which mediate many of its biological actions. The hypothesis of the present research assumed that PPARs affect the gut response to different challenge factors in chickens (C. perfringens vs. lipopolysaccharides (LPS) from E. coli), and that CBD can mediate the pathways of this response. The study proved that CBD and the challenge factors significantly affect the expression level of PPARα (p = 0.001) and selected genes determining gut barrier function. A positive correlation was demonstrated between PPARs and genes involved in the formation of tight junctions, immune, and oxidative stress responses in chickens. Dietary supplementation with CBD actively mediated the expression rate of PPARs, but the mechanism of interaction between CBD and PPARs was different depending on the stress factor used. The addition of CBD to the birds' diets did not contribute to reducing intestinal permeability under induced stress conditions nor cause stress, as indicated by the absence of elevated blood cortisol and endotoxin levels. CBD also supported the mechanisms of protecting intestinal cells from the cytotoxic effects in a C. perfringens challenge through the levels of genes involved in oxidative stress. This study indicates the importance of research toward understanding the mechanisms of PPARs as a target for enhancing intestinal barrier function, provides new results on the biological action of CBD in chickens, and shows a constant PPAR association with the jejunum mucosa of birds.

Effect of Lead, Cadmium, and Their Combination on the Heart Rate Regulation in Nonlinear Rats.

We studied heart rate variability (HRV) and the concentrations of heavy metals in the heart tissue after 14-fold peroral administration of heavy metal salts: lead acetate (50 mg/kg), cadmium chloride (5 mg/kg), and their combination. After administration of lead, its concentration in the myocardium exceeded the control values by 1.2 times or did not change in case of combination with cadmium; after administration of cadmium, its concentration in the myocardium exceeded the control value by 6.1 times or by 2 times after combined administration. After lead administration, a moderate increase in HR, low values of stress and centralization indices, and an increase in the power in all ranges of the HRV spectrum were recorded. After cadmium intoxication, a tendency to a decrease in heart rhythm variability, a moderate increase in HR, stress and centralization indices, and an increase in the contribution of VLF waves in the HRV spectrum were observed. After combined administration, a pronounced increase in HR and stress index and a moderate increase in the centralization of heart rhythm control were recorded, which was similar to changes in HRV observed after administration of cadmium alone. In the experiment, the concentration of cadmium in the myocardium increased to a much greater extent than the concentration of lead. After lead administration, the autonomous type of regulation persisted and parasympathetic influences increased. Cadmium apparently acts as a stress factor and increases the role of sympathoadrenal influences and central ergotropic structures in the heart rhythm regulation.

Development and Validation of a "Stress and Coping Assessment Tool Associated with Maintaining Oral Health among Children with Special Health-care Needs".

In our routine pediatric dental practice, many of us encounter parents and caretakers of Children with Special Health Care Needs (CSHCN) who complain about the difficulties they face in daily tooth brushing of their children. Some parents may have to accept defeat as their children face overwhelming medical conditions to cater to; ultimately leading to paradigm shift of oral hygiene leading to increase of dental caries and gingival problems. To develop and validate a comprehensive tool that can help us in assessing parent related stressors and coping factors with regard to maintenance of oral hygiene of their children. Data related to stress and coping factors encountered during maintenance of oral hygiene of their children and their experiences during the child's dental treatment (if any) were collected from parents of CSHCN. Validation and feedback from content evaluation panel experts were done. A comprehensive assessment tool with 45 items (29 stresses related items and 16 coping related items) was developed after validation. We could develop and validate a 'Stress and Coping Assessment Tool associated with maintaining Oral health among Children with Special health care needs' - abbreviated as "SCATOCS" with a hope to benefit and manage oral health care to the referred population.

Bipolar Disorder and Suicide

Suicide is a dramatic and frequent consequence of bipolar disorder. Prevention of suicidal behavior involves an assessment of suicidal vulnerability factors (history of suicidal behavior, impulsive personality, etc.), characteristics of depression (agitated depression, a subtype of bipolar disorder, etc.), psychiatric comorbidities, and stress factors. Psychosocial at the same time with the characteristics of suicidal behavior in a depressed subject (severe or repeated gestures in particular) make it possible to direct the diagnosis towards a bipolar disorder rather than a major depressive disorder. In addition to training caregivers to screen for bipolar disorder and assess suicidal behavior, the withdrawal of lethal means, networking, and treatment of depression reduce the risk of suicidal behavior. At the medicinal level, the use of lithium salts could be of particular interest in subjects at high risk of suicide.

What is new on peri- and postmenopause?

Menopause is an increasingly discussed topic in recent years. More women are demanding consultancy and help from their doctors via different channels, be it online or in menopause centers.The term genitourinary syndrome of menopause (GSM) comprises vaginal and urological symptoms such as mucosal dryness, itching and burning, dysuria or bleeding and pain during sexual intercourse. GSM can strongly affect quality of life, is common if estrogen deficiency has lasted for 3 months and can be treated locally with very low doses of the weak estrogen estriol."Not feeling like myself anymore" - symptomatic perimenopause may present with sleep disturbances, mastalgia, mood swings, palpitations, panic attacks, but also entail joint pain, vertigo, headache, and brain fog - even years before menopause and in the presence of still adequate estrogen levels. In an online study, 20% of women in the menopausal transition reported symptoms which they could not explain, and which may cause fears of serious illness. This can lead to extensive medical work-ups if the possibility of perimenopause as the cause is disregarded.(Peri-)menopausal complaints last much longer than previously thought: The Study of women's health across the nation (SWAN) reported longer duration of vasomotor symptoms (median: 11,8 years) in women who were already affected in early perimenopause, while those in whom VMS started only after menopause experienced a shorter duration of symptoms (median: 3,4 years).Female hormones protect women from fatty streaks and hypertension, but menopausal hormone therapy (MHT) has positive effects only if started in the first decade after menopause. The interaction with stress, aging and lifestyle factors is complex.For the treatment of VMS, German and international guidelines list both drug and non-drug or non-prescription options, although there is no clear data on their effectiveness.Fezolinetant, a Neurokinin-3 receptor antagonist, is now available in Germany for the treatment of vasomotor symptoms in postmenopausal women with contraindications or aversion against steroid hormones. It modulates the thermoregulation center in the hypothalamus by blocking the KNDy-neurons. Studies on Elinzanetant, another representative of this class of drugs, are still ongoing.

Traumatic Diaphragmatic Hernia in Cats and Factors Affecting Survival (A Clinical Study with 24 Cats)

Diaphragm hernia is still a serious problem in cats exposed to trauma. In this study, it was aimed to contribute to clinical practice and colleagues by notifying clinical observations on traumatic diaphragm rupture in cats and factors effective on survival. In this study, 24 cats with traumatic diaphragm hernia were presented. Contrast radiography has provided great convenience in suspicious cases in terms of diagnosis. 20 out of 24 cats (83%) remained alive, but 4 of them died. The localization of the diaphragm of these cats in 3 cats was in the left half, which was quite high (50%) in the left tears. In the defects on the right, the herniated organ was the liver, small intestine and omentum, while the stomach, small intestine and spleen in the defects on the left. As a result, survival in 83% is important and this is a good prognosis for aperture hernia. Despite many negative stress factors, a good operation management and postoperative maintenance can be increased with the survival rate.

LATE ONSET PSYCHOSIS IN THE ELDERLY

Late-onset psychosis in the elderly is a condition characterized by the onset of psychotic symptoms, such as hallucinations and delusions, after the age of 60. Although psychosis at younger ages is often associated with primary psychiatric disorders such as schizophrenia, diagnosis in the elderly is more complex, as it involves the need to differentiate between various conditions that can affect the brain and behavior, such as dementias, neurological disorders and factors related to brain aging. The impact of brain aging, such as diminished cognitive abilities and changes in brain structure, also plays an important role in the development and course of psychosis in this age group. The aim of this work is to analyze the differential diagnosis of late onset psychosis in the elderly, exploring the conditions that can mimic psychotic symptoms and the impact of brain aging on this process. It also aims to assess the implications of this diagnosis for clinical management and patients’ quality of life. This study uses a systematic review to investigate late onset psychosis in the elderly, its relationship with neurodegenerative diseases, differential diagnoses with dementias and therapeutic approaches, both pharmacological and non-pharmacological. The search was carried out in databases such as SciELO, PubMed, LILACS and Journal of Neurosciences, and included analysis of critical reviews, empirical studies and clinical guidelines. Additional data was obtained from population studies and clinical analyses involving geriatric patients with psychosis. The differential diagnosis of late onset psychosis is challenging, as it involves distinguishing between primary and secondary psychiatric causes. Neurodegenerative disorders, such as Alzheimer’s disease and dementia with Lewy bodies, are often associated with psychotic symptoms in the elderly. Likewise, disorders such as major depression with psychotic features and delirium can present with similar symptoms, and a detailed clinical assessment is essential. The exclusion of underlying medical factors, such as infections, metabolic disorders and adverse effects of medication, is crucial to ensure an accurate diagnosis. Brain aging, in turn, plays a key role in the vulnerability of the elderly to psychosis. With age, structural and functional changes occur in the brain, such as cortical atrophy, reduced neuronal density and alterations in dopaminergic pathways, which can predispose to the emergence of psychotic symptoms. These changes make the brain more susceptible to stress factors, inflammation and sensory deficits, which can precipitate psychotic episodes. Thus, the treatment of late onset psychosis involves a careful approach, given the sensitivity of the elderly to antipsychotics and the increased risk of side effects. The choice of treatment must balance efficacy in controlling symptoms with minimizing risks, and the use of low doses and constant monitoring are recommended to avoid complications. It is therefore concluded that late onset psychosis in the elderly presents significant diagnostic challenges, requiring a multifactorial approach that takes into account brain aging and the various medical conditions that can mimic or contribute to psychotic symptoms. Differential diagnosis is essential to ensure appropriate treatment, which, when properly targeted, can substantially improve patients’ quality of life. The impact of brain ageing on vulnerability to psychosis highlights the need for detailed clinical assessment and individualized therapeutic strategies for this population group.