Symptoms In Patients Research Articles

Elevated serum IL-17 A and CCL20 levels as potential biomarkers in major psychotic disorders: a case-control study

BackgroundMajor psychotic disorders (MPD), including schizophrenia (SCZ) and schizoaffective disorder (SAD), are severe neuropsychiatric conditions with unclear causes. Understanding their pathophysiology is essential for better diagnosis, treatment, and prognosis. Recent research highlights the role of inflammation and the immune system, particularly the Interleukin 17 (IL-17) family, in these disorders. Elevated IL-17 levels have been found in MPD, and human IL-17 A antibodies are available. Changes in chemokine levels, such as CCL20, are also noted in SCZ. This study investigates the relationship between serum levels of IL-17 A and CCL20 in MPD patients and their clinical characteristics.MethodWe conducted a case-control study at the Ibn Sina Psychiatric Hospital (Mashhad, Iran) in 2023. The study involved 101 participants, of which 71 were MPD patients and 30 were healthy controls (HC). The Positive and Negative Symptom Scale (PANSS) was utilized to assess the symptoms of MPD patients. Serum levels of CCL20 and IL-17 A were measured using Enzyme-Linked Immunosorbent Assay (ELISA) kits. We also gathered data on lipid profiles and Fasting Blood Glucose (FBS).ResultsThe mean age of patients was 41.04 ± 9.93 years. The median serum levels of CCL20 and IL-17 A were significantly elevated in MPD patients compared to HC (5.8 (4.1–15.3) pg/mL and 4.2 (3–5) pg/mL, respectively; p < 0.001). Furthermore, CCL20 and IL-17 A levels showed a positive correlation with the severity of MPD. MPD patients also had significantly higher FBS, cholesterol, and Low-Density Lipoprotein (LDL) levels, and lower High-Density Lipoprotein (HDL) levels compared to HC. No significant relationship was found between PANSS components and blood levels of IL17 and CCL20.ConclusionThe current study revealed that the serum levels of IL-17 A and CCL20 in schizophrenia patients are higher than those in the control group. Metabolic factors such as FBS, cholesterol, HDL, and LDL also showed significant differences between MPD and HC. In conclusion, the findings suggest that these two inflammatory factors could serve as potential therapeutic targets and prognostic biomarkers for schizophrenia.

Symptomatic Vitreous Opacities: Exploring the Mismatch between Clinical Observation of Vitreous Alterations and Self-Reported Symptoms

Objectives: To assess the mismatch between the clinical observation of vitreous alterations and self-reported symptoms in young patients complaining of symptomatic vitreous opacities (SVO). Methods: The ophthalmic medical records of young patients presenting primarily with SVO were retrospectively evaluated. Symptoms severity was assessed using a questionnaire. The status of the vitreous body was examined with indirect ophthalmoscopy at the slit-lamp and classified according to an ad hoc severity scale. Results: Sixty eyes of thirty otherwise healthy patients (median age: 32.5 (IQR: 29.0–37.0) years old) complaining of SVO (median duration: 38 months; interquartile range: 18–84 months) were enrolled. SVO was rated as severe by 50% of participants, affecting all the activities explored in the questionnaire. Twenty-three patients (76.6%) reported SVO-related depression and/or anxiety, for which eleven patients (36.6%) were or had been using medication. Fifty-eight eyes (96.6%) showed no evidence of (or minimal) vitreous opacity, while two eyes (3.3%) were found to have significant vitreous opacity. No significant inter-gender differences (p &gt; 0.05) and no significant differences (p &gt; 0.05) were found between the severity of vitreous opacity and patients’ reported symptoms nor with their psychological status and medication use. Conclusions: Severe discomfort related to the perception of vitreous floaters exists in young patients whose vitreous gel examination is unremarkable or shows only minor alterations. We believe this discrepancy can be explained by optical anisotropy; significant forward-scattering of light, which results in floater symptoms; and reduced back reflection, which limits the clinical observation.

A NOVEL TREATMENT FOR PTOSIS COMPLICATION AFTER PRESEPTAL CELLULITIS IN DIABETIC PATIENT (CASE REPORT

Background: Preseptal cellulitis (PC) is an inflammation of the eyelid and surrounding soft tissues covering the anterior portion of the orbital septum (palpebral fascia) characterized by eyelids unilateral swelling, can develop to orbital cellulitis and be fatal for diabetics after complication. Two main mechanisms of the PC development are distinguished. One of them is based on a spread of local infection on the eyelid. The second group of PC causes include eye surgery, trauma or insect bites. In most cases, serious complications are rare, but sometimes sight-threatening infections behind the orbital septum may develop. It is important to be able to distinguish periorbital cellulitis from orbital cellulitis, and treat according to the diagnosis. In this paper, we discuss a case of PC and successful recovery after medical intervention even though due to late presentation to the Clinic, patient developed ptosis. A clinical case of PC developed to complete ptosis, treatment and successful elimination of all residual symptoms in diabetic patient with is described. We used a novel approach to PC treatment and ptosis after PC. Results: We achieved complete recovery from ptosis after PS in a diabetic patient thanks to novel approach to treatment Findings: 1. The use of nepafenac instead of diclofenac helps to enhance the effectiveness of treatment and prevent the spread of infection to nearby tissues during PС. 2. For the treatment PC complication, ptosis, we suggest the simultaneous, not separated in time use of proserin in combination with glycine.

Manual Therapy vs. Surgery: Which Is Best for Carpal Tunnel Syndrome Relief?

Background: Carpal Tunnel Syndrome (CTS) is a common condition characterized by compression of the median nerve, leading to pain, numbness, and hand dysfunction. Both manual therapy and surgical decompression are widely used interventions, but their comparative effectiveness remains uncertain. Methods: A systematic review and a meta-analysis were conducted to compare the short- and long-term efficacy of manual therapy versus surgery for CTS. Studies were selected based on randomized controlled trials (RCTs) that met the inclusion criteria, focusing on outcomes such as pain intensity, hand function, symptom severity, and quality of life. Data were extracted and analyzed by using standardized tools to assess treatment effects. Results: Five RCTs with a total of 533 participants were included. Manual therapy was more effective for short-term pain relief, with significant improvements at 1 and 3 months compared with surgery. However, at 6 to 12 months, surgical intervention provided greater improvements in hand function and symptom severity. Quality-of-life improvements were similar in both groups. Risk of bias was moderate to low across the studies, with limitations in blinding due to the nature of the interventions. Conclusions: Manual therapy offers effective short-term relief for CTS, making it a viable option for patients with mild to moderate symptoms. Surgery provides more durable, long-term outcomes, particularly for severe cases. The choice of treatment should be individualized, considering patient preferences and symptom severity.

Percutaneous Tibial Nerve Stimulation's Impact on Sexual Function in Female Patients with Neurogenic Detrusor Overactivity, Sexual Dysfunction, and Multiple Sclerosis.

Background/Objectives: Multiple sclerosis (MS) frequently results in both urinary and sexual dysfunction, which significantly impairs quality of life. Conventional treatments for bladder dysfunction often prove insufficient, leading to the exploration of alternative therapies such as percutaneous tibial nerve stimulation (PTNS). This study aimed to assess the impact of PTNS on sexual function and bladder symptoms in female MS patients with neurogenic detrusor overactivity (NDO) and female sexual dysfunction (FSD). Methods: A total of 65 female MS patients with NDO were evaluated and underwent 12 weeks of standardized PTNS treatment. Sexual function was assessed using the Female Sexual Function Index (FSFI) and the Female Sexual Distress Scale-Revised (FSDS-R), while bladder symptoms were evaluated using the OAB-v8 questionnaire. Participants were grouped based on the presence of sexual dysfunction and distress and compared to a control group of 20 patients who declined PTNS. Results: Significant improvements were observed in FSFI scores across multiple domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) in the treatment groups (p < 0.05). Additionally, 58.46% of patients showed positive responses to PTNS regarding overactive bladder symptoms (OAB-v8 score), while the control group showed no significant changes. Conclusions: PTNS appears to be an effective therapeutic option for improving sexual function and urinary symptoms in female MS patients with NDO and FSD, offering a promising non-invasive alternative for managing these conditions.

Sterile Intraocular Inflammation Associated With Faricimab

Randomized clinical trials are conducted to establish both drug safety and efficacy. However, evidence of adverse events associated with these drugs in the clinical practice setting can be of value at generating hypotheses regarding less common safety issues, even if causality cannot be determined. To present and analyze cases of intraocular inflammation associated with faricimab therapy in patients referred to a single European institution. This was a review starting in April of 2024 of an observational case series. Patients were from a single academic-based tertiary referral center in Switzerland. Included in the analysis were patients referred for intraocular inflammation soon after receiving a faricimab intravitreal injection between June 1, 2022, and March 5, 2024. Faricimab, 6 mg (0.05 mL of a 120-mg/mL solution), administrated for neovascular age-related macular degeneration or diabetic macular edema. The systemic and ocular histories and imaging data available were reviewed. The following were evaluated: visual acuity measured with habitual correction using the Early Treatment of Diabetic Retinopathy Study charts before and after the event; intraocular pressure; patient symptoms; anterior, intermediate, or posterior location of the intraocular inflammation; and the presence of retinal vasculitis. Multimodal imaging including color fundus photographs, fluorescein angiograms, indocyanine green angiograms, and optical coherence tomography were reviewed. A total of 12 eyes from 7 patients (mean [SD] age, 73.3 [16.7] years; 4 female [57.1%]) over 22 months were identified as having noninfectious intraocular inflammation after intravitreal faricimab injections. Among these cases, in 2 eyes, retinal vasculitis was present together with anterior and posterior inflammation. One of the 2 eyes had an occlusive form of vasculitis of the arteries and veins, leading to subsequent macular capillary nonperfusion and clinically relevant irreversible vision deterioration from 20/80 to 20/2000. The remaining eyes were characterized by moderate anterior segment inflammation without substantial vision changes. The intraocular inflammation event occurred after a median (IQR) of 3.5 (2.0-4.3) faricimab injections. The median (IQR) interval between the last faricimab injection and the diagnosis of inflammation was 28 (24-38) days. Increased intraocular pressure of 30 mm Hg or higher was found in 3 eyes. This case series highlights the occurrence of rare, but potentially severe, intraocular inflammation associated with faricimab therapy. Although these findings do not prove causality and can only generate hypotheses for future investigations, these results suggest the importance of continuous surveillance and monitoring for patients undergoing faricimab therapy to promptly identify and manage potential adverse events.

The ASPECT hydrocephalus system: investigating clinical applicability and system utility

PurposeHydrocephalus presents diagnostic and management challenges due to its heterogeneity. The ASPECT Hydrocephalus System, introduced in 2023, offers a comprehensive approach to describing patients with hydrocephalus. This study investigates the clinical applicability of the ASPECT Hydrocephalus System compared to the International Classification of Disease (ICD-10) and demonstrates its utility.MethodsTwo hundred pediatric and adult patients with hydrocephalus treated at Copenhagen University Hospital between September 2019 and 2020 were described according to the ASPECT Hydrocephalus System. The latest brain imaging served as assessment point.ResultsForty-seven percent of patients had more than one ICD-10 code assigned, and 40.5% of patients had an unspecific ICD-10 code as the most recent. It was possible to apply factor A (anatomy), S (symptomatology), P (previous interventions), C (complications) and T (time of onset) to all patients. Factor E (etiology) categorized 15% of patients as ‘unknown’. Combining factor A and S showed a similar incidence of acute high-pressure symptoms in patients with and without ventriculomegaly on imaging (39.7% vs 39.3%), demonstrating how symptoms and neuro-radiological findings do not necessarily correlate.ConclusionThe ASPECT Hydrocephalus System’s applicability and utility were demonstrated in a large, diverse patient population. Except for ‘Etiology’, all factors could be applied to the entire population showing the system’s robustness. While limitations in ICD-10 may force clinicians to choose between clinical measures, the ASPECT Hydrocephalus System allows comprehensive patient characterization, potentially aiding in clinical decision-making and research. Its use depends on registration quality. Application in prospective cohorts is warranted to assure feasibility.

Use of over-the-counter supplements, sleep aids, and analgesic medicines in rheumatology: results of a cross-sectional survey

Abstract Objectives Pain, fatigue, and sleep are common symptoms in patients with Rheumatic and Musculoskeletal diseases (RMDs) that may prompt the use of over-the-counter (OTC) supplements, sleep aids, and analgesics as self-management strategies. This study evaluated the prevalence of OTC supplements, sleep aids, pain relievers and the financial burden associated with their use in rheumatology. Methods A web-based survey developed with patients, was administered in rheumatology clinics in an English hospital. Participants shared demographic information and detailed their use of OTC supplements, sleep aids, and pain relief in the past week. The data was analysed using descriptive statistics and logistic regression models to identify influencing factors. Results In total 876 people consented to participate in the survey. Over half of patients (54.5%) reported daily supplement intake, typically spending £10/month (IQR 5-20), ranging up to £200 per month. The most commonly administered supplements were vitamin D, multivitamins, vitamin C, vitamin B/B complex, Omega 3/6 supplements, with multiple overlaps. Prescription, OTC, or non-prescription pain relief was reported by 82% of respondents, with sleep aids being used by 13%. Of the 327 patients who took NSAIDs, 165 (50.4%) also reported taking OTC supplements, while among the 131 patients using opioids (20.5%), 66 (50.3%) reported supplement use, some of which have documented interactions. Conclusion The administration of OTC supplements, pain relief, and sleep aids is common in patients with RMDs. Health care professionals should be encouraged to proactively ask about these during consultations especially from a drug safety perspective, but also to provide timely, reliable advice about such strategies that may be sought by patients.

Reduced Sense of Smell in Patients with Severe Chronic Rhinosinusitis and its Implications for Diagnosis and Management: A Narrative Review.

Reduced sense of smell is a common symptom in patients with chronic rhinosinusitis (CRS). Although it is often under-diagnosed by healthcare providers, reduced sense of smell can have a substantial negative impact on patient's quality of life as measured by health-related quality of life (HRQoL) assessments and patient-reported outcomes. This narrative review describes current smell loss diagnosis and management guidelines in CRS, and the relationship between smell loss and CRS. Reduced sense of smell can be an indication of CRS disease severity in patients with (CRSwNP) and without nasal polyps (CRSsNP), and recovery of smell can be an indicator of successful CRS treatment. The current first-line therapeutic options for smell loss are intranasal corticosteroids and nasal irrigation, and second-line therapeutic options include systemic steroids and surgery. Shared decision-making between patient, caregiver, and healthcare provider is important when choosing the most appropriate CRS treatment option. Emerging biologic therapies that target type 2 inflammation signaling pathways, such as dupilumab, omalizumab, and mepolizumab, have been shown to improve smell and taste in randomized controlled trials of patients with CRSwNP.A graphical abstract and video abstract are available with this article.

Efficacy of transcranial magnetic stimulation treatment in reducing neuropsychiatric symptomatology after traumatic brain injury.

Neuropsychiatric disorders are highly disabling in traumatic brain injury (TBI) patients, and psychopharmacological treatments often fail to adequately mitigate their detrimental effects. Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment in neurology and psychiatry, showing potential in treating psychiatric disorders. This study investigates the efficacy of a novel, dual-site sequential rTMS protocol designed to treat neuropsychiatric symptoms in a TBI patient who was refractory to conventional treatments. A 34-year-old woman with severe head trauma and complex psychopathology underwent 20 daily sessions of focal-coil rTMS, combining inhibitory stimulation (1 Hz) on the right dorsolateral prefrontal cortex (DLPFC) and excitatory (10 Hz) on the left DLPFC, guided by a neuronavigation system. Psychiatric and neurocognitive assessments were conducted at baseline and at 2, 4, and 8 weeks following the beginning of rTMS treatment. After 2 weeks of treatment, the patient showed decreased impulsivity and obsessive-compulsive symptoms, along with improvements in attention and processing speed. After 4 weeks, impulsivity further declined, though no other significant changes were noted. At 8 weeks, a persistent positive effect was observed, including enhanced positive emotions. These findings suggest that guided, alternating neurostimulation of the DLPFC may modulate activity within cortico-striato-thalamo-cortical circuits, providing a promising alternative for managing neuropsychiatric symptoms in TBI patients who are resistant to traditional treatments.

Symptom clusters and symptom network analysis during immunotherapy in lung cancer patients.

This study analyzes symptoms in lung cancer patients undergoing immunotherapy to identify core symptom clusters through network analysis and lay a foundation for effective symptom management programs. The sample comprised 240 lung cancer patients receiving immunotherapy. Participants were assessed using the Memorial Symptom Assessment Scale. Exploratory factor analysis was used to extract symptom clusters, and network analysis using JASP 0.17.3 was performed to explore the centrality indices and density of the symptom network. Five symptom clusters were identified, i.e., emotion-related, lung cancer-related, physical, skin, and neural symptom clusters, with a cumulative variance contribution rate of 55.819%. Network analysis revealed that sadness was the most intense symptom (rs = 2.189), dizziness was the most central symptom (rc = 1.388), and fatigue was the most significant bridging symptom (rb = 2.575). This study identified five symptom clusters and a symptom network among lung cancer patients during immunotherapy. The network analysis's centrality indices and network density results can assist healthcare professionals in devising more precise symptom management strategies.

Correlation of patient symptoms with SARS-CoV-2 Omicron variant viral loads in nasopharyngeal and saliva samples and their influence on the performance of rapid antigen testing.

We examined nasopharyngeal and salivary viral loads using samples collected from outpatients with SARS-CoV-2 infection during the Omicron epidemic in Japan and explored the outpatient factors correlated with viral loads. In addition, we evaluated the performance of an authorized rapid antigen testing (RAT) kit using nasopharyngeal and saliva samples with RT-PCR testing as the reference. Intriguingly, a correlation between fever and other symptoms and SARS-CoV-2 viral loads in nasopharyngeal and saliva samples was observed based on one COVID-19 outpatient visit. RAT sensitivity was influenced by viral loads. Nevertheless, nasopharyngeal RAT is considered useful for SARS-CoV-2 point-of-care diagnosis. In patients with distinct symptoms, including high-grade fever, salivary RAT could be a practical diagnostic tool because of the higher estimated viral loads. After the Omicron epidemic, outpatients with mild COVID-19 have become the main focus of diagnosis and treatment. Our study provides valuable information regarding the point-of-care diagnosis of these patients.

Biological methods for diagnosing depressive symptoms in patients with schizophrenia: a narrative review

BACKGROUND: Depressive symptoms in patients with schizophrenia lead to more frequent exacerbations of the underlying disease, worsen the prognosis, and increase the risk of suicide. Clinical practitioners continue to face challenges in diagnosing this disorder. AIM: This study aims to analyze published material on biological markers of depressive symptoms in patients with schizophrenia. METHODS: The search of literature was conducted using the following electronic search engines (the total number of relevant papers found is also specified): ACCESSSS (n=150), Cochrane Library (n=48), PubMed (n=623), eLIBRARY (n=216), and Google Scholar (n=367). The final discussion included 67 papers consistent with the study aim and were published between January 1, 2018 and December 31, 2023. RESULTS: Based on the available scaterred data, it appears that plasma biomarkers (e.g. C-reactive protein, metabolic parameters, hormones, enzymes, neurotrophic factors) are limited in specificity when it comes to diagnosing depressive symptoms in schizophrenia. Our analysis of the neuroimaging findings showed that depressive manifestations are associated with a decrease in the volume of the gray matter in the parietal, frontal, and temporal lobes (particularly in Broca’s and Wernicke’s areas) and in specific regions of the prefrontal cortex (including the medial right superior frontal, medial orbitofrontal, and superior and middle frontal gyri). It has been suggested that the SIRT1, OXT, CDKAL1, and APOE genes are involved in the development of depressive symptoms in patients with schizophrenia. CONCLUSION: Understanding and identifying depressive symptoms in schizophrenia will improve the quality of care for patients with this disorder.

Association of obesity status and the risk of long-COVID: Isfahan COVID cohort study.

People with COVID-19 infection continue to have their symptoms or develop new ones after recovery. This is called long-COVID syndrome. We aimed to examine the association of general and abdominal obesity with long COVID. This study was conducted using Isfahan COVID Cohort (ICC). Totally 4008 including 3213 hospitalized and 795 non-hospitalized patients with positive RT-PCR were included. Body mass index (BMI) and waist circumference (WC) were calculated. BMI >25 kg/m2 and WC >88 cm in women and 102 cm in men were considered generally and abdominally obese, respectively. By using an open-ended questionnaire, subjects were asked whether they had any new or persistent symptom. Reported symptoms were categorized in three different fields including general, cardiac, and respiratory symptoms. Higher BMI and WC tended to increase general symptoms (odds ratio [OR] for BMI = 1.16, 95 % confidence interval (95% CI): 0.97, 1.38, and OR for WC = 1.14, 95% CI: 0.99, 1.32). Higher BMI significantly increased cardiovascular (OR = 1.38, 95% CI: 1.14, 1.67) and respiratory symptoms (OR = 1.43, 95% CI: 1.15, 1.78). Compared with patients with normal WC, the risk of cardiovascular (OR = 1.44, 95% CI: 1.24, 1.69) and respiratory symptoms was significantly higher in subjects with abdominal obesity (OR = 1.31, 95% CI: 1.10, 1.56). We found that general and abdominal obesity were associated with increased risk of cardiovascular and respiratory symptoms in patients with long-COVID symptoms. However, only general obesity was associated with increased risk of general symptoms.

Chinese expert consensus on diagnosis and treatment of spinal cord glioma

Spinal cord glioma is a group of tumors originated from spinal cord glial cells. They typically have an insidious onset, with early symptoms in patients including sensory disturbances, motor disorder, and sphincter dysfunction. When the course of disease develops to a certain extent, it can lead to paralysis, dyspnea, and even result in death. The spinal cord bears the role of nerve conduction, and acts as a lower central hub for somatic and visceral activities and primary neural reflexes. Because the self-repair ability after injury is limited, spinal cord injury caused by tumor and treatment may be permanent, potentially causing huge economic and social burden. To further standardize the diagnosis and treatment of spinal cord glioma, the expert group formulated The Chinese Expert Consensus on the Diagnosis and Treatment of Spinal Cord Glioma according to the current situation of diagnosis and treatment of spinal cord glioma at home and abroad. This consensus elaborates the epidemiology, natural course, clinical manifestations, diagnosis, treatment, follow-up, and prognosis of spinal gliomas and formulates 17 recommendations. It aims to offer reference for medical personnel and other related individuals.

Effectiveness of Walking Exercise in Improving Physical Fitness and Depression in Patients With Schizophrenia.

Patients with schizophrenia often lack physical activity, which, together with physical complications, can lower their expected lifespan. Exercise strengthens their physical and mental health. The primary aim of this study was to examine the effectiveness of a walking exercise intervention in improving physical fitness, body mass index, waist-to-hip ratio, and depressive symptoms in patients with schizophrenia. A quasi-experimental study design was used. Seventy-six participants were recruited from the psychiatric daycare center at a hospital in Northern Taiwan. They were divided into two groups. The intervention group received a walking exercise intervention, while the control completed their daily courses at the psychiatric daycare center. The changes in both groups' physical fitness, BMI, waist-to-hip ratio, and depressive symptoms were monitored. Cardiorespiratory endurance significantly improved in the intervention group, attesting to the effectiveness of the walking exercise intervention. Their depression level significantly decreased across all measurement stages. The group walking exercise reduced sedentary behaviors and increased the participants' autonomous motivation, hip circumference, and cardiorespiratory fitness. Structured exercise programs may increase the patients' hippocampal neuroplasticity and reduce their depressive symptoms. The walking exercise intervention positively affected physiological traits, physical fitness, and mental health of the participants.

The physiological determinants of symptom burden in cirrhosis with ascites.

Paracentesis is commonly used to manage patient discomfort due to ascites. The relationship between ascites pressure, ascites volume, and patient discomfort has not been elucidated. We prospectively enrolled adult patients with non-malignant ascites undergoing outpatient therapeutic paracenteses from 2021 to 2024 at a tertiary care hospital. Patients completed a validated symptom questionnaire (ASI-7, maximum score 35) before, immediately after, and 1week after paracentesis. An open-ended manometer was used to measure ascites pressure at the beginning and end of paracentesis. Mixed effect linear regression was performed to evaluate the relationships between patient characteristics, pressure, volume, and symptoms. One hundred and fifty paracentesis procedures among 48 unique patients with an average Model for End Stage Liver Disease-Sodium 3.0 of 16.7 were included. An average of 6.5L was drained, which reduced abdominal pressure from a mean of 13.7 to 6.0cm H2O (10.1 to 4.4mmHg, p<0.001) and mean symptom score from 22.6 to 6.5 (p<0.001). Regression models identified that symptoms and abdominal pressure linearly correlated above a pressure of 6cm H2O or ASI-7 score of 16 (p<0.01). Taller patients required about 670ml additional drainage per inch above the cohort mean height (5'8″) to achieve the same symptom relief. Pressure measured at the bedside can be used to explore changes in abdominal pressure during paracentesis. Pressure, volume, and patient level factors such as height contribute to patient symptoms but cannot fully explain discomfort associated with ascites and relief after paracentesis.

Characterization of Apathy-Like Behaviors in Mouse Models of Down Syndrome.

Apathy is a state of decreased interest, lack of initiative, reduced goal-directed activity and blunted emotional responses. Apathy is one of the most common neuropsychiatric symptoms (NPS) in patients with Alzheimer's disease (AD) and is also relatively omnipresent in individuals with Down syndrome (DS). Little is known about the apathy-like behaviors in rodent models of AD and DS. This study aimed to characterize apathy-like behaviors with aging in two established DS mouse models: Ts65Dn and Dp16. A battery of behavioral tests including nestlet shredding, marble burying, nest building, and burrowing were performed to examine apathy-like behaviors. Individual z-scores for each mouse for each test, and a composite z-score of apathy-like behavior were analyzed for all mice from these behavioral tests. Analysis of individual test results and composite z-score revealed significant apathy-like behaviors in Ts65Dn mice compared to WT controls. In contrast, Dp16 mice did not exhibit significant apathy-like behaviors. Our study is the first to characterize apathy-like behaviors in mouse models of DS with aging and highlights the difference between Ts65Dn and Dp16 DS model mice regarding apathy-like manifestations with aging.

The role of metabolic disorders in the development of atherosclerosis.

Atherosclerosis is a major risk factor for cardiovascular disease (CVD), which is the leading cause of death worldwide. Atherosclerosis is initiated by endothelial activation, followed by a cascade of events (accumulation of lipids, fibrous elements, and calcification) triggering vasoconstriction and activation of inflammatory pathways. This review focuses on the various stages in the development of atherosclerosis, ranging from endothelial dysfunction to plaque rupture. In addition, disorders of lipid, glucose and amino acid metabolism in atherosclerosis are considered here. The key pathological stages of metabolism disruption and their role in atherosclerosis are considered in detail which may be helpful for the more better understanding of atherosclerosis pathogenesis. Finally, some therapeutic approaches aimed at modulating lipid metabolism will also be presented which show the therapeutic targets (enzymes and transport proteins) which modulation can prevent further deterioration of patients symptoms.

Circadian clock dysregulation: a potential mechanism of depression in obstructive sleep apnea patients

Obstructive sleep apnea (OSA) is characterized by co-occurrence with affective disorders. Our study aims to investigate the association of circadian clock gene expressions, and the presence and severity of depressive symptoms in OSA patients. The study included 184 individuals, who underwent polysomnography (PSG) and had their peripheral blood collected in the evening before and the morning after the PSG. Patients were divided into two groups: the OSA (apnea-hypopnea index (AHI) > 5) and the control group (AHI < 5). RNA was extracted from peripheral blood leukocytes. Expression levels of the selected genes (BMAL1, CLOCK, PER1, CRY1, NPAS2, and NR1D1) were assessed by qRT-PCR. Questionnaire data was collected in the morning (including the Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Chronotype Questionnaire (CQ), and Montgomery–Åsberg Depression Rating Scale (MADRS)). The expression of all examined circadian clock genes in OSA patients was upregulated in the morning compared to the evening (except NPAS2). No differences were observed between OSA and control groups at either time point. Additionally, there was a positive correlation between the severity of depressive symptoms (assessed with MADRS) and morning expression of circadian genes in the group of OSA patients. Finally, in multivariable linear regression, ISI score (B = 0.750, p < 0.001), AM score of CQ (B = 0.416, p = 0.007), and morning PER1 gene expression (B = 4.310, p = 0.042) were found to be predictive factors for greater severity of depression symptoms in OSA patients. Dysregulated circadian clock gene expression in OSA patients is linked to depressive symptom severity, suggesting circadian disruption may underlie affective symptoms in OSA.