Disease Symptoms Research Articles

Cerebellar functional connectivity relates to lower urinary tract function: A 7 Tesla study.

The objective of this study is to explore the functional connectivity (FC) of the cerebellum during the storage phase of micturition, through detecting spontaneous blood-oxygen-level dependent signal between the cerebellum and different brain regions using a high-resolution 7 Tesla magnetic resonance imaging (MRI) scanner. We recruited healthy individuals with no reported history of neurological disease or lower urinary tract (LUT) symptoms. Participants were asked to drink 500 mL of water and then empty their bladders before entering the MRI scanner. They underwent a T1-weighted anatomical scan, followed by an initial (8 min) empty bladder resting state functional MRI (rs-fMRI) acquisition. Once subjects felt the desire to void, a second rs-fMRI scan was obtained, this time with a full bladder state. We established a priori cerebellar regions of interest from the literature to perform seed-to-voxel analysis using nonparametric statistics based on the Threshold Free Cluster Enhancement method and utilized a voxel threshold of p < 0.05. Twenty individuals (10 male and 10 female) with a median age of 25 years (IQR [3.5]) participated in the study. We placed 31 different 4-mm spherical seeds throughout the cerebellum and assessed their FC with the remainder of the brain. Three of these (left cerebellar tonsil, right posterolateral lobe, right posterior lobe) showed significant differences in connectivity when comparing scans conducted with a full bladder to those with an empty bladder. Additionally, we observed sex differences in FC, with connectivity being higher in women during the empty bladder condition. Our initial findings reveal, for the first time, that the connectivity of the cerebellar network is modulated by bladder filling and is associated with LUT function. Unraveling the cerebellum's role in bladder function lays the foundation for a more comprehensive understanding of urinary pathologies affecting this area.

Comparison of oral disease symptoms according to eating habits of adolescents from Korean families and adolescents from multicultural families

Objectives: This study used the 18th Youth Online Health Behavior Data to compare oral disease symptoms according to the eating habits of adolescents from Korean families and adolescents from multicultural families. The total number of subjects was 40,913. Methods: The Rao-Scott chi-square test was used to compare general characteristics, eating habits, and experience with oral disease symptoms. In the final multiple logistic regression analysis, general characteristics and eating habits-related characteristics were used as correction variables to investigate eating habits related to oral disease symptoms in Korean adolescents and adolescents from multicultural families. Results: In Korean family the experience of oral disease symptoms was found to be lower when sweet drink 5-6 times a week 0.89 times, 3-4 times a week 0.77 times, 1-2 times a week 0.65 times, and 0.56 times when not consuming them than when consuming them daily. In multicultural families, the incidence of experiencing oral disease symptoms was 0.47 times lower in those who sweet drink daily than in those who consumed them 1-2 times a week, and 0.32 times lower in those who did not consume them. Conclusions: Based on the above research results, it is thought that customized nutrition education and oral health education programs should be continuously developed and utilized to promote oral health among adolescents from Korean families and multicultural families and to change their eating habits.

Heel Raises and Calf Stretches Exercises Versus Medication Only in Ischemic Intermittent Claudication: A Randomized Controlled Trial.

Intermittent claudication is a primary symptom of peripheral artery disease (PAD). a chronic progressive disease caused primarily by atherosclerosis. It is usually characterized by leg pain, aches, cramps, or fatigue when walking, which improves with rest. Physical therapy, including a supervised exercise program, is often recommended as the first treatment for sprains. This study aims to evaluate the short-term effects of incorporating heel raise and calf stretch exercises with standard medical therapy compared to medical therapy alone in managing intermittent claudication. From May 2022 to November 2023, 160 patients with Stage II Fontaine PAD were randomly assigned to two equal groups. Group A (80 patients) received heel raise and calf stretch exercises in addition to medical treatment, while Group B (80 patients) received only medical treatment. Both groups underwent treadmill walking tests before and after three months to measure absolute walking distance (ACD), peak walking time (PWT), and Walking Impairment Questionnaire (WIQ) scores, including distance, speed, and symptom severity. At baseline, there were no significant differences between the groups in terms of ACD, peak walking time, ankle-brachial index, distance, speed, and symptoms. At follow-up, Group A showed significantly greater improvements in ACD (312.00 ± 45.43 m), peak walking time (8.54 ± 1.55 min), distance (29.46 ± 4.63 km), speed (20.01 ± 3.13 kph), and WIQ symptoms (22.10 ± 1.02) compared to Group B, which had ACD (276.55 ± 29.07 m), peak walking time (6.72 ± 1.70 min), distance (23.68 ± 3.89 km), speed (15.71 ± 2.71 kph), and WIQ symptoms (20.80 ± 1.47) (P < .001). The ankle-brachial index remained similar between the groups (P > .05). We concluded that integrating standard physical therapy exercises, such as calf raises and leg stretches, with medical therapy significantly enhances walking function in patients with ischemic intermittent claudication.

Association between serum IGF‑1 levels and non-motor symptoms in Parkinson's disease.

We aimed to measure serum insulin-like growth factor 1 (IGF-1) levels in Parkinson's disease (PD) patients and assess their correlation with non-motor symptoms (NMS). Emerging evidence suggests that abnormal levels of IGF-1 play a crucial role in the development of PD. Further systematic research is needed to explore the potential roles of abnormal IGF-1 levels in NMS of PD. The study enrolled a total of 129 PD patients and 130 healthy controls (HCs). Within the PD cohort, 74 patients were classified as being in the early stage, while 55 were in the moderate stage. This study found no significant difference in serum IGF-1 levels between PD patients and HC. Further analysis revealed no significant difference in IGF-1 levels between early-stage PD and those in the moderate stages. Linear regression analysis indicated a significant association between serum IGF-1 levels and Nonmotor Symptom Scale (NMSS) scores in PD patients. Linear regression analysis revealed significant correlations between serum IGF-1 levels and general cognitive function, information processing speed, and executive function in PD patients. Furthermore, lower serum IGF-1 levels were associated with fatigue in PD patients. In summary, our study suggests a potential association between serum IGF-1 levels and specific NMS in patients with PD. These findings highlight the importance of long-term follow-up studies to determine whether serum biomarkers can serve as valuable tools for early detection of NMS in PD.

Beat-to-beat analysis of hemodynamic response to mental and psychological stress in sickle cell anemia

Abstract Vaso-occlusive crises are a hallmark symptom of sickle cell disease. Physical stressors can trigger decreased microvascular blood flow and increase the risk for vaso-occlusive crises. However, the effect of mental and psychological stressors on vascular physiology in sickle cell disease is not well-established. We hereby examined fluctuations in continuous blood pressure to evaluate hemodynamic changes in sickle cell disease patients during mental and psychological stress. Thirteen sickle cell disease subjects from the Children’s Hospital Los Angeles and 11 healthy volunteers were recruited. Continuous blood pressure was recorded during two mental tasks and one psychological stress task. Systolic beat-to-beat blood pressure variability measurements were calculated for each subject. Three very short-term blood pressure variability metrics served as outcome measures: standard deviation, coefficient of variation, and average real variability. Peripheral augmentation index was calculated from arterial waveforms. Linear mixed effects models evaluated associations between patient factors and outcome measures. Sickle cell disease patients exhibit increased systolic blood pressure variability in response to psychological stress. All subjects exhibited a decrease in systolic blood pressure variability in response to mental stress tasks. During mental stress, both groups displayed increased augmentation index, reflective of stress-induced vasoconstriction, while psychological stress in sickle cell disease patients led to both decreased mean arterial pressure and increased augementation index, suggestive of uncompensated vasoconstriction. These findings emphasize the impact of mental and psychological stressors on vascular function in sickle cell disease and the potential for monitoring physiological signals to predict vaso-occlusive crisis events.

Clinical genome sequencing in patients with suspected rare genetic disease in Peru

There is limited access to molecular genetic testing in most low- and middle-income countries. The iHope program provides clinical genome sequencing (cGS) to underserved individuals with signs or symptoms of rare genetic diseases and limited or no access to molecular genetic testing. Here we describe the performance and impact of cGS in 247 patients from three clinics in Peru. Although most patients had at least one genetic test prior to cGS (70.9%), the most frequent was karyotyping (53.4%). The diagnostic yield of cGS was 54.3%, with candidate variants reported in an additional 22.3% of patients. Clinical GS results impacted clinician diagnostic evaluation in 85.0% and genetic counseling in 72.1% of cases. Changes in management were reported in 71.3%, inclusive of referrals (64.7%), therapeutics (26.3%), laboratory or physiological testing (25.5%), imaging (19%), and palliative care (17.4%), suggesting that increased availability of genomic testing in Peru would enable improved patient management.

Abdominal Pain in Inflammatory Bowel Disease-Epidemiology, Pathophysiology, and Management: A Narrative Review.

Abdominal pain is a major symptom of inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, and has a significant impact on patients' quality of life. Given the evolving understanding of IBD pathology and management strategies, there is an urgent need to review the recent research findings. In this review, we have analyzed the epidemiology, pathophysiology, and management of abdominal pain in IBD over the past decade. We draw on the current literature and highlight emerging trends, challenges, and advances in this field. By synthesizing key findings, this review provides insights into the complex interplay between abdominal pain, disease progression, and therapeutic interventions for IBD.

Prevalence of elevated cardiac troponin in five non-cardiac diseases

Abstract Background Cardiac troponins (cTns) are regulatory proteins located in the cardiac muscle cells (cardiomyocytes). Since the 1990s, cTns have been the biochemical gold standard for detecting myocardial infarction. CTns are well studied among patients with cardiac illnesses and elevated concentrations are known to reflect myocardial injury. Still, high cTn concentrations are found in several non – cardiac conditions where signs of cardiac dysfunction are absent(1). This is especially found to be true for cardiac troponin T (cTnT) which is, more frequently than cardiac troponin I (cTnI), found to be elevated in patients with non – cardiac conditions(2,3). A study from 2016 of 1012 patients admitted to the emergency room, found troponin T elevations in 40.8% of patients without acute coronary syndrome vs. 7.4% with cTnI elevations(3). To our knowledge, no previous study has investigated cTn elevations across disease -groups where elevations of cTns are frequently detected. Purpose We aimed to investigate the prevalence of cTnT in five clinical non-cardiac disease-groups where frequent elevation of cTnT is previous described; Sepsis, rhabdomyolysis, end-stage renal disease (ESRD), stroke, and major non-cardiac surgery (MNCS). Methods Our study was a single-center prospective cross-sectional cohort study. Over a 6-month period, we included patients in the five above mentioned disease-groups. We excluded patients with any symptoms of cardiac disease or a prior history of cardiac diseases. All patients were included within 48 hours of admission and underwent clinical examination, vital signs, 12-lead electrocardiogram, echocardiography, and collections of blood samples. Cardiac troponin T was measured at patient’s bedside upon inclusion with the Cobas h232, cTnT point-of-care test. Results 89 patients were eligible for inclusion, 15 with sepsis, 18 with rhabdomyolysis, 11 with end-stage renal disease, 22 with stroke and 23 with major non-cardiac surgery. 53% were men. 17 patients (19%) had signs of cardiac disease confirmed on echocardiographic and/or electrocardiographic examinations and were excluded. Out of the 72 patients without signs of cardiac disease, elevated cTnT above the 99th percentile was found in 21 (29%) patients; 4 (36%) with sepsis, 6 (60%) with rhabdomyolysis, 4 (44%) with ESRD, 2 (9.5%) with stroke and 5 (24%) with MNCS. The median of cTnT in patients with elevated cTnT across all patient groups was 79.5 ng/L (IQR 52.5ng/L – 187.8 ng/L). Conclusions Cardiac troponin T elevations are frequent in the five non-cardiac diseases investigated. Elevations are most frequent in patients with rhabdomyolysis and end-stage renal disease. Further investigation is warranted to elucidate the underlying etiology contributing to the elevation of cardiac troponin in non-cardiac diseases.

Monocytic mitochondrial dysfunction and impaired monocytic bioenergetic profile in patients with heart failure symptoms in post-COVID syndrome

Abstract Introduction/Purpose Approximately 35% of COVD-19 patients have persistent symptoms similar to congestive heart failure. The so called post-Covid syndrome, which includes symptoms such as dyspnea and angina pectoris, is presumably associated to cellular metabolism and oxidative stress, yet whether mitochondrial function is impaired in post-COVID patients is still unclear. We thus investigated the mitochondrial function in monocytes of symptomatic post-COVID patients compared to matched controls. Methods Patients with persisting cardiac symptoms in their daily activities and diagnosed with post-COVID syndrome (n=14) were recruited and matched with unaffected controls (n=10) for age, sex and cardiovascular risk factors. Structural heart disease was excluded through cardiac work-up (echocardiography, functional stress testing and when necessary coronary angiography). Primary monocytes were isolated using negative selection method. The bioenergetic status of the monocytes was assessed using the Agilent Seahorse XF Cell Mito Stress Test without and after modulation of reactive oxygen species (ROS) by buthionine sulfoximine (BSO). Results CD14++ monocytes isolated from post-COVID patients showed non-significantly increased basal proton leak (p=0.57), reduced maximal respiration, and reserved respiratory capacity (p=0.19) compared to controls. Induction of additional oxidative stress by ROS modulation revealed a significantly impaired bioenergetic profile of monocytes in terms of reduction of basal respiration (3-fold, p=0.0005), maximal respiration (4-fold, p=0.004) and spare respiratory capacity (5-fold, p=0.008). Conclusions We demonstrated an impaired bioenergetic profile of CD14++ monocytic mitochondria in patients suffering from heart failure symptoms following COVID-19 infection. Whether the findings provide a novel biomarker for measuring systemic oxidative stress conditions or whether there is a direct link between symptoms of post-COVID disease and monocytic function needs to be addressed in further studies.

8.H. Scientific session: Coordinated actions to improve our response to Long COVID at EU and national levels

Abstract The COVID-19 pandemic still has very real and far-reaching consequences for European citizens, healthcare systems and economies. It has been estimated that approximately 10%-20% of people that were infected by SARS-CoV-2, develop Long COVID. Countries within the European Union and elsewhere have been responding to Long COVID in various ways. Some countries initiated a more extensive response to Long COVID, including the creation of multidisciplinary Long COVID clinics. In other counties, Long COVID should be addressed within existing infrastructures within the health care system, which can be hampered by the siloed approach of how services for people with chronic conditions is organised. Moreover, a coordinated and uniform response to Long COVID is complicated by the fact that there is a large variety of terms and definitions of Long COVID and the fact that long COVID symptom are often similar to symptoms of other diseases, thus hampering specific characterisation of patients. While substantial progress has been made in understanding Long COVID we still need more answers about its causes and the most effective treatments. It is also important to understand the impact that Long COVID has on individual lives of those who are being affected - and their families - as well as on societies as a whole. The session aims to take stock of a number of recent insights relating to Long COVID, also with the purpose to identify opportunities for a more coordinated and harmonized approach towards Long COVID at national and international levels. The session will provide room for discussions and engagement with the audience, allowing to help inform future policy agendas. As such, better ways to understand and address Long COVID can also be beneficial for health systems as a whole, given the parallels with how services are provided and policies are set up to address other chronic (non-communicable) diseases. Key messages • Long COVID is still poorly understood, in part relating to the complexity of the condition, also having considerable impacts on individuals and societies. • A more harmonised response can help improve the manners to address it, this to support those still suffering from this long term impact of the COVID-19 pandemic.

Skeletal and respiratory muscle weakness contributes to decreased exercise capacity in hypertrophic cardiomyopathy

Abstract Background and Aims Although decreased exercise capacity (due to dyspnea or angina-like symptoms) constitutes the fundamental characteristics of hypertrophic cardiomyopathy (HCM), the pathophysiology of these symptoms remains only partly understood. We investigated clinical and functional determinants of decreased exercise capacity in a broad range of HCM patients irrespective of primary disease aetiology (either genetic disorder or e.g. infiltrative phenocopies in the course of cardiac amyloidosis), overt heart failure (HF) and the presence of haemodynamically significant left ventricular outflow tract obstruction (LVOTO). Further, we deterimined the contribution of skeletal and respiratory muscle weakness to decresed exercise capacity. Methods We analyzed clinical data and functional assessments (skeletal and respiratory muscle strength, physical fitness) in relation to symptomatology and sub-maximal exercise capacity in 82 clinically stable patients with HCM (females: 32 %; age: 62±16 years; left ventricular ejection fraction [LVEF] 59±7%; intraventricular septum wall thickness [IVS] 19±4 mm; median plasma N-terminal pro-B-type natriuretic peptide [NT-proBNP]: 818 pg/mL [lower and upper quartile: 208-1917]; New York Heart Association [NYHA] class 0/I/II/III: 38/18/33/11 % [0 indicates no HF]; significant LVOTO: 29%). Results HCM patients with more severe symptomatology (NYHA class II-III vs 0-I) were older, had more frequently significant LVOTO and greater comorbidity burden, and had higher NT-proBNP and worse estimated renal function (all p≤0.03). Gender distribution, percentage of beta-blocker therapy and implanted device, body mass index, major echocardiography parameters (including LVEF, left ventricular end-diastolic diameter and IVS), high-sensitive (hs) cardiac troponin type I and hs-C-reactive protein were comparable in these 2 groups of subjects (all p&amp;gt;0.05). In multivariable linear regression models more advanced age, higher circulating natriuretic peptides (NT-proBNP) and previous coronary revascularization were independent predictors of more advanced NYHA class (standardized β-coefficient=0.30, p&amp;lt;0.01; β=0.27, p&amp;lt;0.01; and β=0.22, p&amp;lt;0.05; respectively). Similarly, more advanced age, female sex and higher NT-proBNP were independent correlates of shorter distance in 6-minute walking test (6MWT) (β=-0.46, p&amp;lt;0.001; β=-0.26, p&amp;lt;0.001; and β=-0.36, p&amp;lt;0.001; respectively). All analyzed muscle parameters (including respiratory muscle strength parameters) and objective measures of physical fitness (Functional Fitness Test for older adults) remained independently associated with 6MWT distance (all p&amp;lt;0.001) when adjusted for aforementioned clinical and laboratory correlates of 6MWT. Conclusions Muscle weakness and low physical fitness are related to decreased exercise capacity in HCM and may be potential therapeutic targets to alleviate disease symptoms also in non-obstructive HCM phenotype.

Morphological and Molecular Characterization of Trichotylenchus dispersus (Nematoda: Dolichodoridae), a Newly Recorded Plant-Parasitic Nematode in the Rhizosphere Soil of Tomato Plants in Thailand

Trichotylenchus sp. is a migratory ectoparasitic nematode (PPN) that causes hypoplasia disease symptoms in economic plants, such as maize and banana. In this study, soil samples were collected from 6 locations in a tomato field in Khon Kaen Province, Thailand, for the purpose of nematode extraction using the Cobb’s sieving and flotation-centrifugation techniques. Morphological and molecular characterization of the collected PPN identified it as Trichotylenchus sp., a PPN not previously found in Thai tomato fields. Morphologically, the nematode has a C-shaped body, a rounded lip region, robust stylet and dorsal gland orifice located 2.0 ± 0.5 µm from the base of basal knobs. The tail is conically shaped, and the cuticle exhibits annulations with 3 incisures in the lateral field. The morphological characteristics observed closely matched Trichotylenchus sp. To confirm the identity, diagnosis was done using Polymerase Chain Reaction (PCR) molecular technique. Nematode DNA amplification was conducted with different target genes using primer sets AB28/TW81 for ITS1-5.8S-ITS2 and D2A/D3B for D2-D3 region of the 28S rRNA. The PCR amplification showed DNA fragments of approximately 950 and 800 bp, respectively. The sequences obtained were compared with those in the NCBI GenBank, which showed a 98.0 - 99.4 % identity match with Trichotylenchus dispersus specimens previously documented in China. In addition, the phylogenetic trees reiterated a nematode grouping with T. dispersus, 100 % bootstrap value. To the best of our knowledge, this is the first report of the presence of T. dispersus in the soils of tomato field in Thailand. This nematode is likely to become a major factor limiting tomato production yields if not properly managed. HIGHLIGHTS Six plant-parasitic nematodes (PPNs) were found to be associated with the tomato gown in field. A newly recorded PPN in the genus, Trichotylenchus, found in Thailand, has been documented in this study. Morphological and molecular characterization identified PPN as Trichotylenchus disperses. This is the first report on incidence of dispersus in a tomato field in Thailand. GRAPHICAL ABSTRACT

The condition of the oral mucosa in somatic pathology

Lesions of the oral mucosa (SOPR) are often the primary pronounced clinical symptom of somatic diseases. It is possible to find out which pathogenetic mechanisms and links of somatic pathology create conditions for the implementation of risk factors, the implementation and development of structural and functional disorders in the oral mucosa, with the aim of targeted therapeutic effects on changes in the SOPR and the general condition of the body as a whole. The purpose of the study was to establish the structure of diseases of the oral mucosa depending on gender and age in patients with various somatic pathology. Materials and methods: A survey was conducted of 164 patients who sought advice from the Dental Hospital of Khabarovsk. Between the ages of 18 and 89. The average age of patients was (55.7 ± 1.38) years. All the subjects were divided into 4 groups depending on their age and the presence of diseases of internal organs. The comparison group included 30 somatically preserved patients of similar age and gender, by random sampling. Results: It was found that with pathology of the oral mucosa, women out of the total number of cases were 2.5 times more than men. The greatest number of patients’ complaints about the diseases of COPD was in the age group of 60-74 years, unlike other age groups: 18-44 years by 1.8 times; 45–59 years by 1.2 times; 75–89 years by 2.7 times, respectively. Most diseases of the oral mucosa are manifested in the presence of systemic pathology. Somatic diseases were detected in 62.2 % of patients with COPD. Pathology of internal organs and systems affects 70.42 % of patients with lichen planus, 50 % of patients with leukoplakia, 80 % of patients with candidiasis, 26.32 % of patients with chronic aphthous stomatitis and 79.17 % of patients with glossitis. Diseases of the gastrointestinal tract are 1.2 and 2.8 times more dominant in the structure of the lesions of the SOPR compared to the pathology of the cardiovascular and endocrine system. Findings: The revealed pattern of manifestations of pathological changes in the oral mucosa against the background of somatic pathology is of great diagnostic importance not only for dentists of various profiles, but also for clinicians of specialized departments, since ultimately all this affects the timeliness and quality of medical and diagnostic care for this category of patients.

Candida tropicalis-derived vitamin B3 exerts protective effects against intestinal inflammation by promoting IL-17A/IL-22-dependent epithelial barrier function

ABSTRACT Candida tropicalis-a prevalent gut commensal fungus in healthy individuals – contributes to intestinal health and disease. However, how commensal C. tropicalis influences intestinal homeostasis and barrier function is poorly understood. Here, we demonstrated that the reference strain of C. tropicalis (MYA-3404) ameliorated intestinal inflammation in murine models of chemically induced colitis and bacterial infection. Intestinal colonization of C. tropicalis robustly upregulated the expression of IL-17A and IL-22 to increase barrier function and promote proliferation of intestinal epithelial cells in the mouse colon. Metabolomics analysis of fecal samples from mice colonized with C. tropicalis revealed alterations in vitamin B3 metabolism, promoting conversion of nicotinamide to nicotinic acid. Although nicotinamide worsened colitis, treatment with nicotinic acid alleviated disease symptoms and enhanced epithelial proliferation and Th17 cell differentiation. Oral gavage of C. tropicalis mitigated nicotinamide-induced intestinal dysfunction in experimental colitis. Blockade of nicotinic acid production with nicotinamidase inhibitors lowered the protective effects against colitis in mice treated with C. tropicalis. Notably, a clinical C. tropicalis strain isolated from patients with candidemia lacked the protective effects against murine colitis observed with the reference strain. Together, our results highlight a novel role for C. tropicalis in resolving intestinal inflammation through the modulation of vitamin B3 metabolism.

Risk Analysis Of Musculoskeletal Disorders (MSDs) Of The Material Handling Process In Waste Processing Operators Using The Rapid Whole Body Assessment Method

: Businesses should never stop trying to include every employee in their operations and never skimp on safety precautions. One of the safety methods in the worker-centered approach implementation is the significance of ergonomics. Typically, material handling phases in production processes include physical labor that demands a lot of operator effort. Handling objects by hand raises the possibility of workplace mishaps, which can lead to musculoskeletal injuries. This study focuses on the different labor postures used for gathering, transferring, and positioning waste as well as the manual handling of waste items up to the shredding area. This study evaluates work postures that may result in symptoms of musculoskeletal diseases using the Rapid Entire Body Assessment (REBA) technique. There are three steps in this process. Prior to lowering the waste bucket to the designated place, gather the trash first, then hoist and carry it till it reaches the mechanical area. Three grades 9, 2, and 6 were obtained from the analysis utilizing the REBA (Rapid Entire Body Assessment) approach. Based on these findings, the first stage has to be improved right away. Thus, in order to meet the improvement objective, we created a telescopic reach that enables employees to change the height a device that aids in bettering workers' posture while picking up trash.

Comparative Assessment of the Incidence of Unilateral and Bilateral Lower Limb Deep Venous Thrombosis in Symptomatic and Clinically Suspected Patients

Objective: Deep vein thrombosis (DVT) is a familiar coagulation pathology that can be diagnosed through Doppler ultrasonography. This is a highly specific and sensitive method for the assessment of thrombosis. The present study aims to assess the incidence of lower limb DVT in a cohort of symptomatic and clinically suspected Saudi Arabian patients. Methods: This is a retrospective study that incorporated 1051 DVT patients over three years between January 2015 and December 2017 which presented with signs and symptoms of single or bilateral disease. Data were collected on the history of oedema, swelling, pain, tenderness, weakness, hotness, redness, fever, and vomiting. Possible risk factors that may increase the probability of developing DVT were also recorded. Results: The incidence of bilateral lower limb DVT in suspected patients was 84.5% negative and 15.5% positive. Old age was found to be the most common risk factor that resulted in DVT. The incidence of DVT is more common among females, whereas males were with all the bilateral cases. Conclusions: Screening tests are needed for DVT in symptomatic and asymptomatic patients.

Development of the celiac disease symptom diary version 2.1© (CDSD 2.1©) patient-reported outcome measure.

For patients with celiac disease (CeD), the only current management option is adherence to a strict gluten-free diet (GFD); however, many patients on a GFD continue to experience symptoms with asignificant impact on quality of life. Potential new treatments for CeD are under development and a validated patient-reported outcome measure is required to evaluate their utility in clinical trials. The purpose of this article is to provide a history of the development of the Celiac Disease Symptom Diary (CDSD) 2.1© for use in clinical trials. Qualitative and quantitative studies were conducted from 2010 to 2021, including concept elicitation and cognitive debriefing interviews with adult and adolescent participants with CeD (N = 93) diagnosed via biopsy and/or serology and input from eight interviews with CeD clinical experts. During these studies, different iterations of the CDSD were presented to the US Food and Drug Administration and the European Medicines Agency, and modifications were made in line with their feedback. These studies ultimately led to the development of CDSD 2.1©, a daily diary which focuses on key symptoms of CeD (abdominal pain, bloating, diarrhea, nausea and tiredness). This patient-reported outcome measure was readily understood by adult and adolescent participants with CeD and content validity was demonstrated in both populations. CDSD 2.1© is a content-valid patient-reported outcome measure developed in accordance with best practices and regulatory guidance. A thorough exploration of the psychometric properties of CDSD 2.1© for both adult and adolescent participants with CeDis ongoing to support utilization in clinical trials.

The role of immuno-mediated dysregulation in the progression of allergic pathology in military personnel under occupational stress

In order to identify clinical and immunological predictors of the progression of allergopathology in military personnel participating in special operations under conditions of professional stress, 43 military personnel participating in special operations divided into two groups were examined. Group 1 consisted of officers with allergopathology or who first debuted symptoms of allergic diseases during or within 6 months after participating in special operations (n = 13, average age 36.4±4.5 years). Group 2 included officers participating in special operations who did not have symptoms of allergic diseases (n = 13, average age 36.4±4.5 years). The analysis of complaints and medical documentation were carried out. Clinical and laboratory examination was performed without exacerbation of somatic pathology. The immune status was assessed by the expression of CD3+, CD4+, CD8+, CD16+, CD19+, HLA-DR+, intracellular FoxP3 content in CD4+CD25+T cells, granzyme B in CD3-CD16+ and CD3+CD8+ lymphocytes using appropriate monoclonal antibodies (Beckman Coulter) and taking into account the results on the cytofluorometer “FC 500”. Immunological monitoring was performed before participation in hostilities and 6 months after return. A comparative assessment of the cellular and humoral state of military personnel of both comparison groups before leaving for an area with an unfavorable operational situation revealed the following differences. In the group of military personnel with allergic manifestations, significantly fewer CD4+ lymphocytes were noted, as well as significantly fewer CD3+CD4+CD25+FoxP3 regulatory lymphocytes and an increase in the number of circulating B lymphocytes were recorded. When dynamically monitoring the parameters of the cellular and humoral immune response in military personnel participating in hostilities, 6 months after returning from a business trip to areas with an unfavorable operational situation, unidirectional changes in the immune status were recorded in the form of a violation of the differentiation processes of the T cell link of the immune system. In the group of servicemen suffering from allergic diseases, the revealed changes were accompanied by a weakening of the processes of physiological immunosuppression in the form of a persistent decrease in the content of regulatory T lymphocytes in the dynamics of observation for 6 months.

Analysis of risk factors for carotid artery plaque in asymptomatic adults

ObjectiveThis study aimed to investigate the risk factors affecting the presence of carotid plaque in asymptomatic adults.MethodsAsymptomatic adults (age > 40 years, no symptoms of cardiovascular and cerebrovascular diseases) undergoing routine health examinations from physical examination department were included in this study. Carotid plaque was measured by Resona 7OB and Resona 8EXP color Doppler ultrasound and L9-3U and L4-5WU probes. The focal carotid intima–media thickness was greater than 1.1 mm, and the local protrusion of the artery wall into the artery lumen suggested the presence of carotid atherosclerotic plaque. According to their ultrasound results, 1077 asymptomatic adults were divided into a group with carotid plaque (477) and a group without carotid plaque (600).ResultsA total of 1077 asymptomatic adults were included in this study, of whom 44.3% had carotid plaque. The proportion of men with carotid plaque was 84.5%. Multifactorial logistic analysis suggested that age, fasting blood glucose (FBG), total cholesterol (TC), homocysteine (Hcy) and male gender were risk factors for carotid atherosclerosis. The predictive probability of these risk factor indicators derived from the multifactorial model was calculated using receiver operating characteristic (ROC) curves with SPSS 25.0 software. The calculated area under the receiver operating characteristic curve (AUC) was 0.715 (95% CI, 0.685–0.746).ConclusionAge, FBG, TC, Hcy and male gender are risk factors for carotid atherosclerosis in asymptomatic adults. Gender differences in carotid atherosclerosis deserve further attention.

Reduction in the olfactory ability in aging Mitf mutant mice without evidence of neurodegeneration

Age-related decline occurs in most brain structures and sensory systems. An illustrative case is olfaction. The olfactory bulb (OB) undergoes deterioration with age, resulting in reduced olfactory ability. A decline in olfaction is also associated with early symptoms of neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD). However, the underlying reasons are unclear. The microphthalmia-associated transcription factor (MITF) is expressed in the projection neurons (PNs) of the OB–the mitral and tufted (M/T) cells. Primary M/T cells from Mitf mutant mice show hyperactivity, potentially attributed to the reduced expression of a key potassium channel subunit, Kcnd3/Kv4.3. This influences intrinsic plasticity, an essential mechanism involving the non-synaptic regulation of neuronal activity. As neuronal hyperactivity often precedes neurodegenerative conditions, the current study aimed to determine whether the absence of Mitf causes degenerative effects during aging. Aged Mitf mutant mice showed reduced olfactory ability without inflammation. However, an increase in the expression of potassium channel subunit genes in the OBs of aged Mitfmi-vga9/mi-vga9 mice suggests that during aging, compensatory mechanisms lead to stabilization.