Typical Symptoms Research Articles

Detection of different groups of phytoplasma in palm species of Puerto Rico

Palm trees play important cultural, ecological, and economic roles in the tropics. Native palm species such as the royal palm, Roystonea borinquena O.F. Cook, are extensively planted in landscapes and urban areas of Hispaniola, Puerto Rico and the Virgin Islands. Worldwide, palms are affected by a disease commonly known as lethal yellowing, linked to the presence of phytoplasmas. Coconut Lethal Yellowing (CLY) is the most devastating disease of palms, associated with the 16SrIV phytoplasma group in the Americas. In Puerto Rico, palms displayed symptoms such as leaf chlorosis or yellowing, inflorescence and fruit necrosis, and eventual death. The objective of this research was to identify and characterize phytoplasmas in palms and their potential insect vectors, focusing on a native palm, R. borinquena. To fulfill this objective, 69 palms belonging to the species: Cocos nucifera (n=15), Gaussia attendata (n=1), Leucothrinax morrisii (n=1), Pseudophenix sargentii (n=1), Roystonea borinquena (n=50) and Washingtonia robusta (n=1) were sampled within three transects across the island. Ninety percent of palms sampled displayed typical lethal yellowing symptoms. In addition, 12 different insect species (Auchenorrhyncha: Fulgoroidea) that could act as potential phytoplasma vectors were sweep-collected from palms and grasses near the study area. The 16S ribosomal region of phytoplasmas was amplified using nested polymerase chain reaction (PCR) and subjected to restriction fragment length polymorphism (RFLP) analyses to allow their ribosomal grouping. Overall, 17 palm samples were positive to phytoplasmas. These are C. nucifera (n = 1), L. morrisii (n = 1) and R. borinquena (n = 15). Phytoplasmas detected belong to six ribosomal groups: 16SrII, 16SrIII, 16SrIV, 16SrVI, 16SrIX and 16SrX. The most frequent phytoplasma detected (59%) is enclosed in the 16SrII group. Samples from nine royal palms (R. borinquena) and one key thatch palm (L. morrisii) were positive to the 16SrII-related group. Only one insect specimen, the cixiid Haplaxius crudus collected from a phytoplasma positive R. borinquena palm, was positive for a 16SrII-related group phytoplasma. Another significant epidemiological finding was the detection of a phytoplasma related to CLY in the 16SrIV group in one individual of R. borinquena. This native species is the most abundant palm on the island. To our knowledge this is the first report of a phytoplasma related to the 16SrII group in R. borinquena in Puerto Rico and the world. Detection for the first time of other phytoplasmas related to 16Sr groups -III, -IX and -X in palms deserves further studies.

Immediate and continued results of parasacral transcutaneous electrical nerve stimulation in paediatric patients with overactive bladders

Among the conditions underlying childhood daytime incontinence the most frequent is overactive bladder (OAB). Parasacral transcutaneous electrical nerve stimulation (parasacral TENS) is a promising therapy for OAB treatment in children; however, there is no standard treatment protocol. To evaluate the immediate and continued effects of parasacral TENS monotherapy in children with OAB. 57 children at mean age 10.8 years diagnosed with OAB at a single centre were prospectively enrolled from 2013 to 2018. The inclusion criterion was typical OAB symptoms. The treatment results were evaluated based on objective measurements from bladder diaries, 48h frequency/volume (48hF/V) charts, and uroflowmetry. The parasacral TENS treatment lasted for 4 months, twice daily, with 1h sessions. Results were evaluated at three time points: 2 months of therapy, 4 months (end of active therapy), and 10 months (6 months after cessation of therapy). After 4 months of parasacral TENS treatment, the number of days with daytime incontinence decreased from 7.23 to 3.94/14 days (p<0.05), nocturnal enuresis decreased from 6.81 to 3.77/14 days (p<0.05), and urgency episodes from 7.36 to 3.58 in 14 days (p<0.05). Treatment effects remained stable 6 months after therapy cessation regarding days with daytime incontinence (from 3.94 [immediately after treatment] to 3.28 in 14 days [6 months after treatment cessation]), nocturnal enuresis (from 3.77 to 2.91 in 14 days), and urgency episodes (from 3.58 to 2.12 in 14 days) (p<0.05). Complete response after 6 months of therapy was observed in 32% of patients with daytime incontinence, 35% with nocturnal enuresis, and 50% with urgency episodes. A recent systematic review of parasacral TENS in children with OAB included only two studies with a follow up of 6 months or longer after treatment cessation; therefore, little is known about the continued effects of parasacral TENS. High rates of complete symptom remission were reported in studies where only subjective symptoms were evaluated. Results of our study reveal that the positive effect of treatment persist. The strengths of the present study include its prospective design, large sample size, and uniform standard urotherapy performed prior to TENS. The use of parasacral TENS in children with OAB is effective and results in a significant reduction in daytime incontinence, nocturnal enuresis, and urgency episodes. A longer treatment duration of 4 months leads to more improvement and the effects remain stable 6 months after treatment cessation.

Functional Analysis of RMA3 in Response to Xanthomonas citri subsp. citri Infection in Citron C-05 (Citrus medica)

Citrus bacterial canker disease, caused by Xanthomonas citri subsp. citri (Xcc), poses a significant global threat to the citrus industry. Lateral organ boundaries 1 (Lob1) is confirmed as a citrus susceptibility gene that induces pathogenesis by interaction with the PthA4 effector of Xcc. Citron C-05 (Citrus medica) is a Citrus genotype resistant to Xcc. However, there is little information available on the regulation of Lob1 in resistant genotypes, which is important for the breeding of citrus cultivars resistant to canker disease. This study aimed to identify upstream regulatory factors of Lob1 in Citron C-05 and to investigate its function in disease resistance. ‘Bingtang’ sweet orange (C. sinensis), a susceptible genotype, was utilized as the control. cDNA yeast libraries of Xcc-induced Citron C-05 and ‘Bingtang’ sweet orange were constructed. The capacities of ‘Bingtang’ and Citron C-05 were 1.896 × 107 and 2.154 × 107 CFU, respectively. The inserted fragments ranged from 500 to 2000 bp with a 100% recombination rate. The promoter of Lob1 was segmented into two pieces and the P1 fragment from both genotypes was used to construct a bait yeast (PAbAi-CsLob1-P1; PAbAi-CmLob1-P1). Through library screening with the bait yeast, upstream regulators interacting with the Lob1-P1 promoter were identified and then validated using Y1H and dual-luciferase tests. The expression analysis of the three transcript factors indicated that RMA3 was upregulated by inoculation with Xcc in the resistant Citron C-05, but not in the susceptible sweet orange. The overexpression of CsRMA3 in ‘Bingtang’ sweet orange led to reduced canker symptoms, with a significantly lower pathogen density in the leaves following Xcc inoculation. When CmRMA3 was silenced by virus-induced gene silencing (VIGS) in Citron C-05, typical canker symptoms appeared on the CmRMA3-silenced leaves at 15 days post-inoculation with Xcc. Further expression analyses revealed that the CmRMA3 transcription factor suppressed the expression of Lob1. These results suggest that RMA3 participates in the resistant reaction of Citron C-05 to Xcc infection, and such a response might be in relation to its suppression of the expression of the pathogenic gene Lob1.

Pharmacological characteristics and clinical study results of ensitrelvir fumaric acid (XOCOVA® Tablets 125 ‍mg)

Ensitrelvir fumaric acid (Xocova® hereafter ensitrelvir) is a novel anti-SARS-CoV-2 drug for COVID-19. Hokkaido University and Shionogi & Co., Ltd. engaged in joint research targeting SARS-CoV-2 3C-like (3CL) protease at an early stage and started clinical trials in July 2021. In February 2022, an application was filed for manufacture and sales approval for the indication of "SARS-CoV-2 infection,". Ensitrelvir recieved the first emergency regulatory approval from the Ministry of Health, Labour and Welfare (MHLW) in Japan in November 2022, and has obtained standard approval in March 2024. This emergency approval was based on the confirmed safety in a Phase 2/3 study (T1221) conducted in Japan and other Asian countries (Korea and Vietnam) in patients with mild/moderate COVID-19 and the presumed efficacy in Phase 3 Part (SCORPIO-SR), and the standard approval is based on efficacy from the Phase 3 part. In the Phase 3 part, ensitrelvir administered orally 375/125 ‍mg once daily for five days, in patients with irrespective of risk factors for severe complications and vaccination status, demonstrating a significant reduction vs placebo in the time to resolution of five typical Omicron-related symptoms (stuffy or runny nose, sore throat, cough, feeling hot or feverish, and low energy or tiredness), and also showed a significant reduction in viral RNA on day 4 relative to placebo (P < 0.001). In the Phase 2/3 study, there were no serious adverse events or deaths, indicating good tolerability and safety. We hope that ensitrelvir will contribute as a new treatment option for patients suffering from COVID-19 symptoms.

A case study of Duchenne muscular dystrophy caused by Alu element insertion in DMD gene and analysis of its gray-hair symptoms.

Duchenne muscular dystrophy (DMD) is a severe X-linked recessive genetic disorder caused by mutations in the DMD gene, which leads to a deficiency of the dystrophin protein. The main mutation types of this gene include exon deletions and duplications, point mutations, and insertions. These mutations disrupt the normal expression of dystrophin, ultimately leading to the disease. In this study, we reported a case of DMD caused by an insertion mutation in exon 59 (E59) of the DMD gene. The affected child exhibited significant abnormalities in related biochemical markers, early symptoms of DMD, and multiple gray hair. His mother and sister were carriers with slightly abnormal biochemical markers. The mother had mild clinical symptoms, while the sister had no clinical symptoms. Other family members were genetically and physically normal. Sequencing and sequence alignment revealed that the inserted fragment was an Alu element from the AluYa5 subfamily. This insertion produced two stop codons and a polyadenylate (polyA) tail. To understand the impact of this insertion on the DMD gene and its association with clinical symptoms, exonic splicing enhancer (ESE) prediction indicated that the insertion did not affect the splicing of E59. Therefore, we speculated that the insertion sequence would be present in the mRNA sequence of the DMD gene. The two stop codons and polyA tail likely terminate translation, preventing the production of functional dystrophin protein, which may be the mechanism leading to DMD. In addition to typical DMD symptoms, the child also exhibited premature graying of hair. This study reports, for the first time, a case of DMD caused by the insertion of an Alu element into the coding region of the DMD gene. This finding provides clues for studying gene mutations induced by Alu sequence insertion and expands the understanding of DMD gene mutations.

First Report of Powdery Mildew on Sophora flavescens Caused by Erysiphe diffusa in China.

Sophora flavescens (Fabaceae) is a deciduous subshrub which has been used in Chinese popular medicine for a long history (He et al. 2015). In June 2023, severe powdery mildew symptoms were observed on wild S. flavescens plants on Longwen hill of Guizhou Normal University, Guiyang, China. The incidence was approximately 80% among 100 S. flavescens plants observed. Almost all leaves were infected. Mycelia occurred on both adaxial and abaxial leaf surfaces, petioles, and stems, forming small-to-large patches. Hyphae were hyaline, 5 to 7 μm wide. Hyphal appressoria were solitary. Conidiophores were erect, straight to somewhat flexuous, and 45 to 120 µm long (n = 50). Foot cells were subcylindrical to slightly curved, followed by 2 to 3 shorter cells. Conidia formed singly, were ovoid to cylindrical, 26 to 42 × 12 to18 µm (n = 50). Based on these morphological characteristics, the powdery mildew fungus was tentatively identified as Erysiphe diffusa (Braun and Cook 2012). To confirm the identification, the ribosomal DNA internal transcribed spacer (ITS) and the ribosomal large subunit (LSU) region were amplified and sequenced using primer pairs ITS1/ITS4 (White et al. 1990) and NL1/NL4 (Ziemiecki et al. 1990), respectively. The obtained 647-bp ITS sequence (GenBank accession no. PP130131) displayed 100% identity with the ITS sequences of E. diffusa. The obtained 618-bp LSU sequence (GenBank accession no. PP693303) displayed 100% identity with the ITS sequences of E. diffusa (MT325922 and MT628019) and E. manihoticola (MT106658 and MT106660). Using a phylogenetic tree based on the combined ITS-LSU data, the isolate was grouped in a clade with the E. diffusa strain (GenBank accession no. LC777871). To fulfill Koch's postulates, leaves of three healthy potted S. flavescens plants were inoculated by gently pressing with diseased leaves. Non-inoculated plants were used as controls. All plants were incubated in a greenhouse at 25 ± 2°C, 80% relative humidity. After 15 days, typical powdery mildew symptoms were observed on the inoculated plants, whereas no symptoms were found on the control plants. The reisolated fungus from the inoculated S. flavescens was morphologically identical to that on naturally diseased plants, and the ITS sequence of the reisolated fungus showed 100% identity with PP130131. As the causal fungus of soybean powdery mildew, E. diffusa is known to infect papaya and other legumes, including Lens culinaris and Mimosa caesalpiniifolia (Attanayake et al. 2009; Luz et al. 2019). Particularly, E. diffusa has been previously reported to infect S. flavescens in the United Kingdom (Jones and Baker 2007; Bradshaw et al. 2023), but this is the first report of S. flavescens powdery mildew caused by E. diffusa in China. This work further expands the geographical range of E. diffusa-infected S. flavescens plants.

Wearable Ultrasound Imaging Device for Dynamic Dual-Direction Shear Wave Elastography of Shoulder Muscle.

The shoulder is the most mobile joint in the human body, thus requiring intricate coordination of adjacent muscles. Patients suffered from rotator cuff muscle injuries have several typical symptoms including shoulder pain and difficulty raising the arm, thus reducing work efficiency and compromising the quality of life. Ultrasound has been used widely for shoulder soft tissue imaging as well as ultrasound elastography was introduced in shoulder examination for the dilemma of treating degenerative rotator cuff tears. However, most of the ultrasound examination was performed under a static condition. Providing dynamic information from shoulder muscle is important in clinical applications because the pains sometimes come from various positions of the shoulder during moving. In this study, a customized wearable T-shaped ultrasound transducer (128 + 128 elements) was proposed for shoulder dual-direction shear wave elastography (DDSWE), which provides the SWE for both longitudinal (SW along the muscle fiber) and transverse (SW cross the muscle fiber) directions dynamically. An optical tracking system was synchronized with an ultrasound imaging system to capture shoulder movements in 3-D space with their corresponding ultrasound images. The performance of DDSWE and the accuracy of optical tracking were verified by phantom experiments. Human studies were carried out by volunteers as they are moving their arms. The experimental results show that the bias and precision for the proposed DDSWE in elastic phantom were about 6% and 1.2% for both directions, respectively. A high accuracy of optical tracking was observed using a 3-D motor stage experimental setup. Human experiments show that the shear wave velocities (SWVs) were increased with the angles of shoulder abduction, and the average transverse and longitudinal SWVs were increased from 2.24 to 3.35 m/s and 2.95 to 5.95 m/s with abduction angle from 0° to 60°, respectively, which they are anisotropic-dependent. All the experimental results indicate that the proposed wearable ultrasound DDSWE can quantify the mechanical properties of shoulder muscles dynamically, thereby helping surgeons and physical therapists determine whether the intensity of rehabilitation shoulder be tuned down or escalated in the future.

Virus Infected Papaya Plants Differentially affects Oxidative Stress and Survival in Caenorhabditis elegans

Carica papaya (papaya) leaves has significant nutraceutical properties. However, it is speculated that papaya leaf curl virus (PaLCuV) and papaya ring spot virus (PRSV) can severely affect the therapeutic properties and alter the overall nutraceutical potential of papaya leaves. Therefore, we evaluated the bioactivity of the virus infected papaya leaves extract (PLE) compared to healthy PLE in C. elegans. Viruses infection were confirmed by visual inspection and PCR based detection. Anatomical changes and elemental analysis were analyzed through SEM-EDS. PLE were tested for life span extension and ROS scavenging activity on C. elegans. Infected leaves displayed typical symptoms of curling, distortion and anatomical analysis revealed closed and less number of stomata. Healthy PLE extended (24%) the life span of C. elegans with no significant change in ROS generation while in PaLCuV and PRSV infected PLE, were observed to have significant reduction in the mean life span of 15.4% and 17% with 1.2-fold and 1.9-fold increase in ROS generation.

Molecular Characterization of Feline Parvovirus from Domestic Cats in Henan Province, China from 2020 to 2022.

Carnivore protoparvovirus-1, feline parvovirus (FPV), and canine parvovirus (CPV) continue to spread in companion animals all over the world. As a result, FPV and CPV underwent host-to-host transfer in carnivorous wild-animal hosts. Here, a total of 82 fecal samples of suspected cat FPV infections were collected from Henan Province from 2020 to 2022. The previously published full-length sequence primers of VP2 and NS1 genes were used to amplify the targeted genes of these samples, and the complete gene sequences of 11 VP2 and 21 NS1 samples were obtained and analyzed. Analysis showed that the amino acid homology of the VP2 and NS1 genes of these isolates was 96.1-100% and 97.6-100%, respectively. The phylogenetic results showed that the VP2 and NS1 genes of the local isolates were mainly concentrated in the G1 subgroup, while the vaccine strains were distributed in the G3 subgroup. Finally, F81 cells were inoculated with the local endemic isolate Luoyang-01 (FPV-LY strain for short) for virus amplification, purification, and titer determination, and the pathogenesis of FPV-LY was detected. After five generations of blind transmission in F81 cells, cells infected with FPV-LY displayed characteristic morphological changes, including a round, threadlike, and wrinkled appearance, indicative of viral infection. The virus titer associated with this cytopathic effect (CPE) was measured at 1.5 × 106 TCID50/mL. Subsequent animal regression tests confirmed that the virus titer of the PFV-LY isolate remained at 1.5 × 106 TCID50/mL, indicating its highly pathogenic nature. Cats exposed to the virus exhibited typical clinical symptoms and pathological changes, ultimately succumbing to the infection. These results suggest that the gene mutation rate of FPV is increasing, resulting in a complex pattern of gene evolution in terms of host preference, geographical selection, and novel genetic variants. The data also indicate that continuous molecular epidemiological surveillance is required to understand the genetic diversity of FPV isolates.

A simplified single-leaflet graft inoculation method and a Duplex PCR assay for the identification of the Tomato Yellow Leaf Curl Virus infection in tomatoes

Tomato yellow leaf curl virus (TYLCV), a member of the Geminivirus genus, has caused an epidemic disease in tomato worldwide, including in Azerbaijan. TYLCV is a phloem-limited virus that is transmitted in a semi-persistent manner by whiteflies (Bemisia tabaci). Experimental propagation of TYCV has been performed primarily by using the single-leaflet grafting inoculation method. To develop a simple and effective method for transmission of TYLCV, we investigated grafting single-leaflets from tomato plants infected with TYLCV to recipient tomato seedlings. Fifty-one (51) tomato seedlings were tested and forty-eight (48) were grafted successfully with single-leaflets infected with TYLCV. Among them, forty-six (46) seedlings (92%) were systemically infected with TYLCV and developed typical symptoms. In our study, we found that single-leaflet grafting could provide a sufficient amount of inoculum for the transmission of TYLCV to the grafted tomato seedlings. The reported results regarding the development of the TYLCV inoculation and monitoring method and its application to study host plant-virus interaction showed that it could be used as an efficient alternative inoculation method.

Pigmentary glaucoma – a case report

Pigmentary glaucoma is a type of secondary open-angle glaucoma. Mainly it is a consequence of pigment dispersion syndrome, which is characterized by pigment accumulation in the anterior segment of the eye. Pigment in the trabecular meshwork can cause increased intraocular pressure leading to glaucomatous damage of the optic nerve. We present a case of 40-year-old myopic male with typical symptoms of pigmentary dispersion syndrome who received late diagnosis of the disease. The correct diagnosis of pigmentary dispersion syndrome is crucial in preventing glaucomatous vision impairment.

First report of Diaporthe eres causing white spot of maize in China

Maize (Zea Mays L.) is one of China's most widely grown cereals, a crucial food crop, and a vital source of feed and raw materials for various industries. In March 2023, a disease with typical white spot symptoms was observed on maize across 40% of the planted area in a farm field in Jiangcheng Hani and Yi Autonomous County, Yunnan Province, China. The disease initially showed water-soaked patches on leaves, which eventually faded to dark brown, forming irregular spots with yellow to brownish margins. The Dns14-1 strain, isolated from infected leaves, was identified as Diaporthe eres based on morphological and molecular identification. Pathogenicity tests found it to be one of the causal agents of white spots on maize leaves. To our knowledge, this is the first report of D. eres causing white spots on maize in China.

Copenhagen Mesenteric stent study (COMESS)—a randomized trial of stent versus covered stent treatment for chronic mesenteric ischemia

BackgroundCurrent management of mesenteric ischemia is primarily endovascular stent treatment. Typical CMI symptoms are postprandial abdominal pain, food fear, weight loss, and diarrhea. Revascularization is often necessary, as mesenteric ischemia may progress to bowel necrosis and death if left untreated. This study aims to compare the outcome using bare metal stent (BMS) or covered stent (CS) in the endovascular treatment of chronic and acute on chronic mesenteric ischemia.MethodsThis is an investigator-driven, prospective, randomized, single-blinded, and single-center, national cohort study at the Copenhagen University Hospital, Denmark. A total of 98 patients with chronic mesenteric ischemia (CMI) and acute-on-chronic mesenteric ischemia (AoCMI) will be randomized to treatment with either BeSmooth BMS (Bentley Innomed GmbH) or BeGraft CS (Bentley Innomed GmbH). Randomization occurs intraoperatively after lesion crossing.DiscussionThere is currently no published data from prospective controlled trials regarding the preferred type of stent used for the treatment of chronic and acute-on-chronic mesenteric ischemia. This trial will evaluate the short- and long-term outcome of BMS versus CS when treating CMI and AoCMI, as well as the benefit of a more intense postoperative surveillance program.Trial registrationClinicalTrials.gov NCT05244629. Registered on February 8, 2022.

Polymyalgia Rheumatica Following Respiratory Syncytial Virus (RSV) Vaccination.

Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that causes stiffness and pain in the proximal joints, including the shoulders, hips and neck. The exact cause of polymyalgia rheumatica is yet to be fully understood, but research suggests that both genetic and environmental factors may contribute to it. Studies have previously linked the onset and relapse of polymyalgia rheumatica symptoms to the influenza and COVID-19 vaccines. The Food and Drug Administration approved the respiratory syncytial virus (RSV) vaccine, which is a recombinant protein vaccine for adults over 60, in May 2023. No previous reports of polymyalgia rheumatica onset or relapse have been linked to the RSV vaccine. The human proteome shares some peptides with the RSV F antigen, suggesting a high risk of cross-reactivity when using that antigen in vaccination formulations. A 72-year-old man experienced a new onset of bilateral shoulder pain and stiffness three days after receiving the Abrysvo® RSV vaccine. The symptoms lasted more than an hour (up until noon) and interfered with his activities of daily living. Inflammatory markers such as C-reactive protein were elevated. The patient's symptoms and inflammatory marker levels significantly improved with prednisone therapy. In patients with typical PMR symptoms, it is important for clinicians to carefully review immunisation history to rule out any potentially related adverse effects. Vaccines can trigger autoimmune diseases in some individuals.This case report suggests respiratory syncytial virus (RSV) vaccine is among the possible triggers for polymyalgia rheumatica.

Chemotherapy-related cardiotoxicity and its symptoms in patients with breast cancer: a scoping review

BackgroundChemotherapy-related cardiotoxicity is a significant concern because it is a major cause of morbidity. This study aimed to provide in-depth information on the symptoms of chemotherapy-related cardiotoxicity (CRCT) by exploring literature that concurrently reports the types and symptoms of CRCT in patients with breast cancer.MethodsA scoping review was performed according to an a priori protocol using the Joanna Briggs Institute’s guidelines. The participants were patients with breast cancer. The concept was the literature of specifically reported symptoms directly matched with CRCT and the literature, in English, from 2010, and the context was open. The search strategy included four keywords: “breast cancer,” “chemotherapy,” “cardiotoxicity,” and “symptoms.” All types of research designs were included; however, studies involving patients with other cancer types, animal subjects, and symptoms not directly related to CRCT were excluded. Data were extracted and presented including tables and figures.ResultsA total of 29 articles were included in the study, consisting of 23 case reports, 4 retrospective studies, and 2 prospective studies. There were no restrictions on the participants’ sex; however, all of them were women, except for one case report. The most used chemotherapy regimens were trastuzumab, capecitabine, and doxorubicin or epirubicin. The primary CRCT identified were myocardial dysfunction and heart failure, followed by coronary artery disease, pulmonary hypertension, and other conditions. Major tests used to diagnose CRCT include echocardiography, electrocardiography, serum cardiac enzymes, coronary angiography, computed tomography, and magnetic resonance imaging. In all case reports, CRCT was diagnosed through an incidental checkup according to the patient’s symptom presentation; however, only 10 of these studies showed a baseline checkup before chemotherapy. The five most common CRCT symptoms were dyspnea, chest pain, peripheral edema, fatigue, and palpitations, which were assessed by patient-reported symptom presentation rather than using a symptom assessment tool. Dyspnea with trastuzumab treatment and chest pain with capecitabine treatment were particularly characteristic. The time for first symptom onset after chemotherapy ranged from 1 hour to 300 days, with anthracycline-based regimens requiring 3–55 days, trastuzumab requiring 60–300 days, and capecitabine requiring 1–7 days.ConclusionsThis scoping review allowed data mapping according to the study design and chemotherapy regimens. Cardiac assessments for CRCT diagnosis were performed according to the patient’s symptoms. There were approximately five types of typical CRCT symptoms, and the timing of symptom occurrence varied. Therefore, developing and applying a CRCT-specific and user-friendly symptom assessment tool are expected to help healthcare providers and patients manage CRCT symptoms effectively.

The Fibromyalgia Syndrome Management- A Short Review on Recent Trends

Background: Fibromyalgia (FM) is characterized by widespread musculoskeletal chronic pain, which compromises the patient’s quality of life and is a Somatic symptom disorder. A typical symptom seen in the patients is the lack of acceptance of the disease, since its pathophysiology is not clear. This work aims to clear few new treatment methods at a holistic level, that is, cognitive, physical, and pharmacological therapies. Methodology: A literature review was carried out form researchgate, google scholar, pubmed, scopus etc. that discusses treatment methods that relieves the pain and manage the symptoms of the disease. Results: Fibromyalgia symptoms can be managed by various treatment protocols that include a response to the mind through pain management, response to the body through physical activity, and response to the pain through pharmacological treatment. Conclusions: Treatment for fibromyalgia often involves medications along with complementary treatments, such as exercise, acupuncture, and life style modification.

An original technique for the treatment of Axillary Web Syndrome: the Onorato-Ausbergher method

Axillary Web Syndrome (AWS) is a common complication in patients who have undergone an axillary lymph node biopsy or dissection for breast cancer. This work aims to explore in a preliminary way the effectiveness of a therapeutic approach with Neuromuscular Taping (NMT) for the aforementioned condition. Specifically, five patients have been treated and have undergone specific evaluation of typical AWS signs and symptoms, with a particular focus on the impact on Quality of Life (QoL) and Activities of Daily Life (ADLs). The final aim is to evaluate the efficacy of an innovative approach to AWS, allowing easy application, good tolerability, and few collateral effects.

Evaluate the safety and effectiveness of Bacillus probiotic spores in children with persistent diarrhea

Persistent diarrhea in children under 24 months old has been a global public health concern, including in Vietnam. Therefore, the authors conducted a randomised, double-blind, placebo-controlled clinical trial to evaluate the effectiveness of two Bacillus spore probiotic suspensions, namely LiveSpo CLAUSY containing B. clausii at 2 billion CFU/5 ml ampoule; and LiveSpo DIA30 containing B. subtilis, B. clausii, and B. coagulans at 5 billion CFU/5 ml ampoule, as a supportive treatment for children with persistent diarrhea. Children were randomly allocated into the control (using RO water) and two experimental groups, Clausy (using LiveSpo CLAUSY) and Dia30 (using LiveSpo DIA30), n=30/group. All three groups were treated following the standard protocol at the hospital, supplemented with either placebo or high-dose probiotics up to 4-6 ampoules/day. The results showed that Bacillus spore probiotics helped to shorten the treatment duration by approximately 1-3 days and enhanced treatment effectiveness by 1.3-2.4 folds compared to the control group in reducing the typical diarrhea symptoms, including bowel movements ≥3 times/day, presence of mucus, and diaper stool. Notably, LiveSpo DIA30 exhibited a better efficacy of 10-50% compared to LiveSpo CLAUSY. This is the world’s first clinical study demonstrating the effectiveness of high-dose Bacillus spore probiotics in supporting the treatment of diarrhea symptoms in children with persistent diarrhea.

Alfalfa Spring Black Stem and Leaf Spot Disease Caused by Phoma medicaginis: Epidemic Occurrence and Impacts.

Alfalfa spring black stem and leaf spot disease (ASBS) is a cosmopolitan soil-borne and seed-borne disease caused by Phoma medicaginis, which adversely affects the yield, and nutritive value and can stimulate production of phyto-oestrogenic compounds at levels that may adversely affect ovulation rates in animals. This review summarizes the host range, damage, and symptoms of this disease, and general features of the infection cycle, epidemic occurrence, and disease management. ASBS has been reported from over 40 countries, and often causes severe yield loss. Under greenhouse conditions, reported yield loss was 31-82% for roots, 32-80% for leaves, 21% for stems and 26-28% for seedlings. In field conditions, the forage yield loss is up to 56%, indicating that a single-cut yield of 5302 kg/ha would be reduced to 2347 kg/ha. P. medicaginis can infect up to 50 species of plants, including the genera Medicago, Trifolium, Melilotus, and Vicia. ASBS is more severe during warm spring conditions before the first harvest than in hot summer and cooler winter conditions, and can infect alfalfa roots, stems, leaves, flowers, pods, and seeds, with leaf spot and/or black stem being the most typical symptoms. The primary infection is caused by the overwintering spores and mycelia in the soil, and on seeds and the cortex of dead and dry stems. The use of resistant cultivars is the most economical and effective strategy for the control of ASBS. Although biological control has been studied in the glasshouse and is promising, chemical control is the main control method in agriculture.

Current peri-operative and surgical management of bladder paraganglioma

Introduction: In this article, we provide a narrative review of current peri-operative and surgical management of paraganglioma of the urinary bladder (PUB). Methods: Key articles relating to peri-operative optimisation, intra-operative considerations and post-operative follow-up of patients with PUB were identified for review. Discussion: Although the majority of PUBs are functionally active with potential for catecholamine release, typical catecholaminergic symptoms are often overshadowed by the presence of lower urinary tract symptoms such as painless visible haematuria. Consequently, many cases are diagnosed based on post-operative histopathology, resulting in inferior short- and long-term outcomes. Accurate pre-operative diagnosis is crucial as this informs pre-operative optimisation and choice of surgical approach. Partial cystectomy is the mainstay of treatment, but transurethral resection may be appropriate for non-functional tumours &lt;3 cm. The presence of succinate dehydrogenase ( SDH) subunit B (SDHB) pathogenic variants may prompt upfront radical cystectomy. Long-term outcomes of surgical patients remain incompletely characterised and lifelong follow-up is recommended to exclude tumour recurrence. Conclusion: Patients with PUBs require meticulous peri-operative optimisation under the care of an experienced multidisciplinary team. A pre-operative diagnosis is crucial to ensure optimal outcomes and guide surgical decision-making. Level of evidence: 4