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Background: Despite the global increase in human immunodeficiency virus (HIV) prevalence, there is little knowledge regarding the nature of the HIV clinical profile and patients' sociodemographic characteristics in Upper Egypt. This study aimed to describe the sociodemographic and clinical profile of HIV-infected patients registered in treatment centers in Upper Egypt over the past 7 years. Methods: Data were collected from the available medical records for 650 patients at the three main HIV healthcare centers in Upper Egypt from January 2015 until December 2021. The collected sociodemographic variables included age, sex, occupation, educational level, residence, and risk factors. In addition, clinical examination data, treatment regimens, laboratory investigations, and outcome data were obtained. Results: The study found that most patients (85.5%) were male, with ages ranging from 3 to 78 years and a median age of 33. Intravenous drug use (44.5%) was the most common transmission route, and fever (84.3%) was the most frequently reported symptom. Pneumonia (24.3%) was the most registered opportunistic infection. Median CD4 cell counts were 299 cells/mm3 before treatment and 366 cells/mm³ after treatment. PCR values were available for 631 patients (97%), with viremia evident in 630 patients (99.8%) before treatment. 73.2% of patients showed improvement in outcomes, while 8.3% died. Conclusion: The current study findings provide relevant information for the National AIDS Program (NAP) to design HIV education messages and apply preventive measures accordingly. [ABSTRACT FROM AUTHOR]

The most common cause of severe cognitive impairment in adults is Alzheimer's disease (AD). Depending on the age of onset, AD is divided into early (<65 years) and late (≥65 years) forms. Early-onset AD (EOAD) is significantly less common than late-onset AD, accounting for only about 5–10% of cases. However, its medical and social significance as a disease leading to loss of ability to work and legal capacity, as well as premature death in patients aged 40–64 years, is extremely high. Patients with EOAD, as compared with late-onset AD (LOAD), have a greater number of atypical clinical variants: 25% and 6–12.5%, respectively, which complicates the differential diagnosis of EOAD against other neurodegenerative diseases. Nonetheless, the typical amnestic variant predominates in both LOAD and EOAD. Also, patients with EOAD have characteristic neuroimaging features: brain MRI scans from patients with EOAD often have more severe parietal atrophy and less severe hippocampal atrophy than those from patients with LOAD. This report addresses the features of the clinical and neuroimaging picture in patients with EOAD. A clinical case of a patient with EOAD is presented. [ABSTRACT FROM AUTHOR]

Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder characterized by a highly variable clinical presentation depending on the affected organ/s, extent of tumefactive fibroinflammatory lesions, and associated functional impairment. The disease pursues a chronic, relapsing, often asymptomatic course and hence may pose a significant diagnostic challenge. Diagnostic delay can lead to progressive fibrosis and irreversible organ damage resulting into significant morbidity and even mortality. Given its broad clinical spectrum, physicians of all specialties may be the first clinicians facing this diagnostic challenge. Outside the pancreatobiliary system, the head and neck represents the major site of IgG4-RD with variable organ-specific diffuse or mass-forming lesions. In up to 75% of cases, elevated serum IgG4 levels are observed, but this figure possibly underestimates the fraction of seronegative cases, as the disease manifestations may present metachronously with significant intervals. Together with negative serology, this can lead to misdiagnosis of seronegative cases. A standardized nomenclature and diagnostic criteria for IgG4-RD were established in 2012 and revised in 2020 facilitating scientific research and expanding the range of diseases associated with IgG4 abnormalities. In addition to orbital pseudotumor, dacryoadenitis, Riedel thyroiditis, sinonasal manifestations, and rare miscellaneous conditions, IgG4-related sialadenitis is one of the most frequent presentations in the head and neck region. However, controversy still exists regarding the relationship between sialadenitis and IgG4-RD. This review focuses on the clinicopathological features of IgG4-related sialadenitis and its contemporary diagnostic criteria. [ABSTRACT FROM AUTHOR]

Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes. Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen. Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis. Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%. Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.

Background and Aim: The isopods of the Crustacea are noteworthy. All marine, fresh, and brackish waterways at all depths are home to aquatic organisms. This order also includes species that live on land. This study aimed to report a new occurrence of the isopod Cirolana capricornica on the operculum, mouth, and body cavities of Epinephilus chlorostigma in the Suez Governorate, Egypt. Materials and Methods: With the help of fishermen, 50 live E. chlorostigma (Linnaeus, 1758) were randomly gathered along the Red Sea coast of the Suez Governorate during November and December 2019 for the current investigation. Isopods were isolated from the fish samples and captured using light and electron microscopy for morphological identification. Results: Some fish were emaciated, and minute white isopods were attached externally to the skin near the gills and mouth cavity, and internally to the mouth cavity. No correlation was observed between body cavity attachment and gross lesions. The prevalence of infestation was 16%. Conclusion: C. capricornica was identified using optical and electron microscopy to analyze the isopod specimens’ morphology. This scavenging isopod species is newly discovered in Egypt.

Background and Aim: The isopods of the Crustacea are noteworthy. All marine, fresh, and brackish waterways at all depths are home to aquatic organisms. This order also includes species that live on land. This study aimed to report a new occurrence of the isopod Cirolana capricornica on the operculum, mouth, and body cavities of Epinephilus chlorostigma in the Suez Governorate, Egypt. Materials and Methods: With the help of fishermen, 50 live E. chlorostigma (Linnaeus, 1758) were randomly gathered along the Red Sea coast of the Suez Governorate during November and December 2019 for the current investigation. Isopods were isolated from the fish samples and captured using light and electron microscopy for morphological identification. Results: Some fish were emaciated, and minute white isopods were attached externally to the skin near the gills and mouth cavity, and internally to the mouth cavity. No correlation was observed between body cavity attachment and gross lesions. The prevalence of infestation was 16%. Conclusion: C. capricornica was identified using optical and electron microscopy to analyze the isopod specimens' morphology. This scavenging isopod species is newly discovered in Egypt. [ABSTRACT FROM AUTHOR]

As part of the NorthTick project, co-funded by the European Union through the European Regional Development Fund and the North Sea Region Programme, specialists in the field of tick-borne diseases from seven North Sea countries co-operated with patient organisations and governmental health care institutions to provide this comprehensive overview of diagnostics and treatment recommendations in the region for Lyme borreliosis, Borrelia miyamotoi infection, tick-borne encephalitis, human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis and babesiosis. The main conclusion is that the recommendations in these northern countries are essentially the same, with very few differences. This overview presents the current diagnostics and provides useful clinical guidance.

Background. Anaemic syndrome of complex origin is not uncommon in urinary tract infection, particularly in dietary non-adherence, menstrual cycle disorders, or concomitant digestive diseases, recurrent respiratory infections, etc. However, there is currently insufficient epidemiological data on this comorbidity in the literature. This study aims to establish the features of pyelonephritis course in its combination with anaemic syndrome in children. Materials and methods. We analysed the medical records of 200 children aged 0 to 17 years with acute non-complicated pyelonephritis, complicated and recurrent urinary tract infections for 2012–2017. In the second stage of our work, we comprehensively examined 85 girls aged 11 to 17 who underwent inpatient treatment between 2018 and March 2023. Thirty children of the same age and gender made up the comparison group. A paediatric gastroenterologist, a paediatric gynaecologist and/or urologist examined all patients. Immunochemical method with electrochemiluminescence immunoassay was used to assess ferritin content; also, serum iron and total iron-binding capacity were measured. Results. Anaemic syndrome is common in most girls with urinary tract infections (58.8 % of сases). Among the causes, the follo­wing are distinguished: menstrual cycle disorders with abnormal uterine bleeding (50.0 %), chronic digestive disorders, in particular malabsorption syndrome of unknown origin (25.0 %), recurrent bronchopulmonary disorders (15.0 %), and unbalanced diet (10.0 %). The features of urinary tract infections and concomitant iron deficiency in children include fatigue (55.0 % in acute non-complicated pyelonephritis vs. 40.0 % in complicated urinary tract infections, р 0.05). The ferritin level was the highest in patients with complicated urinary tract infections (18.2 µg/mL). In patients with recurrent urinary tract infections, this indicator was the lo­west — 5.0 µg/mL. Conclusions. Retrospective analysis of medical records confirmed the presence of anaemia in 30.0 % of girls with inflammatory kidney diseases. During the physical examination, 58.8 % of female adolescents with urinary tract infections had signs of anaemic syndrome.

Objectives. To describe the features of the clinical picture and estimate the incidence of HIV-associated cerebellar degeneration in patients with progressive cerebellar ataxia. Materials and methods. A total of 377 patients with progressive cerebellar ataxia were examined using brain MRI, the Scale for the Assessment and Rating of Ataxia (SARA), and screening for cognitive impairment using the Montreal Cognitive Assessment test (MoCa). Autoimmune, deficiency, and other causes of ataxia, opportunistic infections, multiple system atrophy, and common forms of hereditary spinocerebellar ataxia were excluded in patients with HIV infection. Results. Five patients (1.3%) with combined ataxia and HIV infection were identified (two men, three women, aged 31–52 years). The median duration of HIV infection was five years and the duration of ataxia was one year. The clinical picture included not only progressive ataxia, but also pyramidal signs, dysphagia, and, less commonly, ophthalmoparesis, dystonia, postural hand tremor, and affective and moderate cognitive impairment. Brain MRI scans revealed signs of olivopontocerebellar atrophy in three patients and degeneration of the cerebellum (mainly the vermis) in two. All patients received combined antiretroviral therapy in various regimens, though despite this, ataxia was progressive. Conclusions. HIV infection is a rare cause of cerebellar degeneration. This diagnosis remains a diagnosis of exclusion. Cerebellar degeneration can occur and progress even after achieving stable remission of HIV infection on the background of highly active antiretroviral therapy. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide emergency. The disease is characterized primarily by symptoms of the respiratory system, but also by systemic inflammation. Since the onset of the disease, there has been a need for biomarkers to predict the severity of the clinical picture and the outcome of the disease. The aim of this study is to evaluate systemic inflammatory markers for predicting severity of COVID-19. Methods: The study was conducted at the Sarajevo Canton Health Center on a total of 170 adults suffering from COVID-19. 70 subjects had mild clinical picture, while the control group consisted of 100 subjects with moderate clinical picture. The results of complete and differential blood counts, C-reactive protein (CRP), and systemic inflammatory indexes (SII) (neutrophil/lymphocyte ratio [NLR], derived NLR [dNLR], platelet/lymphocyte ratio [PLR], and SII) were used to compare the groups. IBM SPSS Ver. 23 was used for statistical analysis and data processing. Results: The proportion of male patients in the group with a milder clinical picture was higher than the proportion of male patients with a moderate clinical picture, p = 0.016. The values of leukocytes and neutrophils were higher in patients with a moderate clinical picture (p = 0.006 and p < 0.001, respectively). The values of all inflammatory indexes (NLR, dNLR, PLR and SII) were higher in patients with a moderate clinical picture of COVID-19 than in patients with a mild clinical picture (p < 0.001 for NLR, dNLR, and SII; p = 0.023 for PLR). In the research, patient age showed no correlation and CRP showed no correlation with SII. Conclusion: SII show higher values in patients with a moderate compared with a mild clinical picture of COVID-19. These parameters can be cost-effective and useful indicators in patient classification, diagnosis, and probably in monitoring patients with COVID-19.

The present retrospective study analyzed the characteristics of strongyloidiasis in patients who were diagnosed at the Outpatient Clinic of the Department of Parasitology-Mycology, Toulouse, France. Sixty-nine file records were included in the study on the basis of a positive stool examination that used Baermann's method. The prominent epidemiological findings were the presence of former immigrants from Italy or Portugal, veterans from the 1st Indochina war, and autochthonous cases. Almost 1/4 of the patients were asymptomatic. Manifestations of skin allergy were the main clinical feature. Blood eosinophilia was present in 76.8% of the patients, and serum total IgE was ≥150 kIU/L in 79.7%. Immunodiagnosis was achieved from 1990 to 2001 by indirect immunofluorescence (IFAT) that was then replaced with ELISA, both methods using Strongyloides ratti filariform larvae. ELISA was found to be similar to IFAT in terms of specificity but exhibited a greater sensitivity. Patients were primarily treated with albendazole or ivermectin beginning in 1993. Forty-eight patients attended the follow-up consultation. Kinetics of the clinical picture and blood eosinophilia were found to be the most convenient parameters to assess the efficacy of anthelmintic therapy. In conclusion, strongyloidiasis remains a neglected disease in Southwestern France. The resolution of clinical features along with the kinetics of eosinophilia appeared to be the most appropriate parameters to check during the posttreatment follow-up. [ABSTRACT FROM AUTHOR]

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide emergency. The disease is characterized primarily by symptoms of the respiratory system, but also by systemic inflammation. Since the onset of the disease, there has been a need for biomarkers to predict the severity of the clinical picture and the outcome of the disease. The aim of this study is to evaluate systemic inflammatory markers for predicting severity of COVID-19. Methods: The study was conducted at the Sarajevo Canton Health Center on a total of 170 adults suffering from COVID-19. 70 subjects had mild clinical picture, while the control group consisted of 100 subjects with moderate clinical picture. The results of complete and differential blood counts, C-reactive protein (CRP), and systemic inflammatory indexes (SII) (neutrophil/lymphocyte ratio [NLR], derived NLR [dNLR], platelet/lymphocyte ratio [PLR], and SII) were used to compare the groups. IBM SPSS Ver. 23 was used for statistical analysis and data processing. Results: The proportion of male patients in the group with a milder clinical picture was higher than the proportion of male patients with a moderate clinical picture, p = 0.016. The values of leukocytes and neutrophils were higher in patients with a moderate clinical picture (p = 0.006 and p < 0.001, respectively). The values of all inflammatory indexes (NLR, dNLR, PLR and SII) were higher in patients with a moderate clinical picture of COVID-19 than in patients with a mild clinical picture (p < 0.001 for NLR, dNLR, and SII; p = 0.023 for PLR). In the research, patient age showed no correlation and CRP showed no correlation with SII. Conclusion: SII show higher values in patients with a moderate compared with a mild clinical picture of COVID-19. These parameters can be cost-effective and useful indicators in patient classification, diagnosis, and probably in monitoring patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background. Significant progress in the medication of syphilis has been achieved for the past century. Now this disease is diagnosed in the early stages. Accordingly the mark of late stages of the syphilis can only be seen on paleoanthropological materials. The object of this work is the detail characteristic of the pathological changes of syphilitic etiology on the skull of the woman (25-35 years old) who lived in the 17th or early 18th centuries in Primokshanie. Materials and methods. The researchable skull was found during archaeological excavations on the territory of the Kelgininsky burial ground belonging by the Mordva-Moksha. The archaeological site is located on the territory of the Zubovo- Polyansky district of the Republic of Mordovia. The burial dates to the 17th - early 18th centuries. The skull was explored visually and by cone-beam tomography. Visualization of results of tomography was realized out using the GALILEOS Viewer program. Results. The most observable changes have been seen in the zone of the outer surface of the frontal squama, the nasal cavity and the osseous palate. The walls of the nasal cavity are deformed, the nasal bones, shells, vomer are destroyed by a pathological process with noticeable sclerosis of the remaining bones; there are traces of healed gumma on the intermaxillary suture of the osseous palate. Moreover, most of the right and left maxillary sinuses were replaced with porous bone. Conclusions. The results of the research show that the method of conebeam tomography is effective for the study of pathological changes on the human skull. The study let to supplement the clinical picture of syphilis in the later stages of the development of this disease. This is of great importance, since the nature of destructive changes in syphilis is greatly variable.

Coronavirus induced diseases can cause significant damage to agriculture that is associated with high (up to 100%) lethality in young animals. Members of the family Coronaviridae are characterized by the fact that they infect a wide range of animals and birds with expressed species-limited pathogenicity. One more coronavirus specificity involves their ability to simultaneously affect more than one organ. The disease severity is also strongly correlated with the age of the susceptible animal and degree of pathology. Thus, the coronavirus induced diseases are most often acute in newborn and young animals, while such diseases often develop into chronic and latent forms in adult animals. The general property of all coronavirus-induced diseases involves acute impairement of capillary circulation in the affected organ thus leading to the development of further pathology. The proposed review demonstrates brief overview of the history of discovery and examination of the viruses of Coronaviridae family and describes the coronavirus taxonomy. The paper reviews the virus structure, physico-chemical and biological properties; it describes specific features of their cultivation in vitro, some biochemical aspects of the virus replication and analyses the process of their propagation in the sensitive cells. Some data on the virus antigen structure and immunogenicity, on the presence of related antigens in the coronaviruses infecting humans, animals and birds are demonstrated as well. The paper provides data on the significant role the coronaviruses play in the pathology of farm animals and stresses their economic relevance, in particular for the commercial pig and poultry production.

The COVID-19 pandemic proceeds in waves, with variable characteristics of the clinical picture resulting from the evolution of the SARS-CoV-2 virus. This study aimed to compare the epidemiological characteristics, symptomatology, and outcomes of the disease in patients hospitalized for COVID-19 during periods of different variants dominance. Comparing the periods of dominance of variants preceding the Delta variant, the Delta period was characterized by a higher share of hospitalized females, less frequent comorbidities among patients, and a different age distribution. The lowest need for oxygen therapy and mechanical ventilation was observed under Omicron dominance. The triad of classic COVID-19 symptoms, cough, fever, dyspnoea, and fatigue, were most prevalent during the Delta period, and significantly less common under the Omicron dominance. During the Omicron period, nearly twice as many patients as in the previous periods could be discharged from the hospital within 7 days; the overall 28-day mortality was significantly lower compared to that of the Delta period. It also did not differ between periods that were dominated by the BA.1 and BA.2 subvariants. The study indicates that the Omicron SARS-CoV-2 variant that dominated between January and June 2022 caused a disease which resembled the common cold, and was caused by seasonal alpha and beta-coronaviruses with a low pathogenicity for humans. However, one should note that this effect may not only have been related to biological features of the Omicron lineage, but may additionally have been driven by the increased levels of immunization through natural infections and vaccinations, for which we could not account for due to a lack of sufficient data. [ABSTRACT FROM AUTHOR]

Pigeons are highly susceptible to Newcastle disease virus (NDV) infection, which causes economic losses in terms of increased mortalities, immunosuppression, vaccination costs, and probable trade restrictions. NDV belongs to the avian paramyxovirus serotype 1 (APMV-1). The antigenic variant of APMV-1 is termed as pigeon paramyxovirus type 1 (PPMV-1), which is classified in the genus Avulavirus of the subfamily Paramyxovirinae and family Paramyxoviridae. Infections of pigeons with PPMV-1 have been detected since the 1930s, and the virus is still circulating in many countries until now. Domestic, feral, and racing pigeons, doves, and exotic birds are susceptible to PPMV-1 infection. The virus is rapidly spreading between birds through the horizontal route. Infected pigeons may show circling, ataxia, torticollis, head and neck tremors and twisting, leg and wing paralysis, greenish diarrhea, respiratory signs, and polyuria. Some pigeons could be infected with PPMV-1 without apparent signs, and they act as reservoirs for other domestic or free-living birds. The diagnosis of suspected PPMV-1 cases is based mainly on the isolation and identification of the virus, serological detection of specific antibodies, and molecular characterization of the virus. Adoption of strict biosecurity measures as well as vaccination using traditional live or inactivated NDV or even the specific PPMV-1 vaccines are the gold standard methods for preventing pigeons from such infection. Therefore, this review article was designed to focus on PPMV-1 infection regarding the virus characteristics, epidemiology, diagnosis, human infection, and control. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the prevalence, clinical picture, complications, and risk factors associated with Diabetes Mellitus in dogs in Alexandria governorate, Egypt. One hundred and thirty-nine dogs representing fifteen breeds from the Directorate of Veterinary Medicine in Alexandria governorate were involved in the study between November 2020 and April 2021. After a thorough clinical examination and filling out a pre-designed questionnaire, random blood glucose (RBG) test was performed for all animals. Those with high RBG levels were subjected to a complete blood picture (CBC), liver and kidney functions, and HbA1c. A control group of 50 dogs of similar age, sex, breed, and management was selected and subjected to the same analyses. The prevalence of DM among the studied dogs was 7.2 %. All diabetics suffered from polydipsia and polyuria, while 60% suffered from polyphagia and 80% suffered from weight loss. No significant impact of DM on temperature, respiratory rate, anaemia, liver enzymes and platelets count, but there was a significant increase in pulse rate. There was a significant impact of DM on eyes as 80% of the diabetic dogs suffered from cataracts. It had a significant impact on total leucocyte count and on the renal function, where 70 % of the diabetics had impaired renal functions. Regarding the risk factor analysis associated with the occurrence of DM, only breed has been identified as a potential risk factor for cDM (canine diabetes mellitus). So, a spotlight must be thrown on cDM as an essential and not uncommon dog's disease, and we need to raise awareness of cDM among veterinarians and dogs' owners. [ABSTRACT FROM AUTHOR]

Medical history, disease onset, clinical symptoms, and results of neuroimaging of 14 glossopharyngeal schwannoma patients, who were exa­mined and treated in the Subtentorial Neurooncology Department of the State Institution, Romodanov Institute of Neurosurgery of the NAMS of Ukraine (8 patients) and the Neurosurgery Department No. 2 of the Municipal Enterprise, Mechnikov Dnipropetrovsk Regional Clinical Hospital of Dnipropetrovsk Regional Council (6 patients) in 2018 to 2021 have been analyzed in details. The study inclusion criteria were as follows: patient’s age over 18, pre­sence of unilateral primary glossopharyngeal nerve schwannoma. Our study showed that most of clinical signs and symptoms of the glossopharyngeal nerve schwannoma are associated with otolaryngological disorders (such as hearing loss, tinnitus, hoarseness, or dizziness) or cerebellar disorders (such as ataxia, nystagmus, or dizziness). Neuroimaging cerebellopontine angle tumors diagnosis must include brain computed tomography (with mandatory assessment of the state of jugular foramen and internal auditory canal) and IV contrast brain magnetic resonance tomography and inclusion of high-resolution sequences, gradient echo (3D CISS, DRIVE, TRUFFI, B-FFE) with the aim of better visualization and differentiation of various cerebellopontine angle cranial nerves. The study demonstrates the com­plexity of a reliable preoperative diagnosis when using standard diagnostic tools. Preoperative jugular foramen and cerebellopontine angle tumors diagnosis should be based on a systematic approach and include a comparison of results of comprehensive clinical and instrumental examination and neuroimaging studies.

Background: Skin reaction patterns vary across patients with cholinergic urticaria (CholU), but their definition, prevalence, and clinical significance remain ill characterized., Methods: Patients with CholU underwent pulse-controlled ergometry provocation testing to analyze skin reaction patterns and their correlation with location, onset, severity, sweating behaviour, clinical features, disease control, and quality of life (QoL) impairment., Results: Based on the size, color, spacing, and shape of wheals as well as their surrounding skin responses, we identified six distinct types of CholU skin reactions, which differed in prevalence, from 83% (Type I) to 11% (Type VI) of patients affected. Almost all patients (94%) had ≥1 type of skin reaction pattern. Sweating was reduced in the majority of CholU patients and most prominently reduced in patients with Type VI skin signs (very small, round, red, widely spaced wheals with surrounding anemic halo), which emerged exclusively on the extremities. Type V skin signs (large, irregular, anemic, widely spaced wheals with moderate size erythema) were associated with the most severe clinical presentation and poorest QoL., Conclusions: Our analysis showed that most patients have more than one type of skin reaction patterns and that different skin signs are linked to distinct features. Future studies should determine any links between treatment response and types of skin signs in CholU., (Copyright © 2024 Japanese Society of Allergology. Published by Elsevier B.V. All rights reserved.)

The present retrospective study analyzed the characteristics of strongyloidiasis in patients who were diagnosed at the Outpatient Clinic of the Department of Parasitology-Mycology, Toulouse, France. Sixty-nine file records were included in the study on the basis of a positive stool examination that used Baermann’s method. The prominent epidemiological findings were the presence of former immigrants from Italy or Portugal, veterans from the 1st Indochina war, and autochthonous cases. Almost 1/4 of the patients were asymptomatic. Manifestations of skin allergy were the main clinical feature. Blood eosinophilia was present in 76.8% of the patients, and serum total IgE was ≥150 kIU/L in 79.7%. Immunodiagnosis was achieved from 1990 to 2001 by indirect immunofluorescence (IFAT) that was then replaced with ELISA, both methods using Strongyloides ratti filariform larvae. ELISA was found to be similar to IFAT in terms of specificity but exhibited a greater sensitivity. Patients were primarily treated with albendazole or ivermectin beginning in 1993. Forty-eight patients attended the follow-up consultation. Kinetics of the clinical picture and blood eosinophilia were found to be the most convenient parameters to assess the efficacy of anthelmintic therapy. In conclusion, strongyloidiasis remains a neglected disease in Southwestern France. The resolution of clinical features along with the kinetics of eosinophilia appeared to be the most appropriate parameters to check during the posttreatment follow-up.

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: In Japan, epidemiological studies on type 1 diabetes (T1D) have mainly focused on the disease in childhood. Meanwhile, limited information is available regarding the clinical features of adolescent and adult T1D. Therefore, we aimed to investigate their current clinical state in Saitama prefecture near Tokyo, Japan. Materials and methods: We conducted a cross-sectional, hospital-based, multicenter study. Eight institutions participated in the study, all of which treated relatively large numbers of T1D patients. We identified 1241 T1D patients aged 16 or over: 814 with acute-onset T1D (AT1D), 362 with slowly progressive insulin-dependent diabetes mellitus (SPIDDM), and 65 with fulminant T1D (FT1D). Based on the patient's medical records, various clinical parameters and complications were investigated. Results: Of 1241 patients, 739 (59.5%) were females. Among all patients, the median age, onset age, and disease duration were 51, 38, and 13 years, respectively. The patients had a median BMI of 22.6 kg/m2, and 26.1% were obese, corroborating previous nationwide surveys. Moreover, the median HbA1c was 7.8%, similar to previous nationwide surveys. Among patients with AT1D, SPIDDM, and FT1D, 85.6%, 72.1%, and 81.5% carried out multiple daily insulin injection, respectively, while 10.3%, 2.2%, and 18.5% were subject to continuous subcutaneous insulin infusion. The proportions of retinopathy, nephropathy, and neuropathy were 26.3%, 20.8%, and 21.5%. Conclusions: The glycemic control in T1D patients in Saitama was equivalent to that observed in previous nationwide surveys. Moreover, approximately one-quarter of T1D patients had obesity. Future studies should address whether our findings reflect those throughout Japan. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Veterinary Medicine & Pharmacology is the property of Innovation in Health Center and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents the results of studying the effect of complex treatment of mining and metallurgical industry workers – pneumoconiosis in combination with COPD patients, using solutions of bronchodilators, antiinflammatory drugs, mucoregulators with nebulizer, complex vitamin B and hyperbaric oxygenation on clinical symptoms and indicators of spirometry in the system of measures targeted at the treatment and prevention of this occupational lung disease. The object and methods of research. Active treatment group consisted of 25 people who received comprehensive treatment of pneumoconiosis in combination with chronic obstructive pulmonary disease (COPD). Experimental group consisted of 29 workers with pneumoconiosis in combination with COPD, who underwent a course of traditional treatment with a short-acting bronchodilator as needed (dosed inhaler), a tablet form of mucoregulator (ambroxol hydrochloride), and B vitamins intramuscularly during 15 days. The average age of workers was 58.6 ± 2.4 years, work experience in adverse conditions 18.9 ± 0.8 years. Results of the research and their discussion. The obtained data indicate that the total indicator that characterizes dyspnea on the scale of the International Research Council (IRC, in scores) after treatment decreased by 36.8% (p

Background. Acne is one of the most common chronic dermatoses, which occurs in almost 8590% of the population. The disease manifests itself as polymorphic eruptions and is characterized by a recurrent and torpid course. Acne treatment is constantly improving, requires an integrated approach and long courses of therapy. Aims. To increase the effectiveness of acne therapy using new opportunities and promising methodological approaches using a combination of the therapeutic effects of platelet-rich plasma (PRP) and topical bacteriophage therapy. Materials and methods. The study included 30 patients with papulopustular acne of mild and moderate severity. Patients with mild acne were treated with PRP procedures as monotherapy. For moderate acne, PRP therapy was combined with regular applications of a staphylococcal bacteriophage (NPO Microgen, Nizhny Novgorod, Russia). The treatment was carried out on an outpatient basis: at least 3 procedures with an interval of 12 weeks (up to a maximum of 6 procedures within one year). The results were analyzed using descriptive statistics and the parametric Student's t-test. Data processing was carried out using the Biostat software. The value of the level of statistical significance of differences was taken as p 0.05. Results. Evaluation of the effectiveness of treatment was carried out on the basis of an analysis of the immediate outcomes of the disease, the dynamics of clinical symptoms and the severity of acne: regression of inflammatory elements of acne, a decrease in the phenomenon of seborrhea, improvement of the skin relief. As a result of the therapy, a transition to remission was noted in 16.6% of patients, an improvement in their condition 36.7%, a significant improvement 46.7%. Conclusions. An integrated approach combining PRP procedures and bacteriophage therapy can serve as a pathogenetically substantiated strategy for treating acne. A promising direction for further research is the development of new regimens and combinations of alternative therapeutic strategies using bacteriophages.

Medical history, disease onset, clinical symptoms, and results of neuroimaging of 14 glossopharyngeal schwannoma patients, who were examined and treated in the Subtentorial Neurooncology Department of the State Institution, Romodanov Institute of Neurosurgery of the NAMS of Ukraine (8 patients) and the Neurosurgery Department No. 2 of the Municipal Enterprise, Mechnikov Dnipropetrovsk Regional Clinical Hospital of Dnipropetrovsk Regional Council (6 patients) in 2018 to 2021 have been analyzed in details. The study inclusion criteria were as follows: patient’s age over 18, presence of unilateral primary glossopharyngeal nerve schwannoma. Our study showed that most of clinical signs and symptoms of the glossopharyngeal nerve schwannoma are associated with otolaryngological disorders (such as hearing loss, tinnitus, hoarseness, or dizziness) or cerebellar disorders (such as ataxia, nystagmus, or dizziness). Neuroimaging cerebellopontine angle tumors diagnosis must include brain computed tomography (with mandatory assessment of the state of jugular foramen and internal auditory canal) and IV contrast brain magnetic resonance tomography and inclusion of high-resolution sequences, gradient echo (3D CISS, DRIVE, TRUFFI, B-FFE) with the aim of better visualization and differentiation of various cerebellopontine angle cranial nerves. The study demonstrates the complexity of a reliable preoperative diagnosis when using standard diagnostic tools. Preoperative jugular foramen and cerebellopontine angle tumors diagnosis should be based on a systematic approach and include a comparison of results of comprehensive clinical and instrumental examination and neuroimaging studies. [ABSTRACT FROM AUTHOR]

Progressive supranuclear palsy (PSP) is a progressive atypical parkinsonian syndrome characterised by postural instability, supranuclear ophthalmoplegia, dysarthria, dysphagia, executive dysfunction and other features. This clinical presentation represents the classic PSP-Richardson syndrome (PSP-RS). However, several other clinical subtypes have been recognised, including PSP-parkinsonism (PSP-P), probably the second most common PSP variant. Unlike PSP-RS, PSP-P often presents with an asymmetric onset, tremor and a moderate initial response to levodopa, especially during the first years of the disease, thus resembling Parkinson's disease (PD). It runs a more favourable course, but over time, PSP-P may evolve clinically into PSP-RS. Therefore, it may seem that PSP-P stands clinically between PD and PSP. There are several peculiarities that can distinguish PSP-P from these entities. As there is lack of systematic reviews on PSP-P in the literature, we decided to summarise all the necessary data about the epidemiology, clinical picture, neuroimaging, genetics and other aspects of this PSP variant in order to provide complete information for the reader. [ABSTRACT FROM AUTHOR]

The article presents a case of congenital toxoplasmosis in a child. Constant features of congenital toxoplasmosis are liver disease, swollen lymph nodes, enlarged spleen, meningoencephalitis (with the subsequent development of calcifications, seizures, hydrocephalus, mental retardation), eye da­mage. For the prevention of congenital toxoplasmosis, examination of women of childbearing age is necessary during family planning to exclude toxoplasmosis.

Hematuria is the presence of five or more red blood cells in three consecutive urinalyses obtained with an interval of one week. At the level of primary medical care, the doctor must be able to recognize and confirm the presence of hematuria, suggest its possible causes, and select patients who could potentially have a serious illness of the urinary system. The algorithm for providing primary medical care for hematuria in children depends on its clinical variant: macrohematuria, symptomatic microhematuria, asymptomatic microhematuria with proteinuria, asymptomatic isolated microhematuria. Examination which is indicated for children with macrohematuria is: general urine analysis, complete blood count, serum creatinine, calcium/creatinine ratio in a urine sample, ultrasound of the kidneys and bladder. If, as a result of clarification of complaints, medical history, physical and additional examinations, the cause of macrohematuria is not established, the child should be referred to a pediatric nephrologist. Evaluation of children with symptomatic microhematuria is aimed at identifying common (fever, malaise, abdominal pain, etc.), non-specific (rash, arthritis, jaundice, respiratory, gastrointestinal symptoms, etc.) and specific to the urinary system symptoms (dysuria, pollakiuria, urinary incontinence, enuresis, edema, hypertension). The presence of hematuria in combination with proteinuria in children most often suggests the glomerular origin of hematuria. Asymptomatic patients with hematuria and proteinuria persistent for 2–3 weeks should be referred to a pediatric nephrologist for further examination. Asymptomatic isolated microhematuria is the most common type of hematuria in children, it is usually short-term and, as a rule, is not associated with severe renal disease. The most common causes of asymptomatic microhematuria persisting for more than six months are IgA nephropathy, thin basement membrane disease, and hereditary nephritis (Alport syndrome), hypercalciuria, urinary tract infection are less common. At the stage of further examination and further observation of children with asymptomatic isolated microhematuria, the optimal treatment is the phytoneering drug Canephron® N.

In 2017, Ukraine ranked in the top three among European countries in terms of measles incidence, and ranked first in measles growth in 2018. High morbidity, mortality and development of complications make the problem of knowing features of the measles clinical course, timely diagnosis and active prevention highly relevant. The purpose of the research is to study the dynamics of the incidence and clinical features of measles in children during the outbreak of 2018–2019 in the city of Mariupol, Donetsk region. A peculiarity of the measles outbreak in 2018–2019 in Mariupol is prevalence of the disease in preschool children (60.4%), inclu­ding 30.2% – those under one year of age; low vaccination rate: 52.3% of children unvaccinated; only 22.2% of children were vaccinated twice, according to the schedule. In all age groups, a moderately severe measles course prevailed (69.8%). The clinical course of measles in preschool and school age children had definitive features. Thus, Belsky–Filatov–Koplik spots were observed three times more frequently in preschool children than in schoolchildren (63.9% and 23.3%, respectively). Abdominal pain and diarrhea were only observed in children under 6 years of age (30.2%). Skin pigmentation was absent in children under one year of age and was detected in preschool and school-age children (69.8%). Skin sloughing was only observed in schoolchildren (10.4%). Severe disease course occurred in patients of all ages (29.3%), but children aged under one year and preschool children with severe disease were two times more numerous than those of the school age. Among the observed complications, the vast majority were associated with the respiratory organs: pneumonia (38.3%), subcutaneous emphysema (1.7%), bronchitis (53.2%), laryngitis (3.3%), otitis media (5%). No fatalities were observed. The city should form a commitment to immunization, restore public trust in vaccination, using all forms and means of information, and develop a program to implement the vaccination schedule into practice.

Introduction. The autosomal dominant hereditary spastic paraplegia type 3 (SPG3), associated with the ATL1 gene, is a common form of the hereditary spastic paraplegia (HSP). The molecular genetic and clinical features of the SPG3 have not been sufficiently studied. Study aim: to conduct the first clinical, molecular, and genetic study of HSP in Russia, using a high-throughput exome sequencing technology massively parallel sequencing (MPS). Materials and methods. Study subject: 14 identified families with SPG3. Clinical and molecular genetic methods used: Sanger sequencing, MPS panel for spastic paraplegia, multiplex ligation-dependent probe amplification. Results. SPG3 made up 7.2% of the 195 examined families, 13.6% of 103 molecularly identified cases, and 16.9% of the dominant forms, coming in second place after SPG4 (50%). We found 9 missense mutations in 14 families (7 in hot exons), with 4 new ones and the known p.Arg415Trp mutation identified in 4 families. One case was caused by a de novo mutation, the others were familial; incomplete penetrance was found in 5 families (subclinical cases). Gender distribution of the probands was equal, but there were more males among the affected relatives. Most of the 25 examined patients, as well as the relatives with clinical data, had early-onset (in the first decade of life, often at the age of 1 to 3 years), uncomplicated HSP with slow progression; many of those subjects were initially diagnosed with a cerebral palsy. Subclinical axonal polyneuropathy was found in 3 out of 6 cases using EMG. Atypical severe paraparesis was combined with skeletal pathology (likely independent of the major condition) in one female patient. Intellectual disability in males of another family was also considered to be an independent condition. Conclusion. SPG3 has a significant prevalence among HSP in Russian patients. The clinical features in most cases are similar and relatively non-severe; clinical diagnosis may be challenging, especially in non-familial and non-apparent familial (incomplete penetrance) cases, as well as when combined with other conditions. An incorrect diagnosis of cerebral palsy is often made. A verified diagnosis is necessary for genetic counselling and is important for patient management. MPS methods are the most informative in the molecular genetic diagnosis of HSP.

Abstract Background Premenstrual syndrome (PMS) and its more severe form premenstrual dysphoric disorder (PMDD) are highly prevalent conditions, but there seems to be ethnic and cultural variances in their distribution. Aims To explore the prevalence of PMS/PMDD and their typical clinical features in a Bulgarian population. Materials and methods This investigation was designed and executed as a cross-sectional descriptive study. Three hundred and five conveniently recruited females with no psychiatric history filled in a self-evaluation questionnaire based on DSM-IV tapping on different symptoms of PMS. The prevalence of the conditions was calculated. Results 32.1% (N = 98) of the tested females (mean age 31.04 ± 6.31) suffered from PMS and 3.3% (N = 10) were diagnosed with PMDD. The leading symptoms in the sample were irritability, fatigue and changes in appetite, depressed mood, mood swings, and anxiety, and abdominal bloating, breast tension and tenderness. Most of the symptoms were moderately severe. Mild and moderate cases of PMS were near equally distributed and more frequent than severe ones. Conclusion PMS is a common condition which is usually mildly expressed, but severe cases are not an exception. The clinical picture is dominated by almost equally distributed psychological and somatic symptoms.

The COVID-19 pandemic proceeds in waves, with variable characteristics of the clinical picture resulting from the evolution of the SARS-CoV-2 virus. This study aimed to compare the epidemiological characteristics, symptomatology, and outcomes of the disease in patients hospitalized for COVID-19 during periods of different variants dominance. Comparing the periods of dominance of variants preceding the Delta variant, the Delta period was characterized by a higher share of hospitalized females, less frequent comorbidities among patients, and a different age distribution. The lowest need for oxygen therapy and mechanical ventilation was observed under Omicron dominance. The triad of classic COVID-19 symptoms, cough, fever, dyspnoea, and fatigue, were most prevalent during the Delta period, and significantly less common under the Omicron dominance. During the Omicron period, nearly twice as many patients as in the previous periods could be discharged from the hospital within 7 days; the overall 28-day mortality was significantly lower compared to that of the Delta period. It also did not differ between periods that were dominated by the BA.1 and BA.2 subvariants. The study indicates that the Omicron SARS-CoV-2 variant that dominated between January and June 2022 caused a disease which resembled the common cold, and was caused by seasonal alpha and beta-coronaviruses with a low pathogenicity for humans. However, one should note that this effect may not only have been related to biological features of the Omicron lineage, but may additionally have been driven by the increased levels of immunization through natural infections and vaccinations, for which we could not account for due to a lack of sufficient data.

Guillain-Barré syndrome (GBS) is an immune-mediated peripheral polyradiculonevritis, which is clinically characterized by rapid, symmetrical progression of muscle weakness or paralysis, with or without sensitive symptoms. We report the case of a male child aged 4 years is presented for distal weakness in the lower limbs, impossibility of maintaining vertical posture, balance disorders, alternating sleepiness with episodes of psychomotor agitation and dysphonia, headache, with sudden onset about 12 hours before hospitalization. The presented case underlines the importance of accurately describing the clinical picture and evolution in establishing the diagnosis, in total or partial absence of paraclinical data. Also, the low number of cases described in medical jurnals justify the interest in investigating and publishing these cases.

Carcinoma of the middle ear is a rare otologic disease. The development of malignancy is most commonly associated with chronic inflammation of the middle ear, although the mechanisms of this development have not been clarified yet. The symptoms of the carcinoma are not always specific and the cancer is frequently diagnosed in its advanced stage. Early evidence-based diagnosis implies a thorough evaluation and identification of cancer signs and symptoms. If ear discharge is followed by an intensive pain, bleeding from the ear, occurrence of peripheral facial nerve palsy, vertigo and hearing loss, the carcinoma is suspected, although similar clinical symptoms may be recognized in chronic otitis media as well. In addition, the characteristic signs and symptoms of carcinoma are also the following: changes in temporomandibular joint, parotid gland swelling, painless solitary mastoid swelling, neurological disorders, sudden occurrence of polyps and granulation tissue (recurrent polyps and granulation tissues after the removal), signs аnd symptoms of otogenic complications, as well as generalized weakness, weight loss and other biological disturbances. The diagnostic approach may include generally accepted recommendations and treatment protocols.

Objectives: The systemic form of scleroderma (SSc) in children is a very rare disease; therefore, it is recognized relatively late, which increases the risk of complications. The aim of the study was to assess the clinical symptoms of juvenile systemic sclerosis (JSSc) in our cohort patients. Material and methods: A group of (N = 22) scleroderma patients aged between 2 and 16 years were observed. Demographic data and all clinical results obtained during 16 years of observation in the clinic of rheumatic diseases of developmental age were collected and analysed. Results: In all observed children the major JSSc criterion was found, i.e. skin thickening proximal to the metacarpal phalangeal and/or metatarsophalangeal joints. Other symptoms are presented as follows: nailfold capillary abnormalities - 100%, Raynaud's phenomenon - 90.9%, sclerodactyly - 27.3%, digital tip ulcers - 27.3%, dysphagia - 18.2%, gastroesophageal reflux - 27.3% (assessed in only 10 children), arrhythmias - 22.7%, heart failure - 9.1%, new-onset arterial hypertension - 9.1%, pulmonary fibrosis - 72.7%, pulmonary arterial hypertension - 9.1%, neuropathy - 13.6%, carpal tunnel syndrome - 4.5%, tendon friction rubs - 4.5%, arthritis - 22.7%, and myositis - 13.6%. There were no cases of renal crisis. Decreased diffusing capacity of oxygen was confirmed in 12 patients (58.3%). The presence of antinuclear antibodies was noticed in 86.7% of patients, and among SSc selective autoantibodies: anticentromere - 31.8%, anti-topoisomerase I - 18.2%, anti-PM-Scl 100 or 75 - 45.5%, anti-RP11, Th/To, PCNA in total in 27.3% were presented. In 4.5% of cases, apart from the presence of anti-PM-Scl autoantibodies, positive lupus band test, reduced concentration of complement, and antiphospholipid antibodies were also found. In 59% of studied children, the body mass index was below the 25th percentile. Conclusions: The presented retrospective analysis shows that the occurrence of Raynaud's phenomenon with changes in nailfold capillaroscopy is the best screening toll for the assessment of risk of JSSc. All patients of developmental age with Raynaud's phenomenon, especially in the case of the appearance of antinuclear antibodies, should be monitored with capillaroscopy regardless of other laboratory or imaging tests. [ABSTRACT FROM AUTHOR]

As part of the NorthTick project, co-funded by the European Union through the European Regional Development Fund and the North Sea Region Programme, specialists in the field of tick-borne diseases from seven North Sea countries co-operated with patient organisations and governmental health care institutions to provide this comprehensive overview of diagnostics and treatment recommendations in the region for Lyme borreliosis, Borrelia miyamotoi infection, tick-borne encephalitis, human granulocytic anaplasmosis, rickettsiosis, neoehrlichiosis and babesiosis. The main conclusion is that the recommendations in these northern countries are essentially the same, with very few differences. This overview presents the current diagnostics and provides useful clinical guidance. [ABSTRACT FROM AUTHOR]

Localized scleroderma (morphea) is a chronic autoimmune disease of the connective tissue. Its etiopathogenesis is unknown. Most often the disease affects the skin, but may also involve the subcutis, muscles, and the osteoarticular system. The clinical presentation and the course of disease may be diverse. This article presents clinical characteristics of various types of the disease, the classification of its subtypes, recommendations for differential diagnosis and treatment.

Introduction. Free radical processes are General biological mechanisms of protection and tissue damage, their role is described in a variety of diseases, but the number of studies on the status of oxidative stress in children with community-acquired pneumonia are rare. Objective. To establish the state of antioxidant status depending on the severity of pneumonia in children and to assess the effectiveness of the correction of oxidative stress reactions in patients with community-acquired pneumonia. Material and methods. The main group consisted of 51 children diagnosed with acute pneumonia. The evaluation of Imax, S, t parameters depending on the severity of the pathological process was carried out. Results. Threshold values (Imax, S, and t) for medium and severe pneumonia were determined by ROC-analysis to predict the course of the pathological process. Conclusion. There is a violation of the antioxidant status, depending on the severity of the pathological process. It is necessary to correct the antioxidant status of children who belong to the group of frequently ill children.

Introduction. Mitochondrial ataxias are an extremely heterogeneous group of diseases, which include the SANDO (an acronym stands for sensory ataxic neuropathy, dysarthria and ophthalmoparesis) syndrome. SANDO syndrome is one of the characteristic phenotypes associated with mutations in the POLG gene. Study objective. To analyse the clinical picture and the results of clinical and laboratory tests in a Russian case series of genetically confirmed SANDO syndrome. Materials and methods. Nine patients (4 men and 5 women aged 33.411.3 years) with SANDO syndrome and identified mutations in the POLG gene were examined. A clinical evaluation using the SARA and ICARS (for ataxia) and MoCA (cognitive function) scales, laboratory study of liver function, electrocardiography, stimulation electromyography and brain MRI were performed; 6 patients underwent electroencephalography. MLPA analysis and the original multigene NGS panel were used for genetic screening. Results. The average age of disease onset was 27.78.2 years, with significant variability (from 14 to 49 years). The disease was characterized by a rather typical clinical picture, which included sensory ataxia, polyneuropathy, dysarthria and external ophthalmoparesis in all patients; the median score was 13.5/40 [11; 25] points on the SARA scale, 39.5/100 [33; 63] points on the ICARS scale, and 22 [20; 25] points on the MoCA scale. Two patients showed signs of frontal lobe dysfunction. In most patients, MRI revealed changes in the white matter of the cerebellar hemispheres, brainstem, thalamus and semioval centres, but no pathology was detected on MRI in 3 patients. The p.W748S mutation in the POLG gene made up 83% of the mutant alleles, while the p.L931R and p.L311P pathogenic mutations found in 2 patients are new variants and have not been described in international databases. Conclusion. Our findings suggest that the true frequency of SANDO syndrome in the population may be higher than previously thought. Therefore, a suspicion of this disease should be maintained even in the absence of characteristic changes on neuroimaging. For the timely detection of SANDO syndrome, we propose an appropriate diagnostic algorithm, which should be followed when examining patients with ataxia.

This literature review summarizes current data on the epi­demiology, pathophysiology, diagnosis and treatment of calcinosis cutis in patients with systemic sclerosis (SSc). The article deals with the analysis of observational studies of the frequency of calcinosis in SSc and associated clinical features, molecular research of potential pathogenetic mechanisms, clinical cases describing new diagnostic approaches and methods for the treatment of calcinosis. Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. Calcinosis is one of the main, poorly managed clinical problems in patients with SSc, affecting at least one quarter of patients with SSc. Calcinosis is associated with a longer disease duration, digital ulcers, acro-osteolysis, positive anticentromere and anti-topoisomerase antibodies. Although the pathogenesis of calcification is not fully known, there is evidence supporting the role of local chronic traumatization, chronic inflammation, vascular hypoxia and malregulation of bone matrix proteins as potential mechanisms for the development of this pathological condition in patients with SSc. The diagnosis can be established on the basis of clinical data or using plain X-ray. Several pharmacolo­gical treatment methods have been applied in patients with calcinosis with variable and not so significant results; in turn, surgical excision of calcium deposits remains mainstay of treatment.

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Aim: The aim of the study was to conduct a retrospective histopathological and clinical analysis of benign tumors of the orbit in children and adolescents treated in the Clinic of Pediatric Ophthalmology of the Medical University of Silesia in Katowice. Material and methods: The study included 1344 patients, who underwent surgical removal of nodular lesions in the Department of Pediatric Ophthalmology of the Medical University of Silesia in Katowice between 2010 and 2020. Tumors of the orbit constituted 23.7% (172 patients). The excised lesions underwent histopathological examination. The study group consisted of 97 girls (56.4%) and 75 boys (43.6%) aged from 6 months to 17 years. The average age was 3.7 ±4.9 years. The patients were divided into four age groups: 0-4 years, 5-9 years, 10-14 years, 15-18 years. Results: In the above age groups, orbital tumors occurred in 71.5%, 13.4%, 9.3%, and 5.8%, respectively. Histopathology results most often showed: dermoid cysts (47.1%) epidermal cysts (21.5%) and dermolipomas (18%). The majority of dermoids arise in the upper temporal region from the frontozygomatic suture. All patients underwent surgical excisions of lesions because of unpredictable progression and possible complications. Eligibility for resection of dermolipomas or lipomas depended on tumor size, concomitant symptoms and cosmetic aspects. Conclusions: According to our data, the most common benign tumors in children and adolescents were dermoid and epidermal cysts. Choristomas have typical locations and clinical picture. Treatment of these lesions involves a surgical excision, and subsequent histopathological evaluation is always required. [ABSTRACT FROM AUTHOR]

Background: Risk stratification allows guiding treatment for patients with heart diseases. We aimed to provide clinical rules for identifying patients at high risk for mortality owing to heart failure. Methods: The research was a secondary analysis of data from a community cohort study that had been conducted from October 2007 to December 2011 in the United States. In total, 425 adult patients (180 women) with heart failure had been included. The mean (SD) age was 73·5 (13·1) years, and participants had been followed for 2 years. The outcome was mortality and the predictors were a variety of demographic, clinical, and laboratory variables. Results: We recognized two clusters of patients in the sample with different survival probabilities (P

Purpose and objectives: Given their role in homing immune cells to the intestine, CC motif chemokine receptor 9 (CCR9) and its specific ligand CC motif chemokine ligand 25 (CCL25) are interesting candidate genes for celiac disease. These genes are located in regions previously shown to be associated with or linked to celiac disease, but no investigations on their association with various celiac disease phenotypes have so far been conducted. Here we studied such associations of both genotyped and imputed single nucleotide polymorphisms (SNPs) with either regulatory function or exonic location of the CCR9 and CCL25 loci. Results: Exploiting a carefully phenotyped cohort of 625 celiac disease patients and 1817 non-celiac controls, we identified that multiple SNPs with predicted regulatory function (RegulomeDB score ≤3a and/or eQTL effect) located between 100 kB upstream and downstream of CCR9 and CCL25 are associated with celiac disease and/or selected phenotypes. Of the genotyped SNPs in the CCR9 loci, rs213360 with an eQTL effect on CCR9 expression in blood was associated with celiac disease and all investigated phenotypes except high HLA risk. Rs1545985 with an eQTL on CCR9 expression and rs7652331 and rs12493471, both with RegulomeDB score ≤3a, were all associated with gastrointestinal symptoms and malabsorption and the latter additionally with anemia. The genotyped CCL25 SNPs rs952444 and rs882951, with RegulomeDB scores 1d and 1f respectively and eQTL effect on CCL25 expression in small intestine, were associated with gastrointestinal symptoms and malabsorption. The CCL25 SNP rs2303165 identified in sequencing followed by imputation was associated with partial villous atrophy. However, the association did not pass the permutation based multiple testing correction (PEMP2 > 0.05). Conclusions: We conclude that SNPs in the region of CCR9 and CCL25 with predicted functional effect or exonic localization likely contribute only modestly to various celiac disease phenotypes.

Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder characterized by a highly variable clinical presentation depending on the affected organ/s, extent of tumefactive fibroinflammatory lesions, and associated functional impairment. The disease pursues a chronic, relapsing, often asymptomatic course and hence may pose a significant diagnostic challenge. Diagnostic delay can lead to progressive fibrosis and irreversible organ damage resulting into significant morbidity and even mortality. Given its broad clinical spectrum, physicians of all specialties may be the first clinicians facing this diagnostic challenge. Outside the pancreatobiliary system, the head and neck represents the major site of IgG4-RD with variable organ-specific diffuse or mass-forming lesions. In up to 75% of cases, elevated serum IgG4 levels are observed, but this figure possibly underestimates the fraction of seronegative cases, as the disease manifestations may present metachronously with significant intervals. Together with negative serology, this can lead to misdiagnosis of seronegative cases. A standardized nomenclature and diagnostic criteria for IgG4-RD were established in 2012 and revised in 2020 facilitating scientific research and expanding the range of diseases associated with IgG4 abnormalities. In addition to orbital pseudotumor, dacryoadenitis, Riedel thyroiditis, sinonasal manifestations, and rare miscellaneous conditions, IgG4-related sialadenitis is one of the most frequent presentations in the head and neck region. However, controversy still exists regarding the relationship between sialadenitis and IgG4-RD. This review focuses on the clinicopathological features of IgG4-related sialadenitis and its contemporary diagnostic criteria., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Ebola virus disease — natural focal, extremely dangerous infection with severe course characterized by fever, hemorrhagic syndrome and multiple damage to vital organs and body systems. The article describes the epidemiological situation related with the registration of cases, provides the characteristics of the pathogen, mechanisms of development, peculiarities of disease in children. Methods of the treatment and prevention of this disease are described from the modern point of view.

Background. Despite the availability of safe and effective vaccine, measles remains one of the leading causes of death among children around the world. In 2017–2018, European countries and Ukraine have been experiencing a measles outbreak. In Ukraine, on 41st week since the beginning of 2018, 33,165 people were affected by measles, including 13,184 adults and 19,981 children. The purpose of this study was to evaluate the clinical features of measles in children during the current 2017–2018 outbreak. Material and me­thods. Children with measles who underwent in-patient treatment. Results. We studied 140 medical records of hospitalized children diagnosed with measles. Majority of them were children of school age (62.9 %). Children under 2 years of age were only 16.5 % of the total number of patients being studied. In the clinical picture of the vast majority of patients with measles (79.1 %), there were symptoms of the classic triad: conjunctivitis, cough and runny nose. The duration of fever was significantly longer in patients who did not receive measles vaccination, compared with vaccinated persons (7.50 ± 1.92 days and 6.60 ± 1.74 days, respectively). Unvaccinated individuals had also significantly longer duration of the prodromal period, which lasted 3.20 ± 1.48 days versus 2.50 ± 1.31 days in vaccinated patients. Persistence of rash was the shortest in infants (4.96 ± 1.29 days) and the longest — in children aged 1 to 2 years (6.09 ± 2.11 days). The complicated course of the disease was observed in 14.3 % of patients. Most complications (82.9 %) were associated with respiratory tract. Significantly higher incidence of complications was detected in patients with concomitant pathology. Conclusions. Clinical characte­ristics of measles in children depend on age and vaccination status.