Search

Introduction Comorbidities in addiction: It is a rule rather than an exception. The story starts in childhood; even before, in infancy, may be in utero. The dimensional traits have been already there, existing obviously far before any DSM-5 diagnosis. Developmental qualities of stress sensitivity, impulsivity and emotion dysregulation are the leading ones. Besides, comorbidity research (NESARC being one of the prominents) (Hasin and Grant. Soc Psychiatry Psychiatr Epidem, 2015;50 (11): 1609-1640) addressed childhood abuse, neglect or other childhood adverse experiences as a definite risk factor for adolescence and adult mental disorders, particularly substance use disorders. Developmental and environmental adversities in a mutually amplifying pattern make a vicious cycle in which the individual finally finds an illusionary exit, a pathway to addiction. Objectives This presentation aims to discuss the complexities and challenges for the diagnosis and treatment of a patient with a twenty five year follow-up, a survival period for the patient herself as well as for the therapeutic alliance (Ulug, Arch Neuropsychiatr, 2015;52: 213-215). Methods Case study: The history and the life chart of her, diagnosed as having at least seven DSM diagnoses, indicate the depth of pyschopathology and the intensity of interventions, most of which failed due to the lack of a transdiagnostic and holistic perspective. A specific focus of the case study will be on the problematic use of Borderline Personality Disorder formulation/diagnosis and its negative, somehow short-coming, impact on the treatment, course and recovery. Results The challenges brought by comorbid transdiagnostic cases, similar to the subject of this presentation, have become a common practice for addiction professionals. While big data or empirical large datasets can have their own limitations to help the practitioner for overcoming such challenges, as stated in Stein’s article “it is important to recognize the value of a wide range of complementary research designs including the age-old single-case study, which may sometimes provide clinical insights that outweigh those from big data analyses.” (Stein et al. World Pychiatry, 2022; 21(3): 393-414). Conclusions The case study indicates the necessity for transdiagnostic and holistic approach in the management and long term treatment of such difficult-to-diagnose and difficult-to-treat patients. Disclosure of Interest None Declared

In December 2019, cases of pneumonia of unknown origin were detected in Wuhan, Hubei Province, China. It was later determined that the pathogen SARS-CoV, which causes these cases of pneumonia, has been identified as the new enveloped RNA Betacoronavirus 2, now called severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2). In Turkey, the first case was detected on March 10, 2020. This study aimed to evaluate the factors that will enable rapid diagnosis of the disease through comparison of COVID-19 RT PCR results, thorax computed tomography (CT) findings, and laboratory results of patients suspected with COVID-19 who visited Başkent University Ankara Hospital Emergency Medicine Clinic. In our sample of 515 patients (280 female and 235 male patients), infiltration was detected in 113 patients (21.9%) The ratio of females to males increased with age. When the sex distribution of the thoracic CT findings was examined, the incidence of infiltration was higher in male patients. Conversely, no statistically significant dependence was found between the two categories using the chi-squared test. Shortness of breath was observed in 32.7% of patients with positive thoracic CT findings. Other common complaints were chest pain, 12.4%; fever, 10.6%; and weakness, 9.7%, respectively. The other category, which covered unclassified arrival complaints, had the highest percentage in the entire sample. When the thoracic CT distribution of comorbidities was examined (hypertension, 29.2% and diabetes, 25.2%) were more common than the other comorbidities in terms of the presence of infiltration. Thoracic CT results with RT-PCR, which were analyzed using the chi-square test, showed a statistically significant dependence between them. Conversely, COVID-compatible thorax CT findings were detected in 80 of 260 patients who tested negative in the PCR test. No complaints of fever, cough, weakness, shortness of breath, or chest pain associated with COVID were found in 48.6% of patients who were thoracic CT positive. PCR showed a low sensitivity rate. Therefore, thoracic CT is a better choice than PCR for the detection of asymptomatic cases in emergency patients. Because its selectivity rate is high, using PCR as a diagnostic test is more significant. [Med-Science 2023; 12(3.000): 741-5]

Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients’ dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale—Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from −0.95 to −0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to −0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ −2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.

Background: Injury patterns in hypoxic-ischaemic brain injury (HIBI) are well recognised but there are few studies evaluating cerebral injury using neuroquantification models. Objectives: Quantification of brain volumes in a group of patients with clinically determined cerebral palsy. Method: In this retrospective study, 297 children with cerebral palsy were imaged for suspected HIBI with analysis of various cerebral substrates. Of these, 96 children over the age of 3 years with a clinical diagnosis of cerebral palsy and abnormal MRI findings underwent volumetric analyses using the NeuroQuant® software solution. The spectrum of volumetric changes and the differences between the various subtypes (and individual subgroups) of HIBI were compared. Results: Compared with the available normative NeuroQuant® database, the average intracranial volume was reduced to the 1st percentile in all patient groups (p 0.001). Statistically significant differences were observed among the types and subgroups of HIBI. Further substrate volume reductions were identified and described involving the thalami, brainstem, hippocampi, putamina and amygdala. The combined volumes of five regions of interest (frontal pole, putamen, hippocampus, brainstem and paracentral lobule) were consistently reduced in the Rolandic basal ganglia-thalamus (RBGT) subtype. Conclusion: This study determined a quantifiable reduction of intracranial volume in all subtypes of HIBI and predictable selective cerebral substrate volume reduction in subtypes and subgroups. In the RBGT subtype, a key combination of five substrate injuries was consistently noted, and thalamic, occipital lobe and brainstem volume reduction was also significant when compared to the watershed subtype. Contribution: This study demonstrates the value of integrating an artificial intelligence programme into the radiologists’ armamentarium serving to quantify brain injuries more accurately in HIBI. Going forward this will be an inevitable evolution of daily radiology practice in many fields of medicine, and it would be beneficial for radiologists to embrace these technological innovations.

Abstract The diffuse nature of Glioblastoma (GBM) tumors poses a challenge to current therapeutic options. We have previously shown that Acyl-CoA Binding Protein (ACBP, also known as DBI) regulates lipid metabolism in GBM cells, favoring fatty acid oxidation (FAO). Here we show that ACBP downregulation results in wide transcriptional changes affecting invasion-related genes. In vivo experiments using patient-derived xenografts combined with in vitro models demonstrated that ACBP sustains GBM invasion via binding to fatty acyl-CoAs. Blocking FAO mimics ACBPKD-induced immobility, a cellular phenotype that can be rescued by increasing FAO rates. Further investigation into ACBP-downstream pathways served to identify Integrin beta-1, a gene downregulated upon inhibition of either ACBP expression or FAO rates, as a mediator for ACBP’s role in GBM invasion. Altogether, our findings highlight a role for FAO in GBM invasion and reveal ACBP as a therapeutic vulnerability to stall FAO and subsequent cell invasion in GBM tumors.

This is a scientific article detailed information about the essence, principles, rules, elements, basic principles and methods of costume design. The features and tools of costume design are not only found in clothes, but also in works of art. It is presented as a broad theoretical information about color, styles in costume, details about styles and styles, ensembles are discussed in detail.The methods of artistic design of the costume are widely covered with information about decor and plastic and decorative features of selected materials, fashion functions, and accessories used in costume design. Teaches basic concepts of the concept of fashion and the functions of design and ensures the correct and intelligent use of design in future creative work.

Abstract Natural products have been proven to be important starting points for the development of new drugs. Bacteria in the genera Photorhabdus and Xenorhabdus produce antimicrobial compounds as secondary metabolites to compete with other organisms. Our study is the first comprehensive study screening the anti-protozoal activity of supernatants containing secondary metabolites produced by 5 Photorhabdus and 22 Xenorhabdus species against human parasitic protozoa, Acanthamoeba castellanii, Entamoeba histolytica, Trichomonas vaginalis, Leishmania tropica and Trypanosoma cruzi, and the identification of novel bioactive antiprotozoal compounds using the easyPACId approach (easy Promoter Activated Compound Identification) method. Though not in all species, both bacterial genera produce antiprotozoal compounds effective on human pathogenic protozoa. The promoter exchange mutants revealed that antiprotozoal bioactive compounds produced by Xenorhabdus bacteria were fabclavines, xenocoumacins, xenorhabdins and PAX peptides. Among the bacteria assessed, only P. namnaoensis appears to have acquired amoebicidal property which is effective on E. histolytica trophozoites. These discovered antiprotozoal compounds might serve as starting points for the development of alternative and novel pharmaceutical agents against human parasitic protozoa in the future.

Objective: Vaginal length (VL), size and width may show individual differences among women. Hysterectomy causes VL shortening in patients, and this shortening varies according to the type of hysterectomy performed. Some studies in literature have shown that the shortened VL after hysterectomy may cause dyspareunia and have a negative effect on female sexuality. The aim of this study is to compare preoperative and postoperative vaginal lengths, vaginal shortening rate (VSR) not used before in the literature, and postoperative sexual functions according to hysterectomy types. Materials and methods: In the study, which included 136 [55 Total Abdominal Hysterectomy (TAH), 33 Vaginal Hysterectomy (VH), 48 Total Laparoscopic Hysterectomy (TLH)] sexually active patients under the age of 60 who underwent hysterectomy, the patients were divided into three groups according to the type of hysterectomy performed. Groups were compared in terms of demographic variables, preoperative/postop and control VL, vaginal shortening rate and The Female Sexual Function Index (FSFI) scores. Results: Vaginal lengths measured after TLH was longer and vaginal lengths measured after VAH was shorter, the difference was significant (p 15% had statistically significantly lower FSFI scores in lubrication, orgasm, pain and total score than both the VSR

Abstract Aim of this study is to investigate whether the risk of miscarriage increases in pregnant women who had COVID-19 in first trimester. Our study included 52 patients with SARS-CoV-2 infection detected by RT-PCR and 53 patients with negative RT-PCR test in samples taken with nasopharyngeal swab in the first trimester between March 1 and December 31, 2020. Complete abortion, incomplete abortion, blighted ovum, intrauterine exitus, biochemical pregnancies were accepted as in the miscarriage group (MG). Pregnant women with COVID-19 and control group were compared in terms of demographic data, miscarriage rate and laboratory results. Patients were divided into MG and ongoing pregnancy groups (OPG) and compared in terms of the diagnosed weeks, clinical findings, laboratory results, treatments, and hospitalization. While miscarriage was observed in 15 (28.8%) of pregnant women infected with SARS-CoV-2 in the first trimester, this number was 7 (13.2%) in the control group. While the common symptoms in the MG were cough (60%), fever (53.3%), shortness of breath (53.3%), and fatigue (46.7%) (p

The article provides information on the preparation of polyelectrolytes and swelling polymeric hydrogels with different specified properties. The analysis of domestic and foreign scientific literatures is presented. Particular attention of researchers is paid to rare cross-linked polyelectrolytes, the so-called supermoisture absorbents or hydrogels. Thanks to a complex of variable unique properties, supermoisture absorbents have found the widest application on the world market in medicine, industry, agriculture, and in solving water and environmental problems.

Inclusive conservation is promoted as a means to integrate stakeholders in nature, conservation. Despite several studies recognizing that inclusive conservation of protected areas may be challenging and requires explicitly addressing potential tensions between stakeholders, little research has unpacked how these tensions manifest in specific contexts. This paper aims to explore possible approaches for navigating tensions to improve the facilitation of an inclusive conservation approach in the Utrechtse Heuvelrug National Park in the Netherlands. We conducted 18 semistructured interviews with stakeholders such as public and private landowners and, municipal and provincial governments in the national park. Results reveal a longer history of collaboration which still fails to address the root of the tensions. The experiences show that compromising or consensus building amongst stakeholders alone is not sufficient for achieving inclusive conservation. Guidance and clear goals set by policy, as well as sufficient investments in capacity and trust building are recommended to avoid inaction. Furthermore, we found that tensions are inextricably linked to different dimensions of power, such as discursive and structural power. While considering power in inclusive conservation can provide a realistic perspective we also, acknowledge that equalizing power is not the silver bullet underpinning this conservation approach. • We investigate an inclusive conservation approach "on the ground" in a Dutch case study. • Tensions lie in unclarities in governance and collaborative platforms. • Power imbalances contributed to deepening tensions. • Enhancing capacities, leadership, and trust could benefit inclusive conservation approaches. [ABSTRACT FROM AUTHOR]

Background: It is known that the increase in oxidants and proinflammatory cytokines, as well as the decrease in antioxidants, play a role in ovarian ischemia-reperfusion (I/R) injury. The antioxidant and anti-inflammatory properties of ramipril have been studied in various diseases. This study aims to investigate the effect of ramipril on I/R-induced ovarian damage in rats., Methods: Rats were divided into healthy (HG), sham (SG), ovary I/R (OIR), and ramipril + ovary I/R (ROIR) groups (n = 6/each group). One hour before the surgical procedures, ROIR was given 2 mg/kg ramipril. The lower abdomen of the SG, OIR, and ROIR was surgically opened. Right ovarian tissues of OIR and ROIR were subjected to 2 hours of ischemia and 6 hours of reperfusion. Then, all animals were euthanized, and their right ovaries were removed. Ovarian tissues were examined for oxidants (malondialdehyde), antioxidants (total glutathione, superoxide dismutase, and catalase), and proinflammatory cytokines (nuclear factor kappa-B, tumor necrosis factor-alpha, interleukin 1 beta, and interleukin-6) analysis was performed. Tissues were examined histopathologically., Results: The ovarian tissue of the OIR, which underwent the I/R procedure, exhibited a significant increase in oxidant and proinflammatory cytokine levels, along with a decrease in antioxidant levels (P < .001). Ramipril suppressed the I/R-induced increase in oxidants and pro-inflammatory cytokines and the decrease in antioxidants (P < .001). Ramipril also attenuated I/R-induced histopathological damage in ovarian tissue (P < .05)., Conclusion: Ramipril treatment may be a treatment strategy to protect ovarian tissue against oxidative and inflammatory damage of I/R., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Aim of this study is to investigate whether the risk of miscarriage increases in pregnant women who had COVID-19 in first trimester. Our study included 52 patients with SARS-CoV-2 infection detected by RT-PCR and 53 patients with negative RT-PCR test in samples taken with nasopharyngeal swab in the first trimester between March 1 and December 31, 2020. Complete abortion, incomplete abortion, blighted ovum, intrauterine exitus, biochemical pregnancies were accepted as in the miscarriage group (MG). Pregnant women with COVID-19 and control group were compared in terms of demographic data, miscarriage rate and laboratory results. Patients were divided into MG and ongoing pregnancy groups (OPG) and compared in terms of the diagnosed weeks, clinical findings, laboratory results, treatments, and hospitalization. While miscarriage was observed in 15 (28.8%) of pregnant women infected with SARS-CoV-2 in the first trimester, this number was 7 (13.2%) in the control group. While the common symptoms in the MG were cough (60%), fever (53.3%), shortness of breath (53.3%), and fatigue (46.7%) (p<0.05); asymptomatic patients (51.4%) were higher in the OPG (p<0.001). Hospitalized patients were 33.3% in the MG and 8.1% in the OPG (p=0.02). According to the results of our study, the risk of miscarriage increases in pregnant women infected with SARS-CoV-2 (especially in severe infection) in the first trimester.