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Heart failure—either with reduced or preserved ejection fraction (HFrEF/HFpEF)—is a clinical syndrome of multifactorial and gender-dependent aetiology, indicating the insufficiency of the heart to pump blood adequately to maintain blood flow to meet the body's needs. Typical symptoms commonly include shortness of breath, excessive fatigue with impaired exercise capacity, and peripheral oedema, thereby alluding to the fact that heart failure is a syndrome that affects multiple organ systems. Patients suffering from progressed heart failure have a very limited life expectancy, lower than that of numerous cancer types. In this position paper, we provide an overview regarding interactions between the heart and other organ systems, the clinical evidence, underlying mechanisms, potential available or yet-to-establish animal models to study such interactions and finally discuss potential new drug interventions to be developed in the future. Our working group suggests that more experimental research is required to understand the individual molecular mechanisms underlying heart failure and reinforces the urgency for tailored therapeutic interventions that target not only the heart but also other related affected organ systems to effectively treat heart failure as a clinical syndrome that affects and involves multiple organs. [ABSTRACT FROM AUTHOR]

Critical appraisal methods assist the reader in assessing the validity (closeness to the truth) and the relevance (usefulness in everyday practice) of research findings. The specific techniques of critical appraisal can vary somewhat, depending on the nature of the research question. In this paper, the final in a 6-part series on evidence-based dentistry, frameworks are presented to enable the judicious reader of the dental literature to apply sensible questions to the evaluation of papers related to diagnosis, etiology and prognosis. [ABSTRACT FROM AUTHOR]

Heart failure (HF) is a long‐term clinical syndrome, with increasing prevalence and considerable healthcare costs that are further expected to increase dramatically. Despite significant advances in therapy and prevention, mortality and morbidity remain high and quality of life poor. Epidemiological data, that is, prevalence, incidence, mortality, and morbidity, show geographical variations across the European countries, depending on differences in aetiology, clinical characteristics, and treatment. However, data on the prevalence of the disease are scarce, as are those on quality of life. For these reasons, the ESC‐HFA has developed a position paper to comprehensively assess our understanding of the burden of HF in Europe, in order to guide future policies for this syndrome. This manuscript will discuss the available epidemiological data on HF prevalence, outcomes, and human costs—in terms of quality of life—in European countries. [ABSTRACT FROM AUTHOR]

Non-Alcoholic Fatty Liver Disease (NAFLD) is a common condition affecting around 10–25% of the general adult population, 15% of children, and even > 50% of individuals who have type 2 diabetes mellitus. It is a major cause of liver-related morbidity, and cardiovascular (CV) mortality is a common cause of death. In addition to being the initial step of irreversible alterations of the liver parenchyma causing cirrhosis, about 1/6 of those who develop NASH are at risk also developing CV disease (CVD). More recently the acronym MAFLD (Metabolic Associated Fatty Liver Disease) has been preferred by many European and US specialists, providing a clearer message on the metabolic etiology of the disease. The suggestions for the management of NAFLD are like those recommended by guidelines for CVD prevention. In this context, the general approach is to prescribe physical activity and dietary changes the effect weight loss. Lifestyle change in the NAFLD patient has been supplemented in some by the use of nutraceuticals, but the evidence based for these remains uncertain. The aim of this Position Paper was to summarize the clinical evidence relating to the effect of nutraceuticals on NAFLD-related parameters. Our reading of the data is that whilst many nutraceuticals have been studied in relation to NAFLD, none have sufficient evidence to recommend their routine use; robust trials are required to appropriately address efficacy and safety. [Display omitted] [ABSTRACT FROM AUTHOR]

Sour rot (SR) is one of the major diseases affecting grapevine berries, causing severe yield losses and deterioration of wine quality. SR is caused by an etiologic complex of microorganisms, including yeasts, bacteria, and filamentous fungi. This systematic review focuses on the etiology, epidemiology, and control of SR. A total of 74 papers published between 1986 and 2023 were assessed in this review. Description of disease symptoms was quite consistent across the papers, including oxidation of the grape skin, disaggregation of the internal tissues, and detachment of the rotten berries from the pedicel. The affected bunches are characterized by the smell of acetic acid and ethyl acetate that attracts fruit flies (Drosophila spp.). However, several knowledge gaps and/or inconsistencies were identified with respect to SR etiology, epidemiology, and control. Overall, 146 microorganisms were isolated from the affected berries (44.5% yeasts, 34.3% bacteria, and 21.2% filamentous fungi); however, the selected papers could not definitively clarify which species are primarily involved in the etiology of the disease. A general inconsistency was also observed in the methods used to assess the incidence and severity of SR in vineyards, making inter-study comparisons extremely challenging. Inconsistencies were also found in the methods used for pathogenicity assessment in artificial inoculation studies. Furthermore, gaps were detected in terms of SR epidemiology, with a focus on environmental conditions affecting the disease development. The SR management options are limited, and efficacy trials often result in poor, variable, and inconsistent levels of control, which might be attributed to the lack of knowledge on disease epidemiology. These knowledge gaps and inconsistencies were analyzed in this review to inform future research activities. [ABSTRACT FROM AUTHOR]

The International League Against Epilepsy ( ILAE) Classification of the Epilepsies has been updated to reflect our gain in understanding of the epilepsies and their underlying mechanisms following the major scientific advances that have taken place since the last ratified classification in 1989. As a critical tool for the practicing clinician, epilepsy classification must be relevant and dynamic to changes in thinking, yet robust and translatable to all areas of the globe. Its primary purpose is for diagnosis of patients, but it is also critical for epilepsy research, development of antiepileptic therapies, and communication around the world. The new classification originates from a draft document submitted for public comments in 2013, which was revised to incorporate extensive feedback from the international epilepsy community over several rounds of consultation. It presents three levels, starting with seizure type, where it assumes that the patient is having epileptic seizures as defined by the new 2017 ILAE Seizure Classification. After diagnosis of the seizure type, the next step is diagnosis of epilepsy type, including focal epilepsy, generalized epilepsy, combined generalized, and focal epilepsy, and also an unknown epilepsy group. The third level is that of epilepsy syndrome, where a specific syndromic diagnosis can be made. The new classification incorporates etiology along each stage, emphasizing the need to consider etiology at each step of diagnosis, as it often carries significant treatment implications. Etiology is broken into six subgroups, selected because of their potential therapeutic consequences. New terminology is introduced such as developmental and epileptic encephalopathy. The term benign is replaced by the terms self-limited and pharmacoresponsive, to be used where appropriate. It is hoped that this new framework will assist in improving epilepsy care and research in the 21st century. [ABSTRACT FROM AUTHOR]

We investigated whether dried cerebrospinal fluid ( CSF) conserved on filter paper can be used as a substrate for accurate PCR diagnosis of important causes of bacterial meningitis in the Lao PDR. Using mock CSF, we investigated and optimized filter paper varieties, paper punch sizes, elution volumes and quantities of DNA template to achieve sensitive and reliable detection of bacterial DNA from filter paper specimens. FTA Elute Micro Card™ (Whatman, Maidstone, UK) was the most sensitive, consistent and practical variety of filter paper. Following optimization, the lower limit of detection for Streptococcus pneumoniae from dried mock CSF spots was 14 genomic equivalents ( GE)/μL (interquartile range 5.5 GE/μL) or 230 (IQR 65) colony forming units/mL. A prospective clinical evaluation for S. pneumoniae, S. suis and Neisseria meningitidis was performed. Culture and PCR performed on fresh liquid CSF from patients admitted with a clinical diagnosis of meningitis ( n = 73) were compared with results derived from dried CSF spots. Four of five fresh PCR-positive CSF samples also tested PCR positive from dried CSF spots, with one patient under the limit of detection. In a retrospective study of S. pneumoniae samples ( n = 20), the median (IQR; range) CSF S. pneumoniae bacterial load was 1.1 × 104 GE/μL (1.2 × 105; 1 to 6.1 × 106 DNA GE/μL). Utilizing the optimized methodology, we estimate an extrapolated sensitivity of 90%, based on the range of CSF genome counts found in Laos. Dried CSF filter paper spots could potentially help us to better understand the epidemiology of bacterial meningitis in resource-poor settings and guide empirical treatments and vaccination policies. [ABSTRACT FROM AUTHOR]

Sarcopenia is the age-associated loss of skeletal muscle mass and function. It is a major clinical problem for older people and research in understanding of pathogenesis, clinical consequences, management, and socioeconomic burden of this condition is growing exponentially. The causes of sarcopenia are multifactorial, including inflammation, insulin resistance, changing endocrine function, chronic diseases, nutritional deficiencies and low levels of physical activity. Operational definition of sarcopenia combines assessment of muscle mass, muscle strength and physical performance. The diagnosis of sarcopenia should be based on having a low appendicular fat free mass in combination with low handgrip strength or poor physical functioning. Imaging techniques used for estimating lean body mass are computed tomography, magnetic resonance imaging, bioelectrical impedance analysis and dual energy X-ray absorptiometry, the latter considered as the preferred method in research and clinical use. Pharmacological interventions have shown limited efficacy in counteracting the age-related skeletal muscle wasting. Recent evidence suggests physical activity and exercise, in particular resistance training, as effective intervention strategies to slow down sarcopenia. The Italian Society of Orthopaedics and Medicine (OrtoMed) provides this position paper to present the update on the role of exercise on sarcopenia in the elderly. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is the most severe depression type and one of the leading causes of morbidity worldwide. Animal models are widely used to understand MDD etiology, pathogenesis, and treatment, but the efficacy of this research for patients has barely been systematically evaluated. Such evaluation is important given the resource consumption and ethical concerns incurred by animal use. We used the citation tracking facilities within Web of Science and Scopus to locate citations of original research papers on rats related to MDD published prior to 2013—to allow adequate time for citations—identified in PubMed and Scopus by relevant search terms. Resulting citations were thematically coded in eight categories, and descriptive statistics were calculated. 178 publications describing relevant rat studies were identified. They were cited 8,712 times. More than half (4,633) of their citations were by other animal studies. 794 (less than 10%) were by human medical papers. Citation analysis indicates that rat model research has contributed very little to the contemporary clinical understanding of MDD. This suggests a misuse of limited funding hence supporting a change in allocation of research and development funds targeting this disorder to maximise benefits for patients. [ABSTRACT FROM AUTHOR]

Introduction and aim. Invasive aspergillosis is a rare fungal infection in neonates. Aspergillus spp. are moulds that are commonly found in the environment. However, they can cause infections among immunocompromised patients such as premature newborns. Authors discuss obstacles of diagnosis and treatment of aspergillosis in a paediatric group. Description of the case. Authors of the paper described the case of a premature and small for gestational age (SGA) neonate born after 24 weeks of gestation with extremely low body weight. Patient was admitted to our department, because of perforation of the small intestine. During the stay patient developed many skin lesions of unknown aetiology. The diagnostic actions were undertaken and the newborn was given empiric antibiotic therapy with antifungal treatment. The serum galactomannan was positive and Aspergillus fumigatus was isolated from skin lesion swabs. Treatment with liposomal amphotericin B was started, subsequently it was replaced by voriconazole. Treatment did not cause any significant side effects and was successful. It was the first such case in our Department. Conclusion. Diagnosis and treatment of IA poses significant difficulties. Well-established diagnosis and treatment procedure does not exist. Drugs indicated in treatment of invasive aspergillosis in neonates are liposomal amphotericin B, amphotericin B lipid complex and voriconazole. [ABSTRACT FROM AUTHOR]

Background: Genetic epidemiology deals with the aetiology, distribution and control of disease in groups of relatives, and with inherited causes of disease in populations. The main goal of this overview, part of the collaborative study SPHERE (Strengthening Public Health Research in Europe) was to have an up-to-date, detailed summary of the available information for epidemiologists and researchers on the present status of genetic epidemiology in Europe. Methods: The PubMed literature search engine was used to recruit papers published in Europe (EU15, EU + 10 and non-EU countries) in this field restricted to the time period of 1 January 1987 and 31 December 2004. Results: The number of publications increased significantly in Europe in the period analysed, however, the publication activity was restricted mainly to EU15 countries, with only sporadic papers from EU + 10 countries. Research areas studied are slightly different in Europe and in the USA with a larger emphasis on cancer, mental disease and behavioural disease genetic epidemiology in Europe. Conclusion: The aim must be to develop research to support policy in this important field as is already seen in the United States. [ABSTRACT FROM AUTHOR]

Background: Functional somatic symptoms and disorders are common and complex phenomena involving both bodily and brain processes. They pose major challenges across medical specialties. These disorders are common and have significant impacts on patients' quality of life and healthcare costs.Main Body: We outline five problems pointing to the need for a new classification: (1) developments in understanding aetiological mechanisms; (2) the current division of disorders according to the treating specialist; (3) failure of current classifications to cover the variety of disorders and their severity (for example, patients with symptoms from multiple organs systems); (4) the need to find acceptable categories and labels for patients that promote therapeutic partnership; and (5) the need to develop clinical services and research for people with severe disorders. We propose 'functional somatic disorders' (FSD) as an umbrella term for various conditions characterised by persistent and troublesome physical symptoms. FSDs are diagnosed clinically, on the basis of characteristic symptom patterns. As with all diagnoses, a diagnosis of FSD should be made after considering other possible somatic and mental differential diagnoses. We propose that FSD should occupy a neutral space within disease classifications, favouring neither somatic disease aetiology, nor mental disorder. FSD should be subclassified as (a) multisystem, (b) single system, or (c) single symptom. While additional specifiers may be added to take account of psychological features or co-occurring diseases, neither of these is sufficient or necessary to make the diagnosis. We recommend that FSD criteria are written so as to harmonise with existing syndrome diagnoses. Where currently defined syndromes fall within the FSD spectrum - and also within organ system-specific chapters of a classification - they should be afforded dual parentage (for example, irritable bowel syndrome can belong to both gastrointestinal disorders and FSD).Conclusion: We propose a new classification, 'functional somatic disorder', which is neither purely somatic nor purely mental, but occupies a neutral space between these two historical poles. This classification reflects both emerging aetiological evidence of the complex interactions between brain and body and the need to resolve the historical split between somatic and mental disorders. [ABSTRACT FROM AUTHOR]

Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by mythical and fallacious information among the public, hence stifling the prevention, treatment, and management of diseases. This paper focused on comparing selected aspects of the two pandemics, that is, HIV/AIDS and Coronavirus. This comparative analysis is important for drawing informative lessons for effective response and management of pandemics in the future. Through a literature review analysis, the paper established that both pandemics have more similarities than distinctions. The etiology and epidemiology of the diseases assume a similar cascading trajectory; the public health information about the diseases is characterized by myths, conspiracy theories, illusions, and delusions from the public. The myths associated with pandemics prevail around causation, disease transmission, and cure. The pandemics present economic paradoxes, though arguably the negatives outdo the positives. There is a need for the governments and international health custodians to be richly prepared for the pandemics in the future. This implies having special budgetary allocations for possible pandemic outbreaks, investing in vaccine development and disease surveillance, and training and skilling personnel in all social-health-related sectors. [ABSTRACT FROM AUTHOR]

Introduction and aim. Pancreatic cancer was the twelfth most common form of cancer and the fourth most common form of cancer in the United States in 2015. Pancreatic cancer is usually diagnosed at an advanced stage, with only 20% of patients eligible for surgery at the time of diagnosis, and thus a survival rate of around 5%. Pancreatic ductal adenocarcinoma is the most common type of pancreatic cancer. Material and methods. The etiology of pancreatic cancer is unclear, however, risk factors that increase the inflammation of this type of cancer, such as smoking, diabetes, obesity, high alcohol consumption or pancreatitis, have been taken into account, which is why it is so important to further study etiological factors and identify people at risk of the disease. Analysis of literature. Hepatitis B infections are a major global problem affecting at least 2 billion people worldwide. The carcinogenic mechanisms of HBV infection can be explained by the incorporation of viral DNA fragments into the genome of host cells, which leads to the expression of HBx virus proteins, and this may lead to potentially oncogenic mutations. Not only active hepatitis B, but also a history of HBV infection can lead to the development of pancreatic cancer. The detection of silent replication of the virus and the expression of the protoncogenic HBx protein in the neoplastic tissue suggest the involvement of HBV infection in the development of pancreatic ductal adenocarcinoma. Conclusion. The results of meta-analyses indicate that HBV infection may increase the risk of pancreatic cancer in most cases. [ABSTRACT FROM AUTHOR]

Introduction and purpose Non-specific and specific lower back pain syndrome is one of the leading causes of musculoskeletal disability and affects more than half of the population worldwide. The aim of this paper is to confront the problem of lumbar pain, possible diagnostic options, conservative and surgical opportunities with long term satisfactory rate. State of knowledge The paper reviews literature on lower back pain syndrome, sciatica, radiculopathy and lumbar disc herniation in regards to detection of the problem, classifying it and possible methods of resolvent. The WHO defines lower back pain as one of the leading causes of musculoskeletal dysfunction and it focuses on reducing the occurrence by programs like WHO Rehabilitation 2030 Initiative, UN Decade of Healthy Ageing and others. The paper also focuses on nonsurgical options of treatment. Material and method A review of the literature available in the "PubMed" and Google Schoolar was conducted. We focused on differential diagnosis depending on clinical presentation and possible treatment methods depending on symptoms, pathogenesis of the disorder and available procedures. Summary Our review managed to present the current state of development, possible differential diagnosis, prevalence of neural compressions, sciatica and radiculopathy in different diagnostic options. By receiving multiple studies we confront varied opinions of specialists regarding the approach to lower back pain syndrome and favorable forms of care. Additionally we came to the conclusion that the difference of patients' long term satisfactory rate in regards to nonoperative and operative treatment is not significant, and flattens over the years. [ABSTRACT FROM AUTHOR]

Introduction and aim. Primary central nervous system lymphoma is a rare, clinically aggressive tumour of the lymphatic system localising 80-90% to the cerebral hemispheres. The rest are located in the spinal cord, cranial nerves or eyeballs. More than 90% of PCNSL cases originate from B lymphocytes. The incidence of the tumour has increased and it develops not only in immunocompromised, but also in immunocompetent individuals. Description of the case. A 47-year-old female patient presented to the Department of Neurology with sudden speech, behaviour and orientation disturbances preceded by severe headaches. The investigations performed indicated a multifocal brain injury of unknown aetiology, most likely inflammatory. After one month, the patient's condition deteriorated despite treatment and she was readmitted to the neurology department. Brain MRI and spectroscopy performed at the beginning of her hospitalisation revealed progression of previous lesions, however, the perfusion result did not indicate a neoplastic process. The investigations suggested acute haemorrhagic encephalomyelitis. Overnight, the woman's neurological condition worsened and there was a significant progression of poor general condition - inertia and increased muscle tone in the left limbs were demonstrated and the patient needed oxygen therapy and catheterisation. 2 weeks after the start of hospitalisation, lesions present on MRI raised the suspicion of lymphoma/glioma. A biopsy was recommended, which revealed PCNSL, an intravascular large B-cell lymphoma. Conclusion. Primary CNS lymphoma is associated with a poor prognosis. Its correct diagnosis is associated with major diagnostic problems and therapeutic difficulties. The course of PCNSL is usually aggressive and the results of treatment are unsatisfactory. [ABSTRACT FROM AUTHOR]

Introduction and aim. Sight deterioration caused by the defect in the oculomotor nerve is common amongst neurological patients, however, the etiology varies - both cerebral strokes and diabetes or hypertension can cause it. Similarly, headaches are non-specific to one disease. Differential diagnosis is obligatory when treating patients with these symptoms successfully. Description of the case. A thirty-eight-old female was admitted to the hospital because of sudden problems with vision and cephalgia. On history taking, the patient admitted to being three months after her third delivery, neither suffering from any chronic diseases nor taking drugs permanently. Problems with vision were caused by right oculomotor nerve palsy and then were successfully treated with steroids. The results of Magnetic Resonance Imaging in T2 and FLAIR sequences revealed some non-characteristic hyperintensities in the subdural white matter of both cerebral hemispheres and a lesion in the left lobe of the pituitary gland. It is also worth mentioning the diagnosis of COVID-19, confirmed by antigen test during the stay at the hospital. After a careful diagnostic process, arteriovenous malformations were finally claimed. Arteriovenous malformations are mainly congenital abnormalities of vessels, characterized by the lack of development of the capillaries between arteries and veins. In most cases, they do not cause any symptoms. However, in some patients, mainly after the rapture, hemorrhagic strokes or seizures can be the first presentation. Conclusion. The case represents the value of properly undergoing differential diagnosis. The patient's symptoms accompanied by laboratory and imaging test results allowed to diagnose arteriovenous malformations, however excluding more common medical conditions was essential. This case also reminds about the importance of being cautious in history taking and lastly making accurate decisions about the treatment even without knowledge of the accurate etiology of the disease. [ABSTRACT FROM AUTHOR]

Introduction and aim. Generalized fetal edema is described as the accumulation of excessive fluid in the soft tissues and at least two body cavities of the fetus. According to the etiology, it divides into two groups: immune and non-immune. Immune hydrops fetalis is caused by RhD alloimmunization in pregnancy. Non-immune fetal hydrops can have heterogeneous pathogenesis. Description of the case. The presentation will introduce the case of a 33-year-old healthy woman in her fourth pregnancy. G4,P1. The pregnant woman has blood type 0 Rh-. The patient is hospitalized at GA-36 for a suspected fetal malformation. The ultrasound examination describes an abnormal image of the brain with visible multiple porencephalic cavities, which may be in consonance with the condition after CNS hemorrhage or fetal CNS ischemia. Generalized fetal edema was also noted. The other organs are normal structured. The fetal heart rate is 135 beats/min, while the CTG showed a recording of silent oscillation. Conclusion. In described case, considering the patient's obstetric past, it is inclined toward the diagnosis of fetal immune edema due to platelet conflict. Nowadays, this is an extremely rare occurrence. [ABSTRACT FROM AUTHOR]

The article compares research papers on rheumatological studies appeared in several journals during different periods of time. The first volume of "The Annals of the Rheumatic Diseases," which appeared in 1939, featured three articles on viral causes of arthritis. Two therapeutic and four clinical papers were published in the April 1991 issue of the Annals. Information on the design of the papers published in the "British Medical Journal" is also presented.

In this review paper, we present the common etiology, presentation, diagnosis, and management of the following three common bunion formations: dorsal bunion, tailor's bunion, and hallux valgus (HV). Bunions are common pathologies that present to a variety of clinics, so it is important for providers to have a base understanding of these in order to provide the best care to patients. Many of these bunion formations have a variety of causes which allow providers to manage them before surgical intervention is required. The aim of this review paper is to bring attention and expanded insight on these common bunion presentations in order to minimize morbidity early on. The information provided in this review will allow both primary care and subspecialty physicians with the knowledge to accurately diagnose and optimally manage these bony deformities of the lower extremity. [ABSTRACT FROM AUTHOR]

Background: PPHN is a common cause of neonatal respiratory failure and is still a serious condition and associated with high mortality. Objectives: To compare the demographic variables, clinical characteristics, and treatment outcomes in neonates with PHHN who underwent ECMO and survived compared to neonates with PHHN who underwent ECMO and died. Methods: We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature for studies on the development of PPHN in neonates who underwent ECMO, published from January 1, 2010 to May 31, 2023, with English language restriction. Results: Of the 5689 papers that were identified, 134 articles were included in the systematic review. Studies involving 1814 neonates with PPHN who were placed on ECMO were analyzed (1218 survived and 594 died). Neonates in the PPHN group who died had lower proportion of normal spontaneous vaginal delivery (6.4% vs 1.8%; p value > 0.05) and lower Apgar scores at 1 min and 5 min [i.e., low Apgar score: 1.5% vs 0.5%, moderately abnormal Apgar score: 10.3% vs 1.2% and reassuring Apgar score: 4% vs 2.3%; p value = 0.039] compared to those who survived. Neonates who had PPHN and died had higher proportion of medical comorbidities such as omphalocele (0.7% vs 4.7%), systemic hypotension (1% vs 2.5%), infection with Herpes simplex virus (0.4% vs 2.2%) or Bordetella pertussis (0.7% vs 2%); p = 0.042. Neonates with PPHN in the death group were more likely to present due to congenital diaphragmatic hernia (25.5% vs 47.3%), neonatal respiratory distress syndrome (4.2% vs 13.5%), meconium aspiration syndrome (8% vs 12.1%), pneumonia (1.6% vs 8.4%), sepsis (1.5% vs 8.2%) and alveolar capillary dysplasia with misalignment of pulmonary veins (0.1% vs 4.4%); p = 0.019. Neonates with PPHN who died needed a longer median time of mechanical ventilation (15 days, IQR 10 to 27 vs. 10 days, IQR 7 to 28; p = 0.024) and ECMO use (9.2 days, IQR 3.9 to 13.5 vs. 6 days, IQR 3 to 12.5; p = 0.033), and a shorter median duration of hospital stay (23 days, IQR 12.5 to 46 vs. 58.5 days, IQR 28.2 to 60.7; p = 0.000) compared to the neonates with PPHN who survived. ECMO-related complications such as chylothorax (1% vs 2.7%), intracranial bleeding (1.2% vs 1.7%) and catheter-related infections (0% vs 0.3%) were more frequent in the group of neonates with PPHN who died (p = 0.031). Conclusion: ECMO in the neonates with PPHN who failed supportive cardiorespiratory care and conventional therapies has been successfully utilized with a neonatal survival rate of 67.1%. Mortality in neonates with PPHN who underwent ECMO was highest in cases born via the caesarean delivery mode or neonates who had lower Apgar scores at birth. Fatality rate in neonates with PPHN who underwent ECMO was the highest in patients with higher rate of specific medical comorbidities (omphalocele, systemic hypotension and infection with Herpes simplex virus or Bordetella pertussis) or cases who had PPHN due to higher rate of specific etiologies (congenital diaphragmatic hernia, neonatal respiratory distress syndrome and meconium aspiration syndrome). Neonates with PPHN who died may need a longer time of mechanical ventilation and ECMO use and a shorter duration of hospital stay; and may experience higher frequency of ECMO-related complications (chylothorax, intracranial bleeding and catheter-related infections) in comparison with the neonates with PPHN who survived. [ABSTRACT FROM AUTHOR]

Pulmonary fibrosis is a fatal lung disease affecting approximately 5 million people worldwide, with a 5-year survival rate of less than 50%. Currently, the only available treatments are palliative care and lung transplantation, as there is no curative drug for this condition. The disease involves the excessive synthesis of the extracellular matrix (ECM) due to alveolar epithelial cell damage, leading to scarring and stiffening of the lung tissue and ultimately causing respiratory failure. Although multiple factors contribute to the disease, the exact causes remain unclear. The mechanical properties of lung tissue, including elasticity, viscoelasticity, and surface tension, are not only affected by fibrosis but also contribute to its progression. This paper reviews the alteration in these mechanical properties as pulmonary fibrosis progresses and how cells in the lung, including alveolar epithelial cells, fibroblasts, and macrophages, respond to these changes, contributing to disease exacerbation. Furthermore, it highlights the importance of developing advanced in vitro models, based on hydrogels and 3D bioprinting, which can accurately replicate the mechanical and structural properties of fibrotic lungs and are conducive to studying the effects of mechanical stimuli on cellular responses. This review aims to summarize the current understanding of the interaction between the progression of pulmonary fibrosis and the alterations in mechanical properties, which could aid in the development of novel therapeutic strategies for the disease. [ABSTRACT FROM AUTHOR]

Which papers have provided the most interesting recent advances in tuberculosis research? Which new discoveries in pathogenesis, epidemiology, drug discovery or vaccine development have been the most important or are likely to have the highest impact to the field? [ABSTRACT FROM AUTHOR]

Background: The concept of control has long been suggested as a central factor in eating disorder (ED) aetiology. The concept is now so mainstream that it risks being used in a potentially reductionist, stigmatising or otherwise harmful manner. In this paper, we explore and discuss our positions on the use of control-related terminology for EDs. Methods: The authors of this auto-ethnographic position paper include academic researchers, individuals with lived experience and clinicians (not mutually exclusive). In sharing our experiences and observations, we aim to raise awareness of the wider impacts that control framing can have on ED perceptions, treatment, recovery and individuals' lived experience. Results: We argue that although control can play a role in some ED experiences, an overemphasis upon this factor to the exclusion of other conceptualisations is not beneficial. Conclusions: To mitigate against pathologisation of an individual, it is important to challenge a discourse that can lead to EDs being perceived as something 'wrong' with the individual, rather than a consequence of life events or other environmental influences. We identify priorities for the future for researchers, clinicians, policy makers and the wider public. Plain English summary: Control has often been described as a central factor within Eating Disorders (EDs). Whilst control can play a role in ED experiences, we argue that overemphasis upon this factor can result in other important factors being overlooked. For many individuals, EDs are the consequence of life events and/or other environmental influences. With this in mind, discourse which overemphasises control (e.g., rather than coping) can inaccurately portray EDs as something 'wrong' with the individual. It is important to challenge this discourse to encourage more appropriate perceptions of EDs. In turn, this could improve understanding and treatment of EDs, reduce stigma, and promote recovery. [ABSTRACT FROM AUTHOR]

Studies on numerous species have demonstrated strikingly conserved mechanisms that determine the aging process, from yeasts to worms, flies, zebrafish, mice, and humans. The fruit fly Drosophila melanogaster is an excellent model organism for studying the biological basis of normal aging and etiology of age-related diseases. Since its inception in 1967, the Bloomington Drosophila Stock Center (BDSC) has grown into the largest collection of documented D. melanogaster strains (currently > 91,000). This paper aims to briefly review conserved mechanisms of aging and provides a guide to help users understand the organization of stock listings on the BDSC website and familiarize themselves with the search functions on BDSC and FlyBase, with an emphasis on using genes in conserved pathways as examples to find stocks for aging studies. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, pneumonia was the leading cause of respiratory failure and death. In addition to SARS-COV-2, it can be caused by several other bacterial and viral agents. Even today, variants of SARS-COV-2 are endemic and COVID-19 cases are common in many places. The symptoms of COVID-19 are highly diverse and robust, ranging from invisible to severe respiratory failure. Current detection methods for the disease are time-consuming and expensive with low accuracy and precision. To address such situations, we have designed a framework for COVID-19 and Pneumonia detection using multiple deep learning algorithms further accompanied by a deployment scheme. In this study, we have utilized four prominent deep learning models, which are VGG-19, ResNet-50, Inception V3 and Xception, on two separate datasets of CT scan and X-ray images (COVID/Non-COVID) to identify the best models for the detection of COVID-19. We achieved accuracies ranging from 86% to 99% depending on the model and dataset. To further validate our findings, we have applied the four distinct models on two more supplementary datasets of X-ray images of bacterial pneumonia and viral pneumonia. Additionally, we have implemented a flask app to visualize the outcome of our framework to show the identified COVID and Non-COVID images. The findings of this study will be helpful to develop an AI-driven automated tool for the cost effective and faster detection and better management of COVID-19 patients. [ABSTRACT FROM AUTHOR]

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Sarcoidosis is a granulomatous disease of unknown etiology that can affect almost any organ. Although the acute form can have spontaneous regression, a certain number of patients can have a chronic form, which leads to an increase in mortality and a decrease in the quality of life. Considering that the risk factors are still unknown, we wanted to compare the characteristics of patients with acute and chronic forms of sarcoidosis in Serbia in order to determine significant differences between them with hopes of contributing to everyday clinical practice. A total of 2380 patients treated in our clinic were enrolled in this study. They were separated into the following two groups: 1126 patients with acute form and 1254 patients with chronic form. They were further compared by gender, smoking status, radiological status, exposition, biomarkers for sarcoidosis, organ involvement, and other comorbidities; the distribution of patients according to regions of Serbia was also noted. Statistical significance was found in radiological findings (p < 0.001), biomarkers (calcium in 24 h urine p < 0.001; chitotriosidase p = 0.001), and the affliction of organs (p < 0.001). The differences noted in this paper could help improve our understanding of this disease. [ABSTRACT FROM AUTHOR]

Infectious diseases seriously threaten the lives of children. Timely and accurate detection of pathogenic microorganisms and targeted medication are the keys to the diagnosing and treatment of infectious diseases in children. The next-generation metagenomic sequencing technology has attracted great attention in infectious diseases because of its characteristics such as no culture, high throughput, short detection cycle, wide coverage, and a good application prospect. In this paper, we review the studies of metagenomic next-generation sequencing in pediatric infectious diseases and analyze the challenges of its application in pediatric diseases. [ABSTRACT FROM AUTHOR]

Central precocious puberty (CPP) is a rare disease of poorly understood etiology. The cause is mostly idiopathic. However, congenital and acquired structural changes in the central nervous system are also involved. Prevalent organic changes in the central nervous system, especially among boys, prompt imaging assessment in each case of CPP. In addition, genetic and environmental factors have been reported. Safe and effective treatment is available. The time of treatment implementation is crucial to the successful outcome. Proper diagnosis and treatment make it possible to avoid a number of complications of untreated CPP. There are only a few studies analyzing the prevalence and risk factors for the disease. The aim of this paper is to discuss the current causes of CPP with particular consideration of neurological aspects. [ABSTRACT FROM AUTHOR]

Introduction: Alpha-1 antitrypsin (AAT) is a glycoprotein produced by liver, belonging to the serine protease inhibitor family. Alpha-1 antitrypsin deficiency (AATD) is very common autosomal recessive genetic disease caused by point mutation in SERPINA1 gene. Mutations in the alpha-1 antitrypsin gene lead to production of misfolded AAT resulting in impaired release into the blood. This disorder leads to destruction of connecting tissue especially in lungs and to accumulation of retarded protein in the liver. Purpose: Most studies addressing AAT deficiency focus on presenting symptoms related to the lungs and liver. We want to take a broader look at this issue, so we have closely examined scientific reports on the presentation of the disease in organs other than the lungs and liver. The goal is to gather holistic knowledge about the disease to enhance awareness and treatment. Material and methods: In our paper, we endeavored to address the issue of AAT deficiency comprehensively. We explored symptoms with an emphasis on organs beyond the liver and lungs. We also delved into the etiology, diagnosis, treatment, and prognosis of this disease. Discussion: The clinical symptoms of alpha 1 antitrypsin deficiency extending beyond the liver and lungs remain inadequately described. We know that AAT deficiency can lead to excessive destruction of connective tissue in any organ, not just the lungs and liver. Unfortunately, this condition continues to go undiagnosed, and the number of scientific publications on symptoms from other organs is too limited. This affects the insufficient attention given by doctors to tissue destruction in organs other than the lungs and liver. [ABSTRACT FROM AUTHOR]

Simple Summary: Eales' Disease, an ocular condition characterized by unknown pathophysiology, exhibits a higher prevalence among young males. Since the etiology of the disease remains unclear, a comprehensive exploration of clinical presentations and diagnostic approaches is undertaken to deepen insights into its current understanding. Furthermore, potential cofactors that may trigger Eales' Disease are reviewed, investigating the association between Eales' Disease and other ocular conditions such as diabetic retinopathy and glaucoma. Additionally, diverse therapeutic interventions across disease stages are examined to assess the efficacy and possibility of repurposing treatments from related conditions. Through this review, the aim is to extend and elucidate potential study areas to facilitate a comprehensive understanding of Eales' Disease and aid patients in preventing the disease or finding optimal treatment strategies. Eales' Disease is an idiopathic peripheral retinal vasculopathy first described by British ophthalmologist Henry Eales in 1880. Most prevalent in healthy young males, Eales' Disease often presents with symptoms of sudden blurry or decreased vision and floaters. Although no clear, standardized stage of the disease exists, it progresses through three overlapping phases—peripheral periphlebitis, ischemic capillary ischemia, and retinal neovascularization. The etiology of Eales' Disease is unknown and appears to be multifactorial, but post-TB hypersensitivity to tuberculoprotein and M. tuberculosis DNA is the most potential cause in the etiology of Eales' Disease. With a thorough examination of the clinical presentation and diagnosis of Eales' Disease—incorporating the latest clinical findings related to the condition—the investigation for Eales' Disease extends to explore recent potential connections with other ocular conditions or possible cofactors, such as glaucoma, uncontrolled diabetes, drug abuse, or inherited medical conditions. Moreover, focusing on critical insights into the treatment of Eales' Disease across its various stages of progression, the overarching goal of the paper is to refine and suggest possible future diagnostic and therapeutic strategies. Widening our understanding of pathophysiology and utilizing various treatment options for individual patients holds immense potential for advancing ocular medicine and optimizing patient care for people with this disease with unknown pathophysiology. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases, among which includes coronary artery disease, represent one of the most important causes of mortality and morbidity worldwide. Research aimed at determining the risk factors involved recognizes a group of "traditional" risk factors, but also more recent studies identified over 100 "novel" ones which may have a role in the disease. Among the latter is the thrombophilia profile of a patient, a pathology well-established for its involvement in venous thromboembolism, but with less studied implications in arterial thrombosis. This paper reviews the literature, explaining the pathophysiology of the thrombophilia causes associated most with coronary thrombosis events. Results of several studies on the subject, including a meta-analysis with over 60,000 subjects, determined the significant involvement of factor V Leiden, prothrombin G20210A mutation, plasminogen activator inhibitor–1 and antiphospholipid syndrome in the development of coronary artery disease. The mechanisms involved are currently at different stages of research, with some already established and used as therapeutic targets. [ABSTRACT FROM AUTHOR]

Premenstrual syndrome (PMS) is a common disorder affecting women of reproductive age, with an estimated global prevalence of 47.8%, with severe symptoms occurring in 3-8%, significantly affecting daily functioning. GABA conductance and changes in neurosteroid levels, particularly allopregnanolone, are suspected to play a substantial role in the disorder's etiology. In this paper, we provide an overview of recent reports on the etiology and recognized therapeutic approaches, encompassing both pharmacological and non-pharmacological interventions. Our examination includes studies on SSRIs, hormonal agents, neurosteroids, supplementation, and therapeutic roles. We aim to determine the most favorable treatment regimen by comparing medication effects and alternative methods. The treatment of PMS is crucial for enhancing the quality of life for affected women. Medications used in PMS treatment should be individually selected to achieve the best therapeutic effect, considering the clinical situation of the patients. [ABSTRACT FROM AUTHOR]

The article discusses scientific controversy regarding a possible causal link between chronic fatigue syndrome (CFS) and xenotropic murine leukemia virus-related virus (XMRV), noting the postponement of associated research publications. The article describes opposing opinions on the role of XMRV between researchers representing the U.S. Centers for Disease Control and Prevention (CDC) and a team representing the U.S. National Institutes of Health (NIH) and the U.S. Food and Drug Administration (FDA).

A Case of Chromosomal 15q Proximal Tetrasomy Associated with Infantile Spasms and Partial Seizures and Review of Literature.Background:Infantile spasms are an age-dependent epileptic syndrome occurring during infancy, showing repetitive clusters of brief tonic spasms and hypsarrythmia on EEG, as well as psychomotor developmental arrest or deterioration. Numerous studies have been made concerning the etiology of this syndrome. Many causes are known, such as hypoxic encephalopathy during the perinatal period, tuberous sclerosis, and Down syndrome, although the precise underlying mechanism is unknown. Recently a few cases of infantile spasms associated with a chromosomal abnormality, 15q proximal tetrasomy, were reported. Here we present a similar case but with neurologically mild symptoms.Case Report:A 6-month-old girl with 15q proximal tetrasomy had infantile spasms (ISs) and cerebral cortical atrophy. She was born of healthy parents, after 39 weeks of gestation, with birth weight of 2,358 g. The perinatal period was uneventful. Developmental milestones were delayed, with head control at 5 months and rolling at 6 months. When she was age 6 months, her parents brought her to our clinic because of several series of tonic spasms. On physical examination, she showed no neurologically abnormal signs, except general muscle hypotonia. EEG examination showed hypsarrythmia. The brain magnetic resonance imaging and computed tomography showed diffuse cortical atrophy. No abnormal findings were observed in blood examination, CSF, and serologic tests for congenital viral infection of the CNS. A high-resolution analysis of chromosome 15 revealed 15q proximal tetrasomy, and 47,XX,+idic (15)(q13). Before treatment, the DQ score was 62. Tonic spasms subsided after zonisamide monotherapy without adrenocorticotropic hormone (ACTH) treatment. However, soon after the cessation of tonic spasms, she showed partial seizures, which was easily controlled with carbamazepine. Since then, no seizure recurrence was observed during 2 years of follow-up. The total DQ score is 52.Discussion:The supernumerary chromosome may occur in∼0.05% of live births (Buckton, 1980). As many as 50% of supernumerary chromosomes are derived from chromosome 15, and almost 80% of them are inv dup (15). The inv dup (15) individuals are known to manifest mental retardation, psychomotor developmental delay, hypotonia, behavioral abnormality, dysmorphy, and also seizure disorder, with various degrees from normal to severe. Chromosome 15 includes the Prader–Willi syndrome/Angelman syndrome (PW/AS) chromosomal region and also contains some neurotransmitter-related regions such asγ-aminobutyric acid (GABA) receptor subunitsβ3,α5, andγ3, and nicotinic receptorα7. Longer duplication is said to be associated with severe symptoms. However, some cases have large duplications with mild symptoms. The mechanism is unknown. Previously, three cases of 15q proximal tetrasomy with ISs were reported (Kobayashi, 1994; Peter, 1996; Cabrera, 1998). Among cases with inverted duplication of chromosome 15, the duplication occurred at 15pter-q13. In all cases, the ISs were easily controlled with ACTH or ZNS. However, the severity of the subsequent epilepsy varied among cases. Such variable severity is considered to arise from markers related to epileptogenesis present in the regions of duplication, although it is still controversial. Several epilepsy cases were found to be associated with inverted duplication of chromosome 15, but at different regions (i.e., 15q12, 15q14, pter-q11::q13-pter, and direct duplication of 15q15-q24). No ISs cases were among them. One case of ISs with chromosome 15 abnormalities; ring 15, was reported in Japan (Ishii et al., 1988).Conclusions:Chromosome analysis should be included to find out the etiology of West syndrome. In addition, in the case of supernumerary chromosomes, especially in inv dup (15) cases, precise analysis of markers around the PW/AS region provides more information concerning the basic mechanisms of epilepsy. Reciprocal Release Profile Between Hippocampal Monoamine and Acetylcholine Releases in a Novel Spontaneous Epilepsy Model,μ3b-Deficient Mice.Purpose:A novel adaptor protein (AP) complex type 3 (AP-3) was recently identified in mammalian cells. AP-3 is composed of two large subunits (δ andβ3A orβ3B), a medium-sizedμ subunit (μ3A orμ3B), and a smallσ subunit (σ3A orσ3B). Specific expression ofβ3B andμ3B subunits in neurons and neuroendocrine cells has been identified, suggesting that AP-3B, which is composed ofδ,β3B,μ3B, andδ3A/B subunits, has a specific role to play in neurons and may be involved in de novo synaptic vesicle biogenesis in endosomes. Recently we established theμ3B gene knockout mice (μ3B knockout mice), which have lost neuron-specific AP-3B and manifest spontaneous epileptic seizures. To understand the mechanisms of seizures inμ3B knockout mice, we determined the releases of dopamine (DA), serotonin (5-HT), and acetylcholine (ACh) inμ3B knockout mice and wild-type mice, by using hippocampal minislices in vitro.Methods:All of the experiments described here were performed in accordance with the specifications of the Animal Research Committee of Hirosaki University and met the Guidelines for Animal Experimentation of Hirosaki University.μ3B knockout mice were generated essentially as described by Nakatsu et al. (2003) and maintained the C57BL(6J background. Eight-week-old wild-type andμ3B knockout mice were used, and the hippocampal tissue was dissected according to the method of Glowinski and Iversen (1966). The 350× 350-μm thick minislices were prepared on a chopper and were incubated in 0.5 ml artificial cerebrospinal fluid (aCSF) at 35°C for 5 min. The levels of DA and 5-HT in aCSF were determined by high-performance liquid chromatography (HPLC) equipped with electrochemical detection (Eicom, Kyoto, Japan), and the level of ACh was determined by ECD-HPLC (Eicom) equipped with a postcolumn enzymatic reactor containing acetylcholinesterase and cholineoxidase (Eicom). To study the effects of an increase in extracellular K+ level on hippocampal extracellular levels of DA, 5-HT, and ACh, 50 mMpotassium–evoked stimulation was performed for 5 min after confirming stabilization of basal releases.Results:No significant difference was found in the basal releases of DA and 5-HT betweenμ3B knockout mice and wild-type mice in the hippocampus, whereas the basal hippocampal ACh release was higher inμ3B knockout mice than that in wild-type mice (p<0.05). In contrast, 50 mMpotassium–evoked hippocampal releases of DA and 5-HT inμ3B knockout mice were lower than those in wild-type mice (p<0.01), whereas potassium-evoked ACh release was significantly higher inμ3B knockout mice than in wild-type mice (p<0.01).Conclusions:In the present study, we determined the differences in neurotransmitter releases betweenμ3B knockout mice and wild-type mice, by using hippocampal minislices in vitro. This study demonstrated an imbalanced relation between hippocampal monoaminergic and acetylcholinergic transmission inμ3B knockout mice, a reduction of DA and 5-HT release and an increase of ACh release. Therefore these findings indicate that the imbalance between these neurotransmission systems may be, at least partially, involved in the mechanisms of spontaneous seizures inμ3B knockout mice. AP-3B plays an important role in the exocytosis of neurotransmitters by regulating the intracellular secretory and endocytic pathways. Monoaminergic and acetylcholinergic neurons may differentially depend on the molecules of AP complex, especially AP-3B, to exert their functions. [ABSTRACT FROM AUTHOR]

Background. Acute respiratory distress syndrome (ARDS), an acute respiratory failure caused by noncardiogenic pulmonary edema, was first defined by Ashbaugh et al. in 1967. The number of publications increased enormously after the Berlin definition of ARDS was first described in 2012. Objectives. This article intends to provide the physicians and the scientists with a reference guide to assess the most influential publications written about ARDS. Materials and methods. We performed an exhaustive bibliometric analysis to identify publication trends by year, and the most influential research articles, authors, co-authors, journals, and countries. Articles on ARDS published in Science Citation Index (SCI) and Emerging Sources Citation Index (ESCI) journals between 1980 and 2020 were examined. On December 20, 2020, the keywords "ARDS" and "acute respiratory distress syndrome" were searched using the Web of Science Core Collection (WoSCC) database, and data including titles, author information, abstracts, journals, and references were analyzed. Results. A total of 4564 articles related to ARDS published between 1980 and 2020 were identified. After excluding 192 proceedings papers, 19 early access papers, 1 book chapter, 1 research paper, and 1 retracted article, 4350 articles published in SCI and ESCI journals were analyzed. The largest number of articles (n = 557, 12.8%) appeared in 2020. The average citations per article was 38.21, and 4350 articles were cited 166,885 times altogether. The USA was at the top of the list of the most productive countries with 5025 articles. Harvard University was the most contributing institution with 244 articles. M.A. Matthay ranked as the most productive author in ARDS research with 87 published publications. Conclusions. The present study provided a comprehensive, illustrative analysis of ARDS articles published in SCI and ESCI journals over the past 40 years. [ABSTRACT FROM AUTHOR]

The article highlights the study by Paul Elliott and colleagues which investigates the causes of high blood pressure. It relates that Elliott and colleagues have combined information about environmental influences with metabolic profiling, in which they gathered details about diet, alcohol, drug and supplement use from individuals aged between 40 and 59. It notes that the researchers have analysed the amounts of certain urinary constituents and found links between this urinary constituent and a person's diet and blood pressure.

The article features the research conducted by Evan Eichler, a human geneticist at the Howard Hughes Medical Institute, on human genetic structural variation, in Seattle, Washington. Most of the genetic variation between individuals may lie in regions of the genome containing areas of structural diversity but Eichler's research reveals that more than 1,700 such regions, nearly half of which had not been previously sequenced . Such changes in the regions are vital because it hold pertinent information about many diseases and the evolutionary processes that shaped human history.

The article discusses the way three researchers, Aviv Regev, Jill Mesirov and Johanna Daily, began their study on malaria parasite, Plasmodium falciparum. According to the article, Daily approached Mesirov regarding the problem of finding means to know the different stages of the disease. In addition, Mesirov bumped into a conversation with Regev, who gave her a clear understanding of the illness' phases. Furthermore, the three scientists will do a field work in 2008 which is expected to have a strong effect on realizing the beginning of the malady and know how it can be treated.

The article discusses the developments in brain transplantation and the possible clinical applications of such techniques. Through grafting, cerebellar, cerebral cortical and hippocampal grafts survive and develop organotypic maturation as determined by histological and electrophysiological criteria. The effectiveness of an approach depends on the resolution of several issues relating to the aetiology of the disease itself and to the practcal techniques to be used in human patients.

The author reflects on the procedures on how to make manuscripts for the development of the periodical "American Journal of Epidemiology." The author emphasized the advantages of the approach, including the taxing or sleeping-inducing method and strict fixed limit. He further explained the guidelines imposed by the National Institutes of Health regarding the epidemiologic papers.

The article presents a review concerning cancer stem cells and nonstem cells. It keys out two opposing hypotheses of the origin of cancer which forced a reexamination of its properties. It indicates that the demonstration of embryonic-like stem cells provides the determination of which of the hypotheses might explain the cell type for carcinogenic process induction. Since the evidence of the review is yet to be known, future studies are anticipated to determine the vitality of cancer stem cell in the improvement of cancer prevention and therapy.

Recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) present inflammatory, recurrent diseases of the oral mucosa with not fully understood aetiology. Despite numerous attempts to discover an effective treatment for RAS and OLP, the current main treatment strategies are largely confined to the reduction of symptoms. Low-level laser therapy (LLLT) is of interest as a novel treatment modality. The aim of the paper was to discuss the mechanism of action and the biological effects of LLLT and to critically review and summarize recent clinical reports on the management of RAS and OLP. Most of the studies demonstrated the beneficial effect of LLLT in accelerating the healing process and pain reduction. However, the results should be interpreted with caution due to the limited number of studies available and empirical design using various irradiation parameters. [ABSTRACT FROM AUTHOR]

An unbiased, widely accepted estimate of the rate of occurrence of new cases of autism over time would facilitate progress in understanding the causes of autism. The same may also apply to other disorders. While incidence is a widely used measure of occurrence, birth prevalence—the proportion of each birth year cohort with the disorder—is the appropriate measure for disorders and diseases of early childhood. Studies of autism epidemiology commonly speculate that estimates showing strong increases in rate of autism cases result from an increase in diagnosis rates rather than a true increase in cases. Unfortunately, current methods are not sufficient to provide a definitive resolution to this controversy. Prominent experts have written that it is virtually impossible to solve. This paper presents a novel method, time-to-event birth prevalence estimation (TTEPE), to provide accurate estimates of birth prevalence properly adjusted for changing diagnostic factors. It addresses the shortcomings of prior methods. TTEPE is based on well-known time-to-event (survival) analysis techniques. A discrete survival process models the rates of incident diagnoses by birth year and age. Diagnostic factors drive the probability of diagnosis as a function of the year of diagnosis. TTEPE models changes in diagnostic criteria, which can modify the effective birth prevalence when new criteria take effect. TTEPE incorporates the development of diagnosable symptoms with age. General-purpose optimization software estimates all parameters, forming a non-linear regression. The paper specifies all assumptions underlying the analysis and explores potential deviations from assumptions and optional additional analyses. A simulation study shows that TTEPE produces accurate parameter estimates, including trends in both birth prevalence and the probability of diagnosis in the presence of sampling effects from finite populations. TTEPE provides high power to resolve small differences in parameter values by utilizing all available data points. [ABSTRACT FROM AUTHOR]

Myasthenia gravis (MG), Lambert-Eaton myasthenic syndrome (LEMS), and congenital myasthenic syndromes (CMS) represent an etiologically heterogeneous group of (very) rare chronic diseases. MG and LEMS have an autoimmune-mediated etiology, while CMS are genetic disorders. A (strain dependent) muscle weakness due to neuromuscular transmission disorder is a common feature. Generalized MG requires increasingly differentiated therapeutic strategies that consider the enormous therapeutic developments of recent years. To include the newest therapy recommendations, a comprehensive update of the available German-language guideline 'Diagnostics and therapy of myasthenic syndromes' has been published by the German Neurological society with the aid of an interdisciplinary expert panel. This paper is an adapted translation of the updated and partly newly developed treatment guideline. It defines the rapid achievement of complete disease control in myasthenic patients as a central treatment goal. The use of standard therapies, as well as modern immunotherapeutics, is subject to a staged regimen that takes into account autoantibody status and disease activity. With the advent of modern, fast-acting immunomodulators, disease activity assessment has become pivotal and requires evaluation of the clinical course, including severity and required therapies. Applying MG-specific scores and classifications such as Myasthenia Gravis Activities of Daily Living, Quantitative Myasthenia Gravis, and Myasthenia Gravis Foundation of America allows differentiation between mild/moderate and (highly) active (including refractory) disease. Therapy decisions must consider age, thymic pathology, antibody status, and disease activity. Glucocorticosteroids and the classical immunosuppressants (primarily azathioprine) are the basic immunotherapeutics to treat mild/moderate to (highly) active generalized MG/young MG and ocular MG. Thymectomy is indicated as a treatment for thymoma-associated MG and generalized MG with acetylcholine receptor antibody (AChR-Ab)-positive status. In (highly) active generalized MG, complement inhibitors (currently eculizumab and ravulizumab) or neonatal Fc receptor modulators (currently efgartigimod) are recommended for AChR-Ab-positive status and rituximab for muscle-specific receptor tyrosine kinase (MuSK)-Ab-positive status. Specific treatment for myasthenic crises requires plasmapheresis, immunoadsorption, or IVIG. Specific aspects of ocular, juvenile, and congenital myasthenia are highlighted. The guideline will be further developed based on new study results for other immunomodulators and biomarkers that aid the accurate measurement of disease activity. [ABSTRACT FROM AUTHOR]

A new unifying hypothesis for the aetiology of vitligo. is proposed, in which we. postulate that the final destruction of melanocytes in vitiligo results from a cascade of reactions initiated by a disregulation of melanogenesis, caused by activation of the melatonin receptor. These events result in the high and uncontrolled production of free radicals and toxic products of melanogenesis which sequentially damage or destroy melanocytes and keratinocytes, provoke an autoimmune response against exposed intracellular or altered cell surface antigenes, and increase the propensity of melanocytes to undergo malignant transformation. [ABSTRACT FROM AUTHOR]

The article discusses the diagnosis and management of gut fermentation. Details of the discussions attended by physicians gathered for two meetings at the Royal Society of Medicine on the March 15 and March 28, 1990 is also presented in the article. Fatigue, musculo-skeletal aches and pains, abdominal discomfort, bloating, changed bowel habit and catarrhal discharge are the symptoms of the disease. Aetiology, definition, symptomology and management of the disease needs further investigation.

A previous version was presented as an oral paper at the Annual National Conference of The Indian Psychiatric Society (ANCIPS), Ranchi, India, 2018. ABSTRACT Intracranial space-occupying lesions (ICSOLs) like hematomas, neoplasms, granulomas, or brain abscesses can present with diverse neuropsychiatric manifestations. Subtle cognitive deficits, anxiety, affective symptoms--especially depression, personality changes, and psychosis, most commonly hallucinations, have been associated with organic etiology. Catatonia has seen a paradigmatic shift in its etiological basis and space-occupying lesion is a rare yet important cause to be investigated for, as it poses a challenge in terms of searching for early clinical indicators of cerebral pathology and difference in treatment outcome due to etiology. Here we present a case of catatonia due to ICSOL in a patient of affective disorder with a history of recurrent catatonic episodes, highlighting the importance of approaching each catatonic presentation as a syndrome with diverse possible etiology. [ABSTRACT FROM AUTHOR]