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Hydatid disease is an endemic parasitic infection caused by the larval stages of the tapeworm Echinococcus. It is highly endemic in Kazakhstan, with both Echinococcus granulosus and Echinococcus multilocularis widely distributed throughout the country. Hydatid disease can affect almost any organ in the body, with the liver and lung being the most common sites, while cardiac involvement is rare. We report a case of a young female presenting with a 1-year history of stabbing precordial pain, shortness of breath, and weakness. She had a hydatid cyst involving the myocardium of the left ventricle and the left lobe of the liver. The patient underwent surgical resection and received albendazole medication as part of the treatment regimen. [ABSTRACT FROM AUTHOR]

A case of cutaneous asthenia in a Campbell's dwarf hamster is described. The animal was found to have hyperextensible skin, glaucoma and lens dislocation. Histopathological examination revealed an irregular, haphazard arrangement of collagen fibres in the dermis. The animal underwent surgical reduction of the skin folds which provided only temporary relief. [ABSTRACT FROM AUTHOR]

Many series have compared voice quality after radiotherapy or surgery for cT1 glottic carcinoma. Different meta-analyses identify better results for radiotherapy while others do not identify any difference, some finally find a superiority of surgery. The purpose of this study was to compare the voice quality in the long term of patients who underwent transoral surgery versus exclusive irradiation for the treatment of cT1 glottic carcinoma. The VOQUAL study was a pilot comparative multicenter cross-sectional study. The primary endpoint was the Voice Handicap Index comparison between two groups (radiotherapy or surgery). The voice assessment also consisted in the heteroevaluation of voice quality by the Grade, Roughness, Breathness, Asthenia, and Strain rating scale reported by Hirano. The study included 41 adult patients with cT1 carcinoma of the vocal cord treated by cordectomy or exclusive radiation in two oncologic centers. The median Voice Handicap Index value was 20 [8; 32.5] in the surgery group and 10 [4; 18.5] in the radiotherapy group. There was no statistically significant difference between the median values and the various components F, P and E of the questionnaire (P = 0.1585). The median value of the numeric dysphonia Grade, Roughness, Breathness, Asthenia, and Strain scale was 2 [0; 5] in the surgery group and 2 [0.25; 3.75] in the radiotherapy group. There was no statistically significant difference between these values (P = 0.78). Our study did not show any significant difference on the primary endpoints of Voice Handicap Index and Grade, Roughness, Breathness, Asthenia, and Strain scores. III. Clinical trial registration: The VOQUAL study was registered on the ClinicalTrials.gov platform under the number NCT04447456 , in July 2020. [ABSTRACT FROM AUTHOR]

Leptomeningeal carcinomatosis (LC) is a rare site of metastasis in solid tumors, and it is associated with poor prognosis due to disabling symptoms and a scarcity of treatment options. This condition is an uncommon entity in gastric cancer (GC). We present a case of primary LC manifestation in a patient with an incidental diagnosis of localized node-negative GC. We additionally perform a literature review and discuss the diagnostic and therapeutic challenges. In conclusion, LC from GC represents a rare condition with a dramatic prognosis. Its diagnosis might be very challenging. A multidisciplinary approach appears to be the best strategy for the management of LC from GC. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Collagenous gastritis (CG) is an infrequent pathology characterized by the presence of subepithelial gastric collagen deposits. Topics include etiology of CG is unknown, although it could be related to an abnormal inflammatory response of the gastric mucosa; and collagenous gastritis seems to be more frequent in girls and appears to have a bimodal presentation, with a peak in adolescence.

Purpose: Vanishing bile duct syndrome (VBDS) is a rare, but potentially fatal adverse reaction triggered by certain medications. Few real-world studies have shown association between antibiotics and VBDS. We sought to quantify the risk and evaluate the clinical features of VBDS associated with antibiotics. Methods: Data from 2004 to 2022 on VBDS events induced by antibiotics were retrieved from the FDA Adverse Event Reporting System (FAERS) database and disproportionality analyses were conducted. Furthermore, case reports from 2000 to 31 December 2022 on antibiotics-induced VBDS were retrieved for retrospective analysis. Results: We collected 132 VBDS reports from the FAERS database. Fluoroquinolones had the greatest proportion and highest positive signal values of VBDS. The RORs (95% CIs) for antibiotics were fluoroquinolones 23.68 (18.12–30.95), macrolides 19.37 (13.58–27.62), carbapenems 17.39 (7.77–38.96), beta-lactam 13.28 (9.69–18.20), trimethoprim/sulfamethoxazole 9.05 (5.57–14.7), and tetracycline 4.02 (1.50–10.77). Twenty-three cases from 22 studies showed evidence of VBDS, beta-lactam (52.2%) was the most frequently reported agent. The median age was 45 years, the typical initial symptoms included rash (30.4%), fatigue/asthenia (26.1%), dark urine (21.7%) and Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) (21.7%). The median time to onset of VBDS was 2 weeks. All cases had abnormal liver function test, and the median level of total bilirubin was 23.6 mg/dl (range 3.2–80 mg/dl). Cessation of culprit drugs and treatment with ursodeoxycholic acid (83.3%) were not associated with improved outcomes (57.1%). Conclusion: This study identified thirteen antibacterial agents with significant reporting associations with VBDS. Fluoroquinolones may be a neglected agent of inducing VBDS. [ABSTRACT FROM AUTHOR]

Loss-of-function mutation of ABCC9 , the gene encoding the SUR2 subunit of ATP sensitive-potassium (KATP) channels, was recently associated with autosomal recessive ABCC9 -related intellectual disability and myopathy syndrome (AIMS). Here we identify nine additional subjects, from seven unrelated families, harbouring different homozygous loss-of-function variants in ABCC9 and presenting with a conserved range of clinical features. All variants are predicted to result in severe truncations or in-frame deletions within SUR2, leading to the generation of non-functional SUR2-dependent KATP channels. Affected individuals show psychomotor delay and intellectual disability of variable severity, microcephaly, corpus callosum and white matter abnormalities, seizures, spasticity, short stature, muscle fatigability and weakness. Heterozygous parents do not show any conserved clinical pathology but report multiple incidences of intra-uterine fetal death, which were also observed in an eighth family included in this study. In vivo studies of abcc9 loss-of-function in zebrafish revealed an exacerbated motor response to pentylenetetrazole, a pro-convulsive drug, consistent with impaired neurodevelopment associated with an increased seizure susceptibility. Our findings define an ABCC9 loss-of-function-related phenotype, expanding the genotypic and phenotypic spectrum of AIMS and reveal novel human pathologies arising from KATP channel dysfunction. [ABSTRACT FROM AUTHOR]

Primary intracranial melanocytoma is an uncommon benign pigmented tumor arising from leptomeningeal melanocytes. Neuroimaging characteristics of central nervous system melanocytoma are distinct from similarly presenting intracranial neoplasms and can aid in diagnosis prior to histopathological examination. In rare cases, there may be more than one lesion present. We report a case of a 19-year-old woman presenting with progressively worsening headaches, nausea, emesis, and generalized weakness of 2 months. Imaging revealed tumors in the parietal and ipsilateral medial temporal lobe. The patient underwent gross total resection of the parietal lesion which histopathological assessment revealed to be primary intracranial meningeal melanocytoma. This case highlights the utility of specific imaging criteria such as diffusely increased T1 signal without enhancement in the initial diagnostic evaluation of intracranial melanocytoma. We also describe the clinical characteristics, management strategy, and histopathological features of a rare case of a patient with multiple primary intracranial melanocytoma lesions. [ABSTRACT FROM AUTHOR]

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Background: Cancer-related fatigue is a prevalent condition in all stages of oncologic disease that is poorly diagnosed, with a negative impact on physical function to perform activities of daily living. Fatigue is also one of the main manifestations in post-COVID-19 syndrome, and few studies have explored the functionality of cancer patients after infection by the new coronavirus. This study was designed to assess cancer-related fatigue symptoms and their implications on physical function and quality of life during the pandemic. Methodology: An observational study with a cross-sectional survey in cancer patients ≥ 18 years of age was conducted. The Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F), the perception of asthenia and performance status were evaluated, and the differences between groups according to the history of COVID-19 were calculated. Results: A total of 60 cancer patients had an average age of 33.5 ± 10.11 years, 73.3% were female, and 98.3% had an Eastern Cooperative Oncology Group-Performance Status level < 2. Severe fatigue was found in 43.3% of patients, and the average FACIT-F score was 33.5 ± 10.11. The proportion of coronavirus infection was 13,3%, and the performance of this group was worse on the scale compared to the group without infection (25 ± 10,40 vs. 34,81 ± 9,50 [p = 0,009]). There was a significant correlation between visual analog scale values and FACIT-F scale scores (Pearson's r = -0.76). Conclusion: SARS-CoV-2 infection could increase cancer-related fatigue symptoms, limiting activities of daily living and impairing quality of life. [ABSTRACT FROM AUTHOR]

Elliptocytes are most abundant in hereditary elliptocytosis. Isolated deletion 20q [del(20q)] associated with elliptocytosis in a patient with myelodysplastic syndrome (MDS) is very rare, and only a few cases are reported in the literature. This report describes a case of an MDS‑related autoimmune disease (Sjögren’s syndrome) with acquired elliptocytosis and del(20q). We discuss their clonal relationship and del(20q) status in the process of disease progression. A 58‑year‑old woman, with a history of Sjögren’s syndrome, was admitted for investigation of pancytopenia. An initial evaluation revealed a regenerative normochromic normocytic anemia with hemoglobin of 9.2 g/dL, an absolute reticulocyte count elevated at 245 × 109 /L, a platelet count of 70 × 109 /L, white blood cells of 1.4 × 109 /L, and polynuclear neutrophils (PNNs) at 0.64 × 109 /L. A slightly elevated total bilirubin of 28 µmol/L prompted a hemolytic workup. A peripheral blood smear showed frequent elliptocytes and occasional spherocytes. In addition, the PNNs were hyposegmented and hypergranular. Bone marrow aspirate smears showed significant dysplasia of all hemopoietic lineages indicating a diagnosis of multilineage dysplasia. Cytogenetic analysis showed a 20q deletion. The IPSS‑R score was 4, stratifying her to the intermediate‑risk IPSS‑R group. MDS is frequently associated with a variety of autoimmune disorders. Connective tissue diseases account for 25%–30% of MDS‑related autoimmune diseases but Sjögren’s syndrome has been rarely reported. [ABSTRACT FROM AUTHOR]

Background Trastuzumab deruxtecan (T-DXd) demonstrated unprecedented efficacy in patients with pretreated HER2+ metastatic breast cancer (mBC). However, few data are available about its efficacy in routine clinical practice. In this multicenter retrospective study, we examined effectiveness and safety of T-DXd in a real-world population. Methods Clinico-pathological information about patients with HER2+ mBC who received T-DXd were collected from 12 Italian hospitals. HER2 status was determined locally. Patients who received at least one administration of T-DXd, as any therapy line for advanced disease were included in the analysis. The primary endpoint was real-word PFS (rwPFS). Results One hundred and forty-three patients were included. Median age was 66 (range: 37-90), and 4 men were included. Hormone receptor (HR) status was positive in 108 (75%) patients and negative in 35(25%). T-DXd was administered as first, second, third, or subsequent lines in 4 (3%), 16 (11%), 42 (29%), and 81 (57%) patients, respectively. Among 123 patients with measurable disease, the ORR was 68%, and the DCR was 93% (9 CRs, 74 PRs, and 30 SD). Nine (7%) patients had a primary resistance to T-DXd. With a median follow-up of 12 months, the median rwPFS was 16 months. RwPFS was 84%, 59%, and 39% at 6, 12, and 18 months, respectively. A favorable trend in rwPFS was reported in patients receiving T-DXd as I/II line versus further lines (17 vs. 15 months; P  = .098). Any-grade toxicity was registered in 84 patients (59%). Most common adverse events (AEs) reported were nausea (33%), neutropenia (21%), and asthenia (21%). Liver toxicity and diarrhea were uncommon (5% and 1%). Severe toxicities was registered in 18% of patients, and the most frequent were neutropenia, nausea/vomiting, and ILD observed in 15, 2, and 3 patients. AEs led to dose reduction in 37 patients (26%). Dose reduction and AEs do not affect patients' response and survival outcomes. Conclusions Efficacy and safety of T-DXd were confirmed in an unselected real-world population of HER2+ mBC. These results are consistent with the results of known findings, and no new safety concerns were reported. [ABSTRACT FROM AUTHOR]

Introduction: The problem of asthenic disorders is determined by their high prevalence, the lack of diagnostic criteria and recommendations for therapy, and the absence of unified principles of coding in ICD-10. The aim of the study was to evaluate the current practice of neurologists and physicians of the Russian Federation (RF) in the diagnosis and pharmacotherapy of asthenic syndrome (AS). Materials and Methods: An anonymous author-developed questionnaire survey of physicians on the issues of diagnostics and treatment of asthenia was conducted on the Google forms platform. Results: Total 238 specialists from 23 regions of the RF, 62.5% of neurologists and 37.5% of physicians, took part in the survey. Women suffer from AS more often than men. AS is most frequently verified at the age of 40-60 (65.5%) and under 40 (39.6%). Doctors use the codes G90.8 – other disorders of the autonomic nervous system – and I67.8 – other specified cerebral vascular lesions. The main causes of AS are affective disorders in 67.2% of patients and infectious diseases in 70% of patients. Almost 67% of doctors use anxiety and depression assessment scale, and only 13% of respondents use MFI-20 scale. The choice of therapy depended on the psychopathologic syndrome in 73.9% of cases. Most doctors favored nootropic drugs, metabolic action drugs, and B vitamins. Conclusion: The current medical practice of diagnosing and treating AS was studied and informative data were obtained with regard to understanding the clinical-typological structure and nosological affiliation of AS. The results demonstrate the expediency of developing a unified algorithm for the management of patients with various manifestations of AS.

Headache is a common symptom of influenza infection; however, its causes and consequences remain uncertain. In this manuscript, we analyzed which demographic and clinical factors were associated with the presence of headache during the course of influenza infection and whether patients with headache had a different prognosis, evaluated by need of hospitalization, sick leave or school absenteeism. The influence study (NCT05704335) was an observational study that analyzed data routinely collected from the Health Sentinel Network between 2010 and 2020. During the study period, 7832 cases were considered, among which, 5275 (67.4%) reported headache. The presence of headache was independently associated with myalgia (2.753; 95%CI: 2.456–3.087, P < 0.001), asthenia (OR: 1.958; 95%CI: 1.732–2.214, P < 0.001), shivering (OR: 1.925; 95%CI: 1.718–2.156, P < 0.001), nasopharyngeal erythema (OR: 1.505; 95%CI: 1.293–1.753, P < 0.001), fever (OR: 1.469; 95%CI: 1.159–1.861; P = 0.001), sudden onset of symptoms (OR: 1.380; 95%CI: 1.120–1.702, p = 0.004), female sex (OR: 1.134; 95%CI: 1.023–1.257, P = 0.018), and gastrointestinal symptoms (OR: 1.169; 95%CI: 1.039–1.315; P = 0.01). Patients with headache had a sex and age adjusted lower odds of being referred to the hospital (OR: 0.463; 95%CI: 0.264–0.812, P = 0.007) and a higher odd of having a sick leave and/or school absenteeism (absenteeism (OR: 1.342; 95%CI: 1.190–1.514, P < 0.001). In conclusion, the presence of headache seems associated with symptoms caused by the innate immune response. These findings support a headache pathophysiology linked with the innate immune response. Due to the potential negative consequences and its treatable nature, clinicians should systematically evaluate it and, whenever necessary, treat it too. [ABSTRACT FROM AUTHOR]

Objective: Functional dysphonia can impair the language expression ability and adversely affect the career development of some patients. Therefore, an active exploration of effective treatment options is imperative. This study investigated the effect of Akson therapy on acoustic parameters in patients with functional dysphonia. Materials and Methods: In this retrospective analysis, 79 patients with functional dysphonia who received conventional voice correction training from June 2020 to June 2021 were included in the reference group (RG). Our hospital has implemented Akson therapy since July 2021. Correspondingly, 72 patients with functional dysphonia who underwent Akson therapy from July 2021 to July 2022 were enrolled in the observation group (OG). The acoustic parameters such as fundamental frequency (F0), jitter, shimmer, and normalized noise energy (NNE); the aerodynamic parameters including maximum phonation time (MPT), mean airflow rate (MFR), and Voice Handicap Index-10 (VHI-10) score; and the Grade, Roughness, Breathiness, Asthenia, and Strain scale (GRBAS) score were measured before and after treatment and compared between the two groups. Results: The F0, jitter, shimmer, NNE, MPT, and MFR values as well as the VHI-10 score and the grade (G), roughness (R), and breathiness (B) scores on the GRBAS did not significantly differ between the two groups before treatment (P > 0.05). However, significantly lower F0, jitter, shimmer, NNE, and MFR values and higher MPT levels were found in the OG compared to the RG after treatment (P < 0.001). Furthermore, the VHI-10 score and the G, R, and B scores were significantly lower in the OG than in the RG after treatment (P<0.001), whereas the asthenia (A) and strain (S) scores remained at 0 before and after treatment. Conclusion: Akson therapy can improve the acoustic parameters of patients with functional dysphonia to a certain extent, indicating its potential application value. [ABSTRACT FROM AUTHOR]