bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effectiveness of Orthoses as a Conservative Treatment in Treating Carpometacarpal Joint Osteoarthritis: A Systematic Review
Authors: Wells Andrew , Sangiacomo Franca , Brown Lindsay , Hollins Nancy
Published: May 2024

Objectives: The purpose of this research is to review the evidence regarding the impact and effectiveness of orthoses on pain, pinch, and grip strength for individuals diagnosed with carpometacarpal joint osteoarthritis. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and then literature was gathered across nine databases. To be included in this review, studies had to be classified as a level 1 or 2 research study and the studies must include participants who were over 40 years of age, have a diagnosis of carpometacarpal joint osteoarthritis, and must utilize an orthosis for their symptoms. Articles were excluded from the review if participants utilized steroids or have past surgeries on the carpometacarpal joint. Researchers analyzed the quality of studies and extracted evidence pertaining to the effectiveness of various orthosis designs based upon outcomes of pain, pinch, and grip strength for individuals diagnosed with carpometacarpal joint osteoarthritis. Results and Implications for Future Practice: The evidence strongly supports the use of a custom-made butterfly short opponens orthosis to decrease pain and increase pinch and grip strength. Prefabricated Neoprene and Custom-made Thumb Splint designs are effective for decreasing pain and increasing pinch, only. A Thumb Spica Splint and Colditz Splint are effective for increasing pinch strength. There is moderate evidence to suggest the use of the Ballena Orthosis and Colditz Orthosis to decrease pain. The evidence suggests that the Neoprene Comfort Cool Splint and Custom-made Hybrid splint should not be used to address issues of pain, decreased grip strength, and decreased pinch strength. Key words: activities of daily living (ADLs), carpometacarpal joint (CMC), instrumental activities of daily living (IADLs), interphalangeal joint (IP), metacarpophalangeal joint (MCP), occupational therapy (OT), orthoses, osteoarthritis (OA), splints, trapeziometacarpal joint (TMC). Research Question: What is the impact of using orthoses on pain and pinch/grip strength for individuals diagnosed with CMC joint OA?
Mental health in Kindergarten to Grade 12 schools during the COVID-19 crisis: Literature review and survey suggesting multi-tiered support systems
Authors: Li Dan , Li Yueqi , Zheng Ziyi , Zhou Xin , Castro Danielle , Vermund Sten , Brault Marie
Published: May 2024

Background: As a result of the COVID-19 pandemic, educational systems worldwide were disrupted. Students, educators, and parents faced challenges from the rapid switch to distance learning with attendant social isolation and limited teacher or peer interaction, along with excessive demand and worries from the lasting pandemic. It exacerbated preexisting mental health crises within school communities. Amidst such challenges, psychiatrists prescribed tailored medication regimens to manage individual mental health in the time of crisis, ensuring continuity of care and support for those affected. Methods: A scoping review was conducted to identify studies of Kindergarten to 12th grade school members' mental health and mental health support programs offered by schools and institutions during the COVID-19 pandemic. We also conducted a survey to examine mental health concerns faced by grade 6 to 12 teachers, school staff, children, and parents in Connecticut, United States. Results: While publication bias may be extant, we found well-documented studies of exacerbation and the emergence of mental health problems among parents, teaching staff, and students during the COVID-19 pandemic. Based on our comprehensive review of relevant literature and analysis of survey results, we have identified four key themes pertaining to the mental health challenges encountered by parents, teaching and non-teaching staff, and students in Kindergarten through 12th grade (K-12). Moreover, upon examining pertinent mental health interventions and models, we have identified the multi-tiered systems of support as an effective approach to address these difficulties, with explanations on how to utilize the framework during a crisis. This system is designed with tiers that provide various levels of interventions aimed at helping schools effectively manage the psychological well-being of their members during a crisis. Conclusions: Drawing on findings from literature reviews and surveys, this study sheds light on the difficulties surrounding mental health in schools during times of crisis such as the COVID-19 pandemic. Moreover, it puts forward a recommendation for employing multi-tiered support strategies to address these challenges and promote psychological well-being within educational settings amidst crisis. By adopting a multi-tiered systems of support framework that integrates various interventions tailored to individual needs, schools can effectively manage mental health concerns among their members. The study underscores the critical role of psychiatry in providing specialized care and medication management to support mental health in educational environments, particularly during times of crisis, with important implications to address the urgent mental health demands in Kindergarten to 12th grade schools.
Use of Lithium in Bipolar Disorder is Shockingly Low: The Need for a Re-evaluation
Authors: M. Post Robert
Published: May 2024

Bipolar disorder often starts on childhood or adolescence but is too often poorly recognized and treated leading to the evolution of an illness with considerable disability. While lithium is widely recognized a first line treatment option its use is declining in comparison to other less effective agents. Here we review the major assets of lithium a drug that can prevent many aspects of illness progression as a function of increased numbers of episodes experienced. More episodes are related to faster and more severe recurrences cognitive deficits, and treatment refractoriness. Many of the side effects of lithium, such as renal dysfunction, are based on earlier and uncontrolled literature and are over emphasized. Given lithium's unique therapeutic profile, a re-evaluation of its under-utilization is definitely indicated.
The Management of Children with Pre-School Medulloblastoma – A Review of Four Decades of Multi-Disciplinary and Multi-Institutional Collaboration.
Authors: Finlay Jonathan
Published: May 2024

Background: The management and consequent survival and quality of survival for young children with medulloblastoma have undergone substantial improvement over the last four decades. While many of these changes reflect improvements in pediatric neurosurgical, neuro- imaging and radiation oncologic technology and training, as well as in supportive care experience and expertise, this review will focus particularly upon improvements in chemotherapeutic approaches. Methods: This review focuses only upon prospective clinical trials conducted in young children with newly-diagnosed medulloblastoma since the 1980s. The upper age limits for these trials varied from under three to up to six years of age at diagnosis. Results: Certain but not all trials endeavoring to improve outcomes for young children with now- recognized pathological and molecular low-risk characteristics, specifically the Sonic Hedgehog (SHH) sub-type, representing some 50-60% of young children with medulloblastoma, have reaped substantial gains in event-free and overall survival, irradiation-free survival as well as neuropsychological outcomes. Those successful trials utilized either induction including intravenous high-dose methotrexate and intraventricular (intra-Ommaya) methotrexate without consolidation by marrow-ablative chemotherapy with autologous hematopoietic progenitor cell rescue (AuHPCR), or induction with or without intravenous high-dose methotrexate (but not intra-ventricular methotrexate) followed by consolidation with marrow-ablative chemotherapy with AuHPCR. These two approaches have consistently produced superior outcomes compared with other trials. For children with molecularly-characterized Groups 3 or 4 medulloblastoma, representing those at high-risk of relapse, some modest improvements have been made over the years, but much room for improvement remains, especially for those presenting with the highest- risk molecular characteristics (CMYC-amplified Group 3 medulloblastoma) as well as for children with metastatic disease at initial diagnosis. Conclusions: Substantial gains in improving outcomes for young children with medulloblastoma have been achieved with acceptable short- and long-term morbidities of treatment. However, the inclusion of intra-ventricular therapies (conventional chemotherapeutic, radio-labeled monoclonal antibody or adaptive cellular immunotherapeutic approaches) as well as the identification of targeted systemic therapies (biological and/or immunological) and their incorporation into prospective multi-center clinical trials, must be investigated prospectively if we are to improve outcomes for those children at high-risk for relapse, even with the inclusion of refined irradiation therapeutic approaches.
Zinc Deficiency: A Harbinger of Vestibular Dysfunction?
Authors: U Dr Madhusudhan , H Neemu , M Kalpana , G Vidya , G Archana , Singaravelu Vidya , P Anand , John Nitin , Taranikanti Madhuri , P Parag
Published: May 2024

Background: Role of zinc in the maintenance of redox homeostasis have been explored & is established to have antioxidant effects in the body. Presence of zinc in auditory system & its role in deafness & tinnitus is well established. Zinc supplementation has shown to not only improve tinnitus but also dizziness associated with it which marks the presence of zinc in vestibular system 4. The possible role of zinc in modulating neurotransmission across the glutaminergic synapses in vestibulo cerebellar, vestibulo-occular pathways are established. So, this study aims to assess serum zinc levels in vestibular disorder patients & correlate with severity of the vestibular dysfunction Methodology: This was Cross sectional comparative study, 40 patients with vestibular disorders & 40 subjects without vestibular dysfunction were included in the study. After thorough history taking, these patients were subjected to Dix Hallpike test, Head Impulse test Romberg test on foam with eyes closed /The Clinical Test of Sensory Interaction and Balance (CTSIB) to confirm vestibular dysfunction. After that, Dizziness handicap inventory (DHI) to assess the severity of the vestibular dysfunction. Serum zinc levels along with other, micronutrients like magnesium, calcium & Serum vitamin B12 & vitamin D were also assessed. Serum zinc levels were compared with age matched controls. Results: Out of 40 patients, 24 had mild & 16 had moderate scores according to DHI. Serum zinc levels in study group was 60.63±10.10 which was significantly (p<0.005) lower than compared control group 70.50±19.1. Also, Serum zinc levels were corelated with the severity of the vestibular dysfunction, (r=0.89, p<0.00) which shows that more severe the dysfunction lesser the serum zinc levels. Conclusion: Role of zinc as an antioxidant is well established and deficiency of zinc is linked with the pathogenesis of various diseases. Since evidences suggest involvement of zinc in vestibular system, zinc supplementation in vestibular disorder patients can be considered as add on therapy, which might have a beneficial role with respect to cognitive function as well.
Implications of Untreated Hypertension on Chronic Kidney Disease: A Literature Review
Authors: Zaman Mustafa
Published: May 2024

The untreated progression of hypertension holds significant implications for the development and progression of chronic kidney disease (CKD). Therefore, necessitating the implementation of strategic hypertension management measures to mitigate its impact on CKD. This review highlights the necessity of precise diagnostic methodologies that employ oscillometric equipment and advocates for pharmacological interventions, the incorporation of combination therapies such as the "Polypill" to effectively control hypertension, and lifestyle adjustments. The pivotal role of the renin-angiotensin-aldosterone system (RAAS) in hypertension is acknowledged, noting the importance of stringent blood pressure regulation and the utilization of RAAS-blocking agents to attenuate its association with CKD. A comprehensive analysis is provided on the effects of various classes of antihypertensive medications on renal function, encompassing diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs), and nonsteroidal mineralocorticoid receptor antagonists. Additionally, both non-invasive and invasive therapeutic modalities for managing resistant hypertension in CKD patients are examined, alongside discussions on prognostic indicators and outcomes across different stages of CKD. Lifestyle modifications such as sodium restriction, weight management, and moderation of alcohol intake are assessed for their influence on CKD prognosis. The review also extensively delves into the impact of ethnicity on the prevalence and outcomes of hypertension-induced CKD, highlighting disparities and distinctive trends among diverse ethnic cohorts including Indian, African American, Middle Eastern, Chinese, Pacific Islander, Native American, and Hispanic populations. Additionally, this study addresses the intricate relationship between cardiovascular abnormalities and CKD, the significance of gastrointestinal disorders, and the importance of multidisciplinary approaches in CKD management. Furthermore, insights are provided into the significance of neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for identifying renal injury and CKD progression, alongside factors influencing adverse prognosis and life expectancy in CKD patients. This study accentuates the importance of tailored treatment assessments and interventions to address varied patterns and obstacles within ethnic groups, with the aim of optimizing CKD management strategies and reducing health disparitie
Simultaneous initiation of quadruple therapy for heart failure with reduced ejection fraction: initial experience in Afro Caribbean Jamaican population
Authors: Felix Nunura , Delani Campbell
Published: May 2024

Background: Among Afro Caribbean Jamaican patients with heart failure with reduced ejection fraction (HFrEF), improvements in cardiac function associated with simultaneous initiation of quadruple therapy, have not been previously reported and we aimed to assess this special population. Methods: Combined quadruple therapy (angiotensin-receptor neprilysin inhibitor, beta-blocker, mineralocorticoid receptor antagonist, and Sodium-glucose cotransporter-2 inhibitors) was simultaneously initiated in 120 Afro Jamaican patients with HFrEF from the Heart Institute of the Caribbean. Patient data was consecutively recorded in our electronic medical records. Changes in Ejection fraction (EF) and N-terminal pro b-type natriuretic peptide (NT-ProBNP) levels, were evaluated after 90 days and statistically analysed during this two-year study. Results: Patient mean age was 63 ± 12.7 years old, 68% male, with mean Body Mass index (BMI) 32.2±6.7 Kg/m2. Hypertension was observed in 62.5 %, T2Diabetes Mellitus in 31.7%, and history of old myocardial infarction in 15.7 %. Atrial fibrillation was present in 7.8% and left bundle branch block in 16.5 %. Other cardiomyopathies (idiopathic, peripartum and non-compaction) were noted in 16.6 %. After the quadruple therapy for a median follow-up period of 90 days, significant improvements of cardiac function were achieved. The mean NT pro-BNP level was significantly decreased from a Baseline of 3111.21 pg/mL ± 4535 to 1806.6 ± 2265.3 pg/ml. A mean change in NT Pro BNP of 1305 pg/mL ± 5069 (p < 0.001). The mean left ventricle ejection fraction (LVEF) improved from a baseline of 33.4 % ± 7.8 to 44.4 % ± 10.9. A mean change in LVEF of 11.3% ± 9.1 (p <0.001). Notably, an improvement of >10% in the LVEF was observed in 41.5% of the total population. In a separate analysis, the subgroup with T2 Diabetes mellitus showed more pronounced (mean change in EF 9.1% ± 11.0) improvement in LVEF than the non-diabetic (mean change in EF 7.7% ± 11.7) but no significant differences in the change of the NT pro-BNP levels were noted between both subgroups. The most frequent therapy adverse effect was hypotension (13.63%) followed by cough (6.81%) and kidney dysfunction (2.27%) but none of the patients presented Angioedema. Conclusion: Among Afro Caribbean Jamaican patients with heart failure and reduced ejection fraction, simultaneous initiation of the quadruple therapy was demonstrated to be feasible, well tolerated and associated with significant functional improvement.
Influence of Abdominal Obesity on the Relationship of Low-Density Lipoprotein Cholesterol with Atherosclerosis and Cardiovascular Risk in Rheumatoid Arthritis
Authors: Karpouzas George , Ronda Nicoletta , Budoff Matthew , Ormseth Sarah
Published: May 2024

Methods. Coronary artery calcium, number of coronary plaques, and extensive ( 5 plaques) or obstructive (>50% stenosis) disease was evaluated with computed tomography angiography in 150 patients at baseline and 101 patients 6.9±0.4 years later. Cardiovascular events were recorded. Oxidized LDL was measured with monoclonal antibody E06. Serum cholesterol loading capacity on macrophages was measured as intracellular cholesterol content with a fluorometric assay. Results. Abdominal obesity was not associated with per-patient number of coronary plaques or coronary artery calcium score at baseline. Low LDLc positively associated with number of plaques (b 2.13 [95% confidence interval 1.03 to 3.22]), likelihood of extensive or obstructive plaque (odds ratio 6.58, 95% confidence interval [1.63 to 26.46]), and log-transformed CAC (b 1.90 [0.89 to 2.91]) exclusively in nonobese patients (p-for-interaction <0.001, 0.061, and 0.001 respectively). Low LDLc associated with increased likelihood of >median oxidized LDL and higher ratio of cholesterol loading capacity to LDLc in nonobese patients (p-for-interaction 0.041 and 0.001 respectively). Abdominal obesity negatively associated with likelihood of plaque stenosis progression (odds ratio 0.19 [0.07 to 0.54]). Low LDLc associated with greater likelihood of per-segment plaque formation (OR 4.68 [2.26 to 9.66]) and increased stenotic severity (odds ratio 5.35 [1.62 to 17.67]) only in nonobese patients (p-for-interaction 0.002 and 0.040 respectively). Abdominal obesity was not linked to cardiovascular risk (Hazard Ratio 1.57, 95% confidence interval [0.66-3.73]). Low LDLc associated with higher cardiovascular risk in nonobese (Hazard Ratio 7.94 [1.52 to 41.36]) but not obese patients (p-for-interaction=0.017). Conclusion. Abdominal obesity was not linked to plaque progression or cardiovascular risk in RA. Only in nonobese patients, low LDLc associated with higher atherosclerosis burden, plaque progression and cardiovascular risk. This may reflect higher oxidation and macrophage cholesterol loading capacity of LDL when LDLc is <70mg/dl.
Headache, Migraines, Obesity and Medication Burden on Fibromyalgia Impact and Quality of Life
Authors: Abdullah Youssef , Aziz Rija , Diaz Michelle , Yu Lianbo , Castellvi Silvia , Sebastian Katherine , Giusti M. Monica , Saona Luis , Hackshaw Kevin
Published: May 2024

Fibromyalgia (FM) is a common, complex, and chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and tenderness in localized areas. A multitude of other central sensitization related symptoms contribute to a profound medication burden and diminished quality of life for affected individuals. We evaluated the impacts of gender, chronicity of headache, migraine, obesity and medication burden on overall FM impact. We used the following validated questionnaires: Fibromyalgia Impact Questionnaire (FIQR), Beck Depression Inventory (BDI), Central Sensitization Inventory (CSI) and measured weight and body mass index (BMI) on a large university cohort of FM subjects. We found that female subjects with FM showed a significant increase in FIQR compared to males with FM. Additionally, we noted positive correlations between weight (Wt) and FIQR, BDI and CSI; BMI and FIQR, and BMI and CSI. Fibromyalgia subjects with a history of migraines (FM-migraine) showed statistically significant increases in FIQR, BDI and CSI compared to FM subjects with no reported history of migraines (FM-non-migraine). There was a steady increase in FIQR, BDI and CSI values with an increase in the frequency of headaches in both the FM -migraine and FM -non-migraine groups. When evaluating BMI, when comparing survey responses of overweight and obese patients to normal weight patients, all FIQR, BDI and CSI values were significantly increased in the various classes of overweight except CSI for the overweight category which appeared to approach significance (p=0.057). There were no statistically significant differences in questionnaire responses for individuals with FM on medications relative to those on no medications. Taken together, a history of migraines and headaches, frequency of headaches and obesity may impact survey responses significantly, negatively impact quality of life and correlate with higher levels of depression but medication burden did not.
Simplifying COVISimplifying COVID-19 Data Analytics for Efficient Pandemic Management: A Novel ApproachD-19 Data Analytics for Efficient Pandemic Management: A Novel Approach
Authors: Arce J. Rodríguez
Published: May 2024

This study presents a streamlined approach to pandemic management by simplifying COVID-19 data analytics. It focuses on the significant role of mobility patterns in forecasting case trajectories. Utilizing open mobility data from Google and Apple, a novel predictive model is proposed that aids health authorities in scenario projection and case monitoring. This model facilitates informed decision-making with minimal economic impact during future outbreaks. Key findings highlight the profound link between mobility changes and COVID-19 case trends, emphasizing the necessity of integrating mobility data into predictive models. The model, employing linear and polynomial regression analyses and incorporating the basic reproduction number, R0, forecasts can be extended up to 90 days. The study acknowledges limitations, particularly the reliance on mobility data that does not fully encompass all variables affecting virus transmission. Moreover, it explores the mental health implications of mobility restrictions, suggesting a broader impact of pandemic management strategies. The proposed model is a practical tool for managing pandemics through mobility data analysis, underscoring the need for comprehensive studies on the wider effects of mobility changes to guide public health policies
From Fragmentation to Integration in Emergency Medicine: Providing Care Our Patients Deserve
Authors: Venkataraman Anantharaman , Chin Lim Steven , Hao Lim , Wee Jeremy
Published: May 2024

The emergency care systems of most communities around the world have multiple components through which patients move and which are, at best, disjointed and not well coordinated. Illnesses and injuries which begin in the community and frequently preventable often do not have the benefit of bystander assistance or dedicated immediate emergency ambulance care and arrive at Emergency Departments that are crowded. Patients often spend long hours in these Emergency Departments and, if requiring inpatient care, have to wait many hours before an inpatient bed becomes available. Those requiring further convalescent care may often find inadequate arrangements available for them to recover smoothly. The end result is delays and adverse clinical outcomes that are often not measured or even appreciated. This report discusses each of ten components of the emergency care system as in exists in most communities, including injury and illness prevention, the community burden of emergencies, bystander first responder care, ambulance-based second responder care, emergency department crowding and its contributory factors, transitions of care to the inpatient departments and community convalescent care units, coordination of emergency departments in the community, the patient’s family and, of course, the emergency patient. The effects of fragmentation in each of these components are described and strategies to address each mentioned. There is a need for a patient-centric, integrated approach to the provision of emergency care in any community which can break down the barriers created by fragmented care and provide the seamless, high-quality care that all our patients deserve.
Mosquito Control To Achieve Zero Yellow Fever and Zero Malaria
Authors: Tran Phi
Published: May 2024

Mosquitoes are the most harmful insects that cause 2 million illnesses and kill 28,000 people daily, mostly in underdeveloped countries. [1],[2] Their environment is similar to that of the Panama Canal. During its construction, mosquito control measures successfully reduced yellow fever and malaria to zero. [3] The challenge for researchers is to replicate these results in hard-hit regions. To do so, they must produce an achievable road map for communities to follow. In this study we analyze the lessons of the past, recommend the same or alternative measures based on today’s technology and knowledge base, and present experiments to support their effectiveness.
Evaluation of Intraocular Pressure in Eyes After Femtolasik Surgery
Authors: Leite João , Ribeiro Bruno , Abreu Ana , Monteiro Sílvia , Figueiredo Ana , Reis Rita , Sampaio Isabel , Pinto Maria , Menéres Maria
Published: May 2024

Introduction: Femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) surgery is a surgical procedure performed in the treatment of refractive errors. Given the changes in central corneal thickness, intraocular pressure may be lower and underestimated, which may lead to a late diagnosis of ocular hypertension/glaucoma. Aims: The aim of this study was to evaluate and compare intraocular pressure, by different methods, before and after FS-LASIK, for correction of myopia or myopic astigmatism. Methods: Retrospective and observational study, which included eyes undergoing FS-LASIK surgery (November 2020 to November 2022). The intraocular pressure values were measured (preoperatively, on the 1st, 3rd and 6th postoperative month) using contact tonometry (Goldmann applanation tonometry) and non-contact tonometry (by Corvis®ST according to the formulas: pachymetry – Ehlers, Shah, Dresden, Spoerl – and biomechanics – corrected and uncorrected). The intraocular pressure values obtained at 6 months with the different methods were compared with the Goldmann applanation tonometry intraocular pressure values obtained at baseline. Results: Ninety patients (of a total of 174 eyes) underwent FS-LASIK, with a preoperative spherical equivalent of -3.7±1.7. Preoperatively (mean ± standard deviation) Goldmann applanation tonometry was 15.0±1.9 mmHg; the intraocular pressure values obtained through the Corvis® ST (in mmHg) according pachymetry: Ehlers (13.5±2.6), Shah (14.3±2.3), Dresden (14.5±2.2) and Spoerl (14.5±2.1); and biomechanics: corrected (14.4±1.9) and not corrected (15.3±2.1), respectively. At 6 months postoperatively, all showed statistically significant differences, with the exception of Shah's formula (p=0.074); comparing the preoperative Goldmann applanation tonometry with each of the formulas at the end of the follow-up, the Ehlers formula did not present statistically significant differences (p=0.434), the Shah formula a value of p=0.047 and the others a value of p<0.001. Conclusion: Femtosecond laser-assisted laser in situ keratomileusis surgery underestimates intraocular pressure measurement by contact tonometry. In non-contact tonometry, at 6-month follow-up, the Shah formula appears to be less influenced by this bias. More studies are needed to evaluate the best method to assess I intraocular pressure measurement after FS-LASIK surgery.
Risk Reduction Strategies for Rabies Exposures and Prophylaxis in Children
Authors: Siegel Jerry
Published: May 2024

Annually, 59,000 people die of rabies, the world’s oldest known infectious disease, globally. In the United States, canine rabies has been virtually eliminated but the risk of rabies due to wildlife, especially raccoons, skunks, and bats, has required post exposure prophylaxis (PEP) be administered to more than 60,000 patients annually1. In 2021, 5 people in the United States2 died of rabies mostly due to misinformation or improper treatment. Rabies post exposure prophylaxis consists of three steps, wound washing, administration of human rabies immune globulin (HRIG) and a full course of vaccine3. In 2022, Whitehouse4 published that there were 122 breakthrough rabies infections when PEP was given due to four factors: 1) deviations from core practice 2) delays in seeking health care 3) errors in administration of HRIG 4) comorbidities or immunosuppression. It is estimated that over 40% of PEP administration is given inappropriately. The publication,” Safety, and efficacy of rabies immunoglobulin in pediatric patients with suspected exposure”, Human Vaccines & Immunotherapeutics, 17:7, 2090–20965, was the first study that prospectively reviewed the use of human rabies immune globulin 150 IU/ml in 30 pediatric patients ages 0.5–14.9 years old. Globally, 40% of people bitten by animals suspected of being infected with the rabies virus are children under the age of 15.6 This paper will look at risk reduction strategies that will include: Proper Identification of major rabies vectors Special risks associated with bat exposures in children Administration of human rabies immune globulin with volume considerations in children Special administration consideration for rabies vaccines “Just -in- time “Education for health care providers Illustrative cases will be used to demonstrate each of these strategies of risk as well as the strategies for risk reduction.
Insights Into Long COVID Fatigue Biology: Potential Treatment Implications Using Multi-Targeted Action of AXA1125, a Novel Endogenous Metabolic Modulator Composition
Authors: Azer Karim , Russell Matthew , Wani Revati , Pradines Joel , Koziel Margaret , Beheshti Afshin
Published: May 2024

With ongoing global research efforts to tackle coronavirus disease 2019 (COVID-19), increasing attention is directed toward the long-term sequelae of COVID, entitled “long COVID” or post-acute sequelae of COVID-19. These long-COVID symptoms persist beyond 12 weeks in over 10%–40% of patients, with exertional fatigue predominant in at least 50%. Scientific evidence has linked long COVID fatigue with mitochondrial dysfunction and energetic dysregulation in multiple biological pathways. Single target- directed treatments could be insufficient to treat these heterogeneous disorders. A novel multi-targeted therapeutic strategy could better address long COVID fatigue by restoring mitochondrial function. Our systems biology platform identified mechanisms implicated in long COVID and prioritized the composition of endogenous metabolic modulators focused on amino acid combinations, related precursors, and metabolites with the potential to address mitochondrial dysfunction. AXA1125 is a novel composition of five amino acids (Leucine, Isoleucine, Valine, Arginine, and Glutamine) and an amino acid derivative (N-acetylcysteine) that could safely target multifactorial disease pathophysiology of fatigue-dominant long COVID. Our phase IIa, double-blind, randomized trial (NCT05152849) in exertional fatigue patients associated with long COVID interrogated this proposition and showed promising results. We hypothesize that AXA1125 holds the potential for improving functional clinical outcomes by targeting multiple disease pathways and improving mitochondrial function and energetics.
NAZAN BEKİROĞLU’NUN NAR AĞACI VE MÜCELLÂ ADLI ROMANLARINDA AZLA ÇOĞU ANLATMAK ÜZERİNE
Authors: Kanmaz Aysun
Published: May 2024

İşaretler ve kurallar dizgesi olan dil, konuşura / yazara, bir varlığı, olayı, duyguyu, durumu ince ayrıntılarıyla anlatma imkânı verir. Bununla beraber deyimler, atasözleri, metaforik söyleyişler gibi azla çoğu ifade eden enstrümanlar da sağlar. Bunlar, en az çaba yasasının sonucu olmakla birlikte anlatımda etkili olma gayretinin de ürünüdür. Bu nedenle yazarlar, eserlerinde deyimlere ve eğretilemeli söyleyişlere yer verir. Geleneği, tarihî olayları, yaşamından izler taşıyan hadiseleri romanlarında başarılı bir şekilde işlemesiyle modern Türk edebiyatında öne çıkan Nazan Bekiroğlu da bu yazarlardan biridir. Özellikle Nar Ağacı ve Mücellâ adlı romanları bu açıdan dikkat çekmektedir. Çalışmada bu romanlardaki deyim ve metaforik söyleyişler tespit edilmiştir. Deyimler, TDK Türkçe Sözlük’ten ve Ahmet Turan Sinan’ın Türkçenin Deyim Varlığı eserinden taranmıştır. Deyimlerin mevcut biçimleriyle bahsi geçen sözlüklerde bulunmadığı ve deyimlerde varyantlaşma olduğu görülmüştür. Bu doğrultuda Bekiroğlu’nun eserlerinde metaforik söyleyişlere, yeniden üretimle oluşan deyim varyantlarına yer vererek Türkçenin söz varlığına katkıda bulunduğu sonucuna varılmıştır.
Histopathological spectrum of gastrointestinal lesions - In a tertiary care centre
Authors: GK Parvathidevi , H Chaithra , HV Sriharsha
Published: May 2024

Gastrointestinal (GI) pathology is one of the largest sub- specialities in pathology. Histopathological evaluation of GI lesions is the gold standard for providing essential diagnostic and prognostic information to the clinicians for the best timely management of each patient.

: This is an unicenter retrospective and prospective study of 510 patients with GI lesions over a period of 2 years from July 2021 to June 2023. Biopsies and resected specimens of gastrointestinal tract were fixed in 10% formalin. Those specimens were then processed in automatic tissue processor. Routine Haematoxylin and Eosin stain and special stains, including immunohistochemical stains were done, whenever indicated. Then slides were examined and data generated from observation and was used for statistical analysis.

Out of total 2462 histopathological specimens received in 2 years, over 21% of specimens were GIT lesions of them 510 were GI specimens. Gall bladder was the most common specimen received [34.3%] followed by appendix specimens [18.6%] and gastric biopsies [13.9%]. Non neoplastic GI lesions [89.3%] were the most common followed by neoplastic lesions [10.7%]. Males outnumbered female patients having M: F ratio1.3:1. The peak incidence of non neoplastic lesions are found in the age group of 21-40 years and that for neoplastic lesions found in the age group of 50-70 yrs. Chronic cholecystitis was the most common GI pathology [34.3%] followed by appendicitis [18.1%]. Adenocarcinoma was the most common histopathological malignancy [52.7%] followed by squamous cell carcinoma [47.2%]. Most common lesion in the oesophagus and oral cavity was squamous cell carcinoma whereas adenocarcinoma was most common in colo-rectum.

This study enables the overview of the spectrum of histopathological lesion encountered in the surgical pathology department and also reiterates that the histopathological evaluation is a valuable diagnostic tool for definitive and early diagnosis of GI lesions which has an impact on management of neoplastic lesions.
Inflammatory myofibroblastic tumor of urinary bladder in young male: A case report and literature review
Authors: Kalariya Jigna Jerambhai
Published: May 2024

The objective of this study is to present a rare case of inflammatory myofibroblastic tumor (IMT) of the urinary bladder in young male, detailing its clinical presentation, diagnostic approach, treatment strategy, and outcome. Additionally, the objective includes conducting a literature review to provide insights into the characteristics, management, and prognosis of this uncommon tumor entity.

A 20-year-old male presenting with dysuria and dribbling of urine underwent diagnostic workup including imaging studies, cystoscopy. On cystoscopy there was a presence of 5x4 cm sized pedunculated mass in the urinary bladder. Partial cystectomy is done and specimen is examined for histopathology. Histopathological examination and Immunohistochemistry study of the tumor specimen was performed to confirm the diagnosis of inflammatory myofibroblastic tumor. A thorough literature review was conducted to gather relevant studies on IMT of the urinary bladder, focusing on clinical presentations, diagnostic modalities, treatment approaches, and outcomes. Diagnostic evaluation revealed a mass lesion in the urinary bladder, and histopathological examination following partial cystectomy confirmed the diagnosis of inflammatory myofibroblastic tumor. The patient underwent surgical excision of the tumor followed by adjuvant therapy. Regular follow-up examinations showed no evidence of tumor recurrence. The literature review identified a limited number of reported cases of IMT of the urinary bladder in young male, emphasizing its rarity and diverse clinical presentations. Various diagnostic modalities and treatment options, including surgery, chemotherapy, and targeted therapy, were discussed in the reviewed literature. Inflammatory myofibroblastic tumor of the urinary bladder is a rare neoplasm at younger age that can present with nonspecific symptoms, making its diagnosis challenging. However, timely recognition and appropriate management, including surgical resection and adjuvant therapy, can lead to favorable outcomes with low recurrence rates. This case report highlights the importance of considering IMT in the differential diagnosis of bladder masses in young patient and underscores the need for further research to better understand the pathogenesis and optimal treatment strategies for this rare tumor entity.
Syringocystadenocarcinoma Papilliferum: A rare Pathological entity
Authors: Nikumbh Dhiraj , Dad Bhakti , Tambse Manjusha
Published: May 2024

Syringocystadenocarcinoma papilliferum is a malignant form of its benign tumour that is syringocystadenoma papilliferum. Regarding clinical morphology it mimics varied skin tumors so diagnosis is difficult. Histopathology is ultimate role in final clinical diagnosis of these tumours. We present an uncommon case of SCACP arising from back mass in 45 years male in view of only handful cases have been reported in the literature with little information is available on its clinical and morphological aspect.
STRUCTURE OF PERIODONTAL DISEASES IN AGE-RELATED PSYCHIATRIC INPATIENT
Authors: Ilyina Roza , Muchamedzhanova Lubov
Published: May 2024

The literature provides information on the high prevalence of periodontal diseases and hard tooth tissues in patients in a psychiatric hospital. The relationship between periodontal microbiota and psychiatric pathology and the need to maintain oral health among this group of patients is discussed.
The aim of the investigation was the study of the structure of periodontal diseases in patients of a psychiatric hospital, in various age groups.
Material and methods of research. In the Republican Clinical Psychiatric Hospital named after V.N. Bekhterev (Kazan) in the period from 2014 to 2018, 200 patients (95 women and 105 men) aged 35 to 65 years (average age 56,26 ± 6,74) were examined. The questionnaire recorded the patient's age, sex, diagnosis of the underlying disease, dental formula, a standard periodontal diagram was filled in. The maximum depth of the periodontal pocket was determined by sequential measurements.
The results of the study. In 100% of patients in a psychiatric hospital, periodontal tissue damage was detected, of which 86.5% in the form of chronic periodontitis. The maximum number of patients with periodontitis was detected in the age group of 51–60 years. The largest number of teeth removed in patients over 70 years of age. There was a direct strong correlation between age and the number of teeth removed (rp = 0.923; p < 0.001).
The maximum depth of the periodontal pocket was also in the age group of 51–60 years and amounted to 4,25 ± 1,14 mm. A direct strong correlation of the depth of the periodontal pocket with the number of teeth removed was revealed. The deeper the patient has pathological pockets, the more teeth are removed (rp = 0.892).
Conclusions. The results of the study suggest the need to develop training programs for patients and psychiatric hospital staff to improve the quality of life of patients and general health.
MATHEMATICAL MODELING OF STRESS DISTRIBUTION IN THE WALLS OF CONE IMPLANTS MADE OF VT6 ALLOY
Authors: Avanisyan Vazgen , Dolgalev Aleksandr , Stomatov Dmitry , Sergeev Yuriy , Choniashvili David , Akramov Maksim , Gezuev Gimalai
Published: May 2024

Today, an interdisciplinary approach to solving the problems of implantology is the key to the effective use of intraosseous dental implants. The possibilities of preclinical modeling of the state of bone tissue and the future implantation and prosthetic beds allow us to assess the possible risks of implant rejection, calculate the necessary tightening force of screws in implantation systems and predict the points of application and stress distribution of dental implantation materials, taking into account the latter, the desire to improve modeling will allow us to obtain a predictable treatment result. In this study, a mathematical model of the stress distribution on the walls of a conical implant was investigated, taking into account the physical properties of the VT 6 material, an assessment was carried out using the example of computer models with embedded alloy characteristics, and the Mises distribution indicators were calculated. It is worth noting that the VT6 alloy has a very high quality, thanks to alloying additives. This titanium alloy includes aluminum, which has a beneficial effect on the strength of implants, as well as vanadium, which can increase the strength of the metal and make it more ductile. Titanium alloy VT6 has characteristics that are comparable to those of stainless steel, due to which it is considered as an inert metal for use in the oral cavity. The novelty of the proposed model lies in the fact that it operates with the minimum possible set of input data and provides adequate estimates of the most significant output parameters that are necessary for practical application. The obtained analytical results are illustrated by examples of calculating equivalent stresses in implants and peri-implant tissue for real structures of the future orthopedic prosthesis.
ASSESSMENT OF PHONETIC ADAPTATION OF DENTAL PATIENTS AFTER TREATMENT WITH COMPLETE REMOVABLE PROSTHESIS
Authors: Zhivotov Dmitriy , Pchelin Igor' , Polyanskaya Ol'ga
Published: May 2024

Background. As a result of teeth loss, a complex of factors arises that leads to changes in the dental system and impaired speech of the patient. Speech is an important communicative function, and assessing its intelligibility allows us to evaluate the result of prosthetic treatment. It is necessary to ensure unimpeded movement of the tongue, lips, cheeks and to fill in the missing components of the sound-producing system to restore phonetics. The optimal method of restoring complete absence of teeth is treatment with complete removable plate dentures made of acrylic plastics. Adaptation to this design over time restores the functions of sound pronunciation and the digestive system. The adaptation process depends not only on the patient’s abilities, but also on the quality of the manufactured structure. The discrepancy between the prosthetic bed and the base of the orthopedic structure is manifested by a violation of fixation and stabilization, which leads to pain.
Aim. To evaluate the dynamics of the phonetic adaptation process of patients after the application of a complete removable prosthesis.
Materials and methods. Application of phonetic control according to W. Wright and logopedic exercise “Drawing”.
Results. During the study, the results were obtained that patients of groups II, III and IV improved their initial indicators, while group III increased their indicators by 25%. On average, the groups that followed the recommendations improved their results by 19.4%.
Conclusions. According to the results obtained, the exercises used help patients with removable plate prostheses to adapt to them faster and accelerate the restoration of sound reproduction.
REVIEW AND COMPARISON MODERN 3D-TECHNOLOGIES FOR DENTISTRY AVAILABLE ON RUSSIAN MARKET
Authors: Murashov Mikhail , Zhurina Arina , Platonova Maria , Stepanova Svetlana , Bobrovich Kirill
Published: May 2024

Subject. SLA and LCD 3D-printing technologies used in dentistry and maxillofacial prosthetics.
Objectives. To compare and systematize SLA and LCD 3D printing devices and technologies available in the Russian Federation. To Print a prototype of the ear epithesis.
Methodology. collection and analysis of available literature sources, systematization of the information received. Comparison of various 3D printers, recommendations for usage depending on the required tasks. 3D-Print of epithesis of the ear by using LCD technology.
Results. SLA and LCD printing technologies are similar in a number of parameters we studied. LCD technology showed higher printing speed compared to SLA technology. At the same time, the accuracy of the product for all SLA printers turned out to be higher in comparison with the most accurate LCD technology printer. The cost of SLA printers is on average higher than LCD printers. The prototype of the epithesis of the auricle can be reproduced using LCD technology.
Conclusion. Photopolymer 3D printers with SLA technology produce more detailed and sharper end products than LCD printers. Photopolymer 3D printers with SLA technology are slower than LCD technology. SLA and LCD technologies are quite close in certain parameters. LCD technology can be used at the stages of rehabilitation of patients with ear defects.
FINITE ELEMENT STUDY EVALUSTION OF GLASS FIBER REINFORCED FIXED PROSTHESES MADE OF ACRYLIC AND BIS-ACRYLIC RESIN MATERIALS
Authors: Petrikas Oleg , Trapeznikov Dmitriy , Kostin Igor , Bulanov Vitaliy
Published: May 2024

The use of interim (provisional) prostheses is an obligate stage of modern dental practice. The problem of provisional bridges recognized by most experts is their use under heavy occlusal stress due to the possibility of their fracture. The development of a simple method of reinforcing provisional of prostheses during a clinical appointment that does not require special equipment is an urgent scientific and practical task.
Objectives. The goal of this study was to evaluate the stress distribution in fiberglass reinforced and non-reinforced short-span and long-span provisional bridges according to different acrylic and bis-acrylic resin.
Methodology. For this purpose, four finite element models were developed to reproduce the properties of prosthetic materials and hard dental tissues (Young’s modulus, Poisson’s ratio, hardness). Each model was subjected to a vertical load of 100 N applied to the middle of the bridge. Calculations were carried out in APM 3D Studio, and the results obtained were monitored in Ansys 12.2. The results obtained were displayed on the monitor screen, printed and analyzed.
Results. Stress distribution pattern for an acrylic non-reinforced short-span bridge (model 1) showed the highest stress (4.2–5.2 n/mm2) in the area of the occlusal surface.
Stress distribution pattern for an acrylic non-reinforced long-span bridge (model 2) showed the highest stress (11.4–12.3 n/mm2) both in the load zone and in the cervical zones of the connector facing the defect.
Stress distribution pattern for acrylic reinforced long-span bridge (model 3) showed the highest stress (10.5–12.0 n/mm2) in the area where the fiber reinforcing tape is located deep in the bridge.
Stress distribution pattern for bis-acrylic reinforced long-span bridge (model 4) showed the highest stress (9.8–10.5 n/mm2) observed both in the area where the glass fiber reinforcing tape is located and on the occlusal surface.
Conclusion. Finite element analysis confirmed the feasibility of fiberglass reinforcement of long-span provisional bridges made of acrylic or bis-acrylic resin.