The endometriosis daily diary: qualitative research to explore the patient experience of endometriosis and inform the development of a patient-reported outcome (PRO) for endometriosis-related pain

Purpose Endometriosis is a chronic disorder of the female reproductive system characterized by debilitating symptoms, particularly endometriosis-related pain (ERP). Patient-reported outcome (PRO) measures of symptoms and impacts are required to assess disease severity in ERP clinical studies and clinical practice. A content-valid instrument was developed by modifying the Dysmenorrhea Daily Diary (DysDD) to form the Endometriosis Daily Diary (EDD), an electronic PRO administered via handheld device. Methods Qualitative research with US females with ERP was conducted in three stages: (1) Development of an endometriosis conceptual model based on qualitative literature and conduct of concept elicitation (CE) interviews (N = 30). (2) Cognitive debriefing (CD) interviews (N = 30) conducted across two rounds to assess relevance and understanding of the EDD, with modifications between interview rounds. (3) Pilot testing to assess usability/feasibility of administrating the EDD daily on an electronic handheld device (N = 15). Clinical experts provided guidance throughout the study. Results The conceptual model provided a comprehensive summary of endometriosis to inform modifications to the DysDD, forming the EDD. CD results demonstrated that EDD items were relevant for most participants. Instructions, items, response scales, and recall period were well-understood. The resulting daily diary assesses severity of cyclic and non-cyclic pelvic pain, dyspareunia, impact of ERP on functioning and daily life, symptoms associated with ERP, and bowel symptoms. Participants were able to complete the diary daily and found the device easy to use. Conclusion The EDD demonstrated good content validity in females experiencing ERP. The next step is to perform psychometric validation in an ERP sample.

Systemic Sclerosis: From Pathophysiology to Novel Therapeutic Approaches

Systemic sclerosis (SSc) is a systemic, immune-mediated chronic disorder characterized by small vessel alterations and progressive fibrosis of the skin and internal organs. The combination of a predisposing genetic background and triggering factors that causes a persistent activation of immune system at microvascular and tissue level is thought to be the pathogenetic driver of SSc. Endothelial alterations with subsequent myofibroblast activation, excessive extracellular matrix (ECM) deposition, and unrestrained tissue fibrosis are the pathogenetic steps responsible for the clinical manifestations of this disease, which can be highly heterogeneous according to the different entity of each pathogenic step in individual subjects. Although substantial progress has been made in the management of SSc in recent years, disease-modifying therapies are still lacking. Several molecular pathways involved in SSc pathogenesis are currently under evaluation as possible therapeutic targets in clinical trials. These include drugs targeting fibrotic and metabolic pathways (e.g., TGF-β, autotaxin/LPA, melanocortin, and mTOR), as well as molecules and cells involved in the persistent activation of the immune system (e.g., IL4/IL13, IL23, JAK/STAT, B cells, and plasma cells). In this review, we provide an overview of the most promising therapeutic targets that could improve the future clinical management of SSc.

Role of Tumor Microenvironment in Cancer Stem Cells Resistance to Radiotherapy

Cancer is a chronic disorder that involves several elements of both the tumor and the host stromal cells. At present, the complex relationship between the various factors presents in the tumor microenvironment (TME) and tumor cells, as well as immune cells located within the TME, is still poorly known. Within the TME, the crosstalk of these factors and immune cells essentially determines how a tumor reacts to the treatment and how the tumor can ultimately be destroyed, remain dormant, or develop and metastasize. Also, in TME, reciprocal crosstalk between cancer-associated fibroblasts (CAFs), extracellular matrix (ECM), hypoxia-inducible factor (HIF) intensifies the proliferation capacity of cancer stem cells (CSCs). CSCs are subpopulation of cells that reside within the tumor bulk and have the capacity to self-renew, differentiate, and repair DNA damage. These characteristics make CSCs develop resistance to a variety of treatments, such as radiotherapy (RT). RT is a frequent and often curative treatment for local cancer which mediates tumor elimination by cytotoxic actions. Also, cytokines and growth factors that are released into TME, have been involved in the activation of tumor radioresistance and the induction of different immune cells, altering local immune responses. In this review, we discuss the pivotal role of TME in resistance of CSCs to RT.

Finger Tapping Measures for Parkinson’s Disease: Preliminary Evaluation of an Android Application for Data Collection in Australia

Parkinson’s Disease (PD) is a progressive chronic disorder with a high misdiagnosis rate. Because finger-tapping tasks correlate with its fine-motor symptoms, they could be used to help diagnose and assess PD. We first designed and developed an Android application to perform finger-tapping tasks without trained supervision, which is not always feasible for patients. Then, we conducted a preliminary user evaluation in Australia with six patients clinically diagnosed with PD and sixteen controls without PD. The application could be used in research and healthcare for regular symptom and progression assessment and feedback.

Genetics Landscape of Nonsyndromic Hearing Loss in Indian Populations

Congenital nonsyndromic hearing loss (NSHL) has been considered as one of the most prevalent chronic disorder in children. It affects the physical and mental conditions of a large children population worldwide. Because of the genetic heterogeneity, the identification of target gene is very challenging. However, gap junction β-2 (GJB2) is taken as the key gene for hearing loss, as its involvement has been reported frequently in NSHL cases. This study aimed to identify the association of GJB2 mutants in different Indian populations based on published studies in Indian population. This will provide clear genetic fundamental of NSHL in Indian biogeography, which would be helpful in the diagnosis process.

Anti-SARS-CoV-2 S-RBD IgG Antibody Responses after COVID-19 mRNA Vaccine in the Chronic Disorder of Consciousness: A Pilot Study

Objective: In the last year, a large amount of research has investigated the anti-spike protein receptor-binding domain (S-RBD) antibody responses in patients at high risk of developing severe acute respiratory syndrome because of COVID-19 infection. However, no data are available on the chronic disorder of consciousness (DOC). Methods: Here, we evaluated anti-S-RBD IgG levels after vaccination in chronic DOC patients compared with demographically matched healthy controls (HC) by indirect chemiluminescence immunoassay. All individuals completed a two-dose-cycle vaccination with Pfizer mRNA vaccine (BNT162b2), and antibody responses were evaluated at 30 and 180 days after the administration of the second dose of vaccination. Results: We compared 32 DOC patients with 34 demographically matched healthy controls. Both DOC and HC groups showed a similar antibody response at 30 days, whereas at follow-up (180 days) DOC patients were characterized by lower S-RBD IgG levels with respect to controls. Additional multiple regression analyses including demographical and clinical comorbidities as predictors revealed that age was the only factor associated with the decrease in S-RBD IgG levels at follow-up (180 days). Elderly individuals of both groups were characterized by a reduction in the antibody responses with respect to younger individuals. Conclusions: Our results show an efficacy seroconversion in DOC patients in the first period after vaccination, which significantly declines over time with respect to healthy controls.

Perspectives of physical medicine and rehabilitation specialists and rheumatologists towards fibromyalgia syndrome in Turkey

Objective: Fibromyalgia syndrome (FMS) is a chronic disorder characterized by widespread, unexplained pain in the muscles, including the head, neck, and sides of the hips, and fatigue. We aimed to evaluate the familiarity of physical medicine and rehabilitation and rheumatology physicians with fibromyalgia syndrome (FMS) in Turkey by means of a survey and to determine if these physician groups followed the 1990 FMS diagnostic criteria and 2010 FMS classification criteria for diagnosis. Material and Methods: The survey questions consisted of two parts; the first part consisted of 10 questions about demographics and professional experience, as well as the number of patients who had been diagnosed, treated, and followed up with in the prior 3 months by physicians. The second part consisted of 15 questions about perspectives on the 1990 FMS diagnostic criteria and 2010 FMS classification criteria. Results: One hundred and seventy one physicians participated in this survey. The majority of physicians 105 (99.1%) from physical medicine and rehabilitation and 59 (90.8%) rheumatologists could diagnose FMS. The rate of diagnosis and the rate of follow-up for FMS patients were significantly higher with physical medicine and rehabilitation specialists than with rheumatologists (p= 0.013 and p = 0.000; respectively) and were statistically significant. Conclusion: Differences in the awareness and descriptions of as well as approaches to FMS by physical medicine rehabilitation physicians and rheumatologists were examined in this study.

Cataloguing of Attention Deficit Hyperactivity Disorder (ADHD) among Children

<p>Children are the dream of parents. Children ADHD is a bygone and chronic disorder which leads to problems in children. If not solved in childhood stages will continue in future till adolescents. The disorder consequences are difficulty to study the tasks which are related to anxiety, depression and other psychological problems. Hence the disorder must be resolved in the early stage to control any type of consequences in future for our children. The medical field is an eminent area in today’s world such as signal processing, Imaging, MRI, EEG etc. to diagnose and offer treatment. Even technology field too contributing to ADHD children by providing different techniques in different areas such as IoT, mobile, Robot, Application, virtual reality, augmented reality, machine learning techniques etc. to give diagnosis and treatment methods. The paper reviews and summarizes the set of features, diagnosis methods, treatment rules for ADHD children.</p>

Cataloguing of Attention Deficit Hyperactivity Disorder (ADHD) among Children

<p>Children are the dream of parents. Children ADHD is a bygone and chronic disorder which leads to problems in children. If not solved in childhood stages will continue in future till adolescents. The disorder consequences are difficulty to study the tasks which are related to anxiety, depression and other psychological problems. Hence the disorder must be resolved in the early stage to control any type of consequences in future for our children. The medical field is an eminent area in today’s world such as signal processing, Imaging, MRI, EEG etc. to diagnose and offer treatment. Even technology field too contributing to ADHD children by providing different techniques in different areas such as IoT, mobile, Robot, Application, virtual reality, augmented reality, machine learning techniques etc. to give diagnosis and treatment methods. The paper reviews and summarizes the set of features, diagnosis methods, treatment rules for ADHD children.</p>