COVID-19 Related Acro-Ischemic Neuropathic-like Painful Lesions in Pediatric Patients: A Case Seriese

Background: A variety of skin manifestations have been associated with COVID-19 infection. Acral lesions on hands and feet, closely resembling chilblains, have been reported in association with COVID-19, which are nonspecific. These acro-ischemic painful lesions have been described mainly in asymptomatic and mildly symptomatic pediatric COVID-19 positive patients, without a precise pathogenetic mechanism.COVID-19-induced chilblains may portend an indolent course and a good outcome. In young patients, the IFN-1 response induces microangiopathic changes and produces a chilblain lupus erythematosus-like eruption with vasculitic neuropathic pain features. Objectives: This paper presented a case series of pediatric patients with COVID-19-related skin lesions and neuropathic-like pain. Methods: Clinical outcomes were collected from 11 patients diagnosed with painful erythematous skin lesions with neuropathic-like pain and positive IgG for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Results: It is a mildly symptomatic condition not related to severe pain rates, and it is treated with paracetamol due to the transitory nature of the problem, which provides good results. Conclusions: A particular point of interest is skin lesion manifestation as a further indirect sign of SARS-CoV-2 infection. Due to the initial manifestation of chilblains in pauci-symptomatic pediatric patients, they need to be immediately tested and isolated. Chilblains can be considered a clinical clue to suspect SARS-CoV-2 infection and help in early diagnosis, patient triage, and infection control.

Diagnostic Value of High-resolution Ultrasound for the Evaluation of Capsular Distension in Temporomandibular Joint Effusion

Objectives. The aim of this study was to evaluate if the increased temporomandibular joint (TMJ) capsular thickness, measured by ultrasound (US), is associated with the presence of effusion, diagnosed using MRI imaging.Methods. 102 patients with signs and symptoms of temporomandibular disorders were included in the study. Each patient underwent US and MRI examination, 1 to 7 days following clinical examination. The US was performed with an 8–40 MHz linear transducer operating at 20 MHz. MRI was performed using an 1.5 T MRI device. The ROC curve was analyzed to identify the optimal cut-off value for capsular distention, which can be used as an indirect sign of TMJ effusion.Results. The capsular width values were found to be between 0.7-3.6mm. The best cut-off value was 2.05 mm with sensitivity of 55.9% and specificity of 94.7% (p<0.05). The next optimal cut-off value was 1.75 mm with sensitivity of 67.6% and specificity of 82.4%. The area under the ROC curve was 0.78 (95 % CI 0.68, 0.87). Conclusions. Ultrasound measured capsular width can be used as an indirect sign of TMJ effusion. The most accurate cut-off value obtained in this study was 2.05 mm.

Flexor hallucis longus hypertrophy secondary to Achilles tendon tendinopathy: an MRI-based case–control study

Purpose The purpose of this study was to outline an indirect sign of advanced Achilles tendinopathy on magnetic resonance imaging (MRI), based on the hypothesis that these patients would present with secondary hypertrophy of the flexor hallucis longus muscle (FHL). Methods MRI scans of Achilles tendon were analyzed retrospectively in two cohorts. The study group consisted of consecutive patients presenting with clinical signs of Achilles tendinopathy and no previous surgeries, while the control group were patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4–5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the FHL muscle. Ratios (FHL/TS) were calculated for area (Ar) and diameter (Dm) measurements. Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both ratios to assess potential cutoff points to differentiate between the groups. Results A total of 60 patients for each study group were included. Both ratios Ar(FHL/TS) and Dm(FHL/TS) showed significant higher values in the tendinopathy group (p < 0.001). There were strong to very strong intraclass correlation coefficients (ICC = 0.75–0.93). A diameter ratio Dm (FHL/TS) of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy. Conclusion In our patient cohort, FHL hypertrophy was observed in patients with Achilles tendinopathy as a possible compensatory mechanism. Measuring a diameter ratio Dm(FHL/TS) of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.

Flexor Hallucis Longus Hypertrophy Secondary to Achilles Tendon Tendinopathy: An MRI-based Case-Control Study

Background: The purpose of this study was to outline an indirect sign of advanced Achilles tendinopathy on magnetic resonance imaging (MRI), based on the hypothesis that these patients would present with secondary hypertrophy of the flexor hallucis longus muscle (FHL).Methods: MRI scans of Achilles tendon were analyzed retrospectively in two cohorts. The study group consisted of consecutive patients presenting with clinical signs of Achilles tendinopathy and no previous surgeries, whilst the control group were patients that had an MRI due to other reasons and no signs of tendinopathy. Two parameters from two muscle bellies were measured and compared on axial MRI scans 4 to 5 cm above the ankle joint line at the level of greatest thickness: area and diameter of the triceps surae (TS) and of the FHL muscle. Ratios (FHL/TS) were calculated for area (Ar) and diameter (Dm) measurements. Interobserver agreement was analyzed. A receiver operating characteristic (ROC) curve was created for both ratios to assess potential cut-off points to differentiate between the groups.Results: A total of 60 patients for each study group were included. Both ratios, Ar(FHL/TS) and Dm(FHL/TS) showed significant higher values in the tendinopathy group (p<0.001). There were strong to very strong intraclass correlation coefficients (ICC=0.75-0.93). A diameter ratio Dm (FHL/TS) of 2.0 or higher had a sensitivity of 49% and specificity of 90% for concomitant Achilles tendinopathy.Conclusion: In our patient cohort, FHL hypertrophy was observed in patients with Achilles tendinopathy as a possible compensatory mechanism. Measuring a diameter ratio Dm(FHL/TS) of 2.0 or higher on an axial MRI, may be indicative as an indirect sign of functional deterioration of the Achilles tendon.

Indirect Translation: A Semiotic Perspective

Grounded on the historical development of indirect translation mainly in China, a critical analysis of the definitions previously given for indirect translation has been made in terms of its nature, features, referential range, and classification, as well as the sign typology involved hereby. This results in a new definition of indirect translation as a process and as an end product respectively, highlighting its referential range, including relay translation, (tech- or human-based) mediated translation, adaptation, and free translation. The definition further divides it into seven types of operational mechanism (conventional single-sourced indirect translation, conventional double-sourced indirect translation, single-sourced relay translation, multi-sourced relay translation, interpreter-based relay translation, indirect translation in reverse translation, single-sourced multi-layered relay translation) and seven types of indirect sign transformation, namely: (1) T→T indirect translation; (2) T→I indirect translation; (3) I→T indirect translation; (4) T+I→T indirect translation; (5) T+I→I indirect translation; (6) T→T+I indirect translation; and (7) I→T+I indirect translation. Finally, the operational mechanism of indirect translation is explored on the macro level of Peirce’s Firstness–Secondness–Thirdness, on the meso level of Peirce’s First–Second–Third, and on the micro level of Peirce’s Sign–Object– Interpretant.

Barrett’s esophagus: genetic features

The aim of the study was to evaluate the genetic characteristics of the pathological process in patients with biopsy-proven PB. Materials and methods: Dynamic observation and treatment of patients with morphologically confi rmed diagnosis of Barrett’s esophagus (PB) was performed at the Bank of Russia Multidisciplinary medical center in Moscow in the period from 2014 to 2019.the study included 52 patients. Among them, men — 33 (63.4%) and women –19 (36.5%) aged from 28 to 70 years, the peak incidence was mainly in the age range from 50–71 years. As a result, morphological types of PB epithelium were identifi ed at the time of the study: cardiac — 8(15.3%), small — bowel — 25 (48%), large-bowel without dysplasia-17 (32.6%) and large-bowel with mild dysplasia foci –2 (3.8%). The expression of the p53, P63, and Ki-67 genes responsible for cell proliferation and diff erentiation was studied using an immunohistochemical method. Results. As a result of the study, it was found that genetic changes in patients with morphologically confi rmed PB increase from the cardiac type of epithelium in the segment to the detection of dysplasia foci on the background of colonic metaplasia. An exception is tokokishechnaya metaplasia, which may be an indirect sign of the development of highly diff erentiated epithelium in response to gastroesophageal or duodenogastroesophageal refl ux Summary. 1. Mutation of the p 53 genes responsible for regulating cell transcription and activating apoptosis and the P63 gene responsible for cell diff erentiation occurs in all morphological types of PB, with the number of mutations increasing as metastatic changes progress in accordance with the Correa cascade 2. The combination of p53 and P63 gene mutations in almost equal proportions indicates parallel processes of cell proliferation and diff erentiation disorders. 3. Ki-67 expression increases from the cardiac type of epithelium in the segment to the detection of dysplasia foci on the background of metaplastic epithelium. An exception is tokokishechnaya metaplasia, which may be an indirect sign of the development of highly diff erentiated epithelium in response to gastroesophageal or duodenogastroesophageal refl ux. Conclusion. Studies have shown that there are a number of genetic features of the pathological process in patients with morphologically confi rmed PB, the combination of which is more reliable and reliable assessment of the risk of neoplastic changes than individual indicators. To date, it remains relevant to develop a marker panel that is suitable for use in clinical practice, informative for both assessing individual risk and stratifying risk groups, and useful for monitoring the eff ectiveness of treatment.

ANALYSIS OF SOIL DEGRADATION AND DESERTIFICATION IN SOUTHERN BALKASH DESERT BASED ON GIS

Desertification and degradation provide a clear picture of global environmental and socio-economic issues. Most of Kazakhstan is located in a desert region, including the suburbs of South Balkhash. The reason is that desertification of the region has a strong influence on natural and anthropogenic factors. To consider the geomorphological state of the region and the problem of desertification of the territory, it is necessary to determine the importance of the process of relief of geological structure and relief of tectonics. In recent years, the environmental situation in Balkhash has deteriorated sharply not only as a result of river flow regulation, but also as a result of non-commercial economic activities. Therefore, it is very important to assess the situation of desertification and degradation in the Balkhash region. Desert vegetation has been identified, since information in the spectral range is often insufficient to describe the state of plants, plant indices often develop by combining two or more spectral bands. Land cover index is the percentage of vegetation over a given surface area. Remote sensing information was used to detect the entire land cover. Remote sensing with time and space limitations is widely used to classify vegetation cover. In this work, the proportion of vegetation was estimated by NDVI. The proportion of land cover is based on the relationship between NDVI (NDVIS) and NDVI (NDVIV) in the soil. Using the NDVI index, land cover zones were determined based on satellite images of 2006 and Landsat-5 from 2011. TCT (Tasseled Cap Transformation) coefficients are used in the widest range of problems solved using Earth remote sensing data: from recognition of the coastline of water bodies to determination of forest disturbances. Stressful vegetation may be an indirect sign of the presence of salt in soils. Saline soils are usually characterized by poorly planted areas. A normalized differential salinity index (NDSI) was also determined.