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Acute myocarditis remains a diagnostic issue with a wide spectrum of clinical manifestations that could mimic ST-elevation myocardial infarction (STEMI). We present a case of a 26-year-old male with left-sided intense squeezing chest pain associated with elevated troponin, ST-segment elevations, and reduced ejection fraction. The patient was initially suspected of having a STEMI with non-obstructed coronary arteries (MINOCA). However, due to positive pair troponin tests, increased inflammatory markers there was suspected myocarditis and cardiac MRI confirmed this diagnosis. This case highlights the clinical significance of assessment of laboratory markers and cardiac MRI in diagnostics of myocarditis. more...

Objective: Inhibition of dihydroorotate dehydrogenase suppresses magnetic resonance imaging brain lesions and disease activity in multiple sclerosis but has limiting tolerability. We assessed the safety and efficacy of vidofludimus calcium, a novel, selective dihydroorotate dehydrogenase inhibitor, in patients with relapsing-remitting multiple sclerosis., Methods: This double-blind, 24 weeks, placebo-controlled, phase 2 trial (EMPhASIS) enrolled patients 18-55 years with relapsing-remitting multiple sclerosis. Eligible patients were randomly assigned (1:1:1) to once-daily vidofludimus calcium (30 mg or 45 mg) or placebo. The primary endpoint was the cumulative number of combined unique active lesions to week 24 between vidofludimus calcium 45 mg and placebo (clinicalTrials.gov number NCT03846219; EudraCT 2018-001896-19)., Results: After 24 weeks, the mean cumulative number of combined unique active lesions was 6.4 (95% CI: 2.8-13.9) with placebo compared to 2.4 (95% CI: 1.1-4.9) with vidofludimus calcium 45 mg (rate ratio 0.38, 95% CI: 0.22-0.64; p = 0.0002); the rate ratio between vidofludimus calcium 30 mg and placebo was 0.30 (95% CI: 0.17-0.53; p < 0.0001). Treatment-emergent adverse events occurred in 30 (44%) of patients assigned placebo and 60 (43%) of patients assigned vidofludimus calcium. Serious adverse events occurred in one (1%) assigned placebo and two (1%) assigned vidofludimus calcium. No increased incidence of infectious, hepatic, or renal treatment-emergent adverse events or serious adverse events was observed., Interpretation: Treatment with vidofludimus calcium led to a reduction in new magnetic resonance imaging lesions in patients with relapsing-remitting multiple sclerosis and was well tolerated with a favorable safety profile. Assessment in longer, larger trials is justified., (© 2022 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.) more...

The purpose of this article is to study individual aspects of the impact of the COVID-19 pandemic on the mental state of PLHIV. The study covered 146 patients with HIV-related diseases who attended the outpatient department of the communal enterprise "Dnepropetrovsk Regional Center for Socially Significant Diseases of the Dnepropetrovsk Regional Council" during September-October 2020. HIV-infected were interviewed using a self-developed questionnaire. We used integrative test of anxiety by A.P. Bizyuk to investigate anxiety. The frequency of increased anxiety over the past half year among respondents is 15.75%; frequency of insomnia, weight loss, eating disorders - 12.32%; In 10.42% (n=15) cases, PLHIV had episodes of acute feelings of fear, palpitations, shortness of breath, chest tightness, panic while watching news about COVID-19. A high level of average value of situational anxiety among PLHIV was revealed - 7.8 (1.3) stanins - M (SD), in the structure of which "social defense reactions", a phobic component and anxious assessment of prospects prevail. 74.6% of HIV-infected strictly adhered to additional protection against COVID-19; 63.01% - considered crowded places a threat to their health; 52.74% were afraid to get sick with COVID-19; 49.31% - had an increased interest of PLHIV in COVID-19 in Ukraine and the world. The respondents used the following additional methods of protection: self-isolation (60%), strict adherence to distance (75%), disinfection of their belongings and household items (10%). The mental state of PLHIV during the coronavirus pandemic indicates the presence of symptoms of distress: the manifestations of anxiety-depressive disorders, insomnia have increased, a fixation has appeared on their physical condition, social isolation and distancing have increased. Further research into the characteristics of the psychoemotional state of PLHIV will help improve the organization of medical and social assistance in the current situation of the COVID-19 pandemic. more...

The problem of studying, diagnosing and correcting stress-associated disorders resulting from exposure to psychogenic factors, the sources of which are various traumatic events, is one of the most relevant.; The purpose of the work is to create a psychological portrait of a combat participant for the subsequent development of preventive measures for stress-associated disorders. To study the psychological characteristics and psycho-emotional state, a comprehensive clinical and psychological examination of 147 military personnel was carried out after mostly mine-blast injuries received while performing official duties in the ATO zone.; The state of mental functions, and the emotional-volitional sphere and personality traits were evaluated. The points and characteristics of the test methods were analyzed, the total number of points was calculated separately on each scale.; A generalization of the results of the study allowed us to determine the main aspects of the psychological portrait of a military man. The essence of the portrait consists in harmonious restructuring from conscious to unconscious psychological attitudes and vice versa, in changing the subjective hierarchy of values and also to note that the character of the traumatic situation is not important in the portrait of the ATO participant, but the personal attitude of the participant and his environment. more...