Age-related Characteristics Research Articles

Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices.

A mercury sphygmomanometer (MS) has been the gold standard for pediatric blood pressure (BP) measurements, and diagnosing hypertension is critical. However, because of environmental issues, other alternatives are needed. Noninvasive BP measurement devices are largely divided into auscultatory and oscillometric types. The aneroid sphygmomanometer, the currently used auscultatory method, is inferior to MS in terms of limitations such as validation and regular calibration and difficult to apply to infants, in whom Korotkoff sounds are not audible. The oscillometric method uses an automatic device that eliminates errors caused by human observers and has the advantage of being easy to use; however, owing to its measurement accuracy issues, the development of an international validation protocol for children is important. The hybrid method, which combines the auscultatory and electronic methods, solves some of these problems by eliminating the observer bias of terminal digit preference while maintaining measurement accuracy; however, the auscultatory method remains limited. As the age-related characteristics of the pediatric group are heterogeneous, it is necessary to reconsider the appropriate BP measurement method suitable for this indication. In addition, the mobile application-based BP measurement market is growing rapidly with the development of smartphone applications. Although more research is still needed on their accuracy, many experts expect that mobile application-based BP measurement will effectively reduce medical costs due to increased ease of access and early BP management.

Electrical Activity of the Heart in the Older Adults Suffering from Chronic Kidney Disease: Ethnic and Age Characteristics

The aim of the study was to investigate the ethnic and age-related characteristics of the electrical activity of the heart in older adults with chronic kidney disease (CKD). Methods and Results: A total of 522 patients aged between 60 and 89 years with different stages of CKD were examined. For a comparative analysis, we formed 3 ethnic groups (Yakuts, Evens, and Russians) and 2 age groups (60-74 years and 75-89 years). All patients underwent ECG. The laboratory analysis included determining the blood creatinine level for further calculation of the GFR using the Cockcroft&Gault formula, followed by determining the stage of CKD. A decrease in renal function was more typical for people of 75-89 years. The results of the study confirmed the close relationship of CKD in older adults with the pathology of the cardiovascular system. Changes in the electrical activity of the heart predominated in Russians, compared to other ethnic groups, and were less pronounced in the Evens.

Age-Related Changes in Cerebral Hemodynamics in Children Undergoing Congenital Cardiac Surgery: A Prospective Observational Study

To explore age-related cerebral hemodynamic characteristics before and after pediatric cardiac surgery. Prospective observational study. Single-center study based at a tertiary care center in Shanghai, China. Fifty-three children with congenital heart disease (CHD) aged zero-to-six years undergoing cardiac surgery with cardiopulmonary bypass were enrolled, and 44 children finally were analyzed. Cerebral hemodynamics were measured by transcranial color-coded duplex sonography in the right temporal window before and after surgery. The resistance index (RI), pulsatility index (PI), and cerebral blood flow velocity (CBFV), including time average maximum flow velocity (Vtamax), mean blood flow velocity (Vmean), and the peak systolic flow velocity (Vpeak), of the right middle cerebral artery (MCA) and regional cerebral oxygen saturation (rScO2) of the right frontal lobe were measured and analyzed. Heart rate and mean arterial pressure were also recorded during ultrasound. RI and PI decreased exponentially with age before and after cardiac surgery. While PI remained unchanged after cardiac surgery, RI was significantly reduced. Furthermore, RI reduction after cardiac surgery was more significant in children >18 months compared to those ≤18 months. CBFV of the right MCA also showed exponential increase with age, but rScO2 linearly increased. Cardiac surgery significantly changed the cerebral hemodynamics, but it did not affect rScO2 in children regardless of age. Age-related cerebral hemodynamic changes exist in children with CHD. Cardiopulmonary bypass surgery led to greater cerebrovascular dilation in children aged ≤18 months than those >18 months.

ЛАБОРАТОРНОЕ ИССЛЕДОВАНИЕ ЭФФЕКТИВНОСТИ ВОССТАНОВЛЕНИЯ ВОЗРАСТНЫХ ОСОБЕННОСТЕЙ КОНТАКТНЫХ ПОВЕРХНОСТЕЙ БОКОВЫХ ЗУБОВ МЕТОДОМ ПРЯМОЙ КОМПОЗИТНОЙ РЕСТАВРАЦИИ

The methods of aesthetic restoration of posterior teeth with composite materials currently used in practical dentistry make it possible to create only a point contact, which does not correspond to the age characteristics of the patients' teeth, therefore, it is important to develop methods for creation and positioning the contact areas, taking into account the age characteristics of structures of the teeth. A laboratory study of the effectiveness of the method of recreation of the age-related characteristics of the contact areas of the posterior teeth using the method of direct aesthetic restoration using light-cured composite materials with a specially developed tool – a contact-former was carried out. Phantom models were used to evaluate the significant characteristics of 40 restorations of posterior teeth with cavities of class 2 according to Black, performed in accordance with the traditional method, 80 restorations performed in accordance with the developed algorithm for restoring the contact points of posterior teeth by the method of direct composite restoration, taking into account age characteristics: 40 restorations with using a contact former with a working part of 1×2 mm (S = 2 mm2), 40 restorations - using a contact former with a working part of 1.5×3 mm (S = 4.5 mm2). It was found that the usage of the approved method of restoration of the contact points of posterior teeth using the method of direct composite restoration, taking into account age characteristics with the use of a contact-former in the process of tooth restoration, allows to obtain the required planar shape of the contact area (95.0±2.44%) to obtain its desired localization (90.0±3.35%), to form the functional configuration of interdental embrasures (86.7±3.79%) with a high degree of probability. There was a significant (p˂0.05) difference in indicators characterising the quality of positioning and restoration of the contact areas of the posterior teeth when using the tested technique in comparison with the traditional technique of restoration of teeth with carious defects of class 2 according to Black. The effectiveness of the tested method of direct restoration of the contact surfaces of the posterior teeth while taking into account age characteristics has been proved. The efficiency and ergonomics of the contact-former developed by us for this technique have been confirmed. It is concluded that it is advisable to study the effectiveness of the proposed technique in a clinical setting.

ВОЗРАСТНЫЕ ОСОБЕННОСТИ КОНТАКТНЫХ ПУНКТОВ БОКОВЫХ ЗУБОВ С ТОЧКИ ЗРЕНИЯ РЕСТАВРАЦИОННОЙ СТОМАТОЛОГИИ

Reconstruction of the age-related anatomical and physiological features of the contact surfaces and contact points inherent in natural teeth in the treatment of caries of posterior teeth with a direct restoration with light-cured composite is one of the unsolved problems of practical dentistry. The study is devoted to the determination of age-related characteristics of the localization and shape of contact points of posterior teeth in permanent dentition. The assessment of localization and shape of 1224 contact points of posterior teeth in 236 patients aged 20 to 59 years was carried out. Comparison of data about the surface area, shape, vertical and horizontal positions of contact points related to teeth anatomic structures in the interdental space was performed. The analysis of interproximal intraoral radiography data, examination and measurement of the parameters of interdental contacts using dental floss, analysis of the display of contact points on dental impressions made according to a special technique were carried out. The localization of the contact areas of the posterior teeth with a displacement in the vestibular direction, the associated asymmetry of the buccal and lingual (palatal) interdental embrasures, as well as a gradual increase in the surface area of contact areas and a decrease in the depth of the occlusal interdental embrasures, correlated with the age of the patients, were recorded. The average numerical values of the listed parameters are derived, taking into account the age of the patients. Anatomical and topographic features of the interdental spaces of the posterior teeth in adult patients are characterized by the following features: the contact areas of the posterior teeth are displaced in the vestibular direction, the buccal and lingual (palatal) interdental embrasures are asymmetric; dynamics of the depth of occlusal interdental embrasures, linear dimensions and area of contact areas is expressed as average digital values for different age groups: 20-40 years: contact areas – 1×2 mm, S = 2 mm2, depth of occlusal interdental embrasure – 1.5 mm; over 40 years old: contact pads – 1.5 × 3 mm, S = 4.5 mm2, the depth of the occlusal interdental embrasure – 1.0 mm.

Age-related changes in the parameters of carbohydrate metabolism and supply of vitamins B1, B2 in residents of two northern regions.

A great deal of research was being done in studying of the age-related characteristics of carbohydrate metabolism and the provision of vitamins B1, B2 among the population of the Subarctic (SR) and Arctic (AR) regions, differing in the extreme natural and climatic-geographic living conditions. The surveyed population was divided into five age groups: 16-21, 22-35, 36-45, 46-60 and 61-74 years old. The parameters of carbohydrate metabolism (glucose, lactate, pyruvate) were determined in the blood serum, the content of thiamine (thiamin diphosphate effect) and riboflavin - in hemolysates, and the values of the lactate/pyruvate ratio (Lac/Pyr) were calculated. Statistical data processing was performed by nonparametric methods. An increase in glucose levels was found in persons of older age groups. Age-related fluctuations of metabolites of carbohydrate metabolism were manifested by a lower content of lactate and the value of the Lac/Pyr ratio in persons aged 16-21 years. Regardless of the age and region of the survey, there were revealed high lactate concentrations, Lac/Pyr values and reduced pyruvate levels, as well as low glucose levels in group aged 16-21 year in AR. For vitamins B1, B2, no pronounced age-related changes were observed, while the content of riboflavin was higher in persons of SR. Moderate hypovitaminosis of thiamin was detected in 13-20,1% and 6,1-22,7% of cases in SR and AR, pronounced - 8,3-11,6% and 4,6-23,5%, respectively, vitamin B2 deficiency was noted in 19,4-23,9% of persons in the AR and in 33,8-42,9% of persons in the AR. Vitamins in both regions at different age periods contributed to the formation of levels of indicators of carbohydrate metabolism: glucose and pyruvate in SR, lactate in AR.

Age-Related Individual Behavioural Characteristics of Adult Wistar Rats.

Simple SummaryRats are considered adults from 2 to 5 months. During this period, they are used for experimentation in physiology and pharmacology. Adult rats, depending on their age, can be in a different physiological state, which can influence the results of experiments carried out on them. Despite this, age-related changes in adult rats have not yet been examined. Our results showed that as male and female rats progressed from 2 to 5 months of age there was a decrease in the level of motor and exploratory activities, and an increase in the level of anxiety-like behaviour. Age-related changes were dependent upon initial individual characteristics of behaviour. For example, animals that demonstrated high motor activity at 2 months become significantly less active by 5 months, and animals that showed a low level of anxiety at 2 months become more anxious by 5 months. Low-activity and high-anxiety rats did not show any significant age-related changes from 2 to 5 months of age. The results of this work should be taken into account when choosing the age of rats for conducting behavioural experiments.The aim of this work was to study age-related changes in the behaviour of adult Wistar rats using the open field (OF) and elevated plus maze (EPM) tests. Behavioural changes related to motor activity and anxiety were of particular interest. Results showed that as male and female rats progressed from 2 to 5 months of age, there was a decrease in the level of motor and exploratory activities and an increase in their level of anxiety. Age-related changes were dependent upon initial individual characteristics of behaviour. For example, animals that demonstrated high motor activity at 2 months become significantly less active by 5 months, and animals that showed a low level of anxiety at 2 months become more anxious by 5 months. Low-activity and high-anxiety rats did not show any significant age-related changes in OF and EPM tests from 2 to 5 months of age, except for a decrease in the number of rearings in the EPM. Thus, the behaviour of the same adult rat at 2 and 5 months of age is significantly different, which may lead to differences in the experimental results of physiological and pharmacological studies using adult animals of different ages.

Redefining the age-specific therapeutic ranges of lamotrigine for patients with epilepsy: A step towards optimizing treatment and increasing cost-effectiveness

ObjectiveThe pharmacokinetics of lamotrigine exhibits age-related characteristics. Nevertheless, current evidence regarding the therapeutic range of lamotrigine has been derived almost exclusively from studies in adult patients, and the applicability of this therapeutic range to the pediatric population remains unclear. The purpose of this study was to establish the appropriate age-specific therapeutic ranges of lamotrigine corresponding to adequate clinical responses for patients with epilepsy. MethodsThis prospective cohort study of therapeutic drug monitoring included 582 Chinese epilepsy patients receiving lamotrigine monotherapy. Patients were divided into three age-related subgroups: (1) toddler and school-age group (2–12 years old, n = 168), (2) adolescent group (12–18 years old, n = 171), and (3) adult group (>18 years old, n = 243). Patients with a reduction in seizure frequency of 50 % or greater than baseline were defined as responders, and the remaining patients were non-responders. The relationship between lamotrigine serum concentrations and clinical response was assessed using multivariate logistic regression analysis. A receiver operating characteristic curve was generated to determine the representative cut-off values of lamotrigine trough levels, to distinguish responders from non-responders. The upper margin of the therapeutic range of lamotrigine was determined by developing concentration-effect curves for the three age-related subgroups. ResultsThe median trough levels of lamotrigine were significantly higher in responders than in non-responders from all three age-related groups (P < 0.0001). Results of logistic regression analysis revealed that higher serum concentrations of lamotrigine predicted a higher probability that seizure frequency would be reduced by more than 50 % compared to baseline (adjusted odds ratio: 1.228, 95 % CI: 1.137–1.327; P < 0.0001), and younger children were less likely to be responders (adjusted odds ratio: 1.027, 95 % CI: 1.012–1.043; P = 0.001). Based on a trade-off between sensitivity and specificity, the optimal cut-off values for lamotrigine trough concentrations corresponding to clinical response were 3.29 mg/L, 2.06 mg/L, and 1.61 mg/L in the toddler and school-age group, adolescent group, and adult group, respectively. By reducing interpatient variability, the results of the concentration-effect curves suggested no additional clinical benefit from a continued increase of doses for lamotrigine concentrations exceeding 9.08 mg/L, 8.43 mg/L, and 10.38 mg/L in the toddler and school-age group, adolescent group, and adult group, respectively. In conclusion, the therapeutic ranges of lamotrigine trough concentrations corresponding to adequate clinical response were 3.29–9.08 mg/L in the toddler and school-age group, 2.06–8.43 mg/L in the adolescent group, and 1.61–10.38 mg/L in the adult group. ConclusionsThe study determined age-specific therapeutic ranges corresponding to optimal clinical efficacy for lamotrigine. Our findings lay the foundation for catalyzing novel opportunities to optimize treatment and reduce therapeutic costs. Based on the age-specific therapeutic ranges identified in this study, individualized and cost-effective algorithms for lamotrigine treatment of epilepsy patients may be developed and validated in larger cohort studies of therapeutic drug monitoring.

Age-Related Characteristics of Sleep Impairments in a Model of the Preclinical Stage of Parkinson’s Disease in Rats

Age-Related Characteristics of Sleep Impairments in a Model of the Preclinical Stage of Parkinson’s Disease in Rats

Indicators of the Immune Status in Children after a New Coronavirus Infection

Background. The mechanism of the immune response in patients with COVID-19 is still poorly understood and differs from other respiratory infections. Immunodeficiencies and age-related characteristics of immunity can be regarded as factors influencing reinfection and a predisposition to prolonged persistence of SARS-CoV-2. Most of the studies report about post-infection immunity to SARS-CoV-2 for adults and less for children. However, understanding the dynamics of antibody production to SARS-CoV-2 among children as well as other unique features of immune response is extremely important, because this provides to avoid possible complications and long-term outcomes of COVID-19, and predict the epidemic spread of the new coronavirus in the organized groups of children such as kindergartens, schools, study groups and clubs.Aim: to evaluate the humoral and cellular immunity after SARS-CoV-2 infection in children.Materials and methods. We reported data of the first phase prospective cohort study of immunity among 60 children living in Irkutsk, Russia within a month after SARS-CoV-2 infection, which took place in October and November 2020.Results. Immunity of children one month after SARS-Cov-2 infection was characterized by suppressed cell-mediated and humoral immunity, and phagocytosis dysfunction. Reduced phagocytosis by neutrophils was noted for 61.6 % of individuals.Conclusions. Children after COVID-19 had impaired immunity to SARS-CoV-2, which may be a predictor of chronic infection and other long-term outcomes of COVID-19.

168-LB: Latent Autoimmune Diabetes in Youth (15–29 Years Old): The Heavier End of an Autoimmune Disease Spectrum

Context: Latent autoimmune diabetes in youth (LADY) falls in a grey zone of the current diabetes scheme due to the lack of established definition and diagnosis criteria. Objective: To investigate the prevalence and clinical features of LADY patients between 15-29 years old as a component of an age-related continuous diabetes spectrum. Methods: This nationwide, multi-center, cross-sectional study included 1803 newly diagnosed diabetic youth of 15-29 years old across China from April 2015 to October 2017. Glutamic acid decarboxylase autoantibody (GADA) was screened in 1508 phenotypic T2DM subjects and those with positive GADA were defined as LADY. Metabolic status, insulin resistance and residual β-cell function of LADY were investigated and compared with other 658 adult-onset latent autoimmune diabetes (LADA) patients enrolled at the same time. The age-related characteristics of the latent autoimmune diabetes spectrum were explored. Results: LADY accounted for 7.9% (119/1508) of the phenotypic T2DM youth. Compared with GADA-negative T2DM youth, LADY patients had better metabolic control, less insulin resistance, and lower levels of β-cell function, which were closely related to their GADA levels (all P &amp;lt; 0.05). After stratifying LADA patients according to their age of onset, the GADA level decreased across the LADY, ‘Y-LADA’ (young LADA, age of onset &amp;lt;60 years old) and ‘E-LADA’ (elderly LADA, age of onset ≥60 years old) groups, with the prevalence of metabolic syndrome, levels of insulin resistance and residual β-cell function presenting an increasing trend (all P &amp;lt;0.05). Conclusions: A high prevalence of LADY exist in phenotypic T2DM youth. The latent autoimmune diabetes occurred at different ages formed a continuous clinical spectrum from LADY to LADA, in which the LADY patients carried heavier autoimmune load. Disclosure J. Cheng: None. X. Tang: None. X. Yan: None. S. Luo: None. X. Li: None. Z. Zhou: None. Funding National Science and Technology Infrastructure Program (2013BAI09B12, 2015BAI12B13); National Key R&amp;D Program of China (2016YFC1305000, 2017YFC1309604)

A geospatial analysis of age disparities in resolute localities of tobacco and vaping-specific storefronts in California.

INTRODUCTIONConcomitant with the popularization of vaping, vape shops have dramatically proliferated over the past years. This study assesses whether vape storefronts in California are significantly associated with density of different age groups, and whether this differs between tobacco storefronts or non-specific tobacco retailers.METHODSAddresses for licensed tobacco retailers were obtained from the California Department of Tax and Fee Administration. Business names and addresses were used to obtain store categories cross-referenced from Yelp. Using a cross-sectional ecological design, stores categorized as ‘Vape Shop’ or ‘Tobacco Shop’ were geolocated and compared with age-related variables from the American Community Survey. Regression was conducted in R to determine relationships between age group concentration, in ventiles, and proportion of tracts with tobacco-specific or vape-specific stores. Geospatial visualization was conducted using ArcGIS.RESULTSWe found 848 vape shops, 820 tobacco shops, 419 categorized as both, and 20320 retailers with neither category. Overall, 1800 tobacco and/or vape shops were categorized in 1557 of California’s 23194 census tracts. A positive linear association was found between ventiles of two age categories, 20–24 and 25–34 years, and proportion of tracts with vape-specific or tobacco-specific shops separately.CONCLUSIONSPositive associations were found for ages 20–34 years but not for other ages, suggesting vape shops are strategically located in areas populated by young adults. Location-based targeting increases access, thereby increasing proportion of tobacco users, and could be a critical factor in e-cigarette uptake and use. Further study to identify additional age-related demographic characteristics among clientele of tobacco storefronts is warranted.

Age-Related Features of the Response of the Liver and Stem Cells during Modeling of Liver Cirrhosis.

We studied the age-related characteristics of the response of stem cells and liver in male Wistar rats to administration of carbon tetrachloride (CCl4) and ethanol. It was shown that modeling of liver cirrhosis caused inflammation, fibrosis, damage to sinusoidal capillaries, necrosis, and disturbances in the functional activity of hepatocytes in young rats. These processes were accompanied by mobilization of profibrotic mesenchymal stem cells (MSC), proinflammatory hematopoietic stem cells (HSC) and lymphocytes (CD45hiCD133+) from the bone marrow into the blood and migration to the liver. On the other hand, the number of hepatocyte precursors expressing Sox9 (cells of Hering's canal), immature cholangiocytes, Ito cells, oval cells, and endothelial cells of the liver sinusoids) sharply increased in the liver. In young rats, mobilization and migration of MSC, HSC, and hepatocyte precursors against the background of liver cirrhosis were more intensive than in old animals. The higher resistance of old rats to exposure is associated with age-related changes in the niches as well as in mobilization and migration of cells.

Evaluation of Villus Synovium From Unaffected Metacarpophalangeal Joints of Adult and Juvenile Horses

Horses are a widely accepted model for osteoarthritis (OA) research. Synovial tissue sampling is commonly used in studies to evaluate and grade the progress of OA or to assess treatment effects. Synovial explants play an important role in ex-vivo studies, increasingly replacing the use of living animals. To understand histomorphological changes in the process of joint-related diseases such as OA, detailed information about histomorphometric parameters of unaffected synovial villi is necessary.The objective of the present study was to evaluate the mean width of the intimal synovial lining and its cellularity as well as the vascularization of the subintimal layer in juvenile and adult horses not affected by a joint-related disease.One hundred synovial samples from both metacarpophalangeal joints from 25 horses (one day to 24 years old) were collected to evaluate the following parameters on digitalized hematoxylin-eosin stained samples: Width of intimal synovial lining measured by the distance from the inner joint surface to the subintimal layer; density of the cells making up the intimal synovial lining by counting cell nuclei; vascularization of the subintimal layer measured by the number and size of vessels in relation to the subintimal area.The median width of the intimal lining did not differ among juvenile (22.34 µm) and adult (23.34 µm) horses. The cellularity of the intimal lining was significantly lower in juvenile (one cell/143.8 µm2) than in adult (one cell /188.7µm2), (P < .001) horses as well as the density of blood vessels per mm2 within the subintimal layer (juveniles 1/mm2 vs. adults 0.05/mm2), (P < .001).This study provides morphometric data regarding synovial intimal width, intimal cellularity, and vascularization of equine synovial villi of unaffected horses. For future studies, age-related characteristics should be taken into consideration when synovial tissue samples are used for in-vivo and in-vitro studies.

Comparative characteristics of human thalamus parameters in the first period of mature age and in senile age in mesocephals

The problem of demographic aging intensity growth is increasingly raised in the scientific community. Patients belonging to the senile age group have a number of reasons that reduce their quality of life, as well as reduce the effectiveness of treatment and rehabilitation. The most important information node involved in providing functions such as an integrative role in cognition, starting from learning and memory and ending with flexible adaptation is the structure of the intermediate brain – the thalamus. The aim of the study was to conduct a comparative analysis of agerelated morphometric characteristics of human thalamuses in the first period of adulthood and in old age according to magnetic resonance imaging. Material and methods. The results of morphometric study of the thalamuses of 83 people were analyzed, which were divided into two groups based on their age. Group I included 46 people of the first period of Mature age, group II included 37 people of senile age. All patients had a history of diseases and injuries of the Central/peripheral nervous system, alcohol and drug addiction, and were right-handed. The transverse, longitudinal, and vertical parameters of the thalamuses in both hemispheres of the brain were determined. Results. It was found that the parameters of the thalamus prevail in the first period of adulthood in both men and women (p&lt;0.01). At the same time, there was no statistically significant difference between the morphometric parameters of the thalamuses in the hemispheres, but there was a tendency to a predominance of linear dimensions in the left thalamus (p&gt;0.05). We found a tendency to slightly exceed the indicators of the thalamus in men in comparison with the indicators established in women (p&gt;0.05). Conclusion. The results obtained can serve as starting points as the equivalent of the anatomical age norm of the human thalamus in the first period of adulthood and senile age, which in the future will allow for a personalized approach in medical practice.

Continuous combined low-dose hormone replacement therapy in perimenopause: an algorithm of choice

In the age of broad medical options, women’s health has received sufficient attention. The different periods of a woman’s life are characterised by specific physiological changes, based on the age-related characteristics of the reproductive system. The onset of menopause can have a negative impact on health in varying degrees. Clinicians have a clear understanding of the effects of estrogen deficiency and the therapeutic options for managing it with menopausal hormone therapy (MHT) and alternative methods of treatment. However, to date, methods for optimising and individualising the correction of menopausal disorders continue to improve. The individualization of MHT is aimed at increasing the efficacy of menopausal management and minimizing possible adverse events. Individualization is based on the selection of a hormone drug taking into account age, menopausal status, somatic health of the woman and her main complaints against the background of estrogen deficiency. The next stage of transformation of MHT concerned the composition of the drugs and the doses of their components. The evolution of the estrogenic component began with the use of conjugated estrogens, whose metabolism is not fully clarified, and stopped at the production of bioidentical estrogens (17p-estradiol and estradiol valerate), which in their structure are as close as possible to ovarian estradiol. The type, dose and combination of estrogens and progestogens determine the severity and specificity of the effect of the hormone. This article will present a clinical case study of the low- and ultra-low-dose combination of 17p-estradiol and dydrogesterone (E/DG).

Macro-Microscopic Characteristics of the Glands of the Hepatic Ducts in Postnatal Human Ontogenesis

The aim was to study the macro-microanatomy and morphometric characteristics of the glands of the right, left and common hepatic ducts in people of different ages under conditions of relative norm.Material and methods. The experimental material included a complex consisting of the left, right and common hepatic ducts obtained from the corpses of 126 persons of different age groups who died from causes not related to the pathology of the digestive system. The glands of the hepatic ducts were selectively stained with methylene blue according to R.D. Sinelnikov, followed by fixation in a saturated solution of ammonium picric acid. The macroscopic structure and microstructure of gels were studied using an MBS-9 stereomicroscope. The analysis included the percentage of glands with different numbers of initial divisions. The studied morphometric parameters included the total number of glands, the length and width of their initial part. Methods of parametric statistics based on the Statistica 6.0 software were used for statistical data processing. Statistical data processing included the calculation of the arithmetic mean indicators, their errors, the analysis of the amplitude of the variation series of each indicator was carried out.Results. According to the results of the study, the number of glands in the walls of the common hepatic duct during postnatal ontogenesis was 1.30–1.84 times higher (p&lt;0.05) compared to the right hepatic duct and 1.39–2.13 times higher (p&lt;0.05) than the same indicator in the walls of the left hepatic duct. There was also a tendency according to which the size of the initial section of the glands of the common hepatic duct was larger than that of the right and left hepatic ducts. The minimum and maximum individual values of the total number of glands, the length and width of the initial section in the walls of the common hepatic duct were also higher in comparison with the analogous parameters of the right and left hepatic ducts.Conclusion. Age-related, regional and individual characteristics of the number and size of the glands of the hepatic ducts have been revealed; variants of the shape of the glands in different age periods have been determined, which is important not only for the development of a new scientific direction – morphological exocrinology, but also for gastroenterology, surgery of the extrahepatic biliary tract.

КОМОРБИДНАЯ ПАТОЛОГИЯ У ПАЦИЕНТОВ С БРОНХИАЛЬНОЙ АСТМОЙ: ОБЗОР ЛИТЕРАТУРЫ

The article contains a literature review that presents the results of studies of the prevalence of comorbidy in patients with bronchial asthma (BA), as well as the gender- and age-related characteristics of comorbidity in such patients. More than half of asthma patients suffer from the comorbid pathology, which negatively affects the clinical course of asthma, as well as the quality of life. The number of chronic comorbid diseases increases with age, on average to 5 comorbid conditions in BA patients aged 75 years and older. The most common diseases, the prevalence of which increases with age, are cardiovascular, ophthalmological and otolaryngological diseases and diseases of the musculoskeletal system. Female patients with BA, as a rule, are more likely to suffer from comorbid diseases, and on average have more comorbid pathologies than men. The comorbid diseases with the largest gender difference in prevalence are recurrent urinary tract infection, thyroid diseases, migraine and osteoporosis, which are prevalent in women. Among the factors and mechanisms influencing the presence and course of comorbid pathology in asthma patients, there are factors that have an effect before birth and during early childhood, systemic inflammation, hyperinsulinemia, leukotrienes and mitochondrial dysfunction. Despite the vast amount of data, research results are often quite contradictory; further investigations of the mechanisms underlying the relationship between comorbid pathology and asthma are necessary.

ВОЗМОЖНАЯ РОЛЬ ЭССЕНЦИАЛЬНЫХ ЭЛЕМЕНТОВ В ЭТИОПАТОГЕНЕЗЕ РАССТРОЙСТВ АУТИСТИЧЕСКОГО СПЕКТРА И ЗАДЕРЖКИ ПСИХОРЕЧЕВОГО РАЗВИТИЯ У ДЕТЕЙ РАЗНОГО ВОЗРАСТА

An imbalance of trace elements plays a significant role in the etiopathogenesis of Autism Spec-trum Disorder (ASD) and Speech Development Delay (SDD). The aim of the study was to analyze an essential trace elements content in the hair samples of children with ASD and SDD for better understanding age and gender related diversity. The study included 258 children with ASD and 239 children with SDD. Control group consisted of 620 healthy children of similar age. All children were divided into two age categories (1.5 to 3 years old and 4 to 13 years old). It was shown that girls with ASD had more deviations in hair essential trace elements levels than boys. Children with ASD and SDD (1.5 to 3 years old) had significantly decreased hair iodine level (by 48-58%, p &lt; 0.0001). Low iodine level can be a significant indicator of mental and speech development delay. Normalization of hair iodine level in older boys with ASD accompanied by significant decrease in hair cobalt level (by 24%, p = 0.0001) may reflect age-related characteristics of iodine and cobalt metabolism. Low hair manganese level (by 12-44%, p &lt; 0.05) was observed in all groups of children. It’s possibly associated with decreased manganese excretion from the body and can provoke manganese-induced neurotoxicity. The decrease in copper levels in girls of different ages (by 9-17%, p &lt; 0.01) is probably influenced by hormonal status and earlier onset of puberty.

COMPARATIVE CHARACTERISTICS OF THE PARAMETERS OF THE CEREBELLUM OF MEN AT A YOUNG AND OLD AGE ACCORDING TO MAGNETIC RESONANCE TOMOGRAPHY

Investigation which devoted to the study of the age characteristics of the human body are becoming increasingly important. Magnetic resonance tomography is the most informative diagnostic method for intravital visualization of tissues and structures of the brain. It also allows you to more accurately see the picture of morphological features with age-associated changes. The aim of the study was to carry out a comparative analysis of the age-related morphometric characteristics of the cerebellum in male with mesocranic type of cranium in young and old age according to the data of magnetic resonance tomography. The analysis of the results of a morphometric study of the cerebellum on tomograms of 91 men examined for medical reasons was carried out. Depending on the age, the subjects were divided into two groups. Group I included 52 young men (22–27 years old, inclusive), group II included 39 elderly men (from 78 to 83 years old, inclusive). The transverse, longitudinal and vertical dimensions of the cerebellum were determined. When comparing the parameters of the linear dimensions of the cerebellum in the studied age groups of men, a statistically significant decrease in all indicators in old age compared with young age was revealed (p=0.042). There was no statistically significant difference between the parameters of the longitudinal and vertical sizes of the cerebellar hemispheres in individuals of each age group (p&gt;0.05); there is a tendency for these sizes to prevail in the right cerebellar hemisphere. The results obtained can serve as the equivalent of the age-related anatomical norm of the cerebellum in young and old men, which will make it possible to use these data in basic and clinical research, as well as in medical practice.