Aggravating Factor Research Articles

In HIV-infected patients, intestinal bacteria-derived products interfere with CD4<sup>+</sup>T cell regeneration

Despite successful suppression of viral replication by antiretroviral drugs there is no significant increase in the number of peripheral CD4+T lymphocytes in some HIV-infected patients (immune nonresponse to therapy). One of the crucial factors for immunodeficiency aggravation is immune activation developing in response to the bacterial products entry into the bloodstream through the damaged intestinal barrier. Additionally, the intestinal microflora produces various solutes that accumulate in the blood and exhibit toxic properties. This work aimed to evaluate the effect of intestinal microbial products (para-cresol sulfate and indoxyl sulfate) on the number of CD4+T lymphocytes in HIV-infected patients receiving antiretroviral therapy. The object of the study was the peripheral blood of HIV-infected subjects with different immune system restoration efficiency during the therapy. Uninfected donors were enrolled as healthy controls. Plasma concentrations of IL-6 (p = 0.012), IP-10 (p = 0.0004), and sCD14 (p = 0.003) in HIV-infected immune nonresponders were increased compared with those in individuals with effective restoration of CD4+Tcells (immune responders). Although both groups of HIV-positive subjects did not differ in plasma lipopolysaccharide and I-FABP levels, para-cresol sulfate (p = 0.001) and indoxyl sulfate (p = 0.042) concentrations were increased in immune non-responders. In vitro experiments showed a negative dose-dependent effect of para-cresol sulfate and indoxyl sulfate on the viability and mitotic activity of CD4+T lymphocytes. Thus, in HIV-infected patients with impaired regeneration of CD4+T lymphocytes during antiretroviral therapy, a higher level of systemic inflammation is noted than in subjects responding to treatment with an increase in the number of CD4+T cells. The severity of the intestinal barrier damage and the load of bacterial components released into the bloodstream are approximately the same in HIV-infected individuals with different efficiency of immune recovery in response to treatment. Simultaneously, the blood plasma of immune non-responders is significantly enriched with microbial products of intestinal origin: para-cresol sulfate and indoxyl sulfate. The significant decrease in the proliferative capacity of CD4+T cells stimulated in vitro and the induction of their death in the presence of these toxins may be a reason for the ineffective restoration of the number of CD4+T lymphocytes in HIV-infected individuals receiving antiretroviral therapy.

Investigating the effects of structural parameters on seismic aggravation of two-dimensional sedimentary valleys

The valley-induced ground motion amplification has been well-documented and validated in previous studies, however, it remains challenging to fully integrate them into ground motion models, seismic hazard assessment, and engineering practice. In this paper, we first investigate the 2D seismic response in the Mygdonian basin, Greece, and compare the numerical results with comparable studies to validate the feasibility of our numerical toolbox in quantifying ground motion aggravation. In order to orientate towards more generally applicable conclusions rather than a site-specific, 32 idealized three-layered sediment-filled trapezoidal valleys are constructed with reference to the geological structure of the Mygdonian basin, aiming to explore the sensitivity of their additional effects attributes to the subsurface structure parameters of the valley. The half-width of the valley surface is divided into three subregions according to the wave propagation path, similar to the concept of seismic microzonation. The multivariate analysis reveals that the seismic response of each sub-region has differential or even diametrically opposite sensitivity to these structural parameters. The aggravation factor of the valley edge region shows a significant tendency to decrease with increasing edge angle, but poor sensitivity to the shape factor. On the contrary, the aggravation factor of the central region is positively correlated with the shape factor, but largely independent of the valley edge angle. Furthermore, we performed a quantitative statistical analysis and gave a simple correspondence between the seismic aggravation factor and structural parameters for different period intervals, which is an acceptable quantitative scheme from an engineering point of view.

MATERNAL DEATHS IN PUNJAB: A 3-YEAR AUDIT FROM A TERTIARY LEVEL GOVERNMENT INSTITUTE

Objective: This study aims to recognize the most common causes and delays in maternal death. Methods: This is an observational study from Government Medical College Amritsar from the period December 2017 to November 2020 which included all cases of maternal death irrespective of gestational age and up to 42 days postpartum. Results: Maternal mortality ratio in our institute during 3-year study period (2018–2020) was 1081 per 100,000 live births. About 90.9% of the maternal deaths were unregistered emergency cases, 11.7% were brought dead, and 33.8% deaths took place within 24 h of admission. Direct obstetric causes were the most common causes of maternal death (49%), while indirect causes were responsible for 42.8% deaths. Hypertensive disorders and hemorrhage were responsible for almost one third cases and severe anemia was an aggravating factor in 31.5%. Maternal deaths were associated with type 1 delay in 57.6%, type 2 delay in 9% cases, and type 3 delay in 21.2%. Conclusion: Hypertensive disorders of pregnancy and obstetric hemorrhage continue to be the leading threats to maternal lives. Improvement in public health services and special campaigns focusing on prevention of viral hepatitis and other infectious diseases can be helpful in decreasing maternal death due to indirect causes. Need of the hour is quality intrapartum and emergency obstetric care at first referral units. Indirect causes of maternal death are a significant public health issue which needs to be addressed.

Risk Factors for the Aggravation of Sagittal Balance After L5–S1 Posterior Lumbar Interbody Fusion

Retrospective comparative study OBJECTIVE: To identify the risk factors for the aggravation of sagittal alignment after single-level L5-S1 PLIF. Eighty-six patients who underwent L5-S1 PLIF were divided into two groups according to the postoperative changes in the segmental angle (SA; group I: increase; group D: decrease). The two groups were compared in terms of demographic, clinical, and radiological outcomes. Multivariate logistic regression analysis was performed to identify the risk factors for aggravation of sagittal alignment. Of the study patients, 39 (45%) were categorized as group I and 47 (55%) as group D. The demographic and clinical parameters were not significantly different between the two groups. Group D showed postoperative deteriorations in the local sagittal parameters, including lumbar lordosis (LL; p=.034), sacral slope (p=.012), and pelvic tilt (p=.003). In contrast, group I showed improved LL after surgery (p=0.021). Large preoperative values of lumbosacral angle (LSA; odds ratio [OR], 1.287; p=.001), SA (OR, 1.448; p<.001), and flexion LSA (OR, 1.173; p=.011) were independent risk factors for the aggravation of sagittal balance. Surgeons treating patients with large preoperative SA, LSA, and flexion LSA at L5-S1 level should be cautious of the possible aggravation of sagittal balance after L5-S1 PLIF and may consider different surgical approaches such as anterior or oblique lumbar interbody fusion.

Modern definitions of the depressive territories and the criteria of their definition

Transformation processes in the economy of Ukraine and its integration into the world economic space necessitate the elimination of asymmetry of socio-economic development of regions, which resulted in the aggravation of the emergence of depressed territories with low levels of financial support for their development. In this context, a feature of regional policy is its focus on overcoming the depressiveness of territories and addressing the most urgent financial support problems for developing these territories. The article aims to study the content and specifics of the definition of "depressed territory", to determine the characteristic features of a depressed territory and to identify the factors that aggravate the socio-economic problems of depressed territories in modern conditions. The article explores and analyzes scientific approaches to defining the concept of “depressed territory”. The genesis of the terms “depression” and “depressive” are examined to determine the essence of the concept of “depressed territory” as a specific object of study of the regional economy, and approaches to their definition are analyzed. Much attention is paid to identifying the characteristic features inherent in this type of territorial entity, in particular: disproportionality of development, lack of developed production, presence of problems of crisis nature, low level of budget financing, and absence of adequate incentives at the state level for intensifying their development. Based on the research, the factors of aggravation of socio-economic problems of depressed territories under current conditions of increasing regional disparities were determined. The problems of processes of origin, continuation, and termination of territorial depressions are among the most urgent in the economy. Depressed territories are always considered by scholars in close association with developed areas to determine the nature and level of interaction and development patterns. Thus, in examining states' economic growth, scientists are paying attention to depressed territories as a phenomenon that hurts this complex process. Keywords: depression, depressed region, depressed territory, criteria, socio-economic development.

Regulation of Renin Expression by Β1-Integrin in As4.1 Juxtaglomerular Line Cells

(1) Background: Renal dysfunction and hypertension are mutually aggravating factors; however, the details of their interaction remain unclear. In a study using renal tissue from diabetic rats, we found that β1-integrin, a cell-substrate adhesion molecule, is specifically phosphorylated in juxtaglomerular cells that secrete renin, a blood pressure regulator. (2) Methods: A mouse juxtaglomerular cell line (As4.1 cells) was used for the following experiments: drug-induced promotion of β1-integrin phosphorylation/dephosphorylation; knockdown of β1-integrin and the cell adhesion molecule connexin-40 (a candidate for the main body of baroreceptor); and pressurization to atmospheric pressure + 100 mmHg. culture in hypotonic liquid medium. The expression of renin under these conditions was measured by qRT-PCR. (3) Results: Phosphorylation of β1-integrin suppressed the expression of renin, while dephosphorylation conversely promoted it. β1-integrin and connexin-40 knockdown both promoted the expression of renin. Pneumatic pressurization and hypotonic medium culture both decreased the expression of renin, which was restored by the knockdown of β1-integrin. (4) Conclusions: β1-integrin plays an inhibitory role in the regulation of the expression of renin, which may be controlled by phosphorylation and dephosphorylation. It is hypothesized that β1-integrin and other adhesion factors regulate the expression of renin by altering the sensitivity of baroreceptors on the plasma membrane.

Predictable factors for aggravation of cervical alignment after posterior cervical foraminotomy.

This study aimed to investigate the risk factors for aggravation of cervical alignment after posterior cervical foraminotomy (PCF) and to identify their relationships with kyphotic changes in cervical curvature. Ninety-eight patients who underwent PCF for unilateral radiculopathy and received follow-up for more than 2 years were retrospectively reviewed. Segmental Cobb angle (SA), cervical Cobb angle (CA), Pfirrmann grade, foraminal stenosis, and clinical outcomes including neck pain, arm pain, and Neck Disability Index scores were assessed. Radiological and clinical outcomes were compared between groups C (control group with kyphotic change in CA < 5°) and K (kyphotic group with kyphotic change in CA ≥ 5°). Multivariate regression analysis was performed to determine the risk factors for kyphotic change ≥ 5° after PCF. Group K was significantly older than group C (p = 0.002) and had a higher Pfirrmann grade (p = 0.025). In group K, neck pain had significantly increased at last follow-up (p < 0.001). Multivariate linear regression analysis revealed that kyphotic changes in CA were related to older age (p = 0.016, B = 0.420) and Pfirrmann grade of the operative levels (p = 0.032, B = 4.560). Preoperative hypolordosis was not an independent risk factor for kyphotic changes in CA. Receiver operating characteristic curve analysis showed that the cutoff value for kyphotic changes in patients with CA ≥ 5° was Pfirrmann grade 3.417 (p = 0.008). Contrary to previous studies, preoperative hypolordosis was not a risk factor for kyphotic changes in CA after PCF. Older patients with disc degeneration of Pfirrmann grade IV or greater for should be carefully considered.

Electricity Production and Sustainable Development: The Role of Renewable Energy Sources and Specific Socioeconomic Factors

An eco-friendly and sustainable power production system constitutes the cornerstone of every country’s strategic plan to tackle climate change and enhance energy resource autonomy. Carbon dioxide abatement in electricity generation, in addition to being a necessary condition for t “green” energy transition, can contribute greatly to cleaner industrial production and sustainable development. Emphasizing this key role of the power sector, the present research focuses on shedding light on the impact of renewable energy resources (RES), per capita gross domestic product (GDP), electricity gross fixed capital formation (GFCF) and urbanization in the CO2 intensity, and the sustainability level of electricity production. The analysis is based on a comprehensive dataset of 31 countries including 26 European countries, U.S.A., Japan, Australia, Canada, and New Zealand from 1995 until 2018. The econometric outcomes revealed the strong statistical significance of all variables and a plethora of causality relationships, upon which several policy suggestions are made. Interestingly, GDP per capita beyond a certain level can gradually become an aggravating factor for the electricity carbon footprint. Similarly, the vital role of RES in clean electricity production was confirmed as expected, yet surprisingly, this effect also appears to reverse after a certain percentage of total RES reliance. In contrast to urbanization, the electricity GFCF parameter is estimated to have an adverse effect on electricity CO2 intensity, indicating that the vast amount of new investments in the power sector concerns carbon-intensive technologies. Finally, a dynamic analysis is carried out, revealing to policy makers the necessary time frame after which the implementation of new energy policies can have the full impact on the carbon emissions of electricity generation.

New views on pathogenesis and diagnosis of peritoneal carcinomatosis

Peritoneal metastasis occurs in a number of heterogeneous tumors originating from the ovaries, stomach, intestines, pancreas, lungs, breast, and melanoma. Peritoneal carcinomatosis significantly reduces overall survival. While being almost unresponsive to treatment, dissemination of tumor cells along the peritoneum aggravates the course of the disease. Despite the use of locoregional treatment, peritoneal carcinomatosis is still considered to be an aggravating factor with a poor prognosis. Peritoneal carcinomatosis cannot be defined as a separate locoregional process with its own biology and oncogenesis due to the lack of clear understanding the molecular and biological features of peritoneal metastasis, as well as generally recognized standards for diagnosis and treatment of malignant neoplasms with various localizations. Addressing peritoneal carcinomatosis as a separate developing molecular event will enhance the understanding of its morpho- and oncogenesis and strengthen the search for therapeutic, diagnostic and preventive approaches to its management. Th e paper presents a bibliographic study of publications on exploring peritoneal metastases from various sites, including the abdominal and pelvic organs. Th e known mechanisms of tumors metastasis to the peritoneum are characterized in the paper. Diagnostic approaches to peritoneal carcinomatosis were assessed and compared. Th e collected data analysis revealed the main gaps in the understanding of peritoneal carcinomatosis oncogenesis.

A study of clinical profile of 100 icteric leptospirosis cases

Background: Leptospirosis is a widespread zooanthroponosis prevalent in tropical regions due to its etiologic agent's favorable environmental survival conditions. The disease has protean clinical manifestation. The present study was conducted to describe clinical signs, symptoms, and outcomes in severe icteric leptospirosis cases. Materials and Methods: This observational study was carried out in Surat from r 2012–2014. A total of 100 confirmed cases of icteric Leptospirosis was included in the study. Clinico-socio-demographic profile of the cases was noted. The symptoms and signs were described. The clinical outcome was described in terms of laboratory and other findings. Results: Fever was seen as the most common presenting symptom in 100% patients. Icterus (100%) crepts (86%) and tachypnea (80%) were the most common presenting signs. Breathlessness and hemoptysis were significantly more common in nonsurvivors than survivors. Mortality was more common in cases who had not taken chemoprophylaxis, platelet count <50,000/mm3, serum creatinine more than three mg%, international normalized ratio less than two, and multiorgan dysfunction. Conclusion: The study brought out common sign and symptoms of icteric leptospirosis. Sociodemographic and clinical parameters associated with poor outcome were also delineated. Smoking and alcohol seemed to be important contributory factors in aggravation of the disease. Chemoprophylaxis was preventive in adverse outcome. The clinical parameter may help in prediction of the course of the disease.

Correlation Between Total Bilirubin, Total Bilirubin/Albumin Ratio with Disease Activity in Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic inflammatory disorder with unknown etiology. Oxidative stress and immune imbalance play a critical role in the pathogenesis of rheumatoid arthritis. Bilirubin has recently been recognized as a potent antioxidant as well as an immunomodulatory agent of physiological importance. The aim of this study was to explore whether increased bilirubin concentrations are correlated with good clinical prognosis of rheumatoid arthritis. In this cross-sectional study, we included 197 healthy individuals and 197 RA patients in the Affiliated Hospital of North Sichuan Medical College from October 2020 to February 2022. The latter were classified into three classes of disease activity according to DAS28-ESR: remission and low (DAS28-ESR<3.2), moderate (3.2≤DAS28-ESR≤5.1), and high (DAS28ESR>5.1). Based on the clinical and laboratory data, we evaluated the association of bilirubin levels with disease activity in RA using multivariable ordered logistic regression. The levels of total bilirubin and total bilirubin/albumin ratio were significantly lower (P < 0.001; P < 0.001) in RA patients compared with healthy controls. In RA patients, Spearman's rank correlation analysis revealed that bilirubin and total bilirubin/albumin ratio were negatively correlated with disease activity and inflammatory marker (C-reactive protein, erythrocyte sedimentation rate, Interleukin-6). In multivariable ordered logistic regression, higher total bilirubin (OR=0.77, 95% CI: 0.67-0.89, p<0.001) independently predicted lower disease activity. Bilirubin levels remain associated with a reduction of disease activity, suggesting that bilirubin may be a protective factor for RA aggravation.

Association between vaccination status and severe health consequences among community-dwelling COVID-19 patients during Omicron BA.1/BA.2 and BA.5-predominant periods in Japan.

Many previous studies have reported that COVID-19 vaccine effectiveness decreased over time and declined with newly emerging variants. However, there are few such studies in Japan. Using data from a community-based retrospective study, we aimed to assess the association between vaccination status and severe COVID-19 outcomes caused by the Omicron variant, considering the length of time since the last vaccination dose. We included all persons aged ≥12 diagnosed with COVID-19 by a doctor and notified to the Chuwa Public Health Center of Nara Prefectural Government during the Omicron BA.1/BA.2 and BA.5-predominant periods in Japan (January 1 to September 25, 2022). The outcome variable was severe health consequences (SHC) (i.e., COVID-19-related hospitalization or death). The explanatory variable was vaccination status of the individuals (i.e., the number of vaccinations and length of time since last dose). Covariates included gender, age, risk factors for aggravation, and the number of hospital beds per population. Using the generalized estimating equations of the multivariable Poisson regression models, we estimated the cumulative incidence ratio (CIR) and 95% confidence interval (CI) for SHC, with stratified analyses by period (BA.1/BA.2 or BA.5) and age (65 and older or 12-64 years). Of the 69,827 participants, 2,224 (3.2%) had SHC, 12,154 (17.4%) were unvaccinated, and 29,032 (41.6%) received ≥3 vaccine doses. Regardless of period or age, there was a significant dose-response relationship in which adjusted CIR for SHC decreased with an increased number of vaccinations and a longer time since the last vaccination. On the one hand, in the BA.5 period, those with ≥175 days after the third dose had no significant difference in people aged 65 and older (CIR 0.77; 95% CI, 0.53-1.12), but significantly lower CIR for SHC in people aged 12-64 (CIR 0.47; 95% CI, 0.26-0.84), compared with those with ≥14 days after the second dose. A higher number of vaccinations were associated with lower risk of SHC against both BA.1/BA.2 and BA.5 sublineages. Our findings suggest that increasing the number of doses of COVID-19 vaccine can prevent severe COVID-19 outcomes, and that a biannual vaccination is recommended for older people.

Association between vaccination status and COVID-19-related health outcomes among community-dwelling COVID-19 patients in Nara, Japan

Many previous studies have reported COVID-19 vaccine effectiveness, but there are few studies in Japan. This community-based, retrospective observational study investigated the association between vaccination status and COVID-19-related health outcomes in COVID-19 patients by SARS-CoV-2 variant type. The study participants were 24,314 COVID-19 patients aged 12 or older whose diagnoses were reported to the Nara Prefecture Chuwa Public Health Center from April 2021 to March 2022, during periods when the alpha, delta, and omicron variants of COVID-19 were predominant. The outcome variables were severe health consequences (SHC) (i.e., ICU admission and COVID-19-related death), hospitalization, and extension of recovery period. The explanatory variable was vaccination status at least 14 days prior to infection. Covariates included gender, age, population size, the number of risk factors for aggravation, and the number of symptoms at diagnosis. The generalized estimating equations of the multivariable Poisson regression models were used to estimate the adjusted incidence proportion (AIP) and 95% confidence interval (CI) for each health outcome. We performed stratified analyses by SARS-CoV-2 variant type, but the association between vaccination status and COVID-19-related health outcomes was stratified only for the delta and omicron variants due to the small number of vaccinated patients during the alpha variant. Of the 24,314 participants, 255 (1.0%) had SHC; of the 24,059 participants without SHC, 2,102 (8.7%) were hospitalized; and of the 19,603 participants without SHC, hospitalization, and missing data on recovery period, 2,960 (15.1%) had extension of recovery period. Multivariable Poisson regression models showed that regardless of SARS-CoV-2 variant type or health outcome, those who received two or more vaccine doses had significantly lower risk of health outcomes than those who did not receive the vaccine, and there was a dose-response relationship in which the AIP for health outcomes decreased with an increased number of vaccinations. A higher number of vaccinations were associated with lower risk of COVID-19-related health outcomes, not only in the delta variant but also in the omicron variant. Our findings suggest that increasing the number of COVID-19 vaccine doses can prevent severe disease and lead to early recovery of patients not requiring hospitalization.

Factors Predisposing and Triggering the Phenomenon of Shrinkage-Swelling of Clay Soils in the Urban Center of Diamniadio

The phenomena of shrinkage and swelling of clay induce damage to housing structures every year. Precipitation, climatic changes and drought are the cause of wall cracks due to subsidence or swelling of the supporting soil. This movement alters the balance between the soil and the structures. To explain this defection, the soil is made up of three elements: the solid, the liquid and the gas. Sometimes in a natural way or following a human intervention, one of these elements undergoes an abnormal variation that causes the loss of the balance between land and works. It is in this sense that this article deals on the one hand with the factors of predisposition and triggering of the phenomena of shrinkage-swelling of the clay soils of Diamniadio and on the other hand, the factors of aggravation linked to the lithological heterogeneity and the variation in the thickness of the layers susceptible to shrinkage-swelling. The studies carried out have enabled a deeper understanding of the behavior of expansive soils following their interactions with climate, vegetation, hydrology, hydrogeology, constructions among others, but also the influence of lateral and vertical variations of fine soil facies.

Role of Leptin as a Link between Asthma and Obesity: A Systematic Review and Meta-Analysis.

Asthma and obesity are considered as highly prevalent diseases with a great impact on public health. Obesity has been demonstrated to be an aggravating factor in the pathogenesis of asthma. Adipose tissue secretes proinflammatory cytokines and mediators, including leptin, which may promote the development and severity of asthma in obese patients. This study is a systematic review and a meta-analysis based on the relationship between leptin and asthma during obesity. MEDLINE, Cochrane, EMBASE and CINAHL databases were used. Data heterogeneity was analyzed using Cochran's Q and treatment effect with the DerSimonian and Laird method. Random effect analyses were carried out to test data sensitivity. Asymmetry was estimated using Begg's and Egger's tests. All studies showed significant differences in leptin levels. The effect of the measures (p &lt; 0.001), data sensitivity (p &lt; 0.05) and data asymmetry were statistically significant, as well as tBegg's test (p = 0.010) and Egge's test (p &lt; 0.001). Despite the existing limiting factors, the results of this study support the relevant role of leptin in the pathophysiology of asthma in obese subjects. Nevertheless, further studies are needed to obtain better insight in the relationship between leptin and asthma in obesity.

Veno-venous extracorporeal membrane oxygenation, cytokine removal and continuous renal replacement therapy in a severe burn adult patient.

Acute respiratory distress syndrome (ARDS) can develop early in burn patients with inhalation injury in the presence of cytokine storm and the proinflammatory response can be a supplemental factor for ARDS aggravation. We report the case of a 41-years old male with 25% total body surface area deep partial thickness burns to upper body extremity and grade II inhalational injury who developed severe ARDS, nosocomial pneumonia, and septic shock. Veno-venous extracorporeal membrane oxygenation (VV ECMO) and continuous renal replacement therapy (CRRT) with hemoadsorption were successfully used at different moments to overcome critical situations. Although debatable, the use of ECMO in burn patients with severe ARDS could be considered when conventional treatment fails. The use of CRRT combined with hemoadsorption may limit the proinflammatory response sustained by the combination between major burn, ECMO and sepsis.

The Impact of Common Acne on the Well-Being of Young People Aged 15-35 Years and the Influence of Nutrition Knowledge and Diet on Acne Development.

Acne is a disorder of sebaceous glands, and it most commonly develops on the face. The role of the diet in triggering and treating acne is controversial and has been widely debated in the literature. A knowledge of the environmental factors that contribute to acne could improve the patient's physical and emotional well-being, increase the efficacy of treatment, and minimize the risk of anxiety and depressive disorders. The aim of this study was to assess the impact of acne on the daily lives and well-being of people aged 15-30 years, to analyze young people's knowledge about the influence of various foods and other dietary factors on the prevalence, severity, and treatment of acne, as well as their adherence to an anti-acne diet. The study was conducted between April 2021 and May 2022. A total of 1329 respondents, including 963 women and 366 men, participated in the study. In 99% of men and women respondents, acne breakouts were typically located on the face. An analysis of HADS scores revealed moderate anxiety in 57% of women (F) and 22.5% of men (M) respondents. Acne breakouts located on the face were problematic for 81% of the study population (regardless of sex). More than ¾ of women and 2/3 of men claimed that acne made them feel less attractive. The impact of acne on the participants' emotional well-being and social life differed between genders. Women experienced psychological discomfort more frequently than men (p = 0.0023). More than 50% of the participants eliminated acne-triggering foods from their diets, and 2/3 of these respondents observed a marked improvement or disappearance of skin breakouts as a result. A significantly higher number of respondents with severe/moderate anxiety were convinced that acne breakouts were affected by diet (OR 1.56; 95% CI 1.23-1.87, p &lt; 0.001) and foods with a high glycemic index (OR 1.56; 95% CI 1.23-1.94, p &lt; 0.001). Acne affects the patients' emotional well-being. It can act as a barrier to social interactions and lead to mood disorders of varied severity. Persons with moderate/severe mood disorders associated with anxiety significantly more often recognized the role of dietary factors in acne aggravation, and the severity of mood disorders was directly correlated with more frequent consumption of sweets, sweetened beverages, and foods with a high glycemic index.

NAFLD and HBV interplay - related mechanisms underlying liver disease progression.

Non-alcoholic fatty liver disease (NAFLD) and Hepatitis B virus infection (HBV) constitute common chronic liver diseases with worldwide distribution. NAFLD burden is expected to grow in the coming decade, especially in western countries, considering the increased incidence of diabetes and obesity. Despite the organized HBV vaccinations and use of anti-viral therapies globally, HBV infection remains endemic and challenging public health issue. As both NAFLD and HBV have been associated with the development of progressive fibrosis, cirrhosis and hepatocellular carcinoma (HCC), the co-occurrence of both diseases has gained great research and clinical interest. The causative relationship between NAFLD and HBV infection has not been elucidated so far. Dysregulated fatty acid metabolism and lipotoxicity in NAFLD disease seems to initiate activation of signaling pathways that enhance pro-inflammatory responses and disrupt hepatocyte cell homeostasis, promoting progression of NAFLD disease to NASH, fibrosis and HCC and can affect HBV replication and immune encountering of HBV virus, which may further have impact on liver disease progression. Chronic HBV infection is suggested to have an influence on metabolic changes, which could lead to NAFLD development and the HBV-induced inflammatory responses and molecular pathways may constitute an aggravating factor in hepatic steatosis development. The observed altered immune homeostasis in both HBV infection and NAFLD could be associated with progression to HCC development. Elucidation of the possible mechanisms beyond HBV chronic infection and NAFLD diseases, which could lead to advanced liver disease or increase the risk for severe complications, in the case of HBV-NAFLD co-existence is of high clinical significance in the context of designing effective therapeutic targets.

Working conditions and their hygienic assessment in multidisciplinary medical organizations

At present, one of the main tasks of the state and society is preservation and strengthening of the health of the able-bodied population. Employees of medical organizations are exposed to the combined effects of a significant number of harmful production and professional factors. In particular, the factors of the working environment include biological, chemical, and physical factors, while those of the labor process involve tension and severity. Therefore, the study of working conditions of medical personnel is a priority in occupational health. The purpose of the study is to analyze the working conditions of employees of medical organizations and iden tify priority production-related and occupational pathologies arising from the impact of unfavorable production and occupational factors in order to develop preventive measures. Materials and methods. The object of the study was 1,443 reports of the special assessment of working conditions. We carried out our own studies of the parameters of the microclimate and lighting in the premises: the number of measurements was 5,398, measurements were carried out in 60 premises of medical organizations, and 727 air samples were taken to determine the microbial load. Results. According to the studies of the conditions and nature of work at the workplaces of medical workers in the examined medical organizations and according to the results of a special assessment of working conditions and our own research, the conditions corresponded to a harmful class of 1–3 degrees and of the 4th degree for workers of the oncological hospital. The level of maximum microbial load in the doctors' lounges and nursing rooms increased by the middle of the work shift and remained high until the end of the working day. Since the air movement speed in the studied rooms was very low, this criterion may be a risk factor for aggravation of the course of general somatic pathologies and, as a result, the development of work-related morbidity in medical workers. It can also be noted that fungi were found in 100 % of samples, with their number decreasing by the end of the work shift, while the number of the genus Staphylococcus representatives, on the contrary, tended to increase by the end of the working day. Conclusion. According to the results of the special assessment of working conditions, the conditions and nature of the labor of medical workers in the studied medical organizations corresponded to the harmful class of 1–4 degrees. The 4th degree of the 3rd class of working conditions was due to the personnel’s work with cytostatic drugs. Microclimatic parameters corresponded to hygienic standards (at low air speeds). Fungi and representatives of the genus Staphylococcus were found in 100 % of air samples. A detailed study of the species identification of micromycetes in the indoor air showed that the number of Penicillium and Aspergillus micromycetes significantly exceeded the number of other species.

HIV Infection Induces Aberrant Myeloid Lineage Differentiation

AbstractIntroduction: Numerous studies on hematopoietic changes caused by HIV infection have focused on immune cell depletion, while research on other hematopoietic lineages development have been sparse and inconclusive. In this study, we used precise markers to detect changes in the distribution of bone marrow hematopoietic stem/progenitor cells in HIV-infected patients and analyzed the dynamic changes of mature cells of each lineages in 782 patients with disease progression. Furthermore, we sought to explore the potential relationship between abnormal development of these lineage cells and survival of HIV patients. Our study provides evidence for a more comprehensive understanding of the effects of HIV on hematopoiesis. Methods: We included 782 HIV-infected patients who underwent bone marrow aspiration from January 2016 to October 2020 in Zhongnan Hospital, and were followed up until January 2022. Examination including flow cytometry and bone marrow aspiration were performed to detect the development of hematopoietic cells. 509 cases were tested for lymphocyte subsets. According to CD3+CD4+ cell count, 325 patients (63.9%) were in the very low group, 61 patients (12.0%) in the low group, 55 patients (10.8%) in the medium group, and 68 patients (13.4%) in the high group. By January 2022, 84 patients had been lost to follow-up and 425 patients had accurate and complete follow-up data. We analyzed the risk factors for HIV death in 425 patients and established a predictive model. Results: Flow cytometry analysis showed an increased proportion of granulocytemonocyte progenitors (GMP) but a decreased proportion of common lymphoid progenitors (CLP) in HIV patients. In myelogram, the percentage of granulocytes and granulocytes/erythroid cells (G/E) increased with the decrease of CD3+CD4+ count (both P<0.001). In addition to the increase in cell proportion, we also observed that the morphologic abnormalities in granulocyte increased with the progression of the disease, including toxic granulation, cytoplasmic vacuolization, Intracellular and extracellular plasma (P<0.001), Döhle bodies (P=0.033) and increased lobulation in megakaryocyte (P=0.048). Subsequent LASSO binary logistic regression also confirmed that the increased granulocyte ratio was an important factor in patients' disease. Conclusion: HIV infection directly or indirectly induces bias on myeloid lineage differentiation. Increased granulocyte ratio is an important risk factor for disease aggravation and death in HIV patients. Our research provide a new perspective for evaluating the status and prognosis of HIV patients by focusing on the changes of myeloid granulocytes. Disclosures No relevant conflicts of interest to declare.