Subgroup 1B Research Articles

Appraisal of vitreous syphilis antibody as a novel biomarker for the diagnosis of syphilitic uveitis: a prospective case-control study.

To determine the sensitivity and specificity of syphilis antibody tests in vitreous samples and to propose an algorithm using vitreous syphilis antibody as a supplementary test to confirm syphilitic uveitis (SU). A prospective case-control study was conducted at the Retina and Uveitis Clinic from May 2017 to January 2020. Initially, patients were classified based on syphilis serology into group 1 (positive testing) and group 2 (negative testing). Group 1 was further divided into 2 subgroups (group 1A and 1B) depending on their relevant clinical manifestations and clinical improvement. Group 2 served as a control group. Thirty-eight patients were enrolled in the study: 14 in group 1A, 5 in group 1B, and 19 in group 2B. No patient was assigned to group 2A. All patients in group 1A, representing definite SU, completed syphilis test (rapid plasma reagin [RPR], enzyme immunoassay [EIA], and fluorescent treponemal antibody-absorption [FTA-ABS]) for vitreous, and all vitreous samples yielded positive results. Of the 5 subjects in group 1B, 3 cases were considered to be not SU with different conditions, and 2 were indeterminate for SU. They presented with different features not typical of SU, and they had variable and fewer positive syphilis antibody responses. The most sensitive test for detecting syphilis antibodies in vitreous was EIA (90.9%), followed by RPR (80.0%) and FTA-ABS IgG (78.9%). EIA and FTA-ABS had the highest specificity, detecting 100% of the syphilis antibody. Vitreous analysis of syphilis antibody can serve as a supplementary test to confirm SU in selected cases as the proposed algorithm.

Анализ течения и исходов родов у пациентов высокого риска по пренатальному скринингу

Objective. To study the course and outcome of labor in patients who are at high risk of pre-eclampsia (PE), fetal growth restriction (FGR), preterm birth (PB), and fetal chromosomal abnormalities (CA) according to the results of prenatal screening. Patients and methods. We performed a prospective analysis of the course of labor in 443 women with singleton pregnancy who underwent the first trimester prenatal risk assessment based on the Astraia program. Group 1 (n = 235) included highrisk subgroups for CA – 1A (n = 69); PE – 1B (n = 66); FGR – 1C (n = 48); PB – 1D (n = 52). Risk combinations were excluded, and one of the four assessed outcomes was considered. Group 2 (control group, n = 208) was comprised of lowrisk women. Results. The risk of PB (>34 and <37 weeks) was higher in group 1 than in group 2 (р < 0.05). Full-term birth in both groups had no differences (р > 0.05). Post-term birth was more common in group 2 (р < 0.05). Labor induction prevailed in group 1 and subgroups 1B, 1C (р < 0.05). Labor complications were more common in group 1 (р < 0.05). Prelabor rupture of membranes was more frequent in the subgroups 1B and 1D of group 1 (р < 0.05). Fetal distress and a combination of complications (distress, weak contractions, and rupture of membranes) prevailed in group 1 (p < 0.05). Cesarean section was performed more frequently in group 1 than in group 2 (р < 0.05). Indications in group 1 were placental insufficiency (PI) and PE (р < 0.05). The dif-ference in the frequency of PI between subgroups 1C and 1B was significant relative to 1A, 1D (р < 0.05). Fetal distress was noted in one third of both groups and subgroup 1C (р > 0.05). Conclusion. In the high-risk group based on the results of prenatal screening compared with the control group, there was a significantly higher frequency of prelabor rupture of membranes (in subgroups 1B (PE), 1D (PB)), fetal distress, and a combination of complications, as well as cesareans delivery (subgroups 1B (PE) and 1C (FGR)) (р < 0.05). Key words: fetal distress, labor induction, labor complications, prenatal screening, risk level

Новые возможности терапии экссудативного среднего отита у детей

Anti-inflammatory therapy for otitis media with effusion (OME) in patients with chronic diseases of the Waldeyer's tonsillar ring is a key stage of treatment. Patients and methods. This observational study included 85 patients. Group 1 comprised 50 OME patients with grade I–II pharyngeal tonsil hypertrophy who were further divided into two subgroups: 1A (n = 30) and 1B (n = 20). Group 2 involved 35 OME patients on the second day after adenectomy; they were divided into subgroups 2A (n = 20) and 2B (n = 15). Children in subgroups 1A and 2A received standard OME therapy plus ammonium glycyrrhizinate (AG) for 30 days, whereas children in subgroups 1B and 2B received standard OME therapy alone. Results. Patients from the experimental subgroups (1A and 2A) who received AG demonstrated significantly lower VAS scores of both auditory symptoms (hearing loss and congestion/noise in the ear) and initial manifestations (rhinorrhea and nasal congestion) already by first follow-up visits compared to controls (subgroups 1B and 2B). Maximum differences were observed on day 30: the severity of symptoms in children from group 1A was 2.5 times lower than in children from subgroup 1B; patients from subgroup 2A also demonstrated a 2-fold reduction in symptom severity compared to children from subgroup 2B (p < 0.05). Tympanometry showed that 90% of patients in the experimental subgroups (1A and 2A) had complete restoration of auditory tube function by day 30, while in control subgroups 1B and 2B, the proportion of such patients was significantly lower (55% and 73%, respectively). Audiometry results suggest that complete hearing restoration by day 30 was more frequent in patients receiving AG than in controls (1A and 1B: 94% vs 70%; 2A and 2B: 100% vs 80%). Patients of the experimental subgroups were more satisfied with treatment results. Conclusion. The inclusion of AG into the treatment scheme for OME and auditory tube dysfunction after elective adenectomy increases treatment efficacy by normalizing drainage and ventilation functions of the middle ear, elimination of exudate, and ensuring hearing restoration. Key words: otitis media with effusion, children, auditory tube, Waldeyer's tonsillar ring, hearing loss, impedance audiometry, ammonium glycyrrhizinate

MORPHOLOGICAL AND IMMUNOHISTOCHEMICAL FEATURES OF PLACENTAL DAMAGE DUE TO THE INCORPORATION OF 137Cs.

to investigate the morphological and immunohistochemical features of placental damage due to theincorporation of 137Cs depending on the scenario of pregnancy completion. The study material consisted of placentas from 60 women with reproductive losses inanamnesis and signs of termination of the current pregnancy (first group) and placental samples from 30 women with an uncomplicated gestation and an unencumbered anamnesis (control group). The detailed study required the distribution of placental samples from the first group into subgroups. Subgroup 1a included 38 placentas from women who gave birth at 37-40 weeks, despite signs of termination of the current pregnancy. Subgroup 1b - placentas of 13 women who gave birth at a gestation period of 28-36 weeks + 6 days. Subgroup 1c - 9 placental samples from women who gave birth at a gestation period of 22-27 weeks + 6 days. The volumetric activity of the 137Cs in the placentas was measured using β-spectrometer. The histology of the placenta was studied using a standard technique. The following expressions were studied in placenta: CD31 / PECAM-1, CD45 / T200 / LCA, CD56 / NCAM-1, CEA / CD66e Ab-2, Vimentin, using indirect streptavidin peroxidase detection method. Placentas accumulate 137Cs. The different volumetric activity of the isotope correlates with scenarios of pregnancy. Due to the action of incorporated 137Cs with a specific mass of more than 1.1 Bq/kg, placental dysfunction develops. The consequences of placental dysfunction depend on the volumetric activity of the 137Cs and the preservation of adaptive and compensatory reactions in the placenta. Morphological and immunohistochemical features of placental damage to incorporated 137Cs were established, depending on the scenario of completion of pregnancy. A marker of unfavorable completion of pregnancy is the expression of a carcinoembryonic antigen (CEA) in the placenta. Premature termination of pregnancy (PTP) is a multifactorial pathology associated with pathological changes in immune and neuroendocrine regulation and hereditary, infectious, and environmental factors that disrupt the adaptation mechanisms in the mother-placenta-fetus system. Intraplacental irradiation of 137Cs is one of the factors in the multifactorial nature of reproductive losses. As a result of intraplacental irradiation of 137Cs, the architecture of the placenta is disturbed, the activity of pro-inflammatory cytokines CD45 and CD56 increases, and the coagulation cascade is activated. Extreme effects depend on the volumetric activity of the isotope incorporated in the placenta and the organ's compensatory capacity. Accumulation of up to 1.0 Bq/kg 137Cs does not affect the course of gestation. Internal irradiation with an activity of 4.5-10.4 Bq/kg 137Cs triggers late preterm labor. The nature of the damages corresponds to the category of «lesion of the maternal stroma» of the placenta. The volumetric activity of 137Cs over 10.4 Bq/kg is a probable cause of early preterm labor and antenatal fetal death. At the same time, the maternal and fetal structures of the placenta suffer damage. Expression of vimentin is a marker of placental destruction due to internal irradiation of 137Cs with a specific gravity of more than 4.5 Bq/kg. Expression of CEA in the structures of the placenta of women with PTP is a unique find and marker of premature birth and antenatal fetal death with intraplacental irradiation of 137Cs with an activity of more than 4.5 Bq/kg.

Intravitreal Injection for Diabetic Macular Edema as Adjunctive Therapy for Proliferative Diabetic Retinopathy: A Retrospective Study.

PurposeTo detect the impact of intravitreal injection (IVI) therapy with sole anti-vascular-endothelial-growth-factor (VEGF) or combined with steroids treating diabetic macular edema (DME) on activity of proliferative diabetic retinopathy (PDR) based on total number of panretinal photocoagulation (PRP) spots needed within 2 years.Patients and MethodsA retrospective study of 102 eyes with primary-onset PDR and minimum follow-up of 24 months divided into 2 groups: Group 1 (G1) 40 eyes received only PRP and did not develop DME. Group 2 (G2) 62 eyes received additional IVI-therapy due to concomitant DME, with anti-VEGF only (subgroup 2a, G2a) or in combination with steroids (subgroup 2b, G2b). Main outcomes: central macular thickness (CMT, µm), best-corrected visual acuity (BCVA, LogMAR) and total number of needed PRP spots and IVI after 24 months.ResultsCMT was significantly higher in G2 compared to G1, initially (p < 0.01) and after 24 months (p = 0.01). CMT was significantly higher in G2b compared to G2a, both initially (p = 0.01) and after 24 months (p < 0.01). BCVA was significantly higher in G1 compared to G2, initially and after 24 months (p = 0.01). BCVA was not significantly different between the two subgroups, initially (p = 0.54) and after 24 months (p = 0.29). The total number of PRP spots was significantly higher in G1 compared to G2 (p < 0.01) but not significantly different between the subgroups (p = 0.8).ConclusionRegardless of severity of concomitant DME, IVI with sole anti-VEGF or combined with steroids reduced the total number of PRP spots needed within 2 years significantly indicating a favorable effect on activity of PDR.

Клинические проявления постковидного синдрома

Aim: to assess the prevalence of various clinical manifestations in COVID-19 survivors, depending on the time interval after the disease, clinical severity, and the presence of polymorbidity. Patients and Methods: the study included 253 patients (187 females and 66 males), 18–85 years old, who survived COVID-19. The patients were split into two groups based on the disease severity during the acute phase: group 1 consisted of patients with mild COVID-19 illness (n=133); group 2 consisted of patients with moderate and severe COVID-19 illness (n=120). In addition, patients of each of the groups were divided into two subgroups, depending on the time elapsed from the acute phase of COVID-19 illness: in subgroups A the health assessment of patients was performed within 3 months (12 weeks) after the acute phase of the diseases and in subgroups B — 3 months (12 weeks) after the disease, i.e. the time interval ranged from 3 months to one year after COVID-19 illness. A multi-stage phone interview of the patients was used to reveal the presence of symptoms. Also, outpatient medical records of those patients who addressed therapists or narrow specialists, were reviewed. Results: symptoms were revealed both in patients of subgroup 1A (45/52 (86.5%)) and subgroup 2А (42/45 (93.3%)), or, in other words, the symptoms were absent in 7 (13.5%) and 3 (6.7%) patients, respectively. Three months after COVID-19 illness, the symptoms were absent in 34 (42%) patients of subgroup 1B and in 13 (17.3%) patients of subgroup 2B (p&lt;0.001), while at least one symptom persisted in 47/81 (58%) patients of subgroup 1B and 62/75 (82%) patients of subgroup 2B. In both patient groups the most common symptoms comprised fatigue, shortness of breath, and cough. In group 2 patients central nervous and cardiovascular system consequences and arthralgia were frequently reported. The prevalence of comorbidities was higher in group 2 patients than that in group 1 patients, and the difference was statistically significant (p &lt; 0.01). Conclusions: the development of post-COVID-19 syndrome does not depend on the illness severity during the acute phase, and it may occur both in mild and moderate or severe cases. However, in the latter category the patients will have more symptoms. In patients recovered from COVID-19, most of the disease sequela were revealed in central nervous, bronchopulmonary, and cardiovascular systems. Comorbidities are associated with the severity of the novel coronavirus disease during the acute phase. COVID-19 survivors need follow-up care during the first three months after the acute phase and in the later period which should be provided by multidisciplinary team of specialists for achieving complete recovery of the patients’ health and improving the quality of life. KEYWORDS: coronavirus infection, COVID-19, post-COVID-19 syndrome, comorbidities, central nervous system disorders, bronchopul - monary system disorders, cardiovascular system disorders. FOR CITATION: Asfandiyarova N.S., Filippov E.V., Demikhov V.G. et al. Clinical manifestations of post-COVID-19 syndrome. Russian Medical Inquiry. 2022;6(11):612–617 (in Russ.). DOI: 10.32364/2587-6821-2022-6-11-612-617.

Experimental studies on risk factors of necrotizing enterocolitis

Introduction. Necrotizing enterocolitis (NEC) is one of the most life-threatening conditions in the neonatal period. This disease is considered to be polyethiological one; however, the pattern of NEC pathogenesis is not clear yet. The aim of the present research is to study in details NEC risk factors and pathogenetic mechanisms in experiment.Material and methods. NEC was induced in 28 rat pups (breed: Wistar). Newborn animals (21-day gestation age) were labored from three female rats aged 9-12 months. In the research, the experimental animals were induced: hypoxia, inadequate formula feeding and bacterial contamination. The observation period lasted for 96 hours; the obtained results were assessed by the following criteria: clinical symptoms, mortality, intraoperative findings, histological findings and microbiological spectrum.Results. NEC clinical signs were seen both in subgroup 1A (animals had hypoxia and inadequate formula feeding) and in subgroup 1B (additionally, animals had microbial contamination). Clinical and morphological findings were more pronounced in subgroup 1B. Mortality in subgroup 1B was 50%. The histological picture in subgroup 1A corresponded to that of NEC stage 1A-2A and in subgroup 1B – to NEC stage 2B–3B (by Walsh and Kliegmann). In subgroup 1B, there was a massive intestinal colonization in the intestinal lumen.Conclusion. Hypoxia and inadequate formula feeding are, as such, risk factors of necrotizing enterocolitis. Additionally, bacterial aggression significantly worsens the course of necrotizing enterocolitis and its prognosis. However, the lack of bacterial component does not rule out NEC onset in newborns.

A 21-Year Survey of Escherichia coli from Bloodstream Infections (BSI) in a Tertiary Hospital Reveals How Community-Hospital Dynamics of B2 Phylogroup Clones Influence Local BSI Rates.

ABSTRACTThis is a longitudinal study comprising 649 Escherichia coli isolates representing all 7,165 E. coli bloodstream infection (BSI) episodes recorded in a hospital (1996 to 2016). Strain analysis included clonal identification (phylogenetic groups/subgroups, STc131 subclades, pulsed-field gel electrophoresis [PFGE], and whole-genome sequencing [WGS]), antibiotic susceptibility (13 antibiotics), and virulence-associated genes (VAGs; 29 genes). The incidence of E. coli BSI increased from 1996 to 2016 (5.5 to 10.8 BSI episodes/1,000 hospitalizations, average 7 to 8/1,000). B2 isolates predominate (53%), with subgroups B2-I (STc131), B2-II, B2-IX, and B2-VI representing 25%, 25%, 14%, and 9%, respectively. Intertwined waves of community-acquired (CA) plus health care-associated and community-onset health care-associated (HCA) and hospital-acquired (HA) episodes of both B2 and non-B2 phylogroups occurred. A remarkable increase was observed only for B2-I-STc131 (C1/C2 subclades), with oscillations for other B2 subgroups and phylogroups throughout the years. Epidemic and persistent clones (comprising isolates with highly similar/identical PFGE types and genomes differing in 6 to 173 single nucleotide polymorphisms [SNPs]) of B2-I (STc131), B2-II (STc73), B2-III (STc127), B2-IX (STc95), and B2-VI (STc12) were recovered from different patients, most at hospital admission, for long periods (2 to 17 years), and extended-spectrum beta-lactamase (ESBL) producers or resistance to ciprofloxacin in B2 isolates was almost restricted to B2-I (STc131) subclade C. STc131 contributed to increasing the B2 rates but only transiently altered the E. coli population structure. The increase of E. coli BSI was determined by waves of CA+HCA BSI episodes that predate the waves of HA BSI. Besides the risk of hospital transmission that led to temporal increases in BSI, this study suggests that E. coli populations/clones from community-based healthy individuals may occasionally have an epidemic structure and provide a source of transmissible strains influencing the HA BSI incidence.IMPORTANCE Sepsis is the third leading cause of mortality in Western countries and one of the Global Health Threats recognized by the WHO since 2017. Despite Escherichia coli constituting the most common cause of bloodstream infections (BSI), its epidemiology is not fully understood, in part due to the scarcity of local and longitudinal studies. Our work analyzes the long-term dynamics of E. coli causing bacteremia in a single institution and reveals waves of different clonal lineages that emerge periodically and successfully spread afterward in both the community and hospitals. Because the origin of E. coli bloodstream infections is the gut, the microbiota of healthy individuals might occasionally have an epidemic structure, providing a source of E. coli strains to influence the incidence of hospital BSI. The study complements previous fractionated observations focusing on specific E. coli lineages or antibiotic-resistant isolates in the last decades and helps to understand the epidemiology of E. coli BSI and the dynamics of pandemic clones.

Vancouver Scar Scale for Assessing the Long-term Cosmetic results of surgical treatment of children with deep neck burns

BACKGROUND: Deep neck burns always result in cicatricial changes in the skin. Scars in this area can lead not only to functional disorders but also affect the psychoemotional status of the patient and family. Current studies have reported on the results of the treatment of deep neck burns in both adults and children. However, among foreign and Russian publications available, no studies have assessed the cosmetic results of treatment using validated scales.&#x0D; AIM: This study aimed to analyze the long-term cosmetic results of surgical treatment of deep neck burns in children using the Vancouver Scar Scale.&#x0D; MATERIALS AND METHODS: A non-interventional case control study was conducted. The article analyzes the long-term cosmetic results of treatment of 64 children with deep neck burns. All patients were divided into the main group 1 35 (29%) children who received early surgical treatment] and control group 2 29 (45%) children after staged treatment]. The main group was further divided into subgroups 1a, 1b, and 1c. Subgroup 1a included 13 (20%) children who underwent tangential necrectomy with simultaneous autodermoplasty, subgroup 1b included 12 (19%) children who underwent radical necrectomy with simultaneous autodermoplasty, and subgroup 1c included 10 (16%) children who underwent necrectomy with delayed autodermoplasty. The Vancouver Scar Scale was used to assess the vascularization, pigmentation, elasticity, and size of the scar mass. For statistical analysis, the results of different options for early surgical treatment were compared with a staged method.&#x0D; RESULTS: The best indicators for vascularization, elasticity, size of the formed cicatricial mass, and overall score were obtained in children who received surgical treatment of deep neck burns by early necrectomy (tangential or radical) with simultaneous autodermoplasty in comparison with staged surgical treatment. When analyzing the pigmentation indicator, the scores of patients who underwent all types of early surgical treatment were comparable with those in patients who received staged surgery.&#x0D; CONCLUSIONS: According to the analysis of the Vancouver Scar Scale, the best cosmetic results in children with deep neck burns can be achieved by performing tangential or radical necrectomy with simultaneous autodermoplasty.

Kidney Dysfunction and Its Progression in Patients Hospitalized Duo to COVID-19: Contribution to the Clinical Course and Outcomes.

The disease caused by coronavirus SARS-CoV-2 (COVID-19) can affect almost all organs of the human body, including kidneys. We conducted a one-center study to comprehensively analyze the effects of kidney involvement on the course and outcomes in patients hospitalized with COVID-19, depending on the estimated glomerular filtration rate (eGFR) at admission. Out of the 1958 patients, 1342 (68.54%) had eGFR ≥ 60 mL/min/1.73 m2 (group A) and 616 (31.46%) had eGFR < 60 mL/min/1.73 m2 (group B). Group B was additionally divided into subgroups B1, B2, and B3 based on eGFR. We found that mortality rates during hospitalization, as well as after 90 and 180 days, were much higher in group B than group A. The highest mortality was observed in the B2 subgroup with eGFR of 15–29. The mortality of B patients was associated with comorbidities, respiratory dysfunction, immunological impairment, and more frequent development of AKI. AKI had a negative impact on patients’ survival, regardless of the initial renal function. At discharge, 7.4% of patients had serum creatinine levels 30% higher, or more, as compared to admission. The disease course and outcomes in COVID-19 patients are associated with baseline eGFR; however, AKI during hospitalization is a more significant predictor of poor prognosis regardless of the initial renal function.

Influence of the quality of viscoelastic removal on phacoemulsification results. Part 1. Type of the postoperative period course depending on the quality of viscoelastic removal in phacoemulsification

BACKGROUND: The reasons for the development of postoperative reactive inflammation under optimal conditions for the operation are errors in the surgical technique and the presence of viscoelastic residues. The likelihood of developing ophthalmic hypertension exists with the use of viscoelastic of any type. Its incomplete evacuation can be explained by the difficult visualization due to its transparency. Analysis of the dependence of the postoperative period course on the quality of viscoelastic removal at phacoemulsification can be considered to be relevant and expedient.&#x0D; AIM: The aim was to study the type of the postoperative period course depending on the quality of viscoelastics removal at phacoemulsification.&#x0D; MATERIALS AND METHODS: 104 eyes of randomly chosen patients who underwent femto-laser assisted phacoemulsification, divided into 2 groups according to ophthalmic viscoelastics characteristics (colored or transparent). Both groups were split into 2 subgroups each depending on method of viscoelastics removal. Tonometry and biomicroscopy were performed 3 hours after phacoemulsification and on the post-op Day 1. Patients with Tyndall effect were examined daily until its disappearance.&#x0D; RESULTS: At comparable preoperative IOP indices, its elevation 3 hours after surgery took place in subgroups 2a and 2b, the highest being in subgroup 2a. The greatest number of eyes with Tyndall effect, at all follow-up periods, was found in subgroup 2a, the lowest in subgroup 1b. The total number of eyes with keratopathy (as epitheliopathy) observed 3 hours after surgery was 7, four of them being from subgroup 2a.&#x0D; CONCLUSIONS: The conducted research showed that the type of early postoperative period course of phacoemulsification depends on visualization possibility of the viscoelastic and of the method of its removal. Minimal changes of hydrodynamics and maximal number of eyes with absence of inflammation took place when using colored viscoelastic and impulse irrigation method.

Pathogenetic significance of the male factor in an uncompleted pregnancy

Introduction. When pregnancy failure occurs, not only the woman should be examined, but also her partner. Purpose of the study — to evaluate the significance of spermogram values in the partners of patients with an uncompleted pregnancy. Materials and methods. A retrospective comparative cohort study was conducted. A total of 197 married couples were ncluded in the study. Group 1 consisted of 71 couples with a history of miscarriag. Chromosomal abnormalities (CA) were detected during embryo cytogenetic examination in 45 cases; these patients were included in subgroup 1a; the rest constituted subgroup 1b. The control group (group 2) consisted of 126 couples without a history of pregnancy loss. A detailed anamnesis and general clinical examinations were performed in all the couples. Spouses of the patients underwent spermogram analysis. Results. The proportion of men who abused alcohol was higher in group 1 than in group 2 — 40.8% vs. 19% (p&lt;0.01). In subgroup 1b chronic diseases were noted in 61.5% of men, in group 2 — only 28.6% (p&lt;0.001). Differences in the number of men with normal spermogram were found between group 2 and subgroup 1b, 65.1% and 35.3%, respectively (p=0.036). In group 1, 45% of men had teratozospermia (43.5% in subgroup 1a, 47.1 in subgroup 1b) and in group 2, only 16.3% (p=0.004). Discussion. In most cases, the leading etiological factor in pregnancy failure is a chromosomal abnormality n the embryo (fetus). The role of the "male" factor is increasing in the genesis of pregnancy failure. Examination of thspouse should be an integral component of pre-conceptional preparation. Conclusion. Spousal alcohol abusrisk factor for CA in the embryo and for pregnancy failure. The presence of chronic diseases in the spouse is also a risk factor for pregnancy failure. Among the spermogram parameters, the number of spermatozoa with normal morphology is the most significant in assessing the ririsk of pregnancy failure in a married couple, teratozoospermia significantly increases the risk of non-pregnancy.

A historical overview of advances in molecular genetic/genomic studies of the ABO blood group system.

In 1990, 90 years after the discovery of ABO blood groups by Karl Landsteiner, my research team at the Molecular Biology Laboratory of the now-defunct Biomembrane Institute elucidated the molecular genetic basis of the ABO polymorphism. Henrik Clausen, Head of the Immunology Laboratory, initiated the project by isolating human group A transferase (AT), whose partial amino acid sequence was key to its success. Sen-itiroh Hakomori, the Scientific Director, provided all the institutional support. The characterization started from the 3 major alleles (A1, B, and O), and proceeded to the alleles of A2, A3, Ax and B3 subgroups and also to the cis-AB and B(A) alleles, which specify the expression of A and B antigens by single alleles. In addition to the identification of allele-specific single nucleotide polymorphism (SNP) variations, we also experimentally demonstrated their functional significance in glycosyltransferase activity and sugar specificity of the encoded proteins. Other scientists interested in blood group genes later characterized more than 250 ABO alleles. However, recent developments in next-generation sequencing have enabled the sequencing of millions of human genomes, transitioning from the era of genetics to the era of genomics. As a result, numerous SNP variations have been identified in the coding and noncoding regions of the ABO gene, making ABO one of the most studied loci for human polymorphism. As a tribute to Dr. Hakomori's scientific legacy, a historical overview in molecular genetic/genomic studies of the human ABO gene polymorphism is presented, with an emphasis on early discoveries made at his institute.Graphical abstract

Estimated efficiency of uterine cavity suturing in patients during organ-preserving surgery with placenta increta while examining reproductive function in the postpartum period

Aim: to assess the reproductive function of patients who underwent organ-preserving delivery using a modified method of uterine cavity suturing placenta increta.Materials and Methods. There were retrospectively investigated 77 history cases of patients admitted for planned delivery in 2018–2020, subdivided into two groups: Group 1 (control) – 32 patients with uterine scar after previous cesarean section, Group 2 (main) – 45 patients diagnosed with placenta increta further assigned to 2 subgroups – 2A (n = 23) underwent a modified uterine cavity suturing, and subgroup 2B (n = 22) where a linear suturing was used.Results. The groups studied were comparable on anthropometric data and reproductive history. The ultrasound examination of the uterus size 6 months later revealed more prominent changes in main group that might be due to larger volume of excised uterine tissue during surgery. Significant differences in subgroup 2A (uterus length – 54 [48; 62] mm, uterus width – 38 [29; 47] mm; p = 0.036 and p = 0.024, respectively) and subgroup 2B (uterus length – 51 [42; 60] mm, uterus width – 30 [24; 44] mm; p = 0.003 and p &lt; 0.001) vs. control group (uterus length – 60 [55; 66] mm, uterus width – 48 [42; 54] mm) were observed. Magnitude of change in size and shape of the uterus were found in subgroup 2A vs. 2B (p = 0.022 for uterus length, p = 0.004 for uterus width). Examining intrauterine blood flow revealed no significant differences between the groups compared (p &gt; 0.1).Conclusion. Assessing results of the applied new method for uterine cavity suturing in patients with placenta increta showed a marked efficiency in maintaining anatomically most natural shape of the uterus and uterine cavity. Despite the results obtained, the problem of restoring female reproductive function after organ-preserving delivery remains a pressing issue relevant and requires to be further investigated.

Уровень NT-рroBNP как предиктор развития фибрилляции предсердий у больных острым коронарным синдромом

Актуальность. Фибрилляция предсердий (ФП) отягощает течение инфаркта миокарда в 15,5 % случаев и ассоциирована с увеличением летальности на 40–50 %. Поэтому поиск маркеров риска развития ФП у больных острым коронарным синдромом (ОКС) является актуальным заданием. Целью исследования было определение предикторной ценности уровня NT-proBNP относительно риска развития ФП у больных ОКС. Материалы и методы. Обследованы 125 больных ОКС. Больные, у которых ФП впервые возникла во время госпитализации по поводу ОКС, составили подгруппу 1а (n = 41); больные, у которых ФП была в анамнезе, составили подгруппу 1б (n = 24). В группу 2 вошли больные без указаний на ФП (n = 60). Образцы крови для определения уровня NT-proBNP методом иммуноферментного анализа забирали в первые сутки заболевания. Результаты. Больные группы 2 были моложе больных подгрупп 1а (р = 0,019) и 1б (р = 0,002). В группе 2 было больше больных, чем в подгруппе 1б, которые курили (р = 0,029). У больных группы 2 уровень гемоглобина был выше, чем у больных подгруппы 1а (р = 0,014). Больные подгруппы 1б по сравнению с больными 2-й группы имели более высокий уровень гликемии при поступлении (р = 0,010). Уровень NT-proBNP оказался наивысшим в подгруппе 1а: 1592,00 (439,20; 3281,00) пг/мл. В подгруппе 1 б и группе 2 уровни NT-proBNP составили 1281,00 (844,45; 2012,50) пг/мл и 226,50 (54,40; 822,00) пг/мл соответственно (р1а–2 = 0,002; р1б–2 = 0,010). Выявлены корреляционные связи уровня NT-proBNP с возрастом больных (r = 0,500; р = 0,00006), женским полом (r = 0,286; р = 0,030), частотой сердечных сокращений и гликемией при поступлении (r = 0,363; р = 0,005 и r = = 0,482; р = 0,0001 соответственно), скоростью клубочковой фильтрации (r = –0,459; р = 0,0003), уровнем гемоглобина (r = –0,307; р = 0,019). Методом ROC-анализа, в который были включены больные подгруппы 1а и группы 2, установлена предикторная ценность уровня NT-proBNP относительно риска развития ФП у больных ОКС: при использовании пороговой точки &gt; 1774 пг/мл чувствительность метода составляла 48 %, специфичность — 95,2 %, площадь под ROC-кривой составляла 0,77 (95% доверительный интервал 0,64–0,91). Выводы. В нашем исследовании уровень NT-proBNP был ассоциирован с клинико-анамнестическими показателями. Он был наивысшим в группе больных, у которых ФП развилась впервые на фоне ОКС; уровень NT-proBNP &gt; 1774 пг/мл был ассоциирован с риском развития ФП.

Risk factors for neonatal intrauterine infection in pregnant women with urogenital infection

Objective.To determine the clinical and anamnestic risk factors for neonatal intrauterine infection (IUI) in pregnant women with urogenital infections (UGI).Materials and methods.431 patients were examined: the main group (group 1) — 353 women with UGI during pregnancy (subgroup 1A — 215 women whose children were diagnosed with IUI, subgroup 1B — 138 women whose children were born without signs of IUI; the comparison group (group 2) — 78 women without UGI during pregnancy (subgroup 2A — 44 patients whose children were born with signs of IUI, subgroup 2B — 34 women whose children did not have IUI. We studied the obstetric and gynecological, somatic anamnesis of the patients, the course of their pregnancy.Results.The presence of gynecological and somatic diseases in the anamnesis of the pregnant women with UGI was associated with a signifcant increase of the risk for neonatal IUI (p = 0.003 and p = 0.005, respectively). Vaginitis (p = 0.041), background and precancerous diseases of the cervix (p = 0.027) were signifcantly most prevalent in the pregnant women with UGIs in their history. Pregnancy complicated by UGI proceeded with a recurrent miscarriage risk (p = 0.046) was most often accompanied by acute respiratory infection (p ˂ 0.001) and signifcantly most often ended in premature birth — 24.7% (p = 0.009).Conclusion.The search for objective criteria for the development of neonatal IUI is an important and complex task of modern obstetrics. The analysis of the anamnesis of pregnant women with urogenital infections, as well as timely diagnosis and adequate treatment of urogenital infection and acute respiratory infection will reduce the miscarriage rate and the incidence rate of neonatal IUI.

Prevalence, Prognosis, and Outcome in Egyptian Children with Primary Immune Thrombocytopenia: A Single-Center Experience

Background: Idiopathic (immune) thrombocytopenic purpura (ITP) is a heterogeneous clinical disorder characterized by immune-mediated platelet destruction. ITP is usually a benign, self-limiting disease in children. Objective: To assess prevalence, prognosis, and outcome of Egyptian children with primary immune thrombocytopenia. Patients and Methods: This cross-sectional study was carried on 80 children (1-13 years) with primary ITP who presented to the Pediatric Hematology Unit and outpatient clinic of Zagazig University Hospitals, during the period from April 2020 to June 2021. Patients were divided into two groups; Group (1): included 20 healthy matched subjects (control), Group (2): included 60 patients with primary ITP. The group was subdivided into 3 subgroups, Subgroup (2A) included 20 patients with newly diagnosed ITP, Subgroup (2B) included 20 patients with persistent ITP, and Subgroup (2C) included 20 patients with chronic ITP. Results: There were significant differences between the studied groups in age, sex, and weight. There was a statistically significant association between prognosis and general characteristics of the studied ITP patients. Conclusion: primary ITP in children is a nonthreatening and self-limited disease, usually lasting less than one year, and chronic form has different prognostic parameters. The use of these parameters can early distinguish children who are expected to have short and uneventful disease duration, to minimize their exposure to pharmaceutical intervention.

The platelet-rich plasma lysate use in the treatment of persistent epithelial defects after keratoplasty

AIM:to evaluate the effectiveness of the platelet-rich plasma lysate (PRP lysate) use in the treatment of persistent epithelial defects (PED) after keratoplasty.&#x0D; MATERIALS AND METHODS:In the study, 60 patients with PED after keratoplasty were included. The 1st group (24 cases)included patients after keratoplasty with low risk of rejection, and the 2nd group 36 cases after keratoplasty with highrisk of rejection. Each group was divided into two subgroupscontrol subgroups 1a (cases 10) and 2a (cases 16), where patients received only standard postoperative therapy, and the main subgroups 1b (cases 14) and 2b (cases 20), in which PRP lysate was prescribed against the background of standard therapy, starting from the Day 15 post-op. As the criterion for effective treatment, complete persistent epithelialization after keratoplasty was considered.&#x0D; RESULTS:The effectiveness of the use of PRP lysate in the subgroup 1b was 85.7%, while complete epithelialization in the control subgroup 1a was recorded in 70%; in the subgroup 2b, complete epithelialization was observed in 55%, in the control subgroup 2ain 43.75%.&#x0D; CONCLUSION:The use of PRP lysate in the treatment of PED after corneal transplantation as an adjuvant therapy is effective and safe in both high and low risk keratoplasty. In the examined category of patients, treatment with blood derivatives increases the frequency and rate of complete epithelialization.

A Useful MRI Classification for Symptomatic Discoid Lateral Meniscus

PurposeThe purpose of this study is to classify the discoid lateral meniscus (DLM) according to the signal and shape in magnetic resonance imaging (MRI), and to provide information not only in diagnosis but also in treatment.Materials and MethodsWe reviewed 162 cases who diagnosed with DLM by MRI and underwent arthroscopic procedures from April 2010 to March 2018. Three observers reviewed MRI findings of all cases and predicted arthroscopic tear using three MRI criteria (criterion 1,2 and 3). Among three criteria, the criterion that most accurately predicts arthroscopic tear was selected. Using this criterion, the cases of predicted tear were named group 1. In addition, group 1 was divided into three subgroups (group 1a, 1b and 1c) by deformation or displacement on MRI and arthroscopic type of tear and procedures were analyzed according to these subgroups.ResultsThe intra-meniscal signal change itself (criterion 3) on MRI showed the highest agreement with the arthroscopic tear. No meniscal deformation and displacement on MRI (group 1a) showed no specific type of tear and more cases of meniscal saucerization. The meniscal deformation on MRI (group 1b) showed more simple horizontal tears and more cases of meniscal saucerization. The meniscal displacement on MRI (group 1c) showed more peripheral tears and more cases of meniscal repair and subtotal meniscectomy. Comparing arthroscopic type of tear and type of arthroscopic procedure between three subgroups, there were significant differences in three groups (P < .05).ConclusionsIntra-meniscal signal change itself on MRI is the most accurate finding to predict arthroscopic tear in symptomatic DLM. In addition, subgroup analysis by deformation or displacement on MRI is helpful to predict the type of arthroscopic tear and procedures.

Частота асимптоматической гиперурикемии среди взрослых больных сахарным диабетом 1-го и 2-го типа

Цель исследования — изучить частоту асимптоматической гиперурикемии у больных сахарным диабетом (СД) 1-го и 2-го типа в украинской популяции на примере жителей г. Харькова и области. Материалы и методы. Обследованы 316 больных СД: 81 больной СД 1-го типа (группа 1), 150 больных СД 2-го типа (группа 2) и 85 больных СД 2-го типа с абсолютной инсулинозависимостью (группа 3). Оценку состояния пуринового обмена проводили путем определения концентрации мочевой кислоты в сыворотке крови и моче. Уровни мочевой кислоты определяли колориметрическим методом с помощью набора реагентов «СпайнЛаб, UricasePOD» (Украина). Для оценки влияния возраста больного, возраста больного на момент манифестации заболевания, продолжительности заболевания и индекса массы тела группы обследуемых были разделены на две подгруппы (А и Б соответственно) с учетом уровня урикемии и урикурии. Подгруппу 1А составили 60 больных СД 1-го типа без гиперурикемии (ГУ) и/или гиперурикурии (ГУУ), подгруппу 1Б — 21 больной с ГУ и/или ГУУ, подгруппу 2А — 76 больных без ГУ и/или ГУУ, подгруппу 2Б — 74 больных с ГУ и/или ГУУ, подгруппу 3А — 57 больных без ГУ и/или ГУУ, подгруппу 3Б — 28 больных с ГУ и/или ГУУ. Результаты. Частота нарушений пуринового обмена среди взрослых больных СД 1-го и 2-го типа составляет 38,9 %. Самая высокая частота нарушений пуринового обмена наблюдается у больных СД 2-го типа (49,3 %). Возраст больного при проведении исследования и на момент манифестации СД, продолжительность заболевания и индекс массы тела не являются определяющими факторами, влияющими на формирование нарушений пуринового обмена у больных СД 1-го и 2-го типа; возрастной фактор и продолжительность заболевания являются факторами риска нарушений пуринового обмена у больных СД 2-го типа с абсолютной инсулинозависимостью. Выводы. Асимптоматическая гиперурикемия диагностирована у 27,8 % обследованных больных сахарным диабетом. Частота асимптоматической гиперурикемии значительно выше у больных сахарным диабетом 2-го типа, чем у больных сахарным диабетом 1-го типа (3,48 и 24,4 % соответственно); абсолютная инсулинозависимость у больных сахарным диабетом 2-го типа не влияет на частоту асимптоматической гиперурикемии.