Comprehensive Therapy Research Articles

A modified intensive, comprehensive aphasia program (mICAP) has better reported outcomes than usual care: a randomized controlled trial

ABSTRACT Background Intensive Comprehensive Aphasia Programs (ICAPs) are a new model of service delivery that show promising pre-post outcomes but have yet to be compared with usual care. Aim To compare the clinical effectiveness of a modified Intensive Comprehensive Aphasia Program (mICAP) to usual care in a parallel two arm study utilizing stratified block randomisation. Methods & Procedures Participants were a referred sample with post stroke aphasia from ten local speech pathology departments. Assessments were completed prior to, immediately after, and follow up at 3 months after the mICAP. While 269 participants with aphasia were approached for the study, only 52 were eligible to be randomised with 113 participants approached not meeting selection criteria and 99 of eligible participants declining to participate. Block randomization was based on matched moderate/mild versus severe aphasia pairs. Three of the 26 mICAP participants withdrew. In the experimental arm of the mICAP (the LIFT program), participants with aphasia and their family attended goal directed tailored therapy three times weekly for 8 weeks. Therapy included 14 hours each of impairment therapy, functional communication therapy, and computer therapy and 7 hours of group therapy and a challenge task. The main outcome measures were the self-reported Assessment for Living with Aphasia (ALA) and Content Information Units (#CIU’s) in connected speech. Outcomes & Results Linear Mixed Modelling was completed on the remaining 42 participants’ data and found a significant benefit for the mICAP on the ALA Total score (p= .014; 95% CI= −21.48- −2.57) ALA Aphasia domain (p = .027; 95% CI= −3.23 - −0.203), ALA Environment domain (p = .017; 95% CI= −4.70 - −0.493) immediately post intervention with maintenance of effects for the ALA Aphasia domain in the follow up period (p = .014; 95% CI= −3.64 - −0.438). Family members in the mICAP reported significant reduction in caregiving burden in the follow up period (p= .017; CI= −14.12 - −1.52.). There were no significant differences on the other main outcome measure of Content Information Units (95% CI= −34.94 – 55.15). Conclusions For those suitable and interested, the mICAP was more beneficial than usual care for participants with aphasia and their family members. However, lack of significant differences in discourse and other language functions, suggests that individual elements of mICAPs and their evaluation require review. Based on these results, the LIFT program has been refined to become the Comprehensive High-dose Aphasia Therapy (CHAT) program.

The Effects of Using Modern Technologies in the Neurorehabilitation Process of a Patient after Traumatic Brain Injury – A Case Study

This study presents an analysis of the case of a 44-year-old male patient who experienced a traumatic brain injury, resulting in spastic quadriplegia, meningitis, right-sided craniotomy, ventriculoperitoneal shunt placement, and right hip arthroplasty. Data was collected over a four-year comprehensive therapy process involving treatment periods, during which the patient was under the care of an interdisciplinary team and participated in an individualized rehabilitation program, consisting of 3-4 hours of physical therapy daily for 5-6 days per week. The material included results from functional tests, muscle tone assessments, and balance evaluations. Numerical data from robotic gait therapy devices were also considered. With the consent of the patient and his family, the therapy process was documented via video recordings and photographs, which were then used for a retrospective visual analysis of recorded material at various stages of rehabilitation. For this purpose, the ShapeCare.Fizjo device was used, along with Blaze Pose software, based on a moving person’s skeletal detection model. The results indicated that comprehensive therapy using innovative tools such as C-eye, ReoGo, ReoAmbulator, and LeviActive system improved the patient’s balance and motor skills, as well as facilitated the gait re-education process. The use of modern technologies in neurorehabilitation not only optimizes therapeutic outcomes but also reduces the risk of musculoskeletal strain for the therapist during their professional work.

Incidence of malignant neoplasms and organizational aspects of cancer care in the Republic of Kazakhstan

BackgroundThis study aims to investigate the incidence and mortality rates of malignant neoplasms in Kazakhstan in 2022 and to analyze the organizational aspects of cancer care. MethodsData from 33,177 patients with malignant neoplasms registered in oncological institutions in 2022 were analyzed. The study focused on treatment completion rates and the distribution of treatment modalities, including surgical, radiation, medicinal, combined, comprehensive, and chemo-radiation therapies. Comparative analysis with international data was conducted to assess the effectiveness and adherence to global oncological standards. ResultsThe analysis revealed that 55.2 % of patients completed specialized treatment, with complex treatment being the most common modality (94.3 %). High completion rates were observed in breast cancer (65.9 %) and cervical cancer (68.8 %), reflecting the effectiveness of early detection and multidisciplinary approaches. However, lower completion rates were noted in liver cancer (26.2 %) and leukemia (23.0 %), highlighting the need for improved diagnostic and treatment strategies. Comparative international data indicated similar trends, with countries like the USA, UK, Japan, and Australia demonstrating the effectiveness of multidisciplinary and comprehensive treatment approaches. ConclusionThe study underscores the importance of a multidisciplinary approach in treating malignant neoplasms, with Kazakhstan's practices largely aligning with international standards. Nevertheless, there is a need to enhance early diagnosis and treatment completion rates for specific cancers such as liver cancer and leukemia. Strengthening screening programs, improving access to modern treatments, and integrating international best practices can further improve patient outcomes in Kazakhstan.

ASSESSMENT OF THE THICKNESS OF THE SKIN-FAT LAYER IN SCHOOLCHILDREN OF DIFFERENT AGE GROUPS

The rise in overweight and obesity among school-age children is currently one of the most serious public health problems. With the progress of science and medicine, obesity and the development of various problems caused by it are widespread among schoolchildren and adults in general. In this sense, as a serious problem of medical science, it is alarming and relevant (Calonje Eduardo et. al, 2020). Obesity, as one of the diseases of civilization, is the result of hypodynamia, a disturbance of fat metabolism in the body, which leads to excess weight gain. ("Obesity and overweight Fact sheet N°311".WHO. January 2015. Retrieved 2 February 2016). In this sense, it is important to take into account the age period, and the deviations observed during normal development because each age period has its characteristics of fat metabolism. It has been shown that female schoolchildren of middle school age have a higher rate of obesity, which is not only determined by gender but also by age and body composition or somatotype. Middle and high-school-aged female schoolchildren have a peripheral type of obesity, that is, fat is predominantly stored in the subcutaneous tissue of the thighs, abdomen, and buttocks. It has been shown that there is a clear correlation between fat metabolism and somatotype in middle and high school children. The results of the study suggest that physical activity should be part of a comprehensive weight loss therapy program and weight control strategy since it promotes excess weight loss and its sustainable maintenance, for which it is important to regularly monitor indicators of subcutaneous fat thickness and the relative content of adipose tissue throughout the body․

Inhibition of KDM4A restricts SQLE transcription and induces oxidative stress imbalance to suppress bladder cancer

In clinical practice, the limited efficacy of standard comprehensive therapy for advanced bladder cancer and the lack of targeted treatment options are well recognized. Targeting abnormal epigenetic modifications in tumors has shown considerable potential in cancer therapy. Through drug screening in tumor organoids, we identified that ML324, a histone lysine demethylase 4A (KDM4A) inhibitor, exhibits potent antitumor effects in both in vitro and in vivo cancer models. Mechanistically, Kdm4a demethylates H3K9me3, leading to chromatin opening and increased accessibility of Gabpa to the squalene epoxidase (Sqle) gene promoter, resulting in transcriptional activation. Inhibition of Kdm4a downregulates Sqle transcription, blocking cholesterol synthesis and causing squalene (SQA) accumulation. This process induces reactive oxygen species (ROS) clearance and suppresses JNK/c-Jun phosphorylation, ultimately inducing apoptosis. Furthermore, ML324 treatment significantly inhibited tumor growth in bladder cancer patient-derived xenograft (PDX) models. Our findings reveal the presence of a Kdm4a-Sqle-ROS-JNK/c-Jun signaling axis that regulates oxidative stress balance, offering a novel strategy for targeted therapy in bladder cancer.

An Intelligent Triple Assisted Gold Cluster‐Based Nanosystem for Enhanced Tumor Photodynamic Therapy

Comprehensive SummaryPhotodynamic therapy (PDT) has been attracted a surge of research interest. However, there are several obstacles to limit the efficacy of PDT, such as hypoxic tumor microenvironment (TME), overexpressed glutathione (GSH), inefficient reactive oxygen species (ROS) generation, and so on. Herein, a smart responsive nanosystem was constructed, which was composed of Au25 modified with triphenylphosphine (Au25‐TPP), catalase (CAT) and GSH‐responsive diselenide‐bridged mesoporous silica nanoparticles (Se‐MSN). When the nanosystem arrived at tumor site, Se‐MSN was degraded by the intracellular overexpressed GSH to release Au25‐TPP and CAT. The Au25‐TPP was targeted to mitochondria and generated ROS under the 808 nm NIR laser irradiation to kill tumor cells. Simultaneously, CAT could catalyze hydrogen peroxide to provide oxygen for relieving the hypoxia of TME. Besides, GSH was consumed by the diselenide bond to diminish the ROS loss. The above tactics (mitochondria targeting, hypoxia relieving and GSH consuming) jointly enhanced the PDT efficacy. The nanosystem showed distinct in vitro anticancer effect significantly stronger than other groups containing one or two assistance. Moreover, the in vivo results suggested that the tumors could be restrained obviously. The current study provides a new inspiration for constructing novel inorganic nanomedicines with multiple enhancement effect of PDT efficacy.

Therapy adherence after interdisciplinary tumour board discussion is associated with improved outcome in soft tissue sarcoma: A Charité Comprehensive Cancer Centre analysis.

Centralising soft tissue sarcoma (STS) treatment in expert centres and implementing comprehensive therapy concepts through interdisciplinary tumour boards (ITB) has led to significant treatment progress. However, our knowledge on the implementation of the ITB recommendations and its impact on patient outcome is limited. In this retrospective analysis, we examined a cohort of 222 adult patients (pts) with primary STS who were presented to the ITB of the Charité Comprehensive Cancer Centre between 2015 and 2020. In localised disease (n = 188), resection was recommended in 71% (n = 134) of pts. The treatment modalities chemotherapy with or without regional deep hyperthermia, and radiotherapy were recommended in 37% (n = 69), 26% (n = 48) and 52% (n = 97), respectively. Complex multidisciplinary concepts were established in 29% (n = 54) including ≥3 treatment modalities. Only partial adherence, either by choice of patient or treating physician, was associated with a higher risk of both progression (HR 4.0 95%-CI 1.6-9.7 p < .01) and mortality (HR 5.3 95%-CI 1.7-16.4 p < .01). Pts inable to follow the ITB recommendations due to complications or rapid progression showed a high-risk profile with increased mortality and progression rates (HR 18.1 95%-CI 8.5-38.2 p < .001; HR 21.5 95%-CI 8.5-54.7 p < .001). To our knowledge, this represents the first German Comprehensive Cancer Centre analysis of therapy adherence in STS. It provides further real-world evidence that full adherence to ITB recommendations and the ability to adhere to them are of prognostic value for patient outcome and underlines the importance of interdisciplinary decision-making and treatment planning for STS patients.

MODERN VIEWS OF USE OF TELEREHABILITATION IN URINARY TRACT DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS

Multiple sclerosis is a chronic disease of the nervous system that often leads to various disorders, including urinary tract dysfunction. This significantly affects the quality of life of patients, causing physical and psychological complications. The term "bladder rehabilitation" summarizes treatment options aimed at restoring its function in patients with neurourological symptoms. A strong contraction of the sphincter of the urethra and/or pelvic floor, as well as anal dilatation, manipulation of the genital area, and physical activity reflexly inhibit urination. A comprehensive physical therapy program for patients with pelvic disoders includes pelvic floor vibration massage, training in proper breathing patterns, pelvic floor muscle relaxation and stabilization exercises and should last several months, during which the patient regularly visits the doctor. The pandemic and war have created barriers that affect almost every aspect of life, treatment and rehabilitation, especially for people with chronic neurological conditions. Traditional rehabilitation methods used to correct urinary tract dysfunction have their limitations, including difficulties in accessing specialists, especially in remote areas. This stimulates the development and implementation of telerehabilitation as an alternative approach. Telerehabilitation involves the use of digital technologies for the remote provision of medical services and patient monitoring. It allows doctors to monitor the condition of patients, provide recommendations and adjust treatment without the need for personal visits. Considering the existing data and our own clinical experience, we consider it appropriate to use telerehabilitation for the correction of disorders of the lower urinary tract, especially in the conditions of war, when access to rehabilitation centers may be difficult. In the department of medical rehabilitation of the University Clinic of the Kharkiv National Medical University, we successfully conducted telerehabilitation using Google Meet video conferencing for 10 patients with urinary incontinence on the background of multiple sclerosis, whose EDSS was no more than 4.0. When conducting online classes under the guidance of a physical therapist, patients noted a desire to strictly follow the recommendations and perform regular exercises. All patients kept a urination diary, according to which the frequency of urination was reduced by an average of 20-25%, which had a positive effect on their quality of life. Although our observations are not representative, in combination with existing studies, we consider telerehabilitation to be a promising direction in complex therapy and rehabilitation of this pathology. Conclusion The use of telerehabilitation for urinary tract dysfunction in patients with multiple sclerosis is a promising direction that requires further research. This approach can significantly improve the quality of life of patients, reduce the burden on the health care system and provide a more affordable and convenient treatment. A multidisciplinary team should be involved, including a neurologist, a urologist, a gynecologist, and a physical therapist to select the optimal tactics of drug treatment and physical therapy. A promising direction of further research is the development of standard protocols for conducting telerehabilitation for patients with lower urinary tract dysfunction against the background of multiple sclerosis and other pathologies.

Possibilities of Adding Pulmonary Surfactant to Comprehensive Therapy of Patients with Respiratory Tuberculosis: Results of a Prospective Comparative Study

The objective: to assess effectiveness and safety of the surfactant as part of comprehensive anti-tuberculosis therapy in pulmonary tuberculosis patients depending on the drug resistance pattern and HIV status.Subjects and Methods. 184 patients with pulmonary tuberculosis were enrolled in the study, of them 130 (70.7%) were men and 54 (29.3%) were women. All patients were randomized into Main Group (MG) and Control Group (CG). Surfactant therapy was added to comprehensive anti-tuberculosis therapy of the patients from Main Group. Additionally, each group was divided into subgroups based on HIV status.Results. The addition of surfactant therapy to comprehensive anti-tuberculosis therapy increases effectiveness of treatment improving such parameters as sputum conversion and cavity healing regardless of drug susceptibility pattern including patients with concomitant HIV infection. At the same time, the agent used for surfactant therapy demonstrated good tolerability.

Efficacy of Hydrogen Sulfide Baths in Complex Burn Rehabilitation: a Single-Center Observational Study

INTRODUCTION. The healing of burn wounds often leads to pathological scars and scar contractures, significantly deteriorating the quality of life for patients who have experienced burn trauma. In comprehensive anti-scar therapy, balneotherapy with sulfide (hydrogen sulfide) waters can be applied alongside primary methods. However, due to a lack of modern information on its effectiveness, this method is not frequently included in rehabilitation programs. AIM. To determine the significance of hydrogen sulfide baths in comprehensive rehabilitation and improve treatment outcomes for patients with hypertrophic post-burn scars. MATERIALS AND METHODS. In the years 2021–2022, 110 patients, including adults and children, participated in an observational study at the Matsesta Balneological Resort (Sochi, Russia) titled “Evaluation of the Effectiveness of Balneotherapy for Post-Burn Scars in Adults and Children”. All patients received a course of 10 hydrogen sulfide irrigations or baths at the Matsesta Balneological Resort. Before the start of the procedure and after completion, scar tissue assessment using the Vancouver Scar Scale and patient surveys were conducted by a physiotherapist. RESULTS AND DISCUSSION. Among the patients, there were 40 adults and 60 children. The age of patients ranged from 2 to 61 years, with an average of 19.8 years; 49 were male, and 51 were female. The burn area in patients ranged from 5 to 90 % (average 33.1 %) of the body surface. After the first course of sulfide irrigations, the scar tissue assessment on the Vancouver Scar Scale decreased by 2.1 points in children and 2.2 points in adults. After a repeat course of sulfide irrigations, scar tissue assessment decreased by 1.3 points in children and 1.8 points in adults. According to surveys based on the Dermatology Life Quality Index, before treatment, patients subjectively rated their condition on average at 3.45 points, and after treatment, at an average of 2.76 points. The decrease in scores was mainly due to the reduction or disappearance of symptoms such as dryness, burning, pain, and paresthesia in the scar. CONCLUSION. Balneotherapy with sulfide waters for patients with hypertrophic post-burn scars within the first 24 months after burn trauma is effective for both children and adults.

High-Frequency 10-kHz Spinal Cord Stimulation Provides Long-term (24-Month) Improvements in Diabetes-Related Pain and Quality of Life for Patients with Painful Diabetic Neuropathy.

The SENZA-PDN study evaluated high-frequency 10-kHz spinal cord stimulation (SCS) for the treatment of painful diabetic neuropathy (PDN). Over 24 months, 10-kHz SCS provided sustained pain relief and improved health-related quality of life. This report presents additional outcomes from the SENZA-PDN study, focusing on diabetes-related pain and quality of life outcomes. The SENZA-PDN study randomized 216 participants with refractory PDN to receive either conventional medical management (CMM) or 10-kHz SCS plus CMM (10-kHz SCS + CMM), allowing crossover after six months if pain relief was insufficient. Postimplantation assessments at 24 months were completed by 142 participants with a permanent 10-kHz SCS implant, comprising 84 initial and 58 crossover recipients. Measures included the Brief Pain Inventory for Diabetic Peripheral Neuropathy (BPI-DPN), Diabetes-Related Quality of Life (DQOL), Global Assessment of Functioning (GAF), and treatment satisfaction. Over 24 months, 10-kHz SCS treatment significantly reduced pain severity by 66.9% (P < .001; BPI-DPN) and pain interference with mood and daily activities by 65.8% (P < .001; BPI-DPN). Significant improvements were also observed in overall DQOL score (P < .001) and GAF score (P < .001), and 91.5% of participants reported satisfaction with treatment. High-frequency 10-kHz SCS significantly decreased pain severity and provided additional clinically meaningful improvements in DQOL and overall functioning for patients with PDN. The robust and sustained benefits over 24 months, coupled with high participant satisfaction, highlight that 10-kHz SCS is an efficacious and comprehensive therapy for patients with PDN.

12224 Addressing Blood Glucose Fluctuations and Fasting Challenges in Sheehan Syndrome: A Case Study

Abstract Disclosure: H.A. Awadalla: None. A.N. Kiani: None. W. Taha: None. N.N. Solanki: None. A. Lattouf: None. A. Shermetaro: None. A. Taweel: None. Introduction: Sheehan's syndrome (SS) is a rare condition characterized by hypopituitarism resultingfrom ischemic necrosis of the pituitary gland due to severe postpartum hemorrhage.Patients may have hormonal insufficiencies, ranging from single pituitary hormoneinsufficiency to total hypopituitarism. The diagnosis of SS is often delayed due to itsnonspecific signs and symptoms, leading to many undiagnosed and untreated cases. Case Presentation:A 33-year-old African American female with a history of panhypopituitarism secondaryto Sheehan Syndrome presented with syncope, lightheadedness, and severehypoglycemia (blood glucose 12mg/dL). Despite regular food intake, she struggled withglycemic control, experiencing recurrent hypoglycemic episodes associated withnausea, vomiting, unintentional weight loss (25kg), and polydipsia/polyuria. Laboratoryfindings revealed low ACTH, sodium, cortisol, and elevated liver enzymes, consistentwith hypopituitarism. Cosyntropin stimulation test confirmed adrenal insufficiency. MRIshowed an empty sella. Initially treated with high-dose hydrocortisone, then transitionedto lower maintenance doses, she continued to experience glycemic fluctuations.Intravenous dextrose and insulin sliding scale were initiated. Upon discharge, she wasprescribed hydrocortisone and levothyroxine. Despite adjustments, hypoglycemiapersisted, managed with dietary modifications. This case underscores the challenges inmanaging Sheehan Syndrome-associated panhypopituitarism and the need for tailoredtreatment approaches to achieve metabolic stability. Conclusion: This case underscores the complexities of managing panhypopituitarism secondary toSheehan syndrome, emphasizing the importance of comprehensive hormonalreplacement therapy and thorough monitoring to achieve symptom control andmetabolic stability. Tailored treatment regimens and continuous assessments arecrucial to addressing individual hormone deficiencies and preventing associatedcomplications effectively in these patients. Presentation: 6/1/2024

STING agonists and PI3Kγ inhibitor co-loaded ferric ion-punicalagin networks for comprehensive cancer therapy

Nanoparticles-based drug delivery system has been a promising approach for the treatment of colorectal cancer (CRC), which can be combined with chemotherapy, targeted therapy and immunotherapy to improve the treatment of CRC. 2′3’ cyclic guanosine monophosphate-adenosine monophosphate (cGAMP) is an agonist of the STING signaling pathway activating antitumor immunity. IPI-549 is a small-molecule inhibitor for phosphatidylinositol 3-kinase γ (PI3Kγ), which can induce M1 macrophages polarization to provide pro-inflammatory microenvironment to suppress tumors. Here, we developed a ferric ion-punicalagin network (Fe-PU), which can be not only used as an inducer of ferroptosis, but also serve as a carrier to load cGAMP and IPI-549 to obtain nanohybrid (Fe-PU/CD-IPI). In order to improve the delivery effect and targeted ability to CRC, a cyclic arginine-glycine-aspartic acid peptide linked-bovine serum albumin were utilized to modify Fe-PU/CD-IPI to prepare nanohybrid Fe-PU/CD-IPI@cBSA. The therapeutic effect of various nanohybrids were validated in the mice with spontaneous tumor in the colorectal area and tumor-bearing mice, which lead to the increase of ferroptosis, the activation of STING signaling pathway, and the repolarization of macrophages. Collectively, the cGAMP and IPI-549 co-loaded nanohybrids effectively reshaped the tumor immune microenvironment, and exhibited prominent treatment effect of anti-colorectal cancer in vitro, patient-derived organoids, and in vivo.

Gamabufotalin loaded micro-nanocomposites for multimodal therapy of metastatic TNBC by efficiently inducing ICD

Gamabufotalin (CS-6), a main active compound derived from Chinese medicine Chansu, exhibits a robust inhibitory effect on programmed death-ligand 1 (PD-L1) in triple-negative breast cancer (TNBC) cells. Despite its potential for tumor therapy, the medical application of CS-6 is constrained by its hydrophobic nature, lack of targeting capability, and weak immunogenic cell death (ICD) effect. To address these limitations and improve the therapeutic efficiency of this drug against metastatic TNBC, we designed a new kind of CS-6@CPB-S.lux that integrates carboxy-Prussian blue nanoparticles (CPB NPs), CS-6, and attenuated Salmonella typhimurium (S.lux) for TNBC therapy. In vitro and in vivo results have confirmed that CS-6@CPB NPs were efficiently delivered to neoplastic tissue by the tumor hypoxic chemotaxis property of S.lux, wherein the nanomedicine induced significant tumor cell necroptosis and apoptosis via photothermal therapy (PTT) of CPB NPs and chemotherapy of CS-6, which elicited ICD and inhibited PD-L1 expression, resulting in dendritic cells (DCs) maturation and effector T cells activation to comprehensively eliminate tumors. Additionally, the CS-6@CPB-S.lux + Laser treatment significantly transformed the immunosuppressive tumor microenvironment (TME), enhancing antitumor immunity through promoting the polarization of tumor-associated macrophages into antitumorigenic M1 and reducing Tregs recruitment. Consequently, this comprehensive therapy not only inhibited primary and abscopal tumor progression but also prevented TNBC metastasis, which significantly prolonged survival time in animal models. In summary, these findings indicated an alternative approach for metastatic TNBC therapy.

A Novel Targeted Microtubules Transformable Nanopeptide System Yields Strong Anti-Prostate Cancer Effects by Suppressing Nuclear Translocation of Androgen Receptors.

The extended use of androgen deprivation therapy (ADT) may often lead to the progression from castration-sensitive prostate cancer (CSPC) to castration-resistant prostate cancer (CRPC) in prostate cancer. To address this, it is essential to inhibit the nuclear translocation of the androgen receptor (AR) as part of an effective disease-modifying strategy. Microtubules play a central role in facilitating AR nuclear translocation, highlighting their importance as a therapeutic target. In this regard, a designated as the targeted microtubules transformable nanopeptide system (MTN) is developed. This system is designed to disrupt microtubule structure and function through dual-targeting of prostate-specific membrane antigen (PSMA) and β-tubulin. Initially, MTN targets prostate cells via PSMA and then specifically binds to β-tubulin within microtubules, leading to the formation of nanofibers. These nanofibers subsequently induce the polymerization of microtubules, thereby disrupting AR transport. Notably, MTN exhibits efficient and prolonged suppression of prostate cancer across the spectrum from CSPC to CRPC, with a highly favorable safety profile in normal cells. These findings highlight the potential of MTN as a novel and promising approach for comprehensive prostate cancer therapy throughout its entire progression.

Head injury management in road accident patients: a case report

Objective: To examine recovery outcomes for patients with head injuries from road traffic accidents (RTAs), focusing on neurosurgical care. Methodology: We studied patients admitted to our hospital with head injuries from RTAs. This included a case study of a 55-year-old man severely injured in a road accident, highlighting neuropsychological assessments and treatment outcomes. Results: The case report presents the successful recovery of a 55-year-old patient who sustained severe head injuries from a road traffic accident. Following neurosurgical intervention to remove blood clots and comprehensive neuropsychological therapy, the patient showed significant improvement in memory and cognitive functions. The outcomes demonstrate a positive response to the integrated treatment approach, with the patient regaining substantial normalcy in life over the course of three months. Conclusion: The case of a 55-year-old patient highlights the challenges and outcomes of treating severe head injuries resulting from RTAs. Key findings include the importance of immediate and appropriate neurosurgical care and neuropsychological support.

Polycystic ovary syndrome: new and promising treatment methods

Polycystic Ovary Syndrome (PCOS) - is a polygenic endocrine disorder caused by genetic, hormonal, and epigenetic factors. The importance of addressing PCOS lies in its prevalence, affecting approximately 10 to 13% of women, as well as the associated health conditions that can have a negative impact on women's lives, including infertility, dermatological manifestations of hyperandrogenism (such as hirsutism and acne), cardiovascular pathologies, metabolic disorders, and psychoemotional disorders. Currently, many theories of the development of this disease have been proposed, and as a consequence of methods of influencing and treating it. According to the clinical recommendations of the Ministry of Health of the Russian Federation, modifying the patient's lifestyle forms the basis of comprehensive therapy. We have analyzed about 60 articles on various dietary approaches to the treatment of PCOS, sourced from PubMed, Nature Reviews, Oxford Academic, Clinical Nutrition, EJOG, ScienceDirect, and MDPI. The Mediterranean diet, the DASH diet, the ketogenic diet and the low-carb diet have proven themselves the best. Also, it's necessary to add vitamin D, E, folic acid, calcium, various pro- and prebiotics to a woman's diet. Currently, the use of inositol and GPP-1 is becoming a promising method of PCOS therapy. According to the results of the analysis, a positive effect of diet therapy on the anthropometric and biochemical parameters was noted. Based on the analysis, a positive effect of diet therapy on anthropometric and biochemical parameters has been observed. It is crucial to consider the individual characteristics of each patient and not rely solely on drug therapy when approaching the treatment of PCOS.

LACTIC ACID BACTERIA AS INGREDIENTS OF PROBIOTIC PREPARATIONS

Lactic acid bacteria have a long and extensive application record as probiotic strains. Lately, due to wide-spread use of molecular-genetic, transcirptomic, proteomic, metabolomic etc. studies and the massive accumulation of data on the structure and functions of symbiotic intestinal microbiota, the interest in probiotic microorganisms tends to expand year-by-year. Lactic acid bacteria were the first used probiotic species, are still of sharp market demand and have been recognized as the most thoroughly studied microbes among functional relatives. However, characteristics inherent to probiotic bacteria are strain-specific, as a rule, and for preparations with defined purpose it is essential to select special strains showing a complex of appropriate properties. It accentuates the top relevance of research aimed at selection of lactic acid bacterial strains suitable for diverse probiotic preparations. For several decades we curried out investigations to isolate strains of lactic acid bacteria from various natural sources, to characterize their properties and to derive technologies of producing pro- and prebiotic preparations for farm stock, poultry, veterinary practice, food processing, cosmetic formulas, etc. Enrichment, in addition to bifidobacteria, of probiotic product Poultrybac with lactic acid bacteria showing high antagonistic activity toward pathogen Salmonella typhimurium and producing enzymes capable to hydrolyze feed oligo- and polysaccharides, promotes prevention of salmonellosis cases, normalizes gut microbiocenosis, contributes to assimilation of fodder, accelerates growth of broilers. Bacteria of genera Lacticaseibacillus, Limosilactobacillus, Lactococcus constitute bacterial preparation Bilametrit designed for prophylaxis and complex therapy of endometrites in cows, actively suppress growth of pathogenic microorganisms of the genera Staphylococcus, Streptococcus, Pseudomonas, Salmonella, Escherichia, including isolates from uterus exudate from animals with post-partum endometritis. Owing to the pronounced adhesive ability to protein ligands the selected lactic acid bacteria recover microbiocenosis in reproductive system, especially after antibiotic therapy, facilitate regeneration of endometrium, produce organic acids, antimicrobial peptides, amino acids, enzymes of carbohydrate and protein metabolism. Inclusion, in addition to bifidobacteria, of microorganisms of genus Lactiplantibacillus with a high antagonistic activity against pathogenic and opportunistic microorganisms responsible for inflammation of the mammary gland in animals as component of dry probiotic preparation Bactomast shifts the bias of the mammary gland biocenosis towards lactic acid bacteria, curtails general insemination level 2.4–4.8 times, provides a shield protecting from penetration of pathogenic agents, decreases the ratio of somatic cells in milk. The constituent bacterial strains raise non-specific macro host resistance, display tolerance to a series of antimicrobial compounds (antibiotics of aminoglycoside and cephalosporin groups), allowing to recommend it for comprehensive therapy of mastites in cows. Bactomast is not inferior to veterinary drug iodomastin in therapeutic efficacy (83.3%). A crucial characteristic of the above-mentioned preparations, as well as probiotics Lactimet, Bilavet (liquid form), Bilavet-C (dry product), complex probiotic Synvet, probiotic ingredient Lyobact in whole milk substitutes, dry bacterial concentrate IM-pro fortifying dairy products with probiotics is that they are safe and eco-friendly, i.e. they will not cause adverse effects on the body and reproductive functions of humans, animals, poultry, are not accompanied by health complications, do not deteriorate quality of milk and meat products. Farm products may be consumed without restraints following treatment with biopreparations.

Microliposuction and Radiofrequency Combined With Fat Grating as a New Method for Hybrid-Type Nasolabial Folds.

The hybrid-type nasolabial fold is a special, complex type of nasolabial fold with various causes, making it difficult to obtain an ideal effect with a single treatment. This study aimed to investigate the effect and complications of a comprehensive therapy combining microliposuction, radiofrequency, and fat grafting on hybrid-type nasolabial folds. Twenty-one patients aged 27 to 45 (mean: 34.71±5.41) years, who underwent the therapy for hybrid-type nasolabial folds were retrospectively analyzed. All patients were followed up for 12 months. Two independent observers conducted postoperative follow-ups at 1 week and 12 weeks. One week postoperatively, the hematoma, mass nodule, and skin scald ecchymosis scores were 1.24±0.43, 1.62±0.58, and 1.48±0.59, respectively. At 12 weeks, the scores of mass nodules and skin scald ecchymosis decreased (1.19±0.39 and 1.05±0.21, respectively) without obvious hematoma. The WSRS grade decreased from 4.33±0.47 to 2.19±0.39 (P<0.001), and the hybrid-type nasolabial folds significantly improved. The Face-Q scale score was 20.43±2.63 points (standard score: 85.12±10.95 points). 76.19% of the patients scored more than 80 points in the subjective Face-Q evaluation. Microliposuction and radiofrequency combined with fat grafting effectively treats hybrid-type nasolabial folds, resulting in high patient satisfaction. Most complications can be prevented, and optimal outcomes can be obtained by comprehensive surgical methods and correct procedures, which is thus worthy of clinical promotion.

Clinical presentations and diagnostic approaches of pediatric necrotizing tracheobronchitis with influenza A virus and Staphylococcus aureus co-infections

In March 2023, our pediatric intensive care unit (PICU) retrospectively examined six cases of pediatric necrotizing tracheobronchitis (NTB), focusing on co-infections with influenza A virus (IAV) and Staphylococcus aureus (S. aureus). This study aimed to elucidate NTB’s clinical characteristics, diagnostics, and therapeutic approaches. Diagnostics included symptom assessment, microbiological testing that confirmed all patients were positive for IAV H1N1 with a predominant S. aureus co-infection, and bronchoscopy. The patients predominantly exhibited fever, cough, and dyspnea. Laboratory analysis revealed decreased lymphocyte counts and elevated infection markers like C-reactive protein and procalcitonin. Chest computed tomography (CT) scans detected tracheobronchial obstructions in half of the cases, while bronchoscopy showed severe mucosal congestion, edema, necrosis, and purulent-hemorrhagic exudates. Treatments encompassed comprehensive strategies like oxygen therapy, intubation, bronchoscopic interventions, thoracentesis, oseltamivir, and a regimen of antibiotics. Our findings suggested potential correlations between clinical markers, notably lymphocyte count and procalcitonin, and clinical interventions such as the number of rescues and intensive care unit (ICU) duration. This research highlights the importance of early detection and the role of bronchoscopy and specific markers in assessing NTB, advocating for continued research in larger cohorts to better understand its clinical trajectory and refine treatment approaches for this challenging pediatric disease.