Organ Disorders Research Articles

On the issue of surgical treatment of patients with congenital orofacial clefts combined with other organ and system comorbidities

Relevance. Surgical treatment of patients with congenital orofacial clefts and comorbidities of other organs and systems remains a complex problem in specialized surgery, and it requires concentration of knowledge of individual characteristics and diagnosed disorders during their implementation, taking into account the sequence, volume and time of execution.Purpose. Optimize the tactics of surgical treatment of children born with orofacial clefts combined with disorders of other organs and systems, improving rehabilitation effectiveness.Material and methods. The work focuses on the results of a study of 2475 patients with congenital orofacial defects during the long-term follow-up period (1998-2022) in the Bonum Medical Center (Yekaterinburg). There were 823 cases of congenital orofacial clefts combined with disorders of other organs and systems. The disease combination groups were systematized and determined the tactics of surgical treatment of orofacial defects and the rehabilitation techniques for comorbid defects.Results. To date, out of 823 patients with orofacial clefts and comorbidities of other organs and systems, 591 (71.81%) patients are known to have received comprehensive surgical rehabilitation, part of them turned 18 years and were withdrawn from the long-term follow-up care, the rest – 232 (28.19%) continued to receive specialized care in the Bonum Center system. Of the 823 patients, 370 children needed primary cheilo-rhinoplasty, 196 people (52.97%) had surgery at the traditionally accepted time (in the first six months of the child's life), 302 children (81.62%) had surgery by the age of nine months, and 329 children (88.92%) by one year. Based on the individual indications, thirty-six children (9.73%) had surgery after one year, of which eight patients (2.16%) after two years. Of the 823 patients, 770 people needed palatoplasty (cleft repair of hard and soft palates), while in the conditions of special preparation, the operation was performed in 360 children (46.75%) by 18 months, in 483 children (62.73%) by24 months, and 588 children (76.36%) by the age of 3 years. Considering the cleft palate complexity, 102 children (13.25%) needed further treatment later due to physical condition restrictions and social reasons.Conclusion. The proposed strategy of surgical treatment of children with orofacial clefts combined with disorders of other organs and systems allows treatment of congenital orofacial malformation in the most favourable period based on the patient's physical condition.

ANALISIS KUALITATIF FAKTOR PERILAKU SEKSUAL PRANIKAH REMAJA BERDASARKAN TEORI PERILAKU LAWRENCE GREEN (Studi Kasus di Wilayah Kerja Puskesmas Cilembang Kota Tasikmalaya)

Adolescence is a period of transition from children to adults. Adolescence is a period of transition from children to adults. Behavior that leads to intimacy, sexual attraction and sexual habits carried out by two people of the same sex or the opposite sex before a legal marriage is called premarital sex behavior. This study aims to determine what factors can influence adolescent premarital sexual behavior based on the behavioral theory of Lawrence Green and Sarwono and how it impacts. The method in this research is a qualitative method with a case study approach. Informants are teenage girls who have premarital sex. The results of this study indicate predisposing factors for premarital sexual behavior, namely lack of knowledge, increased sexual libido, emotions, expectations, enabling factors for sexual behavior, namely the use of technological developments and information that is not wise. Reinforcing factors for sexual behavior are the attitudes of parents who taboo on sex, attitudes of peers that have a negative influence, delaying the age of marriage, tabooing sex, sexual violence, role vacancies, economics, conditions for joining the group. The impact of this sexual behavior is depression, low self- esteem, reproductive organ disorders, STD, pregnancy out of wedlock, sex addiction, regret, decreased school performance, social sanctions, sex becomes a teenage lifestyle, and sexual deviations. Therefore, to overcome this, it takes a wise attitude from parents, the community, health workers, and the youth themselves, so that they can get through the transition period safely.

TREM1 КАК ВАЖНЫЙ УЧАСТНИК В РАЗВИТИИ КРИТИЧЕСКИХ ОСЛОЖНЕНИЙ У КАРДИОХИРУРГИЧЕСКИХ ПАЦИЕНТОВ

Introduction: It is known that the variability of immune response genes and the corresponding immune profile modulate the risk of a number of pathologies. Understanding the role of the immunogenetic status based on the variability of innate immunity receptors in the dynamics of the systemic inflammatory response of non-infectious genesis in open cardiac surgery, as well as the issues of objective assessment and possible correction of complications in the form of multiple organ failure (MOF), remain relevant. Objective: To determine those alleles of the TREM1 gene that are associated with the risk of developing POF in patients after coronary artery bypass grafting and which levels of sTREM1 may be of diagnostic significance. Materials and methods: A comprehensive examination of 680 patients with atherosclerosis of the coronary arteries was performed on the basis of the Federal State Budgetary Scientific Institution "NII KPSSZ" in the preoperative and early postoperative periods of coronary artery bypass grafting. Two groups were retrospectively formed, differing in the presence/absence of MOF in the early postoperative period. Based on clinical and laboratory data, the first group included 30 patients (4.4%) with MOF established in the early postoperative period (SOFA score over 4 points, combined dysfunction of 2 or more systems with further progression of organ disorders) and 650 patients (95.6%) were included in the second group - with an uncomplicated course of the postoperative period (score on the SOFA scale less than 4 points, disorders of 1-2 organ systems that occur with minor clinical manifestations and do not require long-term correction and support). Serum concentrations were determined by ELISA twice - before surgery and 24 hours (1 day) after surgery. Genotyping of 8 TREM1 polymorphic variants (rs1817537, rs3804277, rs6910730, rs7768162, rs2234246, rs4711668, rs9471535, rs2234237) was performed according to the protocol of the TagMan probe manufacturer by PCR with real-time detection of amplification products. Statistical data processing was carried out using SNPstats and GraphPad Prism 8 software. Results: It was found that in individuals with the T rs2234246 allele (p=0.0076), the G rs1817537 allele (p=0.019) and the T rs3804277 allele (p=0.019) of TREM1, the risk of developing POF after coronary artery bypass grafting increases. Carrying a homozygous genotype for a rare allele in these polymorphic variants is associated with a high concentration of sTREM1 at the preoperative stage (p=0.0005). It was also found that the most pronounced increase in the concentration of sTREM1 in the preoperative and early postoperative periods was observed in critically ill patients. Differences in sTREM1 concentrations between groups were significant throughout the intraoperative period (p<0.0001 and p<0.0001, respectively). Conclusion: It has been established that the concentration of sTREM and the carriage of rare alleles in certain polymorphic sites of the TREM1 gene (T rs2234246 allele, G rs1817537 allele and T rs3804277 allele), as well as their relationship with the level of circulating sTREM, demonstrate their significance in the development of MOF in patients with coronary artery disease after undergoing coronary artery bypass grafting.

Structural similarity of human papillomavirus E4 and polyomaviral VP4 exhibited by genomic analysis of the common kestrel (Falco tinnunculus) polyomavirus

Polyomaviruses are widely distributed viruses of birds that may induce developmental deformities and internal organ disorders primarily in nestlings. In this study, polyomavirus sequence was detected in kidney and liver samples of a common kestrel (Falco tinnunculus) that succumbed at a rescue station in Hungary. The amplified 5025 nucleotide (nt) long genome contained the early (large and small T antigen, LTA and STA) and late (viral proteins, VP1, VP2, VP3) open reading frames (ORFs) typical for polyomaviruses. One of the additional putative ORFs (named VP4) showed identical localization with the VP4 and ORF-X of gammapolyomaviruses, but putative splicing sites could not be found in its sequence. Interestingly, the predicted 123 amino acid (aa) long protein sequence showed the highest similarity with human papillomavirus E4 early proteins in respect of the aa distribution and motif arrangement implying similar functions. The LTA of the kestrel polyomavirus shared <59.2% nt and aa pairwise identity with the LTA sequence of other polyomaviruses and formed a separated branch in the phylogenetic tree among gammapolyomaviruses. Accordingly, the kestrel polyomavirus may be the first member of a novel species within the Gammapolyomavirus genus, tentatively named Gammapolyomavirus faltin.

Identification and detection of microRNA kidney disease biomarkers in liquid biopsies.

MicroRNAs (miRNAs) are emerging rapidly as a novel class of biomarkers of major organ disorders, including kidney diseases. However, current PCR-based detection methods are not amenable to development for high-throughput, cost-effective miRNA biomarker quantification. MiRNA biomarkers show significant promise for diagnosis and prognosis of kidney diseases, including diabetic kidney disease, acute kidney injury, IgA nephropathy and delayed graft function following kidney transplantation. A variety of novel methods to detect miRNAs in liquid biopsies including urine, plasma and serum are being developed. As miRNAs are functional transcripts that regulate the expression of many protein coding genes, differences in miRNA profiles in disease also offer clues to underlying disease mechanisms. Recent findings highlight the potential of miRNAs as biomarkers to detect and predict progression of kidney diseases. Developing in parallel, novel methods for miRNA detection will facilitate the integration of these biomarkers into rapid routine clinical testing and existing care pathways. Validated kidney disease biomarkers also hold promise to identify novel therapeutic tools and targets. http://links.lww.com/CONH/A43.

Clinical and hematological сhanges in viral panleukopenia in cats

Cat infectious diseases have become widespread due to the increase in the number of stray cats; feline viral panleukopenia is no exception. It is caused by a single-stranded DNA virus of feline parvovirus, characterized by high contagiousness, fever, damage to the gastrointestinal tract, respiratory organs, heart, general intoxication, and body dehydration. The research aimed to study the hematological indices of blood and biochemical indices of plasma in viral panleukopenia of cats. During the development of intestinal panleukopenia syndrome in animals, vomiting and diarrhea were noted. The development of inflammatory processes in the digestive organs causes pain in the abdominal cavity, due to which a specific “sitting posture” occurs. An acute course was most frequently noted, characterized by a sudden increase in temperature to 42 °C, vomiting, diarrhea, and cachexia. Studies of hematological indices of blood indicate the development of thrombocytosis, neutrophilia, monocytosis, and lymphocytosis, which corresponds to the acute course of the disease with a focal inflammatory process. Erythropenia leads to systemic disorders of the cardiovascular system, which provoke the weakening of the body, accompanied by cachexia. Studies of biochemical parameters of plasma indicate systemic disorders of organs developing in the body. Thus, an increase in total protein indices and globulin fractions indicates inflammatory processes in the body, particularly the digestive and urinary organs. In addition, one of the renal impairment indices was an increase in creatinine and urea, and an increase in glucose, total bilirubin, AST, and α-amylase indicates liver and pancreas dysfunction. In some cases, hepatitis and infectious toxicosis may develop. The study of hematological indices of blood and biochemical indices of plasma will ensure a complex picture of morphological changes that develop in the body of cats with panleukopenia. The obtained data will permit the monitoring of an animal's condition with the applied therapeutic scheme and the form of a prognosis.

Наднормативні концентрації хлороформу та сульфату алюмінію у питній воді та їхній вплив на метаболічні процеси в організмі лабораторних тварини

Objective: determination of the nature and features of changes in biochemical indicators in the blood of animals under conditions of chronic exposure to different concentrations of chloroform and aluminum sulfate in drinking water in an isolated and combined state to substantiate the criteria for hygienic evaluation of their adverse effects on the body. Materials and methods: combined effect of chloroform and aluminum sulfate on biochemical indicators. Results: According to the results of biochemical studies, it should be noted that the most pronounced changes were observed in groups of animals that were exposed to CLF and Al in isolation at the level of 3 MPC and 5 MPC, and in groups of animals with combined exposure to the specified substances - CLF + Al at the level of 3 MPC аnd 5 MPC. A decrease in the content of AsT and an increase in the level of AlT in the above experimental groups of animals may indicate functional disorders of the liver, especially its enzymatic function. The indicated changes in the content of glucose and amylase in the blood as indicators of carbohydrate volume may indicate the activation of the processes of glycogenesis and glycolysis in the animal body, which may lead to functional disorders of the pancreas. Іt was established that the nature and severity of the effects depended on the nature of the influence of the studied factors (isolated or combined action), their MPC levels, and the time of exposure. Conclusions. The nature and features of changes in biochemical indicators in the body of experimental animals during a six-month chronic sanitary-toxicological experiment with isolated and combined effects of chloroform and aluminum sulfate in drinking water may indicate metabolic disorders in organs and changes in the intensity of regenerative processes at the cellular level in response to the adverse effects of toxicants. Such a tendency to imbalance indicators can be a kind of indicator of metabolic compensatory changes in the body under the influence of a complex of factors, depending on the current level and duration of action.

Effects of low doses of methylmercury (MeHg) exposure on definitive endoderm cell differentiation in human embryonic stem cells.

Fetal development is one of the most sensitive windows to methylmercury (MeHg) toxicity. Laboratory and epidemiological studies have shown a dose-response relationship between fetal MeHg exposure and neuro performance in different life stages from infants to adults. In addition, MeHg exposure has been reported to be associated with disorders in endoderm-derived organs, such as morphological changes in liver cells and pancreatic cell dysfunctions. However, the mechanisms of the effects of MeHg on non-neuronal organs or systems, especially during the early development of endoderm-derived organs, remain unclear. Here we determined the effects of low concentrations of MeHg exposure during the differentiation of definitive endoderm (DE) cells from human embryonic stem cells (hESCs). hESCs were exposed to MeHg (0, 10, 100, and 200nM) that covers the range of Hg concentrations typically found in human maternal blood during DE cell induction. Transcriptomic analysis showed that sub-lethal doses of MeHg exposure could alter global gene expression patterns during hESC to DE cell differentiation, leading to increased expression of endodermal genes/proteins and the over-promotion of endodermal fate, mainly through disrupting calcium homeostasis and generating ROS. Bioinformatic analysis results suggested that MeHg exerts its developmental toxicity mainly by disrupting ribosome biogenesis during early cell lineage differentiation. This disruption could lead to aberrant growth or dysfunctions of the developing endoderm-derived organs, and it may be the underlying mechanism for the observed congenital diseases later in life. Based on the results, we proposed an adverse outcome pathway for the effects of MeHg exposure during human embryonic stem cells to definitive endoderm differentiation.

The Relationship Between Spiritual Well-Being and Post-Traumatic Growth in Turkish Patients Undergoing Solid Organ Transplantation.

This study was conducted to determine the relationship between spiritual well-being and post-traumatic growth in solid organ transplant patients. This cross-sectional study was conducted with 366 patients who presented to the organ transplantation polyclinic of a university hospital between September 2021 and February 2022 in Turkey. The mean Post-Traumatic Growth Inventory and Spiritual Well-Being Scale scores of solid organ transplant patients were 81.33 ± 20.28 and 37.18 ± 8.69, respectively. There was a significant positive correlation between post-traumatic growth and spiritual well-being. According to linear regression analysis, spiritual well-being, gender, marital status, transplanted organ, donor type, and previous mental disorders were statistically significant predictive factors that affected post-traumatic growth. Spiritual well-being was an important variable that affected post-traumatic growth in solid organ transplant patients. Therefore, healthcare providers can provide individualized psychosocial-spiritual care and counseling services that increase post-traumatic growth in patients after organ transplantation.

Extracellular water to total body water ratio, a novel predictor of recurrence in patients with colorectal cancer.

Total body water (TBW) fraction, which accounts for 60% of body weight, is an important indicator of body composition, and the extracellular water to TBW ratio (ECW/TBW) is reportedly useful in predicting clinical outcomes of patients with organ disorders. We aimed to clarify the clinical impact of preoperative ECW/TBW status on survival outcomes in cancer patients. We used a database of 320 colorectal cancer (CRC) patients who underwent potentially curative resections. Preoperative ECW/TBW was measured using a bioelectrical impedance analysis (BIA), and its correlation with patient survival outcomes, clinicopathological factors, laboratory data, and comorbidities were analyzed. A high preoperative ECW/TBW was significantly associated with poorer relapse-free survival (RFS; p = 0.001) and overall survival (OS; p = 0.003). A high ECW/TBW ratio was significantly associated with older age (p < 0.001), low BMI (p = 0.009), and right-sided tumors (p = 0.03). In a multivariate analysis, a high ECW/TBW significantly predicted a higher RFS mortality (HR: 2.07, 95% CI: 1.10-3.88, p = 0.024) and OS mortality (HR: 3.23, 95% CI: 1.25-8.36, p = 0.016). Furthermore, a high ECW/TBW was significantly associated with lower hemoglobin (p < 0.001) and albumin levels (p < 0.001), but not comorbidities. A high preoperative ECW/TBW was a predictive factor for recurrence and poorer overall survival independent of the tumor, node, and metastasis (TNM) stage. Our data suggest that preoperative evaluation of ECW/TBW using BIA might serve as a novel tool for developing CRC treatment strategies.

Dysregulations of metabolites and gut microbes and their associations in rats with noise induced hearing loss.

Noise exposure could lead to hearing loss and disorders of various organs. Recent studies have reported the close relations of environmental noise exposure to the metabolomics dysregulations and gut microbiota disturbance in the exposers. However, the associations between gut microbial homeostasis and the body metabolism during noise-induced hearing loss (NIHL) were unclear. To get a full understanding of their synergy in noise-associated diseases, it is essential to uncover their impacts and associations under exposure conditions. With ten male rats with background noise exposure (≤ 40 dB) as controls (Ctr group), 20 age- and weight-matched male rats were exposed to 95 dB Sound pressure level (SPL) (LN group, n = 10) or 105 dB SPL noise (HN group, n = 10) for 30 days with 4 h/d. The auditory brainstem response (ABR) of the rats and their serum biochemical parameters were detected to investigate their hearing status and the potential effects of noise exposure on other organs. Metabolomics (UPLC/Q-TOF-MS) and microbiome (16S rDNA gene sequencing) analyses were performed on samples from the rats. Multivariate analyses and functional enrichments were applied to identify the dysregulated metabolites and gut microbes as well as their associated pathways. Pearson correlation analysis was performed to investigate the associations of the dysregulations of microbiota and the metabolites. NIHL rat models were constructed. Many biochemical parameters were altered by noise exposure. The gut microbiota constitution and serum metabolic profiles of the noise-exposed rats were also dysregulated. Through metabolomics analysis, 34 and 36 differential metabolites as well as their associated pathways were identified in LN and HN groups, respectively. Comparing with the control rats, six and 14 florae were shown to be significantly dysregulated in the LN group and HN group, respectively. Further association analysis showed significant correlations between differential metabolites and differential microbiota. There were cochlea injuries and abnormalities of biochemical parameters in the rats with NIHL. Noise exposure could also disrupt the metabolic profiles and the homeostatic balance of gut microbes of the host as well as their correlations. The dysregulated metabolites and microbiota might provide new clues for prevention of noise-related disorders.

Abstract P2105: Store-Operated Channels Mediate Metabolic Adaptations In Activated Fibroblast During Cardiac Fibrosis

Endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR) are associated with developing fibrotic disorders in multiple organs, including the heart. Many ER resident chaperones require calcium (Ca2+) as a co-factor to mediate protein folding. Store-operated Ca2+ entry (SOCE) mediated by the Orai1 channels primarily maintains the ER- Ca2+ homeostasis. However, the role of the Orai1 channels in the modulation of ER-stress/UPR and downstream cellular processes that lead to cardiac fibrosis is not entirely understood. To investigate the role of Orai1 channels on the ER-stress/UPR signaling we utilized a multilayered approach that includes both genetic and pharmacological inhibition of Orai and a combination of long-term real-time cell imaging combined with genetically encoded sensors for several metabolites signaling. Our results showed that Orai1 expression was upregulated in the fibrotic mouse heart. Transcriptome analysis of fibrotic tissue from a fibroblast-specific Orai1 knock-out mouse model revealed the dysregulation of many genes associated with cell metabolism and collagen turnover. Pharmacological inhibition of Orai1 channel activity in cultured cardiac fibroblast decreased ER-Ca2+ and mitochondrial Ca2+ levels and was sufficient to trigger ER-stress/UPR and promote mitochondrial dysfunction. Like the in vivo fibrotic model, comparative transcriptome and pathway analysis between cells treated with Orai1 blocker (YM-58483, 48 hours) and controls identified dysregulated metabolic pathways and ER-stress/UPR signaling. Bioenergetic analysis showed that Orai1 inhibition induced an overall decrease in oxygen consumption rate (OCR), and mitochondrial membrane potential and reduced cellular ATP levels. Accordingly, we found that Orai1 loss-of-function increased glycolysis and reduced fatty acid oxidation (FAO), substantially reducing fibroblast fuel flexibility. This is a remarkable novel function of Orai1 channels because perturbations in fibroblast metabolic dynamic are the initial steps in the injury response. Our results suggest that Orai1 could be a novel target for developing treatments for fibrosis.

EFFECT OF RED DRAGON FRUIT (HYLOCEREUS POLYRHIZUS) PEEL ETHANOL EXTRACT ON VAGINAL WALL COLLAGEN EXPRESSION IN MENOPAUSE MODEL RATS

The skin of red dragon fruit (Hylocereus polyrhizus) contains polyphenols, in particular anthocyanins, which may act as phytoestrogens and antioxidants. Phytoestrogens can help synthesize collagen through their bonds with estrogen receptors and antioxidants prevent the accumulation of free radicals that can damage collagen, so the skin of red dragon fruit has the potential to prevent vaginal organ disorders due to the reduced amount of collagen in the vaginal wall during menopause. This study aims to prove the effectiveness of the ethanol extract of Hylocereus polyrhizus rind in preventing decreased collagen in the vaginal wall of menopausal rats. This study was structured using a randomized post-test only control group design on 30 female Wistar rats, which were divided into three groups, namely the control group (P0) was given normal saline, the treatment group (P1) was given ethanol extract 60mg/200grBW and (P2) was given ethanol extract 90mg/200grBB. Dosing rats orally for 30 days, then vaginal wall samples were taken to examine vaginal collagen levels with Sirius red staining. The amount of collagen is calculated by the percentage area of ??the collagen pixels compared to the pixels of the entire vaginal tissue. The results show that the mean amount of collagen at P0, P1 and P2 is 55.53 ± 8.12 respectively; 67.50±3.89; 78.14±5.87. The One-way ANOVA test shows statistically significant differences among the groups (p = 0.000). The post hoc analysis using the LSD test finds that the mean amount of vaginal collagen in P2 is the highest than P0 (p=0.000) and P1 (p=0.001) and P1 is higher than P0 (p=0.000). It is concluded that giving of ethanol extract of Hylocereus polyrhizus rind is able to prevent the decrease in vaginal wall collagen in menopausal rats.

Influence of obesity on the tone of bronchial smooth muscles in rats

Background. Overweight and obesity are key factors for the occurrence of many morphofunctional disorders in organs and tissues, including bronchopulmonary system.The aim. To study the influence of metabolic disorders that occur against the background of obesity on the state of the airways tone in rats.Materials and methods. Obesity in male Wistar rats was induced using a high-fat and high-carbohydrate diet. In animals, body weight and fat mass were measured, and the heart-lung complex was extracted. In blood serum, the levels of glucose, insulin, leptin, triglycerides, and cholesterol were assessed. Bronchoalveolar lavage fluid was obtained by an open method, in which the concentration of protein, interleukin (IL) 6 and IL-10 was determined. The contractile activity of the isolated bronchial smooth muscle segments was studied using mechanographic method. The effect of acetylcholine (10–7–10–4 M), indomethacin (10–5 M), and forskolin (10–7–10–5 M) on the changes in the tone of airway smooth muscles was assessed.Results. High-fat and high-carbohydrate diet caused an increase in body weight, visceral obesity, hyperglycemia, insulin resistance, leptinemia, dyslipidemia in rats of the experimental group. In the bronchoalveolar lavage fluid of experimental animals, an increase in the content of protein and IL-6 was found, which positively correlated with the level of leptin and the fat mass. In obese rats, the contractile responses of bronchial smooth muscle segments increased in response to the effect of the cholinergic agent acetylcholine. The bronchoconstrictor effect of acetylcholine was reduced by the cyclooxygenase inhibitor indomethacin. In turn, the adenylate cyclase activator forskolin caused relaxation of the airway segments smooth muscles in rats of both groups, which was more pronounced in the experimental group.Conclusion. The obtained results indicate that the change in the reactivity of the respiratory tract can be the cause of bronchospastic conditions in obesity and of the inflammatory reaction in the respiratory system induced by obesity.

Human Health and Exposure to Hazardous Substances

Hazardous chemicals are called life-threatening particles because they have the ability and character to pose a threat and risk to human health and the environment. They have ignitability, toxicity, corrosivity, oxidative and ecotoxicity characteristics, which may be included in flammable liquids, gases, solids, explosive or blasting substances, and infectious or infectious radioactive agent elements. The route of exposure is either through ingestion, inhalation, absorption or injection by contact of people which hazardous chemicals containing water, soil, food and air. This causes many health hazards, including chronic and acute disorders of eyes, skin and other body organs and damages the functioning of specific organs. However, these substances' health surveillance and risk assessment exposure can be controlled.

Difficulties of diagnosis and the need for a comprehensive approach to treatment of patients with X-ray non-contrast orbital foreign bodies

Introduction. An orbital foreign body, especially of an organic nature, is often difficult to diagnose during the initial examination. A thorough history taking, clinical examination, and the use of additional imaging techniques are of great importance. Due to the risk of purulent-inflammatory complications, foreign bodies must be surgically removed.The aim of the work was to demonstrate the importance of timely diagnosis and complex approach to treatment of patients with X-ray non-contrast foreign bodies of the orbit using the example of clinical observation.Materials and methods. Patient R. came in with complaints of redness, pain, lacrimation and lack of vision in the left eye after falling and hitting the left side of his face on a metal corner. Left eye visual acuity = 1/∞PrLinc, IOP = T−3 (palpatory).Results. Control X-ray computed tomography (CT) of the orbits and paranasal sinuses (PNS) suspected the presence of a radiopaque foreign body. A rhinoendoscopic examination was performed by an otorhinolaryngologist and a fragment of a large wooden foreign body was found in the nasopharyngeal arch. Surgeons of the ophthalmologic and otorhinolaryngologic departments performed surgery: removal of the foreign body, endonasal endoscopic opening of the labyrinth on the left, endoscopic endonasal maxillary sinus maxillary sinus maxillotomy on the left, left microcoidectomy, resection of trauma-exposed tissue. During his stay in the 2nd Ophthalmologic Department of the Regional Clinical Hospital named after N.A. Semashko. N.A. Semashko Regional Clinical Hospital, the patient’s condition improved, infection was eliminated, prevention of possible complications was carried out. The patient was referred to the Pirogov National Medical-Surgical Center, where the following surgery was performed: microinvasive vitrectomy + FEC + PFOS + retinotomy + endotamponade with silicone oil 1300 of the left eye, and a consultation with a laser surgeon was recommended for laser iridectomy.Discussion The clinical case considers a comprehensive approach to the treatment of intraorbital foreign bodies, the participation of a multidisciplinary team of specialists, while the patient still has a long road to rehabilitation.Conclusion In orbital trauma with penetration of a foreign body, an accurate history, timely diagnosis, and rational surgical and conservative treatment are important. This will help to avoid serious complications and prevent visual and oculomotor disorders of the visual organ.

Improvement of System Thinking Skills on Excretory System Subject

Background: System thinking skills are a learning process that improves system thinking or systematic thinking in students. The purpose of this study was to determine the increase in Systems Thinking Skills (KBS) by using the Guided Inquiry Learning Model on Human Excretion System Material for class XII MIPA students in a school in Subang. Methods: This research method uses quantitative research with a quasy experimental design. Results: The results of the analysis of the increase or N-gain obtained by system thinking skills (KBS) using the guided inquiry model show that there are five categories of high system thinking skills (KBS) indicators, namely the fourth indicator analyzes disorders of the excretory system organs of 0.5472, and the indicator that the lowest, namely the second indicator examines the four functions of the excretory system of 0.0220. Conclusion: Thus it can be concluded that there is a positive influence of the Guided Inquiry Learning Model on Systems Thinking Skills (KBS) in Excretion System Material for Class XI MIPA Students in Subang Regency. Keywords : Guided Inquiry; Systems Thinking Skills; Learning model

Impact of using the principle of spectral-dynamic analysis of the intensity of the electret field of the "Vim Vitae" electronic complex on a living organism

The narrow-specialization approach that dominates academic medicine today does not contribute to the development of a health preservation strategy. Treatment "according to the scheme" practically ignores the individual characteristics of each organism with its momentary states. The success of the fight for people's health is largely determined by the degree of development and implementation of an effective strategy for diagnosis, correction and continuous monitoring of the quality of life of a specific person. Purpose: of the article is to substantiate the effectiveness of the use of innovative quantum technologies in the system of providing correctional and rehabilitation services to persons with functional disorders of the psycho-physical state (post-acute syndrome, protection against electromagnetic radiation, bacterial and viral forms). Material &amp; Methods: The implementation of the research became possible due to the use of the hardware and software complex "Vim Vitae", which included an electronic device for receiving and transmitting electrical bio-potentials; electronic module for converting electromagnetic vibrations; a special computer program for a smartphone, personal computer (PC), laptop, tablet, etc.; servers with algorithms for automatic processing of personalized data, databases of electronic markers, recommendations, etc. The work also used the results of a survey of the center's clients. The individual questionnaire (98 questions) included information about the reasons for contacting the Center, subjective self-assessment of the quality of life, and also contained data about the functional capabilities of individual body systems, about the diet, daily movement patterns, and psycho-emotional state. Results: Innovative technologies and informatics-metric methods of diagnosis and correction of a person's psycho-physical state allow not only to quickly and accurately identify the causes of functional changes in the body, but can also become a convenient and effective means of control/self-monitoring of health, remote monitoring, and health protection from electromagnetic radiation, bacterial and viral forms. Conclusions: According to the key provisions of the "WHO Strategy in the Field of Traditional Medicine 2014-2023," the results of our research prove the effectiveness of using hardware complexes "ARC", "АRK.exe", "VV". Innovative technologies using the mentioned hardware complexes can be recommended as an independent method of early (pre-clinical) detection of psycho-physical state disorders, organization of correctional rehabilitation activities, and/or in combination with other methods of therapy for functional disorders of organs and systems in order to provide modern multi-functional assistance to individuals, as well as an individual remote means of monitoring (self-monitoring) the state of health, when the generally accepted in medical practice means of therapy have shown their inefficiency.

The Current Market of Pharmacological Drugs for the Prevention and Treatment of Obesity in Ukraine: A Review

Obesity is one of the problems of current century, which is the cause of complex disorders of organs and systems of the human body, up to the development of lethal outcomes. The modern market of pharmaceutical medicine preparations for treatment and prevention is quite extensive. The main treatment of diseases that is proven on the basis of evidence, including for preventive purposes, is the inclusion of such drugs in fever protocols throughout the country. The purpose of this study is to examine the current market of drugs for the prevention and treatment of obesity in Ukraine.

Cellular Pathophysiology of Leptospirosis: Role of Na/K-ATPase.

Inada and Ido identified Leptospira sp. as the pathogen responsible for Weil's Disease in 1915. Later, it was confirmed that Leptospira causes leptospirosis. The host microorganism's interaction at the cellular level remained misunderstood for many years. Although different bacterial components have been isolated and purified, the complexity of the molecular interactions between these components and the host and the molecular mechanisms responsible for the systemic dysfunctions still needs to be fully unveiled. Leptospirosis affects virtually all animal species. Its cellular pathophysiology must involve a ubiquitous cellular mechanism in all eukaryotes. Na/K-ATPase is the molecular target of the leptospiral endotoxin (glycolipoprotein-GLP). Na/K-ATPase dysfunctions on different types of cells give rise to the organ disorders manifested in leptospirosis. Concomitantly, the development of a peculiar metabolic disorder characterized by dyslipidemia, with increased levels of circulating free fatty acids and an imbalance in the fatty acid/albumin molar ratio, triggers events of cellular lipotoxicity. Synergistically, multiple molecular stimuli are prompted during the infection, activating inflammasomes and Na/K-ATPase signalosome, leading to pro-inflammatory and metabolic alterations during leptospirosis. Leptospirosis involves diverse molecular mechanisms and alteration in patient inflammatory and metabolic status. Nonetheless, Na/K-ATPase is critical in the disease, and it is targeted by GLP, its components, and other molecules, such as fatty acids, that inhibit or trigger intracellular signaling through this enzyme. Herein, we overview the role of Na/K-ATPase during leptospirosis infection as a potential therapeutic target or an indicator of disease severity.