First Year Of Observation Research Articles

Prognostic factors for restoring orgasmic function in patients after radical prostatectomy

Background. Radical prostatectomy (RP) remains the gold standard in prostate cancer treatment. RP often has side effects that negatively affects quality of life. Influence on sexual life, in particular, orgasmic function (OF) of patients is one of the most actual issues that require additional research.Objective. Analysis of OF after RP as well as OF's pathologies are presented in our study.Materials and methods. The study includes 146 patients with safe sexual life on preoperative period, who underwent RP for prostate cancer in S.P. Botkin City Clinical Hospital. 79.5 % had robot-assisted laparoscopic prostatectomy and 20.5 % — retropubic RP. Mean age of patients was 61.1 ± 6.5 years. Erectile function was assessed by the International Index of Erectile Function (IIEF), the sum median was 25 points. Observation period was 12 months.Results. OF recovered in 65.7 % of patients in one year after RP versus 30.1 % in erectile function recovery. Climacturia was detected in 21.9 % patients, painful orgasm in 13 % patients.Conclusion. OF recovered in most patients till the end of the first year of observation. Younger age, safe pre- and postoperative erectile function, nerve-sparing surgery have positively affected OF recovery. Further researches needed to find statistically more relevant OF recovery predictors after RP, prevention of its pathologies.

Kidney Function, Kidney Function Decline, and the Risk of Dementia in Older Adults: A Registry-Based Study.

ObjectiveCommunity-based reports regarding the association between the estimated glomerular filtration rate (eGFR) and dementia risk show conflicting results. The aim of this study is to investigate the links among kidney function, kidney function decline, and dementia incidence.MethodsWe analyzed the association of eGFR with the risk of dementia (defined as a new dementia diagnosis or initiation of dementia treatments) among 329,822 residents of Stockholm who accessed health care during 2006 to 2011, were ≥65 years of age, had no history of dementia, or underwent kidney replacement therapy. We also estimated the rate of eGFR decline among 205,622 residents with repeated eGFR measurements during the first year of observation and investigated its association with subsequent dementia risk.ResultsWe detected 18,983 cases of dementia (5.8% of participants) over a median follow-up of 5 years. Dementia incidence rates were progressively higher with lower eGFR: from 6.56/1,000 person-years in those with eGFR of 90 to 104 mL/min to 30.28/1,000 person-years in those with eGFR <30 mL/min. After multivariable adjustment, lower eGFR was associated with a higher dementia risk (hazard ratio [HR] 1.71, 95% confidence interval [CI] 1.54–1.91 in eGFR 30–59 mL/min; HR 2.62, 95% CI 1.91–3.58 in eGFR <30 mL/min) compared with eGFR of 90 to 104 mL/min. A steeper decline in eGFR (decline >2 mL/min/1.73 m2/y) within 1 year was associated with higher dementia risk. Risk magnitudes were stronger for vascular dementia than for Alzheimer dementia. As many as 10% (95% CI 6%–14%) of dementia cases could be attributed to eGFR <60 mL/min/1.73 m2, a proportion higher than that attributed to other dementia risk factors such as cardiovascular disease and diabetes.ConclusionsBoth lower kidney function and steeper kidney function decline are associated with the development of dementia.

Initial Results of Long-term Continuous Observation of Lightning Discharges by FALMA in Chinese Inland Plateau Region

We started a long-term continuous observation of lightning discharges in the Chinese inland plateau region using a fast antenna lightning mapping array (FALMA). During the first year of observation, 2019, we recorded lightning discharges on 25 days in Yinchuan city, the capital of Ningxia. Most of the lightning discharges appeared to occur in the afternoons of individual thunderstorm days in August. We studied the cloud-to-ground (CG) flash percentages, lightning discharge source spatiotemporal distributions, and preliminary breakdown (PB) process characteristics for the two thunderstorm cases that produced the most frequent lightning flashes in 2019 over a wide area. It was found that (1) CG flashes in these two thunderstorms accounted for 28.4% and 32.5% of total lightning flashes, respectively; (2) most lightning discharge sources in these two thunderstorms occurred at temperatures between 5 and −30 °C, with a peak at around −10 °C; and (3) more than 90% of well-mapped PB processes of intracloud (IC) flashes propagated downward. By overlapping the altitudes and the progression directions of the PB processes on the lightning source spatiotemporal distributions, we inferred that the main negative charge of the two storms observed in Ningxia, China, was at a height of around −15 to −25 °C (7 to 9 km) and the main positive charge was at a height of around 5 to 0 °C (2 to 4 km).

Characteristics and Long-term Prognosis of Danish Patients With Varicella Zoster Virus Detected in Cerebrospinal Fluid Compared With the Background Population.

Risk factors for, and long-term outcomes following, detection of varicella zoster virus (VZV) DNA in the cerebrospinal fluid (CSF) are unknown. We performed a nationwide population-based cohort study of all Danish residents who had VZV DNA detected in the CSF by polymerase chain reaction (PCR) between 1 January 1997 and 1 March 2016 (VZV cohort; n = 517) and an age- and sex- matched comparison cohort from the general Danish population (n = 9823). We examined potential risk factors and mortality, neurologic morbidity, psychiatric morbidity, redemptiom of prescriptions for nervous system medicine prescribed for the nervous system, and social outcomes. Prior hospital admission, redemption of immunosuppressive medicine, comorbidity, and immunosuppressive conditions were associated with detection of VZV DNA in the CSF. Mortality was increased in the VZV cohort, especially during the first year of observation and among patients with encephalitis. Patients in the VZV cohort had an increased risk of dementia and epilepsy. The redemption of antiepileptics and antidepressants was increased in the VZV cohort. Immunosuppression and comorbidity are associated with increased risk of detection of VZV DNA in the CSF and the condition is associated with increased mortality and neurological morbidity.

Results of Anti-Recurrent measures in the Active Course of Chronic parenchimatic parotitis in Children

Aim: To establish the effectiveness of anti-relapse measures in the active phase of chronic parenchymal mumps in children in time of remission. materials and methods: The material for writing this work was the results of a survey in remission for 5 years of 38 children with active chronic parenchymal mumps. General clinical, special and additional research methods were used to establish the effectiveness of anti-relapse measures. Results: According to the generalization of scientific information, it was found that for dynamic monitoring of the course of mumps are quite informative ultrasound diagnosis and sialography, cytological and microbiological study of parotid liquid. Preventive measures, which were carried out twice a year, allowed for a five-year period in 24% of children to achieve recovery, in 76% to improve the condition, and the number of exacerbations decreased by 14 times compared to the first year of observation. Conclusions: To monitor the effectiveness of anti-relapse measures in the active course of chronic parenchymal mumps in remission, it is necessary to study the qualitative properties of the secretion of glands, its cellular composition and the nature of the microbial composition. Quite valuable information is ultrasound diagnostic and sialography, which together allows to establish the severity of violations of their anatomical structures, the quality of specialized care and timely measures to prevent exacerbations, which has a positive effect on the functional activity of the parotid salivary glands.

Implant loss and crestal bone loss in early loading versus delayed and immediate loading in edentulous mandibles. A systematic review and meta-analysis.

BackgroundInformation about the risk of early loss and crestal bone loss of dental implants which have been loaded early is scant if compared with data available for those conventionally or immediately loaded. A meta-analysis of early loss and crestal bone loss in immediate or delayed loaded full mandibular denture retaining dental implants has been recently published. It is interesting to evaluate also the risks of early versus immediate and delayed loading in complete mandibular restorations. The purpose of this systematic review and meta-analysis was to study early (EL) versus immediate (IL) and delayed loading (DL) protocols in edentulous mandibles to determine whether differences exist in implant success and crestal bone loss. Material and MethodsThe literature review was conducted in PubMed, Web of Science, and the Cochrane Library. Seven randomized clinical trials were included. ResultsThe result of a meta-analysis of implant loss before 1 year in EL versus IL was 0.34 (95% CI: 0.08, 1.52), favoring the EL control group, while the outcome for crestal bone loss at the three-year observation was -0.10 (95% CI: -0.28, 0.09), with a tendency toward reduced bone loss for EL. In the EL versus DL group, the result of the meta-analysis of implant loss before one year was inconclusive, while in the comparison regarding crestal bone loss in the first year of observation, the result was -0.03 (95% CI: -0.08,-0.02) with a tendency to less bone loss in EL. ConclusionsThe risk of early implant loss in the IL group was higher than in the EL group. The results in terms of early implant loss in EL versus DL are inconclusive. Besides, crestal bone loss is greater in immediately and delayed loaded implants, at 1 and 3 years of observation, compared to those loaded early. Key words:Dental implants, early dental implant loading, dental prostheses, implant- supported, alveolar bone loss, meta-analysis.

Effectiveness of tuberculosis prophylaxis in patients with HIV/AIDS – retrospective analysis of data from Almaty, Kazakhstan, 2010–2015

According to data from the National Centre for Prevention and Control of AIDS, in the Republic of Kazakhstan, 45.8% of patients in the symptomatic stages of HIV infection are diagnosed with tuberculosis (TB) which is the cause of death in 36% of patients infected with HIV. The aim of the study was to conduct a retrospective analysis of the effectiveness of tuberculosis (TB) chemoprophylaxis among people living with HIV in the Republic of Kazakhstan (RK) in Central Asia. Materials and method. A retrospective analysis of patient health status was performed for each of the 648 patients (323 in the study group and 325 in the control group) during 2010-2015. Data from outpatient treatment charts were used concerning each patient infected with HIV observed at AIDS Treatment Centres. From among the 648 patients infected with HIV, 136 were receiving isoniazid in 2010, and 187 in 2011. The control group consisted of 325 people living with HIV (PLW HIV), who did not received isoniazid during observation. Results. The incidence of TB in patients who underwent chemoprophylaxis did not exceed 0.555/ 100,000 population in the first year of observation. Within 5 years, the TB incidence dropped to 0. In the control group, the TB incidence rate during the first year of observation was 3.262/100,000, with a decrease to 0.364 observed in 2015. Cumulated incidence rate in 2011-2015 in the study group accounted for 1.276/100,000. In the control group, the cumulative incidence was 4.3 times higher and accounted for 5.527. A significant difference in the mortality rate due to TB in the study and control groups was observed, the share of deaths due to TB in study group was 21.6% - nearly 3 times lower than in the control group (57.0%). Conclusions. The effectiveness of chemoprophylaxis for TB depends on biomedical, organizational and cultural factors. The presence of HIV co-infections is a special situation. Opposite to the majority of reports, in own study, no drug-resistant forms of tuberculosis were observed in relation with chemoprophylaxis with isoniazid. In the examined population, TB chemoprophylaxis reduced the incidence and cumulative incidence of TB among PLW HIV by 3.4-4.8 times. Isoniazid chemoprophylaxis decreased 4-fold the annual and cumulative mortality due to TB.

Ambulatory Care Fragmentation and Subsequent Hospitalization: Evidence From the REGARDS Study.

Previous studies have suggested that highly fragmented ambulatory care increases the risk of subsequent hospitalization, but those studies used claims only and were not able to adjust for many clinical potential confounders. The objective of this study was to determine the association between fragmented ambulatory care and subsequent hospitalization, adjusting for demographics, medical conditions, medications, health behaviors, psychosocial variables, and physiological variables. Longitudinal analysis of data (2003-2016) from the nationwide REasons for Geographic And Racial Differences in Stroke (REGARDS) study, linked to Medicare fee-for-service claims. A total of 12,693 Medicare beneficiaries 65 years and older from the REGARDS study who had at least 4 ambulatory visits in the first year of observation and did not have a hospitalization in the prior year. We defined high fragmentation as a reversed Bice-Boxerman score above the 75th percentile. We used Cox proportional hazards models to determine the association between fragmentation as a time-varying exposure and incident hospitalization in the 3 months following each exposure period. The mean age was 70.4 years; 54% were women, and 33% were African American. During the first year of observation, participants with high fragmentation had a median of 8 ambulatory visits with 6 providers, whereas participants with low fragmentation had a median of 7 visits with 3 providers. Over 11.8 years of follow-up, 6947 participants (55%) had a hospitalization. High fragmentation was associated with an increased hazard of hospitalization (adjusted hazard ratio=1.18; 95% confidence interval: 1.12, 1.24). Highly fragmented ambulatory care is an independent risk factor for hospitalization.

Association between hyperthyroidism and risk of incident in Parkinson's disease.

Hyperthyroidism contributes to many other disease conditions, including neurodegenerative diseases. Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. The purpose of this study was to investigate the risk of PD in patients with hyperthyroidism. A total of 8788 patients with hyperthyroidism and 8788 controls (without hyperthyroidism) matched by age, gender, index year, and Charlson Comorbidity Index (CCI) score were enrolled between 2000 and 2012. Patients were then followed until the end of 2013 using Taiwan’s National Health Insurance Research Database, at which time participants who developed PD were identified. Cox regression analysis was used to calculate the hazard ratio (HR) with a 95% CI of PD incidence rate between patients with hyperthyroidism and unaffected controls. Patients with hyperthyroidism had a significantly increased risk of PD compared with unaffected controls (1.21 vs 0.45 per 1000 person-years, HR: 2.69, 95% CI: 1.08–6.66) after adjusting for age, gender, CCI score, comorbidities, and antithyroid therapy. Hyperthyroidism and PD may share common manifestations. After excluding the first year of observation, a similar result is obtained (HR: 2.57, 95% CI: 1.61–4.01). Also, this study found that older age (HR: 3.74–8.53), more comorbidities (HR: 1.58–1.63), and specific comorbidities (brain injury (HR: 1.57) and cerebrovascular disease (HR: 3.44)) were associated with an increased risk of developing PD. Patients with hyperthyroidism have an increased risk of developing PD. Additional prospective clinical studies are warranted to examine the relationship between hyperthyroidism and PD and determine if there is an intervention that could reduce PD risk.

Неблагоприятное течение тромбоэмболии легочной артерии в течение года наблюдения

Цель исследования: изучение частоты и причины неблагоприятных исходов, а также факторов, с ними связанных, в течение года наблюдения у пациентов с тромбоэмболией легочной артерии (ТЭЛА). Материалы и методы: В одноцентровый регистр проспективного наблюдения методом сплошного включения включены 185 пациентов с ТЭЛА. Проводилось стандартное обследование пациентов, диагноз подтверждался по результатам мультиспиральной компьютерной томографии. Период наблюдения составил 12 мес, в течение которого отслеживали исходы пациентов, выписанных под амбулаторное наблюдение. Конечными точками являлись все случаи смерти и рецидивов ТЭЛА. Статистическую обработку результатов осуществляли с помощью пакета программ MedCalc Version 16.2.1 (Softwa, Бельгия). Результаты: Годовые исходы были определены у 161 пациента. Фатальный исход в течение года после выписки из стационара наступил у 22 (13,6%) больных ТЭЛА: у 45,5% по причине рецидива ТЭЛА, у 22,7% — онкологической патологии, у 13,6% — из-за острого нарушения мозгового кровообращения (ОНМК). Развитие летальных исходов было ассоциировано с такими факторами, как пожилой возраст, наличие ишемической болезни сердца, злокачественных новообразований, застойной сердечной недостаточности, ОНМК, а также со снижением глобальной сократимости миокарда левого желудочка, высоким риском по шкале PESI (англ. Pulmonary Embolism Severity Index) и отказом от антикоагулянтной терапии в течение первых 6 мес. Рецидив ТЭЛА в течение года наблюдения выявлен в 11,2% случаев и был связан с наличием тромбоза глубоких вен нижних конечностей, нижней полой вены и подвздошных вен, застойной сердечной недостаточностью и дилатацией правых отделов сердца. Установлено, что отказ от антикоагулянтной терапии в течение 11 мес после первичного эпизода повышает риск развития рецидива ТЭЛА. Заключение: У пациентов с ТЭЛА в течение первого года наблюдения летальный исход развился в 13,6% случаев, а рецидив ТЭЛА — в 11,2%. Наиболее значимым неблагоприятным фактором, связанным с данными конечными точками, являлся отказ от антикоагулянтной терапии ранее 6 мес после эпизода ТЭЛА. Objectives: to study the incidence, causes and factors associated with adverse outcomes in patients with pulmonary embolism (PE) during the year of observation. Patients/Methods: The single-center prospective follow-up register included 185 patients with PE. Standard examination was carried out; the diagnosis was confirmed by multispiral computed tomography. During follow-up period of 12 months we tracked outpatient outcomes. The endpoints were all-cause mortality and PE relapses. Statistical analysis was performed by MedCalc Version 16.2.1 software package (Softwa, Belgium). Results: Twelve-month outcomes were determined in 161 patients. Post-discharge fatal outcome within a year occurred in 22 (13.6%) patients with PE: in 45.5% due to PE relapse, in 22.7% due to oncological pathology, in 13.6% because of acute stroke. Lethal outcomes were associated with elderly age, ischemic heart disease, malignant neoplasms, congestive heart failure, stroke, reduction of left ventricular global myocardial contractility, a high risk according to PESI (Pulmonary Embolism Severity Index) scale and the refusal of anticoagulant therapy during the first 6 months. Within a year of observation PE relapse was detected in 11.2% of patients and was associated with deep vein thrombosis of the lower limbs, inferior vena cava and iliac veins, congestive heart failure and dilatation of right heart compartments. Refusal of anticoagulant therapy within 11 months after the initial episode increased the risk of PE relapse. Conclusions: In patients with PE during the first year of observation a fatal outcome occurred in 13.6% patients with PE and PE relapse — in 11.2%. Refusal of anticoagulant therapy earlier than 6 months after the episode of PE was the most significant adverse factor associated with these endpoints.

Changes in Respiratory Function and Physical Capacity among Smokers after Switching to IQOS: One Year Follow-Up

Background: Combustible cigarettes (CC) smoking is a common risk factor for chronic obstructive pulmonary disease (COPD), which is the fourth leading cause of death in Kazakhstan. Switching to "heat-not-burn" tobacco products (IQOS) has been shown to have less deleterious health effect compared to CC for those who cannot quit smoking. The goal of the study was to explore respiratory and physical effects of switching from CC to IQOS in a population of long-time smokers in Kazakhstan. Methods: Two cohorts of men and women aged between 40 and 59 residing in Almaty (a large two-million city of Kazakhstan) were recruited into two cohort of 801 CC smokers and 400 IQOS users and matched by gender, age, education, and smoking history. Analyses also included 627 CC smokers and 308 IQOS users who maintained their tobacco product use during the first year of observation. Spirometry measurements and the 6-minute walk test (6MWT) were performed as a part of the baseline and one-year comprehensive assessments. In addition to spirometry, clinical assessments included components of metabolic syndrome and anthropometry. For comparative analysis between two cohorts Student’s t-test and Chi-squared tests were used. Results: We observed significantly better outcomes for IQOS users in most of CAT scores, spirometry outcomes, and in some metabolic syndrome components. Although changes in the results between the baseline and the one-year assessments show comparable results, smokers of CC often show significantly faster decline in the health status compared to IQOS. Specifically, the changes in CAT score and in spirometry FEV1 over FVC ratios were worsening at higher pace for CC smokers compared to IQOS users. Conclusions: After one year of observation IQOS users demonstrated better outcomes for most of CAT scores and in the ratio of FEV1 over FVC in comparison to CC smokers.

Diagnosis and treatment of uterine carcinosarcoma.

e18111 Background: Uterine carcinosarcoma (UCS) is rare and highly aggressive malignant tumor belonging to mixed epithelial and mesenchymal tumors and classified as high-grade endometrial carcinoma. UCS is more prone to metastasis, especially in the lymph nodes, and 35% of the diagnostics show advanced process and worse treatment results. High UCS aggressiveness, unsatisfactory treatment results and the lack of standard approaches to its treatment require more researches. Methods: Clinical and morphological data of 72 patients from N.N. Petrov National Medical Research Center of Oncology treated from 2004 to 2014 were analysed. 28 patients were included with the UCS I – III stages based on clinical and morphological data. The average age of the patients was 61.5 years (43 to 82). Results: 15 patients had stage I (53.6%), 3 - stage II (10.7%), 10 – stage III (35.7%) with ovarian metastases 14.3% and omental - 18.2%. 5 patients received only surgical treatment; 21 received combined treatment, including surgery and radiation therapy (RT). Postoperative remote RT in combination with brachytherapy was applied in 18 patients, only brachytherapy - 5. Chemotherapy (CT) was used in 6 patients. Metastatic lesion of the iliac lymph was morphologically proven in 6 of 18 patients (31.6%). No correlation between frequency of regional metastasis and depth of tumor invasion to the myometrium was found. Overall survival was 52%, relapse-free - 32%, for stage I – II it reached 72.2%. Five-year survival for stage III was 44.4%. Recurrence rate after total hysterectomy with pelvic lymphadenectomy was 2 times lower compared to that without lymphadenectomy (30 and 62.5%, respectively). The relapse rate in patients with UCS I – II stages after surgical treatment without adjuvant RT reached 33.3%, with brachytherapy - 40%, with remote RT in combination with brachytherapy - 20%. Systemic treatment was applied to 6 patients, 2 of them did not undergo RT (relapses in these 2 patients were noted during the first year of observation). Conclusions: The overall 5-year survival and relapse-free survival of patients with UCS I – III stages is quite low: about 50% and 30%, respectively. Optimal surgical staging (which involves performing pelvic lymphadenectomy) and the use of adjuvant RT, can reduce the frequency of relapses. The use of systemic CT as an adjunct to surgical and radiation treatment is justified for patients with UCS from the standpoint of the same frequency of both local relapses and distant metastases.

MALIGNANT TUMORS OF THE THYROID GLAND (C73) IN SAINT PETERSBURG. MORBIDITY, MORTALITY, INDEX OF ACCURACY, YEAR-BY-YEAR LETHALITY AND SURVIVAL OF PATIENTS

Thyroid tumors are divided into benign and malignant. Special attention should be paid to malignant tumors. A feature of thyroid cancer is its slow progression, compared to other tumor localities, and in the vast majority of cases successful treatment, especially in the early stages of the disease. Thyroid cancer - can be attributed to rare malignancies. Its specific weight in the General structure of oncopathology is about 2.0%, in the structure of mortality from malignant neoplasms-less than 0.5%. Thyroid cancer is registered in women 3-4 times more often than in the male population. Increased attention to the study of the characteristics of the prevalence of thyroid cancer is primarily associated with the accident at the Chernobyl nuclear power plant. We can trace the dynamics of morbidity in the population of Leningrad - Saint Petersburg from 1980 to 2018. for the periods before and after the accident. The purpose of our study is to study the dynamics of morbidity in the population of the world, Russia and St. Petersburg with a sharply increased incidence of thyroid cancer. In addition to morbidity and mortality, it is planned to consider such analytical indicators that are practically not used in Russia as the reliability of accounting, partial lethality and five-year survival of patients with thyroid cancer calculated according to the international standard. Every year, more than 13 thousand (13,250 - 2018) new cases of thyroid cancer are registered in Russia. In recent years, in St. Petersburg, more than 150 new cases of malignant neoplasms of this localization of tumors are registered annually among men, and among the female population more than 800. We created the first Russian Population cancer registry in St. Petersburg, which has accumulated a huge amount of information about malignancies, including thyroid cancer. This is one of those localities of malignancies where the specific weight of detected early stages of the disease correlates with the survival rate of patients in stage I and II of the disease, where its value is 98.0%, and the mortality rate of patients for all patients in the first year of observation slightly exceeded 11.0% for men and 4.0% for women.

Application of Horticultural and Tissue Culture Methods for Ex Situ Conservation of Endangered Primula farinosa L.

Our study aimed at active conservation of the last location of &lt;em&gt;Primula farinosa&lt;/em&gt;, an endangered species in Poland, and assessed reproduction by seeds and plant propagation on sterile media in tissue culture conditions. We identified gibberellic acid (GA&lt;sub data-id="subscript-1"&gt;3&lt;/sub&gt;) as the key factor stimulating germination of &lt;em&gt;P. farinosa&lt;/em&gt; seeds. Growing juvenile plants under controlled temperature of 18/16 °C day/night yielded good quality plant material without mycorrhization. In tissue culture, the most favorable medium for shoot propagation was MS supplemented with the lowest tested concentration of indole-3-butyric acid (IBA; 0.05 mg dm&lt;sup data-id="superscript-1"&gt;−3&lt;/sup&gt;) and 6-benzyl-aminopurine (BAP; 0.1 mg dm&lt;sup data-id="superscript-2"&gt;−3&lt;/sup&gt;). The rooting ability of shoots was high and comparable for all auxins used. 2C DNA content of seed-derived and micropropagated plants did not indicate any change in the ploidy level during in vitro cultivation. Plants derived from seeds and tissue cultures were compared in a 2-year study. Of all the characteristics compared, only the number of flowers per inflorescence was lower for micropropagated plants when compared with the seed-origin plants in the first year of observation. The difference was of transient nature and was not observed in the second year of the study. Effective protocols for in vivo and in vitro propagation of &lt;em&gt;P. farinosa&lt;/em&gt; were developed, which can be used in practical species protection.

Association of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans

Reports indicate that long-term opioid therapy is associated with cardiovascular disease (CVD). Using VA electronic health record data, we measured the impact of opioid use on the incidence of modifiable CVD risk factors. We included Veterans whose encounter was between October 2001 to November 2014. We identified Veterans without CVD risk factors during our baseline period, defined as the date of first primary care visit plus 365 days. The main exposure was opioid prescriptions (yes/no, long-term (i.e. ≥90 days) vs no opioid, and long-term vs short-term (i.e. <90 days)), which was time-updated yearly from the end of the baseline period to February 2015. The main outcome measures were incident CVD risk factors (hypertension, dyslipidemia, diabetes, obesity, and current smoking).After excluding prevalent CVD risk factors, we identified 308,015 Veterans. During the first year of observation, 12,725 (4.1%) Veterans were prescribed opioids, including 2028 (0.6%) with long-term exposure. Compared to patients without opioid use, Veterans with opioid use were more likely to have CVD risk factors. Those with long-term exposure were at higher risk of having hypertension (adjusted average hazards ratio [HR] 1.45, 99% confidence interval [CI] 1.33–1.59), dyslipidemia (HR 1.45, 99% CI 1.35–156), diabetes (HR 1.30, 99% CI 1.07–1.57), current smoking status (HR 1.34, 99% CI 1.24–1.46), and obesity (HR 1.22, 99% CI 1.12–1.32). Compared to short-term exposure, long-term had higher risk of current smoking status (HR 1.12, 99% CI 1.01–1.24).These findings suggest potential benefit to screening and surveillance of CVD risk factors for patients prescribed opioids, especially long-term opioid therapy.

Real clinical practice of antiangiogenic therapy in patients with age-related macular degeneration. Retrospective analysis of functional results

To assess the functional results of antiangiogenic therapy in patients with exudative form of age-related macular degeneration (AMD) in real clinical practice. The study included 90 people (90 eyes) with active choroidal neovascularization (CNV) on the background of AMD. All patients were divided into 6 groups depending on the year of treatment - from 2013 to 2018, all patients were divided into 6 groups and overall the retrospective study sited at Research Institute of Eye Diseases (Moscow) lasted 8 years. All patients underwent standard ophthalmological examination including visometry, biomicroscopy and ophthalmoscopy under drug-induced mydriasis, as well as optical coherence tomography, fundus angiography and OCT-angiography. According to the results of the analysis of OCT data obtained from 2013 to 2017, among all patients with exudative AMD, patients with types I and II of CNV and single patients with RAP prevailed, which explains the high visual acuity - about 0.5 - in all groups after the start of the treatment (table 1 and 2). In 2018, 33.3% of patients were diagnosed with RAP (the same number of eyes as with types I and II of CNV), which can be explained by the introduction of OCT-angiography into wide clinical practice. The lack of increase in visual acuity is most likely associated with a small amount of intravitreal injections (IVI) - 4.8 IVI in the first year and 3.3 IVI in the second injection year. In patients who received more than three IVI in the first year of observation, visual acuity increased from 0.49±0.03 to 0.6±0.03 (p=0.04), in the case of less than three IVI in the first year, visual acuity was not changed, amounting to 0.42±0.1 before and 0.44±0.1 (p=0.655) after the treatment. Patients of all groups exhibited proportional stabilization of visual acuity, a decrease in the thickness of the retina and total macular volume. The lack of improvements of visual acuity is most likely associated with a small amount of IVI.

The prognosis of patients with chronic heart failure, depending on adherence to observation in a specialized heart failure treatment center

Actuality. The risk of death of patients with chronic heart failure (CHF) after acute decompensation of heart failure (ADHF) is directly related to the quality of the treatment of CHF after discharge from the hospital. In order to achieve the maximum effect of therapy in patients with CHF, experts in Europe and the USA recommend the creation of centers of specialized medical care for patients with CHF. Objective: to determine the risks of general, cardiovascular mortality and death from ADHF in patients with CHF during two years of observation, depending on their adherence to observation in a specialized center for the treatment of chronic heart failure (center CHF).Materials and methods. The study consistently included 942 patients with CHF after ADHF. The adherence of patients to follow up in center CHF was analyzed and 4 groups were distinguished: group 1 (n = 313) included patients who were observed continuously for two years; group 2 (n = 382) included patients who, after discharge, had never been observed in the center CHF; group 3 (n = 197) consisted of patients who were monitored at center CHF during the first year and then discontinued, and group 4 (n = 49) united patients who, when included in the study, abandoned observation, but after a year began to be constantly observed during the second year center CHF.Results.Statistically significant differences in age were registered only between groups 1 and 2 (69.6+9.9 and 71.8+11 years, respectively, р1/2=0.006). The overall mortality over the 2 years of follow-up was significantly higher in group 2 (32.4%) versus group 1 (1.2%, OR=3.8, 95% CI 2.5-5.7; p1/2&lt;0.001 ); compared with group 3 (9.1%, OR=4.8, 95% CI 2.8-8.1; p2/3&lt;0.001) and group 4 (8,2%, OR = 5.4, 95% CI 1.9-15.3; p2/4=0.0005). Cardiovascular mortality (CVM) for 2 years of follow-up was significantly higher in group 2 versus group 1 (8.1% and 1.3% of cases, OR=6.8, 95% CI 2.4-19.5; p1/2&lt;0.001), as well as in comparison with group 3 (CVM 3% for 2 years, OR=2.8, 95% CI 1.1-6.8; p2/3=0.02). CVM in group 4 (6.1%) was 5 times higher in comparison with group 1 (OR=5.0, 95% CI 1.1-23.2; p1/4=0.02). The risks of death from ADHF over the 2 years of follow-up were significantly higher in group 2 (16.4%) compared with all groups: with group 1 (6.4%) OR=2.9, 95% CI 1.7-4, 9, p1/2&lt;0.001; with group 3 (5.1%) OR=3.7, 95% CI 1.8-7.3, p2/3&lt;0.001; and with group 4 (2%) OR=9.5, 95% CI 1.3-69.7, p2/4= 0.008. The combined endpoint (CVM and death from ADHF in 2 years of follow-up) was also significantly higher in group 2 (24.5%) compared with all compared groups: group 1 (7.7%), OR=3.9, 95% CI 2.4-6.3, p1/2&lt;0.001; group 3 (8.1%), OR=3.7, 95% CI 2.1-6.5, p2/3&lt;0.001; and group 4 (8.2%), OR=3.7, 95% CI 1.3-10.4; p2/4=0.01.Conclusion.Surveillance of patients with CHF after an episode of ADHF in a specialized center CHF, both for a long time (two years) and partially during the first year of observation, reduces the risk of all-cause death, CVM and death from ADHF.

Sickle cell disease in Germany: Results from a national registry.

Limited data on the prevalence and medical care of sickle cell disease (SCD) in Germany are available. Here, we make use of a patient registry to characterize the burden of disease and the treatment modalities for patients with SCD in Germany. A nationwide German registry for patients with SCD documents basic data on diagnosis and patient history retrospectively at the time of registration. A prospective annual documentation provides more details on complications and treatment of SCD. For the current analyses, data of 439 patients were available. Most patients had homozygous SCD (HbSS 75.1%, HbS/β-thalassemia 13.2%, and HbSC 11.3%). The median age at diagnosis was 1.9 years (interquartile range, 0.6-4.4 years), most patients were diagnosed when characteristic symptoms occurred. Sepsis and stroke had affected 3.2% and 4.2% of patients, respectively. During the first year of observation, 48.3% of patients were admitted to a hospital and 10.1% required intensive care. Prophylactic penicillin was prescribed to 95.6% of patients with homozygous SCD or HbS/β thalassemia below the age of six and hydroxycarbamide to 90.4% of patients above the age of two years. At least one annual transcranial Doppler ultrasound was documented for 74.8% of patients between 2 and 18 years. With an estimated number of at least 2000, the prevalence of SCD in Germany remains low. Prospectively, we expect that the quality of care for children with SCD will be further improved by an earlier diagnosis after the anticipated introduction of a newborn screening program for SCD.

Assessment of reproductive parameters of privately bred ring-necked parakeets (Psittacula krameri)

The aim of this study was to assess the reproductive parameters of privately bred ring-necked parakeets (Psittacula krameri). The study was carried out in an amateur breeding facility in the Masovian voivodeship in 2013–2017. Observations were carried out on four pairs of ring-necked parakeets kept year round in outdoor aviaries. The analysis was based on the following indicators: number of eggs laid, number of chicks hatched, and number of chicks reared from two broods each year. The reproductive parameters of the pairs of ring-necked parakeets were varied. There were marked differences between individual pairs of birds concerning both the number of eggs in the clutch and the number of chicks reared. Most pairs reared two broods each year. In the first year of observation, the birds reared eight chicks from 13 laid eggs, while in the last year of data collection they reared 11 chicks from 16 eggs.

Validation of the CUETO scoring model for predicting recurrence and progression in T1G3 urothelial carcinoma of the bladder

Introduction and objectivesVarious studies tried to validate Club Urológico Español de Tratamiento Oncológico (CUETO) tables, yet, none of this papers focused on the high and very high risk bladder cancers. The aim of the study was to externally validate the CUETO model for predicting disease recurrence and progression in group of T1G3 tumours treated with BCG immunotherapy. Patients or materials and methodsData from 414 patients with primary T1G3 bladder cancer were analyzed. To evaluate the model discrimination, Cox proportional hazard regression models were created and concordance indexes were calculated. ResultsThe median follow-up was 68 months. The recurrence was observed in 212 (51.2%) and 64 patients (15.5%) experienced the recurrence more than once during the study follow-up. Progression of the cancer was observed in 106 patients (25.6%). Radical cystectomy was performed in 115 patients (27.8%) and there were 64 (15.5%) cancer specific deaths. For recurrence and progression probability, the concordance index of the CUETO models was 0.633 and 0.697 respectively. CUETO tables underestimated significantly the risk of recurrence and marginally the risk of progression in the first year of observation. For 5 years of observation, the trend for the recurrence was much less clear. On the contrary, there was slight overestimation in the risk of progression. The study is limited by retrospective nature. ConclusionsIt was shown that the CUETO risk tables exhibit a fair discrimination for both disease recurrence and progression in T1G3 patients treated with BCG. CUETO scoring model underestimates the risk of tumour recurrence, but predicts well risk of progression.