First Year Of Observation Research Articles

Modification in Quality of Life and Health in Medical Students across Graduation

Abstract Background Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. POLLEK study aims to identify and evaluate the quality of life by simultaneously assessing their determinants in Polish medical students during long-term observation. We have also examined the prevalence of chronic diseases, specifically focusing on overweight and obesity, and identified their risk factors. Methods The POLLEK is the follow-up cohort study conducted among medical students at the Medical University of Silesia in Katowice. Students were followed during two observation periods: in their first year of studies, the academic year 2021/2022 (T1), and in their second year, the academic year 2022/2023 (T2). Results The total number of participants in the first year of observation (T1) was 427 while in the second year (T2) was 335. We identified that the QoL score significantly decreased in their second year of studies mainly in the somatic and psychological domain. The determinants of QoL domains common to T1 and T2 remained self-declared health status, frequency of physical activity, and current financial situation. In the initial year of evaluation, 56 students (13.10%) were overweight or obese, and 52 (15.8%) in the second. Regardless of the academic year, the increased risk of being overweight or obese was significantly associated with dissatisfaction with personal health, financial deficiencies, and a diet abundant in animal products. Conclusions The QoL of medical students and selected indicators of their health status deteriorated during the observation period. Our findings suggest that medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study. Key messages • Medical students experience numerous demands during the education process, determining their quality of life (QoL) and health status. • Medical schools should actively promote the activity needed to achieve a balance between schoolwork and the personal life of medical students from the beginning of university study.

The state of cancer care in Russia: pancreatic cancer (C25). Diagnosis, prevalence, quality of accounting, typical mortality. Part 1. (clinical and population-based research)

The study focuses on pancreatic cancer (C25), a malignant neoplasm arising from the ductal epithelium or glandular tissue of the pancreas, which accounts for 3% of the overall cancer incidence in Russia. The rates of incidence and mortality are rising, with the number of newly registered patients in Russia being lower than the number of recorded deaths, although the one-year mortality rate among patients is decreasing. The direct cause of pancreatic cancer (C25) remains unknown. Risk factors for developing this condition include genetics, smoking, alcohol abuse, a sedentary lifestyle, excessive meat consumption, and a lack of plant-based foods in the diet. Diseases associated with a high risk of this pathology include long-standing chronic pancreatitis, newly diagnosed type 2 diabetes in individuals aged 50-70, and cystic neoplasms of the pancreas. The aim of the study is to examine the patterns of incidence and mortality, the quality of patient registration, the characteristics of tumor localization, and the histological structure of pancreatic cancer (C25). The study will also track the nature of annual mortality among patients and explore the possibilities, methods, and techniques of modern diagnosis and treatment for these patients. The research confirmed the significant burden of pancreatic cancer (C25), primarily due to the late detection of this disease. The study provided sufficient material to analyze age-related risk factors, as well as the patterns of incidence and mortality in the population. It also examined and presented mortality rates among patients, including during the first year of observation.

Long-term results of outpatient rehabilitation after coronary artery bypass graft surgery

Aim. To assess the impact of adherence to various outpatient rehabilitation programs during the first three months after coronary artery bypass grafting (CABG) on the development of cardiovascular events over four years of follow-up.Materials and Methods. The study evaluated the influence of adherence to outpatient cardiac rehabilitation programs on the incidence of cardiovascular events in patients following open coronary artery revascularization surgery. Adherence to cardiac rehabilitation was assessed over a threemonth period, and the observation period for cardiovascular events extended to four years from the time of the surgery.Results. During the first year of observation, we did not find significant differences in the effectiveness and safety of outpatient cardiac rehabilitation programs. However, we revealed statistically significant differences in the patient adherence to physical training. Over the four-year observation period, a higher number of cardiovascular events were recorded in the group of patients who were non-adherent to physical training. Statistically significant differences were observed with regards to the incidence of myocardial infarction and cardiovascular death.Conclusion. Adherence to recommendations following open revascularization procedures is crucial for the prognosis of myocardial infarction and cardiovascular death. Modern methods of providing medical care in the outpatient phase of cardiac rehabilitation enable patients to engage in effective and safe physical training comparable to those conducted in specialized cardiac rehabilitation facilities under the direct supervision of medical personnel.

The effectiveness of cardiac contractility modulation: results of two-year follow-up

Aim. To evaluate the survival and dynamics of clinical and instrumental data in patients with chronic heart failure (CHF), atrial fibrillation (AF) and cardiac contractility modulation (CCM).Methods. There were included 54 patients (40 men, median age 59.7 [56.6; 63.9] years) with signs of CHF II (n=27, 50%) functional class and III (n=27, 50%) NYHA functional class, significantly decreased left ventricular ejection fraction (LVEF=30 [24,7; 35,5]%), LV dilatation and paroxysmal (n=27, 50%) or permanent (n=27, 50%) AF. In all patients, devices for CCM were implanted. The dynamics of clinical and instrumental parameters were assessed in 2, 6, 12 and 24 months after implantation. The actual survival patients with CCM was compared with the predicted survival calculated using the Seattle model of heart failure and MAGGIC risk score.Results. In 14 (28%) of patients CCM resulted in significantly increased clinical, echocardiographic parameters (increase in LVEF by 15 [11; 20]%, decrease in end-systolic volume by 68,5[37.5;104.5] ml and end-diastolic volume by 44 [30,100] мл), increase in walking distance during 6-minute walking test and decrease of NT-proBNP. The only factor significant for maximal response was non-ischemic etiology of CHF (χ2=4.54, p=0.034). During 2 years 21 (42%) patients died. The all-cause mortality in patients with CCM to the first year of observation was 16%, two-year all-cause mortality - 40%. These figures turned out to be significantly higher than predicted according to the Seattle model (χ2=10.93, p=0.001). The predicted and actual risk of death at 12-month follow-up turned out to be comparable when assessing survival parameters according to the MAGGIC scale. (χ2=2.24, p=0.134).Conclusion. CCM therapy in some patients with CHF of non-ischemic etiology can lead to an improvement of all clinical and instrumental characteristics. At the same time, there is no effect of CCM on the prognosis of patients with CHF. This fact may suggest the need of additional studies with increased number of cases.

#2662 Octreotide-LAR in ADPKD patients with very low kidney function: a monocentric real-life experience

Abstract Background and Aims Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, characterized by development of fluid-filled renal cysts leading to progressive expansion of kidney volume, with decline in kidney function up to end-stage renal disease (ESRD). Octreotide long-acting release (OCT-LAR) is a synthetic somatostatin analogue, which has been shown to reduce kidney and cysts growth and to slow the progression of kidney function decline in ADPKD patients. Although the evidence of the literature supporting the protective effect of the OCT-LAR against progression of the disease in ADPKD patients with both early and later-stages, to date no data are available in ADPKD patients treated with this somatostatin analogue in a real-world clinical setting. In August 2018 OCT-LAR was approved only in Italy for the treatment of ADPKD adult patients with eGFR ranging from 30 to 15 mL/min/1.73 m2 at elevated risk of progression towards ESRD. The present study is aimed to report for the first time the effects on renal function of OCT-LAR in ADPKD patients with severe renal insufficiency (stage 4 CKD) receiving this somatostatin analogue for therapeutic indication in a real-world clinical setting. Method We conducted a retrospective, ADPKD-population-based cohort study using healthcare data from the medical records of patients with ADPKD referred to the Department of Nephrology of University “Federico II” of Naples from November 2018 to April 2023 aimed to analyse within-patient clinical outcomes, including eGFR decline, before and after treatment with OCT-LAR. We include adult ADPKD patients (≥18 years) with GFR (eGFR) between 30 and 15 mL/min/1.73 m2, stably treated from at least 1 years with the regular dose of OCTR-LAR. The primary endpoint was the assessment of eGFR decline from 1 year before the start of the treatment (T-1) to baseline (T0), and after 1 year of therapy with OCT-LAR (T1) in the overall population and in two subgroups of patients with eGFR ≥ or < 25 ml/min/1.73 m2. Results 31 ADPKD patients were analysed (18 with eGFR ≥ 25 and 13 with eGFR < 25). Compared to pre-treatment period, eGFR decline significantly slowed during therapy with OCT-LAR in both eGFR groups (Table 1), while no difference was found between eGFR groups. After the first year of observation, 7 patients required dialysis (all with eGFR <25). Conclusion This is the first study reporting the effects of OCT-LAR on eGFR of ADPKD patients with advanced chronic kidney disease (CKD) in a real-world clinical setting. Our results suggest that, compared the last year of follow-up pre-treatment, OCT-LAR slows eGFR decline after 1 year.

Urate-lowering therapy for gout: Difficulties in goal achieving the and ways to overcome

Urate-lowering therapy for gout: Difficulties in goal achieving the and ways to overcome

ДОЛГОСРОЧНЫЕ СОСУДИСТЫЕ ЭФФЕКТЫ УСИЛЕННОЙ НАРУЖНОЙ КОНТРПУЛЬСАЦИИ У ПАЦИЕНТОВ С ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА, ОСЛОЖНЕННОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ

Aim. To study the long-term effect of complex therapy with the addition of enhanced external counterpulsation (EECP) on the structural and functional parameters of the cardiovascular system in patients with ischemic chronic heart failure (CHF). Material and methods. Patients with ischemic CHF NYHA class II-III (n=59; median age 64.8 [57.6; 71.2] years; 81.4% men), receiving EECP in addition to optimal medical treatment (35-hour course every 6 months; compression pressure 220-280 mmHg) had an assessment of exercise tolerance (distance in the 6-minute walk test; 6MWT), structural and functional state of large vessels and microvasculature (computer video capillaroscopy of the periungual bed, photoplethysmography, applanation tonometry), assessment of echocardiographic parameters (volume dimensions, systolic and diastolic functions of the left ventricle) at baseline, after 12, 24 and 36 months. The follow-up period was 36 months. Results. Significant stable positive dynamics of tolerance to physical activity (the distance in the 6MHT increased by 59.4%) was found. Functional parameters of the heart (LVEF from 40.6 [34.6; 43.2] to 49.2 [43.0; 52.7] %, p=0.003; NT-proBNP from 246 [167; 341] to 120 [93; 148] pg/ml), large (occlusion index by phase shift) and small (occlusion index by amplitude, percentage of perfused capillaries, percentage of capillary restoration) vessels significantly improved already in the first year of observation, while structural parameters (volume dimensions; indexed LV myocardial mass from 94.3 [79.4; 97.4] to 121 [109; 134] g/m2, p=0.010; radial augmentation index, stiffness index, occlusion index) began to change significantly by 2-3-years. Conclusion. A stable positive effect of EECP treatment in patients with ischemic heart failure on the structural and functional parameters of the heart and blood vessels has been demonstrated. At the same time, the rate of improvement in functional indicators was much faster than that of structural parameters.

Ambulatory Care Fragmentation and Total Health Care Costs.

The magnitude of the relationship between ambulatory care fragmentation and subsequent total health care costs is unclear. To determine the association between ambulatory care fragmentation and total health care costs. Longitudinal analysis of 15 years of data (2004-2018) from the national Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, linked to Medicare fee-for-service claims. A total of 13,680 Medicare beneficiaries who are 65 years and older. We measured ambulatory care fragmentation in each calendar year, defining high fragmentation as a reversed Bice-Boxerman Index ≥0.85 and low as <0.85. We used generalized linear models to determine the association between ambulatory care fragmentation in 1 year and total Medicare expenditures (costs) in the following year, adjusting for baseline demographic and clinical characteristics, a time-varying comorbidity index, and accounting for geographic variation in reimbursement and inflation. The average participant was 70.9 years old; approximately half (53%) were women. One-fourth (26%) of participants had high fragmentation in the first year of observation. Those participants had a median of 9 visits to 6 providers, with the most frequently seen provider accounting for 29% of visits. By contrast, participants with low fragmentation had a median of 8 visits to 3 providers, with the most frequently seen provider accounting for 50% of visits. High fragmentation was associated with $1085 more in total adjusted costs per person per year (95% CI $713 to $1457) than low fragmentation. Highly fragmented ambulatory care in 1 year is independently associated with higher total costs the following year.

Efficiency of Combining Heated Eye Mask with Intense Pulsed Light Therapy as a Treatment Option for Evaporative Dry Eye Disease.

Background and objectives: The study aimed to establish the efficiency of combining the Posiforlid heated eye mask with intense pulsed light therapy (IPL), as a treatment strategy for evaporative dry eye disease. Materials and methods: This study included 110 patients, respectively 220 eyes, diagnosed with evaporative dry eye disease, patients between 18 and 86 years old, divided into two study groups. The first one, the control group, consisted of 73 patients treated with IPL therapy, and the second of 37 patients, who underwent IPL therapy associated with Posiforlid heated eye mask. Subjective evolution was assessed using an eye fitness test (EFT) regarding symptomatology. Objective assessment of the ocular surface was performed by tear film stability evaluation (TFSE), non-invasive first break-up time (NIFBUT), non-invasive average breakup time (NIABUT), ocular surface inflammatory evaluation (OSIE), measuring of the central tear meniscus height (CTMH) and thinnest tear meniscus height (TTMH). The assessment was performed at the beginning of the IPL treatment, during the IPL sessions, at the end of the IPL treatment, and afterward, at 3, 6, and 12 months. Results: Tear film stability has increased in both study cases, but no statistically significant difference was observed between the two groups studied. For the control group, tear film stability evaluation (TFSE) started from 310.56 ± 389.54 at baseline (time 1 presentation) to 114.40 ± 122.90 after 12 months, and for the heated mask group, from 391.11 ± 456.45 (time 1 presentation) to 97.38 ± 105.98 after 12 months. NIABUT increased from 10.72 ± 4.90 seconds to 14.79 ± 3.72 seconds in the control group, and from 11.11 ± 5.08 seconds to 15.84 ± 2.26 seconds in the second group. OSIE decreased, as expected, from 7.18 ± 7.93 percent in the control group to 2.24 ± 2.38 percent after 12 months and from 7.42 ± 7.77 percent to 2.47 ± 2.50 percent in the Posiforlid group. Although significantly lower, there was no significant difference between the two studied groups. No statistically significant changes were registered in the studied quantitative parameters. Using the EFT test, great improvements were registered regarding symptomatology, with a score increasing from 29.99 ± 8.60 to 39.10 ± 5.08 in the control group and from 27.35 ± 9.24 to 38.35 ± 4.62 in the other group. Again, the same statistical result was registered on this variable. Conclusions: The improvement of tear film stability, ocular surface inflammatory condition, and subjective symptoms during IPL therapy sessions and the first year of observation after the completion of the treatment was not necessarily increased by the additional use of a heated eye mask. Abbreviations: IPL = intense pulsed light therapy, EFT = eye fitness test, NIFBUT = non-invasive first break-up time, NIABUT = non-invasive average break-up time, OSIE = ocular surface inflammatory evaluation, TFSE = tear film stability evaluation, CTMH = central tear meniscus height, TTMH = thinnest tear meniscus height, DED = dry eye disease, MGD = meibomian gland dysfunction, SD = standard deviation.

Patient global assessment and inflammatory markers in patients with idiopathic inflammatory myopathies – A longitudinal study

AimTo explore if patient global assessment (PGA) is associated with inflammation over time and if associations are explained by other measures of disease activity and function in patients with idiopathic inflammatory myopathies (IIM). MethodsPGA and systemic inflammatory markers prospectively collected over five years were retrieved from the International MyoNet registry for 1200 patients with IIM. Associations between PGA, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and creatine kinase (CK) were analyzed using mixed models. Mediation analysis was used to test if the association between PGA and inflammatory markers during the first year of observation could be explained by measures of disease activity and function. ResultsPGA improved, and inflammatory markers decreased during the first year of observation. In the mixed models, high levels of inflammatory markers were associated with worse PGA in both men and women across time points during five years of observation. In men, but not in women, the association between elevated ESR, CRP and poorer PGA was explained by measures of function and disease activity. With a few exceptions, the association between improved PGA and reduced inflammatory markers was partially mediated by improvements in all measures of function and disease activity. ConclusionIncreased levels of systemic inflammation are associated with poorer PGA in patients with IIM. In addition to known benefits of lowered inflammation, these findings emphasize the need to reduce systemic inflammation to improve subjective health in patients with IIM. Furthermore, the results demonstrate the importance of incorporating PGA as an outcome measure in clinical practice and clinical trials.

Does excessive body mass affect the rhGH therapy outcomes in GHD children?

For 35 years, recombinant human growth hormone (rhGH) has been successfully used worldwide to treat children with short stature related to growth hormone deficiency (GHD). Growth hormone therapy requires an individual approach to the patient due to varying responses to the treatment. Excessive body weight is one of the factors influencing the response. To evaluate the impact of excessive body mass on rhGH therapy effectiveness in GHD children. 165 short-statured children with isolated GHD (mean age 10.72 ±3.33 years), treated with rhGH for at least one year (mean follow-up 4.32 ±1.80 years), were separated into 3 groups based on their BMI standard deviation score (SDS). Bone age, height, weight, insulin-like growth factor 1 level, and rhGH dose were obtained up to 10 years with one-year intervals. The mean change in height SDS in the first year was 0.52 ±0.41 SD and 0.60 ±0.32 SD for normal and excessive body weight children, respectively. The mean height velocity, based on the height SDS measured over the consecutive 5 years, was 0.44±0.25 SD/year for the normal-weight group and 0.32 ±0.24 SD/year for the excessive body weight group (p<0.1). Excess body weight has asignificant impact on rhGH therapy outcomes. This correlates with the height increase in the first year of observation; however, long-term observation has shown that children diagnosed with overweight or obesity achieve significantly worse results compared to their normal-weight peers.

Long-term outcomes and immune profiling in children with multisystem inflammatory syndrome (MIS-C).

Existing follow-up data after MIS-C is limited. to investigate the long-term consequences in children who have undergone MIS-C. The retrospective study included 93 children. The identified changes were divided into the following periods: occurred within first 6 months, 1 year, 2 years, and more than 2 years after MIS-C. Besides, 31 children underwent prospective immunophenotyping of peripheral blood and the determination of cytokines during the acute period of the disease and after discharge. Outpatient monitoring events included pneumonia (9.6%), somatic disorder syndrome (11.8%), visual impairment (7.5%), joint damage (6.6%), weight changes (2.2%), and MIS-C recurrence (2.2%). A study of the cardiovascular system showed a statistically significant decrease in the frequency of the right and left heart dilatation, left ventricular dysfunction, pericarditis, pulmonary arterial hypertension, coronaritis, mitral regurgitation. But at the same time an increase in pulmonary and tricuspid valve regurgitation and arrhythmias compared with the acute period was detected. Most of the changes took place within first year of observation. Immune profiling showed reconstitution of CD3, CD4 T-lymphocytes, NK-cells, maintenance of a high relative value of CD8, reduction of CD19+ B-cells, expression of CD3-HLA-DR+, CD25, CD279, CD95. After the history of MIS-C, children in the long-term follow-up had various somatic disorders and disease recurrence. Most patients (64.1%) showed subclinical signs of myocardial involvement within first year of observation. Low expression of CD95 may justify an certain role in the pathogenesis of the disease.

OBSERVATIONS ON THE DEVELOPMENT OF FETAL ATTACHMENT RETENTION IN INTENSIVELY BREEDING COWS

"The evolution of the puerperium is conditioned by the course of parturition - eutopic or dystocic, but also by possible placental retention or uterine atony and not rarely by infection with bacterial germs. After parturition, energy consumption increases with uterine involution, the volume of milk production and the needs determined by local and general self-defence. The puerperal period is one of the most important stages in the reproductive cycle of cows. Early and correct diagnosis of conditions during this period can lead to appropriate and more effective treatment regimens. Research in the literature indicates that special attention should be paid to high milk-producing females, especially in the intensive breeding system, as it is known that some diseases can easily develop in the genital tract during the puerperal period. An important aspect of reproduction in cows is sterility or inability to reproduce due to incurable lesions of the genital tract following dystocic parturitions. The aim of this paper is to complete the existing research and studies in the literature with some major aspects of reproductive pathology in cows, namely to highlight some of the factors that can generate the anaesthesia syndrome. In the first year of observation (2021), the incidence of fetal adnexal retention was 12.4% of the 242 cows monitored, and in 2022 out of a total of 270 cows, 9.6% of females were diagnosed with this condition. Analyzing the incidence of fetal appendix retention by calendar month, it was found that in 2021 no cases were reported in August, one case (0.4%) was recorded in June and July, and the highest level was recorded in February, 2.5%. In 2022, similar incidence of fetal appendage retention was recorded including the highest level of 1.8% being reported also in February. The incidence of fetal attachment retention in cows correlates with the level of milk production per lactation increasing progressively with the volume of milk production. Thus, in the year 2021 in cows with milk production ranging between 5000-5500 liters of milk/lactation the lowest level was obtained, i.e. 0.8% of fetal attachment retention.in the herd of 26 monitored females. Of the 45 cows with milk production between 7001-7500 l milk/lactation 3.3% of the females showed fetal attachment retention."

Significant Increase in Cytomegalovirus (CMV) Infection in Solid Organ Transplants Associated With Increased Use of Thymoglobulin as Induction Therapy?

Cytomegalovirus (CMV) infection remains one of the most common viral pathogens affecting solid organ transplants (SOT). In 10 years of following the outcome of transplants, we noticed an increased incidence of CMV infection, along with increased use of rabbit anti-thymocyte globulin (rATG). The study aims to assess the incidence of active CMV infection and disease, response to treatment, and recurrence in a cohort of SOT. Furthermore, we look for correlating the CMV incidence with the type of induction therapy: r-ATG or interleukin 2 receptor-blocking antibody (basiliximab). This was a single-center, retrospective 10-year study in patients submitted to kidney, kidney-liver, and kidney-pancreas transplants who used a preemptive therapy protocol for CMV. Among the 476 enrolled transplant recipients, 306 (64.2 %) had at least one episode of CMV infection (replication), and 71/306 patients (23.2 %) presented CMV-related disease. The most frequent clinical conditions associated with CMV disease were gastrointestinal. Among the 476 transplant patients, 333 received immunosuppressive induction with rATG (69.9 %); 140 (29.4 %) received induction with interleukin 2 receptor-blocking antibody (basiliximab). The initial maintenance immunosuppressive therapy in the patients who presented CMV infection was primarily performed with prednisone, tacrolimus, and sodium mycophenolate (91.7 %). The induction with rATG increased from 35.2%-94.6% in 10 years. The incidence of CMV infection was 20.7 % in the first year of observation and gradually increased to 87.3 % in the last year. The data suggest that the increase in the use of rATG in recent years could be responsible for the very expressive increase in the incidence of CMV infection/disease.

Cancer risk and temporal trends in people with HIV during a quarter of a century – a nationwide population-based matched cohort study

Background It is important to understand current trends in cancer risk among people living with HIV (PLWH) to improve outcomes and to commission and delivery appropriate services. Methods Nationwide, population-based, matched cohort study on all adult PLWH treated at Danish HIV health care centres since 1 January 1995 and a comparison cohort, randomly selected from the background population and matched on sex and date of birth. Results We included 6327 PLWH and 63,270 individuals in the comparison cohort − 74% were men and median age was 37 (interquartile range: 30–46). For both smoking related cancers, virological cancers and other cancers, incidence was substantially higher in the first year of observation for PLWH than for the remaining observation period. The risk of smoking related cancer remained stably increased throughout the observation period, whereas the relative risk of virological cancers decreased, especially in the first year of follow up. Finally, the risk of other cancers for PLWH decreased to a level below that of the background population during the study period. Conclusion The fact that the risk of other cancers was probably not higher among PLWH than in the comparison cohort is encouraging, as the excess risk of virological and smoking related cancers is potentially preventable by timely treatment of HIV and smoking cessation.

ОЦЕНКА РИСКОВ РАЗВИТИЯ КАРИЕСА В ПОСТОЯННЫХ МОЛЯРАХ У ДЕТЕЙ МЛАДШЕГО ШКОЛЬНОГО ВОЗРАСТА В ЗАВИСИМОСТИ ОТ ТИПА МИКРОКРИСТАЛИЗАЦИИ РОТОВОЙ ЖИДКОСТИ

The goal of this paper was to study the risks of occurrence and development of caries of permanent molars in primary school-aged children and effectiveness of preventive measures from the nature of mixed saliva microcrystallization.&#x0D; Material and methods. The complex clinical and laboratory study involved 242 primary school-aged children. The observation included assessment of the cf (carious and filled teeth), cf + CFE (carious, filled and extracted teeth) and CFE indexes, as well as an increase in caries intensity (ICI), and the state of hygiene according to the index of Fedorov Y.A. – Volodkina V.V. (1971). Microcrystallization (SMC) was assessed in native oral fluid samples using the LEICA DM 1000 stereomicroscope. The experimental subjects were divided into two groups as follows: I – with SMC score 1, II – with SMC scores 2–3. To assess the differences in the frequency of dental lesions in the follow-up, the McNemar test with Edwards’s correction was used for intragroup comparisons and the chi-squared test with Yates’s correction for intergroup comparisons. To assess the relationship between the intensity of the lesion of the molars and the type of SMC, the contingency and association coefficients were calculated. &#x0D; Results. Examination of caries intensity in 1.6, 2.6, 3.6 and 4.6 teeth with SMC type 1 score showed no significant differences in the dynamics of caries intensity increase over three years of follow-up (p &gt; 0.5), with SMC type 2–3 scores also showed no significant differences from baseline for 1.6, 2.6 and 3.6 teeth (p &gt; 0.1), but revealed differences at the third year for 4.6 teeth (p &lt; 0.05). When comparing the frequency of lesions of teeth 1.6, 2.6, 3.6 for groups with ISS type 1 and 2–3 points, significant differences were observed from the second year (p &lt; 0.05), reaching the significance of differences p &lt; 0.001 in the third year, intergroup comparisons for teeth 4.6 became significant already in the first year of observation (p &lt; 0.05), for ISS type 2–3 points from the second year of observation, p &lt; 0.05. &#x0D; Conclusion. The data obtained indicate a direct correlation between caries lesions of first molars and the nature of SMC.

Congenital methemoglobinemia and abnormal hemoglobin M variant in a newborn with cyanosis

Congenital methemoglobinemia, especially caused by pathological hemoglobin M, is an extremely rare cause of cyanosis in newborns. The time to onset and severity of clinical manifestations in hemoglobin M disease depends on which globin chain the mutation occurred in.Purpose. To present the case of congenital methemoglobinemia associated with hemoglobin M disease, not recognized in the neonatal period, to summarize the data on diagnosis, therapy, and prognosis for this pathology.Clinical case. In a full-term child without organ pathology, the development of diffuse cyanosis in the early neonatal period, a decrease in pSO2 of 70%, resistant to oxygen therapy, and increasing anemia were noted. The level of methemoglobin is up to a maximum of 17%. A decrease in the level of methemoglobin to 5.7% and stabilization of pSO2 &gt;90% were obtained after two transfusions of erythrocyte suspension. No pathological forms of hemoglobin were detected during electrophoresis on the 5th day of life. Repeated electrophoresis at the age of 5 months revealed a pathological hemoglobin fraction of 8.9% corresponding to hemoglobin M Iwate. During the first year of observation, the growth and development of the child corresponds to the age norm. Stable acrocyanosis. Methemoglobin in the blood remains at the level of 8.7–8.9% without specific therapy for the last 6 months.Conclusion. The diagnosis of congenital methemoglobinemia due to the presence of defective hemoglobin M (M-hemoglobinopathy) was established basing on the high persistent level of methemoglobin (9–12%) and hemoglobin electrophoresis identified an abnormal hemoglobin M (HbM Iwate) variant.

Effect of the 23-valent pneumococcal polysaccharide vaccine on the incidence of hospitalization with pneumonia in adults aged ≥65 years: retrospective cohort study using a population-based database in Japan

ObjectivesThe effectiveness of the 23-valent pneumococcal polysaccharide vaccine (PPV23) in preventing pneumonia in older adults remains controversial. Some studies have suggested differences in their effectiveness according to age or sex. MethodsWe conducted an observational study using a database of vaccine subsidization data and health insurance claims for a city in Japan. Participants were residents from 2014 to 2018 turning 65, 70, 75, 80, 85, 90, or 95 years during a given fiscal year, and PPV23 during the first year of observation were identified. We matched vaccinated and non-vaccinated individuals of the same age using propensity scores for vaccination. The incidence of hospitalization with pneumonia was compared using the Fine-Gray regression model. We summarized the results for each age using random-effects meta-analysis and conducted a subgroup analysis by sex. ResultsA total of 102 136 participants were included, of whom 35% received PPV23. Propensity score matching selected 32 510 pairs of vaccinated and non-vaccinated individuals. Overall, PPV23 administration was associated with a decreased incidence of hospitalization with pneumonia (17.2 vs. 20.4 per 1000 person-years, sub-distribution hazard ratio: 0.84, 95% CI: 0.77 to 0.91). Vaccine effectiveness was the highest among those aged 70 years and decreased with increasing age. No statistically significant effect was observed in those aged 90 or 95 years. Vaccine effectiveness was observed in both males and females. ConclusionsPPV23 was associated with an overall decrease in hospitalization with pneumonia in older adults. However, vaccine effectiveness was significant in those aged 65 to 85 years but not in the older population.

Future Prospects on Constraining Neutrino Cosmology with the Ali CMB Polarization Telescope

We forecast the constraints on the parameters of neutrino physics with the constructions of Cosmic Microwave Background (CMB) temperature, E-mode polarization, and lensing spectra for the ground-based Ali Cosmic Microwave Background Polarization Telescope (AliCPT). To implement the forecast calculations, we perform numerical simulations which show that AliCPT would yield the result σ(N eff) = 0.56 and M ν < 1.10 eV (95% CL.) with TT, TE, EE, and CMB lensing power spectra for the first year of observation. Moreover, we investigate how the instrumental parameters, such as noise level, FWHM, and sky coverage can affect the constraints on these two parameters. Our forecasting results find that a larger aperture telescope with a larger sky survey strategy would significantly improve the current constraints for AliCPT.

Medical treatment of patients with cardiovascular diseases during the first year after hospitalization for COVID-19

Aim. To evaluate the medical treatment of patients with cardiovascular disease (CVD) during the first year of follow-up after hospitalization for coronavirus disease 2019 (COVID-19) in a prospective registry.Material and methods. The material for the study was obtained from the database of the TARGET-VIP inhospital registry. The registry included 1130 people. Of 863 patients discharged from the hospital with a diagnosis of COVID-19, 473 (548%) patients with CVD were selected, and 31 (40,8%) patients were selected from 76 patients in whom the diagnosis of COVID-19 was not confirmed with CVD.Results. At the stage of discharge from the hospital, the quality of therapy for CVD was insufficient on average, the frequency of proper prescriptions was 59,5%. During the first year, there was a significant trend towards a decrease in the prevalence of antihypertensive therapy for hypertension (p=0,018), anticoagulants for atrial fibrillation (p&lt;0,001) and an increase in prescribing angiotensinconverting enzyme inhibitors/angiotensin receptor blockers for heart failure (p=0,037). The average prevalence of prescribing proper cardiovascular pharmacotherapy after 30-60 days and 6 months of follow-up was significantly less than at discharge from the hospital. In both groups of patients, when comparing the average frequency of compliance with proper prescriptions at all follow-up periods, as well as when comparing these indicators between groups, no significant differences were found, with the exception of the stage of 30-60 days after discharge from the hospital (p=0,009).Conclusion. In the TARGET-VIP registry after discharge from the hospital, the prevalence of proper appointments for CVD was insufficient. During the first year of observation, patients with CVD showed a significant decrease in the frequency of proper prescription of antihypertensive therapy for hypertension and anticoagulants for atrial fibrillation. When comparing groups of patients with confirmed and non-confirmed COVID-19, a higher average rate of adherence to proper prescriptions was found in patients with confirmed COVID-19. However, significant differences were found only 30-60 days after discharge.