Involutional Changes Research Articles

Трехмерная эхография в оценке морфофункционального состояния эндометрия у пациенток с хроническим сальпингоофоритом

Objective. To evaluate the morphofunctional state of the endometrium in patients with chronic salpingo-oophoritis before and after surgical treatment. Patients and methods. The study included 112 reproductive-aged patients with chronic salpingo-oophoritis. The mean age of patients was 29.5 ± 1.47 years. Two patient groups were identified: the first group (n = 62) included patients with one or two fallopian tubes removed, the second group – 50 patients with preserved fallopian tubes. Patients underwent pelvic 3D ultrasound in the mid-luteal phase before surgery and after 6, 12 months. The thickness, volume and echo structure of the endometrium were studied, as well as volumetric blood flow indices: vascularization index (VI%); flow index (FI) and vascular flow index (VFI). Based on the ESHRE consensus (2022), the ovarian reserve was assessed. Results. Improvement of perfusion in the endometrium was recorded by one year after surgery. After 12 months, compensatory restoration of ovarian morphofunctional properties and indirect improvement of endometrial receptivity were observed in patients with preserved fallopian tubes. The opposite situation was seen in the group of patients with removed fallopian tubes, especially in those who underwent bilateral salpingectomy and had involutional changes in the uterine mucosal layer and ovarian follicular apparatus, which characterizes the pattern of endometriopathy and premature ovarian insufficiency. 3D-ultrasound is an additional objective method to assess endometrial volume and hemodynamics at the level of basal and parabasal arteries. Key words: 3D ultrasound, AMH, salpingo-oophoritis, endometrium, VOCAL

Clinical Evaluation of the Effectiveness of Combined Neocollagenogenesis Stimulation with High-Intensity Focused Ultrasound (HIFU) and Poly-L-Lactic Acid (PLLA) in Involutional Skin Changes

Clinical Evaluation of the Effectiveness of Combined Neocollagenogenesis Stimulation with High-Intensity Focused Ultrasound (HIFU) and Poly-L-Lactic Acid (PLLA) in Involutional Skin Changes

Statistical analysis of predictors of effectiveness of complex physiotherapeutic treatment in patients with involutional skin changes

BACKGROUND: Analysis of predictors of the effectiveness of various treatment regimens for diseases, as well as the correction of involutionary processes in the human body, is increasingly becoming a standard in scientific medical research. The technology for identifying them traditionally includes the use of correlation and regression analysis, as well as the principles of correlation adaptometry, which makes it possible to approach the solution of this problem from the position of system analysis. AIM: Analysis of predictors of the effectiveness of correction of involutive skin changes in middle-aged and older women with metabolic syndrome using various therapeutic regimens, including hyaluronic acid laser phoresis and the use of transcranial magnetic therapy in combination with oxygen barotherapy. MATERIALS AND METHODS: The study was carried out with the participation of 60 patients from middle and older age with involutional changes in the skin against the background of metabolic syndrome. All patients were divided into 2 groups using simple fixed randomization. The first group (comparison, 30 patients) received laser phoresis of hyaluronic acid in the form of a 1.5% sodium hyaluronate gel using a laser and laser-vacuum therapy device LAZMIK. Patients of the second group (main group, 30 patients) were prescribed combined physiotherapy. For transcranial magnetic therapy, the Amo-Atos device with the Headband attachment was used, and oxygen barotherapy was carried out in single pressure chambers of the Oka-MT or Irtysh-Shch1 type under a pressure of 2 atm for 1 hour. RESULTS: It was found that in the initial state, the quality of life of patients with involutional changes in the skin against the background of metabolic skin syndrome was largely determined by the presence of pathological correlation galaxies that integrate changes in the condition of the skin, metabolic disorders, indicators of oxidative stress and microhemodynamics, and the activity of proinflammatory cytokines. At the same time, the leading role in the deterioration of the quality of life belonged to the age of the patients, the insulin resistance index, transepidermal water loss and microcirculation indicator. However, predictors of effectiveness varied across different treatment regimens. With laser phoresis of hyaluronic acid, its effectiveness increases in younger women with minimal involutional manifestations of skin aging, tested for the condition of the skin, while combined physiotherapy is also most effective in women with a low average age limit, with minimal manifestations of metabolic syndrome and inflammatory processes, as well as against the background of high activity values of one of the enzymes of antioxidant protection ― superoxide dismutase. CONCLUSION: The results obtained convincingly prove the effectiveness of combination therapy in correcting involutive skin changes in middle-aged and older women due to metabolic syndrome, which is comparable in a number of parameters to the effectiveness of hyaluronic acid laser phoresis. At the same time, predictors of effectiveness depend on the characteristics of the mechanisms of therapeutic action of the treatment regimens used, which allows for a more correct approach to the choice of personalized treatment methods.

Connective Tissue Dysplasia As A Predictor Of Premature Skin Aging

Background — One of the manifestations of connective tissue dysplasia (CTD) is premature skin aging. The latter can have different etiological factors. The objective of our study was to investigate the effect of predictors of premature skin aging, especially CTD, on the severity of involutional changes in the skin, as well as to develop the approach for the management of patients with premature aging. Material and Methods — We included in our study 78 women 35-45 years of age with no substantial anti-aging treatment procedures in their anamneses. We considered genealogical and cosmetological anamneses, and life history (including somatic pathology), physical examination; determined prevailing type of facial skin aging; identified predictors of CTD, assessed psychoemotional state of the patient, and performed sonography of the skin and biochemical examination of patient serum. At a clinical stage, we conducted a randomized comparative study of biorevitalizant efficacy in patients with normal and premature patterns of skin aging. Results — Our study established the role of CTD in assessing the risk of premature skin aging. In addition to the presence of CTD, the importance of identifying isolated phenotypic manifestations of CTD (such as arachnodactyly, hypermobility syndrome, low relative weight of the patient, and skin manifestations of CTD) was shown. Other predictors were also analyzed; their identification can help assessing the risk of premature skin aging. Among them, somatic pathology (varicose veins, herniated discs, visceroptosis, autonomic vascular dystonia) and physical examination data (such as pallor of the facial skin, swelling, skin hyperelasticity) were noted. When assessing the clinical efficacy of biorevitalization, the greatest satisfaction of patients with premature skin aging regarding its results was characteristic for the group of patients after 7% collagen treatment. The clinical efficacy according to sonography and histological examination in patients with premature skin aging was significantly higher after the use of collagen or a complex hyaluronic acid (HA) preparation, compared with native HA. Patients with premature skin aging exhibited high level of anxiety and/or depression, which in turn increased the risk of underestimating the outcome of procedures. Conclusion — The presented study confirmed the role of CTD in assessing the risk of premature skin aging. Predictors were revealed (somatic pathology, type of facial aging, physical examination data of the patient, etc.) that could be used to assess the risk of premature skin aging. In patients with premature aging, preparation with native HA (as a biorevitalizant) had a low clinical efficacy comparable to using placebo. A collagen-based preparation and a complex HA-based preparation exhibited high clinical efficacy. Also, patients with premature aging of the skin had a higher score of anxiety and depression, while patients with high levels of anxiety and depression were more likely to underestimate the satisfaction with the results of their aesthetic treatment.

Stimulation of Cerebral Angiogenesis and Neurogenesis with Transcatheter Intracerebral Laser Photobiomodulation Therapy in Alzheimer’s Disease and Vascular Parkinsonism Aggravated by Dementia

AbstractBackgroundThe research is focused on the stimulation of cerebral angiogenesis and neurogenesis using Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT) in patients with dementia in Alzheimer’s disease (AD) and patients with vascular parkinsonism (VP).MethodThe examination of 155 patients included assessment of CDR, The Tomography Dementia Rating scale (TDR), MMSE, cerebral CT, MRI, SG, rheoencephalography (REG) and cerebral MUGA.85 patients were selected, of whom:• 48 (30.97%) people suffering from AD, aged 34‐80 (mean age 67.5), men ‐ 17 (35.42%), women ‐ 31 (54.58%). According to dementia severity, patients were subdivided: preclinical stage (TDR‐0) ‐ 4, mild stage (TDR‐1) ‐ 16, moderately severe stage (TDR‐2) ‐ 21, severe stage (TDR‐3) ‐ 7 patients.• 37 (23.87%) people suffering from VP, aged 58‐80 (mean age 77), men 28 (75.68%), women ‐ 9 (24.32%). 19 (51.35%) had a mild dementia stage (CDR‐1).In hospital conditions, in a specialized cath lab, all patients underwent Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT) (wavelength 632.8 nanometers).ResultAll 48 (100%) patients with AD underwent angiogenesis stimulation resulting in cerebral collateral capillary revascularization and closure of atreriovenous shunts.Simultaneously, patients showed a 10‐20% increase in cerebral temporal lobes volume, which indicates cerebral neurogenesis development and tissue regeneration. The process was accompanied by dementia level decrease and cognitive functions restoration. Consequently, patients were transferred to a milder TDR group. Depending on the initial dementia severity, the resulting positive effect was observed from 2 to 15 years.All 37 (100%) patients with VP underwent angiogenesis stimulation resulting in cerebral microcirculation improvement and cerebral involutive changes decrease, which indicates the neurogenesis development and tissue regeneration. The process was accompanied by decreased dementia and cognitive functions restoration. The resulting positive effect was observed over 10 years.ConclusionDespite the differences in AD and VP etiology, Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT) is an effective treatment for dementia in these diseases. The method stimulates angiogenesis and improves blood supply to the brain, it stimulates neurogenesis and the restoration of normal tissue structures, which leads to improved mental and cognitive functions. The resulting effect persists for a long time.

Risk factors for prolonged pregnancy beyond 40 weeks

Prolonged and postterm pregnancy at the current stage is one of the urgent problems in the field of obstetrics and gynecology. It is due to both the high frequency of pathological processes during childbirth and in the context of pathological changes occurring with the fetus, which leads to an increase in perinatal mortality. Perinatal mortality rates, depending on literary sources, reach 19%, and neonatal morbidity can be up to 28%. All these complications are associated with poor resistance of the fetus to hypoxia due to increased maturity of brain structures and reduced oxygen supply due to dystrophic and involutional changes in the placenta. Therefore, studying the risk factors for prolonged pregnancy after 40 weeks becomes especially important.Therefore, postterm pregnancy should be considered as a pathological condition arising under the influence of various factors.Aim. To carry out a retrospective analysis of the records of childbirth with prolonged pregnancy for more than 40 weeks and to evaluate the risk factors for the occurrence of this pathology.Material and methods. In order to study the immediate and long-term consequences of the development of the prolongation of pregnancy for more than 40 weeks, we conducted a retrospective study of 100 pregnancy and childbirth cases for 2021-2022 at the Chernivtsi Regional Perinatal Center The standard method of mathematical analysis using Student's criteria, the standard and specialized computer program Libre Office Calc 7.0 was used for statistical processing of the obtained data.Results. In order to identify the risk factors of prolonged pregnancy, a comparative analysis of somatic, obstetrical and gynecological anamnesis, features of pregnancy in 100 women with prolonged and postterm pregnancies was carried out. As can be seen from the data presented in Table 1, no significant difference between the number of young first-borns in the groups was found. The share of young first-borns (up to 20 years old) is somewhat higher in prolonged pregnancies (28% versus 22% in late pregnancies). It is characteristic that there were 1.1 times more patients over 30 years of age in the postterm pregnancy group than in the prolonged pregnancy group (78% and 72%, respectively).Conclusions. The analysis of the somatic and obstetric and gynecological history, as well as the characteristics of the course of the current pregnancy, allows to determine the risk factors that indicate the possibility of the development of a delayed pregnancy.

Age-related and varicose disease-related structural changes in the inner lining of the large subcutaneous vein

Introduction. There is a growing number of people over 60 years old and consequently a growing number of elderly and senile patients with varicose veins globally. These patients have involutive changes that occur in the body, and therefore they need a special and personalized approach to examination and treatment. Aim. Study and evaluate age-related and varicose disease-related structural changes in the inner lining of the large subcutaneous vein. Materials and methods. 135 fragments of the large subcutaneous vein were examined, 55 of which belonged to deceased people who had no venous disease, 80 operated patients with varicose veins. There are 4 age groups: young, middle, elderly and senile. Histological, morphometric and electron microscopic examination was performed. Results and discussions. The study showed that involutive changes are characterized by a decrease in the number of endothelial cells along the inner perimeter and their flattening, loosening and edema of the subendothelial stroma in persons over 75 years of age. In varicose veins, morphological changes progress with increasing patient age and disease duration. In young and middle-aged people with varicose veins, endotheliocytes flatten, protrude into the lumen of the vessel, collapse, areas of endothelial atrophy appear along the perimeter, signs of myoelastofibrosis appear, as indicated by an increase in the volume fraction of intima due to connective-woven structures. In patients over 60 years of age, endothelial desquamation is more evident in intimacy, the preserved cells are destructively changed, the volume fraction of intima significantly decreases, which corresponds to the signs of intima sclerosis. Conclusions. Under normal conditions in senile age, the volume fraction is significantly reduced compared to the middle age group (p < 0.005). In case of varicose veins, structural changes, both qualitative and quantitative, progress against the background of involutive changes and disease duration, which aggravates endothelial dysfunction.

Combined use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid in treatment of involutive changes in facial skin

Combined procedures can be performed during one appointment to solve several problems for the patient. However, some treatments should be planned over several consecutive sessions to avoid complications and achieve optimal results. The purpose of our study was the scientific substantiation and development of an algorithm for the complex use of microneedle radiofrequency lifting and injection fillers based on hyaluronic acid in patients with involutive changes in the facial skin, taking into account the data of the pathomorphological research method. The patients were divided into three groups, depending on the treatment methods. In order to assess the effectiveness of therapy, a histological examination was carried out in five patients from each group, and a morphometric assessment was carried out. The histological picture and morphometric assessment of microslides from patients from different study groups indicate that microneedle RF lifting entails scar-type changes, which thins the thickness of the epidermis. However, the use of hyaluronic acid smoothes out these changes and leads to faster tissue restoration. At the same time, in the complex treatment group, better regenerative potential was noted than in the monotherapy groups, which is confirmed by the maximum value of basal epidermocytes per unit length.

Morphological signs of neurogenic inflammation in rat epicardial adipose tissue during aging

The aim of this work is to study the neuroinflammatory process in the epicardial adipose tissue (EAT) of the aorticpulmonary region of the rat heart during aging. The work was performed on Wistar rats aged 18-23 months (n=18). The adipose tissue of the pericardial region of rats was the object of study. Neuroimmunohistochemical markers (9.5 protein, tyrosine hydroxylase, synaptophysin) were used to study EAT innervation. The method of staining with toluidine blue and azure-eosin was used to study inflammation processes. Using histological and immunohistochemical methods, involutive and neurodegenerative changes in parasympathetic and sympathetic postganglionic nerve fibers were revealed in the white and brown adipose tissue of the heart of old rats (18-23 months old). A number of pathological changes were revealed in EAT: fibrosis, dystrophic changes and lysis of white adipocytes, disintegration of varicose axons of the terminal nerve plexus, as well as the formation of focal monocyticlymphoid infiltrates. It has been shown that the axons of the terminal nervous network are in close relationship with immune and inflammatory cells (lymphocytes, plasmablasts, monocyte-macrophage elements, mast cells). The noted morphological features indicate a neurogenic type of immune inflammation in the EAT of the heart. The identified changes may be the cause of chronic disorders of lipid metabolism during aging, leading to the development of pathological processes in the tissues of the main vessels of the aortic-pulmonary region of the heart, and also serve as prognostic indicators for clinical practice.

Effect of an anti-aging care product on the main morphofunctional skin parameters

Introduction. Cosmetic care occupies an important place in the correction of visible involutive skin changes. Existing high-tech methods of preserving and delivering active ingredients to the skin allow us to create unique ampoule concentrate, in particular Anti-Aging Reviving Elixir from LaCabine, the main components of which are snow algae powder, probiotics and chamomile extract.Aim. To study the effect of Anti-Aging Reviving Elixir by LaCabine on the main morphofunctional skin parameters (hydration, elasticity, pigmentation, fine wrinkles, sensitivity) and evaluate the organoleptic properties and ease of use. e for 28 days. Using the Aramo ASW device, the following skin parameters were determined before and after the course: hydration, elasticity, pigmentation, fine wrinkles, sensitivity. For a general visual assessment, photography was carried out in the aesthetics mode with the FotoFinder device.Results. The organoleptic properties, adverse events, as well as the ease of use of the properties were evaluated by an oral survey of each patient. The results showed that the course use of Anti-Aging Reviving Elixir by LaCabine leads to enhanced appearance of the skin, improved morphofunctional parameters, in particular hydration and elasticity, and reduced fine wrinkle severity. Due to ease of use and good organoleptic properties, the product is characterised by a high level of compliance.Conclusion. Anti-Aging Reviving Elixir by LaCabine can be recommended for home care as part of anti-aging skin care programs.

Ultrasound examination of mammary glands in patients with infertility on background violations of menstrual function

The objective. Іs to investigate the state of the mammary glands in patients with infertility of endocrine genesis. Materials and methods. The study was conducted in 110 patients with endocrine infertility who underwent an ultrasound examination of the mammary glands. The first group (n=52) consisted of patients with a regular menstrual cycle against the background of luteal phase insufficiency, the second group (n=58) consisted of patients with a menstrual cycle disorder with anovulation. Statistical processing of the research results was carried out using the standard programs "Microsoft Excel 5.0" and "Statistica 8.0". Results and their discussion. Changes in the mammary glands according to the type of PCH in the studied group were found in 44 out of 110 patients (40.0%), underdevelopment of the structural elements of the mammary glands - in 19 out of 110 (17.3%), early involutional changes - in 6 out of 110 (65, 4%), focal formations – in 4 out of 110 (3.6%). The frequency of fibrocystic disease in patients of the II group was 1.3 times higher compared to the I group - 24 (41.3%) versus 20 (38.4%), respectively, p<0.01. At the same time, focal mammary gland formations of the fibroadenoma type were diagnosed 3.5 times more often in patients of the I group - 3 (5.8%) versus 1 (1.7%) in the II group, p<0,01. Conclusions. In infertility of endocrine genesis, the first place in the structure of mammary gland pathology is diffuse fibrocystic disease - 40.0%. The frequency of underdevelopment of mammary glands is 17.3%, early involutional changes 10.3%, and focal formations like fibroadenoma are 3.6% of cases.

ASSESSMENT OF THE RATIONALITY OF PHARMACOTHERAPY IN ELDERLY PATIENTS WITH CARDIOVASCULAR DISEASES USING STOPP/START NON-COMPLIANCE MODELS

Elderly patients, due to involutive changes in the body, have peculiarities of pharmacokinetics and pharmacodynamics, which must be taken into account when prescribing drugs. There are various tools for individualizing therapy: use the 7-step algorithm, STOPP/START criteria, anticholinergic load scales, assessment of triggers of undesirable events - GerontoNet scale, Brighton Adverse Drug Reactions Risk scale. The article examined the use of STOPP/START criteria by physicians in practical activities. It is determined that doctors pay more attention to STOPP criteria when treating the patient and prescribing drugs. It is determined that doctors pay more attention to STOPP criteria when treating the patient and prescribing drugs. Based on the data obtained during the assessment of the use of the rational pharmacotherapy tool, prognostic non-compliance with the criteria was calculated and the factors affecting this were determined: BMI for (for STOPP criteria) and a score on the Age Not Hindrance questionnaire (for START criteria).

Modern approaches to the correction of age-related skin changes in women

The article is devoted to the literature review on the correction of age-related skin changes in women. Skin aging is a physiological process that is caused by the constant action of unmodified factors, for example, endocrine disorders, shortening of telomeres, etc., in combination with periodic influence of modified (exposomal) factors. Ultraviolet radiation takes first place among external factors affecting the progression of degenerative changes in skin, however, in women, involutional changes in skin are primarily associated with a fading of synthetic function of ovaries. During the first five years from the onset of menopause, content of collagen fibers I and III types is reduced by 30% in combination with a further reduction of 2% annually for the next 15 years.Involutive transformations occur in all layers of skin and are visually characterized by the presence of wrinkles, roughness of the epidermal surface (with photoaging) or a decrease in its thickness (with chronic aging), dryness, pigmentation disorders in the form of uneven hyperpigmented spots, telangiectasias, oval deformations.Today, there are many methods of aesthetic correction of age-related skin changes. In the arsenal of a cosmetologist there are both invasive (PRP-therapy, microneedling, microneedle radio wave lifting, administration of preparations based on calcium hydroxyapatite, polylactic and hyaluronic acid, etc.) and minimally invasive (administration of botulinum neuroprotein, application of chemical acid peelings, IPL-therapy and laser polishing, photodynamic therapy) methods. Patients prefer minimally traumatic procedures due to the fact that they almost do not disturb the processes of socialization, however, each of these methods has both advantages and disadvantages.Modification of a woman life quality in peri- and menopause in form of changes in lifestyle and eating behavior, increasing physical activity, quitting smoking and limiting the use of alcoholic beverages is an integral part of therapeutic care. However, the appointment of menopausal hormonal therapy, including the use of estrogens, progestogens and combined hormonal drugs, allows to achieve a stable and long-lasting effect from cosmetology procedures and home care.

Relationships between anthropometric and body composition characteristics and age in Polish women over 60 as affected by their socioeconomic and health status and physical activity levels.

Background: Little is known about changes in anthropometric and body composition (A&BC) characteristics during the aging process. Research indicates that body composition can be linked with socioeconomic status (SES), health status (HS), and physical activity (PA) levels. Aim: The aim of this study was to evaluate age-related changes in A&BC characteristics in female seniors aged 60+ in view of their SES, HS, and PA levels. Methods: The survey was conducted in November and December 2022 on a total of 661 female seniors. A questionnaire survey was conducted to obtain information about the participants' socioeconomic status (chronic diseases, health status, marital status, membership in social organizations, financial status, place of residence, education). The respondents' PA levels were assessed with the International Physical Activity Questionnaire (IPAQ), and their A&BC characteristics were determined in a bioelectrical impedance analysis with the InBody 270 body composition analyzer. The relationships between A&BC characteristics and age were evaluated based on the values of the Pearson correlation coefficient (r). Results: The mean values of Percent Body Fat (PBF), Body Mass Index (BMI), and the waist-hip ratio (WHR) were relatively high (37.2%, 28.5kg/m2, and 0.8, respectively) and indicative of overweight and gynoid obesity. A higher number of significant negative correlations between A&BC characteristics and age were observed in seniors with lower values of SES, HS, and PA, which points to more rapid involutional changes in this group of respondents. A segmental analysis also revealed significantly lower values of fat-free mass (FFM) and body fat mass (BFM) (both indicators were calculated in percentage and kg), in particular in the upper limbs, in women with lower SES, HS, and PA levels. Conclusion: Environmental factors, including biological, physiological, environmental, psychological, behavioral, and social factors, are significantly associated with aging in women. Age-related changes in A&BC characteristics tend to proceed more rapidly in female seniors with low values of SES and HE and insufficient PA levels.

Pediatric hepatic vascular tumors: clinicopathologic characteristics of 33 cases and proposed updates to current classification schemes

Pediatric hepatic vascular tumors (HVTs) are rare neoplasms with features distinct from their cutaneous counterparts. Their behavior ranges from benign to malignant, with each subtype having therapeutic differences. Histopathologic descriptions of large cohorts are scarce in the literature. Thirty-three putative HVTs diagnosed from 1970 to 2021 were retrieved. All available clinical and pathologic materials were reviewed. Lesions were reclassified according to the World Health Organization (WHO) classification of pediatric tumors [1] ashepatic congenital hemangioma (HCH; n=13), hepatic infantile hemangioma (HIH; n=10), hepatic angiosarcoma (HA; n=3), and hepatic epithelioid hemangioendothelioma (HEH; n=1). Vascular malformations (n=5) or vascular-dominant mesenchymal hamartoma (n=1) were excluded. HCH frequently showed involutional changes, whereas HIH often had anastomosing channels and pseudopapillae formation. HA had solid areas with epithelioid and/or spindled endothelial morphology, significant atypia, increased mitoses, high proliferation index, and occasionally necrosis. On morphology analysis, a subset of HIH showed features worrisome for progression to HA including solid glomeruloidproliferation, increased mitoses, and epithelioid morphology. The widely metastatic and fatal HEH was observed in a 5-year-old male with multiple liver lesions. Immunohistochemically, HIHs and HA were Glucose transporter isoform 1 (GLUT-1) positive. One HIH patient died from postoperative complications, whereas 3 are alive without disease. Five HCH patients are alive and well. Two of three HA patients died of disease, and 1is alive without recurrence. To our knowledge, this is the largest series of pediatric HVTs reviewing clinicopathologic features based on current Pediatric WHO nomenclature [1]. We highlight diagnostic challenges and propose inclusion of an intermediate category between HIH and HA which warrants closer follow-up.

Anti-aging technologies and physiotherapy innovations

The aim of the study is to improve the quality of medical and aesthetic care for patients with age-related changes in the skin of the face and body by including injection carboxytherapy and platelet injection technique (PRP) in the treatment protocol. Material and methods. 81 patients (42 women and 39 men) with age-related involutive changes in facial skin were examined. All patients were examined using dermatological methods: corneometry, dermatoscopy, pH assessment, ballistometry and cutometry. All patients were randomized into comparison groups: the main group (20 patients) received injection carboxytherapy and platelet method (PRP), the control group (20 patients) did not receive methods of apparatus physiotherapy, two comparison groups (comparison-1, 20 patients) received injection carboxytherapy and (comparison-2, 20 patients) received the platelet method (PRP). Statistical data analysis was carried out in Microsoft Office Excel (2017) and SPSS statistical processing (PASW Statistics version, 2018). We used parametric (linear correlation method, Student's t-test) and non-parametric methods (Spearman's rank correlation coefficient, unpaired Wilcoxon-Mann-Whitney test and paired Wilcoxon test). Differences were considered significant at p < 0.05. Results. After the complex therapy, a significant increase in the hydration index of the facial skin by 12.8±1.1 units, an increase in the level of elastin by 9.4±2.9 units was noted, which contributed to a decrease in the depth of wrinkles after the combined method of injection carboxytherapy and PRP - by 1.4 points.

Possibility of stimulation of cerebral angiogenesis and neurogenesis with transcatheter intracerebral laser photobiomodulation therapy during dementia in patients with Alzheimer’s disease and in patients with distal cerebral atherosclerosis

AbstractBackgroundThe research is dedicated to stimulation of cerebral angiogenesis and neurogenesis with Transcatheter Intracerebral Laser Photobiomodulation Therapy (PBMT) in patients with dementia during Alzheimer’s disease (AD) and patients with distal forms of cerebral atherosclerosis.Materials & Methods350 patients with dementia were examined.We carried out determination of CDR, Tomography Dementia Rating scale (TDR), MMSE, cerebral CT, MRI, SG, rheoencephalography (REG), cerebral MUGA.48 (13.71%) patients with AD aged 34‐80 (mean age 67.5) were selected: 17 men (35.42%), 31 women (54.58%). According to their dementia severity, the patients were subdivided: preclinical stage (TDR‐0) ‐ 4, mild stage (TDR‐1) ‐ 16, moderately severe stage (TDR‐2) ‐ 21, severe stage (TDR‐3) ‐ 7.302 (86.29%) patients with distal cerebral atherosclerosis aged 58‐81 (mean age 78) were selected: 226 men (74.83%), 76 women (25.17%). According to their dementia severity, the patients were subdivided: mild stage (СDR‐1) ‐ 284 (94.04%), moderately severe stage (СDR‐2) ‐ 18 (5.96%).At hospital, all the patients underwent PBMT.ResultsAll 48 (100%) patients with AD showed improved cerebral microcirculation and 10‐20% increase in the volume of cerebral temporal lobes, which indicates cerebral neurogenesis development and tissue regeneration. The process was accompanied by a decreased level of dementia and restoration of cognitive functions. Consequently, the patients were transferred to milder TDR groups. Depending on the initial dementia severity, the resulting positive effect was observed during 2‐10 years.All 302 (100%) patients with distal cerebral atherosclerosis showed improved cerebral microcirculation and declining cerebral involutional changes, which indicates neurogenesis development and tissue regeneration. The process was accompanied by a decreased dementia level and cognitive functions restoration. The resulting positive effect was observed for over 10 years.ConclusionsDespite differences in the etiology of AD and distal cerebral atherosclerosis, PBMT is an effective treatment for dementia in these diseases. The method improves the blood supply of the brain; it stimulates neurogenesis and tissue structures restoration, which leads to an improvement in mental and cognitive functions. The resulting effect persists for a long time.

Исследование предоперационной симметрии дистанции «экватор хрусталика – цилиарные отростки» у пациентов с сочетанием возрастной катаракты с клиническими проявлениями инволюционной соединительнотканной дисплазии

Purpose. Study of state of the Zonule of Zinn in patients with combination senile cataract with systemic involutional connective tissue dysplasia. Material and methods. 97 patients (97 eyes) – combination senile cataract with involutional pathology in connective tissue (the main group). 1st subgroup: 31 patients with kyphoscoliotic deformity of the 3d and 4th degree (classification by V.D. Chaklin (1973)); 2nd subgroup – 66 patients with chronic venous insufficiency 2nd and 3d degree (the CEAP classification) against the background of varicose veins of the lower extremity. Patients of both subgroups were comparable in terms of cataract stages and nuclear cataract lens density in Buratto classification. The control group – 55 patients (55 eyes) similar sex and age with senile cataracts without involutional connective tissue pathology. We estimated the symmetry of distance «lens equator – ciliary processes» in 2 meridians: at 6 and 12 hours. The presence of asymmetry of 0.3 mm or more was sign of weak zonular support (according to ultrasonic biomicroscopy). Results. In the control group, the distance was 0.3 mm in 3 eyes (5%), with intraoperative formation of folds in the anterior capsule. In 10 eyes of the 1st subgroup of the main group (32%), the presence of distance asymmetry was revealed: intraoperative, signs of subluxation of the lens of the 1st degree were detected in 7 eyes. In the 2nd subgroup of the main group, distance asymmetry was detected in 24 eyes (37%). Folded anterior lens capsule was determined intraoperative in 14 eyes (21%) during anterior capsulorhexis and lens mobility during nucleus emulsification. Conclusion. A statistically significant difference in frequency of asymmetries of distances «lens equator – ciliary processes» in 2 opposite meridians was revealed between groups of patients with senile cataract against the background of systemic somatic involutional pathology of connective tissue and without it (35% vs. 5%; p < 0.01). Keywords: senile cataract, Zonule of Zinn, involutional changes in connective tissue, ultrasound biomicroscopy

Features of the Peribiliary Glands of the Extrahepatic Biliary Tract in the Elderly and Long-Living Individuals

The aim of the study was to analyse histologically and morphometrically the peribiliary glands of the extrahepatic biliary tract in the elderly and long-living people.Material and methods. The study included wholemounts of the gallbladder, the cystic, hepatic and common bile ducts obtained from the corpses of both sexes aged 22 to 35 years (n=16) and older than 76 years (n=39). Macro-microscopy was used to evaluate the number, localization, sizes and shape of the glands, the area of the lumen of the excretory duct orifices, the area of the initial section of the glands, the number of initial (terminal) parts and the proportion of epithelial parenchyma in their composition.Results. With age, there is a decreased proportion of "complexly branched" glands with a significant number of initial sections and excretory ducts of the 1st order. The proportion of "simple" glands, with one initial section increases to 70.2–78.3% in the senile age, while it is 41.0–52.1% in people of mature age. In long-living people, there is an increased number (up to 70–85%) of glands with ampullar extensions of the common excretory duct. The total number, density of gland localization, the length and width of the initial section of the peribiliary glands tend to decrease from the period of mature age to longevity. In senile age, the size and quantitative parameters of the glands stabilize, and do not modify in long-living people.Conclusion. The results of the morphological analysis demonstrate that there is no progression of involutive changes in the peribiliary glands of the extrahepatic biliary tract from senile age to the period of longevity. In some cases, long-living individuals manifest compensatory-adaptive reactions, such as an increased severity of the epithelial parenchymal component in the composition of the glands and an increased proportion of glands with an ampullar expansion of the common excretory duct.

EVALUATION OF KIDNEY FUNCTION IN AN ELDERLY PATIENT WITH ACUTE MYELOBLASTIC LEUKEMIA AFTER HEMATOPOIETIC STEM CELL TRANSPLANTATION: A CASE REPORT

Relevance: Kidney functions in treating acute myeloblastic leukemia (AML) undergo serious effects, especially in elderly patients. Chemotherapeutic drugs used to prepare for hematopoietic stem cell transplantation (HSCT) inevitably affect elderly patients’ kidney function. Moreover, involutive changes in the kidneys can physiologically decrease kidney function.
 The study aimed to evaluate kidney function in an elderly patient with AML after HSCT.
 Methods: The article describes a clinical case of AML in an elderly patient who underwent allogeneic HSCT.
 Results: We analyzed the dynamics of the functional state from the moment of registration of AML to +100 days after HSCT. During the entire follow-up period, we did not detect any renal dysfunction in the elderly patient. Despite the HSCT and the effects of nephrotoxic drugs in an elderly patient + 100 days after HSCT, kidney function was preserved.
 Conclusion: The described case highlights the importance of maintaining renal function in elderly patients after HSCT and long-term renal monitoring.