Involutional Changes Research Articles

Changes in clinical condition and quality of life of patients with involutional changes of facial skin and metabolic syndrome after the course of treatment with therapeutic physical factors

BACKGROUND: The presence of concomitant chronic non-infectious diseases, which significantly increase in probability and severity with age, contributes to the intensity of external manifestations of involutional processes. This is absolutely true for the metabolic syndrome, which is confirmed to be associated with involutional changes in the skin and soft tissues of the face through systemic mechanisms of comorbidity, determining mutual additive influences. AIM: The aim of the study was to evaluate the clinical efficacy of the combined use of transcranial magnetic field therapy, oxygen bar therapy, and laser phoresis of hyaluronic acid for the treatment of involutional skin changes in patients with metabolic syndrome. MATERIALS AND METHODS: Using a simple randomization technique, patients with involutional skin changes associated with metabolic syndrome (n=120) were divided into 4 groups of 30 subjects each. Subjects in group 1 (control group) received only laser phoresis of hyaluronic acid; subjects in group 2 (comparator group 1) received one course of transcranial magnetic therapy; subjects in group 3 (comparator group 2) received one course of oxygen bar therapy; subjects in group 4 (experimental group) received one course of combined treatment (laser phoresis of hyaluronic acid + transcranial magnetic therapy + oxygen bar therapy). Results were evaluated based on changes in the severity of key clinical and functional signs of age-related skin changes. In addition, the quality of life of the patients was evaluated using the Dermatologic Index, and the overall aesthetic improvement was evaluated using the Global Aesthetic Improvement Scale (GAIS). RESULTS: The comorbidity of chronoaging with metabolic syndrome is associated with subjectively more severe major clinical manifestations of facial skin aging and indicative changes in its morphological and functional parameters. A comparative analysis of the effectiveness of using different monotherapy regimens showed the most significant regression of clinical manifestations with the laser phoresis of hyaluronic acid. The total subjective score of major clinical manifestations of age-related skin changes decreased by 39.8% on a visual analog scale (VAS), and the quality of life increased by 61.7%. The GAIS score was 2.48. Visual analog scale scores were largely consistent with changes in objective skin parameters. In the transcranial magnetic therapy and oxygen bar therapy groups, the effect was weaker and almost equal. The highest efficacy was reported in the experimental group: regression of clinical manifestations of skin chronoaging and restoration of objective dermal parameters were reliable and exceeded the level of the control group after the treatment. CONCLUSION: The combined treatment shows a significant increase in clinical efficacy due to the pathogenetic effect on the metabolic syndrome. Sinergy of therapeutic physical factors is achieved by different modalities, sites of treatment, and mechanisms of biological potential.

Paracetamol overdose associated with cortical blindness-complicated acute leukoencephalopathy: a case report

BackgroundParacetamol is one of the most used antipyretics and analgesics among pediatrics, and its overdose is highly encountered among pediatrics especially in the pre-school age. While it is well-known that paracetamol overdose may lead to toxicities including severe hepatic toxicity, some recent reports have highlighted its “in situ” toxicity on brain tissue at high doses, even in the absence of hepatotoxicity. This can result in acute leukoencephalopathy (AL), coma, or even death. This report describes a case of a child who developed cortical blindness-complicated AL, following a paracetamol overdose.Case presentationAn 18-month-old previously healthy girl accidentally ingested 300 mg/kg of paracetamol suspension. After ingestion, the child was in an initial bad condition that has gradually improved. Several days after ingestion, the patient lost her vision, and she remained blind since then despite a newer appreciation to light. The initial brain magnetic resonance imaging (MRI) suggested AL demonstrated as a faint high T2/fluid-attenuated inversion recovery (FLAIR) signal intensity in the cortical and subcortical regions of both parieto-occipital lobes with sulcal effacement and restricted diffusion. After around 3 months, the subsequent brain MRI showed involutional changes that were manifested as a brain volume loss in the same areas with evidence of gyri-form laminar necrosis in both parieto-occipital regions without restricted diffusion. Other brain MRI findings include right cerebral convexity hyperacute subdural hematoma with prominent subarachnoid spaces.ConclusionsThe child developed cortical blindness-complicated AL following a paracetamol overdose. It is well- known that AL may result from several toxins by their direct and/or indirect effect on the cerebral white matter. However, there is still no enough data in the literature clearly explaining the relation of paracetamol overdose to AL. The generally proposed effect of paracetamol on the brain is mainly justified by the excessive oxidative stress. Further studies at the cellular and genetic levels are still needed to investigate the exact association between paracetamol overdose and AL, as well as the underlying mechanisms involved.

Acute Decompensation of Chronic Cardiac Failure in Elderly and Senile Persons: Focus on Renal Dysfunction

The heart and kidneys, as well as their synergy, are necessary conditions for maintaining hemodynamic homeostasis in the human body. Since the beginning of the 19th century, it has been recognized that cardiovascular and renal diseases often coexist and have a mutually aggravating effect on each other. During the aging process, involutive changes in organs and body systems, especially the cardiovascular and urinary systems, lead to many physiological and functional changes that can increase the risk of developing acute complications, including acute decompensation of chronic heart failure (CHF). The prevalence of CHF is increasing among the population of older age groups all over the world, which is explained not only by involutive changes in the cardiovascular system of the body, but also by the high frequency of concomitant diseases, in particular chronic kidney disease. Age-related changes in the urinary system also play an important role in maintaining homeostasis of the body, however, during the aging process, along with a decrease in the number of nephrons, a decrease in the concentration function of the kidneys is observed, as well as a change in their structural integrity. These involutive changes in renal tissue may complicate the diagnosis and treatment of conditions associated with acute decompensation of CHF. Therefore, consideration of age-related changes in the cardiovascular and urinary systems and their contribution to the development of acute decompensation of CHF represents an important area for further research and practical applications aimed at improving medical care and quality of life in older people. The review article examines scientific literature data on cardiorenal relationships in acute decompensation of chronic heart failure in elderly and senile people.

CLINICAL PROFILE OF FEMALE PATIENTS WITH INVOLUTIONAL CHANGES IN THE FACIAL AND NECK SKIN

Objective. To assess the clinical profile of female patients with complaints of involutional changes in the face and neck planning to undergo contouring surgery for facial/neck correction. Materials. This study is based on a prospective analysis of 210 fe-male patients with involutional changes in the face and neck who consulted an aesthetic surgeon. Results. The mean age of the patients was (52.51±4.94) years (range 36-65). The majority were middle-aged (46-65 years) – 92.86%. Women aged 36-45 years most often considered the upper third of the face as problematic, those aged 46-55 years focused on the middle/lower third of the face, and those aged 56-65 years identified the middle part of the face and neck as problem areas. The average score for subjective assessment of facial involution was 3.35 points (range 2-4). Younger patients rated the severity of their facial changes with lower scores, while patients over 55 years old tended to choose a score of four. Four typical morphotypes of facial aging were identified: tired or gravitational morphotype (27.14%), fine-wrinkled morphotype (17.14%), deformational morphotype (35.71%), and combined morphotype (20.0%). Conclusions. The majority of patients (88.6%) indicated that problematic areas involved various thirds of the face: the middle third of the face (60.47%), the lower third of the face (43.81%), and the neck (24.28%). Younger patients rated the severity of involutional changes in their face with lower scores, whereas a significant number of patients over 55 years old chose a score of four. The first type of Glogau aging was most common among patients with a fine-wrinkled morphotype, the second type with a gravitational morphotype, and the third and fourth types with a deformational morphotype.

Poly-L-lactic acid in the correction of age-related changes in facial skin

Age-related changes in the skin of the face and neck are the result of a number of interrelated biochemical processes occurring in various tissues (dermis and epidermis, subcutaneous fat, musculoskeletal apparatus and bone tissue). Currently, there are a number of minimally invasive techniques to correct age-related changes in the skin of the face, but the discussion regarding the clinical efficacy and duration of retention of the effect in correcting age-related facial changes continues. Poly-L-lactic acid (PLLA) is popular with specialists and is used as an effective method of correcting involutive changes in the skin of the face, however, despite the extensive experience of its use, there is not enough research in foreign and domestic literature to study the duration of retention of the effect of drugs based on poly-L-lactic acid. The article presents an analysis of the data of modern literature devoted to the study of the effectiveness of the use of poly-L-lactic acid as a method of correcting age-related changes in the skin of the face.

ГЕНЕТИЧЕСКАЯ ПРЕДРАСПОЛОЖЕННОСТЬ КАК ФАКТОР ВЫБОРА КОМБИНИРОВАННЫХ ПРЕПАРАТОВ ДЛЯ РЕГРЕССИЙ ИНВОЛЮЦИОННЫХ ИЗМЕНЕНИЙ КОЖИ

Background. Advances in the study of skin aging have proven the importance of high-quality synthesis of collagen types I and III. Protein synthesis is a genetically determined process, encoded by a multitude of genes, mutations in which led to disruption of this process. Purpose. FLG, AQP3, COL1A1, MMP1, ELN genes responsible for skin aging correlate with the certain skin morphotypes and the studied variability of gene transformations opens prospects for predicting the development of aging signs at any age and, as a consequence, timely prevention of aging problems. Materials and Methods. The article presents interim results of a conservative study, methods for correcting involutional changes in the face and neck skin. Patients in the comparison groups with the main signs of skin aging received corrective therapy according to scheme 1 (SKINOPRO ACTIVE) 8 mg/ml, once every 7 days and scheme 2 (SKINOPRO FORTE) 12 mg/ml, once in 7 days. The effectiveness of therapy with drugs based on hyaluronic acid, silicon and zinc is assessed based on the analysis of the pathomorphological picture of biopsy specimens and immunohistochemical studies of Ki-67, p53, AP-1, collagen I, collagen III, TGF-b, Clotho, Calreticulin protein expression. Results. The results obtained confirm the importance of determinaining aberrations in genes encoding skin collagensynthesis for the purpose of personalized selection of treatment methods for correcting aging signs in different morphotypes. Conclusion. The possibility of conducting further studies of pharmacological preparations used to correct morphofunctional signs of aging of the face and neck skin was discussed, based on the presented data.

B - 41 Mild Head Injury (MHI), Unrelated Abnormal Brain Findings, Collateral Support, Video EEG and Neuropsychological Findings: a Case Study of Functional Seizure Disorder

Abstract Objective Functional seizure disorders, a form of conversion disorder with contributing biological, psychological, and social factors, pose a differential diagnostic challenge. Integrating video EEG, CT Brain Scan, collateral support and neuropsychological findings in diagnosis is discussed. Method The absence of epileptiform activity in video-EEG distinguishes functional and epileptic seizures. A case study is presented of a young adult male who sustained a MHI in a motor vehicle accident, presenting with a seizure disorder two weeks thereafter. Twenty-four-hour video EEG using photic stimulation revealed grunting sounds, head extension, clenched hands, back arching, jerking with associated paradoxical heavy breathing (shown in video clip), similar to family eyewitness descriptions. Hyperventilation was associated with generalized slowing. No epileptiform activity was noted. Unenhanced CT Brain Scan revealed global symmetrical age-incongruent cerebral involutional change. Results Neuropsychological assessment using CNS Vital Signs Test revealed variable scores, with “very low” scores on Complex Attention (raw score 17; SS = 68; 2nd Percentile); Cognitive Flexibility (raw score 28; SS =66; 1st percentile) and Processing Speed (raw score = 38; SS = 67; 1st percentile). “Above average” scores were found for Composite Memory (raw score 107; SS = 113; 81st percentile) and Verbal Memory (raw score = 59; SS = 122; 93rd percentile). Conclusions Brain involutional changes suggest pre-existing functional immaturity, instability of brain regions, or reduced neural connections may precede the diagnosis of Functional Seizure Disorders, precipitated by the MHI. In addition to video EEG, selected neuropsychological findings and collateral information provide additional support to confirm this complex disorder.

Application of the method of vibration compression massage in aesthetic medicine

Purpose. To study the effectiveness of vibrocompression massage using the Beautylizer apparatus in patients with involutive changes in facial skin. Materials and methods. 20 patients with involutive changes in facial skin aged from 25 to 59 years (average age 46±5.7 years) were observed on an outpatient basis. The patients underwent a course of 10 vibrocompression massage procedures with a frequency of 2 times a week. The effect after treatment was assessed using the Global Aesthetic Improvement Scale (GAIS) and studying the qualitative characteristics of the skin. Results of the study: under the influence of a course of vibrocompression massage carried out using the Beautylizer apparatus in patients with involuting changes in the facial skin, pronounced lymphatic drainage and vasocorrective effects were obtained, which was confirmed by an improvement in the quality characteristics of the skin according to the GAIS scale (in 10 % an exceptional improvement was achieved, in 40 % significant improvement, 35 % improvement, 15 % no changes), as well as the indicators «moisture» (p<0.001), «elasticity» (p<0.001) and a decrease in the indicator «severity of wrinkles» (p<0.001), which gives grounds to recommend the use of this technique for involuting changes in facial skin in patients of different ages.

Changes in physical fitness and body build of women and men surveyed in 2004 and 2022-A longitudinal study.

Physical fitness plays a crucial role in determining human health and overall well-being. The objective of the study was to assess the changes in body structure and physical fitness among individuals examined in 2004 and 2022 (persons aged 32-34 and 50-52). The research material consists of data from the Krakow Continuous Study (KCS) of somatic development and physical fitness of people born in 1970 and 1972, conducted in Krakow in the years 1976-2022. In total, in 2004, 103 women and 122 men took part in the study, and in 2022-47 women and 67 men. Of these participants, 37 women and 53 men were present for both measurements. The following measurements were performed-physical fitness tests: handgrip strength of left and right hand, standing broad jump, sit-and-reach test and overhead medicine ball throw (2 kg); anthropometric measurements: body height, body weight and tissue composition, circumferences of the chest (relaxed and in deep inspiration), waist, hips, thigh, mid-upper-arm (MUAC, relaxed and in deep inspiration), forearm and calf, thickness of biceps, triceps, subscapular, abdominal, suprailiac and calf skinfolds; width of shoulders and hips, depth and width of the chest. A comparative analysis of the two series showed that all fitness test scores deteriorated. The percentage decrease was greater in women than in men in the tests of right and left handgrip strength and overhead medicine ball throw than in men, in the standing broad jump test similar in both sexes, in the sit-and-reach test-lower in women than in men. The greatest decreases were observed in the standing broad jump (by 14%) and the 2 kg medicine ball throw (15-12%), both in women and men. In contrast, the level of development of most of the somatic characteristics studied in 2022 was higher compared to the previous study, and, apart from body height, elbow and knee width and calf skinfold in both sexes, the differences in arithmetic means between the 2004 and 2022 series were statistically significant. Furthermore, the absence of involutionary changes in body height can be highlighted. In conclusion, the decrease in physical fitness occurring in adulthood and the increase in most somatic characteristics between 32 and 34 year-olds and 50 and 52 year-olds were confirmed.

Efficiency and safety of thread implantology in the long term: data from a pathomorphological study

The evolution of methods used in aesthetic medicine includes a transition to less invasive procedures with high safety and minimal recovery time. That is why numerous non-invasive methods for correcting involutive changes in facial skin (thread lifting, hardware techniques) have been studied for effectiveness and safety over the past decades. Such techniques can improve treatment results and avoid or delay surgical intervention.Material and methods. The work involved a pathomorphological study of material taken by biopsy at the sites of thread implantation and surrounding tissues (1 cm indentation) (Nano spring, Excellence Visage, Excellence Visage HA) within 12 months after thread lifting. Paraffin sections with a thickness of 5–7 microns were made from ready-made paraffin blocks and stained with: hematoxylin – eosin; according to the Weigert-Van Gieson method; Sirius Red paint. Using a microscope with a Sony digital photo attachment with a resolution of 12 megapixels, five photographs were taken from each histological specimen.Research results. As a result of a pathomorphological study of a flap of skin and subcutaneous fat with a synthetic thread in the adipose tissue, it was revealed that along the periphery of the studied material there was moderate chronic inflammation (giant cells of the type of foreign body cells, lymphocytes, fibroblasts) and weak fibrosis, as well as a predominance type I collagen in the skin, and type III collagen predominated in subcutaneous fat tissue.

The possibilities of correction of premature greying of hair and involutive hair changes

The review highlights the available published data on the etiopathogenesis of early graying, hair involution and restoration methods. Early graying of hair is defined as settlement before the age of 20 in Caucasians, before the age of 25 in Asians and before the age of 30 in Africans. In etiopathogenesis, an imbalance between oxidative stress and the antioxidant system is considered as the leading mechanism, a significant role is played by genetic predisposition, hormonal disorders of the thyroid gland, acute stress; the causes may also be deficiency of vitamin B12, copper, iron. Currently, the active molecule palmitoyl tetrapeptide-20 is used to prevent pigment loss and restore it. The endocannabinoid system in the hair follicle is also considered as a target for stimulation during the restoration of hair growth.

Metabolic-associated fatty liver disease and older age

With the growing obesity epidemic around the world, metabolic associated fatty liver disease (MAFLD), formerly called non-alcoholic fatty liver disease (NAFLD), has become a common cause of liver disease, including in older age groups, the incidence of which is increasing significantly due to significant social change economic development and improvements in health care over recent years. While NAFLD primarily focuses on the accumulation of fat in the liver, MAFLD considers both the presence of fatty tissue in the liver and associated metabolic risk factors such as diabetes mellitus, dyslipidemia or obesity, providing a more detailed approach to diagnosis and treatment of steatotic liver disease. Thus, the introduction of the term MAFLD reflects a more comprehensive approach to encompass the diverse spectrum of patients affected by this disease and recognizes the complex relationship between metabolic disorders and liver health. Age-associated structural changes can significantly affect the morphology, physiology and oxidative capacity of the liver. With age, the weight of the liver decreases, the functionality of liver cells decreases, leading to a decrease in the rate of protein synthesis, its participation in fat, carbohydrate, pigment, water-electrolyte metabolism decreases, detoxification function and vitamin synthesis are inhibited. That is, the involutive effect on the structure and functional activity of the liver during the aging process, the presence of comorbidity and features of structural and functional changes in MAFLD in elderly people require a special approach in choosing tactics for managing this group of patients. The review article examines data from scientific studies on the prevalence and diagnosis of MAFLD, taking into account involutive changes in the liver in elderly people.

Эффективность микроигольчатого радиочастотного лифтинга и инъекционных наполнителей на основе гиалуроновой кислоты в комплексной терапии инволютивных изменений кожи лица

The purpose of the study is to scientifically substantiate and develop an algorithm for the complex use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid in patients with involutive changes in facial skin. Material and methods. 83 patients with involutive changes in facial skin were observed on an outpatient basis. Depending on the method of correction of involutive changes, the patients were divided into three groups. The control method was the Scientific Assessment Scale of Skin Quality (SASSQ). Results. It was revealed that the combined use of microneedle radiofrequency lifting and injectable fillers based on hyaluronic acid significantly reduces the severity of clinical manifestations in patients with involutive changes in the facial skin: 11 [9; 12], 10 [9; 11], 8 [8; 9] in the first, second, third groups, respectively, according to SASSQ. Conclusion. Thus, the combined use of microneedling radiofrequency lifting and injectable fillers based on hyaluronic acid can be recommended for patients with involutive skin changes in practical healthcare.

Molecular mechanisms of inhibition of cellular senescence

Introduction. Advances in studying skin ageing processes have proven the importance of high-quality synthesis of type I and III collagen. Protein synthesis is a genetically conditioned process encoded by many genes. Mutations in these genes lead to disorders in this process. The skin ageing genes FLG, AQP3, COL1A1, MMP1, ELN correlate with certain skin morphotypes, and studying the variability of gene transformations opens up new vistas for predicting the development of signs of ageing at any age and, as a result, timely prevention of ageing problems.Aim. To evaluate the effect of skin ageing correction therapy based on the ageing protein expression and the type I and III collagen production according to genetically conditioned ageing variants.Materials and methods. Patients in the comparison groups who had the major signs of skin aging received correction therapy according to regimen 1 (SKINOPRO ACTIVE 8 mg/ml every 7 days) and regimen 2 (SKINOPRO FORTE 12 mg/ml every 7 days). Evaluation of the efficacy of therapy with hyaluronic acid, silica and zinc drugs was based on an analysis of the pathomorphological view of biopsy specimens and an immunohistochemical analysis of Ki-67, p53, AP-1, Collagen I, Collagen III, TGF-b, Klotho, calreticulin expression.Results. The results support the importance of identification of aberrations in genes encoding the skin collagen synthesis to personalize treatment methods for correcting signs of aging in patient with different morphotypes.Conclusion. The article presents interim results of a comparative analysis of methods for correcting involutional changes in the face and neck skin. The possibility of further clinical studies of pharmacological drugs used to correct the morphofunctional signs of aging of the face and neck skin using the presented test findings is discussed.

Crystalloscopic analysis in detection of saliva metabolome specialties in elderly people

The purpose of this study was to assess the features of saliva crystallization in middle-aged and elderly people. The study included middle-aged (45-60 years old; n=63) and elderly (over 60 years old; n=78) men who signed an informed consent to participate. Crystalloscopic analysis of saliva in order to characterize the metabolic characteristics of the body and the composition of biological fluids. The intrinsic crystallization of mixed saliva was studied using the method of classical crystalloscopy. The structure index, crystallizability, facia destruction degree and the clearity of the marginal protein zone were determined. Each of the parameters was expressed on a 5-point scale. In general, the study made it possible to establish the presence of shifts in the crystallogenic properties of mixed saliva in the older age group (over 60 years old) relative to middle-aged people. Thus, the features of the crystalloscopic picture of biological fluid in elderly subjects included a decrease in the total crystallogenic potential of biological fluid, which was manifested in a decrease in crystallizability and the structural index of dehydrated saliva facies. In addition, the involutive shifts of the crystallograms were represented by an increase in the degree of destruction of facies and the expansion of the marginal zone of micropreparations. The revealed transformations of the crystallogenic properties of the biological medium allow us to speak about age-dependent characteristics of the component composition and physico-chemical parameters of saliva and, therefore, indirectly describe the involutive changes in the metabolome of this biological fluid.

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.