Subgroups A1 Research Articles

Алгоритм диференційованого лікування пацієнток з ендометріомою яєчників і безпліддям

Purpose - to improve fertility in women with ovarian endometrioma (ОЕ) and infertility using the proposed algorithm and treatment methods. Materials and methods. The prospective study was conducted in 2 stages. In the first stage, 93 women with infertility were included in the study, who were divided into the following groups depending on the surgery performed: the Group 1 - with ОЕ sclerotherapy followed by platelet-rich plasma (PRP) injection into the ovarian tissue; the Group 2 - laparoscopic cystectomy followed by PRP injection into the ovarian tissue; the Control (C) group - with classical laparoscopic cystectomy. After dynamic observation, assessment of ovarian reserve and control of pregnancy for 12 months, an algorithm for differentiated treatment of ОЕ in women with infertility was developed. At the 2nd stage, 20 women (the Group 3) were treated with the proposed methods of treatment, such as sclerotherapy with ОЕ + PRP (the Subgroup 3a) and laparoscopic excision of the ОЕ + PRP capsule (the Subgroup 3b), based on the algorithm, and analyzed. Statistical processing of the results was performed using Microsoft Excel. Results. The mean level of anti-mullerian hormone (AMH) in the Subgroup 3a increased from 1.76 (CI: 1.47-1.71) ng/ml to 1.87 (CI: 1.63-1.86) ng/ml (p=0.036). In the Subgroup 3b, AMH changed from 2.15 (CI: 1.89-2.48) ng/ml to 2.22 (CI: 1.91-2.53) ng/ml (p>0.05). The number of antral follicles (AF) in the Subgroup 3a increased from 8.88 (CI: 7.90-9.90) to 11.10 (CI: 10.40-11.80) (p<0.001). In the Subgroup 3b, from 10.60 (CI: 9.90-11.20) to 11.00 (CI: 10.50-11.50) (p>0.05). Spontaneous pregnancy within 6 months occurred in 6 (60%) patients from the Subgroup 3a, and in 4 (40%) women from the Subgroup 3b (p>0.05). After 6 months of follow-up, 2 underwent assisted reproductive technology. The remaining women from the Subgroup 3a (3 (30%)) and the Subgroup 3b (5 (50%)) also had spontaneous pregnancies by 1 year of follow-up (p>0.05). Conclusions. The proposed methods of treatment of ОЕ, sclerotherapy + PRP and laparoscopy + PRP, showed a significant positive effect on the preservation of ovarian reserve. A differential approach to the treatment of ОЕ based on the proposed algorithm increases the occurrence of spontaneous pregnancy. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Clinical significance of endocrine disorders in the development of early vascular aging in males with abdominal obesity and concomitant arterial hypertension: An observational cohort study

Background. Visceral obesity is a risk factor in the development of metabolic and endocrine disorders leading to arterial hypertension and cardiovascular complications. Their early predictors include increased vascular stiffness and early vascular aging. The current literature lacks studies into the effects of changes in testosterone, cortisol, and aldosterone levels in serum on vascular stiffness and the development of early vascular aging in patients with visceral obesity. Objective. To determine the relationship between hypercortisolemia, hyperaldosteronemia, and hypotestosteronemia and vascular stiffness and the presence of early vascular aging in male patients with visceral obesity. Methods. An observational cohort study of 78 males aged 35–45 years (mean age 38.1 ± 6.5 years) diagnosed with abdominal obesity and grade 1 arterial hypertension was conducted. The mean waist circumference ranged 105.5 ± 6.9 cm; systolic and diastolic blood pressure ranged 152.5 ± 5.0 and 92.5 ± 5.0 mm Hg, respectively. The vascular age of the studied patients (n = 78) comprised 44.1 ± 6.2 years, which was statistically higher than their passport age (р < 0.001). The studied patients were divided into subgroups according to both total testosterone (< 12.1 nmol/l in subgroup 1A (n = 49) and ≥ 12.1 nmol/L in subgroup 1B (n = 29)) and cortisol in the evening saliva portion (> 4.5 nmol/L in subgroup 2A (n = 24) and ≤ 4.5 nmol/L in subgroup 2B (n = 24)). All the patients completed the study. To assess the hormonal status, the total testosterone sex steroid-binding globulin (SSBP) and insulin in morning serum samples were investigated. Insulin resistance was assessed based on the NOMA-IR index. The concentration of total testosterone was determined by enhanced chemiluminescence (Ortho-Clinical Diagnostics, J&J); the SSBP and insulin levels were determined by delayed fluorescence. Aldosterone content was determined by radioimmunoassay; free cortisol and testosterone were measured by luminescent LIA. Free and bioavailable testosterone concentrations in serum were calculated using an online calculator (issam.ch/freetesto.htm). The cardio-ankle vascular index (CAVI) was determined using a VaSera VS-15000N device, which automatically calculated the vascular age. Statistical analysis was performed using the Statistica 10.0 Windows package (StatSoft, Inc., USA). Results. The vascular age of patients with hypogonadism was statistically significantly ( р < 0.001) higher than their passport age and the vascular age in males without hypogonadism. The CAVI and vascular age were also statistically significantly higher in males with functional hypercorticism (р < 0.001) compared with a subgroup of patients without hypercorticism. The vascular age and CAVI increased with an increase in the salivary cortisol concentration 2200 (r = 0.5; р < 0.05) and decreased with an increase in the salivary cortisol level 900 (r = –0.5; р < 0.05). These parameters decreased with an increase in serum aldosterone obtained in the morning (r = –0.4; p < 0.05) and increased with an increase in serum aldosterone in the evening (r = 0.4; p < 0.05). In 23% (n = 18), an inversion of the daily rhythm of cortisol production was observed; in these patients, salivary cortisol levels of 2200 exceeded salivary cortisol levels of 900. The vascular age of patients with the inversion of cortisol production (49.4 ± 4.4 years) was statistically significantly ( р < 0.001) different from that of patients with normal changes in salivary cortisol concentrations (41.9 ± 4.9 years). CAVI was also higher (р < 0.001) in males with inverted fluctuations in salivary cortisol levels (7.51 ± 0.62) compared to those with normal diurnal rhythm (6.45 ± 0.69). The results of aldosterone evaluation revealed that 17% of the patients (n = 13) had higher aldosterone levels in the evening serum portion compared to the morning serum portion. In these patients, the vascular age (45.8 ± 5.1 years) was higher ( р < 0.001) than that in males with normal physiologic changes in aldosterone levels (41.6 ± 5.7 years). A similar pattern was observed when comparing vascular stiffness indices. Thus, the CAVI in men with inverted changes in aldosterone concentration (6.9 ± 0.8) was significantly higher ( р < 0.001), compared to that in men with physiological changes in blood aldosterone levels (6.4 ± 0.8). Conclusion. Endocrinologic disorders in male patients with visceral obesity and concomitant arterial hypertension (functional hypogonadism, functional hypercorticism, inverted daily rhythms of cortisol and aldosterone production) contribute to the development of early vascular aging by increasing vascular stiffness.

Effectiveness of Different Etching Agents on Enamel Surface and Shear Bond Strength: An In Vitro Evaluation.

Background Enamel etching is of utmost importance during the orthodontic bonding procedure. Phosphoric acid, hydrofluoric acid, and citric acid are used in specific concentrations to create surface irregularities on enamel surfaces, enhancing the bond strength of the orthodontic attachment. Therefore, it is essential to evaluate the type of etchant for reliable orthodontic bracket bonding with minimal damage to the enamel surface. Aims and objectives This study aimed to investigate the morphological changes on the enamel surface after treatment with different surface etchants, assess the depth of penetration, and evaluate the shear bond strength (SBS) of orthodontic brackets. Materials and methods One hundred and one extracted premolar teeth were used to investigate morphological changes on the enamel surface treated with 37% phosphoric acid, 11% hydrofluoric acid, and 20% citric acid. It was evaluated on a scanning electron microscope (Jeol Scientific Equipment, Jeol Limited, Akishima, Japan), and the SBS of brackets on enamel treated with different etching agents was evaluated using an Instron Universal Testing Machine (UTM; Instron Model: 5982, Universal Testing Systems, Norwood, MA). Group A had 60 test samples. Group B had 40 test samples. One control without any acid etching was used in both groups. Subgroup A1 (n = 30) was evaluated for surface characteristics of acid-etched enamel. Subgroup A2 was assessed for the penetration depth of various etchants. Group B (n = 40) was tested for SBS. The results were tabulated and analyzed using IBM SPSS Statistics, version 20.0 (IBM Corp., Armonk, NY). Post hoc Tukey HSD test and one-way analysis of variance were used to assess SBS and penetration depth of etchants (P ≤ 0.05). Pearson's correlation test was used to correlate SBS, etching pattern, and penetration depth. The chi-square test was used to test the frequency of types of etching patterns. Results Intergroup correlations between etching depth, etching pattern evaluated on SEM, and SBS evaluated on the UTM showed a high statistical correlation between etching depth & SBS, etching depth & etching pattern, and SBS & etching pattern between A1, A2, and group B (P ≤ 0.001). A highly significant negative correlation between SBS & etching pattern (P = 0.42) was observed among intra-group correlation. Non-significant correlations were found between etching depth & SBS and etching depth & etching pattern within the 20% citric acid etch group (P = 0.370 and 0.141, respectively). Conclusion Penetration depth obtained was highest with 11% hydrofluoric acid, followed by 37% phosphoric acid and20% citric acid. In addition, 11% hydrofluoric acid showed the highest bond strength. Acid etching showed better penetration depth and bond strength than control.

Tactics of combined/complex treatment of patients with breast cancer with isolated metastatic lesions of supraclavicular or parasternal lymph nodes

Purpose. To evaluate the treatment tactics for patients with breast cancer (BC) with isolated metastatic lesions of the supraclavicular or parasternal lymph nodes (LNs). Material and methods. We analyzed the data of 134 patients with breast cancer, who were divided into 2 groups: 1st (n=83) – patients with lesions of the supraclavicular and parasternal lymph nodes, both isolated and in combination with lesions of any other groups of lymph nodes; 2nd (n=51) – patients with isolated or combined lesions of only subclavian or axillary lymph nodes. In group 1, lymphadenectomy was performed in 27 patients (subgroup 1A), radiation therapy of the affected lymph nodes was performed in 56 (subgroup 1B). In group 2, patients received chemotherapy for the affected lymph nodes. Results. Survival after 1 year of observation was almost the same in subgroups 1A (surgical treatment of lymph nodes) and 1B (radiation therapy of lymph nodes) – 96.3 and 96.4%, respectively; after 3 years of observation – 77.8 and 80.4%, respectively; 5-year survival rate – 33.3 and 44.6%, respectively. However, the data obtained were statistically unreliable. Conclusion. When comparing 5-year overall survival, surgical removal of metastatic supraclavicular and parasternal lymph nodes is inferior to radiation therapy. Thus, it can be assumed that excluding the surgical stage of LN treatment does not worsen the results of therapy in the group of patients with breast cancer and metastatic lesions of supraclavicular or parasternal LNs.

Risk factors for development of type 2 diabetes mellitus in patients with obesity in late post-COVID period

Objective. To study the risk factors for developing type 2 diabetes mellitus in patients with obesity after COVID-19. Materials and methods. 61 case histories and outpatient card abstracts of patients with obesity, who suffered from moderate and severe forms of COVID-19 from 02.2021–04.2022 were analyzed. Demographic, laboratory and clinical parameters were studied during hospitalization and 12 months after discharge from the hospital. All patients initially were divided into 2 groups according to the glycated hemoglobin level. Group 1 consisted of 46 patients with prediabetes and group 2 included 15 patients without carbohydrate disorders. Results. The median age of all patients was 64 (59–66) years. Median of HbAlc was 6,0 (5,6–6,2) %, BMI –34 (33–35) kg/m2. 24 patients from group 1, who took DPP-4-inhibitors in early post-COVID-19 period constituted subgroup 1A and 22 patients, who refused treatment with these drugs, constituted subgroup 1B. Currently, 2 patients from subgroup 1A and 10 patients from subgroup 1B (χ2=8,2 р=0,004) have been diagnosed with DM2. In patients who developed DM2 in late post-COVID period the levels of HbAlc, fasting plasms glucose and BMI at the time of admission to the hospital were significantly higher (n=12) than in patients with persistent prediabetes (n=34), (p0,05). Positive correlation between these parameters and the risk of developing DM2 (R=0,5, p0,05; R=0,74, p0,05; R=0,54, p0,05, respectively) was determined. In group 2, DM2 is currently diagnosed in 2 male patients with BMI over 40 kg/m2. When comparing subgroup 1B and group 2, it was found out that DM2 in the post-COVID period occurs in every second patient with the previous initial carbohydrate disorders: in 10 people of 22 – in subgroup 1B (every 2nd patient) versus 2 patients from group 2 (every 7th patient), (χ2=4,2, p=0,04). Online calculator from medstatistic. ru was used to determine relative risk (RR). Conclusions. Thus, presence of impaired glucose tolerance increases the risk of development of DM2 in late post-COVID period. In patients with hyperlycemia on hospitalization for COVID-19, who did not receive incretin therapy (subgroup 1B) risk of DM2 was 3,4 times higher (CI 95 %=0,87–13,40). Patients, who received incretin (subgroup 1A) had risk of DM2 = 0,6 (CI 95 %=0,09–3,97). It should be assumed that incretin therapy prevents development of DM2 in patients with hyperglycemia/impaired glucose tolerance after COVID-19.

Variation of Number of Pores on the Carapaces of Group A Species of the Genus Loxoconcha (Crustacea, Ostracoda) Following the Molting

Phylogeny of all extant twenty-eight species of Group A of the genus Loxoconcha are examined in this study. Basing on the total number of pores on carapaces, three species subgroups of this genus are shown by Differentiation of Distributional pattern of Pore-system (DDP) analysis. All species possess identical number and same distributional pattern of pore-system in and before A-4 instar. The difference in the total number of pores on carapaces is found from the instar A-3 to adult and thus three patterns are recognized. In the instar A-3, these numbers of subgroup A1, A2 and A3 are 42, 43 and 44, respectively. Additionally, the present study shows an identical number of anterior false radial pores among the subgroups at all instars. However, the number of posterior false radial pores is different among three subgroups from A-3 instar. In this instar, these numbers of subgroup A1, A2 and A3 are equivalent to 3, 4 and 5. By combination of this study and previous studies, geographical distribution of three subgroups is shown. Species of subgroup A1 distribute worldwide except the distributional areas of subgroups A2 and A3. While, species of subgroup A2 and A3 only reside in Atlantic coasts of Europe, northern Africa and coasts of the Mediterranean Sea.

Long-term obstetric, perinatal, and surgical complications in singleton pregnancies following previous cesarean myomectomy: a retrospective multicentric study.

The safety of cesarean myomectomy has been proven by previous studies. Our study aimed to reveal the long-term perinatal, obstetric, and surgical outcomes of cesarean myomectomy (CM) by comparing different CM techniques. This retrospective multicentric case-control study involved 7 hospitals and included 226 singleton pregnancies that underwent repeated cesarean section (CS) between 2015 and 2020. Among these pregnancies, 113 of 226 cases had CM (Group A), and 113 had only CS (Group B). Of the 113 cases in which CM was performed, 58 underwent endometrial myomectomy (EM) (Subgroup A1) and 55 underwent serosal myomectomy (SM) (Subgroup A2). The groups were compared in terms of obstetric, perinatal, and surgical outcomes, and fibroid recurrence, myomectomy scar healing rate, and adhesion formation were noted. There was no significant difference between the groups in terms of maternal age, body mass index, gravidity, parity, and fibroid diameter in previous CS (p > 0.05). In the perinatal and obstetric evaluation of the groups, there was no significant difference between the groups in terms of neonatal weight, Apgar score, fetal growth restriction, preterm premature rupture of membranes, preterm delivery, hypertension in pregnancy, and diabetes mellitus (p > 0.05). The fibroid recurrence rate was 28.3%, and the myomectomy scar good healing rate was 99.1%. There was no difference between the groups in terms of CS duration, preoperative and postoperative hemoglobin levels, perioperative blood transfusion rates, febrile morbidity, and prolonged hospitalization (p > 0.05). In terms of adhesion formation, although the adhesion rate of the SM group was higher than that of the EM group, no statistically significant difference was detected between the groups. This study showed that in pregnancies following CM, obstetrical, perinatal, and surgical outcomes were unaffected. Obstetricians can safely use CM, either the trans-endometrial or serosal technique, as it is a safe and effective method with long-term results.

Перименопаузальные расстройства у женщин после COVID-19

Aim: to assess the health-related quality of life (HRQOL) of women with perimenopause after COVID-19 and to determine the possibilities of hormone replacement therapy (HRT) in the postcovid period. Patients and Methods: 96 female patients aged 45 to 54 years were examined. Group 1 consisted of 52 female patients who were being treated in a hospital for COVID-19 12–16 weeks before study. Group 2 (comparison group) consisted of 44 female patients without COVID-19. Further, HRT was performed in 21 female patients of group 1 without contraindications (subgroup 1A). HRT regimen: estradiol hemihydrate, 1.58 mg, transdermally sequestered and dydrogesterone, 10 mg, per os. In subgroup 1B, 31 female patients did not undergo HRT. All patients were examined, which included the following: survey, follow-up, hormone blood test and hemostasiogram. HRT efficacy was evaluated after 3 months. Results: group 1 had more significant neurovegetative, psychoemotional and metabolic disorders, as well as an increase in the frequency of menstrual disorders versus group 2. In group 1, 43/52 (82,7%) of the respondents experienced hot flashes, where 23/52 (44,2%) of female patients noted the first occurrence of hot flashes after suffering COVID-19. In group 2, 16/44 (36,3%) of patients were concerned about this symptom. In group 1, 42.3% (22/52) of patients reported menstrual disorders. In patients of subgroup 1A, the severity of neurovegetative, metabolic and psychoemotional disorders decreased after HRT versus those in subgroup 1B. Conclusion: in female patients who suffered moderate to severe COVID-19, perimenopausal disorders include more significant neurovegetative, psychoemotional and metabolic symptoms. Cyclic HRT using transdermal estrogens significantly improves the life quality of women, however, the unfavorable comorbid background observed may reduce the effect of hormone therapy KEYWORDS: perimenopause, menopausal syndrome, COVID-19, postcovid syndrome, modified Kuperman Index, hormone replacement therapy FOR CITATION: Irgasheva S.U., Nadirkhanova N.S., Azamkulova N.O. Perimenopausal disorders in women after COVID-19. Russian Journal of Woman and Child Health. 2024;7(2):110–115 (in Russ.). DOI: 10.32364/2618-8430-2024-7-2-4.

Оценка обеспеченности витамином D и эффективности его саплементации у детей, находящихся длительно на безмолочном типе питания

The purpose — to determine the level of vitamin D availability and to evaluate the effectiveness of its supplementation in children who have been on a dairy-free diet for a long time. Material and methods. At the first stage of the study, the availability of vitamin D and calcium in children were assessed. 62 children were examined who had been on a dairy-free diet (group I). The control group consisted of 30 conditionally healthy children who did not keep any restrictive diets. At stage II, a scheme of vitamin D supplementation was proposed, which consisted in taking an aqueous solution of cholecalciferol in a therapeutic dose during one month, depending on the initial level of calcidiol in blood serum: at the level of 11–20 ng/ml (vitamin D deficiency), 3000 IU/day was prescribed, at the level of 21–29 ng/ml (insufficient vitamin D) — 2000 IU/day, switching to the dose of 1000 IU/day. Children with adequate provision of vitamin D were prescribed a prophylactic dose of cholecalciferol — 1000 IU/day. Subgroup Ia consisted of 32 children who received cholecalciferol supplementation. Subgroup Ib included 30 children who had no supplementation. The importance of daily consumption of foods rich in calcium and vitamin D was explained to children of both subgroups and their parents. The assessment of vitamin D and calcium availability was repeated after 4 months of follow-up. Results. The proportion of children with insufficient vitamin D in group I was 62.9%, which was statistically significantly higher (p < 0.001) relative to the proportion of children with normal concentration or deficiency of vitamin D in blood serum. A decrease in serum calcium levels among patients of this group was found in 64.5% of children, which was statistically significant (p < 0.001) relative to children of the control group. After the course of cholecalciferol supplementation in subgroup Ia, insufficient vitamin D was found in 18.8%. Normal micronutrient availability was established in 81.2%. Among children of subgroup Ib, the proportion of children with normal vitamin D availability at the control visit was 33.3%, which was less (p < 0.01) relative to subgroup Ia. Normal values of calcium in blood serum against the background of complementation were found in 78.1% of children of subgroup 1a and in 36.7% of children in subgroup 1b. Conclusions. For children who follow a dairy-free diet, insufficient vitamin D and calcium levels are characteristic. Supplementation with an aqueous solution of cholecalciferol has shown its effectiveness in normalizing the level of calcidiol and calcium in the blood serum of children on a dairy-free diet.

Comparative assessment of the state of the cornea after YAG-laser interventions on anterior segment structures

This study evaluates the condition of the cornea after laser discission (LD) of secondary cataracts (SC) and laser iridectomy (LI) using corneal confocal microscopy (CCM). Group 1 included patients with the diagnosis "Pseudophakia, secondary cataract", they underwent LD of SC. Patients of group 1 were divided into 2 subgroups depending on the initial state of the cornea: group 1A included patients with unaltered corneas; group 1B - with changes in the corneas. Group 2 included patients diagnosed with angle-closure glaucoma (ACG) or suspected ACG, they underwent LI. CCM was performed on the Heidelberg HRT-III system. Laser treatment was performed using the Nd:YAG-laser LPULSA SYL-9000, λ=1.064 µm. Immediately after treatment, subgroup 1A exhibited singular hyperreflective deposits and negligible endothelial cell loss (ECL). After 1 month, CMM findings revealed no changes in this subgroup. In subgroup 1B, a post-LD reduction in endothelial cell density led to increased polymegathism, decreased pleomorphism, heightened endothelial cell nucleus reflectivity, and moderate hyperreflective deposits after 1 month. In the second group, significant hyperreflective deposits of various sizes, increased nucleus reflectivity, and notable endothelial cell density reduction were observed immediately and 1 month after LI. The results of this study show that the possibility of developing corneal complications after photo destructive laser interventions is to a certain extent related to the initial state of the cornea. The risk of developing corneal damage increases with decreasing distance between the cornea and the irradiated structure. An increase in the level of laser radiation energy and its total values also contributes to damage to the cornea, which is possible with dense secondary cataracts and thick irises.

The influence of a transferred infection of COVID-19 on the development of atrial fibrillation and changes in its course depending on clinical and anamnestic data

The aim – to study the influence of clinical and anamnestic characteristics, namely: arterial hypertension, coronary heart disease, diabetes, previous myocardial infarction, acute cerebrovascular accident, metabolic cardiomyopathy, of myocarditis in the anamnesis and chronic heart failure on the development of atrial fibrillation (AF) de novo or the deterioration of the course of an already existing arrhythmia in patients after suffering a coronavirus infection (CI).Materials and methods. The study involved 116 patients with AF who were hospitalized in the department of clinical arrhythmology and electrophysiology from September 20.09.2020 to 21.12.2021 and had a history of coronavirus infection (CI). The 1st group – 36 people (31 %) in whom AF occurred after CI. The 2nd group – 25 patients in whom the form of AF has changed. The 3rd group – 55 patients in whom the form of AF did not change. In the 3rd group, two subgroups were formed: 3A – 35 patients in whom, although the form of AF did not change, the frequency or duration of arrhythmia paroxysms increased, and 3B – 20 patients without significant changes in the course of AF. As the first control group (C1), 49 patients with AF without a history of CI were examined. The second control group (C2) was formed by 22 patients after a CI in whom AF did not develop.Results and discussion. In patients of the 1st group, hypertension occurred 1.4 times more often (p<0.001) than in the subjects of the 2С comparison group. The presence of hypertension, especially of the 3rd stage, increased the probability of the appearance of AF after a previous CI, which probably contributed to the emergence of a new, more serious form of AF and worsened the course of this arrhythmia. CHD was probably more common in patients of group 2, compared to group 3. Coronary heart disease was also statistically more frequent in patients of subgroup 3A – in patients in whom the form of AF did not change, but the course of the arrhythmia worsened – the frequency and duration of paroxysms increased, in contrast to the subgroup 3B, in whose patients the course of AF did not fundamentally change. In patients with AF who underwent CI and had a history of аcute violation of cerebral circulation, its course worsened, compared to group 3B, in which the course of this arrhythmia did not change (p<0.001). Myocarditis in the anamnesis was probably much more common in patients of the 1st group, in comparison with the C2 group. There was a significant difference between the frequency of myocarditis in the anamnesis in patients of the 2nd group, in which the form of AF after CI changed to a more severe one, and in the patients of the 3rd group, in which the form of this arrhythmia did not change. Diabetes significantly and reliably affected the deterioration of the course of AF in patients who had this arrhythmia before CI, and contributed to a change in the form of AF to a more unpleasant one (2nd group) in comparison with patients without a change in the form of this arrhythmia (3rd group). Metabolic cardiomyopathy was reliably significantly more common in patients of the 1st group compared to the C2 group. There is a big difference between the frequency of metabolic cardiomyopathy in patients of the 2nd group in comparison with the patients of the 3rd group. In the patients of the 2nd group, in whom the form of AF changed to a more threatening one. There were statistically more people with heart failure IIA, and a higher stage of HF in the digital form in equal to persons of the 3rd group, which included patients in whom the form of AF did not change.Conclusions. In patients with atrial fibrillation who suffered a coronavirus infection, the most common concomitant diseases were found to be: HF I–IIA stage – 92 % (in more than half of the cases – in 51.4 % it was HF IIA stage), arterial hypertension – 83 %, coronary heart disease – 60 %, myocarditis – 28 %, diabetes was recorded in 12 % of patients. Arterial hypertension, especially of the 3rd stage, myocarditis in the anamnesis, heart failure of the II A stage caused the appearance of paroxysms of AF de novo after the transferred coronavirus infection in the cohort of patients studied by us. The aforementioned factors, as well as ischemic heart disease, myocardial infarction, and acute cerebrovascular accident in the anamnesis, have been established as markers of the transformation of the paroxysmal form of atrial fibrillation into persistent, or persistent atrial fibrillation into a permanent form of this arrhythmia after being infected with COVID-19.

Genome-wide identification and characterization of the plant defensins (Pdfs) gene family in selected Leguminous crops and their expression profiles in response to biotic and abiotic stresses

Plant defensins (Pdfs) represent a subset of cationic antimicrobial peptides characterized by a distinct tertiary structure. Similar to their counterparts in insects and mammals, they play a pivotal role in the innate immunity of plants, exhibiting broad-spectrum antifungal activity. This study focused on a comprehensive genome-wide survey to identify Pdfs genes within eight distinct legume crops. This study revealed the presence of Pdfs genes in eight leguminous plants such as 13 in P. sativum, 6 in P. vulgaris, 16 in M. trunculata and 4 in C. cajon, 6 in G. max, 5 in A. hypogea, 5 in C. arietinum, and 4 in V. angularis. Utilizing various bioinformatic analyses including phylogeny, motif, and gene structure analysis, identified Pdfs genes were categorized into two distinct groups i.e., group A (comprising subgroups A1, A2, A3, A4, A5) and group B 2 (B1 and B2). This clustering was based on protein sequences, where the presence of a proline-rich domain at the N-terminal and a linker DNA domain at the C-terminal facilitated differentiation. Gene structural analysis uncovered a variable range of 1 to 3 introns within Pdfs genes. Moreover, promoter analysis highlighted the abundance of cis-regulatory elements upstream of Pdfs genes, responsive to a diverse spectrum of biotic and abiotic stress stimuli. Expression analysis underlined the crucial role of Pdfs protein in defense responses in leguminous plants against both pathogenic and environmental stressors. These findings underscore the involvement of Pdfs in strengthening the defense mechanisms of legumes and provide fundamental insights essential for prospective investigations into Pdfs.

Effect of XP-Endo Finisher Rotary File on Removal of Smear Layer on the Root Canal Wall Using Different Rotary Files and Different Irrigants (An Ex- vivo Study)

Objective: To evaluate the efficacy of XP- endo finisher (XPF) in removing the residual smear layer as a final step following the useof the One Curve and 2Shape files. Methods: Sixty extracted maxillary first molar teeth with (MB) root curvature within (10-25°) were selected, and only (MB) rootswere used in this study. After that, the teeth were divided randomly according to the type of file used for canal preparation into twomain groups (1 and 2). Then the main groups were divided into three subgroups (A, B, and C). In subgroups A1, B1, and C1, the2Shape file was used for canal preparation; in subgroups A2, B2, and C2, the One Curve file was used. In subgroups A1 and A2,NaOCl was used during instrumentation and XPF to improve the residual smear layer removal with EDTA. In subgroups B1 and B2,NaOCl was used during instrumentation, and EDTA was used for 1 min to remove the residual smear layer. In subgroups C1 and C2,normal saline was used during instrumentation and with XPF. Then the roots were linearly sectioned into two parts. The coronal,middle, and apical thirds were quantified for the remaining smear layer under the scanning electron microscope (SEM). The Kruskal– Wallis- test and Mann- Whitney U test were used to measure the subgroups' differences. All tests were performed at the significant (p < 0.05) level. Results: The subgroup C1 had the highest mean score and lowest efficiency in removing the residual smear layer. The result showed that the subgroup A2 exhibited the best residual smear layer removal effectiveness. Significant differences were observed between subgroups A1 and A2 (p < 0.05). At the same time, there were significant differences between subgroups B1 and B2 (p < 0.05), and subgroups A2 and B2 exhibited significant differences from C2 (p < 0.05). Furthermore, significant differences were observed when subgroups C1 and C2 were compared to all the other subgroups (p < 0.05). Conclusions: Using the One Curve file with NaOCl during instrumentation and using XPF to improve the residual smear layer removal with EDTA exhibited the best efficacy for removing the residual smear layer.

The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves’ disease

Graves’ disease is one of the most common causes of hyperthyroidism. Guideline recommendations advocate the intake of thionamides for at least 1 year. If hyperthyroidism persists, subsequent radioiodine-131 treatment (RIT) is a therapeutic option. Thionamides are known to influence intra-thyroidal bio-kinetics of iodine and should therefore be discontinued at least 3 days prior to RIT if possible. However, the required therapeutic activity has to be calculated individually by pre-therapeutic measurement of the uptake prior to RIT [radioiodine-131 uptake test (RIUT)] in Germany according to national guidelines. Therefore, the aim of this study was to quantify the influence of thionamides on intra-therapeutic uptake. A cohort of 829 patients with Graves’ disease undergoing RIUT and RIT was analysed. Patients were subdivided into three groups. Group A: patients with carbimazole medication (n = 312), group B: patients with methimazole medication (n = 252) and group C: patients without thionamides (n = 265). Group A and B were further subdivided depending on the reduction of dosage of thionamides. In order to analyse the influence of thionamides, the variance of the determined individual extrapolated maximum intra-thyroidal uptake (EMU) between RIUT and RIT within the single groups and within the subgroups was statistically evaluated. When administering an equal dose of thionamides or no thionamides in RIUT and RIT (groups A1, B1 and C) no significant differences were detected when comparing EMU in RIT to EMU in RIUT (p > 0.05). In the subgroups A2–A4 (reduced dosage of carbimazole prior to RIT) EMU was significantly increased in RIT compared to RIUT [21% for a reduction of 0 to < 10 mg/d (A2), 39% for a reduction of 10–15 mg/d (A3) and 80% for a reduction of > 15 mg/d (A4)]. In the subgroups B2–B4 (reduced dosage of methimazole prior to RIT) EMU was as well significantly increased in RIT compared to RIUT [26% for a reduction of 0 to < 10 mg/d (B2), 36% for a reduction of 10–15 mg/d (B3) and 59% for a reduction of > 15 mg/d (B4)]. A significant dose-dependent increase of EMU in RIT compared to EMU in RIUT in patients discontinuing or reducing thionamides was detected. Therefore, thionamides should be discontinued at least 2 days prior to RIUT in order to achieve the designated target dose more precisely and to minimize radiation exposure of organs at risk.

Taxonomic implications of leaf morphology and epidermal anatomy for 14 species of Gagea (Liliaceae) from Xinjiang, China

BackgroundLeaf morphology and epidermal characters are important for phylogenetic and taxonomic studies of many plants, but there is currently insufficient data to use them to help distinguish species of Gagea, which is a taxonomically difficult genus mainly due to polyploidy and hybridization. Therefore, leaf morphology and epidermal characters of Gagea were studied to assess the characters that can be used to elucidate the taxonomy and systematics of 14 species of Gagea collected in Xinjiang, China. Using light microscopy (LM), six qualitative and three quantitative leaf epidermal anatomical characters were examined for both the adaxial and abaxial surfaces. Hierarchical cluster analysis (HCA) was employed to reveal the similarities based on leaf morphology and epidermal characters of the investigated species.ResultsBasal leaf of these species can be terete or flat, and it is triangle, flat, or circular in transverse section. Anticlinal wall patterns of the leaf epidermal cells were straight and sinuous, and only three species had epidermal hairs. Shape of long cells varies, ranging from quadrangular to irregular. HCA revealed that the 14 species could be divided into two groups. Group A was arranged into three subgroups (A1, A2 and A3), based on the Euclidean distance of 6.96. Subgroup A1 consisted of three species with indumentum; subgroup A2 had four species with sinuous type anticlinal walls; and subgroup A3 comprised of two species with a fistulose basal leaf. Group B included five species with short cells.ConclusionsLeaf morphology and epidermal characters did not differ significantly among populations of the same species in Gagea, whereas they differ significantly among species. Thus, leaf morphology and epidermal characters provide diagnostic information for differentiating G. nigra and G. filiformis; G. altaica, G. jensii and G. alberti, which are morphologically similar species.

Associated Risks and Pathogenic Effects of Consumption of Calcium Carbide-Ripened Banana Before and/or During Pregnancy on Maternal and Neonatal Livers

Calcium carbide (CaC2) is a commonly used ripening agent, although its primary use is in welding. Use of CaC2 in ripening fruits is considered harmful because it contains traces of phosphorous and arsenic. Aim of this study was to investigate associated risks and pathogenic (biochemical and histological) effects of consuming CaC2-ripened banana as a meal, before and/or during pregnancy on maternal and neonatal livers of adult female wistar rats. 36 healthy-looking, nulliparous, adult female wistar rats weighing between 150-200g were utilized. Rats were divided into 2 groups namely Group A and Group B. Each group had 4 subgroups (A1, A2, A3 and A4) for Group A as well as (B1, B2, B3 and B4) for Group B. Rats in group A received CaC2-ripened banana blended into their meal before and during pregnancy while group B rats received the same meal during pregnancy only. Subgroups A1 and B1 (positive control) received a naturally ripened banana with 0% CaC2, subgroups A2 and B2 received 1% CaC2-ripened bananas whereas subgroups A3 and B3 received 2% CaC2-ripened bananas. Subgroups A4 and B4 received CaC2-ripened bananas (bought from the market) randomly. The two groups A and B had one common negative control group which did not receive any banana (CaC2-ripened or non-CaC2-ripened) blended meal. Liver enzyme assay for group A showed that the positive control subgroup (A1) had mean AST (26.00±2.00 iu/L), ALT (33.00±3.00 iu/L), albumin (3.80±0.20 g/dL), direct (conjugated) bilirubin (1.10±0.10 mg/dL), and total bilirubin (1.95±0.15 mg/dL). These values were not significantly different (p≥0.05) compared with their respective values in the negative control subgroup except for ALT (p&lt;0.05). Group B showed that subgroups B2, B3, and B4 had mean AST, ALT, albumin, direct bilirubin and total bilirubin values which were not significantly different (p≥0.05) compared with their respective values in the negative control subgroup. Histological findings confirm a damaging effect on the liver’s histoarchitecture of both mother and neonate. Consumption of CaC2-ripened banana before and/or during pregnancy has associated risks and pathogenic effects on maternal and neonatal livers.

Thrombodynamics and Quantitative phase imaging of platelets in the assessment of hemostasis in pregnant women with protein C / protein S deficiency

Relevance. A hypercoagulable state caused by hereditary or acquired deficiency of antithrombotic factors can contribute to disruption of the uteroplacental circulation with the development of serious pregnancy complications, which requires effective monitoring of hemostasis during the use of pathogenetic anticoagulant therapy.The purpose of the study is to improve methods for diagnosing and monitoring hemostatic disorders in pregnant women with thrombophilia (protein C/protein S deficiency) and complicated pregnancy based on the use of an integral thrombodynamic test and quantitative phase imaging of platelets.Material and methods. 45 pregnant women were examined in the first and second trimester: 20 women with normal pregnancy (comparison group) and 25 (main group) with thrombophilia (protein S/protein C deficiency). 16 pregnant women (subgroup 1A) received a full course of preconception preparation with the prescription of LMWH, 9 pregnant women (subgroup 1B) did not complete the course in full for various reasons. To study hemostasis, along with routine methods (determination of APTT, TT, PT, Fibrinogen, INR and D-dimer), an integral assessment of coagulation using the Thrombodynamics method and quantitative phase imaging (QPI) of platelets in real time were performed.Results. It was found that routine methods are not sufficiently informative; statistically significant changes against the background of thrombophilia and during treatment with LMWH were noted only based on the results of assessing the level of fibrinogen and D-dimer. In the complex of thrombodynamics indicators, the most sensitive parameters were the steady-state clot growth rate (Vst), clot size at 30 minutes of the study (CS) and clot density (D). The QPI method revealed features of the morphological structure of platelets with a predominance in pregnant women with protein S/protein C deficiency of the activated cell population with an increase in the median values of diameter and perimeter by 14 and 20 %, respectively (p &lt; 0.05). The effectiveness of LMWH therapy was assessed by normalization of the analyzed parameters.Conclusion. Timely and adequate correction of hemostasis disorders, carried out while monitoring coagulation and platelet parameters, taking into account all clinical data, can significantly reduce the risk of complications for the mother and fetus.

RISK FACTORS FOR THE DEVELOPMENT OF VENOUS THROMBOEMBOLISM IN PATIENTS WITH UNCOMPLICATED ACUTE CALCULOUS CHOLECYSTITIS

The aim is to identify and analyze risk factors for venous thromboembolism in patients diagnosed with uncomplicated acute calculous cholecystitis.&#x0D; Materials and Methods. A prospective analysis of clinical data of 71 patients diagnosed with uncomplicated acute calculous cholecystitis was conducted. Two clinical groups were formed: subgroup 1A (n=6) included patients diagnosed with venous thromboembolism, and subgroup 1B (n=65) included patients without venous thromboembolism.&#x0D; Results and Discussion. During the study, the coagulation potential of the patients was studied. The prothrombin index on the third day of the postoperative period and at the time of discharge was significantly higher in subgroup 1A patients (109.1% and 123.0%) compared to subgroup 1B patients (98.0% and 96.4%). The situation with total fibrinogen is similar: the mean level of this indicator during the entire observation period was significantly higher in patients of subgroup 1A (p&lt;0.05). The mean D-dimer level at the time of hospital discharge in subgroup 1A was 3.6 mg/ml higher compared to the level of this indicator on the first day after surgery, and in subgroup 1B it was only 0.5 mg/ml higher. The risk of venous thromboembolism according to the Caprini score in subgroup 1A was 7.5 [5.5; 9.0] points, compared to 6.0 [4.0; 8.0] points in subgroup 1B. Assessment of the risk of venous thromboembolism according to the Rogers scale showed similar results: 8.0 [6.3; 9.8] points for patients of subgroup 1A and 7.0 [6.0; 8.0] points for subgroup 1B. When assessing the interleukin 1 beta (IL1b) level, its increased value was detected in subgroup 1A - 14.0 [7.0; 33.7] pg/ml, as opposed to subgroup 1B, where it was 9.0 [3.5; 26.2] pg/ml. Similar results were found in the assessment of tumor necrosis factor TNF: the mean values of this cytokine level were also higher in subgroup 1A (13.9 [7.9; 15.8] pg/ml) than in subgroup 1B (8.8 [6.0; 13.1] pg/ml).&#x0D; Conclusions. According to the results of the study, the following factors for the development of venous thromboembolism in patients with uncomplicated acute calculous cholecystitis were determined: elevated levels of indicators of total fibrinogen, D-dimer, interleukin 1 beta (IL1b) and tumor necrosis factor (TNF) at the time of admission. The mean values of the total risk assessment points according to the Caprini score and Rogers scale were significantly higher (p&lt;0.05) in the subgroup of patients with uncomplicated acute calculous cholecystitis who later developed venous thromboembolism.

Potential Significance of Serum Autoantibodies to Endometrial Antigens, α-Enolase and Hormones in Non-Invasive Diagnosis and Pathogenesis of Endometriosis.

The objective of the study was to evaluate the profile of serum autoantibodies and their diagnostic and pathogenetic significance in ovarian endometrioma (OEM) and deep infiltrative endometriosis (DIE). The study enrolled 74 patients with endometriosis (Group 1), including 53 patients with OEM (Subgroup 1a); 21 patients with DIE without ovarian lesions (Subgroup 1b); and 27 patients without endometriosis (Group 2). The diagnosis was confirmed by laparoscopic surgery and histologic examination of resected tissues. Antibodies (M, G) to tropomyosin 3 (TPM), tropomodulin 3 (TMOD), α-enolase (ENO), estradiol (E2), progesterone (PG), and human chorionic gonadotropin (hCG) were identified in blood serum using modified ELISA. In endometriosis, antibodies to endometrial antigens, hormones, and ENO were detected more often than antiphospholipid and antinuclear antibodies. Higher levels of IgM to TPM, hCG, E2, and PG and IgG to TMOD, ENO, E2, and hCG were found in Subgroup 1a compared to Group 2. IgM to TPM, hCG, E2, PG, and IgG to E2 and ENO had a high diagnostic value for OEM (AUC > 0.7), with antibodies to TPM having the highest sensitivity and specificity (73.6% and 81.5%). In Subgroup 1b, only the levels of IgM to TPM and hCG were higher than in Group 2. These antibodies had a high diagnostic value for DIE. Thus, endometriosis is associated with autoantibodies to endometrial antigens, α-enolase, steroid, and gonadotropic hormones. A wider spectrum of antibodies is detected in OEM than in DIE. These antibodies have a high diagnostic value for OEM and DIE and potential pathogenetic significance for endometriosis and associated infertility.

Evaluation of the effect of mechanical alteration of enamel surface on shear bond strength of self-adhering composites utilizing different adhesive modalities

Abstract Background: Self-adhering flowable composite (SAC), which has currently been launched, is said to be postoperatively responsive and less technique-reactive than previous materials. Clinical demands for bonding to undamaged, modified, or prepared enamel surfaces—which may attach differently with adhesive resins—often accompany restorative demands. Very little information was available for SAC. Aim: This study was carried out to determine the impact of mechanical enamel surface modification on shear strength properties in various bonding procedures. Materials and Methods: The three groups of prepared enamel surfaces (group A, n = 60), unprepared enamel surfaces (group B, n = 60), and prepared enamel surfaces plus etch-and-rinse (group C, n = 20), which served as the control group, were randomly assigned to the 140 constructed samples. Subgroups A1, B1 (nanohybrid composite + self-etch), A2, B2 (self-adhering composite), and A3, B3 (self-adhering composite + self-etch) were created from groups A and B, respectively (n = 40). Composite resin cylinders with the unique bonding protocols of each group were created using Teflon ring molds. Testing for shear bond strength was done, and information was examined. Results: The control group C was found to have the highest mean shear bond strength (29.77 MPa), whereas subgroup B2 had the lowest mean shear bond strength (8.4 MPa). For all adhesive techniques, shear bond strength values for prepared enamel surfaces were considerably greater than those for unprepared enamel surfaces (P &lt; 0.01). The following were the mean shear bond strength values: C &gt; A1 &gt; A3 &gt; A2 &gt; B1 &gt; B3 &gt; B2. Conclusions: Shear bond tensile properties on prepared enamel surfaces were higher than those of unprepared enamel surfaces. Higher shear bond strength values of the self-adhering composite in prepared and unprepared enamel surfaces were produced by using a self-etch agent first.