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In this section you can check out Belarusian author’s publications in foreign periodicals which are accessible in RSML. To order a full text, use Electronic medical library or the Electronic document delivery service.
| Медведева, Е. А. Инновационная гиполипидемическая терапия: опыт применения инклисирана в Республике Беларусь / Е. А. Медведева (Минск), Е. А. Григоренко (Минск), Н. П. Митьковская (Минск) // Российский кардиологический журнал [Москва]. – 2023. – Т. 28, № 4. – С. 53–61. – Библиогр.: 18 назв.
(Innovative lipid-lowering therapy: experience of inclisiran use in the Republic of Belarus) |
The article reflects modern aspects of lipid-lowering therapy, based on the assessment of cardiovascular risk, and the possibilities of triple therapy, including statins, ezetimibe, and inclisiran.
We present our own data on the use of the drug inclisiran in patients with lipid metabolism disorders in the framework of secondary and primary cardiovascular prevention. Low-density lipoprotein levels at different times after the injection is described. The potential of innovative lipid-lowering therapy in liver transplant recipients in the long-term postoperative period are discussed. The addition of inclisiran to statin and ezetimibe therapy is safe and leads to a decrease in low-density lipoprotein levels by more than 50% of baseline values in the general population. |
| Прогностическая роль фибрилляции предсердий у пациентов с некомпактной кардиомиопатией / С. М. Комиссарова (Минск), Н. М. Ринейская (Минск), О. П. Мельникова (Минск), Т. В. Севрук (Минск), А. А. Ефимова (Минск) // Российский кардиологический журнал [Москва]. – 2023. – Т. 28, № 8. – С. 44–53. – Библиогр.: 27 назв.
(Prognostic role of atrial fibrillation in patients with non-compaction cardiomyopathy) |
Aim. To evaluate the prognostic role of atrial fibrillation (AF) as a predictor of adverse events and outcomes in a cohort of patients with non-compaction cardiomyopathy (NCCM).
Material and methods. We examined 216 patients with NCCM (140 men and 76 women, median age, 39 (30; 50) years). In addition to traditional clinical methods, all patients underwent late gadolinium-enhanced cardiac magnetic resonance imaging (MRI). The endpoints of the study included progression of NYHA class III heart failure (HF) with the need for hospitalization, ventricular tachyarrhythmias, and thromboembolic events (TEEs). Results. There were 54 out of 216 (23,6%) patients with AF, of which 18 had paroxysmal AF, 16 — persistent AF, and 20 — permanent AF. During the follow-up period (median follow-up, 36 (6; 72) months), 98 out of 216 (45,4%) patients with NCCM had adverse events and outcomes as follows: 16 (7,4%) had ventricular tachyarrhythmias, of which 12 (5,6%) — sudden cardiac death with successful resuscitation and implantation of an implantable cardioverter-defibrillator; 62 (28,7%) patients had NYHA III-IV class HF progression; 20 (9,3%) patients had TEEs. The rate of adverse cardiac events was significantly higher in patients with AF (74,1% vs 35,8%, χ2=23,93, p<0,001) compared with patients without AF, including the incidence of TEEs (20,4% vs 5,6%, χ2=10,58, p=0,002) and HF progression to class III (46,3% vs 22,8%, χ2=10,9, p=0,002). Multivariate analysis showed that the following most significant predictors of HF progression risk: left ventricular ejection fraction (LVEF) <50% according to cardiac MRI (hazard ratio (HR), 95,8; 95% confidence interval (CI), 10,2 -898,6; p=0,0001), presence of AF (HR, 8,2; 95% CI, 2,2-31,3; p=0,0022) and left atrial volume index (LAVI) >43 ml/m2 (HR, 5,2; 95% CI, 2,1-12,8; p=0,0004); predictors of TEE risk were the presence of AF (HR, 6,5; 95% CI, 2,0-20,8; p=0,0020) and LAVI >43 ml/m2 (HR, 6,0; 95% CI, 1,8-19,7; p=0,036). No association of AF with ventricular tachyarrhythmias was found in the study cohort of patients with NCCM. Predictors of ventricular tachyarrhythmias were LVEF <50% (HR, 4,5; 95% CI, 2,950,4; p=0,0241) and the presence of non-sustained ventricular tachycardia (HR, 3,5; 95% CI, 1,3-9,3 p=0,0139). Conclusion. The present study shows that, along with the traditional predictor of adverse events in patients with NCCM (LVEF <50%), the identified additional predictors (AF and LAVI >43 ml/m2) can be used to identify patients at high risk of complicated NCCM for the timely prevention and treatment. |
| Характеристика изменений ультраструктуры нейронов коры головного мозга крыс с частичной церебральной ишемией / Е. И. Бонь (Гродно), Н. Е. Максимович (Гродно), С. М. Зиматкин (Гродно), О. Б. Островская (Гродно), В. Ю. Смирнов (Гродно), М. А. Носович (Гродно), К. А. Храповицкая (Гродно) // Ульяновский медико-биологический журнал [Ульяновск]. – 2023. – № 1. – С. 137–144. – Библиогр.: 12 назв.
(Changes in the cerebral cortex neuron ultrastructure in rats with partial cerebral ischemia) |
The ultrastructural characteristics of neuronal organelles are significant indicators of brain damage under ischemic exposure, which necessitates the study of changes in the ultrastructure of brain neurons. The aim of the study was to examine the disorders of brain neurons under its partial ischemia at the ultrastructural level using an experimental model. Materials and Methods. The experimental group included 12 male rats weighing 260±20 g, the control group consisted of 6 falsely operated male rats of the same weight. Partial cerebral ischemia (PCI) was modeled by right common carotid artery ligation. The material was taken 1 hour after the operation. Results. The study showed that the size and shape of the mitochondria of neurons of the parietal cortex and the hippocampus in PCI rats did not differ from those of the control group (p>0.05), except for a smaller number of cristae per unit area in the mitochondria of parietal cortex neurons (by 18 %, p<0.05). The size and shape of the Golgi complex and lysosomes did not differ in the groups either. However, there was an increase in the number of free ribosomes in the cytoplasm of neurons in the parietal cortex and hippocampus of PCI rats, by 58 % and 54 %, respectively (p<0.05). The ratio of fixed and free ribosomes in control rats decreased from 3.4 to 0.8 in the parietal cortex (p<0.05) and from 2.33 to 0.7 in the hippocampus (p<0.05). Conclusions. In general, the neuron ultrastructure in PCI rats was similar to that in the control group, which might be due to blood flow compensation in the circle of Willis. An increase in the number of free ribosomes is a sign of deranged protein biosynthesis in neurons. A decrease in the number of mitochondrial cristae in neurons in the parietal cortex indicates energy deficiency |
| Поиск новых генов наследственного рака яичника посредством полноэкзомного анализа пациенток, продемонстрировавших выраженный ответ на платиносодержащую терапию / А. П. Соколенко, Р. В. Бройде, В. И. Ни, Т. Н. Соколова, Т. В. Городнова, Е. Л. Савоневич (Гродно), Р. С. Мулкиджан, Е. Ш. Кулигина, Е. Н. Имянитов // Вопросы онкологии [Санкт-Петербург]. – 2023. – Т. 69, № 4. – С. 676–683. – Библиогр.: 26 назв.
(Search for Novel Hereditary Ovarian Cancer Susceptibility Genes through Whole-Exome Sequencing of Responders to Platinum-Based Therapy) |
Introduction. Clinical data have shown that mutations in BRCA1/2 and other DNA repair genes confer a high sensitiv-ity of ovarian tumors and certain other types of carcinomas to platinum or similar drugs. Analysis of BRCA1/2-negative ovarian cancers (OCs) that have shown a good response to platinum-based therapy appears to be a promising approach in the search for novel hereditary cancer genes.Aim. To search for novel genetic OC determinants by ana-lyzing clinical cases of successful primary treatment.Materials and Methods. DNA samples from 123 patients with prolonged clinical remission were subjected to a three-stage analysis: 1) analysis of common pathogenic BRCA1/2 alleles; 2) targeted sequencing of other hereditary cancer genes (ATM, BLM, BRCA1, BRCA2, CDH1, CHEK2, MLH1, MRE11A, MSH2, MSH6, MUTYH, NBN, NF1, NF2, PALB2, PMS2, POLD1, POLE, PTCH1, PTEN, RAD51C, RAD51D, RB1, TP53, TSC1, TSC2, WRN); 3) whole exome sequencing (WES).Results. There were 41 (33 %) BRCA1/2 mutation car-riers and seven patients carrying pathogenic variants in other hereditary cancer genes: ATM, BLM, NBN (n = 3), PALB2, and RAD51D. Based on whole exome analysis, 12 genes with putative loss-of-function variants were selected: AEN, ATF5, BRIP1, CEBPA, FANCM, GREB1, GRWD1, P4HTM, POLA2, RAD50, RAD54B, STK36. Loss of heterozygosity at the corresponding gene locus was observed in the tumor tissue of carriers of inactivating variants in ATF5 and P4HTM. In the additional cohort of consecutive diagnostic OCs (n = 107), three more cases with putative inactivating variants in ATF5, BRIP1, and FANCM were identified.Conclusion. Patients who exhibit a good response to plati-num-based therapy represent a promising group for identifying hereditary OC susceptibility genes. |
| Как сделать поликлинику более привлекательной? Согласованное мнение пациентов и участковых врачей-терапевтов / И. Л. Аршукова, Е. А. Добрецова, И. М. Акулин, А. В. Шульмин (Витебск) // Профилактическая медицина [Москва]. – 2023. – Т. 26, № 9. – С. 49–56. – Библиогр.: 14 назв.
(How to make polyclinics more attractive? Opinion of head doctors.) |
Significance. State polyclinics are the main elements in primary health care. Shortcomings in their performance affect the quality of medical care. Head doctors are a valuable resource; they understand major problems of polyclinics from within.
The purpose of the study was to identify major shortcomings in performance of state polyclinics in Krasnoyarsk from the viewpoint of head doctors and analyze possible ways to improve the situation. Material and methods. During 2019, the interview of all head doctors and heads of polyclinic branches with assigned adult population of Krasnoyarsk state polyclinics was conducted. As a result, 23 people were interviewed. An approach of informal semi-structured in-depth interview was used. The resulting data were quantitatively processed with the help of content analysis approaches. Descriptive statistics of categorical variables are presented as percentages. Results. According to the opinion of head doctors, in order to increase attractiveness of primary care facilities, it is necessary to look for opportunities to expand appointment slots, reduce the shortage of medical stuff, reduce work pressure on general practitioners, and reconstruct cooperation with health insurance organizations, improve appointment making, improve office and medical equipment, focus attention of medical universities on training young doctors to work in polyclinics. Conclusion. The study has analyzed opinion of head doctors regarding major problems they face in daily work. Improvements in the identified areas will make it possible to increase attractiveness of city polyclinics. |
| Профилактика ингибиторной формы тяжелой гемофилии А у детей в Республике Беларусь: 12-летний опыт работы / Е. В. Дмитриев (д. Боровляны), Л. И. Волкова (Минск), О. В. Алейникова (д. Боровляны), А. В. Любушкин (д. Боровляны) // Вопросы гематологии / онкологии и иммунопатологии в педиатрии [Москва]. – 2023. – Т. 22, № 3. – С. 36–42. – Библиогр.: 13 назв.
(The prophylaxis of severe hemophilia A with inhibitors in children in the Republic of Belarus: a 12-year experience) |
The development of inhibitory antibodies against FVIII is the most serious complication associated with the use of FVIII concentrates in hemophilia A patients. There is a need for more research on measures that could reduce the risk of inhibitor formation in previously untreated patients (PUPs) with severe hemophilia A. The purpose of this study was to determine the effectiveness of the prevention of clotting inhibitor development in PUPs (or minimally treated patients) with severe hemophilia A by administering plasma-derived factor VIII concentrate (pdFVIII) at a dose of 25 IU/kg once a week for a year. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (the Republic of Belarus). Between 2010 and 2022, 56 boys were newly diagnosed with severe hemophilia A. Twenty-one of them received pdFVIII as on-demand treatment to stop bleeding (Group 1). Thirty-five boys received pdFVIII at a dose of 25 IU/kg body weight once a week during the first 50 weeks of treatment for the prevention of inhibitor development (Group 2). The administration of pdFVIII at a dose of 25 IU/kg once a week in the PUPs (or minimally treated patients) contributed to a decrease in the cumulative incidence of inhibitors to 15.9 ± 7.7% (4 out of the 35 patients who had been treated prophylactically) compared with 43.7 ± 11.8% (8 out of the 21 patients who had received hemostatic therapy to stop bleeding) (log-rank test, p = 0.041). Thus, the administration of pdFVIII concentrate at a dose of 25 IU/kg once a week for the first 50 weeks of treatment lead to a decrease (p = 0.009) in the cumulative incidence of inhibitors against the administered coagulation factor VIII to 15.9 ± 7.7%. |
| Молекулярно-генетическая диагностика в группе пациентов с гемофилией А в Республике Беларусь: 12 новых аллельных вариантов в гене F8 / А. В. Любушкин (д. Боровляны, Минск), И. Е. Гурьянова (д. Боровляны, Минск), Е. В. Дмитриев (д. Боровляны), В. Р. Вертелко (д. Боровляны), Е. А. Полякова (д. Боровляны, Минск), Л. И. Волкова (Минск), О. В. Алейникова // Вопросы гематологии / онкологии и иммунопатологии в педиатрии [Москва]. – 2023. – Т. 22, № 3. – С. 48–57. – Библиогр.: 36 назв.
(Molecular genetic diagnosis in the group of hemophilia A patients in Belarus: 12 new allelic variants in the F8 gene) |
Hemophilia A is the most common severe bleeding disorder caused by various genetic changes in the F8 gene, leading to coagulation factor VIII deficiency. Hemophilia A is characterized by high heterogeneity of genetic defects. The severity of hemophilia A varies depending on the type of genetic defects in the F8 gene. More than 3000 unique variants of the F8 gene are associated with the hemophilia A. Approximately 30% of genetic defects occur de novo. The aim of this study is to determine the spectrum of genetic defects in the F8 gene in children with hemophilia A in Belarus. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (the Republic of Belarus). The study included 98 patients with hemophilia A, who had been treated or followed up at the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (the Republic of Belarus). Patients were categorized into 3 groups based on the severity of their disease: severe (n = 82), moderate (n = 3), and mild (n = 13). Twenty (20.4%) patients had a history of inhibitors to factor VIII. For our study, we used venous blood samples. Genomic DNA was isolated from leukocyte suspension (obtained from the whole blood samples) using phenol-chloroform extraction. All severe hemophilia A patients were prescreened for intron 22 and 1 inversions in the F8 gene using inverse and multiplex polymerase chain reaction assays, respectively. Sequencing of F8 coding regions was carried out by next generation sequencing. All clinically relevant variants were confirmed by Sanger sequencing. Genetic testing revealed that 99% of the patients with hemophilia A (n = 97) had pathogenic variants in the F8 gene. Intron 22 and intron 1 inversion mutations within the F8 gene were detected in 45.1% (n = 37) and 1.2% (n = 1) patients with severe hemophilia A, respectively. Two patients had an abnormal pattern of intron 1 inversion, not previously described in the literature. A total of 48 different variants in the F8 gene were detected in 57 patients using next generation sequencing. Eleven of the 48 genetic variants identified have not been previously reported. |
| Дмитриев, Е. В. Факторы риска появления патологических ингибиторов свертывания у детей с тяжелой гемофилией А / Е. В. Дмитриев (д. Боровляны), А. В. Любушкин (д. Боровляны) // Вопросы гематологии / онкологии и иммунопатологии в педиатрии [Москва]. – 2023. – Т. 22, № 3. – С. 58–64. – Библиогр.: 16 назв.
(Risk factors for coagulation inhibitor development in children with severe hemophilia A) |
Aim of the study: to examine the role of potential risk factors in inhibitor development in previously untreated patients (PUPs) (or minimally treated patients) with severe hemophilia A. The study was approved by the Independent Ethics Committee and the Scientific Council of the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (the Republic of Belarus). The study included 89 boys who underwent regular follow-up for severe hemophilia A at the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology (the Republic of Belarus) from 1998 to 2022. The median age (10th–90th percentile) at diagnosis of hemophilia was 8.0 (1.0–21.0) months, the baseline factor VIII activity was 0.7% (0.4–0.95%). Age at first exposure to factor VIII concentrate was 11.0 (1.0–31.0) months. Out of 89 patients, 23 children had severe hemophilia A with inhibitors. The cumulative incidence of inhibitors in the whole group of PUPs was 31.0 ± 5.6%. The cumulative incidence of hemophilia A with inhibitors was higher in the patients with null mutations (37.0 ± 6.9%) than in the patients with non-null mutations (6.5 ± 6.0%) (the log-rank test, p = 0.041). The use of plasma-derived FVIII concentrate (approved for use in neonates and for prophylaxis) from one manufacturer was associated (c2 = 8.53; p = 0.004) with a lower incidence of factor VIII inhibitors (up to 21.3 ± 8.5%) compared with the incidence in the group of patients treated with FVIII concentrates from different manufacturers (45.2 ± 7.8%). Age (> 1 year old or < 1 year old) at first exposure to FVIII had no effect on the formation of inhibitors (the log-rank test, p = 0.746). Such factors as age at diagnosis of hemophilia (odds ratio (OR) 0.99; 95% confidence interval (CI) 0.93–1.024; p = 0.991) and baseline factor VIII activity (OR 0.99; 95% CI 0.8–1.06; p = 0.09) were not associated with inhibitor development. The first measurements of activated partial thromboplastin time (APTT) ratio (patient APTT value over the APTT reference value) (OR 1.89; 95% CI 0.72–5.09; p = 0.21) and FVIII recovery in vivo (OR 0.74; 95% CI 0.27–2.01; p = 0.55) were not associated with inhibitor development either. We have confirmed that one of the main risk factors for FVIII inhibitor development is F8 gene mutations. The incidence of inhibitors among the patients who received plasma-derived FVIII concentrates (recommended for use in PUPs in the neonatal period) from one manufacturer was lower than among those who received FVIII from different manufacturers. |
| Использование технологий секвенирования следующего поколения в диагностике врожденных ошибок иммунной системы / Е. А. Полякова (д. Боровляны), И. Е. Гурьянова (д. Боровляны), В. Р. Вертелко (д. Боровляны), А. В. Любушкин (д. Боровляны), Е. Я. Скоповец (д. Боровляны), С. Н. Алешкевич (д. Боровляны), Ю. С. Жаранкова (д. Боровляны), С. О. Шарапова (д. Боровляны), М. В. Белевцев (д. Боровляны) // Вопросы гематологии / онкологии и иммунопатологии в педиатрии [Москва]. – 2023. – Т. 22, № 3. – С. 177–184. – Библиогр.: 22 назв.
(The use of next generation sequencing technologies for the diagnosis of inborn errors of immunity) |
Primary immunodeficiencies are congenital genetically determined immune disorders. Recent advances in molecular genetic technologies have enabled a simultaneous analysis of a large number of genes in a patient. The purpose of this study was to analyze the mutational spectrum in DNA samples collected from patients with various types of primary immunodeficiencies. In this study, we applied next-generation sequencing technology using a panel developed at the Belarusian Research Center for Pediatric Oncology, Hematology and Immunology and consisting of 290 genes that are associated with primary immunodeficiencies according to the existing literature. The testing was carried out in 96 patients with a clinical history suggesting a primary immunological defect. As a result, 37.5% of cases (36/96 patients) were found to harbor genetic defects that lead to disorders of the immune system |
| Определение минимальной остаточной болезни при В-линейном остром лимфобластном лейкозе методом проточной цитометрии. Рекомендации российско-белорусской кооперативной группы по диагностике острых лейкозов у детей / А. М. Попов, Е. В. Михайлова, Т. Ю. Вержбицкая, Л. В. Мовчан (д. Боровляны), Ж. В. Пермикин, Т. В. Шман (д. Боровляны), А. И. Карачунский, Г. А. Новичкова // Вопросы гематологии / онкологии и иммунопатологии в педиатрии [Москва]. – 2023. – Т. 22, № 3. – С. 199–209. – Библиогр.: 41 назв.
(Minimal residual disease monitoring in B-lineage acute lymphoblastic leukemia using flow cytometry. Guidelines of the Russian-Belarusian multicenter group for pediatric acute leukemia studies) |
Multicolor flow cytometry is now routinely used in laboratory practice for minimal residual disease (MRD) monitoring in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). This article describes the methodology of MRD detection in BCP-ALL using flow cytometry as recommended by the Russian-Belarusian multicenter group for pediatric acute leukemia studies. This wellharmonized approach includes recommendations for the choice of monoclonal antibodies, sample preparation, cytometer setup, flow cytometry data analysis and interpretation as well as for reporting. These guidelines allow application of multicolor flow cytometry for MRD monitoring in BCP-ALL in children and adults both in local laboratories and in multicenter settings in prospective clinical trials.
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| Зиматкин, С. М. Методы функциональной нейрогистологии и их практическое применение / С. М. Зиматкин (Гродно) // Морфология [Санкт-Петербург]. – 2022. – Т. 160, № 2. – С. 111–124. – Библиогр.: 33 назв.
(Methods of functional neurohistology and their practical application) |
Functional neurohistology is a field of morphological studies that uses histological methods to assess the structural basis of the functions of nervous system, nervous tissue and nerve cells, their functional potential, and to determine the morphological equivalent of their functions. The review describes the methodological approaches and methods used to assess the functional state of nerve cells in normal and pathological conditions. The advantages and necessity of using a complex of neurohistological methods for a more complete assessment of the state of neurons are substantiated. Key words: functional neurohistology, methods, morphofunctional relationships, morphological equivalent of functions. |
| Факторы риска и прогнозирование бактериальных осложнений при трансплантации печени / А. Е. Щерба (Минск), Л. Л. Кузьменкова (Минск), Д. Ю. Ефимов (Минск), А. В. Носик (Минск), П. С. Прилуцкий (Минск), С. В. Коротков (Минск), А. М. Дзядзько (Минск), О. О. Руммо (Минск) // Анналы хирургической гепатологии [Москва]. – 2023. – Т. 28, № 3. – С. 10–20. – Библиогр.: 22 назв.
(Risk factors and prediction of bacterial complications in liver transplantation) |
Aim. To conduct a systems analysis of clinical and epidemiological risk factors of bacterial complications associated with liver transplantation, to evaluate the effectiveness of their prevention algorithm. Materials and methods. The authors analyzed the treatment outcomes of 1000 recipients who underwent liver transplantation from April 2008 to April 2023. The study involved analysis of correlation between infections associated with health care and main risk factors, including contamination of different loci and preservation solution. Results. The incidence of healthcare-associated infections accounted for 22.2%. The cumulative incidence of donor organ and recipient contamination was 9.85%. Transmission of infection occurred in 29% of cases. Sepsis developed in 8% of all recipients with healthcare-associated infection. The mortality rate was 70% in cases of sepsis. After liver transplantation, in-hospital mortality was 9.3%. Urgent transplantation was required in 10.7% of observations. Univariate regression analysis shows the highest risk contribution to healthcare-associated infection for the MELD score, contamination of preservation solution with multidrug-resistant flora, severe early graft dysfunction, blood loss, and warm ischemia time. Conclusion. Contamination of preservation solution increases the risk of bacterial complications associated with liver transplantation. The resistance profile affects the development time, structure and outcome of these complications. Timely diagnosis and infection control measures are fundamental to preventing the infectious complications |
| Салимов, У. Р. Бактериальные осложнения после трансплантации печени. Перспективы дальнейших исследований / У. Р. Салимов (Минск), А. Е. Щерба (Минск), О. О. Руммо (Минск) // Трансплантология [Москва]. – 2023. – Т. 15, № 2. – С. 238–250. – Библиогр.: 65 назв.
(Bacterial complications after liver transplantation. Promising directions for further research) |
This article is presented in form of a current literature review on bacterial complications of the early post-liver transplantation period and promising areas for studying the effect of bacterial flora in patients after liver transplantation. The paper describes the problem of the emergence, spread, and pathogenesis of various bacterial complications, as well as current concepts of various bacterial complication’s impact on the results of liver transplantation. The results of ventilatorassociated pneumonia in patients after liver transplantation are given. A theoretical analysis of bacterial complications from the standpoint of microbiota effects on the biliary tree was carried out. The review also highlights a relatively new conceptual approach in examining the results of scientific research using the “Machine Learning Method”. The so-called CDC “Big Four” was chosen as the main infectious nomenclature in this article. However, catheter-associated bacterial complications, which pathogenesis has been sufficiently studied to date, have been replaced by a relatively new group of complications – bacteriobilia. This review also contains a brief statistical data collected in the frames of the NCT04281797 study. Own cohort data consisted of 57 patients who underwent orthotopic liver transplantation from a post-mortem donor. Surgical site infection was the most common bacterial complication of the early postoperative period. The most common causative agent of bacterial infection was Klebsiella pneumonia and Enterococcus. |
| Барановская, Е. И. Формирование истмоцеле после кесарева сечения / Е. И. Барановская (Минск) // Российский вестник акушера-гинеколога [Москва]. – 2023. – Т. 23, № 5. – С. 32–37. – Библиогр.: 24 назв.
(Formation of isthmocele after caesarean section) |
The article presents modern data on the causal relationship between surgical features of caesarean section and isthmocele. The main factors associated with the formation of isthmocele are the method of uterine wall closure, repeated cesarean section, and opening of the uterine pharynx. The key cause of isthmonele formation is the violation of uterine wall anatomy during its suturing due to inaccurate juxtaposition of muscle layers of the wound edges and suturing the uterine wall with a single-row suture without peritonization, fibrosis in the lower segment during repeated cesarean sections. Double-row suture decreases the incidence of isthmoele formation or reduces the proportion of large-sized niches by increasing the thickness of the muscle layer. An additional pathophysiologic factor in the formation of isthmoele may be endometritis, conditions for the development of which arise when the cervical canal is closed and the outflow of the uterine cavity is obstructed. |
| Стеняева, Н. Н. Менопауза и нарушения сна / Н. Н. Стеняева, Д. Ф. Хритинин, Е. Ю. Стеняев (Минск) // Медицинский совет [Москва]. – 2023. – Т. 17, № 15. – С. 119–124. – Библиогр.: 41 назв.
(Menopause and sleep disturbances) |
The menopause in a woman’s life is one of the most significant events indicating the large-scale changes in the hypothalamus-pituitary-ovarian axis function. Gonadal steroid hormones are actively involved in the central nervous system (CNS) growth, differentiation, physiology and ageing processes. Sleep provides restoration of the central nervous system, and also contributes to memory consolidation. Sleep influences the two primary effector systems, the hypothalamus-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS), which in turn regulate adaptive and innate immune responses. During sleep, blood levels of cortisol, adrenaline and norepinephrine drop, whereas the levels of neurotransmitters such as growth hormone, prolactin and melatonin show a steep increase. We get more and more facts showing the role of sleep in the processes of immunogenesis and metabolism, in particular fat metabolism. A systematic modern literature analysis on the prevalence and structure of sleep disturbances in women during pre-, peri- and postmenopause was carried out. The results of individual studies revealing the relationship between sleep disturbances and hormone levels including levels of sex steroids are presented. A review of current scientific evidence shows conclusively that the neuroendocrine system significantly determines the sleep quality. Sleep disturbances associated with RLS, COAC are highly prevalent, especially among postmenopausal women, due to declining ovarian function and deficiency of sex steroids. The results of conducted studies support the continued study and analysis of the relationships between gender, neuroendocrine factors, sleep disorders and the search for effective methods for their treatment. SonNorm Duo containing melatonin, peppermint leaf oil, and motherwort herb extract is one of the drugs used to manage sleep disturbances. SonNorm Duo is an adaptogenic sedative drug that is indicated for sleep disturbances, circadian rhythm sleep-wake disorders associated with rapid travel across multiple time zones. |