bluuebunny/crossref_metadata_2025 huggingface dataset:
Intrathecal morphine pretreatment ameliorated hepatic ischemia-reperfusion injury by reducing inflammation through peripheral and spinal opioid activation in rats
Authors: Wang Yuan , Liu Jueying , Qu Yifeng , Fan Yinghui , Yu Weifeng
Published: January 2020

Background Hepatic ischemia-reperfusion injury (IRI) is a common phenomenon after liver transplantation and liver tumor surgery. Morphine provides analgesia and prevents hepatic IRI. Besides morphine in the spinal cord has the protective effect on hepatic IRI. But the mechanism has not been well characterized. This study investigated whether morphine administrated intrathecally mimic the protective effect by reducing inflammation, and whether this kind of effect was mediated by phosphatidylinositol-3-kinase (PI3K)/Akt pathway. Methods We established models of hepatic IRI and intrathel catheter insertion on Sprague-Dawley. Morphine was administrated 10min prior hepatic ischemia flowed with 6h reperfusion. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST), histological changes and liver cell apoptosis assessed liver IRI. Similar maneuvers were repeated using the optimal dose and opioid receptor antagonist naloxone methiodide (NM). Serum ALT and AST, histological staining, hepatic apoptosis and serum levels of tumor necrosis factor alpha (TNF-α) and interleukin 1β (IL-1β) were assessed. Expression of Akt and its downstream protein Erk were evaluated by Western blotting. Results Morphine pretreatment intrathecally at dose of 10μg·mg -1 reduced ALT and AST levels, hepatic apoptosis, inflammation and preserved liver structure. These changes were partially reserved by NM 10min prior morphine injection. Morphine elevated the expression of Akt and Erk, however, NM did not decrease Akt and Erk expression. Conclusion Intrathecal morphine pretreatment reduced rats’ livers’ inflammation through both peripheral and spinal opioid receptors activation. The potential mechanism contributed to moderate PI3K/Akt pathway.
Improving Ruminal Degradibility Of Oil Palm Fronds Using Enzyme Extracts From White Rot Fungi
Authors: Nicholas Ahmad Fariz - , Hassim H.A. - , Nicholas A.F. - , Lourenço Marta - , Dias A.A - , Goh Y.M. , Fievez V. -
Published: January 2020

Background: Oil palm fronds (OPF) when pretreated with white rot fungi (WRF) shows increased rumen degradability but with significant biomass loss. Thus, effects of pre-treated OPF with enzyme extracts from WRF on rumen degradability were studied in vitro. The enzyme extracts were prepared by inoculating OPF with three WRF, i.e Ceriporiopsis subvermispora, Lentinula edodes and Ganoderma lucidum, for 15, 30 and 45 days with either ammonium sulphate, (NH4)2SO4 and sodium nitrate, NaNO3 added to the culture media for each inoculation period. After preparation of enzyme extracts, the enzyme activities were determined. OPF was then pre-treated with enzyme extracts in a citrate buffer (pH 5.0) in a forced air oven at 40 oC during 5 days. Further, the in vitro rumen degradation of OPF pre-treated with enzyme extracts, with respect to the short chain fatty acid (SCFA) production, was determined after 24 h incubation. Activity of lignolytic (laccase and MnP), cellulolytic (CMCase and avicelase) and hemicellulolytic (xylanase) enzymes were measured in all of the extracts irrespective on the inoculation period. Results: Treatment of OPF with enzyme extracts from G. lucidum after 45 days of inoculation showed a numerical increase (13%) in total SCFA and apparently rumen degradable carbohydrates (ARDC) after 24 h in vitro incubation, without any loss of biomass. However, this increase was not clearly correlated to results of the enzyme assays. Conclusion: This study indicates pre-treatment of OPF with enzyme extracts from specific WRF to be promising to enhance the ruminal degradability of OPF without simultaneous loss of biomass.
Secernin 1 promotes cell invasion and migration by activating the TGF-β/Smad3 pathway in oral squamous cell carcinomas
Authors: Xiao Li , Wen Shuqiong , Zhang Qianyu , Peng Yanshuang , Zheng Kaiyue , Yang Lianjie , Wang Zhi , Liu Ying
Published: January 2020

Background Secernin-1 (SCRN1) is a regulator of exocytosis in mast cells. Recently, SCRN1 has been reported to be correlated with the prognosis of colorectal cancer and gastric cancer but its functional effects on oral squamous cell carcinoma (OSCC) remains unclear. Our aim was to explore the expression pattern and the migration and invasion effects of the newly identified SCRN1 in OSCC. Methods Western blotting (WB) was used to measure SCRN1 expression in human OSCC tissue samples and OSCC cell lines. Then, the effects of SCRN1 on OSCC cell proliferation, invasion and metastasis were analyzed by cell counting kit-8 (CCK-8) and transwell assays. The secretion of matrix metalloproteinase (MMP)-2 and MMP-9 in SCRN1 knockdown OSCC cells and vector cells was investigated by enzyme-linked immunosorbent assay (ELISA). The expression levels of TGF-β, Smad3 and phosphorylated Smad3 (p-Smad3) in SCRN1 knockdown OSCC cells and vector cells were measured by WB. Results The expression of SCRN1 was significantly elevated in the OSCC tissues and cell lines. Furthermore, SCRN1 knockdown attenuated the proliferation, migration and invasion of SCC15 and HSC3 cells. SCRN1 knockdown reduced the secretion of MMP-9 from HSC3 and SCC15 cells, but the secretion of MMP-2 did not obviously change. Additionally, SCRN1 knockdown reduced the expression of TGF-β and p-Smad3 in HSC3 and SCC15 cells. Conclusions Our study demonstrated that SCRN1 is upregulated in OSCC. Further studies demonstrated that SCRN1 promotes proliferation, invasion and metastasis of OSCC cells via TGF-β/Smad3 signaling.
Prevalence and Risk Factors of Periodontal Disease among Pregnant Women in a Rural Area of China
Authors: Chen Mengqi , Su Yi , Xiong Xu , Peng Jinxiang , Zhu Xiaoling , Wang Jinhua , Jiang Hong , Qian Xu
Published: January 2020

BackgroundPeriodontal disease is one of the most important common oral diseases contributing to the global burden of chronic disease. Systematic reviews have demonstrated that poor periodontal condition during pregnancy was significantly associated with adverse pregnancy outcomes such as preterm birth, low birth weight, preeclampsia, etc. Oral health care is often a neglected area in low- and middle- income countries, particularly in rural areas due to the limited health human resources and poor infrastructures resources. Very few studies have explored the risk factors of periodontal disease among pregnant women in rural areas of China.MethodsA cross-sectional study was conducted among 648 women between 2 and 28 weeks of gestation at an antenatal clinic in Maternal and Child Health Hospital of Leping, Jiangxi Province, China. Periodontal Screening & Recording (PSR) was used to determine periodontal disease. Data on respondents’ demographic characteristics, gestational age, regular oral health habits, and mental health condition were collected using a self-administered questionnaire. ResultsThe prevalence of periodontal disease in pregnant women was 79.78% (95% CI: 76.7%~82.7%). Periodontal disease was significantly associated with increased maternal age (aOR =1.13, 95%CI: 1.06~1.21, P<0.001) and gum bleeding during tooth brushing (aOR =3.76, 95%CI: 2.05~7.00, P<0.001). The severity of periodontal disease advanced with the increased maternal age and gum bleeding during pregnancy. ConclusionsPregnant women with increased maternal age and gum bleeding during tooth brushing were at a higher risk of periodontal disease and needed to have the access to oral health care.
Oral impacts mediate the association between reduced dentition and self-perceived need for complete dentures
Authors: Campos Fernanda Lamounier , Kawachi Ichiro , Rhodes Gabriela Aparecida Caldeira , Sampaio Aline Araujo , Chalub Loliza Luiz Figueiredo Houri , Ferreira Raquel Conceicao
Published: January 2020

Background: To evaluate the direct association and oral impact-mediated association between a reduced dentition and the self-perceived need for complete dentures (CD) in dentate adults. Methods: Data from the Brazilian National Oral Health Survey (2010) were analyzed. Self-perceived need for complete dentures was investigated by the question "Do you think you need to wear CD?". The hierarchical dental functional classification defined reduced dentitions: at least one tooth in each arch, 10 teeth in each arch, 12 anterior teeth, posterior occluding pairs (POPs) of premolars (≥3) and molars (≥1 bilateral). Presence of all these criteria were defined as functional dentition (FDClassV). Oral impacts were assessed using the Oral Impacts on Daily Performances scale. Associations were investigated using logistic regression and structural equations. Results: FD(ClassV) was associated with less self-perceived need for CD both directly (p<0.001) and mediated by oral impacts (p=0.003). Dentitions without molar POPs were associated with the outcome mediated by oral impacts (p=0.002). Individuals with 10 teeth in each arch (with or without anterior teeth and POPs) had similar frequencies of self-perceived denture needs. Individuals with <10 teeth in each arch and 12 posterior teeth did not have a higher frequency of self-perceived denture need. Conclusions: Oral impacts mediated the association between reduced dentitions and self-perceived denture needs. Clinical relevance: Individuals with tooth loss may report need for CD, even when they have dental configurations compatible with functionality. The dentist must taken into account patient-centered measures to make decision about oral health prevention and treatment.
Evaluation of vascular cell adhesion molecule-1, intracellular cell adhesion molecule-1 and E-selectin levels in preeclampsia: A Systematic Review and Meta-Analysis.
Authors: Li Xueli , Tang Qian , Liu Shiguo , Xu Yinglei , Li Miaomiao , Cao Caixia , Zhang Lu
Published: January 2020

BackgroundSoluble adhesive molecules are potential mediators of endothelial dysfunction in preeclampsia. The purpose of this study was to examine the relationship between pre-eclampsia and maternal circulation vascular cell adhesion molecule-1 (VCAM-1), Intracellular cell adhesion molecule-1(ICAM-1) and E-selectin.MethodsVCAM-1, ICAM-1 and E-selectin studies of maternal circulation in preeclampsia and normal pregnant women were reported by systematic literature search in PubMed (Medline), with 21 eligible reports. The standardized mean difference (MD) and their 95% confidence intervals (CIs) were calculated as random effect analysis of association among studies.ResultsPreeclampsia is associated with elevated VCAM-1 [mean difference (MD) = 1.17 ng/ml, 95% confidence interval (CI) 0.85-1.50 ng/ml], and E-Selectin (MD = 2.18ng/ml, 95% CI 1.16-3.20ng/ml), but not associated with ICAM-1 (MD= 0.43ng/ml, 95% CI -0.03-0.90ng/ml). In the subgroup analysis of mild and severe preeclampsia, VCAM-1, ICAM-1 and E-selectin all showed increased levels compared with normal pregnancy women.ConclusionThe meta-analyses have shown elevated VCAM-1 and E-selectin levels in the circulation of pregnant women with preeclampsia.
The DPP-4 inhibitor sitagliptin alters the gut microbiota and prevents neuronal damage of hippocampus in STZ induced type 2 diabetic rats
Authors: Chang Ying , Xiang Ting , Wang Hongyan , Zhou Fanlin , Liang Jie , Deng Wuquan , Li Shengbing , Chen Wenwen , Li Ke , Li Yu , Liu Dongfang , Yang Gangyi , Tian Mingyuan
Published: January 2020

Background : Type 2 Diabetes mellitus is characterized by impaired glucose metabolism and insulin resistance with increasing risk of specific complication, including central neuropathy. Dipeptidyl peptidase 4 (DPP-4) inhibitors are agents designed to regulate hyperglicemia through increasing the half-life of incretins. Although they are administered orally, their effects on central neuropathy and gut microbiota remain unclear. Our objective was aimed to identify the impact of the DPP-4 inhibitor sitagliptin on gut microbiota and central neuropathy in a rat model of streptozotocin (STZ)-induced diabetes
Methods: Diabetic rats were induced by a high-fat diet and streptozotocin injection. Diabetic rats were orally administered a dose of sitagliptin (10mg/kd/d), and normal diet for 12 weeks. Fecal DNA extraction and sequencing based on analysis of 16S rRNA genes was used to determine the overall structure of microbiota in fecal samples. Then rats were killed, of which the brain tissue sections were observed for changes of neurons in the hippocampus by HE staining.
Results: Sequencing of the V3-V4 regions of 16S rRNA genes revealed that sitagliptin significantly altered the gut microbiota. Compared to the diabetic group, Shannon index and the abundance of phylum Bacteroidetes decreased significantly, whereas the proportion of phylum Firmicutes increased significantly in the sitagliptin-treated rats. Moreover, higher abundance of a few putative short-chain fatty acid-producing bacteria, including Clostridium and Fusobacterium was observed remarkably after sitaglitin treatment. Genera Lactobacillus , Streptococcus and Clostridium, which could produce some neurotransmitters, were also found increased substantially in the sitagliptin-treated rats. Notably, we found that sitagliptin treatment could ameliorate the abnormal changes of pyramidal neurons in hippocampus with HE staining.
Conclusions: Our study demonstrated that sitagliptin prevented the neuronal damage of hippocampus in type 2 diabetic rats, accompanied by changes of gut microbiome. It indicated that sitagliptin might alleviate diabetic central neuropathy through triggering “microbiota-gut-brain” axis.
Developing a Machine Learning prediction model for bedside decision support by predicting readmission or death following discharge from the Intensive Care unit
Authors: Thoral Patrick J. , Fornasa Mattia , Bruin Daan P. de , Hovenkamp Hidde , Driessen Ronald H. , Girbes Armand R.J. , Hoogendoorn Mark , Elbers Paul W.G.
Published: January 2020

Background Unexpected ICU readmission is associated with longer length of stay and an increase in mortality. Real time support systems could prevent untimely discharge from the ICU. We aim to develop a machine learning model for implementation at the bedside by predicting the risk of ICU readmission or death at time of potential discharge, showing feature importance and visualizing day-to-day changes in risk. Methods Data from adult patients, admitted to our mixed surgical-medical ICU between 2004 and 2016, were used in the analysis. Patient characteristics, clinical observations, (automated) physiological measurements, laboratory studies and treatment data were considered as model features. Different supervised learning algorithms were trained to predict ICU readmission and/or death, both within 7 days from ICU discharge, using 10-fold cross-validation. Feature importance was determined using SHapley Additive exPlanations. We constructed readmission probability-time curves to identify subgroups. Results Our dataset included 14,105 admissions. The combined readmission/mortality rate within seven days of ICU discharge was 5.3%. Using Gradient Boosting, the model achieved a Receiver Operating Characteristic AUC of 0.802 (95% CI 0.789-0.816) and a Precision-Recall AUC of 0.198 (95% CI 0.185-0.211). The most predictive features were well-known parameters, including physiological parameters, as well as less apparent features like nutritional support. Impact analysis using probability-time curves identified specific patients groups, that might lead to a change in discharge management with a relative risk reduction of 17%. Conclusions We developed a model that can accurately predict readmission and mortality after ICU discharge. Impact analysis showed that a relative risk reduction of 17% could be achievable. Given the large and increasing number of ICU admissions worldwide, this modest reduction may have significant impact for patients and society.
Structural equation modelling the ‘control of gut overgrowth’ in the prevention of ICU acquired Gram-negative infection.
Authors: Hurley James C
Published: January 2020

Background: Conceptually, the ‘control of gut overgrowth’ (COGO), including ‘abnormal Gram-negative bacilli’ (AGNB), is key to the mediation of infection prevention by Selective Digestive Decontamination (SDD). However, the relative importance of the SDD components; topical (TAP), enteral (EAP) and protocolized parenteral antibiotic prophylaxis (PPAP), versus other methods of infection prevention and versus other contextual exposures cannot be resolved within individual studies. Methods: Generalized structural equation models (GSEM) based on COGO concepts were confronted with data derived from >200 infection prevention studies reporting incidences of overall, Pseudomonas and Acinetobacter bacteremia as well as ventilator associated pneumonia (VAP) data including the following group level exposures; TAP, EAP and PPAP use versus antiseptic versus non-decontamination mode of infection prevention; proportion receiving mechanical ventilation (MV); trauma ICU; mean length of ICU stay and concurrency versus non-concurrency of TAP study control groups. Results: In GSEM modelling of Pseudomonas and Acinetobacter gut overgrowth (GO) as latent variables, anti-septic interventions had the strongest negative effect against Pseudomonas GO but no intervention was significantly negative against Acinetobacter GO. Strikingly, PPAP and concurrency each have positive effects in the model, EAP is neutral and Acinetobacter bacteremia incidences are high within TAP studies, moreso with PPAP exposure. Paradoxically, TAP (moreso with PPAP) appears to provide the strongest summary prevention effects against bacteremia and VAP overall. Conclusions: GSEM modelling of published data provides novel insights into the COGO concept and the complex and profoundly paradoxical relationships between various interventions, concurrency and other exposures in relation to infection with AGNB.
Designing a tool for measuring the awareness of predisposing factors and dimensions of low back pain in operating room personnel and evaluating its psychometric properties
Authors: Tavakkol Reza , Eslami Jamshid , Zarshenas Ladan , Amiri Azadeh
Published: January 2020

Background: Low back pain is the most common type of work-related musculoskeletal disorders and one of the costliest health problems. This study aimed to design a psychometric tool to measure the operating room personnel’s awareness of predisposing factors and dimensions of low back pain. Methods: This methodological study aimed to design a psychometric tool for assessing the operating room personnel’s awareness of predisposing factors and dimensions of low back pain in. In the first step, the main dimensions and concepts were developed by reviewing the literature and consulting with professors and experts. In the second step, the initial items of the questionnaire were formulated. Finally, the psychometric properties of the questionnaire were determined using face, content and construct validity, internal consistency, and test-retest reliability. Results: In the first phase of the study, the concept of low back pain and its risk factors were determined, and then the initial items of the tool were developed. In the next step, face and content validity of the instrument were determined both qualitatively and quantitatively (content validity ratio=0.91 and content validity index=0.95). Indeed, construct validity was assessed by convergent and divergent validity using chronic pain and general health questionnaires, respectively (correlation coefficient in convergent validity=0.70 and correlation coefficient in divergent validity=-0.37). Finally, the reliability of the instrument was determined using internal consistency (α=0.60) and test-retest reliability (0.77). Conclusion: Considering the design, validity, and reliability of the instrument for measuring the awareness of predisposing factors and dimensions of low back pain in operating room personnel, we suggest that it should be used for evaluation of the awareness and different dimensions of low back pain among the operating room personnel.
Effects of Rare Earth Elements on Growth and Determination of Secondary Metabolites under In Vitro Conditions in Salvia miltiorrhiza
Authors: Fan Zhibin , Zhang Kai , Wang Fengyun , Zhao Xiaodan , Bai Ruiqin , Liu Boling
Published: January 2020

Salvia miltiorrhiza, known as danshen, is one of most valued medicinal plants in China. Although it has been cultivated since ancient times, an optimal culture system needs to be standardized for this important species. Here, we explored the phytochemical properties of S. miltiorrhiza with the treatments of rare earth elements (REEs) to develop an optimal tissue culture system. Four-week-old in vitro-grown S. miltiorrhiza plantlets were used as explants. The experiment was conducted in a randomized block design on a Murashige and Skoog (MS) medium containing 0.2 mg·L−1 naphthaleneacetic acid (NAA) to induce rooting at four different concentrations (50, 100, 200, and 300 μM) of REEs such as cerium (Ce), lanthanum (La), or praseodymium (Pr), respectively. Compared with all REEs at different concentrations, 100 μM Pr induced greater root length than Ce or La at any concentrations. Concomitantly, 0.38 μg tanshinone IIA/mg dry weight (DW) was observed, which was 54.84% higher than in the control. Similarly, chlorophyll content, antioxidant enzyme activity, and secondary metabolite were enhanced in rooting medium supplemented with 100 μM Pr. Therefore, this study showed that 100 μM Pr is an adequate concentration in the optimal culture system for promoting plant growth as well as enhancing secondary metabolite content in S. miltiorrhiza.
Prognosis of prolonged disorders of consciousness outcome based on the determination of certain hormones and natriuretic peptide
Authors: Kondratieva E. A. , Dryagina N. V. , Aybazova M. I. , Kondratiev S. A. , Denisova A. A. , Ivanova N. E. , Yarmolinskaya M. I. , Kondratiev A. N.
Published: January 2020

Introduction: Changes in hormonal status in patients with prolonged disorders of consciousness (PDC) remain poorly understood. There are no studies devoted to the investigation of prognostic value of hormonal changes to predict the outcome which is primarily due to a relatively small number of patients, different variants of structural brain disorders in vegetative state (VS) patients, concomitant somatic pathology including typical complications.The objective: to study the correlation between outcomes in VS patients with hormonal status and the level of natriuretic peptide. Subjects and methods. 275 patients in VS were examined for the time period from 2007 to 2017. 152 patients had sequela of traumatic brain injury (TBI) and 123 patients suffered from hypoxic brain damage. All patients matched the international criteria of VS diagnosis. In all patients, blood samples were collected during the first week after admission to ICU to test hormones and natriuretic peptide levels. ACTH, cortisol, TSH, free T3 and T4 , STH, prolactin and natriuretic peptide were tested in the period from 2 to 4 months of staying in VS. In men, the level of total testosterone, LH and FSH was additionally tested. The obtained data were compared with VS outcome.Results. The tested hormones were stably insufficient only in few VS patients. None of the tested hormones of the hypothalamic-pituitary-adrenal axis made a reliable criterion for predicting VS outcome. The tendency of disrupted rhythm of cortisol secretion was found to be most frequent and consistent, with higher rates in the evening hours. The average value of STH was higher in men with sequela of traumatic brain injury who had recovered consciousness versus those who remained in VS. A significant decrease in testosterone levels, regardless of age, was found in the patients with TBI sequela. Mean levels of LH were higher in patients with TBI sequela and hypoxia who remained unconscious versus patients who later restored consciousness. The average level of FSH was higher in patients who had recovered consciousness compared to those who remained in chronic VS. The increased level of natriuretic peptide was observed both in patients who remained in chronic VS and in those who restored consciousness.Conclusions. When investigating levels of certain hormones, no specific endocrine background characterizing this category of patients was found. Abnormal rhythms of some hormones secretion, in particular cortisol, can be considered typical of VS patients especially patients with TBI sequela.
Pectoral nerves block as a component of multimodal analgesia in breast cancer surgery
Authors: Buyanov A. S. , Stadler V. V. , Zabolotskiy D. V. , Koryachkin V. A. , Vozdvizhenskiy M. O. , Borisov A. P. , Tkachev M. V.
Published: January 2020

Objective:to evaluate the efficacy and safety of adding pectoral nerve block to anesthesia regimen in radical mastectomy.Subjects and methods.65 female patients underwent unilateral radical mastectomy under general anesthesia. All patients enrolled into the study were divided into two groups. Group 1 included patients (the main one,n= 33) who had PEC block and general anesthesia; Group 2 (the control one,n= 32) had general anesthesia only.Results.The group of patients with PEC block versus the Control Group, demonstrated a lower score of the visual analogue scale at all stages of the study. The intra-operative fentanyl consumption was statistically significantly lower in Group 1 versus the Control Group (290.91 ± 67.84 and 393.75 ± 66.90 μg, respectively,p< 0.033). The consumption of opioid analgesics during the 1st day in the Main Group was 2-fold lower compared to the Control Group – 30.91 ± 12.34 and 63.75 ± 9.42 mg, respectively (p< 0.026). In Group 1, the time till the first analgesia with promedol made 309.55 ± 56.59 minutes.Conclusions.Pectoral nerves block combined with general anesthesia provides effective analgesia during breast surgery with axillary lymph node dissection.
Infiltrative analgesia of the skin flap in children with craniosynostosis after reconstructive surgery on skull bones
Authors: Pulkina O. N. , Ivanov V. P. , Gurskaya V. I. , Parshin E. V.
Published: January 2020

The objective of the study is to evaluate the effectiveness of analgesia by infiltration of the skin flap with local anesthetic in children with craniosynostosis after reconstructive surgery.Materials and subjects. 50 children with craniosynostosis, who underwent reconstructive surgery on skull bones, were divided into two groups based on the method of postoperative anesthesia: in Group 1(experimental), the infiltration of the skin flap was used within multimodal anesthesia, while in Group 2, it was standard parenteral use of analgesic drugs. In the postoperative period, pain severity was assessed by FLACC scales, the amount of opioid and non-opioid analgesics consumed was assessed by the formalized Analgesiс Assessment Scale (FSA), and non-invasive hemodynamic monitoring (BP, HR) was performed.Results. The statistical analysis of the results revealed significant differences between groups in the assessment results of FSA and FLACC scales. In Group 1, the level of postoperative pain was significantly lower compared to Group 2. The amount of opioid and non-opioid analgesics consumed was also significantly lower in Group 1.Conclusion. The use of the infiltration of the skin flap as part of multimodal analgesia in children with craniosynostosis, after reconstructive surgery on skull bones significantly reduces the intensity of pain and the amount of opioid analgesics consumed in the postoperative period.
Comparative assessment of efficacy of various anesthesia options after cesarean section
Authors: Ryazanova O. V. , Аleksandrovich Yu. S. , Gorokhova Yu. N.
Published: January 2020

The article describes the comparative assessment of efficacy of transversus abdominis plane block as a component of multimodal analgesia during cesarean section.Subjects and methods. 165 primiparous women were enrolled into the study, their average age made 30.5 years. Operative delivery was performed under spinal anesthesia. All patients were divided into five groups. In the patients in Groups 1 and 3, postoperative analgesia was performed using transversus abdominis plane (TAP) block without ultrasound guidance, while in Groups 2 and 4, TAP block was guided by ultrasound. In Groups 1 and 2, ropivacaine hydrochloride was used at a concentration of 0.2%, in Groups 3 and 4 - 0.375%. In Group 5, paracetamol in combination with narcotic analgesics was used for analgesia. Pain intensity was assessed every hour using a visual analogue pain scale at rest and during movement during the 1st day after delivery. To assess the severity of the stress response and metabolic status of patients, concentrations of cortisol, prolactin and glucose in blood plasma was tested. The levels of cortisol and prolactin were tested in 4 stages: before surgery, 1 hour after surgery, 6 and 24 hours after delivery. Plasma glucose was tested in 3 stages: before surgery, 1 hour and 6 hours after surgery.Results. TAP block in combination with paracetamol provided adequate postoperative analgesia, reduced the consumption of analgesics, and also contributed to the earliest activation of new mothers after cesarean section. The use of 0.2% ropivacaine hydrochloride solution with TAP block was equally effective as the use of 0.375% solution of ropivacaine hydrochloride. Ultrasound guided TAP block significantly improved the quality of postoperative pain management. TAP block reduced the level of stress hormones in patients but in 24 hours, the levels of stress hormones in all groups of patients receiving and not receiving TAP block did not differ.
The Influence of Social Contexts towards the Identity Development of the Main Character in The Bluest Eye By Toni Morrison
Authors: Sofiani Nana , Akhadiah Sabarti , Emzir Emzir
Published: January 2020

This research aimed to show how the social contexts influencing the main character of The Bluest Eye, Pecols’s identity development, and the stage of her identity development with the help of Erikson and Marcia’s theories. The research used qualitative research through the literary psychology approach. The data collection had been taken from the novel entitled The Bluest Eye by Toni Morrison, selected and sorted to find out how many among them were supporting the research. The steps were data analysis and data validity. The results show that social contexts greatly affected Pecola’s life, and therefore her identity cannot be developed.; racism, thus, has an influence on all aspects of the black people. Pecola undergoes multiple oppression and abuse as a result of racism, which leads to her self-loathe. She, thus, believes that having blue eyes is the only hope to escape from the suffering she undergoes. It is a warning of identity confusion since she wants to change her identity and becomes white. It pushes her to insanity. Racism and abuse ruin a person’s life by creating hatred and damaged to a person’s soul, and segregate society into groups. It results in the division of groups through the use of terms such as ‘them’ and ‘us’, implying that they are not equal.
ACTIVE VITAMIN D METABOLITES IN THE TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS
Authors: Yakushevskaya O. V.
Published: January 2020

The article presents the basic definitions related to the treatment of postmenopausal osteoporosis, and certain sections from the guidelines of the Russian Association on Osteoporosis (2016) dedicated to the prescription of active vitamin D metabolites (alfacalcidol).
OVERACTIVE BLADDER IN WOMEN WITH GENITAL PROLAPSE DURING MENOPAUSE
Authors: Imelbayeva A. G. , Yaschuk A. G. , Musin I. I.
Published: January 2020

Epidemiological studies showed that overactive bladder (OAB) syndrome is among the ten most common diseases, ahead of diabetes, gastric ulcer and duodenal ulcer. In addition, the number of patients with OAB is steadily growing every year. Prevalence of OAB ranges from 12 to 22%, and despite a significant decline in the quality of life, only 4–6,2% of patients seek the help of professionals.
VENOUS THROMBOEMBOLIC COMPLICATIONS IN OBSTETRICS AND GYNECOLOGY
Authors: Totchiev G. F. , Tarek F.
Published: January 2020

At the end of the second decade of the twenty-first century, venous thromboembolic complications continue to be one of the most critical issues, affecting the professional interests of doctors in various clinical fields. This is primarily due to the high potential risk for the health and life (less frequently) of patients [1, 2].
ADMINISTRATION OF A COMBINED ORAL CONTRACEPTIVE CONTAINING ESTRADIOL VALERATE/DIENOGEST (E2V/DNG) BY WOMEN WITH MENORRHAGIA
Authors: Dovlethanova E. R. , Mezhevitinova E. A. , Mgeryan A. N. , Abakarova P. R.
Published: January 2020

Menorrhagia is the pathological condition which is negatively affecting physical, emotional and social quality life of the woman. Medicines of the choice of therapy of uterine bleedings are the combined oral contraceptives (COC). The estradiol valerate/ dienogest (E2V/DNG), represents the combined oral contraceptive (COC) recommended for women as contraceptive. Gives to feature of influence of medicine on endometrium the chance of its application in case of uterine bleedings. The hormones which are a part suppress excessive proliferation of endometrium that leads to reduction of amount of menstrual allocations. Results of a research which confirm successful application of E2V/DNG in case of the menorrhagia at the women of reproductive age in clinical situations who aren’t requiring operational treatment are provided.
COMBINED HORMONAL CONTRACEPTION AND NOT ONLY…
Authors: Erofeeva L. V.
Published: January 2020

Chlormadinone acetate-containing combined contraceptives are well researched, they have a high degree of reliability during prolonged use in different modes. They have a protective anti-atherogenic properties and is offset by the risk for cardiovascular system, because the existing data indicate that the risk of thromboembolism against the background of chlormadinone preparation is minimal to date among all COCs and is comparable with the «first-generation» progestins, like levonorgestrel. The undeniable advantage of CMA-containing COC is a neutral impact on carbohydrate metabolism and blood coagulation system. CMA COCs have anti-atherogenic effect, which makes them “the drugs of choice” in patients with sclerocystic ovaries, metabolic syndrome and systemic diseases associated with hypercoagulability.

Russian scholars and Western specialists who studied the effect of CMA-containing combination drug, allow us to recommend COC Belara® to assign not only with the contraceptive purpose, but also as a product for the stability of the menstrual cycle, as the drug of choice in the hyperpolimenorrhea, al’go – and dysmenorrhea, hyperandrogenism, expressed in the form of acne, hirsutism, oily seborrhea, decrease in sexual activity because of dyspareunia, as well as to anxiolytic and sedative effect in PMS.
VITAMINS FOR PREGNANT, ACTIVE FOLATES WITH 100% ABSORPTION
Authors: Khilkevich E. G. , Yazykova O. I.
Published: January 2020

Study objective. To study the efficacy of folic acid drugs, in particular metafolin, at the stage of pregravid preparation and during pregnancy to prevent congenital malformations and complications of pregnancy.

Material and methods. We conducted a search of the literature sources by the keywords «folic acid», «folates», «metafolin», «pregnancy», «methyltetrahydrofolate» in domestic and foreign databases: elibrary, Medline/PubMed, Embase, CINAHL. 23 sources were selected.

Study results. One of the main challenges that the obstetrician faces is the prevention of pregnancy complications and congenital malformations of the fetus. In the literature there is considerable amount of evidence about the effectiveness of folic acid. However, the natural food folates and folic acid preparations may not be absorbed to a sufficient degree by the body in women with defects in folate-converting enzymes, the incidence rate of which reaches 50%.

Conclusion. All women at the stage of pregravid preparation and during pregnancy should take folates to prevent complications of pregnancy and congenital malformations in the fetus. Given the high prevalence of mutations in genes responsible for folateconverting enzymes, in clinical practice it is recommended to use folates able to be absorbed by the body regardless of genetic variants of the folate cycle enzymes.
MONITORING THE RESISTANCE OF CLINICAL STRAINS OF CANDIDA YEAST TO FLUCONAZOLE (A BRIEF LITERATURE REVIEW)
Authors: Zheltikova T. M.
Published: January 2020

The article analyzes the global and national research on the resistance of Candida yeasts to fluconazole. The studies demonstrate that the formation of resistance is determined by many factors: type of yeast, choice of the antimycotic medication, geographical location, etc. In addition, one can not disregard the socio-economic and even political causes. The frequency of detection of drug-resistant strains of different species of Candida yeast to fluconazole varies across different regions, between countries of the same region, and may vary from year to year within a country. In other words, the formation of yeast resistance/ susceptibility to fluconazole, and to other antifungals alike, is dynamic and may be reversible.

Therefore, both global and national studies conducted over the past decades and devoted to the formation of resistance of Candida yeast to azoles, in particular, fluconazole, have shown that it is still the medication of choice for the treatment of candidiasis, including acute vulvovaginal candidiasis, as well as for relief and prevention of exacerbations of recurrent vulvovaginal candidiasis. C. krusei was and remains one of the most fluconazole-resistant yeast species. Other species, such as C. inconspicua and C. norvegensis, the number and incidence of which is too low for the moment to make any statistically valid conclusions, may in the future be added to the list.
EVALUATION OF THE EFFECTIVENESS OF ALTERNATIVE TREATMENTS FOR MENOPAUSAL SYMPTOMS IN POSTMENOPAUSAL WOMEN
Authors: Yureneva S. V. , Ermakova E. I.
Published: January 2020

Menopause is the final cessation of menstrual cycles due to loss of follicular activity of the ovaries. According to the results of a meta-analysis of 36 studies performed in 35 countries, the average age of menopause onset is 48.8 years (95% CI 48,3 – 49,2) with significant fluctuations of this indicator depending on the geographical region of residence of women: lower in Africa, Latin America and middle East countries (47,2–48.4 years) and later in Europe and Australia (50,5–51,2 year) [1]. The number of women in peri- and postmenopausal phase in connection with the increase in life expectancy is increasing. In Russia it is currently more than 21 million. The average age of the menopause onset in Russia ranges from 49 to 51 years, at the same time women live in conditions of estrogen deficit for 1/3 of their life [2, 3].
ESTRIOL IN THERAPY OF VARIOUS GYNECOLOGICAL DISEASES
Authors: Prilepskaya V. N. , Nazarenko E. G.
Published: January 2020

Estriol is an effective and safe drug to treat climacteric syndrome, genitourinary syndrome, in a complex therapy of genital organs prolapsed, atrophic processes at the menopause stage, hypoestrogenia, at cervical factor of infertility.
TOFISOPAM: PROSPECTS FOR NON-HORMONAL THERAPY OF NEURO-VEGETATIVE AND PSYCHO-EMOTIONAL DISORDERS ASSOCIATED WITH MENOPAUSAL SYNDROME
Authors: Dobrokhotova Y. E. , Saprykina L. V.
Published: January 2020

Despite the proven effect of menopausal hormone therapy on menopausal syndrome, a number of factors prevent perimenopausal women from receiving the treatment. The article is a review of literature on the possibility of non-hormonal treatment with tofisopam for neuro-vegetative and psycho-emotional disorders associated with climacteric syndrome. The article tells about the efficacy and safety of the drug taking into account its pharmacodynamic properties.
MENOPAUSAL HORMONE THERAPY WITH DYDROGESTERONE: ASPECTS OF EFFICACY AND SAFETY OF ULTRA-LOW DOSES
Authors: Smetnik A. A.
Published: January 2020

A number of studies have shown that menopausal hormone therapy (MHT), consisting of 1 mg 17ß-estradiol and 5 mg dydrogesterone, is effective to reduce the severity of menopausal symptoms and increases bone mineral density in postmenopausal women [1] and at the same time has a favorable safety indicators for the endometrium and the pattern of bleeding [2, 3]. Nevertheless, current guidelines recommend the use for the treatment of menopausal symptoms of the lowest effective dose of estrogen [4–6]. In this regard, we developed a new combined mode of MHT with continuous use of ultra-low doses of hormones – 0.5 mg 17ß-estradiol and 2.5 mg of dydrogesterone. The use of ultra-low doses of estrogen protects the endometrium by lower doses of progestogen. Similar combinations of low doses of MHT can reduce the incidence of adverse events, such as the sensitivity of the mammary glands, uterine bleeding, cardiovascular disease, ischemic stroke and venous thromboembolic complications, and at the same time, to maintain effectiveness against menopausal symptoms [7–11]. The appearance of in the arsenal of gynecologists of ultra-low dose MHT is likely to improve the patient’s adherence to this treatment regime. In addition, a low dose of estrogen is particularly useful for older women (>59 years).
DIABETES MANAGEMENT AND CURRENT PROSPECTS FOR SELF-MONITORING OF BLOOD GLUCOSE
Authors: Goncharova E. V. , Petunina N. A.
Published: January 2020

Diabetes mellitus implies the need for self-monitoring under the supervision of the attending physician. In the conditions of increasing prevalence of diabetes, the physician’s key task is to properly educate the patient in applying the main principles of self-monitoring. Learning the principles of glycemic control with a portable glucometer is an essential component of diabetes treatment.
ROLE AND PLACE OF DAPAGLIFLOZIN IN THE MANAGEMENT OF 2nd TYPE DIABETES: FROM THEORY TO PRACTICE
Authors: Khalimov Y. S. , Agafonov P. V. , Kuzmich V. G.
Published: January 2020

A new approach to the treatment of the Type 2 diabetes mellitus (T2DM) based on drug-induced glycosuria and reduction in renal threshold of glucose, and drugs with a similar mechanism of action belong to an innovative class of antidiabetic drugs: inhibitors of 2nd type sodium-glucose cotransporter (GLT-2). In addition to improving glycemic control SGCT-2 inhibitors promote moderate weight loss and blood pressure (BP), increased sensitivity of tissues to insulin and improve β-cell function. Dapagliflozin an oral SGCT-2 inhibitor, which is due to the insulin independent mechanism of action is characterized by the minimal risk of hypoglycemia compared to traditional antidiabetic drugs, such as sulfonylurea and insulin. For this reason, the drug has the unique ability to combine with other oral hypoglycemic agents (OHGA). In addition, due to its natriuretic effect and ability to reduce body weight and blood pressure dapagliflozin is the drug of choice in patients with T2DM and cardiovascular diseases of atherosclerotic genesis. A combination of advantages, including a favorable safety profile of dapagliflozin allows extensive use of this drug for the initiation and intensification of T2DM treatment.
CARDIOVASCULAR SAFETY OF GLIPTINS. FOCUS ON ALOGLIPTIN
Authors: Petunina N. A. , Goncharova E. V. , Potapova S. A.
Published: January 2020

Type 2 diabetes is a chronic progressive disease the prevalence of which is increasing. The development of new strategies for the treatment of diabetes, among which drugs that modulate the “incretin effect” are worth noting, continues. Dipeptidyl peptidase-4 inhibitors (DPP-4, gliptins) are a group of oral antidiabetic incretin drugs that enhance the glucose-induced activity of β-cells and suppress excessive glucagon secretion by pancreatic α-cells. This group of antidiabetic drugs is widespread due to a number of relevant benefits, such as neutral effect on body weight, low risk of hypoglycaemia, convenient administration scheme and good adherence to treatment. Efficacy and safety of treatment demonstrated by global multicenter trials allow for a wide use of gliptins in clinical practice.
EARLY EXPERIENCE OF GPP-1 LIRAGLUTIDE 3.0 MG ANALOGUE IN RUSSIA AND ITS EFFECT ON METABOLIC RISK FACTORS IN OBESITY PATIENTS
Authors: Komshilova K. A. , Troshina E. A. , Ershova E. V. , Logvinova O. V.
Published: January 2020

Obesity is a chronic disease associated with cardiometabolic risk factors of cardiovascular diseases and type 2 diabetes. In 2016, in Russia a new drug was registered for the treatment of patients with adiposity - liraglutide 3.0 mg, which is an analog of human glucagonoma peptide-1. The study purpose: to study the efficacy of liraglutide 3.0 mg/day and its impact on cardiometabolic risk factors in patients with obesity. We examined 30 patients aged 25-59 with obesity without diabetes. Patients received therapy with liraglutide 3.0 mg/day for 3 months. The examination included measurement of anthropometric parameters, blood sampling with the estimation of the parameters of lipid and carbohydrate metabolism.

Results: after 3 months of treatment with liraglutide 3.0 mg a significant improvement of anthropometric parameters was observed: reduction of weight, BMI and waist circumference and a significant improvement in parameters of metabolic comorbidities.

Conclusions: complex therapy with use of liraglutide 3.0 mg per day for 3 months is effective for therapy of obesity and correction of obesity-associated cardiometabolic disturbances.
CURRENT VIEWS ON THE TREATMENT OF ACROMEGALY WITH SOMATOSTATIN ANALOGUES
Authors: Ilovaiskaya I. A.
Published: January 2020

Acromegaly is a disease with multiple organ failure. Furthermore, acromegaly is frequently accompanied by psychological disorders, with a significant decrease in the quality of life. Neurosurgical treatment (transsphenoidal adenomectomy) is recommended as first-line treatment for most patients with acromegaly. According to the recent guidelines, patients after surgery who failed to achieve biochemical control should receive pharmacotherapy. [1, 2, 6] If radical removal of somatotropinoma is unlikely (for an invasive tumor that spread outside the sella, 20 mm or more in size) and there are no strict indications for surgery, many global experts recommend somatostatin analogues as the first-line treatment, which are the absolute leaders among drugs for the treatment of acromegaly.
DIABETES INSIPIDUS AND COMORBID VIOLATIONS OF FLUID-SALT BALANCE
Authors: Lukyanchikov V. S.
Published: January 2020

Aim. To prove that formally low incidence and frequency of diabetes insipidus (ND) and other variants of syndrome poliuriapolydipsia (SPP) did not reflect the true prevalence and clinical significance of such disturbances.

Material and methods. Demonstrated etiology and pathogenesis diversity of SPP, difficulties in its classification and diagnosis.

Results and conclusions. Proposed diagnostic and therapeutic approaches.