bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of tracheostomy timing in adult patients with mechanical ventilation: a systematic review and network meta-analysis
Authors: Kishihara Yuki , Yasuda Hideto , Ozawa Hidechika , Fukushima Fumihito , Kashiura Masahiro , Moriya Takashi
Published: April 2022

Background
An appropriately timed tracheostomy for adults receiving prolonged mechanical ventilation may have several benefits of tracheostomy, including decreased use of analgesics and sedatives and expedited rehabilitation. These clinical benefits may contribute to improve patient prognosis. Although randomized control trials (RCTs) and meta-analyses have researched this, each RCT has a different definition of early tracheostomy and report different outcomes. Meta-analyses that integrate results from these RCTs are also difficult to evaluate because of the conceptual heterogeneity due to the different definitions and reported parameters in each RCT. As a result, there is no established evidence for the appropriate timing of tracheostomy. Therefore, our objective was to perform a network meta-analysis (NMA) on multiple tracheostomy timings using data from existing RCTs.
Methods
MEDLINE, CENTRAL, ClinicalTrials.gov, and WHO-ICTRP were searched. We included RCTs that included mechanically ventilated patients aged 18 years or older. Multiple reviewers independently selected RCTs to compare tracheostomy timings. Considering the definitions of the timing of tracheostomy and clinical importance, we subdivided RCTs into three groups based on the time of tracheostomy as follows: within 4 days from intubation, 5–12 days, or 13 days or later. We performed the NMA with random effects and used the Confidence in NMA framework to assess the degree of treatment effect certainty. The primary and secondary outcomes were short-term mortality and adverse events, respectively.
Results
Seven RCTs (1,021 patients) were included. There were no specific reasons for intubation, and both traumatic and non-traumatic patients were included. There was a significant difference in short-term mortality when comparing tracheostomies performed within 4 days of intubation and those performed 13 days or later (relative risk 0.65 [95% confidence interval 0.46–0.93]). There were no significant differences in adverse events between any of the examined groups.
Conclusions
Tracheostomy performed within 4 days of intubation may reduce short-term mortality compared with tracheostomy performed 13 days or later. However, early tracheostomy should be considered for critically ill patients based on careful consideration of whether or not intubation will be prolonged, such as patients with severe traumatic brain injury or respiratory failure.
Clinical features and survival outcome of aggressive splenic lymphoma: a retrospective study
Authors: Wang Lulu , Chen Rongrong , Zhu Lixia , Huang Xianbo , Sun Jianai , Li Li , Zhou De , Wang Lijun , Zhao Kui , Xie Wanzhuo , Ye Xiujin
Published: April 2022

Purpose The present study aims to explore the clinical features, imaging manifestations, pathologic characteristics, treatment, and prognosis of aggressive splenic lymphoma (ASL) patients.Methods From January 2001 to March 2021, patients who were histologically proven splenic lymphoma were enrolled in this study. The survival curves of overall survival (OS) and progressive-free survival (PFS) were calculated by the Kaplan–Meier survival analysis and log-rank test. Univariate and multivariate Cox regression analyses were performed to estimate the potential prognostic factors.Results Sixty-nine patients who were histologically proven ASL in this study. The median follow-up time was 76.3 months (95%CI, 60.194-92.406). Patients with ASL underwent the splenectomy had better PFS and OS than that of patients who did not (OS 61% vs 35%, P=0.084; PFS 57% vs 25%, P=0.061), yet the difference was not remarkably significant. In addition, splenic lymphomas of T-cell origin (OS HR, 3.398[95%CI, 1.327-8.704], P=0.011; PFS HR, 2.776[95%CI, 1.107-6.959], P=0.029) and present with B symptoms (OS HR, 2.703[95%CI, 1.219-5.994], P=0.014; PFS HR, 2.890[95%CI, 1.348-6.194], P=0.006) were independent risk factors correlated with OS and PFS. After establishing a risk-stratified model in combination with cell of origin (COO) and B symptom to divide patients into three risk subgroups: 36 were in low-risk group, 28 were in intermediate-risk group, and 5 were in high-risk group. The differences between each group were statistically significant (OS: χ2=41.000, P<0.001; PFS: χ2=47.739, P<0.001).Conclusion Splenic T-cell lymphoma patients with B symptom at initial diagnosis had the worst outcome among aggressive splenic lymphoma.
MHD Boundary Layer Analysis of Hybrid Nanofluid over 3-D Sinusoidal Cylinder
Authors: Elsaid Essam M. , Abdelwahed Mohamed
Published: April 2022

This research deals to investigate the boundary layer surroding a three-dimensional sinusoidal cylinder, the boundary layer was assumed to be filled with hybrid nanofluid consists of water + Cu nanoparticle as main fluid and supported with a small concentration of Al2O3 or Ag nanoparticle. The boundary layer is described by a set of nonlinear partial differential equations due to the continuity, momentum, and energy equations whose transformed to a set of dependent coupled nonlinear ordinary differential equations. The obtained system of equations was solved using composite numerical technique mix of shooting and fifth-order Runge Kutta methods. The behavior of boundary layer under the varies of type and concentration of nanoparticles and the influence of magnetic field has been depicted by a set of graphs and tables.
HP 2-2 genotype Predicts Rapid Disease Progression in Nondialysis Patients and Mortality among South Indian ESRD Patients
Authors: Vasudevan Varadaraj , Ramprasath Tharmarajan , Sampathkumar Krishnaswamy , Puhari Shanavas Syed Mohamed , Yuvaraj Subramani , Selvam Govindan Sadasivam
Published: April 2022

Objectives
Haptoglobin (HP), a plasma glycoprotein, binds to free hemoglobin and prevents the loss of iron and kidney damage. In a prospective study, we determined whether HP variants (HP 1–1, HP 2 − 1, HP 2–2) are associated with chronic kidney disease (CKD).
Design & Methods
: From the Southern part of India, 392 CKD patients (nondialysis, ND; n = 170, end stage renal disease, ESRD; n = 222) and 202 healthy individuals were enrolled, and followed up for up to 70 months. The patients' blood samples were used for determining biochemical parameters and HP genotyping. Gene frequency and biochemical parameters were statistically analyzed for disease association.
Results
Higher HP 2–2 genotype frequency showed an increased hazard ratio for overall disease progression among ND patients (hazard ratio = 3.86; 95% CI = 1.88 to 7.93; P = 0.0002). Survival analysis also showed that Non HP 2–2 patients have a statistically significantly decreased risk for mortality compared to patients with the HP 2–2 genotype (ESRD patients hazard ratio = 4.05; P = 0.04). Thus, our data confirm that HP 2–2 polymorphism was statistically associated with the risk for all-cause rapid disease progression in CKD patients.
Conclusions
Concluding our results, HP 2–2 genotype could be an independent predictor of all-cause mortality in patients with CKD.
Nomogram for predicting rebleeding after initial endoscopic epinephrine injection monotherapy hemostasis in patients with peptic ulcer bleeding: a retrospective cohort study
Authors: He Shan , Liu Linlin , Ouyang Liu , Wang Jingsong , Lv Nonghua , Chen Youxiang , Shu Xu , Zhu Zhenhua
Published: April 2022

Background: Although the current guidelines recommend endoscopic combination therapy, endoscopic epinephrine injection (EI) monotherapy is still a simple, common and effective modality for treating peptic ulcer bleeding (PUB). However, identifying rebleeding patients after EI monotherapy is unclear, which is highly important in clinical practice. This study aimed to identify risk factors and constructed a predictive nomogram related to rebleeding after EI monotherapy.Methods: We consecutively and retrospectively analyzed 360 PUB patients who underwent EI monotherapy between March 2014 and July 2021 in our center. Then we identified independent risk factors associated with rebleeding after initial endoscopic EI monotherapy by multivariate logistic regression. A predictive nomogram was developed and validated based on the above predictors.Results: Among all PUB patients enrolled, 51 (14.2%) had recurrent hemorrhage within 30 days after endoscopic EI monotherapy. After multivariate logistic regression, shock [odds ratio (OR) = 12.691, 95% confidence interval (CI): 5.129-31.399, p < 0.001], Rockall score (OR=1.877, 95% CI: 1.250-2.820, p =0.002), tachycardia (heart rate>100 beats/min) (OR=2.610, 95% CI: 1.098-6.203, p =0.030), prolonged prothrombin time (PT>13 s) (OR=2.387, 95% CI: 1.019-5.588, p =0.045) and gastric ulcer (OR=2.258, 95% CI: 1.003-5.084, p =0.049) were associated with an increased risk of rebleeding after an initial EI monotherapy treatment. A nomogram incorporating these independent high-risk factors showed good discrimination, with an area under the receiver operating characteristic curve (AUROC) of 0.876 (95% CI: 0.817–0.934) (p<0.001).Conclusions: We developed a predictive nomogram of rebleeding after EI monotherapy, which had excellent prediction accuracy. This predictive nomogram can be conveniently used to identify low-risk rebleeding patients after EI monotherapy, allowing for decision-making in a clinical setting.
Factors affecting condom-use behaviors among emerging adults in South Korea
Authors: Lee Jungmin , Ross Ratchneewan
Published: April 2022

Purpose: To date, no studies have examined the association between gender-driven power dynamics and the decision-making process for condom use in South Korea. This study aimed to identify predictors of condom-use behaviors among female emerging adults in South Korea. Participants and methods: A cross-sectional survey was conducted using social network services, and the participants comprised 169 female college students aged 18‒25 years who were actively engaging in sexual intercourse. Results: The results showed that attitudes toward condom use was a stronger predictor of condom-use behaviors than sexual double standards. A significant implication of this study is the need for novel approaches to address condom use in female emerging adults. Potential approaches should consider gender dynamics and have cultural and social relevance for South Korean society. Conclusion: The current findings offer insight into developing future interventions tailored to the population to promote condom use, thereby preventing STDs/HIV, unwanted pregnancies, abortions, and other negative consequences in female emerging adults in South Korea.
Sutureless versus purse string with complete sac dissection in Laparoscopic inguinal hernia repair in children: A randomized clinical trial
Authors: Elsayem Karam , Abdelmotaal Yehia S , Kaddah Sherif , Elbarbary Mohammed M , Taher Heba
Published: April 2022

Introduction: Pediatric inguinal hernia is a common surgical problem with cumulative incidence of 4.2%. Minimal invasive surgery role is growing in the treatment of this problem. We compared the outcome of laparoscopic sutureless herniotomy and purse string with sac dissection repair regarding complications and operative time. Methods: one hundred fifty two patients were operated in two centers with two different techniques: Sac dissection and purse string suture and sutureless repair. Operative time and recurrence were the main outcomes of comparison. Results: Sutureless repair has shorter operative time (29±10 minutes) compared to purse string repair (38±13 minutes). The recurrence rate showed no statistical significance difference. However, the recurrence rate of Sutureless repair was three folds higher than the purse string repair and all recurrences were in large defects of 10-15 mm. Conclusion: Sutureless repair is safe for defects up to 10 mm with excellent operative time. However, it had an unfavorable outcome in larger defects. Research and ethical committee approval number: D-11-2020
Abnormal Cortical Thickness and Structural Covariance Networks in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations
Authors: Li Shu , Bai Ru , Yang Yifan , Zhao Ruotong , Upreti Bibhuti , Wang Xiangyu , Liu Shuang , Cheng Yuqi , Xu Jian
Published: April 2022

Background
Non-neuropsychiatric systemic lupus erythematosus (non-NPSLE) has been confirmed to have subtle changes in brain structure before the appearance of obvious neuropsychiatric symptoms. Previous literature mainly focuses on brain structure loss in non-NPSLE; however, the results are heterogeneous, and the impact of structural changes on the topological structure of patients' brain network remains to be determined. In this study, we combined neuroimaging and network analysis methods to evaluate the changes in cortical thickness and its structural covariance networks (SCNs) in patients with non-NPSLE.
Methods
We compare the cortical thickness of non-NPSLE patients (N = 108) and healthy controls (HCs, N = 88) using both surface-based morphometry (SBM) and regions of interest (ROIs) method, respectively. After that, we analyzed the correlation between the abnormal cortical thickness results found in the ROIs method and a series of clinical features. Finally, we constructed the SCNs of two groups using the regional cortical thickness, and analyzed the abnormal SCNs of non-NPSLE.
Results
By SBM method, we found that cortical thickness of 34 clusters in the non-NPSLE group was thinner than that in the HCs group. ROIs method based on Destrieux altas showed that cortical thickness of 57 regions in the non-NPSLE group was thinner than that in the HCs group and related to the course of disease, autoantibodies, the cumulative amount of immunosuppressive agents, and cognitive psychological scale. In the SCNs analysis, the cortical thickness SCNs of the non-NPSLE group did not follow the small-world attribute at a few densities, and the global clustering coefficient appeared to increase. The area under the curve analysis showed that there were significant differences between the two groups in clustering coefficient, degree, betweenness, and local efficiency. There are a total of seven hubs for non-NPSLE, and five hubs in HCs, the two groups do not share a common hub distribution.
Conclusion
Extensive and obvious reduction in cortical thickness and abnormal topological organization of SCNs are observed in non-NPSLE patients. The observed abnormalities may not only be the realization of brain damage caused by the disease, but also the contribution of the compensatory changes within the nervous system.
The Establishment and Validation of Reference Intervals for Plasma Pentraxin-3 in Healthy Volunteers and Patients with Takayasu's Arteritis
Authors: Zhou Xiang , Han Qing , Wang Xiqing , Zhang Ming , Li Xiang , Ma Wenhui , Wang Xueying , Yang Weidong , Zhu Ping , Wang Jing , Kang Fei
Published: April 2022

Objective
To establish reference intervals (RIs) for PTX-3 and to validate the performance of these RIs in a population including healthy volunteers and Takayasu's arteritis (TAK) patients.
Methods
Enzyme-linked immunosorbent assays were used to determine the plasma PTX-3 levels of 166 healthy volunteers and 63 TAK patients. RIs were established in healthy volunteers according to guidelines from the Clinical and Laboratory Standards Institute (CLSI, C28-A3). Global assessment was used to quantitatively diagnose active/non-active TAK patients. PTX-3 cut-off values and RI-derived values were calculated as candidate standards for quantitative diagnosis. Screening and monitoring performances were validated by identifying active TAK patients from the whole population or diagnosed TAK patients. Traditional inflammatory markers C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were included in the comparison.
Results
PTX-3 level increased with age but were not significantly different among different age or gender groups (p > 0.05). The PTX-3 RI was calculated to be 0.87–2.78 ng/mL (RI median: 1.66 ng/mL). For screening purposes, the cut-off value (1.55 ng/mL) had a high sensitivity of 90.32% and the RI upper limit (2.78 ng/mL) had a high specificity of 97.94%. For monitoring purposes, the sensitivity/specificity of the cut-off value (1.55 ng/mL) and RI median were 90.32%/90.63% and 80.85%/90.63%, respectively. These screening and monitoring performances of PTX-3 were superior to those of CRP and ESR.
Conclusion
The distribution of serum PTX-3 levels was stable and uniform across the population. The screening and monitoring performances of the cut-off value and RI-derived values of PTX-3 were higher than CRP and ESR.
Aberrant expression of JAM2 inhibits invasion and migration in lung adenocarcinoma
Authors: cui yuan , Xie Zhuolin , Chen Jun , Li Chang , Ju Sheng , Ding Cheng , Xu Chun , Tong Xin , Zhao Jun
Published: April 2022

Purpose: lung adenocarcinoma (LUAD) is the most prevalent histologic subtype in lung cancer. As a number of Junctional adhesion molecule (JAM) family, JAM2 involves in multiple functions, such as cell-cell contacts, as well as tumor development. Different expression profiles and roles of JAM2 have also been studied in various cancers. However, the clinical and biological significance of JAM2 in LUAD has not been fully illuminated. Methods: Four gene expression profiles were downloaded from the Gene Expression Omnibus database (GEO) to identify differentially expressed genes (DEGs) between LUAD and normal tissure. Then, GEPIA was employed to unveil expression level and prognosis value of JAM2 in LUAD. Enrichment analyses were performed among coexpression genes in different JAM2 subgroups. Moreover, a protein-protein interaction (PPI) network of the coexpression genes was constructed, and hub genes were explored with Cytoscape software. The expression of JAM2 was verified in LUAD cell lines, wound-healing assays and transwell assays were used to identify cell migration and invasion abilities.Results: we confirmed that JAM2 was downregulated in LUAD, which may be the result of methylation. JAM2 could be served as an independent prognostic gene to predict the outcomes of LUAD patients. It played a broad role in LUAD inflammatory infiltration and higher JAM2 expression may predict a better immunotherapy response. What’s more，we found migratory and invasive capabilities of LUAD cells were significantly suppressed when JAM2 was overexpressed. Conclusion: According to the findings, JAM2 may be a promising molecular target for early diagnose and targeted therapy of LUAD.
Impact of chemotherapy resumption on the outcome of Staphylococcus aureus bacteremia in patients with solid tumors
Authors: Edagawa Shunji , Naito Tateaki , Yamamoto Shuhei , Terada Norihiko , Nakaya Yuichiro , Mori Keita , Kurai Hanako
Published: April 2022

Purpose
Staphylococcus aureus bacteremia (SAB) is a common infection in patients with solid tumors undergoing chemotherapy. In medical oncology, this dilemma often arises between infection control and cancer treatment. We aimed to explore whether early resumption of chemotherapy yielded unfavorable outcomes in oncologic patients with SAB.
Methods
We retrospectively reviewed patients who received antineoplastic chemotherapy within 90 days of SAB onset. We divided patients who resumed chemotherapy into early and late resumption groups and investigated whether chemotherapy after SAB was associated with treatment failure. Treatment failure included recurrence or relapse, 90-day all-cause mortality after initiation of antibiotics toward susceptible microorganisms, and 30-day all-cause mortality after resumption of chemotherapy.
Results
Among the 78 eligible patients, catheter-related bloodstream infection was the most common (51 patients, 65.4%). Thirty-six patients (46.2%) resumed chemotherapy under the supervision of infectious disease specialists. The median interval from the date of negative blood culture to the date of chemotherapy resumption was 17.5 days (0–69). Two patients in the early resumption group (\(<\)17.5 days, 11.1%) and one in the late resumption group (\(\ge\) 17.5 days, 5.6%) died within 90 days after the initiation of antibiotics toward susceptible microorganisms. One patient (5.6%) in the early resumption group experienced SAB recurrence. None of the patients experienced SAB relapse or died within 30 days of resuming chemotherapy.
Conclusion
Early resumption of chemotherapy may not be directly associated with unfavorable outcomes in SAB in patients with solid tumors under appropriate infection management.
Biosorption of lead by a soil isolate Aspergillus neoalliaceus
Authors: Aracagök Y. Doruk
Published: April 2022

This study focused on Pb (II) elimination from aqueous solutions using fungal soil isolate which is identified as Aspergillus neoalliaceus. The sorption of lead with fungal mass studies was performed as a function of pH, biomass dose, contact time, and initial dye concentration. The solution pH value strongly affected the sorption of lead fungal mass. To examine the effect of hydrogen ions on biosorption in solutions containing lead, solutions with different pH values were used and pH 5 was found to be the most suitable pH value for lead removal. Lead biosorption was remained very low below pH 4 because of the competing effect of hydrogen ions in solution. It has been observed that the removal of lead ions based on biosorption with Aspergillus neoalliaceus is better explained by Langmuir isotherm and pseudo-second-order kinetic models compared to other used models.
Meta-Analysis of the efficacy of DPMAS-based artificial liver in the treatment of ACLF
Authors: Ma Lina , Zhang Xu , Ma Wanlong , Ding Xiangchun
Published: April 2022

Background & Aim: Many references have reported the feasibility of various artificial liver support systems in the treatment of acute-on-chronic liver failure caused by Hepatitis B. However, there is still controversy over their efficacy, safety, and impact on survival rates. Meta-analysis was conducted to assess the efficacy, safety, adverse reactions, and survival rate of hepatitis B-caused ACLF treated with artificial liver support systems based on the double plasma molecular absorption system (DPMAS). Methods: The keywords or abstractions “liver failure, severe hepatitis, acute-on-chronic liver failure” were searched on the databases such as CBM, PubMed, Cochrane library, etc. and the Revman5.3 software was used to analyze the literature data. Results: After analysis, DPMAS improved total bilirubin and 90-day survival rate higher than plasma exchange (PE). However, there was no statistical significance in international standardized ratio (INR). the results of international normalized ratio (INR) were [MD=0.06, 95% CI (-0.38, 0.49), P>0.05], that of 90-day survival rate were [OR=3.07, 95% CI (1.87, 5.02), P<0.05]. The improvement of total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), the adverse reactions, the 90-day survival rate and the improvement rate after treatment all were better in DPMAS+PE than PE. However, there were no statistical significance in prothrombin activity (PTA), prothrombin time (PT),blood platelet (PLT), international standardized ratio (INR), hemoglobin (HB), and creatinine (Cr). Conclusion: Total bilirubin are reduced more in DPMAS than in PE after treatment, which might be related with the special bilirubin adsorption column (BS330II) in DPMAS. Whereas, the improvement in INR was not significant in DPMAS compared to PE, which may require additional investigation. The combination of DPMAS and PE reduced total bilirubin more effectively. Furthermore, while they were able to boost ALB, there was no difference in coagulation function, owing to the fact that PE could supply the proteins and coagulation components required by the human body. This meta-analysis also demonstrated that DPMAS+PE reduced the incidence of adverse reactions, increased the effective rate following treatment, and improved 90-day survival rate. Perhaps it's because DPMAS reduces the use of plasma products and removes more toxic substances like bilirubin and inflammatory agents
Assessment of xenon-induced depth of hypnosis according to Kugler’s scale in elderly and senile patients undergoing knee replacement surgery: a prospective open-label cohort study
Authors: Lisichenko Ivan A. , Gusarov V. G. , Teplykh B. A. , Chayanov N. V. , Zamyatin M. N.
Published: April 2022

INTRODUCTION. Anesthesia with xenon is characterized by stable hemodynamic parameters, cardio- and neuroprotection preferable in elderly. Assessment of the depth of hypnosis remains challenging. The Kugler classification based on electroencephalogram has been suggested for such assessment. OBJECTIVES. To assess the feasibility of Kugler scale for objective assessment of the depth of hypnosis induced by xenon alone or in combination with narcotics and regional anesthesia during knee arthroplasty in elderly. MATERIALS AND METHODS. The study included 57 patients divided into 2 groups. In group 1, general anesthesia with xenon was performed, fentanyl and femoral nerve block were used for pain control. In group 2, xenon anesthesia was performed in combination with femoral and sciatic nerve block. The depth of hypnosis was monitored using EEG and matched with the Kugler scale. Also, the bispectral index (BIS) was recorded. RESULTS. At xenon concentration of 40 %, the depth of hypnosis reached D2 stage in group 1 and D1 in group 2 patients, while at 55 % and above it was D2 in both groups. Fentanyl increased the δ-rhythm by 19.08 %, which corresponded to reduction in the effective xenon concentration by 20 %. A correlation between δ-rhythm decrease and BIS was seen in groups 1 (r = –0.78; R2 = 60 %) and 2 (r = –0.61; R2 = 37 %). The differences could be related to the use of fentanyl in group 1. The intergroup difference between the reduction of BIS was not significant. CONCLUSIONS. In elderly patients undergoing knee arthroplasty under combined anesthesia, stage D2 according to Kugler scale (proportion of δ-rhythm more than 50 %) is achieved at xenon concentration of 55 % without narcotics and at concentration of 40 % with fentanyl. The diminished correlation between δ-rhythm and BIS in group 2 and no difference in decrease of BIS suggests that BIS is less accurate for determining the depth of hypnosis during xenon monoanesthesia.
Efficacy of using helium-oxygen mixture in the intensive care of pneumonia in adult patients: a systematic review and meta-analysis
Authors: Lakhin Roman E. , Shapovalov P. А. , Shchegolev A. V. , Kozlov K. V. , Zhdanov A. D.
Published: April 2022

OBJECTIVES. Evaluation of the effect addition helium-oxygen mixture (HOM) in adult patients with pneumonia compared with standard therapy. MATERIALS AND METHODS. Literature was searched in PubMed databases; Google Scholar and eLIBRARY.RU. The following factors were analyzed: the effect of HOM on mortality, SpO2 level, SpO2 recovery, C-reactive protein (CRP), ferritin, D-dimers, frequency of transfer to artificial lung ventilation, duration of stay in the intensive care unit (ICU), hospitalization, cough. Quality assessment, statistical data processing was performed in the Review Manager program, version 5.4.1. The reliability of evidence was evaluated using the GRADE approach using the GRADEpro GDT online program. RESULTS. The meta-analysis included 8 studies with a total of 1097 patients. In 4 out of 10 studied effects (mortality, ventilator rate, length of stay in the ICU, ferritin level), the results did not show the effect of adding HOM to standard therapy. A general meta-analysis of HOM effect showed an increase on SpO2 levels (MD: 1.68; 95% CI: 1.13–2.24; p < 0.001); the maximum effect was on 3–5 days and lasted up to 7 days. Positive effect HOM led to a faster recovery of SpO2 (MD: −2.91; 95% CI: −3.72 … −2.10; p < 0.001). Positive effect HOM led to reduction duration of hospitalization (MD: −3.40; 95% CI −6.05 … −0.76; p = 0.01), cough duration (MD: −3.00; 95% CI: −4.41 … −1.59; p < 0.001), CRP (MD: −16.83; 95% CI: −25.69 … −7.98; p = 0.0002), D-dimer (SMD: −0.48; 95% CI: −0.84 … −0.13; p = 0.007). CONCLUSIONS. The data obtained indicate that the addition of KGF to traditional therapy can improve oxygenation. The inclusion of HOM in therapy can reduce the duration of cough, as well as reduce the level CRP and D-dimers. There was no decrease in mortality, frequency of transfer to mechanical ventilation, duration of stay in the ICU.
Assessment and forecasting of Ukraine’s financial security: Choice of alternatives
Authors: Rekunenko Ihor , Zhuravka Fedir , Nebaba Natalia , Levkovych Oksana , Chorna Svitlana
Published: April 2022

Financial security of a country is an integral part of its economic security and the basis of national security. The paper aims to assess and forecast the level of Ukraine’s financial security using two methodological approaches (the existing one and the authors’ elaboration) to choose the best alternative. The first one is based on the Methodology of the Ministry of Economy of Ukraine. The alternative one has been developed as a multiplicative model of non-linear convolution of relevant direct and indirect impact indicators, considering the opportunity and risk, which is based on a combination of a power function and the Harrington method. A database of input indicators was formed with further differentiation according to their impact on Ukraine’s financial security. The research results demonstrated that during 2013–2019 Ukraine’s financial security integrated index was cyclical and constantly changing. A comparison of the existing methodology and the developed model demonstrated a certain discrepancy between the obtained results. It was substantiated that the proposed multiplicative non-linear convolution model for assessing and forecasting the state’s financial security is more relevant, includes current indicators sorted by their direct and indirect impact, and adjusts them according to the risk of impact on overall security in the country.
Peptic ulcer: the current state of the problem
Authors: Maev I. V. , Andreev D. N. , Samsonov A. A. , Cheryomushkina A. S.
Published: April 2022

Peptic ulcer disease (PUD) is a chronic polyetiological recurrent disease of gastroduodenal region. In most cases, the pathogenesis of PU is caused by imbalance between the aggressive factors and protective factors of the gastric or duodenal mucosa. Helicobacter pylori (H. pylori) infection and the use of non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin, are the major causative factors leading to PUD development. 65% of gastric ulcers and 80% of duodenal ulcers were found to be associated with H. pylori infection. In turn, NSAIDs account for 30% of gastric ulcers and 15% of duodenal ulcers. About 0.1–1% of  all PUs are caused by Zollinger-Ellison syndrome. Abdominal pain is the leading symptom in the clinical findings of patients with exacerbation of PUD. Dyspeptic syndrome (vomiting, nausea, belching, abnormal bowel pattern) is much less common in   patients with PUD. Endoscopic examination of the upper gastrointestinal tract is currently the gold standard test used in   the  diagnosis of PUD and is recommended for all patients suspected of having this disease (unless contraindicated). Antisecretory therapy including proton pump inhibitors is the main approach to the treatment of PUD, as well as the prevention of its complications. Integral to the treatment of patients with H. pylori-associated PU is the eradication therapy of the infection. It is  reasonable to use a cytoprotector rebamipide, which accelerates ulcer healing and improves the resulting scar quality, as part of the pharmacotherapy of PUD. In addition, the use of rebamipide in H. pylori eradication therapy regimens contributes to increased efficiency of elimination of the microorganisms.
New treatment options for a patient with chronic heart failure and chronic obstructive pulmonary disease
Authors: Statsenko M. E. , Turkina S. V. , Lopushkova Yu. E. , Kosivtsova M. A.
Published: April 2022

Introduction. The number of  patients with chronic heart failure  (CHF) and chronic obstructive pulmonary disease  (COPD) is increasing every year. In both CHF and COPD, secondary mitochondrial dysfunction is observed. In this regard, the attention of researchers is attracted by drugs that have their therapeutic effects at the level of mitochondria, one of which is meldonium. Meldonium has proven itself in the treatment of various diseases, however, the evaluation of the clinical efficacy of meldonium has not yet been carried out in comorbid patients with CHF and COPD.

Aim. To study the  effects of  meldonium as part of  basic therapy on the  clinical condition, the  main functional parameters of the heart and lungs, and the quality of life in patients with CHF and COPD.

Materials and methods. The randomized open study included 60 patients with CHF II A stage, II–III FC (clinical recommendations of the RSC, OSSN 2020) and COPD I–III degree of airflow limitation (GOLD 2021 classification) in remission (age 45–70 years). The patients were divided into 2 groups: the 1st group – the main group (n = 30) with CHF and COPD took meldonium at a dosage of 1000 mg/day in addition to the basic therapy, the 2nd group – the control group (n = 30) was only on basic therapy for CHF and COPD. The observation period is 12 weeks.

Results. In patients with CHF and COPD, in the dynamics of therapy with the inclusion of meldonium, as a result, the severity of clinical symptoms decreased, improvement was revealed in the main structural and functional parameters of the heart, external respiration function, and quality of life.

Conclusions: a significant beneficial effect of combination therapy with the inclusion of meldonium on the clinical and functional parameters of the heart and lungs, indicators of quality of life in patients with CHF and COPD has been established, which makes it possible to recommend the use of meldonium as part of combination therapy in comorbid patients.
Chronic diseases of adults programmed in childhood
Authors: Pshenichnikova I. I. , Zakharova I. N. , Berezhnaya I. V. , Koba Yu. V. , Dyatlova A. A.
Published: April 2022

The conditions of human development during the stages of early ontogenesis are of great importance for human health throughout the rest of his life. The period of intrauterine development and childhood are vulnerable stages of organism formation, when metabolic processes have the greatest plasticity and can be subject to deformation. Exposure to a number of external factors during this period of time can have a significant impact on the functional activity of genes controlling neurotransmission, immune response, endocrine functions and, thus, program the spectrum of metabolic disorders that can lead later to the formation of chronic diseases: obesity, type 2 diabetes, atherosclerosis and diseases of cardiovascular system. Negative programming influence on the metabolic profile and cardiovascular risk is caused by such factors as maternal obesity, complicated pregnancy and childbirth, prematurity, early separation from the mother, violation of child feeding in the 1st year of life. The risk of early development of cardiovascular disease, metabolic syndrome, obesity and diabetes mellitus is significantly increased in individuals who have experienced traumatic stressors during childhood associated with economic disadvantage of the family, parental divorce, neglect, abuse, parental neglect, sexual violence, death of parents, family members, close friends, bullying in the children's community. An in-depth study of this problem, along with the development and organization of measures for monitoring and prevention, in the long term can reduce the burden of chronic non-infectious diseases, improve quality of life, reduce disability, incapacitation and mortality in the adult population..
Current views on the pathogenesis and treatment of atopic dermatitis in adults. Experience with the JAK inhibitor baricitinib in patients with moderate to severe atopic dermatitis
Authors: Svechnikova E. V. , Zhufina S. E. , Evdokimov E. Yu.
Published: April 2022

Atopic dermatitis is a common, chronic, immunoinflammatory disease, the study of the pathogenesis of which has recently stepped forward and served as the impetus for the development of new drugs. For the last 10–15 years, in clinical practice, the choice of therapy for patients with moderate and severe atopic dermatitis, which would provide a stable positive effect and possess a favorable safety profile for patients, including those with comorbidities, has become a rather pressing problem. The main links in the pathogenesis of atopic dermatitis and an approach to the management of adult patients with moderate to severe atopic dermatitis are considered. The role of JAK and the JAK-STAT signaling pathway in the mechanisms of inflammation in atopic dermatitis is discussed. The article presents two clinical cases of successful treatment of patients with moderate to severe atopic dermatitis with the JAK inhibitor baricitinib, who had an insufficient response to standard baseline anti-inflammatory therapy. The first case involved the treatment of a 32-year-old patient, who had been ill since early childhood, followed by a long remission and exacerbation in 2016 when the disease began to have a frequent relapsing character. In the second case, a 45-year-old patient had had frequent relapses since the age of 16. Fast and stable results in both cases were achieved with treatment with baricitinib. The drug showed a favorable safety profile and satisfactory tolerability.
Clinical characteristics of the course of atopic dermatitis during pregnancy
Authors: Kandrashkina J. A. , Orlova E. A. , Shtakh A. F.
Published: April 2022

Introduction. Atopic dermatitis (AD) is a chronic hereditary recurrent skin disease. Dermatosis is the most common pathology in pregnant women among skin and allergic diseases. According to some reports, exacerbations of dermatosis during gestation worsen the course of pregnancy, childbirth and the postpartum period.

Purpose of the study. Тo study of the features of the course of AD in pregnant women.

Materials and methods. An open, comparative, prospective study was conducted in which 55 pregnant women with a diagnosis of AD in the acute stage took part. The SCORAD index was used to assess the severity. Beck’s Depression and Anxiety Scales were used to identify violations of the psychoemotional status. To assess the impact of the disease on vital activity – the dermatological index of the quality of life. The pruritus-5 D scale was used to analyze pruritus.

Results. Among pregnant women, AD, newly diagnosed during pregnancy, was recorded in  20  (36.4%) women, in  23  (41.8%) – an exacerbation occurred during pregnancy after prolonged remission, in 12 (21.8%) – recorded annual aggravation in the spring and autumn seasons. The role of the hereditary factor was registered in 28 patients (50.9%). Among the pregnant women with AD included in the study, only 5 (9.1%) needed inpatient treatment for exacerbation of the disease, 50 (90.9%) were observed on an outpatient basis. Severe degree was recorded in 7 pregnant patients (12.7%), moderate severity – in 32 (58.2%), mild degree – in 16 (29.1%).

Conclusion. The results of our research can serve as a basis for new directions of research work in terms of studying the etiopathogenetic and clinical aspects of AD in pregnant women.
Pathophysiological disorders in iron metabolism in the development of obesity and metabolic syndrome
Authors: Smirnova O. V. , Moskalenko O. L. , Kasparov E. V. , Kasparova I. E.
Published: April 2022

Obesity and metabolic syndrome are one of the major public health problems in the 21st century due to their prevalence. Nonalcoholic fatty liver disease, dyslipidemia, type 2 diabetes mellitus, arterial hypertension, chronic inflammation and anemia are non-communicable diseases accompanying obesity. With obesity, there is a violation of iron metabolism, iron deficiency, which further contributes to the  development of  metabolic disorders. Iron is the  second most abundant metal on Earth, and its bioavailability is reduced due to the formation of insoluble oxides, while iron deficiency is the most common nutritional disorder. Iron metabolism in the body is associated with the formation of reactive oxygen species involved in lipid peroxidation processes. Iron metabolism in the human body is regulated at all levels; dysregulation of any stage of metabolism can lead to iron deficiency and the development of anemia associated with obesity. This review article summarizes data on molecular and cellular abnormalities in iron metabolism in obesity and metabolic syndrome. The aim of our study was to study, according to the literature, pathophysiological disorders in iron metabolism in the development of obesity and metabolic syndrome. In the future, more research is required to study iron metabolism in obesity with the aim of their preventive and therapeutic effects. The role of oxidative stress in impaired iron metabolism in obesity has not been fully studied, while iron deficiency enhances lipid peroxidation processes in antioxidant deficiency. Under these conditions, oxidative stress can damage cells and destroy red blood cells. The question arises whether the restoration of iron homeostasis in obesity can improve metabolic, inflammatory disorders and reduce the manifestation of oxidative stress, becoming a new innovative approach to the treatment of concomitant metabolic diseases associated with obesity.
How to optimize treatment in patients with different forms of coronary artery disease
Authors: Gilyarov M. Yu. , Konstantinova E. V.
Published: April 2022

Coronary artery disease (CAD) retains top positions in terms of morbidity and mortality both in our country and many countries of the world. CAD takes many acute and chronic clinical forms and can be observed in patients with various cardiac and extracardiac pathologies. The therapy should be personalized to improve the prognosis for each patient with CAD. The COMPASS trial showed that administration of rivaroxaban at a dose of 2.5 mg twice daily combined with a longterm use of acetylsalicylic acid is reasonable in patients with stable coronary artery disease, a high risk of thrombotic complications and a low risk of bleeding to prevent the development of atherothrombotic cardiovascular events. The clinical benefit of this combination therapy is especially high in patients with diabetes mellitus. Once the percutaneous coronary intervention (PCI) is performed in a patient with CAD and atrial fibrillation (AF), we face the task to minimize the risk of atherothrombotic events, including the possibility of stent thrombosis, and the development of ischemic stroke, given the increased risk of bleeding due to such therapy. The results of PIONEER AF-PCI trial have become the  grounds for recommendation of rivaroxaban 15 mg as part of combination antithrombotic therapy for this group of  patients with AF. An option to add rivaroxaban to therapy may be considered in the presence of sinus rhythm in patients with reduced left ventricular ejection fraction and high thromboembolic risk to reduce the incidence of neurological events, as was shown in the COMMANDER HF trial. So there is a wealth of evidence that rivaroxaban may be used as an important component of the combination therapy of patients with CAD in a variety of clinical situations.
Prospects for finding means of non-specific prevention of COVID-19 infection
Authors: Usenko D. V.
Published: April 2022

With the ongoing pandemic of the SARS-CoV-2 virus and the emergence of its new genovariants, along with the relevance of  addressing the issue of vaccination of the population, the importance of non-specific prophylaxis, which is designed to reduce the viral load on the body and slow down the rate of virus spread, is increasing. The currently available research and experience in the use of antiseptic drugs or their combinations with the antimicrobial peptide lysozyme can be used for this purpose.Currently available research and experience in the use of antiseptic drugs or their combinations with the antimicrobial peptide lysozyme can be used for this purpose. Under conditions of lysozyme deficiency unhindered accumulation of non-hydrolyzed substrate, which is a constant source of autoantigens, is accompanied by immunity, metabolic and tissue homeostasis disorders. Analysis of a comparative study of different groups of antiseptics showed high virulicidal efficacy of cetylpyridinium chlorideCetylpyridinium chloride has an electrostatic effect on viral membrane lipids, causing their aggregation and dissolution, which leads to disruption of the integrity of the virus membrane, its interaction with mucosal epithelial cells and penetration into target cells, having a direct virulicide effect on SARS-CoV-2. An important factor of innate mucosal immunity is lysozyme, it has antiviral, antibacterial, antifungal and anti-inflammatory effects, normalizes microbiocenosis, restores immune system activity, increases mucosal barrier function. The combination of cetylpyridinium chloride and lysozyme hydrochloride has a dual antiviral effect, reducing the viral load on the body and enhancing the ability to control the spread of SARS-CoV-2 both from patients in the prodromal period of the disease or with its clinical manifestations, and from asymptomatic carriers with confirmed COVID-19 infection status.
The effectiveness of a specialized food product for prevention and rehabilitationof cognitive impairments
Authors: Pilat T. L. , Nikityuk D. B. , Radysh I. V. , Semin D. A. , Khanferyan R. A.
Published: April 2022

Introduction. Neurological pathologies are typical not only for adults, but are also widespread in childhood. These are disorders of speech and language functions, autism spectrum disorders, attention deficit hyperactivity disorder, emotional disorders. Also, many cognitive impairments affect patients who have had acute viral diseases, especially the coronavirus infection.

Purpose – to evaluate the effectiveness and safety of a specialized dietary therapeutic food product and dietary preventive nutrition – jelly "Good Memory" and the phytocomplex included in it at various neurological symptoms.

Materials and methods. In a 30-day study with 68 individuals (34 adults and 34 children, ages 1 to 21), the effect of a monthly intake of a phytotherapeutic complex on memory parameters was tudied,attention, intellectual performance of volunteers included in  the study according to Bourbon tests, methodology «Kraepelin score», Eysenck subtests, graphical test and IQ indicators according to the Denver test.

Results. A 30-day intake of a specialized food product jelly «Good memory» contributed to improving the performance of  various types of memory and attention, reducing fatigue, increasing efficiency. The survey showed that the intellectual performance of the comparison group decreased by 59% for all three indicators of mental activity. So, in terms of mathematical abilities, the improvement was 47.1%, for linguistic – 34.7% and for the total indicator – 52.2%. At the same time, the main indicators stabilized intellectual performance.

Conclusion. The results of the study allow us to recommend a specialized nutrition jelly «Good Memory» children over 1 year old  and adults to maintain the integrative functions of the brain and other parts of the mental process, as well as for the prevention and rehabilitation of post-covid cognitive impairment, recovery of mental, intellectual performance.