bluuebunny/crossref_metadata_2025 huggingface dataset:
Features of nephropathy in various types of thrombotic microagniopathies in obstetric practice
Authors: Kirsanova T. V. , Balakireva A. I. , Fedorova T. A.
Published: October 2021

Introduction. We assessed the features of kidney injury in patients with different types of TMA during pregnancy, taking into consideration the fact that the acute kidney injury (AKI) that occurs during pregnancy or in the early postpartum period is main- ly caused by various types of thrombotic microangiopathies (TMA), and AKI itself is a serious obstetric complication with the risk of serious complications and mortality for both mother and fetus.

Objective of the study. To study the features of nephropathy in different types of pregnancy-associated TMA.

Materials and methods. The study included 313 pregnant women, women in childbirth and puerperas, of which 71 women had atypical hemolytic uremic syndrome (aHUS), 124 – HELLP syndrome, 70 – varying degrees of severity of PE, a group of patients with more rare causes of TMA was also identified: TTP, CAPS and sepsis (13 patients) and 45 patients for the control group. We assessed and compared the main clinical, laboratory and instrumental data, and assessed the outcome of labour. Also, histological examination of the kidneys was performed in five patients with aHUS.

Results and discussion. The results of the study have shown that the most severe manifestations of TMA in the form of target organ injury and nephropathy are usually occur in patients with aHUS, where all women developed AKI, in some cases with the formation of chronic kidney disease. In the HELLP syndrome group, AKI was recorded in 39%, but renal function quickly restored. It was found that the very fact of the presence of AKI points to a more unfavourable prognosis not only for the patients themselves, but also for the child, being the main risk factor for perinatal death. The findings of urinary sediment tests and morphological evaluation indicate that the resulting ischemia of the renal tissue in cases of aHUS, HELLP syndrome and other types of TMA can lead to tubular necrosis as compared with PE. Our results suggest that it is AKI in HELLP syndrome that is the main risk factor for perinatal death. Alas, this relationship is difficult to trace in patients with aHUS, as all of them had AKI.

Conclusions. Timely recognition of the AKI phenomenon in all cases of obstetric TMA can reduce the risks for both mother and fetus. Both the prognosis for mother and the prognosis for child depend on AKI, and timely therapy can lead to a regression of AKI phenomena and the complete restoration of renal function.
Placental mosaicism and complications of pregnancy
Authors: Sivik A. A. , Tetruashvili N. K.
Published: October 2021

Timely diagnosis of chromosomal aneuploidies plays an important role in determining the proper approach to the management of pregnancy. This article outlines the current ideas on the likelihood of occurrence of obstetric pathology, depending on the number of cells with genetic aberration, especially in the placenta. Such obstetric complications include fetal growth retardation, premature birth, and some forms of preeclampsia. The article describes the prenatal examination techniques, which help obtain timely information about the development of the fetus and predict pregnancy complications, more specifically, non-invasive prenatal DNA screening as a new technique with its advantages and limitations, based on the analysis of DNA of placental origin. It also highlights other latest diagnostic tools that allow to get more accurate information about placental mosaicism and the development of pathology. We have reviewed publications over the past 10 years, which are devoted to the factors responsible for the formation of placental mosaicism, the prenatal diagnostic procedures required for an accurate diagnosis, and the likelihood of obstetric pathology in case of prolonged pregnancy complicated by genetic aberrations. Foreign studies confirm the direct dependence of the likelihood of obstetric pathology on the number of cells with genetic aber ration. In accordance with the above study results, it would be only right to note that placental insufficiency can be observed in any case of genetic aberration, especially if a large volume of cells is involved in the pathological process at an early stage of differentiation. In addition, the article discusses the issue of need of thorough prenatal diagnosis to prevent the development of pregnancy pathology, including the use of the latest technologies and minimizing invasive methods.
Correction of postcovid anemia in pregnant women with impaired dental health status
Authors: Esayan M. S. , Gasanova L. G. , Zaydiyeva Z. S. , Bezuglova E. S.
Published: October 2021

Introduction. The novel coronavirus pandemic makes the issue of iron deficiency in pregnancy even more urgent and forces multidisciplinary clinicians to search for modern ways to correct disorders caused by this infection.

Objective. To assess the features of the course of post-covid anemia associated with combination therapy, as well as the effect of therapy on the dental health status in pregnant women.

Materials and methods. 30 pregnant women (treatment group 1) in the third trimester who had coronavirus infection with mild IDA during gestation were enrolled in the prospective study. Comparison group 2: included 15 patients with mild IDA who did not have coronavirus infection during gestation. Control group 3: included 15 conditionally healthy pregnant women without IDA who did not have a novel coronavirus infection during gestation.

Results. Pregnant women who had COVID-19 during gestation were significantly more likely to suffer from gum bleeding, angular cheilitis, oral erosive and ulcerative lesions. Gum bleeding was significantly more common in pregnant women with IDA against the background of coronavirus infection, than in the women in the comparison and control groups (SBI index, p < 0.05). The decrease in the normal microflora suggests the presence of dysbiotic changes in all pregnant women against the background of IDA, however, the patients after the COVID-19 infection had the most significant changes in it.

Conclusions. The novel coronavirus infection, which the women had during gestation, aggravates the course of IDA, reduces the quality of life of patients with characteristic complaints (gum bleeding, angular cheilitis, oral erosive and ulcerative lesions), leads to dysbiotic oral microbiome changes. The management of this group of patients requires a systemic correction of the microflora balance, the introduction of individual oral hygiene regimens and adequate treatment of IDA using high-technology medicinal products
Striae of pregnancy
Authors: Dvoriankova E. V.
Published: October 2021

Striae may form on the skin due to a number of factors: rapid weight gain, muscle hypertrophy, endocrinopathies, breast enlargement, as a side effect of long-term topical use of strong corticosteroids. However, in some rare circumstances, striae can develop as a complication due to the use of tissue expanders. This cosmetic defect develops most often on the skin of the thighs, abdomen, mammary glands in women and the shoulders in men. Striae of pregnancy are a common cosmetic skin defect. The development of striae is associated with stretching and rupture of connective tissue in susceptible individuals against the background of influence of genetic and hormonal factors. The appearance of striae gravidarum does not have a significant effect on the health of patients, however, a cosmetic defect caused by the appearance of striae can generate psychoemotional (psychoemotional) stress and lead to a decrease in quality of life. The striae development occurs in certain stages. The initial period of striae development – red (immature) striae – is characterized by the absence of changes in the epidermis and signs of inflammation in the dermis. The appearance of white (mature) striae is accompanied by the architectural distortion of elastic fibre net and changes in the viscoelastic properties of the affected skin, which becomes much less elastic. The correction of striae requires topical treatment that help moisturize and soften the skin, stimulate the processes of collagen production, as well as physiotherapy techniques. However, many of them have contraindications for use during pregnancy. The article discusses the issues of the use of cosmetic products that can be used during pregnancy.
Citrate therapy for ur olithiasis in postmenopausal women
Authors: Khashukoeva A. Z. , Ryzhova T. E. , Zenkov S. S. , Overko A. V.
Published: October 2021

A tendency towards growing life expectancy in old age can be clearly observed in most countries of the world over the past number of decades. This tendency is also seen in our country. Despite the fact that people started living longer, which would seem to be a good indicator of the country’s socio-economic development, the doctors have encountered a rather difficult challenge to overcome. The question at issue is that health specialists are faced with many somatic diseases due to the fact that people started living longer. When life expectancy was much less, many of them have never encountered such a volume of diseases. Today, the share of the elderly in the population has significantly increased and they live longer, which, accordingly, has an impact on the number of nosological units in the clinical practice of almost any health specialist. This article is focused on the issue of non-decreasing incidence of urinary tract diseases; in particular, the challenges of bladder stone disease (BSD) are considered. According to the latest data, the disease prevalence does not tend to decrease. Moreover, the incidence of BSD in women has increased significantly, although this pathological condition is more typical for men. In light of the fact that female patients spend about a third of their lives in the postmenopausal period, it is worth paying special attention to some features of the woman’s body functioning during this time period due to the likelihood of the formation of an inflammatory process, which often mediates the development of the BSD. Older female patients are often concerned about inflammatory bladder diseases, which can lead to the development of BSD by ascending infection in the future. Therefore, it is crucially important to know what therapeutic capabilities doctors have today to effectively fight the BSD.
Patterns of clinical presentation of climacteric syndrome and total body composition in women with menopausal metabolic syndrome
Authors: Shulukian Z. E. , Tselkovich L. S. , Balter R. B. , Ivanova T. V. , Ibragimova A. R. , Hamadianova A. U. , Ilchenko O. A.
Published: October 2021

Introduction. Modern gynecological endocrinology widely discusses various disorders accompanying the onset of menopause. Metabolic disorders are one of the leading risk factors for the development of ischemic heart disease and vascular dystonia in menopausal women. That is why the drugs prescribed as part of menopausal hormone therapy are contraindicated for patients with severe metabolic disorders and predisposition to thrombosis. Women with a normal body mass index may develop the menopausal metabolic syndrome, since its presentations largely depend on the total body composition and the specific gravity of visceral adipose tissue.

Aim. To assess the patterns of clinical presentation of menopause in women with metabolic menopausal syndrome.

Materials and methods. In the furtherance of that aim, we examined 184 women who were in menopause 1 to 5 years at the age of 52 to 57 years (average age 54.2 ± 0.5 years). Of these, 87 were diagnosed with metabolic syndrome – they were included in the main group. The comparison group included 97 menopausal women without metabolic disorders.

Results and discussion. We assessed the severity of clinical presentations and the total body composition of the patients in the selected groups. It has been established that the body mass index cannot serve as a criterion for evaluation of metabolic processes, despite the sufficient simplicity of its computation.

Conclusions. The authentic view of the risks of metabolic disorders in menopausal women requires the study of total body composition.
Recurrent vulvovaginal candidiasis during COVID-19 pandemic: medical algorithm
Authors: Nazarova N. M. , Gusakov K. I. , Pavlovich S. V. , Dovletkhanova E. R.
Published: October 2021

The review article presents data on the prevalence of candidiasis of various localization against the history of coronavirus infection (COVID-19). The predisposing factors for the development and recurrence of candidiasis in patients after therapy for coronavirus infection have been analysed. Candida is one of the most common pathogens in intensive care units (ICUs), affecting 6 to 10% of patients, and some studies have reported an increasing trend in the prevalence of candidemia. The literature data that we analysed showed that the most common types of fungal infection among patients with a severe course of COVID-19 were C. albicans, then C. auris, C. glabrata, C. parapsilosis, C. tropicalis, S. cerevisiae, C. krusei and Rhodotorula spp. Candida non-albicans species, in particular C. glabrata, C. auris, were the most common causes of death. The previous treatment regimens for patients with COVID-19 included antibiotics, but at present time corticosteroids are more often used, which have an immunosuppressive effect and, accordingly, predispose to the development of candidiasis. The epithelial injury caused by SARS-CoV-2 also enables Candida to attach to the basement membrane, subsequently triggering the development of mucosal candidiasis. As the systemic and local candidiasis are conditioned by common immune mechanisms that are affected by coronavirus infection, vulvovaginal candidiasis (VVC) may recur during COVID-19 therapy. The timely diagnosis and treatment of fungal infections in patients who underwent COVID-19 are crucial for achieving a positive clinical outcome. The article provides an algorithm for the management of patients with recurrent VVC, the principles of action of antifungal drugs, their acceptability and efficacy.
The effectiveness of a monopreparation containing a combination of ciprofloxacin – ornidazole in the treatment of infectious-inflammatory and dysbiotic vagina diseases
Authors: Bezhenar V. F. , Molchanov O. L. , Kukes I. V. , Meznikov A. A. , Galiullina L. A. , Zosimovskiy A. Yu. , Poznyak A. L.
Published: October 2021

Introduction. Infectious inflammatory and dysbiotic diseases of the vagina represent a major concern facing obstetric and gynecological science. Individually, the two most common specific diseases can be distinguished, namely: bacterial vaginosis (BV) and nonspecific vaginitis (NV). The therapeutic strategy for these diseases requires a word of clarification and adjustment.

Objective. To conduct a comparative analysis of treatment with the combination drug Orcepol WM (ciprofloxacin (500 mg) and ornidazole (500 mg)) and a combination of monopreparations in a dosage form similar to Orcepol WM.

Materials and methods. As a comparison object, we used the method of simultaneous administration by patients of tablet forms of ciprofloxacin and ornidazole as mono-preparations in a dosage of 500 mg similar to Orcepol. The study included 64 patients with diagnoses of “bacterial vaginosis” or “nonspecific vaginitis” or "decompensated mixed vaginal dysbiosis". The average age of the patients was 35.34 ± 5.95 years. The patients were divided into two groups: group 1 (n = 32) received the combination drug Orcepol WM, group 2 (n = 32) received ciprofloxacin and ornidazole with two mono-preparations. The drugs were prescribed as a five-day course, two times a day. The patients were followed up by a doctor during two visits and one remote interview on day 30–45 after the end of treatment (visit 2).

Results. In both groups, all patients received a full course of antibacterial therapy. There were no adverse drug reactions. In both groups, there was an improvement in clinical symptoms from the first to the second visit: discomfort, itching, burning, dyspareunia, hyperemia of the mucous membrane against the background of normalization of laboratory findings of the vaginal microbiocenosis condition. At the same time, the best results were higher in group 1. Manifestation of mycotic vaginitis with the development of strong clinical symptomatology on days 3 and 4 of treatment respectively were recorded in 4 (12.5%) patients from group 1 and 7 (21.9%) from group 2. The results of comparative observation showed that the number of relapses after the end of therapy were the same in group 1 (8 out of 32 patients, 25%) and in group 2 (9 out of 32 patients, 28%). The relapse occurred on average day 12 and 17 after the end of therapy, respectively.

Сonclusion. Thus, the use of Orcepol WM showed a greater therapeutic efficacy as compared to the use of tablet forms of ciprofloxacin and ornidazole in similar dosages as a single-drug administration, which can be explained by a stronger patients' adherence to the treatment.
Human papillomavirus-associated cervical intraepithelial neoplasia in the presence of iodine deficiency
Authors: Sahautdinova I. V. , Khamadianova A. U. , Balter R. B. , Ivanova T. V. , Ibragimova A. R.
Published: October 2021

Introduction. Cervical cancer holds one of the top positions in the oncological diseases ranking among the female population in the presence of iodine deficiency in the territory of the Republic of Bashkortostan. It's commonly believed that it is caused by the development of cervical intraepithelial neoplasia (CIN) associated with highly oncogenic strains of the human papillomavirus (HPV). The article pays special attention to the risk factors for the development of precancerous and cancerous diseases of the cervix and their timely treatment.

The aim of the study was to improve the diagnosis and therapy of HPV-associated CIN in the presence of iodine deficiency in the Republic of Bashkortostan.

Materials and methods. 256 women aged between 21 and 45 years with identified HPV-associated CIN I were enrolled in our study. The first stage of treatment known as preoperative was carried out in the outpatient setting. At stage 2, the patients were offered a radio-wave surgery treatment of the cervix.

Results and discussion. The video colposcope analysis showed that the average time of epithelialization of the cervix after exposure to the destruction depended on the age and duration of the disease. For instance, complete epithelialization of the cervix in the group of patients aged between 21 to 38 years was reported in 72% of cases by Day 40, and in 62% of cases in the group of 39-45 years old on Day 40. The complete elimination of the virus was observed in 236 patients out of 256 cases (92%) 70 days after the end of therapy.

Сonclusion. The study proves the effectiveness of the combination treatment of patients with HPV-associated CIN.
The role of antioxidants in the treatment of infertile men with varicocele
Authors: Shatylko T. V. , Gamidov S. I. , Popova A. Yu. , Bitsoev T. B.
Published: October 2021

Varicocele is a common disease that occurs in 35–40% of men with primary infertility and in 80% of men with secondary infertility Disturbance of microcirculation in the testicles, which occurs during varicocele, lead to ischemia and hypoxia of the testicles, which provoke degenerative changes in all testicular cell populations. Retrograde blood flow from the testicular vein and the external spermatic vein into pampiniform venous plexus leads to an increase of hydrostatic pressure in the testicular vascular system and rise of temperature, and it also contributes to the development of sterile inflammation. Oxidative stress, nitrosative stress, and hypoxia are generally recognized elements of the pathogenesis of infertility associated with varicocele. It is known that when the supraphysiological level of reactive oxygen species in the ejaculate is reached, their concentration disrupts the structure and function of spermatozoa. Nitric oxide (NO) is involved in the regulation of body temperature, NO-dependent mechanisms may contribute to the increased scrotal temperature during varicocele. The physiological concentration of NO pro duced by testicular macrophages stimulates steroidogenesis in Leydig cells. However, in the presence of certain reactive oxygen species, NO can transform into peroxynitrite and other strong cytotoxic metabolites, which lead to dysregulation of testosterone synthesis involved in spermatogenesis. Also, manifestations of varicocele among infertile men have decreased expression levels of the testis-specific heat-shock protein, HSPA2, and abnormal methylation of sperm DNA. Therefore, the use of combined anti oxidant supplements as part of adjuvant therapy after surgical treatment or as an independent application in some clinical cases appears to be an adequate strategy to optimize fertility in patients with varicocele. In this review, we evaluated the importance of various antioxidants, such as vitamin E, folic acid, carnitine, inositol, arginine, acetylcysteine, zinc, selenium in spermatogenesis and their effect on reproductive function during varicocele.
Analysis of the clinical efficiency of human menopausal gonadotropins in the assisted reproductive technology program
Authors: Drapkina Yu. A. , Makarova N. P. , Smolnikova V. Yu.
Published: October 2021

Introduction. Comparative analysis of urinary and recombinant gonadotropins is ongoing to improve the efficiency of assisted reproductive technology programs. Particular interest focused on the identification of individual groups of patients with maximal efficacy of using certain ovarian stimulation drugs in an assisted reproductive technology program.

Objective. To review the application of Menopur Multidose 1200 IU for ovarian stimulation in assisted reproductive technology protocols with gonadotropin-releasing hormone agonists (GnRH) or gonadotropin-releasing hormone antagonists (GnRH antagonists) in the current clinical practice.

Materials and methods. The study retrospectively enrolled 4,080 women aged 20-43 years. Ovarian stimulation in the Assisted Reproductive Technology program was performed using the GnRH antagonist protocol in 65.8% of patients and the GnRH agonist protocol with Menopur Multidose 1200 IU with or without the additional Menopur 75 IU in 34.2% of women.

Results. Clinical and laboratory data of the patients, stimulated cycle parameters, characteristics of the embryological stage, and results of the assisted reproductive technology program were analyzed. The frequency of obtaining degenerated oocytes did not exceed 5%. The relative number of blastocysts of good quality was 59.9%, while for patients in the older age group, the figure was 54.6. The average pregnancy rate in patients in the “Menopur Multidose 1200 IU p/k” group was 39.3%, which corresponds to high-performance indicators of the assisted reproductive technology program.

Conclusions. Administration of highly purified human menopausal gonadotropin (hMG) (Menopur Multidose 1200 IU) to stimulate ovarian function in patients of different ages is accompanied by an adequate number of mature oocytes, good quality blastocysts, and satisfactory clinical pregnancy rates. Thus, highly purified human menopausal gonadotropin is not inferior to recombinant follicle-stimulating hormone(r-FSH) concerning the efficacy of assisted reproductive technology programs.
Emergency contraception methods: efficacy, safety and acceptability
Authors: Abakarova P. R. , Gusakov K. I. , Dovletkhanova E. R. , Mezhevitinova E. A.
Published: October 2021

Prevention of unwanted pregnancies, abortions and their complications is one of the major problems of healthcare. The most effective method of unwanted pregnancies prevention is family planning with highly effective contraceptive methods. Currently number of unwanted pregnancies cases is still numerous. Problem of unwanted pregnancy cannot be solved completely with any method of contraception. Every fourth pregnancy in the world is considered as unplanned, more than half of them end in abortion, which can pose a threat to health of the patient. Overall, more than 90% of abortions are performed due to unwanted pregnancies. Emergency contraception continues to play an important role in family planning today. It is known that the effectiveness of emergency contraception decreases with the time after unprotected sex. Today a variety of emergency contraception methods exists, which allows individual approach to specific patient. The article presents the results of randomized clinical trials and meta-analyses evaluating all currently used methods of emergency contraception from the evidence-based point of view. The article also describes drugs specifics, features, and effects on the reproductive system.
Clinical-anamnestic features and life quality of patients with nodular and diffuse adenomyosis
Authors: Gorpenko A. A. , Chuprynin V. D. , Smolnova T. Yu. , Buralkina N. A.
Published: October 2021

Introduction.Adenomyosis remains one of the significant challenges in modern gynecology and affects a large number of women of reproductive age. The clinical presentation of adenomyosis is variable, with severity of symptoms depending on the form of the disease. In case of the occurrence of severe pelvic pain, dysmenorrhea and dyspareunia, the disease disrupts social functions and leads to a decrease in the patient’s quality of life.

Aim.To study clinical and anamnestic features and patient’s quality of life with diffuse and nodular forms of adenomyosis.

Materials and methods.The study included 126 patients with various forms of adenomyosis (45 patients with nodular adenomyosis (NAM), 81 with stage III – IV DAM). The control group included 20 patients with tubo-peritoneal factor of infertility, without adenomyosis based on the ultrasound and hysteroscopy findings. All patients underwent a comprehensive examination, including general clinical, instrumental and laboratory tests. The study included a comparative analysis of the obtained data and determination of the clinical and anamnestic characteristics of the patients with stage III – IV DAM as compared with the patients with NAM. We also studied the quality of life of patients with NAM and DAM on the basis of a specialized questionnaire on the study of the quality of life of patients with endometriosis – Endometriosis Health Profile, ENR-5+6. Statistical analysis and data processing were conducted using Microsoft Excel (version 16), Statistica 10.0, StatPlus 7.3, GraphPad Prism 9 software. Data processing was performed in accordance with the guidelines for medical and biological research.

Results and discussion.As compared with patients with nodular adenomyosis, the patients with stage III-IV diffuse adenomyosis are characterized by an older age (42.1 (4.6) and 34.6 (6.2) years, respectively; p <0.001), have a high prevalence of somatic (96 and 77%, respectively; p < 0.05) and gynecological pathology (79 and 51%, respectively; p < 0.001) in past medical history, a higher frequency of intrauterine manipulations (hysteroscopy, separate diagnostic curettage) (73 and 42%, respectively; p < 0.001) and medical abortions (52 and 28%, respectively, p < 0.001). Complaints of heavy menstruation, bloody vaginal discharge between periods, and intestinal symptoms had a special place among the complaints of such patients. Moderate to severe anemia, as a consequence of heavy menstrual bleeding, was also a frequent concomitant pathology.

Conclusions.Stage III-IV DAM is characterized by a more severe course and marked symptoms as compared with NAM, and significantly affects the patient’s quality of life.
Correlation analysis of clinical and medical history records of married couples receiving infertility treatment
Authors: Fedorov I. S. , Drapkina Ju. S. , Lobanova N. N. , Makarova N. P. , Timofeeva A. V.
Published: October 2021

Introduction. Despite the availability of general principles and regimens for ovarian stimulation on the assisted reproductive technology (ART) programs, an individual situational modification is required in each specific case.

Objective. To optimize the ovarian stimulation protocols on the ART program based on the clinical and medical history records of the married couple.

Materials and methods.The clinical and medical history records, as well as the stimulation cycle parameters of 60 married couples were analysed. The married couples enrolled in this study were diagnosed with infertility caused by tubo-peritoneal (44 married couples), male (5 married couples), combined factor (6 married couples), as well as external genital endometriosis combined with a male factor (3 married couples), and tubo-peritoneal factor (2 married couples). All married couples underwent IVF/ICSI procedures under the gonadotropin-releasing hormone antagonist (GnRH-ant) protocol and ovarian stimulation on day 2 or 3 of the menstrual cycle.

Results. All married couples were divided into two groups: 38 couples with a negative implantation result and 20 married couples with positive implantation results. The surgical removal of fallopian tubes has been shown to be inversely correlated with the duration of infertility. The use of hCG positively correlates to the ratio of mature oocytes and oocyte-cumulus complexes (OCC) and the onset of pregnancy. A reduced percentage of morphologically healthy sperm with an overall high concentration of sperm in the ejaculate can be interpreted as fertile sperm.

Conclusions. During ovarian stimulation on the ART program, special attention should be paid to the duration of stimulation, the types of interventions for triggering final oocyte maturation and the total gonadotropin dose. A differentiated approach to conducting the surgical removal of fallopian tubes is required. The reduced percentage of morphologically healthy sperm with an overall high concentration of sperm in the ejaculate serves as a favourable prognostic factor for the outcome of ART programs.
Modern approach to the treatment of patients with androgen-dependent dermatopathies
Authors: Manukhina E. I. , Gevorkyan M. A. , Safaryan I. R.
Published: October 2021

Introduction. About 10–20% of patients among women of reproductive age suffer from signs and symptoms of androgen excess in hyperandrogenism. Its skin symptoms may include hirsutism, acne, seborrhea and alopecia.

Aim. To assess the effect of cyproterone acetate on skin symptoms of hyperandrogenism and improvement in the patients’ quality of life after treatment.

Materials and methods. The study included 120 patients with skin symptoms of hyperandrogenism. The patients ranged in age from 18 to 35 years. The inclusion criteria were the main complaints of the patients as follows: acne, hirsutism and alopecia. The patients underwent a comprehensive clinical and laboratory examination. The drug of choice for the treatment of androgendependent dermatopathies was cyproterone acetate at a dose of 50–100 mg daily.

Results and discussion. All patients were divided into three groups: 44 (37%) patients with hirsutism, 55 (53%) with acne, 12 (10%) with alopecia. Moreover, 32 (27%) patients had a mix of symptoms at the same time. Such patients were assigned to one of the groups depending on the predominant complaint. All patients were prescribed cyproterone acetate at a dose of 50-100 mg once daily, depending on the severity of symptoms from day 1 to day 10 of the menstrual cycle, and 54 (52%) patients were prescribed cyproterone acetate 20 mg and ethinyl estradiol 35 mg from day 1 to day 21 of the menstrual cycle. The study showed stabilization of the psychoemotional state, relief of anxiety, depressive disorders, enhancement of self-esteem and sociability, and improvement of the quality of life in its various manifestations in the majority of patients after the treatment.

Сonclusion. When assessed using the dermatology life quality index questionnaires, all patients reported the stabilization of the psychoemotional state and the improvement in the quality of life after the treatment. The anxiety and depressive disorders decreased in 109 (91%) patients, which favourably influenced various areas of quality of life, enhanced self-esteem and sociability with a positive effect on personal relationships.
Myocarditis and pericarditis in association with COVID-19 mRNA-vaccination: cases from a regional pharmacovigilance centre
Authors: Istampoulouoglou Ioanna , Dimitriou Georgios , Späni Selina , Christ Andreas , Zimmermanns Barbara , Koechlin Sarah , Stoeckmann Oliver , Winterhalder Clemens , Marono David , Toma Valeriu , Leuppi-Taegtmeyer Anne B
Published: October 2021

In this article we summarize suspected adverse events following immunization (AEFI) of pericarditis, myocarditis and perimyocarditis that were reported by our regional pharmacovigilance centre after COVID-19 mRNA-vaccination and discuss their association with these vaccines. Seventeen cases were reported between March and July 2021. Of these, nine had perimyocarditis, five myocarditis and three pericarditis. Twelve patients were male (71 %). The median age was 38 years (range 17 - 88). The most commonly observed presenting symptom was acute chest pain (65%). While 47% of the patients were previously healthy, 53% had at least one pre-existing comorbidity, with hypertension being the most prevalent (24%). The European Society of Cardiology diagnostic criteria for the reported AEFIs were fulfilled in twelve cases (71%). The AEFIs occurred after the first vaccine dose in six cases (35%), after the second vaccine dose in ten cases (59%) and after both doses in one case (6%). The median latency of all AEFIs taken together was 14 days (range 1 - 28) after the first vaccination and 3 days (range 1 - 17) after the second one. All patients except one were hospitalized (94%) with a median length of stay of 7.5 days (range 3 - 13). The majority of patients (n = 11, 65%) did not experience any complications, and 13 (77%) of the patients were recovered or recovering at the time of discharge. In 16 of the 17 cases (94%), the association between the AEFI and mRNA-vaccination was considered possible by the pharmacovigilance centre.
Hypertriglyceridaemia: Contemporary management of a neglected cardiovascular risk factor
Authors: Khan Tina Z , Schatz Ulrike , Bornstein Stefan R , Barbir Mahmoud
Published: October 2021

Hypertriglyceridaemia represents one of the most prevalent lipid abnormalities, however it is often eclipsed by focus on LDL cholesterol and is frequently overlooked by clinicians, despite it being an important cardiovascular risk factor. For most patients, hypertriglyceridaemia arises from a combination of environmental factors and multiple genetic variations with small effects. Even in cases with apparent familial clustering of hypertriglyceridaemia, a monogenetic cause is rarely identified. Common secondary causes include obesity, uncontrolled diabetes, alcohol, and various commonly used drugs. Correction of these factors, along with lifestyle optimisation, should be prioritised prior to commencing medication.The goal of drug treatment is to reduce the risk of cardiovascular disease in those with moderate hypertriglyceridaemia and the risk of pancreatitis in those with severe hypertriglyceridaemia.Recent and ongoing trials demonstrate the important role of triglycerides (TG) in determining residual risk in patients with cardiovascular disease (CVD) already established on statin therapy. Novel and emerging data on omega-3 fatty acids (high-dose icosapent ethyl) and the selective PPAR modulator pemafibrate are eagerly awaited and may provide further clarity for clinicians in determining which patients will benefit from TG lowering and help inform clinical guidelines. There are numerous novel therapies on the horizon that reduce TG by decreasing the activity of proteins that inhibit lipoprotein lipase such as apolipoprotein C-III (including Volanesorsen which was recently approved in Germany) and ANGPTL 3/4 which may offer promise for the future.
Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation
Authors: Nagy Mohamed , Hosny Hatem , El Sawy Amr , Mahgoub Ahmed , Yacoub Magdi H
Published: October 2021

Background: There is a pressing need to improve early and long-term results of the Mustard operation. A modification of the operation was introduced at the Aswan Heart Centre for this purpose which relies on creating new functional atria rather than the two rigid channels in the classical Mustard operation.Objectives: To evaluate the morphology and function of the neo-atria, shortly after modified mustard operation for a ‘neglected’ patient with TGA, VSD and severe pulmonary hypertension.Methods: A 6-year-old with neglected TGA, VSD and pulmonary hypertension presented with severe cyanosis, clubbing and haemoconcentration (Hb 22 g/dL), underwent the modified Aswan-Mustard operation (MAM) with rapid smooth postoperative recovery. Repeated 2D echograms and multi-slice CT scans, followed by 3D segmentation, were performed after the operation. The size, shape, and morphology of the neo-atria were measured and measurements of the patterns of instantaneous filling and emptying of the right and left ventricles were quantified.Results: The neo-systemic venous atrium consisted of three components with a combined volume of 78 mL/m2, all of which contributed to the reservoir, conduit, and importantly contractile function of the neo-atrium. The pulmonary venous atrium consisted of two components with a combined volume of 66 mL/m2. These measurements were made at atrial end diastole. The volumes of the systemic venous and the pulmonary venous diminished to 51 and 54 mL/m2, respectively, at the end atrial systole - indicating relatively preserved contractile functions.
Anomalous origin of the left main from the right coronary sinus presenting with sudden cardiac death: utility of mechanical circulatory support
Authors: Al Hennawi Hussam Eddin T , Fahsah Ibrahim , Mathbout Mohammad F
Published: October 2021

Anomalies involving the origin of the coronary arteries are extremely rare, with the left main artery coronary artery (LMCA) originating from the right coronary sinus (RCS) one of its rarest forms. Anomalous origin of left main from right coronary sinus poses a high risk of sudden cardiac arrest. In our report, we shed light on the case of a 43-year-old female who suffered a witnessed cardiac arrest due to underlying anomalous origin of the left main artery from right coronary sinus. The patient was initially pronounced dead until return of spontaneous rhythm with concomitant myocardial infarction led to the diagnosis of anomalous coronary artery. This case stresses important points to consider when dealing with the acute management and chronic treatment plan for this subset of high-risk patients. We also consider the utility of mechanical circulatory support in management of this condition.
Performance analysis ofNidentical PVT-CPC collectors with an active single slope solar distiller and helically coiled heat exchanger using CuO nanoparticles
Authors: Dharamveer  , Samsher  , Kumar Anil
Published: October 2021

This paper presents performance analyses based on temperatures, thermal energy (overall), thermal exergy (overall), electrical exergy, and yield of the systems that have been investigated. In the present study, an analytical expression of N identical partly covered photovoltaic compound parabolic concentrator collectors connected in series (N-PVT-CPC-SS-HE) with an active single slope solar distiller unit and helically coiled heat exchanger has been found. The performance analyses of the proposed system have been executed for 0.25% concentration of CuO nanoparticles for collectors (N = 4), and fluid-flow rate 0.02 kg/s in 280 kg mass of basin fluid. The system's performance is compared with a previous system of N identical partly covered photovoltaic flat plate collectors connected in series (N-PVT-FPC-DS-HE) with an active double slope solar distiller unit and helically coiled heat exchanger. The thermal energy is 112,109.1 kWh, thermal exergy 312.07 kWh, and yield 3,615.05 kg annually. It is found that daily enhancement in thermal energy of the proposed system with CuO nanoparticles compared with the previous system with various nanofluids CuO, Al2O3, TiO2, and water is found to be 16.75%, 51.13%, 61.82%, and 80.67% more significant correspondingly. The enhancement in yield of the proposed system is obtained for CuO nanoparticles greater than the previous system with CuO by 11.19%, Al2O3 17.2%, TiO2 26.25%, and water 32.17%. The electrical exergy is almost the same as the previous system.
Modified bentonite as a conditioning agent for stabilising heavy metals and retaining nutrients in sewage sludge for agricultural uses
Authors: Cheng Yu , Chon Kangmin , Ren Xianghao , Li Meiling , Kou Yingying , Hwang Moon-Hyun , Chae Kyu-Jung
Published: October 2021

The management and disposal of excess sludge are emerging issues owing to the high costs associated with treatment. In this study, the viability of a modified bentonite was investigated as a conditioning agent for the stabilisation of heavy metals (i.e., Cu, Zn, Cr, Pb, and Cd) and the retention of nutrient species (i.e., total nitrogen (TN), total phosphorus (TP), available nitrogen (available N), and Olsen-phosphorus (Olsen-P)) in sewage sludge for agricultural use. Five grams of modified bentonite resulted in the highest stabilisation rate of heavy metals and strongly contributed to the stabilisation of heavy metals. However, increased amounts of modified bentonite might increase the TN, available N, and TP losses in the conditioned sewage sludge. Through the analytic hierarchy process modelling, optimal concentrations of nutrient species and heavy metals remaining in the conditioned sewage sludge were achieved when the ratio of bentonite to sewage sludge was 1:12.5 (4 g bentonite : 50 g sludge). Moreover, the optimal mixing ratio of the conditioned sewage sludge to the soil (1:2) was suggested for agricultural use. Based on these observations, modified bentonite allowed the sewage sludge to be used as a fertiliser in agriculture by stabilising heavy metals and retaining nutrient species.
Öğretmenlerin Kişilik Özellikleri ile Etkili İletişim Becerileri Arasındaki İlişkinin İncelenmesi
Authors: ÜNSAL Yasemin , İHTİYAROĞLU Neslin
Published: October 2021

Bu araştırmanın amacı, öğretmenlerin kişilik özelliklerinin etkili iletişim becerileri üzerindeki yordama rolünü incelemektir. İlişkisel tarama modelinin kullanıldığı bu araştırmada veriler, “Sıfatlara Dayalı Kişilik Testi” ve “Etkili İletişim Becerileri Ölçeği” ile elde edilmiştir. Verilerin analizinde parametrik testlerden t-testi, tek yönlü varyans analizi (ANOVA), korelasyon ve çoklu regresyon analizi kullanılmıştır. Korelasyon analizi sonuçlarına göre, kişilik özellikleri ile etkili iletişim becerileri arasındaki en yüksek ilişkilerin dışadönüklük ile empati, deneyime açıklık ile kendini tanıma-kendini açma ve yumuşak başlılık ile ben dilini kullanma düzeyleri arasında olduğu görülmüştür. Çoklu regresyon analizi sonuçlarına göre ise, duygusal dengesizlik/nevrotizm, dışadönüklük, deneyime açıklık ve yumuşak başlılık değişkenlerinin öğretmenlerin etkili iletişim becerilerinin %48 oranında anlamlı birer yordayıcısı olduğu saptanmıştır. Araştırmanın sonunda, öğretmenlerin olumlu kişilik özelliklerinin geliştirilmesine yönelik öneriler sunulmuştur.
Görsel Sanatlar Öğretmen Adaylarının Eleştirel Pedagoji Konularını Öğrenmeye Yönelik Görüşleri
Authors: TURHAN TÜRKKAN Buket , BORAN ŞENOCAK Belgin
Published: October 2021

Çalışmanın amacı, görsel sanatlar öğretmen adaylarının eleştirel pedagojiye yönelik konuları öğrenmeye ilişkin istek ve gereksinimlerini belirlemektir. Bu çalışma, nitel bağlamda gerçekleştirilen betimsel bir araştırmadır. Araştırmanın katılımcılarını belirlemek için kolay ulaşılabilir örnekleme yöntemi kullanılmıştır. Araştırmanın katılımcılarını 2015-2016 eğitim-öğretim yılında, Türkiye’nin güneyinde bulunan bir devlet üniversitesinde güzel sanatlar eğitimi bölümü resim-iş eğitimi anabilim dalında öğrenim görmekte olan sekiz öğretmen adayı oluşturmaktadır. Araştırmanın verilerinin toplanmasında yarı-yapılandırılmış görüşme tekniği kullanılmıştır. Araştırmanın verileri tümevarımsal analiz yaklaşımıyla çözümlenmiştir. Araştırmanın sonuçları doğrultusunda, öğretmen adaylarının eleştirel pedagojiye yönelik görüşlerinin genel olarak olumlu olduğu, eleştirel pedagojiye yönelik konuları öğrenmek istedikleri saptanmıştır. Bunun yanı sıra, öğretmen adaylarının, eleştirel pedagojiye yönelik konuları öğrenmenin çeşitli açılardan katkıları olacağını düşündükleri, eleştirel pedagoji konularını nasıl öğrenmek istediklerine yönelik görüşleri olduğu belirlenmiştir. Araştırma sonuçları doğrultusunda çeşitli öneriler geliştirilmiştir.
Lise Öğrencilerinin Kimya Dersine Yönelik Tutumları ve Kimya Bilgilerini Günlük Yaşam İle İlişkilendirme Dereceleri Üzerine “Bilimden Doğaya, Doğadan Bilime: Problemlere Çözümler” Projesinin Etkisi
Authors: BİLİR Volkan , KARAÇAM Sedat , DANIŞMAN Şahin
Published: October 2021

Bu çalışmanın amacı, TÜBİTAK 4004 Doğa Eğitimi ve Bilim Okulları programı kapsamında gerçekleştirilen “Bilimden Doğaya, Doğadan Bilime: Problemlere Çözümler” projesinde yapılan etkinliklerin, öğrencilerin kimya dersine yönelik tutumlarına ve dokuzuncu sınıf kimya dersinde kazandıkları bilgileri günlük yaşam ile ilişkilendirme derecelerine etkilerini belirlemektir. Araştırmada nicel araştırma yöntemlerinden kontrol grupsuz yarı deneysel desen kullanılmıştır. Araştırmanın çalışma grubunu 2017-2018 öğretim yılında Düzce ili merkez liselerinin dokuzuncu sınıfı bitiren ve araştırmaya gönüllü katılan 28 öğrenci oluşturmaktadır. Araştırmada öğrencilere fizik, kimya, biyoloji, çevre ve matematik alanlarında toplam 16 etkinlik yaptırılmıştır ve bu etkinliklerin 4’ü kimya ile ilgilidir. Etkinlikler, katılımcıların günlük yaşamlarında karşılaşabilecekleri problem durumlarına göz önüne alınarak, araştırma, sorgulama ve öğrenme isteklerinin tetiklenmesini sağlayacak biçimde hazırlanmıştır. Araştırmada veri toplama araçları olarak “Kimya Dersine Yönelik Tutum Ölçeği” ile kimya derslerinde edindikleri bilgileri günlük yaşamla ilişkilendirme derecelerine (“hiç ilişkili değil=1” ile “tamamen ilişkili =10”) göre değerlendirmelerinin istendiği bir anket kullanılmıştır. Bu veri toplama araçları araştırmanın başlangıcında ve sonunda katılımcılara uygulanarak veriler toplanmıştır. Toplanan veriler parametrik olmayan istatistik tekniklerinden bağımlı gruplar için kullanılan Wilcoxon İşaretli Sıralar Testi ile analiz edilmiştir. Araştırmada yapılan kimya alanındaki etkinliklerin, öğrencilerin kimya dersine yönelik tutumlarını olumlu yönde geliştirmede ve kimya dersinde edindikleri bilgileri günlük yaşamla ilişkilendirme derecelerini arttırmada olumlu etkisinin olduğu tespit edilmiştir.