bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obesity, caesarean section, antibiotics and their impact on the distortion of the breast milk microbiota
Authors: Kuchina A. E. , Zakharova I. N. 
Published: April 2022

The autonomous regulation of the composition of breast milk according to the baby’s needs is perhaps the most unique and mysterious mechanism. Under physiological conditions, the first drops of milk are rich in antioxidants that the newborn needs to combat oxygen deprivation. Milk to nourish boys is more nutritious and night milk is rich in melatonin, which can soothe and put the baby to sleep. Unfortunately, the conditions surrounding a pregnant woman and her newborn baby are not always natural. Many external factors are considered in the context of the risk of adverse effects on the health of the mother and the baby. This article discusses the most common factors that distort the microbiota of breast milk: obesity, delivery mode and antibiotic prophylaxis. Caesarean section, which significantly depletes the bacterial diversity of breast milk, is reported to be the most important factor. The associated disruption of microbial colonisation in infancy leads to a high risk of inflammatory bowel disease (including Crohn’s disease and ulcerative colitis), diabetes mellitus, rheumatoid arthritis and celiac disease in children. However, there is another opinion that attributes all the consequences of caesarean section to the necessary preoperative antibiotic prophylaxis in most countries. Maternal obesity also leads to low microbial diversity and impoverishment of breast milk with members of the Bifidobacterium genus, which in turn leads to reduced immunomodulatory potential of breast milk in these women. Often these three factors constitute a vicious circle of problems that interfere with the natural and proper process of forming a healthy microbiome in the newborn and require individualised and professional paediatric care.
Current guidelines for the selection of an antibacterial drug in children with community-acquired pneumonia
Authors: Zaytseva S. V. , Zaytseva O. V. 
Published: April 2022

The COVID-19 pandemic has affected the incidence of acute respiratory infections in the modern world. Despite the growing etiological significance of viruses in the structure of infectious diseases, the importance of bacterial pathogens in the development of respiratory pathology remains. The risk of unreasonable prescription of antibacterial drugs increases. The irrational use of antibacterial drugs has affected the spread of microorganisms with high resistance to antibiotics. The article presents current knowledge on the role of the most common pathogens of community-acquired pneumonia in children, data concerning the S. pneumoniae strain with reduced sensitivity and resistance to penicillin, macrolides. Information about isolates of S. Pneumoniae with decreased susceptibility to third-generation parenteral cephalosporins (cefotaxime and ceftriaxone) have appeared. The number of β-lactamase-producing strains of H. influenzae resistant to unprotected aminopenicillins is rising. The main steps of the diagnostic process of community-acquired pneumonia approved in the clinical guidelines for community-acquired pneumonia in children in 2022, which were adopted by the Russian Ministry of Health, are considered. This document sets out clear algorithms for diagnosing and selecting antibacterial therapy in children on an outpatient basis. Algorithms for selecting initial antibacterial therapy in outpatient settings are also proposed. In most cases, S. pneumoniae is a causative agent of community-acquired pneumonia in children, which defines the selection of an initial antibacterial drug. According to the clinical guidelines, oral amoxicillin at a standard dose of 45–55 mg/kg/day given in 2–3 divided doses is such a drug for children aged 3 months and older. Particular attention is paid to amoxicillin in the form of dispersible tablets.
Efficacy of adding systemic glucocorticosteroids to standard therapy in adolescents with severe acne: a randomized controlled trial
Authors: Kruglova L. S. , Gryazeva N. V. , Tamrazova A. V. 
Published: April 2022

Introduction. Isotretinoin is the first-choice drug in the treatment of severe forms of acne vulgaris. The combination of systemic retinoids with durant corticosteroids helps to reduce the likelihood of developing “retinoic” dermatitis and exacerbation of acne in the initial stages of isotretinoin therapy.Purpose of the study. Determination of the effectiveness of the combined use of isotretinoin and a durant corticosteroid in the treatment of severe forms of acne vulgaris.Materials and methods. Twenty six patients with “severe” or “very severe” grade on the IGA scale were included in this randomised, controlled comparative study. Thirteen patients (group A) were treated with isotretinoin 0.5 mg/kg/day (cumulative dose from 120 to 150 mg/kg) for 8 months and 2 injections of betamethasone dipropionate + betamethasone sodium phosphate at dose 1 ml (2 mg + 5 mg/1 ml) at first month (1 injection per two weeks) and thirteen patients (group B) were treated with combined therapy with isotretinoin at a dose of 0.5 mg/kg/day (cumulative dose from 120 to 150 mg/kg) for 8 months and assessment was based on the IGA scale, counting the number of inflammatory and non-inflammatory elements, indicators DIA (dermatological index of acne) and DLQI and was done at baseline, 1, 4 and 8 months of treatment.Results. At month 8, compared to group B, group A showed more significant decrease in IGA score and 76% patients achieved “clear” or “almost clear skin” degree (76% vs. 30%). The reduction in the number of inflammatory and non-inflammatory elements showed a marked clinical improvement in group A (89.2% vs 22.3 % for nodules). The decrease in DIA was 88.3% in group A and 71.3% in group B. Exacerbations of acne were recorded in 0% (group A) vs 38.0% (group B) of patients. We also found a relationship between the achievement of a 2-point reduction in the degree on the IGA scale after 8 months and the presence of exacerbations while taking isotretinoin (p = 0.012). Analyzing the DLQI between the two, we were unable to identify statistically significant differences.Conclusions. Combines use of long acting steroid with isotretinoin provides synergic effect while minimizing the side effect of isotretinoin (decreases the number of exacerbations), demonstrates a visible effect to patients within a month, thereby increasing compliance, improving the quality of life and reducing the risk of scarring.
Changes in cornea structure after corneal collagen crosslinking in keratoconus
Authors: Avetisov S. E. , Bubnova I. A. , Surnina Z. V. , Averich V. V. , Sarkisova K. G. 
Published: April 2022

Introduction. The article considers an objective assessment of the state of morphofunctional status of cornea in keratoconus after a corneal collagen crosslinking procedure.Aim. To assess changes in cornea structure after corneal collagen crosslinking in keratoconus. Materials and methods. The study included 24 patients: 30 eyes with KC stage I–III aged 17 to 42 years. The patients were examined before and after the corneal collagen crosslinking procedure. The postoperative follow-up period was 12 months. The patients underwent anterior segment OCT (AS-OCT) imaging to assess the demarcation line depth. The cornea and cornea nerve fibers were assessed layer-by-layer using сonfocal laser scanning microscopy, followed by the analysis of resulting confocal images through the author’s analysis algorithm.Results and discussion. The epithelialization of the cornea completed on day 3–5 after the procedure. According to OCT findings, the depth of the demarcation line averaged to 260 µm in the center and 140 µm in the periphery. The pronounced edema of the outer stroma was observed during the first-week follow-up, and a decrease in the density and apoptosis of keratocytes was noted during the first month. Over a 3–12-month postoperative follow-up period, the transient lacunar edema regressed and the density of keratocytes was restored to the baseline level. During the first three months, a pronounced disruption of the direction and structure of the cornea nerve fibres is seen.Conclusion. The crosslinking procedure results in changes in the cornea structure, one of which is appearance of the demarcation line in the stroma, which indicates the depth of penetration of the photochemical corneal collagen crosslinking process. The laser corneal confocal microscopy allows to objectively assess the depth of this effect, while the values obtained in the same follow-up periods are comparable with the findings of OCT imaging.
New opportunities in the treatment of asthenic symptoms after a new coronavirus infection
Authors: Shishkova V. N. , Martynov A. I. 
Published: April 2022

Introduction. Asthenia is an urgent problem during the pandemic of new coronavirus infection (COVID-19) because of its high frequency regardless of the severity of the disease.The purpose of this subanalysis of data from the multicenter controlled randomized clinical trial TONUS was to evaluate the efficacy and safety of meldonium therapy for аsthenia in COVID-19 survivors.Materials and methods. A total of 880 patients with asthenia who underwent COVID-19 within the last 6 months were included in the analysis. The efficacy of asthenia therapy was assessed by the MFI-20 scale, Schulte tables, and the General Clinical Impression (CGI) scale. All patients were previously randomized in two parallel branches of the TONUS study, including patients without concomitant disease in TONUS-1 (who received meldonium 500 mg/day for 14 days in the main group) and patients with cardiovascular or cerebrovascular disease in TONUS-2, who received meldonium at a dose of 1000 mg/day for 42 days in the main group. In both arms of the study, the drugs in the comparison groups were multivitamin complexes.Results. For the TONUS-1 groups.In the group of patients receiving meldonium compared with the control group (p < 0.001): total MFI-20 score decreased and was 31 (25; 40); MFI-20 –35 (–46; 23); performance value –5 (–11; –2) seconds; proportion of patients with significant improvement (by CGI-I) by the end of follow-up was 92.8%. For TONUS-2 groups.In the group of patients receiving meldonium compared with the control group (p < 0.001): total MFI-20 score decreased to 35 (27; 44); MFI-20 –34 (–46; –21), performance value –5 (–11; –2), proportion of patients with significant improvement (by CGI-I) by end of follow-up – 90.8%.Conclusion. Significant positive dynamics and regression of asthenia were noted in the groups of patients receiving meldonium in comparison with the control groups.
Scoliotic deformity of the spine: epidemiology, classification, surgical treatment, prediction and correction of intraoperative blood loss
Authors: Smirnov I. V. , Rojtberg G. E. , Lazarev V. V. , Buralkina N. A. , Batyrova Z. K. 
Published: April 2022

In this review are discussed the most important questions of diagnostics, surgical treatment and complications in the context of anaesthesia choice and performance in children and adolescents with different variants of vertebral scoliotic deformity. Vertebral scoliotic deformity is a multi-etiological disease and significant clinical problem due to frequency and severity of complications when disease progresses. Surgery is performed in severe and super severe scoliotic deformity when conservative treatment is not effective. Surgical treatment of severe scoliotic deformity allows to improve physiological function of vertebral column and internal organs’ function, improve quality of life and increase life expectancy. Surgical treatment of severe scoliotic deformity is one of the most complex problem in traumatology and orthopedics which requires multidisciplinary coordination of surgeon, anesthesiologist, narrow specialists and the patient at every step of treatment. The most significant problems in surgical treatment of severe scoliotic deformity are forecasting and blood loss management during the operation and in post-operative care which could reach several circulating blood volumes. The problems of blood loss minimization are discussed: patient’s position on operating table, acute normovolemic haemodilution, managed hypotension, use of antifibrinolythic medications, blood collection and re-infusion, blood transfusion. Blood loss forecasting is an important instrument to get a proactive information to develop personalized approach to patient’s care with assessment of intraoperative blood loss, risk of hemorrhagic shock and disseminated intravascular coagulation syndrome.
Streptococcal toxic shock syndrome in an adolescent
Authors: Ryzhakova N. A. , Krivonogova T. S. , Golikova E. V. , Zhelev V. A. , Loshkova E. V. , Terentyeva A. A. , Solnyshko A. L. , Vaganova T. V. , Liulka T. S. 
Published: April 2022

A special form of streptococcal infection is streptococcal toxic shock syndrome (STS), characterized by rapid development of symptoms and high mortality. Patient O., 14 years old, was taken to the infectious diseases department of OGAUZ DBNo. 1 by the SMP team with complaints of shortness of breath, vomiting, loose stools in a state of moderate severity due to intoxication syndrome. Diagnosis upon admission: Acute infectious gastroenteritis of moderate severity. Acute respiratory infections rhinopharyngitis, acute bronchitis, pneumonia (?), DN1. During examination in the UAC, anemia, leukocytosis, acceleration of ESR, in the biochemical blood analysis – an increase in CRP, in the coagulogram — increased INR, APTT, RFMC, decreased PTI, in urine tests – protein, erythrocytes, on the X–ray — bilateral pleural effusion, in the tank. sputum culture — Streptoccocus oralis 10/3 KOE/ml, PCR SARS-CoV-2: negative, blood test for antistreptolysin-O (ASL-O): 800 IU/ml (norm up to 200 IU/ml), blood for sterility 19.05.20: no bacterial microflora growth was detected. After receiving laboratory data, the diagnosis was made: Acute glomerulonephritis?, Аcute intestinal infection. Double-sided hydrothorax. Internal combustion engine. Anemia of the 1st degree. The final diagnosis: Acute post-streptococcal glomerulonephritis with a debut in the form of streptococcal toxic shock syndrome, a period of extensive clinical and laboratory changes, with a decrease in the debut of kidney function in the form of acute renal failure, recovery period. Against the background of the treatment (2 courses of antibiotic therapy (cefotaxime, amoxicillin), infusion therapy, pulse therapy with metipred (5 pulses), double transfusion of freshly frozen plasma, prednisone, lasix, veroshpiron, enap, curantil, heparin, and other accompanying therapy), pronounced positive clinical and laboratory dynamics was noted. She was hospitalized for 43 days, of which 9 days were in the intensive care unit (5 days on a ventilator). On the 44th day, the child was discharged in a satisfactory condition with recommendations under the supervision of a pediatrician, a pediatric nephrologist at the place of residence
Fosfomycin in antibiotic prophylaxis of infectious complications after biopsy of the prostate
Authors: Grigoriev N. A. , Abdullin I. I. , Loginov A. V. , Zhilyaev E. V. 
Published: April 2022

Introduction. Biopsy of prostate is a routine urologic procedure. More than 1 million biopsies are performed worldwide annually. The frequency of infectious-inflammatory complications remain high, despite the recommended antibiotic prophylaxis schemes.Aim. The evaluation of effectiveness and safety of combined antimicrobial prophylaxis: Fosfomycin and Fluoroquinolones of 3rd generation.Materials and methods. 80 patients underwent prostate biopsy in our study and were divided into 2 groups: the first group of 40 patients received routine prophylaxis: Levofloxacin 500 mg 6 hours before the biopsy and 500 mg per day during 4 days after biopsy. The second group of 40 patients, along with standard prophylaxis as in the first group, additionally after biopsy received Fosfomycin 3 gr single-shot.Results and discussion. In the first group, infectious and inflammatory complications occurred in 8 patients (20%). 12.5% of patients from the first group were hospitalized for paranteral antibiotic therapy. The average length of stay in hospital was 3.4 ± 1.45 days. In all cases, in the first group of patients, E. coli was detected, in 70% of cases fluoroquinolone-resistant strain of the bacterium was received. In the second group of patients now hospitalization was required. One patient out of forty (2.5%) from this group showed signs of urinary tract infection, which was not accompanied by an increase of body temperature, as well as changes in blood and urine tests.Conclusion. Our results show good effectiveness and safety of fosfomicin for antibiotic prophylaxis for transrectal prostate biopsy.
The Role of Heat Shock Protein 27 in Carcinogenesis and Treatment of Colorectal
Cancer
Authors: Asgharzadeh Fereshteh , Moradi-Marjaneh Reyhaneh , Marjaneh Mahdi Moradi 
Published: April 2022

Abstract:
The incidence of colorectal cancer (CRC) has significantly increased in recent decades, which has made this disease an important global health issue. Despite many efforts, there is no useful prognostic or diagnostic biomarker for CRC. Heat shock protein 27 (Hsp27) is one of the most studied members of Hsp family. It has attracted particular attention in CRC pathogenesis, since it is involved in fundamental cell functions for cell survival. Evidence show that Hsp27 plays important roles in CRC progression and metastasis. Hsp27 overexpression has been observed in CRC and suggested to be associated with CRC poor prognosis. In the present review, we focus on the current knowledge on the role of Hsp27 in CRC carcinogenesis and the underlying mechanisms. In addition, we discuss the value of targeting Hsp27 in CRC treatment.
A Combined QSAR and Molecular Docking Approach for Identifying Pyrimidine Derivatives as Penicillin Binding Protein Inhibitors
Authors: Sharma Smriti , Sharma Brij K. , Jain Surabhi , Gulyani Puja 
Published: April 2022

Background:Antimicrobial resistance has been rising continuously in the past few years due to the overuse and exploitation of existing antimicrobials. This has motivated the search for a novel scaffold that has the capability of rapid antimicrobial action. The hybridized pyrimidines have attracted us due to their widespread biological activities, such as anti-bacterial and antifungal activities.Objective:The present study incorporates a series of pyrimidine-based antimicrobial agents for the 2D quantitative structure-activity relationship analysis (2D QSAR) and docking analysis.Methods:The exploration of the chemical structures in combination with the biological activity in CPMLR led to the detection of six descriptors (Constitutional descriptors, Topological descriptors, Modified Burden Eigenvalues and 2D autocorrelations) for modeling the activity. The resulted QSAR model has been validated using combinatorial protocol in multiple linear regression (CP-MLR) and partial least squares (PLS) analysis.Methods:The exploration of the chemical structures in combination with the biological activity in CPMLR led to the detection of six descriptors (Constitutional descriptors, Topological descriptors, Modified Burden Eigenvalues and 2D autocorrelations) for modeling the activity. The resulted QSAR model has been validated using a combinatorial protocol in multiple linear regression (CP-MLR) and partial least squares (PLS) analysis.Results:The best QSAR model displays the r2 t value of 0.594, Q2 LOO value of 0.779, Q2 L5O value of 0.767. Further docking study was executed using Autodock Vina against Penicillin-binding protein (PBP2a).Conclusion:From the results, Compounds 4, 11and 24 were found to possess a good binding affinity towards PBP2a.
Peripheral Vascular Disease is Associated with Impaired Activities of
Daily Living in the Elderly with Dementia: A Prospective Study
Authors: Safer Umut , Naharci Mehmet Ilkin , Tasci Ilker , Safer Vildan Binay 
Published: April 2022

Background:
Although distinct disorders, peripheral vascular disease (PVD) and dementia
are both associated with a progressive decline in activities of daily living in elderly patients.

Objective:
This study aimed to compare the functional performance scores between elderly patients
with and without dementia and with or without PVD.

Methods:
Patients with Alzheimer’s disease, vascular dementia, and mixed type dementia and controls
were prospectively enrolled. Functional performance scores for basic activities of daily living (BADL)
and instrumental activities of daily living (IADL) were evaluated using the Barthel scale and Lawton
scale, respectively. PVD was diagnosed using the ankle brachial index (ABI).

Results:
Controls without PVD were age- and sex-matched with 57 patients with both dementia and
PVD and with 69 patients without dementia. The patients with PVD in both groups had lower mean
BALD scores. Adjusting for age, clinical dementia rating, and depression, PVD was associated with a
higher likelihood of being in the quartiles of lower BADL scores in those with dementia (p=0.020).
Adjusting for age, sex, Mini-Mental State Examination (MMSE) score, depression, and comorbidity
and drug counts among the patients without dementia, a significant association was observed with
PVD and a higher likelihood of being in the quartiles of lower BADL scores (p=0.044). PVD was
related to a higher likelihood of being in the quartiles of lower IADL scores in the non-dementia subjects
(p=0.001) after adjusting for age, depression, MMSE, education, and comorbidity count.

Conclusion:
PVD presence determined the poorer status of BADL in demented individuals but not of
the level of IADL. It is still unclear whether modifying PVD health risks and undergoing ABI screening
may help demented people become more independent.
A Case Series of Hypertrophic Cardiomyopathy Conducted in Vietnam Revealing a Novel Pathogenic Variant of the TNNT2 Gene
Authors: Pham Hung Manh , Tran Van Khanh , Mai Trung Anh , Luong Long Hoang , Le Pham May , Nguyen Chi Khanh , Nguyen Hoai Thu Thi , Pham Minh Nhat , Thuy Can , Le Thanh Tuan , Van Ta Thanh , Tran Thinh Huy 
Published: April 2022

Background:
Hypertrophic Cardiomyopathy (HCM) is one of the leading causes of sudden cardiac death in adults.HCM is inherited in an autosomal dominant manner; however, the genetic etiology of the disease is not fully explained and studies on the hereditary characteristics in family trees are still underway.

Methods:
Ten HCM patients and 31 of their relatives were recruited. Targeted sequencing for 4 HCM related-genes, including MYH7, MYBPC3, TNNT2, and TNNI3, using targeted next-generation sequencing (NGS) was carried out. Demographic, clinical, electrocardiography, and echocardiography characteristics were also characterized.

Results:
Among the 10 HCM patients, 5 were identified with the HCM pathogenic variants in MYH7 (3 patients), MYBPC3 (1 patient), and TNNT2 (1 patient) genes. Eleven out of 31 relatives from these 5 genotype-positive patients carried the same pathogenic variants. We found the novel c.822-2 A>G variant in the splicing site of the TNNT2 gene responsible for HCM disease in a family with 7 subjects genotype positive and 3 others who suffered from sudden cardiac death.

Conclusion:
This case series highlighted the importance of genetic testing for clinically confirmed HCM patients and family members. The genetic information can be used as a molecular marker to complement the clinical presentation in the diagnosis of HCM, as well as a prognostic tool for the patients and their family members.