Epidemiological analysis of the malignant tumors of the larynx in Belarus over 2000–2019

Objective. To analyze basic medico-statistical indices of the morbidity rates of the malignant tumors of the larynx in the Republic of Belarus.Materials and methods. Data of the Belarusian Cancer Register on all detected cases of the malignant tumors of the larynx in the Republic of Belarus over 2000-2019 served as the material of the study. The following rates were studied: age standardized morbidity, gross intensive morbidity, morbidity separately in the general population and working age population, in urban and rural population, males and females. All epidemiological indices for the periods 2000-2005 and 2015-2019 in the country and across the regions of the Republic of Belarus were compared.Results. The age standardized morbidity rate in Belarus increased from 4.2 cases/year per 100,000 population in 2000 to 5.8 in 2019. The gross intensive morbidity rate increased from 5.5 to 7.3, respectively. An increase in the morbidity rate from 4.0 in 2000 to 4.3 in 2019 was noted in the working age population. The gross intensive morbidity rates in males were on average 33.9 times higher than in females, and in the urban population – 1.7 times lower than those in the rural population. The maximal increase in the morbidity rate was registered in the working age population of rural areas – by 60.3% during the monitored period. A statistically significant increase in the morbidity rate was noted in the city of Minsk. The morbidity rates registered in Minsk were statistically significantly lower than those in the republic. In other regions, there was no significant difference in the morbidity rates and growth dynamics from the indices in Belarus as a whole.Conclusion. Malignant tumors of the larynx are characterized by a slow increase of the morbidity rate for the last 20 years in Belarus. The observed epidemiological trends deter

Analysis of in vitro activity of high dilutions of Euphorbia tirucalli L. in human melanoma cells

Aveloz (firestick cactus; Euphorbia tirucalli L.) belongs to Euphorbiaceae family, characterized by the production of a toxic latex that has corrosive effects on the skin and mucous membranes. Continual topic use of the latex is recommended by popular medicine to treat warts, and epitheliomas. To validate this indication, ultra diluted latex and homeopathic medicine Euphorbia tirucalli were tested in vitro on the proliferation of melanoma cells. Ultra diluted latex was prepared in homeopathic dilutions 5cH, 15cH and 30cH by dilution and agitation (trituration for solid and sucussion for liquid phases) using 70º GL (Gay Lussac) ethylic alcohol (70º GL EtOH 70ºGL) as inert medium according to the guidelines in Farmacopéia Homeopática Brasileira (FHB). Homeopathic medicine Euphorbia tirucalli was prepared from mother-tincture according to the centesimal Hahnemannian method. Solutions 0.5% and 5% of 70ºGL EtOH were succussed and used as control. Human melanoma cells were cultured, treated and monitored by method MTT for 24 to 72 hours. It was observed that 0.5% 70ºGL EtOH solution had little or no effect on the proliferation of melanoma cells (5.1% maximal inhibition in dilution 30cH). Positive correlation was observed in most groups between inhibition of proliferation and diluted preparations, maximal increase (9%) was seen in with 5% latex. Moreover, mother-tincture proved to be more active than latex; treatment with 0.5% solution of latex 30cH exhibited 19.7% inhibition, whereas treatment with 0.5% solution of Euphorbia tirucalli 30cH exhibited 32.1% inhibition of cell proliferation (p

Dietary Macronutrients Do Not Differently Influence Postprandial Serum and Plasma Brain-Derived Neurotrophic Factor Concentrations: A Randomized, Double-Blind, Controlled Cross-Over Trial

Objectives: Brain-derived neurotrophic factor (BDNF) plays a role in cognition and metabolism. Specific nutrients can affect fasting BDNF concentrations, which are potentially mediated by insulin and/or glucose. Since macronutrients trigger each a different insulin and glucose response, we examined postprandial effects of meals rich in fat, carbohydrates, or protein on BDNF concentrations. BDNF was analyzed in serum and plasma, since concentration differences can be found between matrices.Methods: Healthy overweight/obese male participants (n = 18) participated in this randomized, double-blind, cross-over trial consisting of three test days with 1 week wash-out periods. Either a high-fat (En% fat, carbohydrates, protein: 52.3, 39.2, 8.0), high-carbohydrate (En% 9.6, 81.5, 8.6) or high-protein meal (En% 10.6, 51.5, 36.9) was consumed on each test day. BDNF concentrations were measured after 0, 60, and 240 min. Glucose and insulin concentrations were measured after 0, 15, 30, 45, 60, 90, 120, and 240 min.Results: BDNF concentrations were higher in serum compared with plasma (P < 0.001). Postprandial BDNF concentrations in serum decreased significantly after the high-fat (P = 0.013) and high-carbohydrate meals (P = 0.040), and showed a trend after the high-protein meal (P = 0.076). No differences were found between meals (P = 0.66). Postprandial BDNF concentrations measured in plasma did not significantly change after the different meals (P = 0.47). As total area under the curve (AUC) for glucose was significantly higher after the high-carbohydrate meal compared with the high-fat (P = 0.003) and high-protein meals (P < 0.001), and the total AUC for insulin was higher after the high-carbohydrate (P < 0.001) and high-protein meals (P < 0.001) compared with the high-fat meal, it seems that acute changes in glucose and insulin do not affect postprandial BDNF concentrations. However, after the high-protein meal, the higher total AUC for glucose correlated with lower serum BDNF concentrations, and a higher maximal increase in glucose correlated with a lower maximal increase in plasma BDNF concentrations. There were no correlations with insulin concentrations after either meal.Conclusion: Serum BDNF concentrations were higher than plasma concentrations. Since postprandial BDNF responses were not different between the meals, we conclude that there is no role for insulin or glucose in regulating postprandial BDNF concentrations.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03139890].

Assessment of the absorbed doses in the fetus from the computed tomography of the chest for the pregnant women

The number and contribution of high dose imaging modalities, computed tomography in particular, is rapidly increasing both in the 'Russian Federation and other developed countries. Maximal increase in the number of computed tomography examinations in Russia was observed in 2020 due to the full-scale application of this imaging modality for the diagnostics of the novel coronavirus infection COVID-19. The use of computed tomography for the examination of the chest for the pregnant women is associated with several issues. An internationally accepted approach for the provision of the radiation safety of the pregnant patients is the assessment of the absorbed dose in the fetus after each X-ray examination. However, there are no existingn approved methods for the assessment of the absorbed dose in the fetus in the Russian Federation. The aim of the current study was to assess the doses in the fetus for the pregnant women undergoing computed tomography of the chest due to the COVID-19 and to estimate the probability of the development of the deterministic effects for the fetus. The study was based on the collection of the parameter of Russian and international computed tomography protocols. Parameters of the international computed tomography protocols were collected viameta-analysis of the existing publications; Russian protocols — via data collection in computed tomography departments in St-Petersburg hospitals. Absorbed dose in the uterus of the female patient and effective dose for the fetus were calculated using NCICT 3.0 software for 8, 10, 15, 20, 25, 30, 35 and 38 weeks of pregnancy. The results of the calculations indicate the lack of significant differences between absorbed doses in the uterus and effective doses for the fetus for all stages of pregnancy. Maximal doses for the selected computed tomog­ raphy protocols were in the range of 0.5 mGy (mSv) for 8-25 weeks, 0.6 mGy (mSv) for 30 week, 1.4 mGy (mSv) for 35 week and 2.7 mGy (mSv) for 38 week. The threshold for the development of the deterministic effects equal to 100 mGy cannot be exceeded even for repeated (10-15) computed tomography chest scans. Hence, the use of computed tomography as the primary method of COVID-19 diagnostics and staging will not be associated with the development of deterministic effects in the fetus.

Influence of Dispersed Oil on the Remote Sensing Reflectance—Field Experiment in the Baltic Sea

Remote sensing techniques currently used to detect oil spills have not yet demonstrated their applicability to dispersed forms of oil. However, oil droplets dispersed in seawater are known to modify the local optical properties and, consequently, the upwelling light flux. Theoretically possible, passive remote detection of oil droplets was never tested in the offshore conditions. This study presents a field experiment which demonstrates the capability of commercially available sensors to detect significant changes in the remote sensing reflectance Rrs of seawater polluted by six types of dispersed oils (two crude oils, cylinder lubricant, biodiesel, and two marine gear lubricants). The experiment was based on the comparison of the upwelling radiance Lu measured in a transparent tank floating in full immersion in seawater in the Southern Baltic Sea. The tank was first filled with natural seawater and then polluted by dispersed oils in five consecutive concentrations of 1–15 ppm. After addition of dispersed oils, spectra of Rrs noticeably increased and the maximal increase varied from 40% to over three-fold at the highest oil droplet concentration. Moreover, the most affected Rrs band ratios and band differences were analyzed and are discussed in the context of future construction of algorithms for dispersed oil detection.

Imaging of microvascular disease

Beside obstructive disease of the epicardial coronary arteries dysfunction of the coronary microvasculature has emerged in the past 20 years as an additional mechanism of myocardial ischaemia. The coronary microvasculature cannot be directly visualized in vivo, therefore, both invasive and non-invasive techniques, have been developed to assess parameters that depend directly on coronary microvascular function. Studies at the microcirculatory level entail the use of vasodilators to obtain near-maximal vasodilation. The ratio of the maximal increase of blood flow above its resting value the coronary flow reserve (CFR) allows to gain an insight into the integrated circulatory function. The diagnostic accuracy of imaging techniques can be exploited to detect impairments of myocardial perfusion in asymptomatic subjects with cardiovascular risk factors. The assessment of the coronary microvascular function has provided novel details on the pathophysiological role of coronary microvascular dysfunction in the development of myocardial ischaemia bearing also important prognostic implications.

Testing of Adrenal Axis Function in Patients With Combined Pituitary Hormone Deficiency Caused by PROP1 Mutation

Background: The mechanism of adrenal axis deterioration in PROP1 mutation remains uncertain and challenging. Aim: The aim of the project was to investigate the adrenal axis function in patients with combined pituitary function deficiency and PROP1 mutation. Methods: We performed the corticotrophin (CRH) stimulation test in 15 patients ((8W/7M) with confirmed CPHD due to the PROP1 mutation. 9/15 were familial cases from four families. Time of observation (ToO) was calculated since the first pituitary axis/ACTH insufficiency has occurred. The results were reported in the group with confirmed Adrenal Insufficiency (AI) and without AI defined as cortisol >18 ug/dl at any point during CRH test. ACTH is reported in pg/ml and cortisol in ug/dl, time of test is given in minutes (0‘, 15’,30’,45’,60’,120’). Results: The mean age of the group was 40,6 ± 12,1 years with mean 34,7 ± 10,3 years of CPHD observation (range 18 – 54 years). The In 5/15 the cortisol response met the criteria excluding AI. Among siblings there were patients both with/without AI. Both subgroups had similar ToO (without AI 35,6 ± 10,0 years vs 34,2 ± 10,3 years with AI). Mean time of AI duration was 15,0 ± 9,3 years. In the group of 5 patients without AI the mean morning cortisol was 12,48 ± 4,31 and ACTH was 31,26 ± 5,43. The mean maximal concentration of cortisol and ACTH were 24,94 ± 3,6 and 123,6 ± 39,9 respectively; Mean increase of cortisol was 12,46 ±4,04 and 92,34±34,48 for ACTH. In 10 patients with AI the mean morning cortisol was 3,33±1,39 and ACTH 22,71±6,75. The mean maximal concentration of cortisol and ACTH were 10,15±4,47 and 97,05 ± 59,15 respectively; Mean increase of cortisol was 6,83 ± 3,41 and 74,35 ± 53,72 for ACTH. For two patients high ACTH increase from 36,7 to 260 and from 28,65 to 112,0 was observed. Analysis of cortisol and ACTH response in both groups revealed that in group without AI the time of peak of ACTH was observed in 15’ (2/5) and 30’ (3/5) vs. in 15’(3/10), 30’(6/10) and 45’ in group with AI. The peak cortisol was observed in 30’, 45’ and 60’ (3/5) in group without AI vs 60’(6/10) or 120’ (4/10) in AI group. The mean maximal increase of ACTH was by 4,09±1,46 and 4,12±1,58 in AI group vs no AI group respectively. Conclusions: In patients with PROP1 mutation the adrenal axis can deteriorate long after other axis insufficiencies, however there are patients with no adrenal insufficiency even during lifelong observation. There is no specific order of deterioration even among affected siblings. In the vast majority of patients independently of cortisol increase there is ACTH response after CRH. Further studies on the pituitary function deterioration in patients with PROP1 mutation should be carried out to understand better the underlying mechanism and to set up the diagnostic timing and procedures.

CLINICAL AND LABORATORY PREDICTORS OF LATENT HERPESVIRUS INFECTION IN CHILDREN WITH ROTAVIRUS GASTROENTERITIS

To achieve the aim there has been examined 104 children aged 1–3 years with moderate and severe forms of intestinal infection of rotavirus etiology, for which they received appropriate treatment in Kharkiv Regional Children's Infectious Diseases Clinical Hospital. Patients were divided into 2 groups: 1 group — 33 children with no concomitant herpesvirus, and 2 groups — 71 patients with rotavirus gastroenteritis and latent herpesvirus infection, caused by cytomegalovirus, Epstein-Barr virus or human herpes virus 6. Children in examined groups were comparable by gender, age, severity of main disease and other parameters.Prognosis of latent herpesvirus infection was made by means of multiple binomial regression. Independent predictors of concomitant herpesvirus infection included maximal daily number of vomiting, maximal increase of body temperature, time of onset of catarrhal symptoms since beginning of disease, level of ketone bodies in urine, amount of leukocytes, rod-shaped neutrophils and eosinophils in common blood count during acute phase of disease. As a reference group, we used respective clinical and paraclinical indices of patients with rotavirus infection only. Accuracy of model is 81.73 %.

Role of cytokines in pathogenesis, diagnosis and efficiency evaluation of immunotherapy in various variants of sclerotic lichen in women

Our aim was to evaluate diagnostic and pathogenetic significance of plasma cytokines (IL-20, IL-23, IL-10, TNFα, IFNγ) in the patients with various clinical and histological variants of sclerotic lichen and to assess opportunity for their use as effectiveness criteria of immunotherapy for this disease using a drug based on eukaryotic deoxyribonucleic acid (Derinat). The prospective cohort study included assessment of the clinical manifestations (itching and dyspareunia) and measurement of blood cytokine contents (IL-20, IL-23, IL-10, TNFα, IFNγ) in women (n = 114) with various clinical variants of sclerotic lichen (atrophic, sclerotic and sclerotic-atrophic) before and after immunotherapy with a nucleic acid-based drug (Derinat). Derinat was chosen due to the fact of being an agonist of Toll-like receptors, and a number of immunoregulatory effects, including the ability to modulate cytokine production and to exert a positive influence upon regeneration processes. In addition, based on visual inspection, vulvoscopy and morphohistochemical examination results (evaluation criteria: skin thickness, number of collagen fibers, severity of fibrosis and sclerosis, etc.), the corresponding subgroups were classified within the II group, i.e., 2.1 (minimal sclerotic signs, n = 14), and 2.2 (pronounced sclerotic signs, n = 20). The control group consisted of conditionally healthy women, without history or presence of vulvar pathology (n = 30), with an age ranging from 20 to 50 years. Along with cytokine assessment by enzyme immunoassay, the study used the data of clinical examination (anamnesis collection, examination, palpation, vulvoscopy), as well as complex morphohistochemical evaluation of vulvar tissues. In atrophic variant, we have observed an increase in plasma IL-23 content, along with decreased TNFα; in lichen sclerosis, a maximal increase in IL-20, IL-23, and IFNγ was revealed; in sclerotic form of sclerotic lichen variant with severe sclerotic features, maximally enhanced IL-20, IL-23, TNFα, IFNγ, along with minimal levels of IL-10 was registered, as compared with other groups. Immunotherapy using Derinate resulted into significant reduction in the clinical manifestations in sclerotic lichen, i.e., itching of the vulva and dyspareunia, as well as normalization of cytokine indexes. Our studies have demonstrated an opportunity of using plasma concentrations of IL-20, IL-23, IL-10, TNFα, IFNγ as biomarkers of sclerotic lichen variants, and as laboratory criteria for efficiency of immunotherapy.

Association between multitarget tyrosine kinase inhibitors and changes in CT appearance of submucosal fat in the gastrointestinal tract

Introduction: Submucosal fat deposition (SMF) in the gastrointestinal tract can be seen in patients treated with vascular endothelial growth factor receptor multitarget tyrosine kinase inhibitors (mtTKIs). We aimed to assess the association between mtTKIs treatment and appearance of SMF on computed tomography (CT). Methods: We performed retrospective evaluation of patients who started mtTKI treatment between 2016 and 2018, with a comparison patient cohort treated with single-target tyrosine kinase inhibitors (stTKIs). SMF amount for each gastrointestinal tract segment (stomach, duodenum, jejunum, ileum, terminal ileum, right colon, left colon) was scored as follows: 0 = none; 1 = low amount (<2 mm thick); 2 = high amount (>2 mm layer). For each CT, segment scores were aggregated to create an SMF index (SMFI). Maximal increase in SMFI between pretreatment and posttreatment CTs was documented. SMF ⩾3 was defined as positive. Results: Forty patients treated with mtTKIs and 23 patients receiving stTKIs were included. Maximal increase in SMFI during treatment was 0–1 in 56/63 patients (89%) and 3–6 in 7/63 patients (11%). All patients with positive SMFI received mtTKIs compared to 0 patients treated with stTKIs (17.5% vs. 0%; p = 0.04). mtTKI treatment was associated with higher incidence of nausea/vomiting (4/7) and diarrhea (4/7) when positive SMF was noted, as compared to patients with negative SMF (6/33 patients each; p = 0.048). Conclusion: Gastrointestinal tract SMF deposition occurs in a considerable proportion of patients treated with mtTKIs with association to abdominal symptoms. This may be unique to mtTKIs and was not found in patients receiving stTKIs.