Microbiota of fetal membranes in intact amniotic sac and full-term pregnancy

Aim of research. To study the microbial landscape of intact fetal membranes in full-term pregnancy. Materials and methods. In 19 pregnant women (mean age — 31.0 ± 5.3 years, mean gestational age — 39.3 ± 0.65 weeks) with intact fetal membranes, the fetal membrane tissue was collected during elective cesarean section to detect by polymerase chain reaction the following microorganisms: Lactobacillus spp., Enterobacteriaceae, Streptococcus spp., Staphylococcus spp., Gardnerella vaginalis/Prevotella bivia/Porphyromonas spp., Eubacterium spp., Sneathia spp./Leptotrihia spp./ Fusobacterium spp., Megasphaera spp./Veillonella spp./ Dialister spp., Lachnobacterium spp./Clostridium spp., Mobiluncus spp./Corynebacterium spp., Peptostreptococcus spp., Atopobium vaginae, Mycoplasma hominis, Ureaplasma (urealyticum + parvum), Candida spp., Mycoplasma genitalium. Results. Sterile membranes were found in 5 pregnant women (26.3%), in the remaining cases, the total bacterial load (TBL) was 104.5 (103.5–105.8) genome equivalents (GE) per sample. Representatives of the Enterobacteriaceae family prevailed — 104.5 GE per sample on average, only in one case Candida spp. were detected. In 42.1% of cases, when determining TBL, specific types of microorganisms were not identified. Conclusion. On the fetal membranes in full-term pregnancy, the average TBL corresponding to 104.5 (103.5–105.8) GE per sample, in which Enterobacteriaceae prevail in the amount of 104.5 GE per sample on average, is acceptable.

Immunomodulating properties of the probiotic preparation, VedaBiotic in aging

The homeostatic immunological dialogue between the host and its microbiota is critical to maintaining health. The weakening of the organism occurring with age, its greater dependence on the external life conditions, make old age the period of the greatest morbidity. In the context of a progressive increase in life expectancy, more and more attention is being paid to the possibility of influencing human health through personalized nutritional and therapeutic strategies aimed at modifying the intestinal microbiota, which include the use of pro- and prebiotics. The aim of this work is to study the effect of the VedaBiotic preparation, which is an original complex of probiotics (freeze-dried biomass of live active bifidobacteria, lactobacilli, Streptococcus thermophilus), prebiotics (microcrystalline cellulose, lactulose) and vitamin C, on the cellular immune response and functional activity of immunocytes in age-dependent mammals (male mice at the age of 10 months). It was found that in age-dependent mammals, a course administration of the drug leads to the stimulation of the proliferative activity of immunocytes and the cellular immune response, also including the case of the induced immunosuppression (when the delayed-type hypersensitivity reaction increased to the level observed in intact animals of similar age). The VedaBiotic also has a modulating effect on the cytokines production, causing a decrease in the pro-inflammatory cytokines IL-1β and IFN-γ, and an increase in the anti-inflammatory cytokine IL-10. Thus, the VedaBiotic preparation has a favorable immunomodulatory effect and can be used as a nutritional supplement — as a source of probiotic microorganisms — to reduce the negative side effects of cytostatic treatment, as well as by elderly persons to improve the quality of life and to prevent the development of age-associated pathology.

The effect of bee venom and hyperthermia on the lipoperoxidation and antioxidant activity of the blood of tumor-bearing animals

Introduction. Nowadays, it has been shown that one of the possible ways to increase the effectiveness of the treatment of malignant tumors is the use of combined treatment methods. Aim. To study the intensity of lipid peroxidation (LPO) and the activity of superoxide dismutase (SOD) in hyperthermia against the background of bee venom in the blood of tumor-bearing rats. Materials and methods. The experimental animals were divided into 5 groups: 1st — intact; 2nd — control (tumor-bearing animals (PS-1 tumor strain) with intraperitoneal (IP) administration of saline solution); 3rd, 4th and 5th groups — tumor-bearing animals with IP administration of 0.5 ml of bee venom against the background of hyperthermia 42, 43 and 44°C respectively. The content of diene and triene conjugates, Schiff bases (SB) and SOD activity in the blood of animals was determined. Results. From the 1st day after the end of the experiment, a statistically significant decrease in triene conjugates was recorded in all experimental groups compared to the control group. SB decreased on the 1st–7th day after the end of the experiment with the action of hyperthermia 42°C and bee venom, on the 7th–28th day — with the action of hyperthermia 43°C and bee venom, and on the 28th day — with the action of bee venom and hyperthermia 44°C, which was accompanied by an increase in SOD activity from the 7th day in all experimental groups compared to the control group. Conclusion. Hyperthermia in combination with the action of bee venom causes a decrease in lipid peroxidation products and an increase in antioxidant activity in the blood of tumor-bearing rats. The most effective action, in our opinion, is the use of bee venom against the background of hyperthermia of 43°C, at which a prolonged effect is recorded both with respect to a decrease in the concentration of SB and an increase in the activity of SOD.

Predictive capabilities of the Gastrointestinal Symptom Rating Scale in the eradication of Helicobacter pylori in patients with type 2 diabetes mellitus

The study aimed to determine the predictive capabilities of the Gastrointestinal Symptom Rating Scale (GSRS) for assessing the effectiveness of eradication therapy in Helicobacter pylori (HP) infected patients with type 2 diabetes mellitus. The study involved 60 patients of both sexes with a diagnosis of type 2 diabetes mellitus and chronic HP-associated gastritis, the average age of patients was 61.9 years, average duration of type 2 diabetes was 10.1 years. For statistical analysis of the data, we used the method of constructing ROC curves, which allowed us to identify prognostic factors (in this case, gastroenterological syndromes, such as abdominal pain, refl ux, indigestion, diarrhea and constipation) that influence the effectiveness of eradication therapy in patients with type 2 diabetes. It was found that high values of refl ux and indigestion syndromes scales of the GSRS are associated with the probability of low eradication therapy response in patients with type 2 diabetes, i.e. these syndromes can act as complicating factors for the elimination of Helicobacter pylori. The obtained data suggest the need for screening diagnostics of Helicobacter pylori, clinical manifestations of gastrointestinal pathology and subsequent etiological and pathogenetic treatment.

ISCHEMIA trial. The relationship between medical and interventional approach to stable ischemic heart disease treatment. Myocardial ischemia with non-obstructive coronary arteries (INOCA)

Introduction. Approaches to the stable coronary heart disease (CHD) treatment have been the subject to debate a long time. One of the fi rst and fundamental studies in the treatment of stable coronary heart disease patients is the COURAGE trial, which showed the advantage of rational drug therapy in comparison with percutaneous intervention in such patients. However, the CHD high prevalence with medical and social signifi cance necessitate the future consideration of the relationship between medical, that is conservative, and invasive approaches in treatment of this disease. It was particularly the focus of the recently completed multicentre ISCHEMIA trial. Another urgent problem of modern cardiology is myocardial ischemia in non-obstructive (<50% luminal occlusion) coronary arteries (INOCA) identifi ed in approximately 70% of patients who underwent coronary angiography. Aim of the research. Analysis of the available data on the management of stable CHD patients based on the ISCHEMIA trial data and review of publications on the INOCA problem. Results. In the ISCHEMIA trial, the occurrence rate of the primary outcome (cardiovascular death, myocardial infarction (MI), resuscitated cardiac arrest, hospitalization for chronic heart failure) was 13.3% in the routine invasive strategy group and 15.5% in the conservative strategy group (p = 0.34). The occurrence rate of the main secondary outcomes also did not differ between the groups signifi cantly. Quality of life in the invasive group was higher only in patients who had angina at baseline. The study subanalysis demonstrated that borderline left coronary artery stenosis is associated with a poor prognosis, and an invasive strategy relieves the angina symptoms. Women who participated in the ISCHEMIA trial had a higher incidence of angina attacks, despite less extensive coronary arteries (CA) lesions and less severe ischemia manifestations than men. Among patients with stable CHD accompanied with moderate to severe ischemia and severe chronic kidney disease patients, no evidence for the benefi t of the initial invasive strategy in reducing the risk of death or nonfatal myocardial infarction compared to the conservative strategy was found. As for ischemia in non-obstructive coronary arteries (INOCA), it is diagnosed in at least one in five patients who have undergone coronary angiography. This requires the search for new diagnostic methods, verifi cation of risk factors, causes, and optimal treatment approaches. Conclusion. The ISCHEMIA trial data demonstrated the necessity for a more careful selection of patients with stable CHD for invasive treatment, taking into account the angina pectoris severity and modern antianginal therapy possibilities. Management of patients with myocardial ischemia accompanied by non-obstructive CA lesions should be carried out on the basis of the EAPCI Expert Consensus Document on Ischaemia with INOCA (2020) which discusses the genesis of angina, as well as the diagnosis and treatment of this condition.

Myocardial stress of the left ventricle during occupational vibration

Aim. Study of intramyocardial stress of the left ventricle (LV) in persons exposed to occupational vibration and patients with hand-arm vibration syndrome (HAVS). Materials and methods. We examined 15 individuals exposed to vibration, 44 individuals with grade 1 HAVS, 10 individuals with grade 2. The control group consisted of 20 persons without cardiovascular pathology, who had not been exposed to hazardous occupational factors. The main occupational hazards in persons with HAVS were vibration, noise, physical exertion. Echocardiography was carried out to determine the total volume of LV (Vtotal); the volume of myocardium (Vm); myocardial mass (LVMM); myocardial mass index (LVMMI); systolic intraventricular pressure; the intensity of the functioning of the LV structures; LV circumferential and meridional diastolic and systolic stresses (σcd, σcs and σmd, σms respectively); LV tension in the circumferential and meridional direction during systole and diastole (Tcs, Tcd and Tms, Tmd respectively). Results. In persons exposed to vibration, in comparison with those who have not been exposed to occupational hazards, there is an increase in σmd by 2.5 times (p < 0.05) and σcd by 2.8 times (p < 0.05). The tension increases during systole and diastole both in the circumferential (Tcs by 17.35%, p < 0.05; Tms by 2.74 times, p < 0.05) and in the meridional (Tcd by 14.59%, p < 0.05; Tmd by 2.76 times, p < 0.05) directions. In persons with grade 1 HAVS, there is an increase during diastole σmd by 2.2 times (p < 0.05), σcd by 2.4 times (p < 0.05), and Tmd (p < 0.05) and Tms by 2.5 times (p < 0.05). In patients with grade 2 HAVS, in contrast to those with grade 1 and persons exposed to vibration, there is a change in the working conditions of LV. With the same values of Vtotal, Vm, LVMM and LVMMI, as in the described groups, in patients with grade 2 HAVS, there is a decrease by 12.3% (p < 0.05) in systolic intraventicular pressure against the background of an increase in σmd by 14.7% (p < 0.05), Tmd by 13.6% (p < 0.05), as well as σms by 2.25 times (p < 0.05) and Tcd by 1.97 times (p < 0.05). Conclusion. In the group of persons exposed to vibration and patients with grade 1 HAVS, in contrast to those who are not exposed to occupational hazards, there is an increase in stress and tension, primarily in the circumferential direction during diastole, which indicates the activation of the heterometric type of autoregulation of activity of the heart. In patients with grade 2 HAVS, stress and tension increase in the meridional direction during systole, which indicates the levelling of LV hyperfunction by isotonic type.

Uterine cancer at a glance

Among gynecological tumors, malignant uterine tumor (MUT) is the 6th most common cancer in women and the 15th most common cancer overall. There were approximately 382 069 new cases and 89 929 deaths attributed to this type worldwide in 2018. Therefore, MUT was the second most common gynecological cancer and the fourth leading cause of death due to gynecological cancer in 2018, and is expected to increase the incidence rate by more than 50% globally by 2040. Mortality rates are lowest in Central and South Asia and most of Africa. Survivors of MUT may experience treatment-related issues, including infertility, early onset of menopause, sexual problems, and lower limb lymphedema. Wbuilds its own database from national modeling incidence estimates, using incidence ratios with a sampling method that relies on the calculation of a weighted or simple average of the most popular local rates applied to the population of a few regions or by an approximate estimate based on data provided by health establishments in neighboring countries. While in Algeria, existing statistical and epidemiological data and updated information on the pathology are insuffi cient. The objective of this work is to highlight the importance and the situation of the MUT in this country and to describe the different recent aspects (etiology, diagnostics and treatment) related to the disease.

Morphological assessment of the mucous membranes of the bladder and vagina in chronic cystitis in women

The study involved 107 women aged 20 to 52 years with chronic recurrent cystitis (57 of them with leukoplakia) developing under conditions of a pathogenic and/or opportunistic infection. All patients underwent a conventional clinical and instrumental examination. Biopsy samples for culture-based and microscopic examination were taken from the area of the Pawlik’s trigone of the vagina and the Lieutaud’s trigone of the urinary bladder, in case of leukoplakia — from the field of visually healthy tissue. The carried out cytomorphological analysis and assessment of pathological processes in the adjacent tissues suggest that the infection from the vagina penetrates through the intersynaptic clefts, interstitial cell nests, the blood and lymphatic microcirculatory system into the bladder, causing cystitis inherent changes — from initial morphological forms to rough ones, up to leukoplakia. A complex of clinical, functional and pathomorphological changes that fit into the framework of the chronic cystovaginitis concept was identified.

The chronic heart failure early stage predictors in type 2 diabetes mellitus

Introduction. Type 2 diabetes mellitus (T2DM) is considered to be the equivalent of cardiovascular disease due to its micro- and macrovascular complications. Insulin resistance and hyperinsulinemia, impaired glucose tolerance and fasting glucose, and their subsequent maladaptive responses lead to myocardial dysfunction several years before the onset of T2DM. Pathological changes in the cardiovascular system in T2DM can progress without any symptoms for a long time. Aim. To identify clinical, laboratory, echocardiographic predictors of the early manifestations of chronic heart failure (CHF) in patients with T2DM. Materials and methods. The study included 94 patients with T2DM with and without initial symptoms of CHF at the age of 40 to 65 years. All patients had obesity or excess body weight and arterial hypertension (AH), 37 patients had stable coronary heart disease (CHD). Patients underwent general clinical and laboratory examination, a 6-minute walk test (6MWT), echocardiography. The concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP ) was also determined. The patients were divided into 2 groups: without CHF symptoms (group 1, n = 54) and with initial symptoms of CHF (group 2, n = 40) and then these groups were compared. Results. Differences were revealed between the second and first groups in the duration of T2DM (10.5 vs 7.5 years, p = 0.02) and AH (15 vs 10 years, p = 0.009); the incidence of stable CHD (70 vs 16.7%, p < 0.0001); distance covered during 6MWT (375 vs 425 m, p < 0.0001); the median level of NT-proBNP (38.5 vs 27.2 pg/ml, p = 0.031); the left atrium (LA) size (4.4 vs 4.2 cm, p = 0.044); the left ventricular posterior wall thickness (PWT) (1.05 vs 0.95 cm, p = 0.02); the level of triglycerides (2.3 vs 1.6 mmol/l, p = 0.03) and the glomerular filtration rate (GFR) (74.1 vs 79.1 ml/min/1.73 m2, r = 0.04). The discriminant analysis revealed combination of factors associated with initial symptoms of CHF: the duration of CHD (taken as 0, if absent, p < 0.00001), PWT of the LV (p = 0.000007), GFR (p = 0.0009), the LA size (p = 0.005), the level of triglycerides (p = 0.03), the duration of T2DM (p = 0.046). The NT-proBNP level > 125 pg/ml was detected in 16% of patients with T2DM and correlated with the duration of diabetes over 10 years (p = 0.0085), the presence of stable CHD (p < 0.0001), and left ventricular mass index (p = 0.0005) and the ejection fraction of the LV (p < 0.0001). Conclusion. Predictors of the initial manifestations of chronic heart failure in patients with type 2 diabetes mellitus were the presence and duration of stable CHD, an increase in the PWT of the LV, the LA size, the level of triglycerides, and the duration of diabetes. An elevated level of NT-proBNP (more than 125 pg/ml) in patients with T2DM was detected in 16% of cases and was associated with the duration of diabetes for more than 10 years, presence of stable CHD, initial symptoms of CHF, left ventricular myocardial hypertrophy, and a lower left ventricular ejection fraction according to echocardiography.

Forensic assessment of clinical manifestations when taking ethanol with carbonation

The differences in clinical manifestations of oral administration of 40% ethanol (vodka) with carbonation compared with neat (non-carbonated) vodka were studied. It was found that when taking carbonated ethanol, both subjective and objective symptoms appear, which are absent when taking ethanol without carbonation. The symptoms of alcohol intoxication characteristic of ethanol, both with and without carbonation, persist longer when carbonated ethanol is ingested. The maximum heart rate values when taking ethanol with carbonation, recorded 4 hours after ingestion, were 18.4% higher relative to the baseline (the time of intake), and when taking ethanol without carbonation — by 9.6%. There was no significant difference in the change in blood pressure indicators when taking ethanol with and without carbonation.