Adolescence represents a pivotal phase in the transition from childhood to adulthood. Adolescent gynecology is the clinical specialty that focuses on the management of gynecologic problems during this period. This study's primary objective is to emphasize the importance of adolescent gynecology by examining the gynecological causes of adolescent presentations and highlighting the differences that warrant consideration in the clinical approach to adolescent patients. The study was designed as a retrospective cohort study in an academic tertiary hospital and included adolescent individuals presenting to the obstetrics and gynecology emergency department or outpatient clinic. The analysis encompassed a range of factors, including age, presenting symptoms, examination findings, ultrasound results, laboratory data, and the necessity for hospital admission. The study cohort comprised 750 adolescent patients, 71.3% seeking gynecological care. Adolescents most frequently presented for menstrual irregularities (57.6%) and secondly for dysmenorrhea. The results of the gynecological clinical evaluations indicated that 62.9% of the patients had menstrual disorders. Of these, 53.4% had irregular menstrual cycles, 4.5% had prolonged and/or heavy bleeding, and 3% had amenorrhea. Ultrasound imaging revealed the presence of pathological findings in 25.8% of the patients. In conclusion, this study's findings indicate that irregular menstrual cycles are the most common gynecological condition in the adolescent population. The physiological characteristics of adolescents require a distinct approach to diagnosis and treatment compared to adult women, which can significantly impact future fertility and overall reproductive health.
VIEWS 109
Post-COVID asthenic syndrome (PCAS) is still the subject of active study. The study was aimed to assess the effects of systemic ozone therapy used to complement drug therapy on plasma levels of TNFα, IL1β, IL6 and parameters of mental status in patients with PCAS. Two randomized groups of patients with PCAS (n = 140, age 18–45) were assessed and treated: patients of the index group (n = 70) received systemic ozone therapy in addition to drug therapy; patients of the comparison group (n = 70) received drug therapy without systemic ozone therapy. Plasma levels of TNFα, IL1β, IL6 were measured and the patients’ mental status was assessed using the MFI-20, MoCa, ISI, HARS, and CGI-S scores before and after treatment. After the end of therapy (on day 30) the TNFα, IL1β, IL6 levels reported for the index group showed no significant differences from the values reported for the control group (р > 0.05) and were lover, than the values of the comparison group by 39% (р = 0.003), 33.3% (р = 0.022), and 36.1% (р = 0.012), respectively. The changes in mental status were also more pronounced in the index group, than in the comparison group: the average final MFI-20 score was lower by 36.7% (р = 0.001), ISI by 50.5% (р < 0.001), HARS score by 45.8% (р = 0.001), while MoCa score was higher by 10.9% (р = 0.046), respectively. In the index group, the number of patients with “no disease” based on CGI-S was 94.2%, while in the comparison group it was 62.9% (р = 0.001). In our study adding systemic ozone therapy to drug therapy in patients with PCAS allowed us to achieve normalization of the TNFα, IL1β, IL6 levels and complete reduction of PCAS clinical manifestations in 94.2% of cases. Thus, the use of systemic ozone therapy can be considered as one of the effective and pathogenetically substantiated strategies for combination treatment of patients with PCAS in outpatient settings.
VIEWS 117
Prevention of fibrosis during the oral mucosal wound regeneration is a pressing issue of today’s surgical dentistry. The study was aimed to perform morphological assessment of the effects of biocompatible piezoelectric membranes on fibrous tissue formation during regeneration of the oral mucosal wounds. We assessed cell–cell interactions of macrophages and fibroblasts, along with changes in the CD68 and TGFβ1 marker expression and their effects on the development of fibrosis under conditions of using biocompatible polymeric membranes with piezoelectric properties at various stages of the oral mucosal wound defect regeneration. Comparative morphological assessment of the oral mucosal structures was conducted in animals having intact mucosa (n = 15), having open wound defects (n = 15), and having wounds covered with biocompatible piezoelectric membranes (n = 15). Biomaterial was collected from the wound defect site on days 3, 7, and 12 of the experiment; collection of biomaterial from intact animals was performed on the same days. In the group, where biocompatible membranes were used, signs of proliferation phase at the defect site were detected as early as on day 3 of the study; the faster shift from macrophage infiltration to fibroblast infiltration, the decline in inflammatory response were detected on day 7; restoration of the numerical density of macrophages and fibroblasts to the intact values was detected on day 12. The expression of CD68 and TGFβ1, the prognostic markers of fibrosis, was lower in the group, where no membranes were used. Reduction of the dense fibrous connective tissue specific area was observed at the microscopic level, severe soft tissue deformation was reported at the macroscopic level. In the group with no wound covering, extensive cell infiltration and increased CD68 and TGFβ1 expression persisted throughout the experiment, which resulted in the fact that specific area of dense fibrous connective tissue was larger, than that of loose connective tissue, on day 12 of the study, as well as in the cicatricial soft tissue deformities.
VIEWS 128
Polycaprolactone as a material used when constructing nanocomposite structures is sufficiently studied in terms of therapeutic effect and safety of use. However, its biocompatibility in the form of three-dimensional carrier macrochambers is still a matter of debate due to changes in the way the 3D printing is done. The study was aimed to determine biocompatibility of the diffusion chamber made of polycaprolactone after implantation in the rat femoral neurovascular bundle. The study involved mature male Wistar rats. Animals of group 1 (experimental, n = 4) underwent implantation of the polycaprolactone diffusion chamber in the femoral neurovascular bundle. Group 2 (control, n = 3) included intact rats. Macroscopic assessment revealed no abnormalities at the site of implantation and in the target organs. Tissue microscopy revealed no systemic response; the number of binucleated hepatocytes was 1.05%. The stromal–parenchymal relationship values were as follows: liver — 1/33.20, adrenal glands — 1/19.53, kidney — 1/23.65, spleen — 1/26.52. On day 40, hemogram showed the increase in lymphocyte counts by 4%, the decrease in segmented neutrophil counts by 17% and monocyte counts by 17%. These findings confirm safety of using the polycaprolactone diffusion chamber and its biocompatibility when installed in the large neurovascular bundle. However, the effects of polycaprolactone degradation products require more extensive study over the longer periods of biointegration.
VIEWS 127
The features of polyamine and amino acid metabolism play a key role in the cellular processes, and the search for their role as prognostic and diagnostic (assessment of fetal condition severity) markers in obstetrics can contribute to improvement of perinatal outcomes in fetal growth restriction (FGR) syndrome, both isolated and combined with early onset preeclampsia (PE). The study was aimed to determine the features of polyamine and amino acid levels associated with placentaassociated pregnancy complications. Liquid chromatography coupled with mass spectrometry was used to determine blood levels of polyamines and amino acids in 156 pregnant women divided into the following groups: with FGR — 48 pregnant women, with early onset PE — 56 pregnant women, control group — 52 somatically healthy women having no pregnancy complications. As a result, we managed to distinguish significant differences in these metabolites, depending on the obstetric complication (PE or FGR), and to determine correlations of those with a number of clinical data. We revealed a strong negative correlation between the increasing fetal condition decompensation in FGR and the length of the newborn’s hospital stay for the PE and FGR groups, as well as between the levels of 1,7-diaminoheptane polyamine (r = –0.78, CI = –0.92 – ‒0.37, p = 0.002; r = –0.76, CI = –0.95 – 0.23, p = 0.003) and proline amino acid and the increasing fetal condition decompensation in FGR (r = –0.56, CI = –0.86 – –0.034, p = 0.03). Considering the diversity and complexity of metabolic pathways responsible for adaptation in the context of hypoxic damage, the results obtained suggest that regulation of amino acids and polyamines is coordinated. Metabolic pathways of low molecular weight antioxidants, proline and polyamines, are associated with clinical pregnancy outcomes in FGR and early-onset PE.
VIEWS 156
Quantification of the subcutaneous and visceral fat depot in the abdominal region is a promising method to assess individual risk of cardiometabolic disorders and estimate the efficacy of certain drugs. The local bioimpedance analysis (BIA) represent a new promising method for separate quantification of two fat depots in the abdominal region. The method combines high accuracy, low cost, and noninvasiveness. The study was aimed to analyze the relationships between the impedance estimates obtained in the local BIA lead and the complex of anthropometric and biochemical characteristics in males and females. A total of 147 females and 42 males aged 18–73 years were assessed. To estimate subcutaneous fat, we used the local BIA lead (АВС-02 Medass) in accordance with the earlier proposed electode placement scheme. Local impedance (Z50sc, Ohm) was recorded using the АВС-02 Medass software. The correlation analysis revealed significant correlations of Z50sc with the waist-to-height ratio, insulin concentration, body fat percentage, and HOMA-IR. Markers of the risk of cardiometabolic diseases (abdominal obesity, insulin resistance, and body fat percentage) are associated with the increased Z50sc values. The results of ROC analysis with the insulin resistance index (AUC 0.79 [0.72; 0.84], p < 0.000) make it possible to consider Z50sc a promising marker of the risk of cardiometabolic diseases. The differences between subgroups are confirmed by both statistical significance and large effect size.
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