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{"title":"Perinatal Outcomes in the Discordance of the Physical Development of Monochorionic Twins","authors":"M. Pavlichenko, N. V. Kosovtsova, Y. Pospelova, T. V. Markova","doi":"10.31550/1727-2378-2023-22-1-68-75","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-68-75","url":null,"abstract":"Aim: To compare perinatal outcomes in the group of monochorionic discordant twins, depending on the complications of the antenatal period. Design: Cohort retrospective study. Materials and methods. 104 pairs of discordant monochorionic twins were examined: 44 pairs with feto-fetal transfusion syndrome (TTTS) and 60 pairs with signs of selective fetal growth retardation (SSFGR). Results. In the TFFT + CVDGR group, cervical insufficiency was more common (p = 0.004), delivery before 32 weeks of gestation (OR = 4.84; 95% CI: 1.78–13.18) and there was a higher risk of extremely severe discordance (≥ 50%) (p = 0.018): OR = 4.12; 95% CI: 1.2–14.6. Severe asphyxia was recorded more often in children who underwent TTTS — 34 (38.6%) patients versus 26 (21.7%) newborns of the SSFGR group: OR = 2.36; 95% CI: 1.28–4.36, p = 0.006. An inverse correlation was determined between gestational age and the degree of discordance in the SSFGR group. Conclusion. Differences in perinatal outcomes in monochorionic diamniotic twins with discordant physical development were revealed depending on the type of specific complication of intrauterine development. Keywords: growth discordance, feto-fetal transfusion syndrome, selective fetal growth retardation syndrome","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85743248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Options and Periods of Epigenetic Influences on the Development of the Fetus","authors":"P. L. Sokolov, N. V. Chebanenko","doi":"10.31550/1727-2378-2023-22-3-61-64","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-61-64","url":null,"abstract":"Aim: To analyze modern research on the variants and frequency of epigenetic effects on fetal development. Key points. Epigenetic influences provide operational adaptation to the conditions of existence. Immediately after fertilization, the first wave of demethylation, “erasing” of methylation marks of parental gametes. After implantation, the first wave of methylation in blastocyst is carried out. The second wave of demethylation takes place at the beginning of the development of gametes. We know three types of epigenetic effects in the process of ontogenesis: direct influences of life experience refers to changes that occur in human life and caused by “direct life experience” of its adaptation to the conditions of existence. External indirect influences (transgenerations) are an impact of epigenetic changes that have developed in previous generations (both intrauterine and postnatally). Obviously, external indirect influences have a faster route for the transfer of hereditary information in comparison with the genetic mechanisms of inheritance. Conclusion. Thus, the expansion of our ideas about the epigenetics allows you to see in it the most important mechanism for the adaptation to the conditions of the external environment both on the organism and in the population levels. Keywords: development, epigenetics, ontogenesis, methylation, histone modifications, chromatin remodeling, noncoding RNAs.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75249185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabesity in Women: Long-term Health Effects","authors":"M. R. Orazov, V. Radzinsky, M. Khamoshina, I. A. Mullina, Yu.S. Artemenko, V. Ryabova","doi":"10.31550/1727-2378-2023-22-1-11-15","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-11-15","url":null,"abstract":"Objective of the Review: To present the available data on the impact of obesity on woman’s health and quality of life. Key Points. The term “metabesity” includes a range of conditions associated with obesity and its sequelae. From pathogenic point of view, it is an obesity-associated metabolic aberration: subacute inflammation, mitochondrial dysfunction, and changed gut microbiome. Together with a genetic component, the phenotypes of metabesity are mostly a result of sedentary lifestyle and unhealthy eating. Metabesity is associated with a number of both health- and life-threatening comorbidities, including arterial hypertension, cardiac failure, myocardial infraction, and stroke. Insulin resistance, hypertensive disease, advanced arteriosclerosis, dyslipidemia and fatty hepatosis are more frequent in obese people than in the general population. This literature overview presents a modern idea of the metabesity impact on the long-term health of a woman. Conclusion. Recently, forecasting and prevention of diseases affecting the quality and duration of life have been attracting more and more interest. Taking into account the regular changes in the gender component of the population with age, obesity and its impact on the health of women from various age categories are of special interest. Obesity increases the risk and overall cancer mortality. Metabesity affects hormonal homoeostasis in the female body and increases the risk of degenerative conditions, including dementia. Taking into account the genetic component, the strategies to tackle metabesity, including a campaign against sedentary lifestyle and unhealthy eating, should be initiated since early childhood. Lifestyle modification is the only proven way to manage/prevent metabesity and associated diseases. Keywords: metabesity, obesity, metabolic syndrome, female health, cancer, diabetes, insulin resistance.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90161628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast Milk Oligosaccharides: Their Role in Immune Reactions and Potential Role in Allergy Prevention","authors":"E. Mukhametova","doi":"10.31550/1727-2378-2023-22-3-81-88","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-3-81-88","url":null,"abstract":"Aim: To describe the known and expected effects of breast milk oligosaccharides (BMOs) on immune system modulation and allergy prevention; to present results of the studies of medicated formulas with the addition of a combination of two BMOs in babies with cow's milk protein allergy (CMPA). Key Points. The period of infancy is a window of opportunities for allergy prevention. Breast milk contains immune system modulating components, including BMOs, which protect an infant during this critical period. Recently, a number of BMO impacts over immune system maturity have been found, including their ability to modulate microbiota composition, to enhance expression of short-chain fatty acids, to directly bind to pathogenic agents, and to interact with intestinal epithelium and immune cells. In addition, it is assumed that BMOs can be used for prevention of paediatric allergies. Conclusion. BMOs have a significant contribution to the positive effect of breast milk over a child; they ensure healthy microbial colonization of intestines, inflammation inhibition, immune protection, and intestinal barrier maturity. Currently BMOs are considered one of the most important bioactive components of breast milk, since they act both as antimicrobials, antiviral agents and modulators of intestinal epithelial cells, as specific prebiotics, intestinal microbiota effectors and immunomodulating factors. Nevertheless, additional studies of the effect of some BMOs and their combinations on clearly defined clinical and immune outcomes are required, including tolerance and therapeutic potential in CMPA. Keywords: breast milk oligosaccharides, children, food allergy, cow's milk protein allergy, immunity, tolerance.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89820103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping Strategies and Quality of Life of Women with Various Somatic Disorders","authors":"M. Kuzmin, A. Marianian, L. Suturina","doi":"10.31550/1727-2378-2023-22-1-76-85","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-1-76-85","url":null,"abstract":"Aim: Identification of coping strategies specific to individuals with various somatic pathologies and different quality of life. Design: Retrospective, case-control. Materials and Methods: 749 women were examined (249 did not indicate the presence of somatic pathologies, 500 indicated them in their medical history and as current, 353 had currently experienced pathologies; mean age 41.9 ± 11.48 years) using the \"Ways of Coping Questionnaire\", \"Method of Determining Individual Coping Strategies\", S. Maddi's Hardiness test, SF-12. Results. Productive coping strategies were found to be characteristic of women with higher quality of life, while unproductive coping strategies were found to be characteristic of women with lower quality of life. Specific coping strategies were discovered that differentiate women with various diseases from healthy women. Women who reported different illnesses in their medical history or were currently experiencing them showed greater severity of unproductive coping strategies (resignation, dissimulation, confusion, distancing). Coping strategies specific to various diseases were identified. Conclusion. The obtained results were compared with those presented in the literature. They can be used to correct coping strategies that worsen well-being and are negatively associated with patient quality of life. Keywords: coping strategies, women, quality of life, somatic pathologies.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88764384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction of Metabolic Disorders in Patients with Type 2 Diabetes Mellitus Using a Type 2 Sodium-Glucose Cotransporter Inhibitor","authors":"A. V. Zhigareva, A. Ametov, H. H. Sharafetdinov, E. Pashkova","doi":"10.31550/1727-2378-2023-22-4-53-58","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-4-53-58","url":null,"abstract":"Aim: Comprehensive (clinical, laboratory, instrumental) assessment of the clinical efficacy of metabolic disorders correction in patients with type 2 diabetes mellitus using a type 2 sodium-glucose cotransporter inhibitor. Design: Randomized comparative study. Materials and methods. A 26-week study included 130 patients with the presence of visceral obesity (56.3 ± 2.1 years) who did not reach the target parameters of glycated hemoglobin (HbA1c) on metformin monotherapy 2 g/day. The main group (68 people) received canagliflozin 300 mg/day, in combination with metformin 2 g/day; the control group (62 people) continued to receive monotherapy with metformin 2 g/day. At baseline and in 6 months, all patients underwent laboratory and instrumental examination methods, which included an assessment of carbohydrate metabolism (fasting glycemia (FG), postprandial glycemia (PPG), HbA1c); lipid profile (cholesterol levels, high and low density lipoproteins, triglycerides); content of adipocytokines- adiponectin (ADN), leptin (L). Visceral fat area (AVF) was assessed using a bioimpedance analyzer and magnetic resonance imaging (MRI) at the L4 level. Results. In 6 months, both groups showed significant positive dynamics of FG, PPG and HbA1c. In main group, HbA1c decreased by 2.7 ± 0.3% (p < 0.01), in control group by 0.2 ± 0.1% (p < 0.01). The FG and PPG levels in main group decreased by 4.5 ± 0.4 mmol/L (p < 0.01 ) and 5.8 ± 0.5 mmol/L (p < 0.01), respectively, in control group by 1.3 ± 0.2 mmol/L (p < 0.01) and 1.7 ± 0.4 mmol/L (p < 0.01). The level ADN in main group increased by 102.8 ± 4.8 mcg/ml (p < 0.01), in control group by 8.2 ± 2.1 mcg/ml (p < 0.01). L in main group decreased by 10.3 ± 0.9 ng/ml (p < 0.01), in control group by 4.1 ± 0.7 ng/ml (p < 0.01). In main group, there was a decrease in the VFA of by 18.6 ± 2.3 cm2 (p < 0.01) according to MRI, in control group by 4.7 ± 2.4 cm2 (p < 0.01). According to bioimpedance analysis, there was a decrease in the area of AVF by 26.7 ± 3.2 cm2 (p < 0.01) in the main group, and by 4.7 ± 2.5 cm2 (p < 0.01) in the control group. Conclusion. Combination therapy with canagliflozin and metformin makes it possible to achieve high clinical efficacy of carbohydrate metabolism correction in combination with a decrease in visceral fat depot and normalization levels of the main markers of metabolic health. Keywords: type 2 diabetes mellitus, leptin, adiponectin, canagliflozin.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"124 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86762018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Mellitus Outcome in Pancreatic Diseases the Missing Link between Type 1 and Type 2 Diabetes Mellitus","authors":"A. S. Ametov, E. Pashkova, A.G. Erokhina, K. Amikishieva","doi":"10.31550/1727-2378-2023-22-4-29-35","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-4-29-35","url":null,"abstract":"Aim: To study the features of pathogenesis, diagnosis and management of patients with diabetes, frolicking during various pathologies of the exocrine part of the pancreas. Key points. Diabetes of the exocrine pancreas (DEP) is a common problem among patients with chronic pancreatitis, pancreatic cancer, hemochromatosis, after pancreatectomy. We discuss various aspects of this type of diabetes: its etiology, pathogenesis, diagnostic features, the importance of diagnosis for proper management. There are a comparative analysis of disorders of the relationship of various pancreatic hormones in DEP, their influence on the pathogenesis of the disease and clinical significance in the differential diagnosis of DEP with diabetes mellitus 1 and 2 types. Conclusion. The increasing incidence of chronic and acute pancreatitis, better survival rates in patients with pancreatic cancer with the subsequent development of DEP, led to the evidence that the differential diagnosis of this disease, the development of guidelines for the management of such patients have become relevant. Keywords: diabetes mellitus, diabetes of the exocrine pancreas, acute pancreatitis, chronic pancreatitis, exocrine pancreatic insufficiency, islets of Langerhans, somatostatin, glucagon, C-peptide, amylin.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81947259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Efficacy of Contrast-Enhanced Ultrasound in Patients with Chronic Viral Hepatitis","authors":"A. V. Tikhankova, A. Borsukov","doi":"10.31550/1727-2378-2023-22-2-39-44","DOIUrl":"https://doi.org/10.31550/1727-2378-2023-22-2-39-44","url":null,"abstract":"Aim: to determine the diagnostic efficiency of contrast-enhanced ultrasound of the liver in patients with chronic viral hepatitis B and C. Study Design: open randomized study. Materials and methods. 240 people were examined on the basis of the Smolensk Clinical Hospital No. 1 from 2019 to 2021: patients with chronic viral hepatitis who have been examined by contrast-enhanced ultrasound; patients with chronic viral hepatitis who have not been examined by contrast-enhanced ultrasound to determine the diagnostic effectiveness of the method in assessing the complicated course development, patients without chronic viral hepatitis who have been examined by contrast-enhanced ultrasound to determine the standardized CEUS parameters. Liver biopsy and shear wave elastography were used as reference methods. Results. It was found that the greatest changes in contrast-enhanced ultrasound parameters were observed in patients with F4 fibrosis stage according to the METAVIR score. It was also found that the assessment of qualitative parameters according to the proposed standardized program has the highest diagnostic potential, and among the quantitative parameters — the difference of quantitative parameters in the proximal and distal zones (time of arrival, time to peak, peak intensity, half-time washout). Conclusion. The use of a contrast agent increases the value of the ultrasound method in the diagnostic algorithm for patients with chronic viral hepatitis. Keywords: contrast-enhanced ultrasound, chronic viral hepatitis, contrast agent, arterial phase, portal venous phase, late venous phase, qualitative parameters, quantitative parameters.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"99 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85784955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity and COVID-19: Insights from Two Pandemics","authors":"Y. Khalimov, P. V. Agafonov, E. B. Kireeva, Y. Orlov","doi":"10.31550/1727-2378-2022-21-2-59-66","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-2-59-66","url":null,"abstract":"Objective of the Review: To present the pathophysiological mechanisms of the coronavirus infection in obese patients, and approaches to obesity correction in this group of patients following an overview of large randomized clinical trials of cardiovascular safety from PubMed, Cochrane Library, Google Scholar. Key Points. Clinical trials have demonstrated that obesity is a significant risk factor of a number of comorbidities, including severe and fatal cases of the novel coronavirus infection. A higher prevalence and severity of the novel coronavirus infection in obese patients is caused by a set of factors, with the most significant factor being an increased cardiovascular risk, including tendency to blood-clotting, reduced respiratory efficiency, impaired immune response, and chronic inflammations. Main groups of medicinal products that can be used to manage lipotoxicity have been listed. Conclusion. It has been proven that a range of positive effects from new antihyperglycemic agents (glucagon-like peptide-1 receptor agonists and sodium-glucose linked transporter-2 inhibitors), combined with a well-studied efficiency and safety profile, is a new method to manage obesity during the coronavirus pandemic. Keywords: novel coronavirus infection, obesity, glucagon-like peptide-1 receptor agonists, sodium-glucose linked transporter-2 inhibitors, cardiovascular complications, prevention.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77666627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Dydrogesterone in Threatened Miscarriage: a Systematic Review and Meta-analysis","authors":"N. Tetruashvili, E. Shih","doi":"10.31550/1727-2378-2022-21-5-53-61","DOIUrl":"https://doi.org/10.31550/1727-2378-2022-21-5-53-61","url":null,"abstract":"Objective of the Review: To review all studies using dydrogesterone in threatened miscarriage and to evaluate the effect of dydrogesterone treatment on miscarriage rates in women with miscarriage. Key points. Many years of experience in many clinical studies confirm that progestogens contribute to the preservation of pregnancy in the event of a threatened miscarriage. Dydrogesterone and progesterone are the most suitable progestogens for pregnant women. The high result of dydrogesterone in high-risk pregnancy is due to its chemical structure. This systematic review and meta-analysis includes data only from randomized trials, in particular those based on comparisons of dydrogesterone with placebo. The results demonstrate that in the group of patients treated with dydrogesterone, the frequency of miscarriages was statistically significantly lower than in the group of patients treated with placebo. These findings correlate with previous data from meta-analyses and reviews of randomized clinical trials in 2017–2021, where dydrogesterone also significantly reduced the risk of pregnancy loss in threatened and recurrent miscarriage. Moreover, the largest direct comparative randomized study IPD LOTUS (2020) demonstrated a higher efficacy of dydrogesterone compared to micronized vaginal progesterone. Conclusion. According to the results of this systematic review and meta-analysis of randomized clinical trials based on the comparison of dydrogesterone with placebo, in the group of patients who received dydrogesterone, the frequency of miscarriages was statisticallysignificantly lower than in the group of patients who received placebo. The use of dydrogesterone is not only justified, but an essential component of the treatment of recurrent pregnancy loss. Keywords: miscarriage, recurrent pregnancy loss, habitual miscarriage, progestagens, dydrogesterone, progesterone.","PeriodicalId":11479,"journal":{"name":"Doctor.Ru","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72727257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}