Vol 41, No 3 (2024)

Objective. To study the features of the colon microbiota, as well as the associations of microbial representatives with anthropometric, anamnestic and biochemical parameters in young patients with metabolic syndrome.

Materials and methods. 118 young people took part in a single-center, one stage, controlled study. 87 of them were diagnosed with obesity, and 31 people with normal body weight formed the control group (“C”). 87 obese patients were divided into 2 groups: “MS-” which consisted of 43 people (49.4 %), and “MS+” including 44 people (50.6 %) with metabolic syndrome. When stratifying the groups, the NCEP ATP III criteria were used. Blood for biochemical test was taken from all the participants, and the condition of the colon microbiota was assessed using polymerase chain reaction («Colonoflor-16 (premium)»). The Microsoft Excel 2010 and IBM SPSS Statistics 26.0 application software package were used for statistical calculations. The results were evaluated as statistically significant at a level of p < 0.05.

Results. In the MS+ group Fusobacterium nucleatum (Fusobacteriaceae family) was detected statistically significantly more often than in individuals from group “C” (40.5 %). Differences in the bacterial composition of the intestinal microbiota between two groups of obese people were revealed: in the “MS+” group there was a significant decrease in bacteria of the genus Bifidobacterium (Bifidobacteriaceae family), Prevotella (Prevotellaceae family) and Faecalibacterium prausnitzii (Ruminococcaceae family) (p < 0.05). In addition, correlation patterns between the species and generic composition of the microbiota on the one hand and age, BMI, waist circumference, hip circumference, breastfeeding duration, indicators of carbohydrate (glucose, insulin, HOMA-IR index) and lipid (total cholesterol, triglycerides, low-density lipoproteins, very low-density lipoproteins, high-density lipoproteins) metabolism, CRP on the other hand have been established.

Conclusions. The colon microbiota in obese patients is characterized by proinflammatory changes. For the metabolically unhealthy phenotype of obesity these changes are most characteristic. It is clear that further research is needed to determine the mechanisms underlying the influence of bacterial-fungal associations on metabolism in obese individuals, as these mechanisms are likely to play a key role in the development of metabolic diseases.

Objective. To assess functional disorders in children with narrowing of the dentition from the perspective of the international classification of functioning.

Materials and methods. The indicators of the components of the international classification of functioning were analyzed and assessed in 75 children with narrowing of the dentition aged 6–9.

Results. Nasal breathing impairments and speech disorders were found in children with narrowing of the dentition.

Conclusions. Orthodontists, otorhinolaryngologists, and speech therapists can use the parameters of the international classification of functioning to assess functional disorders in children with narrowing of dentition. It will help interdisciplinary planning in early diagnosis and treatment.

Objective. To study the prevalence of the main risk factors and the value of proinflammatory cytokines in patients with acute coronary syndrome (ACS) depending on the determined level of serum myostatin.

Materials and methods. 120 patients with ST elevation ACS (STE-ACS) and non-ST-segment elevation ACS (NSTE-ACS), hospitalized in the cardiology department of the regional vascular center were examined. In 86 patients, the level of serum myostatin and proinflammatory cytokines was determined on the 5th day of the development of acute coronary syndrome.

Results. Patients were divided into two subgroups depending on the level of serum myostatin which was determined: group 1 – with a lower level of myostatin, group 2 – with a higher level of myostatin. Group 1 (serum myostatin level from 0.038 to 0.084 ng/ml) consisted of 23 patients (16 males). Group 2 (serum myostatin level from 0.137 to 0.630 ng/ml) contained 21 patients (14 males). The main risk factors for cardiovascular diseases such as family history of early development of cardiovascular diseases, smoking, dyslipidemia, obesity, arterial hypertension and type 2 diabetes mellitus were assessed.

The levels of pro-inflammatory cytokines were determined. Tumor necrosis factor alpha (TNF-alpha) and interleukin 18 (IL-18) levels were significantly higher in patients with higher myostatin levels. Correlation analysis revealed a relationship between serum myostatin concentration and TNF-alpha level (r = 0.34; p = 0.0016).

Conclusions. No differences in the prevalence of risk factors in patients with ACS and different myostatin levels, except for smoking were revealed in the study, the frequency of smoking was higher in the group with higher myostatin levels. Greater activity of pro-inflammatory cytokines TNF-alpha and IL-18 was revealed in patients with higher levels of myostatin, as well as a significant correlation between the level of myostatin and TNF-alpha.

Post-COVID-19 condition (PCC) is a condition that occurs in patients with a history of SARS-CoV-2 infection 3 months after the onset of COVID-19 with symptoms that last at least 2 months and are not explained by any other diseases. PCC affects from 17 % to 28 % of patients and includes a wide range of clinical manifestations, including cognitive dysfunction. Cognitive dysfunctions can be manifested by a wide range of symptoms, such as memory impairment, attention deficit, executive dysfunction, and reduced information processing speed. Risk factors for developing PCC, with or without cognitive impairment, include late adulthood, pre-existing medical conditions, and severity of acute illness. The underlying mechanisms remain unclear, but suspected factors include neuroinflammation, hypoxia, vascular damage and latent reactivation of the virus, this does not exclude the possibility of direct viral central nervous system invasion. The analysis of retrospective cohort studies showed that the risk of cognitive deficits, dementia, psychotic disorders and seizures remained elevated even 2 years after the infection of SARS-CoV-2. It is interesting to note that there were no differences in the risks of neurological and psychiatric outcomes between infections caused by Omicron (B.1.1.529) or Delta (B.1.617.2) variants. Recent researches show that cognitive deficits after infection of SARS-CoV-2 persist for two years after the infection and were the greatest in individuals with more severe SARS-CoV-2 infection [2].  COVID-19 can impair the function of the interoceptive network of the brain selectively, while exteroceptive brain processing remains undamaged [3].

The issues of epidemiology, risk factors, and pathogenetic mechanisms of non-alcoholic fatty liver disease during pregnancy are considered in the review. The impact of liver steatosis and obesity on the course and outcome of pregnancy, the perinatal state of the mother and fetus are described. Fluctuations in the hormonal spectrum, an increase in body weight, which can affect the development and progression of liver steatosis, occur during pregnancy. Women of reproductive age with metabolic syndrome, obesity require a thorough examination and, if it is necessary, optimization of metabolic health before planning pregnancy. Pregnant women with liver pathology need dynamic control and prevention of disease progression and associated obstetric complications.

The problem of obesity becomes more and more urgent due to its rising incidence and unfavourable effects on health of both children and adults. Various factors leading to an increased energy consumption while its output is reduced at different periods of life (from conception to adulthood) are considered in the article. Different ways of exogenous-constitutional obesity prevention in children and adolescents are described. Influence of phones/television/computers on the formation of hypodynamia and inadequate nutrition which can result in an excess body weight and obesity is characterized. The significance of behavioral response in the pathogenesis of obesity which should be considered while developing preventive methods is stressed.
Thus, the problem of obesity requires further studies and discussion.

Objective. To determine the probabilities of predicting possible complications after surgery in patients with the diagnosis of prostate cancer using artificial intelligence methods.

Materials and methods. Case histories of 701 patients who underwent prostatectomy were analyzed in the study. The anamnesis, findings of clinical, laboratory and instrumental study, as well as objective data of clinical observations were evaluated. The average age was 64.72. On the basis of the set of examination results, patients were selected according to the following inclusion criteria: prostate cancer patients without confirmed metastases with disease stage from T1N0M0 to T3N0M0; absence of previous and concomitant special treatment (immunotherapy or targeted therapy); informed consent to the surgery. Logistic regression, a binary classifier using a sigmoidal activation function on linear combinations of features, was used as a machine learning model.

Results. It was determined that the logistic regression model based on selected parameters (prostate volume, pain syndrome, disease duration), predicts the probability of complications quite well (TPR = 1). The overall accuracy of the model is: Accuracy = 0.98. At the same time, it can be noticed from the agreement matrix that the trained model plays it safe and classifies some cases without complications incorrectly in 5.3 % (FNR = 0.053). However, the model never made an error and did not classify cases with a high risk of complications as those in which such a possibility was unlikely.

Conclusions. The results obtained show that on the basis of just three parameters (prostate volume, pain syndrome, duration of the disease), it is possible to build a fairly good predictive model of the probability of complications after prostatectomy based on such machine learning method as logistic regression.

Objective. To analyze the mortality from endocrine pathology of the population in the Republic of Sakha (Yakutia).

Materials and methods. A retrospective analysis of the mortality rates from endocrine diseases and diabetes mellitus of the population of the Republic of Sakha (Yakutia) from 2018–2022 was carried out. The analysis was based on the data of YARMIAC and the republican register of diabetes mellitus.

Results. An increase in the death rate from endocrine pathology, from diabetes mellitus was noted during the analyzed period. In the structure of mortality from endocrine pathology, deaths from diabetes mellitus were 96 %. The structure of causes of death in patients with diabetes mellitus includes renal failure, CHF, acute myocardial infarction, PE and pneumonia.

Conclusions. The results obtained during the study will allow us to justify the need for improving the endocrinological service in the Republic of Sakha (Yakutia) scientifically and will form the basis for the regional program “Combating diabetes mellitus”.

Ectopic pregnancy occupies a significant place in the structure of causes of maternal mortality. Timely diagnosis is even more complicated when there is a combination of both uterine and ectopic localization of the ovum. The article describes the clinical observation of heterotopic pregnancy, features of the clinical picture, diagnostic search and treatment strategy. The possibility of preservation of intrauterine pregnancy after surgical removal of a pathologically located second fertilized ovum has been shown. The patient was admitted to the gynecological department with complaints of bleeding from the genital tract against the background of delayed menstruation. An ultrasound examination revealed the presence of dichorionic diamniotic twins, with one fertilized egg localized in the interstitial part of the fallopian tube stump. Surgical removal of the stump with the fertilized egg was performed. The intrauterine pregnancy was preserved. Thus, with timely diagnosis of heterotopic pregnancy and adequate tactics, it is possible to maintain intrauterine pregnancy.

A clinical case of HIV-associated Kaposi's sarcoma with skin and lung lesions is presented. A patient referred to the Perm Regional Center for the Prevention and Control of AIDS and Infectious Diseases complaining of rash on the skin of the right wing of the nose, forehead, in the right axillary and right inguinal areas, on the shins. The first skin changes occurred in December 2020 on the right wing of the nose, later the pathological process spread to other areas of the skin. HIV was revealed in 2009 and the patient had not received specialized medical care until 2022 as he had been in prison. Since March 2022, the patient has been registered at the dispensary and regularly receives antiretroviral therapy. In April 2022, PET/CT tests and histological examination of a biopsy of skin rashes were performed. On the basis of these findings the diagnosis of Kaposi's sarcoma with skin and lungs lesions was made.

HIV-associated Kaposi's sarcoma is accompanied by lesions of the skin and internal organs. Skin changes in Kaposi's sarcoma are characterized by the primary localization of foci on the face and upper extremities, and without antiretroviral therapy, by rapid progression and generalization of the pathological process. Visceral lesions worsen the course of the disease and complicate its prognosis. Patients with HIV-associated Kaposi's sarcoma need dynamic monitoring and complex therapy from infectious diseases specialists, dermatovenerologists, oncologists.