Vol 78, No 4 (2023)

Background. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy associated with infertility and metabolic disorders. The ethology and pathogenesis of PCOS are not fully understood. The role of gut microbiota (GM) disorders in the genesis of insulin resistance and in the development of PCOS is ambiguous.

Aims — to compare the GM of patients with PCOS and healthy women, to evaluate the relationship of various groups of microorganisms with markers of chronic inflammation.

Methods. A single-center cross-sectional study was conducted involving 148 women: 118 with PCOS and 30 somatically healthy women aged 18–40 years. A comprehensive clinical, laboratory and instrumental examination was performed, as well as an assessment of the composition of the GM using the cultural analysis method.

Results. In PCOS, a decrease in the GM diversity Margalef index was revealed compared to healthy women. A statistically significant decrease in the level of colonization of Bacteroides (B. vulgatus, B. eggerthii, B. caccae), Lactobacillus gasseri, Lacticaseibacillus rhamnosus, Escherichia coli (E.coli) and, on the contrary, an increase in the population of gamma-proteobacteria of the family Enterobacteriaceae and beta-proteobacteria of the order Burkholderiales, as well as Erysipelatoclostridium ramosum (E. ramosum), compared with healthy women. Correlation analysis revealed a negative correlation of bacteria of the genera Lactobacillus, Bifidobacterium, Bacteroides with IL-6, as well as E. coli with IL-6 and C-reactive protein in patients with PCOS. A positive correlation was observed between the level of IL-6 and the abundance of bacteria of the species E. ramosum.

Conclusions. The GM of PCOS patients is characterized by a decrease in Margalef diversity index, aggravated by the imbalance in microbial communities, accompanied by an increase in the levels of pro-inflammatory markers, compared with healthy women.

Introduction. Dysregulation of the immune system and inflammationis associated with the pathogenesis of psoriasis andmanifestedas significant changes in cytokine profile. This fact can be used to monitor the course of the disease and its treatment. However, the results of these studies are insufficient, sometimes contradictory and require a more in-depth analysis.

Aim — to identify matches between cytokine profile, clinical scoresof psoriasis severity and the presence of psoriatic arthritis (PsA).

Methods. Standardized clinical scores (PASI, BSA, and sPGA) were used to assess the severity of psoriasis. It was defined as moderate if 10 ≤ PASI < 20 and sPGA was 2–3, and as severe if PASI ≥ 20 and sPGA was 4–5. Determination of the cytokine levelsin plasma was carried out by the multiplex immunological analysis using xMAP technology. Statistical analysis and visualization of the obtained data was carried out using RStudio for MacOS and the R programming language.

Results. The total 113 patients with psoriasis vulgaris of moderate and severe severity were enrolled in the present study. On the basis of PASI score, moderate psoriasis was diagnosed in 55 (48.7%) patients and severe in 58 (51.3%) patients. PsA was diagnosed in 41 (36.3%) patients. Depends on disease severity the differences in the levels of IL-12, IL-20 and IL-22 were revealed. Significant difference in IL-6 level between patients with PsA and without it were shown. We have identified two independent cytokine networks, represented by a cluster of cytokines associated with psoriasis severity scores (IL1β–TNFα–IL-17A, IL-22, and IL-20), and a cluster which was not associated with severity (IL-21, IL-23, IL-25, IL-17F, IL-31, IL-33, IL-4, and IL-10).

Conclusion. The results of the study for the first time describe the cytokine networks associated with the systemic inflammation in psoriasis; characterize the main effector cytokines determined the severity of the inflammatory response in skin and the development of PsA.

Chronic thromboembolic pulmonary hypertension is group IV of pulmonary hypertension, which develops with occlusive-stenotic lesions of the pulmonary artery after a pulmonary embolism. There are no clear data on the epidemiology of this disease. At the same time, it is obvious that it is much more widespread than is commonly believed. This is due to the nonspecific clinical picture and the lack of awareness of clinicians about this disease. On the one hand, the pathogenesis of CTEPH is well studied and in many respects similar to pulmonary arterial hypertension, on the other hand, it is not clear why blood clots do not dissolve in a certain percentage of patients. Diagnosis of chronic thromboembolic pulmonary hypertension is fairly well described and should be carried out according to a special algorithm. The treatment of choice is pulmonary endarterectomy. In inoperable patients and patients with residual pulmonary hypertension after surgery, it is possible to perform balloon angioplasty of the pulmonary artery and PAH-specific therapy. In our study, the safety and efficacy of a new method for the treatment of a residual form of chronic thromboembolic pulmonary hypertension, radiofrequency denervation of the pulmonary artery, has been proven. The pathogenetic basis of this technique is the desympathization of the pulmonary circulation by radiofrequency destruction of the autonomic ganglia of the bifurcation of the pulmonary artery and the interruption of the so-called pulmo-pulmonary reflex.

Background. There are no paediatric amplification clinical practice guidelines in Russia at the moment. At the same time the technological progress of hearing aids’ (HA), new algorithms and functions requires the objective evidence of safety and effectiveness for the hearing impaired children. For these reasons paediatric amplification algorithm was developed by the authors. Besides the standard procedures the algorithm includes an objective electroacoustic verification of the output parameters and separate HA functions. The research is devoted to the investigation of the protocol’s advantages.

Aim — development and evaluation the paediatric amplification protocol, based on objective electroacoustic verification of the output and functions of hearing aid.

Materials and Methods. Prospective, randomized, controlled clinical trial was performed. Two protocols’ effectiveness were compared. Standard protocol (control group) is based on the subjective verification. Experimental protocol suggests an electroacoustic verification of the output and different HA functions: feedback cancellation, amplitude and frequency compression, microphone directionality, digital noise reduction (experimental group). Each group included 56 children (3–17 years old) with permanent hearing loss from moderate to moderately-severe degree. Initial amplification was performed for each child; the results were estimated in 1, 3 and 6 months using PEACH and LIFE questionnaires, speech audiometry and phoneme testing. DataLogging and first fitting appointment time were also estimated.

Results. In preschool-age children of the experimental group post-amplification PEACH results were 6% better than in controls. In school-age children (LIFE questionnaire) results were 11% better comparing with control group. Speech intelligibility in quiet was 3.1% (p > 0.05) higher for pre-schoolers in the experimental group and 9.3% (p < 0.01) higher for school-age children comparing with control group. Speech intelligibility in noise was higher in experimental group than in control: 7.8% (p < 0.05) in pre-schoolers and 13% (p < 0.01) for school-age children. Phoneme recognition was better in experimental group as well: 4.5% (p < 0.05) in pre-schoolers and 9.8% (p < 0.01) in school-agers than in control group. After HA fitting following an experimental protocol DataLogging time was 11–12% longer in comparison with standard procedure. On the other hand, experimental protocol took in average 1.5 hours for the first fitting and standard protocol — 53 minutes.

Conclusions. Protocol of paediatric amplification based on objective electroacoustic verification of HA output and functions allows to significantly increase the effectiveness of hearing rehabilitation in children.

Hepatic forms of glycogen storage diseases (GSD) are a group of diseases in which abnormal accumulation or cleavage of glycogen leads to potentially life-threatening hypoglycemic conditions and metabolic disorders. The use of specialized diet therapy with the addition of raw corn starch has significantly improved the results of GSD treatment, turning a pathology previously considered fatal into a condition in which people can feel satisfactory with proper care. Despite many years of research, there is no consensus on the optimal dietary treatment of GSD. This article describes the evolution of dietary therapy of hepatic forms of GSD (types 0, I, III, VI, IX and XI), presents historical and modern approaches to the prevention of hypoglycemia and related complications.

Up to date data analysis of development and advance of gastrostomy surgical technique as well as its evolution are presented in details. Principal technical modalities of gastrostomy creation including laparotomy, miniinvasive laparoscopic approach, percutaneous endoscopic and percutaneous X-ray endoscopic gastrostomy are summarized alongside with their technical pitfalls and disadvantages. Clinical data of gastrostomy is imposed. Possible options of complications caused by technical drawbacks and functioning of gastrostomy are highlighted and described. Analysis of literature review allowed us make the conclusion of percutaneous endoscopic gastrostomy to be the most perspective from the technical and clinical efficacy point of view.

The pandemic of a new coronavirus infection has become a serious challenge for the health system of all countries, so as of May 2023, 766 million confirmed cases of the disease and more than 6.9 million deaths have been registered in the world. More than 22 million cases and 398 thousand deaths from a new coronavirus infection have been registered in the Russian Federation. The rapidly changing epidemiological situation necessitated the systematization of the material for analytical work. The need to create special tools for aggregating an array of heterogeneous information has become obvious. The high rate of accumulation of mutations in the genome of the pathogen made it necessary to study circulating genovariants both from the standpoint of their escape from postmorbid and postvaccinal immunity, and from the point of view of the characteristics of the epidemic process caused by individual variants of the virus and their significance for practical health care and the organization of antiepidemic measures. The significant heterogeneity in terms of population density, geographical and economic conditions of the constituent entities of the Russian Federation necessitated the organization of work on the implementation of continuous molecular genetic monitoring of the variability of the COVID-19 pathogen. The active development of computing technologies and the challenges faced by the epidemiological surveillance system during the COVID-19 pandemic created the prerequisites for the rapid development of the process of digital transformation in epidemiology. Three platforms were created on the basis of Central Research Institute of Epidemiology — the Russian data aggregation system VGARus, SOLAR and an analytical platform for analyzing the epidemiological situation regarding the new coronavirus infection based on the Superset program, which were the main tools for epidemiological monitoring of the new coronavirus infection.

On August 19, 2023, Academician of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences Larisa Konstantinovna Moshetova, a recognized leader in the field of ophthalmology, turned 85 years old.