JOURNAL OF EDUCATION AND SCIENTIFIC MEDICINE

GENERALIZATION OF INFECTION IN LONG-TERM NON-HEALING WOUNDS

B.Y. Umarov — 2024-11-09

Surgical sepsis must still be solved in the modern tanotogenetic statistical data structure. Sepsis against the background of the wound process, also known as wound sepsis, is considered the most common etiological cause of the development of this complication. Meanwhile, in the case of the development of wound infection, according to the literature, most authors pay attention to acute wounds, which, as is known, have a different pathogenetic mechanism of the course of the disease. However, in the context of the development and course of long-term non-healing wounds, there are few possible options for the generalization of infection in the literature. In this regard, our study aimed to identify the frequency of the development of clinical and laboratory signs of the systemic inflammatory response syndrome in patients with long-term non-healing wounds.

CURRENT INFORMATION ON THE PREVALENCE, DIAGNOSTIC CRITERIA AND CLINICAL PRESENTATION OF METABOLIC SYNDROME

A.B. Khamdamov — 2024-11-30

METABOLOMIC PROFILE OF SEX STEROID HORMONES IN WOMEN WITH INFERTILITY

M.A . Yuldasheva — 2024-12-02

Background. Studying the metabolic profile of sex steroid hormones offers new prospects in reproductive medicine. Identifying metabolic markers can aid in early diagnosis and personalized treatment of infertility.

Materials and methods. The study involved 60 women with infertility, divided into two groups: 30 women with early reproductive age infertility (Group I) and 30 women with late reproductive age infertility (Group II).

Results. The study revealed significant differences in the metabolomic profile of steroid hormones between groups: a 25% increase in estrogen metabolites in women with infertility indicates an imbalance affecting ovulation and reproductive function. Progesterone metabolite levels were elevated by 15%, which may indicate issues with the luteal phase and implantation. A 20% decrease in testosterone levels suggests impaired ovarian function and reduced fertility. ROC analysis demonstrated the high diagnostic accuracy of the model for predicting infertility (AUC=0.82), highlighting the importance of metabolomic markers in diagnosis.

Conclusion. The results indicate the importance of hormonal metabolic pathways in the development of infertility. Metabolomic analysis can serve as an early indicator of hormonal imbalances, allowing for personalized therapeutic strategies. The identification of specific metabolites, such as 2-hydroxyestrone and dehydroepiandrosterone, could form the basis for the development of early diagnostic methods.

INNOVATIVE APPROACH TO FERTILITY RESTORATION IN WOMEN OF LATE REPRODUCTIVE AGE WITH LOW OVARIAN RESERVE

F.I. Shukurov — 2024-12-02

Background. Fertility restoration in women of late reproductive age with low ovarian reserve is one of the pressing challenges in modern reproductive medicine. The decline in ovarian reserve, combined with age-related changes, limits the chances of natural conception, increases the risk of reproductive failures, and prompts specialists to seek effective and safe stimulation methods.

The aim of the study. Evaluation of the Effectiveness of PRP Therapy in Combination with a Clomiphene-Containing Drug for Fertility Restoration in Women of Late Reproductive Age with Low Ovarian Reserve

Materials and methods. The study included 110 women of late reproductive age with low ovarian reserve. Among them, 60 women with low ovarian reserve who received PRP therapy (Group I), and 50 women with extremely low ovarian reserve who received PRP therapy in combination with a clomiphene-containing drug (Group II). The control group consisted of 30 healthy women. All patients underwent a comprehensive clinical-laboratory, hormonal, immunological, and instrumental examination.

Results. The results showed that the use of PRP therapy in combination with a clomiphene-containing drug in women of late reproductive age with low and extremely low ovarian reserve led to ovulation in 75.3% and 72.5% of women, respectively, as well as pregnancy in 73.3% and 62.5% in these groups..

Conclusion. The use of PRP therapy in combination with a clomiphene-containing drug in women of late reproductive age with low and extremely low ovarian reserve led to a 2.2-fold reduction in infertility rates, a 2.2-fold increase in fertility restoration, and a fourfold reduction in treatment costs, highlighting both the medical and economic effectiveness of this approach.

EFFICACY OF BARIATRIC SURGERY IN THE TREATMENT OF PATIENTS WITH METABOLIC SYNDROME IN ASSOCIATION WITH GASTROESOPHAGEAL REFLUX DISEASE

M.SH. Khakimov — 2024-12-01

The term "bariatric" surgery, derived from the Greek word baros, meaning weight, defines surgical procedures aimed at significant weight loss. Accordingly, the goals of bariatric surgery initially evolved around achieving substantial, sustainable weight loss. Weight loss is only one of the outcomes of such an operation. Bariatric surgery may be associated with significant other health benefits, including improving or normalizing hyperglycemia. Hyperlipidemia, blood pressure, obstructive sleep apnea, and improved quality of life. Due to the broad benefits of weight loss and the growing evidence that some bariatric surgeries cause metabolic changes that cannot be fully explained by their effects on body weight alone, the name "bariatric metabolic surgery" is becoming more appropriate.

DIAGNOSTIC AND PROGNOSTIC VALUE OF THE STUDY OF NEUROTROPHIC FACTORS

D.A. Okhunova — 2024-12-10

Most degenerative disorders of the central nervous system that lead to the development of dementia are not limited to brain damage. In the development of such pathological processes, a great role is given to systemic changes not only at the biochemical, but also at the molecular level. This creates certain difficulties in choosing effective prognostic markers that are most acceptable for assessing the risk of dementia. Back in 1998, this consensus was reached by the Alzheimer's Association, the working groups on molecular and biochemical markers of Alzheimer's disease at the Ronaid and Nancy Reagan Research Institute, and the National Institute on Aging. The resolution agreed that none of the systemic changes that are proposed as characteristic biological markers of dementia can be adopted for widespread use at this time. However, research has continued and to date there is a clear understanding that systemic changes also depend on the stage of the disease. Proponents of this hypothesis came to a conclusion based on discoveries made in the field of the pathophysiological role of neurotrophic factors in neurodegenerative diseases, in particular in Alzheimer's disease. This review article is devoted to the diagnostic and prognostic capabilities of neurotrophic factors.

ANALYSIS OF THE NEUROPSYCHOLOGICAL STATE OF PATIENTS WITH AUTONOMIC DISORDERS IN CHRONIC CEREBRAL ISCHEMIA (CCI)

D.S. Tolibov — 2024-12-11

Background. The syndrome of autonomic dysfunction is currently considered as a comorbid pathology of chronic cerebral ischemia (CCI), accompanying it as it develops. Changes occurring in the autonomic nervous system precede the subsequent neurological disorders and serve as a manifestation of maladaptive reactions.

Purpose. To conduct a neuropsychological study to identify cognitive impairment in patients with autonomic dysfunction at various stages of chronic cerebral ischemia.

Methods. A study was conducted on 99 patients with autonomic dysfunction in CCI. There were examined cognitive violations at help special neuropsychological scales – MMSE, MoCA, HADS. The assessment of the vegetative status was performed using the Wayne questionnaire.

Results. The results of our study revealed the absence of a direct proportional relationship between the patient's age and the stage of CCI, but there was a clear tendency towards an increase in the manifestations of CCI as the age of the patients increased. When studying the cognitive sphere with the MMSE scale, a direct correlation was noted between the worsening of cognitive impairment and the increase in the stage of chronic cerebral ischemia. The MoCA test showed memory impairment, difficulties in performing speed and attention tasks, as well as delayed recall in patients with stages II and III of chronic cerebral ischemia. Assessment of anxiety and depression using the HADS scale revealed an increase in anxiety-depressive manifestations with an increase in the severity of chronic cerebral ischemia (stage I – 8,0±1,5 points; stage II – 12,3±1,5 points and stage III – 14,2±1,7 points).

Conclusion. In patients with autonomic dysfunction in chronic cerebral ischemia, cognitive impairment was observed. For definitions expressions cognitive dysfunctions follows apply special evaluation scales. Our studies revealed direct correlation changes in the severity of cognitive impairment with an increase in the stage of CCI.

MODERN UNDERSTANDING OF IMMUNOLOGICAL ASPECTS OF BONE REGENERATION

A.O. Okhunov — 2024-12-12

The immune system plays an active role in the regeneration of bone tissue. This reasoning can be based on the peculiarity of populations of immune cells, which, as is known, are diverse and heterogeneous. Such functional and cytological versatility of bone tissue may indicate the similarity of their natural relationship. The basis of this connection is regenerative processes, which we decided to describe in this review scientific article. Fundamental information about the bone cell system points to the fact that the monocytic line of bone marrow stem cells is considered a matrix for the formation of macrophages. Along with this, it is this ancestral line of the cell that acts as the basis for the regeneration of the bones of the skeleton – osteoclasts.

COMPARATIVE ANALYSIS OF THE MICROBIOTA OF THE REPRODUCTIVE SYSTEM IN WOMEN WITH PRIMARY AND SECONDARY INFERTILITY

A.Zh. Zhuraeva — 2024-12-12

Background. In recent years, the study of the microbiota of the reproductive system has attracted the attention of scientists due to its important role in maintaining reproductive health. An imbalance in the microbiota can lead to the development of gynecological diseases, negatively affecting fertility.

Aim. To conduct a comparative analysis of the microbiota of the reproductive system in women with primary and secondary infertility.

Materials and Methods. The study included 130 women: 50 with primary infertility (Group I), 50 with secondary infertility (Group II), and 30 healthy women (control group). Microbiota samples were collected using vaginal and cervical swabs. Microbiota identification was performed using 16S rRNA sequencing with the Illumina MiSeq platform. Statistical data processing was performed using SPSS version 25.0.

Results. The duration of infertility was 4.2 ± 1.5 years (Group I) and 5.1 ± 1.7 years (Group II). Comparative analysis showed that the level of Gardnerella vaginalis in women from Group I was 80%, which was significantly higher compared to 30% in Group II and absent in the control group (p < 0.05). The presence of Atopobium vaginae was also higher in Group I (60%) compared to Group II (20%) and absent in the control group (p < 0.05). Relative proportions of Lactobacillus spp. were significantly lower in women with primary infertility (70%) compared to Group II (90%) and the control group (100%) (p < 0.05).

Conclusion. The results of the comparative analysis of the microbiota of the reproductive system in women with primary and secondary infertility showed significant differences in the composition of the microbiota compared to the control group. Women with primary infertility are characterized by lower microbiota diversity and higher levels of conditionally pathogenic bacteria. These results highlight the importance of the microbiota in maintaining reproductive health and indicate the need for further research to develop new diagnostic and therapeutic approaches.

FEATURES OF PDL-1 EXPRESSION IN ABORTIVE TISSUES OF WOMEN WITH NON-DEVELOPING PREGNANCY ASSOCIATED WITH COVID-19 INFECTION

F.I. Shukurov — 2024-12-15

Background. Coronavirus infection significantly impacts the immune system, contributing to the development of inflammatory reactions that may disrupt normal implantation and embryo development.

Aim. To study the level of Pdl-1 receptor expression in abortive tissues from non-developing pregnancies associated with COVID-19 and to evaluate the correlation between Pdl-1 expression and the clinical course of the infection.

Materials and methods. The study included 60 women with non-developing pregnancies associated with COVID-19 infection. Participants were divided into two groups: Group I consisted of 30 women with pregnancies of 5-7 weeks, terminated by vacuum aspiration; Group II included 30 women with pregnancies of 8-12 weeks, terminated by medical abortion. The control group comprised 30 women who terminated pregnancies of 6-12 weeks by choice.

Results. The results of IHC analysis of abortive tissues in Group I showed focal Pdl-1 receptor expression in decidual tissue in 67% of cases, heterogeneous expression in chorionic villi in 58% of patients, and diffuse expression in syncytiotrophoblast in 54% of cases. In Group II, moderate Pdl-1 receptor expression in decidual tissue was found in 57% of samples. Focal expression in syncytiotrophoblast was observed in 53% of cases, and heterogeneous expression in chorionic villi was detected in 51% of cases. In the control group, Pdl-1 expression was significantly lower compared to both COVID-19 groups, indicating the virus’s impact on the immunohistochemical characteristics of the tissues.

Conclusions. The study revealed a high level of Pdl-1 receptor expression in abortive tissues from both groups with non-developing pregnancies associated with COVID-19. This increased expression likely reflects the negative impact of SARS-CoV-2 on fetal tissues, possibly due to the virus entering and damaging these tissues. Additionally, a correlation was identified between the level of Pdl-1 receptor expression and the severity of COVID-19’s clinical course. Specifically, a weak positive correlation was found between Pdl-1 expression levels and severe COVID-19 (r=0.24) and mild COVID-19 (r=0.14). This suggests that the severity of COVID-19 infection may be associated with Pdl-1 receptor expression levels in abortive tissues, potentially indicating a direct link to the immune response.

REVIEW OF EARLY CLINICAL MANIFESTATIONS OF MULTIPLE SCLEROSIS

M.R. Yunusova — 2024-12-15

Multiple sclerosis (MS) is a chronic demyelinating disorder that affects the central nervous system. Until recently, little attention was paid to the early preclinical and clinical manifestations of multiple sclerosis. It is only in the past decade that researchers have started to focus on the prodromal phase of the disease. Knowledge of the prodrome is important for suspecting and, eventually, diagnosing the disease. This article synthesizes the current literature regarding the early clinical manifestations observed in patients with MS. Because the early identification of individuals diagnosed with MS is of considerable significance, as it facilitates the prompt implementation of therapeutic strategies designed to mitigate the risk of relapses and long-term disability.