Uterine leiomyoma in the pediatric population: literature review

Uterine fibroids are the most common benign neoplastic tumor of the uterus, occurring in adolescents with a frequency of less than 1%. According to literature data, 87.5% of young patients, as a rule, have a variety of symptoms, the most frequent of which is abnormal uterine bleeding, anemizing the patient, abdominal pain, abdominal enlargement in volume. Diagnosis in adolescent girls may be difficult, due to the rarity, as well as the presence of some limitations in the echographic examination performed, as a rule, by transabdominal access. Methods of treating leiomyomas in women are well known and are widely described in clinical guidelines ranging from surgical to medicinal, however, they are not standardized for the pediatric population. Currently, no more than 25 clinical observations have been described in the literature, which indicates the importance of accumulating clinical data in order to develop an optimal clinical approach aimed at preserving reproductive function in such patients

The recombinant fusion protein CFP10–ESAT6–dIFN has protective effect against tuberculosis in guinea pigs

Development of effective vaccine candidates against tuberculosis (TB) is currently the most important challenge in the prevention of this disease since the BCG vaccine fails to guarantee a lifelong protection, while any other approved vaccine with better efficiency is still absent. The protective effect of the recombinant fusion protein CFP10–ESAT6–dIFN produced in a prokaryotic expression system (Escherichia coli) has been assessed in a guinea pig model of acute TB. The tested antigen comprises the Mycobacterium tuberculosis (Mtb) proteins ESAT6 and CFP10 as well as modified human γ-interferon (dIFN) for boosting the immune response. Double intradermal immunization of guinea pigs with the tested fusion protein (2 × 0.5 µg) induces a protective effect against subsequent Mtb infection. The immunized guinea pigs do not develop the symptoms of acute TB and their body weight gain was five times more as compared with the non-immunized infected guinea pigs. The animal group immunized with this dose of antigen displays the minimum morphological changes in the internal organs and insignificant inflammatory lesions in the liver tissue, which complies with a decrease in the bacterial load in the spleen and average Mtb counts in macrophages

Development of management abilities of motor transportation companies’ leaders

The paper presents main ways of development of management abilities of motor transportation companies’ leaders. Summary of modern investigations devoted to development of management abilities in made. Peculiarities of management abilities is motor-transportation branch are shown. The study devoted to personal traits of motor transportation leaders that can be a factor of their better quality and higher effectiveness at work is done and its results are presented. It was proved that several personal traits give the basis of a better quality at work of motor transportation leaders: activity, communicativeness, persistence, stress tolerance, purposefulness, and absence of the role conflict at work. These traits and qualities can be taken as a basis when we decide to develop management abilities of motor transportation leaders. At the particular motor transportation company in Irkutsk (Siberia region) where the investigation was done the majority of leaders have these traits and qualities at much lower level than it is required. As a result, the developing program for them was proposed. This program included the description of conditions on which the developing work can be done effectively and the content of the developing work itself. The proposed and tested program consists of four blocks including developing, modelling and correcting psychological technologies that taken in common had shown a significant shift of management abilities of motor transportation leaders

Oral Immunogenicity of Plant-Made Mycobacterium tuberculosis ESAT6 and CFP10

Two lines of transgenic carrot plants producing Mycobacterium tuberculosis proteins (ESAT6 and CFP10) have been constructed. The target proteins are present in carrot storage roots at a level not less than 0.056% of the total storage protein (TSP) for ESAT6 and 0.002% of TSP for CFP10. As has been shown, oral immunization of mice induces both the cell-mediated and humoral immunities. These data suggest that the proteins in question are appropriate as a candidate edible vaccine against tuberculosis

Endometriosis in Adolescents: Diagnostics, Clinical and Laparoscopic Features

Background: The early diagnosis of endometriosis in adolescents is not developed. Objective: We aim to conduct clinical, imaging, laparoscopic and histological analyses of peritoneal endometriosis (PE) in adolescents in order to improve early diagnosis. Methods: In total, 134 girls (from menarche to 17 years old) were included in a case–control study: 90 with laparoscopically (LS) confirmed PE, 44 healthy controls underwent full examination and LS was analyzed in the PE group. Results: Patients with PE were characterized with heredity for endometriosis, persistent dysmenorrhea, decreased daily activity, gastrointestinal symptoms, higher LH, estradiol, prolactin and Ca-125 (<0.05 for each). Ultrasound detected PE in 3.3% and MRI in 78.9%. The most essential MRI signs are as follows: hypointense foci, the heterogeneity of the pelvic tissue (paraovarian, parametrial and rectouterine pouch) and sacro-uterine ligaments lesions (<0.05 for each). Adolescents with PE mostly exhibit initial rASRM stages. Red implants correlated with the rASRM score, and sheer implants correlated with pain (VAS score) (<0.05). In 32.2%, foci consisted of fibrous, adipose and muscle tissue; black lesions were more likely to be histologically verified (0.001). Conclusion: Adolescents exhibit mostly initial PE stages, which are associated with greater pain. Persistent dysmenorrhea and detected MRI parameters predict the laparoscopic confirmation of initial PE in adolescents in 84.3% (OR 15.4; <0.01), justifying the early surgical diagnostics and shortening the time delay and suffering of the young patients

Altered Monocyte and Lymphocyte Phenotypes Associated with Pathogenesis and Clinical Efficacy of Progestogen Therapy for Peritoneal Endometriosis in Adolescents

Background: Immunological imbalances characteristic of endometriosis may develop as early as the primary manifestations of the disease in adolescence. Objective: To evaluate subpopulation dynamics of monocytes and lymphocytes in peripheral blood and peritoneal fluid of adolescents with peritoneal endometriosis at diagnosis and after 1-year progestogen therapy. Methods: This study included 70 girls, 13–17 years old, diagnosed laparoscopically with peritoneal endometriosis (n = 50, main group) or paramesonephric cysts (n = 20, comparison group). Phenotypes of monocytes and lymphocytes of the blood and macrophages of the peritoneal fluid were analyzed by flow cytometry at diagnosis and during progestogen therapy. Results: Differential blood counts of CD16+ (p + (p = 0.017) monocytes were identified as independent risk factors for peritoneal endometriosis in adolescents. During the treatment, cytotoxic lymphocytes CD56dimCD16bright (p = 0.049) and CD206+ monocytes (p p = 0.017). The CD56dimCD16bright blood counts before (p p = 0.006), as well as CD206+ blood counts during the treatment (p = 0.038), were associated with the efficacy of pain relief after 1-year progestogen therapy. Conclusions: Adolescents with peritoneal endometriosis have altered counts of pro- and anti-inflammatory monocytes and lymphocytes both before and after 1-year progestogen therapy, correlating with treatment efficacy and justifying long-term hormonal therapy

Androgen Insensitivity Syndrome with Bilateral Gonadal Sertoli Cell Lesions, Sertoli–Leydig Cell Tumor, and Paratesticular Leiomyoma: A Case Report and First Systematic Literature Review

Androgen insensitivity syndrome (AIS) is a rare Mendelian disorder caused by mutations of the androgen receptor (AR) gene on the long arm of the X chromosome. As a result of the mutation, the receptor becomes resistant to androgens, and hence, karyotypically male patients (46,XY) carry a female phenotype. Their cryptorchid gonads are prone to the development of several types of tumors (germ cell, sex cord stromal, and others). Here, we report a 15-year-old female-looking patient with primary amenorrhea who underwent laparoscopic gonadectomy. Histologically, the patient’s gonads showed Sertoli cell hamartomas (SCHs) and adenomas (SCAs) with areas of Sertoli–Leydig cell tumors (SLCTs) and a left-sided paratesticular leiomyoma. Rudimentary Fallopian tubes were also present. The patient’s karyotype was 46,XY without any evidence of aberrations. Molecular genetic analysis of the left gonad revealed two likely germline mutations—a pathogenic frameshift deletion in the AR gene (c.77delT) and a likely pathogenic missense variant in the RAC1 gene (p.A94V). Strikingly, no somatic mutations, fusions, or copy number variations were found. We also performed the first systematic literature review (PRISMA guidelines; screened databases: PubMed, Scopus, Web of Science; ended on 7 December 2023) of the reported cases of patients with AIS showing benign or malignant Sertoli cell lesions/tumors in their gonads (n = 225; age: 4–84, mean 32 years), including Sertoli cell hyperplasia (1%), Sertoli cell nodules (6%), SCHs (31%), SCAs (36%), Sertoli cell tumors (SCTs) (16%), and SLCTs (4%). The few cases (n = 14, 6%; six SCAs, four SCTs, two SLCTs, and two SCHs) with available follow-up (2–49, mean 17 months) showed no evidence of disease (13/14, 93%) or died of other causes (1/14, 7%) despite the histological diagnosis. Smooth muscle lesions/proliferations were identified in 19 (8%) cases (including clearly reported rudimentary uterine remnants, 3 cases; leiomyomas, 4 cases). Rudimentary Fallopian tube(s) were described in nine (4%) cases. Conclusion: AIS may be associated with sex cord/stromal tumors and, rarely, mesenchymal tumors such as leiomyomas. True malignant sex cord tumors can arise in these patients. Larger series with longer follow-ups are needed to estimate the exact prognostic relevance of tumor histology in AIS

Altered Glycolysis, Mitochondrial Biogenesis, Autophagy and Apoptosis in Peritoneal Endometriosis in Adolescents

Energy metabolism plays a pivotal role in the pathogenesis of endometriosis. For the initial stages of the disease in adolescents, this aspect remains unexplored. The objective of this paper was to analyze the association of cellular and endosomal profiles of markers of glycolysis, mitochondrial biogenesis, apoptosis, autophagy and estrogen signaling in peritoneal endometriosis (PE) in adolescents. We included 60 girls aged 13–17 years in a case–control study: 45 with laparoscopically confirmed PE (main group) and 15 with paramesonephric cysts (comparison group). Samples of plasma and peritoneal fluid exosomes, endometrioid foci and non-affected peritoneum were tested for estrogen receptor (Erα/β), hexokinase (Hex2), pyruvate dehydrogenase kinase (PDK1), glucose transporter (Glut1), monocarboxylate transporters (MCT1 and MCT2), optic atrophy 1 (OPA1, mitochondrial fusion protein), dynamin-related protein 1 (DRP1, mitochondrial fission protein), Bax, Bcl2, Beclin1, Bnip3, P38 mitogen-activated protein kinase (MAPK), hypoxia-inducible factor 1 (Hif-1α), mitochondrial voltage-dependent anion channel (VDAC) and transforming growth factor (TGFβ) proteins as markers of estrogen signaling, glycolysis rates, mitochondrial biogenesis and damage, apoptosis and autophagy (Western-Blot and PCR). The analysis identified higher levels of molecules associated with proliferation (ERβ), glycolysis (MCT2, PDK1, Glut1, Hex2, TGFβ and Hif-1α), mitochondrial biogenesis (OPA1, DRP1) and autophagy (P38, Beclin1 and Bnip3) and decreased levels of apoptosis markers (Bcl2/Bax) in endometrioid foci compared to non-affected peritoneum and that in the comparison group (p p < 0.05). The results of the differential expression profiles indicate microenvironment modification, mitochondrial biogenesis, estrogen reception activation and glycolytic switch along with apoptosis suppression in peritoneal endometrioid foci already in adolescents

Развитие лидерских способностей студентов-психологов средствами психологического консультирования

Introduction. The today’s strategy of the education system declaratively aims to train specialists with well-developed leadership abilities. In fact, universities graduate very few such specialist, which is especially relevant for psychological education. Leadership abilities, which form the basis for many professionally important qualities of a psychologist, are minimally developed in many students; traditional university-based training of psychologists does not provide their purposeful development. This empirical study is the first to prove that group psychological counseling may increase the level of leadership abilities of psychology students within a relatively short time. Psychological counseling can be integrated into the educational process. Methods. The empirical study involved 50 full-time bachelor-level students studying at the Faculty of Psychology, Irkutsk State University. The research used the following methods: (a) the test method of multi-scale personality inventories; (b) developing, modeling, teaching, and analytical methods of psychological counseling; and (c) methods of nonparametric statistics (Fisher’s angular transformation). Results. Psychological counseling of psychology students resulted in a substantial increase in the level of leadership abilities, in the levels of communicative and organizational skills associated with leadership, and in the levels of leadership qualities (for example, extraversion, lability, and spontaneity). Discussion. Psychological counseling contributes to an increase in the level of future psychologists’ leadership skills. Leadership skills are improved both in terms of leadership qualities and communication skills associated with leadership. Conclusion. The development of leadership abilities of future psychologists by methods of psychological counseling can and should become a part of their professional training. Group counseling sessions aiming at the development of leadership skills may be implemented within specialized elective courses and disciplines that provide the development of personality and leadership (social psychology, psychological counseling, etc.).Введение. Современная стратегия системы образования, декларативно нацеленная на подготовку специалистов с развитыми лидерскими способностями, фактически таких специалистов выпускает критически мало, что особенно негативно проявляется в психологическом образовании. Лидерские способности, содержательно составляющие основу для многих профессионально важных качеств психолога, у многих студентов развиты минимально, и традиционная вузовская подготовка психологов не предусматривает их целенаправленного развития. Было предпринято эмпирическое исследование, в котором мы впервые доказали, что проведение группового психологического консультирования за относительно короткий срок позволяет добиться повышения уровня лидерских способностей студентов-психологов и что эта работа может быть интегрирована в учебный процесс. Методы. В эмпирическом исследовании приняли участие 50&nbsp;студентов, обучающихся на разных курсах очной формы бакалавриата факультета психологии Иркутского государственного университета. В исследовании были использованы следующие методы: тестовый метод многошкальных личностных опросников; развивающие, моделирующие, обучающие и аналитические методы психологического консультирования; методы непараметрической статистики (угловое преобразование Фишера). Результаты. В результате проведенной консультационной работы со студентами-психологами нам удалось повысить не только собственно показатель лидерских способностей, но и показатели сопряженных с ним коммуникативных и организаторских способностей, а также показатели личностных лидерских качеств (например, экстраверсии, лабильности, спонтанности). Обсуждение результатов. Психологическое консультирование способствует повышению уровня лидерских способностей будущих психологов: лидерские способности улучшаются как в части лидерских личностных качеств, так и в части сопряженных с лидерством коммуникативных способностей. Заключение. Развитие лидерских способностей будущих психологов методами психологического консультирования может и должно стать частью их профессиональной подготовки. Групповые консультационные сессии по развитию лидерских способностей могут быть реализованы как в рамках специализированных факультативов, так и в контексте дисциплин, содержание которых предусматривает развитие личности и лидерства (социальная психология, психологическое консультирование и др.)