Latent iron deficiency therapy in pregnant women

According to various studies, the overall population incidence of latent iron deficiency (LID) ranges from 70% and more. However, routine tests cannot detect LID during preconception examination and in the first trimester of pregnancy; therefore, women receive no proper treatment, and iron deficiency manifest in the second and third trimesters of pregnancy. LID causes hypoxia, leading to pregnancy, labor, and postpartum complications. Aim. To evaluate the effectiveness of iron with folic acid supplements compared to vitamin-mineral complexes in pregnant women with LID to improve maternal and perinatal outcomes. Materials and methods. A prospective cohort non-interventional study (observational program) in real clinical practice was conducted. In total 461 pregnant women aged 19 to 35 with LID were included in the study. During the study, women were divided into two groups according to the method of LID correction: administration of iron sulfate 247.25 mg, which corresponds to an iron content of 80 mg + folic acid 350 g (Gyno-Tardyferon), or vitamin-mineral complexes with an iron content of 1418 mg. Routine complete blood count, serum iron, serum ferritin, and transferrin were monitored over time. Results. Gyno-Tardyferon showed high therapeutic and prophylactic efficacy; the rate of favorable outcomes was 100% and 35% for multivitamin iron-containing complexes. No LID progression to manifest iron deficiency during pregnancy can also be considered a favorable outcome. Conclusion. The results showed that timely treatment of LID with an iron-containing medication (Gyno-Tardyferon) prevents manifested iron deficiency and hemic and circulatory hypoxia, which ultimately reduces the rate of pregnancy, labor, and postpartum complications

Genetic landscape in Russian patients with familial left ventricular noncompaction

BackgroundLeft ventricular noncompaction (LVNC) cardiomyopathy is a disorder that can be complicated by heart failure, arrhythmias, thromboembolism, and sudden cardiac death. The aim of this study is to clarify the genetic landscape of LVNC in a large cohort of well-phenotyped Russian patients with LVNC, including 48 families (n=214).MethodsAll index patients underwent clinical examination and genetic analysis, as well as family members who agreed to participate in the clinical study and/or in the genetic testing. The genetic testing included next generation sequencing and genetic classification according to ACMG guidelines.ResultsA total of 55 alleles of 54 pathogenic and likely pathogenic variants in 24 genes were identified, with the largest number in the MYH7 and TTN genes. A significant proportion of variants −8 of 54 (14.8%) −have not been described earlier in other populations and may be specific to LVNC patients in Russia. In LVNC patients, the presence of each subsequent variant is associated with increased odds of having more severe LVNC subtypes than isolated LVNC with preserved ejection fraction. The corresponding odds ratio is 2.77 (1.37 −7.37; p <0.001) per variant after adjustment for sex, age, and family.ConclusionOverall, the genetic analysis of LVNC patients, accompanied by cardiomyopathy-related family history analysis, resulted in a high diagnostic yield of 89.6%. These results suggest that genetic screening should be applied to the diagnosis and prognosis of LVNC patients

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

INDICATORS OF OVARIAL RESERVE, PRO- AND ANTIOXIDANT SYSTEM, CYTOKINE STATUS OF PERIPHERAL BLOOD AND PERITONEAL LIQUID IN PATIENTS WITH ENDOMETRIOID OVARIAN CYSTS

The aim of this work was to identify the characteristics of the cytokine status and state of the pro- and antioxidant systems in patients of late reproductive age with endometrioid cysts and determine their role in changing the ovarian reserve.Materials and methods. A total of 89 patients with endometrioid ovarian cysts (EOC) were examined. The control group consisted of 35 healthy patients admitted for surgical sterilisation. Peripheral blood was collected before surgery, while the peritoneal fluid collection was performed intraoperatively. In peripheral blood and peritoneal fluid, the level of cytokines was determined. The calculation of the anti-inflammatory index was performed, along with the evaluation of the content of lipid peroxidation products and the antioxidant activity. The analysis of the ovarian reserve parameters was conducted.Results. In patients of late reproductive age suffering from EOC, a decrease in the ovarian reserve is observed under the preserved hormonal background. The presence of EOC is accompanied by the activation of lipid peroxidation, both at the systemic and local levels, under a pronounced inhibition of the antioxidant defence link. At the systemic and local levels, patients with EOC experience an imbalance in the cytokine system with a significant activation of the pro-inflammatory component.Conclusion. The disruption of oxidative homeostasis and activation of immune inflammation, detected in patients of late reproductive age with EOC, may lead to the damage of the structural cell components of the functional ovarian tissue, thereby reducing the ovarian reserve.Conflict of interest: the authors declare no conflict of interest

MANAGEMENT OF PREGNANCY AND LABOUR AFTER KIDNEY TRANSPLANTATION: CLINICAL CASE

Aim. To present a clinical case of pregnancy and childbirth in a woman with a kidney transplant with a favourable outcome for the mother and the fetus. Materials and methods. We studied all medical documents — the pregnancy record, observations and delivery record — of a woman with a transplanted kidney. Clinical case. The article describes the clinical observation of a pregnant woman, who is intended for continuous immunosuppressive therapy after the operation on cadaveric kidney allotransplantation. Conclusion. Pregnancy management in patients with a transplanted kidney should be carried out under the supervision of an obstetrician-gynecologist, nephrologist and urologist, as well as under the permanent clinical and laboratory monitoring of all indicators of the mother’s body (blood and urine tests, blood pressure control) and the fetus (ultrasound, Doppler). This category of patients belongs to a high-risk group in terms of complications for the mother and fetus

Poly[[tri-μ-aqua-dodecaaquatris(μ3-1-hydroxyethylidene-1,1-diphosphonato)tricalcium(II)tripalladium(II)] pentahydrate]

The asymmetric unit of the title compound, {[CaPd{CH3OHC(PO3)2}(H2O)5]·5/3H2O}n, consists of one half of the complex [Pd{CH3OHC(PO3)2}]2− anion (point group symmetry m..), one Ca2+ cation [site symmetry (.2.)] that is surrounded by three water molecules (one of which is on the same rotation axis) and by three disordered lattice water molecules. The anions form a trinuclear metallocycle around a crystallographic threefold rotation axis. The cations are related by a twofold rotation axis to form a [Ca2(H2O)10]2+ dimer. The slightly distorted square-planar coordination environment of the PdII atoms in the complex anions is formed by O atoms of the bidentate chelating phosphonate groups of the 1-hydroxyethylidene-1,1-diphosphonate ligands. In the crystal, cations are bound to anions through —Ca—O—P—O— bonds, as well as through O—H...O hydrogen bonds, resulting in a three-dimensional polymer. The structure is completed by five disordered solvent molecules localized in cavities within the framework