38 research outputs found

    Ovarian reserve and autoimmune thyroid diseases

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    Present literature review provides information about clinical trials that evaluated the association of the carriage of antithyroid antibodies (ATA) and the reduction of the ovarian reserve, as well as the effectiveness of assisted reproductive technologies. The ambiguity and sometimes the opposite of the conclusions of different authors, makes it possible to recommend a balanced attitude to the advisability of screening for ATA in women with a reproductive dysfunction as well as the therapeutic measures proposed in some guidelines based on the results of such examination

    Phenological shifts of abiotic events, producers and consumers across a continent

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    Ongoing climate change can shift organism phenology in ways that vary depending on species, habitats and climate factors studied. To probe for large-scale patterns in associated phenological change, we use 70,709 observations from six decades of systematic monitoring across the former Union of Soviet Socialist Republics. Among 110 phenological events related to plants, birds, insects, amphibians and fungi, we find a mosaic of change, defying simple predictions of earlier springs, later autumns and stronger changes at higher latitudes and elevations. Site mean temperature emerged as a strong predictor of local phenology, but the magnitude and direction of change varied with trophic level and the relative timing of an event. Beyond temperature-associated variation, we uncover high variation among both sites and years, with some sites being characterized by disproportionately long seasons and others by short ones. Our findings emphasize concerns regarding ecosystem integrity and highlight the difficulty of predicting climate change outcomes. The authors use systematic monitoring across the former USSR to investigate phenological changes across taxa. The long-term mean temperature of a site emerged as a strong predictor of phenological change, with further imprints of trophic level, event timing, site, year and biotic interactions.Peer reviewe

    Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

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    BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

    Correlations and age-related changes in central and peripheral hemodynamic parameters

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    BACKGROUND: One of the current issues of fundamental and clinical medicine is the early diagnosis of pathological changes that may lead to the development of cardiovascular disease. AIM: The study aimed to investigate age-related changes in the cardiovascular system in healthy individuals by a comprehensive assessment of the correlations between hemodynamic and microcirculatory parameters at different age. METHODS: The study was conducted on 136 adult volunteers with no clinical or laboratory manifestations of cardiovascular disease. The material was divided into five age groups: adolescence, I and II periods of adulthood, old age, and senile age. Males and females accounted for 50.73% and 49.27%, respectively. Central and peripheral hemodynamic parameters were measured using high-resolution compression oscillometry, ultrasound duplex scanning of aortic arch branches, echocardiography, and reactive hyperemia test on the brachial artery. Microcirculation indices in the skin of the right index finger were studied using a laser Doppler flowmeter before and after the treadmill test. The digital data were processed by the methods of variation statistics using the JASP 0.16.4.0 statistical software package. RESULTS: An age-related decrease in skin microcirculation indices was observed. A significant statistical dependence of changes in microcirculation indices after physical activity in the groups of old and senile age was found. Left ventricular ejection fraction, cardiac output, cardiac index, stroke volume, and stroke index progressively decreased with increasing age; diastolic blood pressure increased; pliability of the brachial artery vascular wall decreased; total and specific peripheral resistance increased. Blood flow indices in the common carotid arteries (diameter and linear and volumetric blood flow velocity) decreased, whereas resistance index and intima-media thickness increased. Blood flow indices in vertebral arteries (linear and volumetric blood flow velocity) and indices of total blood flow to the brain progressively decreased with age. In addition, the dependence of some indices on gender was revealed. CONCLUSIONS: With increasing age in healthy people, changes in central and peripheral hemodynamic parameters occur, which do not lead to cardiovascular diseases. Age-related changes in macro- and microcirculation are best detected during functional stress tests and should be considered in clinical practice as a manifestation of the normal aging process

    Quantitative characteristics of the phases of winter dormancy of conifer species at a site in Central Siberia

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    Traditionally the registration of seasonal changes in plant growth and development has been carried out phenologically, i.e., qualitatively using visual inspection. However, since the process of plant acclimatization to winter dormancy involves reversible biochemical and physiological changes at the level of cells, quantitative methods can be applied to determine the duration and the depth of winter dormancy in perennial plants. We used a method based on detecting thermally induced changes in the zero-level fluorescence (TICZF) on needles from four Siberian coniferous trees. Needles of Picea obovata Ledeb. and Abies sibirica Ledeb. recover from the state of winter dormancy much faster than those of Pinus sibirica Du Tour and Pinus sylvestris L. The photosynthetic apparatus in the needles of A. sibirica may be damaged during the spring period, characterized by unstable weather, when after several days of warm weather, the plants prematurely recover from winter dormancy. We conclude that under conditions of climate warming tree, species like A. sibirica may suffer from severe diebacks due to desiccation caused by premature break of winter dormancy

    Vliyanie HBV- i HCV- infektsii na razvite autoimmunnogo otveta i funktsiyu beta-kletok podzheludochnoy zhelezy u bol'nykh sakharnym diabetom

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    Цель. Изучение воздействия гепатотропных вирусов (HBV и HCV) на развитие аутоиммунных процессов к (3-клеткам поджелудочной железы и их секреторную функцию у больных СД типа 2. Материалы и методы. Обследовали 173 больных с клиническим диагнозом СД типа 2. Все больные были разделены на группы в зависимости от обнаружения у них серологических маркеров HBV- и HCV-инфекции и репликативной активности вирусов: 1-я группа (п=7) - больные СД 2 типа, инфицированные HBV, фаза репликации (HbsAg + антиНВс, R+); 2-я группа (п=68) - инфицированные HBV, нерепликативная фаза (антиНВс, R-); 3-я группа (п=23) ? инфицированные HCV, фаза репликации (анти-HCV, R +); 4-я группа (п=13) - инфицированные HCV, нерепликативная фаза (анти-HCV, R-); 5-я группа (п=62) - неинфицированные больные СД 2 типа. Определяли антитела к декарбоксилазе глутаминовой кислоты (GADA) и антител к островковым клеткам (цитоплазматическим компонентам бета-клеток) (ICA) в сыворотке крови, уровень С-пептида. Результаты. Анализ показал значимо более высокую частоту выявления GADA у больных, инфицированных HBV и HCV (в группе 1-й - 57,1%; во 2-й - 36,7%; в 3-й - 34,8%; 4-й ? 53,9% соответственно), в сравнении с больными СД 2 типа, неинфицированными HBV и HCV (в группе 5-й ? 9,7%). Проведенный анализ показал высокую частоту выявления 1СА у больных, инфицированных HBV и HCV, в сравнении с больными СД типа 2, неинфицированными HBV и HCV. Отмечалось снижение уровня С-пептида к 3-у году течения СД у инфицированных и неинфицированных больных, которое прогрессировало с увеличением длительности СД. Выводы. У HBV- и HCV-инфицированных больных СД типа 2 наблюдается высокая частота обнаружения антител к р-клеткам: GADA в 39,6% и ICA в 25% случаев. У больных СД типа 2, инфицированных HBV и HCV, с увеличением длительности заболевания быстрее прогрессирует снижение секреции инсулина, чем у неинфицированных больных. Одним из патогенетических механизмов снижения секреции инсулина может являться аутоиммунная агрессия, направленная к р-клеткам, инициированная HBV- и HCV-инфекцией. У 36% HBV- и HCV-инфицированных больных СД типа 2 обнаружены как антитела к р-клеткам, так и низкая секреция инсулина, что свидетельствует о развитии у них аутоиммунного сахарного диабета

    Forecast of urban air pollution level by expertise

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    Introduction. A climate pattern with marine features is typical for St. Petersburg. Vagaries of weather and climate conditions in the last decade specify the timeliness of this work, the purpose of which is to outline the expected level of the open air pollution in St. Petersburg by the “decision tree” method. Materials and Methods. Current data of weather observations carried out at station 26063 (St. Petersburg) from 2006 to 2014 are studied and processed. Within the framework of the study, the data were considered on the vertical profile of the atmosphere obtained through radiosounding the atmosphere of St. Petersburg at 00.00 and 12.00 UTC (Universal Time Coordinated) at Voeykovo station. Research Results . In the course of the investigation, the dependence of the atmospheric air pollution level on the synoptic process and the inertial factor was established which made it possible to figure a scheme for forecasting the air pollution level in the form of the decision tree by expertise. Accuracy of the predictive determination of the expected air pollution group in St. Petersburg was calculated on the dependent material and topped 90% (nighttime hours) and 91% (daytime hours) for a cold period; and - 84% (nighttime hours) and 87% (daylight hours) for a warm period of the year. This suggests that the proposed schemes allow obtaining a more efficient prediction of the atmospheric air pollution level in a cold period of the year. Discussion and Conclusions . In conclusion, basic outcomes and inferences are summarized. - Archives of baseline standard meteorological data and data of the atmosphere radiosounding, as well as synoptic situations and information on the level of atmospheric air pollution in St. Petersburg for the period from 2006 to 2014, are formed. - Groups of synoptic processes typical for St. Petersburg from 2006 to 2014 are established. - Schemes for forecasting the atmospheric air pollution level are developed using the “decision tree” method with accuracy of 84-91%. The research results are applicable for forecasting the urban air pollution level
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