ROLE OF THE REGULATORY T CELLS IN PROGRESSION OF PROSTATE CANCER

The existing data on regulatory T cells (Tregs) in prostate cancer suggest that these cells may penetrate the prostate gland malignant tissue, suppressing antitumor immune response, thus promoting aggressive clinical course and low survival of the cancer patients. Evaluation of T cell subpopulations from the tumor microenvironment has shown that the number of CD4+Tregs is associated with inferior clinical prognosis. In particular, each additional CD4+Treg cell has been shown to cause a statistically significant increase in prostate cancer mortality by 12%, regardless of other clinical factors. There are several possible explanations for the increased infiltration of prostate cancer tissue with regulatory T cells. Firstly, malignant cells or tumor-associated macrophages are capable of secreting chemokine CCL22, which has an affinity for the CCR4 receptor expressed on Treg cells. Secondly, cytokines secreted by prostate tumors, such as TGF-β, may regulate the FoxP3 expression, thus expanding the Treg population. TGF-β, in turn, is a multifunctional cytokine that promotes survival and proliferation of transformed cells, including prostate epithelium, as evidenced by increased amounts in the patients with metastatic disease

Urinary tract infections in patients with type 2 diabetes mellitus with pharmacological glucosuria

Selective inhibitors of sodium-glucose cotransporter belong to a new class of drugs for the treatment of type 2 diabetes mellitus. The mechanism of their action is based on insulin-independent reduction of glucose reabsorption in the proximal renal tubules, which leads to stimulation of its excretion in the urine and, accordingly, to a decrease in the concentration of glucose in the blood plasma. Drugs of this group demonstrate effectiveness in the treatment of type 2 diabetes, but their use may be associated with an increased frequency of urinary tract infections. Pharmacological glucosuria, which leads to a decrease in the concentration of glucose in the blood, creates the preconditions for the occurrence of urinary tract infections. Urinary tract and genital infections are the most common adverse events associated with the use of sodium-glucose cotransporter inhibitors. In the presented literature review for 20162019, the relationship between urinary tract infections in patients with type 2 diabetes mellitus and therapy with sodium-glucose cotransporter inhibitors was analyzed

Bridging therapy in maxillofacial and dental surgery

The article discusses approaches to temporary transition from oral anticoagulants to parenteral heparins (so called bridge therapy) which are often used to provide maxillofacial and dental surgery, and decreases the risk of bleeding in patients receiving warfarin. Features of bridge therapy in dental surgery have been described

Modern approaches to the correction of the gut microbiota

The article presents modern data on the formation, structure, functions and possibilities of correction of the gut microbiota. The gut microbiota is a collection of living organisms that inhabit the human intestine and form a complex microecological system that performs many functions. It is known that the composition and state of the gut microbiota is influenced by both environmental factors, such as diet and lifestyle, and the human body, including genetic predisposition. A violation in this system (dysbiosis) can provoke the development of a number of diseases and pathological conditions, in which the correction of the gut microbiota may be a promising therapeutic strategy. The most common methods of correcting dysbiosis are dieting, the use of pro-and prebiotics, and fecal microbiota transplantation. The diet affects the qualitative and quantitative composition and functions of the gut microbiota, the activity of its individual representatives. Probiotics are used to modulate, preserve the gut microbiota in dysbiosis, as well as to prevent its development. Fecal microbiota transplantation is performed by transferring the microbiota from a healthy donor. This method is one of the most effective ways to treat Clostridium difficile infection. This review article also presents the results of fecal microbiota transplantation in patients with inflammatory bowel disease and hepatic encephalopathy. It is shown that after transplantation, there is a rapid change in the composition of the gut microbiota, which becomes similar to the microbiota of a healthy donor. Each of these methods of correction demonstrates a different degree of influence on the gut microbiota, and their therapeutic effectiveness depends on the direct characteristics of the methods used, as well as the specific disease and requires further study

The Effect of Stress on Menstrual Dysfunction in Female Students of Higher Educational Institutions in Moscow

Background: Gynecological morbidity in women of young reproductive age remains an urgent issue in modern medicine. Along with many adverse factors affecting the health of girls and young women, who should be considered as expectant mothers, stress takes one of the leading positions. Objective: To study the level of stress in female students with menstrual dysfunction. Materials and methods: 136 female students from 18 to 23 years old (average age 19.3 +/- 2.6 years). All of the participants completed a questionnaire compiled by the authors on the basis of standard questions in collecting general and gynecological anamnesis, criteria for diagnosing premenstrual syndrome, psychological stress scale PSM-25 (fully included, no changes), and Beck scale (fully included, no changes). The following features of the menstrual cycle were studied: cycle duration, menstruation duration, profusion, soreness, and regularity of menstruation as well as the presence of psychoemotional changes during the phase changes of the cycle. A systematic review was carried out of 25 studies (review articles, qualitative studies, questionnaires, retrospective and prospective studies) published in Russian and English from 2000 to 2019 (with a predominant including (88%) data for the last 10 years) using the PubMed, ScienceDirect, ProQuest and GoogleScholar databases. Results: 82.4% (n = 112) of the examined female students had various menstrual dysfunctions; the highest frequency was premenstrual syndrome (91.1%) and primary dysmenorrhea (85.7%). Students with high levels of stress and depression expressed significantly more often (p<0.05) with irregular rhythms of menstruation in comparison to the healthy group. Conclusions: It is recommended to physicians take into account the stress influence on gynecological pathology, while the awareness of young women about their health status should also be raised

Risk factors of the fungal urinary tract infections

The role of fungi as causative agents of infections is growing. In in-patients, especially at intensive care units, fungal infections might cause serious problems. Studies conducted over recent years shows an increase of fungi detection in urine in in-patients from 5,01 up to 10,63%. Most often, the appearance of fungi in the urine connected with contamination or colonization of the urinary tract. However, in immunocompromised patients, this could be the part of urinary tract infection and even of disseminated fungal process. Candida is the most common cause of fungal urinary tract infections. At the same time, the presence of Candida in urine (candiduria) not always comes with clinical signs of urethritis, cystitis and pyelonephritis. Detection of noCandida albicans agents in urine is increasing, new Candida species revealed are resistant to antifungal drugs so risk of complications is increasing. Recent researches reveal new mechanisms of how Candida interacts with the bacteria that cause urinary infections. The main mechanisms of Candida virulence factors are dimorphism, adhesion proteins — Als1-7,9 and Gls, invasion enzymes — phospholipase, Als3 and Ssa1, as well as enzymes that neutralize reactive oxygen species. The most significant risk factors of fungal urinary tract infection are the presence of a urinary catheter, diabetes mellitus, immunosuppression and previous antibiotic intake. The study of the formation process of the cellular and immune response to Candida makes it possible to identify the main links in the pathogenesis of urinary tract candidiasis, as well as the main role of immunosuppression in the development of the disease

CHARACTERISTICS OF GUT MICROBIOTA IN AUTOIMMUNE DISEASES OF THE THYROID GLAND AND THE METHODS OF ITS CORRECTION

Gut microbiota is considered as a pathogenetic factor of various diseases nowadays. The patients with autoimmune diseases are known to suffer from dysbiosis. There arc studies in the modern literature that demonstrate changes in the composition of the gut microbiota in case of thyroid dysfunction. This review examines a contemporary view of the gut microbiota, its role in the development of autoimmune diseases. We investigated the interaction between the thyroid gland and the gut microbiota, its species composition in hypo- and hyperthyroidism. Possible methods of correction, including the use of pre- and probiotics and transplantation of fecal microbiota have been demonstrated

Treatment of migraine in general practice

Migraine is a rather common disorder in general practice. The article discusses the problems of pathogenesis and diagnosis of migraine, including the severe forms of the disease and its' different masks. The paper contains the data on the current approach to curing acute attacks and preventive treatment of migraine in general practice