ОСОБЛИВОСТІ ПРОЯВІВ БОЙОВИХ СТРЕСОВИХ РОЗЛАДІВ У ПОРАНЕНИХ ВІЙСЬКОВОСЛУЖБОВЦІВ ЗБРОЙНИХ СИЛ УКРАЇНИ – УЧАСНИКІВ БОЙОВИХ ДІЙ

Early diagnosis of negative mental states, post-stress states allows detecting early and severe manifestations of combat mental trauma and its consequences in wounded servicemen of the Armed Forces of Ukraine, and also allows developing individual tactics and methods of prevention and recovery of each examined serviceman. The lack of a unified, scientifically sound comprehensive approach to the organization of effective measures of medical, psychological and social rehabilitation, the urgent need to improve the quality of life, medical care, social protection and medical and psychological assistance to servicemen, led to the urgency of the study. Disorders among servicemen of the Armed Forces of Ukraine – participants in hostilities. In the course of work it is revealed that participation in the armed conflict, the received wound is a powerful stress factor leading to various functional disturbances of the body, including psychological. When studying such changes in servicemen who were injured, a significant part of them showed signs of post-traumatic stress response. Accordingly, this category of patients needs both medical and psychological rehabilitation.Рання діагностика негативних психічних і постстресових станів дозволяє на ранніх етапах виявити у поранених військовослужбовців Збройних сил України ранні та тяжкі прояви бойової психічної травми та її наслідки, а також розробити індивідуальну тактику і способи профілактики та відновлення кожного обстеженого військовослужбовця. Відсутність у державі єдиного, науково обґрунтованого комплексного підходу до організації проведення ефективних заходів медичної, психологічної та соціальної реабілітації, гостра потреба у підвищенні якості життя, медичного обслуговування, соціального захисту та медико-психологічної допомоги військовослужбовцям зумовили актуальність дослідження, метою якого стало вивчення особливостей проявів бойових стресових розладів серед військовослужбовців Збройних сил України – учасників бойових дій. У процесі роботи виявлено, що участь у збройному конфлікті, отримане поранення є потужним стресовим фактором, що призводить до різнопланових функціональних порушень організму, в тому числі й психологічних. При вивченні таких змін у значної частини військовослужбовців, які отримали поранення, виявлено ознаки посттравматичної стресової реакції. Відповідно дана категорія пацієнтів потребує як медичної, так і психологічної реабілітації

Astaxantin and Isoflavones Inhibit Benign Prostatic Hyperplasia in Rats by Reducing Oxidative Stress and Normalizing Ca/Mg Balance

Benign prostatic hyperplasia (BPH) is a common pathology among aging men. Despite the broad pharmacological interventions, the available remedies to treat BPH are yet not devoid of side effects. Herbal compounds are suggested to be an alternative option for the BPH treatment. In our study, we evaluated the effect of kudzu isoflavones and astaxanthin on the BPH animal model. The animals were randomly divided into five groups: control; testosterone-induced BPH group; and three BPH-induced groups, which received intragastrically for 28 days finasteride (5 mg/kg) as a positive control, isoflavones (200 mg/kg), and astaxanthin (25 mg/kg). BPH was induced by castration of animals and subsequent subcutaneous injections of prolonged testosterone (25 mg/kg). Prostate index and histology, biochemical parameters, and antioxidant activity were evaluated. A significant decrease in prostate weight, immunohistochemical markers, and normalization of prostate Ca/Mg ratio was found in all treatment groups. Astaxanthin treatment also resulted in decreased epithelial proliferation and normalized superoxide dismutase activity. In conclusion, both isoflavones and astaxanthin inhibited BPH development at a level comparable to finasteride in terms of prostate weight, prostatic epithelium proliferation, and prostate tissue cumulative histology score. These results suggest that isoflavones and especially astaxanthin could serve as a potential alternative therapy to treat BHP. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Funding: This research was funded by Russian Science Foundation, grant number 20-65-47025

PREGNANCY MANAGEMENT IN PATIENTS WITH MESENCHYMAL DYSPLASIAS

The article presents an overview and results of clinical research of rare but very important diseases - mesenchymal displasias including Marfan syndrome, Ehlers-Danlos (EDS) syndrome, Osler-Weber-Rendu disease. The basic component of these diseases is the hereditary connective tissue disorder. Patients may have different symptoms, because various organs may be involved: skeletal, ocular, cardiovascular systems etc. The diagnosis is based on the clinical criteria and molecular tests. The pathogenesis of these disorders has not been fully elucidated. Pregnancy usually increases the risk of life threatening complications. Early diagnosis and multidisciplinary management of pregnancy and delivery are essential for good outcomes. The aim of this study was to evaluate the course of pregnancy and the delivery outcome in patients with mesenchymal dysplasias. Materials and methods. Fifty six pregnant women with mesenchymal dysplasias (23 with Marfan syndrome, 22 with Ehlers-Danlos syndrome, 11 with hereditary hemorrhagic telangiectasia - HHT) were examined in a specialized cardiological maternity ward. The patients underwent physical examination, routine laboratory tests, hemostasis tests, ECG, echocardiography, MRI, X-ray examination, and pulse oximetry. Results. All patients had hemorrhagic complications of various localization; 18 women with Marfan syndrome had aggravated mitral regurgitation, 10 - aortic insufficiency, 13 - mitral valve insufficiency. One patient with Marfan syndrome died because of aortic dissection on day 45 upon delivery. Pulmonary arteriovenous malformations were found in 10 patients with HHT; the symptoms of hypoxemia developed in 6 HHT patients who were diagnosed with right-to-left blood shunting. One patient with HHT developed the symptoms of vena cava inferior compression caused by an aneurism in the truncus brachiocephalicus. Forty patients showed abnormal hemostasis results (platelet dysfunction - 38 patients; DIC syndrome - 31). Cesarean section was performed in 53 patients. Vaginal delivery (3 patients with EDS) was complicated by massive postpartum hemorrhage and deep vaginal tears. Conclusion. Patients with mesenchymal dysplasias are under increased risk of different complications during pregnancy and delivery; they need multidisciplinary management and repeated hemostasis testing. Cesarean section is the preferred method of delivery in such patients

THE BASIC POINTS OF SAFE MANAGEMENT OF PREGNANCY AND DELIVERY IN PATIENTS WITH MARFAN SYNDROME

Marfan syndrome is dominantly inherited connective tissue diseases, associated with microfibrillar fiber connective tissue deficiency in vascular walls, heart valves, joints, dural membrane,  bones, and other organs. Diagnosis may be confirmed by clinical  criteria and molecular tests. Pregnancy bears a risk of fatal complications,  including aortic dissection, aortic root dilation, mitral valve insufficiency.  Women must be followed and managed in a high risk pregnancy unit by a team from obstetricians, cardiologists, anesthetists, pediatricians, neonatologists  and cardiac surgeons who are skilled in high risk pregnancies. This approach allows to avoid the serious maternal and fetal complications. Caesarean section should be offered for such patients, because it minimizes the hemodynamic changes, associated with vaginal delivery. Some authors recommend to perform post-cesarean hysterectomy, because of the high incidence of massive hemorrhage in postpartum

Pregnancy and mesenchimal dysplasias (Marfan syndrome, Ehlers-Danlos syndrome, hereditary hemorrhagic telangiectasia)

<p>The objective of this article is to attract the attention of clinical physicians to the rare but extremely relevant clinical pathology of mesenchymal dysplasias (Marfan syndrome, Ehlers–Danlos syndrome, hereditary hemorrhagic telangiectasia) and especially specific characteristics of such diseases during pregnancy. Connective tissue pathology can cover different organs and systems, symptoms of the same disease can vary in different patients thus making diagnostics significantly difficult. Here clinical diagnostic criteria and methods of molecular diagnostics of diseases are described. The pathogenesis of mesenchymal dysplasias is not currently well understood. For the patients with mesenchymal dysplasias pregnancy is fraught with high risk of life-threatening complications. The preferred delivery method for such patients is caesarean section.</p

Pregnancy and Zika virus

Zika virus (ZIKV) is an arthropod-borne virus (arbovirus) in the genus Flavivirus and the Flaviviridae family. In 1947 and 1948 ZIKV was first isolated from a nonhuman primate as well as from mosquitoes in Africa, respectively. For half a century, ZIKV infections in human were sporadic prior to 2015–2016 pandemic spreading. Transmission of ZIKV from mother to fetus can occur in any trimester of pregnancy, even if mother was an asymptomatic carrier. The clinical signs of ZIKV infection are nonspecific and can be misdiagnosed as some other infectious diseases, especially those caused by arboviruses such as Dengue and Chikungunya. ZIKV infection was solely associated with mild illness prior to the large French Polynesian and Brazil outbreaks, when severe neurological complications, Guillain–Barre syndrome and dramatically increased rate of severe congenital malformations (including microcephaly) were reported. The adaptation of ZIKV to an urban cycle in endemic areas suggests that the incidence of ZIKV infections may be underestimated. The pandemic of novel coronavirus infection (COVID-19) demonstrates that lessons from ZIKV pandemic propagation has not been learned properly

Laboratory monitoring of COVID-19 patients and importance of coagulopathy markers

The pandemic of a novel coronavirus infection COVID-19 has become a real challenge to the mankind and medical community and has raised a number of medical and social issues. Based on the currently available information on COVID-19 clinical cases, it follows that COVID-19 patients in critical condition exhibit a clinical picture of disseminated intravascular coagulation (DIC), septic shock with developing multiple organ failure, which justifies use of anticoagulant therapy in COVID-19 patients. In addition to isolating virus RNA from biological material and polymerase chain reaction diagnostics, use of simple and easily accessible laboratory blood markers is necessary for management of COVID-19 patients. If the activation of coagulation processes is sufficient enough, consumption of platelets and blood clotting factors can be diagnosed by laboratory methods as prolongation of routine blood clotting tests and increasing thrombocytopenia. Hyperfibrinogenemia, increased D-dimer level, prolonged prothrombin time, thrombocytopenia, lymphopenia, leukocytopenia, increased concentration of interleukin-6 and ferritin are observed in most COVID19 patients. The degree of increase in these changes correlates with severity of the inflammatory process and serves as a prognostically unfavorable sign. Here we discuss value of laboratory monitoring playing an essential role in such pathological crisis that contributes to patient screening, diagnosis as well as further monitoring, treatment and rehabilitation

Effects of Isoflavone-Rich NADES Extract of Pueraria lobata Roots and Astaxanthin-Rich Phaffia rhodozyma Extract on Prostate Carcinogenesis in Rats

Prostate cancer (PCa) is one of the most common male malignancies worldwide. In the current study, we evaluated the effects of a natural deep eutectic solvent (NADES) extract of Pueraria lobata roots rich in isoflavones (ISF) and Phaffia rhodozyma extract rich in astaxanthin (ASX) on an N-methyl-N-nitrosourea plus testosterone PCa model in rats. ISF consisted of puerarin, daidzein, genistein, formononetin and other polyphenols, while ASX contained lipids and unsaturated species in addition to astaxanthin. Extracts were administered through a whole promotion period in daily doses shown by our group to successfully inhibit benign prostate hyperplasia (BPH) development &mdash; 200 mg/kg for ISF and 25 mg/kg for ASX. Though a similar effect was found for BPH processes accompanying PCa induction, the incidence of PCa in animals treated with placebo, ISF and ASX was 37%, 37% and 41%, respectively, showing no chemopreventive activity of ISF and ASX. PCa development was associated with a decrease in the Ca/Mg ratio in serum and an increase in prostate tissue. Treatment with both extracts produced a normalization effect on Ca balance in serum, which, combined with a decrease in the prostatic index, suggests some positive health effects of ISF and ASX