Features of the Functional State of the Hypophysis-Ovarian System and Processes of Lipid Peroxidation – Antioxidant Protection in Women with Hyperandrogenism of Ovary Genesis in the Early Reproductive Period

Background. Women with polycystic ovary syndrome in the early reproductive period have hormonal and metabolic dysfunction and an increased risk of long-term health consequences. The article presents the results of the study of hormonal indicators and the parameters of lipid peroxidation – antioxidant protection in women  with polycystic ovary syndrome in early period of reproductive age (from 18 to 35 years old).Aim: evaluation of the functional state of the pituitary-ovarian-adrenal system and the lipid peroxidation – antioxidant protection system and the establishment of intersystemic relationships in women of the early reproductive period with polycystic ovary syndrome.Materials and methods. Study included 33 women with ovarian hyperandrogenism and 17 healthy women of early reproductive age. A questionnaire survey, general medical and gynecological examinations, and ultrasound examination of the pelvic organs were conducted. Immunoenzyme method for detection the concentration of hormones, spectrophotometric and spectrofluorometric (determination of the concentration of  lipoperoxidation products, parameters of antioxidant protection), statistical methods were used.Results. Women of early reproductive age (from 18 to 35 years old) with polycystic ovary syndrome characterized by an increase of 17-OH-progesterone by 2.2 times (p = 0.0005), and dehydroepiandrosterone sulfate by 1.3 times (p = 0.0001). A decrease in the total antioxidant activity of the blood by 25 % (p = 0.0005), an increase in the content of oxidized glutathione by 14 % (p = 0.0001) and a decrease in the concentration of retinol by 26 % (p = 0.0012) compared to the control values were shown. The increase in the  degree of oxidative stress was indicated by the value of the coefficient of oxidative stress equal to 2.8.Conclusion. The obtained data indicate the features of the functional state of the pituitary-ovarian-adrenal system and the processes of LPO–AOP, as well as the need for timely diagnosis and effective correction of hormonal and metabolic disorders in women with polycystic ovary syndrome in the early reproductive period

Pulmonary homograft dysfunction after Ross procedure in adults: a single center experience

The Ross procedure was first proposed by Donald Ross in 1967. Numerous studies show excellent long-term outcomes of the Ross operation. One of its disadvantages is the intervention on two valves due to pulmonary homograft dysfunction.Aim.  To study long-term outcomes of pulmonary homograft use after Ross operation (cumulative incidence of pulmonary homograft dysfunction, freedom from reoperation on pulmonary homograft, long-term survival, predictors of pulmonary homograft dysfunction) using data from one Russian center.Material  and  methods. A retrospective study included patients aged 18 years and older with aortic valve disease who underwent Ross procedure from April 2009 to December 2020 by a single surgeon. The age of the patients was 35 (26-44) years (men, 159 (75%)). Infective endocarditis as a cause of aortic valve pathology was diagnosed in 55 (26%) patients. Bicuspid aortic valve was diagnosed in 131 (62%) patients. The median follow-up period was 79 (26,5102,7) months.Results. Combined interventions were performed in 40 cases (18,9%). The modified Ross procedure was used in 54 (25,5%) cases (intra-aortic — 29, using Dacron tube graft — 25). Inhospital mortality was 0,5%. The 5- and 10-year allcause survival rates were 98,5% and 95,4%, while the 10-year cumulative pulmonary valve reoperation rate and pulmonary homograft dysfunction was 4,6% and 35,2%, respectively. The only factor affecting pulmonary homograft dysfunction was patient age ≤30 years (odds ratio =0,2 with 95% confidence interval: 0,06-0,7; p=0,02).Conclusion. Fresh pulmonary homografts have a low incidence of dysfunction and reintervention after Ross procedure. Young age is the only independent risk factor for pulmonary homograft dysfunction

Modified Ross operation (literature review)

One of the surgical methods for treating aortic valve pathology is the Ross operation, which was proposed by the British cardiac surgeon D. Ross in 1967. Numerous studies have shown excellent long-term outcomes of this operation. However, in some patients, pulmonary autograft dilatation may occur in the long term. To avoid this complication, technical modifications of this procedure have been proposed. A literature review on modified Ross operation as a prevention of pulmonary autograft dilatation is presented

Дилатация легочного аутографта и ее факторы риска после классической процедуры Росса: ретроспективное одноцентровое исследование

   Introduction. Aortic valve replacement with pulmonary autograft (Ross procedure) demonstrated excellent immediate and long-term results. Dilation of the pulmonary autograft in the long-term period is the main reason for repeated surgery. Aim: to study the prevalence of pulmonary autograft dilatation and its risk factors.   Materials and methods. From April 2009 to December 2022, 158 patients underwent classical Ross surgery. Inclusion criteria: patients aged 18 and older, patients who underwent classical surgery. Exclusion criteria: patients under 18, modifi ed methods of Ross procedure. Follow-up period: 104 (49–124) months.   Results and discussion. The median age of patients was 33 (25–43) years. Hospital mortality accounted for 0.6 %. Perioperative myocardial injury was 3.8 %, conduction disorder requiring permanent pacemaker implantation accounted for 1.9 %, the incidence of strokes and acute kidney injury requiring hemodialysis was 0.6 %. Ten-year freedom from autograft reoperation was 88.4. Ten-year freedom from reoperation for aortic aneurysm accounted for 92 %. Predictors of autograft dilatation in the long-term period were: age (OR: 0.942; 95% CI: 0.901–0.984, p = 0.008) and the initial size of sinuses of Valsalva (OR: 1.18; 95% CI: 1.027–1.215, p = 0.01).   Conclusion. Ten-year freedom from autograft reoperation due to aortic dilatation and freedom from aortic dilatation ≥ 45 mm was 92 % and 37.2 %, respectively. The main predictors of autograft dilatation in the postoperative period are the age and the initial diameter of the sinuses of Valsalva.   Введение. Протезирование аортального клапана (АК) легочным аутографтом (операция Росса) продемонстрировала отличные непосредственные и отдаленные результаты. Дилатация легочного аутографта в отдаленном периоде является основной причиной повторной операции.   Цель: изучить распространенность дилатации легочного аутографта и изучить факторы ее риска.   Материалы и методы. В период с апреля 2009 по декабрь 2022 гг. 158 больным выполнена операция Росса классическим способом. Критерии включения в исследования: возраст больных 18 лет и старше; больные, кому была выполнена операция классическим способом. Критерии исключения: пациенты моложе 18 лет, модифицированные методики операции Росса. Период наблюдения 104 (49–124) месяца.   Результаты и обсуждение. Медиана возраста больных составила 33 (25–43) года. Госпитальная летальность — 0,6 %. Периоперационное повреждение миокарда — 3,8 %. Нарушение проводимости, потребовавшее имплантации постоянного ЭКС, — 1,9 %, частота инсультов и острого почечного повреждения, потребовавшего гемодиализа, — 0,6 %. Десятилетняя свобода от реоперации на аутографте — 88,4. Десятилетняя свобода от реоперации по поводу аневризмы аорты — 92 %. Предикторами развития дилатации аутографта в отдаленном периоде стали: возраст (ОШ 0,942; 95 % ДИ 0,901–0,984, р = 0,008) и изначальный размер синусов Вальсальвы (ОШ 1,18; 95 % ДИ 1,027–1,215, р = 0,01).   Заключение. Десятилетняя свобода от реоперации на аутографте в связи с дилатацией аорты и свобода от дилатации аорты ≥ 45 мм составили 92 и 37,2 % соответственно. Главными предикторами развития дилатации аутографта в послеоперационном периоде являются изначальный диаметр синусов Вальсальвы и возраст

STUDY OF COPPER-POLYMER COMPLEXES AND THEIR PRODUCTION

The article presents the process of obtaining the copper-polymer complex by a dry mechanochemical metho

Clinical-epidemiological and pathogenetic features of viral hepatitis C in the hemodialysis departments

Background. Today, the programmed hemodialysis belongs to the clinical medicine area where patients are at a constant risk of viral hepatitis infection. This is associated with surgical interventions on the vessels, fairly frequent transfusions of blood components, and regular hemodialysis procedures. But in recent years, the ratio of reported cases of viral hepatitis B and C in patients on programmed hemodialysis has changed significantly. With an abrupt increase in the incidence of viral hepatitis C, there is a decrease in the number of registered viral hepatitis B cases.The aim. To study the clinical, epidemiological and pathogenetic features of viral hepatitis C in hemodialysis units.Material and methods. A multicenter study was conducted that enrolled the patients from the Programmed Hemodialysis Units in Tashkent and the regional departments of the Republic of Uzbekistan. The study involved 395 patients on programmed hemodialysis for 7.5 ± 0.7 years. The age of patients was 43.5 ± 0.91 years. The diagnosis of chronic viral hepatitis C was made on the basis of medical history, clinical and laboratory data, and detection of anti-HCV IgG and RNA-HCV in blood.Results. When analyzing the clinical examination and laboratory test results of 395 patients, the parenteral viral infection markers were detected in 181 patients (45.8%). The analysis of the overall incidence of viral hepatitis showed that chronic viral hepatitis C had the highest rates and was found in 125 patients (31.6%). The analysis of the chronic viral hepatitis C course in the presence of the end-stage chronic renal disease showed that in 11 (34%) of 32 patients of the Main group the disease proceeded as a fulminant form of chronic renal-hepatic failure with the development of adverse outcomes. Twenty seven patients (84%) in this group developed progressive anemia. In 16 patients (50%), persistent polyserositis developed in the form of hydrothorax, ascites, and pericarditis, which reflected the aggravating effect of chronic viral hepatitis C on the course of chronic renal disease.Conclusions. In Hemodialysis Units, both in the city of Tashkent, and in the regional departments of the Republic of Uzbekistan, the incidence of chronic viral hepatitis C prevails, having the form of a pathological process with a minimally low activity. Chronic viral hepatitis C has an aggravating effect on the course of the underlying disease with the development of adverse outcomes