Structure of mortality among patients with diabetes mellitus in the republic of Uzbekistan during COVID-19 pandemia

BACKGROUND. The COVID-19 pandemic has caused enormous damage to all countries of the world. Patients with diabetes mellitus are a separate risk group for the consequences of COVID-19, both in the acute and in the long-term period.AIM. To study change in the structure of mortality among patients with diabetes in the Republic of Uzbekistan during the COVID-19 pandemic.MATERIALS AND METHODS. We analyzed the data of the report forms of endocrinological dispensaries for reasons of deaths registered among patients with 2 diabetes mellitus in 2020 and compared these indicators with the data of 2019.RESULTS. In 2020, mortality among patients with diabetes increased 1.5 times compared to 2019 and was 4.3% (compared to 2.8% in 2019). Among the causes of deaths, cardiovascular accidents prevailed: 57,9% in 2020 (48,0% in 2019), cerebrovascular accidents (15,6% in 2020 and 24,2% in 2019), chronic kidney disease (12,0% and 15,1%), gangrene, sepsis (1,2% and 1,8%), the frequency of hyper- and hypoglycemic comas as causes of death was 0.6% both in 2019 and in 2020, however, the absolute number increased in 2020. Among the «other» causes of death (12.8% in 2020 and 10,2% in 2019), COVID-19 itself was 52,3%, pneumonia 17,2%, pulmonary embolism 1%, oncological diseases 12%, liver cirrhosis 12%.CONCLUSIONS. Despite the fact that COVID-19 caused deaths in 6.7% of patients with diabetes, the COVID-19 pandemic caused a significant increase in mortality — 1.5 times — among patients with diabetes, mainly due to acute cardiovascular accidents, stroke, as well as accelerating the progression of chronic complications of diabetes, in particular chronic kidney disease

Factors influencing the severity of COVID-19 course for patients with diabetes mellitus in tashkent: a retrospective cohort study

BACKGROUND: Since the very first outbreak, scientists have been trying to determine the most critical pathogenetic mechanisms for the development of COVID-19 and related complications, analyze individual subpopulations of patients with chronic diseases and develop optimal tactics to combat not only the infection itself but also its acute and chronic complications.AIM: to assess the COVID-19 course among patients with Type 1 and Type 2 DM.MATERIALS AND METHODS: A retrospective cohort study of Tashkent inhabitants, who had COVID-19 from April to D ecember 2020, was performed. The data were obtained from the single electronic database of registered cases of COVID-19. All data were analyzed using a logistic regression in STATA 17.0 software. Further, the matched case-control study was performed for patients with type 2 DM and no DM based on age, gender, and BMI.RESULTS: Of the 5023 analyzed subjects, 72.63% had no diabetes mellitus (DM), 4.24% had type 1 DM, 15.19% had type 2 DM, and 7.94% was diagnosed with DM during the COVID-19 infection. DM, overweight, and obesity were associated with severe COVID-19; the most significant risk of a severe course was found in persons with type 2 DM. The risk of a lethal outcome and the need for prescription of glucocorticoids did not show a significant association with diabetes in Tashkent. The clinical features of COVID-19 were more common in patients with type 2 DM, especially for shortness of breath, chest pain, and arrhythmia. The persons receiving SU have complained of dyspnea significantly more often than matched patients without DM. Metformin and DPP4i were the groups of drugs that were not associated with significantly increased risk of hospitalization of patients because of COVID-19. The matched case-control study did not reveal statistically significant differences in the disease course severity, need for hospitalization and glucocorticoids, and death depending on the glucose-lowering therapy preceding the onset of COVID-19.CONCLUSION: Diabetes, age and overweight/obesity were associated with severe course of COVID-19 in Tashkent. There was no statistical difference in COVID-19 severity depending on initial glucose-lowering therapy

Факторы риска развития несостоятельности колоректального анастомоза и методы ее профилактики: ретроспективное когортное исследование

Background. Colorectal anastomotic leakage (AL) has always been one of major challenges in rectal surgery.Objective: to perform multivariate analysis of risk factors for AL.Materials and methods. In this retrospective cohort study, we analyzed patients that had undergone resection of the rectum with anastomosis formation between 2013 and 2020. We included patients with favorable prognostic factors (tumor located >5 cm above the anal verge, no history of chemoradiotherapy). We performed multivariate analysis using logistic regression to assess risk factors for AL.Results. The use of more than 3 linear stapler firings to suture the rectum significantly increased the risk of AL (risk ratio 3.035; 95 % confidence interval 1.473–6.252; p = 0.003). The univariate analysis demonstrated that reinforcement of the anastomosis was significantly associated with an increased risk of AL (risk ratio 2.35; 95 % confidence interval 1.112–5.762; p = 0.027); however, this association failed to reach statistical significance (risk ratio 1,520; p = 0,066). Pelvic peritoneum suturing had no impact on the AL incidence, but in case of its development, pelvic peritoneum reconstruction prevented peritonitis (p = 0.002).Conclusion. The number of stapler firings >3 used to suture the rectum, as well as reinforcement of the anastomosis tended to increase the risk of AL; however, these findings did not reach the level of statistical significance. Pelvic peritoneum reconstruction did not affect the incidence of AL, but significantly reduced the risk of peritonitis.Введение. Несостоятельность колоректального анастомоза (НА) остается одной из основных проблем хирургии рака прямой кишки.Цель исследования – провести многофакторный анализ риска развития НА.Материалы и методы. В ретроспективном когортном исследовании за период 2013–2020 гг. Проанализированы данные историй болезни пациентов, которым по поводу рака выполнялась резекция прямой кишки с формированием анастомоза. Включали пациентов с благоприятными прогностическими факторами (локализация опухоли выше 5 см от переходной анальной складки, отсутствие предшествующей химиолучевой терапии). Оценивали влияние факторов риска на частоту развития НА на основании многофакторного анализа методом логистической регрессии.Результаты. Использование более 3 кассет линейного степлера для прошивания и пересечения прямой кишки достоверно повышает частоту НА (отношение рисков 3,035; 95 % доверительный интервал 1,473–6,252; p = 0,003). При однофакторном анализе отмечено достоверное повышение частоты развития НА при укреплении линии аппаратного шва (отношение рисков 2,35; 95 % доверительный интервал 1,112–5,762; p = 0,027), однако при многофакторном анализе статистически значимой достоверности увеличения частоты НА не было отмечено (отношение рисков 1,520; p = 0,066). Ушивание тазовой брюшины статистически значимо не влияло на частоту НА, однако в случае ее возникновения восстановление тазовой брюшины препятствовало развитию разлитого перитонита (p = 0,002).Выводы. Использование более 3 кассет линейного степлера для прошивания и пересечения прямой кишки, укрепление линии аппаратного анастомоза имеют тенденцию к повышению риска развития НА, но статистически значимо не влияют на него. Восстановление тазовой брюшины не влияет на частоту НА, но достоверно снижет риск развития перитонита

The efficacy evaluation of proposed treatment policy and anemia prevention among teenage girls

A clinical blood analysis of 462 teenage girls was ascertain. As a result, the main group, which consisted of 110 teenage girls with iron deficiency anemia the age of 12-17, was formed. In order to compare results, experimental group (control group), which consisted of 50 healthy teenage girls, was formed. Implementation of the complex treatment (hemostatic and, in some cases, hormonal cure in combination with iron preparation) led to a positive result in health of teenage girls with anemia.У 462 девушек-подростков был определен общий анализ крови. В результате сформировалась основная группа, состоящая из 110 девушек-подростков с железодефицитной анемией в возрасте от 12 до 17 лет. С целью сопоставления данных была сформирована группа сравнения (контрольная группа) - 50 здоровых девушек-подростков. Проведение комплексного лечения (гемостатические и в отдельных случаях гормональные средства в сочетании с препаратами железа) привело к положительному результату у девушек-подростков с анемией

About the study the clinical data in women in early natural and surgical postmenopausal women

Climacteric syndrome remains an urgent problem today. The climax is both the norm and disease: the norm because the menopause in the female body is a natural phenomenon, but a disease because it is a persistent violation of the regulation, leading eventually to decreased viability of the organism. We examined 207 women aged 40-55 years with climacteric syndrome in early natural (110 women) and surgical postmenopausal (97 women). The study of clinical data revealed some differences in the occurrence of menopausal women in early natural and surgical postmenopausal women.Климактерический синдром остается актуальной проблемой и на сегодняшний день. климакс является одновременно и нормой и болезнью: нормой потому, что климакс в женском организме явление закономерное, а болезнью потому, что это стойкое нарушение регуляции, приводящее в конечном итоге к снижению жизнеспособности организма. Нами было обследовано 207 женщин в возрасте 40-55 лет с климактерическим синдромом в ранней естественной (110 женщин) и хирургической постменопаузе (97 женщин). Изучении клинических данных выявило некоторые различия в протекании менопаузы у женщин в ранней естественной и хирургической постменопаузе

Features of clinical data in women in early surgical postmenopausal women

Surgical deactivation of ovarian function in women of reproductive age remains one of the urgent problems of modern medicine. This analysis was performed in 60 women of the main group aged 40-55 years in early surgical postmenopausal women who underwent abdominal gynecological operations with ovarian excision. Indications for surgical interventions on the organs of the reproductive system in women are ovarian tumors, combined pathology of the reproductive system, severe purulent processes of the genitals and others, the volume of which includes removal of the ovaries.Хирургическое выключение функции яичников у женщин репродуктивного возраста остается одной из актуальных проблем современной медицины. Данный анализ был проведен у 60 женщин основной группы в возрасте от 40 до 55 лет в ранней хирургической постменопаузе, которые перенесли абдоминальные гинекологические операции с удалением яичников. Показаниями для оперативных вмешательств на органах репродуктивной системы у женщин являются опухоли яичников, сочетанная патология половой системы, тяжелые гнойные процессы гениталий и другие, объем которых включает удаление яичников

Features of lipid metabolism and bone metabolism in elderly women

We studied 65 elderly women bone turnover markers and investigated for osteoporosis and to assess lipid profile. In the study of the risk of osteoporosis is set significantly more rapid loss of BMD in women mnogorozhashih both trabecular and cortical bone in the structures. Infringing content lipoprotein spectrum of blood were found in all women surveyed, but the extent of these changes was also more pronounced in multiparous womenУ 65 пожилых женщин изучен костный обмен и исследованы маркеры остеопороза, а также оценен липидный спектр. При изучении степени риска развития остеопороза установлена достоверная более быстрая потеря МПКТ у многорожаших женщин как в трабекулярных, так и в кортикальных костных структурах. Нарушения содержания липопротеинового спектра крови выявлены у всех обследованных женщин, однако степень этих изменений была более выраженной также у многорожавших женщи

Rapid Evolution of Coral Proteins Responsible for Interaction with the Environment

Christian R. Voolstra is with King Abdullah University of Science and Technology, Shinichi Sunagawa is with the European Molecular Biology Laboratory, Mikhail V. Matz is with UT Austin, Till Bayer is with King Abdullah University of Science and Technology, Manuel Aranda is with King Abdullah University of Science and Technology, Emmanuel Buschiazzo is with University of California Merced, Michael K. DeSalvo is with University of California San Francisco, Erika Lindquist is with the Department of Energy Joint Genome Institute, Alina M. Szmant is with University of North Carolina Wilmington, Mary Alice Coffroth is with State University of New York at Buffalo, Mónica Medina is with University of California Merced.Background -- Corals worldwide are in decline due to climate change effects (e.g., rising seawater temperatures), pollution, and exploitation. The ability of corals to cope with these stressors in the long run depends on the evolvability of the underlying genetic networks and proteins, which remain largely unknown. A genome-wide scan for positively selected genes between related coral species can help to narrow down the search space considerably. Methodology/Principal Findings -- We screened a set of 2,604 putative orthologs from EST-based sequence datasets of the coral species Acropora millepora and Acropora palmata to determine the fraction and identity of proteins that may experience adaptive evolution. 7% of the orthologs show elevated rates of evolution. Taxonomically-restricted (i.e. lineage-specific) genes show a positive selection signature more frequently than genes that are found across many animal phyla. The class of proteins that displayed elevated evolutionary rates was significantly enriched for proteins involved in immunity and defense, reproduction, and sensory perception. We also found elevated rates of evolution in several other functional groups such as management of membrane vesicles, transmembrane transport of ions and organic molecules, cell adhesion, and oxidative stress response. Proteins in these processes might be related to the endosymbiotic relationship corals maintain with dinoflagellates in the genus Symbiodinium. Conclusion/Relevance -- This study provides a birds-eye view of the processes potentially underlying coral adaptation, which will serve as a foundation for future work to elucidate the rates, patterns, and mechanisms of corals' evolutionary response to global climate change.This work was supported by DEB-1054766 to M.V.M. and National Science Foundation grants IOS-0644438 and OCE-0313708 to M.M., and by a Collaborative Travel Fund to C.R.V. made by King Abdullah University of Science and Technology (KAUST). The work conducted by the U.S. Department of Energy Joint Genome Institute is supported by the Office of Science of the U.S. Department of Energy under Contract No. DE-AC02-05CH11231. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Biological Sciences, School o

Особенности получения биодизеля первого поколения в аппарате с вихревым слоем

The possibility of intensifying the process of transesterification of triglycerides of carboxylic acids of vegetable oils with alcohols C1-C3 in the presence of potassium hydroxide in an apparatus with a vortex sheet is shown. Analysis of the composition of mixtures of methyl esters of carboxylic acids of sunflower oil showed that the redistribution of hydrogen and the destructive transformation in the system take place along with the transesterification reactions. This results in the expenditure of octadecyl acid ether.Показана возможность интенсификации процесса переэтерификации триглицеридов карбоновых кислот растительных масел спиртами С1-С3 в присутствии гидроксида калия в аппарате с вихревым слоем. Анализ состава смесей метиловых эфиров карбоновых кислот подсолнечного масла показал, что наряду с переэтерификацией в системе протекают реакции перераспределения водорода и деструктивные превращения, приводящие к исчезновению в биодизеле метилового эфира октадеценовой кислоты

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8–13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05–6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50–75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron