Excessive body weight and obesity in childhood and adolescence are becoming more and more important unfavorable factors that entail extremely adverse consequences and require close attention of physicians of any specialty. Along with the high prevalence of obesity and metabolic syndrome in pediatric patients, children and adolescents in the majority of countries are diagnosed with vitamin D deficiency. Among the non-calcaemic effects of vitamin D, a significant role is played by its impact on the hormonal regulation of glucose metabolism and the synthesis of adipokines by fat tissue. The review presents literature data indicative of a close pathogenic relationship between vitamin D insufficiency and impaired tissue insulin sensitivity. It demonstrates the role of vitamin D insufficiency in immune reactions resulting in development of subclinical inflammation in fat tissue infiltrated with macrophages and lymphocytes. It also shows the role of adipokines, immune system cells and pro-inflammatory cytokines produced by them in the pathogenesis of obesity, as well as the function of vitamin D as an endocrine and paracrine regulator of the process of inflammation in adipose tissue. The relationships between the principal adipokines (leptin, adiponectin, resistin) are revealed in the presence of normal vitamin D content and in vitamin D deficiency. The carbohydrate and lipid metabolism parameters in overweight children and adolescents with vitamin D insufficiency are analyzed. A high prevalence of vitamin D insufficiency in overweight and obese children and adolescents (increasing along with the severity of obesity) is demonstrated. The review also presents the current recommendations for the correction of vitamin D insufficiency and underlines the need for higher cholecalciferol doses to achieve serum calcifediol targets in overweight and obese children and adolescents.

This investigation reports the mineralogy and possible pathological significance of urinary stones removed from patients in Fars province, Iran. X-ray diffraction (XRD), scanning electron microscopy (SEM) and polarizing microscope (PM) techniques were used to investigate the mineralogical compositions of urinary stones. The identified mineral components include whewellite, weddellite, hydroxyapatite, uricite and cystine. These techniques revealed that the whewellite and uricite were the most common mineral phases. Platy-like/monoclinic whewellite, prismatic/monoclinic uric acid and hexagonal cystine crystals were revealed by SEM. Biominerals (calcium carbonate) and quartz were also identified in PM images. Of the variables determining the type of precipitated minerals, the effects of pH on depositional conditions proved to be the most apparent parameter, as shown by occurrences and relationships among the studied minerals. Our results revealed the importance of detailed knowledge of mineralogical composition in assessing the effects of age and sex. The highest incidence of urinary stones was observed in the 40–60 age group. Calcium oxalate and uric acid stones are more frequent in men than women. Finally, the study concluded that knowledge of the mineralogical composition of urinary stones is important as it helps the scientific community to explain the chemistry and the etiology of the calculi in the urinary system.

In respect that, lack dynamic of morbidity incidence of acute appendicitis and frequency of postoperative complications, against the backdrop of increasing the number of antibiotics. The problem of prevention of purulent-inflammatory complications during its surgical treatment remains relevant. The authors compared the intensity of accumulation of ceftriaxone in the appendix tissues depending on the method of injection. It turned out that with the intramuscular injection of ceftriaxone in 1–2 hours before the operation, its accumulation in appendix in an amount sufficient to delay the growth of the laboratory culture of Escherichia coli is not observed. After intravenous injection of the drug, accumulation occurs slowly, significantly far behind to the lymphotropic technique. With the lymphotropic injection of ceftriaxone, 1 hour before the operation, a dose of growth retardant culture test is already fixed, and with the intjection of 2 hours before the operation – the dose of ceftriaxone practically corresponds to the maximum possible, that is, the action of a “pure” antibacterial drug. The method of selecting antibiotic therapy for acute appendicitis is the introduction of ceftriaxone by lymphotropic route.

COVID-19 patients may experience disability related to Intensive Care Unit (ICU) admission or due to immobilization. We assessed pre-post impact on physical performance of multi-component therapeutic exercise for post-COVID-19 rehabilitation in a post-acute care facility. A 30-minute daily multicomponent therapeutic exercise intervention combined resistance, endurance and balance training. Outcomes: Short Physical Performance Battery; Barthel Index, ability to walk unassisted and single leg stance. Clinical, functional and cognitive variables were collected. We included 33 patients (66.2±12.8 years). All outcomes improved significantly in the global sample (p<0.01). Post-ICU patients, who were younger than No ICU ones, experienced greater improvement in SPPB (4.4±2.1 vs 2.5±1.7, p<0.01) and gait speed (0.4±0.2 vs 0.2±0.1 m/sec, p<0.01). In conclusion, adults surviving COVID-19 improved their functional status, including those who required ICU stay. Our results emphasize the need to establish innovative rehabilitative strategies to reduce the negative functional outcomes of COVID-19

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The aim of this review is to clarify the relative association between adenomyosis and infertility and the possible treatment for an infertile patient. Although adenomyosis is detected more often in women of late reproductive age, its influence on pregnancy rates is important, especially considering the tendency to delay pregnancy among women in developed countries. In this article, we present a critical analysis of the literature data concerning the impact of adenomyosis on fertility. The possible effects of treatment on the pregnancy rate will also be discussed. We conducted a literature search; publications from Pubmed, Embase and Cochrane databases published from 1982 to 2019 were retrieved using terms ’adenomyosis and infertility’ and ’adenomyosis and pregnancy outcomes’, extensively studied in the aspects of diagnosis, pathogenesis of infertility and possible treatment methods. Molecular studies have given deep insight into the pathogenesis of adenomyosis in the recent few years, but there is a huge discrepancy between in vitro studies and praxis. Oral contraceptive pills, anti-prostaglandins, oral or parenteral progestins, danazol and gonadotrophinreleasing hormone (GnRH) analogues have all been used to control menstrual pain and menorrhagia in women with adenomyosis, but they temporarily suppress the menstrual cycle. Additionally, endometrial ablation and hysterectomy used to alleviate pain caused by adenomyosis exclude pregnancy planning. The development of imaging techniques—ultrasound and MRI—enables the diagnosis of adenomyosis with very high accuracy nowadays, but the methods of treatment mentioned above have not given satisfactory results in women planning pregnancy. For these patients, the high-intensity-focused ultrasound method (HIFU) and combined treatment before assisted reproductive techniques can prove beneficial in adenomyosis patients

Coronavirus disease 2019 (COVID-19), caused by coronavirus severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2), has caused extensive disruption and mortality since its recent emergence. Concomitantly, there has been a race to understand thevirus and its pathophysiology. The clinical manifestations of COVID-19 are manifoldand not restricted to the respiratory tract. Extrapulmonary manifestations involvingthe gastrointestinal tract, hepatobiliary system, cardiovascular and renal systems havebeen widely reported. However, the pathophysiology of many of these manifestationsis controversial with questionable support for direct viral invasion and an abundanceof alternative explanations such as pre-existing medical conditions and critical illness.Prior research on SARS-Co-V and NL63 was rapidly leveraged to identifyangiotensin-converting enzyme 2 (ACE2) receptor as the key cell surface receptor forSARS-CoV-2. The distribution of ACE2 has been used as a starting point for estimating vulnerability of various tissue types to SARS-CoV-2 infection. Sophisticatedorganoid and animal models have been used to demonstrate such infectivity ofextrapulmonary tissues in vitro, but the clinical relevance of these findings remainsuncertain. Clinical autopsy studies are typically small and inevitably biased towardspatients with severe COVID-19 and prolonged hospitalization. Technical issues suchas delay between time of death and autopsy, use of inappropriate antibodies forparaffin-embedded tissue sections and misinterpretation of cellular structures as virusparticles on electron micrograph images are additional problems encountered in theextant literature. Given that SARS-CoV-2 is likely to circulate permanently in humanpopulations, there is no doubt that further work is required to clarify the pathobiologyof COVID-19

Multiple factors are involved in the development and progression of type 2 diabetes mellitus (DMII) to DMII with metabolic syndrome (MetS) and cardiovascular complications. To identify some of these factors, we aim to investigate the changes in erythrocyte membrane Na+/K+-ATPase activity, serum glucose, insulin, lipid profile, hemoglobin A1C (HbA1c), high-sensitivity C-reactive protein (hs-CRP), anthropometric measurements, and blood pressure in DMII with and without MetS. This cross-sectional study comprised 155 male subjects distributed into three groups as healthy controls (50 non-DMII volunteers), Group I (50 DMII without MetS), and Group II (55 DMII with MetS). Fasting blood samples were taken for the measurement of glucose, insulin, HbA1c, hs-CRP and lipid profile. Na+/K+-ATPase activity was determined in erythrocyte ghost. Na+/K+-ATPase activity was significantly decreased in DMII groups compared with controls. No significant difference was shown in Na+/K+-ATPase activity between DMII groups. Total ATPase activity, total cholesterol and low-density lipoproteincholesterol levels were similar in the three groups. Levels of insulin, hs-CRP, triacylglycerols, systolic blood pressure, weight, waist and hip circumference, waist/hip ratio, and body mass index were significantly elevated and high-density lipoprotein-cholesterol significantly decreased only in Group II. Significant differences in serum glucose and hip circumference were seen between the groups. No significant differences in HbA1c levels were observed between DMII groups. Changes in many of the measured risk factors that occurred only in Group II compared with controls and Group I may provide an explanation of how DMII progresses to DMII with MetS and future cardiovascular complications