卷 30, 编号 6 (2024)

BACKGROUND: Higher-education implies exposure to multiple stress factors for students while studying, communicating with group-mates and teachers, or when regular environments change. These stress factors contribute to untoward symptoms of emotional state.

AIM: To analyze untoward symptoms of emotional state among students and to develop preventive measures.

MATERIALS AND METHODS: Questionnaires completed by 273 Russian and 239 foreign students were analyzed. Mean values, error of the means, intensive and extensive properties were calculated, a method to compare relative values and identify statistically significant differences was used for statistical analysis.

RESULTS: Untoward symptoms of emotional state were found to be significantly more common in foreign than in Russian students.

CONCLUSION: Individual and/or group sessions with a psychologist are needed to minimize untoward symptoms of emotional state in students.

BACKGROUND: The annual increase in patients with symptoms of affective disorders caused by COVID-19 highlights the need to investigate this issue.

AIM: To investigate the risk of COVID-19 consequences presented with symptoms of affective disorders in students of higher education institutions.

MATERIALS AND METHODS: The study included 131 female (n=89) and male (n=42) students of higher education institutions aged 18 to 31 years. All participants had COVID-19 (U04.9, U07.1, U07.2) and were not diagnosed with any mental disorder (ICD-10 codes F00–F99). Clinical psychophysiological and psychometric evaluation techniques, as well as descriptive statistics were used.

RESULTS: Most students (75.6%, n=99) in the study group had a mild infection. Female and male students had psychophysiological COVID-19 consequences of asthenia (77.9% of participants, n=102) and cognitive decline (54.2%, n=71). Affective disorders were diagnosed in 40.4% female participants, symptoms of mood disorders were much less frequent in men. Post-COVID-19 hypochondriac thoughts were found to be more common in women. Among all respondents, COVID-19 consequences of psychophysiological symptoms not only occurred within the first weeks after the viral disease, but also persisted for several months (in 36.6% of respondents, n=48), without resulting in an affective disorder. Psychometric evaluation techniques (State-Trait Anxiety Inventory, Hypomania Checklist, Beck Depression Inventory) revealed higher anxiety and cyclothymic mood swings in female and male students.

CONCLUSION: In COVID-19 recovered students without prior affective disorder, the most common disease consequences were asthenic symptoms (men and women were equally affected). Cyclothymic mood swings were noted, with a higher prevalence in women. Additional psychometric evaluation techniques found that state and trait anxiety in men and women was moderate, with women being more prone to depression.

BACKGROUND: Meibomian gland dysfunction (MGD) and chronic blepharitis remain significant challenges in ophthalmology. Standard therapy comprises phytoblepharohygiene and eyelid massage, with anti-inflammatory and tear substitutes. However, the efficacy of the sequential use of phytoblepharohygiene and the ophthalmic gel containing metronidazole, hyaluronic acid, Aloe vera extract and sulfur preparations (Blepharogel Forte®; Geltek-Medica, Russia) for chronic blepharitis and MGD, remains underexplored.

AIM: To evaluate the therapeutic effect of a sequential regimen comprising a line of phytoblepharohygiene products, including the ophthalmic gel containing metronidazole, hyaluronic acid, Aloe vera extract and sulfur preparations (in patients with prolonged chronic blepharitis and MGD).

MATERIALS AND METHODS: The study involved 42 patients (84 eyes) aged 16–73 years, including 30 men (60 eyes, 71.4%) and 12 women (24 eyes, 28.6%), diagnosed with chronic blepharitis, MGD, and dry eye syndrome. Depending on the treatment method, two groups were formed. Patients of control group I (20 subjects, 40 eyes, 47.6%) received eyelid massage and phytoblepharohygiene with the ophthalmic gel containing hyaluronic acid and Aloe vera extract (agent 1) or the ophthalmic gel containing hyaluronic acid, Aloe vera extract, and sulphur preparations (agent 2) (in case of confirmed demodicosis). The comparison group II (22 subjects, 44 eyes, 52.4%) underwent eyelid massage and phytoblepharohygiene, which was completed by applying the ophthalmic gel containing metronidazole, hyaluronic acid, Aloe vera extract, and sulfur preparations (agent 3) (irrespective of a positive or negative test for demodicosis).

RESULTS: From the first week onwards, the indices characterizing hyposecretion of meibomian glands in groups I and II were already 1.9±0.2 and 1.1±0.3 points lower than the initial values of 2.6±0.2 and 2.4±0.3 points, respectively (p <0.05). Furthermore, the dynamics of hypersecretion indices exhibited a comparable trend, with values of 1.6±0.2 and 1.5±0.2 points recorded after a week in comparison with the initial values of 2.3±0.3 and 2.2±0.2 points, respectively (p <0.05). The index characterizing eyelid edema at this stage of the study exhibited a statistically significant decrease only in group II of patients who received the ophthalmic gel containing metronidazole, hyaluronic acid, Aloe vera extract and sulfur preparations (1.4±0.2 points after a week in comparison with the initial 2.3±0.2 points) (p <0.05). In group I, only the initial results were maintained, whereas in group II, a stable increase was observed.

CONCLUSION: The ophthalmic gel containing metronidazole, hyaluronic acid, Aloe vera extract and sulfur preparations can be effective in the treatment of patients with blepharitis and MGD due to its superior therapeutic effectiveness compared with the standard blepharohygiene and phytoblepharohygiene regimens.

BACKGROUND: The nutritional status of patients with cystic fibrosis significantly affects their survival and the function of all organs, particularly the lungs. Due to increased protein and energy needs, these patients often require high-calorie and high-protein oral nutritional supplements (ONS).

AIM: To assess the tolerability, efficacy, and safety of Fresubin Protein® powder, a protein module.

MATERIALS AND METHODS: The data of 14 patients with mixed form of cystic fibrosis and nutritional deficiencies, aged between 6 and 16 years, were analyzed. Five patients received Fresubin Protein® powder as monotherapy (Group 1), four patients received the same therapeutic food together with emulsion of medium-chain triglycerides (Group 2), and five patients received ONS balanced in protein, fat, and carbohydrates (control group). The dynamics between percentile and Z-Scores of body mass index (BMI) at the beginning and at the end of the study period (day 180±2) were used as the main efficacy parameter of the investigated food. Body fat and lean body mass were assessed by caliperometry as additional efficacy parameters.

RESULTS: All patients showed an increase in Z-Score and BMI percentile from baseline while taking Fresubin Protein® powder both as monotherapy and in combination with medium-chain triglyceride emulsion. There were no statistically significant differences from the control group (p >0.05). However, Group 1 (100% of patients) demonstrated positive changes in muscle mass gain, as evidenced by caliperometry data, which was statistically significant (p <0.05) compared with the control group (20%). In Group 2, muscle gain was observed in 75% of the patients (p >0.05).

CONCLUSION: These findings suggest that protein-enriched ONS not only increase BMI but also contribute to muscle mass gain in patients with cystic fibrosis. New therapeutic approaches are needed, such as the inclusion of high-protein ONS in the diet to prevent muscle mass loss, along with the monitoring of body composition to improve control of disease progression.

Urinary tract infections (UTI) are the most common bacterial infections in children, with the potential to impair renal function, particularly in toddlers who experience complications or recurrences.

The overview aim was to analyze all latest global clinical guidelines on UTIs in children for the period 2018 to 2024.

Up-to-date data on incidence of UTIs in children were analyzed by age and sex. The classification was presented, the main diagnostic challenges and the latest treatment and prevention approaches were discussed.

The overview of clinical UTI guidelines demonstrated that the disease should be suspected in all toddlers with temperature above 38 °C and no focus of infection. Empiric antibacterial therapy should be initiated within the first 24–48 h; oral antibiotics are more beneficial (III generation cephalosporins are more common nowadays); however, local antibacterial resistance should be considered. All current clinical guidelines highlight the growth of resistant pathogens and decrease of their susceptibility to inhibitor-protected penicillins. All guidelines recommend to consider a group at high risk of recurrence including children with vesicoureteral reflux (VUR), neurogenic bladder, constipation, and non-circumcised boys under 1 year of age, and to perform prompt imaging studies for these children. According to almost all global guidelines on diagnosis and treatment of UTI in children, long-term antibacterial prevention should be provided only if strictly indicated and considering risk factors, primarily in children with high and low-grade VUR.

Over the last years, many up-to-date global clinical guidelines on UTI in children have been developed. This overview of the most recent global guidelines on the disease over the past 7 years will help to use current expertise of pediatricians, pediatric nephrologists, and pediatric urologists in Russia.

BACKGROUND: This study presents a rare clinical case of progressive chronic ulcer of the gastrojejunoanastomosis in a young female patient who developed two classical complications, particularly perforation and penetration, within 14 months of undergoing laparoscopic mini gastric bypass. Remarkably, the medical history did not reveal any significant predictors of ulcerogenesis. The ulcer formed within the first six months after mini gastric bypass surgery when taking antisecretory drugs. There was no connection with smoking, helicobacter infection, or use of non-steroidal anti-inflammatory drugs.

CLINICAL CASE DESCRIPTION: The patient was initially subjected to laparotomy, with perforation suturing and Roux-en-Y gastrojejunostomy performed to exclude the bile reflux into the gastric pouch. The postoperative outcome (ulcer progression with a new complication — penetration — within six months) aligns with the recent literature data on the potential exaggeration of the role of biliary reflux in ulcerogenesis following mini gastric bypass. The follow-up surgery, performed laparoscopically in the presence of significant adhesion formation in the abdominal cavity, involved adhesiolysis, gastric pouch resection with anastomosis, and reconstructive Roux-en-Y gastric bypass. Clinical and endoscopic evaluations ten months after the reconstructive surgery indicates the patient’s recovery.

CONCLUSION: The value of the observation is the possibility of analyzing the effect of the primary operation, which included not only suturing of the perforated defect, but also enteroenterostomy according to Roux to divert bile from the anastomosis. The result of the operation is consistent with the literature data on the possibly exaggerated role of biliary reflux in ulcerogenesis after mini-gastroshunting, which determines the relevance of new studies to identify significant pathogenetic factors, including the length of the pouch and the method of forming a single anastomosis.