General movement assessment efficacy for assessment of nervous system integrity in children after hypoxic-ischemic encephalopathy in middle income countries.

BACKGROUND: Many infants who survive hypoxic-ischemic encephalopathy (HIE) face long-term complications like epilepsy, cerebral palsy, and developmental delays. Detecting and forecasting developmental issues in high-risk infants is critical. AIM: This study aims to assess the effectiveness of standardized General Movements Assessment (GMA) and Hammersmith Infant Neurological Examinations (HINE) in identifying nervous system damage and predicting neurological outcomes in infants with HIE. DESIGN: Prospective. SUBJECTS AND MEASURES: We examined full-term newborns with perinatal asphyxia, classifying them as Grade 2 HIE according to Sarnat and Sarnat. The study included 31 infants, with 14 (45.2 %) receiving therapeutic hypothermia (Group 1) and 17 (54.8 %) not (Group 2). We evaluated general movements during writhing and fidgety phases and conducted neurological assessments using the HINE. RESULTS: All infants exhibited cramped-synchronized - like movements, leading to cerebral palsy (CP) diagnosis. Three children in Group 1 and four in Group 2 lacked fidgety movements. During active movements, HINE and GMA showed high sensitivity and specificity, reaching 96 % and 100 % for all children. The ROC curve's area under the curve (AUC) was 0.978. CONCLUSION: Our study affirms HINE and GMA as effective tools for predicting CP in HIE-affected children. GMA exhibits higher sensitivity and specificity during fidgety movements. However, study limitations include a small sample size and data from a single medical institution, necessitating further research.

General movements assessment: A bibliometric analysis.

This bibliometric analysis provides an in-depth exploration of the scholarly landscape in the field of Prechtl General Movement Assessment (GMA) research, spanning the period from 1961 to 2023. It offers valuable insights into the evolutionary trajectory and global impact of GMA. The study employs a longitudinal approach, meticulously tracking trends in scholarly output, international collaborations, and authorship patterns. Notably, our findings reveal a significant increase in GMA-related publications, highlighting the growing prominence of this field. The dominance of Australia and Austria in scholarly contributions underscores their pivotal roles. International collaborations are prominent, with active participation from European nations and the Americas. However, it is essential to acknowledge certain limitations, including potential data source biases and a reliance on English-language publications. This analysis serves as a valuable resource for stakeholders in the field, emphasizing the need for ongoing evaluation and collaborative efforts to enhance GMA applications and further our understanding of its clinical implications.

Selective screening for inborn errors of metabolism using tandem mass spectrometry in West Kazakhstan children: study protocol.

Data on the prevalence of most inborn errors of metabolism are still unavailable in Kazakhstan. The study aims to perform selective screening for hereditary metabolic diseases among patients aged from 1 day to 18 years in western Kazakhstan using the LC-MS/MS method, with establishing the reference values for the content of amino acids, acylcarnitines, and succinylacetone in blood samples of healthy children. Tasks: 1. To assess the burden of metabolic disorders detected by LC-MS/MS in western Kazakhstan by examination of children at clinical risk in pediatric clinics throughout the region; https://www.frontiersin.org/register?returnUrl=https://loop.frontiersin.org 2. To set the reference values of metabolites in the child population; 3. To analyze the age distribution, prevalence, and age of onset for each identified IEM, further comparing the obtained findings with those from previously published reports in other populations. METHODS: To set the reference values of 51 metabolites in the child population, 750 healthy children will be included. The selective screening will be performed among 1,500 patients aged 1 day to 18 years with suspected hereditary metabolic disorders. ANTICIPATED RESULTS: The results of selective screening will be interpreted by comparison with the reference values established. Diagnosis will be based on clinical signs, blood levels of amino acids, acylcarnitines, succinylacetone, and urine levels of organic acids and tests for gene mutations. An assessment of 37 inborn errors of metabolism frequencies in high-risk children will be performed. The research will further develop the national as selective as expanded newborn screening programs. The study was registered in clinicaltrials. gov (https://www. CLINICALTRIALS: gov/study/NCT05910151) on 16 June 2023.

Correction to: The levels of oxidative stress in a combination of stress factors.

[This corrects the article DOI: 10.25122/jml-2021-0060.].

Comparison of the performance of lipoperoxidation-antioxidant protection system in rats at different periods under immobilization stress effects.

Background: Under physiological conditions, the activity of the formation of active oxygen is low. The activity of these processes is intensified under stress-induced situations. This study aimed to investigate the role of free-radical oxidation (FRO) in adrenal tissues and immunocompetent organs and cells in mature white rats after 6 hours of immobilization stress. Methods: The studies were performed on 40 White male rats of the Wistar line with a bodyweight of 200 to 240 g. Two series of experiments were conducted: I series: determination of indices in intact rats (10 rats); II series: determination of indices after a 6-hour immobilization stress action on them. Animals of II series were divided into 3 groups of 10 rats in each: group 1: those undergoing acute immobilization stress, withdrawal from the experiment in 1 hour; group 2: those undergoing acute immobilization stress, withdrawal from the experiment in 25 hours; and group 3: those undergoing acute immobilization stress, withdrawal from the experiment in 49 hours. The obtained data were processed by statistical methods with the help of the "Biostat" and "Excel" software packages. Results: In groups 1, 2, and 3, the animals were simulated acute immobilization stress by fixing the animals for 6 hours in bright light. The results of the conducted studies indicate changes in lipid peroxidation and antioxidant system (LPO-AOS) in case of immobilization stress-excitation. In developing free-radical pathology at immobilization stress-excitation, the more expressed disturbance of LPO-AOS, and accordingly the intensity of lipoperoxidation in the structural membrane of all investigated organs was high at the initial stage of exposure. Conclusion: At 49 hours after immobilization, stress less pronounced influence on the lipoperoxidation process was noted. The increase in the intensity of excessive lipoperoxidation testifies to the inhibited manifestation of AOS in the organism.

Diagnostic Relevance of Ferrokinetic Laboratory Markers in Anemic Pregnant Women.

OBJECTIVES: Different forms of anemia are considered as the most frequent complication of the gestational period. By its etiology, pathogenesis, and clinical hematology, it is not a single disease. Among all forms of anemia occurring during pregnancy, iron deficiency anemia (IDA) is the most common, accounting for 80-95% of all cases. DESIGN: The article describes a theoretical basis for the diagnosis of the anemic syndrome among pregnant women, the determining factors of its development, and the diagnostic methods at different gestational periods. Participants/Materials, Setting, and Methods: Diagnostic and prognostic values of iron balance indicators in the body were established for IDA during pregnancy to improve the outcome of childbirth. A total of 140 anemic patients were examined. The control group consisted of 50 pregnant women without anemia and other significant health problems, 48 IDA pregnant women, and 42 pregnant women with anemia caused by various chronic diseases, including rheumatoid arthritis. All patients of the main and control groups were registered on clinical records at the Family Planning Center in Aktobe city, Kazakhstan. RESULTS: Ferrokinetic indicators were suggested for diagnosing IDA and anemia of chronic diseases. It was established that IDA is characterized by low ferritin levels during gestation, while increased ferritin and C-reactive protein are typical for anemia of chronic diseases. LIMITATIONS: Differential diagnostics was applied for pregnant women with IDA and anemia of chronic diseases to observe the dynamics of serum ferritin and C-reactive protein (CRP) levels at different gestational periods. The article presents the results of a study on ferrokinetics in pregnant women with IDA and anemia caused by inflammation or chronic diseases. Other causes of anemia leading to a decrease in hemoglobin (Hb) levels to <90 g/L include hemoglobinopathies, which were not considered in this study. CONCLUSIONS: Determination of iron deficiency in pregnant women at different gestational periods will allow for identifying the risk group of anemic patients and deciding on the treatment. IDA (Hb <100 g/L) can be effectively measured by ferritin level <15 ng/mL, iron level of <11.5 µmol/L, and transferrin level >2.6 mg/L at p < 0.001. Anemia due to chronic diseases (Hb <100 g/L) can be effectively diagnosed with ferritin above 15 µg/L and CRP above 10 mg/L at p < 0.001.

Simvastatin attenuates the aberrant expression of angiogenic factors induced by glucose variability.

AIM: Over the last few years, studies have indicated that fluctuant hyperglycemia is very likely to increase the risk of cardiovascular complications of diabetes. Statins are widely used in diabetes for the prevention of cardiovascular complications, but it is still not clear whether simvastatin could also prevent glycaemic variability - induced aberrant angiogenesis which plays a significant role in the development of atherosclerosis. METHODS: Wistar rats were divided into four groups: (1) simvastatin-treated (20 mg/kg for 8 consecutive weeks) type 2 diabetes rat model with daily glucose excursions, (2) placebo-treated type 2 diabetes rat model with daily glucose excursions, (3) placebo-treated stable well-controlled type 2 diabetes rat model and (4) placebo-treated non-diabetic rats. Daily glucose fluctuations and several angiogenic factors: cVEGF, mRNA VEGF, VEGF-R1, VEGF-R2, TGF-beta expression, circulating endothelial and progenitor endothelial cells were measured in all groups. RESULTS: Simvastatin decreased several factors enhanced by glucose excursions: circulating VEGF, mRNA TGF-beta expression in the myocardium and mRNA VEGFR-2 expression in the aorta. Simvastatin increased some factors attenuated by glucose fluctuations: mRNA VEGF expression and mRNA VEGFR-1 expression in the myocardium and in the aorta. In the simvastatin-treated group with glycaemic variability, the percentage of circulating endothelial cells was lower and the percentage of progenitor endothelial cells in peripheral blood was higher than in the placebo-treated rats with glucose-fluctuations. CONCLUSIONS: Simvastatin used in the rat model of type 2 diabetes with glucose variability reduces glucose variability and limits glucose fluctuations-induced changes in the expression of angiogenic factors in the cardiovascular system.

Circulating monocyte chemotactic protein 1 (MCP-1), vascular cell adhesion molecule 1 (VCAM-1) and angiogenin in type 2 diabetic patients treated with statins in low doses.

Statins are known as agents promoting a biphasic dose-dependent effect on angiogenesis under experimental conditions. Dysregulation of angiogenesis plays an important role in the development of atherosclerosis and it may be affected by metabolic factors. The aim of this research was to explain how low doses of statins modify serum concentrations of pro-angiogenic factors MCP-1 and angiogenin in type 2 diabetic patients. Measurements of metabolic control parameters were performed in 30 patients with type 2 diabetes treated with low doses of statin, and in 34 statin-free patients with type 2 diabetes. The serum levels of MCP-1 and VCAM-1 in statin-treated patients were lower than those of the statin-free group. ANCOVA results revealed that these effects were dependent only on the use of statins. In type 2 diabetic subjects, overall positive correlation was found between total cholesterol or LDL serum concentration and MCP-1 serum level. The angiogenin concentration in the serum did not show differences and was comparable in both groups. The angiogenin serum level correlated negatively with HDL, LDL and with HbA1c. Multivariate regression analysis indicated that angiogenin serum levels in type 2 diabetic patients were determined mainly by HbA1c, HDL-cholesterol and diabetes duration. It has been shown that statins used in low doses in type 2 diabetic subjects decrease MCP-1 and VCAM-1serum levels, most likely due to the statins-related effect on the lipid profile, while angiogenin serum levels in this group are determined rather by the current metabolic control.