ABSTRACT
The severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) and the Ñoronavirus disease 2019 (COVID-19) have become a global health threat. At the height of the pandemic, major efforts were focused on reducing COVID-19-associated morbidity and mortality. Now is the time to study the long-term effects of the pandemic, particularly cognitive impairment associated with long COVID. In recent years much attention has been paid to the possible relationship between COVID-19 and Alzheimer's disease, which is considered a main cause of age-related cognitive impairment. Genetic predisposition was shown for both COVID-19 and Alzheimer's disease. However, the analysis of the similarity of the genetic architecture of these diseases is usually limited to indicating a positive genetic correlation between them. In this review, we have described intrinsic linkages between COVID-19 and Alzheimer's disease, pointed out shared susceptibility genes that were previously identified in genome-wide association studies of both COVID-19 and Alzheimer's disease, and highlighted a panel of SNPs that includes candidate genetic risk markers of the long COVID-associated cognitive impairment.
ABSTRACT
Cervical cancer ranks third among all new cancer cases and causes of cancer deaths in females. The paper provides an overview of cervical cancer prevention strategies employed in different regions, with incidence and mortality rates ranging from high to low. It assesses the effectiveness of approaches proposed by national healthcare systems by analysing data published in the National Library of Medicine (Pubmed) since 2018 featuring the following keywords: "cervical cancer prevention", "cervical cancer screening", "barriers to cervical cancer prevention", "premalignant cervical lesions" and "current strategies". WHO's 90-70-90 global strategy for cervical cancer prevention and early screening has proven effective in different countries in both mathematical models and clinical practice. The data analysis carried out within this study identified promising approaches to cervical cancer screening and prevention, which can further enhance the effectiveness of the existing WHO strategy and national healthcare systems. One such approach is the application of AI technologies for detecting precancerous cervical lesions and choosing treatment strategies. As such studies show, the use of AI can not only increase detection accuracy but also ease the burden on primary care.
ABSTRACT
OBJECTIVES: To assess the effects of the cyclooxygenase-1/cyclooxygenase-2 inhibitor lornoxicam on systemic complications in patients with acute pancreatitis, Toll-like receptor (TLR)2 and TLR4 messenger RNA expression, and cytokine secretion (IL-6, IL-8, tumor necrosis factor-α). METHODS: Adult patients with acute pancreatitis were randomized to standard therapy or standard therapy plus lornoxicam. Standard therapy included analgesics, spasmolytics, octreotide, pantoprazole, and intravenous fluids. The TLR2 and TLR4 expression levels and TLR2- and TLR4-mediated cytokine production in peripheral blood mononuclear cells were assessed in patients with severe complications and in healthy volunteers (n = 15). RESULTS: A total of 334 patients received standard therapy (n = 246) or standard therapy plus lornoxicam (n = 88), 172 (51.5%) of whom developed systemic complications. Occurrence of complications was higher with standard therapy compared with lornoxicam (57.3% versus 35.2%; P = 0.00034), as was mortality (19.1% versus 6.8%; P = 0.006). The TLR2 and TLR4 expression and TLR2 and TLR4-mediated cytokine production were significantly higher in patients with systemic complications of acute pancreatitis compared with healthy volunteers. Relative TLR2 expression and cytokine production were significantly reduced in patients receiving lornoxicam versus standard therapy. CONCLUSIONS: The use of lornoxicam at the onset of acute pancreatitis decreased TLR2 and TLR4 expression and the production of proinflammatory cytokines, thereby reducing the risk of systemic complications and mortality.
Subject(s)
Cyclooxygenase Inhibitors/therapeutic use , Inflammation Mediators/blood , Interleukin-6/blood , Interleukin-8/blood , Leukocytes, Mononuclear/drug effects , Pancreatitis/drug therapy , Piroxicam/analogs & derivatives , RNA, Messenger/blood , Toll-Like Receptor 2/drug effects , Toll-Like Receptor 4/drug effects , Tumor Necrosis Factor-alpha/blood , Acute Disease , Adult , Aged , Biomarkers/blood , Female , Humans , Leukocytes, Mononuclear/metabolism , Male , Middle Aged , Pancreatitis/blood , Pancreatitis/complications , Pancreatitis/diagnosis , Pancreatitis/genetics , Pancreatitis/mortality , Piroxicam/therapeutic use , Prospective Studies , RNA, Messenger/genetics , Russia , Time Factors , Toll-Like Receptor 2/genetics , Toll-Like Receptor 4/genetics , Treatment OutcomeABSTRACT
BACKGROUND AND STUDY AIMS: Colorectal endoscopic submucosal dissection (ESD) is associated with significant technical difficulty, long procedure time, and increased risk of complications, especially perforation. This study aimed to determine the factors associated with clinical results of ESD during the learning curve. PATIENTS AND METHODS: In total, 44 patients with sessile and flat rectal and sigmoid colon lesions underwent ESD from November 2009 to September 2013.âThe procedure time, resection method, tumor size, location, gross morphology, presence of fibrosis, histologic findings, rates of en bloc and piecemeal resections and perforation were analyzed. The ESD procedure was classified as technically difficult in the case of procedure time >â120 minutes and/or piecemeal resection. The whole study time was divided into two periods: first period: resections 1â-â22, second period: resections 23â-â44. RESULTS: En bloc and R0 resection have been achieved in 84.1â% of lesions. The mean procedure time was 119.95â±â11.22 minutes (range 25â-â360 minutes). Perforation was seen in five cases (11.4â%). A larger tumor size was a risk factor for difficult ESD (Pâ=â0.0001). A finding of fibrosis was a risk factor for piecemeal ESD (Pâ=â0.0074), and perforation (Pâ=â0.0012). There was a high direct positive correlation between tumor size and operation time (râ=â0.83, Pâ<â0.0001, 0.95 and 0.99 confidence interval for rho 0.71â-â0.904). There was no significant difference between the first and second period in terms of mean procedure time, en bloc resection or complication rate. CONCLUSION: A larger tumor size was associated with technically difficult ESD. Severe submucosal fibrosis was a risk factor for both piecemeal resection and perforation.
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Helicobacter pylori in Vladivostok, Far Eastern Russia, was investigated during 2004 to 2009. The genotype cagA(+) vacA(+) (s1/m1 or m2) accounted for 74.7%, with cagA(-) vacA(+) (s2/m2) at 11.2%. The CagA EPIYA type was mainly Western ABC, with minor types (ABCCC and novel AAABC) or non-Western/non-East Asia type (AB). Regarding drug resistance, metronidazole resistance was the highest, with a marked decrease in 6 years (from 71.4% to 30.8%); in contrast, levofloxacin and clarithromycin resistance increased. The data indicate that in Vladivostok, H. pylori was mainly the Western (not East Asian) type and dynamic changes in drug resistance occurred during 6 years.