The relationship between vitamin D and adolescents' parathyroid hormone and bone mineral density.

Introduction: To detect the relationship between 25-hydroxy vitamin D (25(OH)D) and adolescents' parathyroid hormone (PTH) and bone mineral density (BMD). Material and methods: Two hundred adolescent girls were recruited for this cross-sectional comparative study. After detailed evaluation, a pelvic sonography was performed for the studied adolescents to rule out any pelvic pathology. Adolescents' blood samples were collected to measure the thyroid stimulating hormone, prolactin, glycosylated haemoglobin (HbA1C), PTH, and 25(OH)D. The studied adolescents' BMD and the T-score were evaluated at 2 anatomical sites. The studied adolescents were classified according to their serum 25(OH)D into 2 groups: a 25(OH)D-deficient group (study group; 25(OH)D < 20 ng/ml) and normal controls (25(OH)D > 30 ng/ml). Student's t-test was used for analysis of the studied adolescents' variables, and correlation analysis (Pearson`s correlation) was used to detect the relationship between 25(OH)D and adolescents' PTH and BMD. Results: The parathyroid hormone was statistically higher in the 25(OH)D-deficient group than in the normal controls (41.3 ±3.4 pg/ml vs. 21.1 ±2.8) (p = 0.02), and the BMD was statistically lower in the 25(OH)D-deficient group than in the normal controls (-1.25 ±0.5 vs. 0.3 ±0.4) (p = 0.01). The 25(OH)D had a significant negative correlation with the adolescents' PTH (r = -0.9175; p < 0.00001) and a significant positive correlation with the adolescents' BMD (r = 0.756; p < 0.00001). The parathyroid hormone had a significant negative correlation with the adolescents' BMD (r = -0.7006; p < 0.00001). Conclusions: The parathyroid hormone in this study had significant negative correlations with both 25(OH)D and BMD. The 25(OH)D had a significant positive correlation with the studied adolescents' BMD.

Regarding cornual pregnancy as a rare entity of ectopic pregnancy: A case report.

The published Toumi et al's article is somewhat confusing to the readers. The cornual pregnancy (CP) defined as a pregnancy that occurs in a rudimentary horn of a uterus with a Müllerian anomaly according to William's textbook. The interstitial ectopic pregnancy (IEP) occurs in the interstitial part of the fallopian tube where it crosses the uterine muscular to enter the uterine cavity. The IEP sonographic findings include an empty uterus with an eccentrically placed gestational sac, located ≥1 cm from the endometrial margin and bordered by ≤ 5 mm myometrial rim.

Maternal and fetal outcomes after bariatric surgeries.

Introduction: Obesity is the most common medical problem affecting reproductive-age women. To detect the prevalence of obesity, and bariatric surgeries (BSs) in reproductive-age women, and the impact of obesity vs. BSs on the subsequent pregnancy outcomes. Material and methods: Obese-pregnant women, and women underwent BSs before the current pregnancy, with complete antenatal, and delivery records were included in the current study. Collected data were analyzed using MedCalc 20.106 to calculate the odd ratio (OR), and relative risk (RR) of adverse maternal, and fetal outcomes in relation to maternal obesity vs. BSs. Results: Data of 14,474 pregnant women were collected during this study; 33.94% (4912/14474) of them were obese, and 3.8% (546/14474) of them had previous BSs before the current pregnancy. The obese group has significantly higher odds, and RR of gestational diabetes mellitus (GDM) [OR 1.9 (p = 0.0001), and RR 1.79 (p = 0.0001)], gestational hypertension [OR 1.7 (p = 0.0002), and RR 1.6 (p = 0.0003)], and preeclampsia (PE) [OR 1.7 (p = 0.0001), and RR 1.6 (p = 0.0001)] compared to BSs group. The obese group has also significantly higher odds, and RR of cesarean sections (CSs) [OR 1.3 (p = 0.008), and RR 1.25 (p = 0.01)], and large for gestational age [OR 1.39 (p = 0.01), and RR 1.3 (p = 0.02)] compared to BSs group. Conclusions: About 33.94% of the reproductive-age women in Kuwait are obese, and 3.8% of them had previous BSs. Obese-pregnant women are at increased risks of GDM, gestational hypertension, PE, and CSs. Bariatric surgeries reduced the rates of GDM, gestational hypertension, PE, and CSs significantly.

The relation between primary dysmenorrhea in adolescents and body mass index.

Introduction: The aim was to assess the relation between primary dysmenorrhea in adolescents and body mass index (BMI). Material and methods: Two-hundred and ten adolescents were recruited for this cross-sectional research. After detailed evaluation, pelvic sonography was performed for the studied adolescents to rule out any pelvic abnormalities and/or lesion(s). The severity of the studied adolescents' dysmenorrhea was assessed by the visual analogue scale (VAS). The studied adolescents were divided into underweight, normal-weight, overweight, and obese adolescent groups based on their BMI (kg/m2). Collected data were analyzed using the ANOVA test, and correlation analysis (Pearson's correlation) to assess the relation between primary dysmenorrhea in adolescents and BMI. Results: The visual analogue scale of dysmenorrhea was statistically higher in the underweight adolescent group (8.7 ±0.8) compared to normal-weight (6.5 ±0.5) (p = 0.000001), and overweight (6.3 ±0.6) (p = 0.000001) adolescent groups. The visual analogue scale of dysmenorrhea was also statistically higher in the obese adolescent group (9.4 ±0.6) compared to underweight (8.7 ±0.8) (p = 0.000001), normal-weight (6.5 ±0.5) (p = 0.000001), and overweight (6.3 ±0.6) (p = 0.000001) adolescent groups. Conclusions: The visual analogue scale of dysmenorrhea was statistically higher in the underweight adolescent group compared to normal-weight, and overweight adolescent groups, and there was a strong negative relation between the VAS and BMI in the underweight adolescent group. In addition, the VAS of dysmenorrhea was statistically higher when the obese adolescent group was compared with the overweight, normal-weight and underweight adolescent groups, and there was a moderate positive relation between the VAS and BMI in the obese adolescent group.

Epidemiology of spontaneous pregnancy loss in Kazakhstan: A national population-based cohort analysis during 2014-2019 using the national electronic healthcare system.

INTRODUCTION: Spontaneous pregnancy loss (SPL) is a common health problem that affects 1:10 of childbearing women, and is linked with physical and psychological complications. As the number of nationwide studies on the incidence of SPL is few, especially from middle-income countries, in this study we investigated the epidemiology, complications and outcomes of SPL before 22 weeks of gestation by analyzing large-scale healthcare data from the Unified Nationwide Electronic Healthcare System (UNEHS) in Kazakhstan. MATERIAL AND METHODS: A population-based study among women who experienced SPL in any healthcare setting of the Republic of Kazakhstan during the period of 2014-2019. The International Classification of Diseases (ICD) 10th edition and ICD 9th edition's procedural codes were utilized to retrieve data using relevant diagnostic and procedural codes. RESULTS: In total, 207 317 records of women who have experienced an SPL before 22 weeks of gestation were analyzed from all Kazakhstani regions. The estimated prevalence of SPL was 8.7%, with a 20% decline over a 6-year period. The SPL cases ratio comprises on average 6.2 per 1000 reproductive-age women. Incomplete miscarriage (ICD-10 code "O03.4") was the most common type (37.8%), followed by blighted ovum (ICD-10 code "O02.0"; 34.1%) and missed abortion (ICD-10 code "O02.1"; 13.5%). The most common management methods were dilation and curettage of the uterus (ICD-9 code "69.0"; 84.7%) and aspiration curettage of the uterus (ICD-9 code "65.0"; 15%), whereas medical management was rarely performed (2.6%). CONCLUSION: The information available in UNEHS adequately identifies types of miscarriages and treatment methods. Although the prevalence of SPL before 22 weeks of gestation is decreasing, management of miscarriages requires closer attention.

Vitamin D and vitamin D receptor polymorphism in Asian adolescents with primary dysmenorrhea.

BACKGROUND: The expression of vitamin D receptor in the normal endometrium and ovaries supports the role of vitamin D in local immunity and inflammatory cytokines regulation. OBJECTIVE: This study aimed to detect the relation between serum 25(OH)D and primary dysmenorrhea in Asian Adolescents. METHODS: Two hundred and five (205) adolescents complaining of primary dysmenorrhea (study group) were compared in this prospective study to matched controls (210 controls) after informed consent following the Helsinki Declaration. After thorough evaluation, including a thorough history and pelvic ultrasound examination, blood samples were collected from the studied adolescents to measure serum 25(OH)D and for vitamin D receptor TaqI (rs731236) genotyping. The studied adolescents' data were analyzed using the Pearson's correlation to detect the relation between serum 25(OH)D and primary dysmenorrhea (primary outcome). The secondary outcome measures the odds of primary dysmenorrhea in Asian adolescents with vitamin D receptor TaqI (rs731236) polymorphism. RESULTS: The serum 25(OH)D was significantly lower in the studied-dysmenorrhea group compared to controls (16.17 ± 7.36 versus 17.65 ± 6.36 ng/ml, respectively), (P = 0.01). The correlation analysis showed a significant negative correlation between the serum 25(OH)D and visual analogue scale of dysmenorrhea (r = -0.9003, P < 0.0001). The studied-dysmenorrhea cases with vitamin D receptor T/t and t/t genotypes had significantly lower serum 25(OH)D (16.7 ± 8.05 and 14.4 ± 4.1 ng/ml, respectively) compared to controls (18.97 ± 6.7 and 21.4 ± 2.45 ng/ml, respectively), (P = 0.02 and 0.004, respectively). The VDR T/t and t/t polymorphisms significantly increase the odds of primary dysmenorrhea (OR 1367.2, P < 0.0001 and OR 106.2, P = 0.001, respectively). CONCLUSION: The serum 25(OH)D was significantly lower in the studied-dysmenorrhea group compared to controls. The studied-dysmenorrhea cases with VDR T/t and t/t TaqI genotypes had significantly lower serum 25(OH)D compared to controls. The VDR T/t and t/t polymorphisms significantly increase the odds of primary dysmenorrhea.

Recurrent Pregnancy Loss Etiology, Risk Factors, Diagnosis, and Management. Fresh Look into a Full Box.

Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are accepted for recurrent pregnancy loss but the types of pregnancy and gestational age at miscarriage. Due to the heterogeneity of definitions and criteria applied by international guidelines for recurrent pregnancy loss, the true incidence of recurrent miscarriage, which is reported to range from 1% to 5%, is difficult to estimate. Moreover, the exact etiology of recurrent pregnancy loss remains questionable; thus, it is considered a polyetiological and multifactorial condition with many modifiable and non-modifiable factors involved. Even after thoroughly evaluating recurrent pregnancy loss etiology and risk factors, up to 75% of cases remain unexplained. This review aimed to summarize and critically analyze accumulated knowledge on the etiology, risk factors, relevant diagnostic options, and management approach to recurrent pregnancy loss. The relevance of various factors and their proposed roles in recurrent pregnancy loss pathogenesis remains a matter of discussion. The diagnostic approach and the management largely depend on the etiology and risk factors taken into consideration by a healthcare professional as a cause of recurrent miscarriage for a particular woman or couple. Underestimation of social and health consequences of recurrent pregnancy loss leads to compromised reproductive health and psychological well-being of women after miscarriage. Studies on etiology and risk factors for recurrent pregnancy loss, especially idiopathic, should be continued. The existing international guidelines require updates to assist clinical practice.

Relationship between vitamin D and adolescents' hypothyroidism - a cross-sectional study.

Introduction: To detect the relationship between 25(OH)D and hypothyroidism in adolescents. Material and methods: A total of 180 adolescents were included in the current study, which was conducted in West Kazakhstan (Aktobe) over 2 years. After thorough evaluation, blood samples were collected from the studied participants to measure the thyroid stimulating hormone (TSH), free thyroxine (T4), prolactin, glycosylated haemoglobin, and 25(OH)D. Participants were classified into a 25(OH)D-deficient group (study group) and controls. MedCalc and correlation analysis (Pearson's correlation) were used to detect the odds of hypothyroidism and the relationship between 25(OH)D and adolescents' hypothyroidism, respectively. Results: Thyroid-stimulating hormone was statistically higher in the 25(OH)D-deficient group than in the normal controls (3.71 ±1.4 mIU/ml vs. 2.67 ±0.99) (p = 0.0006), and the free T4 was statistically lower in the 25(OH)D-deficient group than in normal controls (1.4 ±0.56 ng/ml vs. 1.5 ±0.4) (p = 0.0008). The 25(OH)D deficient group had higher odds of subclinical (OR 4.89; p = 0.016), and clinical hypothyroidism (OR 4.3; p = 0.013) compared to controls. A significant negative correlation between the 25(OH)D and TSH (r = -0.793; p < 0.00001), and a significant positive correlation between the 25(OH)D and free T4 (r 0.55; p < 0.00001) were detected in this study. Conclusions: The thyroid-stimulating hormone was statistically higher and the free T4 was statistically lower in the 25(OH)D-deficient group than in normal controls. The 25(OH)D-deficient group had higher odds of both subclinical and clinical hypothyroidism compared to controls. A significant negative correlation between the 25(OH)D and TSH, and a significant positive correlation between the 25(OH)D and the free T4 were detected in this study.

Relation between vitamin D and adolescents' serum prolactin.

Introduction: To detect whether there is a relation between vitamin D (Vit. D) and adolescents' serum prolactin (PRL) or not. Material and methods: Hundred and seventy-six adolescent girls were recruited for the current study, which was conducted in West Kazakhstan (Aktobe) over two years. After thorough evaluation, blood samples were taken from adolescents to measure thyroid stimulating hormone (TSH), free thyroxine (T4), PRL, glycosylated hemoglobin and 25(OH)D. The studied adolescents were classified into study group [25(OH)D deficient] and controls [normal 25(OH)D]. The acquired adolescents' variables were analyzed using the Student t-test and Pearson's correlation. Results: The serum TSH and PRL were statistically higher in the study group than normal controls (3.73 ±1.45 mIU/ml and 47.5 ±7.6 ng/ml vs. 2.67 ±1.0 and 10.8 ±5.1, respectively), (p = 0.0003 and p = 0.0001, respectively). The free T4 was statistically lower in the study group than normal controls (1.4 ±0.6 ng/ml vs. 1.5 ±0.4), (p = 0.0001). Strong negative associations between the serum PRL and 25(OH)D [r = -0.803 (p < 0.00001)], and between the serum PRL and free T4 [r = -0.6959 (p < 0.00001)] were detected in this study. Additionally, there was a strong positive association between the serum PRL and TSH [r = 0.8137 (p < 0.00001)]. Conclusions: A strong negative association between the serum PRL and 25(OH)D and a strong positive association between the serum PRL and TSH were detected in this study. This study recommends further studies to confirm the relation between Vit. D and PRL and screening Vit. D deficient adolescents for PRL and thyroid disorders.

The impact of primary dysmenorrhea on adolescents' activities and school attendance.

Primary dysmenorrhea is the most commonly encountered menstrual issue among adolescents, often leading to significant school absenteeism. This study aimed to detect the impact of primary dysmenorrhea on adolescents' activities and school attendance. We conducted a cross-sectional comparative study involving 180 adolescents aged 12 to 18 who experienced primary dysmenorrhea. A comprehensive trans-abdominal pelvic sonography was performed to rule out any underlying pelvic conditions. The severity of dysmenorrhea was evaluated using the visual analog scale (VAS), categorizing adolescents into groups with mild dysmenorrhea (VAS ≥1 to ≤3), moderate dysmenorrhea (VAS >3 to ≤7), and severe dysmenorrhea (VAS >7 to ≤10). Adolescents were surveyed to determine whether the severity of dysmenorrhea had an adverse effect on their physical and social activities as well as their school attendance. We used one-way ANOVA to compare the groups. There was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' physical activities (r=0.395; p<0.00001) and social activities (r=0.658; p<0.00001). Additionally, there was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' school attendance (r=0.416; p<0.00001). The odds of a negative impact on adolescents' physical and social activities and school attendance were significantly higher in adolescents experiencing moderate and severe dysmenorrhea than in adolescents with mild dysmenorrhea.

The effects of vitamin D and calcium on primary dysmenorrhea: a systematic review.

Dysmenorrhea, affecting approximately 80% of adolescents, significantly impairs quality of life, disrupts sleep patterns, and induces mood changes. Furthermore, its economic impact is substantial, accounting for an estimated $200 billion in the United States and $4.2 million in Japan annually. This review aimed to identify the effects of vitamin D and calcium on primary dysmenorrhea. We conducted a comprehensive literature search across Web of Science, PubMed, Scopus, and Science Direct, focusing on studies published from 2010 to 2020. Keywords included 'primary dysmenorrhea', 'vitamin D', '25-OH vitamin D3', 'cholecalciferol', and 'calcium'. The quality assessment of the articles was done using the Consolidated Standards of Reporting Trials (CONSORT) and the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists, and the risk bias was assessed using the Cochrane assessment tool. Abnormal low Vit. D levels increased the severity of primary dysmenorrhea through increased prostaglandins and decreased calcium absorption. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics. This systematic review found an inverse relation between the severity of dysmenorrhea and low serum Vit. D and calcium.. Vitamin D and calcium supplements could reduce the severity of primary dysmenorrhea and the need for analgesics.

The effect of vitamin D on adolescents' primary dysmenorrhea.

Vitamin D receptor (VDR) expression in the female reproductive tract explains the regulatory role of vitamin D on inflammatory cytokine and prostaglandin (PGD) synthesis. This study aimed to evaluate the effect of vitamin D on adolescents' primary dysmenorrhea and the relationship between Vit. D and adolescents' primary dysmenorrhea. Eighty-five adolescents were included in the current study. After a detailed evaluation, pelvic sonography was performed for all participants to rule out any pelvic pathology. Blood samples were collected to measure thyroid stimulating hormone (TSH), prolactin, glycosylated hemoglobin (HbA1C), and 25-hydroxyvitamin D (25[OH]D). Participants were administered vitamin D (50,000 IU weekly for five months), and their dysmenorrhea symptoms were evaluated before and after this period using the Visual Analog Scale (VAS) and the Verbal Multidimensional Scoring (VMS). The mean VAS and VMS scores of dysmenorrhea statistically decreased from 8.7±0.91 and 2.65±0.93 to 4.8±0.75 and 0.80±0.75, respectively, after vitamin D intake (p=0.03 and 0.025, respectively). Significant negative associations between 25(OH)D and VAS (R = -0.886; p<0.00001) and VMS of dysmenorrhea (R = -0.885; p<0.00001) were detected in this study. Vit. D could be a useful therapeutic option to reduce the severity of primary dysmenorrhea and could limit the use of non-steroidal anti-inflammatory drugs.

Chromium as a Risk Factor for Breast Cancer: A Meta-Analysis.

BACKGROUND: Chromium (Cr) is a transition metal, natural element. Chromium is the 21st most abundant element in Earth's crust. Cr is found in soil, rocks and living organisms. It may have various oxidation states, from -2 to +6, but most of these states are too unstable to exist in any significant quantities. The purpose of this review and meta-analysis is to critically assess the scientific evidence on the carcinogenic effects of chromium (Cr) and to determine whether there is currently sufficient evidence to suggest that that there is a link between chromium levels in hair and blood serum and breast cancer in women. MATERIAL AND METHODS: Research on the relationship between heavy metal chromium and the risk of developing breast cancer has been searched in PubMed, EMBASE, Web of Science, Scopus among papers published between January 2000 and September 2020. The search used the following terms (MeSH): breast cancer, women, trace elements, metals, chromium, chemically-induced, hair, serum using additional terms. RESULTS: In the second group of comparisons of women from "ecologically clean" districts of Aktobe Region, there were significantly lower indicators of the microelements in tumor tissue. The amount of Fe ranges from 38.46 to 65.39 ug/g (average 49.56±5.81 ug/g), Cu from 2.8 to 6.69 ug/g (average 5.06±1.01 ug/g), Zn from 1.89 to 5.38 ug/g (average 3.88±0.89 ug/g), Cr from zero to 6,1 ug/g (average 2.13±1.29 ug/g), Ni from 0.11 to 0.42 ug/g (average 0.28±0.067 ug/g) и Pb from zero to 0.19 ug/g (average 0.098±0.06 ug/g). CONCLUSION: The article established that women who live or work in ecologically polluted areas or have problems with micronutrient exchange need in-depth screening and more frequent screening for early detection of pre- and breast cancer.

Hair Toxic Trace Elements of Residents across the Caspian Oil and Gas Region of Kazakhstan: Cross-Sectional Study.

This study aimed to assess the relationship between the content of toxic trace elements, such as aluminum (Al), arsenic (As), beryllium (Be), cadmium (Cd), mercury (Hg), and lead (Pb), in the hair of the adult population of western Kazakhstan and the distance of their residence from oil and gas fields. The cross-sectional study included 850 adults aged 18-60 years. Inductively coupled plasma mass spectrometry was used to measure the level of Al, As, Be, Cd, Hg, and Pb in hair. The relationship between the concentration of toxic trace elements in the hair and the distance from oil and gas fields was assessed in three groups (<16 km, 16-110 km, and >110 km), using multiple linear regression analysis. The highest concentration of Hg = 0.338 µg/g was determined in the group living near oil and gas fields (0-16 km), whereas the lowest concentration of Al = 3.127 µg/g and As = 0.028 µg/g was determined in participants living at a long distance (more than 110 km) (p < 0.001). The concentration of Al (-0.126 (CI: -0.174; -0.077)), Hg (-0.065 (CI: -0.129; -0.001)), and Pb (0.111 (CI: 0.045; 0.177)) is associated with the distance to oil and gas fields. The obtained data indicate a change in the toxic trace element content in the hair of residents in the Caspian region of western Kazakhstan, a change that is most pronounced in residents living in the zone of oil and gas pollution. The distance to the oil and gas fields affects the content of toxic elements in scalp hair. In particular, the concentration of Al and Hg is associated with a decrease in the distance to oil and gas fields, while the concentration of Pb is associated with an increase in the distance to these fields. The lowest content of Al and As was determined in the hair of study participants living in the most remote areas (more than 110 km from oil and gas fields). Our results demonstrate the need for the biomonitoring of toxic elements to determine long-term temporal trends in the impact of chemicals on public health in western Kazakhstan.

Genetic and clinical characteristics of BRCA-associated hereditary breast cancer in the West region of Kazakhstan.

Breast cancer is the most common cancer in women and is cause mortality in many countries. The purpose of this article is to determine the BRCA1 BRCA2 gene mutation polymorphisms, as well as to determine the clinical, histopathological and prognostic characteristics in patients with breast cancer in the western region of Kazakhstan. A study was conducted on the genotyping of 278 patients in the MC ZKMU Marat Ospanov with an established diagnosis of breast cancer, which revealed that out of 278 patients, of three cases were identified. In the age category up to 50 years, 70 cases were detected (25.1%) after 50 years 208 cases were identified (74%). Number of patients in stage I was 20 (7.1%) in stage second 204 (73%) and in stage third 54 (19%). By tumor size, 30 (10%) cases were T1, 194 (69%) cases were T2, 35 (12.5%) cases were T3 and 19 cases were T4 (6.8%). According to metastasis of the lymph nodes, no lymph nodes were detected in 107 (38%) cases, 1-3 l/n (Lymph Nodes) in 95 (34%) cases, 4-9 l/n in 12 (4%) cases, 10 l/n in 4 (1.4%) cases and unknown cases was 60 (21%). In 99.6% of patients no distant metastases was detected. According to the molecular classification of the tumor, Luminal type A is most found in this study 147 (52.8%), then Luminal type B 57 (20.5%), HER-2 positive 26 (9.3%) and Triple negative 48 (17.2%). By ethnicity the Kazakh race is 182 (65%) the Caucasian race was 96 (34%). Large population screening studies involving all BRCA1/2 polymorphisms are required to confirm the penetrance, frequency and significance of a wide range of variations of BRCA1/2 genes in the Kazakh population.

The Effect of Endurance and Endurance-Strength Training on Bone Mineral Density and Content in Abdominally Obese Postmenopausal Women: A Randomized Trial.

The optimal type of exercise that simultaneously decreases body weight and preserves bone health in people with obesity is unknown. This parallel randomized trial aimed to compare the effect of endurance and endurance-strength training on bone mineral density (BMD) and content (BMC) in abdominally obese postmenopausal women. A total of 101 women were recruited and randomly assigned to endurance or endurance-strength training groups. Participants trained for 60 min per day, three times per week for 12 weeks. The endurance exercises were performed at an intensity of 50-75% of the maximum heart rate, whereas the strength exercises were at 50-60% of the one-repetition maximum. Pre- and post-intervention BMD and BMC of the total body, lumbar spine, and femoral neck and physical capacity were measured. There were no differences among the densitometric parameters in the endurance group, but a significant increase in whole-body BMD in the endurance-strength group was found. Moreover, there was a significant difference between the groups in the changes in the lumbar spine BMC. Furthermore, both training programs significantly improved physical capacity with no differences between groups. Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further studies with a long-term follow-up should be considered to confirm these findings. The study was registered with the German Clinical Trials Register within the number DRKS00019832, and the date of registration was 26 February 2020 (retrospective registration).

Comparative Analysis of Vaginal Microbiota in Women with Breast Cancer in Kazakhstan.

OBJECT: The relevance of the article is that the breast cancer is a leading oncological disease in women in developed countries and has the highest mortality caused by malignant neoplasms in women. The purpose of the study is to evaluate vaginal microbiota in women with various breast cancer subtypes and compared groups. METHODS: The study involved 278 women with breast cancer, of whom 174 were patients receiving combination therapy; the control group consisted of 104 patients who had had breast cancer 2-4 years ago. RESULTS: It was found that despite a significant decrease in the total number of Lactobacillus spp., there were no statistically significant changes in the numbers of microorganisms in patients with different subtypes of breast cancer. According to the results of the comparative analysis, the representatives of obligate anaerobic flora Peptostreptococcus spp. prevailed in vaginal microbiota in luminal A and luminal B subtypes, and the representative of the facultative anaerobic organisms Staphylococcus spp. - in unfavourable outcomes in Her2/Neu+ and triple-negative subtypes. CONCLUSION: The observed features of the vaginal microbiota in women with different subtypes of breast cancer require further studies for preventive purposes.
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Correlations between Specific and Nonspecific Vaginal Immunity in Women with Breast Cancer in Kazakhstan.

Background: The most common malignant tumor in women is breast cancer (BC). The ability of regulatory cells to inhibit cellular immune response as well as to participate in the modulation of antitumor immunity has attracted much interest of scientists. The purpose of this study was to assess the correlation between the specific and nonspecific vaginal immunity in women with BC. Methods: This was an experimental study. The study involved 278 women, 174 of whom received chemotherapy. The sampling was performed using a universal probe. The qualitative and quantitative assessment of the vaginal microflora was done using the polymerase chain reaction method. Statistical processing of the analysis was performed using the Statistica 10.0 licensed software. The parameters of the immune status before and after chemotherapy were analyzed, and the correlation between the number of cells in the main populations of lymphocytes before and after chemotherapy was investigated. Results: The study of the correlation between the number of cells of the main lymphocyte populations before and after chemotherapy showed an inhibition of B-lymphocytes (CD3-CD19+) in the study group, as the subpopulations of T-cytotoxic (CD4-CD8+) and CD3+HLA-DR+ (activated E-lymphocytes) were increased in both groups. Direct correlations were observed between local vaginal immunity and the immune status of the examined women in the study group between Megasphaera spp. and Enterobacteriaceae, with a certain population of immunocompetent cells. Conclusion: It was concluded that impaired biocenosis and suppression of local immune responses in women with BC were the reason for the active involvement of the components of the immune system.