RESUMEN
Obstructive sleep apnea (OSA) syndrome is not only a widespread pathology, but also has far-reaching social consequences due to patients' poor quality of nighttime sleep and high daytime sleepiness. To date, a large number of methods, both conservative and surgical, have been developed for the treatment of OSA. Surgeries performed for OSA are aimed at correcting the structures of the nose, pharynx, larynx, as well as the hyoid and jaw bones and the muscles attached to them. Despite the seventy-five-year history of the use of surgical treatment methods, there is still no complete clarity regarding the advisability of certain types of operations. The article presents data from meta-analyses published over the last ten years and devoted to various types of surgical procedures aimed at combating OSA in adult and pediatric populations. Rhinosurgical approaches, uvulopalatopharyngoplasty, surgical advancement of the lower jaw in adults and expansion of the upper jaw in children, interventions on the hyoid bone and mental tubercle, removal of the palatine and pharyngeal tonsils, operations for laryngomalacia and bariatric surgery are considered. Data on the effectiveness of the most common operations: tonsillectomy in adults (85%), multilevel pharyngoplasty (60%); and about a wide range of data on the effectiveness of uvulopalatoplasty (25 to 94%) are presented. Effective surgical options and criteria for a positive prognosis of such treatment, the possibility of complete cure of OSA, that is, reducing the apnea/hypopnea index (AHI) below 5 events per hour in adults, are discussed. In conclusion, the need to continue research using Sher's criteria for the effectiveness of surgical operations is emphasized: a reduction in AHI by 50% or more or below 20 events per hour. Research that includes long-term postoperative follow-up is especially important.
Asunto(s)
Apnea Obstructiva del Sueño , Humanos , Apnea Obstructiva del Sueño/cirugía , Tonsilectomía/métodos , Faringe/cirugía , Resultado del Tratamiento , Procedimientos Quirúrgicos Otorrinolaringológicos/métodos , Cirugía Bariátrica/métodosRESUMEN
Microorganisms in human life play a huge role: in particular, those that coexist with the host organism, inhabiting the skin, upper respiratory tract, external genitalia and especially the digestive tract. The intestinal microbiota, including bacteriome, mycobiome and virome, not only takes part in the digestion process, but also provides the synthesis of a number of vitamins. The intestinal microbiome also serves as the basis for a system of extensive bidirectional neuroendocrine pathways that connect microbiota with various regions of the central nervous system, the hypothalamic-pituitary-adrenal system, and the peripheral parts of the autonomic nervous system. This system of connections has got the name of gut-brain axis and has attracted close attention of scientists over the past two decades, since a targeted impact on the intestinal flora is potentially capable of changing the nature of nervous system regulatory influences on the whole body. It is especially important to study patterns of functioning of the gut-brain axis in patients with the nervous system pathology, namely neurodegenerative and demyelinating diseases. Methods for their treatment continue to improve, and perhaps the correction of the gut microbiotic composition will serve as an additional therapeutic approach. The review article describes current views on the role of the intestinal microbiota, provides the latest data on the composition of bacteriome, mycobiome, and virome in patients with relapsing-remitting multiple sclerosis.
Asunto(s)
Microbioma Gastrointestinal , Esclerosis Múltiple Recurrente-Remitente , Esclerosis Múltiple , Humanos , Microbioma Gastrointestinal/fisiología , Encéfalo/fisiología , Esclerosis Múltiple Recurrente-Remitente/metabolismo , Esclerosis Múltiple/metabolismo , Sistema Nervioso CentralRESUMEN
Selective inhibitors of sodium-glucose cotransporter belong to a new class of drugs for the treatment of type 2 diabetes mellitus. The mechanism of their action is based on insulin-independent reduction of glucose reabsorption in the proximal renal tubules, which leads to stimulation of its excretion in the urine and, accordingly, to a decrease in the concentration of glucose in the blood plasma. Drugs of this group demonstrate effectiveness in the treatment of type 2 diabetes, but their use may be associated with an increased frequency of urinary tract infections. Pharmacological glucosuria, which leads to a decrease in the concentration of glucose in the blood, creates the preconditions for the occurrence of urinary tract infections. Urinary tract and genital infections are the most common adverse events associated with the use of sodium-glucose cotransporter inhibitors. In the presented literature review for 20162019, the relationship between urinary tract infections in patients with type 2 diabetes mellitus and therapy with sodium-glucose cotransporter inhibitors was analyzed.
Asunto(s)
Diabetes Mellitus Tipo 2 , Glucosuria , Inhibidores del Cotransportador de Sodio-Glucosa 2 , Infecciones Urinarias , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Glucosuria/inducido químicamente , Humanos , Hipoglucemiantes/efectos adversos , Inhibidores del Cotransportador de Sodio-Glucosa 2/efectos adversos , Infecciones Urinarias/tratamiento farmacológicoRESUMEN
The vomeronasal system (VNS) provides regulation of a wide range of autonomic and affective functions, behavioral reactions in response to the specific chemical stimuli pheromones secreted by mammals, including humans. The results of experimental studies confirming the existence of VNS and explaining the basic mechanisms of its functioning are presented. The results of studies of healthy volunteers, explaining the effect of pheromones on a number of functions of the human body, are considered.
Asunto(s)
Feromonas , Órgano Vomeronasal , Animales , Humanos , Mamíferos , Conducta SexualRESUMEN
AIM: To study the mechanism of the development of amblyopia using the analysis of brain grey matter parameters. The areas primarily associated with visual cortex in children with amblyopia were analyzed. MATERIAL AND METHODS: The study group comprised 8 right-handed children with left-sided amblyopia. MRI images were obtained by 1.5T Toshiba scanner with 3D MP-RAGE. T1-images were processed with FreeSurfer (5.3.0 version, http://surfer.nmr.mgh.harvard.edu/). RESULTS AND CONCLUSION: No significant interhemisphere differences by cortical thickness were identified in all tested regions of interest. In correlation analysis, only the positive correlation between visual acuity in the left eye and cortical thickness in the left pericalcarine as well as the positive correlation between visual acuity in the left eye and cortical thickness in the left V1 area obtained using another anatomical atlas survived multiple comparison correction. The findings support the hypothesis that pathological ontogenetic processes in children with amblyopia lead to the structural abnormalities of the primary visual cortex.