Репозиторий Университета

© 2018 Nutritec. All Rights Reserved. The article presents modern approaches to dietary support of patients with diabetic nephropathy (DN) characterized by gradual sclerosis of the renal tissue, leading to a loss of filtration and nitrogen excretory function of the kidneys. An analysis of publications of domestic and foreign authors indicates a slowdown in the progression of chronic kidney disease against the background of low-protein diets. However, the role of protein restriction and its qualitative composition in the diet of patients with DN is the subject of comprehensive discussion. KDOQI (2007) Clinical Practice Guidelines and Clinical Practice Guidelines for Kidney Disease determine the target level of protein intake in individuals with diabetes and chronic kidney disease 1-4 stages at the level of 0.8 g/kg of body weight per day. In the recommendations on nutrition for patients with DN, along with a controlled reduction in protein content, great importance is attached to reducing sodium intake from food to 1.5-2.3 gperday. In recent years, close attention has been paid to the use of highly active natural antioxidants for the treatment and prevention of type 2 diabetes, including DN, which was determined by the results of studies demonstrating their beneficial effects on DN patterns. It has been shown that one of the ways to optimize the nutrition of patients with DN is the use of specialized foods modified by protein, fat and carbohydrate composition, including food ingredients with hypoglycemic, hypolipidemic and antioxidant effects.

© 2018 Izdatel'stvo Meditsina. All rights reserved. Aim of the study. To compare the effects of tranexamic acid (TXA), factor XIII concentrate (FXIII) and fibrinogen concentrate on clot formation and fibrinolytic resistance in the in vitro model of hyperfibrinolysis induced by tissue-(tPA) vs urokinase-type (uPA) plasminogen activators. Materials and methods. Citrated whole blood from 28 adult healthy volunteers was supplemented with 10 μg/ mL TXA, 2 lU/mL FXIII, or 3 mg/mL fibrinogen concentrate. Hyperfibrinolysis was induced by spiking the blood with PA or uPA at their half-maximal effective concentrations (90 and 33 lU/mL, respectively). Clotting was induced by recalcification and addition of tissue factor and monitored using rotation thromboelastometry. Results. The use of TXA increased maximal clot firmness in the presence of tPA and markedly inhibited clot lysis in the presence of any of the plasminogen activators. Supplementation of blood with FXIII significantly increased clot firmness and improved fibrinolytic resistance in the presence of either PA or uPA. Supplementation with fibrinogen concentrate elicited a strikingly different effect on clot formation and lysis depending on the type of plasminogen activator. In the presence of tPA, fibrinogen concentrate significantly increased clot firmness and attenuated clot lysis. In contrast, in the presence of uPA, the use of fibrinogen markedly reduced clot firmness and promoted clot lysis. Similar effects of fibrinogen concentrate were observed in platelet-rich and microparticles-free plasma. Conclusion. In hyperfibrinolysis, effect of the hemostatic drugs significantly depends on the type of plasminogen activator used. Therefore, mechanisms of hyperfibrinolysis should be taken into consideration while administering hemostatic drugs.

© Izdatel'stvo Meditsina. All rights reserved. The professional standard is the basis of education and training. It should meet modern requirements to ensure the sanitary and epidemiological wellbeing of the country's population, the labor market. The current professional standard does not fully take into account the various types of economic activity in which young professionals of the medical and preventive profile will work. The main task of a specialist in the medical and prophylactic profile is to carry out activities aimed ensuring the sanitary and epidemiological wellbeing of the population (informing the control subject concerning mandatory sanitary and epidemiological requirements, implementation, assessing the effectiveness and effectiveness of their implementation, implementing production control, expert control, sanitary-epidemiological audit). The main employers for these young professionals are organizations of the sanitary and epidemiological services; hospitals, sanatorium, spa and resort organizations; organization of disinfection and deratization, organizations of industrial equipment, testing and analysis of the composition and purity of materials and substances; testing and analysis in the field of food hygiene; testing and analysis of physical and mechanical properties of materials and substances; examination of design documentation and engineering survey results; monitoring of environmental pollution. The professional standard of the young professionals in the hygiene profile has a particular set of qualities, skills, and behaviors that ensure the success of the career. There is a set of standards for education and training of professionals in the hygiene profile. There are sanitary and epidemiological diagnostic - activities to establish compliance (inconsistency) with the requirements of the legislation of the Russian Federation in the field of public health. Also, there is the support of the sanitary and epidemiological wellbeing of the population, technical regulation, labor protection, various activities concerning and preventive measures; organization of monitoring and sanitary-epidemiological assessment of the risk of environmental factors affecting health. The education and training of students of medical-prophylactic faculties should be carried out taking into account modern approaches to the professional standard for the specialist of the hygienic profile and the educational standard developed on the basis of it.

© 2018 Izdatel'stvo Meditsina. All rights reserved. Succinate is an endogenous substrate of the human organism that participates in various redox processes, reactions of the Krebs cycle, and the mitochondrial oxidation chain. This universal intracellular metabolite plays an important role in the regulation of physiological, metabolic, and energy-producing processes. The article discusses the issues of neuroplasticity, the importance of correction of energy deficiency, oxidative stress and other pathophysiological processes, and maintenance of adequate functional activity of neuronal structures after cerebral circulation disorders. The problems of neuroprotective therapy in ischemic stroke, which is pathogenetically justified in all stages of restorative treatment after cerebrovascular accident, are considered. Cytoflavin is one of the most studied original cytoprotectors, which demonstrated safety, efficacy, and good tolerability. Results of numerous clinical trials revealed significant positive clinical and morphological dynamics of cytoflavin administration in patients after ischemic stroke.

© 2018 The Authors. Published by Elsevier B.V. Identification of genes variants (alleles) in organisms can become a time-consuming task due to great diversity. Polymorphism is also a feature of HLA, the main complex of human histocompatibility. Errors in sequencing can also cause incorrect determination of alleles. The authors of the paper propose a method for analyzing high-performance sequencing data, which allows observing high accuracy in the problem of genotyping HLA.

THE PURPOSE OF THE STUDY: determination of the optimal parameters of the action of various types of current, which have the most pronounced irritating effect on the receptor apparatus of the tooth pulp. The study involved 102 volunteers aged 19 to 72 years (53 females and 49 males). The study was conducted on 217 teeth: 86 molars, 25 premolars, 19 canines and 98 incisors. 137 (63%) teeth were intact, in 48 (22%) teeth caries were found, in 32 (15%) teeth there was pulpitis or teeth were depulpated. Electroexcitability of the teeth was determined with the help of various types of electric current: an impulse variable, an impulse constant and a sinusoidal variable. The optimal current for carrying out an electroodontodiagnosis proved to be sinusoidal variable current with a frequency of 50 Hz. This current does not cause polarization of tissues, it is easy to dose, it causes a clear, but not painful sensation, gives the smallest spread of the indicators during repeated studies. The obtained results allowed formulating requirements for electroodontodiagnosis devices.

© 2018 Media Sphera Publishing Group. All rights reserved. In this article we present problems of prognostic value of day-by-day blood pressure (BP) variability, its role in development and progression of damage of target organs in arterial hypertension, and impact on risk of cardiovascular, cerebral-vascular complications, and mortality. We also discuss methodological aspects of assessment of day-by-day BP variability. The article contains literature data on effects of antihypertensive therapy on variability of home BP, and consideration of evidence base of possibilities of the fixed amlo-dipine/perindopril combination for lowering day-by-day BP variability.

© 2018, Media Sphera Publishing Group. All rights reserved. Over the past few decades, there has been growing concern among researchers about the health status of teachers due to their professional activities. Objective - to investigate the relationship of professional burnout (PB) in teachers towards their attitude to their own health and healthy lifestyle. Subject and methods. A total of 317 teachers (26 men and 291 women) were examined. The program encompassed a medical examination, rapid diagnosis of the stress level (L. Reeder), diagnosis of the level of emotional exhaustion (burnout) according to the questionnaire designed by V.V. Boiko, and a survey using the questionnaire that included a sociodemographic unit and questions about health attitudes. Results. Analysis of the teachers’ health self-assessment showed that 23% of women and 35% of men rated their health as good and very good; 70% of women and 62% of men regarded as satisfactory; and the remaining considered as bad. Health self-assessment decreased with higher levels of burnout. The results showed a low level of physical activity in the teachers, non-compliance with the work and rest regime, inability to manage their emotions and cope with stress, low competence in a balanced diet, and the presence of bad habits (smoking and alcohol). The number of alcohol abusers is growing in the group of women with higher PB. The women were statistically significantly ascertained to have a lower regular physical activity with a higher level of PB. Conclusion. The results show that PB has an adverse impact on health self-assessment, health attitudes, and healthy lifestyle behavior. In order to prevent PB, it is recommended that a package of preventive measures should be developed.

© 2018 Media Sphera Publishing Group.All Rights Reserved. Aim. To study the oxidative damage of biopolymers (proteins and nucleic acids) in blood of patients with type 2 diabetes mellitus (DM). Materials and methods. In the blood of 50 patients with DM and 25 patients without disorders of carbohydrate metabolism were estimated: the level of oxidized low-density lipoprotein (oxLDL) by immunochemical method, the content of SH-groups in plasma proteins, the activity of Cu, Zn-superoxide dismutase (SOD) in erythrocytes, the length of telomere in leukocyte DNA, the level of 8-hydroxy-2'-deoxy-gunosine (8-oxo-dG) in plasma and urine. Results and discussion. It is shown that in DM patients the level of oxLDL increases and the content of SH-groups in proteins and peptides of the blood plasma decreases, which indicates the development of oxidative stress. In addition, a carbonyl-dependent modification of erythrocyte SOD was detected in DM patients, as well as oxidative DNA destruction (decrease in telomere length in leukocytes and an increase in the level of 8-oxo-dG in blood plasma and urine). Conclusion. On the basis of the definition of a complex of correct indicators, a multiple oxidative modification of biopolymers of blood (proteins and DNA) was detected in patients with DM.

© 2018 Russian Association of Endocrinologists. All rights reserved. In recent years, a large amount of data has been accumulated on the relationship between cognitive impairment, dementia and diabetes mellitus. This article presents an overview of modern literature, including the definition of cognitive functions, the modern classification of cognitive impairment, pathogenetic mechanisms of diabetes mellitus influence on the development of cognitive impairment and dementia (neurogenesis, integrity of the blood-brain barrier, systemic inflammatory reactions, hyper- And hypoglycemia, insulin resistance, vascular dysfunction of the microvasculature and increase in glucocorticosteroids). The influence of anti-diabetic medications on cognitive functions has been examined in detail: insulin preparations, oral hypoglycemic agents of the biguanide group (metformin), thiazolidinediones (rosiglitazone and pioglitazone), sulfonylurea derivatives (glycazide, glipizide), a-glucosidase (acarbose) inhibitors, incretin-directed therapy (receptor agonists glucan-like peptide (exenatide and liraglutide) and inhibitors of dipeptidylpeptidase type 4 (sitagliptin, vildagliptin and alogliptin)), sodium glucose inhibitors cotransporter type 2. The data demonstrating a multidirectional effect on the cognitive functions of various antidiabetic drugs is presented, the possible influence on the rate of progression of cognitive impairment and the risk of dementia of intensive control of plasma glucose level in comparison with the standard decrease in patients with type 2 diabetes is analyzed.

© 2018 Ima-Press Publishing House.All right reserved. Objective: to study changes of acute-phase reactants (erythrocyte sedimentation rate – ESR, C-reactive protein – CRP), autoantibodies (IgM/IgA rheumatoid factors – RF, anti-citrullinated protein antibodies), immunoglobulin classes G, M, and A, and CD19+ B-lymphocytes in patients with rheumatoid arthritis (RA) 12 and 24 weeks after initiation of therapy with a rituximab (RTM) biosimilar at a total dose of 1200 mg. Subjects and methods. Examinations were made in 20 patients with a reliable diagnosis of RA (including 18 women; median age, 61.5 [54; 66.5] years; disease duration, 39.5 [20; 84] years; DAS28, 5.6 [4.9; 6.8]). All the patients received two intravenous infusions of RTM (Acellbia®) 600 mg at a 2-week interval during therapy with methotrexate, nonsteroidal anti-inflammatory drugs, and glucocorticoids. Clinical and laboratory parameters were analyzed immediately before therapy and then 12 and 24 weeks after the first infusion of the drug. Results and discussion. DAS28, ESR, and CRP level in respondents significantly decreased 12 and 24 weeks after RTM administration. The serum IgM RF concentration in the respondents was found to be significantly reduced at weeks 12 and 24 and amounted to 79.7 and 87.1% of baseline, respectively. The IgA RF level significantly decreased by 72 and 85% of baseline at weeks 12 and 24 of RTM therapy, respectively, in patients with a good response, and by 59.7 and 67.5% at weeks 12 and 24 in patients with a satisfactory response. The serum concentration of anti-cyclic citrullinated peptide antibodies in the respondents remained high throughout the follow-up. All the patients achieved CD19+ B-cell depletion at week 12 of therapy (absolute levels, 0); there was an increase in the level of CD19+ B-lymphocytes at week 24 (0.0030 [0.0003; 0.0270] 109/l). In both in the good and satisfactory response groups, the mean immunoglobulin levels remained within normal limits. Conclusion. The analysis of the efficiency of two infusions of the RTM biosimilar at a total dose of 1200 mg following 24 weeks of therapy initiation suggests that the drug is able to cause reductions in disease activity, laboratory signs of inflammatory activity, autoantibody concentrations, and complete B-lymphocyte depletion.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study cognitive functions, anxiety and depression levels, 24-hour blood pressure (BP) profile, cerebral blood flow (CBF) perfusion in treatment-naive middle-aged patients with uncomplicated essential arterial hypertension (EAH) depending on the white matter hyperintensities (WMH) burden. Material and methods. Forty-one hypertensive patients (mean age 46.2±4.6 years) and 41 healthy volunteers (mean age 50.3±6.7 years) were enrolled to the study. All subjects underwent brain MRI (MAGNETOM Skyra 3.0T, T1, T2 FSE, T2 FLAIR, T1 MPRAGE, ASL), Montreal cognitive assessment (MoCA), 10-word learning task, verbal fluency test, trail making test, Stroop color and word test, anxiety and depression assessment with Hamilton rating scales, 24-hour blood pressure monitoring (ABPM). Results. WMH were found in 22 (53.7%) hypertensive patients and in 3 (7.3%) healthy volunteers (p=0.0002). Hypertensive patients had the significantly lower CBF compared to controls (p<0.001). Conclusion. WMH were identified in treatment-naive middle-aged patients with uncomplicated mild to moderate EAH. There was an association between WMH and lower CBF in the cortical plate of frontal lobes, SBP variability and worse cognition. Cerebral hypoperfusion can cause cognitive impairment even in the earliest stages of EAH, which increases due to emotional disorders.

© Bionika Media Ltd. Objective. To investigate whether early endometrial cancer can be treated and whether fertility can be preserved in young women, by using a hormonal combination: levonorgestrel intrauterine hormonal system (LNG-IUS; Mirena 52 mg of LH) and gonadotropin-releasing hormone agonists (Zoladex 3.6 mg). Subjects and methods. The investigation covered 79 patients. The case histories of 37 patients with atypical hyperplasia and 42 with stage IA (T1aNxMo) endometrial cancer were analyzed. The patients’ mean age was 33 years. The investigation was conducted at the Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation. Results. Primary treatment was completed in 67 (84.8%) patients and in 12 (15.2%) during hormonal treatment. After completion of special treatment, 8 (11.9%) of the 67 women had 10 pregnancies that resulted in childbirth and spontaneous miscarriage in 8 and 2 cases, respectively. Recurrences and incurable disease were stated in 3 (4.2%) and 9 (12.8%) cases, respectively. Repeated hormone therapy cycles were not performed because the patients had refused organ-sparing treatment. All the 12 (17.1%) patients were successfully operated on. Conclusion. The proposed treatment regimen is a highly effective medical treatment in patients with precancer and early endometrial cancer. Independent hormone therapy is undoubtedly the best alternative to hysterectomy today in this group of patients who want to preserve reproductive function.

© 2018, Dynasty Publishing House. All rights reserved. The objective. A quantitative analysis of the levels of environmental contaminants from the class of polychlorinated diben-zoparadioxins, furans (PCDD/F) and polychlorinated biphenyls (PCB) as sensors of chemical alteration in the reproductive system in idiopathic infertility. Patients and methods. The examination included 122 women diagnosed with «idiopathic infertility». The levels of ecopollutants were determined by a combination of high-performance capillary gas chromatography and high-resolution gas chromatography/ mass spectrometry according to the standard protocol. Results. In follicular fluid of patients, the total content of dioxins/furans did not exceed 15.7 pg/g of lipids, i.e. was at the sensitivity threshold of the employed method. PCB concentrations were also low (not more than 28.6 pg/g of lipids), but PCB153 and PCB180 congeners associated with fertility disorders have not been found. Conclusion. As has been hypothesized, this class of xenobiotics does not play a leading role in the genesis of environmentally-conditioned reproductive pathologies in women.

© Saint Petersburg Pasteur Institute. All rights reserved. The review is devoted to the analysis of pertussis incidence of children in the age group of 5-7, as well as strategies of DTP immunization with the help of the drugs in foreign countries. Mass vaccination against pertussis began in the middle of the 20th century, which contributed to a reduction in incidence and mortality rate from this infection. However, in the last decade, there has been an opposite tendency of increasing incidence of patients among children under school age, school age and adults. Atypical forms of the disease and complications due to ARVI, respiratory mycoplasmosis and cytomegalovirus infections are described in the review. Various strategies for the use of whole-cell and acellular pertussis vaccines as part of DTP drugs are described, as well as the epidemiological effect of introducing an additional booster dose of vaccine to children under school age. The expediency of revaccination of children aged 6-7 in Russia is argued, which can help to reduce the overall incidence of pertussis. The research materials related to the study of the properties of acellular anti-pertussis vaccine, such as immunogenicity and safety in comparison with whole-cell vaccine, are analyzed. The main drugs and their composition, which are used to vaccinate children against pertussis, are described in the review. It is assumed, that the increase in the incidence among children and teenagers, with the appearance of atypical forms of pertussis, is associated with a number of factors, such as the spread of new genotypes of Bordetella pertussis bacterium, emerged from mutations, as well as short duration of immunity after vaccination with acellular drugs, in comparison with whole-cell, and the use of more modern methods of detecting the pathogen. The mechanisms of the immune response due to different types of pertussis vaccines are also reviewed. It is concluded, that revaccination of children aged 6-7 with an additional fifth dose of an acellular vaccine against pertussis, as part of the DTaP instead of the Td drug, which is regulated in the National Calendar of preventive vaccinations, will have a favorable effect on the epidemic situation with pertussis infection in Russia.

© 2018 Ruslania. All Rights Reserved. One of the prevalent genetic causes of idiopathic male sterility is related to micro-deletions in AZF locus located in Y-chromosome. In total population, rate of such micro-deletions makes up to 1:4000. however, in infertile males their rate varies from 2% to 10%. In AZF locus three subregions are distinguished: AZFa, AZFb andAZFc. The loss of one or several subregions can result in disorder of spermatogenesis of various degree - from decreasing of its activity to Sertoli-cell syndrome manifested by azoospermia or oligospermia of severe degree. Therefore, implementation of genetic testing for presence of micro-deletions in AZF locus is a necessary test in case ofprognosis of male sterility and its treatment. The purpose of study is to develop and test a diagnostic system of detection of micro-deletions in subregions ofAZF locus using multiplex polymerase chain reaction in real-time. As a reference method a technique was implemented described in guidelines of the European Academy ofAndrology conjointly with European Molecular Genetics Quality Network. The technique testing specified analysis of 33 samples of DNA separated from blood of males with azoospermia and oligospermia ofsevere degree. No discordant results were received as compared with reference method. In 27 DNA samples the deletions were detected in AZF locus: 4 AZFa deletions (15%), 2 AZFb deletions (7%), 17 AZFc deletions (63%) and 6 combined deletions of AZFb+candu AZFa+b+c (22%). The proposed technique permits detect micro-deletions of subregions ofAZF locus.

© 2011-2018 NSPU Bulletin. All rights reserved. Introduction. The authors investigate the problem of determining the epistemological foundations of pedagogical knowledge. The purpose of the article is to establish epistemological foundations of theoretical standard in pedagogical knowledge. Materials and Methods. The research employed a set of methods, including: a) an analysis of scientific literature on the topic of the article; b) a synthesis of generalized philosophical and scientific ideas, ideas of domain-specific research methodology of natural sciences and their influence on educational research methodology; c) clarifying the content of modern pedagogical knowledge, forms of its presentation to scientific and professional community, and methods of obtaining new pedagogical knowledge. Results. The article proposes an idea about such categories as dbjective subject reality "and Scientific-subject reality"unrepresented in theoretical education studies. The authors clarify the epistemological construct called theoretical standard of pedagogical knowledge" It consists of scientific-problem description of educational reality, fixing the difference between an educational event and a scientific fact, the subject of education and the idealized scientific object ofpedagogics, the correct nomination of problems and hypotheses and their epistemological verification. Conclusions. The authors conclude that the methodological concept of "theoretical standard of pedagogical knowledge" can become a reference point in the process of establishing pedagogics as epistemologically verified humanitarian knowledge.

© 2018 Onkopediatria. All rights reserved. Background. Analysis of statistical data in the federal districts of the Russian Federation provides opportunities to assess the quality of medical care delivery in children with cancer and plan further development with consideration for the point elimination of existing defects. Objective. Our aim was to analyze the main indicators characterizing medical care for children with cancer in the North-West Federal District. Methods. The study analyzed operative reports for 2017 provided by the executive public health authorities of 11 subjects of the Russian Federation affiliated to the North-West Federal District. Results. The pediatric population was 2 537 133 children (0-17 years), the pediatric oncological bed capacity - 174 (0.7 per 10 000 aged 0-17 years), the annual berth average occupancy - 290.7 days. 6 (54.5%) subjects did not provide pediatric population with departments of pediatric oncology, 4 (36.4%) subjects did not have bed capacity. The number of practitioners providing medical care to children with cancer was 38, 27 among them (71%; 0.1 per 10 thousand 0-17 years) had a certificate of pediatric oncologist. 2 (18.2%) subjects did not have pediatric oncologists in the medical stuff. The incidence of malignant tumors in children aged 0-17 was 15.6 (per 100,000), the prevalence was 92.6 (per 100,000), the mortality rate was 2.6 (per 100,000), one-year mortality rate - 4.5% (18/397). The number of patients identified actively was 11 (2.8%). 160 (40.3%) primary patients were sent to Federal medical facilities, 6 (1.5%) - left the territory of the Russian Federation for the further treatment. Conclusion. The incidence and mortality rates are rather low which indicates the defects in patient detection and lack of reliable follow-up data. The percentage of patients referred for treatment to Federal medical facilities is not very high; however, to interpret this indicator according to patient routing, we have to analyze the medical history of all the patients. We can assert that health care delivery service for children with oncological diseases is at an acceptable standard level but needs to be improved.

© 2011-2018 Research Institute of Mechanics of Moscow State University. All rights reserved. Aim. To carry out a comparative analysis of self-rated health, medical activity, and satisfaction with the quality of medical care in public health institutions by residents of rural settlements of the Untsukul district, Republic of Dagestan. Methods. The study was conducted by the method of questioning 2643 respondents, among them 1453 women and 1181 men. Results. According to the results of the survey, the majority of the interviewed residents of Untsukul district (68.2%) are satisfied with their health. Medical activity of the population at the time of the study was 60.6%. As to respondents who applied to the medical institutions of the Untsukul district during this period, 13.5% are not satisfied with the quality of medical care in public health institutions, 23.5% are fully satisfied, 30% are not fully satisfied. Conclusion. A social survey in the form of a questionnaire is one of the most effective methods of obtaining information about the self-rated health of the population. Timely analysis of medical activity of the population, its satisfaction with the quality of medical care will improve the efficiency of the health system.

Copyright © 2018 by the MediaSphere. Assisted reproductive technologies (ART) are currently widely used around the world because of the increased prevalence of infertility (presently, about 15% of married couples suffer from infertility), as well as the increased access to treatment and public funding for this method. Hence, the number of children conceived by ART is steadily increasing every year. This review focuses on the pressing problem of the health status of children conceived by assisted reproductive technologies (ART) by analyzing modern publications on the state of physical, gonadal and psychosomatic development, features of the endocrine system and cardiometabolic diseases, the risk of imprinting changes, congenital malformations and oncological disorders. The data presented that there is no increased risk of childhood cancer or deterioration in quality of life. However, it is expected that the cardiovascular and metabolic risk factors found in childhood can worsen in later life and may ultimately be responsible for chronic cardiometabolic disease. Furthermore, the issue of fertility, especially in the male population conceived by ART, remains open, thus requiring additional longer-term research.