Search

Research objective: An analysis of the archaeological sites of the Middle Ages and the ethnographic characteristics of the village Tatarskaya Bashmakovka in the Cis-Volga region of the Astrakhan region. Research matherials: The writings by Abu Hamid al-Gharnati, reports on archaeological expeditions in the Astrakhan region, and the data of ethnographic studies were used in this research. Research results and novelty: The surroundings of the Tatarskaya Bashmakovka village in the Astrakhan region abound in medieval archaeological monuments. A new approach to the analysis of the funeral rites in the burial grounds located in the vicinity of the Tatarskaya Bashmakovka allows us to draw a conclusion about the penetration of the traditions of Islam among the population of the Volga Delta since the pre-Mongol period. The comparative craniological analysis data suggests that the population that is found in these burial grounds was anthropologically close to some ethnic groups of the Khazar era. This was the population of the Saqsin region that existed in the Volga Delta from the eleventh to thirteenth century. Subsequently, this population became an integral part of the Golden Horde Tatars. Ethnographic characteristics of Tatarskaya Bashmakovka are also of academic interest. One of the parts of the ethno-specific population group of the Astrakhan region is the Yurt Tatars. Most ethnographers and historians consider them descendants of the indigenous population of one of the fragments of the Golden Horde, the Astrakhan Khanate. Based on the ethnographic material, the article presents the local characteristics of the Yurt Tatars of the village Tatarskaya Bashmakovka. As we see it, this information will significantly complement the history of the peoples of the Lower Volga region and above all the Turkic peoples, the heirs of the Golden Horde, who are called the Yurt Tatars today. It will also show the processes of their ethnic interaction with other Turkic-Tatar ethnic groups which today comprise one of the main ethnic components in the Astrakhan region.

Objectives: Endoscopic mucosal resection (EMR) is an alternative to surgery for the treatment of large laterally spreading lesions. Residual or recurrent adenoma is a major limitation. This study aimed to quantify early and late recurrences and to assess its associated risk factors., Methods: The study was a single-center, multiendoscopist, longitudinal study conducted between January 1, 2013 and April 26, 2017. A total of 480 patients with 500 polyps who underwent an endoscopic resection were included. Surveillance colonoscopy (SC) was performed at 4 to 6 months (SC1) and 16 to 18 months (SC2)., Results: At SC1, early recurrence was noted in 77 of 354 (21.8%) lesions; 76 (98.7%) were treated endoscopically. The remaining 277 of 354 (78.2%) lesions had no recurrence at SC1; only 41 lesions (15%) were followed up at SC2. Recurrence at SC2 was found in 4 lesions (9.8%), all of which were treated endoscopically. Lesion size >40 mm was associated with recurrence. Recurrence at both SC1 and SC2 was successfully treated endoscopically in 78 of 81 lesions (96.3%)., Conclusions: EMR is an effective, minimally invasive technique for the treatment of large laterally spreading lesions. Although recurrence is a concern, its risk is low (21.8% on SC1 and 9.8% on SC2) and was managed endoscopically in 96.3% cases on follow-up endoscopy.

Background: Endoscopic mucosal resection (EMR) is an effective and minimally invasive alternative to surgery for large polyps and laterally spreading lesions. Gross morphology and surface characteristics may help predict submucosal invasion of the lesion (SMIL) during endoscopic evaluation. This is one of the largest single-center studies reporting endoscopic mucosal resection for larger (≥ 20 mm) colorectal lesions in the United States., Aim: To determine the recurrence rate of adenomas and endoscopic features that may predict submucosal invasion of colonic mucosal neoplasia., Methods: This is a retrospective cohort study of all the patients referred for endoscopic mucosal resection for lesions ≥ 20 mm, spanning a period from January 2013 to February 2017. The main outcome measure was identifying features that may predict submucosal invasion of mucosal lesions and predict recurrence of adenomas on follow-up surveillance colonoscopy performed at 4-6 mo., Results: A total of 480 patients with 500 lesions were included in the study. The median age was 68 (Inter quantile range: 14) with 52% males. The most common lesion location was ascending colon (161; 32%). Paris classification 0-IIa (Flat elevation of mucosa - 316; 63.2%); Kudo Pit Pattern IIIs (192; 38%) and Granular surface morphology (260; 52%) were most prevalent. Submucosal invasion was present in 23 (4.6%) out of 500 lesions. The independent risk factors for SMIL were Kudo Pit Pattern IIIL + IV and V (Odds ratio: 4.5; P value < 0.004) and Paris classification 0-IIc (Odds ratio: 18.2; P value < 0.01). Out of 500, 354 post-endoscopic mucosal resection scars were examined at surveillance colonoscopy. Recurrence was noted in 21.8% (77 cases)., Conclusion: There was overall low prevalence of SMIL in our study. Kudo pit pattern (IIIL + IV and V) and Paris classification 0-IIc were the only factors identified as an independent risk factor for submucosal invasion. The independent risk factor for recurrence was adenoma size (> 40 mm). Almost all recurrences (98.8%) were treated endoscopically., (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

Background: Endoscopic ultrasound-guided liver biopsy (EUS-LB) using a 19-gauge (19-G) EUS needle is becoming increasingly popular. We evaluated the efficacy and safety of a 22-G EUS fine needle biopsy (FNB) needle for performing EUS-LB., Methods: Patients referred for evaluation of elevated liver enzymes and without obstructive disease requiring endoscopic retrograde cholangiopancreatography (ERCP) were included. Using a 22-G FNB needle, two passes were made from the left lobe and one from the right. The main outcome measure was adequacy of the specimen for histology interpretation, and the secondary outcome was the safety of EUS-guided liver biopsy with a 22-G FNB needle. Patients were followed for post-procedure complications for 30 days., Results: 40 patients (median age 61 years; 26 women) underwent EUS-LB. Analyzing by needle passes, the median longest core fragment was 12 mm (1st quartile - 3rd quartile 10 mm - 16.25 mm, interquartile range [IQR] 6.25 mm) from the left lobe and 11 mm (10 mm - 15.75 mm, IQR 5.75 mm) from the right lobe. The median cumulative core length per patient was 55 mm (44.5 mm - 68 mm, IQR 23.5 mm). The median cumulative number of complete portal triads (CPTs) per patient was 42 (28.5 - 53, IQR 24.5). The specimen was considered adequate in all 40 patients (100 %). Self-limiting abdominal pain was reported in 6 patients (15 %)., Conclusions: EUS-LB using a 22-G FNB needle is a safe and viable alternative to the use of larger gauge needles, yielding adequate tissue for evaluation of parenchymal disease in 100 % of the patients., Competing Interests: The following authors disclosed financial relationships relevant to this publication. Muhammad K. Hasan is a consultant for Boston Scientific and Olympus America. Robert Hawes is a consultant for Boston Scientific, Olympus America, and Medtronic. Shyam Varadarajulu is a consultant for Boston Scientific and Olympus America. All other authors disclosed no financial relationships relevant to this publication., (© Georg Thieme Verlag KG Stuttgart · New York.)

The indigenous populations of inner Eurasia-a huge geographic region covering the central Eurasian steppe and the northern Eurasian taiga and tundra-harbour tremendous diversity in their genes, cultures and languages. In this study, we report novel genome-wide data for 763 individuals from Armenia, Georgia, Kazakhstan, Moldova, Mongolia, Russia, Tajikistan, Ukraine and Uzbekistan. We furthermore report additional damage-reduced genome-wide data of two previously published individuals from the Eneolithic Botai culture in Kazakhstan (~5,400 BP). We find that present-day inner Eurasian populations are structured into three distinct admixture clines stretching between various western and eastern Eurasian ancestries, mirroring geography. The Botai and more recent ancient genomes from Siberia show a decrease in contributions from so-called 'ancient North Eurasian' ancestry over time, which is detectable only in the northern-most 'forest-tundra' cline. The intermediate 'steppe-forest' cline descends from the Late Bronze Age steppe ancestries, while the 'southern steppe' cline further to the south shows a strong West/South Asian influence. Ancient genomes suggest a northward spread of the southern steppe cline in Central Asia during the first millennium BC. Finally, the genetic structure of Caucasus populations highlights a role of the Caucasus Mountains as a barrier to gene flow and suggests a post-Neolithic gene flow into North Caucasus populations from the steppe.

Background: Glasgow-Blatchford score (GBS) has been developed for risk stratification in management of acute upper gastrointestinal (GI) bleeding. However, the performance of GBS in patients with lower GI bleeding is unknown., Aim: To evaluate the performance of full or modified GBS and modified GBS in prediction of major clinical outcomes in patients with lower GI bleeding., Methods: A retrospective study of patients admitted to a tertiary care center with either non-variceal upper GI bleeding or lower GI bleeding was conducted. The full and modified GBS were calculated for all patients. The primary outcome was a combined outcome of inpatient mortality, need for endoscopic, surgical, or radiologic procedure to control the bleed or treat the underlying source, and need for blood transfusion., Results: A total of 1026 patients (562 cases for upper GI and 464 cases for lower GI) were included in the study. Hospital-based interventions and mortality were significantly higher in upper GI bleeding group. The performance of the full GBS in lower GI bleeding (area under the receiver operating curve (AUROC) 0.78, 95% CI 0.74-0.82) was comparable to full GBS in upper GI bleeding (AUROC 0.77, 95% CI 0.73-0.81) in predicting the primary outcome. Similarly, the performance of modified GBS in lower GI bleeding was shown to be comparable to modified GBS in upper GI bleeding (AUROC 0.78, 95% CI 0.74-0.83 vs. AUROC 0.76 95% CI 0.72-0.80)., Conclusion: In patients with lower GI bleeding, both full GBS and modified GBS can predict the need for hospital-based interventions and mortality.

Objective: Gastrointestinal bleeding (GIB) is a common cause of hospitalization in the older adult population. The aim of the study was to identify factors that are associated with the need for a therapeutic intervention in patients older than 65 years with nonvariceal GIB., Methods: This is a retrospective cohort study of older adult patients admitted to a tertiary care center between 2009 and 2011 with nonvariceal GIB. The primary outcome was a composite endpoint of inpatient mortality or need for an endoscopic, surgical, or radiologic procedure to control the bleed or to treat the underlying source of the bleed., Results: A total of 314 patients were included. In-hospital mortality was 1.3% (4 patients). An intervention to control the bleeding was performed in 15 patients (4.8%). Four patients (1.3%) needed a nonurgent intervention. Twenty-three patients (7.23%) had the primary combined outcome of in-hospital mortality or need for any therapeutic endoscopic, surgical, or radiologic intervention. Factors that were independently associated with the primary outcome were systolic blood pressure within the first 24 hours of <90 mm Hg (odds ratio 3.05, 95% confidence interval 1.08-8.59, P = 0.001), and initial hemoglobin of <7 g/dL (odds ratio 4.81, 95% confidence interval 1.56-14.74, P = 0.006)., Conclusions: Nonvariceal GIB in older adult patients ceases spontaneously in most patients without an invasive intervention. Systolic blood pressure within the first 24 hours of <90 mm Hg and an initial hemoglobin level of <7 g/dL could be used to identify high-risk patients who may benefit from an urgent therapeutic intervention.