Репозиторий Университета

PURPOSE: To analyze the condition of the lacrimal gland in patients confirmed to have sarcoidosis. MATERIAL AND METHODS: The study included 46 patients (92 orbits) with verified diagnosis of systemic sarcoidosis that were examined during the period of 2009 to 2014. The age of patients ranged from 23 to 65 years and the average was 45.1 years. Among the examined patients, 66% were female and 34% male. In all patients, the diagnosis was verified according to modern criteria. RESULTS: Acoustic structure of 46 lacrimal glands of patients with systemic sarcoidosis (92 orbit), and lacrimal glands of 30 healthy individuals (60 orbits) were examined. In-depth in vivo examination of morphological changes was done using 'advanced' analysis of three-dimensional images. CONCLUSION: The analysis of a large number of studies devoted to changes in the lacrimal glands caused by sarcoidosis revealed a difficult problem: are there any differences between isolated involvement of the lacrimal gland tissue and the defeat of various organs and tissues? For now, the question remains unanswered.

© 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. Impaired B-cell immunological tolerance plays a central role in the pathogenesis of autoimmune rheumatic diseases and autoimmune diseases of another nature. B-cells link innate and acquired immunity: they express Toll-like receptors that respond to danger signals; act as antigen-presenting cells; induce an antigen-specific immune response; determine the development of immunological memory; and synthesize a wide range of cytokines that regulate (stimulate or suppress) an immune response and inflammation. In autoimmune diseases, there are metabolic and B-cellular signaling disturbances that lead to defects in B-regulatory, T-regulatory, follicular T-helper, and dendritic cells. B-cells synthesize organ-nonspecific and organ-specific autoantibodies that are biomarkers for autoimmune diseases and play an important role in their immunopathogenesis. Anti-B-cell therapy that causes B-cell depletion in blood and target organs is effective in a wide range of autoimmune diseases. Its efficiency is determined by various mechanisms, such as suppression of pathogenic autoantibody synthesis; modulation of the function of B-cells (antigen presentation, cytokine synthesis, and costimulation), T-lymphocytes and dendritic cells. Further study of a strategy for targeted anti-B-cell therapy, mechanisms of action, and new targets is important for the progress of modern rheumatology to improve the treatment strategy of autoimmune rheumatic diseases.

© 2018, Dynasty Publishing House. All rights reserved. Preoperative anemia is common in clinical practice, particularly in women of reproductive age, and it worsens the outcomes of operative treatment. Red blood cell hemotransfusions can be used for management of anemia developing in the perioperative period, however, they have only a short-term effect and can lead to serious complications. Introduction of blood saving strategies can prevent the development and progression of perioperative anemia and hence avoid hemotransfusions. The review considers modern perioperative blood saving strategies based on recent guidelines of the European and American societies of anesthesiologists.

© 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.

© Ruslania 2018. All rights reserved. According many publications, rate and severity of various diseases of oral cavity are significantly increasing in drug-dependent patients. One of drugs using in many countries as a substitution therapy is methadone. However, last research data testifies that negative effect of methadone on human organism in general is more expressed as compared with case of heroin. So, significance is acquired by those studies that testify pathological alterations in organs and systems of patients, including effect on oral cavity. The article presents the results of analysis if crystallography of biological fluids of drug-dependent patients using heroin and methadone. Te study established dependence of character ofgrowth of crystals from type of used drug.

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.

The aim of the study was to provide a mathematical justification of the possibility of using 6.5 mm IRIS implants and to evaluate the results of orthopedic treatment in patients with partial loss of teeth. For the calculations was constructed of a composite three-dimensional computer models: the abutment screw-implant-bone. A total of 3 models were prepared: M1-implant in the spongy bone tissue, this model corresponds to the implantation on the HF when replacing one molar; M2-2 implants in the spongy bone tissue located at a distance of 4 mm connected via abutments, this model corresponds to the implantation of RF when replacing two molars; M3-implant in the cortical bone tissue, this model corresponds to the implantation of LF when replacing one molar. Loading of implants was carried out by occlusive force applied to its end surface. The results of the calculations showed that the equivalent stresses and limiting stresses of compression-tension are within the permissible values, which were obtained by us earlier in respect of the irregular implants and are consistent with the results of calculations for other systems of short implants. The clinical part of the work consisted in the treatment of 27 patients with partial loss of teeth, who had 41 iris evolution implants with a diameter of 5 mm, length of 6.5 mm after 3 years, there was a slow bone resorption in the cervical region not exceeding 0.35 mm, which corresponds to generally accepted international standards. During the first three years of operation there were no cases of loss of established implants. Thus, the data of mathematical modeling by finite element method and retrospective three-year analysis of prosthetics on IRIS evolution implants with length of 6.5 mm showed that the use of short implants in the recovery of upper and lower jaw molars is an effective method with a high success rate at long - term and resorption level of 0.34 mm.

© 2018 Media Sphera Publishing Group.All Rights Reserved. The review illuminated actual issues of the diagnostic efficiency of computed tomography (CT) of the coronary arteries in the planning of the procedure percutaneous coronary intervention (PCI) in patients with chronic occlusion of coronary arteries (CTO). The results of researches of detection of predictors of unsuccessful recanalization according to traditional coronary angiography (CAG) and CT angiography were presented. The major CT characteristics of the CTO, which can supplement the coronary angiography data to predict outcomes of the PCI were discussed.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Cardiovascular diseases remain leading cause of high mortality in diabetes patients. The article is focused on the influence of diabetes on cardiovascular risks. The prevalence presented, as the significance of the main and additional risk factors of cardiovascular diseases in the development of macrovascular complications in diabetes. In the context of influence on cardiovascular risks, modern glucose lowering drugs are considered, the safety and efficacy properties. Advantages of dapagliflozin underscored, the novel oral drug of new generation, with safe and prominent antidiabetic effect and ability to correct the main factors of cardiovascular risk (obesity, hypertension).

© 2018, Dynasty Publishing House. All rights reserved. Chronic pancreatitis, being a complex multifactor clinico-genetic phenomenon, is a significant medical, social and economic problem. Study of pancreatitis remains a topical theme also for the paediatric cohort, especially taking into account practically similar morbidity rates in adults and children. The review presents information and analyzes main genetic risk factors of the development of pancreatitis. Mutations and polymorphisms of the CFTR, CTRC, SPINK1, CPA1, PRSS1, PRSS2 genes that are significant for functioning of the pancreas are discussed in detail. Examples of genetic variants associated with increased or decreased risks of developing disease are given. Special attention is paid to difficulties of interpreting the results of molecular-genetic testing associated with certain gene homology, presence of pseudogenes and disease cases conditioned by spontaneous mutation. Detection of genetic risk factors of chronic pancreatitis allows to early prevent the development of disease in the proband’s relatives, and also to take a more personalized approach to the patient’s treatment.

© 2018, Media Sphera Publishing Group. All rights reserved. The present article deals with the problems pertaining to the forensic medical diagnostics of the HIV-associated pathological conditions taking into consideration the materials available from the Moscow City Centre for AIDS Prophylaxis and Control with special reference to the number and structure of the diagnosed HIV-associated diseases. We undertook the analysis of co-morbid HIV/AIDS causes of violent and sudden deaths documented at the Bureau of Forensic Medical Expertise of the Moscow Health Department during the period from 2013 till 2016. The study revealed the tendency toward a rise in the number of deaths from the HIV-associated infections including tuberculosis, pneumonias, chronic immunodeficiency conditions refractory to the treatment, and from malignant neoplasms. A peculiar feature of the aforementioned period was the increased age of the deceased subjects. In the cases of violent deaths, the HIV-associated conditions were diagnosed as the concomitant diseases, with the markedly predominant ones being acute drug and alcohol intoxication, injures, and attempts at suicide. The available results of the studies give evidence of the necessity and importance of the cooperative work of the specialists for the further improvement of forensic medical diagnostics and monitoring of HIV-associated conditions.

© Bionika Media Ltd. Objective. To investigate the clinical efficacy of Elgyna in the medical treatment of human papillomavirus (HPV)- associated cervical intraepithelial neoplasias (CIN). Subject and methods. The results of antibacterial therapy prior to destructive treatment were comparatively analyzed in 53 patients with severe dysbiosis in HPV-associated CIN. A study group included 27 patients who took the combined drug Elgyna as one vaginal tablet twice daily (6 administrations); a comparison group of 27 patients received the combined drug Tergynan as one vaginal tablet twice daily (6 administrations). A control group comprised 20 women with the visually unchanged cervix. All the women underwent standard examinations and vaginal microbiocenosis estimation by RT-PCR assay using the Femoflor test. Results. The use of the combined drug Elgyna during medical treatment before destruction was found to normalize molecular biological parameters at the local level and contributes to a significant reduction in the time of epithelialization and a decline in the number of recurrences. Conclusion. HPV-associated cervical neoplasias are accompanied by the development of pronounced dysbiotic processes in the vagina with the predominant involvement of obligate anaerobes. Taking into account the properties of the combined drug Elgyna that provides a normalizing effect on the parameters of biocenosis in accelerating healing and in preventing a recurrence of the process, it is appropriate to prescribe the drug before destructive treatments.

© 2018 Ima-Press Publishing House. All rights reserved. We have considered it appropriate to publish this case due to the rarity of progressive myoclonus epilepsy; diagnostic difficulties, particularly in the early stages of the disease (the female patient has been long followed up for diagnosed juvenile myoclonic epilepsy); the relative role of a genetic study because it has not brought results in this case, and, finally, a problem with therapy, and a significant contribution to the achievement of certain success of currently available antiepileptic drugs, levetiracetam in particular.

© 2018 Russian Electronic Journal of Radiology. All rights reserved. Purpose. The purpose of this study was to determine ultrasound criteria of normal temporomandibular joint structure and function. Materials and methods. Prospective study was conducted upon normal 16 TMJs of 9 patients (4 male, 5 female with mean age of 22.9 years) without clinical or radiological signs of disc displacement. All the patients underwent high-resolution ultrasound (Samsung SONO ACE R3, 12 MHz linear probe) and MR imaging of TMJs with the mouth closed and during the maximal mandibular range of motion. Both examinations were performed and interpreted independently by blinded expert operators. Results. Mouth opening range varied from 4.4 cm to 5.4 cm, average amount was defined as 4.94 ± 0.39 cm. Also average heights of the front, middle and rear parts of disc were measured (0,42 ± 0,07 cm; 0,35 ± 0,07 cm and 0,41 ± 0,05 cm, respectively). Structure of the TMJ disc can be defined as fine-grained, hypoechoic and homogeneous. The average height of lower joint space was defined as 0,12 ± 0,03 cm. Average amount of maximal parasagittal mandible condyle movement was defined as 14.7 ± 1.38 mm. Conclusion. Obtained results of ultrasound criteria of normal temporomandibular joint structure and function correspond to the provisions of normal human anatomy and the norm values established for the MRI of the TMJ. Thus, ultrasound criteria of normal temporomandibular joint can be used for assessment of TMJ internal degenerative diseases.

© 2018 Media Sphera Publishing Group. All rights reserved. This article presents current views on the classification, diagnosis, treatment, and prevention of drug dependence caused by the co-use of several psychoactive substances (PASs). It describes the fundamental regularities of the development and course of the disease, the patterns of consumption, and the issues of laboratory diagnosis. Particular attention is paid to the clinical diagnosis of the most common patterns of use of various PASs. In order to make and propose the reader the most complete basis for evidencebased strategies for the treatment of various variants of polydrug abuse, the authors studied the results of investigations that enrolled patients using more than one PAS at least 1 month before the start of treatment. The section on therapy is presented as clinical recommendations, taking into account the levels of evidence and the grades of recommendations.

© 2018 Izdatel'stvo Meditsina. All rights reserved. The healing process in the adult rabbit conjunctiva and sclera tissues after translimbal microdrainage with the use of either biodegradable antiglaucomatous drainage (BDAD) or iGen was studied. Wound areas showed similar acute inflammatory response to the implantation of both matrixes on the 7th day. Complete lysis degradation of iGen and BDAD was observed on 30th day and 60th day, respectively. Within 60 - 90 days after BDAD implantation, the wound areas of conjunctiva and sclera showed intensive angiogenesis and poor extracellular matrix scarring. In contrast, on the 90th day after iGen implantation, a decrease in angiogenesis and intensive extracellular matrix scar formation were observed. As a result of scarring the thin-walled vessels were compressed, which led to the reduction of aqueous humor outflow.

© 2018 Ima-Press Publishing House. All rights reserved. Objective: to investigate the effect of various biological agents (BAs), including combined treatment with rituximab (RTM) and belimumab (BLM), on the activity of systemic lupus erythematosus (SLE) and to evaluate their efficacy and impact on some parameters of humoral immunity. Subjects and methods. BAs were prescribed to 54 patients with a reliable diagnosis of SLE with high and medium activity according to SLEDAI-2K; 40 of them received RTM, 7 – BLM; 7 – combined therapy with RTM and BLM. Clinical and laboratory examinations were made in all the patients at the time of their inclusion and then every 3 months during a year. The results were assessed using SLEDAI-2K, BILAG index, Lupus Erythematosus National Assessment (SELENA)-SLEDAI Flare index (SFI) (a moderate, severe exacerbation), and SLE Responder Index (SRI). Results and discussion. At 3, 6, and 12 months after start of therapy, the use of BAs in all the patients resulted in a disease activity reduction. It was statistically significant (p < 0.00001) in the RTM group; and no statistical analysis was carried out in the BLM and RTM+BLM groups due to the small numbers of patients. At the same time, there was a progressive decrease in the levels of anti-double-stranded DNA (ds-DNA) antibodies (Abs) and an increase in the concentration of the complement fractions C3 and C4 in the RTM and RTM+BLM groups (p < 0.05) at one-year follow-up. After 12 months of therapy with BAs, there was a decrease in IgG (p < 0.02) and IgM (p < 0.03) levels; but overall it remained within the reference ranges. Prior to therapy, irreversible organ damages were recorded in 23 (42.6%) of the 54 patients. The increased damage index at 12 month was observed only in patients receiving RTM, which is probably due to the use of higher-dose glucocorticoids. Conclusion. All three methods of therapy with BAs in SLE patients demonstrated good efficiency shown as a significant decrease in clinical and laboratory activity measures that were assessed by SLEDAI-2K and the levels of anti-ds-DNA and complement components C3 and C4. The decrease in immunoglobulin levels did not go beyond the reference values. Therapy with BLM and RTM+BLM allowed for managing patients with the low and average doses of oral glucocorticoids, which contributed to the reduction of not only the activity, but also risk of irreversible organ damages.