Репозиторий Университета

© 2018 Ima-Press Publishing House. All Rights Reserved. Objective: to investigate the effectiveness of cognitive and motor training as an additional method to basic therapy in patients with Alzheimer's disease (AD) and vascular cognitive impairment (VCI). Patients and methods: The investigation enrolled 41 patients (15 women and 26 men; mean age. 73.59±6.3 years), including 32 patients with AD (mean age 74.94±5.15 years) and 9 patients with VCI (mean age, 72.31±4.98 years). Cognitive impairment (CI) corresponded to mild dementia in 15 patients (5 women and 10 men; mean age 74.6±2.8 years) and to moderate dementia in 29 (10 women and 19 men; mean age 72.1±3.2 years). The patients were randomly assigned to individual, group, and mixed (individual and then group) cognitive training groups. Quantitative scales were used to assess changes in CI and emotional and behavioral disorders after 1.5, 3, and 6 months of therapy. Results and discussion: During cognitive and motor training, all the groups showed a significant decrease in the severity of CI (p < 0.05), depression, anxiety, and apathy. The effectiveness of the training was further influenced by the severity of concomitant cardiovascular disease, the degree of apathy, adherence to the training, and the early initiation of basic symptomatic therapy. The greatest positive changes in anxiety and depressive disorders were noted in the patients receiving group cognitive and motor training. Conclusion: The results of the investigation allow group cognitive and motor training to be recommended as a mainstay in the therapy of patients with CI concurrent with emotional disorders.

© 2018 Ima-Press Publishing House. All Rights Reserved. The recently discovered glymphatic system (GS) ensures the efficient clearance of interstitialfluid and soluble compounds from the central nervous system into cerebrospinal fluid (CSF), which compensates for the lack of conventional lymphatic vessels in the brain parenchyma. This unique anatomical and physiological phenomenon had been unknown until 2012. GS lacks inherent proper vessels P the cuirent of CSF and interstitial fluid is carried out directly inside the arterial walls (the perivascular pathway) or near the walls of the cerebral arteries and veins (the paravascular pathway). Current biorheological technologies could establish a special role of aquaporin-4 in the filtration of CSF and interstitial fluid. The close link between GS and the CSF circulatoiy system allows the established views on fluid dynamics within the brain to be reconsidered. The discoveiy ofGS can contribute to our understanding of the pathogenesis of increased intracranial pressure and neurodegenerative diseases, as well as to the elaboration of new therapeutic approaches to their treatment.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. The purpose of this study was to determine possibilities of functional computed tomography for diagnostics of the knee endoprosthesis loosening. Materials and methods. A total of 12 patients with suspected knee endoprosthesis loosening were observed. We performed dynamic computed tomography on the Toshiba Aquilion One 640. On MIP images in the three planes of the joint in the static position, we marked up to 5 lines. Every line connected the point in prosthesis component with the point in the periprosthetic cortical bone. After that, the computer analysed the functional research reconstruction and showed the length of the same lines at each stage of knee flexion. If the length of at least one of the lines changes by more than 1.1 mm, we can confirm loosening of the endoprosthesis component. Results. According to data of dynamic computed tomography, in 2 patients we identified loosening of the tibial components, 1 patient – the loosening of the femoral component and 1 patient – the loosening of both components. In 8 patients knee implants were stable. In 10 patients we performed total revision knee arthroplasty. Computed tomography data were fully confirmed by intraoperative examinations. 4 patients were operated because of components loosening, 6 patients were operated because of patellofemoral in-congruence. 2 patients were treated conservatively with good results. Conclusion. The dynamic computed tomography of the knee after total arthroplasty showed high efficiency in diagnostics of the knee endoprosthesis loosening.

© 2018 S. Karger AG.All right reserved. Therapeutic plasma exchange (PE) is a procedure of removing and replacing a large volume of plasma with various biologically active substances that have a pathological effect on the patient. Plasma exchange in some diseases is one of the components of pathogenetic therapy (ANCA-associated systemic vasculitis, antiphospholipid syndrome, Goodpasture's syndrome, thrombotic microangiopathy, etc.). PE removes circulating immune complexes damaging tissues and organs and restores the coagulation system. In the practical recommendations of the American Apheresis Society (2016) leading experts in the field of apheresis therapy, based on an analysis of numerous clinical studies, gave clear recommendations to use the apheresis technologies for extracorporeal detoxification. Also 4 categories of indications and contraindications, assessing the benefits of carrying out apheresis procedures for a specific nosology were specified. A number of new diseases have been introduced, such as atopic (neuro) dermatitis (atopic eczema), cardiac neonatal lupus, Hashimoto encephalopathy, HELLP syndrome, in which PE is one of the leading therapeutic approaches as well as cytotoxic and glucocorticosteroid therapy. However, the use of plasma exchange in the treatment of some diseases remains controversial, for example, sepsis. So further research is needed.

© 2018 Nutritec. All Rights Reserved.  The aim of this study was to examine the effect of polyphenol quercetin on morphological changes in nonalcoholic fatty liver disease (NAFLD) in rats fed high-fructose diet. Material and methods. For 20 weeks animals (n=8 in each group) of the 1 st group were given standard diet and water; the 2 nd group - standard diet and 20% fructose solution; the 3 rd group - standard diet with quercetin supplementation (0.1%) and 20% fructose solution. Formalin-fixed and paraffin-embedded liver samples were sectioned, stained (hematoxilin and eosin, Van Gieson's stain), evaluated with the use of the SAF and NAS scales. Results and discussion. Histological assessment did not reveal pathology in the structure of the liver of the 1 st group rats (SOAOFO; NAS - 0, fibrosis - 0). The 2 nd group rat livers disclosed micro-, mid- and macrovesicular steatosis, inflammation without ballooning, pericellular and periportal fibrosis (S2A1F2; NAS - 3, fibrosis - 2). Quercetin-treated rats exhibited in liver significantly less steatosis without significant changes in inflammation and fibrosis features (S1A1F2; NAS - 2, fibrosis - 2) compared with rats of the 2 nd group. Conclusion. The data obtained demonstrate the ability of quercetin to inhibit the development of NAFLD in rats fed a diet with a high content of fructose, by reducing the severity of hepatostatosis.

© 2018, Media Sfera. All rights reserved. Condition of the ocular surface greatly depends on functional integrity of corneal nerve fibers. Improving the methods used to study corneal nerve fibers allows their condition to be timely evaluated and adequately interpreted. The article reviews the structure, function, chemical composition of corneal nerve fibers, specifics of their innervation, as well as application of modern methods of their evaluation in diagnostics of various pathological conditions.

© 2018 Izdatel'stvo Meditsina.All rights reserved. Studied the diagnostic and prognostic significance of N-terminal precursor of natriuretic peptide C-type (NT-proCNP) and brain natriuretic peptide (NT-proBNP) in patients with COPD with pulmonary hypertension (PH). The study included 47 patients with COPD (II-IV degrees of severity, 2016 GOLD, men-44, women-3, mean age 59, 3±9.12 years, disease dura-tion of 13.7±5.93 years, the index of Smoking at 23.1±10, 93 pack-years, BAH of 27.2±12, 06 m!kg2.). Criteria of pulmonary hypertension on the basis of the doppler-echocardiography was an increase ofpulmonary artery systolic pressure (PASP) > 40 mmHg alone. Depending on the presence and degree of enhancement PASP patients were divided into three groups: I-without pulmonary hypertension (PASP < 40 mmHg, n=168), 2-moderate pulmonary hypertension (PASP 40-55 mmHg, n=101), 3-group with severe pulmonary hypertension (PASP > 55 mmHg, n=19). There was a statistically significant intergroup differ-ences (p. 2 0, 001, p J} 0, 001, pl3< 0, 001) values of NT-proCNP and NT-proBNP. There was a significant correlation relation-ship SDLA with the concentration of NT-proCNP (r=0, 53, p<0, 05) and NT-proBNP (r=0, 67; p=0, 05). A high diagnostic value of determination of NT-proCNP and NT-proBNP to predict the development and severity of PH in patients with COPD. Cox regression analysis showed that elevated levels of NT-proCNP and NT-proBNP in COPD patients ofPH c are the predictors of hospital mortality.Grant: The study had no sponsor support.

© 2018, Media Sphera Publishing Group. All rights reserved. Inflammasomes are macromolecular complexes that contain many copies of receptors recognizing molecular patterns of pathogenic agents (PAMP) and damage-associated structures (DAMP), and also include molecules of adapter protein ASC and procaspase- 1. Activation of inflammasomes leads to the formation of active caspase-1 that, in turn, provides the maturation of pro-IL-1β and pro-IL-18 to IL-1β and IL-18. The latter cytokines play an important role in control of neuroinlfammation in the central nervous system contributing to the pathogenesis of a series of neurological, neurodegenerative and mental disorders. The review discusses the involvement of NLRP3 inflammasome and other their types in the development of the traumatic brain injury, ischemic and hemorrhagic stroke, brain tumors, CNS infections, Alzheimer’s and Parkinson’s diseases, epilepsy, amyotrophic lateral sclerosis, depressiver, and consequences of alcohol abuse. The elucidation of molecular mechanisms and signaling pathways controlled by inflammasomes will allow the development of new therapeutic measures for diseases, in which neuroinflammation plays a leading pathogenetic role.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article deals with the modern tactics of pulmonary hypertension therapy, used in case of unsatisfactory clinical response to previous therapy. All classes of pathogenetic therapy of pulmonary hypertension are presented, as well as modern views on the risk stratification of annual mortality of patients. Switching to a more effective drug both within one group of pathogenetic PAHtherapy, and to drugs of other classes is discussed. The latest classification of pulmonary hypertension (Nice, 2018) is presented.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Purpose: to elucidate predictors of development of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE). Material and methods. We included in this study 210 patients hospitalized with diagnosis of submassive and massive PTE from 2013 to 2017. In 1 to 3 years after initial hospitalization these patients were invited for control examination. According to results of this examination patients were divided into two groups: with (group 1, n=45) and without (group 2, n=165) signs of CTEPH. Severity of pulmonary artery vascular bed involvement was assessed by multislice computed tomography (MSCT) angiography and lung scintigraphy. For detection of thrombosis in the inferior vena cava system we used ultrasound angioscanning. Examination also included echocardiography. Results. In the process of mathematical analysis, the following risk factors for the development of CTEPH embolism were determined: duration of thrombotic history (group 1 - 13.70±2.05 days, group 2- 16.16±1.13 days, p=0.015), localization of venous thrombosis in the lower extremities (the most favorable - shin veins, popliteal, and common femoral veins, unfavorable - superficial femoral vein). The choice of the drug for thrombolytic and anticoagulant therapy: streptokinase and urokinase were significantly more effective than alteplase, rivaroxaban was superior to the combination of unfractionated or low molecular weight heparins with warfarin. Also, risk factors for the development of CTEPH were the initial degree of pulmonary hypertension and tricuspid insufficiency, as well as the positive dynamics of these indicators at the background of thrombolytic or anticoagulant therapy. Of concomitant diseases, significant risk factors for development of CTEPH were grade 3 hypertensive disease, diabetes mellitus, postinfarction cardiosclerosis. On the other hand, age, gender, degree of severity at the time of admission, presence of infarction pneumonia, surgical prevention of recurrent pulmonary embolism, number of pregnancies and deliveries, history of trauma and malignancies, cardiac arrhythmias produced no significant impact on the development of CTEPH.

The purpose of the study was to determine effects of quercetin on protective capacity parameters in the experiment on rats fed a high fructose diet. Rats of the control group received a semi-synthetic (s/s) diet and water; animals from the P' experimental group-s/s diet and 20% fructose solution instead of drinking water; rats of the 2nd experimental group-s/s diet with quercetin (0.1% indiet) and 20% fructose solution instead of drinking water for 20 weeks. Parameters of antioxidant status [total antioxidant activity (AOA), the content of malondialdehyde (MDA) and lipids hydroperoxides, the level of reduced andoxidizedglutathione, activity of superoxide dismutase, catalase, glutathione peroxidase, paraoxonase-1, hemeoxygenase-1, NAD(P)H-quinone oxidoreductase], the activity of xenobiotic-metabolizing enzymes [CYP1A1, CYP1A2, CYP2B1, CYP3A, UDP-glucuronosyltransferase (UDP-GT) and glutathione transferase] were studied in plasma and liver of rats. Consumption of the high-fructose diet led to changes in some parameters: diminution of AOA in blood plasma, decrease of AOA and MDA level, unsedimentable activity of lysosomal enzymes, increase of the UDP-GT activity in liver. The inclusion of quercetin in the diet did not affect the studied parameters, except for a more pronounced decrease of the unsedimentable activity of lysosomal enzymes in rat liver. The results of the study indicated that there was no significant effect of quercetin on the protective capacity of rats at the initial stage of obesity caused by high-fructose diet.

The purpose of our study was to assess the efficiency of toothpaste 'Intensive strengthening of supersensitive teeth with nano-GAP' INNOVA and the suspension 'Liquid Enamel' INNOVA on the sensitivity of teeth with gingival recession. We examined 40 people aged 20-25 years. Each group consisted of 20 people: 10 women, 10 men. The first group (observations) used the paste and the suspension for 14 days, and the second group (comparisons) cleaned teeth only with a brush without a paste. Schiff aerial test was performed to assess the rate of hypersensitivity. As a result of the study, it was found that the combination of paste and liquid suspension with nano-hydroxyapatite for 14 days effectively reduced the hypersensitivity of the teeth with gingival recession that was shown by a statistically significant decrease in the Schiff index in the observation group. Thus, this combination is the method of choice in the treatment of hyperesthesia and can be used as an alternative substitute therapy.

The purpose in this study was to compare the force decay of laboratory and clinical NiTi closed coil springs. Specimens were 30 NiTi coil springs (clinical) and 15 (laboratory in artificial saliva 36.6 ºC) springs were tested by dynamometer to evaluate force loos at different intervals: 1, 2 and 3 months of use. Data (gF) were analyzed statistically using. Clinical and laboratory data were compared to evaluate effect of the oral environment on force loss. It was observed a significant force loss of NiTi springs. NiTi springs showed force loss (13.2%) at 28 days of clinical use, with a further significant loss from 4-12 weeks (~21%); force levels remained steady thereafter. Were not statistically different in clinical and laboratory force loss data. Space was closed at an average rate of 1 mm/month.

© 2018, Silicea-Poligraf. All rights reserved. Pregnancy is a physiological condition that takes a defined period of time in a woman’s life. For nine months, the mother’s heart works under conditions of daily additional load, which is necessary to ensure placental blood flow. In this regard, structural and functional adaptation of the heart develops in a healthy woman with a normal pregnancy. A pregnant woman with some heart diseases is less likely to adapt. That leads to greater susceptibility to stress resulting in pathological changes of pregnancy. In addition, each pregnancy may develop new heart diseases, which in some cases may be relatively innocent, but in others — fatal. In this regard echocardiography (EchoCG) is a necessary procedure for assessing a woman’s health status that needs before bearing a fetus, during and after pregnancy.

© 2019, Privolzhsky Research Medical University. All rights reserved. The study of the epidermis and derma histogenesis, including its epigenetic regulation, is an actively developing field of histology and embryology. The results of the study can elucidate the mechanisms of pathogenesis of some skin diseases of unknown etiology. Wnt signaling is a key regulator of the main morphogenetic processes — cell proliferation and differentiation. Downstream of Wnt signaling is carried out by canonical and non-canonical pathways. Impairments of Wnt signaling in prenatal and postnatal development lead to degenerative and tumor diseases of the skin and hair. Clinical manifestations of the prenatal disorders of skin development epigenetic regulation in the period may appear long after the birth. Identification of factors that disturb the regulation of morphogenetic processes is an important task for investigators. It was found out that activation of the mother’s immune system in the early pregnancy resulted in the development of transient alopecia in the offspring of mice. There was the correlation established between the disorders of epidermal and dermal histogenesis and alopecia as well as the development of regional dysmorphogenetic changes in the skin, which indicate the need to study the rates and features of skin development in various parts of the body.

© 2018 Academic Research Publishing Group. The use of new information technologies in the educational process intensifies the need for analyzing the existing resources suitable for teaching students in conformity with professional standards. The objective of this study is to consider the significance of survey services in teaching students market research, to analyze the efficiency of survey services, to prove their positive impact on the learning process and to determine requirements for educational survey services. The materials of the study were students' reports on conducting consumer surveys using either paper or online questionnaires. The research is based on a pedagogical experiment to analyze the applicability of Internet resources in the educational process. The results of students' research were processed through the comparison of the data obtained. The authors of the article have developed the life cycle of educational survey services. Based on stages of the life cycle, the authors have determined desired functional characteristics of free survey services, which will simplify the task of selecting a suitable educational tool. It has been confirmed that the exclusive use of Internet technologies in teaching students market research cannot be sufficient, and they should be used in combination with basic approaches to a marketing theory. The conducted pedagogical experiment has proved the consistency of Internet technologies as an educational tool. The authors of the article have revealed that despite undeniable advantages of online survey services they also have significant shortcomings, which makes it impossible to completely replace classic methods of collecting market information from this moment on. The introduction of free survey services into the educational process increases teaching efficiency and develops professional competencies within the existing standards. Defining functional requirements of the above-mentioned life cycle, teachers can choose the best educational survey service taking into account the stages students will go through while using it. An extensive use of information technologies is essential to the formation of new teaching materials and the renewal of the existing ones based on the synthesis of the classical theory of marketing and innovations.

Liver resection remains the method of choice for treatment of colorectal liver metastases with good long-term results. Regional lymph nodes involvement is significant negative prognostic factor. Moreover, it has been considered as a contraindication for liver resection for a long time. The role of lymphadenectomy remains controversial. Current state of this problem is reviewed in the article. Liver regional lymph nodes involvement takes place in 10-20% of cases. PET/CT is the most sensitive method of preoperative diagnosis. Involvement of liver regional lymph nodes is currently not absolute contraindication for liver resection. Routine lymphadenectomy does not make sense, and, perhaps, is justified only within scientific trials for more accurate disease staging. Indications for lymphadenectomy are suspicious changes of lymph nodes revealed by preoperative visualization methods or by intraoperative exploration. Modern chemotherapy regimens allow to reconsider the prognostic importance of liver regional lymph node metastases and to extend indications for liver resections.

© 2018 Russian Association of Endocrinologists. The prevalence of cholelithiasis, its close pathogenetic connection with metabolic syndrome, high frequency of surgical intervention, significant economic losses put forward this comorbid pathology in a number of leading problems of modern clinical medicine. The factors associated with the metabolic syndrome not only increase the risk of developing cholelithiasis, but also form the basis of non-drug and drug therapy. Metabolic syndrome often determines the occurrence of three common and potentially life-Threatening complications of cholelithiasis: Acute cholecystitis, acute cholangitis and biliary pancreatitis. Therefore, the solution of this problem is associated with the need for early detection of additional risk factors for cholelithiasis, optimization of the early diagnostic and prognostic model of existing multi-organ pathology with the aim of reducing the progression of the disease and its complications. The data obtained in recent years on the human genome with metabolic syndrome and cholelithiasis make it possible to predict the development of comorbid pathology and to fully ensure the effectiveness of primary prevention.

The article reviews the literature on methods of evaluating the morphological and functional state of the eyelids in chronic blepharitis. Development of methods continues together with further research on the etiology and pathogenesis of the disease.

Corneal transplantation is the most successful and frequently performed allotransplantation procedure. Benign outcome of penetrating and posterior keratoplasty depends on viability of the corneal tissue and presence of the proper endothelial layer, which retaining is one of the main objectives of preservation of donor material. Methods designed to reach this goal may be classified according to storage duration as short-term (storage in a moist chamber), medium-term (hypothermia), long-term (organ cultivation) and unlimited (cryopreservation). While there are reports of successful application of cryo-conserved corneas for penetrating keratoplasty, its use for this type of transplantation is limited due to complexity of the method and very high requirements for the quality of donor material. However, being a method of unlimited storage, it still attracts the attention of researchers. Taking into account the ongoing development of innovative keratoplasty technologies and the tendency for predominant use of layered grafts that in some cases do not need viable endothelium, methods of preservation of such material for anterior lamellar and intralamellar keratoplasties become relevant. In this context, cryopreservation without the use of cryoprotective agents is promising because it allows simple and fast accumulation of large amount of material with long storage time. Further research on the development of preservation methods of the corneal endothelial layer at sub-zero temperatures may allow storing the material by cryopreservation that will be suitable for penetrating and posterior keratoplasty.