Репозиторий Университета

© 2018 Media Sphera Publishing Group.All Rights Reserved. The aim of the study was to evaluate the clinical and interferon-modulating efficacy of a combination of rectal and topical dosage forms of IFN-α2b with antioxidants in the treatment of acute respiratory infections (ARIs) in comparison with other variants of antiviral therapy. Materials and methods. A total of 90 servicemen aged 19.2±0.9 years with uncomplicated forms of ARI were hospitalized not later than 48 hours after the onset of the disease. Patients were randomized into 3 groups of 30 people each. In the first group, patients received rectal suppositories containing IFN-α2b (1 million IU) and antioxidants (alpha-tocopherol acetate and ascorbic acid) twice a day for 5 days. In the second group, patients received intranasally a gel formulation containing IFN-α2b (36 000 IU/1 g) and antioxidants 3 times a day in addition to the above suppositories. In the third group, patients were prescribed umifenovir (reference drug) at dose of 200 mg 4 times a day for 5 days. The dynamics of regression of clinical manifestations of ARI in different groups, changes in concentrations of IFN-α and IFN-γ in blood plasma, as well as spontaneous and induced production of these cytokines by blood cells ex vivo were evaluated. After that, the patients were observed for another 3 months to register repeated cases of hospitalization for ARI. Results. Marked tendency to accelerate the regression of symptoms of intoxication and fever was observed when intranasal dosage form of IFN-α2b was administered to patients receiving the rectal form of this cytokine. The combination of rectal and topical dosage forms of IFN-α2b with antioxidants was more effective than monotherapy with the rectal suppositories in preventing repeated hospitalization for ARI. The above combination caused the most complete correction of induced production of IFN-α by blood cells ex vivo at its initial deviation from the norm. Conclusion. The obtained data indicate the expediency of using the combination of rectal and topical dosage forms of IFN-α2b with antioxidants for treatment of ARI.

© 2018 Media Sphera Publishing Group.All Rights Reserved. The article discusses the problem of the role of pets as a source of zoonotic infections, representing a hidden threat to modern society. Since the content is now very popular at home, both traditional and exotic animals, it is necessary to develop an interdisciplinary program to control the spread of zoonotic infections and the risks of their infection with people. Since the problem lies in the intersection of several disciplines, joint efforts of doctors, veterinarians, health organizers and laboratory specialists are necessary.

© 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.

© 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.

© Bionika Media Ltd. Aim. To estimate the effectiveness of the thrombin generation assay (TGA) in identifying high thrombogenic risk in pregnant women. Material and methods. The study comprised 30 healthy non-pregnant women (control group) and 32 women in the third trimester of pregnancy. Of the latter group, 22 women with complicated pregnancy comprised the study group while the remaining ten women made up the comparison group. After delivery, the patients in the study group were divided into subgroups with a favorable (n = 15) and adverse (n = 7) pregnancy outcomes. The state of the hemostatic system was examined using standard coagulation tests and TGA. Results. Thrombin generation assessed as endogenous thrombin potential (ETP), was statistically significantly higher in pregnant than in non-pregnant women (2300 ± 400 vs. 1700 ± 400, respectively, p <0.005). The patients with adverse pregnancy outcomes had statistically significantly higher ETP compared with women with favorable outcomes (2700 ± 600 vs. 2300 ± 300, respectively, p <0.005). Conclusion. TGA can be used to predict adverse pregnancy outcomes. Elevated ETP is associated with adverse pregnancy outcomes.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Aim. To evaluate the prevalence of arterial hypertension (AH) in heart transplant recipients, and its influence on the risk of adverse events, as the efficacy and safety of antihypertension medications (AHM). Material and methods. To the study, were consequently included all heart transplant recipients operated in the Shumakov Centre during the years 2013 to 2016 and survived 90 days after orthotopic heart transplantation. Results. Totally, 353 recipients included, with AH or AHM intake in anamnesis in 62 (17,6%). Within 90 days post surgery, AH that demanded for medication therapy was found in 151 (42,8%) patients. In posttransplant AH patients there were the following specific parameters in preoperational period: higher body mass index - 25,7±4,1 vs 24,9±4,4 (р=0,026), blood creatinine concentration - 100,6±62,6 vs 68,8±4,8 (р<0,001), donor heart posterior wall thickness - 11,9±0,8 vs 11,3±0,7 (р=0,034), creatinine concentration in 3 month after operation - 131,7±101,6 vs 94,1±46,5 (p<0,001). There was relation revealed, of AH development risk with anamnesis of AH and renal failure, as a necessity for renal replacement therapy within 30 days post surgery and episodes of acute antibody-mediated reaction on transplant. In the recipients taking angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACEi/ARB) before operation, the survival rate free from adverse events was better than in those taking calcium channel blockers (CCB) (plog-rank=0,042). Conclusion. The results of the study point on high prevalence of AH in heart recipients. Presence of AH in anamnesis, renal failure, episodes of humoral, but not cellular, reaction to the transplant, and donor heart hypertrophy do significantly increase the probability of AH development after transplantation. Comparison revealed significant benefit of ACEi/ ARB versus CCB as antihypertension medications in either monotherapy or in combination with diuretics.

© 2011–2018 NSPU Bulletin All rights reserved Introduction. The problem of the article is addressed to clarify the question of how the content of practical pedagogical knowledge accumulated by the society can be understood from the point of view of an epistemologically correct theoretical scheme, to what extent this scheme itself is now formed in the methodology of pedagogy and what are the immediate prospects for such formation. The aim of the article is to reveal the epistemological coding of the modern state of educational theory as an object of research reflection and the prospects for its further formation. Materials and Methods. Among our research methods, we consider it possible to include: analysis of literature on the topic of the work, a theoretical substantive generalization, heuristic synthesis, the formulation of a hypothesis about the possible content and activity filling the field of reflection of researchers in the field of pedagogy, and a prospectus of further approaches to the study of the problem. Results. The modern initial stage of the theoretical interpretation of pedagogy is identified, the difficulties of which are explained by the polyphony of coding: the object of pedagogy, its fundamental foundations, the rules for deducing consequences from general provisions, the correct implementation of generalizations and analogies, and the methods for carrying out the experiment and identifying experimental confirmation of an experted theory. As the nearest stage in the solution of these problems, the authors design correct theoretical constructs of a restricted nature which must include the following aspects: identifying weak research development of several segments of pedagogical reality, raising hypotheses about the possibility of describing them from the point of view of the positively valuable educational outcome for the learner and the ways of achieving it, finding the criteria for its evaluation and implementing them in a diagnostic format. Conclusions. The presented variant of polyaspect reflection of the results of educational research based on the theoretical scheme covers both retrospective and prospective reflective forms; it also shows all the procedures traditionally indicated by psychologists: stopping, removing, fixing, reviewing, objectifying; allows educational researchers to evaluate their investigations according to scientific norms which achieve a theoretical status. All the theses of the problematic format presented in the article are a possible field of application for beginning researchers.

AIM: To define optimal terms of surgery for acute adhesive non-strangulatory small bowel obstruction.MATERIAL AND METHODS: The analysis included 703 publications from e-LIBRARI.RU (342 works) and NCBI (361 works) databases for acute adhesive intestinal obstruction. The vast majority of articles presented retrospective analysis of single-center experience.RESULTS: It has been established that short course of medication is predominantly used for acute adhesive intestinal obstruction in the Russian Federation. International studies point 2-5 days for conservative treatment. The advantages and disadvantages of short and long courses of medication were analyzed. Therefore, multicenter, prospective, randomized trial 'Comparison of early operative treatment (12-hour medication) and long-term conservative treatment (48 hours) for acute adhesive small bowel obstruction' (COTACSO) was planned and registered (Unique Protocol ID: 14121729). The study protocol involves clinical, laboratory and instrumental exclusion of strangulation, randomization and conservative treatment of 2 groups of patients for 12 and 48 hours. Patients will undergo surgical interventions if obstruction will be present by that date. The main endpoint is mortality rate in both groups. The end of the study is December 2020.

© Team of authors, 2018. Objective. To investigate the expression of transporters of different neurotransmitters (glutamate, aspartate, lactate, choline) in the culture of astrocytes isolated from different regions of the brain (cortex, hippocampus and brainstem) in 3- and 11-day rats. Material and methods. An experimental study was performed on 24 3-(n=12) and 11-days (n=12) old rats (Rattus norvegicus). The results of high-performance sequencing were analyzed. Results. The expression of glutamate and aspartate transporters in the brainstem of 3-day rats was higher than in other regions, however, an opposite effect was observed in 11-day rats. The expression of lactate transporters with age became identical to those of the cortex. Conclusion. The data demonstrate the particular qualities of neuro-astrocytic connections and the important role of astrocytes in signal transmission. Results of the study performed by using genetic methods developed by the authors for the study of neurotransmitter transporters make it possible to recommend these methods to control the neurogenesis and neurohomeostasis, including in cerebrovascular and neurodegenerative diseases.

© Russian Journal of Cardiology.  Aim. Evaluation of clinical specifics, predictors of repeat hospitalizations and mortality in chronic obstructive pulmonary disease (COPD) patients according to pulmonary hypertension (PH) severity grade. Material and methods. To the study, 288 COPD patients included (II-IV severity grade, GOLD 2016; males 276, females 12; mean age 59,5±9,27 y. o., smoking 23,1±11,42 pack/years; 2,4±0,89 exacerbations annually, body mass index (BMI) 27,2±12,06 kg/m 2 ). According to the presence and grade of systolic pressure increase in pulmonary artery (SPPA) the patients were selected to three groups: 1st — with no PH (SPPA <40 mmHg, n=168), 2nd — with moderate PH (SPPA 40-55 mmHg, n=101), 3rd — with severe PH (SPPA >55 mmHg, n=19). Results. Increase of SPPA was found in 120 (41,7%) patients: moderate PA — in 101 (35,1%), severe PH — 19 (6,6%). It was shown that the presence and severity of PH do increase the severity of clinical signs of COPD, hemodynamic disorders, increase the rate of repeat hospitalizations and mortality rate. The predictors of repeat hospitalizations in COPD patients are increased SPPA and C-reactive protein concentration (CRP); mortality predictors are severity of symptoms by CAT, Borg dyspnea, number of exacerbations during one year, size of the right atrium, grade of SPPA increase, CRP concentration, fibrinogen, N-terminal precursors of C-natriuretic peptide (NT-proCNP) and brain peptide (NT-proBNP) in the blood. Conclusion. PH in COPD patients in most cases is moderate, and it worsens the clinical picture, hemodynamic disorders, shows only moderate correlation with breathing disorders, increases the rate of rehospitalizations and mortality risk. The survival rate of COPD and PH patients depends on the severity.

© 2018 Medical Education. All rights reserved. The aim of the study was to investigate an efficacy of short-term treatment with acetazolamide (ACET) in patients with acute exacerbation of COPD (AECOPD) and noninvasive ventilation (NIV). Methods. This was a prospective case-control study. The study involved 20 patients. Inclusion criteria were as follows: AECOPD; pH > 7.33; PaCO2 > 48 mmHg; HCO3 - > 26 mmol/L; and treatment with NIV. Clinical characteristics, Charlson comorbidity index, APACHE II score, arterial blood gases, and serum electrolytes were recorded before inclusion. Patients were defined as cases when they had received ACET (500 mg per day) for 3 days; they were compared to a matched control group who did not receive ACET. Clinical parameters, arterial blood gases, serum electrolytes, potential adverse effects, and length of hospital stay were monitored daily. Results. No significant differences in baseline characteristics, comorbidities, or concomitant drugs used were found between the groups. Mean duration of hospital stay was significantly shorter in the ACET group (16.2 ± 8.4 days vs 19.1 ± 2.8 days; p = 0.023). An iIntra-group analysis showed a significant improvement in clinical and arterial blood gas parameters in both groups already in the first day of the treatment. In the ACET group, systolic blood pressure (SBP), respiratory rate (RR), and SpO2 significantly improved at day 4 (112.5 ± 4.9 mmHg vs 125 ± 7.1 mmHg (p = 0.001); 15.2 ± 1.1 min-1 vs 17.1 ± 0.9 min-1 (p = 0.001) and 94.7 ± 1.1% vs 92.3 ± 0.8% (p = 0.0001), respectively). There was a significant decrease in PaCO2, pH and HCO3- at day 3 (48 ± 3.8 mmHg vs 52.4 ± 5.3 mmHg (p = 0.0288); 7.374 ± 0.4 vs 7.502 ± 0.17 (p = 0.0015) and 26.4 ± 2.8 mmol/L vs 36.9 ± 4.1 mmol/L (p = 0.00001), respectively) and day 4 (44 ± 2.4 mmHg vs 48.4 ± 4.6 mmHg (p = 0.0115); 7.387 ± 0.02 vs 7.480 ± 0.02 (p = 0.00001) and 24.2 ± 2.1 mmol/L vs 35.6 ± 3.0 mmol/L (p = 0.00001), respectively) in the ACET group. No adverse events were recorded in both groups. Conclusions. ACET adjuvant to NIV appears to be effective and could prevent post-NIV alkalosis occurrence and could reduce the length of hospital stay in patients with AECOPD and mixed metabolic disorders (respiratory acidosis and metabolic alkalosis).

© 2018 Human Stem Cell Institute. All rights reserved. Cell therapy is one of the most promising directions in the treatment of critical limb ischemia (CLI). In spite of certain advances achieved in this field in the last decades, which are related to application of bone marrow stem cells (BMSC), a large number of problems still remain unsolved. In this review, we discuss the BMSC biology, mechanisms of their therapeutic effect in the CLI treatment and results of the most notable BMSC-based clinical studies in detail.

© 2018, Peter the Great St. Petersburg Polytechnic University. The magnetomodulation differential weak magnetic-field sensor, based on the Bi-2223 high-temperature superconducting ceramics has been investigated. The high magnetic-field resolution (∼20 pT) and wide measurement range (125-140 dB) have been obtained. The possibility of using this sensor for noninvasive control of magnetic particles or implanted medical electronic devices in biological objects at a distance of up to 30 mm from the skin surface is discussed.

© 2018 Ima-Press Publishing House. All rights reserved. Chronic cerebral ischemia (CCI) is one of the most common diagnoses in middle-aged and elderly patients in the practice of an outpatient neurologist. Unfortunately, the diagnosis of CCI in these patients is often established only on the basis of complaints of headache, dizziness, instability during walking, and lower mood. At the same time, other diseases that cause these symptoms are not diagnosed, patients do not receive treatment, which considerably worsens quality of life and leads to anxiety and depression. A variety of diseases, such as headache, peripheral vestibular vertigo, depression, Alzheimer's disease, and Parkinson's syndrome, are frequently hidden under the diagnosis of CCI. The leading neurological syndrome in CCI is cognitive impairment that can be both moderate and reach the level of dementia. Approximately 40% of patients with chronic cerebrovascular disease complain of headache that is usually caused by mixed primary headache. The management tactics for a CCI patient suffering from headache is aimed at treating primary headache, modifying vascular risk factors, and managing cognitive impairment. The paper discusses the use of choline alphoscerate in patients diagnosed with CCI.

© 2017 Elsevier B.V. The purpose of this work was to investigate experimentally the capacity of passive acoustic thermometry (PAT) for the reconstruction of 1D, time-variable distributions of the internal temperature. Because in the PAT a noise signal is measured, a considerable integration time (about one minute) is required to attain an acceptable error level (0.5–1 K). To optimize the time, an algorithm was proposed to take account of the fact that the temperature satisfied the heat equation. The problem was reduced to that of determining two parameters (initial temperature and thermal diffusivity) of the object under study. The desired parameters were considered constant and were not determined anew after each measurement; instead, their values were refined using all the previous measurements. The proposed algorithm was tested experimentally (where the temperature was reconstructed in a model object, a slab of polytetrafluoroethylene) and investigated by means of computer modeling. The duration of one measurement was about 5.5 s. As a result, an error of the temperature reconstruction of about 0.5 K, acceptable for medical applications, was attained after 30–60 s (depending on the depth) from the beginning of the measurements. After that, temperature distributions can be reconstructed after each measurement without loss of the reconstruction accuracy. The proposed method can be used to control the temperature under a local hyperthermia, lasting 1 min and more, of the human body.

© Izdatel'stvo Meditsina. All rights reserved.  Introduction. Single-walled carbon nanotubes (SWCNTs) can create risks to human health when they enter the body by oral route when used in packaging materials, as promising agrochemicals and pesticides. The aim of the study. Evaluation of the subacute oral toxicity of SWCNT in rats. Material and methods. In the 92-days of the experiment, the SWCNTs were administered to rats along with drinking water at doses of 0 (control); 0.01; 0.1; 1.0 and 10 mg/kg body weight (BW) in the groups 1-5, respectively. Hematological indices of blood, apoptosis of hepatocytes, levels of pro- and anti-inflammatory cytokines in blood plasma and their production by cells of the spleen ex vivo, the content of the main and transient components of the intestinal microbiocenosis in the cecum were studied. There were determined hematological blood counts, hepatocyte apoptosis, levels of pro- and anti-inflammatory cytokines in blood plasma and their production by spleen cells ex vivo, content in the cecum of the main and transient components of the intestinal microbiocenosis. Results. At the SWCNT dose of 0.01 mg/kg BW there was a decrease in the number of neutrophils and basophils, an increase in the number of lymphocytes, and a decrease in the number and volume of platelets. At a dose of 0.1 mg/ kg bw there was noted a decrease in the number of cells in the early stage of apoptosis and the total number of cells in apoptosis, as well as a significant decrease in the levels of cytokines IL-10, IL-2, IL-4, IL-13, chemokine MIP-3a, TGF-β isoform 1; at a dose of 1.0 mg/kg IL-12p70, and TGF-β isoforms 1 and 3. TGF- β 2 level was significantly elevated in group 5. The suppressive effect was noted for SWCNTs on the mold flora in intestinal contents at all doses of nanomaterial used, whereas the number of yeasts increased at 1 mg/kg BW. The immunization of rats with ovalbumin had a clear modulating effect on the immunotropic effects of SWCNTs administered at a dose of 0.1 mg/kg BW in a 28-days experiment. Discussion. The mechanisms of the observed changes development are likely to be associated with both systemic anti-inflammatory effects and with a decrease in the effect of SWCNT on the permeability of the intestinal barrier to protein antigens and microbial toxins. Conclusion. SWCNTs exhibit a number of effects in relation to the studied indices that do not demonstrate a monotonic dependence on the dose of nanomaterial, which, apparently, is related to the processes of aggregation of the SWCNT.

© 2018 Trans Tech Publications, Switzerland  This paper presents the results of experimental studies of arrays of Ag 0.52 Au 0.48 alloy nanoparticles. Arrays were formed by vacuum-thermal evaporation on an unheated substrate and subsequent low-temperature vacuum annealing. The TEM images of the obtained nanoparticle arrays and corresponding histograms of particle size distribution are shown. The transmission spectra of these arrays showing the displacement of the plasma frequency as a function of the mean particle size are obtained. Spectra of Raman scattering from a thin film of amorphous carbon in presence of AgAu particles are obtained, and a comparative analysis of Raman scattering amplification factors for pure Ag, pure Au and Ag 0.52 Au 0.48 alloy nanoparticles is presented.

© 2018, Canadian Science Publishing. All rights reserved. The aim of this study was to assess the impact of atorvastatin and simvastatin on myocardial contractility during the different degrees of hyperhomocysteinemia (HHcy) in rats. Study was conducted on adult male Wistar albino rats (n = 90; 4 weeks old; 100 ± 15 g body mass) in which HHcy was achieved by dietary manipulation. Animals were exposed to pharmacology treatment with atorvastatin in dose of 3 mg/kg per day i.p. or simvastatin in dose of 5 mg/kg per day i.p. at the same time every day, according to equivalent therapeutic doses of these statins (10 mg atorvastatin = 20 mg simvastatin). After the dietary manipulation and pharmacological treatment and confirmation of HHcy, all animals were sacrificed, hearts were isolated, and cardiac function was tested according to the Langendorff technique. Size of recovery of maximum rate of left ventricular development (dp/dtmax), minimum rate of left ventricular development (dp/dtmin), systolic left ventricular development, diastolic left ventricular development, heart rate, and coronary flow at the 40, 60, 80, 100, and 120 cmH2O coronary perfusion pressure were measured in state of physiological condition (homocysteine less than 15 μmol/L), mild HHcy, and moderate HHcy. Atorvastatin treatment significantly attenuated homocysteine-induced impairment of myocyte contractility and dominantly decreased dp/dtmax, dp/dtmin, and heart rate and induced greater changes in systolic left ventricular development compared with simvastatin. Treatment with atorvastatin seems able to revert systolic abnormalities and improve contractility during the different degrees of HHcy.

© 2018 Dynasty Publishing House. All rights reserved. One of the most important tasks of clinical medicine is to stop bleeding as soon as possible. Despite the broad spectrum of modern haemostatic materials, the available local blood-stopping products are not without certain limitations and shortcomings when used in various clinical situations. The article discusses the potential of «Polygemostat», a Russian haemostatic for external and local use, which simultaneously has an antiseptic and wound-healing effect.

© 2018 Media Sphera Publishing Group. All rights reserved. Objectives: This article reports 1-year clinical outcomes of patients with rheumatoid arthritis (RA) receiving abatacept (ABA) therapy. Materials and methods: Patients (n=91) with high RA activity (DAS28 = 5.1 ± 1.0) and an inadequate response on synthetic DMARDs (mainly methotrexate, 70.3%) and biologics (mainly TNF-α inhibitors, 93%) were included in the study. The majority of patients were middle- Aged (49 ± 13.5) womens, RF (72.5%) and ACPA (77%) positive, with moderate functional impairment - HAQ = 1.4 (0.9-2). ABA were administered IV, 10 mg/kg according to the standard scheme. The evaluation of the effectiveness of the therapy was carried out according to the EULAR / ACR 2011 criteria using SDAI, CDAI, HAQ and the intention to treat approach. Results: ABA led to a significant (p <0.05) decrease activity of RA. Clinical improvement according to EULAR criteria after 6 months of treatment was registered in 70.9%, after 12 months 63%. Almost a third of patients (28.7%) achieved a good response after 3 months of therapy, 39,2% - After 6 months and 39% - After 12 months. The retention rate of ABA therapy after 6 months was 77%, after 12 months - 60%. There were no significant differences between "bio-naive", 1 Bio and ≥2 Bio groups in achieving EULAR response. A good response was achieved in 38%, 38% and 43%, respectively, but the lowest number of non-responders was registered in ≥2 Bio - 38%, 36% and 43%. ABA significantly improved functional status of patients, after 12 months a marked and moderate improvement in the HAQ was achieved in 39% and 21% of patients, respectively. Adverse events (AE) were registered in 22 patients. The most frequent AE were upper respiratory tract infections - 11 (12%) patients. Conclusion: Abatacept was effective in the overall population, and in all subgroups of patients. It has shown significant improvement of clinical and functional status in patients who had an inadequate response to previous therapy. ABA has a good safety profile. AE were registered only in a small number of patients.