Репозиторий Университета

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

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

© 2018 Izdatel'stvo Meditsina. There was performed a study of the diagnostic activity of sera with antibodies to Toxocara spp. and Echinococcus spp. in conditions of long storage at different temperature regimes. The use of cryoprotectants makes it possible to increase the safety of diagnostic sera by two times during prolonged storage at low temperatures.

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

© 2018 Ruslania. All rights reserved. This literature review is devoted to modem notions about molecular mechanism of action of the selective modulators of progesterone receptors. The superfamily of nuclear receptors represents ligand-activated transcription factors and includes receptors for steroid hormones, lipophilic vitamins, sterols, and bile acids. These receptors serve as targets for creating numerous drugs. As a result, a new class of compounds (ligands) appeared exhibiting agonistic/partial agonistic/antagonistic functional activities depending on the context (tissue or gene target). This class of ligands is called selective modulators of nuclear receptors. Initially, mifepristone was developed as the progesterone receptor antagonist, but further it demonstrated the properties of a selective modulator of progesterone receptor and became the ancestor of this group. At present, the development of new selective modulators of progesterone receptor is aimed at obtaining higher selectivity with respect to progesterone receptors and decreasing the anti-androgenic and anti-glucocorticoid properties. Unfortunately, most of the subsequent selective modulators of progesterone receptors exhibited hepatotoxicity, which limited their wide introduction into clinical practice.

© 2011–2018 NSPU Bulletin All rights reserved  Introduction. The authors investigate the problem of effective use of distance technologies in the educational process. The purpose of the article is to identify the potential of the Moodle electronic distance learning platform as a source for improving the quality of technical education. Materials and Methods. The authors used a set of research methods, including: 1) analysis of scientific literature on the topic of the article; 2) proposition of a hypothesis about the possibility of expanding the didactic functions of the Moodle distance learning platform by integrating interactive content into it; 3) constructing a methodological model which includes innovative educational content, characterized by an interactive format; 4) experimental approbation of teaching methods with elements of statistical analysis of the results of the control and experimental groups of students using the Pearson criteria – χ 2 . Results. As a result of the research, the following statements were identified: 1) determining factors for the realization of the capabilities of the Moodle platform in the educational process for the disciplines of physical, mathematical and technical fields; 2) the authors developed an algorithm for evaluating students’ work and showed the possibilities of placing models in a distance learning system to perform laboratory work necessary for the qualitative studying these disciplines; 3) the statistical analysis showed a positive result in terms of improving the quality of mastering basic knowledge elements. Conclusions. The authors summarize the characteristic features of the potential of the Moodle e-learning platform as a source for improving the quality of technical education.

© КОЛЛЕКТИВ АВТОРОВ, 2018 The most abundant protozoan Blastocystis spp. from human and animal intestines is one of the poor-studied pathogens causing the occurrence of a protozoal infection of the human gastrointestinal tract. In Russia, no Blastocyst invasion is recorded and neither included in the forms of state statistical reporting. The manifestations of the epidemic process of blastocyst can be judged based on a small number of studies. Analysis of clinical observations and literature data indicates a variety of forms, localization, and nature of the infection manifestation. This article is devoted to substantiating the need to detect blastocysts in environmental objects (water, soil, surfaces) as potential risk factors for the occurrence of a protozoal infection. At the same time, the studies both of the survival duration in the external environment and influence of various factors the Blastocystis survival have both the theoretical and practical importance. This information can be used in problems of epidemiology and epizootiology, for developing new methods for Blastocystis elimination, and identifying ways of spreading these parasites. Infection risk factors are sanitary and hygienic problems of environmental objects (geographical, environmental and social factors), profession features, contact with animals, use of contaminated water and food, immigration and travel to tropical countries, as well as people with weakened immune status.

© 2018, Dynasty Publishing House. All rights reserved. The objective. A comparative diagnosis of dispersion performance by the dynamic characteristics and dispersion composition of aerosol-spray forms of drugs for treatment of inflammatory disease of the throat in children (from the age of 3 years) and adults. Materials and methods. The objects of the study were 10 medications for treatment of inflammatory diseases of the throat, 9 of which have the drug form of a metered-dose spray and 1 drug has the form of undosed aerosol. A comparative diagnostics of the drugs was performed by the following dynamic spray characteristics: total length and length of particular spray phases, spray cone angle and a form of droplet population of the cone. The dispersion composition of spray was characterised by the mean and mass-median diameters of particles, particle size distribution. These characteristics were measured by a direct observation method – shadow photography – with digital processing of images using the «Actual Flow» software. Results. Diagnostics of spray dispersion by dynamic characteristics has shown that the most effective dispersion in the shape of a wide hollow cone was obtained in the drugs Tantum® Verde and Grammidin®. Diagnostics of sprays by their dispersion composition has confirmed the correspondence of all the examined preparations to pharmaceutical sprays for local treatment of the upper respiratory tract. Practically in all sprays, the maximal portion of the drug content is transferred by droplets of the optimal for spray sizes from 10 to 100 μm. The mass content of «hazardous» small droplets with sizes less than 10 μm is insignificant and amounts to less than 1%. Conclusion. Based on diagnostics of 10 sprays by the method of shadow photography on the basis of all examined parameters of the dynamics and fineness of dispersion the most effective dispersion from the viewpoint of drug delivery to throat mucous membranes is achieved in the drug Tantum® Verde.

© 2018, Dynasty Publishing House. All rights reserved. The article presents non-pharmaceutical methods of rehabilitation of children with acute respiratory infections (ARI) used at a hospital, polyclinic (rehabilitation centre), medical resort. Specificities of administering medical exercise therapy, massage, inhalation therapy, balneo-halotherapy and other methods at different stages of rehabilitation are discussed. The authors analyse the results of research works that are demonstrative of the necessity of including in rehabilitation programmes for children with ARI of the drug levocarnitine that enhances their effectiveness. Administration of levocarnitine in doses of 50 to 100 mg/kg/day 2 times daily, as 1–1.5-month courses, prevents the development of repeat episodes of acute respiratory viral infections in children and reduces their duration, restoring the activity of immune cells. Also, recommendations are given to physicians about the use of Elcar® in children who fall ill frequently and for prevention of respiratory infections. physicians about the use of Elcar in children who fall ill frequently and for prevention of respiratory infections.

© 2018, Dynasty Publishing House. All rights reserved. The objective. Assessment of the surveillance and control over rabies in the Russian Federation in order to determine the main directions of improving these systems under modern conditions. Materials and methods. Data of rabies surveillance in the Russian Federation in 2000–2017 were used, as well as official statements and governmental reports of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and the Federal Service for Veterinary and Phytosanitary Surveillance, epidemiological descriptive-evaluative methods and GIS technology. Results. The current situation with rabies in the Russian Federation has been specified, which is characterized by a decrease of human morbidity rates against the background of a growth of rabies cases found in animals. Central Russia and the Volga region are among high-risk territories, where the maximal intensity of epizootics among wild carnivores has been observed since 2014. As has been shown, the existing rabies surveillance system permits to determine risk territories, groups, cohorts and time periods. On the other hand, there are problems related to the epidemiological diagnostics and low awareness of the population. Conclusion. Successful surveillance and control over rabies in the Russian Federatiuon under modern conditions requires improvement of the normative-legislative basis, professional preparation of specialists, further scientific research, and also consolidation of resource provision and inter-organisational interaction.

© 2018 Ruslania. All rights reserved. This review summarizes the published literature devoted to the analysis of diagnostic role of microRNAs in cardiovascular disease. MicroRNAs are a class of small non-coding RNAs that regulate gene expression and affect various cellular functions. Modern methods for the detection ofmicroRNA are described. The data of variations in their concentration in ischemic heart disease, heart failure and other diseases are analyzed. At present, the accumulation of clinical data on the role of these biomarkers will allow to determine the diagnostic and prognostic significance of microRNAs (microRNA sets) in cardiovascular diseases.

© 2018, Dynasty Publishing House. All rights reserved. We analysed the association between levels of various cytokines and specificities of the clinical course and severity of toxic syndrome in pregnant women with influenza А(H1N1)pdm09, complicated by pneumonia. Cytokines reduce the sensitivity of the warm receptors and increase that of the cold receptors, which is regarded by patients as episodes of chills. According to correlation analysis data, IL-6 has the largest direct correlation with the persistence of fever, whereas interrelations between other cytokines and persistence of higher temperature proved to be less significant. It is noteworthy that elevated IL-6 levels lead to impairment of sleep architecture, which contributes to increased and persistent weakness, drowsiness. As has been shown, persistence of cough is to a significant degree determined by correlations between the levels of such cytokines, as TNF-α, IL-4 and IL-8. We assessed correlations between individual signs of systemic inflammatory response syndrome (SIRS) and cytokine levels. In diagnosing SIRS according to procalcitonin levels in viral-bacterial pneumonia 3 significant correlations were found (association with IL-8 – 0.72, TNF-α – 0.76 and IL-6 – 0.66). In pregnant women with pneumonia, generalised inflammatory process and a subsequent development of SIRS lower levels of the anti-inflammatory cytokine IL-4 have been found. A quantitative correlational approach to assessment of cytokine interrelationships has been proposed, permitting to differentiate between uncomplicated and complicated forms of influenza.

© 2018 Media Sphera Publishing Group.All rights reserved. Purpose: To assess the prevalence of atrial fibrillation (AF) and use of antithrombotic agents in adult patients with acute coronary syndrome (ACS). Materials and Methods. We consecutively enrolled all ACS patients (n=1155) who were hospitalized in two Moscowbased percutaneous coronary intervention centers (each center performs over 500 PCIs a year) between October 2017 and February 2018. AF was diagnosed in 204 patients (17.7%). The risk of thromboembolic complications was assessed using the CHA2DS2-VASc Score. The risk of hemorrhagic complications was assessed using the HAS-BLED Score. The data were processed using StatSoft Statistica 10.0 and IBM SPSS Statistics v.23 software. Results. The prevalence of diagnosed AF was 13.6%, while the prevalence of undiagnosed AF was 4.1%. Of the 179 discharged patients with AF, only 2 had a low risk of ischemic stroke (IS). One hundred and fifty patients (83.8%) eligible for oral anticoagulant therapy received oral anticoagulants. Patients with diagnosed AF were administered oral anticoagulants (OACs) significantly more often than patients with undiagnosed AF [125 (91.9%) vs. 25 (58.1%), р 0.001]. Novel oral anticoagulants (NOACs) were administered four times more often than vitamin K antagonists [120 (80.0%) vs. 29 (19.3%), р0.001]. Rivaroxaban was used in 51.3% of cases. Of the 29 patients treated with warfarin, only 3 (10.3%) achieved the target international normalized ratio (INR) at discharge. Of the 107 patients who underwent percutaneous coronary intervention (PCI), 77 patients (80%) received an OAC and two antiplatelet agents (with 74% receiving this three-agent therapy for one month), 11 patients (10.3%) received an OAC and an antiplatelet agent, and 18 patients (16.8%) received two antiplatelet agents. The only antiplatelet agent used as part of the three-agent therapy was clopidogrel. The three-agent therapy without PCI was administered in 43.1% of cases. Conclusion. We found that the prevalence of AF in patients with ACS was high. The fact that doctors administered NOACs suggests that they are aware of the need to use these agents to prevent thromboembolic complications in AF patients.

© Published under licence by IOP Publishing Ltd. In this paper, a method of fabrication of an Al-Ni powder energetic material with a 90-100 nm particles is proposed and experimental results of a study of its properties are presented. High values of specific energy and the rate of its release make it possible to use this material as an heat release element in thermoelectric power generation devices. It has been demonstrated experimentally that it is possible to maintain a voltage value higher than 1 V for 45 seconds as a result of combustion of a 3 gram Al-Ni sample that using a simple DC-DC converter will allow charging supercapacitors or accumulators.

AIM: To evaluate the efficacy and safety of zonisamide as an add-on therapy in structural focal epilepsy in children with cerebral palsy (CP). MATERIAL AND METHODS: Sixty-four patients (36 boys and 28 girls) with spastic CP and structural focal epilepsy with refractory seizures were followed up. Patients received zonisamide in a dose of 6-8.8 mg/kg/day for ≥6 months. Treatment efficacy was assessed by the reduction of seizures depending on CP form, type of epileptic seizures, combination of zonisamide with other drugs and adverse-effects. RESULTS AND CONCLUSION: A reduction of seizures by ≥50% was identified in 60.9% of children, 10.9% showed a better recovery. The best efficacy (35.9%) was demonstrated in the treatment of generalized seizures with focal onset and in the combination with levetiracetam (35.9%). Adverse effects of mild to moderate severity were noted in 26.5% of children. The treatment was discontinued in 7.8%. Therefore, zonisamide is an effective treatment for refractory structural focal epilepsy in children with CP and comorbid pathology, which reduces the frequency of seizures without severe side-effects.

© 2018 Media Sphera Publishing Group. All rights reserved. Aim. Analysis of the treatment response rates of different therapy regimens of functional constipation, including Ipidacrine, a cholinesterase inhibitor, based on assessment of adaptation and compensatory mechanisms in the therapy forecast. Materials and methods. 77 functional slow-transit constipation patients were examined after therapy regimens of functional constipation, the mean age is 44.30±14.58 y.o. Results and discussion. The treatment response rates of different therapies with Ipidacrine depends on the patient's initial adaptation and compensatory mechanisms (ACM index); certain aspects allowing to predict the expected result depending on the current mental state were identified; the severity of the state of functional constipation, ACM index and MMPI test psychometric indicators are correlated; adaptation and compensatory mechanisms of functional constipation patients were found to be reduced; the prognosis of the treatment response rates and, accordingly, the choice of the therapy regimen depend on the patient's adaptation potential (index). Conclusions. Therapy regimens for functional constipation patients should be selected on the basis of the original ACM index, behavioral pattern, degree of compliance and the patient’s age.

© 2018, © 2018 Informa UK Limited, trading as Taylor  &  Francis Group. The aim of our study was to determine a chemical composition of methanol extract of Galium verum as well as to assess its effects on functional recovery and redox status of isolated rat heart after ischemia. Rats were divided into control and G. verum group, which included animals treated with 500 mg/kg of methanol extract of G. verum for 28 days. Parameters of heart function and oxidative stress markers were estimated. Cell morphology was evaluated by hematoxylin and eosin (HE) staining. Our results demonstrated for the first time that G. verum extract preserved cardiac contractility, systolic, and diastolic function as wells as structural damage of the heart after ischemia. Furthermore, G. verum extract modulated the activity of antioxidant enzymes and alleviated the production of pro-oxidants.

© 2018 Stolichnaya Izdatelskaya Kompaniya. All rights reserved.  Aim. Investigation of comparative dissolution kinetics of generic medicinal products containing moxonidine versus reference drug. Material and methods. Objects of the research were film-coated tablets containing moxonidine (INN) in a dose 0.4 mg: a reference drug Physiotens ® and 4 generic drugs. In vitro dissolution test of moxonidine from the study drugs was performed using comparative dissolution kinetics test (CDKT). The CDKT was performed in the media with the following pH: 1.2 (1:9 mixture of 0.1 M hydrochloric acid and water), 4.5 (acetate buffer solution, prepared as per State Pharmacopoeia, XIII), and 6.8 (phosphate buffer solution, prepared as per State Pharmacopoeia, XIII). The sampling for dissolved moxonidine was performed 5, 10, 15, 20, and 30 min after the test was started. An high performance liquid chromatography method with ultraviolet detection at 220 nm was used to assay. Results. Within 15 min more that 85% of moxonidine dissolved from the reference drug and all study drugs at pH 1.2; dissolution profiles were similar without calculation of similarity factor f 2 . Similarly, at pH 4.5 dissolution profiles of study drugs #2 and #3 were similar to that of the reference drug, and the similarity factor f 2 was not calculated. However, in case of study drugs #1 and #4 significant differences were observed at a single time point (15 min), which suggests that their dissolution profiles are non-similar to that of the reference drug. Similarity factors f 2 were calculated 17.52 and 35.30, respectively (less than 50). At pH 6.8 similarity factors f 2 for all study generic drugs were also less than 50 (23.8, 49.8, 38.6, and 35.9), so their dissolution curves were non-similar to that of reference drug. Conclusion. In our study we observed difference in release in vitro of medicinal products containing moxonidines: none of the study drugs was fully similar to the reference drug in all media. The differences observed at pH 6.8 were noteworthy, where the samples had or faster kinetics (study drugs #2 and #3), or slower dissolution kinetics (test drugs #1 and #4). Observed differences in moxonidine release rate may impact absorption of active pharmaceutical ingredient into the blood following drug administration.

© 2018 Russian Academy of Medical Sciences. All Rights Reserved. Cancer immunotherapy represents a promising and rapidly developing approach for the treatment of oncological diseases. Among the methods of personalized adjuvant immunotherapy, neoantigenic peptide-based drugs have demonstrated substantial efficiency. These drugs are designed to target mutant proteins arising from somatic alterations in the genome of tumor cells and thus stimulate immune response against tumor tissues. The methods of individual screening for potentially immunogenic mutations are mostly based on next-generation exome sequencing of tumor samples, which is a complex and costly procedure for clinical application. Targeted gene sequencing panels limited to a certain set of genes represent a reasonable alternative to WES. Targeted sequencing is also more efficient when there is a low amount of the sample DNA available. We have estimated the potential efficiency of targeted oncological panels in terms of somatic neoantigen profiling in colorectal cancer (colon and rectal adenocarcinoma). The clinical practice of identification of frequent somatic variants does not provide enough data for designing an efficient personalized drug when applied to low and medium mutated cancers such as colorectal cancer. Our analysis of 11 commercially available panels containing different number of genes has shown that neither the larger size of a panel nor its initial customization for colorectal cancer provides a significantly better estimation of an individual somatic mutation profile. The optimal approach is to use the general-purpose medium-sized cancer panels (2300-11200 amplicons and/or 150-600 genes). These panels allow to detect a sufficient number of immunogenic epitopes (>3) per patient for over 30-50% of patients.