Репозиторий Университета

© 2018, Media Sphera Publishing Group. All rights reserved. Surgery of intracerebral tumors involving long association fibers is a challenge. In this study, we analyze the results of intraoperative mapping of the superior longitudinal, arcuate, and frontal aslant tracts in surgery of brain gliomas. Purpose. The study purpose was to compare the results of intraoperative mapping and the postoperative speech function in patients with gliomas of the premotor area of the speech-dominant frontal lobe, which involved the superior longitudinal, arcuate, and frontal aslant tracts, who were operated on using awake craniotomy. Material and methods. Twelve patients with left frontal lobe gliomas were operated on: 11 patients were right-handed, and one patient was a left-hander retrained at an early age. Histological types of tumors were represented by Grade II diffuse astrocytomas (6 patients), Grade III anaplastic astrocytomas (1 patient), Grade IV glioblastoma (1 patient), Grade II oligodendroglioma (1 patient), and Grade III anaplastic oligodendrogliomas (3 patients). The mean age of patients was 45 (29?67) years; there were 6 males and 6 females. All patients underwent preoperative and postoperative MRI with reconstruction of the long association fibers and determination of the topographic anatomical relationships between the fibers and the tumor. Surgery was performed using the asleep-awake-asleep protocol with intraoperative awakening of patients. All patients underwent cortical and subcortical electrophysiological stimulation to control the localization of eloquent structures and to clarify the safe limits of resection. For intraoperative speech monitoring, a computerized naming test was used with naming of nouns or verbs, and automatic speech was evaluated (counting from 1 to 10, enumeration of months and days of the week), which was complemented by a talk with the patient. Speech disorders before, during, and after surgery were evaluated by a neuropsychologist. The mean current strength during direct electrical stimulation was 3 (1.9?6.5) mA. Results. The association fibers were intraoperatively identified in all patients (SLF/AF in 11 patients; FAT in one patient). In 4 patients, the cortical motor speech area was intraoperatively mapped; in three cases, tumor resection was accompanied by speech disturbances outside the stimulation. During direct electrical stimulation, speech disturbances developed in 7 of 12 cases. All patients underwent control MRI within the first 48?72 h: total resection (more than 90% of the tumor) was performed in 7 cases; subtotal resection was achieved in two patients; partial resection was performed in two cases. According to postoperative MR tractography, the resected tumor bed was adjacent to the SLF/AF complex in 7 cases, located near the SLF/AF complex in three cases, and adjacent to the FAT in two cases. Postoperatively, 11 out of 12 patients had worsening of neurological symptoms in the form of various speech disturbances. In one patient, speech disturbances developed 2 days after surgery, which was associated with an increase in edema. On examination 3 months after surgery, severe speech disturbances remained in 1 patient. Conclusion. Resection of frontal lobe tumors in the speech-dominant hemisphere using early postoperative awakening is associated with a high rate of complex speech disorders due to injury to the SLF/AF complex and FAT. In these cases, intraoperative speech mapping with allowance for the course of long association fibers is an essential procedure. Preoperative tractography in combination with intraoperative speech mapping enables identification of association fibers of the SLF/AF complex and FAT, which may help to avoid severe conduction aphasia with poor speech recovery after tumor resection.

Carboxytherapy (the treatment based on carbon dioxide injections) is a multipurpose and widely used medical technology. The use of CO2 injections (intracutaneous, subcutaneous, and pneumopuncture) have substantially supplemented and increased the practical relevance of carboxytherapy as a method for the treatment of many diseases. Thanks to it physiological properties, CO2 has antihypoxic, antioxidant, vasodilatory, anti-inflammatory, analgesic, and spasmolytic activities; moreover, it improves blood viscosity, stimulates neoangiogenesis, and regenerative processes. Carbon dioxide is a sort of biochemical 'peacemaker' in tissue oxygenation: when blood cells are exposed to high CO2 concentrations (Bohr effect), the rate of gas exchange (CO2 and O2) increases. The human organism interprets carboxytherapy (local hypercapnia) as oxygen deficiency and responses to it by boosting not only the blood flow, but also the vascular endothelial growth factor which stimulates neoangiogenesis and in the long run improves blood supply and tissue trophism. The multiple mechanisms of action, polymodal efficacy, a tool kit with a wide range of detectors and various modes of treatment make carboxytherapy a popular medical technology all over the world, namely in cosmetology, dermatology, aesthetic medicine, angiology, orthopaedics, cardiology, neurology, pulmonology, gynaecology, urology, proctology, plastic and general surgery, and other areas. Carboxytherapy provides a perfect example of the off-label usage in medicine that made it one of the most extensively applied medical technology for the treatment of various diseases despite the lack of the preclinical data and scarce relevant information available in textbooks, reference books and booklets.

© 2018 Russian Photodynamic Association. All rights reserved. A comparative experimental study of the specific activity of drugs based on 5-aminolevulinic acid (5-ALA) and its hexyl ester (5-ALA HE) was carried out. Their ability to induce the synthesis of photoactive protoporphyrin IX in the healthy tissues of the rabbit bladder when instilling the drug solutions at various concentrations has been estimated. It was shown that 5-ALA HE results in the induction and accumulation of PPIX in the rabbit bladder epithelium at much lower concentrations than 5-ALA. Thus, a significant increase in the fluorescence intensity in comparison with the control was achieved by instillation of 5-ALA HE solution in the rabbit' bladder at a concentration of only 0.0001% (fluorescence intensity 2.20±0.60 a.u.), and for 5-ALA - only when using a solution at a concentration of 0.3% (fluorescence intensity 2.60±1.02 a.u.).

© Ima-Press Publishing House. All rights reserved. Objective: to investigate the effect of indapamide/perindopril fixed-dose combination (FC) on 24-hour blood pressure (BP) and cognitive functions in antihypertensive treatment-naive middle-aged patients with uncomplicated grade 1-2 essential arterial hypertension (EAH). Patients and methods. The open prospective study enrolled 25 patients (9 men and 16 women) aged 40-59 years with a diastolic BP of 90-109 mm Hg and/or a systolic BP of 140-179 mm Hg, as evidenced by routine measurements. As starting antihypertensive therapy, the patients received indapamide 1.25/perindopril 5 mg FC once daily in the morning; if necessary, after 2 weeks (if the routine blood pressure was ≥140/90 mm Hg) they took indapamide 2.5/perindopril 10 mg once daily in the morning. The follow-up period was 14-16 weeks. Before and at the end of the follow-up, the patients underwent 24-hour ambulatory BP monitoring (ABPM) and evaluation of cognitive functions using the Montreal Cognitive Assessment (MoCA), ten-words test (immediate and delayed word recall), verbal association test (literal and categorical associations), number connecting test (Trail making test (TMT), part A and numbers and letters connecting test (TMT) part B), and Stroop test. Results. At the end of the follow-up period, treatment with indapamide/perindopril fixed-dose combination showed a statistically significant reduction in BPs, as evidenced by routine measurements and ABPM (during 24-hour, and awake and sleep periods); a statistically significant cognitive improvement: an increase in the number of the so-called words in the ten-words test during both immediate (from 5.5±1.6 6.5±1.5 words; p=0.02 vs baseline) and delayed (from 6.2±1.7 to 7.4±1.4 words; p=vs baseline) recalls, a decrease in the performance time of TMT-B (from 112.6±42.5 to 90.4±28.4 sec; p=0.02) and Stroop test Part 3 (from 135.5±50.1 to 112.6±19.6 sec; p=0.02), and a larger number of called words in the categorical associations test (from 6.5±2.4 to 8.1±2.9 words; p=0.02). Conclusion. The results obtained indicate that in treatment-naive middle-aged patients with EAH, indapamide/perindopril fixed-dose combination assures an effective reduction in BPs, as evidenced by routine measurements and ABPM, also improves cognitive functions, particularly attention, information processing speed, semantic memory, cognitive flexibility, and short-term and long-term memory.

© 2018 Onkopediatria. All rights reserved. Background. Analysis of medical care delivery for children with cancer in armed conflict is highly important because the high-tech treatment in this context is extraordinary difficult and challenging task. Objective. Our aim was to analyze the morbidity and mortality rates in children with malignant tumors, to assess the pediatric patient capacity and medical service density in the Donetsk People's Republic. Methods. The ecological study was conducted where the units of analysis were represented by the aggregated data of the Republican Cancer Registry on the number of primary and secondary patients with malignant and benign tumors, the deceased patients in the DNR in 2014-2017, pediatric patient capacity, and medical service density. Results. The number of pediatric patient capacity for children with cancer was 10 (0.27 per 10,000 children aged 0-17), pediatric patient capacity for children with hematological disorders - 40 (1.37 per 10,000 children aged 0-17). The treatment of children with cancer was performed by 5 healthcare providers: 1 pediatric oncologist (0.02 per 10,000 children aged 0-17), 3 hematologists (0.08 per 10,000 pediatric population aged 0-17), and 1 practitioner who did not have a specialist certificate in oncology. Morbidity rate for malignant neoplasms from 2014 to 2017 decreased by 25% (in 2014 - 9.6 per 10,000 children aged 0-17; in 2017 - 7.2). In the morbidity structure, the incidence proportion of hemoblastoses was 68.4%, brain tumors - 2.6%, other solid tumors - 29%. The death rate due to malignant neoplasms decreased by 37% (in 2014 - 2.7; in 2017 - 1.7). Conclusion. Low levels of the incidence rate and pattern of morbidity indicate defects in the identification and recording of patients. This explains the performance of the bed: low average bed occupancy per year and low turnover. For a reliable analysis of mortality statistical data is not available: in 2014-2015 only the number of in-hospital deceased patients is presented. Limited data is due to the lack of reliable patient catamnesis which is explained by the high rate of population migration.

© 2018, Silicea-Poligraf. All rights reserved. Aim. To classify established clinical types of the right ventricle arrhythmogenic dysplasia (RVAD) taken a variety of genetic and inflammatory mechanisms, and to analyze the specifics of differential diagnostics and management of the respective types. Material and methods. Main group consisted of 50 patients with evident (n=26), probable (n=13) and possible (n=11) RVAD diagnosis, mean age 38,1±14,6 y. o., males — 20 (40%), follow up time 13,5 [4; 34] months. Comparison group consisted of 58 patients with some of the RVAD criteria insufficient for evident diagnosis. All patients underwent ECG, Holter ECG 24 hours, EchoCG; in the main group additionally — DNA-diagnostics (n=46), cardiac MRI (n=44), high definition ECG (n=16), endomyocardial biopsy of the RV (n=2), autopsy (n=2). In comparison group, MRI was done in 32 patients, biopsy to 7, and in 1 case — autopsy. Results. Based upon the clinical data and specifics of the disease course, 4 types of established clinical RVAD were selected, that do not tend to overlap: latent arrhythmic (50% patients), manifest arrhythmic (20%), RVAD with predominant biventricular chronic heart failure (CHF, 16%), and RVAD with non-compaction left ventricle myocardium (14%). The development of one or another type is based on genetic factors, as on comorbid myocarditis (in percent in the following, respectively). In diagnostics of the latent arrhythmic type (frequent right ventricle extrasystoly, VE and/or non-sustained right ventricular tachicardia, VT) the key role played female sex, syncopes in anamnesis (16%), family history of sudden death (12%), ECG-criteria and positive results of DNA diagnostics (24%). For manifest arrhythmic type (sustained VT) — sudden death family anamnesis (in 20%), MRI-criteria (enlarged RV with lower EF), ECG-criteria and positive DNA tests (50%). For RVAD with progressing CHF — sustained VT (50%), syncopes (37,5%), predominance of RV failure with its severely reduced EF (25,7±15,0%), major MRI-and ECG-criteria, decreased QRS-voltage and positive DNA test (38%). Comorbidity of RVAD and non-compaction myocardium differ by frequent VE, aggressive VT (57,1%), syncope (42,9%) and CHF with significantly lower than in DCMP EF LV. Mortality rate in I-IV types was, respectively, 0%, 10%, 25%, 14,3%, and relevant shocks in 8 of 13 (61,5%) patients with ICD. Conclusion. It is worthy to use the proposed RVAD classification in clinical practice to define the spectrum of diagnostical and management events and assess the individual patient prognosis.

© 2018, Bionika Media Ltd. All rights reserved. Aim. To investigate the clinical features of the course and outcomes of pregnancy and placental morphology in HIV-infected pregnant women. Material and methods. This study is a retrospective analysis of 29 pregnant women. The study group comprised 14 pregnant women with antenatal human immunodeficiency virus infection. Fifteen women with a physiological course of pregnancy made up a control group. The mean age of patients in the study and control group was 28.0 ± 2.6 and 21.1±2.3 years, respectively. The analysis included gynecological history, the course of pregnancy and childbirth, and perinatal outcomes of newborns. The morphological study of placenta included macroscopic and histological examinations, and immunohistochemical studies using antibodies targeting CCR5 receptors. Results. Pregnant women in the study group had a gynecological history of sexually transmitted infections. The most frequent complications of the second and third trimesters of pregnancy were anemia (78.6%), the threatened preterm birth (35.7%), and preeclampsia (28.6%). Complications of labor were premature rupture of membranes (35.7%) and uncoordinated uterine activity (14.3%). Placental morphology showed signs of inflammation and hypoxia. Immunohistochemical studies identified a higher expression of CCR5 in chorionic villi. Conclusion. The findings indicate increased levels of CCR5 expression and the development of chronic placental insufficiency in HIV-infected pregnant women, which indicates the need for dynamic monitoring of this group of patients.

© 2018 Informing Science Institute. All rights reserved. Aim/Purpose The present quantitative, cross-sectional study aimed to investigate objective and subjective factors in the self-determination of doctoral students in their educational activities. Objective determinants included major discipline and forms of academic and scholarly activity (that is, attending classes and writing papers), and subjective determinants included personal characteristics of the doctoral students, including dispositional autonomy and perceptions of environmental supports for students' basic psychological needs. Background The quality of students' motivation for learning has been linked with many different outcomes. Specifically, students who are more internally motivated (that is, who engage in learning activities for reasons that are personally important and freely chosen) demonstrate better performance outcomes and are more likely to choose and to persist in challenging tasks, to enjoy learning, to exhibit greater creativity, and in general to experience greater psychological well-being. Important questions remain, however, regarding the sources that affect student motivation, in particular at the level of graduate school. The present study expands on existing research by exploring contributions to students' motivation both from the students, themselves, and from supports stemming from two interpersonal contexts: close relationships and the university environment. Methodology Participating in the study were 112 doctoral students from various natural sci-ences departments of a major university in the Volga region of Russia. Self-report measures included dispositional autonomy, motivation for various types of academic and scholarly activity, and satisfaction of basic needs for autonomy, competence, and relatedness in various interpersonal contexts. Analyses includ-ed descriptive statistics, comparison of mean differences, correlation, and struc-tural equation modeling. Contribution The present study goes beyond existing research by considering both disposi-tional and situational factors that influence the motivation of doctoral students for their scholarly and academic activities, and by comparing the impact on mo-tivation of close personal relationships with that of various interpersonal con-texts in the university setting. Findings Doctoral students reported greater supports for their basic needs (for compe-tence, autonomy, and relatedness) from their close personal relationships than in their university contexts. Students felt less support for their autonomy and competence with their research supervisor than in other university settings. The early stages of a scholarly activity, such as gathering sources and analyzing mate-rials, were more likely to be characterized by external motivation, whereas the later stages, like the actual writing of a manuscript, were more likely to be inter-nally motivated. When competing for variance, need supports from university-based but not from close personal relationships were significant contributors to students internal motivation for scholarly and academic activity; this effect, however, was fully mediated through students own dispositional autonomy. Recommendations for Practitioners The present study underscores the importance of creating an environment in the university that supports doctoral students needs for autonomy, competence, and relatedness. Educators, and in particular research supervisors, should attend to the ways in which their policies and practices support versus undermine these needs, which are shown to play an important role in promoting doctoral stu-dents own internal motivation for their scholarly and academic activities. Recommendations for Researchers Although in this sample need supports from university-based interpersonal con-texts outweighed the role of need supports from close personal relationships, in terms of doctoral students scholarly and academic motivation, it seems im-portant to keep both contexts in mind, given the general importance of close relationships for motivation and other educational and well-being outcomes. As well, accounting for students own dispositional attributes, such as their own personal tendency toward autonomy, seems a critical counterpoint to looking at environmental contributions. Future Research Future research should examine whether the mediational model tested in the present study applies to other samples of doctoral students, for example, to those from other disciplines, such as the humanities, and those in other cultural or geographic locations, where it is possible that close personal relationships may contribute more substantially to students motivation than was the case in the present sample. As well, future studies would do well to include other rele-vant outcomes, such as academic grades, successful degree completion, and measures of well-being, in order to confirm previous findings of the link be-tween internal motivation and various educational outcomes.

© The Author(s) 2018. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. Vitamin B12 (B-12) deficiency is still relatively common in low-, medium-, and high-income countries, mainly because of dietary inadequacy and, to a lesser extent, malabsorption. This narrative review is based on a systematic search of evidence on methods to assess B-12 bioavailability and technologies to enhance its absorption. A total of 2523 scientific articles identified in PubMed and 1572 patents identified in Orbit Intelligence were prescreened. Among the reviewed methods, Schilling's test and/or its food-based version (using cobalamin-labeled egg yolk) were used for decades but have been discontinued, largely because they required radioactive cobalt. The qualitative CobaSorb test, based on changes in circulating holo-transcobalamin before and after B-12 administration, and the14C-labeled B-12 test for quantitative measurement of absorption of a low-dose radioactive tracer are currently the best available methods. Various forms of B-12 co-formulated with chemical enhancers (ie, salcaprozate sodium, 8-amino caprylate) or supplied via biotechnological methods (ie, microbiological techniques, plant cells expressing cobalamin binding proteins), encapsulation techniques (ie, emulsions, use of chitosan particles), and alternative routes of administration (ie, intranasal, transdermal administration) were identified as potential technologies to enhance B-12 absorption in humans. However, in most cases the evidence of absorption enhancement is limited.

© 2018, Media Sphera Publishing Group. All rights reserved. Hereditary thrombophilias (HT) and undifferentiated connective tissue dysplasia (uCTD) are important causes of female infertility. Moreover, there are signs of their common pathogenesis: a number of proteins, such as PAI-1, play an important role in the pathogenesis of both conditions, as well as in the development of infertility in patients with HT and uCTD Objective — to determine the morphological substrate and molecular mechanisms of impaired pregnancy outcomes in women with uCTD and HT. Subject and methods. A study group included 130 reproductive-aged female patients with primary infertility and a control group consisted of 11 patients (surrogate mothers). An endometrial pipelle biopsy sample was taken from each patient on days 6—8 after ovulation according to the ultrasound findings. The study group patients were divided into subgroups: 1A) infertility and HT (n=91); 1B) infertility, NT, and uCTD (n=19); 1C) infertility and uCTD (n=20). The investigators examined obstetric/gynecological history data, determined the levels of PAI-1 and homocysteine in the blood samples of patients in the subgroups with HT (1A and 1B); assessed the results of the methionine test, and identified the polymorphism or mutations of the following genes: FII, FV (Leiden), FVII, FXII, FXIII, GpIa, GpIb (-5), GpIb (T145M), GpIIIa, PAI-1, FBGb, MTHFR, MTRR, MTR, SLC19A1, angiotensin gene (M235T and T145M), angiotensin-converting enzyme, and their homo-or heterozygosity. Endometrial morphological and immunohistochemical examinations were carried out using primary antibodies to sex hormone receptors, LIF, PAI-1, and osteopontin. Results. The number of pregnancies in the study group was comparable to the number of patients in each subgroup. Childbirth was considered to be a favorable pregnancy outcome; missed miscarriage was an unfavorable one. There were the most favorable outcomes in Subgroup 1C with uCTD and the least one in Subgroup 1B. Comparison of hemostatic system indicators revealed statistically significant differences only in the incidence of disaggregated thrombopathy (88% in Group 1B and 55% in Group 1A). In the endometrium of the study group, there was delayed maturation; sclerotic foci and dyscirculatory disorders were more frequent in the stroma. Conclusion. In HT, uCTD, and, to a greater extent, its concurrence, a genetically determined predisposition to impaired implantation develops due to genetically determined endometrial remodeling that leads to infertility and impaired pregnancy outcomes.

© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The problem of devising an education quality assessment system at a medical higher educational institution has been analyzed in the article. The authors compare the views on the interpretation of the concept of “quality of education”, as well as examine the principles and criteria for the quality of education. A new approach to the internal system for assessing the quality of education at a medical higher education is offered in the article on the basis of the integration of all the components of the pedagogical system. The following components of the internal system of education quality assessment are considered: the conceptual component (forecasting, planning the strategic areas of the educational process development to achieve the quality of education, the mission and objectives), the procedural content component (monitoring at the initial and final stages of the education quality assessment), the self-analysis component (the analysis of students, teachers, department chairs’ activity); the analytical component (visualization of information obtained on the basis of transparency, informational openness of learning and upbringing results, the analysis and elimination of identified shortcomings, the introduction of advanced pedagogical experience into the educational process). Method: The study was conducted at the FSAEI HE I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University) in the period from February 2011 to March 2017. The sample group size was determined with the use of a special formula. Based on the sample size, 450 respondents were included in the study, and the number of people who would drop out was determined in the sample (n = 429), so the sample was representative in terms of quality and quantity. The students from 1 to 6 years were involved in the study in five training programs of the university who were randomly selected. An original questionnaire was devised. The questionnaire contained some standard questions and special questions on the research topic. Results: The main contingent of students is satisfied with the quality of education at Sechenov University and the level assessment of the quality of education is higher in comparison to other universities, but among the final-year students the assessment of the quality of education compared with other universities does not differ significantly. To attract applicants to FSAEI HE I.M. Sechenov First Moscow State Medical University the significant factors were: preserving a good reputation of the university (64.7%), prestige (53%) and the quality of education (50.7%). The most popular competencies among students of all the faculties and courses were the following: willingness to work with modern medical equipment (45% ± 2,3%), knowledge of innovative medical technologies (31,9% ± 2,2%). Almost every second student (55% ± 2.3%) believes that the quality of education at Sechenov University corresponds to the requirements of the current labor market. Conclusion: The conclusion has been drawn on the basis of the conducted research, that the internal system of assessing the quality of education is directed to increasing prestige of Russian higher medical education, its integration into the international educational space.

© 2018 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All Rights Reserved. Academician of the Russian Academy of Sciences, Professor, Doctor of Science (Med) Vladimir Petrovich Sergiev is a famous scientist who made a significant contribution to the Russian epidemiology and parasitology. After graduating from the Sechenov First Moscow medical institute in 1966, he worked at the Martsinovsky Institute of medical parasitology and tropical medicine (Moscow), where he defended his thesis on the created vaccines against zoonotic cutaneous leishmaniasis. In 1974 he was transferred to the Ministry of health of the USSR by the head of the main Department of quarantine infections. In 1988 he was appointed Director оf the Martsinovsky Institute of medical parasitology and tropical medicine, since 2002 he is head of the Chair of tropical medicine and parasitic diseases of Sechenov University. He combines educational work with research activities to study the problems of epidemiology of helminthiasis and tropical diseases, their prevention, as well as medical geography and molecular parasitology. Professor Sergiev is the author of 15 monographs and manuals, more than 400 scientific publications, Editor-in-Chief of the journal «Medical Parasitology and Parasitic Diseases», consultant of the World Health Organization on malaria and leishmaniasеs. Under his leadership, 5 doctoral and 7 masters theses were defended.

© 2018 Ima-Press Publishing House. All right reserved. Objective: to analyze the levels of CD3+, CD3+CD4+, CD3+CD8+, and CD3-CD56+ T lymphocytes, FoxP3+ regulatory T cells (Treg), and CD19+ B lymphocytes in patients with early and advanced rheumatoid arthritis (RA). Subjects and methods. The investigation enrolled 45 patients previously untreated with methotrexate (MTX-naive) who had early RA and 15 patients who had advanced RA. Immunofluorescence staining and multicolor flow cytome-try assays were used to estimate the percentage and absolute (abs) counts of CD3+, CD3+CD4+, CD3+CD8+, CD3-CD16+CD56+, CD19+, Treg (FoxP3+CD25+; surface CD152+; intracellular CD152+; FoxP3+CD127; CD25+CD127-; FoxP3+ICOS+; FoxP3+CD154+; and FoxP3+CD274+. Results and discussion. The patients with early RA were found to have a lower percentage of FoxP3+CD25+ cells and lower percentages and abs counts of FoxP3+ ICOS+ cells, FoxP3+CD154+ cells, and FoxP3+ CD274+ T cells than healthy donors (p0.05 in all cases). The patients with advanced RA were also recorded to have a lower percentage of FoxP3+CD25+ cells and lower percentages and abs contents of FoxP3+ ICOS+ cells, FoxP3+CD154+ cells, and FoxP3+ CD274+ T cells (p0.05 in all cases). The patients with advanced RA compared to those with early RA had a higher content of CD4+ lymphocytes (50.7 [44.4; 53.1] and 45.0 [38.0; 49.2]) and lower percentages of CD25+CD127- T lymphocytes (5.0 [4.0; 5.7] and 6.5 [5.1; 7.9] respectively; p0.05 in all cases). Conclusion. Patients with RA (with the early or advanced stage of the disease) show a decrease in both the counts and functional activity of Treg. The patients with advanced RA compared with those with early RA showed an increase in CD4+ lymphocyte counts and a decrease in CD25+CD127- cell levels, which suggests that there are more pronounced impairments in Treg homeostasis in advanced RA.

© 2018 Ima-Press Publishing House. All right reserved. The response rate to therapy for rheumatoid arthritis (RA) rarely exceeds 60%. Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) substantially affect the evaluation of the efficiency of RA therapy. Adequate psychopharmacotherapy is one of the possible approaches to optimizing the treatment of RA. The factors influencing the efficiency of RA therapy with standard disease-modifying antirheumatic drugs (DMARDs) and biological agents (BAs) in combination with adequate psychopharmacotherapy have not been previously identified. Objective: to determine the predictors of response to therapy in patients with RA receiving DMARDs and BAs with or without adequate psychopharmacotherapy for ADS disorders. Subjects and methods. The investigation included 128 patients (13% men and 87% women) with a reliable diagnosis of RA. At baseline, 75.1% of patients received DMARDs; 7.8% - BAs. ADS disorders were detected in 123 (96.1%) patients. Psychopharmacotherapy was offered to all the patients with MDs; 52 patients agreed to treatment and 71 refused. The following therapeutic groups were identified according to the performed therapy: 1) DMARDs (n = 39); 2) DMARDs + psychopharmacotherapy (n = 43); 3) DMARDs + BAs (n = 32); 4) DMARDs + BAs + psychopharmacotherapy (n = 9). The changes of MDs symptoms and the outcomes of RA were assessed in 83 (67.5%) patients at five-year follow-up. The efficiency of RA therapy was evaluated with DAS28 (EULAR criteria). Predictors of response to therapy were determined using linear regression modeling. Results and discussion. At 5 years, 22 (26.5%) and 37 (44.6%) patients were recorded to show good and moderate responses to therapy, respectively; 24 (28.9%) patients were non-respondents. The linear regression model included 14 factors (p<0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p<0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response.

© 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, Slovak Academy of Sciences. All rights reserved. The therapeutic use of cisplatin for the treatment of solid tumours is associated with organ toxicity. Amongst those, the cardiotoxicity is an occasional but very serious and severe side effect. To prevent or reduce these negative effects, many cisplatin analogues have been synthesized and evaluated in terms of being a less toxic and more effective agent. In present study, we examined the effects of cisplatin and its three analogues in the isolated rat heart to determine whether changes in the structure of the platinum complexes (changing of carrier ligands – ethylenediamine; 1,2-diaminocyclohexane; 2,2’:6’,2’’-terpyridine) can influence their cardiotoxic effects. The results of our research indicate that the introduction of aromatic rings in the structure of the platinum complexes has a negative influence on the heart function. Conversely, the other two examined complexes had less negative effects on heart function compared to cisplatin. Our findings may be of interest for a possible synthetic strategy of introducing a carrier ligand that will exert a less cardiotoxic effect.

© 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 Media Sphera Publishing Group. All rights reserved. This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF. Analysis of literature showed greater efficacy and safety of drugs from the group of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC), rivaroxaban in particular, in comparison with warfarin. Drugs from the NOAC group can be recommended for prevention stroke, cognitive impairment and dementia in elderly patients with AF.

© 2018, Canadian Science Publishing. All rights reserved. Homocysteine, an amino acid containing a sulfhydryl group, is an intermediate product during metabolism of the amino acids methionine and cysteine. Hyperhomocysteinemia is used as a predictive risk factor for cardiovascular disorders, the stroke progression, screening for inborn errors of methionine metabolism, and as a supplementary test for vitamin B12 deficiency. Two organic systems in which homocysteine has the most harmful effects are the cardiovascular and nervous system. The adverse effects of homocysteine are achieved by the action of several different mechanisms, such as overactivation of N-methyl-D-aspartate receptors, activation of Toll-like receptor 4, disturbance in Ca2+ handling, increased activity of nicotinamide adenine dinucleotide phosphate-oxidase and subsequent increase of production of reactive oxygen species, increased activity of nitric oxide synthase and nitric oxide synthase uncoupling and consequent impairment in nitric oxide and reactive oxygen species synthesis. Increased production of reactive species during hyperhomocysteinemia is related with increased expression of several proinflammatory cytokines, including IL-1α, IL-6, TNF-α, MCP-1, and intracellular adhesion molecule-1. All these mechanisms contribute to the emergence of diseases like atherosclerosis and related complications such as myocardial infarction, stroke, aortic aneurysm, as well as Alzheimer disease and epilepsy. This review provides evidence that supports the causal role for hyperhomocysteinemia in the development of cardiovascular disease and nervous system disorders.

© 2018 Stefania Leuci et al. Mucous membrane pemphigoid (MMP) is a heterogeneous group of rare, systemic, autoimmune subepidermal inflammatory disease that affects mucous membranes and the eye. In its most severe forms, this disease needs systemic therapy, usually based on steroids and immunosuppressant agents. In unresponsive cases or in the presence of contraindications or severe side effects due to conventional systemic corticosteroid and/or immunosuppressant therapy, a therapy shift to high-dose intravenous immunoglobulins (IVIg) has been recommended in other reports. This new therapy has proven to be effective in stopping ocular pemphigoid, but the data regarding the long-term effect on the disease activity or reactivation are extremely scarce, so the novel scientific aim of this study was to evaluate the clinical outcomes after a 9-year follow-up in 12 eyes (6 patients) affected by MMP with ocular involvement, successfully treated with IVIg therapy, as previously described in our report published in 2008. The evaluation of ocular and extraocular disease progression was performed at the end of IVIg therapy and at the end of the follow-up period. After 9 years, all the eyes enrolled showed a long-lasting remission of ocular and oral symptoms with a significant steroid-sparing effect. In conclusion, the IVIg has to be considered as a safe and successful alternative therapy in patients with severe ocular mucous membrane pemphigoid; furthermore, this kind of therapy seems to be effective in maintaining the clinical remission by the time.