Репозиторий Университета

© 2019, Privolzhsky Research Medical University. All rights reserved. The aim of the study was to assess the efficiency of the method for registration of video fluorescence of 5-ALA-induced protoporphyrin IX in stomach and esophagus diseases, to adapt it for clinical conditions, i.e. for conducting differential diagnosis and detecting precancer conditions, and to formulate recommendations on the best photosensitizer doses and time of application in order to make the diagnostic procedure for these diseases more accurate. Materials and Methods. Registration of fluorescence for diagnostic purposes was performed on 57 patients with gastropathology (mainly with stomach cancer) with the help of single-channel (n=50) and dual-channel (n=7) laser video fluorescence registration systems. The study was performed using 5-aminolevulinic acid (5-ALA) (Alasens). 39 endoscopic, 18 intraoperative/laparoscopic investigations, and 7 studies on the macropreparation have been performed. Results. When both systems were used, no fluorescence was registered in cases of stomach ulcer, chronic gastritis, massive tumor necrosis and blood admixture in the stomach as well as in the patient with subcompensated stenosis and a stented output section of the stomach without serous membrane invasion and low 5-ALA concentration. In all other cases, a distinct fluorescence was recorded, the data of which may be used for establishing exact diagnosis and choosing further treatment tactics. Conclusion. Laser video fluorescence technique is a promising method for differential diagnosing and definition of the tumor extension process in the stomach and esophagus which can be used as an express method in diagnostically complex cases.

© 2018 Izdatel'stvo Meditsina. All rights reserved. BACKGROUND: Alcohol dependence is often combined with affective disorders, in particular, depressive disorder (DD), which worsens adversely affects the prognosis of the course of both diseases and their outcomes. For the treatment of DD, drugs from the group of selective serotonin reuptake inhibitors, whose representative is fluvoxamine, are used. Fluvoxamine therapy is often associated with a risk of development is shown to be ineffective, and a part of patients develop dose-dependent adverse drug reactions (ADR) and pharmacoresistance. OBJECTIVE: To study the effects of CYPD6 isoenzyme activity on the efficacy and safety of fluvoxamine therapy in patients with depressive disorders, comorbid with alcoholism. METHODS: The study was conducted on 117 Russian patients with DD, alcohol-dependent comorbid. For the purpose of correction of depressive disorders within the framework of cyclothymia, fluvoxamine (Fevarin) was administered to patients at a dosage of 50−150 mg/day. Genotyping was carried out by the method of polymerase chain reaction in Real-time mode with allele-specific hybridization. Efficacy and safety were assessed using validated psychometric scales and an assessment of the severity of ADR. To evaluate the activity of CYP2D6, the method of high performance liquid chromatography with mass spectrometry was used to measure the urinary content of the endogenous substrate of this isoenzyme and its metabolite, the ratio of 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline. RESULTS: By the 9th day of the study, the severity of depressive symptoms on the HAMD scale was statistically significantly different in patients with different genotypes: (GG) 7.0 [6.0; 8.0], (GA) 4.0 [3.0; 5.0] (p<0.001); safety indicator, estimated on a UKU scale: 3.0 [2.0; 4.0], (GA) 4.0 [4.0; 4.2] (p<0.001). The presence of differences persisted on the 16th day: (GG) 5.0 [3.0; 6.0], (GA) 1.5 [1.0; 3.0] (p<0.001); safety indicator, estimated on a UKU scale: (GG) 9.0 [9.0; 10.0], (GA) 6.0 [6.0; 7.0] (p<0.001). The calculation of the correlation coefficients between the difference in the number of scores on psychometric scales and the metabolic ratio showed a statistically significant inverse correlation of the average power degree between the efficiency index estimated by the HAMD scale (r=-0.467, p<0.05). There was no connection with the difference on the UKU scale (r=0.173, p>0.05). CONCLUSION: In a study of a group of 117 patients with DD, comorbid with alcohol dependence, the effect of CYP2D6 activity, estimated by the ratio of the endogenous substrate concentrations of pinolin and its metabolite 6-hydroxy-1,2,3,4-tetrahydro-beta-carboline, on the efficacy of fluvoxamine therapy. This effect was also shown using the results of genotyping. The results of genotyping also showed the existence of a difference in the safety index in patients with different genotypes from the polymorphic marker CYP2D6 1846G>A.

As a result of the studies carried out on 20 extracted frontal teeth it was reliably shown that after 10 minutes the concentration of the photosensitizer in enamel at full depth reached values sufficient for performing photodynamic teeth whitening. At the same time, the penetration of the photosensitizer into the deep layers of dentin was not detected which allows to carry out the photodynamic bleaching procedure only within the enamel and enamel-dentine boundary, thus not affecting the pulp of the tooth.

© 2018, Pediatria Ltd.. All rights reserved.  Objective of the research – to reveal the correlation between neurochemical criteria in the neonatal period and the consequences of severe hypoxic hemorrhagic CNS lesions in children according to catamnesis data. Materials and methods: researchers analyzed 54 cases of newborns of different gestational age (GA) that were in the ICU after birth due to severe condition; all newborns had combined hypoxic hemorrhagic brain lesion detected by neurosonography – periventricular leukomalacia (PVL) and intraventricular hemorrhage (IVH) of various severity. Catamnesis follow-up was performed up to 2–2,5 years of age. The control group consisted of 20 newborns, comparable in GA, body weight at birth, with an Apgar score of at least 6 points in the 1st minute of life and without changes in neurosonography. In the neonatal period, serum concentrations of S100, BDNF, VEGF, ALCAM, DR5 were studied in dynamics using the quantitative ELISA (Enzyme Linked Immuno Sorbent Assay) according to a standard protocol. Results: the concentration of factors contributing to destructive changes in tissues (S100, DR5, ALCAM) in the serum, was in inverse correlation with the level of VEGF and BDNF. The latter had a direct correlation relationship. VEGF directly correlated with CNTF by the end of the 2 nd week of life. Results of catamnesis follow-up: 43 children diagnosed with cerebral palsy, 25 with spastic diplegia, 18 with spastic tetraparesis, and 11 without evident motor disorders. In 28 children I–III level of motor disorders was determined according to GMFS, in 26 children – IV–V level. At the age of 2 years, all children underwent MRI of the brain and gliio-atrophic changes were detected. Significant differences in the implementation of neurological consequences were found between the number of children with grade I and II IVH and PVL and III–IV degree IVH and PVL. Conclusion: children with PVL and IVH III–IV degree have a high risk of severe neurological outcomes – spastic tetraparesis, impaired motor activity by GMFS IV–V level, mental retardation and symptomatic epilepsy.

AIM: To determine optimal treatment strategy for acute malignant colonic obstruction. MATERIAL AND METHODS: 349 patients with acute malignant colonic obstruction were retrospectively analyzed for the period 2005-2017. All patients were divided into two groups depending on surgical approach. Surgical group comprised 259 patients, endoscopic group - 90 patients. Both groups were comparable by gender, age, level of intestinal obstruction and duration of the disease. However, morbidity and mortality rate were significantly different. RESULTS: In surgical group incidence of complications was 63.3%, mortality - 19.7%. In group of endoscopic stenting the same values were 8.9% and 6.7%, respectively. Significant differences of morbidity and mortality were observed between groups (p<0.05). CONCLUSION: Endoscopic stenting should be preferred over surgery to eliminate colonic obstruction in patients with acute malignant ileus.

© 2018, Bionika Media Ltd.. All rights reserved. Objective. To improve cervical cancer screening programs via clinical introduction of a diagnostic vaginal swab self-sampling test for the detection of high-risk human papillomavirus (hrHPV). Subjects and methods. A total of 455 residents of the Lipetsk Region were examined; vaginal swabs tested for HPV were taken both independently by a woman with a Qvintip device and by a gynecologist with a universal urogenital probe. The women were asked whether it was convenient for them to self-collect a vaginal swab. Results. In the surveyed sample of 455 women, there were 35 (7.7%) cases of hrHPV identified on the swabs collected by the Qvintip and 38 (8.4%) women with hrHPV detected on those taken by the physician, out of them 26 (68.5%) women had atypical squamous cells of undetermined significance. 70.3% of women preferred the Qvintip self-sampling method. Conclusion. The Qvintip self-sampling method for hrHPV testing shows high diagnostic efficiency, simplicity, and ease-to-use. The method may be recommended for the detection of hrHPV to increase cervical cancer screening coverage.

© 2018, Bionika Media Ltd.. All rights reserved. Objective. To investigate the relationship of the levels of preactivated (primed) neutrophils in the peripheral blood of pregnant women with preeclampsia. Subjects and methods. The investigation enrolled 14 women with preeclampsia (a study group, Group 1), 15 women with physiological pregnancy (a control group, Group 2), and 11 non-pregnant women (to obtain normative values). Formyl peptide, Ficoll-Hypaque (1.077 and 1.119 g/ml) gradients, lucigenin, Roswell Park Memorial Institute (RPMI) 1640 medium, Hanks medium, and fetal calf serum (Sigma-Aldrich) were determined in the peripheral blood. Neutrophils were isolated from the blood samples obtained from the ulnar vein (the anticoagulant heparin 35 IU/ml) using a two-step Ficoll-Hypaque gradient. Red blood cells were destroyed by hypotonic lysis. Neutrophils in the suspensions were at least 96%. The live cells tested with trypan blue were 94%. Suspensions containing 1×106 сells/ml were prepared. Formyl-methionyl-leucyl-phenylalanine (fMLP, 2 µM) was used as a stimulant. The formation of oxygen radicals was recorded in imp/sec, by using the luminophor lucigenin (30 µM) on a Biotox-7 chemiluminometer (Russia). The maximum radical formation amplitude, the time of its achievement, and the light sum were determined for a fixed time period. Results. The cell suspensions from non-pregnant women showed a monotonic spontaneous increase in oxygen radical formation at a very low rate. The rate increased by 1.3 times in healthy pregnant women (p > 0.05). The rate of spontaneous oxygen radical generation rose sharply in pregnant women with preeclampsia. In this group, the formation of oxygen radicals reached maximum values and plateaued at 24±7 min. The spontaneous radical formation might be due to the stimulation of initially primed neutrophils as a result of their adhesion on the cell walls. To test this assumption, the standard stimulant fMLP that strongly stimulates the neutrophil generation of oxygen radicals were added to the suspensions from the women with preeclampsia. It should be noted that in both non-pregnant women and healthy pregnant women, fMLP significantly increased the level of radicals compared to the responses of neutrophils in women with preeclampsia. Conclusion. The potentiated response to formyl peptide due to spontaneous neutrophil stimulation in pregnant women with preeclampsia suggests that their peripheral blood contain primed cells. This total response may suggest that the mechanism of stimulation of neutrophils due to their adhesion on the cell wall and to fMLP stimulation is different, additive in nature, and is carried out by different processes.

© 2018, Bionika Media Ltd.. All rights reserved. The authors have established a relationship between intraepithelial cervical lesions and vaginal biocenotic disorders in pregnant women with human papillomavirus (HPV) infection and determined their management tactics. The HPV–positive pregnant women have a high incidence of vaginal dysbiosis (38.7%) that is, in most of them, characterized by co–infection (65%), mainly by anaerobic and aerobic infections (44.1%). High-rate HPV in the pregnant women is associated with bacterial vaginosis, mixed dysbiosis, and their recurrences and with the frequency of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) in the presence of an inflammatory response. Restoring the normal microflora contributes to the disappearance of the inflammatory response and to the reduction of ASCUS. Therapy for dysbiosis does not change the rate of LSIL at 3-month follow-up.

© Allerton Press, Inc., 2018. A technique of extracting cotinine in urine and wastewaters, followed by its quantitative determination, using high performance liquid chromatography combined with tandem mass-spectrometric detection is presented. The method is characterized by low detection limits and high levels of efficiency and sensitivity. The optimal conditions for the solid-phase extraction of cotinine from urine and wastewaters are found. This technique makes it possible to reliably estimate the content of cotinine in the urine of active and passive smokers and in wastewaters.

© 2018 The Royal Society of Chemistry. Since the commercialization of white light-emitting diodes (WLEDs) in 1996, they are rapidly replacing conventional lighting sources and have become an essential commodity for day-to-day human life. At present, most of the WLEDs existing in the market are rare-earth based, which are very limited, expensive and often not available due to monopolistic supply conditions. Hence, there is a serious demand for novel rare-earth free phosphors to achieve cost-effective and energy-efficient WLEDs with excellent luminous efficacy for general illumination. Herein we report on highly efficient rare-earth free Cs(1-x)RbxVO3 phosphors as a single emitting compound for near UV-based WLEDs manufactured by the citrate sol-gel method for the first time. Rietveld refinement is performed for the X-ray diffraction patterns of the CsVO3 host and CsVO3:0.25Rb phosphors to reveal their orthorhombic pyroxene structure. The difference in the ionic radii of Rb+ and Cs+ ions led to a more distorted VO43- tetrahedron with a broken Td symmetry, which allows spin forbidden transitions for CsVO3:0.25Rb phosphors, resulting in enhanced internal and external quantum efficiencies of 94.7% and 84.5% along with superior luminescence properties compared to the CsVO3 host. When varying the input current from 20 to 200 mA, the fabricated WLED exhibited a good color rendering index of 69.7-81.5 and an extremely high luminous efficacy of 94.8-58.7 lm W-1, which are among the highest values for the same host lattice. These rare-earth free CsVO3:0.25Rb phosphors with a single emitting center may emerge as a new class of advanced inorganic phosphors for near UV-based WLEDs in the lighting industries.

© 2018 Media Sphera Publishing Group.All Rights Reserved. The article describes the clinical observation with an unfavorable outcome of the generalized form of salmonella infection caused by Salmonella typhimurium group B in a woman of 60 years without immunodeficiency, complicated by the development of multiple abscesses of the lower parts of abdominal cavity, probably of appendicular origin. In a short literary review, the pathogenetic mechanisms that contribute to the formation of generalized and extraintestinal forms of salmonella infection are discussed.

© 2018, Dynasty Publishing House. All rights reserved. The article reviews scientific literature, current recommendations dealing with the topical problems of the incidence and methods of diagnosing H. pylori infection, including among the pediatric population. The authors of the article pay attention to different figures of the global prevalence of H. pylori, to the dependence of infection on many factors, among them low socio-economic status and educational levels, overpopulation, pollution of sources of drinking water. Based on the principles of evidence-based medicine, the article analyses the level of sensitivity and specificity of the main methods of identification of H. pylori, emphasizes that the sensitivity of serological diagnostic method does not depend on factors decreasing bacterial load, such as intake of proton-pump inhibitors (PPIs), antibiotics, bismuth preparations, and also on gastric haemorrhage and gastric metaplasia. The serological diagnostic method in pediatrics remains attractive due to its non-invasiveness and low cost. But the problem of looking for highly informative and non-invasive methods of diagnosing H. pylori infection remains topical and needs further research.

© Bionika Media Ltd. The article presents an explanation of the relevance of using regimens incorporating highly effective antimycotics in modern society, which is dictated by the lifestyle of large cities and the modern generation. After the symptoms of the disease disappear, many patients discontinue a prescribed drug treatment regimen on their own, interrupting the full cycle, which can lead to recurrences and unresponsiveness to treatment in the future.

© Bionika Media Ltd. Antiphospholipid syndrome (APS) is a systemic process that affects all organs and tissues of the body and diagnosed upon fulfilment of clinical and biological criteria. The currently accepted clinical morbidities affect two organs: the vascular tree, leading to thrombotic manifestations, and the utero-placental unit, leading to pregnancy complications. Obstetric APS (oAPS) is an autoimmune disease leading to the synthesis of autoantibodies directly capable of activating key cells of vascular and/or placental pathophysiology. During pregnancy, placenta serves as the most important organ. Violations of the placenta function due to endothelial dysfunction, ischemia, and placenta microthrombosis are responsible for the development of obstetric complications: pre-eclampsia, HELLP-syndrome, placental abruption.This manuscript describes a data of a different clinical experience in the field of APS. APA directly or indirectly affects the implantation process and early embryonic stages. The thorough systematic review on histopathology in the placenta of oAPS women found, on the sincytiotrophoblast (sTB) side, a decreased trophoblast (TB) proliferation, increased TB death rates, a decreased syncytialisation process, an increased sTB death rate with increased cell debris, and areas of sTB denudation and of fibrin deposition. Experimental in vitro data confirmed that ab2GP1 Abs decrease fusion of TB cells, thus inhibiting sTB formation. Reduced eTB invasion was associated with decreased placenta anchorage, reduced transformation of maternal spiral arteries and reduced maternal flow to the placenta, mirroring the conditions in placenta-mediated late pregnancy complications such as preeclampsia.Our studies and over 20 years of clinical experience indicate the presence of etiopathogenetic relation between APS and obstetric complications and the high efficacy of prophylaxis with anticoagulants when it starts early, since the period of preconception.

© 2018 The Author(s). The rapid development of graphics processing units (GPU) allowed to use in practice resource-intensive methods of artificial intelligence such as neural networkS. At present, the authors got preliminary results on detection of some forms of leukocyteS. The article presents the first results of the work.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Arterial hypertension is associated with elevated risk of cognition decline and vascular dementia development, as the Alzheimer disease development. Therefore, antihypertension therapy might be of preventive value. The review is focused on literary data that witness on, despite controversial, evidence of cerebroprotective action of the range of antihypertension medications. Especially, dihydropyridine calcium antagonists, diuretics and some blockers of reninangiotensin-aldosterone system. These act not only via blood pressure decrease, but due to additional specific neuroprotective mechanisms. This makes it to consider calcium antagonists and diuretics as a major component of systemic hypertension management, incl. Elderly and senile patients, aiming to prevent cognition decline and dementia of various types development. Nitrendipine, among the calcium channels antagonists, and indapamide among diuretics have acquired the broadest evidence that points on their cerebroprotective properties.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To analyze the data available in the modern scientific medical literature on contemporary aspects of the diagnosis, staging and differential treatment tactics in patients with epithelial ovarian cancer. Materials and methods: Research method used in this article is the systematic analysis of the medical literature, including Pubmed and ClinicalTrials.gov. Results: This article attempts to summarize the worldwide experience of modern medicine in management of epithelial ovarian cancer. The current version of the ovarian cancer classification is described. The possibilities of imaging techniques and their place in the staging are determined. The accurate criteria for tumor resectability assessment and the main treatment tactics are given in details. The possibilities of imaging methods in treatment control and monitoring treatment response are provided. The leading imaging modalities for recurrent disease evaluation are delineated. Conclusion: Ovarian cancer is a serious diagnostic challenge in terms of differential diagnosis, staging and selection of optimal treatment strategy. Proper use of visualization modalities allows better management of primary and recurrent ovarian cancer. Moreover, it is necessary to conduct further investigations aimed at developing well-defined diagnostic protocols in monitoring during treatment in order to obtain response evaluation with minimal time delay.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: Demonstration of various radiological methods possibilities in diagnosis, evaluation of the lung resection volume, planning of thoracoplasty and efficacy monitoring of the surgical treatment of destructive pulmonary multi-drug resistant (MDR) tuberculosis (TB). Results: Plain chest film revealed a widespread pulmonary tuberculosis inflammation. With CT application, the nature and prevalence of pulmonary parenchymal involvement was clarified, indications and volume of complex surgical intervention were determined, and surgical treatment efficacy was controlled. Digital tomosynthesis application determined the state of the lung tissue after resection and the volume of the planned postponed thoracoplasty. Discussion: Taking into account the incidence of pulmonary tuberculosis in our country, the similarity of its clinical and radiological picture with a number of other pathological processes, as well as the polymorphism of alterations, it is necessary to know the pathomorphological, clinical and radiological manifestations of this disorder. A reliable assessment of the respiratory organs state according to the radiography data has objective limits due to the presence of a cumulative effect and other factors. So, CT is the priority method in diagnosis, evaluation of lung resection volume, planning of thoracoplasty, and monitoring of surgical treatment efficacy. Due to layer-by-layer visualization, the method of digital tomosynthesis makes it possible to obtain additional information, in comparison with radiographic data, in pulmonary parenchyma state assessment at pre- and postoperative stages, which indicates the prospects of its application in solving this tasks. Conclusion: Due to modern radiological methods in the study of respiratory organs TB, the question of the expediency of surgical treatment or refusal in favor of conservative therapy is solved, which is of particular relevance in patients with MDR TB. Accurate determination of lung resection and thoracoplasty volume significantly reduces the risk of postoperative complications, which contributes to improving the quality of life of the patient. A correct control of respiratory TB surgical treatment efficacy with CT application allows estimating the state of the zone of interest, and timely reveal the relapse of a specific process.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To investigate the prevalence of anatomic and pathologic findings in the maxillary sinus detected through cone-beam computed tomography (CBCT) in the routine of Stomatology. Materials and methods: The sample consisted of 954 CBCT scans from male (n: 330) and female (n: 624) patients aged between 2 and 86 years (mean age: 33 years). CBCT scans were taken from each patient for dental and maxillofacial diagnosis and treatment planning. The iCAT CBCT device and the inherent VisionQ software package (Imaging Science International, Hatfield, PA, USA) were used. X2 test was used to associate the anatomic and pathologic findings with patients' sex and age. Results: In both males and females, the most prevalent anatomic and pathologic findings in the maxillary sinus were, respectively, the sinus septa (21.2%) and thickening of the sinus mucosa (62.3%). Higher prevalence of maxillary sinus findings were detected within patients in the age range from 12 and 18 years (p<0.05). CBCT exams showed a high prevalence of anatomic and pathologic findings in the maxillary sinus that may have a significant clinical relevance. Conclusions: Stomatologists, Maxillofacial Surgeons and Physicians must properly interpret CBCT exams and must be aware of the occurrence of anatomic and pathologic findings prior to procedures that involve the maxillary sinus.

© 2018, Media Sphera Publishing Group. All rights reserved. Delayed facial palsy is a complication developing 3 or more days after surgery. The etiology and pathogenesis of this condition has not been fully explored, and there are no treatment standards for it. As in the case of Bell’s paralysis, glucocorticosteroids (GCSs) are currently used to treat delayed facial palsy. However, patients with contraindications to GCSs need new therapy modalities. Aim - we aimed to evaluate the efficacy and safety of botulinum therapy in patients with delayed facial palsy after neurosurgical interventions. Material and methods. We examined 33 patients with delayed facial palsy developed 3 or more days after resection of vestibular schwannoma. The main group included 18 patients with contraindications to GCSs who received injections of botulinum toxin A (BTA) into the facial muscles of the healthy side for muscle relaxation. The comparison group consisted of 15 patients who received a course of prednisolone (1 mg/kg/day) for 5-7 days. The efficacy of treatment was assessed using the House-Brackmann scale and Clinical Global Impression Scale. The follow-up period after therapy was 3 months. Results. Delayed facial palsy was more common in the following cases: the facial nerve was located near the antero-inferior tumor pole; the tumor was adherent to the facial nerve; the tumor extended in the oral direction; the tumor had with unclear borders and was 11 to 30 mm in size. In most patients of both groups, facial muscle palsy developed more than 11 days after surgery. Treatment both in the main and control groups resulted in a significant improvement: complete regression of the facial asymmetry in patients of the main group and comparison groups 3 months after treatment onset was 83.3 and 93.3% (House-Brackmann scale), respectively. Conclusion. Botulinum therapy may be recommended for patients with delayed facial palsy developed after vestibular schwannoma resection, who have contraindications to GCSs.