Репозиторий Университета

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

© 2018 Stolichnaya Izdatelskaya Kompaniya. All rights reserved. The key to successful treatment in patients with acute coronary syndrome is maximally early revascularization of the coronary arteries. Treatment of multifocal atherosclerosis with lesions of the coronary and peripheral arteries requires coordinated work of the multidisciplinary team of doctors. Critical ischemia of the lower limbs requires urgent revascularization in order to prevent limb amputation. However, it is not always possible to perform revascularization using specialists of the same profile – endovascular or surgical. The use of hybrid methods of treatment (surgical and endovascular) allows to significantly improve the prognosis in saving the limb. The article presents a clinical observation of successful multistep treatment of a patient with acute coronary syndrome in combination with critical ischemia of the lower limb. The first stage was performed by multiple stenting of the coronary arteries with bioabsorptive scaffolds; the second stage was the hybrid treatment – femoral-tibial bypass with simultaneous recanalization and angioplasty of the lower leg arteries with good postoperative and long-term outcome.

© 2018 Izdatel'stvo Meditsina. All rights reserved. Results of studying the comparative bioavailability of pharmaceutical preparations - alternative analogs of endogenous compounds containing calcium and colecalciferol are presented. The drug concentrations were recalculated with allowance for the endogenous calcium level, in accordance with the relevant normative guidelines. The standard methodology of bioequivalence studies can be used to evaluate the quality of reproduced calcium preparations, taking into account low values of intra-individual variability of pharmacokinetic parameters.

© 2018 Russian Academy of Sciences. Wide circulation of HIV-infection/AIDS is a socially important problem for the majority of the countries of the world now. Against the background of the remaining high rates of infection spread beyond the borders of risk groups, a series of the negative phenomena aggravating an epidemiological situation on HIV-infection and other socially important diseases is observed (tuberculosis, hepatitises, etc.): depression of the general indicators of health of the population, urbanization, complicating of life rhythm, wide circulation of dependences on psychoactive agents, and, above all - serious transformation of institute of family, liberalization of sex behavior, of traditional family values. Now in representations of Russians the typical HIV-positive-a young childless and single man regardless of sexual orientation who is living in the large city, having an average special educations or being in process of its receiving whith level of income comparable to average one. The HIV-positive has been Infected as a result of a youth error (unprotected sexual contact or the intravenous use of drugs) and lives with this diagnosis several years, leads a risk-free life more often, at the same time usually hiding the diagnosis and separated from social communications. Existence of this diagnosis involves social trouble and the social not approved behavior, but if the disease affects the loved one, many Russians are potentially ready to give moral and psychological support (56%), financial support (including in purchase of drugs), the help in search of necessary experts and visit of the medical organizations (6,9%) and also to care for the HIV infected and their children (6%). According to authors, the widespread negative perception of people with "HIV-infection" diagnosis is in many respects caused by insufficient informing the population on HIV-infection/AIDS problems.

© 2018 Maik Nauka-Interperiodica Publishing. All rights reserved. Changes in the power and coherence of the EEG theta-1 (4-6 Hz) and theta-2 (6-8 Hz) activity were studied in subjects (31 males, 18-21 years old) with different performance levels in logical tasks. EEG was recorded to the International 10-20 System from the occipital (O2, O1), parietal (PA, P3), central (C4, C3), frontal (FA, F3), and temporal (T4, 73) leads. The achievement of better performance during the tests based on logical reasoning positively correlated with higher spectral power of theta-1 band potentials in the left cortical areas. The theta-1 band potential power increased during testing and compared to the previous period in the left occipital, parietal, central and temporal cortical areas. The simultaneous increasing in intrahemispheric coherence of theta-1 band potentials was observed in the left frontal and central areas, as well as in the left frontal and parietal cortical areas. The spectral power of theta-2 band potentials decreased during testing and compared to the previous period in the right central frontal and temporal cortical areas. The inter- and intrahemispheric coherence of the EEG theta-2 band potentials decreased during testing in the system of relationships with the focus in the left and right occipital and right parietal cortical areas. The desynchronization in the EEG theta 2 band in all cortical areas was observed at transition from a state of quiet wakefulness with eyes closed to a state with eyes open. The conclusion is made about the different functional significance of the electrical activity of the low and high frequency theta EEG bands under cognitive activity.

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

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To test the main hypothesis that the deficit phenomena in schizophrenia act not in the «pure» form, but in the form of aggravating personality characteristics, forming so-called «common» syndromes with personality disorders (PD). Material and methods. The results of the psychopathological study (with the use of psychometric methods) of deficit disorders in a sample of 170 patients with schizophrenia and schizophrenia spectrum disorders (63 men, 107 women) are presented in relation to the abnormal structure of premorbid personality (PD of clusters A, B, C). An analysis of negative symptoms according to the comparability of defect to the profile of premorbid personality made it possible to distinguish three groups of deficit states associated with PD - «common syndromes»: defensive schizoidy by the type of deficit schizoid and expansive schizoidy by the type of «verschroben» (cluster A); pathological hysterical infantilism, malignant hysteria and defective erotomania (cluster B); pseudo-psychasthenia and pathological rationalism (cluster C). Results. It has been found that the symptomatology of «common syndromes» is subject to patterns reflecting the dichotomy of the basic defect. This pattern is valid not only for one single cluster of PD, but extends to all psychopathy- like disorders, regardless of their affiliation with a particular cluster. The pathocharacterological component of the «common syndromes» coexisting with the deficit symptom complexes is subject to the basic deficit component of the defect and is separated into polar dimensions (defensive-expansive) within specific clusters of PD, and then unified in accordance with the dichotomy of schizophrenic defect in categories with the predominance of emotional or apathoabulic disorders. Conclusion. ?sychopathy-like symptom complexes in the space of «common syndromes» can be qualified as a psychopathological construct secondary to basic deficit disorders, and their isolation as an independent entity of negative disorders appears to be unjustified.

Literature data devoted to transplantation of Langerhans cells have been analyzed. The main stages, indications, dissection of islets, immunosuppressive therapy, complications and data of the latest clinical trials were discussed.

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

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

Numerous studies have demonstrated the efficacy of anti-VEGF medications for exudative (wet) age-related macular degeneration (AMD). Significant IOP elevation is one of the side effects of anti-VEGF intravitreal injection. PURPOSE: To study the changes in the parameters of anterior segment of the eyeball against acute IOP elevation after repeated intravitreal injections (IVI) of anti-VEGF medication. MATERIAL AND METHODS: The study was conducted on a random sample of 45 patients (45 eyes) diagnosed with exudative (wet) form of AMD. All patients received two 0.05 ml intravitreal injections of ranibizumab with one-month interval. Measurements of IOP were performed with rebound tonometer Icare-Pro (ICare, Finland) before intravitreal injection, then one minute, 30 minutes and 3 hours after. The parameters of the ocular anterior segment, namely thickness and optical density of the cornea, volume and angle of the anterior chamber were evaluated by Scheimpflug imaging (Pentacam HR, Oculus, Germany) before IVI, and 15 minutes after. RESULTS: Statistically significant (p<0.05) elevation of IOP to 40 mm Hg (confidence interval 32-48 mm Hg) was recorded one minute after injecting 0.05 mL of ranibizumab solution into the vitreous cavity with IOP having the tendency for gradual normalization. When measured 15 minutes after IVI, the following parameters of the ocular anterior segment structures had reliably changed in the setting of elevated IOP: corneal thickness had increased to 27 µm (confidence interval 14-38 µm), corneal optical density - to 16.7 (confidence interval 10.4-19.5). No significant changes of either volume or angle of anterior chamber were revealed. Comparative analysis showed no significant changes of parameters after the 1st and the 2nd IVI. CONCLUSION: The revealed changes were transient in nature and did not require any corrections since all parameters returned to baseline after each injection.

The article presents a clinical observation of ocular thrombotic microangiopathy in atypical hemolytic-uremic syndrome - a rare genetic disease characterized by systemic thrombosis caused by uncontrolled activation of alternative complement pathway. A typical manifestation of this ocular lesion in this disease is bilateral Purtscher-like retinopathy. Timely diagnostics of atypical hemolytic-uremic syndrome, including ophthalmologic examination, determines the early start of a highly effective pathogenetic therapy with complement inhibitor eculizumab.

© 2018 Media Sphera Publishing Group.All Rights Reserved. Aim. Determination of desialized apolipoprotein-B-100 (apoB-100) and lipoprotein-containing circulating immune complexes in patients with chronic kidney disease (CKD) in program hemodialysis with type 2 diabetes mellitus. Materials and methods. We examined 81 patients with CKD (50 men / 31 women) treated with program hemodialysis, of which 36 (17/19) with type 2 diabetes mellitus, 45 (33/12) non-diabetic patients. The levels of total cholesterol, triglycerides and desialylated apoB-100 in blood plasma and lipoprotein-containing circulating immune complexes. A color duplex scan of brachiocephalic arteries was used to assess the extent of development of atherosclerosis with the determination of the thickness of the intima-medial complex. Results and discussion. Patients with diabetes had high values of total cholesterol, triglycerides (p<0.05). Duplex scan of brachiocephalic arteries showed an increase in the thickness of intima-medial complex in all patients for program hemodialysis, however, in patients with diabetes, the thickness was 13% higher (p<0.05). In patients with diabetes, plaques with stenosis up to 50% prevail, compared with non-diabetic patients, p<0.05. The incidence was significantly higher for desialized apoB-100 by 46% in patients with diabetes on hemodialysis compared non-diabetic patients (p<0.05). An increase in the level of lipoprotein-containing circulating immune complexes by 39%, (p<0.05) in patients with diabetes mellitus was observed, compared with patients non-diabetic patients. The correlation between desialized apoB-100 and duplex scan of brachiocephalic arteries parameters (r=0.325), as well as between the cholesterol level and stenosis up to 50% (r=0.465) in patients with diabetes mellitus, was found to be of medium strength. The patients with diabetes and CKD, myocardial infarction developed 79% more often than in patients without diabetes (p<0.05). Thus, immunogenic lipid markers of atherosclerosis can be considered both as mechanical factors of atherogenesis and diagnostic and prognostic characteristics in type 2 diabetic patients with impaired renal function and chronic renal insufficiency. The conclusion. Accelerated development of atherosclerosis with diabetes and CKD, confirmed with the help of duplex scan of brachiocephalic arteries, may be associated with an increase in the level of modified low density lipoprotein.

© 2013-2018 Federal Scientific Center for Medical and Preventive Health Risk Management Technologies. Yessotoxin (YTX) is a polyether. There are more than 90 known derivatives of yessotoxin. YTX was excluded from diarrhea toxins group as it, unlike okadaic acid, doesn't cause diarrhea. YTX chemical structure is similar to that of brevetoxins and ciguatoxins that influence functioning of calcium-sodium pump and trans-membrane ion channels. So, YTX can exert influence on functioning of all the organs and systems in a body. YTX is known to promote apoptosis in the cerebral tissues. Average lethal dose LD50 for YTX and its analogues varied from 100 μg/kg to 500-750 μg/kg; the figures were obtained in various experiments performed on mice. Safe YTX level for acute impact (acute reference dose) amounts to 25 μM/kg of body weight. Nowadays toxicity parameters for YTX and some of its analogues are determined; its basic action mechanisms and a role it plays in promoting apoptosis are well-known. In spite of more and more data on biological effects produced by YTX on a warm-blooded organism, experts are still unable to describe its action mechanisms precisely. Our research goal was to examine YTX toxicity in experiments in vivo in doses that were lower than the detected acute reference dose. The experiment was performed on 72 male Wistar rats with initial body weight being equal to 100±10 g. Animals were given dry balanced feedstuffproduced by "Laboratortakorm" LLC (Russia) and had free access to it. We used YTX preparation produced by "National Research Council Canada" (Canada) in our experiment; the preparation was a methanol solution (YTX content was equal to 4.3 μmol). We determined mass of internal organs, biochemical and hematological blood parameters, apoptosis of brain cells, malonic dialdehyde level in the brain and reduced glutathione in the liver. We showed that YTX doses (2μM/kg, 8μM/kg and 12μM/kg) lower than ARfD=2μM/kg can exert toxic impacts on a warm-blooded organism. The obtain data prove it is necessary to additionally assess risks of an increase in maximum permissible YTX contents in shellfish from 1 mg/kg to 3.75 mg/kg.

© The authors team, 2018.All Rights Reserved. Due to its cardinal differences from the adult oncology the children's oncology takes a special place in the national cancer control program. The article analyzes up-to-date problems and suggests their solutions. It contains statistical indicators and a three-level model of medical care for children with cancer. The tasks of the national program stated in the article reflect the author's point of view and are to be further discussed.

© Springer Nature Switzerland AG 2018. Video games are often seen as a reason for numerous psychological changes, both positive and negative, in players. For instance, many authors believe that video games push children and adults towards risky behaviors and impulsivity. The study aimed to analyze both theoretical and empirical evidences of that sort, as well as to investigate parameters of personal and cognitive impulsivity and risk-readiness in adult video gamers. The sample of gamers included 223 participants, all from Russia. Impulsivity and related personal traits were measured with Eysencks’ Impulsiveness Scale (I-7) and Kornilova’s Personal Risk Factors Questionnaire. Impulsivity as cognitive style was measured by Kagan’s MFFT. No evidence of high impulsivity was found, though video game players, who played more than 12 h per week turned out to be more venturesome, compared to less active gamers. Sex-related differences were investigated: female gamers scored lower in empathy, while male gamers showed higher venturesomeness. In a cognitive style study, video gamers were more accurate compared to non-gamers, and thus showed no tendency for impulsivity. The results are contrasted to the published data, when applicable.

© Bionika Media Ltd. The authors have carried out a systems analysis of the data available in the current literature on the effect of micronutrients, such as iodine, polyunsaturated fatty acids, folic acid, and vitamin D, on a woman’s reproductive health. Due to its geographical location, climatic features, and eating habits, our country has the proven deficiency of a number of micronutrients that play an important role in the periconceptional period. These micronutrients include iodine, polyunsaturated fatty acids, folic acid, and vitamin D. The content of micronutrients should not exceed the physiological daily requirement in the basic complexes intended for the prevention of deficiency, The excessive content of components can cause undesirable reactions and contribute to the allergization of newborns. In clinically pronounced deficiency, the basal complex can be combined with a monocomponent vitamin preparation for the targeted correction of vitamin and mineral status.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To study the quality of life of feeding mothers and toe establish whether the adherence to breastfeeding influences physical and mental health of women. Patients and methods. We conducted a questionnaire survey of 151 mothers who had small infants. Their quality of life was studied with the help of the SF-36 questionnaire. Results. As we have found, the higher is the material wellbeing of the family, the less women adhere to breastfeeding (per capita income of the family of breastfeeding mothers are almost 2 times lower than in nonbreastfeeding women – 22500 ± 3.800 and 43958.33 ± 4.240 rubles, respectively, р < 0.05). Subjective perceptions of physical health (functioning), parameters of life activity (Vitality – VT) and subjective assessment of their health (General Health – GH) were similar in both breastfeeding and nonbreastfeeding mothers (VT 56.48 ± 3.77 and 58.33 ± 2.91; GH 68.52 ± 4.13 and 65.83 ± 1.95, р > 0.05). Irrespective of breastfeeding adherence, women after childbirth did not report of worsening of their health (50.93 ± 4.01 and 44.79 ± 2.61, respectively, р > 0.05). But in breastfeeding mothers parameters of the quality of life were demonstrative of a higher endurance (physical functioning 73.89 ± 1.66 and 85.22 ± 3.19, role functioning 52.78 ± 2.16 and 65.63 ± 3.73, р < 0.05). Breastfeeding mothers more rarely had difficulties in routine activities due to their physical condition and pain (bodily pain 73.89 ± 3.77 and131.35 ± 2.16, р < 0.05), physical and emotional condition did not interfere with communication and social activity (social functioning 67.13 ± 1.93 and 139.8 ± 6.92, р < 0.05, mental health 95.11 ± 7.18 and 58.17 ± 8.11, р < 0.05). They are less prone to depression and have higher values of the positive emotions parameter (role emotional functioning 64.08 ± 3.98 and 215.73 ± 12.67, р < 0.01). Conclusion. The results of the study can be used in programmes aimed at expanding breastfeeding.

© Saint Petersburg Pasteur Institute. All rights reserved. The aim of the present systematic literature review is to summarize data on the role of TLRs in maintaining homeostasis of the female genitals, in maintaining the physiological development of pregnancy, provision of anti-infective resistance in pregnant women with intrauterine infection. The review substantiates the importance of TLRs of female genitals as a necessary and determining factor in the reaction to various changes in the environment, and also responsible for changes in metabolic, structural, or energy, in the maintenance of anti-infective resistance and homeostasis. As universal regulators of vital activity of organism TLRs in conjunction with other receptors of innate immunity provide maintaining the general reactivity and anti-infective resistance at the physiological level. In physiologically developing pregnancy in a background of immunosuppression in response to pregnancy TLRs during contact with infectious and non-infectious pathogens stimulate the production of nonspecific adaptive immunity factors (defensins, cathelicidins, histatines, etc.), which together with the non-specific innate factors lysozyme, complement, properdin, etc. support anti-infective resistance of the female genitals at a high level at the beginning of the infectious process. Possible violations of the development of pregnancy may be accompanied by changes in the response of TLRs to infectious and non-infectious factors until hyper-reaction, excessive inflammation or apoptosis, which requires adequate management of pregnancy. Was established the significance of the influence of pathogens of infectious and noninfectious origin in intrauterine infection indirectly through TLRs in the homeostasis of the organism, on the formation of breaches in anti-infective resistance at the organism and community level the identification of new pathophysiological and immunological pathogenetic mechanisms of development of pathological processes. IUI is a penetration of microorganisms into the tissues of fetus and it's infection. The inhibition of the functional activity of TLRs is accompanied by the direct effect of the pathogen on the tissues, and during hyper-reaction of TLRs to pathogens revealed a pronounced inflammatory response in the fetus. The level of expression of TLRs correlates directly with the severity of the process that can be considered as early markers of infection. Depending on the nature of the pathogen an increased expression of one or the other TLRs is observed. Explained the lack of symptoms, the possibility of atypical manifestations, the asymptomatic course of infection.

AIM: To investigate the role of video-assisted subtotal esophageal resection in treatment of patients with benign esophageal diseases. MATERIAL AND METHODS: Fifty-one patients with benign esophageal diseases have undergone subtotal esophageal resection in our department for the period 2010-2017. Thoracoscopic technique was applied in 25 cases, open approach - in 26 patients. Total surgery time, thoracoscopic stage duration, length of hospital-stay (LOS), ICU-stay, Clavien-Dindo morbidity rates with separate registration of respiratory complications, mortality have been considered. RESULTS: Groups were similar in terms of age, gender, ASA status. Thoracoscopic stage duration gradually decreased from 175 to 65 min with average time of 102 (75; 123) min. Total surgery time was 390 (270; 495) min in group 1 and 465 (341; 561) min in the control group (р=0.035). Mean ICU-stay decreased up to 2 (1.25; 3.75) days compared with the control group (5 (3.92; 5.85) days, р<0.0001). Conversion rate was 8%. In the main group complications Clavien-Dindo grade 2 were detected in 10 (40%) patients compared with 20 (69%) cases in the control group (р=0.009). Respiratory complications occurred in 5 patients in group 1 and in 13 cases of the control group (р=0.039). Mortality was absent. CONCLUSION: Thoracoscopic subtotal esophageal resection may be advisable alternative to open surgery for patients with benign esophageal diseases due to lower postoperative morbidity and earlier rehabilitation followed by improved outcomes.