Репозиторий Университета

© 2018, Dynasty Publishing House. All rights reserved. The objective. Was to develop echographic and Doppler prognostic markers of lesions of the central nervous system (CNS) in premature newborns. Patients and methods. In accordance with the objective of the study we conducted a complex prospective examination of 196 pregnant women diagnosed with threatened preterm labour. The treatment group consisted of 166 women, whose pregnancy ended with spontaneous births at terms 22–36 wks, and premature newborns later developed various disorders of CNS. Results. We found morphological ultrasound and Doppler ultrasound specificities of fetal CNS against the background of threatened preterm labour depending on the term of gestation at the moment of birth and subsequent neurological disorders in premature infants. The most significant were changes of the ventriculo-cranial index, width of anterior horns of lateral ventricles, thalamo-occipital distance, systolic-diastolic ratio between vertebrobasilar vessels of the brain. Conclusion. Such a detailed prenatal diagnosis contributes to noninvasive prognostication of the severity of neurological lesions of CNS in premature infants. The results showed interrelations between perinatal outcomes and initial blood flow impairment of fetal CNS in 97% of observations.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To evaluate the incidence and prevalence of hepatitis C in Russia and estimate the impact of hepatitis C virus on liver cirrhosis, hepatocellular carcinoma and liver-related mortality before the implementation of the national program for the elimination of viral hepatitis. Materials and methods. We analyzed statistical data on the incidence of hepatitis C in Russia in 2001–2017, the incidence, prevalence and mortality rates from liver cirrhosis and malignant liver tumors in 2011–2015. An analysis of the incidence and prevalence of HCV was carried out in various age-sex groups. The structure of genotypes of the hepatitis C virus was determined in patients at different stages of liver fibrosis and with different levels of viral load. Results. In 2017, 50 798 cases of HCV were registered in Russia (34.6 per 100 thousand of the population). As of January 1, 2017, the total number of patients with chronic hepatitis C under medical observation was 591 830 (405 per 100 thousand population). The incidence rate of fibrosis and cirrhosis in Russia in 2015 was 12.7 per 100000 population (18640 cases), the total number of registered patients – 75.9 per 100 thousand population (110951 people). The incidence rate of malignant liver tumors in 2015 was 5.5 per 100 thousand population (8083 cases), the total number of patients on dispensary observation was 5.0 per 100 thousand population (7360 people). In 2015, the estimated number of deaths from liver cirrhosis and hepatocellular carcinoma in the outcome of chronic hepatitis C was 14 792 and 1635, respectively. Conclusion. Hepatitis C is the main cause of liver cirrhosis (excluding alcoholic etiology), hepatocellular carcinoma and liver-related mortality in Russia. To reduce the prevalence of HCV and mortality from liver cirrhosis and primary liver cancer, it is necessary to provide all patients with HCV with antiviral drugs.

The article considers problem of implementation of interactive technologies into educational environment of medical universities. The experience is considered related to usage of the social network "VKontakte" in 2015/2016 academic year and first half of 2016/2017 academic year as a platform for extracurricular activities of the student scientific research circle on history of medicine of the "The I.M. Sechenov First Moscow State Medical University". The methodological recommendations are proposed concerning organization of extracurricular activity of the student scientific research circle in social networks. The possibility of implementation of education in habitual for student youth social media environment and availability of large spectrum of technical resources assignable by "VKontakte" permit to draw a conclusion about expediency of application of the given technology promoting efficiency of organization of extracurricular independent activity of students in the educational process.

© 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, Media Sphera Publishing Group. All rights reserved. Inflammasomes are macromolecular complexes that contain many copies of receptors recognizing molecular patterns of pathogenic agents (PAMP) and damage-associated structures (DAMP), and also include molecules of adapter protein ASC and procaspase- 1. Activation of inflammasomes leads to the formation of active caspase-1 that, in turn, provides the maturation of pro-IL-1β and pro-IL-18 to IL-1β and IL-18. The latter cytokines play an important role in control of neuroinlfammation in the central nervous system contributing to the pathogenesis of a series of neurological, neurodegenerative and mental disorders. The review discusses the involvement of NLRP3 inflammasome and other their types in the development of the traumatic brain injury, ischemic and hemorrhagic stroke, brain tumors, CNS infections, Alzheimer’s and Parkinson’s diseases, epilepsy, amyotrophic lateral sclerosis, depressiver, and consequences of alcohol abuse. The elucidation of molecular mechanisms and signaling pathways controlled by inflammasomes will allow the development of new therapeutic measures for diseases, in which neuroinflammation plays a leading pathogenetic role.

The paper considers the necessity of using ketogenic diet and its efficacy in epilepsy. Direct and indirect effects of ketones on brain cells and molecular mechanisms of their action are discussed in detail.

© 2018 Media Sphera Publishing Group. All rights reserved. Àim. To compare the efficacy of prophylactic administration of mineral-vitamin complexes "Feroglobin-B12" and "Complivit iron" with different degrees of Fe valence. Materials and methods. 120 female subjects were examined. To determine the quality of life, the SF-36 questionnaire was used. The presence of anxiety was determined on the Spielberger-Khanin Alarm Scale. 30 women with a deficit of Fe were divided into 2 groups of 15 people each. The first group received "Ferroglobin-B12", the second – "Complivit iron" for a month. Results. In a month after the initiation of preventive therapy in women of the 1 group the content of Fe serum was normalized. In the second group, its concentration approached the control values. The difference in Fe content in the 1 and 2 groups was of a reliable nature. Conclusion. The intake of "Ferroglobin-B12" was not accompanied by side effects, and performance indicators, social activity and mental health reached control values, unlike the group of patients taking Complivit iron.

© Bionika Media Ltd. Objective. To conduct a comparative analysis of the effectiveness of an improved imidazole derivative (2% clotrimazole cream) as part of complex therapy with standard treatment regimens for the development of bacterial vaginosis and vulvovaginal candidiasis. Materials and methods. The study included 90 women who had combinations of Atopobium vaginae, Gardnerella vaginalis and Candida krusei. These pathogens caused not only the development of an infectious process in the lower part of the urogenital tract, but also its complicated course. Results. The study showed that the use of the improved imidazole derivative (2% clotrimazole cream) could arrest the main symptoms of the disease after the first use. The drug is highly effective against difficult-to-cultivate pathogens of bacterial vaginosis and Candida non-albicans, and also does not adversely affect the amount of lactobacilli in vaginal biocenosis. Conclusion. The experience of using the improved imidazole derivative shows that the drug is no less effective in inflammatory diseases of the lower parts of the urogenital tract than its counterparts. Its purpose is appropriate in the complex therapy of complicated bacterial vaginosis and vulvovaginal candidiasis.

© 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.

Published by Oriental Scientific Publishing Company © 2018. The study assessed stress and brux activity among dental students during exam (stress) and non-examination (non-stress) periods. The study was initiated as a single group design with the total number of participants 36 (25 females and 11 males). All the participants were examined twice (once in a stress period and once in a non-stress period) according to “Clinical Functional Analysis”, which includes questions about students’ medical and dental history, as well as muscle palpation results. Two «BruxCheckers» (BCs) were applied, one for the upper jaw, the other for the lower jaw, two times for examination and non-examination periods. After the use, the «BCs» were photographed according to the research protocol and the abraded facets area on «BCs» was calculated in square millimeters. The research showed that during a stress period students may have headaches, cramps and pain in shoulder and neck muscles. The research also revealed that during the stress situation the abraded area shifts from frontal teeth to chewing teeth and brux episodes can occur more frequently and with a higher load. Chewing teeth (premolars in our study) are more adapted and more useful for such a condition. Accordingly, our students shifted their brux behavior from teeth 33 and 31 to teeth 15 and 24. Therefore, exams are a strong stress factor for dental students. In turn, prolongated stress can be an indicator of risk factor and have a negative effect for health of the craniomandibular system.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article covers the development of the problem of sudden cardiac death prevention with the implantable cardioverterdefibrillators from the moment of creation of these devices to our days. The current concept of primary prevention of sudden cardiac death, based on the severity of manifestation of heart failure and left ventricular dysfunction, is not effective enough. Its practical application is difficult because it requires mass application of implantable defibrillators, with low predictive accuracy of these criteria in terms of development of lifethreatening arrhythmias. The development of methods for visualizing the myocardium, allowing to assess the severity of myocardial fibrosis, as well as the possibilities of medical genetics, at the present stage, allows us to clarify indications for implantation of cardioverterdefibrillators and thereby significantly improve the concept of preventing sudden cardiac death with these instruments.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. The article deals with the modern tactics of pulmonary hypertension therapy, used in case of unsatisfactory clinical response to previous therapy. All classes of pathogenetic therapy of pulmonary hypertension are presented, as well as modern views on the risk stratification of annual mortality of patients. Switching to a more effective drug both within one group of pathogenetic PAHtherapy, and to drugs of other classes is discussed. The latest classification of pulmonary hypertension (Nice, 2018) is presented.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Purpose: to elucidate predictors of development of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE). Material and methods. We included in this study 210 patients hospitalized with diagnosis of submassive and massive PTE from 2013 to 2017. In 1 to 3 years after initial hospitalization these patients were invited for control examination. According to results of this examination patients were divided into two groups: with (group 1, n=45) and without (group 2, n=165) signs of CTEPH. Severity of pulmonary artery vascular bed involvement was assessed by multislice computed tomography (MSCT) angiography and lung scintigraphy. For detection of thrombosis in the inferior vena cava system we used ultrasound angioscanning. Examination also included echocardiography. Results. In the process of mathematical analysis, the following risk factors for the development of CTEPH embolism were determined: duration of thrombotic history (group 1 - 13.70±2.05 days, group 2- 16.16±1.13 days, p=0.015), localization of venous thrombosis in the lower extremities (the most favorable - shin veins, popliteal, and common femoral veins, unfavorable - superficial femoral vein). The choice of the drug for thrombolytic and anticoagulant therapy: streptokinase and urokinase were significantly more effective than alteplase, rivaroxaban was superior to the combination of unfractionated or low molecular weight heparins with warfarin. Also, risk factors for the development of CTEPH were the initial degree of pulmonary hypertension and tricuspid insufficiency, as well as the positive dynamics of these indicators at the background of thrombolytic or anticoagulant therapy. Of concomitant diseases, significant risk factors for development of CTEPH were grade 3 hypertensive disease, diabetes mellitus, postinfarction cardiosclerosis. On the other hand, age, gender, degree of severity at the time of admission, presence of infarction pneumonia, surgical prevention of recurrent pulmonary embolism, number of pregnancies and deliveries, history of trauma and malignancies, cardiac arrhythmias produced no significant impact on the development of CTEPH.

© 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 Izdatel'stvo Meditsina. All rights reserved. NMDA receptor modulators are a new class of antidepressants with rapid onset of action and lasting antidepressant effect. These drugs increase BDNF level in CNS and adult hippocampal neurogenesis, which events are in common for both NMDA receptor modulators and classical antidepressants. However, unlike classical antidepressants, drugs of this new group produce no direct influence on the monoaminergic system, but regulate the neuroplasticity in the prefrontal cortex and hippocampus via modulation of the glutamatergic neurotransmission. Clinical tests of ketamine and rapastinel confirmed the rapid onset of action and the continuation of stable antidepressant effect (upon single administration per 7 days) for both usual and treatment-resistant forms of depression.

The purpose of the study was to determine effects of quercetin on protective capacity parameters in the experiment on rats fed a high fructose diet. Rats of the control group received a semi-synthetic (s/s) diet and water; animals from the P' experimental group-s/s diet and 20% fructose solution instead of drinking water; rats of the 2nd experimental group-s/s diet with quercetin (0.1% indiet) and 20% fructose solution instead of drinking water for 20 weeks. Parameters of antioxidant status [total antioxidant activity (AOA), the content of malondialdehyde (MDA) and lipids hydroperoxides, the level of reduced andoxidizedglutathione, activity of superoxide dismutase, catalase, glutathione peroxidase, paraoxonase-1, hemeoxygenase-1, NAD(P)H-quinone oxidoreductase], the activity of xenobiotic-metabolizing enzymes [CYP1A1, CYP1A2, CYP2B1, CYP3A, UDP-glucuronosyltransferase (UDP-GT) and glutathione transferase] were studied in plasma and liver of rats. Consumption of the high-fructose diet led to changes in some parameters: diminution of AOA in blood plasma, decrease of AOA and MDA level, unsedimentable activity of lysosomal enzymes, increase of the UDP-GT activity in liver. The inclusion of quercetin in the diet did not affect the studied parameters, except for a more pronounced decrease of the unsedimentable activity of lysosomal enzymes in rat liver. The results of the study indicated that there was no significant effect of quercetin on the protective capacity of rats at the initial stage of obesity caused by high-fructose diet.

Lutein and zeaxanthin are carotenoid pigments that affect the function of the visual analyzer. They selectively accumulate in the yellow spot of the retina, form macular pigment and determine the density of the retina macula. Lutein and zeaxanthin slow down the progression of age-related macular degeneration, a leading cause of senior-age blindness. The main food sources of non-vitamin carotenoids are green leafy vegetables, zucchini, pumpkin, green peas, broccoli. The aim of the study is a retrospective assessment of the levels and sources of alimentary intake of lutein and zeaxanthin in young people and research of the effect of lutein and zeaxanthin in the diet on macula density. A specially designed questionnaire was used to quantify the content of lutein and zeaxanthin in the diet, reflecting the amount of consumption of the main sources of these carotenoids on the day preceding the survey. A non-invasive non-contact method of optical coherence tomography of the retina was used to determine the density of the macula. The study involved 96 students of Sechenov University at the age of 21-27 years. The study found that only 6.25% of the respondents had daily intake of lutein and zeaxanthin of 6 mg or more, 8.33% had 4.6-5.9 mg, 8.33% had 3.0-4.5 mg, in 18.75% - 1.5-2.9 mg, in 45.83% <1.4 mg 12.5% of respondents didn't include sources of lutein and zeaxanthin in the diet. The more common sources of lutein and zeaxanthin in the diet were eggs and fresh tomatoes. Retinal density indices corresponded to the age standards in the majority of the examined. In 8.3% surveyed the thickness of the retina was decreased, and 4.2% had higher thickness of the retina in comparison with the standards. Significant differences in the Central subfield thickness in men and women were revealed. There was no dependence of the levels of lutein and zeaxanthin coming from food sources on the retina thickness indicators.

© 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.