Репозиторий Университета

© 2018 Dynasty Publishing House. All rights reserved. The objective: to study the diagnostic efficiency and to establish normative values of stiffness of ovaries in healthy women of reproductive age, using multiparametric ultrasound (MPUS), advanced with the 2DSWE mode. Patients and methods: In order to establish stiffness of structures of normal ovaries, MPUS with measurement of Jung's modulus in kPa of right and left ovary were held in 25 healthy women of reproductive age between the 5th-7thday of menstrual cycle. For more precise quantitative parameter of Jung's modulus, measurements were repeated at least in two menstrual cycles in every woman. Results: At ovarian MPUS with the 2DSWE technology, determination of stiffness of ovaries in healthy women of reproductive age was carried out at the average volume of ovary 4,9 ± 0,5 cm3(minimum is 3.7 cm3maximum of 6.9 cm3). In addition, in healthy women of reproductive age, quantitative indicators of Jung's modulus of stiffness of structures of ovary (2,5 - 97,5 percentile - 95% interval) were as follows: median Emean is 8.7 kPa (2,1 - 16,9), the SD of 2.6 kPa (0,7 - 4,1). Qualitative analysis of color elastomers obtained showed a uniform homogeneous blue background of intact ovaries in all cases of the study. Conclusion: When extending the algorithm of MPUS with the 2DSWE technology, the effectiveness of the method in the study of normative values of Jung's modulus of stiffness of ovaries in healthy women of reproductive age was 100%.

© 2018 Ima-Press Publishing House. All rights reserved. Chronic cerebral ischemia (CCI) is one of the most common diagnoses in middle-aged and elderly patients in the practice of an outpatient neurologist. Unfortunately, the diagnosis of CCI in these patients is often established only on the basis of complaints of headache, dizziness, instability during walking, and lower mood. At the same time, other diseases that cause these symptoms are not diagnosed, patients do not receive treatment, which considerably worsens quality of life and leads to anxiety and depression. A variety of diseases, such as headache, peripheral vestibular vertigo, depression, Alzheimer's disease, and Parkinson's syndrome, are frequently hidden under the diagnosis of CCI. The leading neurological syndrome in CCI is cognitive impairment that can be both moderate and reach the level of dementia. Approximately 40% of patients with chronic cerebrovascular disease complain of headache that is usually caused by mixed primary headache. The management tactics for a CCI patient suffering from headache is aimed at treating primary headache, modifying vascular risk factors, and managing cognitive impairment. The paper discusses the use of choline alphoscerate in patients diagnosed with CCI.

© 2018 Ima-Press Publishing House. All rights reserved. Cognitive impairment (CI) is a basis for the clinical presentation of chronic cerebral ischemia (CCI). However, the role of the mechanisms of inflammation and angiogenesis in the origin of CI is unclear, as is its relationship to the number and localization of foci during a neuroimaging examination. Objective: to investigate the relationship between the presence of CI, focal brain tissue changes, and the plasma and serum levels of vascular endothelial growth factor (VEGF) and monocyte chemoattractant protein-1 (MCP-1) in patients with CCI. Patients and methods. Examinations were made in 59 patients with CCI and in 20 apparently healthy individuals. The investigators evaluated the cognitive status using the Mini-Mental State Examination (MMSE) and the clock drawing test), performed brain magnetic resonance imaging (MRI), duplex scanning of cerebral vessels, and determined laboratory indicators: the serum levels of MCP-1 and C-reactive protein, and the serum and plasma concentrations of VEGF. Results. The patients with CI were found to have higher values of inflammatory markers, lower serum and plasma concentrations of angiogenic factors, and a greater number of focal changes on MRI than those without CI (5.06±0.23 and 2.36±0.3 scores, respectively; p(0.05). Imbalance of angiogenic and antiangiogenic factors can cause disease progression and moderate vascular CI in patients with CCI.

© 2018 Media Sphera Publishing Group. All Rights Reserved. The characteristics of mortality in the Russian Federation are that the greatest years of potential life lost are due to deaths among 50-60-year-old men. Objective - to investigate the characteristics of nutrition patterns in a sample of 41-44-year-old Moscow residents with overweight and obesity, by taking into account the role and significance of overweight in the development of cardiovascular diseases and events. Material and methods. Actual nutrition was evaluated according to the special computer program 1C. Value of Nutrition through a 24-hour dietary recall, by applying a special food atlas. A constructed mathematical model and tables of the chemical composition of nutrients were used to obtain information about the energy value of a diet and the pattern of nutrition. Results. A total of 301 men aged 41-44 years were examined. 38.3% of them were overweight. 29% of the men were found to be obese; 83 (28.6%) men had abdominal overweight. Comparative analysis showed that overweight and obese persons consumed statistically significantly more protein and total fat than normal weight ones and people with abdominal obesity ate more saturated fats and cholesterol. There was a paradoxical decrease in the intake of simple and complex carbohydrates with increases in both weight and waist circumference. Conclusion. The findings can be used to improve methods for nutrition assessment and differentiated technology for overweight correction in primary health care facilities.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. The article is focused on the issues of clinical efficacy of telmisartan - angiotensin II type 1 receptor blocker from the perspective of its influence on cardiovascular risk in systemic hypertension patients. The results presented, of a variety of studies, witnessing potent antihypertensive and protective properties of telmisartan. The opportunities described, for usage of the drug in high risk patients, its efficacy in cardio- and nephroprotection. Special attention is paid for an exclusive property of telmisartan to be an agonist of PPAR γ-receptors, hence to correct glucose and lipid metabolism in patients with metabolic syndrome and diabetes.

© 2018 Media Sfera. All Rights Reserved. Purpose: to assess the neurophysiological effect and clinical effectiveness of transcranial direct current stimulation in combination with drug therapy in amblyopic children. Material and methods. The study involved 32 healthy children in the age of 5-12 years and 97 patients of the same age with refractive strabismic amblyopia. All study subjects underwent standard examination including ophthalmological (visometry, refractometry in normal conditions and in cycloplegia, biomicroscopy, ophthalmoscopy, type of vision), neurophysiological methods (determination of retinal electric sensitivity threshold, electric lability of optic nerve, amplitude and latency period of visual evoked potentials, electroencephalogram wave amplitudes, localization of peak electrical activity area of the cerebral cortex), assessment of neuropsychic development and estimation of mental development coefficient with age tests. Results. Dynamics of neurophysiological parameters shows that healthy children develop fully functional retina, visual cortex and cortical-subcortical connections by 12 years. Children with refractive strabismic amblyopia in all age groups show statistically significant (p<0.05) deterioration of neurophysiological parameters of the visual analyzer, retardation of corticalsubcortical connections formation and lower electrical activity of the cerebral cortex. Amblyopic children show lower coefficients of mental development accompanied by intellectual deficiency and deterioration of learning ability. Proposed treatment method improved neurophysiological parameters of the visual analyzer in 83.5% of cases and increased visual acuity in 81.4% of cases. Improvement of psychological development resulted in better logical thinking, memory reinforcement and better adaptation to school educational environment in 86.6% of children.

© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present study was to determine the biological age of the unrecognized individuals based on the analysis of CT-scanograms of the skull and the craniovertebral region in the sagittal projection. We investigated the structure of the spongy substance of the clinoid plate of the sella turcica and the clivus of the cranium, involution of the vertebrae configuration in the medial atlantoaxial articulation, frontal and sphenoidal sinuses. A total of 80 skulls of Caucasoid individuals at the age ranging from 4 to 84 years belonging to an Eastern Slavonic population (free from the pathological lesions in the above cranial structures) were available for the examination. The results of the multifactorial analysis gave evidence of the possibility to estimate the age of individual subjects based on the comprehensive aggregate qualitative and quantitative characteristic in the framework of the linear regression model by making use of the age-related changes in the frontal and sphenoidal sinuses, the sella turcica and the clivus of the cranium, the first and the second cervical vertebrae with an accuracy to within 6 years. It is concluded that the application of the systems for the automated statistical analysis of the images for the purposes of forensic medical expertise would allow to obtain the results of great practical and scientific value.

© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present study was to elucidate the characteristic features of the injuries inflicted to the victims of a road traffic accident inside the passenger compartment of a moving car equipped with the modern personal safety systems. The materials available for the present work included the lesions documented in 210 drivers and 150 occupants of the car passenger compartments. Both comparative, morphometric and statistical methods were used to analyze the data obtained. The morphometric analysis included identification of the form of the injury, such as extravasation, wounds, fractures, and lesions of the internal organs (e.g. hemorrhages, ruptures, etc.), their number and localization. Special attention was given to the specific features of the injuries to the occupants of the cars equipped with the modern personal safety systems. The study has demonstrated that the form, frequency, and localization of the injuries inflicted to the victims of a road traffic accident inside the passenger car compartment (including the drivers and other occupants) can be used for determining the positions of the victims at the moment of the accident.

© 2018 Media Sphera Publishing Group. All rights reserved. This article presents an overview of the literature publications concerning pathological changes in the cerebral blood vessels and the factors underlying the development of hemorrhagic complications leading to sudden death of young people. The special emphasis is placed on the most important causes behind the changes in the vascular wall (including the congenital ones) responsible for the high risk of rupture of the intracerebral vessels associated with the development of hemorrhagic complications.

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Culture of mouse macrophages (RAW 264.7 ATCC strain) in wells of a 6-well plate was infected with M. tuberculosis in proportion of 15 mycobacteria per one macrophage and then treated with a lytic strain of mycobacteriophage D29. Antibacterial efficacy of mycobacteriophages was studied using D29 phage (activity 108 plaque-forming units/ml) previously purified by ion exchange chromatography. After single and double 24-h treatment, the lysed cultures of macrophages were inoculated onto Middlebrook 7H10 agar medium. The number of mycobacterial colonies in control and test wells (at least 3 wells in each group) was 300.178±12.500 and 36.0±5.4, respectively (p<0.01).

© 2018, Dynasty Publishing House. All rights reserved.  Objective: to evaluate the possibility of creating a human model of acute Helicobacter pylori infection in healthy volunteers after infecting them with a mutant rifampicin-resistant strain of H. pylori KM-11 (Rif R ), to obtain evidence of H. pylori survival and invasion into the gastric mucosa, describe the symptoms, and assess the efficacy of H. pylori eradication therapy with Stimbifid plus. Materials and methods. In our experiments, we used conventional white mice of both genders weighing 18–20 g. The concentration of bifidobacteria, lactobacilli, and Escherichia (CFU) in animal faeces was determined by inoculating tenfold dilutions of biomaterial onto solid media and further counting of bacterial colonies grown after the incubation period. Microorganisms were cultivated in an anaerobic incubator and then identified by morphological evaluation and using biochemical identification kits. We created a murine model of H. pylori infection by oral administration of H. pylori KM-11 (Rif R ) suspensions to immunocompromised mice that had earlier undergone intramuscular administration of dexamethasone. For a human model of H. pylori infection, we selected healthy male volunteers. They took suspensions of H. pylori KM-11 (Rif R ) isolates in isotonic sodium chloride solution. Fecal specimens were collected from volunteers on daily basis during the entire follow-up period and then 2 weeks and 1 month after treatment completion. Fecal suspensions in isotonic sodium chloride solution were inoculated onto the selective hemin-containing solid media with rifampicin at a concentration of 160 µg·mL –1 . The results of this experiment (H. pylori colony count) were used to evaluate the efficacy of H. pylori eradication therapy with Stimbifid plus. Results. Both in vitro experiments and murine models demonstrated high anti-H. pylori activity of Stimbifid plus and its ingredients, restoration of the gastric microbiota, restoration of gastric colonization resistance, and eradication of H. pylori KM-11 (Rif R ). Self-infection with H. pylori KM-11 (RifR) caused acute infection in volunteers. The disease manifested with mild ailment, epigastric discomfort, belching, increased stool frequency, and changes in the color of stool. The detection of H. pylori KM-11 (Rif R ) in the faeces of volunteers and isolation of pure cultures prior to treatment initiation indicated bacterial adhesion to gastric mucosa and survival of microorganisms. Treatment with Stimbifid plus caused gradual decrease in the number of bacteria isolated from feces and their complete elimination by day 11 of therapy. All fecal specimens collected 2 weeks and 1 month after therapy completion from volunteers were negative for H. pylori KM-11 (Rif R ). None of the study participants required in-patient treatment. Conclusion. The results of our experiments obtained in both murine and human models of H. pylori infection will be used for more detailed assessment of this pathological process, clinical manifestations, impact of H. pylori virulence factors on the host, choosing new methods for the prevention and treatment of chronic gastritis caused by H. pylori, and monitoring the efficacy of eradication therapy.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To estimate a clinical picture of the pertussis-like illnesses caused by Bordetella holmesii. Patients and methods. The research is conducted in Infectious diseases clinical hospital No 1 of the Moscow Department of Healthcare. Under observation there were 7 children (from 1 month to 15 years). Examination is conducted by means of PCR-RT with the primers the IS481, ptxA, IS1001 and hIS1001 for identification of fragments of genomes of B. holmesii, B. pertussis and B. parapertussis, and by means of the AmplySens® Bordetella Multi-FL test system for identification of B. pertussis, B. parapertussis and B. bronchiseptica DNA. Results. At 6 children the disease proceeded an easy form, from them in five children in clinical samples DNA of B. holmesii also is found in one child – B. holmesii and B. parapertussis DNA; at 1 child (1 month) the disease proceeded in a medium-weight form, and B. holmesii and DNA of B. pertussis is found in him in a sample. In a clinical picture of the pertussis-like illnesses caused by B. holmesii at all children the symptoms characteristic of the course of the whooping cough caused by B. pertussis were observed: whooping cough, with office of a transparent phlegm, with hyperaemia of the person. But the disease proceeded in easier form, the health of the child didn't suffer, respiratory frustration weren't observed, duration of a disease was much shorter. Conclusion. The research demonstrates circulation of B. holmesii in the territory of the Russian Federation. At allocation of B. holmesii pertussis-like symptoms are noted, however easier current including at children of early age is registered.

© 2018 Limited Liability Company KlinMed Consulting. All Rights Reserved. Steady increase in the prevalence of chronic kidney disease (CKD) is a serious public health problem, since CKD potentially leads to the development of end-stage renal disease (ESRD) that requires high-cost replacement therapy and is closely associated with increased risk of developing cardiovascular diseases (CVD), which are the cause of death in most patients. Progression of renal dysfunction and development of CVD are significantly affected by hyper- and dyslipidemia. This review contains results of studies evaluating the effect of hypolipidemic therapy on reduction of cardiovascular risk and slowdown of renal dysfunction in patients with CKD at pre-dialysis and dialysis stages of renal failure, as well as in patients with kidney transplant. In addition, recommendations on nutrition and new therapeutic approaches to lipid-lowering therapy in patients with CKD, as well as prospects for the usage of new hypolipidemic drugs are also presented.

© 2018 S. Karger AG.All right reserved. The development of thrombotic microangiopathy (TMA) during pregnancy and in postpartum period requires differential diagnosis between classical obstetric TMA (preeclampsia and HELLP-syndrome) and TMA, for which pregnancy can become a trigger of atypical hemolytic-uremic syndrome (аHUS), thrombotic thrombocytopenic purpura (TTP), obstetric sepsis with DIC-syndrome and catastrophic antiphospholipid syndrome (CAPS) in order to determine treatment strategy. Complement blocking treatment with eculizumab requires aHUS diagnosis, in the pathogenesis of which the main role is played by the uncontrolled activation of the alternative complement pathway. Complement dysregulation occurs in TMAs different from primary aHUS. Short treatment with eculizumab can result in a rapid improvement of patients with secondary aHUS in whom TMA has persisted and renal function worsened despite treatment of the TMA-inducing condition. This observation demonstrates the first experience of successful postpartum catastrophic antiphospholipid syndrome (CAPS) treatment with complement-blocking drug ekulizumab in Russia. Underestimation of the importance of detected laboratory changes and information about a burdened obstetric anamnesis led to the mistaken diagnosis of atypical HUS, which served as the basis for the ekulizumab prescription, without a doubt, saved the patient's life. The role of the complement activation in the pathogenesis of CAPS is discussed. A conclusion is made that the use of complement-blocking therapy in combination with anticoagulants primarily is advised in the obstetric CAPS patients.

© 2018 Bentham Science Publishers. Atherothrombosis-related diseases are one of the world’s leading causes of mortality, and thus the search for new therapeutic approaches in this area remains a very urgent task. Modern pharmacogenomic technologies make it possible to obtain valuable data on disease pathogenesis and optimal therapeutic approaches. One promising research direction is the study of the thromboxane A2 - thromboxane A synthase - thromboxane A2 receptor axis. This review summarizes the recent evidence and suggests that systematic works in this area are creating new and promising opportunities in the treatment of patients with cardiovascular diseases.

© 2018 Media Sphera Publishing Group. All rights reserved. Heart sarcoidosis diagnosis presents great difficulties due to the absence of specific clinical manifestations. Most often, the diagnosis is established during autopsy. Magnetic resonance imaging (MRI) of the heart with contrast enhancement is one of the most informative methods of intravital diagnosis of cardiac sarcoidosis. In this article, two clinical cases, shows the role of MRI of the heart with contrast enhancement in the diagnosis of cardiac sarcoidosis.

© 2018, ABV-Press Publishing House. Attention deficit hyperactivity disorder (ADHD) is the most common cause of behavioral disorders and learning difficulties in preschool and school-age children. Patients with ADHD are often diagnosed with concomitant diseases, which creates additional diagnostic and therapeutic challenges and leads to a more significant reduction in the quality of life. ADHD is often associated with epilepsy: ADHD manifestations are more common in individuals with epilepsy, and vice versa, patients with ADHD are more likely to have epilepsy. The estimated prevalence of ADHD in children is 7-9 %, whereas in children with epilepsy, it reaches 20-50 %. Epilepsy is also one of the most common diseases in children (affecting approximately 1 % of the pediatric population), which is often aggravated by concomitant diseases, including cognitive, behavioral and emotional disorders. Various factors, such as characteristics of epileptic process and lesions in particular portions of the brain, can underlie the development of ADHD in epilepsy. Epileptiform activity and adverse effects of antiepileptic drugs can also play an important etiological role. Some antiepileptic drugs (such as barbiturates) may cause symptoms similar to those in ADHD (in this case, inattentiveness and hyperactivity shall be considered as adverse events that can be reduced or eliminated after cessation of the drug) or exacerbate ADHD symptoms in patients with these disorders. Therefore, the drugs with no negative impact on concomitant diseases or with a positive therapeutic effect for both diseases are preferable in these cases. High prevalence of the ADHD/epilepsy combination leads to a greater reduction in the quality of life, suggesting high relevance of this problem and requiring a revision of therapeutic approaches.

© 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 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.