Репозиторий Университета

© The European Society of Cardiology 2017. Aims: To evaluate safety and efficacy of moderate intensity interval exercise training early after heart failure decompensation on exercise tolerance and health-related quality of life (HRQoL). Methods and results: This is a prospective randomized controlled study. We screened 234 consecutive patients admitted with decompensated heart failure; 46 patients (42 men/4 women; 61±12 years of age) were randomized to a moderate intensity aerobic interval training (n = 24) or to a control group (n = 22). Patients underwent cardiopulmonary exercise testing, echocardiography and Minnesota Living with Heart Failure questionnaire (MLHFQ) at baseline, after three weeks and after three months. After three weeks, peak-VO2 increased by 17% in the training group (p = 0.003) with further increase by 10% after three months (p < 0.001) but did not change significantly in controls. MLHFQ score improved after three weeks, with better results in the training group (from 64.6±15.6 to 30.8±12.9, p < 0.001). After three months, MLHFQ further improved in the exercise training group, but not in controls. Left ventricular ejection fraction was not significantly different between the two groups at baseline and after three months. No serious adverse events related to exercise testing or training wssere observed. Conclusions: Interval exercise training early after an episode of heart failure decompensation is safe and effective in improving exercise tolerance and health-related quality of life in selected patients after achievement of clinical stability. Positive effects remained sustained after three months. Further studies are needed to define role and indications for interval exercise training early after heart failure decompensation.

© 2018 Lippincott Williams and Wilkins. All rights reserved. This article is published on the occasion of the 2nd All-Russian forensic medicine student Olympiad. The Olympiad has been held during three years in succession and attracts attention of the students from different Universities of the Russian Federation and the former Soviet republics. The Olympiad is considered to be a highly efficient form of the intellectual leisure activities of the students; moreover, it facilitates formation of motivation for the self-education and the acquisition of the professional skills and competences envisaged by the state standards for higher education that have not yet been incorporated into the program of modern medical education adopted in the Russian Federation.

© 2018, Media Sphera Publishing Group. All Rights Reserved. Authors present a case-report of a 36-year-old patient with pain syndrome in the face region (craniomandibular dysfunction with occlusive disorders) involving pericranial muscles and shoulder girdle muscles. Thioctic acid was prescribed as a basic therapy, and relaxation tire, mimic gymnastics, post-isometric relaxation, vitamin and mineral complex were additionally used. Thioctic acid was prescribed according to the following scheme: stage I — intravenous injections of thioctic acid (600 mg/daily, 5 procedures, every other day); stage II — oral administration of the drug in the dose of 600 mg/daily for 3 months. A significant reduction of pain syndrome and the palpable tension of muscles were noted; the symmetric even muscle tone was revealed. This case-report demonstrates the high efficacy of thioctic acid in treatment of patients with craniomandibular disorders using the 2-stage scheme. There was a significant improvement of quality of life of the patients due to the additional use of vitamin and mineral complex and medical tools (relaxation tire) for treatment at all stages of pain formation.

© 2018, Peter the Great St. Petersburg Polytechnic University. The interaction of laser radiation with aqueous dispersion of only bovine serum albumin (BSA) 25 wt. %, only bovine collagen (BC) 2 wt. %, and 25 wt. % BSA with single-walled carbon nanotubes (SWCNTs) 0.3 wt. % and 2 wt. % BC with 0.3 wt.% SWCNT was studied. The beam was absorbed mainly by nanotubes, that confirmed by the small value of the nonlinear absorption coefficients for aqueous dispersed media with BSA 6 cm GW-1, as well as dispersion with BK 4 cm GW-1 and the large values of coefficients for these media with addition of SWCNTs, respectively 350 cm GW-1 and 70 cm GW-1. Determination of nonlinear optical parameters was obtained by the method of fixed sample location. Knowledge of the values of these parameters allowed calculating theoretical curve of Z-scan with open aperture what made possible to compare with the experimental data.

© 2018, Peter the Great St. Petersburg Polytechnic University. Layers of different materials, including nanocomposites, containing carbon nanotubes, with the tensoresistive properties are discussed. The investigated layers are divided into two groups: without (group I) and with carbon nanotubes (group II). A group-I material that is the most suitable for fabrication of a tensoresistor is the elastomer with microchannel, filled with a conductive liquid. In group II, these are the (0.2-10)-μm-thick layers consisting of the carboxymethylcellulose matrix, filled with multiwalled carbon nanotubes (∼5 wt.%). The investigated layers can be used as alternative tensoresistors for medical applications.

Copyright © 2018 by the MediaSphere. Diabetes mellitus (DM) is a genetically heterogeneous disease, and some cases of type 1 diabetes mellitus (T1DM) are caused by a mutation of one gene. The child has suffered from brittle diabetes since the age of 1 year and received insulin. The HbA1c level is 9.9-11.4%. The patient was examined at the age of 14 years; the disease duration is 13 years. The daily dose of insulin is 1.15-1.35 U/kg. DM complications include initial manifestations of distal diabetic polyneuropathy as well as cheiropathy. The mother (39 years) and grandmother (74 years) have T1DM with multiple complications. A genetic study revealed that all three family members had a heterozygous substitution p.P274 in the PTF1A gene with an unknown pathological significance. At present, it can not be asserted that the identified mutation is the etiologic factor of diabetes in the described case. We can not exclude T1DM in this child because specific antibodies have not been tested. However, the mutation is detected in all three members of the same family with diabetes, which does not exclude the discovery of a new form of MODY, not described earlier.

Copyright © 2018 by the MediaSphere. MODY3 is one of the most common subtypes of MODY. Obesity in MODY3 patients modifies the disease course and complicates diagnostics at the clinical stage. A proband was diagnosed with type 2 diabetes mellitus (T2DM) at the age of 12 years; metformin therapy was used. A family history of DM involves three generations: The mother, aunt, and maternal grandfather have suffered from insulin-dependent DM since the age of 23, 22, and 40 years, respectively. The patient was examined at the age of 14 years. Obesity was present (SDS BMI 2.3). The insulin and C-peptide levels were 4.4 μU/mL and 1.5 ng/mL, respectively. The HbA1c level was 7.3%. Under glucose load, glycemia reached diabetic values; hyperinsulinemia and insulin resistance were not detected. Specific pancreatic antibodies were absent. Metformin was discontinued, and a sulfonylurea (SU) drug was prescribed, which had a positive effect. The heterozygous mutation p.P291fs was identified in the HNF1A gene. Therefore, MODY3 was verified. The presence of concomitant obesity in the patient significantly complicates the differential diagnosis, and only a careful comprehensive analysis of clinical and laboratory parameters and a family history makes it possible to suspect the diagnosis of MODY3 (requiring subsequent molecular genetic verification) and prescribe pathogenetic therapy.

© 2018 Dynasty Publishing House. All rights reserved. The objective: To optimize a tactics of examination and treatment of patients with a benign cervical pathology associated with papillomavirus infection (PVI) in female patients of reproductive age. Patients and methods: 124 patients aged 22 to 35 years underwent complex examination and treatment. Two groups were singled out: the first (main) group included 72 patients, who in the postoperative period received treatment with an antiviral immunostimulating drug isoprinosine, the second group comprised 52 patients, who did not receive the antiviral medication (control group). Inosine pranobex (isoprinosine) was administered 3 g/day (2 tablets 3 times daily) for 28 days. A carbon dioxide (CO2) laser and argon plasma were used to destroy the affected uterine cervical epithelium. Results: The Pap test found various pathological changes in 112 (90.3%) patients. ASCUS smear results had similar incidence rates in the groups 16 and 18% (p > 0.05). The incidence of LSIL in the groups was 31.9 and 32.6%, respectively (p > 0.05). In the basic group, 60 days afterwards complete elimination of virus was noted in 95.8% of cases; in the control group in 78.8%. The frequency of HPV infection recurrence among patients with complete virus elimination was 2.9% in the basic group, in the control group - 14.6%. Conclusion: The employment of the surgical stage permits to destroy pathological tissue, deactivate virus at the local level and prepare conditions for deactivation of virus in the body. Postoperative antiviral and immunostimulating therapy not only ensures practically complete elimination of virus but also reduces recurrences of PVI.

© 2018 Dynasty Publishing House. All rights reserved. A systematic review substantiates the significance of mutual influence and interaction between infection pathogens, humoral and cell-mediated innate immunity that condition triggering or termination of infectious process, its prodromal period, severity of clinical manifestations and outcomes of urogenital infections in pregnant women. The determining factor is the result of TLRs response to microbial patterns taking into account the preparedness and state of innate immune receptors. The latter might ensure a higher anti-infection resistance to the pathogen up to termination of disease, or to promote the development of infectious process with marked inflammatory reaction, or to make the infectious process chronic up to damaging the tissue cells of the macroorganism. The understanding of the mechanisms of natural anti-infectious resistance and enhanced sensitivity and susceptibility to infectious agents has been objectified. TLRs act as molecular genetic markers of anti-infection resistance of the body and its state of health.

© 2018, Slovenska Vzdelavacia Obstaravacia. All rights reserved. Translation-oriented reading makes it possible to identify the differences and similarities of the professional reading and ordinary reading in psychological and psycholinguistic terms. The translator should comprehend both the meaning of the source text and its linguistic form of representation in order to produce an adequate translation. The analysis of translation-oriented reading based on the cognitive approach suggests that the translator arrives at a concept representing the content and meaning to be retrieved from the text. The obtained results may be used for the future research connected with the professional translator’s training.

© COPYRIGHT SPIE. Downloading of the abstract is permitted for personal use only. Light field intensity distribution in three-dimensional polylactide scaffolds after irradiation with low-intensity light from one side of the samples has been determined in the visible and near-infrared regions of the spectrum. Two different types of scaffolds manufactured by the methods of supercritical fluid foaming and surface selective laser sintering have been investigated. The problem is solved by numerical calculation according to the Monte Carlo method involving experimentally obtained information about effective optical parameters of the scaffold material. Information about intensity distribution of the incident light in the matrix volume is needed to assess the radiation level for the scaffold cells after photobiostimulation. It has been shown that the formation of the light field in case of strongly scattering media, such as polylactide scaffolds, is determined by anisotropy g and the scattering coefficient μs.

© 2018 Media Sfera. All rights reserved. The article reviews development mechanisms of different refractive errors accompanied by marked defocus of light rays reaching the retina. Terminology used for such ametropias includes terms extreme, ultra-high and complicated. Justification of their usage for primary ametropias, whose symptom complex is based on changes in axial eye length, is an ongoing discussion. To comply with thesaurus definitions of «diagnosis» and «pathogenesis», to characterize refractive and anatomical-functional disorders in patients with primary ametropias it is proposed to use the terms «hyperaxial and hypoaxial syndromes» with elaboration of specific symptoms instead of such expressions as extreme (ultra-high) myopia and hypermetropia.

© 2018 Media Sfera. All rights reserved. Bioinorganic chemical composition of the lens of human and experimental animals (cows, dogs, rats, rabbits) have been analyzed in various studies. In most cases, the studies employed different methods to determine the gross (total) composition of chemical elements and their concentrations in the examined samples. Less frequently, they included an assessment of the distribution of chemical elements in the lens and correlation of their concentration with its morphological changes. Chemical elements from all groups (series) of the periodic classification system were discovered in the lens substance. Despite similar investigation methods, different authors obtained contradicting results on the chemical composition of the lens. This article presents data suggesting possible correlation between inorganic chemical elements in the lens substance with the development and formation of lenticular opacities. All currently employed methods are known to only analyze limited number of select chemical elements in the tissues and do not consider the whole range of elements that can be analyzed with existing technology; furthermore, the majority of studies are conducted on the animal model lens. Therefore, it is feasible to continue the development of the chemical microanalysis method by increasing the sensitivity of Scanning Electron Microscopy with Energy Dispersive Spectroscopy (SEM/EDS) with the purpose of assessing the gross chemical composition and distribution of the elements in the lens substance, as well as revealing possible correlation between element concentration and morphological changes in the lens.

© 2018 Media Sfera. All rights reserved. Purpose. To study the effects of long-term instillation of 0.18% sodium hyaluronate artificial tears VISMED multi on ocular surface in glaucomatous patients with long-term instillation of preserved anti-glaucoma drops. Material and methods. The study included 79 patients (40 female and 39 male; 79 eyes in total) with primary open-angle glaucoma (POAG) divided into 3 groups according to disease stage: mild or early (stage I) glaucoma - 15 patients (15 eyes), moderate (stage II) glaucoma - 30 patients (30 eyes), advanced or severe (stage III) glaucoma - 34 patients (34 eyes). Conjunctival and corneal changes were assessed with Norn's test, Schirmer I test and corneal fluorescein staining test. All patients completed Ocular Surface Disease Index (OSDI) questionnaire. Corneal compensated intraocular pressure (IOPcc) was measured using Ocular Response Analyzer (ORA) (Reichert Optics Inc., USA). In addition to hypotensive therapy, all patients received instillations of 0.18% sodium hyaluronate (VISMED multi) three times every day. After 14 days, all examinations were repeated. Results. The condition of eye surface in patients with moderate and advanced (stage II and III) glaucoma depends on the degree of IOPcc compensation. As glaucoma increases in severity, the pathological changes in the ocular surface progress. Instillations of 0.18% sodium hyaluronate solution lead to significant improvement of the test results in all groups, and in early glaucoma patients it restores all objective indicators to normal values. Conclusion. Treatment with 0.18% sodium hyaluronate solution (VISMED multi) leads to statistically significant (p<0.05) improvement of ocular surface condition in glaucoma patients with long-term instillation of preserved antiglaucoma eye drops.

© 2018, Stolichnaya Izdatelskaya Kompaniya. The aim of the review is presenting the possibilities and perspectives of the third generation of thienopyridine P2Y12 receptor inhibitor prasugrel in the treatment of patients with acute coronary syndrome (ACS). The main pathogenetic stage of ACS is intracoronary thrombosis, which develops on the surface of a damaged atherosclerotic plaque. The use of acetylsalicylic acid with addition of the second antiplatelet agent, so-called dual antiplatelet therapy, is a standard component in the treatment of any type of ACS, regardless of reperfusion and the selected treatment strategy. Due to some limitations in the use of clopidogrel as the second component of dual antiplatelet therapy, the possibility of prasugrel or ticagrelor usage should be considered in patients with ACS with percutaneous coronary intervention (PCI). Prasugrel therapy is associated with better clinical outcomes as compared with clopidogrel therapy in moderate or high-risk patients who undergo PCI. Because of higher bleeding risk and the lack of clinical benefits in special subgroups of patients, prasugrel must not be used in patients with a stroke or transient ischemic attack in the past. If, after a thorough individual benefit-risk assessment a decision is in favor of prescribing prasugrel to the patient older than 75 years or with a small body weight the maintenance dose of prasugrel is to be reduced by half. Real clinical practice data has shown that with following these recommendations prasugrel demonstrates optimal efficacy, safety, and even more significant impact on the prognosis than this in clinical trials. Prasugrel is able to reduce significantly the incidence of cardiovascular events such as cardiovascular death, myocardial infarction and stroke in patients with ACS who undergo PCI.

© 2018 Ima-Press Publishing House. All rights reserved. Many physicians have difficulty managing patients with vertigo. Incorrect routine diagnoses are frequently made in patients with peripheral vestibulopathy, which makes therapy fail. Most cases of vestibular vertigo are caused by peripheral vestibular disorders (otolithiasis, hydrops, neuronitis). Rehabilitation maneuvers are effective in the treatment of benign paroxysmal positional dizziness; salt-free diet, diuretics, and betahistine dihydrochloride are for Mnire's disease (syndrome); vestibular rehabilitation is for vestibular neuronitis. Betahistine dihydrochloride is most effective among all the medicines used in different causes of vestibular vertigo, including that of unclear origin. The paper gives the positive experience with betahistine made in Russia for vestibular vertigo.

© 2018 Ima-Press Publishing House. All rights reserved. Cranial dystonia is a common disease of the extrapyramidal nervous system. The clinical manifestations of dystonia are extremely variable; many of its forms are often undiagnosed. Dystonia is a sensorimotor disorder of the nervous system. Damage affects not only one structure, but also a network of the nodes interacting with each other in the somatosensory cortex and associative sensory and motor fields, which play a role in the integration of various sensory modalities coming from both outside the body and from the receptors within it. Botulinum toxin preparations show the highest efficacy in treating cranial dystonia. If their administration cannot achieve a positive result, oral drugs and surgical treatments should be used.

© 2018 Ima-Press Publishing House. All rights reserved. The paper describes a clinical case of dissociative amnesia in a 22-year-old patient. A marked hysterical radical was observed in premorbid. As a result of the psychotraumatic situation, the patient twice lost memories of the events of his life, could not remember his name, place of residence. At the same time, his ability to memorize new information, training knowledge, and some dance skills were preserved. Instrumental examinations detected no organic pathology. Memory in both cases was fully restored within a few months. Patients with similar symptoms were increasingly encountered in psychiatric practice. At the same time, there are different viewpoints on the occurrence of such symptoms. It is obvious that the problem of dissociative amnesia is relevant and requires further investigation.

© 2018 Ima-Press Publishing House. All rights reserved. Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study. Patients and methods. A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followed up. Cognitive functions were evaluated using the Mini-Mental State Examination (MMSE), Mattis dementia rating scale, the clock drawing test, the test on memorizing 12 words, and the Schulte table. During 5 years of follow-up, 61 (17.4%) patients died, including 45 (12.8%) from recurrent stroke; 89 recurrent strokes developed. Results. The first examination did not reveal CI in 59 (17%) patients; 73 (21%) were found to have marked CI (mild or moderate dementia). After 1, 3, and 5years of follow-up, the proportion of patients with marked CI increased up to 23.2, 29.5, and 34.5%, respectively. Within 5 years, there was an average decline of 2 MMSE scores. The maximum decrease in cognitive functions was seen in patients who had experienced a recurrent stroke, but this also occurred in the absence of a stroke. Cognitive functions were substantially better in a group of patients with blood pressure (BP) normalization. Conclusion. The 5-year follow-up has shown that post-stroke CI gradually progresses, which is associated with the progression of both vascular disease and a concomitant neurodegenerative process. BP normalization during antihypertensive therapy contributes to the prevention of progressive post-stroke CI.