The problem of diagnosis of generalized and focal forms of salmonellosis
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01.01.2018 |
Malov V.
Maleyev V.
Parkhomenko Y.
Tsvetkova N.
Smetanina S.
Gorobchenko A.
Belugin V.
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Terapevticheskii Arkhiv |
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0 |
Ссылка
© 2018 Media Sphera Publishing Group.All Rights Reserved. The article describes the clinical observation with an unfavorable outcome of the generalized form of salmonella infection caused by Salmonella typhimurium group B in a woman of 60 years without immunodeficiency, complicated by the development of multiple abscesses of the lower parts of abdominal cavity, probably of appendicular origin. In a short literary review, the pathogenetic mechanisms that contribute to the formation of generalized and extraintestinal forms of salmonella infection are discussed.
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Comparative experimental study of 5-ALA and 5-ALA Hexyl ester specific activity
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01.01.2018 |
Yakubovskaya R.
Pankratov A.
Filonenko E.
Lukyanets E.
Ivanova-Radkevich V.
Trushin A.
Kaprin A.
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Biomedical Photonics |
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0 |
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© 2018 Russian Photodynamic Association. All rights reserved. A comparative experimental study of the specific activity of drugs based on 5-aminolevulinic acid (5-ALA) and its hexyl ester (5-ALA HE) was carried out. Their ability to induce the synthesis of photoactive protoporphyrin IX in the healthy tissues of the rabbit bladder when instilling the drug solutions at various concentrations has been estimated. It was shown that 5-ALA HE results in the induction and accumulation of PPIX in the rabbit bladder epithelium at much lower concentrations than 5-ALA. Thus, a significant increase in the fluorescence intensity in comparison with the control was achieved by instillation of 5-ALA HE solution in the rabbit' bladder at a concentration of only 0.0001% (fluorescence intensity 2.20±0.60 a.u.), and for 5-ALA - only when using a solution at a concentration of 0.3% (fluorescence intensity 2.60±1.02 a.u.).
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Internal motivation among doctoral students: Contributions from the student and from the student's environment
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01.01.2018 |
Lynch M.
Salikhova N.
Salikhova A.
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International Journal of Doctoral Studies |
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1 |
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© 2018 Informing Science Institute. All rights reserved. Aim/Purpose The present quantitative, cross-sectional study aimed to investigate objective and subjective factors in the self-determination of doctoral students in their educational activities. Objective determinants included major discipline and forms of academic and scholarly activity (that is, attending classes and writing papers), and subjective determinants included personal characteristics of the doctoral students, including dispositional autonomy and perceptions of environmental supports for students' basic psychological needs. Background The quality of students' motivation for learning has been linked with many different outcomes. Specifically, students who are more internally motivated (that is, who engage in learning activities for reasons that are personally important and freely chosen) demonstrate better performance outcomes and are more likely to choose and to persist in challenging tasks, to enjoy learning, to exhibit greater creativity, and in general to experience greater psychological well-being. Important questions remain, however, regarding the sources that affect student motivation, in particular at the level of graduate school. The present study expands on existing research by exploring contributions to students' motivation both from the students, themselves, and from supports stemming from two interpersonal contexts: close relationships and the university environment. Methodology Participating in the study were 112 doctoral students from various natural sci-ences departments of a major university in the Volga region of Russia. Self-report measures included dispositional autonomy, motivation for various types of academic and scholarly activity, and satisfaction of basic needs for autonomy, competence, and relatedness in various interpersonal contexts. Analyses includ-ed descriptive statistics, comparison of mean differences, correlation, and struc-tural equation modeling. Contribution The present study goes beyond existing research by considering both disposi-tional and situational factors that influence the motivation of doctoral students for their scholarly and academic activities, and by comparing the impact on mo-tivation of close personal relationships with that of various interpersonal con-texts in the university setting. Findings Doctoral students reported greater supports for their basic needs (for compe-tence, autonomy, and relatedness) from their close personal relationships than in their university contexts. Students felt less support for their autonomy and competence with their research supervisor than in other university settings. The early stages of a scholarly activity, such as gathering sources and analyzing mate-rials, were more likely to be characterized by external motivation, whereas the later stages, like the actual writing of a manuscript, were more likely to be inter-nally motivated. When competing for variance, need supports from university-based but not from close personal relationships were significant contributors to students internal motivation for scholarly and academic activity; this effect, however, was fully mediated through students own dispositional autonomy. Recommendations for Practitioners The present study underscores the importance of creating an environment in the university that supports doctoral students needs for autonomy, competence, and relatedness. Educators, and in particular research supervisors, should attend to the ways in which their policies and practices support versus undermine these needs, which are shown to play an important role in promoting doctoral stu-dents own internal motivation for their scholarly and academic activities. Recommendations for Researchers Although in this sample need supports from university-based interpersonal con-texts outweighed the role of need supports from close personal relationships, in terms of doctoral students scholarly and academic motivation, it seems im-portant to keep both contexts in mind, given the general importance of close relationships for motivation and other educational and well-being outcomes. As well, accounting for students own dispositional attributes, such as their own personal tendency toward autonomy, seems a critical counterpoint to looking at environmental contributions. Future Research Future research should examine whether the mediational model tested in the present study applies to other samples of doctoral students, for example, to those from other disciplines, such as the humanities, and those in other cultural or geographic locations, where it is possible that close personal relationships may contribute more substantially to students motivation than was the case in the present sample. As well, future studies would do well to include other rele-vant outcomes, such as academic grades, successful degree completion, and measures of well-being, in order to confirm previous findings of the link be-tween internal motivation and various educational outcomes.
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Factors influencing the efficiency of therapy in patients with rheumatoid arthritis: The role of comorbid mental and somatic diseases
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01.01.2018 |
Abramkin A.
Lisitsyna T.
Veltishchev D.
Seravina O.
Kovalevskaya O.
Glukhova S.
Nasonov E.
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Nauchno-Prakticheskaya Revmatologiya |
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1 |
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© 2018 Ima-Press Publishing House. All right reserved. The response rate to therapy for rheumatoid arthritis (RA) rarely exceeds 60%. Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) substantially affect the evaluation of the efficiency of RA therapy. Adequate psychopharmacotherapy is one of the possible approaches to optimizing the treatment of RA. The factors influencing the efficiency of RA therapy with standard disease-modifying antirheumatic drugs (DMARDs) and biological agents (BAs) in combination with adequate psychopharmacotherapy have not been previously identified. Objective: to determine the predictors of response to therapy in patients with RA receiving DMARDs and BAs with or without adequate psychopharmacotherapy for ADS disorders. Subjects and methods. The investigation included 128 patients (13% men and 87% women) with a reliable diagnosis of RA. At baseline, 75.1% of patients received DMARDs; 7.8% - BAs. ADS disorders were detected in 123 (96.1%) patients. Psychopharmacotherapy was offered to all the patients with MDs; 52 patients agreed to treatment and 71 refused. The following therapeutic groups were identified according to the performed therapy: 1) DMARDs (n = 39); 2) DMARDs + psychopharmacotherapy (n = 43); 3) DMARDs + BAs (n = 32); 4) DMARDs + BAs + psychopharmacotherapy (n = 9). The changes of MDs symptoms and the outcomes of RA were assessed in 83 (67.5%) patients at five-year follow-up. The efficiency of RA therapy was evaluated with DAS28 (EULAR criteria). Predictors of response to therapy were determined using linear regression modeling. Results and discussion. At 5 years, 22 (26.5%) and 37 (44.6%) patients were recorded to show good and moderate responses to therapy, respectively; 24 (28.9%) patients were non-respondents. The linear regression model included 14 factors (p<0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p<0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response.
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Theology of decorum: Perspectives on women's external appearance among evangelical Christians-Baptists in the late- and post-Soviet periods
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01.01.2018 |
Beliakova N.
French A.
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Gosudarstvo, Religiia, Tserkov' v Rossii i za Rubezhom/State, Religion and Church in Russia and Worldwide |
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1 |
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© 2018 Russian Presidential Academy of National Economy and Public Administration. All rights reserved. This article uses oral history interviews to examine the memory of believers from Evangelical Christian-Baptist (ECB) churches regarding the requirements for women's external appearance as a reflection of their personal piety. While discussing believers' memory of the late Soviet period, the article demonstrates that these congregations focused almost exclusively on women. The conviction that believers were not to reflect the "outside world" in appearance was actually a double standard for women, since women's fashion choices have been much more dynamic than men's in the Soviet and post-Soviet periods. The article discusses the historical and social significance of the emphasis on women's appearance, arguing that both a high view of scripture and a nostalgia for the "Soviet past" perpetuated the patriarchal norms held by both men and women in ECB congregations. The authors then utilize a series of historical photographs from the 1940s to the 1970s to demonstrate the scope of the transformation of ECB believers' memory, which did not always accurately reflect late-Soviet reality. The authors conclude that the extensive changes in the social order in general and in women's fashion in particular in the post-Soviet period strengthened believers' impulse to isolate themselves from the immoral "outside world." By following the accepted norms for their external appearance, ECB women's appearance becomes a marker of their faith and a visible sign of their piety that is so highly prized by their community.
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Medical support of the All-Russian physical culture-sports set «ready for Labor and Defense»
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01.01.2018 |
Sultanova O.
Magomedova A.
Ivanova T.
Mashkovsky E.
Lazareva I.
Krasavina T.
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Profilakticheskaya Meditsina |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. The All-Russian physical culture-sports set «Ready for Labour and Defense» (RLD) is a system that is aimed at health improvement and patriotic education of the nation. This system consists of strength, speed, endurance, agility, and flexibility tests. Statutory requirements for each discipline have been developed taking into account the age and gender characteristics of an organism. The main aim of the RLD set is to improve the population's health; therefore much attention is focussed on the issues of medical support. The medical support of the RLD set can be arbitrarily divided into several stages: to make preliminary medical examination and to gain access to RLD tests; to check whether medical access is available and complies with the health status of their participant at the time of the tests; to render medical care when the RLD standards are fulfilled. This paper proposes to consider the stepwise medical support of the RLD set in accordance with actual normative legal acts.
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Adalimumab discontinuation in patients with rheumatoid arthritis after achieving sustained remission
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01.01.2018 |
Demidova N.
Galushko E.
Glukhova S.
Savushkina N.
Satybaldyev A.
Cherkasova M.
Khoroshko N.
Maglevanyi S.
Gordeev A.
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Nauchno-Prakticheskaya Revmatologiya |
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0 |
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© 2018 Ima-Press Publishing House. All rights reserved. Objective: to assess whether adalimumab (AD) can be gradually discontinued during continuous methotrexate (MTX) use in patients with early rheumatoid arthritis (ERA). Subjects and methods. Within the REMARCA (the Russian study of methotrexate and biological agents in early active arthritis) study, the investigators examined 20 patients (17 women and 3 men; median age, 51 [41.5; 56] years) with ERA (disease duration, 10 [5.5; 20] months; DAS28, 5.17 [4.37; 6.51]; 85% of the patients were seropositive for rheumatoid factor and 85% for anti-cyclic citrullinated peptide antibodies. Results and discussion. All the patients received subcutaneous MTX 25 mg/week. Twelve weeks after beginning therapy with MTX, due to its inefficiency, ADA was added according to the standard scheme. At week 24, the median DAS28 was 3.0 [1.65; 3.73]; 85% of the patients achieved remission or low disease activity. After 3 months of ADA therapy, high or moderate disease activity remained in 3 (15%) patients; median DAS28 was 4.4 [4.3; 6.1]; the drug was discontinued in them due to ineffective therapy. After 12-month follow-up, low DAS28 scores were observed in 5 (29.4%), DAS28 remission was in 12 (70.6%) of the 17 patients who continued ADA treatment; after 24 months, all the 17 patients were noted to have remission. After achieving sustained remission (≥ 6-month duration during ADA therapy), there was a carefully controlled reduction (titration) in the dose of ADA with its complete discontinuation, by maintaining remission at 36-month follow-up; the median DAS28 was 1.6 [1.4; 2.2]. During ADA treatment, one female patient developed pustular psoriasis and therefore the drug was discontinued at 24-month follow-up during the period of sustained remission. Other serious adverse events and tuberculosis cases were not recorded. Conclusion. Thus, the results of the study are indicative of the high clinical efficiency of the therapy. After ADA discontinuation, sustained remission can be maintained in patients with ERA and if they took biological agents early.
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An overtraining syndrome as functional cardiovascular disorder due to physical overload
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01.01.2018 |
Badtieva V.
Pavlov V.
Sharykin A.
Khokhlova M.
Pachina A.
Vybornov V.
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Russian Journal of Cardiology |
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0 |
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© Russian Journal of Cardiology. In the article, an analysis provided of recent views on the overtraining syndrome by the data from local and foreign publications. The witness of the problem actuality is also an existence of controversial opinions and absence of clear definitions on properties of the condition. It has been revealed that the main role in pathogenesis of the overtraining syndrome do play the changes of cardiovascular, endocrine and central nervous systems. These changes are complicated and ambiguous, depend upon multiple factors, as the type of sport, specifics of exertion and loads, stage of pathophysiological process. Entraining effect of exertion, if incorrectly utilized, underestimation of current condition of a sportsman, might not lead to expected results. Moreover, non-rational application of exertion might lead to opposite effect, that is, to decrease adaptation potential and reserves, towards the edge of the condition as an overtraining syndrome, which shows phasic, progressing character, starting from fatigue and mild disorders, to persistent, rigidly reversible processes. Due to controversy, multiple stages and multifactorial of the overtraining syndrome, by now there is no unified approach to its definition, as no unified standards to its diagnostics, treatment and prevention.
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Laparoscopic radical hysterectomy for stages IA2 and IB cervical cancer
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01.01.2018 |
Ovodenko D.
Khabas G.
Makarova A.
Sheshko P.
Sannikova M.
Pirogova M.
Golitsyna Y.
Mamedov S.
Grigoryev V.
Ashrafyan L.
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Akusherstvo i Ginekologiya (Russian Federation) |
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0 |
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© Bionika Media Ltd. Objective. To assess the immediate results of laparoscopic radical hysterectomy for Stages IB2 and IIB cervical cancer (after neoadjuvant chemotherapy) and for the early stages of the disease. Material and methods. The paper presents the results of treating 59 patients with cervical cancer who have undergone Piver type III laparoscopic radical hysterectomy, including 33 patients with early stages (IA2, IB1, IIA1) of the disease and 26 patients with its locally advanced forms (IB2, IIA2, IIB) after neoadjuvant chemotherapy. Results. The histopathological parameters of radical surgery (the number of lymph nodes, the level of removal of the parametrium and a vaginal cuff) did not differ at the early and locally advanced stages of cervical cancer. Conclusion. Laparoscopic radical hysterectomy after neoadjuvant chemotherapy for Stages IB2–IIB cervical cancer is an effective method for the surgical treatment of patients.
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Antiretrovirus therapy - A new epoch of prevention of HIV infection
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01.01.2018 |
Tursunov R.
Kanestri V.
Simonova E.
Raichich R.
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HIV Infection and Immunosuppressive Disorders |
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1 |
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© 2018. Modern medicine, relying on a verified strategy and consistent approach, has proved that to date, HIV infection, thanks to effective antiretroviral therapy, has evolved from a category of incurable and deadly diseases into a nosology potentially controlled by medical and diagnostic measures. Moreover, as shown by numerous studies, not only clinical, but also the population effect has been achieved. The life expectancy of HIV-infected people has increased, its quality has significantly improved, and the number of potential sources of infection has decreased. The concept of «treatment as prevention» at the present stage becomes an integral part of the complex of measures to combat HIV infection, since the early onset of ART can significantly reduce the risk of transmission of the pathogen, as well as the level of AIDS-associated morbidity and mortality. In addition to ART, the principles of comprehensive prevention remain unshakable, taking into account the modern epidemiological features of HIV infection.
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The possibility of neoplastic transformation of ovarian endometriosis
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01.01.2018 |
Gromova T.
Sheshukova N.
Bolshakova O.
Zayratyants O.
Levakov S.
Fedotov E.
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Akusherstvo i Ginekologiya (Russian Federation) |
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1 |
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© 2018, Bionika Media Ltd. All rights reserved. Objective. To investigate the signs of neoplastic transformation of the epithelium in the foci of ovarian endometriosis (OE). Material and methods. Histological and immunohistochemical examinations were used to study 78 and 35 OE cases, respectively, and 8 adenocarcinomas. Anti-Ki-67, anti-Bcl-2, anti-p53, and anti-hepatocyte nuclear factor-1β (HNF-1s) antibodies were employed. Results. The epithelium of endometrioid cyst walls showed papillary syncytial changes (39.7%), metaplasia with clear cytoplasm сells (15.4%), and epithelial atypia with a low-to-relatively low Ki-67 and Bcl-2 expression and with a low p53 expression (41.0%). The expression of HNF-1β in the foci with and without atypia was revealed in 94.7 and 56.3% of cases, respectively; it was detected only in clear cell adenocarcinomas. Conclusion. HNF-1s hyperexpression suggests the adaptive nature and histogenetic relationship of OE to clear cell tumors of the ovary.
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Psychophysiologic features and personal-adaptive potential of students with limited abilities
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01.01.2018 |
Kalenik E.
Salakhova V.
Mikhaylovsky M.
Zhelezniakova M.
Bulgakov A.
Oshchepkov A.
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Electronic Journal of General Medicine |
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11 |
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© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The article contains the results of studying homeostasis of the cardiovascular system by the method of cardiointervalography in students with limited abilities of various programs of study at university. A psychological assessment of the attitude of students with limited abilities to their health was made. The problem of the components of the personal-adaptive potential has been studied. A study of the level of human potential of students on a separate component of “health” and in the aggregate has been conducted, as well as conclusions based on this research work have been drawn. Method: To solve the objectives set in the study, the following methods were used: the review of scientific and methodological literature, instrumental and calculated physiological research methods: variational pulsometry; mathematical analysis of the heart rate variability; calculation method for assessing adaptive capacity-adaptive capacity offered by Bayevsky; the questionnaire “Psychological features of a person’s attitude to his health”, in the framework of a study of the human potential index (health component), a questionnaire was developed based on a questionnaire for assessing the quality of life, developed at the Institute of Stress Medicine (USA) in 1993, methods-descriptive mathematical statistics and testing the hypothesis by Student’s t-test. Results: The analysis of the activity index of the sympathic regulation link-mode amplitude (AMo%) according to the standards of homeostasis, in view of variation pulsograms, is characterized in the studied groups, as moderate sympathicotonia. The AMo index in the groups is not statistically different, reflects the stabilizing effect of centralization of the heart rate control, and indicates the activation of the sympathic division of the autonomic nervous system (ANS). AMo 1 year = 40.8 ± 8.1%; AMo 2 year = 44.9 ± 4.8%; AMo 3 year = 43.9 ± 8.8% the index is in the upper limits of the norm, the index is normal only in the group of first year students. It can be stated that the body of students with limited abilities reacts with a nonspecific adaptive response to the study load, and this depends on the specifics of the diseases and functional reserves that are low in this category of students. The indicator of urgent adaptation-vagosympathetic balance (LF / HF) shows the greatest stress in the group of first-year students. The index is statistically reliably different from the LF / HF1 year = 2.074 ± 0.39 * (according to the paired Student’s t-criterion of dependent indices p ≤ 0.5) from that of students in the second LF / HF2 year = 1.174 ± 0.25 and the third LF / HF3 year = 1.308 ± 0.26 years of study, indicating an increase in sympathic influences. A decrease in the ratio of the LF / HF index in the groups of second and third year students can be interpreted as a positive effect. There was general adaptation to the educational process at the university, and the correct construction of training and health-related workloads, in accordance with the medical diagnosis, led to a balanced regulation of the sympathic and parasympathic nervous system. Conclusion: The stress level of regulatory systems is assessed by the value of the adaptation potential. The higher is the adaptive capacity of the circulatory system, the lower the values of the adaptive potential. The adaptive potential is an indicator that determines the interrelation of two opposite concepts: “health” and “disease”, morpho-functional changes. In case of illness, a shift towards disadaptation takes place.
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A draft national adult immunization calendar in russia
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01.01.2018 |
Briko N.
Feldblyum I.
Alyeva M.
Tsapkova N.
Korshunov V.
Kostenko N.
Drapkina O.
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Profilakticheskaya Meditsina |
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0 |
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© 2018, Media Sphera Publishing Group. All rights reserved. The current national immunization calendar is intended for the pediatric population; the general concept of adult immunization is absent, which does not protect target groups under the conditions of the changing epidemic situation and the state of population immunity. Objective - to substantiate and design a national vaccine schedule for adults. Material and methods. The investigation was conducted using the data available in the Russian and foreign literature, the assessments of the epidemic situation among the adult population in the Russian Federation, and the authors’ own studies. Results. The draft national adult immunization calendar consisting of two sections was designed and substantiated. The first section includes information on immunization of different age groups; the second contains that on immunization of groups at epidemiological and social risks. Conclusions. The introduction of the national adult immunization calendar and improvements in the institutional framework of vaccination will achieve further reductions in morbidity and mortality rates in the country.
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Endometriosis, adenomyosis, chronic endometritis: Clinical and pathogenetic relationships and reproductive failures
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01.01.2018 |
Unanyan A.
Sidorova I.
Kogan E.
Belogubova S.
Demura T.
Elisavetskaya A.
Sizova N.
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Akusherstvo i Ginekologiya (Russian Federation) |
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0 |
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© Bionika Media Ltd. The article highlights the clinical and pathogenetic relationships between endometriosis/adenomyosis and chronic endometritis (CE) within reproductive failures. It describes a cause-and-effect relationship between endometriosis/ adenomyosis and CE by the example of its clinical symptomatology and the pathogenic mechanisms involving an autoimmune process, aseptic inflammation, and altered endometrial receptivity. Endometriosis/adenomyosis and CE have a number of common pathogenetic mechanisms of development and clinical manifestations (infertility, miscarriages, and assisted reproductive program failures). This implies the necessity to qualitatively assess the endometrium in women with endometriosis and adenomyosis during pregravid preparation, as well as the search for new therapeutic ways to correct autoimmune disorders. The use of sodium desoxyribonucleate (derinat) showing the pharmacological properties of an activator of the cellular and humoral immune system and a stimulator of reparative and regenerative processes is a promising approach to drug therapy.
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Main directions of reducing patient irradiation doses in computed tomography
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01.01.2018 |
Matkevich E.
Sinitsyn V.
Zelikman M.
Kruchinin S.
Ivanov I.
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Russian Electronic Journal of Radiology |
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2 |
Ссылка
© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To analyze and organize the basic techniques to reduce radiation exposure to patients with computed tomography (CT) scan of the head, chest, abdomen and pelvis. Materials and methods: The analysis of publications was carried out on the databases Scopus, Web of Science, MedLine and RINC. Results: The variants of the use of CT of the head, chest, heart, abdominal and pelvic organs in multidisciplinary institutions with different methods of reducing the dose burden on patients have been analyzed. Conclusion: The factors used to reduce the dose for CT can be systematized in three main ways: 1) methods that depend on the attending physician, radiologist and CT staff; 2) parameters of the research protocol; 3) features of CT-devices and software. Considering the factors reducing the radiation dose of patients in support of the need for CT examination, choice of parameters of the CT protocol, CT devices and software allows to significantly reduce the radiation burden on patients (by 10-78%) without compromising the quality of CT images. The development of methods to reduce the dose of irradiation of patients is extremely urgent, especially in screening, multiple CT studies and CT with contrast.
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Association of polymorphisms of HLA-DRB1 and TNF-308 G/A with radiographic joint damage in patients with early rheumatoid arthritis with high inflammatory activity, treated according to the principle of "Treat to target" (REMARKA study)
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01.01.2018 |
Guseva I.
Smirnov A.
Demidova N.
Krylov M.
Avdeeva A.
Samarkina E.
Luchikhina E.
Karateev D.
Abramov D.
Nasonov E.
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Terapevticheskii Arkhiv |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Objective. To clarify the association between HLA-DRB1 and TNFα (-308G>A) genes polymorphism and joint destruction/further progression during 12 months of the follow-up period (FUP) in patients with early (<6 months), active, predominantly antibodies to cyclic citrullinated peptide (ACCP) and rheumatoid factor (RF)-positive rheumatoid arthritis (RA) treated according to "Treat to target" strategy. Materials and Methods. The study included 85 patients with early RA and duration of symptoms <6 months. All patients were initially assigned to subcutaneous methotrexate (MTX) with rapid dose escalation to 20-25 mg/week. Combination MTX + biological therapy, mainly adalimumab, was used when MTX was ineffective. Joint destruction was assessed by Sharp-Van der Heijde modification scoring method at baseline and after 12 months FUP. Real time polymerase chain reaction (PCR-RT) was used for TNFα gene polymorphism (-308G>A) genotyping. Low resolution PCR-RT with subsequent sequence-based typing of ∗04 were performed to study HLA-DRB1 gene polymorphism. The HLA-DRB1∗01, ∗04:01, ∗04:04, ∗04:05, ∗04:08, ∗10 alleles were categorized as SE+ (Shared Epitope) alleles. Results. As for TNFα gene polymorphism, it was demonstrated that the number of narrowings and total Sharp score values were almost twice as high at baseline in GG genotype carriers as compared to GA genotype carriers (ρ<0,005, and ρ<0,004 respectively). Similar association was found after 12mo FUP. The progression of joint destruction, assessed as the change (Δ) in the number of erosions, joint space narrowings and the total score, was statistically significantly associated with HLA-DRB1∗(SE) genotypes: The carriers of SE (SE+/SE+) double-dose had more advanced progression as compared to (SE+/SE-)/(SE-/SE-) carriers (ρ<0,028, ρ<0,019, ρ<0,035 respectively). Conclusion. Our data suggest that HLA-DRB1 (SE+) gene and TNFα (-308G>A) polymorphisms are associated with the progression of radiographic joint destruction in early, active RA patients managed according to "Treat to target" stratagy.
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Natural aging as as a sequential poly-systemic syndrome
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01.01.2018 |
Krutko V.
Dontsov V.
Khalyavkin A.
Markova A.
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Frontiers in Bioscience - Landmark |
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2 |
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© 2018 Frontiers in Bioscience. All Rights Reserved. We review the progression of aging as a sequential development of multiple syndromes analogous to other diseases. This generalized approach may allow practicing physicians to consider the signs of aging as manifestations of a poly-syndrome disease and facilitate prevention, diagnosis and treatment of common aging-related dysfunctions.
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Computer-assisted cystoscopy diagnosis of bladder cancer
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01.01.2018 |
Gosnell M.
Polikarpov D.
Goldys E.
Zvyagin A.
Gillatt D.
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Urologic Oncology: Seminars and Original Investigations |
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© 2018 Elsevier Inc. Objectives One of the most reliable methods for diagnosing bladder cancer is cystoscopy. Depending on the findings, this may be followed by a referral to a more experienced urologist or a biopsy and histological analysis of suspicious lesion. In this work, we explore whether computer-assisted triage of cystoscopy findings can identify low-risk lesions and reduce the number of referrals or biopsies, associated complications, and costs, although reducing subjectivity of the procedure and indicating when the risk of a lesion being malignant is minimal. Materials and methods Cystoscopy images taken during routine clinical patient evaluation and supported by biopsy were interpreted by an expert clinician. They were further subjected to an automated image analysis developed to best capture cancer characteristics. The images were transformed and divided into segments, using a specialised color segmentation system. After the selection of a set of highly informative features, the segments were separated into 4 classes: healthy, veins, inflammation, and cancerous. The images were then classified as healthy and diseased, using a linear discriminant, the naïve Bayes, and the quadratic linear classifiers. Performance of the classifiers was measured by using receiver operation characteristic curves. Results The classification system developed here, with the quadratic classifier, yielded 50% false-positive rate and zero false-negative rate, which means, that no malignant lesions would be missed by this classifier. Conclusions Based on criteria used for assessment of cystoscopy images by medical specialists and features that human visual system is less sensitive to, we developed a computer program that carries out automated analysis of cystoscopy images. Our program could be used as a triage to identify patients who do not require referral or further testing.
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Modern methods of diagnosing addiction to psychoactive substances: Neurophysiological aspects
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01.01.2018 |
Salakhova V.
Belinskaya D.
Erofeeva M.
Ulyanova I.
Zotova L.
Khammatova R.
Mizonova O.
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Electronic Journal of General Medicine |
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12 |
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© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The study of the features of the higher mental functions of the brain in patients suffering from addiction to psychoactive substances is very important for narcology. It is necessary not only to uncover the mechanisms of addiction, a complete understanding of the neurophysiological processes that determine the nature of the development and severity of the disease, but also to solve practical problems related to the development of treatment methods and the implementation of preventive measures. Method: In the study of patients, a specially designed map was used containing information on the hereditary and demographic characteristics, on the course of the disease, as well as on the socio-cultural status of patients. To determine the functional state of cortical activity in the process of perception of unconscious signals, a special technique was used. The obtained results were subjected to dispersive analysis and the significance of differences was calculated according to Student’s t-criterion. Results: An analysis of premorbid personality traits made it possible to establish the prevalence of instability, pathological conformity, and hysteroidal features in patients. It should be noted that a large percentage of the surveyed had a hereditary burden of alcoholism, mainly in the line of the father. Curiosity, passive submission, imitation of friends were among the motives of the first drug use. All patients in the process of addiction formed the following features: increased excitability, increasing effective disorders (depression, dysphoria), aggravated by exacerbation of craving for the drug, a decline in morals and ethics (egoism, deceit, indifference to one’s fate, hedonism, loss of sense of duty), disorders of the emotional-volitional sphere (emotional instability, hypersensitivity, vulnerability). Conclusion: The analysis of the duration of latent periods and magnitude of the amplitudes of the late positive R3OO wave in patients with heroin addiction revealed clear differences between the data obtained upon presentation of an unconscious neutral and motivationally significant word. Patients who use psychoactive substances, using the method of recording induced potentials of the brain, which is a sensitive indicator of the activity of brain structures in relation to the substance used, revealed a clear diffuse activation of the cerebral cortex in response to an unconscious verbal stimulus related to the motivation prevailing in patients, in particular to “heroin”. Such activation, as well as the difficult dying out of the developed reactions to an unconscious stimulus, indicate certain neurophysiological foundations of the mechanism underlying the changes in the motivational sphere and the stability of the pathological craving for the psychoactive substance.
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Immediate implant placement into fresh extraction sites using single-drilling bur and two loading procedures: Follow-up results
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01.01.2018 |
Bettach R.
Taschieri S.
Mortellaro C.
Del Fabbro M.
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Journal of Craniofacial Surgery |
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Copyright © 2018 by Mutaz B. Habal, MD. Modern clinical protocols in implantology aim at shortening the treatment time and reducing duration and discomfort of the surgical phase, while maintaining optimal treatment outcomes. The purpose of this study was to evaluate clinical outcomes of implants immediately placed in extraction sites, using a single drilling step for implant site preparation. One-hundred thirty-three patients (mean age 55.3 ± 12.7 [SD] years, range 20 – 83 years) were treated at 2 clinical centers. Two-hundred sixty-one implants were inserted in fresh postextraction sockets. One-hundred sixty-five implants were immediately loaded (IL) and 96 underwent delayed loading (DL). Implant survival, peri-implant bone level change and patients’ satisfaction were assessed after at least 3 years of function. No patient dropout occurred. The mean follow-up was 63.61 ± 11.52 months (range 39.71 – 85.71 months) from prosthesis delivery. Two IL and 1 DL implant failed in 3 patients. Implant survival was 98.8% and 99% for IL and DL group, respectively. The mean marginal bone loss after 1 year was 0.48 ± 0.40 mm and 0.52 ± 0.34 mm for IL and DL group. No biological nor mechanical complications occurred. All patients demonstrated full satisfaction. The present protocol with single burs for site preparation produced satisfactory clinical outcomes independent of the loading timing. Further long-term comparative studies are needed to confirm the present findings.
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