Репозиторий Университета

© 2018 Vitebsk State Medical University. All rights reserved. Primary-multifocal malignant tumors hold a specific place in oncology. Present case report describes the combination of two neoplastic processes with different anatomic localization, the analogues to which have not been found either in the domestic literature or foreign sources. The article presents the case of a synchronous primary-multiple malignant neoplasm - malignant tumor from the membranes of the peripheral nerves of the nasal cavity with expansion into the right maxillary sinus, the cells of the ethmoidal sinus т2bN0M0 and moderately differentiated adenocarcinoma of the sigmoid colon т4аN0M0. Physical examination and positron emission tomography combined with the computed tomography confirmed a hypervascular tumor of the posterior cells of the ethmoidal sinus and a nasal cavity without hypermetabolism and the circular tumor of the sigmoid colon with hypermetabolism. Taking into account the primary-multiple character of the lesion and the clinic of intestinal obstruction, a tactic of the treatment was a combined surgery - the removal of the neoplasm of the nasal cavity with resection of the right maxillary sinus with microsurgical technique and a reconstructive-plastic component using a coronary access, laparotomy, resection of the sigmoid colon, lymphadenectomy. The chosen treatment allowed eliminating both of the tumors in a short time and moving on to a further stage of treatment. The patient is under the supervision, there is no recurrence of the disease at the moment.

© 2018; Pediatria Ltd. All rights reserved. Congenital uropathies (CU) are anomalies associated with impaired patency of the upper and lower urinary tract and include congenital hydronephrosis, megaureter, primary vesicoureteral reflux (VUR), infravesical obstruction with prevalence in the pediatric population up to 1,4-2,8%. The most dangerous complication of CU is the development of kidney fibrosis in 30-60% of children combined with a persistent urinary system infection (USI). The lack of effective methods for early diagnosis and evaluation of renal parenchyma fibrosis treatment efficacy dictates the need for further search for molecular indicators of kidney injury. The article describes the study of inflammation biomarkers (interleukin 6 (IL6), inertleukin 8 (IL8), interleukin 10 (IL10)) and fibrosis (monocyte chemoattractant protein 1 (MCP1), transforming growth factor Β1 (TGFΒ1), vasculoendothelial growth factor (VEGF)) in urine in children with CU for diagnosis, monitoring and predicting the course of pathology. The study included 255 patients with various variants of CU (congenital hydronephrosis - 75, VUR - 169, infravesical obstruction - 11). The mean age of the patients was 4,3±3,2 years. The comparison group included 20 almost healthy children stratified by sex and age without USI. Biomarkers were determined by the method of enzyme immunoassay (ELISA) in the dynamics of pathology. All patients had an increase in urinary levels of proinflammatory cytokines (IL6, 8), even without clinical picture of USI. The increase in the concentration of MCP1 and TGFΒ1 in the urine is proportional to the degree and duration of VUR before its treatment, their content increased after 6 months after the correction of VUR and indicated the persistence of latent pyelonephritis and fibrosis progression. Molecular diagnosis of inflammation and fibrosis markers n the urine is a promising noninvasive method for assessing the pathological process in kidneys, the effectiveness and adequacy of the treatment.

© 2019, Pleiades Publishing, Ltd. Abstract: The creation of three-dimensional structures possessing biomimetic properties is of considerable interest for regenerative medicine. Nonwoven materials with a diameter of fibers from 100 nm to 3 µm have been obtained by electrospinning from dispersions of collagen in hexafluoroisopropanol and acetic acid (AA). A study by the circular dichroism method indicates the predominant preservation of a collagen triple helix in produced materials. To preserve the fibrous structure in aqueous media, collagen is cross-linked by genipin in isopropanol and PBS (phosphate buffered saline, pH 7.4). The mechanical and biological properties of cross-linked materials have been studied—it is shown that the mechanical behavior of collagen materials in the physiological range of loads corresponds to the mechanical behavior of the native aorta. Cross-linked fibrous materials do not possess cytotoxicity, and they contribute to the adhesion and proliferation of cells.

© 2019, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved. Introduction: Bruxism is one of the mounting questions in contemporary dentistry due to its high prevalence, various clinical presentations, difficulties in diagnostics and treatment, demanding a complex approach from doctors of different specialties. Aim: The aim of the current study was to describe the electromyographic values of chewing muscles in healthy persons and patients with bruxism and to find the biomarkers for early diagnostics of bruxism. Materials and methods: During retrospective investigation patients with bruxism were divided into two groups: group botox and bruxism. The control group was named the group-no complain. Results: Remarkable differences were found in group botox (no complain) in tests, rest and pressing in occlusion for chewing muscles symmetry index (CMSI%). Conclusion: As a result, we revealed a total bio-electric muscle activity index (BMIAI) in healthy patients and patients with bruxism in tests with pressing in occlusion, grinding and rest. All the values received to hold a high-reliability index, which makes them useful for everyday clinical practice. Clinical significance: Definition of electromyography (EMG) values IMPACT index of chewing muscles in healthy and bruxing conditions allows to carry out early diagnostics of bruxism and to evaluate the effectiveness of mio relaxation therapy.

The atherosclerosis is considered among the most prevalent diseases. In Russia, N. N. Anitchkov and A. L. Miasnikov are founders of atherosclerosis studies. Valentina Iosifovna Miasnikova, doctor of medical sciences, professor of the Chair of Faculty Therapy #2 of the Sechenov University is one the numerous followers of A. L. Miasnikov. From the early 1960s, Valentina Iosifovna, proceeding with ideas of N. N. Anitchkov and A. L. Miasnikov, actively investigated pathogenesis of atherosclerosis. The professor V. I. Kalmykova, one of the first in Russia presented pathogenesis of atherosclerosis as a multi-factorial process and, combining theories existed at that moment, described effect of peroxidation of lipids on all stages of development of atherosclerotic plaque. She carried out a unique scientific investigation concerning studying intensity of peroxidation of lipids and antioxidant activity of lipids in patients with various degree of expression of ischemic heart disease. The gender characteristics of content of peroxides and antioxidant activity of lipids of blood serum were established. The research works of professor V. I. Kalmykova made an invaluable contribution into comprehension of pathogenesis of atherosclerosis and obtained an international approval. The scientific data obtained by V. I. Kalmykova were confirmed by studies of national and international researchers. Nowadays, the role of oxidation process in pathogenesis of atherosclerosis and ischemic heart disease is generally acknowledged.

© 2018 The Authors. Objective: The study was carried out with an objective to characterize the possible bioactive phytochemical constituents from fruits of Schisandra chinensis Bail. by liquid chromatography–mass spectrometry analysis. Methods: Plant material was collected from Schisandra chinensis during August–October. The dried plant fruits were extracted with solvents using ethanol 95% extractor. The results of chromatography–MS analysis performed on the instrument Agilent Technologies established the presence of major and minor components. It was conducted a qualitative and quantitative comparison of infusions using software ChemStationE 02.00 and full library of mass spectra NIST 05.

© 2018 2018 Walter de Gruyter GmbH, Berlin/Boston. Calcium drugs are analogs of endogenous substances. The baseline concentration of endogenous substances in the body and homeostasis mechanisms of regulation make the bioavailability and bioequivalence (BE) evaluation of these drugs very difficult. The aim of the study was to assess the pharmacokinetic parameters of calcium in the studies of comparative bioavailability combined with the assessment of homeostatic regulation mechanisms. The study included 42 healthy male volunteers. We studied the composition of 1000 and 1200 mg of calcium, and 800 and 1000 IU of cholecalciferol. Blood sampling was carried out at 8 a.m. and 0.5, 1, 2, 3, 4, 6, 8 h after administering the drugs. Calcium pharmacokinetic parameters were measured: the area under the curve (AUC) "concentration-time", and maximum concentration (Cmax) in volunteers. The excretion of calcium in urine in terms of creatinine clearance and parathyroid hormone (PTH) levels was assessed. The maximum excretion of calcium was converted to creatinine (calcium/creatinine). Enzyme-linked immunosorbent assay (ELISA) was used to determine the PTH and the o-cresolphthalein method to quantitatively measure the total calcium serum and urine. Results indicated that both the AUC and the excretion of calcium are comparable, and the differences are not statistically significant, p>0.05 (the ratio of calcium and creatinine in the urine maintained within physiological levels). The comparable dynamics of PTH concentration is an indirect measure of the amount of absorbed calcium. The study demonstrates that, along with the standard way of calculating the area under the curve "concentration-time" (total calcium in serum), it is important to assess the calcium excretion in urine in terms of creatinine excretion, as well as focusing on the changes in the PTH levels in volunteers, which could be considered as a marker of the calcium level in the blood.

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. We report a highly efficient, compact low-cost tunable dye laser pumped directly by green laser diodes. A tunable dye laser quasi-longitudinally pumped by two multimode InGaN diodes (520 nm), was implemented in a 200 ns pulsed mode with a 2 Hz repetition frequency. The lasing threshold energies were found to be 0.23–0.37 μ J using an output mirror with 13% transmission. The best efficiency at the lasing maximum for Pyrromethene 567 exceeded 25% when the slope efficiency in broadband cavity configuration was 43% at an absorbed pump energy of 0.75μJ. The laser overlapped a wide spectral region of 145 nm (from 537 to 682 nm) with a linewidth of 1 nm. This indicates that green diodes can be used as an effective pump source for tunable dye lasers. Such lasers will be useful for spectroscopy, medicine and other fields due to their compactness and low cost.

© 2018, The Author(s). Introduction: Trimetazidine (TMZ) was shown to reduce angina symptoms and increase the exercise capacity in stable angina (SA) patients. A new formulation allowing a once-daily (od) dosage could improve patients’ satisfaction and adherence. Methods: ODA was a 3-month, observational, multicenter, prospective Russian study in SA patients with persistent symptoms despite therapy. Angina attack frequency, short-acting nitrate (SAN) consumption, adherence to antianginal medications, and overall efficacy and tolerability of TMZ 80 mg od were assessed in a real-world setting. Results: A total of 3066 patients were included (mean age 62.8, 48% male). After 3 months, TMZ 80 mg od treatment led to a significant (p < 0.001) decrease in angina attack frequency (from 4.7 ± 3.5 to 0.9 ± 1.3/week) and SAN use (from 4.5 ± 3.9 to 0.7 ± 1.3/week). Overall tolerability and effectiveness were rated as “very good” by the majority of physicians. Medication adherence improved significantly, with good adherence reported by 56% of patients (vs. 24% at baseline, p < 0.0001) and non-adherence by 3% (vs. 36% at baseline, p < 0.0001) at month 3. Patient satisfaction with TMZ od was 9.5 [on a scale of 1 to 10 (very satisfied)]. Patients reported improved physical activity: more patients reported no limitations (15% vs. 1% at baseline p < 0.01), slight limitation (46% vs. 5% at baseline, p < 0.001) or moderate limitation (30% vs. 23%, p < 0.01) and fewer patients reported substantial limitation (8% vs. 52% at baseline, p < 0.001) or very marked reduction (1% vs. 19% at baseline, p < 0.01) at month 3. Conclusion: In this prospective, observational study, TMZ 80 mg od effectively reduced angina attacks and SAN consumption, improved physical activity and adherence and was well tolerated in chronic SA patients. Trial Registration: ISRCTN registry Identifier, ISRCTN97780949. Funding: Servier. Plain Language Summary: Plain language summary available for this article.

© 2018 2018 Walter de Gruyter GmbH, Berlin/Boston. The aim was to study seven polymorphic markers of genes encoding proteins involved in the absorption, metabolism and pharmacokinetics of clopidogrel among patients with an acute coronary syndrome (ACS), who have undergone percutaneous coronary intervention (PCI). Eighty-one ACS and PCI patients older than 18 years and treated with dual antiplatelet therapy were enrolled in the study. Platelet function testing and ABCB1, CYP2C19, CYP3A5 and CYP4F2 genotyping were performed. The predictive role of categorical variables, such as genotypes (carriers and non-carriers of polymorphism), on platelet reactivity (platelet reactivity units [PRU] platelet inhibition [PI]) was assessed by logistic regression (for categorical outcomes) and linear regression (for continuous outcomes) analysis. A p-value<0.05 was considered significant. The allele frequencies were estimated by gene counting, and Hardy-Weinberg equilibrium was tested using the chi-square test. Regarding clopidogrel response, 62 patients (76.5%) were clopidogrel responders and 19 were non-responders (23.5%). Mean PRU value and the percentage of platelet inhibition were 170.0±50.9 PRU and 28.6±19.9%, respectively. The effects of the CYP2C19∗2 polymorphisms on PRU (166.0±50.8 vs. 190.7±48.2, p<0.038) and PI (30.6±20.0 vs. 18.1±16.3, p<0.013) were observed, and the rates of high platelet reactivity (HPR) were lower in CYP2C19∗1/∗1 than those in CYP2C19∗1/∗2+CYP2C19∗2/∗2 (16.2% vs. 53.8% p<0.0067). In comparison, no significant difference in PRU value and PI was observed at <5 days between the rest of polymorphisms (p>0.05). Based on the logistic regression analysis, CYP2C19∗2 (OR: 4.365, CI: 1.25-17.67, p=0.022) was an independent predictor of HPR at <5 days, as was the stent diameter (OR: 0.219, CI: 0.002-0.229, p=0.049). The remaining polymorphisms had no influence. The reactivity of the on-clopidogrel platelet in the early phase of ACS is influenced primarily by the CYP2C19 polymorphisms. We believe that the findings of the present study could supply additional evidence regarding the clinical appropriateness of the CYP2C19 genetic testing for designing suitable antiplatelet therapy in the early phase of ACS.

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: The aim of this study was to distinguish different forms of orbital involvement in granulomatosis with polyangiitis (GPA) and to compare their clinical course and outcomes. Methods: Two hundred twenty-six consecutive patients with GPA were retrospectively studied. All patients fulfilled the classification criteria of American College of Rheumatology; diagnosis of localized GPA was established according to Chapel Hill Consensus. Of those, 74 patients with orbital disease were enrolled into further investigation of different forms of orbital disease. Results: Overall ocular involvement was diagnosed in 50% (113/226) of patients; in 5.3% (12/226), inflammatory eye disease resulted in permanent visual loss. Most common ophthalmic manifestations were orbital masses, episcleritis/conjunctivitis, and scleritis (74/226, 32/226, and 12/226, respectively). Seventy-four patients with orbital involvement were divided into three groups: those with orbital mass without primary lacrimal gland involvement (1st group, 45 patients), those with lacrimal gland involvement (2nd group, 26 patients), and those with extraocular myositis (3rd group, 3 patients). Symptoms such as orbital pain, decreased vision, double vision, red eye, scleritis, orbital wall destruction, primary gaze strabismus, and ocular motility restriction were significantly more common in the 1st group. Peripheral ulcerative keratitis (PUK) was present in the 1st group only. Patients of the 1st group suffered from visual loss, double vision, primary gaze strabismus, and ocular motility restriction significantly more often. Eleven of them developed visual loss; 5 of them underwent enucleation, whereas in the group of patients with dacryoadenitis, only 1 patient had BCVA less than 0.3. Conclusions: Three types of orbital disease in GPA were proposed: orbital mass without primary lacrimal gland involvement, dacryoadenitis, and extraocular myositis. Patients with orbital mass without lacrimal gland involvement are characterized with a higher rate of systemic disease, severe clinical course not uncommonly associated with other ophthalmic manifestations (necrotizing scleritis, PUK, orbital walls destruction), relatively unfavorable outcome with high level of morbidity (optic nerve atrophy, anophthalmos, strabismus), and higher rate of recurrences. Dacryoadenitis in GPA showed to be not severe manifestation with favorable prognosis.

© 2018; Pediatria Ltd. All rights reserved. Chronic pathology of the urinary system (US) among children is widespread. Continuously relapsing course of the disease significantly reduces the quality of life (QOL) of patients and their caregivers. Objective of the research - to analyze the necessity of QOL study of children with US chronic pathology. The article presents modern methods, approaches to the assessment of QOL of children of this group. It explains the need to study the evaluation of QOL in children in pediatric practice. QOL indicators of children with chronic diseases are presented as a criterion for assessing the effectiveness of their treatment and socialization. The revealed flaws of QOL of children of different medical and social groups testify to the need to include this indicator in their survey program to optimize medical care for these patients.

© 2018; Pediatria Ltd. All rights reserved. Search for biomarkers, reflecting the severity of inflammation and damage to kidney tissue in children with pyelonephritis is very important. Objective of the research - to study clinical significance of lipocalin 2 associated with neutrophil gelatinase (uNGAL) in urine as a marker of renal parenchymal lesion severity in children with pyelonephritis debut. Study materials and methods: 73 children with pyelonephritis debut hospitalized in the nephrologic department were examined. Children were divided into 2 groups: 1st group - 41 children with acute pyelonephritis (without USO abnormalities), 2nd group - 32 children with acute pyelonephritis combined with various abnormalities of urinary system organs. In all patients, the levels of urea, creatinine, cystatin C, procalcitonin, renal concentration capacity, uric excretion of lipocalin 2 associated with neutrophil gelatinase (uNGAL) were assessed. Results: the study revealed that the level of uNGAL/Cr excretionat the admission in children of both main groups did not differ significantly. A positive correlation was found between uNGAL/Cr value and cystatin C level in patients of the 2nd group. All children had a direct correlation between the duration of febrile fever from the onset of antibiotic therapy and the uNGAL/Cr excretion level. The study also revealed a correlation between uNGAL/Cr excretion level in the acute period of the disease and the degree of renal parenchymal lesion in children from the first and second groups confirmed by static DMCA nephroscintigraphy. Conclusion: a high urinary excretion of uNGAL/Cr in patients with acute pyelonephritis indicates a marked renal parenchyma lesion and requires static nephroscintigraphy with further observation, but not earlier than 6 months after the normalization of clinical-laboratory indicators.

© 2018; Pediatria Ltd. All rights reserved. An expert analysis of lectures and reports at the XIX Congress of the European Union of School and University Medicine and Health (Belgium, Leuven, 2017) presents issues of school and university medicine: modern approaches to assessment of children’s health; ensuring equal access of all children, adolescents and youth to medical care during the period of education in accordance with the Convention on the Rights of the Child, regardless of socioeconomic status, ethnicity and cultural level; the effectiveness of health services, friendly to students, assessment of medical care for students quality; the role of parents in organizing medical care for students; the role of the media in shaping the identity of children in the process of growth and development. The concept of «positive health» focuses on positive and healthy aspects, and not only on medical treatment. The main elements of «positive health» include: physical functioning, daily routine, mental health, social activity, intentions, quality of life. In Europe prevails a program approach to prevention based on targeted work with relevant groups of children and adolescents. There is a need for assessing the impact of environmental factors, access to care and education for children with special needs, providing preventive care for vulnerable children, infants and their families, promoting healthy behavior among students, special approaches to providing mental health to students through available health services and various programs, incl. based on the welfare of children and interventions in the early stages of emotional problems considering risk factors that can be identified in educational institutions. Modern main directions of research in the field of health protection and promotion of students in educational organizations are due to large-scale changes in the environment (pronounced urbanization), the new way of life and quality of life for children and adolescents, their life conditions in a rapidly changing world combined with unfavorable trends in health and development indicators of the growing up generation of Russians.

© 2018 Leonie Korn et al. The weakened heart is supported by a left ventricular assist device (LVAD) to supply the heart muscle with oxygenated blood. In case the heart muscle recovers during LVAD therapy, the patient has to be weaned from the device. To date, there is no adequate method to detect heart muscle recovery in LVAD therapy. In order to establish a novel method based on the measurement of electric conductivity, this study presents a silicone model of a ventricle mock-up to simulate the electrical properties of cardiac muscle tissue. Previously, it has been shown that the electrical properties of myocardial tissue change during ischemia, so that these changes are a possible estimate for measuring the condition of myocardial tissue. To this purpose, this study presents a casting process for a ventricle model and describes the materials used to imitate the electrical properties of the heart muscle to obtain conductive material. Initial results showed that the higher the carbon concentration in the silicone, the higher the conductivity of the silicone samples. The measurements were performed at different frequencies and the samples were analyzed for homogenization.

PURPOSE: The authors present a consecutive series of deep orbital Sub-Q injections to treat enophthalmic sighted eyes in Parry-Romberg syndrome patients.METHODS: Retrospective, interventional case series in 2 centers. Data were collected on patient demographics, Parry-Romberg syndrome onset age, previous orbital and eyelid surgeries, diplopia, ocular movement restriction before and after the injection, number of injections, interval between injections, indication for any top-up or dissolution of filler, and any other complications. In all cases, the hyaluronic acid gel used was Restylane Sub-Q + Lidocaine.RESULTS: A total of 8 injections on 3 patients with Parry-Romberg syndrome, and significant enophthalmos is reported. All injections were with deep orbital Sub-Q filler. All patients were females, aged 32, 24, and 52 years old while their symptoms started at 15, 16, and 30 years old, respectively. None had orbital surgery prior to the injection. Follow up period was 2, 7, and 5 years respectively. All presented a significant enophthalmos of 4 mm which reduced to 1 mm after the injection, and duration effect was 18, 24, and 20 months, respectively. We observed a significant improvement in enophthalmos, lagophthalmos, exposure keratopathy, and even ocular motility. Lagophthalmos improved from 1, 4, and 7 mm to 0, 1, and 2 mm post injection. Ocular motility improved with no onset of new limitation or diplopia. Lower eyelid retraction increased in 1 patient after orbital injection. No other complications occurred.CONCLUSIONS: Deep orbital Sub-Q hyaluronic injection for treatment of enophthalmos in Parry-Romberg syndrome is an useful option in sighted eyes.

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. Promising directions for the discovery of universal carriers for active pharmaceutical ingredients (APIs) are reviewed. Transdermal delivery of the APIs in medicines is attracting increasing attention from designers of drug formulations. A transdermal therapeutic system (TTS) is a dosage form for external use as controlled-release patches or films. TTSs are classified depending on the mode of API incorporation into several basic types such as reservoir, adhesive, matrix, and microreservoir. Methods for developing TTSs based on microemulsions are described in the review.

© 2018 John Wiley  &  Sons A/S. Published by John Wiley  &  Sons Ltd Background: Laparoscopic living donor liver procurement for transplantation has increased in popularity over the past decade. The purpose of this study was to compare the laparoscopic and open approaches in living donor left lateral sectionectomy (LLS) and to assess the safety and feasibility of this laparoscopic approach. Methods: A total of 103 living donor LLSs were performed at our center from May 2016 to December 2017. Of these, 35 were completely laparoscopic procedures, which represented the subject of this study. An additional 68 open living donor LLSs performed during the same period were studied as a comparison group. To overcome selection bias, LLS donors were balanced on a 1:1 ratio (laparoscopic [n = 35]: open [n = 35]) according to covariates with similar values. The PSM was based on the operation date, recipient age, diagnosis, recipient weight, and donor age. Results: There were significant differences between the laparoscopic and open LLS groups (P < 0.001) in terms of blood loss (96.8 ± 16.5 vs 155.8 ± 17.8 mL) as well as the duration of hospital stay (4 ± 0.4 vs 6.9 ± 0.5 days). Conclusion: Laparoscopic LLS is a feasible and efficacious in the setting of a developed program with advanced laparoscopic expertise.