HISTOLOGICAL CHANGES OF THE NEURONS OF THE RATS PARIETAL CORTEX WITH SUBTOTAL CEREBRAL ISCHEMIA WITH COMBINED INTRODUCTION L-NAME AND L-ARGININE
Bon’ E.I., Maksimovich N.Ye., Zimatkin S.M., Valko N.A., Kot V.N., Nedelko E.A.
UDC: 616.831.31-005.4.-092.913:618.33
Abstract: Objective.To study the histological changes in the parietal cortex of the rat brain during subtotal cerebral ischemia on the background of the combined administration of L-NAME, as well as its combined use with L-Arginine. Methods. The experiments were performed on 24 female outbred white rats with an initial weight of 210±20 g. Subtotal cerebral ischemia (SCI) was modeled by ligation of the common carotid arteries. Prior tothe ligation of the common carotid arteries the rats of the SCI + L-NAME group were injected with a non-selective inhibitor of NO-synthase - L-NAME. The rats of the SCI + L-NAME + L-Arginine group were additionally injected with L-Arginine simultaneously with L-NAME. The animals were decapitated after 60 minutes of ischemia. Results.In subtotal cerebral ischemia, significant morphological changes occur in the parietal cortex - reduction in size and deformation of the neurons perikaryons and the appearance of a large number of hyperchromic neurons. On the background of the introduction of L-NAME the violations were more pronounced. With the additional introduction of L-Arginine, the negative changes caused by L-NAME were corrected. Conclusion. Thus, the introduction of the non-selective inhibitor of NO-synthase L-NAME aggravated the histological disorders of the neurons of the parietal cortex during subtotal cerebral ischemia. The use of L-Arginine has a corrective effect, both due to its direct antihypoxic effect, and indirectly, due to the synthesis of NO.
Key words: церебральная ишемия, нейроны, L-NAME, L-Аргинин, cerebral ischemia, neurons, L-NAME + L-Arginine
BRAIN-PROTECTIVE ACTIVITY OF LHT-3-18, ZINC-CONTAINING SALT OF 2-AMINO-ETHANESULFONIC ACID IN ACUTE OXYGEN DEPRIVATION AND
Krainova Yu.S., Blinova E.V., Semeleva E.V., Blinov D.S., Yurochkina A.M., Turovsky E.A., Lobanova E.G., Dagar E.A., Orlov E.A., Shukurov A.S.
UDC: 615.015.44
Abstract: Objective. To study the effectiveness of zinc salt of 2-aminoethanesulfonate acid LHT-3-18 in rats with irreversible ligation of the middle cerebral artery and the effect on the survival of various types of neurons and astrocytic glia cells in a mixed neuroglial culture of the hippocampus under glucose-oxygen deprivation conditions. Methods. The studies were performed on 10 white rats of both sexes (5 females and males) and 20 newborn linear Sprague Dawley rats used to prepare a mixed neuroglial cultureof hippocampal cells (P1-3). Neuroprotective activity was studied on the model of ligation of the middle cerebral artery with subsequent assessment of neurological deficit, quantitative assessment of the amount of damag to the GM - an indicator method using 2,3,5-triphenyltetrazolium chloride (STHMA-Aldrich, Germany), quantitative determination of glutamic acid in иlood plasma and brain homogenate were performed by a fluorimetric method using a Grahamand Aprison on an Emilite1201 photometer (USA). Oxygen-glucose deprivation (OGD) was formed in Hanks' medium by replacing glucose with an equivalent amount of sucrose, followed by displacing dissolved oxygen by purging with argon in a special sealed system. Oxygen-glucose deficiency was assessed by the amplitude and nature of the Ca signals. The number of viable and dead cells was determined by staining with propidium iodide (PI, 1 μg/ml) under fluorescent red light using the FilterSet 49 light filter kit (Carl Zeiss, Germany). Results. Intravenous administration of LHT-3-18 solution in doses of 58 and 29 mg/kg in the prophylactic mode, with irreversible occlusion of the middle cerebral artery resulted in the formation of a milder neurological deficit, reduced the amount of cerebral necrosis, reduced glutamic acid, had a significant protective effect on astrocytes in the hippocampus culture, reducing OGD-induced increase in Ca and suppressing death. Conclusion. Studies have shown that salt LHT-3-18 has pronounced neuroprotective properties, suppresses the percentage of cells dying due to necrosis in the mixed hippocampal culture and reduces the OGD-induced increase in Ca.
Key words: окклюзия средней мозговой артерии, глутаминовая кислота, NMDA-рецепторы, кислородо-глюкозный дефицит, occlusion of the middle cerebral artery, glutamic acid, NMDA receptors, oxygen-glucose deficiency
PYRIMIDINE DERIVATIVES - PERSPECTIVE CORRECTORS OF METABOLIC AND FUNCTIONAL BRAIN DISORDERS IN THE CONDITIONS OF CHRONIC TRAUMATIC ENCEPHALOPATHY
Voronkov A.V., Miroshnichenko K.A., Pozdnyakov D.I., Potapova A.A., Kodonidi I.P., Anenko D.S.
UDC: 616.831-001.34
Abstract: Objective. To evaluate the effect of pyrimidine derivatives on changes in metabolic and functional brain disturbances in chronic traumatic encephalopathy conditions. Method. Chronic traumatic encephalopathy was modeled in rats (Wistar line, weighing 240-260 g) by the load (weight of 150 g) free fall method from the height of 50 cm on the parietal region of the animal skull single time a day for 7 days. On the 8th day we evaluated the preservation of the memorial trace with the «conditioned reflex of passive avoidance» and «extrapolation disposal»tests, the changes in the concentration of lactic, pyruvic acids and homocysteine, as well as the state of vasodilating function of the endothelium of the brain vessels. Results. The study found that the administration of the compound under the SHEPS cipher contributed to a decrease in lactate and homocysteine levels by 46.6% (p<0.01) and 65.1% (p<0.01), as well as an increase in the concentration of pyruvate by 30.5% (p<0.05) respectively in comparison with a group of animals deprived of pharmacological support. Against the background of SEDM compound administration, lactate concentration decreased and pyruvate content increased by 38.7% (p<0.01) and 2 times (p<0.001) respectively in relation to the negative control group of rats. In addition, the administration of the test-objects SHEPS and SEDM noted recovery of endothelial function and memory trace in animals. It should be noted that the pharmacological effect of the introduction of the compound SHEPS was comparable to that of the reference drugs - choline alfoscerate (100 mg/kg) and hopantenic acid (100 mg/kg). Conclusion. Based on the obtained results, we can assume the prospects for further study of pyrimidine derivatives as drugs of targeted pharmacocorrection of chronic traumatic encephalopathy.
Key words: хроническая травматическая энцефалопатия, эндотелиопротекторы, холина альфосцерат, гопантеновая кислота, производные пиримидина, chronic traumatic encephalopathy, endothelioprotectors, choline alfoscerate, hopantenic acid, pyrimidine derivatives
PROTECTIVE PROPERTIES OF ARGINASE II SELECTIVE INHIBITORS IN EXPERIMENTAL PREECLAMPSIA
Severinova O.V., Lokteva T.I., Gureev V.V.
UDC: 618.3-008.6-08-039.71
Abstract: Objective. To study the protective effect of arginase II selective inhibitors KUD-974, KUD-975, KUD-259 on functional parameters in rats with ADMA-like preeclampsia. Methods. The study was conducted in 140 female Wistar rats weighing 250-300 g. ADMA-like agent (L-NAME) was introduced intraperitoneally at a dose of 25 mg/kg/day from 14 to 20 days of gestation. Аrginase II selective inhibitors KUD-974, KUD-975, KUD-259 at a dosage of 1 mg/kg/day was introduced intragastrically through a probe 1 time per day from 14 to 20 days of gestation. On the 21st day of gestation, functional tests and laboratory tests were performed. Results. The analysis of the obtained in this experimental study results showed that a decrease in the activity of arginase leads to an increase in the production of nitric oxide, which has a beneficial effect on vascular function. Conclusion. Arginase II inhibitors are currently a promising group of drugs for the treatment of hypertensive conditions in pregnant women
Key words: преэклампсия, ингибиторы аргиназы, эндотелиальная дисфункция, preeclampsia, arginase inhibitors, endothelial dysfunction
EXPERIMENTAL EVALUATION OF BERBERINE AND SILYMARIN EFFICIENCIES IN THE SELF-EMULSIFYING DRUG DELIVERY SYSTEM FOR ENHANCING THEIR HEPATOPROTECTIVE ACTIVITIES UNDER TOXIC HEPATITIS
Sut’ko I.P., Shlyahtun A.G., Titko O.V., Yankevich N.V., Kolodko A.V., Telegin P.G., Zverinsky I.V.
UDC: 615.322:615.451.232+616.36-002.1+577.15
Abstract: Objective. Development of a self-emulsifying delivery system with berberine and silymarin in order to increase their bioavailability after oral administration and to evaluate its hepatoprotective activity in vivo under toxic hepatitis induced by carbon tetrachloride in rats. Methods. The solubility of berberine and silymarin in potential components of the self-emulsifying system was investigated, taking into consideration their toxicity, dissolving ability, miscibility and self-dispersibility. The combinations of the components of the system with the smallest content of surfactant exhibiting the ability to self-emulsifying were chosen. The pharmacokinetic parameters of berberine and silymarin were evaluated after their intragastric administration to rats in 0.5% starch and in the self-emulsifying composition. A comparative analysis of the hepatoprotective effect of silymarin and berberine in the self-emulsifying delivery system and in the free form was performed on rats with toxic hepatitisinduced byi. p. infections of 2 ml/kg 20% (v/v) carbon tetrachloride suspended in vegetable oiltwice a week for 4 weeks. Results. The berberine peak plasma concentration and the total area under the plasma concentration-time curve were higher when berberine was administered with silymarin. The berberine and silymarin administration in the composition of the self-emulsifying system contributed to an increase in the area under the pharmacokinetic curve and the mean residence time for both silymarin and berberine. It was established that the administration of silymarin and berberine in the self-emulsifying system to a greater extent stabilized hepatocytecellular membranes and reduced their permeability, normalized antioxidant enzyme activities, including the components of the glutathione antioxidant system. Conclusions.Analysis of the obtained results allows to conclude that the berberine and silymarin oral bioavailability is increased after the use of self-emulsifying delivery composition, which is a mixture of oleic acid, tween-80, polyethylene glycol-400.
Key words: берберин, силимарин, самоэмульгирующаяся система, токсический гепатит, крысы, berberine, silymarin, self-emulsifying system, toxic hepatitis, rats
ULTRASTRUCTURAL CHANGES OF THE RATS TESTES ON ADMINISTRATION OF LIPOPOLYSACCHARIDE ON THE 3RD DAY AFTER EXPOSURE
Poplavskaja E.A., Poplavskij D.Ju., Hilmanovich E.N.
UDC: 591.463.2:[577.114/.115:579.842.21]:599.323.4
Abstract: Objective. To study and analyse the ultrastructural changes in the testes of rats on the 3rd day after the administration of bacterial lipopolysaccharide Serratia marcescens . Methods. Male rats were injected LPS of S. marcescens at a dose of 50 mg/kg intraperitoneally, once. Part of the testis was fixed in a 1% solution of osmium tetraoxide at 0.1 m Millonig Buffer, pH 7.4, at 40°C for 2 hours, the samples were poured into Araldite, semi-thin sections (400 nm), prepared and stained with methylene blue for electron microscopic examination. Electron microscopic preparations were studied in an electron microscope JEM-1011 (JEOL, Japan) at increases of 5 000-20 000 at an accelerating voltage of 80 kW. To capture images used a series of digital camera Olympus Mega View III (Olympus Soft Imaging Solutions, Germany).Results. As a result of the study, it was established that on the 3rd day after exposure to LPS S. marcescens in the testes of male rats a number of ultrastructural changesincluding swelling of the interstitial stroma and an increase in the diameter of hemocapillaries of the interstitial stroma and an increase in the diameter of hemocapillaries, as well as changes in the ultrastructure of interstitial endocrinocytes develop. In the convoluted seminiferous tubules of the testes, swelling of the basal membrane and changes in the ultrastructure of the epithelial-spermatogenic layer cells are observed. In the sustentocytes no plasmolemmapleats are present; the nuclei of the cells decrease in size and are characterised by polymorphism. The nuclear envelope and cytoplasm have a higher electron density than in the control. In the cytoplasm numerous, sometimes confluent areas of accumulation of phagolysosome, the hypertrophic Golgi complex, polymorphic mitochondria with varying degrees of fragmentation and reduction of the crist and enlightened mitochondrial matrixare registered. In spermatogonia, the activation of the nuclear apparatus, damage to the mitochondria and moderate hyperplasia of the lysosomal apparatus are observed. In the cytoplasm of primary spermatocytes - mitochondrial hypertrophy and their displacement to plasmolemma, the appearance of numerous phagolysosomes zre revealed. Secondary spermatocytes are characterized by round nuclei, chromatin granules which are unevenly distributed, and nucleoli, with poorly-defined electron density. Mitochondria in the cytoplasm are rare, shifted to the cytolemma, with single cysts, while the cytolemma has numerous pores. Spermatids are reduced in size and are poor in organelles. Among them there are cells with signs of degeneration both from the nucleus and from the cytoplasm and organelles. The appearance of wide vacuum-like spaces both between the sustentocytes and between the cells of the spermatogenic epithelium, often reaching significant sizes, are observed.Conclusion. It is concluded that a single intraperitoneal injection of bacterial LPS of S. marcescens at a dose of 50 mcg/kg to male rats on the 3 day after exposure causes the development of a variety of ultrastructural changes in the testes of rats: swelling of the interstitial stroma and an increase in the diameter of hemocapillaries; swelling of the basal membrane of convoluted seminiferous tubules of the testes, changes of the ultrastructure of cells interstitium (interstitial endocrinocytes) and epithelio-spermatogenic layer (sustentocytes,spermatogonia, spermatocytes, spermatids).The above-mentioned ultrastructural changes in the testes of rats, caused by the introduction of LPS S. marcescens , can lead to a slowdown in the proliferation and differentiation of spermatogenic epithelial cells, disruption of their functions, and ultimately to a violation of the function of the organ as a whole.
Key words: липополисахариды, cеменник, сперматогенез, крысы, lipopolysaccharide, testis, spermatogenesis, rats
SOIL EXCHANGE BY TOXOCARA CANIS HELMINTHS EGGS IN THE CONDITIONS OF THE REPUBLIC OF TAJIKISTAN
Kayumova M.U., Odinaev F.I., Aliev S.P., Tursunov R.A.
UDC: 616.995.132:595.13
Abstract: Objective. To study soil contamination with Toxocara canis helminth eggs in the Republic of Tajikistan. Methods. Sanitary and helminthological soil study was conducted in 2017 in various territories (26 settlements) - in all climatic and geographical zones of the Republic of Tajikistan. The results of studies of 4785 soil samples were analyzed for the presence of helminth eggs of toxocariasis in different seasons of the year. Results. Out of 4,785 soil samples, 1560 (32.6±0.5%) were positivefor the presence of toxocarcosis helminth eggs. The highest rates of toxocar eggs in soils were found in the northern (37.6±1.7%) and southwestern regions (36.9±1.8%) of the republic, as well as in the Gissar Valley - 366 (32.9±1.9%). The lowest indicators of the presence of helminth eggs in soils were found in the Gorno-Badakhshan Autonomous Region - 186 (19.2±1.6%). The highest rates of soil contamination by toksokar eggs were found in spring in the household plots (gardens) and sandboxes in the yards, which respectively amounted to 17.9±3.4% and 16.1±2.4%; in winter - in playgrounds (17.3±3.4%) and in the sandboxes of kindergartens (13.2±3.1%); in the autumn - in the sandboxes in the yards (15.5±3.1%) and in kindergartens (12.5±2.8%), whereas in summer there is a significant decrease in soil contamination - on an average from 5.8±1.5 % to 10.4±1.9%. Conclusions. The data obtained indicate that Toxocara canis eggs are infected with various environmental objects in all climatic-geographical zones of the Republic of Tajikistan, which requires intensified measures to protect and improve the environment in the Republic of Tajikistan, both in terms of reducing or eliminating the risk of new infections, and for increasing the efficiency measures for the prevention of helminthiasis.
Key words: гельминтозы, почва, токсокароз, Toxocara canis, обсемененность, helminthiasis, soil, toxocarosis, Toxocara canis, seeding
METHOD OF EVALUATING THE INFORMATIVENESS OF DIAGNOSTIC FEATURES IN MEDICINE AND PHARMACOLOGY
Lyamec L.L., Evseev A.V.
UDC: 519 253
Abstract: Objective. Assessment of the information content of diagnostic signs is necessary for their objective ranking by importance and determining the order of their consideration in the process of diagnosis. For the signs that are continuous quantities with unknown probability distribution functions, evaluating the information content based on the results of sample studies is a difficult task. The purpose of the theoretical study was to develop a method that, based on inductive conclusions obtained as a result of statistical research, allows us to evaluate their information content based on the use of well-known mathematical constructs. The method is intended for use in biomedical research and in practical medical activities related to the differential diagnosis of diseases, as well as the identification of conditions caused by pharmacological effects. Method. A review of publications on computational diagnostic methods based on statistical methods for analyzing experimental medical data was carried out. Peculiarities of features that are continuous physical quantities are described, for the quantitative representation of which real numbers are used. The problematic issues of evaluating the information content of continuous signs are identified. Mathematical constructs are studied, which, based on threshold values, allow the categorization of continuous features by a threshold and bring them to a dichotomous ordinal scale. The application of the Kullback information measure for evaluating the information content of categorized dichotomous features is considered. Results. A method for evaluating the informative value of continuous features was developed. The method is based on the categorization of continuous features by a threshold value, which is calculated based on the analysis of empirical cumulative functions (ECF). The optimal threshold value is calculated for the maximum modulus of the difference between the studied ECF. The threshold values of diagnostic features are of an independent scientific and practical value for the differential diagnosis of nosological forms. To identify a statistically significant difference between ECF, the Kolmogorov-Smirnov criterion is shown. To identify a statistically significant difference between the criteria categorized by a threshold value, the chi-square test (Pearson) and the Fisher exact test were used (for contingency tables ). The possibility of applying these statistical criteria to substantiate the optimal threshold value for the categorization of continuous features is shown. To assess the information content of the signs in the developed method, the Kullback information measure was used. Conclusion. As a result of theoretical research, a method was developed for evaluating the informative value of continuous diagnostic signs. The method is based on the categorization of continuous features by the optimal threshold value. Categorization allows to convert a continuous sign into an ordinal dichotomous sign with two ordered gradations. This transformation makes it possible to use the Kullback information measure to evaluate the information content of diagnostic signs. The developed method is an information technology that allows, on the basis of primary statistical data, to select features for differential diagnosis based on an assessment of their information content. The method of evaluating information content may be of practical interest for scientists carrying out research in the field of evidence-based medicine based on computational diagnostic methods and using statistical methods in their work to analyze experimental data and make decisions.
Key words: непрерывные случайные величины, эмпирическая кумулятивная функция, категоризация непрерывных величин, пороговые значения, информативность признаков, вычислительные диагностические методы, дифференциальная диагностика, continuous random variables, empirical cumulative function, categorization of continuous variables, threshold values, informative features, computational diagnostic methods, differential diagnostics
DEVELOPMENT, STRUCTURE AND FUNCTIONS OF THE SEPTAL REGION OF THE RAT'S BRAIN
Bon’ L.I.
UDC: 612.823
Abstract: Objective. Analysis and generalization of literature data on the development, structure and functions of the septal region of the rat's brain. Methods. For this research, various literature on the relevant topic was collected and analyzed. Results. Four groups of nuclei are located in the septal region: lateral, medial, caudal and ventral. The neurons forming them are very diverse in their neurotransmitter nature. The nucleus of the septal region forms morphofunctional connections with at least three other brain regions: the hypothalamus, the hippocampus and the amygdala. Conclusion. The septal region is a complex of nuclear structures, the neurons of which are very diverse in their neuromediator nature and form numerous afferent and efferent connections with other parts of the brain. The nuclei of the septal region are involved in a wide range of neuroendocrine, behavioral and cognitive reactions and their further study in normal conditions and in experimental pathology provides a fundamental basis for integrating the results into clinical studies.
Key words: септальная область, крысы, головной мозг, septal region, rats, brain
IMPROVEMENT OF CLINICAL EFFECTIVENESS OF GONARTHROSIS TREATMENT USING PERSONALIZED THERAPY SCHEME
Ryabinin S.V., Samodai V.G., Peleshenko E.I.
UDC: 616.72-002-07-08
Abstract: Objective. Comparative analysis of therapy regimens efficacy with the use of different numbers of pharmacotherapeutic remedies from the therapy standards provided for deforming knee joint osteoarthritis as well as therapy regimens supplemented with autoplasma rich in platelet growth factor and hyaluronic acid preparations. Materials. Examination and treatment of 63 patients with the diagnosis of 2 or 3 stage of gonarthrosis were performed. The first group patients were given standard therapy (ST). In the second group ST was coupled with injections of autoplasma rich in platelet growth factor. In the third group ST was added with hyaluronic acid preparations and autoplasma rich in platelet growth factor. The patients’ conditions before and after the therapy were assessed using conventional scales and questionnaires and by electrolytic composition of synovial fluid (synovia). Results. The best therapy results were observed inthe 3 group of patients. Reduction of painful sensations intensity and longer remission period were observed. Increased range of motions and mineral metabolism normalization in synovial fluid (synovia) due to decreased ratio of Са/РОwere also present. Conclusion. The use ofthe proposed gonarthrosis therapy regimen according to the scheme ST accompanied by hyaluronic acid preparations and autoplasma rich in platelet growth factor allows to improve the treatment results and increase the patients’ life quality.
Key words: гонартроз, схемы терапии, богатая тромбоцитами аутоплазма, гиалуронаты, синовиа, показатели минерального обмена, gonarthrosis, therapy regimens, autoplasma rich in platelet growth factor, hyaluronates, synovia, mineral metabolism rates
OUR EXPERIENCE OF THE USE OF OSTEOPLASTIC MATERIALS IN THE SURGICAL TREATMENT OF BONE CYSTS IN CHILDREN
Drozdetskiy A.P., Ovsyankin A.V., Kuzminova E.S., Prokhorov A.N., Popov Yu.S., Sharov V.A., Popov I.V., Kuzminova A.D.
UDC: 616-006-053.2:616.712.1-089.844
Abstract: Objective. To analyze the use of a number of osteoplastic materials in the treatment of children with tumors and tumor-like diseases of the musculoskeletal system. Methods. Treatment of 83 children was analyzed. Average age - 11.3±3.97.Main pathology - bone cyst 49 (59.1%). Most frequent localizations: humerus 31 (37.3%), tibia 19 (22.4%), femur 18 (21.2%). Clinical parameters: age, gender, process localization, used osteoplastic material. Surgical tactics depended on the diagnosis, size of the defect. Histological examination was performed to verify the diagnosis. Alloimplants, synthetic osteoplastic materials, composite osteoplastic materials were used to fill the defects. In 3 cases autologous bone was applied. X-ray control was recommended in 3, 6 and 12 months after surgery. The assessment of bone defect replacement quality was carried out according to the X-ray results and modified Neer classification. Results. Complete healing of the bone defect (Neer 1) was observed in 77 cases (90.6%). Incomplete (Neer 2, 3, 4) - in 8 cases (9.4%). 7 cases (87.5%) of incomplete healing were registered after surgery of aneurysmal cysts. A higher frequency of incomplete substitution was found (31%)if large defects were filled with a combination of materials with different rates of biodegradation. The best rearrangement was demonstrated by «chronOS» (β-tricalcium phosphate), «BoneMedik-S» (silicon-containing coral hydroxyapatite), «Osteomatrix» (bone allocollagen, bone allosulfatedglycosaminoglycans, xenohydroxyapatites). Children with Osteomatrix often had febrile fever. There was one pathological fracture 2 months after sugery. Conclusions. All materials have flaws. The choice of osteoplastic materials is requires further study.
Key words: дети, костная пластика, костные кисты, children, bone grafting, bone cysts
VIOLATION OF THE INTESTINAL MICROBIOTA IN CHILDREN WITH SECONDARY OXALATE NEPHROPATHY
Artikova M.A., Sharipov A.M.
UDC: 616.61-053.3.612.0
Abstract: Objective. To analyze the use of a number of osteoplastic materials in the treatment of children with tumors and tumor-like diseases of the musculoskeletal system. Methods. Treatment of 83 children was analyzed. Average age - 11.3±3.97.Main pathology - bone cyst 49 (59.1%). Most frequent localizations: humerus 31 (37.3%), tibia 19 (22.4%), femur 18 (21.2%). Clinical parameters: age, gender, process localization, used osteoplastic material. Surgical tactics depended on the diagnosis, size of the defect. Histological examination was performed to verify the diagnosis. Alloimplants, synthetic osteoplastic materials, composite osteoplastic materials were used to fill the defects. In 3 cases autologous bone was applied. X-ray control was recommended in 3, 6 and 12 months after surgery. The assessment of bone defect replacement quality was carried out according to the X-ray results and modified Neer classification. Results. Complete healing of the bone defect (Neer 1) was observed in 77 cases (90.6%). Incomplete (Neer 2, 3, 4) - in 8 cases (9.4%). 7 cases (87.5%) of incomplete healing were registered after surgery of aneurysmal cysts. A higher frequency of incomplete substitution was found (31%)if large defects were filled with a combination of materials with different rates of biodegradation. The best rearrangement was demonstrated by «chronOS» (β-tricalcium phosphate), «BoneMedik-S» (silicon-containing coral hydroxyapatite), «Osteomatrix» (bone allocollagen, bone allosulfatedglycosaminoglycans, xenohydroxyapatites). Children with Osteomatrix often had febrile fever. There was one pathological fracture 2 months after sugery.
Key words: гипероксалурия, вторичная оксалатная нефропатия, микробиота, Oxalobacter formigenes, оксалотрофные бактерии, hyperoxaluria, secondary oxalate nephropathy, microbiota, Oxalobacter formigenes, oxalotrophic bacteria
MAGNETIC RESONANCE IMAGING OF THE BRAIN AND TRANSCRANIAL ELECTRIC STIMULATION WITH MONITORING: PROSPECTS FOR USE
Morozova T.G., Chuhonceva E.S., Borsukov A.V.
UDC: 615.849.1
Abstract: Objective. Assessment of the clinical possibilities of joint use of MRI of the brain and TETOS (transcranial electrical stimulation with feedback) as a method of standardized stimulation of the cerebral cortex. Methods. Analysis of anamnestic data, general clinical and neurological examination, magnetic resonance imaging of the brain, transcranial electrostimulation using the TETOS method were carried out in patients with functional asthenia at the age of 22±1.9 years. Essential in the study was the assessment of cerebral blood flow before TETOS and after using the perfusion MRI without the introduction of a contrast agent (ASL). Results. All patients had complaints characteristic for functional asthenia. Focal pathology in the neurological status in 100% of cases was identified. 71.4% of patients had fluctuations in blood pressure, mixed dermographism, 28.6% of patient had not deviations. 100% of patients had no pathology of the substance and cerebral vessels on the MRI of the brain, and 43% of patient had slight expansion of the cerebrospinal fluid spaces. Absolute values of cerebral blood flow rate (CBF) at rest up to TETOCwere 53±3.5ml/100g/min. Next, the patients underwent a transcranial electrostimulation session with feedback (TETOS). The exposure time of the corrective stimulation was 5 minutes; the current strength was individually up to 1.0 mA. After TETOS, the analysis of repeated perfusion MRI shows an increase in cerebral perfusion within the normal range depending on the selected measurement zone. Conclusion. When exposed to the brain of patients with functional asthenia by transcranial electrostimulation by the TETOS method, a hemodynamic response is noted in the form of increased cerebral blood flow. TETOS should be used in the fMRI ASL protocols as a standardized stimulus of the cerebral cortex.
Key words: перфузионная МРТ, транскраниальная электростимуляция с обратной связью, функциональная МРТ, церебральная перфузия, perfusion MRI, transcranial electric stimulation with monitoring, functional MRI, cerebral perfusion
FEATURES OF HEMODYNAMICS WITH HIGH NORMAL BLOOD PRESSURE AT A YOUNG AGE
Kovaleva O.A., Milyagin V.A., Punin D.A., Safronov V.V.
UDC: 616.12-008.331.1
Key words: артериальная гипертензия, артериальное давление, аппланационная тонометрия, аугментация пульсовой волны, амплификация пульсовой волны, arterial hypertension, arterial pressure, applanation tonometry, pulse wave augmentation, pulse wave amplification
CLINICAL AND LABORATORY CHARACTERISTICS OF INFLUENZA IN THE TRANS-BAIKAL TERRITORY AT THE PRESENT STAGE
Chuprova G.A., Emel'yanova A.N., Emel'yanov A.S., Kalinina E.H.N., Klimovich K.I., Radyukin N.O., Radyukina E.O., Vitkovskii Y.U.A.
UDC: 616.921.5-071(571.55)
Abstract: Objective.To perform a retrospective analysis of clinical and epidemiological features and some laboratory parameters of influenza in adults at the present stage in the Trans-Baikal territory. Methods.Case histories of patients with influenza were analyzed. The diagnosis was verified by examining nasopharyngeal mucus and identifying influenza virus RNA by PCR. General clinical laboratory parameters and lymphocyte-platelet adhesion (LTA) index were studied by the method of Yu.A. Vitkovsky. Results. In the epidemiological season of 2016-2017 and 2017-2018 most of the hospitalized had influenza A (H3N2). Among the hospitalized, women with a moderate course of the disease prevailed. It was established that during the analyzed epidemic seasons the flu was of the moderate form. In patients with influenza, lymphocyte-platelet adhesion rises compared with healthy residents. Conclusion. Thus, influenza in the region most often occurs in the moderate form, regardless of the etiological factor. Among the hospitalized patients, the complicated forms of the disease predominate in those who are not vaccinated against influenza with a burdened premorbid background and who have chronic somatic pathology.
Key words: грипп, пневмония, клиника, эпидемиология, заболеваемость, лимфоцитарно-тромбоцитарная адгезия, influenza, pneumonia, clinic, epidemiology, morbidity, limphocyte-trobocytic adhesion
ETIOLOGICAL STRUCTURE OF HOSPITAL-ACQUIRED INFECTIONS CAUSED BY THE ORDER ENTEROBACTERALES IN MULTI-PROFILE HOSPITALS IN RUSSIAN FEDERATION
Vinogradova A.G., Kuz'menkov A.Yu.
UDC: 616.981.48-036.2
Abstract: Objective. To analyze the etiological structure of hospital-acquired infections, which are associated with the order Enterobacterales in multi-profile hospitals in the Russian Federation. Methods. The study is retrospective and based on the data accumulated during the prospective multicenter epidemiological antibiotic resistance researches for the period from 2002 to 2016 years. All of the 5987 patients above the age of 18 and with laboratory confirmed hospital-acquired infectious diseases were included in the study from 37 cities of the Russian Federation. The etiological structure and its changes over time and variations as a function of hospital geographical location were analyzed within the current study. Results. The most frequent nosocomial enterobacterial infectious agents in multi-profile hospitals are K. pneumoniae and E. coli , up to 72,79% of the number of pathogens. The significant fluctuations from national medians are observed in the Far Eastern federal district, due to the revealed opposite changes in the parameters for four microorganisms. However, the ratio of microorganisms in federal districts almost for all geographical objects is identical. Conclusion. Based on the results, we determinated that K. pneumoniae (43,06%), E. coli (29,73%), P. mirabilis (7,48%), E. cloacae (7,07%) и S. marcescens (4,76%) are the most common pathogens in the etiological structure of hospital-acquired infections caused by Enterobacteriaceae.
Key words: нозокомиальные инфекции, энтеробактерии, этиологическая структура, представители порядка Enterobacterales, hospital-acquired infections, Enterobacteriaceae, etiological structure, members of the order Enterobacterales
Potapova V.E., Lysenko I.M.
CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF ANEMIA IN PREMATURE INFANTS
Potapova V.E., Lysenko I.M.
UDC: 616.155.194-053.32
Abstract: Objective. To study the timing and frequency of anemia in deeply premature babies, to assess their clinical, morphological and laboratory features. Methods. A clinical and laboratory study of premature babies was conducted, an assessment of the morphological features of red blood cells, an assessment of the effect of the severity of anemia on clinical manifestations. Results. Anemia occurs in 100% of babies born before the 31st week of gestation. The morphological feature of anemia is characterized by early anisocytosis, a decrease in the average erythrocyte volume and the average concentration of hemoglobin in the red blood cell. In premature infants with an infectious pathology, these signs are significantly more likely and persisted during therapy longer than in children without an infectious premorbid background. In children who underwent blood transfusion, the course of anemia assumed a wave-like character, which can be explained by inhibition of erythropoiesis by this manipulation. Conclusion. In the development of anemia in premature infants, the leading pathogenetic mechanism is not only an iron deficiency state, but also a violation in ontogenesis, vitamin deficiency and low erythropoietin production. Anemia in premature infants has a tendency to a severe course, and therefore it is necessary to develop modern methods of treatment and medical prevention.
Key words: недоношенный новорожденный, анемия, гемоглобин, эритроцит, premature newborn, anemia, hemoglobin, erythrocyte
STUDY OF THE EFFECT OF COMBINED METHODS OF TREATMENT USING MEDICATION ON THE BASIS OF "GRAMICIDIN C" AND LIGHT EMITTING DIODE RADIATION ON THE DYNAMICS OF THE PAIN SYNDROME IN THE ALVEOLITIS OF THE JAWS
Bogatov V.V., Kulaeva E.S.
UDC: 616.716.85-002-009.62:615.33:615.849.19]-07
Abstract: Objective. To determine for the first time the intensity of pain in alveolitis, as well as to study the effectiveness of the combined treatment of alveolitis with a medication based on "Gramicidin C" and light emitting diode radiationin dynamics. Methods. Depending on the method of treatment, all patients were divided into two equal groups. The treatment of the patients of the first group was carried out using the combined author's technique (patent RU 2678199 C1), and the patients of the second group - using the classical technique with iodoform gauze. To assess pain syndrome in patients with alveolitis of the jaws, McGill Pain Questionaire and a visual analog scale were used. The evaluation took place at the initial treatment on the 3-5-7 day of treatment. Results. Based on the obtained data, pain syndrome plays an important role in assessing the general and mental condition of the patient with alveolitis of the jaws and has a significant impact on the quality of life of the patient. During the analysis and comparison of the intensity of pain syndrome upon the first, second, third visits in patients of the main group after treatment with light emitting diode radiationand a medication based on "Gramicidin C" there was positive dynamics in the form of reducing the intensity of pain. Upon the second visit, the majority of patients noted the absence of pain syndrome. Upon the third visit the pain syndrome was absent, testifying high efficiency of the chosen method of treatment in relief of pain syndrome unlike the classical technique of treatment of alveolitis of the jaws. Conclusions. It is concluded that the relief of pain syndrome in patients of the main group is faster than in patients of the comparison group.
Key words: альвеолит, болевой синдром, визуально-аналоговая шкала, болевой опросник Мак-Гилл, Грамицидин С, низковолновое лазерное излучение, alveolitis, pain syndrome, visual analog scale McGill Pain Questionaire histology, Gramicidin C, light emitting diode radiation
ROLE OF PROTEINS OF THE PANCREAS IN THE FORMATION OF STONES IN CHRONIC PANCREATITIS
Mozheiko L.A.
UDC: 612.342.4:616.37-002.2-02
Abstract: Objecive. To present data on the role of pancreatic proteins in the formation of stones in chronic pancreatitis. Methods.Analysis of modern scientific information of domestic and foreign authors on this subject. Results. It was established that proteins such as trypsin, lactoferrin, GP2, lithostatin can take part in the formation of stones in the pancreatic ducts. It is shown that in the early stages of the development of chronic pancreatitis, their concentration in the pancreatic juice increases. This is facilitated by hypersecretion of proteins, as well as dehydration and increased acidity of pancreatic secretion caused by dysfunction of cystic fibrosis transmembrane conductance regulator (CFTR). Conclusion. In chronic pancreatitis, hyperconcentration of proteins in pancreatic juice, combined with its insufficient outflow, create conditions for precipitation and the formation of stones. Mechanisms, as well as protein components involved in the process of stone formation, are multifactorial.
Key words: поджелудочная железа, хронический панкреатит, трипсин, лактоферрин, литостатин, pancreas, chronic pancreatitis, trypsin, lactoferrin, litostatin
EPIDEMIOLOGICAL ASPECTS INFLUENCE OF THE HUMAN PAPILLOMAVIRUS VACCINE IN PREVENTION OF CERVICAL CANCER AND RECOMMENDATIONS FOR ITS INTRODUCTION IN TAJIKISTAN
Mirzoev A.S., Nazurdinov A.B., Tursunov R.A., Azizov Z.A.
UDC: 616-006.52:618.1 (575.3)
Abstract: Objective. To study the world experience of introducing a vaccine against human papillomavirus (HPV), the effectiveness of its use in preventing cervical cancer and determine the acceptability of its introduction in the conditions of Tajikistan. Methods. The study used available materials from the World Health Organization (WHO) European Regional Office (EURO) on HPV, the WHO Regional Training Seminar on Strengthening Evidence-based Immunization Decision Making System (Copenhagen, Denmark from 14 to 17 May 2018) and a review of published articles on the effectiveness of HPV prophylaxis, the epidemiological situation of HPV and experience in introducing the HPV vaccine. Results. The article presents a general description of HPV and its effect on the development of cervical cancer. A list of diseases caused by different types of HPV is reflected. Using materials from WHO / Europe on global vaccination and cervical cancer prevention, it was established that cervical cancer is the fourth most common type of cancer in women in the world. In 2012, 530,000 new cases were reported, and this type of cancer accounts for 7.5% of all female deaths from cancer. WHO estimates that out of more than 230,000 annual deaths from cervical cancer, 85% occur in least developed countries. Cervical cancer can be prevented by introducing the HPV vaccine, as the two most oncogenic types of HPV, 16 and 18, representing 70% of cervical cancers, pose a particular danger to women. In 2006, the first HPV vaccine was approved for the first time. Currently, more than 70 countries have included this vaccine in the National Immunization Schedule. It is emphasized that it is preferable to vaccinate before the first sexual contact. Conclusions. At the present stage of human development, cervical cancer still remains a serious public health problem. Therefore, the introduction of human papilloma vaccine significantly affects the epidemiological situation of cervical cancer in women of reproductive age. Based on the data obtainedit should be recommended to the National Technical Advisory Group on Immunization to study more deeply the issue of introducing the HPV vaccine into the National Immunization Calendar of the Republic of Tajikistan.
Key words: рак шейки матки, вирус папилломы человека, вакцина ВПЧ, женщин репродуктивного возраста, cervical cancer, human papillomavirus, HPV vaccine, women of reproductive age
SPECTROPHOTOMETRIC ANALYSIS OF LINEZOLID
Tyutrina V.A., Chmelevskaya N.V., Illarionova E.A.
UDC: 543.544.943.3.068.7:615.07
Abstract: Objective.To develop a unified method for the spectrophotometric determination of linezolid in substance and tablets using an optical reference sample.Methods. The optical properties of linezolid, its solubility and stability were investigated. On the basis of the obtained data, the choice of the optimal optical reference sample was carried out, with the use of which the quantitative analysis of linezolid in the substance and tablets was carried out by the spectrophotometric method.Results. Optimal conditions for determination were substantiated: solvent - 95% ethyl alcohol, optical reference sample - potassium hexacyanoferrate (III) (potassium ferricyanide); analytical wavelength - 258 nm. The conversion factor was determined. Validation analysis of the proposed method was conducted. The criteria by which the methodology was validated and proved its suitability are the analytical area of the methodology, convergence, linearity, specificity, reproducibility. The relative standard deviation for the linezolid substance was below 0.01, for tablets - below 0.02. The relative error in the determination of linezolid for the substance did not exceed 0.68%, for tablets - 1.28%. Conclusion. The results obtained confirmed the suitability of the methodology for the implementation of the purposes for which it is intended.ed the suitability of the methodology for the implementation of the purposes for which it is intended.
Key words: ультрафиолетовый спектр, линезолид, оптический образец сравнения, спектрофотометрическое определение, калия феррицианид, коэффициент пересчёта, ultraviolet spectrum, linezolid, optical reference sample, spectrophotometric determination, potassium ferricyanide, conversion factor
DEVELOPMENT OF METHODS FOR ASSESSING THE QUALITY OF THE SUBSTANCE OF 4-METHYLPHENYLAMIDE N-BENZOYL-5-BROMOANTHRANILIC ACID
Andryukov K.V., Lyust E.N., Tumilovich E.Y.U., Korkodinova L.M., Novikova V.V.
UDC: 543:615.276:547.583.5
Abstract: Objective. The study of physico-chemical properties, the development of methods to prove the authenticity, good quality of the content of related impurities and residual organic solvents, and quantitative determination of the substance of 4-methylphenylamide N-benzoyl-5-bromoanthranilic acid. Methods. As the object of the study substance 4-methylphenylamide N-benzoyl-5-bromoanthranilic acidwas used. Thin-layer chromatography (TLC) was performed on plates "Sorbfil" PTSH - AF-A-UV (type of sorbent - silica gel STX 1A) in systems of organic solvents of different composition and polarity. Detection of the studied substances was carried out with the help of an UFS irradiator at a wavelength of 254 nm. Studies on the content of residual organic solvent - ethyl acetate were carried out on the gas chromatograph "Crystal 5000.2" (JSC SKB "Chromatek", Yoshkar-Ola) with a flame ionization detector. Imtroduction of samples was carried out using an automatic dispenser EV-2M. The separation was performed on a capillary column HP-FFAP 50 m × 0.32 mm, 0.52 µm (the stationary liquid phase is polyethylene glycol modified by nitroterephthalic acid). The results were processed using the software "Chromatech Analyst 2.6". Spectrophotometry in the UV region was performed using the Portlab 511 UV/Vis spectrophotometer. Results. Techniques were developed to prove the authenticity, good quality by the content of related impurities and residual organic solvents - ethyl acetate, and quantitative determination by a spectrophotometric method in the UV region; a study of microbiological purity was carried out. Conclusions. The developed methods for the analysis of 4-methylphenylamide N-benzoyl-5-bromoanthranilic acid for the substance of this compound are the most promising and will be used in the development of methods for its determination in medicinal preparations.
Key words: антраниловая кислота, амид, подлинность, хроматография, спектрофотометрия, anthranilic acid, amide, authenticity, chromatography, spectrophotometry
«PLODOIZGNANIE» IS THE MAIN METHOD OF BIRTH CONTROL IN PEASANT WOMEN OF THE XIX CENTURY
Mitsyuk N.A., Pushkareva N.L.
UDC: 618.2-07+396.6
Abstract: Objective.The aimof the study was to analyzethe traditional methods of birth control, widespread among the peasants in the XIX century under the legal prohibition of abortion. Methods.The most relevant were the approaches of gender history, aimed at the study of women's experience, women's everyday life in the history of Russia, as well as the methods of "case study" aimed at the study of specific cases, and case study methods. Adhering to a multidisciplinary approach, we used three kinds of sources: ethnographic (data ethnographers of the XIX century about everyday life of the peasant population), legal (data from courts, cases of suspected abortion) and medical («zemskaj» statistics). Results.Practices of «plodoizgnanie» are traditional methods of birth control. Attitude to them depended on the development of state and social institutions. «Plodoizgnanie» was not a crime until the seventeenth century. It was condemned by religious and moral norms. With the development of absolutism, strengthening of state institutions, the demographic issue has become of particular importance. Control over the reproductive behavior of the population passed to the state. "Plodoizgnanie" became a crime. In the nineteenth century the development of antiabortion legislation began. Among the peasants, different methods of birth control formed. The main channel of transmission of "special knowledge" - "women's network", which consisted of rural midwives ("babushki"), representatives of traditional medicine, older women. Mechanical, chemical (organic and inorganic), ritual, and traditional medicines were spread. Attraction of traditional medicine was associated with the geographical factor. Peasant women used plants that grew in their climatic zone of residence. The history of criminal prosecution for "plodoizgnanie" showed the inefficiency and the difficulty of attracting women to the court, and, therefore, the state control. The harsh criminal law proved to be inapplicable in practice. Court cases showed the nullity of real criminal convictions for artificial termination of pregnancy. Conclusion.The ineffectiveness of criminal prosecution in the face of the growing number of criminal abortions required a new solution to the problem. This created favorable conditions for giving "plodoizgnanie" the status of a socio-medical problem to "fructifications" and the introduction of medical control over the reproductive behavior of the population.
Key words: история медицины, история абортов, история деторождения, «плодоизгнания», контроль рождаемости, история материнства, history of medicine, history of abortion, history of childbirth, "plodoizgnanie", birth control, history of motherhood
ABOUT THE REASONS FOR THE UNPOPULARITY OF THE METHOD OF HYPNOTIC ANALGESIA IN OBSTETRICS AND GYNECOLOGY IN RUSSIA IN THE XIX - EARLY XX CENTURY
Koldman S.D.
UDC: 618.414.4
Abstract: Objective. The aim of the study is a historiographical review devoted to the use of hypnosis in obstetric and gynecological practices in the XIX - early XX century. Methods. The methods of study are historical-genetic, comparative, retrospective. Results. The requirement for women to alleviate the birth pain and organize a calm process, was perceived ambiguous by the Russian society of this period. The methods of analgesia provoked rejection among Christian preachers and the conservative mindset of the society in view of the woman's commandment to bear tribal pain for the redemption of sin committed by Eve. The discussion, in which the mystics entered with the approval of the hypnopractic, did not contribute to the adoption of hypnosis by the Russian Orthodox Church, and only asserted them in the notion of the method of suggestion as an occult practice. The results of the experiments of obstetrician doctors were limited to the instructions of the Medical Department, which required the presence of several doctors during the hypnosis session, which was impossible in childbirth because of the preservation of the traditions of home births, and in the absence of a sufficient number of women in the obstetrical profession. Conclusion. The practice of hypnosis in obstetrics and gynecology in the XIX - early XX century could not become a popular method, because of inadequate knowledge about the reproduction of a woman, the psychological component of the generic process, and also because of the preservation of the religious notion of the need for pain in labor. Decisions of the Medical Department led to a restriction of the application of the method, and a lack of positive statistical data. The male view of childbearing prevailed over the female.
Key words: история акушерства, детородные практики, роды, боль, анальгезия, гипносуггестия, гипноз, гипнороды, повивальное искусство, императрица Александра Федоровна, history of obstetrics, childbearing practices, childbirth, pain, analgesia, hypnosuggestion, hypnosis, hypnorody, midwifery, the Empress Alexandra Feodorovna
UNKNOWN PAGES OF THE BIOGRAPHY OF PROFESSOR SERGEY FOMICH YUSHKEVICH (1878-1943)
Teremov D.D., Vorozhtsova E.S., Nagornaya S.V.
UDC: 929:378.124
Abstract: Objeсtive. The aim of the study was to investigate previously unknown facts about the biography of professor Sergei Fomich Yushkevich, the head of the Department of Organic Chemistry of the Smolensk State Medical Institute (1930-1941) and the Department of Inorganic and Analytical Chemistry of the Molotov (Perm) Pharmaceutical Institute (1941-1943). Methods. The study was performed using historical-genetic and problem-chronological methods. Archival materials, published documentary and literary sources were used. Results. The previously unknown life facts of the famous scientist-chemist S.F. Yushkevich were found - scientific and practical activities before the October Revolution and during the Great Patriotic War. The exact date and place of the death of Sergei Fomich was established. Conclusion. Sergey Fomich Yushkevich was one of the prominent scientists and practitioners who made a significant contribution to Russian science and chemical production, teaching chemical disciplines in medical, pharmaceutical and pedagogical universities in the first half of the 20th century.
Key words: Юшкевич С.Ф, профессор, Смоленский государственный медицинский институт, Молотовский государственный фармацевтический институт, Yushkevich S.F, professor, Smolensk State Medical Institute, Perm (Molotov) Pharmaceutical Institute
SOME ASPECTS OF RESULTS OF BIOIMPEDANCE ANALYSIS WITHIN THE RETROSPECTIVE LONGITUDINAL STUDY OF CHILDREN OF SCHOOL AGENCY OF SMOLENSK
Bekezin V.V., Druzhinina T.V., Peresetskaya O.V., Tsvetnaya I.N., Oleinikova V.M., Volkova E.A., Kozlova L.V.
UDC: 616-008.9-056
Abstract: Objective. To determine the risk factors for the development of primary arterial hypertension depending on the component composition of the body according to the results of bioimpedance analysis as part of a retrospective longitudinal study of school children in Smolensk. Methods. Studies of body composition (bioimpedance analysis) and outpatient blood pressure in 2676 school-aged children (10-17 years old) were performed. Bioimpedansometry was performed on a Medass apparatus (Russia) in the morning according to the standard method. Results. “Latent” obesity was diagnosed in 475 (35.02%) of 1356 schoolchildren with normal body mass index (BMI, kg/m). The frequency of recording “latent” obesity in schoolchildren depends on gender (1,26 times more often in girls) and age (1,6 times more often in adolescents). High relative risks of developing arterial hypertension, as well as arterial hypertension and high normal blood pressure were revealed in schoolchildren with “latent” obesity compared to adolescent children with normal BMI (kg/m) and body fat mass. Conclusion. Preventive examinations of schoolchildren in health centers with the determination of the component composition of the body according to bioimpedansometry can identify children at high risk (“latent” obesity) for the development of primary arterial hypertension.
Key words: школьники, биоимпедансный анализ, артериальная гипертензия, schoolchildren, bioimpedance analysis, arterial hypertension
DYNAMICS OF THE MAIN EPIDEMIOLOGICAL INDICATORS OF TYPE 1 DIABETES IN CHILDREN AND ADOLESCENTS OF THE SMOLENSK REGION FOR THE PERIOD 2010-2018
Alimova I.L., Demyanenko A.N., Labuzova Y.U.V.
UDC: 616.179-008.64-036.22-053.2
Abstract: Objective.To analyze the main epidemiological characteristics of diabetes mellitus (DM) (prevalence, morbidity, mortality, carbohydrate metabolism) in patients under the age of 18 years in the Smolensk region in the dynamics for the period from 2010 to 2018. Methods.A retrospective analysis of prevalence, morbidity, mortality, incidence of diabetic complications (retinopathy, nephropathy, neuropathy) and carbohydrate metabolism was carried out. Results.The total number of DM patients under the age of 18 for the moment of 31.12.2018 was 234. 230 of them were patients with DM 1, including 162 children and 68 adolescents (15-18 years). The prevalence of DM 1 in children was 115.15/100 thousand population, in adolescents - 291.08/ 00 thousand population. The morbidity rate per 100 thousand population was 17.05 in children and 4.28 in adolescents. Microvascular complications (retinopathy and nephropathy) in children and adolescents with DM 1 of Smolensk region were registered in isolated cases (1.97% and 2.78%, respectively). Neuropathywas reported more often and accounted for 7,89% of children and 15,28% of adolescents. The average HbA1c was 8.1% in children, 8.3% in adolescents, and a third of patients had HbA1c <7.0%. The analysis of data of the Federal register of SD in 2018 revealed inadequate quality of its maintaining and untimely updating of information. Conclusions.Among children and adolescents of the Smolensk region for the period 2010-2018 there was an increase in the prevalence of DM 1 with relative stabilization of morbidity, improved control of carbohydrate metabolism and absence of deaths. Further work is needed to improve the quality of conducting the Federal register of the DM and the timely posting of accurate information in patients with increased control by managers of health facilities of the region and the main specialists of the Health Care Department.
Key words: сахарный диабет, эпидемиология, дети, подростки, diabetes mellitus, epidemiology, children, adolescents
EFFECT OF PERSISTENT INFECTIONS ON THE OCCURRENCE OF MYCOBACTERIUM TUBERCULOSIS INFECTION IN YOUNG CHILDREN
Avdeeva T.G., Krikova A.V., Myakisheva T.V., Zaitseva V.M., Dmitrieva E.V.
UDC: 616-01/099
Abstract: Objective. The aim of the study was to compare the incidence of Mycobacterium tuberculosis infection in children under three years of age having a history of persistent infections and uninfected children for early detection of tuberculosis infection and improvement of diagnostic effectiveness. Methods. Legislative documentation, separate indicators of the epidemiological situation of tuberculosis and herpetic infections were studied. Statictical processing of the results was performed with Microsoft Excel 16. Results. The priority directions of the strategic development of the health care system and the regulatory framework were studied. In children with persistent infections,tuberculosis infection was revealed more often, compared to cases in children without persistent infections. The incidence of MBT infection in children on a gender basis among the patients with persistent infections wasnot revealed while MTB infection of children with persistent infections was more characteristic for boys. The risk factor of infection with MBT by the 3rd year of age is the presence of IUI in children in the neonatal period and herpes diseases in anamnesis. Children infected with MBT with persistent infections have persistent changes in General blood tests in the form of monocytosis and anemia, both before and after infection with MBT. Children with virage of the tuberculin skin test should be clinically and immunologically examined for the present of the past persistent infections present prior to MTB infection. This provision should be reflected both in the period of preventive treatment of latent tuberculosis infection and in the period of treatment of local forms of tuberculosis. Conclusion. Criteria of infection with Mycobacterium tuberculosis in young children with previous persistent infections should be studied for timely detection of tuberculosis infection in the early age. This requires the development of a new approach to the diagnosis and treatment of tuberculosis against the background of previous and concomitant persistent infections.
Key words: туберкулез, герпетическая инфекции, персистирующие инфекции, заболеваемость детей, tuberculosis, herpetic infections, persistent infections, morbidity of children
DURATION OF QTC INTERVAL IN CHILDREN WITH DIABETIC CARDIOVASCULAR AUTONOMIC NEUROPATHY DEPENDING ON THE SEVERITY OF HYPOGLYCEMIA ACCORDING TO THE COMBINED MONITORING OF ECG AND GLYCEMIA
Demyanenko A.N., Alimova I.L.
UDC: 616.379-008.64:616.12-008.1-072.7
Abstract: Objective. To study the duration of the QTc interval in children with diabetic cardiovascular autonomic neuropathy depending on the level and duration of hypoglycemia according to the combined monitoring of ECG and glycemia. Methods. 100 patients with type 1 diabetes mellitus aged 10-17 years (14.0 years [12.0-15.0]) were examined including group 1 - with CAN (n=30), group 2 - without CAN (n=70). Synchronous monitoring of glycemia and ECG was carried out. The night period (23 to 7 hours) was estimated. According to the results of glycemic monitoring, periods of hypoglycemia (≤3.9 mmol/l, n=50), optimal glycemia (4.0-9.0 mmol/l, n=112) were distinguished. Among the episodes of hypoglycemia, the following levels were identified: level 1 (≥3.0 and ≤3.9 mmol/l), level 2 (≥2.2 and <3.0 mmol/l), 2A (≥2.2 and <3.0 mmol/l) and 2B (<2.2 mmol/l), level 3 (≤3.9 mmol/l, with cognitive impairment and requiring assistance), on the basis of which the duration of the QTc interval, incidence and duration of QTc registration >450 ms were studied. Results. Long periods of hypoglycemia were recorded in patients with CAN; hypoglycemia level 2 and asymptomatic hypoglycemia were more frequently recorded. The duration of QTc during periods of hypoglycemia in groups 1 and 2 was comparable. QTc interval >450 MS with the same frequency was recorded at different rates of hypoglycemia in patients with CAN, in patients of group 2 - more often in hypoglycemia level 2. The duration of the registration of a QTc interval>450 MS in patients with CANwas more in hypoglycemia level 2 in comparison with patients without CAN. Conclusion. In patients with CAN long, clinically significant asymptomatic hypoglycemia was more often recordedat night. The maximum lengthening of the QTc interval in children with CAN was recorded in periods of hypoglycemia, while the duration of the QTc interval>450 ms in patients with CAN was longer at values of glycemia <3.0 mmol/l.
Key words: дети, сахарный диабет, кардиоваскулярная нейропатия, гипогликемия, QTс, children, diabetes, cardiovascular neuropathy, hypoglycemia, QTс
STERILE MARRIAGE AND HEALTH OF CHIDLEN BORN AFTER ASSISTED REPRODUCTIVE TECHNOLOGIES
Lyisenko I.M., Lyisenko O.V., Rozhdestvenskaya T.A., Lyisenko A.S., Zhuravleva E.V.
UDC: 618.177:618.4-058.86-056.22
Abstract: Objective. To analyze the structure of infertility, especially of delivery of patients who have resorted to assisted reproductive technologies and perinatal outcomes after the using of in vitro fertilization. Methods. A retrospective analysis of 135 delivery was carried out after the application of assisted reproductive technologies conducted in various centers of the Republic of Belarus, which took place in the maternity homes of Vitebsk from 2013 to 2017. For statistical analysis the software package "Statist1ca 6.0" wasused Results. Among those who gave birth after in vitro fertilization, women of late reproductive age prevailed. The duration of infertility was 8,4±1,8 years. The combination of several factors of female infertility was 61,5%. Most often in the structure of female infertility the endocrine factor (47,4%) was revealed. Combined infertility was registered in 45,2% of cases. Male infertility factor was registered in 51,1% cases.Intracytoplasmic sperm injection was used in the course of fertilization in 71,1% of cases. In 63,0% of cases, two embryos were transferred to the uterine cavity.The incidence of multiple pregnancies was 26,7%. In 77,8% of women cesarean section was performed. 42 (31,1%) of the 105 delivery were premature, and 31 (73,8%) of them were with multiple pregnancies.70,4% of newborns were discharged home, 29,6% of newborns were transferred to the second stage, which was determined only by prematurity.During the first 2 years of life it was established that 126 (93,3%) children were practically healthy, the presence of chronic diseases in the compensation stage was noted in 9 (6,7%) people. Conclusion. The causes of infertility are multifactorial in nature, and women come to specialized centers in the vast majority of late reproductive age. More than one embryo is presently transferred to the uterine cavity, which leads to multiple pregnancies and premature births in this group of patients. After delivery of assisted reproductive technologies, the caesarean section remains the leading mode of delivery. Poor perinatal outcomes after assisted reproductive technologies are determined by the frequency of multiple pregnancy, which requires universal transfer of a single embryo.by the frequency of multiple pregnancy, which requires universal transfer of a single embryo.
Key words: бесплодие, вспомогательные репродуктивные технологии, перинатальные исходы, Infertility, assisted reproductive technologies, perinatal outcomes
COMPENSATORY RESOURCES ASSESSMENT IN INFANTS BORN WITH MILDINTRAUTERINE GROWTH AND DEVELOPMENT RETARDAТION
Ivanov D.O., Derevtsov V.V.
UDC: 616-053.3:618.3-06:616-092.1
Abstract: Objective. To assess compensatory resources in infants born with mild intrauterine growth and development retardation. Methods. 734 comprehensive examinations of babies were conducted.166 neonates have been under study since their birth, 72 of them born after abnormal pregnancies including pregnancies with mild intrauterine growth and development restriction (Group 1) and 69 infants - born after high-risk pregnancies without IUGR by mothers with complicated somatic and gynecologic histories (Group 2). In Group 1 symmetrical IUGR was diagnosed in 15 patients (20.83%) (Subgroup 1b), and asymmetrical IUGR was found in 57 infants (79.17%) (Subgroup 1a). Group 3 comprised 25 patients, virtually healthy infants born by virtually healthy mothers after normal pregnancies. All infants were full-term new-borns. The children were examined when they were 1 (156), 3 (143), 6 (134), and 12 (135 children) months old.Outcome recording methods were a comprehensive case history analysis, physical examination, assessment of cardiointervalography, distribution-free statistical analysis methods. Results. Compensatory resources (IN, Me) in children of the group 1 in comparison with children of the groups 2 and 3 were exhausted during 2-3 days (403.65), at 1 and 3 months they were tense (720.49 and 403.65 respectively), at 6 months in comparison with the children of the group 3, theywere exhausted (350.38), at 12 months in comparison with the children of the group 3 the resources were exhausted (258.78), and in comparison with the children of the group 2 - tense. Compensatory resources in children of subgroup 1a in comparison with children of subgroup 1b for 2-3 days, 1 month were depleted (357.14; 675.71), at 6 months - tense (355.65). Compensatory resources in children of the subgroup 1b in the dynamics from 2-3 days to 6 months changed significantly, the similar tendency was observed in children of the subgroup 1a from 6 to 12 months. Conclusion. Mild intrauterine growth and development retardation, both symmetrical and asymmetrical types, induce changes in infants’ compensatory resources.
Key words: компенсаторные ресурсы, младенцы, замедлениевнутриутробного роста, compensatory resources, infants, intrauterine growth and development restriction
CLINICAL-EPIDEMIOLOGICAL FEATURES METAPNEUMOVIRUSES AND BOCAVIRUSES RESPIRATORY INFECTIONS IN THE EPIDEMIC SEASON 2017-2018
Zhilina E.A., Sokolovskaya V.V., Grekova A.I., Shevchenko S.S., Smolyankin N.N.
UDC: 616.988-053.2
Abstract: Objective. To compare clinical-epidemiological peculiarities of metapneumovirusesand bocaviruses infection in children in Smolensk, who were on hospitalization in unit 6 of Clinical hospital in 2017-2018. Methods. A retrospective analysis of 103 case histories of children aged 1 month to 14 years with metapneumoviruses (n=46) and bocaviruses (n=57) infections, which were confirmed using the PCR in smears from the nasopharynx, were treated at the infectious unit 6 ofClinical hospital in 2017-2018. Results. Data on new pneumotropic viruses - metapneumovirus and bocaviruses: laboratory diagnosis, clinical and epidemiological characteristics, complications are presented. The proportion of metapneumoviruses and bocaviruses of infection from a number of etiologically verified cases in hospitalized children was 9% and 11,6%, respectively. Conclusion. It was concluded that the peak of the incidence was in autumn and winter with bocaviruses infection and winter-spring - with metapneumoviruses infection. In HBoV infection,children under 3 yearsprevailed in the age structure, and in HMPV infection-childrenaged 7-14 years. Bocavirus and metapneumovirus infection in hospitalized patients was characterized by acute lesions of the upper and lower respiratory tract. Incase of bocaviruses infection low-grade fever wasobservedin most children, and incase of metapneumoviruses the temperature was febrile. Metapneumovirus infection was more frequently found in association with other pathogens like SARS and bocavirus - in combination with bacterial infection. Unlike metapneumovirus, bocavirus often caused OSLT.
Key words: дети, острые респираторные вирусные инфекции, метапневмовирус, бокавирус, children, acute respiratory virus infections, metapneumovirus, bocavirus
FEATURES OF NEURAL AND MENTAL DEVELOPMENT OF CHILDREN OF THE FIRST THREE YEARS OF LIFE BORN WITH VERY LOW AND EXTREMELY LOW BODY WEIGHT IN THE NORTH-WEST REGION OF KALININGRAD REGION
Muts E.Yu., Shestakova V.N.
UDC: 616.053.32
Abstract: Objective. To study the characteristics of the neuropsychic development of young children born deeply premature in the Kaliningrad region in 2014-2015. Methods. Assessment of the neuropsychic development of young children (up to 3 years old) was carried out using the CAT / CLAMS scale in terms of the corrected age. Results. Children born with very low and extremely low body mass are significantly more likely to have cognitive impairment, as well as motor and speech development. They need early correction and constant support of a multidisciplinary team of specialists with the participation of not only a pediatrician, neurologist, orthopedist, cardiologist, optometrist, surdiologist, but also a speech therapist, pathologist, as the children have a high risk of dysarthria, both bulbar and post-bulbar, general underdevelopment of speech, phonetic and phonemic disorders. Conclusion.Very premature babies require in-depth monitoring not only in the first year of life, but also in subsequent periods of ontogenesis. They have a high-riskof impaired hearing, vision, speech, mental development, motor and emotional-volitional spheres, which requires complex habilitation and rehabilitation in earlier terms using not only basic medication, but also pedagogical, psychological, speech therapy and defectological care.
Key words: недоношенные, дети, нервно-психическое развитие, очень низкая, экстремально низкая масса тела, premature infants, children, neuropsychic development, very low, extremely low body weight
CLINICAL AND EPIDEMIOLOGICAL FEATURES OF PARVOVIRUS INFECTION
Rednenko A.V., Semenov V.M., Dmitrachenko T.I., Semenov D.M., Safonova T.V., Goridovets T.M.
UDC: 616.916.5
Abstract: Objective.To study clinical and epidemiological characteristics of parvovirus infection at the present stage. Methods. 16 patients with laboratory-confirmed diagnosis of parvovirus infection, 188 pregnant women, 113 healthy males were examined. The presence of specific antibodies to parvovirus B19 was determined by enzyme-linked immunosorbent assay, DNA of parvovirus B19 was determined by real-time polymerase chain reaction. Results. The proportion of pregnant women seronegative in relation to the parvovirus infection in the Republic of Belarus reaches 75%. Specific IgM are detected in 28.6% of women with pregnancy pathology.Seropositive for parvovirus infection are 39.8% of males aged 18 to 27 years. There is a difference in the frequency of infection in different regions of the Republic of Belarus (from 32% in the Mogilev region to 50% in the Minsk region).Parvovirus infection manifests itself as an acute onset of the disease, with a short prodromal period in 87.5% of patients, moderate intoxication and fever, usually not exceeding 38.5°C, the appearance of a rash, with localization on the face, trunk and extremities with a characteristic «slap» symptom (75%), a typical mesh pattern of the rash on the periphery, resembling lace (68.75%), moderate leukocytosis. Conclusion. The frequency of infection of young people aged 18 to 27 years with the parovirus infection, not exceeding 40-50%, high proportion of seronegative pregnant women (75%), diagnostic errors of parovirus infection detection in children lead to the need for laboratory diagnostic methods for screening pregnant women during intrauterine infection examination and children with infectious exanthema.
Key words: парвовирусная инфекция, парвовирус В19, пятая болезнь, симптом пощечины, parvovirus infection, parvovirus B19, fifth disease, «slap» symptom
EXPERIENCE OF PROPHYLACTIC APPLICATION OF PROLONGED MONTULUCAST COURSES IN CHILDREN AT RISK FOR THE OCCURRENS OF ASTHMA
Tikhonova N.K., Litvinenko S.N., Tikhonov V.G.
UDC: 616.248-053.2
Abstract: Objective. To study was to evaluate the effectiveness of the prophylactic courses of montelukast of varying duration in children at risk for the occurrence of bronchial asthma. Methods. The study was carried out with the participation of 198 children (106 boys and 92 girls), observed on an outpatient basis for three years, aged 2 to 5 years, assigned to the risk group for the occurrence of AD according to API criteria, without signs of bronchial hyperreactivity. Of these, 72 children received traditional therapy for acute respiratory infection (ARI) and bronchial obstruction (control sample), 126 children, along with ARI treatment, were prescribed montelukast at a dose of 4 mg per day at night, courses from 14 days to 24 months (main group). The duration of the prophylactic use of montelukast was selected individually. Results. The efficacy of Montelukast administration for the prevention of AD in children with a positive API has been established. The dependence of the duration of the course appointed by prophylactic drug therapy on the type of trigger factor. Conclusions. A study of the effectiveness of using montelukast for the prevention of asthma in asthma in children at risk showed its clinical effectiveness. The selection of the duration of the preventive course of montelukast should be determined by the nature of the trigger factors. Children aged 2-5 years with a positive API, wheezing who have wheezing due to acute respiratory infections, are recommended a 14-day course of montelukast from the first day of illness; children with indications of the trigger effect of cold air - a 6-month course of therapy (from September to May); children with signs of polyvalent sensitization to household, food and pollen antigens - continuous use of montelukast for 24 months.
Key words: дети, бронхиальная астма, профилактика, антилейкотриеновые препараты, монтелукаст, children, bronchial asthma, leukotriene blokes, montelukast