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Background. The increase in the number of cardiac surgeries has also led to a growth in cases of infective endocarditis of prosthetic valves and intracardiac devices. Both endocarditis are associated with difficulties in diagnosis, treatment and poor prognosis, which makes it relevant to analyze the clinical manifestations of these forms of endocarditis, especially in comparison with the results of other studies.Objective. To identify the features of clinical manifestations of infective endocarditis of prosthetic valves and endocarditis of intracardiac devices.Materials and methods. We analyzed clinical manifestations, laboratory, echocardiographic data and their dynamics during therapy in patients with infective endocarditis localized on the prosthesis (37 patients) or electrodes in the heart (15 patients). In the comparison group there were 21 patients with IE of the native valve.Results. Older patients were observed in the infective endocarditis group of valve prostheses and intracardiac devices. In all forms of infective endocarditis, the most common symptoms were fever, weakness and malaise; laboratory indicators included accelerated ESR and leukocytosis, and increased CRP. Manifestations of heart failure were more often observed in the group of prosthetic endocarditis (59.4%), in the group of native valve endocarditis in 40% of cases, in the group of electrode endocarditis less often – in 20% of cases. The most common causative agent of infective endocarditis was Staphylococcus aureus. We analyzed diseases and previous operations of infective endocarditis, as well as the time of onset of symptoms.Conclusion. The type of prosthesis and its location do not exclude the possibility of endocarditis. In patients with electrode endocarditis, the infection was localized in 2/3 of cases only on the electrode, in 1/3 of cases – on the electrode and the tricuspid valve. For instrumental diagnosis of prosthetic and electrode endocarditis, transesophageal echocardiography was more informative. Conservative treatment was successful in 75% of patients with prosthetic infective endocarditis, and with electrode infective endocarditis, surgical intervention was required in 53.3%.

Introduction: As the rate of congenital heart diseases (CHD) remains high, medical imaging specialists face a task of early diagnosis of CHD with minimal cost and burden to pregnant women and fetuses and need to verify the prenatal diagnosis in order to develop a strategy for managing pregnant women carrying a fetus with CHD.Objective: To optimize diagnostic measures in fetuses with CHD by comparing fetal echocardiography and cardiac magnetic resonance imaging (MRI).Materials and methods: We retrospectively evaluated findings from 35 fetal standard ultrasonography reports, 29 echocardiography reports, and 35 fetal autopsy reports (termination for medical reasons). We assessed 18 cases of CHD diagnosed by ultrasonography findings on the second screening; in 34% of the cases patients also underwent MRI at that time and a repeated procedure 30 weeks later.Results: When standard ultrasonography and an extended protocol with echocardiography were used together, diagnostic errors were 14.3%. In 85.7% of the fetuses, the findings of different imaging techniques fully coincided with the autopsy findings.Conclusions: In this cohort of pregnant women, the second screening should include more examinations to verify the diagnosis of CHD. Based on the first screening findings (increased nuchal translucency thickness and ductus venosus pulsatility index) patients should be referred to an expert for the second screening. If necessary, to verify the diagnosis of CHD ultrasonography and MRI can be combined during the third screening (34-36 weeks) in order to plan postnatal management of the newborn. The proposed algorithm for fetal CHD diagnosis enables to minimize the likelihood of error and maintain continuity of care between obstetricians-gynecologists, ultrasonographers, radiologists, neonatologists, and cardiologists.

Laboratory data, especially a general blood test, play an important role in the treatment of infectious diseases, including COVID-19. However, in patients with coronary heart disease (CHD) and COVID-19, a general blood test is rarely analyzed and is insufficient to fully assess an impact of the new coronavirus infection on patients with cardiac diseases. The aim of the study was to analyze a COVID-19 effect on hemogram parameters in the early recovery period of patients with coronary heart disease. The study was performed at the Kursk City Clinical Hospital for Emergency Medical Care in the years 2021–2022, which involved 58 mature-aged patients (45–59 years old) suffering from coronary heart disease who had a new coronavirus infection and 62 elderly patients suffering from coronary heart disease alone. Morning blood sampling was carried out from the forearm superficial veins into Vacutainer test tubes added with a coagulation activator. In elderly patients, 3–4 weeks after recovery, significant changes in red blood parameters persisted — a decline in the level of peripheral blood erythrocytes, hemoglobin and hematocrit. Elderly patients with coronary heart disease comorbid with a moderate new coronavirus infection, 3–4 weeks later had also higher count of leukocytes, neutrophils, segmented neutrophils and ESR level relative to comparison group. It should be noted that in the early convalescence period elderly patients with coronary heart disease and COVID-19 had significantly elevated ESR, which confirms ongoing sustained inflammatory process. After evaluating the information content according to the calculated Kullback informativeness assessment for analyzed general blood test parameters, it was found to peak for platelet and leukocyte counts as well as ESR level. Thus, among the analyzed indicators in the general blood test, it turned out that platelet and leukocyte count along with ESR level were most informative and of prognostic significance during early convalescent period of elderly patients with coronary heart disease comorbid with a new coronavirus infection, which are proposed to be used as biomarkers of early convalescent period.

Relevance. The high infectivity and mutagenicity of SARS-CoV-2, combined with the relative short duration of the immune response, means that the problem of controlling the incidence of COVID-19 will continue to be relevant. Aims. To plan anti-epidemic measures, you need to know the quantitative value of the basic reproductive number (R0), however, the available methods for estimating the R0 made it possible to estimate it only for the initial version of SARS-CoV-2. In this regard, the task was set to develop a method for estimating R0 for current pathogen variants based on the rate of change from one variant to another, including both viruses and bacteria. Materials and methods. A modification of the SIR model for two variants of SARS-CoV-2 and actual data on the incidence of COVID-19 and the results of sequencing the virus SARS-CoV-2 isolated in Moscow are used. Results. It was found that for the SARS-CoV-2 Delta variant R0 was about 10, and for the current Omicron variants it exceeds 30. Discussion. In contrast to existing methods, the proposed method allows one to estimate R0 in the context of anti-epidemic measures, as well as by the dynamics of morbidity in a population with a collective immune status, taking into account the typical structure of the circulating SARS-CoV-2. Conclusion. The proposed method makes it possible to estimate the change in the basic reproductive number of the SARS-CoV-2 based on the rate of displacement of one variant by another

Relevance. It is known that the immune response to the administration of immunobiological drugs is variable and depends on the individual characteristics of the organism. Host immunogenetic factors have a significant impact on the effectiveness of vaccination. In this study, the frequencies of alleles of the HLA class I (HLA-A, B, C) and class II genes (HLA-DRB1, DPB1, DQB1) were studied in groups of participants with different levels of antibodies (anti-HBs) after vaccination against viral hepatitis B. Aims of the work was to determine the possible relationship between alleles of HLA genes and the intensity of post-vaccination immunity against hepatitis B. Materials and methods. The study included 271 apparently healthy adults who were divided into 3 groups depending on the specific concentration of post-vaccination antibodies (anti-HBs) using ELISA. All calculations were made relative to the groups anti-HBs >100 mIU/ml (n=82), 10-100 mIU/ml (n=98) (protective antibody level) and anti-HBs

Relevance. Liver transplantation involves reconstruction of several vascular structures. Portal reconstruction presents many difficulties due to the frequent intraoperative detection of thrombosis. Portal vein thrombosis is a condition caused by stagnation of blood flow, vascular injury, or hypercoagulability, leading to partial or complete occlusion of the portal vein. The prevalence of thrombosis ranges from 2.1 to 23.3% among liver transplant candidates without hepatocellular cancer. According to autopsy data, the incidence of thrombosis in liver cirrhosis is 6– 64%.Purpose: to analyze a case of portal vein thrombosis in a patient with two preliminary attempts to install transjugular intrahepatic portosystemic stents and their thrombosis.Materials and methods: a clinical case of thrombosis of the stent and portal vein in a 53-year-old patient with decompensated liver cirrhosis as a result of viral hepatitis C with portal hypertension. The peculiarity of this case is that after double transjugular intrahepatic portosystemic stenting, thrombosis of the venous vein was detected only intraoperatively. A liver transplant was performed; the functionality of the graft was not impaired.Conclusion. This case illustrates the need for future research on the topic of portal vein thrombosis and techniques for identifying it preoperatively.

Introduction . The choice of the method and time of initiation of extracorporeal detoxification (ECD) in septic shock (SSh) complicated by acute kidney injury (AKI) is a debatable problem.The objective was to evaluate the influence of various ECD tactics on the dynamics of markers of systemic endotoxicosis and acid-base status (ABS) in patients with SSh complicated by AKI.Materials and methods. Study included 57 patients. Group 1 – 36 patients used continuous veno-venous hemodiafiltration (CVVHDF) for urgent indications. Group 2 – 21 patients used early combined ECD (LPS-sorption and CVVHDF). A comparative analysis of the main laboratory parameters between the groups was performed.Results. Early combined ECD made it possible to reduce the concentration of leukocytes by the 3rd day of therapy from 20.6 to 12.5 ·109/l (39.3 %) from the initial level in group 2, and from 22.2 to 19.15·109/l (13.7 %) in group 1 ( p=0.04); C-reactive protein by the 5th day of therapy from 284 to 145 mg/l (48.9 %) in group 2, and from 299.3 to 199.8 mg/l (33.2 %) in group 1 ( p=0.02); procalcitonin by the 5th day of therapy from 7.2 to 1.6 ng/ml (77.8 %) in group 2, and from 7.8 to 4.45 ng/ml (42.9 %) in group 1 ( p= 0.02); pH by the 3rd day of therapy from 7.17 to 7.37 in group 2, and from 7.19 to 7.27 in group 1 (p =0.04); IL-6 level by the 5th day of therapy from 764.9 to 361.7 pg/ml (52.7 %) in group 2, and from 700.1 to 542.5 pg/ml (22.5 %) in group 1 (p=0.007).Conclusions. Early combined ECD more quickly reduces markers of systemic endotoxicosis and eliminates impairment of ABS, than CVVHDF.

Relevance. The choice of biliary anastomosis is the main factor determining the risk of developing biliary complications after orthotopic liver transplantation. The two most common forms of biliary tract reconstruction are choledocholedochostomy (duct-to-duct anastomosis) and choledochoeunostomy (connection of the bile duct to the jejunum). The choice of biliary tract reconstruction is determined by a variety of factors, including the underlying pathology of the liver, the size of the bile ducts of the donor and recipient, previous transplantation or previous biliary tract surgery, as well as the preferences of the surgeon performing the operation. Despite the correctly chosen method of reconstruction, complications such as strictures, lithiasis, biloma, and bile leakage occur infrequently.Objective: to present a review of the literature on methods of diagnosis and treatment of biliary complications after liver transplantation.Materials and methods. The analysis of literary sources in English and Russian from 2010 to 2023 on this topic in the databases PubMed, MEDLINE, Google Scholar was carried out. The review highlights clinical studies, as well as literature reviews on similar topics with an emphasis on the treatment and diagnosis of biliary complications.Conclusion. The problem of biliary complications of liver transplantation remains relevant and unresolved to the end. Noninvasive imaging techniques for complications arising after biliary tract surgery have prospects for development. The tactics of percutaneous, endoscopic and open interventions on the biliary graft tree require further improvement.

Introduction. The basis for research, analysis and mathematical optimization of any chemical process is an adequate mathematical model that takes into account the kinetics of the object. Kinetic analysis is a challenge in chemical technology, since it allows for optimizing synthesis processes and predicting their efficiency. Numerous chemical processes involve several stage reactions. For successful design and optimization, a mathematical model that describes each stage is needed. Creating such a model manually can be time-consuming and costly, since it requires processing a large amount of information. The modern level of automation makes it possible to accelerate the obtaining of a mathematical formulation of the kinetics of multistage reactions. In this case, working with data is greatly simplified, and the probability of making mistakes is reduced. The resulting mathematical model can be applied for further analysis and optimization of the process. The paper considers the industrial reaction of catalytic reforming of gasoline, which occupies an important place in the modern scheme of oil refining, since it is a source of high-octane components of commercial gasolines and individual aromatic hydrocarbons. This process is characterized by the participation of a large number (up to 300) of various hydrocarbons, a change in the number of moles, and non-isothermality in it. Mathematical modeling of such processes involves detailing the stages to the required level. The detailing of up to 173 stages is considered. In this setting, automation of the formation of a mathematical formulation of kinetics for catalytic reforming of gasoline has not been carried out before. Therefore, the presented work aimed at implementing effective numerical methods and algorithms for automating the building of a mathematical model taking into account kinetics, thermodynamics, and changes in the number of moles.Materials and Methods. The mathematical formulation of the kinetics of multistage reactions was developed on the basis of the mass action law. The kinetic parameters values were taken from literary sources. The direct kinetics problem was solved using algorithms: the Gear method, the Runge-Kutta method of the 4th order, and the scipy.odeint() method of the Python language. The automation concept was implemented using the IDEF0 methodology. The software was written in the Python programming language.Results. A new software was created to automate the process of forming a mathematical model, taking into account the kinetics, thermodynamics, and the volume of the reaction mixture. The program results were presented by the example of catalytic reforming of gasoline. The model implemented the possibility of taking into account the intermediate heating of the mixture in the reactor cascade. Numerical values of temperature changes corresponding to industrial data were obtained.Discussion and Conclusion. The results obtained through modeling chemical transformations in the cascade of gasoline catalytic reforming reactors confirmed the exothermic nature of the reaction. The developed software product provides displaying changes in the concentrations of reactants, as well as temperature variations in the reactor, and it can be used in scientific research organizations for the analysis of multistage catalytic processes. The results of the reaction kinetics modeling will be used in the subsequent optimization of the process conditions in production.

The work is devoted to the analysis of modern literature data and approaches in performing repeated liver transplantation. The most frequent causes of liver graft loss are PNFT, HAT, recurrent initial disease and chronic rejection. The leading indication for retransplantation in children is HAT. The one-year survival rate after retransplantation is approximately 75%. Reducing the cost of organ retransplantation and the cost-effectiveness of the procedure are controversial issues. Mathematical modeling has identified several significant recipient and donor factors affecting the outcomes of retransplantation. Despite ethical and economic considerations, retransplantation is the only option for transplant patients whose grafts have failed to engraft. The decision to retransplant should be made with some caution, with full multi-type approach in large multidisciplinary transplant centers.

Introduction. The shortage of donor organs has been and remains the basic problem of clinical transplantation and the expansion of the organ pool by using marginal donor organs has become one of its solutions. In this regard, every decision to use a "non-standard" or "non ideal" organ for transplantation should be made carefully.Aim. Demonstration of successful liver transplantation from a donor with brain death and occlusive thrombosis of the splanchnic venous system.Description. A 34-year-old donor without serious concomitant pathology was diagnosed with total portal thrombosis during liver procurement. After cold aortic perfusion, a thrombectomy from the portal vein was performed. At the “backtable” stage, an additional perfusion was made through the portal vein, the results of which confirmed the patency of the portal system. The liver graft was transplanted to a 33-year-old recipient; the postoperative period was uneventful, the patient was discharged on the 17-th postoperative day.Conclusions. Portal vein thrombosis in a donor liver is rare. A positive decision on liver transplantation from a donor with portal vein thrombosis should be based on the confirmed patency of the portal system. It is desirable that these data be supplemented by a histological examination of the donor liver. The donor organs shortage needs to expand the criteria for post-mortem organ donation. However, every decision should be made in the light of individual characteristics of the donor-recipient pair.

Objective: to evaluate the possibilities of dynamic scintigraphy for the diagnosis of esophageal dysmotility (ED) and gastroesophageal reflux (GER) in patients with systemic sclerosis (SS).Material and methods. The study group included 77 patients with established SS of different disease duration (from several months to 30 years) who underwent Technephyt 99mTc dynamic esophageal scintigraphy using two-stage protocol. During the first stage, the esophageal transport function was evaluated; during the second stage, the presence and severity of GER were assessed. Scans were analyzed using visual assessment, quantitative estimation of time/activity curves, and a proposed three-point scale for evaluating ED and GER severity. The control group consisted of 19 practically healthy individuals who underwent a routine examination to exclude digestive system and gastrointestinal tract diseases, the algorithm of which included dynamic scintigraphy.Results. ED was found in 74 of 77 patients (96%). According to three-point scale, severe ED (3 points) was registrated in 41 (55%) patients, moderate ED (2 points) in 15 (21%), and mild ED in 18 (24%). GER was diagnosed in 35 of 77 cases (45%): mild GER in 13 (37%), moderate GER (2 points) in 22 (63%), and none of the patients was found to have severe GER (3 points). A significant relationship between the presence of GER and the severity of ED was not obtained, but a direct correlation was established between ED and GER severity.Conclusion. Most SS patients demonstrated ED of varying severity associated with mild and moderate GER in nearly 45% of the cases. The study results confirm the practical significance of dynamic scintigraphy for assessing the esophageal transport function and GER in SS patients.

Fulminant liver failure is usually characterized as severe acute liver injury with encephalopathy and synthetic dysfunction (international normalized ratio [INR] ≥1.5) in a patient without cirrhosis or previous liver disease. Management of patients with acute liver failure includes ensuring that the patient is cared for appropriately, monitoring for worsening liver failure, managing complications, and providing nutritional support. Patients with acute liver failure should be treated at a liver transplant center whenever possible. Serial laboratory tests are used to monitor the course of a patient's liver failure and to monitor for complications. It is necessary to monitor the level of aminotransferases and bilirubin in serum daily. More frequent monitoring (three to four times a day) of blood coagulation parameters, complete blood count, metabolic panels, and arterial blood gases should be performed. For some causes of acute liver failure, such as acetaminophen intoxication, treatment directed at the underlying cause may prevent the need for liver transplantation and reduce mortality. Lactulose has not been shown to improve overall outcomes, and it can lead to intestinal distention, which can lead to technical difficulties during liver transplantation. Early in acute liver failure, signs and symptoms of cerebral edema may be absent or difficult to detect. Complications of cerebral edema include increased intracranial pressure and herniation of the brain stem. General measures to prevent increased intracranial pressure include minimizing stimulation, maintaining an appropriate fluid balance, and elevating the head of the patient's bed. For patients at high risk of developing cerebral edema, we also offer hypertonic saline prophylaxis (3%) with a target serum sodium level of 145 to 155 mEq/L (level 2C). High-risk patients include patients with grade IV encephalopathy, high ammonia levels (>150 µmol/L), or acute renal failure, and patients requiring vasopressor support. Approximately 40 % of patients with acute liver failure recover spontaneously with supportive care. Predictive models have been developed to help identify patients who are unlikely to recover spontaneously, as the decision to undergo liver transplant depends in part on the likelihood of spontaneous recovery of the liver. However, among those who receive a transplant, the one-year survival rate exceeds 80 %, making this treatment the treatment of choice in this difficult patient population.

The article presents the results of liver transplantation in five HIV-infected recipients with irreversible liver damage. It is shown that four of them survived in the long-term period and are observed in a stable condition, and the only death in the recipient was not related to the HIV infection. The experience in the treatment of these patients was summarized. Analysis of the first results of liver transplantation in HIV-infection in Russia shows its validity and clinical efficacy. The only lethal case is connected with the initial extremely grave condition of the recipient and his age. Two cases of surgical traumatism, lack of consistent vaccination in the preoperative period, as well as lack of patients with hepatocellular cancer, small number of observations are obvious drawbacks of our first experience and should be corrected in the future. The success of a complex and multidisciplinary program of organ transplantation in HIV infection is impossible without participation of HIV-infectionists in the transplantation team.

Background. To plan effective and safe pharmacotherapy for inflammation and pain, it is important to evaluate the mechanisms and spectrum of action of nonsteroidal anti-inflammatory drugs (NSAIDs), including their effects on human proteome.Objective: to identify and evaluate the most significant specific differences of candidate molecule RRS-1 (N-{(Z)-2-(1-methyl-1H-indol-3-yl)-1-[(propylamino)carbonyl]vinyl}benzamide) from other NSAIDs through differential chemoreactome analysis.Materials and methods. Chemoproteomic modeling of pharmacological effects of RRS-1 molecule and a number of well-known NSAIDs (diclofenac, nimesulide, ketorolac) on human proteome was carried out on the basis of numerical prediction algorithms over the space of heterogeneous feature descriptions, developed in the topological approach to recognition by Yu.I. Zhuravlev and K.V. Rudakov scientific school.Results. Significant differences in the effects of the studied molecules were found for 1232 proteins of human proteome. The features of assessing interactions of the studied molecules with 47 target proteins, which most distinguished the effects of RRS-1 molecule from all others were identified. RRS-1 could activate adenosine and dopamine receptors, cannabinoid receptor 2 and GABAA receptor to a greater extent than other molecules. Activation of these receptors corresponded to anti-inflammatory, anti-nociceptive and neuroprotective effects. RRS-1 could preferably inhibit a number of pro-inflammatory proteins, receptor bradykinin 1, metabotropic glutamate receptor 5, matrix metalloproteinases 8, 9, 12, and blood coagulation factor X. Additionally, RRS-1 molecule showed preferable inhibition of a number of kinases targeted in antitumor and anti-inflammatory therapy. RRS-1, less than other studied molecules, interacted with the receptors of vitamin D3, thyroid hormone, acetylcholine, cannabinoids and opioids, orexin, and various metabolic enzymes, which is important in assessment of the safety of using drugs based on this molecule. RRS-1 characteristically exhibited a moderate profile of antivitamin action: the total score of vitamin and mineral loss (7.4±3.7) was significantly less in comparison to diclofenac (11.7±4.5) and was actually on the same level as nimesulide (6.9±3.7) and ketorolac (6.7±3.6).Conclusion. Chemoreactomic and chemoproteomic profiling of RRS-1 candidate molecule provided pre-experimental assessments of its efficacy and safety through modeling interactions with the human proteome.

Breast cancer is the most common cancer in women worldwide. However, the allostatic load in breast cancer patients has not been sufficiently studied. Objective: to study the allostatic load in middle-aged and elderly patients with breast cancer. Material and methods. The study included 65 middle-aged and 60 elderly patients with histologically confirmed breast cancer and 45 people aged 60-74 years, who had no breast cancer. The allostatic load was studied in these three groups according to the level: systolic and diastolic blood pressure, total cholesterol, triglycerides, high and low density lipoproteins, glucose, albumins and waist circumference. Results. The allostatic load score was significantly higher in elderly breast cancer patients than in middle-aged breast cancer patients (4.3 ± 0.3 points versus 2.9 ± 0.2 points, p

Arterial hypertension (AH) is among the life-threatening diseases and requires permanent antihypertensive therapy, including telmisartan. However, the effect of telmisartan upon systemic interleukin profile in elderly hypertensive patients requires further study, due to the limited data on previously analyzed interleukins. The aim of our study was to evaluate the immune pleiotropic effect of telmisartan upon miultiple pro- and anti-inflammatory blood interleukins in the patients with hypertension. The study included examination of 74 patients aged 60-74 years suffering from hypertension treated with telmisartan (80 mg/day in the morning time). The immune response to telmisartan assessed by the blood contents of different interleukins was evaluated following 6 months of treatment. These markers were determined by flow cytometry using “Becton Dickinson FACS Canto 2” device (USA). The pleiotropic immune effect of telmisartan upon the interleukin profile in hypertensive patients aged 60-74 was established by statistically significant changes in multiple pro-inflammatory and anti-inflammatory interleukins. Following 6 months of telmisartan therapy, the patients with arterial hypertension have shown a statistically significant decrease in blood cytokines, i.e., IL-1 в was reduced to 8.1±0.6 pg/ml vs initial 10.5±0.8 pg/ml; IL-2, to 8.6±0.8 pg/ml vs initial 11.8±1.1 pg/ml; IL-6, to 18.4±0.5 pg/ml vs initial 21.2±0.7 pg/ml; IL-8, to 3.5±0.6 pg/ml vs 5.4±0.5 pg/ml. We have also revealed a statistically significant decrease of blood TNFα levels to 5.3±0.5 pg/ml versus initial 6.8±0.4 pg/ml in the elderly patients with hypertension after 6 months of antihypertensive therapy with telmisartan. Moreover, the levels of pro-inflammatory systemic interleukins and, especially, IL-4 showed an increase from 4.6±0.5 pg/ml to 7.0±0.6 pg/ml in the course of telmisartan therapy in these patients. In summary, one may suggest that telmisartan exerts a significant immune pleiotropic effect in the patients with hypertension, confirmed by the systemic changes of interleukin contents. The pleiotropic effects of telmisartan have been established in patients with arterial hypertension, expressed as a significant decrease in IL-1, IL-2, IL-6, IL-8, TNFα levels, along with increased IL-4 and IL-10 contents. The results obtained showed a significant pleiotropic effect of telmisartan in the patients with arterial hypertension upon several interleukins, thus expanding the role of immune inflammation in this disorder, as well as its reversal with telmisartan therapy.

Aim. To analyze newly diagnosed diseases and features of the post-COVID course in patients after a coronavirus disease 2019 (COVID-19) within 12-month follow-up.Material and methods. A total of 9364 consecutively hospitalized patients were included in the ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period.Results. According to the ACTIV registry, 18,1% of patients after COVID-19 had newly diagnosed diseases (NDDs) over the next 12 months. Hypertension (HTN), type 2 diabetes and coronary artery disease (CAD) prevailed in the NDD structure. Comparison of the age-standardized incidence of NDDs (HTN, CAD, diabetes) in the post-COVID period in the ACTIV registry with NDD incidence in 2019 according to Rosstat and the expected incidence of NDDs according to the EPOHA study revealed that HTN, diabetes, CAD in patients after COVID-19 were registered more often as follows: HTN by 7,0 and 4,4 times, diabetes by 7,3 and 8,8 times, CAD by 2,3 and 2,9 times, respectively. NDDs most often developed in patients aged 47 to 70 years. Comparison of the actual and expected number of cases of newly diagnosed HTN, CAD and diabetes depending on age showed that the actual number of cases in the population of patients in the ACTIV register is significantly higher than expected for patients aged 45-69 years and for patients with hypertension or diabetes and aged

Aim. To investigate on post-COVID period in patients of the Eurasian region.Material and methods. A total of 9364 consecutively hospitalized patients were included in ACTIV registry. Enrollment of patients began on June 29, 2020, and was completed on March 30, 2021, corresponding to the first and second waves of the pandemic. Demographic, clinical, and laboratory data, computed tomography (CT) results, information about inhospital clinical course and complications of COVID-19 during hospitalization were extracted from electronic health records using a standardized data collection form. The design included follow-up telephone interviews with a standard questionnaire at 3, 6, and 12 months to examine the course of post-COVID period.Results. According to ACTIV register, 63% of patients after COVID-19 had new adverse symptoms or exacerbations of the existing symptoms lasting for up to 1 year. After hospital discharge, 79,8% of patients sought unscheduled medical attention in the first 3 months, 79,1% at 4-6 months, and 64,8% at 7-12 months. Readmission rate was 11,8% in the first 3 months, 10,9% at 4-6 months, and 10,1% at 7-12 months. The most common reasons for unscheduled treatment in the first 3 months were uncontrolled hypertension, decompensated type 2 diabetes, destabilization of coronary artery disease, gastrointestinal disease, AF episodes, exacerbation of asthma and chronic obstructive pulmonary disease, decompensated heart failure (HF). The 12-month mortality of COVID-19 survivors after the discharge was 3,08%. Multivariate analysis showed that independent risk factors for fatal outcome were age (direct correlation), the levels of hemoglobin (inverse correlation), oxygen saturation (inverse correlation), and aspartate aminotransferase (direct correlation), as well as class III-IV HF, prior stroke, cancer, inhospital acute kidney injury. Based on these identified risk factors, a nomogram was constructed to determine the 3-month mortality risk after discharge.Conclusion. Analysis of ACTIV register showed that end of the acute phase of COVID-19 does not imply a complete recovery.

Aim. To study the lipid profile in hospitalized patients with coronavirus disease 2019 (COVID-19) depending on the outcome of its acute phase according to the AKTIV international registry.Material and methods. The AKTIV registry included men and women over 18 years of age with a diagnosis of COVID-19, who were treated in a hospital. A total of 9364 patients were included in the registry, of which 623 patients were analyzed for levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C) and triglycerides on days 1-2 of hospitalization. The level of high-density lipoprotein cholesterol (HDL-C) was calculated using the Friedewald equation.Results. We found that a decrease in LDL-C level was significantly associated with an unfavorable prognosis for hospitalized patients with COVID-19. This pattern persisted in both univariate and multivariate analyses. LDL-C levels in the final multivariate model had a significant relationship with the prognosis (an increase in the death risk by 1,7 times with a decrease per 1 mmol/l). In addition, we found that the survival of patients with an indicator level of

Metabolic syndrome (MS) is among the main public health challenges worldwide, leading to significant labor losses, increased costs for treatment and rehabilitation of the patients. The aim of the present study was to identify the informative serum interleukins, by determining the odds ratio in elderly patients with MS and hypertension. The main group of 86 patients with MS and arterial hypertension (AH) aged 60-75 years was examined under clinical conditions. The inclusion criteria were as follows: age of 60-75 years, presence of MS, primary hypertension (grade II-III), absence of acute myocardial infarction, malignant neoplasms, disorders of cerebral circulation, kidney failure over last 6 months. Diagnostics of MS and hypertension was carried out in accordance with Expert Guidelines from the Russian Research Society of Cardiology on the MS Diagnosis and Treatment. Our first study of a large range of serum interleukins in elderly patients with MS and hypertension allowed us to reveal the inversely directed changes in pro- and anti-inflammatory cytokine contents. Combined AH/MS in elderly persons is accomplished by sufficient increase of the most proinflammatory cytokines, and vice versa, by significant decrease in anti-inflammatory cytokines in blood serum. This finding clearly points to importance of immunological regulatory systems for initiation of AH with MS at older age. Pro- and anti-inflammatory serum interleukins are actively involved into the AH/MS development in elderly accompanied by their pronounced imbalance. The mentioned immune reactions could underlie the MS/AH condition. High risk of this disorder is connected with changed production of proinflammatory cytokines (IL-8, IL-1β), like as anti-inflammatory serum interleukins (IL-4, IL-10), with predominance of the former. The above interleukins should be considered dominant diagnostic markers of AH/MS in elderly persons. Measurement of serum interleukins and discriminant-based approach allows highly reliable differentiation of elderly patients with AH/MS from similar individuals without this disorder.

Background. Scientists around the world are interested in applying physical phenomena to various fields of science. The development of entire areas united by one concept (‘plasma medicine’, etc.) stands as an outstanding example. This study focuses on only two concepts of interest, which are plasma jet and electric field, as far as results of their combined use in clinical practice and in surgery remain understudied. Objective. Experimental evaluation of the effectiveness of physical methods of treatment in skin wound healing. Material and Methods. Animal testing involved 45 small laboratory animals (rats). They were divided into 5 groups of 9 according to methods for experimental wound healing. To generate the plasma jet, a portable generator was used, which is the original development of specialists of the Peter the Great St. Petersburg Polytechnic University. Planimetric and histological measurements were analysed. The antibacterial effectiveness of methods under research was investigated using Staphylococcus aureus 209P, cultivated in vitro on 6- and 12-millimeter discs. Discussion. A combination of non-thermal atmospheric pressure plasma and frequency-modulated electric field signal exhibited the ability to accelerate eschar separation by 52.1% (p < 0.05) and stimulate restorative regeneration by 56% (p < 0.05). Combination of physical methods of treatment demonstrated pronounced antibacterial effect. A histological examination on biopsy sample on the 21st day of observation revealed formed (mature) granulations and large number of newly formed vessels. The cellular composition of epidermal basement membrane showed high level of differentiation. Conclusion. The data obtained suggest that the use of the proposed methods in clinical practice will improve the treatment process of the patients with wounds of different etiology.

Preterm labour (PL) is a relevant problem in maternal and child healthcare displaying a persistent trend. The risk of death is 25–35 times higher in premature infants than in normal children, whilst PL-associated stillbirth is 8–13 times more frequent over term labours. Severity of complications with prematurity is inversely proportional to the term of gestation. In general, PLs account for up to 70% of perinatal mortality. At the last FIGO Congress in 2018, PL was identified as an unsolved problem with no current treatment. Lack of scientific grounds for the PL aetiology and pathogenesis precludes practical success alike in prevention and treatment of this complication of pregnancy. In the bottom line, the past 60 years have not witnessed a global decline in the PL rate, it reaches to 9.5% of total births (with a slight variation depending on national commonwealth), and 15m premature infants are born annually. Two challenges currently face improvement of the PL perinatal outcomes: understanding the mechanism of PL and developing a strategy to render support at each stage of medical care to postpone, prevent the distress syndrome and sustain the foetus. The article tackles major issues in the diagnosis, treatment and prevention of preterm labour, aside with its impact on neonatal morbidity and mortality.

Organizations in almost every industry and country are reminded, all too frequently, that they operate in a risky world.In this scientific paper, the extent of employees’ training effects on financial and human resource risks is investigated. For this purpose, one of the well-known courses - Geometric Dimensioning and Tolerancing (GD&T) in the gas processing company Fajr Jam was studied and its return on investments (ROI) was measured to determine the key indicators and the actual effectiveness of them that can also affect the risk. All GD&T training courses are considered as integrated and modular. In addition, since calculating the qualitative effects of each training course and converting it into financial impacts is one of the most complex and even impossible parts of ROI, quantitative effects were first calculated in order to identify the least visible effect of training on financial results. Thereby, it is possible to prove that, at least, these courses have a positive impact on the overall productivity of the organization. Then the qualitative effects, that are always the most important and influential role of training were defined.In this research, interviews with experts in this field were used to determine the key indicators that are the basis for calculation ROI and to receive information. At first stage all aspects of the study were considered and then the assessment form of training ROI was compiled according to indicators. The results of this study we reahed, using a paired questionnaire that examines all the various factors in the achievements, which are evaluated to determine the effect of training in this process by the Analytic Hierarchy Process (AHP) method and Expert Choice software. In this research, all GD&T courses were studied for a year and a half. Finally, ROI was 829 %. This circumstance shows that the economic investments in this training course were reasonable and within 5 years, the organization returned 8.29 times of its investments.

In this paper, the authors deal with the processes occurring during boiling of two-phase flows in channels, which differ in many possible regimes, and their analytical description is possible only under strict restrictions within the given regime and the application of empirical data. An approach is proposed in which it is recommended to use a map of flow regimes (boiling) in coordinates φ–lgFrm as an empirical component. The analysis of the process is carried out in the entire range of parameters —mass flow, temperature and pressure taking into account the change of flow regimes. The analytical dependencies presented form together a complete mathematical model, which is implemented in the form of a computer program

Introduction. Effective drug therapy for cancer patients with chronic pain syndrome (CPS) of high intensity is one of the priorities of modern healthcare. Currently, non-narcotic and narcotic analgesics are used for pain relief according to a three-steps scheme. In the absence of contraindications, it is preferable to prescribe medications per os and prolonged forms, which will allow the patient to maintain selfcare and comfort.Aim. To study the pharmacokinetic properties of a drug with a prolonged mechanism of action «Morphine hydrochloride», in a film-coated tablet formof a dosage 30 mg, in cancer patients with severe CPS.Materials and methods. For the analysis of the pharmacokinetics of the studied drug after single and multiple doses of 20 patients who received 10-day analgesic therapy with the studied drug «Morphine hydrochloride», long-acting film-coated 30 mgtablets. manufacturer FSUE Moscow Endocrine Plant, Russia. Route of administration: per os. The study duration was 17 days: screening duration up to 7 days; duration of therapy up to 10 days.Results and discussion. The concentration of morphine in plasma was determined by HPLC-tandem mass spectrometry, within 12 hours after taking the study drug (1 of long-acting, film-coated tablet 30 mg). The following pharmacokinetic parameters were obtained on Day 5: T1/2 – 6.08 ± 4.37 hours and 14.46 ± 30.86 hours, Tmax – 2.5 ± 1.86 hours, Cmax – 43.91 ± 27.24 ng/ml. Values of pharmacokinetic parameters averaged over all days are presented. It was found that T1/2 for the studied drug T1/2 is 9.21 ± 14.94 hours, Tmax 2.87 ± 2.36 hours. The average maximum concentration (Cmax) on the day of the study drug was 36.52 ng/ml.Conclusion. As a result of the study of pharmacokinetics, it was found that the drug «Morphine hydrochloride», long-acting tablets film-coated with a of 30 mg was found in serum after oral administration after 15 minutes and reaches a maximum concentration in the blood in 3 hours, the half-life is on average 9 hours, the maximum concentration is 36.52 ng/ml.

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period.

Iran’s economy has three sectors: hydrocarbons, agriculture and services. Due to the historical trend, Iranian economy is under the influence of government governance in production and services. Considering the role of non-oil exports and the over-reliance of Iranian economy on petroleum and petroleum products, it is necessary to conduct a research to determine the factors, which affect non-oil export.Since oil revenues are not considered as a reliable source of revenue for the government due to their volatility, development of non-oil export is one of the major goals of Iranian most important goals. If the goals, set in this area will be achieved, the country’s position will be improved in terms of foreign exchange, curbing the volatility, caused by oil prices and gaining economic and competitive advantages in the global arena. The most important issue in the development of nonoil exports is the liberalization of economic capacity through new investments.In this article all factors, affecting non-oil exports have been determined, based on studying literature. Considering a survey of 32 executives and experts of Fajre Jam Refining Company as one of the most important condensate exporter companies in the country and region, the most important of them have been identified and then categorized using the affinity graph approach. Pairwise comparisons were used to weight the main and sub-factors with the participation of 10 executives and experts of the mentioned company within the framework of the analytic hierarchy process in expert choice software.

Introduction. The analysis of clinical experience for using biodegradable wound coating based on «HitoPran» chitosan in treatment of patients with burn trauma is presented.Background. Our work included an analysis of clinical experience for using a biodegradable wound coating based on «HitoPran» chitosan for surgical treatment in patients with local and common thermal burns.Material and Methods. A treatment analysis was conducted in 46 male and female patients, aged from 1 to 63 years with thermal burns on an area of 5 to 56% of the body surface. All injured were given surgical treatment in the complex with the use of low-temperature air plasma of arc discharge with atmospheric pressure in the conditions of our burn center in 2017–2018. Depending on the area and depth of the lesion, the patients were divided into two clinical groups: with local burns of II degree and area to 5% of the body surface and common burns of II and III degree and body surface 10% and more. In the course of early surgical treatment in patients with local border burns, the use of the wound coating «HitoPran» allows to achieve spontaneous epithelialization of wounds in dry environment after dermabrasion or escharotomy within the surface layers of dermis due to chitosan adhesion to the wound bottom, to reduce the number of dressings in the postoperative period. Covering skin grafts with perforation index 1:4 and 1:6 with wound «ChitoPran» coating in case of autodermoplasty in deep burn wounds provides satisfactory cellular epithelialization, reduces risk of regression of grafts, reduces consumption of wound coating and dressing material.Conclusion. Application of Russian modern biodegradable coatings based on «HitoPran» chitosan in complex treatment in patients with local and common burns with different depth allows to optimize local treatment of burn injuries, as well as to reduce the cost of used dressing material in comparison with foreign alternatives.

This paper is devoted to the development of an integrated method for calculating heat hydrodynamic characteristics of two-phase flows taking into account the specificity of the flow in minichannels. The proposed approach is based on the methodology for calculating the true volumetric vapor quality and the prediction of two-phase flow regimes. The paper presents experimental data on true volumetric vapor quality and a modified map of flow regimes

In recent times, the number of species of chlamydia associated with a number of inflammatory diseases in animals has expanded considerably. Moreover, in addition to chlamydia, attention was attracted by Сhlamydia-like organisms, which are not only dangerous for animals, but also carry a zoonotic threat. Currently, the most studied Chlamydia-like organisms are Waddlia chondrophila and Parachlamydia acanthamoebae. They are associated with diseases of the reproductive and respiratory systems in cattle and humans. Considering the danger to animals and the zoonotic threat of chlamydia-like organisms along with the absence of tools to discover them in Ukraine, the aim of our work was to develop a PCR test for the identification and species differentiation of Waddlia chondrophila. Conservative 16S rRNA genes were chosen as target genes for developing a PCR test system for identifying Waddlia chondrophila. Primers were selected specifically to be able to create multiplex combinations with the previously developed PCR test for Parachlamydia acanthamoebae. Both primers were designed with the same physical characteristics to provide simultaneous amplification under the same conditions in single or multiplex PCR. For the specificity evaluation of the primers, a panel of following DNA samples was used: Waddlia chondrophila, Parachlamydia acanthamoebae, Chlamydia avium, Chlamydia pecorum, Chlamydia abortus, Chlamydia psittaci, Chlamydia suis, Chlamydia caviae, Clavochlamydia salmonicola, Piscichlamydia salmonis. PCR product of 88 base pairs (b.p.) was formed during amplification only when the Waddlia chondrophila control DNA was present in the sample, as was expected. The small size of the PCR product theoretically allows the use of this pair of oligonucleotide primers for real-time PCR tests. After testing on clinical samples, developed PCR test system for identifying and species differentiation of Waddlia chondrophila can be used by scientists for extensive monitoring, by veterinary medicine doctors to clarify the diagnosis, and might be introduced into the practice of laboratories of veterinary and humane medicine.

Background. To define efficiency of decreased microbial dissemination in burn wounds after low-temperature argon plasma of the arc discharge of atmospheric pressure.Materials and methods. In the present article we described results of efficiency analysis after usage of low-temperature argon plasma of the arc discharge of atmospheric pressure for skin burn treatment Degree II–III (ICD-10). Burns had various etiology (flame, boiled water, contact) and area. We defined change in microflora of burn wounds after single administration of the PLAZMORAN installation in three groups of patients, depending on a surgical treatment type (dermabrasion, early necrotomy with plasty and plasty on the granulating wounds).Results. We noticed that treatment of burn wounds with Plasmoran showed results confirming decreased bacterial dissemination or complete wound sanitation after plasma effect and it reduced risk of possible purulent inflammation and speeded up terms of wound epithelialization.Conclusion. Basing on the bacteriological researches analysis it was determined that use of low-temperature air plasma of the arc discharge of atmospheric pressure reduces dissemination of wounds by pathogenic microflora.

The article presents data on the red flat lichen, chronic skin disease of mucous membranes, scalp, nail plates. Etiological and pathogenetic mechanisms leading to the development of lichen planus, the clinical picture and differential diagnosis of the disease are given, information about the methods of therapy and prevention is presented.

The international AKTIV register presents a detailed description of out- and inpatients with COVID-19 in the Eurasian region. It was found that hospitalized patients had more comorbidities. In addition, these patients were older and there were more men than among outpatients. Among the traditional risk factors, obesity and hypertension had a significant negative effect on prognosis, which was more significant for patients 60 years of age and older. Among comorbidities, CVDs had the maximum negative effect on prognosis, and this effect was more significant for patients 60 years of age and older. Among other comorbidities, type 2 and 1 diabetes, chronic kidney disease, chronic obstructive pulmonary disease, cancer and anemia had a negative impact on the prognosis. This effect was also more significant (with the exception of type 1 diabetes) for patients 60 years and older. The death risk in patients with COVID-19 depended on the severity and type of multimorbidity. Clusters of diseases typical for deceased patients were identified and their impact on prognosis was determined. The most unfavorable was a cluster of 4 diseases, including hypertension, coronary artery disease, heart failure, and diabetes mellitus. The data obtained should be taken into account when planning measures for prevention (vaccination priority groups), treatment and rehabilitation of COVID-19 survivors.

The organizer of the registers “Dynamics analysis of comorbidities in SARSCoV-2 survivors” (AKTIV) and “Analysis of hospitalizations of comorbid patients infected during the second wave of SARS-CoV-2 outbreak” (AKTIV 2) is the Eurasian Association of Therapists (EAT). Currently, there are no clinical registries in the Eurasian region designed to collect and analyze information on long-term outcomes of COVID-19 survivors with comorbid conditions. The aim of the register is to assess the impact of a novel coronavirus infection on long-term course of chronic non-communicable diseases 3, 6, 12 months after recovery, as well as to obtain information on the effect of comorbidity on the severity of COVID-19. Analysis of hospitalized patients of a possible second wave is planned for register “AKTIV 2”. To achieve this goal, the register will include men and women over 18 years of age diagnosed with COVID-19 who are treated in a hospital or in outpatient basis. The register includes 25 centers in 5 federal districts of the Russian Federation, centers in the Republic of Armenia, the Republic of Kazakhstan, the Republic of Kyrgyzstan, the Republic of Belarus, the Republic of Moldova, and the Republic of Uzbekistan. The estimated capacity of the register is 5400 patients.

Aim of the study. Aim of the study was to estimate the occurrence of pathogenic mutations in the BRCA1 gene in Russian breast cancer patients.Material and methods. Complete coding sequence of the BRCA1 gene of 445 early onset breast cancer patients (under 40 years) from Novosibirsk region (Russia) were analyzed by targeted Next Generation Sequencing (NGS) using Ion Torrent platform. Results. Forty (9%) carriers of various pathogenic mutations were revealed. Thirty five (7,9%) patients carried 5382insC mutation, described earlier as a founder mutation for Slavic population. Five (1.1%) patients carried various pathogenic mutations, namely C61G, 462delCC, E143X, 4153delA, and IVS18+1G>T. Besides, 29 genetic variants with no clinical significance or with unknown clinical significance were detected in BRCA1 gene among 445 early onset breast cancer patients. Conclusions. Data on the frequency of genetic variations in the BRCA1 gene among early onset breast cancer patients in the Novosibirsk Region (Russia) were obtained. Proportion of the 5382insC mutation is 87.5% of all pathogenic mutations in the BRCA1 gene found in patients.

Vacuum-assisted aspiration biopsy (VAB) has been in use for over 20 years. It is an accurate and safe procedure with a sensitivity of 97 %, specificity of 100 %, and accuracy of 99 %. VAB is used for the evaluation of nonpalpable tumors suspicious for breast cancer. Since 2000, VAB is widely used as a therapeutic method for total biopsy or resection of benign breast tumors (breast fibroadenoma, recurrent cysts, and intraductal or intracyctic hyperplasia). Many authors consider VAB as an alternative to standard surgery. VAB demonstrates good results in the minimally invasive treatment of nodular mastopathy. VAB technique is continuously being improved, which indicates the progress in medical science and successful implementation of minimally invasive treatments into clinical practice.

Aim. Study of SS-68 impact on primary generalized convulsions in basic estimation tests of anticonvulsant action of agents.Material and methods. Study of the SS-68 impact on primary generalized convulsions included an estimation of anticonvulsant action with maximal electric shock, thiosemicarbazide and pilocarpine antagonism tests performed on white outbred male mice and rats.Results. SS-68 compound possesses dosage dependent anticonvulsant action in maximal electric shock test indicating its ability to prevent death of 100% animals and its activity in thiosemicarbazide and pilocarpine antagonism tests as well. In the maximal electric shock test SS-68 surpassed sodium valproate in its anticolvulsant activity.Conclusion. Neurotransmitter systems of the brain such as GABA, cholinergic and amino acid stimulant system as well as K+, Na+ and Ca2+ channels of neurons shall be the most possible molecular targets of SS-68 anticonvulsant action. Higher activity of SS-68 comparing with sodium valproate in the maximal electric shock test (increasing GABA content in central nervous system) can be related with its wide range of neurotropic action.

The article presents advantages of usе the diffusion-weighted magnetic resonance imaging (DW MRI) for revealing of hypoxic-ischemic brain lesions in neonates. The trial included 105 neonates with perinatal brain lesions who had been undergoing treatment at a resuscitation department or neonatel pathology department in the first month of life. The article shows high information value of diffusion-weighted imagings (DWI) for diagnostics of hypoxic-ischemic lesions. In the event of no structural brain lesions of neonates, pronounced increase in signal characteristics revealed by DWI indicated considerable pathophysiological alterations. Subsequently, children developed structural alterations in the form of cystic encephalomalacia with the expansion of cerebrospinal fluid spaces manifested with pronounced neurological deficit.

The influence of compound SS-68, known for its marked antiarrhythmic properties, on the intension of electrophysiological effects of α1- и β- adrenoreceptors stimulation was studied in right atrial preparations from rat. Activation of α1-adrenoreceptors by methoxamine (3×10-5М) led to prominent prolongation of action potentials without significant changes in their rhythm. SS-68 attenuated this effect with IC50 = 5,27×10-6М. The standard α1-blocker prazosine appeared to be more effective (IC50 = 2×10-7М). The activation of β-adrenoreceptors by isoproterenol (3×10-7М) led to drastic acceleration of sinus rhythm. However, only the highest tested concentration of SS-68 (3×10-5М) reduced this effect, while the conventional β-blocker atenolol effectively inhibited it with IC50 = 3,95×10-6М.

In the experiments on isolated circular segments of the thoracic aorta of a rat it has been proved that indole SS-66 derivative in 10-5 and 10-4 М concentrations can relax smooth muscle cells (SMS) due to its impact on the SMS potassium conduction thus facilitating their hyperpolarization. It results in the block of voltage-sensitive calcium channels, the decrease in calcium input and the SMS relaxing. Lack of the NO-synthase Nω-nitro-L-arginine blocker impact on this process indicates of the lack of the SS-68 impact on the processes connected with the endothelium-dependant SMS relaxation.

In experiments on anaesthetized cats in the sinoatrial node (SAN), located in induced high-frequency electric field, focus glow (FG) is visualized, which upon stimulation of the vagus nerve (VN) by periodic electrical impulses undergoes significant changes, characterized by FG weakening and its migration, the emergence of pacemaker cells odd pools (PCP); bradycardia and sinus arrhythmia are also observed. Intravenous indole SS-68 derivative (50 mkg/kg) injection which is included in III antiarrhythmic class and is M2 holinoblocator, causes the increase in the FG intensity, its returning to the original location, PCP combination, bradycardia relief and sinus arrhythmia arrest. Under vagal-cardiac synchronization (VCS), caused by VN volleys of electrical impulses stimulation, FG in SAN is intensified and increases its square. PCP are combining thus causing bradycardia. SS-68 (50 mkg/kg) intravenous injection does not cause visible changes in the SAN functional state. It is suggested that the lack of SS-68 activity under the experimental conditions is masked by the processes that occur in the SAN under VCS, that requires additional specific investigations.

It was presented that the indole SS-68 derivative (10-6 and 10-5 М) revealed the manifested antianginal action as well as the antiarrhythmic one in experiments on rats' isolated heart, at the same time it had no considerable influence on the contractile myocardium function by the normal perfusion level. The loss of coronary vascular resistance under the influence of SS-68 was considerably restrained by glibenclamid, the blocker of ATP-sensitive K+-ducts (IKATP). The received data allowed us supposing the presence of IKATP incitant properties in SS-68.

Трофобластические новообразования (ТН) - это связанные между собой формы патологического состояния трофобласта: простой пузырный занос, инвазивный пузырный занос, хорионкарцинома, опухоль плацентарного ложа и эпителиоидно-клеточная трофобластическая опухоль. Выделяют два вида пузырных заносов: полный и частичный. В доступной литературе отсутствуют четкие критерии диагностики частичного пузырного заноса во II и III триместрах беременности. Представляем собственное наблюдение беременности, осложнившейся частичным пузырным заносом. Представленный случай позволяет предположить, что возможно вынашивание беременности с ультразвуковыми признаками частичного пузырного заноса при стабильных цифрах ХГЧ и динамическом контроле состояния плаценты и плода.

In the present study we have investigated influence of SS-68, which has been previously demonstrated to produce potent antiarrhythmic effects in mammalian myocardium, on the electrophysiological effects of selective M3 cholinoreceptors stimulation in rat atrial myocardium. M3 receptors were activated with muscarinic agonist pilocarpine (10 jM) in the presence of highly selective blocker of M2 cholinoreceptors methoctramine (100 nM). In isolated left atrial preparations M3 stimulation produced reduction of action potential duration by 20 ± 2,2% of control duration. SS-68 (10 jM) decreased intensity of action potential shortening more than twice - to 7,9 ± 1,1% of control action potential duration. SS-68 also suppressed action potential shortening produced by pilocarpine in the absence of M2 antagonist. Thus, compound SS-68 attenuates effect of joint activation of M2 and M3 receptors as well as the effect of selective M3 stimulation.

Rzayeva A. J., Agayeva K. F., Hatamzada E. M., Mammadbayli A. K. The risk mortality of the population of azerbaijan from circulatory diseases, depending on the season. Journal of Education, Health and Sport. 2015;5(6):115-122. ISSN 2391-8306. DOI 10.5281/zenodo.18393 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%286%29%3A115-122 https://pbn.nauka.gov.pl/works/564136 http://dx.doi.org/10.5281/zenodo.18393 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011 – 2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 21.04.2015. Revised 28.05.2015. Accepted: 05.06.2015. THE RISK MORTALITY OF THE POPULATION OF AZERBAIJAN FROM CIRCULATORY DISEASES, DEPENDING ON THE SEASON A. J. Rzayeva, K. F. Agayeva, E. M. Hatamzada, A. K. Mammadbayli Azerbaijan State Advanced Training Institute for doctors named after A. Aliyev, Baku ABSTRACT The Objective. To obtain evidence-based data about the role of seasons of the year in the formation of the population mortality risk from the circulatory system diseases (CSD) in Azerbaijan and its regions with specific climate. Materials of the study. A case of mortality was a unit of statistical observation. The fatalities from all reasons, including CSD have been distributed by the days of every month in the year. Daily average amount of fatalities by months and seasons ( from 20 December to 19 March – winter; from 20 March to 19 June- spring; from 20 June to 16 September; from 20 September to 19 December - autumn) have been determined. Results. In Azerbaijan the risk of general mortality and mortality from CSD is the highest in winter, it decreases in spring but nonuniformly (the general mortality rate is less than that from CSD). That is why the share of CSD increases among mortality reasons. Conclusions. Seasonal change of mortality risks from CSD is multivariant. Winter-spring increase of risk predominates in Azerbaijan. In some regions of Azerbaijan the mortality risk from CSD increases only once either in spring or in summer or winter. Key words: seasonal dynamics, risk of mortality, circulatory system diseases.

The substance SS-68 relaxes smooth muscles cells of tracheal rings of guinea pig in vitro. Such effect is selective for β2-adrenergic receptors, and type of this influence depends on method of stimulation on insulated trachea. The duration of effect substance SS-68 is not so long (about 15 min for toning after this exposure in concentration 10-7 M or about 60 min after maximum concentration in compare to super selective β2-adrenomimetic substance indacaterol maleate (the tonus of tracheal rings after washing away the substance SS-68 was not resorted. An amplitude of relaxation smooth-muscle cells on influence of the substance SS-68 in concentration 10-7 M is about 47% of the amplitude of relaxation witch has been maded by indacaterol maleate.

The effectiveness of the screening constant magnetic field is multi-layered film screens system of NiFe/Cu, formed on the cylindrical housing of photomultiplier tubes, and compared with screen-based steel material – brand 80NHS permalloy. It is shown that the most effective is the screen on the basis of the multilayered film screens, which provide shielding effectiveness value 8–10 in magnetic fields with induction of 0,1–1 mT, and 80–100 – in magnetic fields with induction of 2–4 mT , which is 4–5 times higher than for the screen of the material 80NHS.

The article presents advantages of use of diffusion-weighted magnetic resonance imaging (DW MRI) for revealing hypoxic-ischemic brain lesions in neonates. The trial included 97 neonates with perinatal brain lesion who had been undergoing treatment at a resuscitation department or neonatal pathology department in the first month of life. The article shows high information value of diffusion-weighted images (DWI) for diagnostics of hypoxic-ischemic lesions in comparison with regular standard modes. In the event of no structural brain lesions of neonates, pronounced increase in signal characteristics revealed by DWI indicated considerable pathophysiological alterations. Subsequently, children developed structural alterations in the form of cystic encephalomalacia with expansion of cerebrospinal fluid spaces manifested with pronounced neurological deficit. DW MRI has been offered as a method of prognosticating further neurological development of children on early stages.