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The transition to the third dimension enables the creation of spintronic nanodevices with significantly enhanced functionality compared to traditional 2D magnetic applications. In this study, we extend common two-dimensional magnetic vortex configurations, which are known for their efficient dynamical response to external stimuli without a bias magnetic field, into the third dimension. This extension results in a substantial increase in vortex frequency, reaching up to 5 GHz, compared to the typical sub-GHz range observed in planar vortex oscillators. A systematic study reveals a complex pattern of vortex excitation modes, explaining the decrease in the lowest gyrotropic mode frequency, the inversion of vortex mode intensities, and the nontrivial spatial distribution of vortex dynamical magnetization noted in previous research. These phenomena enable the optimization of both oscillation frequency and frequency reproducibility, minimizing the impact of uncontrolled size variations in those magnetic nanodevices.

Interest in Babesia species is gaining an increasing attention as an emerging tick-borne pathogen. Infection is primarily transmitted through Ixodes ticks, and alternatively by blood transfusions from asymptomatic donors., Aim: The aim of the study was detection of Babesia seroprevalence in different groups of population with the usage of experimental B. divergens whole-cell slide antigen and commercial B. microti immunofluorescence assay substrate slide., Materials and Methods: Indirect immunofluorescence assay trial was performed by testing of 145 blood samples of different origins: healthy individuals (60 - blood donors), risk groups (30 - HIV-infected individuals, 30 - Lyme disease patients) and false-positive IFA controls (10 - seropositive rheumatoid arthritis patients, 15 - patients with toxoplasmosis)., Results: The study revealed Babesia antibodies to B. divergens (6.9%) and B. microti (3.4%) that were detected with higher (p <0.05) frequency in HIV-infected individuals (26.7%) and in Lyme disease patients (16.7%) than at blood donors (1.7%). Diagnostically significant IgG titres were detected at 23.3% HIV-infected individuals, 13.3% Lyme disease patients and by 1.7% of blood donors and patients with seropositive latent toxoplasmosis. Specific IgM were detected at 20.0% HIV-infected individuals and 13.3% Lyme disease patients. 57.1% of diagnostically significant titres in HIV-infected and Lyme disease patients were represented by IgG and IgM., Conclusions: Immunofluorescence assay has a limited use in babesiosis: in acute form with negative microscopy or PCR; in chronic, asymptomatic and subclinical form with low level of parasitemia; and in retrospective and epidemiological studies of the population immune structure. Clinicians need to have increased awareness of babesiosis, and further studies are needed to clarify the optimal management of this infection in risk groups (including HIV-infected patients and blood donors)., (© 2021 MEDPRESS.)

Nijmegen breakage syndrome (NBS) is a DNA repair disorder characterized by combined immunodeficiency and a high predisposition to lymphoid malignancies. The majority of NBS patients are identified with a homozygous five base pair deletion in the Nibrin ( NBN) gene (c.657&#95;661del5, p.K219fsX19) with a founder effect observed in Caucasian European populations, especially of Slavic origin. We present here an analysis of a cohort of 136 NBS patients of Eastern Slav origin across Belarus, Ukraine, Russia, and Latvia with a focus on understanding the geographic distribution, incidence of malignancy, and treatment outcomes of this cohort. Our analysis shows that Belarus had the highest prevalence of NBS (2.3 per 1,000,000), followed by Ukraine (1.3 per 1,000,000), and Russia (0.7 per 1,000,000). Of note, the highest concentration of NBS cases was observed in the western regions of Belarus and Ukraine, where NBS prevalence exceeds 20 cases per 1,000,000 people, suggesting the presence of an "Eastern Slavic NBS hot spot." The median age at diagnosis of this cohort ranged from 4 to 5 years, and delay in diagnosis was more pervasive in smaller cities and rural regions. A total of 62 (45%) patients developed malignancies, more commonly in males than females (55.2 vs. 34.2%; p =0.017). In 27 patients, NBS was diagnosed following the onset of malignancies (mean age: 8 years). Malignancies were mostly of lymphoid origin and predominantly non-Hodgkin lymphoma (NHL) ( n =42, 68%); 38% of patients had diffuse large B-cell lymphoma. The 20-year overall survival rate of patients with malignancy was 24%. However, females with cancer experienced poorer event-free survival rates than males (16.6% vs. 46.8%, p =0.036). Of 136 NBS patients, 13 underwent hematopoietic stem cell transplantation (HSCT) with an overall survival of 3.5 years following treatment (range: 1 to 14 years). Indications for HSCT included malignancy ( n =7) and immunodeficiency ( n =6). Overall, 9% of patients in this cohort reached adulthood. Adult survivors reported diminished quality of life with significant physical and cognitive impairments. Our study highlights the need to improve timely diagnosis and clinical management of NBS among Eastern Slavs. Genetic counseling and screening should be offered to individuals with a family history of NBS, especially in hot spot regions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Sharapova, Pashchenko, Bondarenko, Vakhlyarskaya, Prokofjeva, Fedorova, Savchak, Mareika, Valiev, Popa, Tuzankina, Vlasova, Sakovich, Polyakova, Rumiantseva, Naumchik, Kulyova, Aleshkevich, Golovataya, Minakovskaya, Belevtsev, Latysheva, Latysheva, Beznoshchenko, Akopyan, Makukh, Kozlova, Varabyou, Ballow, Ong, Walter, Kondratenko, Kostyuchenko and Aleinikova.)

Lifelong withdrawal from the donor population of those who have been diagnosed with babesiosis must be used for transmission prevention., Aim: The aim of the study was a detection of Babesia antibodies level with the usage of experimental Babesia divergens whole-cell slide antigen and commercial B. microti immunofluorescence assay substrate slide (Fuller Laboratories, USA)., Materials and Methods: Experimental B. divergens whole-cell slide antigen in addition to commercial B. microti IFA substrate slide was used to create a diagnostic kit for serum Babesia antibodies level detecting, as well as for a babesiosis serodiagnosis clinical trial of different origins blood samples (patients with Lyme disease, rheumatoid arthritis and toxoplasmosis; human blood donors; cattle)., Results: Antibodies to B. divergens (5.4%) and B. microti (2.3%) were detected with higher (p <0.05) frequency at Lyme disease patients (16.7%) than at blood donors (1.7%). Diagnostically significant IgG titres (= 1:128) were found in 13.3% of blood samples from Lyme disease patients and 1.7% from blood donors. Specific IgM were also found in 13.3% blood samples from Lyme disease patients. Among blood samples from Lyme disease patients, in which diagnostically significant titres of Babesia antibodies were detected (16.7%), 60% of them were represented by IgG and IgM (rA= 0.63), and in 40% only one of them reached diagnostically significant titre. Conclusions. Advantages of babesiosis IFA diagnostics., Conclusions: Advantages of babesiosis IFA diagnostics are combined with its significant disadvantages (principle of evaluation, low sensitivity in the initial period of the disease, probability of false positives, absence of validated test systems and research protocols for B. divergens and B. divergens-like species)., (© 2020 MEDPRESS.)

Background: Variants in recombination-activating genes ( RAG ) are common genetic causes of autosomal recessive forms of combined immunodeficiencies (CID) ranging from severe combined immunodeficiency (SCID), Omenn syndrome (OS), leaky SCID, and CID with granulomas and/or autoimmunity (CID-G/AI), and even milder presentation with antibody deficiency. Objective: We aim to estimate the incidence, clinical presentation, genetic variability, and treatment outcome with geographic distribution of patients with the RAG defects in populations inhabiting South, West, and East Slavic countries. Methods: Demographic, clinical, and laboratory data were collected from RAG -deficient patients of Slavic origin via chart review, retrospectively. Recombinase activity was determined in vitro by flow cytometry-based assay. Results: Based on the clinical and immunologic phenotype, our cohort of 82 patients from 68 families represented a wide spectrum of RAG deficiencies, including SCID ( n = 20), OS ( n = 37), and LS/CID ( n = 25) phenotypes. Sixty-seven (81.7%) patients carried RAG1 and 15 patients (18.3%) carried RAG2 biallelic variants. We estimate that the minimal annual incidence of RAG deficiency in Slavic countries varies between 1 in 180,000 and 1 in 300,000 live births, and it may vary secondary to health care disparities in these regions. In our cohort, 70% ( n = 47) of patients with RAG1 variants carried p.K86Vfs * 33 (c.256&#95;257delAA) allele, either in homozygous ( n = 18, 27%) or in compound heterozygous ( n = 29, 43%) form. The majority (77%) of patients with homozygous RAG1 p.K86Vfs * 33 variant originated from Vistula watershed area in Central and Eastern Poland, and compound heterozygote cases were distributed among all Slavic countries except Bulgaria. Clinical and immunological presentation of homozygous RAG1 p.K86Vfs * 33 cases was highly diverse (SCID, OS, and AS/CID) suggestive of strong influence of additional genetic and/or epigenetic factors in shaping the final phenotype. Conclusion: We propose that RAG1 p.K86Vfs * 33 is a founder variant originating from the Vistula watershed region in Poland, which may explain a high proportion of homozygous cases from Central and Eastern Poland and the presence of the variant in all Slavs. Our studies in this cohort of RAG1 founder variants confirm that clinical and immunological phenotypes only partially depend on the underlying genetic defect. As access to HSCT is improving among RAG-deficient patients in Eastern Europe, we anticipate improvements in survival., (Copyright © 2020 Sharapova, Skomska-Pawliszak, Rodina, Wolska-Kuśnierz, Dabrowska-Leonik, Mikołuć, Pashchenko, Pasic, Freiberger, Milota, Formánková, Szaflarska, Siedlar, Avčin, Markelj, Ciznar, Kalwak, Kołtan, Jackowska, Drabko, Gagro, Pac, Naumova, Kandilarova, Babol-Pokora, Varabyou, Barendregt, Raykina, Varlamova, Pavlova, Grombirikova, Debeljak, Mersiyanova, Bondarenko, Chernyshova, Kostyuchenko, Guseva, Rascon, Muleviciene, Preiksaitiene, Geier, Leiss-Piller, Yamazaki, Kawai, Walter, Kondratenko, Šedivá, van der Burg, Kuzmenko, Notarangelo, Bernatowska and Aleinikova.)

Objective: The aim of the work was to detect a diagnostic value of CNSToxoIndex - index of correlation between albumin concentration and anti-toxoplasma antibodies, which reflects local production of anti-toxoplasma IgG in CNS compared with their level in blood., Patients and Methods: Materials and methods: 30 HIV-infected persons with the IV clinical stage (16 man and 14 women) aged from 25 to 49 years with clinical and instrumental signs of cerebral toxoplasmosis were selected from the general array of the patients treated in the Regional Clinical Infectious Hospital. A retrospective parallel detection of IgG T. gondii was performed in serum and CSF in patients, whose results of ELISA or PCR on T. gondii were positive. Blood serum and CSF were obtained from patients at the same time. All samples for analysis were stored at -20 °C and then tested on the RT-2100C Rayto Life and Analytical Sciences Co., Ltd (China) immunoassay analyser for quantitative detection of the level of specific anti-Toxicoplasma IgG. Detection of albumin concentration in serum and CSF was performed on the Chemray-120 Automated Biochemical Analyzer Rayto Life and Analytical Sciences Co., Ltd (China) using the Liquick Cor-ALBUMIN Diagnostic Kit., Results: Results: Specific IgG to T. gondii in blood plasma was found in 27 patients (90%) while in CSF only in 7 (23 %). The results of the research in this group of patients were represented by the following parameters: patient 1 (blood antiToxo IgG - 200 IU/ml, blood albumin - 36 g/l, CSF antiToxo IgG - 10 IU/ml, CSF albumin - 0.8 g/l, CNSToxolndex - 2.3); patient 2 (150 / 40 / 90 / 0.7 / 34.3, respectively); patient 3 (90 / 35 / 64 / 0.25 / 99.6); patient 4 (140 / 39/ 10/ 0.19/ 14.7); patient 5 (88 / 52 / 48 / 0.21 / 135.1); patient 6 (160 / 48 / 50 /0.15 / 100.0); patient 7 (122 / 42 / 15 / 0.17 / 30.4). Consequently, taking into consideration the diagnostic marker CNSToxolndex more than 10.0, cerebral toxoplasmosis was diagnosed only in six patients from seven, in whom anti-toxoplasma antibodies in CSF were detected. Patient 1, despite clinical symptoms similar to cerebral toxoplasmosis, and substitute signs of cerebral toxoplasmosis detected with the help of neuroimaging methods (volumetric formation of the right frontal lobe with a ring-shaped enhancement), availability of specific anti-toxoplasma antibodies in blood serum and CSF, diagnosis of cerebral toxoplasmosis has not been confirmed. M. tuberculosis DNA was found in CSF by PCR., Conclusion: Conclusions: CNSToxoIndex allows evaluating the local production of anti-toxoplasmic IgG in CNS and their diffusion from blood as a result of the blood-brain barrier damageand it is a powerful method of cerebral toxoplasmosis diagnostics in HIV-positive people as well.

Here we describe a 10-year-old girl with combined immunodeficiency presenting as recurring chest infections, lung disease and herpetic skin infections. The patient experienced two hematopoietic stem cell transplantations and despite full chimerism, she developed bone marrow aplasia due to adenovirus infection and died at post-transplant day 86. Immunologic investigation revealed low numbers of TRECs/KRECs, a severe reduction of memory B cells, absence of isohemagglutinins, and low IgG levels. Whole exome sequencing (WES) identified a novel heterozygous mutation in RAC2(c.275A > C, p.N92 T). Flow cytometric investigation of neutrophil migration demonstrated an absence of chemotaxis to fMLP. Cell lines transfected with RAC2 [N92 T] displayed characteristics of active GTP-bound RAC2 including enhanced NADPH oxidase-derived superoxide production both at rest and in response to PMA. Our findings broaden the clinical picture of RAC2 dysfunction, showing that some individuals can present with a combined immunodeficiency later in childhood rather than a congenital neutrophil disease., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Adenosine deaminase 2 (ADA2) deficiency is an auto-inflammatory disease due to mutations in cat eye syndrome chromosome region candidate 1 ( CECR1 ) gene, currently named ADA2 . The disease has a wide clinical spectrum encompassing early-onset vasculopathy (targeting skin, gut and central nervous system), recurrent fever, immunodeficiency and bone marrow dysfunction. Different therapeutic options have been proposed in literature, but only steroids and anti-cytokine monoclonal antibodies (such as tumor necrosis factor inhibitor) proved to be effective. If a suitable donor is available, hematopoietic stem cell transplantation (HSCT) could be curative. Here we describe a case of ADA2 deficiency in a 4-year-old Caucasian girl. The patient was initially classified as autoimmune neutropenia and then she evolved toward an autoimmune lymphoproliferative syndrome (ALPS)-like phenotype. The diagnosis of ALPS became uncertain due to atypical clinical features and normal FAS-induced apoptosis test. She was treated with G-CSF first and subsequently with immunosuppressive drugs without improvement. Only HSCT from a 9/10 HLA-matched unrelated donor, following myeloablative conditioning, completely solved the clinical signs related to ADA2 deficiency. Early diagnosis in cases presenting with hematological manifestations, rather than classical vasculopathy, allows the patients to promptly undergo HSCT and avoid more severe evolution. Finally, in similar cases highly suspicious for genetic disease, it is desirable to obtain molecular diagnosis before performing HSCT, since it can influence the transplant procedure. However, if HSCT has to be performed without delay for clinical indication, related donors should be excluded to avoid the risk of relapse or partial benefit due to a hereditary genetic defect.

Objective: Introduction: The recently described anaplasmosis infection is widespread but concerns to the insufficiently known group of diseases. The aim of our research is the development of uniform biological model for reproducing of artificial immunodeficient state by experimental anaplasmosis., Patients and Methods: Materials and methods: Algorithm of experimental anaplasmosis reproducing, consisted of such consecutive stages: 1) artificial forming of the immunodeficient state at nonlinear white mise (Mus musculus L.); 2) preparation of the tested biological material samples; 3) inoculation by prepared samples of the laboratory animals with the artificially formed immunodeficient state; 4) sampling from the dead or slaughtered (by the method of chloroformed anesthesia) experimental animals of sectional material (organs and targets tissues); 5) verification of aetiology by express detection of causative agents by the method of PCR in the selected samples of sectional material., Results: Results: Biological model of experimental anaplasmosis have been created suitable for realization of both diagnostic and epidemiological, epizootic, ecobiological and other researches of different origin biological material samples, including samples of solid and liquid consistency material. Formed model realised in premature death of experimental animals in 17.4 % cases; resulted in an onset of disease clinical signs without death during the term of supervision in 43.8 % cases; coursed in the absence of the expressed symptoms of infection in 31.3 % cases., Conclusion: Conclusions: Developed biological model of experimental anaplasmosis consists in that as laboratory animals with the increased sensitiveness to the infection and accumulation of causative agent are used white nonlinear mice with the artificially formed immunodeficient state.

Since the creation of the intensive care unit, active scientific work has been carried out. Pre- and postoperative management of patients undergoing thoracoabdominal surgery was one of the main directions of this work. Diagnostic approaches, preventive measures and standards of treating patients after thoracoabdominal surgery have been developed. The results of this work allowed to reduce significantly contraindications for surgical interventions in these patients, to perform radical operations in patients with severe concomitant diseases, to reduce the incidence of postoperative complications and mortality.

Background and Aims: One of the most severe manifestation displays of tuberculosis (TB) generalization is meningitis/meningoencephalitis. The purpose of this work was to improve the diagnostic efficiency of TB central nervous system (CNS) affection in human immunodeficiency virus (HIV)-infected persons., Materials and Methods: Meninges and cerebral tissues, taken from died patients, who were HIV-infected and dead from TB of CNS affection, were investigated histologically., Results and Discussion: Our examination showed that clinical course of the pathologic process loses the peculiarity of TB-undulating character, and changes in tissues have monomorphism that appears in the presence of the same type of granulomas with a few Pirogov-Langhans cells. Alterative reactions with formation of the large fields of caseous necrosis, necrotic focuses, areas of infiltration with polymorphic cellular elements went out on the first plan in the disorder of cerebrum in patients with the terminal stage of HIV infection. The tendency to decrease in inflammatory-proliferative processes was observed, which is confirmed by the presence of the poorly expressed cellular reaction on the peripheries of focuses of caseous necrosis., Conclusion: Morphologic features of tuberculous meningoencephalitis in HIV-infected patients are the presence of edema, gliosis, trombovasculitis, small focal hemorrhage, tuberculous granuloma formation with a small number of Pirogov-Langhans cells, and the prevalence of alterative-exudative reactions.

Purpose of the study was to define the diagnostic value of clinical and laboratory criteria of sepsis during the postop- erative period Methods. The results of 269 blood tests (biochemical, coagulation, hematology and microbiology) which were per- formed in 115 patients in the early postoperative period (starting from the first postoperative day) and in the late post- operative periods were analyzed., Results: Presepsin and procalcitonin have a similar diagnostic sensitivity in detection of sepsis - 89% (Psp>328.5 ng/l, PCT>1 ng/ml), but presepsin have a statistically significant lower specificity in comparison with procalcitonin (31% and 61%, respectively). This fact limits the use of presepsin in routine practice in multidisciplinary surgical hospital. Quantitative determination ofprocalcitonin is most preferably for the detection of septic complications in patients in the postoperative period, the results ofpresepsin must be interpreted only with other biochemical and hematological parameters.

Background: Omenn syndrome [Mendelian Inheritance (OMIM 603554)] is a genetic disease of the immune system, characterized by the presence of fatal generalized severe erythroderma, lymphoadenopathy, eosinophilia and profound immunodeficiency., Objective: We studied clinical and immunologic presentation of the disease manifestation among East Slavs population with genetically confirmed Omenn syndrome., Results: We collected clinical and immunologic data of 11 patients (1 from Belarus, 5--Ukraine, 5--Russia): 6 females, 5 males. The age of Omenn syndrome manifestation varied from the 1st day of life to 1 year and 1 month, the age of diagnosis--20 days to 1 year and 10 months. Nine out of 11 patients had classic immunologic phenotype T(+/-)B-NK+, 1 pt had TlowB + NK+ with CD3 + TCRgd + expansion and 1 had TlowB+/-NK+ phenotype. Eight out of 11 pts had mutation in RAG1 gene, 4 out of 8 had c.368-369delAA (p.K86fsX118) in homozygous state or heterozygous compound. In our cohort of patients, we also described two new mutations in RAG genes (p.E722Q in RAG1 and p.M459R in RAG2). At present, 7/11 were transplanted and 5 out of the transplanted are alive., Conclusion: This study demonstrates that the most popular genetic abnormality in East Slavs children with Omenn syndrome is c.368-369delAA (p.K86fs118) in RAG1 gene, which may be connected with more favorable prognosis because 4/4 patients survived after hematopoietic stem cells transplantation.

Case records of 1994 patients with injuries of the pelvic ring were analyzed. The article presents the results of examination and treatment of patients with urinary tract dysfunction. A frequent complications of pelvic fractures include overactive bladder syndrome (OAB) (18.9%). Many factors play a role in the development of this syndrome, in particular damage to the pelvic diaphragm and the development of pelvic hematoma. OAB is more common in unstable pelvic fractures (24.8%). Surgical stabilization of the pelvic ring injuries and the use of M-cholinoblockers and a1-blockers lead to a reduction of OAB.

Currently, new technologies of timely diagnosis and correction of disorders of carbohydrate metabolism are constantly introducing in intensive care units. The technologies aimed to improve the safety of the patient during intensive care. These methods include continuous monitoring (subcutaneous, intravascular) and the control of blood glucose levels, based on technologies such as enzymatic and electrochemical, fluorescence, infrared and others. Computer technologies proposed an algorithm of glycemic control with mathematical models occupy an important place. One of such algorithms is eMPC, which predicts blood glucose levels and offers physician a choice of a rate of intravenous administration of insulin and the time of further control of the glucose level. Researchers have demonstrated promising results of such technologies in patients in the ICU. Systems of continuous glucose monitoring can improve the safety of patients suffering from diabetes, as well as during intravenous insulin therapy and artifcial feeding.

Objective: To study efficacy and safety of dexmedetomidine application for long-term (more than 12 hours) artificial lungs ventilation (ALV) and for psychomotor agitation., Methods: We studied 57 patients after thoracic and abdominal surgeries. The patients were divided into three groups. Patients of a group-1 (n=18) received ALV under 12 hours, patients of group-2 (n=26) received ALV more than 12 hours. Patients of group-3 (n=13) received dexmedetomidine due to delirious state. Dexmedetomidine was administered by infusion 0.7 mkg/kg during the first hour. The rate of administration was corrected after the first hour. We recorded the level of sedation according to RASS, need of additional sedative drugs use, duration of ALV duration of ICU stay., Results: Dexmedetomidine infusion provides target level of sedation from 0 to -3 according to RASS in 91% of patients requiring prolonged ALV after thoracic and abdominal surgeries. Bradycardia occurred in 15% of patients and arterial hypotension in 12% of patients. Bolus administration of dexmedetomidine should be avoided.

Recently new technologies of diagnostics and correction of carbohydrates metabolism disturbances are introduced in the ICU to improve the safety for patients during intensive care. 33 patients after pancreas surgery were included into the study 13 patients (39%) had underlying diabetes mellitus. Glucose level changes in the interstitial liquid of the subcutaneous fat during postoperative period were monitored by system of CGM Medtronic MiniMed Guardian RT, MiniMed Paradigm Real-time. Valid values of glucose were from 4.1 to 10.1 mmol/L. Episodes of glucose level increasing occurred in 94% of patients in postoperative period after pancreas surgery. Average level of glucose was within the limits of valid values. However in 64% of cases patients needed insulin therapy Used systems of continuous glucose monitoring in the ICU allow improving the safety for patients receiving artificial nutrition and intravenous insulin therapy.

The article deals with fundamental stages of resuscitation and intensive therapy development in reconstructive surgery during 50 years of Petrovsky National Research Centre of RAMS functioning. Appreciation was given to academician of RAMS R.N.Lebedeva for outstanding services in local public health, as organizer of the one of the first specialized resuscitation and intensive care departments in our country. Researches in the department are traditionally oriented to the diagnostic methods development, prevention and intensive care of vital functions violations in patients after reconstructive operations. It helped to limit contraindications for surgery and to implement radical surgery in patients with severe concomitant diseases, as well as to reduce the number of postoperative complications and mortality

Unlabelled: Stress-damage of upper gastro-intestinal tract (GIT) mucous membrane and gastro-intestinal hemorrhage (GIH) increase the lethality of patients in the departments of reanimation and intensive care unit. The purpose of this study is to evaluate effectiveness and safety of pantoprazole use in patients with at least one risk factor of upper GIT mucosa stresses-damage and GIH. An important part of this study was examination of 24-hour intragastric pH - control results in patients during 1-st day after the surgery., Materials and Methods: Pantoprazole antisecretory therapy conducted in 40 patients, 38 of which had at least one risk factor of upper GIT mucosa stresses-damage and GIH. If there are risk factors, in the postoperative period prescribed pantoprazole (controlok) 80 mg/day bolus intravenously, then went to 40 mg/day per os. The criteria of the preventive therapy efficiency were absence of manifest and/or clinically significant GIH symptoms, the need for emergency upper endoscopy and emergency surgery, caused by the GIH. Among the patients with risk factors were marked out 15 patients: liver cirrhosis, portal hypertension syndrome (esophagus and stomach varix), liver failure (Child-Pugh A/B), high risk of hemorrhage. Within 24 hours, a constant intragastric-Ph monitoring ws carried out., Results: During observation in all patients, which were undergoing upper GIT mucosa stress-damage prevention, there was no need for emergency upper endoscopy. No patients needed to carry out emergency surgery, caused by the GIH. Lethality rate in this group was absent., Conclusions: The use of pantoprazole demonstrates its good efficiency and tolerance.

The amount of non-cardiosurgical interventions rises every year approximately by 1.5%. The main growth is due to the enlargement of old and elderly patients group. This group has the highest evidence of cardiovascular diseases. The frequency of sudden cardiac death and myocardial infarction after non-cardiosurgical interventions is approximately 3.5%. The prevalence of arrhythmias in postoperative period reaches 20%. The issue of postoperative arrhythmias is a very actual problem of intensive care which needs further research. Preoperative arrhythmias are an independent risk factor of cardiological postoperative complications. The treatment by beta blockers and antiarrhythmics can lead to a resistant bradycardia. Different cardio stimulators are being used for the means of prophylaxis and treatment.

The aim of our study was to examine the effect of individual schemes of multimodal analgesia on indicators of immunity and inflammation markers after operations on the colon. Patients of group 1 (n=15) received paracetamol, lornoxicam and epidural ropivacaine, 2nd group of patients (n=15)-paracetamol, epidural ropivacaine and tramadol. Comparison group (n=10) patients underwent patient controlled analgesia by promedol. Before surgery, 1st and 3rd days after surgery we examined the contents of cytokines in plasma: interleukin 12p70, interleukin 10, interleukin 6, and TNF. Before surgery and at 5-7 days after surgery indicators of cellular, fagocytal and humoral immunity were monitored. Before surgery patients with colorectal cancer revealed changes in the indices of different components of immunity, as well as an increase in pro-and anti-inflammatory cytokines compared with healthy donors. Multimodal analgesia in patients after operations on the colon is not accompanied by changes in plasma concentrations of cytokines and parameters of immune status in comparison with monoanalgesia by promedol.

Results of complex treatment of severe combined traumas were compared in 56 patients with using cryosupernatant plasma fraction (CSPF) and fresh frozen plasma--in 112 patients. Better positive dynamics of some laboratory indices was noted as well as lower risk of the development of thromboses, less lethality and better outcomes of the disease when using CSPF. It can be used instead of fresh frozen plasma in complex treatment of patients with severe combined traumas and coexisting DBC-syndrome.

Introduction: A pilot unicenter blind placebo-controlled study comparing different analgesics was conducted in parallel groups, by concurrently using two patient-controlled analgesia (PCA) apparatuses in one patient, was conducted Subjects and methods. The study included patients after laparotomy. Group I patients (n=22) were proposed 2 PCA apparati, one of which contained trimeperidine solution and the other did placebo. Group 2 patients (n=17) were proposed 2 PCA apparatuses, one of which contained trimeperidine solution and the other did lornoxycam. PCA was adjusted in the same manner in both apparati. The patients were asked to determine which analgesic is best in providing 24-hour analgesia., Results: There were no differences in the intensity of pain between the groups. The latter did not differ in the number of adverse reactions. Comparison showed no significant differences in the use of trimeperidine between Groups 1 and 2 patients. Among Group 1 patients, 61% considered trimeperidine as the best analgesic and 22% did placebo; 17% called none. Group 2 patients chose trimeperidine in 41% of cases and lornoxycam in 41%, none was called in 18%., Conclusion: Comparative assessment of analgesics, by employing 2 PCA apparatuses in one patient, allows evaluation of the efficacy of analgesics added to the conventional methods.

The experience of performance of urgent simultant operations (SO) on abdominal cavity organs in 63 patients (of them in 12--using laparoscopic technologies) was summarized. The material was compared and analyzed using statistical methods in three clinical groups, suffering concomitant surgical diseases in patients of gastroenterological, coloproctological and herniological profile. There were shown the possibilities and proved the expediency of SO performance in environment of the abdominal cavity urgent surgery in multiprofile general surgery clinic for enhancement of the patients treatment and an optimal surgical tactics choice.

The literature data concerning the problem of simultant operative interventions were analyzed and the unsolved topics were delineated. Basing on the detailed analysis of results of the operations obtained in 78 patients, performed for coexistent diseases, the authors consider the simultant operative interventions in elective surgery of the abdominal cavity the method of choice in presence of two-three coexistent diseases, which must be surgically treated.

Aim: To compare quality of anesthesia with opioid drug and nonsteroid anti-inflammatory drugs in 123 patients after extensive operative interventions of the lungs and trachea, abdominal organs, lower limbs., Material and Methods: Patients of group 1 took lornoxicam for relief of postoperative pain syndrome, those of group 2--promedol. Quality of anesthesia was assessed by visual-analogue and verbal scales, day dose of analgetic drug, administration of promedol, side effects incidence., Results: Lornoxicam in a dose 8 mg intravenously has comparable with 20 mg promedol analgetic effect. This justifies its use as a basic analgetic for treatment of acute pain after extensive surgery. Lornoxicam allows surgeons to do without opioids in 10-45% patients or to reduce their dose by 32-65%., Conclusion: Adequate anesthesia with lornoxicam and promedol early after surgery on the chest and abdominal organs, major vessels of the lower limbs occurs in 82 and 87% patients, respectively. Lornoxicam administration as continuous intravenous infusion and controlled analgesia in older patients eliminates the need in opioid analgetics in 45% cases and is well tolerated.

This open one-center study included 40 patients operated on the abdomen and chest, who had moderate resting pain in the immediate postoperative hours. Paracetamol was used as a dropwise intravenous 1-g infusion for 10-15 min; the dose of the agent was 4 g. The interval of paracetamol re-infusion was not early than 4 hours. If additional analgesia was required, opioid analgesics (promedol, tramadol) were administered. As a whole, assessment of analgesia within 24 hours showed excellent and good results reported by patients in 85% of cases; and in 71% of the patients the intensity of postoperative pain was less than they had expected before surgery. The use of opioid analgesics was required in 65% of the patients and 25% did not need these agents. The remaining 10% of the patients received a combination of nonsteroidal anti-inflammatory drugs, paracetomol, and opioids. Postoperative analgesia based on the intravenous infusion of paracetamol in a single dose of 1 g (4 g/day) caused a reduction in the intensity and duration of pain. The intravenous formulation of paracetamol should be regarded as one of the essential nonopioid components of multimodality therapy for pain in patients in the early postoperative period.

The species composition and antibiotic susceptibility of microflora isolated from patients with cicatricial tracheostenosis (CTS) and infectious processes were investigated. Schemes for the treatment of CTS with an account of the pathogen species and multidrug resistant staphylococcal infection are described. Comparative efficacy of the combined schemes (antibiotic + bacteriophage) for the therapy of pyoinflammatory processes in the patients with CTS and the efficacy of the treatment of the patients with CTS according to the traditional antibacterial schemes were studied.

The immune status was analyzed in 28 patients with cicatricial stenosis of the trachea for the purpose of determining the type and nature of affection as well as for the purpose of evaluating the clinical efficiency of galavit immunomodulator. Combined impairments were diagnosed in the patients. Moderately decreased CD4+, CD8+, CD16+, significantly decreased CD25+, HLA-DR, CD71+ and increased CD4+/CD8+ were detected at the cell level. An essentially lower CD20+, a higher content of IgG and a reduced FAN were observed in the humoral chain. Therefore, galavit, when used preoperative and immediately after surgery in patients with cicatricial stenosis of the trachea, had a positive effect on the immune status; it reliably increased the count of T-helpers (CD4+) and of natural killers (CD16+) and it induced the phagocyte activity of neutrophils.

The reactivity of cerebral vessels and the reserve of collateral compensation of cerebral flow were studied in 71 patients with perioperative carotid stenosis of different degrees. Cerebral oximetry was made at rest and during hypercapnic and compression loads. The method's efficiency was demonstrated for the preoperative evaluation of the cerebrovascular reserve in patients with atherosclerotic affection of vessels in the brachiocephalic stem. A comparison of the preoperative and intraoperative dynamics of rSO2 at compression points at the feasibility of using the cerebral oximetry in predicting the degree of reduced regional oxygenation of the brain in the basin of an intraoperatively pinched artery.

The physical nature of the macroturbulence in vortex matter in YBCO superconductors is investigated by means of a magneto-optic study of the instability in a single crystal prepared especially for this purpose. The instability develops near those sample edges where the oppositely directed flow of vortices and antivortices, guided by twin boundaries, is characterized by the discontinuity of the tangential component of the hydrodynamic velocity. This fact indicates that the macroturbulence is analogous to the instability of fluid flow at a surface of a tangential velocity discontinuity in classical hydrodynamics and is related to the anisotropic flux motion in the superconductor.

On the basis of studying of trauma epidemiolgy in a large city, principles of optimal organization of specialized medical service for patients with polytrauma have been developed. Urgent specialized service and further treatment of patients with this pathology should be fulfilled in a special department organized on the basis of a multi-profile hospital. The center of this department represents a specialized unit for patients with multiple and combined traumas supplied with all necessary specialists and means required for the management of this difficult group of patients.

We used lornoxicam (n = 16) and ketorolac (n = 20) to study the possibilities of applying the non-steroid anti-inflammatory drugs within the postoperative patient-controllable analgesia (PCA). With respect to a used analgetic, the frequency rate of good PCA anesthetic results was found, on day 1, to be 60-77%. The good anesthetic results were registered in 25% of patients when the routine scheme was in use. Non-steroid anti-inflammatory agents (lornoxicam, ketorolac) can be prescribed within the early postoperative PCA as basic analgetics, which essentially reduces the need in promedol without worsening the analgesia efficiency.

The time course of changes in rSO2 were studied in 58 patients during the uncomplicated course of cardiac operations under extracorporeal circulation (EC) and moderate hypothermia. rSO2 was also compared with central hemodynamic parameters, bioelectrical cerebral activity, and hemoglobin oxygen saturation of the bulb of the internal jugular vein (jbSO2). In the pre- and postperfusion period there was a significant correlation of rSO2 and jbSO2 (p = 0.01), yet with a low correlation coefficient (r = 0.348). During EC, no correlation was found between rSO2 and jbSO2 (p = 0.09, r = 0.386). Changes in rSO2, blood pressure, EEC, body temperature were analyzed in 2 groups of patients at the stages of an operation under EC. Group 1 comprised patients with cardiac valvular apparatus lesions and Group 2 included those with coronary heart disease who differed not only in age, but also in the history of mainly cerebrovascular atherosclerotic lesions, hypertensive disease, myocardial infarction, etc. In patients from both groups, a reduction in rSO2 occurred at the beginning of EC and at the maximum of cooling. But if in Group 1 patients, the significant reductions in rSO2 at the beginning of EC coincided both with that in mean blood pressure (BPmean), as compared to the baseline values (from 75.55 +/- 10.68 to 66.5 +/- 11.73 mm Hg, p = 0.01), and with the change in the frequency spectrum of EEC (a decrease in the frequency of the right edge, as compared to the baseline values, from 20.77 +/- 1.44 to 19.58 +/- 1.14 Hz, p = 0.01), in Group 2 patients, all significant decreases in rSO2 were accompanied only by a significant reduction in BPmean, but without changes in the frequency spectrum of EEG. It should be noted that over the uncomplicated course of an operation all changes in rSO2 were in the normal range of age-related values.

Lornoxicam was used for analgesia in 64 patients on days 1-2 after extensive interventions. The drug efficiency and safety were evaluated depending on the dose and route of administration. Intravenous infusion of lornoxicam in a daily dose of 24 mg (basic therapy) did not involve the use of opioids in 35% patients and its analgesic effect was higher than that of promedol monotherapy. Combined therapy with lornoxicam and promedol allows reduction of promedol dose by 25-50% and the incidence of untoward effects by 27-44%.

The central hemodynamics, external respiration function, and transcapillary liquid exchange in the lungs were assessed in 23 patients operated on the lungs and in 18 subjected to open heart surgery. The content of extravascular liquid in the lungs was increased during the first hours postoperation in the patients with a complicated course of the postoperative period, in contrast to those with an uneventful course thereof. Disorders of transcapillary liquid exchange did not depend on the status of the central hemodynamics and probably reflected the increased permeability of the alveolocapillary membrane.

Clinical observations of 1365 children with the lymph nodes affection were summarized. The diagnosis verification was conducted using the broad arsenal of general clinical and special methods of investigation. In complicated situations the histochemical and immunogenetic methods were applied for the diagnosis. The structure and dynamics of children's morbidity with lymphadenopathies (LAP) was studied up, the age, sexual and seasonal peculiarities were systematized, the analysis of primary localizations and clinico-morphological comparisons was conducted. The basic thesises of the standardized approach were elaborated on the ground of the diagnostical and tactical mistakes results analysis.

A total of 170 examinations of the external respiration function were carried out in 114 patients with postoperative respiratory insufficiency (RI). The patients were examined during air respiration (FiO2 0.21). Pulmonary function was computer monitored. Thirty-four parameters were analyzed, which characterize pulmonary ventilation, gas exchange, respiratory mechanics, and metabolism. Three groups of patients were distinguished: with moderate, expressed, and maximal stages of energy compensation of RI. Augmentation of RI in the course of the postoperative period was found to be characterized by reduction of lung compliance and increase of aerodynamic resistance of the airways and specific and minute Decompensation of RI develops due to fatigue of the respiratory muscles under conditions of increased energy value of respiration, which is proved by the appearance of a reliable inverse correlation between the minute respiratory volume and increased inhalation and exhalation resistance and between respiratory volume and increased inhalation resistance and of a direct correlation between respiratory volume and lung compliance in patients during the maximal energy compensation of respiratory insufficiency. Hence, the energy value of respiration objectively reflects the strain of the compensatory mechanisms during respiratory insufficiency.