[THROMBOTIC COMPLICATIONS AND LATENT HYPERCOAGULATION IN PATIENTS WITH BETA-THALASSEMIA].

The aim of the work is to investigate the clinical symptoms of thrombotic complications (TC) and the tendency of patients to increased thromb-formation in patients with beta-thalassemia (ß-T). Female patients with ß-T aged 18-40 years were studied: 130 beta-thalassemia major (ß-TM), 95 patients beta-thalassemia intermediate (ß-TI), 60 patients with beta-thalassemia minor (ß-Tm). In patients with ßT, the frequency of occurrence of TC was studied. In patients with ßT who do not have TC and splenectomy, hemostasis parameters were studied; and also the risk factors were analyzed for the development of latent hypercoagulation. Conducted questionnaire included questions about the tendency to increased thrombosis (TIT), about various clinical signs, symptoms, extended medical history data. Clinical manifestations of TC (arterial and venous thrombosis, chronic venous insufficiency) were detected in 10.0±2.6% of patients with ß-TM and 14.7±3.6% of patients with ßTI; TC occurred more frequently in splenectomy patients compared to non-splenectomized patients, respectively, with ß-TM 15.0±4.6% and 5.7±2.8% (p≥0.05); with ß-TI 22.5±6.6% and 9.1±3.9% (p≥0.05). The level of D-dimer characterizes the activity of fibrinolysis and the intensity of intravascular hemocoagulation; an increase in this marker of thrombinemia >500 ng/ml was regarded as a predisposition to LH. It was found that 37.9% of patients with ß-TM and 30,4±6,8% of patients with ß-TI had pre-thrombotic readiness for hemostasis ̶ latent hypercoagulability. Questionnaire indicted that in ßT patients with latent hypercoagulability, D-dimer and fibrinogen levels were increased, fibrinolytic activity, activated partial thromboplastin time were reduced, and antithrombin III activity was slightly reduced. Also, questionnaire indicated the validity, significant reliability and internal consistency of the developed propensity to increased thrombosis. The results of the TIT questionnaire indicate an increased propensity for hypercoagulability in a significant proportion of non-splenectomized ß-T patients.

[Results of application of a new method for the treatment of hallux valgus of the first toe].

Background: The aim of the present article was to report our experience with the treatment of patients with hallux valgus and to perform comparative analysis of the results of the newly proposed and standard methods for its surgical correction. Methods: The data on 70patients (101 feet) with hallux valgus that were operated on between 2011 and 2015 in St. Petersburg Hospital No 2 using the new and standard methods were analysed. The functional assessment (AOFAS score) and X-ray examination were performed preoperatively, 3 and 12 months after the procedure. Comparative analysis between patients undergoing surgical correction by the new and standard methods has been undertaken. Results: We did not find any significant difference between the two groups in mean AOFAS score 12 months after surgery. Nevertheless, the function score of the patients treated by the newly proposed method (79.4±6.5 in 3 months) was significantly better than in those given the standard treatment (72.2±7.6 in 3 months). Mean intermetatarsal angle 12 months after surgery by standard and new methods was 9,7±0,7° and 8,6±0,7° (p<0.05), mean metatarsophalangeal angle 13,6±0,9° and 13,0±1,1° (p<0,05) respectively. Conclusion: According to the data obtained, the original method of hallux valgus surgical correction allows to improve its functional and x-ray results.

[About the treatment of battlefield injuries of the musculoskeletal system with the help of new "Rod field package"].

Injuries of the musculoskeletal system are at 60% of all battlefield injures and take first place in modern military conflicts. The main antishock measures are: pain management, emergency bleeding control, bone fragment positioning and fracture fixation. Specialist of the centre of traumatology and orthopaedics of the Burdenko General Military Clinical Hospital in cooperation with specialists of department of battlefield surgery of Mandryka Clinical Research and Training Medical Centre analysed the most effective domestic and foreign external fixators and developed Rod field package (RFP). The above mentioned researched had two stages. On the first (analytical) stage specialists formulated requirements for idea rod field external fixator. On the second (experimental) stage tests with the help of plastic models of long bones were carried out. The performed analysis showed, that installation of the external fixator is easy and fast, the external fixator is light and has capabilities for 3D bone fragment positioning and fracture fixation, the external fixator is radiotransparent. Implementation of this package into the clinical practice of delivery of battlefield emergency surgical care may improve results of treatment.

[The treatment of rectal cancer, complicated by the intestinal obstruction].

202 patients with rectal cancer, complicated by the intestinal obstruction were operated on. There were 93 (46,1%) men and 109 (53,9%)women. Age was 25-80 years. 41(20,3%) patients had radical operations with resection of the rectum and anastomosis. The operation was finished with end-to-end intestinal anstomosis in 34 cases; the rest 7 cases had the side-to-side or end-to-side anastomosis. Rectum resection with colostomy was performed in 91 (45,0%) patients. 70 (34,6%) patients with the decompensated intestinal obstruction with polyorgan failure had palliative operations with ileostomy (14 cases) or two-side colostomy (56 patients). Postoperative complication rate was 40.6% (82 patients). The overall postoperative lethality was 14,8%.

[Specific immunity and polymorphism of breeding plumage in pied flycatcher (Ficedula hypoleuca) males (Aves: passeriformes)].

The relationship between the type of melanin-based plumage coloration and the strength of experimentally induced immune response was studied using as an example a pied flycatcher population from the Moscow Region. The plumage of pied flycatcher males exhibits the full spectrum of transitions from contrasting black-and-white to cryptic brownish, the latter being very similar to the coloration of females. In spite of numerous studies, the nature of this polymorphism still remains vague. Unlike many other avian species with monocyclic breeding, a considerable fraction of pied flycatchers combines two energy-consuming productive processes, breeding and molt. During the main experimental treatment we activated the humoral immunity of free-living males in chick-rearing period by injection of nonpathogenic multigenic antigen (sheep red blood cells, SRBC) and estimated the strength of the immune responses after repeated captures in 6-8 days. In addition, after each capture we estimated the numbers of leucocytes (WBC), heterophil to lymphocyte ratios (H/L) and measured night time basal metabolic rates (BMR). Non-molting males of different color types showed the same immune responses. Among molting birds, the strength of the immune response was significantly higher in pale males (morphs 4-7 by Drost's scale) than in bright males with rich melanin-based coloration (morphs 2-3). This difference resulted from two opposite processes. During molting, pale males heightened the antibody titer after immunization, while bright males tended to reduce the strength of immune response. Possibly such an asymmetry in immunocompetence at the first stage of molt reflects the different life strategies of pied flycatcher males - conspicuous birds less commonly combine breeding with molt than cryptic ones.

[Estimation of heritability and repeatability of resting metabolic rate in birds, with free-living pied flycatchers Ficedula hypoleuca (Aves: Passeriformes) as an example].

Estimates of a trait heritability and repeatability can get at an idea of its usefulness for being an individual characteristic and its ability to change under selection pressure. Heritability and repeatability of energetic parameters still poorly studied in birds. The most important physiological characteristic of homoiotherms is resting metabolic rate (RMR), which, in the absence of productive processes, does not exceed basal metabolic rate (BMR). We estimated BMR repeatability in free-living pied flycatchers in Moscow Region (55 degrees 44' N, 36 degrees 51' E; 1992-2008) and Tomsk (56 degrees 20' N, 84 degrees 56' E; 2008-2009) populations over intervals from 40 days to 3 years. In Moscow Region population, BMR repeatability amounted to tau = 0.34 +/- 0.10 (n=80) if measured over 1 year interval, tau = 0.60 +/- 0.15 (n=19) if measured over 2 years interval, and tau = 0.85 +/- 0.13 (n=6) if measured over 3 years interval providing that consecutive BMR measurements were done in the same period of reproductive season. In Tomsk population, BMR repeatability, measured over 1 year interval, amounted to tau = 0.49 +/- 0.11 (n=50). Repeatability is a measure of a trait constancy and sets the upper limit of its heritability. To estimate RMR heritability, cross-fostering experiments have been conducted in 2003-2005 with flycatchers of Moscow Region population. RMR of chicks positively correlated with BMR of their biological fathers, whereas such correlation in metabolic rates between chicks and their foster fathers was absent. The RMR heritability estimate turned out to be h2 = 0.43 +/- 0.17 (n=210). The obtained estimates of heritability and repeatability of fundamental energetic traits are rather high for physiological features. This suggests the existence of a potential for direct selection on BMR and evolutionary stable diversity of avian populations with regard to basal metabolic rate.

[Maintaining of the morphological specificity and genetic introgression in populations of the great tit Parus major and the Japanese tit P. minor in the middle Amur region].

The ranges of the great tit Parus major and the Japanese tit P. minor overlap in the middle Amur region, where hybridization of these two species occur. These species have contacted for nearly a century on the western slope of the Malyi Khingan Ridge (the central part of the sympatry zone), but the great tit has colonized territories to the east of the ridge only in the last two decades. The percentage of the P. minor's allele of intron 2 of the mioglobin gene has significantly increased from 8.9% in the west to 27.8% in the east in phenotypically major's populations. Thus, the percentage of foreign mtDNA in P. major populations did not change significantly from west (6.2%, n = 120) to east (3.2%, n = 61). Simultaneous use of two genetic markers (one nuclear and the other mitochondrial) supports our conclusion on strong introgression in the populations of both species, which nevertheless maintain their morphological specificity in the contact zone.

[Efficiency of second-generation bisphosphonate in treating patients with prostate cancer and bone metastases].

Majority of patients with prostate cancer develop bone metastases which lead to serious skeletal complications. Prostate cancer guidelines recommend the use of bisphosphonates for men with bone metastases. The objective of this study was to determine the best treatment options for prostate cancer with bone metastases. Patients with clinically confirmed bone metastases were identified and the efficacy of bisphosphonates of second generation was studied. Findings from this study show that pamidronate in dose 90 mg is effective in treatment of different stages of bone metastases. All above mentioned confirms implementation of bisphosphonates of II generation into clinical practice in palliation of prostate cancer patients with bone metastases along with other treatments.

[Epidemiology parameters of stomach cancer in Central region of Azerbaijan Republic].

Stomach cancer (SC) remains the fourth most commonly diagnosed malignancy in the Central region of Azerbaijan Republic (extensive morbidity rate--9.5%); maximal correlation between male and female patients is 2.86:1. The retirees were most liable to SC--42.1%. Intensive morbidity rate in the region was 9.36%. Morbidity rate of SC was 14.4 in males and 4.7 in females per 100,000 of populations. A case rate of SC according to standardizing index for male was 3.1 times higher than in females. Morbidity level of SC increased with age. The age-specific incidence rate was the highest in the age group of 60-69 yrs age male and 70 yrs old female. Death rate 6.5 per 100,000 populations and lethality rate 22.2% in the Central region of Azerbaijan Republic were lower than the average index in the rest of the country.

[Structural and functional aspects of variation of the breeding plumage ornamentation in the male Pied Flycatcher Ficedula hypoleuca (Aves: passeriformes)].

Inter- and intraindividual variation of the breeding plumage ornamentation in male Pied Flycatcher Ficedula hypoleuca from the Moscow province population (55 degrees 44' N 36 degrees 51' E) was studied using long-term data (1996-2005). Eumelanin prevailing colour type (CT) scored according to the seven-step Dorst scale (Dorst, 1936), age, and reproductive status during the current breeding season were analyzed as potential sources of variation of the white ornamentation on the forehead, the wings, and the tail in males. Male CT strongly varied, from almost black to cryptic brownish (2-7, average 4.4, N = 1403). On average CT became I1degree darker with age and tended to be stable after the age of two years. Initial and final CT strongly correlated (r = 0.76). Wing ornamentation and forehead patch (FP) were associated with both initial and final CT, whereas correlation between tail ornamentation and CT was observed only in aged males. Ornamentation was most variable in males with cryptic (pale) CT. Such males had, on average, less intense forehead and wing ornamentation than conspicuous males, compensating this difference by having more intense ornamentation next year. These data suggest the weakening of morphogenetic relations between prevailing colour and ornamentation in males with cryptic phenotype. The return rate (rate of conspicuous males returning to their previous nesting territory) was not related to the success of their previous breeding attempts. Among pale males, the return rate was higher in breeders than in non-breeders. The relation between FP shape and reproductive status was pronounced only in pale males. Among pale males, previous breeders and non-breeders displayed no difference in the degree of prevailing colour darkening next year. In conspicuous males, previous breeding led to the weakening of dorsal eumelanin pigmentation of the new plumage, which suggests the existence of tradeoffs between reproductive efforts and the development of rich eumelanin coloration. Among pale males, previous breeders displayed a higher rate of FP widening next year than previous non-breeders. Diffrerent patterns of relations between male ornamentation and reproductive experience suggest that the females can use plural clues to evaluate the quality of their potential mates.

Mitochondrial DNA and Y-chromosome variation in the caucasus.

We have analyzed mtDNA HVI sequences and Y chromosome haplogroups based on 11 binary markers in 371 individuals, from 11 populations in the Caucasus and the neighbouring countries of Turkey and Iran. Y chromosome haplogroup diversity in the Caucasus was almost as high as in Central Asia and the Near East, and significantly higher than in Europe. More than 27% of the variance in Y-haplogroups can be attributed to differences between populations, whereas mtDNA showed much lower heterogeneity between populations (less then 5%), suggesting a strong influence of patrilocal social structure. Several groups from the highland region of the Caucasus exhibited low diversity and high differentiation for either or both genetic systems, reflecting enhanced genetic drift in these small, isolated populations. Overall, the Caucasus groups showed greater similarity with West Asian than with European groups for both genetic systems, although this similarity was much more pronounced for the Y chromosome than for mtDNA, suggesting that male-mediated migrations from West Asia have influenced the genetic structure of Caucasus populations.

[Rational method of surgical treatment in nephroptosis]. / Ratsional'nye metody khirurgicheskogo lecheniia pri nefroptoze.

The article is devoted to surgical treatment of patients with nephroptosis. New and rational methods of nephropexy are described such as subcapsular along the posterior surface of the lower pole, by paranephral fatty tissue of the lower pole and by the fatty tissue with conducting the muscle flap through it. The data concerned with the number and results of the operations performed are given, the differential approach to using the methods in question being formulated.

Immune challenge affects basal metabolic activity in wintering great tits.

The costs of exploiting an organism's immune function are expected to form the basis of many life-history trade-offs. However, there has been debate about whether such costs can be paid in energetic and nutritional terms. We addressed this question in a study of wintering, free-living, male great tits by injecting them with a novel, non-pathogenic antigen (sheep red blood cells) and measuring the changes in their basal metabolic rates and various condition indices subsequent to immune challenge. The experiment showed that activation of the immune system altered the metabolic activity and profile of immune cells in birds during the week subsequent to antigen injection: individuals mounting an immune response had nearly 9% higher basal metabolic rates, 8% lower plasma albumin levels and 37% higher heterophile-to-lymphocyte ratios (leucocytic stress indices) than sham-injected control birds. They also lost nearly 3% (0.5 g) of their body mass subsequent to the immune challenge. Individuals that mounted stronger antibody responses lost more mass during the immune challenge. These results suggest that energetic expenditures to immune response may have a non-trivial impact upon an individual's condition.

[Analysis of some viral infections, transmitted by parenteral and sexual routes, in the Republic of Azerbaijan]. / Analiz nekotorykh virusnykh infektsii, peredaiushchikhsia parenteral'nym i polovym putem, v Respublike Azerbaidzhan.

Representatives of various population groups in Azerbaijan were tested for infection with human T-lymphotropic (HTLV-I and HTLV-II) and hepatotropic viruses (HCV and HBV). A total of 835 sera were studied by screening and specific tests for virus-specific antibodies and/or antigens. Thirty-five DNA specimens from peripheral blood lymphocytes were analyzed in the PCR for HTLV-I-specific sequences. No HTLV-I or HIV were detected, but two cases with integration of the HTLV-I LTR gene into cellular DNA genome were detected. A high rate of infection with hepatitis B and C was revealed. The level of anti-HCV was 8.7%, HBsAg 4.1%, and antiHBs 23.4%. Six cases with double HBV-HCV infection were detected. High values of ALT among HBV/HCV-seronegative subjects prompts their testing for other types of hepatitis viruses.

[The immune status and hormonal profile of patients with idiopathic thrombocytopenic purpura]. / Immunnyi status i gormonal'nyi profil' bol'nykh idiopaticheskoi trombotsitopenicheskoi purpuroi.

Immune and endocrine parameters were studied in patients with autoimmune thrombocytopenic purpura treated with glucocorticosteroids. Initial differences were registered in the levels of endogenic cortisol, lymphocyte cortisol-resistant fraction, circulating immune complexes and populations of immature lymphocytes for the therapy responders and resistant patients. The findings may be used in rating the efficacy of the on-going treatment.

[Plasmapheresis in the comprehensive treatment of autoimmune hemolytic anemia]. / Primenenie plazmafereza v kompleksnom lechenii autoimmunnykh gemoliticheskikh anemii.

It is shown that low volumes of plasmapheresis can be used in combined treatment of patients with autoimmune hemolytic anemia who did not respond well to the routine therapy. It is a safe detoxication method with immunocorrective, hyposensitizing action that promotes more effective transfusion of red blood cell pack and washed red blood cells, and permits a significant decrease in glucocorticosteroid doses. It has been suggested that plasmapheresis could be used at early stages of the disease treatment.

[The effect of plasmapheresis on the clinical and laboratory parameters of patients with idiopathic thrombocytopenic purpura]. / Vliianie plazmafereza na kliniko-laboratornye pokazateli u bol'nykh idiopaticheskoi trombotsitopenicheskoi purpuroi.

It is shown that plasmapheresis (PA) as an adjuvant modality in combined treatment of idiopathic purpura resistant to glucocorticosteroids helps to partially overcome resistance and induces a positive trend in the clinical and hematological indices. Pretreatment number of glucocorticoid receptors in lymphocytes and the androgenic cortisol level in patients resistant to glucocorticosteroids were significantly lowered and rose after a course of therapeutic plasmapheresis. A PA positive effect is attributed to elimination from the vascular bed of circulating immune complexes, mid-mass molecules as well as raising the blockade of lymphocytic membranes.

[Species characteristics of experimental Candida lung lesions]. / Vidovye osobennosti éksperimental'nykh kandidoznykh porazhenii legkikh.

Intratracheal challenge of rabbits and intranasal challenge of white mice and guinea-pigs by C. albicans without the application of adhesive substances, produced candidiasis pneumonia running more severe course in mice than in rabbits. In guinea-pigs the disease was of medium severity. Specific features of pulmonary inflammation in rabbits were marked polynuclear and especially macrophage reactions, with the phagocyte activity high enough to ensure total elimination of pathogenic microorganisms in the animal. In white mice a weak macrophage reaction was actually a background for a predominant polynuclear reaction producing a massive polynuclear leukocyte disintegration. These processes, though eliminating pathogenic organisms both by phagocytosis and non-phagocytic mechanisms, lead to severe fatal pulmonary edema. Specific differences in experimental lung candidiasis reveal various manifestation of human lung candidiasis.