FINE ARCHITECTURE OF THE HIPPOCAMPUS IN ADOLESCENT, ADULT AND AGED RATS. ELECTRON MICROSCOPIC STUDY.

The study included adolescents (P30-36), adult (P125-130) and aged (P330-340) male Wistar rats - 4 animals in each age group. The rats were housed individually, in wire-top polypropylene cages (30-cm width x 30 cm length x 25 cm height) and maintained on a 12-h light/dark cycle. Standard food pellets and tap water were ad libitum. The animal maintenance and electron microscopic procedures were conducted in accordance with European Union Directive on the protection of animals used for scientific research. The Ultrastructure of adult and adolescent rats are almost same. However, remarkable changes are expressed between adult and senescent rats. Precisely, in the last one there are following ultrastructural modifications - lipofuscin concentrations, small destructive cytoplasmic organelles, changes in presynaptic vesicular and mitochondrial quantity. Rare apoptotic signs in neurons. Analysis of all this means that aging in rat's hippocampus causes selective changes, also it underlines changes in neurotransmission and neuronal developmental pathways.

MANAGEMENT OF ESOPHAGEAL PERFORATION: A CASE REPORT.

Esophageal perforation (EP) is a devastating condition. In modern times it is still associated with substantial morbidity and mortality. 62-year-old male patient came to Surgical Department of the First University Clinic of Tbilisi State Medical University on 17.10.2018 15:00. The patient complained of pain in the chest cavity, especially after eating, shortness of breath, fever, chills, weakness. The patient felt pain in the chest cavity after eating 4 days before hospitalization. CT scan revealed pneumomediastinum, extravasation of contrast medium at the level of the 8th thoracic vertebra. Esophagogastroduodenoscopy revealed a defect in the esophagus at the level of 32 cm from the incisors. Dimensions of defect were 2.0 - 3.0 cm. An urgent operation was performed. Left-sided posterolateral thoracotomy, mediastinotomy, suturing of the defect, buttressing of the sutures with the mediastinal pleura, washing and drainage of the mediastinum and left pleural cavity were performed. A Witzel gastrostomy was performed. After the operation, the patient's treatment continued in the intensive care unit. Since leakage was noted, it was decided to place an esophageal stent in the area of the defect. Stenting was performed on 05.11.2018. A complication in the form of bleeding was noted on 01.12.2018. Bleeding was controlled conservatively. Finally, stent was removed and the patient was discharged from the clinic in good condition on 07.12.2018. New interventional endoscopic techniques, including endoscopic clips, covered metal stents, and endoluminal vacuum therapy, have been developed over the last several years to manage esophageal perforation. Surgery should be undertaken in all patients who do not meet non-operative management criteria. Buttressing the esophageal repair with surrounding viable tissue has been recommended to decrease the risk of leakage. If direct repair of thoracic EP is not feasible esophageal exclusion, diversion, or resection should be performed. Repair over a large size T-tube can be used to create a controlled esophago-cutaneous fistula and minimize mediastinal and pleural contamination. Thus, esophageal perforation continues to present a diagnostic and therapeutic challenge despite decades of clinical experience and innovation in surgical technique.

RECONSTRUCTION OF THE ABDOMINAL WALL DEFECTS USING GELATIN-COATED DECELLULARIZED AND LYOPHILIZED HUMAN AMNIOTIC MEMBRANE.

Ventral hernias, with the incidence of reherniation nearly as high as 50%, still remain to be a real challenge for surgeons worldwide. The use of mesh in the repair of abdominal wall defects reduces the incidence of reherniation; however, using a prosthetic mesh can lead to complications like wound infection, hematoma, seroma, enterocutaneous fistula, small bowel obstruction, recurrent herniation and erosion into adjacent structures including the intestine. The aim of the study was to develop a method for producing gelatin-coated decellularized and lyophilized human amniotic membrane graft and to determine its effectiveness for the reconstruction of the anterior abdominal wall defects. Experiments were conducted on 40 Lewis white laboratory rats. Animals were divided into four equivalent groups. Abdominal wall defects were created in all rats and repaired using the ULTRAPROTM mesh (group I), ULTRAPROTM mesh which was covered by decellularized and lyophilized human amniotic membrane from both sides (group II), mesh from gelatin-coated decellularized and lyophilized human amniotic membrane (group III) and biological surgical mesh XI-S+® (group IV). Three months after implantation, meshes from gelatin-coated decellularized and lyophilized human amniotic membrane were integrated with host tissues so that it was difficult to distinguish it from the surrounding tissues. However, in the second group, ULTRAPROTM mesh was still detectable through the decellularized amniotic membrane. Encouraging results were also observed when using a XI-S+® graft. Three months after implantation, XI-S+® graft was surrounded by a well-defined connective tissue capsule and was tightly fixed to the host tissues. While using gelatin-coated decellularized and lyophilized human amniotic membrane grafts and XI-S+® grafts, all the defects were repaired successfully and none of the rats in these groups showed any evidence of bulging or herniation, development of wound rupture, wound infection or fistula formation in postoperative period. Gelatin-coated Decellularized human amniotic membrane can be used as anti-adhesive barrier in abdominal and pelvic surgery, as well as for the repair of the abdominal wall hernia.

[THE CURRENT STATE OF TREATMENT OF ACUTE PANCREATITIS (REVIEW)].

Acute pancreatitis (AP) is one of the most common acute surgical diseases of the abdominal organs. In 1992 at the International Symposium the classification of AP was established in Atlanta (USA). Over time new knowledge and experience required adjustment in the classification of Atlanta-92. In 2011, an updated classification of AP was presented at the Congress of Pancreatologists in Cochin (India). The severity of AP is determined by local and systemic criteria. Local criteria are sterile or infected Pancreas necrosis . Transient or chronic multiple organ failure belong to Systemic criteria. Acute Pancreatitis severity are divided into mild, moderate and severe types. There are early (1-st week) and late (>1 week) clinical phases of AP. Morphological forms of Apare divided into edematous and necrotic pancreatitis (sterile or infected). Computed tomography (CT) imaging plays an important role in diagnosis and staging of acute pancreatitishas. Local complications of AP are divided into four types, depending on the presence of pancreatic necrosis and the time elapsed since the onset of pancreatitis. With edematous pancreatitis, an acute accumulation of peripancreatic (unencapsulated) fluid formed in the first 4 weeks. A pseudocyst (encapsulated) forms after 4 weeks. With necrotic pancreatitis, acute necrotic congestion (forms in the first 4 weeks), limited necrosis (encapsulated) forms after 4 weeks. Based on these data, the radiologist becomes one of the key members of the multidisciplinary team for the diagnosis and treatment of AP. The principles of treatment methods of AP are established. With mild-edematous pancreatitis, a conservative approach is used. In severely infected pancreatic necrosis, the general principle remains: repeated revisions, sanations, removal of necrotic foci. Thus, the accuracy of prognosis of pancreatic necrosis can be improved while using clinical, laboratory and instrumental data. Nowadays, a single classification of AP has been created, a big step has been taken in the diagnosis of pancreatic necrosis. Methods of the treatment and prevention of complications of AP have been identified, although there is no yet full consensus on these issues and established recommendations.

[OPEN NECROSECTOMY IN THE COMPLEX TREATMENT OF THE SEVERE ACUTE PANCREATITIS].

The aim of the study was to determine the indication for the method of open abdomen-open necroseqtomy in the complex treatment of acute pancreatitis. 74 patients with the diagnosis of acute pancreatitis were selected for the treatment. Patients were divided by severity of disease: mild acute pancreatitis - 29 patients were treated by conservative method; moderate acute pancreatitis - 29 patients were treated by following methods: 17 patients - by conservative method; 4 patients by conservative treatment with fasciotomy; 8 patients - by open abdomen method without fasciotomy after conservative treatment. Severe acute pancreatitis - 16 patients were treated by following methods: 2 patients by open abdomen technique with single necroseqtomy and sanitation after fasciotomy, 8 patients - with the method of open abdomen from which 3 patients needed a single necroseqtomy and sanitation, 3 patients had a double necroseqtomy and sanitation and 2 patients three and four times the necreseqtomy and sanitation were used with a fastener, 6 patient were treated conservatively. We identified indication and contraindication for treatment of severe acute pancreatic necrosis by open necroseqtomy. Indications: 1) Pancreatic and/or peripancreatic necrosis (based on contrast-enhanced dynamic CT scan) complicated by documented infection (guided FNA culture or extraluminal retroperitoneal gas). 2) Sterile necrosis with progressive clinical deterioration despite maximal medical treatment. Contraindications: 1) Pancreatic and/or peripancreatic necrosis without evidence of infection or clinical deterioration. 2) Early operation (within a week from onset of acute pancreatitis) before the systemic inflammatory response syndrome (SIRS) is stopped and intensive conservative treatment is still required.

ASSOCIATION BETWEEN URTICARIA AND INFECTIONS (REVIEW).

Urticaria is a common disease with 20% of prevalence and marked effects on quality of life. The burden of chronic urticaria for patients, their family and friends, the healthcare system and society is substantial. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. The remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Chronic viral infections including hepatitis B and C have been reported to be associated with CSU. More research is needed to make definitive recommendations regarding the role of infections and their management in case of urticaria and urticarial vasculitis. The routine screening of parasitic, bacterial or viral infections in CU is not recommended, however, testing a patient with urticaria for certain infections is a physician's choice based on the specific characteristics of the patient, such are clinical symptoms and laboratory results, dietary and cultural habits, country of origin and residency, traveling history.

ISSUES OF VISUAL ATTENTION AND EXECUTIVE FUNCTIONS IN CHILDREN WITH DYSLEXIA.

Dyslexia is the most common learning disability that affects 10-12% of population. The reading difficulties in dyslexia have neuronal basic and are associated to the problems with brain areas where visual information processing happens, and that are responsible for word analysis and for attention. Visual processing is essential for reading process but there is an ongoing discussion whether attentional deficits in dyslexia plays a role. In the present study we investigated development of visual attention and executive functions in Georgian children with dyslexia. Two groups of children aged between 7-12 years participated in the study: children with dyslexia and age and IQ (general intelligence) match typically developing children. Participants performed visual search task and Wisconsin Card Sorting Test (WCST), and were retested after a year from the first testing. We found no differences in performance (correct responses) of search task between two groups but there were differences in reaction time. Attentional functions improved with getting older in control children, that is confirmed by improvement of reaction time after one year. There were no changes in reaction time in dyslexic children indicating that attentional deficits are not compensated by developmental processes. No correlation was found for any of groups between performances of executive function task and search task. Significant correlation was found between performance of WCST and age of control children, but no correlation between performance of WCST and age of dyslexic children. These results indicate that common development of executive and attentional functions during childhood are different for control and dyslexic children. We conclude that in children with dyslexia ongoing developmental processes in general are slowed down that affects development of attentional and executive functions.

[FASCIOTOMY IN THE COMPLEX TREATMENT OF THE ABDOMINAL COMPARTMENT SYNDROME FOR PANCREATIC NECROSIS].

The long-term history of studying of a problem of acute pancreatitis in its different aspects, is fight against a pancreatic necrosis and a pancreatic infection. Technology progress in improvement of diagnostic methods and treatment of a pancreatic necrosis and its complications, changed a situation, but treatment of such patients remains the most difficult task for the doctors dealing with pancreatitis issues. The main factor of risk at a pancreatic necrosis are: gland necrosis volume, the severity of enzymatic endo intoxication, degree of intraabdominal hypertension, a translocation of microbes from intestines in the blood circulation and an abdominal cavity. The Abdominal Compartment Syndrome (ACS), at a pancreatic necrosis is connected with presence of multiorgan insufficiency, caused by intraabdominal hypertension. Definition of indications of a fasciotomy in the complex treatment of the adominal compartment for pancreatic necrosis was our research objective. Management of intraabdominal hypertension and ACS consists of a maintenance therapy and if necessary, an abdominal decompression which is considered one of treatment methods. The difficulty of a decompression of an abdominal cavity at ACS which arose on the background of a pancreatic necrosis is that laparotomy in the first phase of its treatment is extremely undesirable and even harmful manipulation which is related to infecting necrotic zones that considerably aggravates the prognosis. These requirements are met by a fasciotomy i.e. broad section of an aponeurosis on the white line of a stomach. The volume of an abdominal cavity at this manipulation increases at the expense of a diastasis of rectus muscle and stretching of skin and peritoneum, while the abdominal cavity hermetism is maintained. We have performed subcutaneous fasciotomy in 4 patients for ACS treatment. The fasciotomy is a targeted mini invasive method for the complex treatment of pancreatic necrosis. Performing fasciotomy and use of a modern complex of an intensive care will allow to achieve improvement of results in the treatment of patients with pancreatic necrosis, without performance of traumatic laparotomy and a laparastomy.

CHALLENGES AND MANAGEMENT OF CONGENITAL ABDOMINAL WALL DEFECTS (REVIEW).

Management of congenital abdominal wall malformations is still a challenge in paediatric surgery due to visceroabdominal disproportion, large defects of abdominal wall and immature abdominal cavity. Most of the patients treated with primary closure need artificial substitutes like patches or biomaterials for non-permanent abdominal wall closure. Patches represent the source of constant infections and complications like separation of prosthesis from fascia. Removal of these patches and ventral hernia repair is essential afterwards. As for component separation technique, this method helps to restore normal anatomy of anterior abdominal wall, results in good cosmetic appearance, requires only one-stage operation procedure, minimal skin flap advancement and is associated with lower infection risk. Although, while performing component separation technique, perforator branches of epigastric artery (periumbilical perforators) are damaged and puts the vascularization of the skin at the risk. Only pudendal artery branches and intercostal arteries are left to supply the skin with the blood, which from our point of view is insufficient. Accordingly, for successful treatment of congenital abdominal wall defects, further research in order to develop new operation techniques, as well as search for the ideal biomaterials for the closure of the large defects of anterior abdominal wall is essential. These biomaterials should possess unique biological properties that are important for tissue repair, including anti-inflammatory, antimicrobial, antifibrosis, antiscarring, as well as a reasonable cost and low immunogenicity.

Phase Locking the Spin Precession in a Storage Ring.

This Letter reports the successful use of feedback from a spin polarization measurement to the revolution frequency of a 0.97 GeV/c bunched and polarized deuteron beam in the Cooler Synchrotron (COSY) storage ring in order to control both the precession rate (≈121 kHz) and the phase of the horizontal polarization component. Real time synchronization with a radio frequency (rf) solenoid made possible the rotation of the polarization out of the horizontal plane, yielding a demonstration of the feedback method to manipulate the polarization. In particular, the rotation rate shows a sinusoidal function of the horizontal polarization phase (relative to the rf solenoid), which was controlled to within a 1 standard deviation range of σ=0.21 rad. The minimum possible adjustment was 3.7 mHz out of a revolution frequency of 753 kHz, which changes the precession rate by 26 mrad/s. Such a capability meets a requirement for the use of storage rings to look for an intrinsic electric dipole moment of charged particles.

Results of an allergy educational needs questionnaire for primary care.

It is well recognized that knowledge of allergic conditions is suboptimal in primary care. The Primary Care Interest Group of the European Academy of Allergy and Clinical Immunology undertook an educational needs survey to better understand what they were and how best to meet them, in the primary care environment. An electronic questionnaire was devised and distributed as widely as possible. A total of 2226 people from 63 countries opened the e-questionnaire of which 692 provided evaluable responses. In total, 81% were medical doctors with 299 possessing additional qualifications. Self-declared gaps in knowledge were expressed for most manifestations of allergy with a correspondingly high self-expressed educational need. The preferred learning modalities were online guidelines (69.6%) and courses (68.8%) followed closely by workshops (68%), structured online modules (63.9%) and small local working groups (59.75%). Podcasts and webinars scored poorly with only 25% expressing these as preferred learning modes although there was an age gradient. The preferred electronic platform was the personal computer (82.6%). A better understanding of the needs of primary care should help guide the design of educational initiatives to meet those needs.

PATTERNS OF SENSITIZATION BY FOOD AND INHALANT COMPONENTS IN GEORGIAN PATIENTS.

Molecular-based allergy (MA) diagnostics is a novel approach used to map the allergen sensitization of a patient at a molecular level, using purified natural or recombinant allergen components instead of allergen extracts. The aim of our study was to: 1) investigate sensitization patterns to food and inhalant allergen components in different age groups of Georgian allergic patients 2) evaluate patient's potential risk of systemic reaction and manage dietary modifications. 3) Study food and inhalant components in different age groups in correlation with clinical manifestations of allergic disease. Allergic patient's sera samples were tested by ImmunoCap ISAC and specific IgE levels against 112 different allergen components were detected. The study population was comprising 81 allergic patients, included 26 adults (mean age 36.2±10.9) and 55 children (mean age 6.1±4.58). Results revealed that nGal d 1 (11.3%), nGal d 2 (10.1%) and nBos d 8 (10.1%) were more prevalent among food components. Cyn d 1 (35.4%), nCup a 1 (26.5%), n Amb a 1 (21.5%), rAlt a 1 (10.1%), rFel d1 (12.6%), rDer f 2 (26.50%), nDer p 2 (24%) were more prevalent among inhalant components. PR-10 reactivity was detected in 45%, Profilin - 43% and LTP - 29%. CRD food and inhalant pattern changes associated with age of children were correlating with the development of atopic march in Georgian population. Sensitization to most prevalent food components (Bos d 8 and Gal d 1) are predictors of allergy persistence in later life, in case of emergency individual action plan against anaphylaxis should be fulfilled.

CLOSTRIDIAL PARAPROCTITIS WITH GAS GANGRENE OF FRONT-LATERAL ABDOMINAL WALLS AND NECROTIC FASCIO-MYOSITIS (CASE REPORT).

Anaerobic clostridial infection is the most severe form of paraproctitis. The incubation period is very short, from 3 to 6 hours, sometimes lasting for 1-2 days. Clostridial infection spreads rapidly and induces gas gangrene, causes destruction of cells and other intermediate substances, and impedes blood circulation. This paper presents a case study of an extremely severe form of anaerobic infection with spontaneous gas gangrene, cellulitis, fasciomyositic necrosis, severe intoxication and septic shock on the abdominal front and lateral surfaces. This patient presented as infected with Clostridium septicum, a rare and highly toxic Gram-positive, spore-forming, obligate anaerobic bacillus that progresses and migrates rapidly, affecting all soft tissues (muscle, fascia), and produces four toxins which cause gas gangrene, intravascular hemolysis, tissue necrosis, and septic shock. The mortality rate is typically 80%. In this case study, a positive clinical outcome was achieved by aggressive identification of the microbe, appropriate and immediate therapy, and vigorous surgical intervention. Specifically, immediate surgery was conducted to ensure a wide excision of damaged tissues, necrectomy, curettage, wide drainage, readjustment, oxygenation through drainages, further additional surgical corrections through CT control with wide bandages in the operating area. Further, the diagnostic workup was thorough, identifying the microbe through a properly constructed diagnostic algorithm, ultrasound and CT studies, infectious agent assessments, and bacteriological monitoring carried out on the 1st-2nd-5th-7th-12th-15th-21st-25th days. Rational antibiotic therapy with permanent susceptibility testing informed the selection of an appropriate agent. Finally, markers for the evaluation of severity (Apache scale) were assessed, as they were for stage of infection (prokalcitonin), inflammation (CRP) and other indicators.

How to Reach a Thousand-Second in-Plane Polarization Lifetime with 0.97-GeV/c Deuterons in a Storage Ring.

We observe a deuteron beam polarization lifetime near 1000 s in the horizontal plane of a magnetic storage ring (COSY). This long spin coherence time is maintained through a combination of beam bunching, electron cooling, sextupole field corrections, and the suppression of collective effects through beam current limits. This record lifetime is required for a storage ring search for an intrinsic electric dipole moment on the deuteron at a statistical sensitivity level approaching 10^{-29} e cm.

HYPOGENESIS OF RIGHT LOBE OF LIVER ACCOMPANIED BY PORTAL HYPERTENSION AND ESOPHAGOGASTRIC VARICEAL BLEEDING; A RARE ANOMALY: A CASE REPORT.

Hypo-agenesis of the right lobe of the liver is an extremely rare finding. It is defined as the complete or partial absence of liver tissue on the right side without previous disease or surgery. It is usually an incidental finding. A 32-year-old female patient came to Emergency Department of TSMU the First University Clinic 22.10.2015 with an initial diagnosis of upper gastrointestinal bleeding. Her medical history showed no previous diseases of the liver or episodes of hemorrhage. Dizziness, nausea, vomiting with red blood, melena was presented on admission. Esophagogastroduodenoscopy revealed III degree varicose of veins from middle part of the esophagus to cardiofundal part of the stomach. Hemorrhage was observed from cardial part of the stomach. Control of bleeding was not achieved endoscopically. Sengstaken-Blakemore tube was used to stop bleeding temporarily. Computed tomography with angiography was performed. Right lobe of the liver was presented with VII and VIII segments. Medial edge of the left lobe of the liver is located near the spleen. Liver parenchyma is homogenous. No thrombosis of the portal or hepatic veins was revealed. Gallbladder was dislocated laterally and cranially without pathological changes. Extra- and intrahepatic biliary ducts were not dilated. There was colonic interposition between the liver and diaphragm. Diagnosis was established - hypogenesis of right lobe of liver, atrophy-hypertrophy complex, portal hypertension, varicose of the veins of the esophagus and cardiofundal part of the stomach, hemorrhage from variceal vein of the cardial part of the stomach, acquired coagulation factors deficiency, functional hypersplenism, posthemorrhagic anemia. In our case there was congenital hypogenesis of the right lobe of the liver. Five months follow-up showed no recurrent bleeding.

SENSITIZATION PATTERN AND CLINICAL PECULARITIES OF FOOD ALLERGY IN GEORGIA.

The aim of our study was to investigate sensitization pattern to food allergens in different age groups of atopic patients in Georgia and reveal the associations between food sensitization and clinical manifestations of allergic disease reflecting the development of atopic march. 1000 patients (children-783, adult-217) with different clinical manifestations were involved in the study. Specific IgE antibodies to food mix, cow's milk, casein, egg, wheat, fish, nuts mixture and inhalant allergens were measured by using ImmunoCap (Phadia, Uppsala, Sweden). The prevalence of positive specific IgE to food mix was - 7.08%, cow's milk-4.61%, casein - 4.68%, hen's egg - 2.72%, fish mix - 0.77%, wheat -1.57% and to nuts mixture - 2.86%. The frequency of atopic dermatitis (p<0.0017), urticaria (p<0.0223) and anaphylactic shock (p<0.001) were significantly increased in patients with specific IgE to food mix. Allergic skin manifestations to ingested food were age-dependent, more frequent in children groups. Cow's milk and hen's egg are the commonest food allergens in the age group of <2 years. Sensitization to food mix, cow's milk, casein, hen's egg and wheat were predominated in male patients. Egg allergy was significantly associated with atopic dermatitis, fish allergy to bronchial asthma and severe milk allergy to anaphylactic shock. Present study is a first comprehensive investigation, providing unique data of the prevalence of food allergies in Georgian population. The results of this study are contributing to a better understanding of the disease, serving as a basis for the development of strategies for preventing and treating food allergies.

New Method for a Continuous Determination of the Spin Tune in Storage Rings and Implications for Precision Experiments.

A new method to determine the spin tune is described and tested. In an ideal planar magnetic ring, the spin tune-defined as the number of spin precessions per turn-is given by ν(s)=γG (γ is the Lorentz factor, G the gyromagnetic anomaly). At 970 MeV/c, the deuteron spins coherently precess at a frequency of ≈120 kHz in the Cooler Synchrotron COSY. The spin tune is deduced from the up-down asymmetry of deuteron-carbon scattering. In a time interval of 2.6 s, the spin tune was determined with a precision of the order 10^{-8}, and to 1×10^{-10} for a continuous 100 s accelerator cycle. This renders the presented method a new precision tool for accelerator physics; controlling the spin motion of particles to high precision is mandatory, in particular, for the measurement of electric dipole moments of charged particles in a storage ring.

Prevalence of self-reported food allergy in different age groups of georgian population.

Epidemiological studies in high income countries suggested that a big proportion of the population in Europe and America report adverse reactions to food. Self-reported prevalence of food allergy varied from 1.2% to 17% for milk, 0.2% to 7% for egg, 0% to 2% for peanuts and fish, 0% to 10% for shellfish, and 3% to 35% for any food. The aim of our study was to report the prevalence of self-reported food allergy in the different age groups of Georgian population and to reveal the most common self-reported food allergens. ISAAC phase III study methodology and questionnaires were used for data collection. Questions about food allergy were added to the survey and involved questions about self-reported food allergy. 6-7 years old 6140 children (response rate-94,5%) and 13-14 years old 5373 adolescents (response rate-86,9%) from two locations of Georgia, Tbilisi and Kutaisi were surveyed. 500 randomly assessed adults from Tbilisi aged 18 years and older were added later (response rate-97,6%). Findings revealed that self-reported food allergy among 6-7 years old age group and 13-14 years old age were almost the same (15,7% and 15,9% correspondingly) and slightly lower in adult population - 13,9%. Study revealed, that hen's egg was the commonest implicated food for 6-7 years age group, hazel nut - for 13-14 years old age group followed by hen's egg. Walnut and hazel nut were most reported foods for adult population. The findings also revealed that food allergy is one of the most important risk factor for symptoms associated with asthma (OR-3,05; 95%CI 2.50-3.74), rhinoconjunctivitis (OR-2,85; 95%CI 2.24-3.64) and eczema (OR-5,42; 95%CI 4.08-7.18) in childhood. The data has provided the first epidemiological information related to food allergy among children and adults in Georgia. Results should serve as baseline information for food allergy screening, diagnosis and treatment. Our findings can also inform the public health officials on the disease burden and may offer some recommendations for minimizing the allergy-related risks.

Ige-mediated food allergy - current problems and future perspectives (review).

The incidence and prevalence of FA have changed over time, and many studies have indeed suggested a true rise in prevalence over the past 10-20 years. Recent studies showed that prevalence of self-reported food allergy is 17, 3%, versus challenged confirmed - 0.9%. The majority of allergic reactions to foods, particularly in children, are suggested to be caused primarily by eight foods, namely cow's milk, egg, wheat, soy, peanut, tree nuts, fish, and shellfish. Clinical symptoms of FA include skin, gastrointestinal and systemic reaction anaphylaxis that might be life-threatening and cause fatal reaction. Diagnosis of food allergy is based on SPT, sIgE measurements, component resolved diagnostics (CRD) and double-blind placebo-controlled food challenge (DBPCFC) tests. The primary therapy for food allergy is strict avoidance of the causal foods. Patients should be provided an emergency action plan, including how to administer an epinephrine autoinjector. It is recommended that all infants be exclusively breast-fed, without maternal diet restriction of allergens, until 4 to 6 months of age. Recent studies have shown that oral immunotherapy (OIT) can induce desensitization and modulate allergen-specific immune responses. Further work to evaluate the long-term effectiveness and safety of this therapy is ongoing and needed before they are used in the main-stream care of children or adults with food allergy.

[Personal Telemonitoring: Perspectives of Development in Arhythmology and Cardiology].

Sudden cardiac death (SCD) persists as one of challenging problems in cardiology and cardiac surgery, only in Russia costing more than 350,000 deaths annually. Arrhythmias and ischemic heart disease (IHD) prevail as SCD immediate direct mechanisms. Unfortunately, timely diagnostics of heart diseases is far below the satisfactory level. On the other hand, the number of patients to be followed up is increasing faster than the healthcare capacity. To close the gap, new approaches to diagnostics and prophylaxis of cardiovascular diseases are needed, involving innovative medical technologies. Implantable and external devices for heart arrhythmia and CAD early diagnostics are extensively used in modern cardiologic praxis. Impetuous development of this technique in combination with information and telecommunication technologies during last decade led to origination of completely new medical service based on mobile remote monitoring of patients. Relying on the experience in remote patient monitoring with implantable devices for recording heart electrical activity, Russian Scientific Society.