[Comparative evaluation of effectiveness of different magnetotherapy regimens in patients with osteoarthritis]. / Sravnitel'naya otsenka effektivnosti raznykh rezhimov magnitoterapii u patsientov s osteoartritom.

Impulse low-frequency magnetotherapy is a modern method of treating diseases of the musculoskeletal system, including osteoarthritis. The effectiveness of the therapeutic effect largely depends on the biotropic characteristics of the magnetic fields - the type of magnetic field, induction, frequency, pulse shape, exposure, exposure zone. AIM OF STUDY: To conduct a comparative analysis of effectiveness of applying various modes of magnetotherapy using an impulse low-frequency magnetic field in patients with osteoarthritis. MATERIALS AND METHODS: A randomized, placebo-controlled clinical trial included 262 patients with grade II-III knee osteoarthritis according to the Kellgren-Lawrence classification. The 1st group included 56 patients who received local magnetic therapy on the knee using a running pulsed magnetic field (RPMF) - 20 mT, frequency 6.25 Hz, exposure time 20 min. The 2nd group included 99 patients who were exposed to a magnetic field using a combination of modes: 5 days - an impulse magnetic field (IMF) with induction of 2 mT, frequency of 100 Hz, then RPMF mode - 20 mT, frequency of 6.25 Hz, duration 20 min, number of procedures - 12. The third group included 97 patients who received placebo-magnetotherapy on the knee joint area. When analyzing the results, the VAS (100 mm) and WOMAC scales were used, as well as the subjective assessment of the treatment results by patients (5-point scale). RESULTS: A pronounced symptom-modifying effect of magnetotherapy (according to VAS and WOMAC) was established in the form of a decrease in the severity of pain in patients with gonarthrosis (p<0.01). There was a significant improvement in pain and stiffness indices, as well as functional characteristics (WOMAC), more pronounced in patients who received a combined regime of exposure to a magnetic field (p<0.01). The use of magnetotherapy using various modes is safe for patients and does not cause serious adverse events. CONCLUSION: The application of magnetotherapy equipment, which allows the use of various biotropic characteristics of magnetic field, is an effective and safe technology for treatment of patients with osteoarthritis.

[Chondroprotector transdermal magnetophoresis for osteoarthritis of the knee]. / Transdermal'nyi magnitoforez khondroprotektora pri osteoartrite kolennykh sustavov.

RATIONALE: Treatment of osteoarthritis (OA) is a relevant problem of rheumatology. Despite a significant number of medical approaches and the creation of new drugs, the effectiveness of treatment remains unsatisfactory, which necessitates the creation of complex treatment programs. Pulse low-frequency magnetotherapy is a modern method that makes it possible to potentiate the therapeutic effects of chondroprotectors for transdermal administration using magnetophoresis technology. AIM: To evaluate the efficacy and tolerability of combination therapy using chondroprotective magnetophoresis using 'running' pulsed magnetic field (RPMF) and application of chondroxide (transdermal gel form) in patients with knee OA. MATERIAL AND METHODS: A randomized, placebo-controlled clinical trial included 65 patients with grade II - III knee OA according to the Kellgren-Lwrence classification. The 1st group included 25 patients who received local therapy - chondroxide magnetophoresis using RPMF (20 mT, frequency 6.25 Hz, exposure time 20 min, No. 12); in the 2nd group - 20 patients who underwent placebo-magnetotherapy of chondroxide; in the 3rd group - 20 patients who used RPMF without local chondroprotective therapy. We used VAS, WOMAC scales, EQ-5D questionnaire, OMERACT-OARSI criterion in order to analyze the results. RESULTS: A pronounced analgesic effect of the treatment was registered (according to the VAS and WOMAC scales) in patients receiving magnetotherapy (p<0.01). A significant improvement in functional parameters (according to WOMAC) was noted, more pronounced in patients who used chondroxide magnetophoresis (p<0.001). During the course of treatment, a positive effect of magnetotherapy on the indicators of quality of life (according to EQ-5D) was registered. A high percentage of response (68.1%) to therapy using magnetophoresis of the transdermal form of chondroxide (according to OMERACT-OARSI) was demonstrated. No adverse reactions were registered during treatment. CONCLUSION: The use of the local therapy method in the form of magnetophoresis of the transdermal form of the chondroxide is an effective and safe treatment technology that improves the functional state and quality of life of patients with OA of the knee joint.

[Evaluation of the efficiency of magnetophoresis transdermal diclofenac delivery in patients with knee osteoarthritis]. / Otsenka éffektivnosti primeneniia magnitoforeza transdermal'noi formy diklofenaka u patsientov s osteoartritom kolennogo sustava.

Osteoarthritis (OA) is a serious sociomedical problem, one of the leading causes of persistent disability and reduced quality of life. Modern publications on the use of transdermal drug formulations for OA evaluate the efficiency and safety of isolated drug administration. Pulse magnetotherapy is a modern method for potentiating the therapeutic effects of both the drug and the magnetic field (MF) in the single magnetophoretic technique. AIM: to determine the effect of pulsed MF on the clinical efficacy and tolerability of magnetophoretic transdermal diclofenac delivery in patients with gonarthrosis. SUBJECTS AND METHODS: A clinical randomized placebo-controlled study was conducted in 65 patients with Kellgren-Lawrence grade 2-3 knee OA, who were divided into 3 groups. Group 1 including 25 patients received magnetophoretic diclofenac gel delivery using a traveling MF (intensity, 20 mT; frequency, 6.25 Hz; exposure. 20 min, 12 sessions); Group 2 consisting of 20 patients used placebo magnetotherapy with diclofenac without MF; Group 3 comprising 20 patients had low-frequency pulse magnetotherapy with traveling MF without topical diclofenac therapy. VAS and WOMAC and the EQ-5D questionnaire were used during the examination. The results of treatment were analyzed according to the OMERACT-OARSI criterion. RESULTS: According to VAS and WOMAC scores, combination therapy showed a marked analgesic effect in the patients who had received magnetotherapy (p<0.01), as well as a significant reduction in stiffness and an improvement in functional characteristics, which were more pronounced in those who had magnetophoresis (p<0.001). According to the EQ-5D questionnaire, magnetotherapy was noted to have a positive impact on quality-of-life indicators. Analysis according the OMERACT-OARSI criterion demonstrated a high rate (67.8%) of response to magnetophoretic sis using diclofenac application formulations. CONCLUSION: Magnetophoretic transdermal diclofenac delivery using low-frequency pulsed MF is effective and safe for patients with knee OA and causes no serious adverse events.

[The rationale for the application of magnetophoresis for the treatment of intra-articular pathology]. / Obosnovanie vozmozhnosti primeneniia magnitoforeza pri patologii sustavov.

The present study was designed to elucidate the influence of the magnetic field on the spectroscopic characteristics of nimesulide and glucosamine sulfate preparations. The secondary objective of the study was to evaluate the clinical effectiveness of the combined application of magnetotherapy and transdermal forms containing a non-steroidal anti-inflammatory preparation and a chondroprotector with the use of magnetophoresis. For this purpose, we analyzed the samples exposed to the running magnetic field in an infrared spectrometer to elucidate the changes in the optical characteristics of the preparations of interest. The clinical effectiveness of the combined application of magnetophoresis was estimated in 83 patients presenting with knee osteoarthritis. The use of the infrared spectroscopic technique in the combination with the Fourier analysis made it possible to visualize the absence of coarse optical defects and structural changes in the test samples under the influence of the physical factors which provides the basis for their physiophoretic administration. The clinical studies conducted with the application of the combined physio-pharmacological treatment have demonstrated the feasibility and high effectiveness of this approach for the management of the patients presenting with articular pathology. The rehabilitative measures accelerated the earlier appearance of the pronounced analgesic effect and promoted the restoration of the joint function. Moreover, they reduced the drug load and improved the quality of life of the patients.

[Outcomes of carotid endarterectomy performed in acute stage of ischaemic stroke].

Recent years have witnessed several studies concerning optimal terms of performing carotid endarterectomy after endured acute cerebral circulation disorder (ACCD). However up to now there is no common opinion regarding feasibility and safety of performing carotid endarterectomy in the acute period of ischaemic stroke. The 2013 Russian National Guidelines on surgical management of diseases of extracranial arteries point to feasibility of performing carotid endarterectomy at terms within up to 2 weeks after endured ischaemic stroke (level B evidence). At the same time, there is no data concerning possibility of performing this type of operation in patients with neurological deficit scoring 4 points according to the Rankin scale. Analysing the results of 110 carotid endarterectomies performed in patients with haemodynamically meaningful stenosis of carotid arteries at terms varying from 2 to 14 days after the development of ipsilateral ACCD showed safety of the operation (the rate of postoperative cerebral circulation disorders amounted to 0.9% - 1 patient) and its efficacy in prevention of recurrent ischaemic complications, also determining regression of neurological symptomatology in the overwhelming majority - 86 (78%) patients. Despite the absence of recommendations on possibility to perform carotid endarterectomy in patients after endured ACCD with neurological deficiency scoring 4 points according to the modified Rankin scale we proved efficiency and feasibility of performing this type of operation in the cohort of patients concerned. There was not a single case of transformation of the ischaemic focus into haemorrhagic one. One patient developed fatal ACCD. During the follow up period (12 months) regression of neurological symptomatology was observed in 16 (66.7%) patients of 24 operated patients with baseline deficit of stage 4 according to the Rankin scale.

[Biofilm formation by group A Streptococci of various types and study of antibiotics effect on this process].

AIM: Evaluation of the ability to form biofilms by various M, T and MT-types of group A streptococci (GAS), as well as study of the effect of various antibiotics on biofilm formation. MATERIALS AND METHOD: 43 strains of various M and T type GAS were studied. The cultures were grown in Todd-Hewitt broth with the addition of 0.5% yeast extract. Comparative evaluation of the ability to form biofilm was carried out using photometry. Benzylpenicillin, oxacillin, cepha- losporin, cefuroxime and ceftriaxone antibiotics were used at various concentrations. RESULTS: GAS differ significantly by their ability to form biofilms. The highest ability was noted in 8 strains--2M, 9M, 12M, 13M, 19M, 30M, 36M-types and 6MT type. Simultaneous introduction of GAS cultures and antibiotics into the culture well, except for ceftriaxone, resulted in growth inhibition of both plankton cells and biofilms. CONCLUSION: The ability of GAS to form biofilm depends on streptococci serotype. During simultaneous introduction of GAS with antibiotics into the well, the biofilm does not form.

[Free-radical reactions in Daphnia after low doses of γ-irradiation in vivo].

A violation of free-radical reactions has been found by the method of free-radical copolymerization in the two groups of Daphnia magna exposed to 100 and 1000 mGy of gamma-rays and their non-exposed first generation progeny. The method is based on a quantitative radiometric registration of the polymerization process that develops in the cells of a multicellular organism in tissue in proportion to the existing number of free radicals. The fact of the increased level of free radicals may be indicative of the hereditary transgenerational effect and the cause of lower survival of Daphnia in both generations. However, the effect of a reduced survival rate does not persist in the second generation, which can be explained by the effect of radiation on the embryos of the first generation after acute irradiation of parents.

[Renal calculus microflora in urolithiasis and search for agents of control of biofilms formed by uropathogenic bacteria].

AIM: Study bacterial biofilms in native material (renal calculus) by electron microscopy method and developmeit of biofilm model by isolates in vitro on sterile calculi of various chemical composition. MATERIALS AND METHODS: Bacterial spectra of microflora of renal calculus lavages were studied, isolated pure cultures were identified up to species. Comparisons of urine microflora obtained before operation in patients with urolithiasis with microflora of removed renal calculi were carried out. RESULTS: Urease activity and genes coding pathogenicity factors were detected, and the ability to form biofilms by isolates was studied. Model of formation of biofilms in vitro on sterile renal calculi was developed and candidate agents reducing the biofilm forming ability were tested. CONCLUSION: Uropathogenic microorganisms infecting renal calculi and forming biofilms on them not only support chronic infection by increased resistance to therapy but also facilitate novel lithogenesis.

[Influence of low frequency magnetic field on characteristic of Pseudomonas aeruginosa].

AIM: To assess the level of bacteriostatic effect of low frequency magnetic field (LFMF) on Gram-negative bacteria able to form biofilms (Pseudomonas aeruginosa) compared to able to aggregation oligotrophes Caulobactor crescentus, Arcicella aquatica and Verrucomicrobium spinosum. MATERIALS AND METHODS: Frequencies 0.001-100 Hz with magnetic induction value 450 mcT1 together with various variants of time, duration and conditions of cultivation of bacteria were used. Bacteriostatic effectwas assessed by optic methods. RESULTS: Decrease of bacterial growth activity with efficacy coefficient Keef = 0.79 +/- 0.03 was demonstrated. CONCLUSION: LFMF moderately decreases growth of tested bacterial species.

[The gene encoding the outer membrane lipoprotein lipL32 as a genetic target for developing leptospira genotyping schemes].

The primers flanking the fragments sized 677 bp (external) and 204 (internal) were constructed on the basis of nucleotide sequences of the gene encoding the outer membrane lipoprotein LipL32. PCR-analysis was used to study the prevalence of the gene lipL32 among 79 Leptospiraceae family strains representing different genera and genomic species (77--genus Leptospira, 1--genus Leptonema, 1--genus Turneria). The two amplicons were detected in the pathogenic leptospires--L. interrogans (except L. inadai), but not in saprophytic--L. biflexa. In L. inadai only 204 bp-amplicon was detected. These test-systems can be successfully used to differentiate between two distinct ecological groups of leptospires. The gene encoding the lipL32 seems to be appropriate as an adequate genetic target for developing the leptospira genotyping systems (high prevalence, presence of both conservative and variable sites in its nucleotide schemes).

[Biofilm formation by Legionella spp. in experiment].

Ability of biofilm formation was studied in 28 strains belonging to 12 species of Legionella. Optimal conditions for formation of biofilms were ascertained using reference strain Legionella pneumophila Philadelphia 1. Comparative assessment of the ability of Legionella spp. to form biofilms was performed by cultivation in proteosopepton broth (for 96 hours) and in water (for up to 2 weeks). Highest rates of biofilm formation were observed for strains of L. pneumophila and L. longbeachae. Between L. pneumophila strains the most prominent ability to form biofilms was observed in newly isolated strains BLR-05 and TOTAL 1. Opportunity to use different ability of Legionella species to biofilm formation as a epidemiologically significant marker and for modeling of biofilms of Legionella in association with other microorganisms was discussed.

Some psychosocial aspects of smoking: 10-year experience in "Quit & Win" campaigns in Novosibirsk.

In Novosibirsk International "Quit & Win" campaigns have been conducted by the Institute of Internal Medicine since 1994. The aim is to support people who want to quit smoking, to draw society's attention to the problem, to decrease CVD risk. The registered participants of "Quit & Win" were interviewed in a year after each campaign. In the follow-up study we analysed marital status, education, motivation to participation. The tendencies are clearly seen: the prize was the motivation for 50% of registered participants in 1998 and only for 25% in 2004; illness was the reason to quit for 15% in 1998 and for 25% in 2004; "smoking is harmful" was said by 30% of participants in each campaign. Most of the participants wishing to quit are married (about 75%). Family and friends' support was received by 45% of participants in 1998 and about 85% in 2004. About 30% of participants have high education and about 8% have primary education, the rest have secondary or special professional education. To quit completely was intended by 35% of participants in 1998 and 92% in 2004. Mass anti-smoking campaigns are effective and inexpensive. Support of family members, mass media, friends and medical professionals is very important. Stress, smoking environment and nicotine dependence are the main causes of unsuccessful quitting.

[Biofilm formation by different strains of Salmonella typhimurium in artificial systems].

The ability of 14 different strains of Salmonella typhimurium to biofilm formation depending on genotype and culture conditions was investigated in artificial systems: in 96-well plastic microtitre plates, plastic and glass tubes, plastic Petri dishes and on microscope glasses. Quantitative biofilm growth was monitored by using an assay based on crystal violet staining, while planctonic growth in the same cultures was monitored by absorbance in iEMS Reader MF, and qualitatively--by digital photo and visually. Optimal rate between growth and biofilm indications for all strains was determined at initial cell concentration 10(6-7) KOE/ml and culture incubation at t degrees 28 degrees C. The nutrient content of the medium significantly influenced the quantity of produced biofilm. The nutrient broth LB without NaCl was more effective in promoting biofilm formation, than LB itself. The least quantity of biofilm was formed in water. The genotype of the strains also critically influenced the quantity of produced biofilm. Nonmotile mutants cells had reduced ability to form biofilm. RpoS mutant cells produced significantly less biofilm as compared with cells of isogenic parent strains. The chemical content of plastic and glass also influenced biofilm formation.

[Burkholderia cepacia under different ecological conditions: the amount and variability of the bacterial population].

In a series of prolonged experiments with the use of the bacteriological method and PCR analysis the amount and state of B. cepacia population, associated and not associated with infusoria Tetrahymena pyriformis, were dynamically evaluated under different conditions: in water, brain heart broth, soil extract and at different temperature (4 degrees C and 25 degrees C). In soil extract at 25 degrees C B. cepacia existed in the vegetative state for the period of up to 3 months, while at 4 degrees C, in the absence of protozoa, the transition of these microorganisms into the uncultivable forms occurred in 9 days, and they could be detected only with the use of PCR. Protozoa maintained the existence of the vegetative bacteria for as long as 2 months, and in 3-4 months uncultivable forms of B. cepacia cells were registered. In water at low temperature B. cepacia disappeared in 2 months, evidently, eaten up by infusoria. The population variability of B. cepacia under different conditions of their existence was established: S-R dissociation, a decrease in biochemical activity, growth deceleration. A high level of cytopathogenicity in B. cepacia pigment-forming clones was noted. In the process of transition into the uncultivable state pigment formation in B. cepacia population decreased up. The ecological plasticity and multi-pathogenicity of B. cepacia as phytopathogens and the causative agents of human diseases are discussed.

New approaches to smoking prevention in the north.

Morbidity and mortality rates of noncommunicable diseases (NCD) are very high in Siberia. The prevalence of NCD risk factors is also very high, smoking being one of the most widespread risk factors. Prevention and cessation of smoking may improve the health of the population. Within the framework of the WHO MONICA (Monitoring Cardiovascular Diseases) project, we have conducted three population surveys in Novosibirsk within a 10-year period (1984-1995) to show trends of cardiovascular diseases and their risk factors. We also conducted similar surveys in some Siberian regions. Economic crisis and social stress greatly affect the health of the population, and new methods and approaches to disease prevention are needed. As participants in the WHO CINDI program (Countrywide Integrated Program for Disease Prevention), we started our work to reduce and control the main NCD risk factors. Smoking being widespread in Siberia, we started an anti-smoking campaign in Novosibirsk as participants in the international "QUIT & WIN" campaign in 1994. In 1995 we arranged a similar contest at the local level in the city; and now in May 1996 we are again taking part in the QUIT & WIN campaign.

Up-to-date studies of the Siberian population: international programs of the Institute of Internal Medicine.

The worsening of the health status of northern populations is a matter of concern to scientists in many countries. International collaboration aimed at using international experience in the field of circumpolar health may speed up the research, making it more effective for solving problems of medical science and public health in the North.

[A novel method of concentrating bacterial suspensions for transmission electron microscopy]. / Novyi metod kontsentrirovaniia bakterial'nykh suspenzii dlia transmissionnogo élektronno-mikroskopicheskogo analiza.

Presents a new method for making preparations of bacteria and their unculturable forms from suspensions with low concentrations of cells, from 1 x 108 to 1 x 104 per ml. to be examined under transmission electron microscope. The novelty of the method consists in the technique of concentrating bacteria by making a colloid solution consisting of bovine serum albumin and polyethyleneglycol. Associations of protein molecules, polyethyleneglycol, and bacteria, forming in the solution, are sedimented by centrifugation after 48-hour incubation at 4 degrees C. The solidity of the resultant macroscopic sediment is sufficient for studying the cells contained in it under transmission electron microscope.

[Ultrastructural organization of Salmonella typhimurium cells during long-term starvation and transfer to an unculturable state]. / Ul'trastrukturnaia organizatsiia kletok Salmonella typhimurium pri dlitel'nom golodanii i perekhode v nekul'tiviruemoe sostoianie.

Electron microscopic and immunocytochemical studies of Salmonella typhimurium culture were carried out under conditions of cell transfer into an unculturable state induced by carbon, phosphorus, and nitrogen starvation. Morphological variants of bacterial cells were detected in the course of cell culturing under conditions of starvation. Electron microscopy showed that O-antigen was retained in salmonella after long starvation and transfer into an unculturable state.

[Use of molecular-biological methods for identifying brucella in a comparative analysis of strains, isolated from sick dogs]. / Ispol'zovanie molekuliarno-biologicheskikh metodov identifikatsii brutsell v sravnitel'nom analize shtammov, vydelennykh ot bol'nykh sobak.

Ten strains isolated from sick dogs in 1998 in St. Petersburg were studied by traditional and molecular biological methods of Brucella identification. PCR study confirmed that the isolated cultures were Brucellae, and comparative study of the traditional phenotypical characteristics and protein and antigenic composition allowed referring all the isolated strains to B. canis. Traditional identification showed similarity of 7 strains with the reference B. canis strain RM6/66, and 3 strains were similar to B. canis Mex 51 strain. These results confirmed the division of B. canis into two biovars. Polyacrylamide gel electrophoresis with sodium dodecyl sulfate demonstrated the identity of protein profiles of 10 strains isolated from dogs to the reference B. canis RM6/66 strain. Immunoblotting analysis with S- and R-specific rabbit antisera also demonstrated the identity of antigens binding IgG antibodies in the strains isolated from dogs to the reference B. canis RM6/66 strain.

[Clinical strains of Burkholderia cepacia: characteristic and detection of the components in the quorum sensing regulatory system]. / Klinicheskie shtammy kompleksa Burkholderia cepacia: kharakteristika i vyiavlenie komponentov reguliatornoi sistemy quorum sensing.

Described in the paper are characteristics of B. cepacia clinical strains isolated from patients at Moscow hospitals. The strains were investigated for the presence of proteolytic, chitinolytic, hemolytic and lipase activities as well as for presence of components of the "Quorum sensing" gene activity regulatory system by using biological test-systems and in the polymerase chain reaction with primers to genes cepI and cepR.