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1.
Nature ; 588(7837): 227-231, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33299190

RESUMO

The halo of the Milky Way provides a laboratory to study the properties of the shocked hot gas that is predicted by models of galaxy formation. There is observational evidence of energy injection into the halo from past activity in the nucleus of the Milky Way1-4; however, the origin of this energy (star formation or supermassive-black-hole activity) is uncertain, and the causal connection between nuclear structures and large-scale features has not been established unequivocally. Here we report soft-X-ray-emitting bubbles that extend approximately 14 kiloparsecs above and below the Galactic centre and include a structure in the southern sky analogous to the North Polar Spur. The sharp boundaries of these bubbles trace collisionless and non-radiative shocks, and corroborate the idea that the bubbles are not a remnant of a local supernova5 but part of a vast Galaxy-scale structure closely related to features seen in γ-rays6. Large energy injections from the Galactic centre7 are the most likely cause of both the γ-ray and X-ray bubbles. The latter have an estimated energy of around 1056 erg, which is sufficient to perturb the structure, energy content and chemical enrichment of the circumgalactic medium of the Milky Way.

2.
Ter Arkh ; 95(10): 850-858, 2023 Nov 23.
Artigo em Russo | MEDLINE | ID: mdl-38159017

RESUMO

AIM: To evaluate the efficacy and safety of OM-85 in the treatment of uncomplicated acute respiratory infections (ARI) in adults. MATERIALS AND METHODS: A double-blind, placebo-controlled, multicenter, randomized trial included 556 patients (18-60 years old) with mild and moderate ARI and negative results of polymerase chain reaction analysis for SARS-CoV-2 RNA and rapid test for influenza A and B viruses. Patients were randomized into two groups: in the first group (n=278), patients received OM-85 (Broncho-munal®) one capsule 7 mg/day for 10 days, while the second group (n=278) was treated with placebo in the same regimen. The primary endpoint was the dynamics of the severity of symptoms over 3, 5, 7 and 10 days of treatment according to the 21-item Wisconsin Upper Respiratory Symptom Survey (WURSS-21), which was assessed by the area under the curve. Secondary efficacy criteria were the dynamics of the severity of symptoms according to the Common Cold Questionnaire (CCQ), the time to the resolution of symptoms according to WURSS-21 and CCQ, the proportion of patients with body temperature below 37°C on each day of treatment, frequency of the need for systemic antibacterial therapy. RESULTS: The superiority of OM-85 over placebo by primary endpoint was observed on the 5th, 7th and 10th days of treatment. OM-85 efficacy has also been proven by secondary criteria. OM-85 shortened the time until the symptoms of ARI resolved according to the WURSS-21 and CCQ, increased the proportion of patients with body temperature below 37°C by 2-9 days. The time needed to resolve the symptoms of disease in 20% of patients according to WURSS-21 was 7 and 9 days in patients taking OM-85 and placebo, respectively. Bacterial lysate increased the probability of complete disappearance of symptoms according to CCQ by 45.7% compared to placebo. The analysis of the frequency and severity of adverse events, laboratory tests, physical and instrumental examination results during treatment confirmed the good tolerability and safety of OM-85. CONCLUSION: The study confirmed the efficacy and safety of OM-85 in the complex treatment of ARI in adults.


Assuntos
Resfriado Comum , Influenza Humana , Infecções Respiratórias , Adulto , Humanos , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Lisados Bacterianos , RNA Viral/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Influenza Humana/tratamento farmacológico , Método Duplo-Cego , Bactérias , Resultado do Tratamento
3.
Khirurgiia (Mosk) ; (12): 7-13, 2023.
Artigo em Russo | MEDLINE | ID: mdl-38088836

RESUMO

OBJECTIVE: To study the clinical and economic features of laparoscopic surgery for acute cholecystitis in delayed presentation. MATERIAL AND METHODS: A prospective non-randomized study (2020-2021) included 101 patients (73.2% (n=74) men and 26.8% (n=27) women, mean age 58±14.9 years) with acute cholecystitis who underwent laparoscopic cholecystectomy. Cost-effectiveness analysis of laparoscopic cholecystectomy at various periods after clinical manifestation was performed. RESULTS: Surgical treatment within 72 hours was performed in 15% (n=16) of cases (group 1), within 4-10 days - in 57.5% (n=58) (group 2), after 10 days - in 26.7% (n=27) of patients (group 3). Overall incidence of postoperative complications was 2.9%, postoperative mortality - 1.9% (two patients died from widespread peritonitis). Surgery time was 70 [65-83], 85 [69-110] and 115 [80-125] min (H=15.55, p<0.001), hospital-stay - 6 [5-7], 9 [7-10] and 11 [7-14] days, respectively (H=21.86, p<0.001). Cost of direct (medical and non-medical) treatment amounted to 29484 [27 509-33 885], 41265 [34 306-48 301] and 50591 [37 069-62 483] rubles, respectively (H=29.71, p<0.001)). CONCLUSION: Delayed hospitalization and surgical treatment of acute cholecystitis after 72 hours are accompanied by higher treatment costs by 29% in the period up to 10 days and by 58% after 10 days. These results require further validation and adjustment in large samples.


Assuntos
Colecistectomia Laparoscópica , Colecistite Aguda , Laparoscopia , Masculino , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Estudos Prospectivos , Fatores de Tempo , Colecistite Aguda/diagnóstico , Colecistite Aguda/cirurgia , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Laparoscopia/efeitos adversos , Tempo de Internação , Resultado do Tratamento
4.
Khirurgiia (Mosk) ; (7): 12-18, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35775840

RESUMO

OBJECTIVE: To analyze treatment outcomes and approaches to predicting the postoperative morbidity and mortality in patients with perforated ulcers and cancer. MATERIAL AND METHODS: A non-randomized trial included 194 patients. The first group enrolled 45 (23%) patients with perforated ulcers and concomitant cancer who underwent at the oncology center; the second group included 149 (77%) patients with perforated ulcers and no cancer who underwent surgery in general surgical hospitals. Organ-sparing procedures prevailed (40 (88.9%) and 138 (92.6%) cases, respectively). Resections were performed in 5 (11.1%) and 11 (7.4%) patients respectively. Analyzing the factors affecting treatment outcomes, we studied crude (COR) and adjusted (AOR) odds ratios. ROC-analysis was used to assess diagnostic significance of the models for prognosis of morbidity and mortality. RESULTS: Length of hospital-stay was 10 (range 9-14) and 8 (range 7-9) days respectively. Postoperative complications (Clavien-Dindo grading system) occurred in 18 (40%) in 37 (24.8%) patients, respectively. According to multivariate analysis, predictors of complications in patients of the first group were treatment with NSAIDs/glucocorticoids and Charlson-Deyo index >3. Sensitivity of this model was 82.4%, specificity - 75.0%. Postoperative mortality was 15.6% (n=7) and 7.4% (n=11) respectively. According to multivariate analysis, predictors of mortality were age over 65 years and more than 5 chemotherapeutic courses. Sensitivity of the model was 85.7%, specificity - 97.4%. CONCLUSION: The stratified approach makes it possible to improve prediction of postoperative morbidity and mortality in patients with perforated ulcers.


Assuntos
Neoplasias , Úlcera Péptica Perfurada , Idoso , Humanos , Morbidade , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Neoplasias/mortalidade , Úlcera Péptica Perfurada/complicações , Úlcera Péptica Perfurada/mortalidade , Úlcera Péptica Perfurada/cirurgia , Período Pós-Operatório , Prognóstico
5.
Khirurgiia (Mosk) ; (6): 88-101, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35658141

RESUMO

OBJECTIVE: Comparative assessment of immediate and long-term results of robot-assisted and conventional endoscopic technologies in the Russian Federation. MATERIAL AND METHODS: Searching for primary trials devoted to robot-assisted (RAE) and traditional video endoscopic (TVE) surgeries in the Russian Federation was carried out in the e-library and CENTRAL Cochrane databases. We used the recommendations of the Center for Expertise and Quality Control of Medical Care (2017, 2019) and the current version of the Cochrane Community Guidelines (2021). These guidelines define the features of meta-analysis of non-randomized comparative studies. Review Manager 5.4 software was used for statistical analysis. RESULTS: We enrolled 26 Russian-language primary sources (3111 patients) including 1174 (38%) ones in the RAE group and 1937 (62%) patients in the TVE group. There were no randomized controlled trials in the Russian Federation, and all primary studies were non-randomized. We found no significant between-group differences in surgery time, incidence of intraoperative complications, intraoperative blood loss in thoracic surgery, urology and gynecology, conversion rate, postoperative hospital-stay, postoperative morbidity (in abdominal surgery, urology and gynecology), postoperative mortality. We observed slightly lower intraoperative blood loss for RAE in abdominal surgery and lower incidence of postoperative complications in robot-assisted thoracic surgery. These results can be compromised by methodological quality of comparative studies, significant heterogeneity and systematic errors. CONCLUSION: Currently, we cannot confirm the benefits of robot-assisted technologies, since this approach does not worsen or improve treatment outcomes. Further high-quality studies are needed.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Robótica , Perda Sanguínea Cirúrgica , Humanos , Laparoscopia/métodos , Tempo de Internação , Duração da Cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento
6.
Kardiologiia ; 61(6): 41-51, 2021 Jul 01.
Artigo em Russo, Inglês | MEDLINE | ID: mdl-34311687

RESUMO

Aim      To study features of diagnosis and treatment of acute myocardial infarction (AMI) in Russian hospitals, results of the treatment, and early and late outcomes (6 and 12 months after AMI diagnosis); to evaluate the consistence of the treatment with clinical guidelines; and to evaluate patients' compliance with the treatment.Material and methods  The program was designed for 3 years, including 24 months for recruitment of patients to the study. The study will include 10, 000 patients hospitalized with a confirmed diagnosis (I21 according to ICD-10) of ST segment elevation acute myocardial infarction (MI) (STEMI) or non-ST segment elevation MI (NSTEMI) based on criteria of the European Society of Cardiology Guidelines on Forth Universal Definition of Myocardial Infarction (2018). The follow-up period was divided into three stages: observation during the stay in the hospital and at 6 and 12 months following inclusion into the registry. The primary endpoint included cardiac death, nonfatal MI during the hospitalization and after one-year follow-up. Secondary endpoints were 6-months and one-year incidence of repeated MI, heart failure, ischemic stroke, clinically significant hemorrhage, unscheduled revascularization after discharge from the hospital, and the proportion of patients who continue on statins, antiplatelet drugs, and drugs of other groups for 6 months and 1 year.Results The inclusion of patients into the registry started in 2020 and will continue for 24 months. By the time of the article publication (June, 2021), more than 2,000 patients will be included.Conclusion      REGION-MI (Russian rEGIstry Of acute myocardial iNfarction) is a multicenter, retrospective and prospective observational cohort study that excludes any interference with the clinical practice. Results of the registry will help to analyze a real picture of medical care provided to patients with myocardial infarction and to schedule ways to improve the situation.


Assuntos
Infarto do Miocárdio , Humanos , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/terapia , Estudos Prospectivos , Sistema de Registros , Estudos Retrospectivos , Fatores de Risco , Federação Russa/epidemiologia , Fatores de Tempo , Resultado do Tratamento
7.
Khirurgiia (Mosk) ; (2): 94-100, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33570362

RESUMO

OBJECTIVE: Systematic review and metaanalysis of the effectiveness of open and minimally invasive laparoscopic suturing of perforated peptic ulcer. MATERIAL AND METHODS: Searching for Russian and English language reports included Scientific Electronic Library, Cochrane Collaboration Library and PubMed databases. We have analyzed contents of specialized journals, reviews and their references. Unpublished data were obtained via communication with chiefs of national surgical hospitals. RevMan 5.3 software was used for metaanalysis. RESULTS: We found no international randomized trials in available literature. Metaanalysis was based on national non-randomized studies. Total sample was 1177 cases. Laparoscopic minimally invasive surgery was performed in 43% of cases (n=503), open suturing - in 57% (n=674) of patients. Choice of these procedures is not currently not standardized. Minimally invasive procedures are shorter in time (mean difference -8.02, 95% CI -11.26 - -4.77, p<0.00001) and ensure less hospital-stay (mean difference -1.93, 95% CI -2.97 - -0.88, p=0.0003). Complications were less common (OR 0.14, 95% CI 0.07-0.27, p<0.00001) after minimally invasive operations (2.4%, 12/503) compared to laparotomy (11.4%, 77/674). Incidence of suture failure was similar (OR 0.4, 95% CI 0.1-1.6, p=0.2) (0.4% (2/503) vs. 0.7% (5/674)). Postoperative mortality was higher (OR 0.14, 95% CI 0.05-0.37, p<0.0001) after laparotomy (8%, 54/674) compared to laparoscopy (0.8%, 4/503). CONCLUSION: A metaanalysis indicates the advantage of laparoscopy-assisted suturing of perforated ulcer via minimally invasive approach over laparotomy. The absence of a standardized approach in choosing of minimally invasive laparotomy and conventional approach is a limitation of these results.


Assuntos
Laparoscopia , Laparotomia , Úlcera Péptica Perfurada , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparotomia/efeitos adversos , Laparotomia/métodos , Tempo de Internação , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Úlcera Péptica Perfurada/diagnóstico , Úlcera Péptica Perfurada/cirurgia , Resultado do Tratamento
8.
Khirurgiia (Mosk) ; (11): 93-100, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33210514

RESUMO

OBJECTIVE: To analyze the randomized controlled trials (RCTs) devoted to distal subtotal gastrectomy and gastrectomy with D2 lymphadenectomy in patients with distal gastric cancer. MATERIAL AND METHODS: RCTs were searched in the electronic library, the Cochrane Community database, and PubMed database. A systematic review and meta-analysis were carried out in accordance with the recommendations of the Cochrane Community experts (Higgins et al. 2019). Mathematical calculations of a meta-analysis were made using RevMan 5.3 software package. Statistical criteria were calculated for relative risk (RR), hazard ratio (HR), 95% confidence interval (95% CI) and significance level (p). RESULTS: Seven primary RCTs were selected. A total number of 1463 surgical interventions with D2 lymphadenectomy were observed (805 patients underwent distal subtotal gastrectomy, 658 - gastrectomy). Postoperative mortality is significantly higher (6.5% and 2.6%) after gastrectomy compared to subtotal distal gastrectomy (RR 2.2, 95% CI 1.34-3.64, I2 0%, fixed effect model). Postoperative complications are also significantly more common (28% and 14%) after gastrectomy (RR 1.72, 95% CI 1.16-2.55, I2 heterogeneity 49%, random effect model). Differences in overall five-year survival after gastrectomy and subtotal distal resection (51.6% and 60.8%) are insignificant (HR 0.74, 95% CI 0.45-1.22, I2 90%, random effect model, general reverse inversion). CONCLUSION: The choice of distal subtotal gastrectomy and gastrectomy with D2 lymphadenectomy in patients with distal gastric cancer is not regulated by evidence-based medicine. The boundaries of minimal surgical clearance from the tumor edge vary from 2.5 cm to 6 cm. An updated meta-analysis shows that postoperative mortality and morbidity are significantly higher after gastrectomy compared to distal subtotal gastrectomy while overall 5-year survival is similar.


Assuntos
Gastrectomia/métodos , Neoplasias Gástricas , Gastrectomia/efeitos adversos , Gastrectomia/mortalidade , Humanos , Excisão de Linfonodo/métodos , Margens de Excisão , Ensaios Clínicos Controlados Aleatórios como Assunto , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Neoplasias Gástricas/cirurgia
9.
Khirurgiia (Mosk) ; (11): 37-41, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31714528

RESUMO

OBJECTIVE: To develop a rational surgical strategy for acute biliary pancreatitis and its complications. MATERIAL AND METHODS: A 10-year follow-up enrolled 378 patients with acute biliary pancreatitis. Mild pancreatitis was diagnosed in 304 (80%) patients, moderate and severe course - in 74 (20%). Almost all patients with mild acute biliary pancreatitis underwent surgery within 3-7 days after the attack resolution. Patients with severe biliary pancreatitis had general and local complications that required differentiated treatment strategy. CONCLUSION: Strangulation of the calculus in the major duodenal papilla requires emergency endoscopic papillosphincterotomy. Choledocholithiasis, cholangitis and obstructive jaundice in acute biliary pancreatitis are indications for endoscopic papillosphincterotomy. Cholecystectomy should be performed after resolution of inflammatory changes in the gallbladder and pancreas in patients with severe biliary pancreatitis.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Colelitíase/cirurgia , Pancreatite/cirurgia , Doença Aguda , Colelitíase/diagnóstico , Colelitíase/etiologia , Seguimentos , Humanos , Pancreatite/etiologia
10.
Bull Exp Biol Med ; 164(3): 386-389, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29308563

RESUMO

A comparative immunohistochemical study for the expression of O6-methylguanine-DNA methyltransferase (MGMT) was performed in tissues of the eutopic endometrium and ovarian endometriosis. The highest level of MGMT expression in eutopic endometrial tissue was observed in epitheliocyte nuclei during the proliferative phase. In regions of endometriosis the expression of MGMT in epitheliocyte nuclei was shown to increase during stages I and II, but decreased in stages III and IV. The progression of endometriosis was accompanied by a gradual increase of study parameters in the nuclei and cytoplasm of stromal cells. These changes reflect the impairment of DNA reparation, which probably serves as a stage in the development and progression of endometriosis.


Assuntos
Metilases de Modificação do DNA/genética , Enzimas Reparadoras do DNA/genética , Reparo do DNA , Endometriose/genética , Ovário/enzimologia , Células Estromais/enzimologia , Proteínas Supressoras de Tumor/genética , Adolescente , Adulto , DNA/genética , DNA/metabolismo , Metilases de Modificação do DNA/metabolismo , Enzimas Reparadoras do DNA/metabolismo , Progressão da Doença , Endometriose/enzimologia , Endometriose/patologia , Células Epiteliais/enzimologia , Células Epiteliais/patologia , Feminino , Regulação da Expressão Gênica , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Ovário/patologia , Células Estromais/patologia , Proteínas Supressoras de Tumor/metabolismo , Útero/enzimologia , Útero/patologia
11.
Khirurgiia (Mosk) ; (3): 64-69, 2018.
Artigo em Russo | MEDLINE | ID: mdl-29560962

RESUMO

AIM: To analyze the errors and complications of surgical care in patients with the first episode of spontaneous pneumothorax at different hospitals. MATERIAL AND METHODS: From 2005 to 2015 three hundreds and seventeen patients with the first episode of spontaneous pneumothorax have been treated at the thoracic department of Volgograd State Medical University. Patients were divided into 2 groups: 79 of them underwent thoracotomy while in 238 cases minimally invasive technologies were applied. Faster preoperative management and earlier active surgical tactics were suggested. RESULTS: There were 6 the most typical violations of surgical care in 42% of patients with the first episode of spontaneous pneumothorax. Medical and diagnostic violations at regional centers and central district hospitals were the same, but there were differences in certain types of errors and their incidence. Minimally invasive technologies do not significantly affect the number of violations of thoracic surgery principles. Early procedures against the recurrence by using of thoracoscopic interventions reduce postoperative morbidity from 1.2 to 0.3% and mortality by 8.25 times.


Assuntos
Erros Médicos/prevenção & controle , Procedimentos Cirúrgicos Minimamente Invasivos , Pneumotórax/cirurgia , Complicações Pós-Operatórias , Cirurgia Torácica Vídeoassistida , Toracotomia , Adulto , Tomada de Decisão Clínica , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Avaliação de Processos e Resultados em Cuidados de Saúde , Pneumotórax/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos , Federação Russa/epidemiologia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Cirurgia Torácica Vídeoassistida/mortalidade , Toracotomia/efeitos adversos , Toracotomia/métodos , Toracotomia/mortalidade , Tempo para o Tratamento/normas
12.
Khirurgiia (Mosk) ; (10): 72-76, 2017.
Artigo em Russo | MEDLINE | ID: mdl-29076486

RESUMO

INTRODUCTION: With the unsuccessfulness of an intensive therapy and minimally invasive interventions in severe acute pancreatitis they resort to the 'open' surgical interventions. It is important to know about the classification of complications of such surgeries, the frequency of occurrences, the recognition peculiarities and the determination of a treatment plan for the practical surgery. AIM: The optimization of the usage of 'open' surgeries for patients with severe acute pancreatitis. MATERIAL AND METHODS: An 'open' surgery has been performed on 322 patients for 25 years, 102 (31.6%) of them had different complications, 35 (34%) of them died. The intraoperative, early and 'seamed' complications have been allocated. The rational treatment concepts of the complications of 'open' surgeries, which are special for their diversity and paired with tactical and technical difficulties, have been developed. CONCLUSION: The main reasons for the development of complications of 'open' surgeries for severe acute pancreatitis are the destruction of the wall of the main pancreatic duct, parapancreatitis, the intervention of a hollow organ or a vessel of trunk in a purulent lesion. As a rule, mentioned changes appear due to the long-team course of severe acute pancreatitis.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Complicações Intraoperatórias , Laparotomia/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos , Pancreatite Necrosante Aguda/cirurgia , Complicações Pós-Operatórias , Pesquisa Comparativa da Efetividade , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Feminino , Humanos , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/etiologia , Complicações Intraoperatórias/prevenção & controle , Laparotomia/métodos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Pancreatite Necrosante Aguda/diagnóstico , Pancreatite Necrosante Aguda/epidemiologia , Administração dos Cuidados ao Paciente/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Retrospectivos , Federação Russa/epidemiologia , Índice de Gravidade de Doença , Resultado do Tratamento
13.
Artigo em Russo | MEDLINE | ID: mdl-28884731

RESUMO

This article presents the results of a comparative prospective study of 276 subjects at the age between 40 and 65 years presenting with risk factors (RF) of atherosclerosis and its preclinical stages (APC). All of them were reckoned to be at a moderate risk of developing APC based on the results of evaluation with the use of the SCORE scale which implied the necessity of their differential non-pharmacological treatment during a two-year period with the application of a variety of preventive therapeutic strategies. The patients were allocated to three different (initially comparable) groups. The main group (group 1) was comprised of 98 subjects who received the optimized combined treatment including climatotherapy, dietary therapy, psychotherapy, hydrotherapy, physiotherapy, and hypoxytherapy; in addition, they were involved in the program of therapeutic physical exercises and in the educational program. The group of comparison (group 2) consisted of 88 subjects who were advised to withstand pernicious habits, to keep to the prescribed diet, and intensify the physical activity. The subjects included in the control group 3 were given no preventive treatment whatsoever. The optimized system for the early diagnostics and identification of the risk factors and/or ACD was employed for examining the members of group 1. By the end of the study, risk factors of atherosclerosis and APC were documented in 86.2% and 76.6% of the patients of group 1, respectively. The number of disability days averaged 7.2 per person versus 16.3 and 22.6 in comparison and control groups, respectively. There were no newly diagnosed cases of cardiovascular diseases (CVD) over the study period among the patients of group 1, in contrast to 11.4% and 25.6% such cases in groups 2 and 3, respectively. The results of this study give evidence that the optimized strategy of non-pharmacological correction of the risk factors and the preclinical stages of atherosclerosis at the level of the health resort-based primary care has advantages over the standard therapy because it makes it possible to reduce the frequency of development of new cases of cardiovascular diseases and to decrease the disability rate. It is concluded that the proposed approach enhances the effectiveness of primary prophylaxis of cardiovascular diseases associated with atherosclerosis and relieves the burden of this pathology. It can therefore be recommended for the more extensive application at the level of the health resort-based primary care settings.


Assuntos
Aterosclerose , Estâncias para Tratamento de Saúde/normas , Serviços Preventivos de Saúde/métodos , Atenção Primária à Saúde/métodos , Adulto , Idoso , Algoritmos , Aterosclerose/diagnóstico , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Humanos , Pessoa de Meia-Idade , Serviços Preventivos de Saúde/normas , Atenção Primária à Saúde/normas , Estudos Prospectivos , Fatores de Risco , Federação Russa
14.
Rep Prog Phys ; 79(4): 046901, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27007555

RESUMO

Collisionless shocks, that is shocks mediated by electromagnetic processes, are customary in space physics and in astrophysics. They are to be found in a great variety of objects and environments: magnetospheric and heliospheric shocks, supernova remnants, pulsar winds and their nebulæ, active galactic nuclei, gamma-ray bursts and clusters of galaxies shock waves. Collisionless shock microphysics enters at different stages of shock formation, shock dynamics and particle energization and/or acceleration. It turns out that the shock phenomenon is a multi-scale non-linear problem in time and space. It is complexified by the impact due to high-energy cosmic rays in astrophysical environments. This review adresses the physics of shock formation, shock dynamics and particle acceleration based on a close examination of available multi-wavelength or in situ observations, analytical and numerical developments. A particular emphasis is made on the different instabilities triggered during the shock formation and in association with particle acceleration processes with regards to the properties of the background upstream medium. It appears that among the most important parameters the background magnetic field through the magnetization and its obliquity is the dominant one. The shock velocity that can reach relativistic speeds has also a strong impact over the development of the micro-instabilities and the fate of particle acceleration. Recent developments of laboratory shock experiments has started to bring some new insights in the physics of space plasma and astrophysical shock waves. A special section is dedicated to new laser plasma experiments probing shock physics.

15.
Bull Exp Biol Med ; 161(1): 155-61, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27265142

RESUMO

In the liver of rats subjected to subtotal liver resection (80% organ weight), the expression of sox9 gene and SOX9 protein content increased and cells with hepatocyte morphology expressing SOX9 appeared; the proportion of cells expressing cytokeratin-19 also increased. Based on these data, we cannot completely exclude the involvement of resident progenitor cells and hepatocyte reprogramming in liver regeneration after subtotal resection, however, the contribution of these processes seems to be insignificant. The leading mechanism of liver mass recovery after subtotal resection is proliferation of hepatocytes.


Assuntos
Hepatócitos/fisiologia , Regeneração Hepática , Fígado/fisiologia , Células-Tronco/fisiologia , Animais , Animais não Endogâmicos , Proteínas Reguladoras de Apoptose/metabolismo , Proliferação de Células , Citocina TWEAK , Hepatectomia , Fígado/cirurgia , Proteínas de Membrana/metabolismo , Mitose , Tamanho do Órgão , Ratos Sprague-Dawley , Fatores de Transcrição SOX9/metabolismo , Fatores de Necrose Tumoral/metabolismo
16.
Kardiologiia ; 56(10): 80-89, 2016 10.
Artigo em Russo | MEDLINE | ID: mdl-28290899

RESUMO

Administration of preparations of potassium and magnesium to patients with arterial hypertension is an accepted therapeutic practice. In this paper we examine relationships between the content of potassium and magnesium in the body and levels of arterial pressure. Results of relevant fundamental and clinical studies are also presented. In hypertension and hypotension modulating effects of potassium and magnesium develop with the use of their small doses compensating deficit of these elements.


Assuntos
Pressão Sanguínea , Hipertensão , Magnésio/metabolismo , Potássio/metabolismo , Humanos , Hipertensão/etiologia , Hipertensão/metabolismo , Masculino
17.
Ter Arkh ; 88(5): 118-124, 2016.
Artigo em Russo | MEDLINE | ID: mdl-27458629

RESUMO

This review analyzes whether.it is expedient to use oral probiotics for the stimulation of immune response against pathogens in the respiratory tract. It considers a relationship between.mucosal microbial colonization in different biotopes of the body and mucosal.immunity in the respiratory tract. The principal and terminological controversial issues of colonic dysbiosis and the possibilities of using the medicines and products containing live commensals/symbionts to correct microbiota disturbances are examined. There are data on the degree of resistance and resilience of the colonic microbial community exposed to destabilizing factors, antibiotics in particular. The properties of probiotics that have been proven to enhance host response against pathogens and the phenomena that characterize these probiotics as immunomodifiers and distinguish them from other immunostimulating/immunomodulating agents are described. Criteria for choosing effective and safe oral probiotics to stimulate an immune response in the respiratory tract are formulated. Finally, we review the data on the clinical and immunomodulatory effects of dietary supplement containing a combination of three probiotic strains (Lactobacillus gasseri PA 16/8, Bifidobacterium bifidum MF 20/5 and Bifidobacterium longum SP 07/3) with vitamins and minerals as an agent to prevent and reduce the severity of acute and recurrent respiratory tract infections.


Assuntos
Bifidobacterium , Suplementos Nutricionais , Imunomodulação , Lactobacillus , Probióticos/farmacologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/prevenção & controle , Humanos
18.
Vopr Pitan ; 85(3): 111-119, 2016.
Artigo em Russo | MEDLINE | ID: mdl-30645910

RESUMO

The aim of the study was to examine anthropometry, physical fitness, metabolism at the level of the microcirculation and adaptive processes of the organism as a whole under the inclusion of enzyme-hydrolyzed whey in the diet of 27 weightlifters 17-23 (21.7±2.7) years old, with the level of sports skills of 1 category of up to masters of sports. The body composition was determined by bioimpedance method, functioning of microcirculation system and oxygen transport were determined using the multifunction laser diagnostic complex. For analysis of heart rate variability we used complex "Varicard 2.51", physical fitness was assessed by generally accepted pedagogical tests. The products inclusion in the diet in the increasing dose of 0.5 to 1.5 g/kg of body weight within 21 days increases physical fitness. The growth of physical efficiency provided change of body composition with slight increase in muscle mass by 2% and decrease in fat component by 3.6% (p <0.05). Increasing muscle mass is the functional stimulus for the revitalization of the microcirculation system for the exchange of nutrients and energy. Under the consumption of serum the intensity of microcirculation increased by 131%, elevating dominance of active mechanisms of modulation of the flow over passive. As a result of intensive diffusion of oxygen from the blood into tissues, the saturation rate of mixed blood reduced by 7.7% and consumption of oxygen by cells of work tissues increased by 23.6%. Assimilation of nutrients and energy, adequate to physical exercises, improved functional capacity of the organism in general and extended its adaptive capacity, as evidenced by the increase of the balance of vegetative regulation of cardiac rhythm.

19.
Opt Lett ; 40(16): 3758-61, 2015 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-26274653

RESUMO

We present the experimental studies on optical second-harmonic generation from nanostructures exhibiting magnetic dipole resonances in the visible spectral range. "Nanosandwiches" of the composition Au/MgF(2)/Au with the average disk diameter of 140 nm are packed in a square lattice with the period of 400 nm. We show that at normal incidence, the intensity of the second-harmonic (SH) wave generated by the array of nanostructures increases by an order of magnitude as the excitation wavelength approaches the magnetic-dipole resonance, while the phase of the SH wave experiences a shift up to 330°. Based on the phenomenological description of the SH process, the observed effects indicate the dominant role of the nonlinear magnetic-dipole polarization driven by the χ(emm) susceptibility in SH generation in "nanosandwiches."

20.
J Chem Phys ; 143(15): 154102, 2015 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-26493892

RESUMO

Large-order Rayleigh-Schrödinger perturbation theory (RSPT) is applied to the calculation of anharmonic vibrational energy levels of H2CO molecule. We use the model of harmonic oscillators perturbed by anharmonic terms of potential energy. Since the perturbation series typically diverge due to strong couplings, we apply the algebraic approximation technique because of its effectiveness shown earlier by Goodson and Sergeev [J. Chem. Phys. 110, 8205 (1999); ibid. 124, 094111 (2006)] and in our previous articles [A. D. Bykov et al. Opt. Spectrosc. 114, 396 (2013); ibid. 116, 598 (2014)]. To facilitate the resummation of terms contributing to perturbed states, when resonance mixing between states is especially strong and perturbation series diverge very quick, we used repartition of the Hamiltonian by shifting the normal mode frequencies. Energy levels obtained by algebraic approximants were compared with the results of variational calculation. It was found that for low energy states (up to ∼5000 cm(-1)), algebraic approximants gave accurate values of energy levels, which were in excellent agreement with the variational method. For highly excited states, strong and multiple resonances complicate series resummation, but a suitable change of normal mode frequencies allows one to reduce the resonance mixing and to get accurate energy levels. The theoretical background of the problem of RSPT series divergence is discussed along with its numerical analysis. For these purposes, the vibrational energy is considered as a function of a complex perturbation parameter. Layout and classification of its singularities allow us to model the asymptotic behavior of the perturbation series and prove the robustness of the algorithm.

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