PSYCHOLOGICAL FEATURES OF THE REHABILITATION OF PERSONS IN POST-COVID-19 CONDITION.

The global medical problem has become the COVID-19 pandemic since 2019, which represents one of the most difficult medical realities. One of the crucial medical hypotheses is the effect of SARS-Cov-2 infection on mental health that requires creation of effective psychological and psychiatric management of such patients. In connection with described above, we set the task of our research to develop and test a complex of psychological interventions in the system of psychosocial rehabilitation of patients with cognitive disorders against the background of the endured SARS-Cov-2 infection. The material of the study was the data obtained after passing the GAD-7 test for level of anxiety detection. The persons were divided into two groups with patients who have a history of severe acute respiratory syndrome of coronavirus 2 (SARS-CoV-2) and non-suffered with coronavirus. At the end of the course of psychological rehabilitation, the GAD-7 test was repeated. It was established that people who have endured COVID-19 have a significantly higher level of anxiety during examining the initial level of anxiety by performing the GAD-7 test. So, if most of the examined had a minimal level of anxiety (68%) in the control group, then after COVID-19 the majority of patients had a moderate level of anxiety (64%), and 6% even had a high level of anxiety. A month after the initial testing, the group of patients (after COVID-19) who had not undergone psychological rehabilitation was still predominantly in the zone of moderate level of anxiety (54%). Going through psychological rehabilitation had positive consequences and the majority of patients moved into the minimal level of anxiety zone (58%). Majority of persons who endured COVID-19 suffer moderate level of anxiety with GAD-7 test 10.12±0.43 (6.92±0.33 for non-suffered). Psychological rehabilitation could reduce it to 7.24±0.36. The data obtained in the course of the work testify to the effectiveness of conducting a complex of psychotherapeutic interventions using cognitive training, cognitive-behavioral psychotherapy in the system of psychosocial rehabilitation of patients with cognitive disorders against the background of COVID-19 with reducing level of anxiety. Results provide critical information on the efficacy of psychological rehabilitation for persons who experience persistent cognitive deficits after COVID-19.

PECULIARITIES OF IMMUNE STATUS IN THE PRESENCE OF SECONDARY IMMUNODEFICIENCY OF INFECTIOUS AND NON-INFECTIOUS ORIGIN IN WOMEN OF REPRODUCTIVE AGE.

The design of studies on the immune system does not have gender peculiarities, but the information about the higher frequency of pathology of the female reproductive system in the presence of immunodeficiency condition determines the purpose of this study, namely, to identify the features of immune status in the presence of secondary immunodeficiency of infectious (i.e., HIV infection, AIDS stage) and non-infectious origin (alcohol dependence syndrome) and their combination in women of reproductive age. The material for the study of cellular and humoral immunity was a lymphocyte suspension obtained by centrifugation of peripheral blood (taken within 12 hours after death) in women of reproductive age with HIV infection (AIDS stage), alcohol dependence syndrome and their combination. Immunological examination included the determination of quantitative indicators of cellular immunity using monoclonal antibodies: T-lymphocytes (CD3) and their main subpopulations of T-helper cells (CD4), cytotoxic lymphocytes (CD8), CD4/CD8 immunoregulatory index; as well as indicators of humoral immunity: B-lymphocytes (CD19) and immunoglobulins of the main classes (IgA, IgG, IgM). Additionally, interleukins IL-6 and IL-10 were studied to determine the parameters of the cytokine profile. The study indicates that the number of leukocytes and lymphocytes in the group of deceased women with alcohol dependence syndrome was 3.6±0.38x109/l and 0.82±0.35x109/l; in deceased women with HIV/AIDS, these indicators were reduced - 2.9±0.03x109/l and 0.39±0.04x109/l, respectively; and in deceased women with combined pathology (AIDS and alcohol dependence syndrome), they were reduced even more intensively - 2.7±0.04x109/l and 0.35±0.06x109/l (p<0.01). Compared to the control group - 5.22±0.4x109/l and 1.73±0.21x109/l - the number of leukocytes and lymphocytes was reduced in all study groups. In the group of deceased women with alcohol dependence syndrome, significant impairments in the proliferative activity of T-lymphocytes (CD3) and their subpopulation (CD4), as well as B lymphocytes (CD19) and natural killer cells (CD16) were found compared to the group of healthy individuals. Thus, in the control group, the percentage, and absolute values of CD3 were 60.37±4.2% and 1.04±0.05×106/l, and in women suffering from chronic alcoholism, they were statistically significantly lower - 49.1±3.1% and 0.42±0.08×106/l, respectively, p<0.01. The same tendency was found when comparing the values of T-helper cells (CD4) in the control group (44.2±2.9% and 0.76±0.13×106/l) and in deceased patients suffering from chronic alcoholism (33.7±4.6% and 0.28±0.23×106/l), p<0.01. Secondary immunodeficiencies of infectious and non-infectious origin in women (in particular, those formed in HIV/AIDS, alcohol dependence syndrome and their combination) are characterized by negative changes in the cellular and humoral components of the immune system, as evidenced by the presence of transient immunodeficiency, activation of cytolytic and auto aggressive reactions. As a result of these processes, systemic and organ pathology develops, in particular, weakening of the body's resistance to various infections and pathological changes in organs and tissues, which may be one of the links in the development of pathological processes in internal organs and tissues.

[Dynamics the parameters of mineral metabolism in hospitalized patients with COVID-19, the impact of etiotropic and pathogenetic therapy].

The high prevalence of COVID-19 requires the research progress on the disease pathogenesis. There is a lot of data confirming the association between mineral metabolism and the severity of COVID-19. AIM: To study the dynamics of mineral metabolism parameters in patients with a confirmed COVID-19 at the time of hospitalization and after discharge, including the impact of etiotropic and pathogenetic therapy on them. MATERIALS AND METHODS: A single-center study of 106 patients (aged ≥18 years) with clinically or laboratory confirmed diagnosis of COVID-19 was carried out at the Endocrinology Research Centre, Moscow. Baseline biochemical parameters, including serum calcium, phosphorus, albumin, 25(OH)D, parathyroid hormone (PTH), inflammatory markers, and instrumental assessment of COVID-19 severity were performed before specific immunotherapy, as well as on 3rd and 7th days of hospitalization and before discharge. Statistical analysis was performed with Statistica 13 software (StatSoft, USA). RESULTS: On the first day, hypocalcemia (low albumin-adjusted calcium level) was detected in 40.6% of cases, the prevalence of vitamin D deficiency/insufficiency amounted to 95.3% of cases. At the same time, secondary hyperparathyroidism was identified only in 14.2% of patients. A comparative analysis of mineral metabolism during hospitalization (between 1, 3, 7 days of hospitalization and before discharge) during baricitinib treatment revealed a statistically significant increase in albumin-adjusted calcium by the end of hospitalization (p<0.001, Friedman criterion, Bonferroni correction p0=0.01). A pairwise comparison of subgroups, depending on the therapy, revealed a statistically significantly lower level of albumin-adjusted calcium on 3rd day among patients on baricitinib monotherapy or combined with tocilizumab compared with a subgroup of patients undergoing etiotropic treatment (2.16 [2.13; 2.18] mmol/l vs 2.23 [2.19; 2.28] mmol/l, p=0.002, U-test, Bonferroni correction p0=0.012). CONCLUSION: Patients with severe coronavirus infection are characterized by a high prevalence of vitamin D deficiency and hypocalcemia. Associations between calcium and saturation as well as the severity of lung lesion characterizes hypocalcemia as an important predictor of severe course and poor outcome in COVID-19. Pathogenetic therapy with baricitinib, including in combination with tocilizumab, contributes to achieve normocalcemia, but further studies are required.

Tomographic and centroid reconstructions of plasma emission on C-2W via enhanced 300-channel bolometry system.

The C-2W experimental device at TAE Technologies utilizes neutral beam injection and edge biasing to sustain long-lived, stable field reversed configuration (FRC) plasma. An ongoing effort is under way to optimize the electrode biasing system, which provides boundary control to stabilize the FRC. To this end, tomography offers a powerful and non-invasive technique as tomographic reconstruction of the FRC emission profile provides an important assessment of global stability. Recently, a new signal acquisition system was implemented on a bolometer array dedicated to tomography on C-2W, significantly enhancing the signal-to-noise of the collected data. The array consists of 300 simultaneously digitized photodiode channels that respond to a broad range of wavelengths, from soft x-ray to near-infrared, as well as energetic particles, yielding 180 unique lines of sight that intersect a toroidal plane of the FRC near the mid-plane. Utilizing the collected photo-signals from a set of plasma discharges in which the electrode biasing was intentionally terminated mid-shot, time-resolved reconstruction of the plasma emissivity is achieved via pixel-based 1D and 2D tomographic algorithms, revealing sharply annular profiles with a clear magnetohydrodynamic (MHD) mode structure. In addition, reconstruction of the plasma center-of-emission trajectories via a centroid algorithm applied to the same set of discharges demonstrates a cyclical plasma wobble. Crucially, both the tomography reconstruction and centroid reconstruction indicate an n = 1 toroidal mode that reverses from the electron diamagnetic direction to the ion diamagnetic direction and grows in amplitude after bias termination, qualitatively consistent with the expected stabilizing effect of electrodes.

THE SIGNIFICANCE OF ISCHEMIA FOR THE PROLIFERATIVE ACTIVITY OF THE MUCOSA IN INFLAMMATORY BOWEL DISEASES.

The state of the microcirculatory bed remains one of the determining factors in course of inflammatory bowel diseases (IBD). The presence of small foci of ischemia could realize in dystrophic-necrobiotic consequences, which can also underlie the development or strengthening of the inflammatory process. Based on above, the goal of our study was to determine the impact of the development of mucosal ischemia in the colon on the activity of proliferative processes during inflammation. The study was performed on 12 adult WAG rats with modeling IBD by oral administration of 2.5% solution Dextran Sulfate Sodium. Serial slides of the colon where made with stained with hematoxylin and eosin, according to Rego, immunohistochemical examination (IHC) to Ki67. Volume of ischemic area and Ki67 expression were detected. Statistical comparison was performed. Inspection microscopy in the DSS experimental group determined alterative-desquamative changes in the surface epithelium and epithelium of intestinal glands (crypt); diffuse polymorphic cellular infiltration in the mucous membrane, which in some places spread to the submucosal base, that are morphological manifestations of IBD. Foci of ischemia had been detected in that group with 13.09±0.67% volume as just microfocal changes were observed in intact animals (p < 0.05). Detection of proliferative activity depending on ischemic signs was realized in different level of Ki67 expression. So, lowest level of Ki67 was estimated in mucosa above ischemia (18.06±3.33%). Most pronounced expression of Ki67 was observed in IBD group in area which no connected with ischemia and was even 57.71±4.68% (p < 0.05). Ki67 was strongly expressed in epithelial cells of the colon both in intact tissue and in modeling IBD with significant increasing expression more than twice in inflammatory group (p < 0.05) but spreading of activity process was uneven. Collation of slides with ICH and Rego staining realized in estimation of strong negative correlation between Ki67 expression and ischemia (r=-0.819).

Assessment of the systemic immune response in patients with inflammatory complications of large joint implants.

One of the most common reasons for the progressing of aseptic instability of implanted structures in patients with end-stage osteoarthrosis is a disorder of immunogenulatory processes of bone tissue remodeling along with chronic inflammatory response influenced by endoprosthesis wear components. This research features the specifics of systemic immune response in patients with inflammatory complications in late postoperative period after total replacements of large joints. The factor analysis enabled determining the most significant immunological mechanisms associated with the progressing of implant aseptic instability. Pathogenetically significant components involved in the formation of cellular and humoral immune responses in patients with signs of inflammatory activity in late postoperative period have been identified. Our findings can be used in designing diagnostic and prognostic criteria for systemic inflammatory response severity in preoperative monitoring of the condition of patients in need of large joint arthroplasties, and also in detecting the progress of implant aseptic instability.

MORPHO-FUNCTIONAL CHANGES IN ENDOMETRIUM UNDER THE INFLUENCE OF CHRONIC ALCOHOLISM.

According to data that would have been obtained precisely as a result of studying the changes caused by alcohol abuse in the female body which can help solve many abnormal conditions developing in the female reproductive system, such as oligodysmenorrhea and amenorrhea, the purpose of this study was to identify changes in the endometrium that occur in chronic alcoholism. The study included sectional material, selected from women who, according to history data (interviews with relatives) and autopsy data (presence of alcoholic cirrhosis of the liver), had confirmed alcohol abuse. Microscopic examination of endometrium was carried out followed by morphometric examination with determining: the average diameter of the endometrial glands, the minimum diameter of the endometrial glands, the maximum diameter of the endometrial glands, gland wall thickness, the relative volume of the epithelium, and the thickness of the epithelium for the proliferative or secretory type of the endometrium. Based on the study, it can be assumed that alcohol abuse has a significantly significant effect on the female reproductive system as a whole, in particular, on the morpho-functional state of the endometrium, which is manifested by its statistically reliable thinning, hypoplasia of the glands, which was determined both in proliferative and in the secretory phase of the menstrual cycle. Results of the morphometric study have to be interpreted as tendency to atrophy in endometrium with decreased by 13.7% the average diameter of the endometrial glands (from 51.71±2.90 x10-6 m to 44.65±2.48 x10-6 m), reduced diameter of the endometrial glands from 72.14±2.21 x10-6m to 64.13±3.90 x10-6m, abridged the relative volume of the epithelium. The study shows the importance of an individual approach in working with this cohort of patients, which may consist in proper history taking (to confirm alcohol abuse), detection of pathomorphological changes in the endometrium, which is important for the correct diagnosis and selection of the most effective treatment.

Elementary autonomous surface microfluidic devices based on laser-fabricated wetting gradient microtextures that drive directional water flows.

Topography-dependent tuning of water wettability was achieved on a stainless steel surface textured by nanosecond-laser pulses at different laser fluences, with the minimal contribution of the surface chemical modification. Such differently-wet neighboring surface spots were demonstrated to drive an autonomous directional water flow. A series of elementary microfluidic devices based on the spatial wetting gradients were designed and tested as building blocks of "green", energy-saving autonomous microfluidic circuits.

Cell Immunity in Implant-Associated Infections Caused by Biofilm-Forming Microorganisms.

High biofilm-forming capacity of Staphylococcus spp. strains isolated from biomaterial of patients with infectious complications after primary knee replacement developed within 6-12 months after surgery was experimentally demonstrated. Differential leukocyte counts and some indicators of cell immunity in these patients were compared with those in patients without purulent complications and healthy volunteers. In patients with implant-associated infection, the relative numbers of T cells (both T-helpers and T-suppressors) B cells were significantly (p<0.05) reduced, while the number of NK cells was significantly increased in comparison with the corresponding parameters in other groups. The revealed changes attest to cell immunity failure in biofilm infection.

[Mixed infection: viral hepatitis A and hemorrhagic fever with renal syndrome. Case report].

The article considers a case from clinical practice: a mixed infection of viral hepatitis A and hemorrhagic fever with renal syndrome. Hepatitis had a protracted course and proceeded with the development of acute hepatic encephalopathy. Hemorrhagic fever was characterized by an atypical course with lung and heart damage.

Molecular Pathway Activation Markers Are Associated with Efficacy of Trastuzumab Therapy in Metastatic HER2-Positive Breast Cancer Better than Individual Gene Expression Levels.

Increased expression or amplification of HER2 receptor tyrosine kinase gene ERBB2 is well-known and widely used as a prognostic biomarker of breast cancer (BC) response to the targeted treatment with trastuzumab and its analogs. Considering that part of the BC patients overexpressing HER2 does not respond to trastuzumab, clinical trial NCT03521245 was initiated to identify additional gene expression and molecular pathway activation response biomarkers to trastuzumab treatment in HER2-positive BC. Using RNA sequencing gene expression in 23 formalin-fixed, paraffin embedded HER2 positive BC tissue blocks from patients who either responded or not responded to trastuzumab treatment was profiled. Differentially regulated genes and molecular pathways were identified in the groups of trastuzumab responders and non-responders. These results were next compared with the 42 previously published BC trastuzumab responder and non-responder RNA sequencing profiles from the clinical trials NCT00513292 and NCT00353483. No correlation was observed between the response status and the expression levels of ERBB2 gene in the HER2 positive BC samples. Analysis of the differentially expressed genes and molecular pathways in the combined dataset revealed 15/27 commonly up/down regulated genes and 15/25 pathways, respectively. However, only the intersection of molecular pathways upregulated in trastuzumab responders vs non-responders was statistically significantly enriched compared to the random expectation model. A classifier built using the most significantly upregulated molecular pathway - cAMP Pathway Protein Retention - demonstrated the best performance for prediction of the HER2 positive BC response to trastuzumab for both our experimental and previously reported data. This pathway also predicted time to recurrence in the combined dataset with Log-rank p-value 0.041.

[Improvement of bacterial rhinosinusitis diagnostic procedures.] / Совершенствование Ð¼ÐµÑ‚Ð¾Ð´Ð¸Ñ‡ÐµÑÐºÐ¸Ñ Ð¿Ñ€Ð¸Ñ‘Ð¼Ð¾Ð² диагностики Ð±Ð°ÐºÑ‚ÐµÑ€Ð¸Ð°Ð»ÑŒÐ½Ñ‹Ñ Ñ€Ð¸Ð½Ð¾ÑÐ¸Ð½ÑƒÑÐ¸Ñ‚Ð¾Ð².

The research included evaluation of express-diagnosis capability of immunochromatographic assay (ICA) Binax NOW (Alere, Inc., USA) for diagnosis of the rhinosinusitis caused by to detect the Streptococcus pneumoniae antigen directly in clinical samples. The unique feature of the method included obtaining samples with an electric suction machine in order to evaluate aspirate from deep parts of the nasal cavity. Diagnostic capability of the Binax NOW was determined in a comparative study using classical bacteriological method in 100 clinical samples. Pneumococcus was isolated in 16 patients (16±3,7%) via bacteriological method. ICA utilization allowed to reveal pneumococcal antigen in 20 cases (20±4,0%). ICA test sensitivity equaled 87,5%, specificity - 92,9%. Obtained results allow us to recommend ICA for identification of pneumococcal infection in patients with sinusitis for practicing physicians. The advantages of the evaluated method were fast results (for up to 15 min) and possibility of non-invasive sampling technique of clinical specimens.

Biofilm Formation by Gram-Negative Bacteria during Implant-Associated Infection.

Nonfermenting gram-negative bacteria and enterobacteria isolated from various biomaterials of patients of the orthopedic trauma hospital with implant-associated infection demonstrated significantly (p<0.05) higher biofilm formation capacity than the reference strains. The differences in biofilm formation kinetics were revealed: biofilm maturation and the beginning of its dispersion after 48-h incubation in enterobacteria and longer biofilm maturation phase in nonfermenting gram-negative bacteria. It was found that the strains isolated from sonication fluid have reliably (p<0.05) higher propensity to biofilm formation than bacteria isolated from aspirate and wound exudate.

[EVALUATION OF THE VACUUM-ASSOCIATED METHOD EFFICIENCY IN TREATMENT OF BALLISTIC WOUNDS OF THE EXTREMITIES].

The aim of research - to study the wound process on the VAC-assisted background therapy in patients with multi-structure mine-explosive and comminuted wounds of the extremities in traumatological clinic. The study involved 34 middle-aged patients (32.9±1.5 years) with ballistic wounds of soft tissues complicated by compartment syndrome, large necrotic wounds and open fractures (according to the classification of R.B. Gustilo-Anderson,1984) which were treated at the State Institution «Dnipropetrovsk Regional Hospital¼ (2014-2016). Patients were divided into two wound management groups: the group with VAC-assisted treatment and the group with the conventional wound treatment with antiseptics and gauze saline-soaked dressings like a control group. Terms of the study: "0" (before treatment), on the 3rd and 7th day. The main research methods for controlling the dynamics of healing: general clinical assessment, hematological and biochemical parameters (VEGF concentration in blood serum), cyto-histological and immunohistochemical reactions with ultrastructural microscopic analysis and morphometry, a scale for subjective and objective assessment of changes in the quality of life of patients during treatment. According to the results of the study, it was reliably confirmed that in the group of the VAC-assisted method, wound healing occurs more intensively in comparison with the control group, using the "traditional" method. All applied control techniques demonstrated qualitative and quantitative positive changes in the direction of reparative processes, mainly within 3-7 day-checkpoints from the start of treatment. Due to conditions for the creation of uniform negative pressure (-125 mm Hg), it was accelerated the evacuation of the tissue debris throughout the wound bed, maturation of stromal and microcirculatory components throughout the wound channel. On the background of VAC-assisted therapy, it was accelerated the normalization of leukocytogram parameters as the result of decrease the volume of necrotic processes, as well as a significant decrease of the bacterial load in the wound. The stimulation and acceleration of the processes of angiogenesis in the wound allows the preparation of the wound surface for reconstructive operations in 5.2±0.8 days, in comparison with the control group.

Comparative analysis of the mitochondrial genomes of Orthonectida: insights into the evolution of an invertebrate parasite species.

Among invertebrates, only a few groups still have uncertain phylogenetic position, Orthonectida, a small group of rare multi-cellular parasites of marine invertebrates, being one of them. Recent molecular and morphological findings suggest that orthonectids belong to Lophotrochozoa and are close to Annelida. Nevertheless, phylogenetic relationships between orthonectids and annelids are unclear, and the phylogeny within the group itself has never been studied. Sequencing of mitochondrial genomes is used here to clarify this issue. Complete mt genomes of the orthonectids Intoshia variabili and Rhopalura litoralis were characterized and compared with Intoshia linei mt genome. Our results show that Orthonectida mt genomes have undergone reduction and gene loss, and that they have complicated organization revealed in strand asymmetry in nucleotide composition, in some features of intergenic non-coding regions, tRNA duplication and folding. Moreover, all species of Orthonectida have a unique gene order with complicated rearrangement landscape. Significant differences in mitochondrial genomes in the three orthonectid species could be explained by the fact that their host species belong to different taxa (flat worms, nemertines and gastropods). Among the analyzed mt genomes of Orthonectida, I. linei possesses the closest gene order to the ancestral genome. All Orthonectida species are monophyletic, and in the phylogenetic tree are close to Pleistoannelida, and specifically, to Clitellata.

[Intensive therapy in thoracoabdominal surgery]. / Intensivnaia terapiia v torakoabdominal'noi khirurgii.

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

[IMPROVEMENT OF ETIOLOGICAL DIAGNOSIS OF THE CEREBRAL TOXOPLASMOSIS IN HIV-INFECTED PERSONS].

The objective of the study was to determine the diagnostic value of the parallel detection of the avidity index of the IgG to Toxoplasma gondii in the blood and cerebrospinal fluid by a three-step solid-phase enzyme immunoassay using T. gondii antigen, protein dissociating agent and monoclonal antibodies against human IgG at HIV-infected individuals with a focal damage of the brain. The results of the study showed that conducting of the enzyme-linked immunosorbent assay by a direct and dissociated method makes it possible to detect specific intrathecal and serum immunoglobulins, which is proposed in terms of improving diagnosis of cerebral toxoplasmosis in HIV-infected individuals. The high informative ability of the test system for detecting the avidity index of IgG antibodies to T. gondii allows the possibility to apply it in the algorithm for diagnosing an etiological factor of neuroinfection in HIV-infected individuals.

Superinfection of hepatitis E as a factor in the development of acute hepatic encephalopathy on the background of HBV-cirrhosis of the liver.

The article presents an analysis of the clinical case of superinfection of autochthonous acute hepatitis E against the background of HBV-cirrhosis of the liver. HEV infection was diagnosed in a 39 year old man who did not travel outside the region and the country for a long time and used unboiled water. The peculiarity of the disease in the non-endemic region was: a severe course of hepatitis E against the background of HBV etiology, with the development of the clinic for acute hepatic insufficiency and encephalopathy, the presence of severe cytolysis syndrome, cholestasis, hepatic-cell insufficiency and prolonged convalescence. Timely treatment of the patient for medical aid and intensive pathogenetic therapy of hepatit-E superinfection with compensated HBV-cirrhosis allowed to save the patient's life. However, the prognosis for the patient's later life is unfavorable, due to submissive liver necrosis and the risk of rapid decompensation of cirrhosis. When deciphering undifferentiated in Russia acute hepatitis in persons with cirrhosis of another etiology (viral, alcoholic, medicinal), it is necessary to include the definition of HEVRNA and HEV IgM and G. in the survey design.

[DIAGNOSTIC VALUE OF THE HOMEOSTASIS PARAMETERS IN SEPSIS DETECTING IN PATIENTS WITH INFECTIOUS-INFLAMMATORY COMPLICATIONS DURING THE POSTOPERATIVE PERIOD.]

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

COMPARISON OF INFLUENZA A VIRUS INHIBITION IN VITRO BY SIRNA COMPLEXES WITH CHITOSAN DERIVATIVES, POLYETHYLENEIMINE AND HYBRID POLYARGININE-INORGANIC MICROCAPSULES.

Anti-influenza drugs and vaccines have a limited effect due to the high mutation rate of virus genome. The direct impact on the conservative virus genome regions should significantly improve therapeutic effectiveness. The RNA interference mechanism (RNAi) is one of the modern approaches used to solve this problem. In this work, we have investigated the antiviral activity of small interfering RNA (siRNA) against the influenza A/PR/8/34 (H1N1), targeting conserved regions of NP and PA. Polycations were used for intracellular siRNA delivery: chitosan's derivatives (methylglycol and quaternized chitosan), polyethyleneimine, lipofectamine, and hybrid organic/non-organic microcapsules. A comparative study of these delivery systems with fluorescent labeled siRNA was conducted. The antiviral activity of three small interfering RNAs targeting the NP (NP-717, NP-1496) and PA (PA-1630) influenza A viruses genes was demonstrated, depending on the chosen carrier. The most effective intracellular delivery and antiviral activity were observed for hybrid microcapsules.