[Actual Issues of Choosing Anticoagulant Therapy for Long-term Prophylaxis of Thromboembolic Complications].

The article contains presentation of actual problems of selection of anticoagulant therapy for long term prevention of thromboembolic complications in outpatients with atrial fibrillation, chronic heart failure, and chronic kidney disease.tions in ambulatory Patients with atrial fibrillation, chronic heart failure and chronic kidney disease.

[RELATIONSHIP BETWEEN SMOKING AND INDICATORS OF SYSTEMIC INFLAMMATION IN PATIENTS WITH CORONARY HEART DISEASE].

Aim: To estimate the severity of systemic inflammation in subjects with coronary artery disease (CAD) without bronchopulmonary system comorbidity depending on smoking factor. Materials and methods: The subjects were divided into groups depending on smoking factor. We estimated the following laboratory markers of nonspecific inflammation: interleukine (IL)-12, -1ß, tumour necrosis factor-α, matrix metalloproteinase-9, C-reactive protein. The examination of lungs respiratory function included spirometry, body plethysmography and assessment of diffusing lung capacity. Results: 29.9% of the subjects with CAD smoked, 40% reported discontinuation of smoking in their histories. Smoking in CAD subjects without the history of bronchopulmonary system comorbidity was associated with a higher level of inflammatory markers (IL-12, IL-1ß, TNF-α, ММР-9 and CRP) than in subjects who ceased to smoke and those who have never smoked. No differences in the levels of inflammatory markers were revealed in subjects who had smoked before and never smoked. Conclusion: Smoking is widespread among CAD subjects. It is associated with a higher level of markers of nonspecific inflammation as compared to subjects who have never smoked before or ceased smoking.

[Evoked Potentials on Faces Presented in Emotional Context].

Ability for face recognition is a key skill for our social behavior. A lot of attention is devoted to investigation of emotional faces and expressions perception, but issue of context influence on face recognition process is not so explored. In the current study subjects had watched emotional film fragment before their EEG were recorded during the task with photos of neutral faces: actors from the film and fillers (actors who didn't appear in the film). Method of event-related potentials were used (ERP). The difference between amplitude of P200 component on faces of culprit and victim was found that may be connect with different subjective rele- vance of stimuli for person, who watched the film. Correlations between personal traits of subjects (anxiety, aggression, animosity) and enhanced amplitude of P200 on face of victim in comparison with filler face also were found. Further investigation of emotional context influence on face perception process is necessary.

Balanced crystalloid compared with balanced colloid solution using a goal-directed haemodynamic algorithm.

BACKGROUND: Controversy exists regarding the optimal i.v. fluids for use with a goal-directed haemodynamic algorithm. METHODS: In a double-blind pilot study, we randomly assigned 50 patients with primary ovarian cancer undergoing cytoreductive surgery to receive either balanced crystalloid or balanced starch (HES, 130/0.4, 6%) solutions up to the dose limit (50 ml kg(-1)). Fluids were administered to optimize stroke volume measured by oesophageal Doppler within a goal-directed haemodynamic algorithm. RESULTS: Baseline subject characteristics were similar in both groups. The balanced HES solution maintained stroke volume (P=0.012) better with administration of less fluid. Subjects in the colloid group reached the dose limits of the study medication less frequently (92% vs 62%, P=0.036) and later (2:26 vs 3:33 h, P=0.006) and also required less transfusion of fresh-frozen plasma units (6.0 vs 3.5 units, P=0.035) compared with the crystalloid group. Intra- and postoperative urine output and perioperative plasma levels of creatinine and neutrophil gelatinase-associated lipocalin as renal injury marker were similar in both groups. No differences in the length of intensive care unit and hospital stay were found. CONCLUSIONS: Using a goal-directed haemodynamic algorithm to optimize stroke volume, a balanced HES solution is associated with better haemodynamic stability and reduced need for fresh-frozen plasma. There were no signs of renal impairment by colloid solutions when fluid administration is targeted to optimize cardiac preload.

[Sialic acids and O-acetyl groups as markers of biological activity of microbial polysaccharides in plague and cholera agents].

AIM: To determine sialic acids and O-acetyl groups content in Yersinia pestis and Vibrio cholerae antigens in order to establish their association with biological activity. MATERIALS AND METHODS: The following antigens of Y. pestis EV NIIEG strain--capsular antigen (F1), major somatic antigen (MSA), lipopolysaccharide (LPS), Pla-protease, allergen pestin PP--as well as O-antigens (O-AG) of V. cholerae serogroups O1 and O139 were used in the study. Sialic acids were identified by the thiobarbituric method, and O-acetyl groups--according to Alicino. Specific polysaccharides in the MSA and O-antigens were detected by the immunodiffusion assay. RESULTS: Sialic acids were found in LPS, Pla-protease, allergen pestin PP, and all cholera O-AG; their absence was demonstrated in MSA and F1. O-acetyl groups were identified in cholera O-AG of both studied serogroups as well as in LPS, Pla-protease, MSA and pestin PP of Y. pestis. Tendency to correlation between O-acetyl groups content in MSA and serological activity titer was observed. CONCLUSION: Sialic acids and O-acetyl groups identified in carbohydrate-containing antigens of Y. pestis and V. cholerae could be characterized as reaction-active markers of pathogenetic mechanisms of cholera and plague infections as well as immunochemical activity of microbial polysaccharides.

[Impact of a pneumonia prevention protocol on the results of treatment in patients in the acute period of stroke].

To evaluate the efficiency of introducing a local protocol for preventing pneumonia in the acute period of stroke, the authors analyzed the results of treating 52 intensive care unit patients who had a higher than 75% pneumonia risk. These patients were divided into 2 groups: a control group (before introduction of the protocol) (n = 25) and a study group (after introduction of the protocol (n = 27). A retrospective analysis showed a significant reduction in the total incidence of pneumonia (56 and 18.5%; p < 0.05), in the incidence of ventilator-associated pneumonia (65/1000 and 19/1000 days of artificial ventilation (AV); p < 0.05), total mortality (48.0 and 14.8%; p < 0.01) and mortality among patients on AV (78.6 and 21.1%; p < 0.005).

[Evaluation of the efficacy and safety of application of the drug cortexin in the complex rehabilitation of verticalization in patients with ischemic stroke in the acute period]. / Otsenka éffektivnosti i bezopasnosti primeneniia lekarstvennogo preparata Korteksin v komplekse reabilitatsionnykh meropriiatii po vertikalizatsii u patsientov s ishemicheskim insul'tom v ostrom periode.

AIM: To evaluate the efficacy and safety of cortexin in the complex of rehabilitation measures for verticalization in patients with ischemic stroke in the acute period. MATERIAL AND METHODS: The study included 90 patients with hemispheric ischemic stroke. Patients of the first group (n=30) received cortexin in a dose of 20 mg per day intramuscularly for 10 days, along with basic therapy during early verticalization. Patients of the second group (n=30) received basic therapy during early verticalization and patients of the third group (n=30) received only basic therapy without verticalization. To assess the severity of condition, NIHSS, modified Rankin scale, the Barthel index, the Rivermead mobility index, MMSE, MOCA were used. To study cardiovascular function in patients, the segmental part of the autonomic nervous system was studied: a test with isometric load, a Valsalva test, a test based on the change in heart rate with slow deep breathing. All studies were conducted before and 10-14 days after treatment. RESULTS AND CONCLUSION: The most complete regression of neurological deficits and manifestations of cardiac autonomic neuropathy during the acute period of ischemic stroke was observed in the group of patients treated with cortexin (20 mg per day for 10 days), along with basic therapy and early verticalization, compared to the groups, which received basic therapy with early verticalization or basic therapy without verticalization.

[Clinical significance of nitric oxide levels in patients with chronic glomerulonephritis].

Nitric oxide (NO) takes an active part in the regulation of the main renal functions, water-salt metabolism, and system arterial pressure. Under pathological conditions, NO plays the leading role in the development and progression of nephrosclerosis. The aim of this study was to evaluate the clinical significance of serum and urine levels of stable NO metabolites in patients with various clinical forms of chronic glomerulonephritis (CGN), as well as CGN patients with chronic renal failure (CRF). Ninety-seven CGN patients, including 56 ones with preserved nitrogen excretion and 41 ones with CRF, were examined. The levels of stable NO metabolites (nitrites and nitrates) in serum and 24-hour urine were measured. The highest serum and urine NO levels were found in patients with nephrotic and hematuric CGN; patients suffering from latent and hypertonic CGN displayed the lowest levels. Patients with CRF had higher serum levels of NO compared with non-CRF patients. A reverse correlation between serum levels of creatinine and NO in patients with CRF was revealed. In CGN patients without CRF, the activity of inflammatory process, observed by high C-reactive protein levels, was associated with elevation of blood and urine levels of NO, while such an association was not found in patients with CRF.

[Stenosis of the carotid artery in women with ischemic stroke and markers of inflammation]. / Stenozy karotidnykh arterii u zhenshchin s ishemicheskim insul'tom i markery vospaleniia.

AIM: To assess the relationship between the severity of stenosis of the carotid arteries, the level of female sex hormones and markers of subclinical inflammation in women with ischemic stroke (IS). MATERIAL AND METHODS: Two hundred and eleven women (mean age 68.9±9.23 years) were examined. A history of cardiovascular disease, previous cardiovascular events, type and subtype of stroke were recorded. Neurological status was assessed using neurological scales. Atherosclerosis was diagnosed by color duplex scanning of brachiocephalic arteries and laboratory testing (estradiol, markers of subclinical inflammation). RESULTS: Carotid artery stenosis of ≥50% was found in 13.3% of patients, less severe stenosis in 36.0%. Stenosis of ≥50% was positively correlated with the level of IL-18, TNF-alpha, and negatively correlated with the level of IL-6, IL-4, and MMSE score. In dynamics, there was a decrease in the level of TNF-alpha in all groups of patients, and an increase in the IL-4 level in women with carotid artery stenosis of ≥50%. CONCLUSION: Study of the influence of markers of subclinical inflammation on the atherosclerosis progression and recurrent disorders of cerebral circulation in women with IS should be continued.

[Laboratory service optimization in the implementation of a complex programme for detection and treatment patients with tuberculosis].

The paper presents a model of laboratory service in implementing a complex program aimed at detecting and treating patients with tuberculosis in the Tomsk Region. Organizational, methodological, and managerial measures to set up bacteriological stations and a main (reference) laboratory for microbiological sputum study in Tomsk, intensification of this work at all clinical-and-diagnostic laboratories of general health care facilities have improved the quality of the whole system detecting bacterial isolators and ensured a close organizational and methodological interaction between the therapeutic-and-diagnostic institutions of the general medical system and tuberculosis-controlling service.

Low rates of recurrence after successful treatment of multidrug-resistant tuberculosis in Tomsk, Russia.

SETTING: Tomsk, Russia, where multidrug-resistant tuberculosis (MDR-TB) is prevalent. OBJECTIVES: To report rates of recurrence following successful treatment of MDR-TB in a program providing individualized treatment regimens designed according to the current global standard of care. DESIGN: A retrospective cohort study of 408 adults successfully treated for pulmonary MDR-TB from 10 September 2000 to 1 November 2004, and followed for up to 6 years post-treatment. We used Poisson regression with generalized estimating equations to assess whether recurrence rates changed significantly with time. RESULTS: We analyzed 399 (97.5%) patients with at least one follow-up visit (15 850 person-months of observation [PMO]). Baseline resistance to second-line drugs was common (65.2%); 398 patients (99.7%) were human immunodeficiency virus (HIV) negative. In the first year of post-treatment follow-up, there were six episodes of recurrence (1.4/1000 PMO, 95%CI 0.5-3.0). After the first post-treatment year, there were 21 episodes of recurrence (1.8/1000 PMO, 95%CI 1.1-2.8). The rate did not change significantly with time. CONCLUSION: Individualized regimens designed according to the current global standard of care achieved low rates of MDR-TB recurrence among non-HIV-infected persons treated in a programmatic setting.

Combined trisomy 1q and monosomy 17p due to translocation t(1;17) in a patient with myelodysplastic syndrome.

A nonconstitutional translocation, t(1;17)(q21;p11), has been observed in bone marrow cells from a young patient with myelodysplastic syndrome during a 4-year period. Cytogenetic findings and some clinical aspects are briefly discussed.

[Correlation of the activity of the key enzymes of glycolysis and respiration in hepatomas with different growth rates]. / Sootnoshenie aktivnosti kliuchevykh fermentov glikoliza i dykhaniia v gepatomakh s razlichnoi skorost'iu rosta.

It is shown that an increase in the activity of glycolysis resulting from the rise of the hepatoma growth rate is accompanied by a decrease in the activity of the pentose-phosphate pathway and respiratory chain. It is supposed that variations in the activity both of different carbohydrate catabolism ways and the respiration with a rise of the hepatoma growth rate reflect changes in the relative content of cells at different phases of the cell cycle.

[Adenosine cyclic-3',5'-monophosphate phosphodiesterase in hepatomas with different growth rates]. / Fosfodiésteraza tsiklicheskogo adenozin-3',5'-monofosfata v gepatomakh s razlichnoi skorost'iu rosta.

The cAMP phosphodiesterase activity in mouse hepatomas 46, 61 and 22A is established to be lower than in the normal liver. Sensitivity of enzymes to inhibitors in tumours is also lower. Dibutyryl-cAMP inhibits the growth of hepatoma 46 and leads to an increase in the functional activity of tumour cells.

[Variability of satellite DNA II and IV in cattle, various representatives of the subfamily Bovinae and their hybrids]. / Izmenchivost' satellitnoi DNK II i IV u krupnogo rogatogo skota, nekotorykh predstavitelei podsemeistva Bovinae i ikh gibridov.

Polymorphism of satellite DNA II and IV was studied in Bos taurus by means of Southern blotting and dot hybridization. Of primary interest is the absence of restriction fragment length polymorphism at the individual and interbreed levels. Differences in the content of satellite II in the genome are demonstrated for animals of the Kholmogorskaya and Yakutian breeds. The specific features of satellite IV organization in the bison, banteng and yak are revealed, allowing the use of the satellite as a specific genetic marker. Superposition of parental organizational types of this class of repeats is detected for the interspecies hybrids yak x cattle, banteng x cattle, and bison x cattle. At the same time, several cases of deviation from classic inheritance of such parental types in the interspecies hybrids were found.

[Paramagnetic properties of hepatic tissues and transplantable hepatomas]. / Paramagnitnye svoistva tkanei pecheni i perevivaemykh gepatom

Paramagnetic properties of frozen samples of normal, fetal and regenerating liver tissues and of a number transplantable hepatomas of different level of differentiation were studied. The results obtained indicate that ESR spectrum character and the concentration of paramagnetic centres in frozen samples of live tissues as well reflect the differentiation level, and the level of tissue functional activity. It is shown of hepatoma 22 taken as an example that tumour growth is accompanied with a change of the content of free radicals and some paramagnetic centres in the tumour and hosts liver. It can be considered as a manifestation of a biophysical shift which characterizes the tumour growth and includes the system effect of the tumour on the organism.

[Preparation and immunochemical properties of monoclonal antibodies to potato ring rot pathogen Corynebacterium sepedonicum]. / Poluchenie i immunokhimicheskie svoistva monoklonal'nykh antitel k vozbuditeliu kol'tsevoi gnili kartofelia Corynebacterium sepedonicum.

Five stable hybridoma lines producing monoclonal antibodies to Corynebacterium sepedonicum were obtained. The specificity of monoclonal antibodies obtained was characterized. Interactions of the antibodies with native cells and antigenic preparations from bacterial cell extracts were studied. The epitope specificity of these antibodies to their recognized antigens and the use of the antibodies in advanced immunodiagnostic assays are discussed.

[Myocardial energy metabolic disorders in emotional-pain stress and the prevention of these disorders by using sodium gamma-oxybutyrate]. / Narusheniia énergeticheskogo metabolizma miokarda pri émotsional'no-bolevom stresse i profilaktika étikh narushenii s pomoshch'iu gamma-oksibutirata natriia.

Marked disorders of energy metabolism in the heart muscle simultaneously with the development of ulcerous lesions of the stomach were revealed in animals which had suffered an emotional-pain stress (EPS). These disorders are displayed in the fact that two hours after EPS, the glycogen reserve in the animal's myocardium diminishes, resynthesis of glycogen and oxidation of the main substrates of the tricarboxylic acid cycle are inhibited, and malate dehydrogenase and possibly other dehydrogenase systems of the mitochondria are partly inactivated. Such decrease in the activity of the metabolic tracts is attended by depression of the force and rate of cardiac contractions revealed on inducing a high rate of contractions. The preliminary administration of sodium gammaoxybutyrate to a considerable extent prevents all the changes in the animal's myocardium occurring due to the effect of EPS.