[FIRES Syndrome in a Preschool Child]. / Sindrom FIRES u doshkol'nika.

Severe epileptic syndromes of childhood are an urgent problem for pediatric neurologists and neuroresuscitators. The article presents a clinical observation of FIRES syndrome in a pediatric patient, which is a form of severe drug-resistant epilepsy in children of preschool and school age, the development of which is caused by hyperthermia, probably associated with herpesvirus (human herpesvirus type 6) infection. The features of the progressive course and the difficulties of diagnostic search are reflected. An empirical approach to etiotropic therapy is described, since the disease manifested itself with respiratory manifestations and fever. The tactic of pathogenetic treatment is described, in which drugs of polyfunctional action, such as Cytoflavin, have a priority, many years of experience in the use of which allows the authors to recommend it as a starting intensive therapy.

[Modern concepts on the pathogenesis of neuroborreliosis]. / Sovremennye predstavleniya o patogeneze neiroborrelioza.

The analysis of publications on the websites PubMed, ClinicalKey, devoted to the pathogenesis of neuroborreliosis (NB), using keywords for search: «pathogenesis of neuroborreliosis¼, «neuroborreliosis in children¼, «pathogenesis of Lyme disease¼, as well as an analysis of the results of the published research results of the staff of the Research Institute of Pediatric Infections, St-Petersburg, Russia is presented. Syndromes of early and late NB are more often observed among the forms without migrating erythema, and their development can be caused by all representatives of the species B. burgdorferi s.l. (B.b.), but more often - B. garinii, since it most effectively suppresses the factors of innate and adaptive immune response, reducing interferon production, phagocytosis and complement synthesis. The cause of immunosuppression with the development of NB may be simultaneous infection with several genovids and borrelia species or pathogens of other infections transmitted by Ixodes ticks, for example, infection with B.b. and tick-borne encephalitis virus. The ability to move along peripheral nerves, the change of surface antigens of the VlsE protein, as well as the formation of atypical cysts and granular forms allows B.b. to affect different structures of the peripheral and central nervous system, avoid an immune response and persist for a long time, causing chronic neuroinfection. Both the B.b. themselves, capable of being outside and inside glial cells and neurons, and inflammatory reactions developing in response to their introduction and associated with the synthesis of cytokines and chemokines and mimicry, cause damage to the vascular endothelium, vasculitis and impaired blood supply to the brain, demyelination, autoimmune inflammation and degeneration, leading to the development of NB syndromes, the spectrum of which varies depending on the duration of neuroinfection. In the development of NB and its outcomes, the following are also important: early initiation of treatment, the effectiveness of antibacterial drugs, the use of immunotropic agents that optimize the patient's immune response to the fight against neuroinfection, as well as the timely use of pathogenetic drugs, such as Cytoflavin, which have a complex effect on the vascular endothelium.

[Possibilities for optimizing the pathogenetic therapy of purulent meningitis in children]. / Vozmozhnosti optimizatsii patogeneticheskoi terapii gnoinykh meningitov u detei.

AIM: To assess an effect of the combined use of Cytoflavin and Sulodexide on the course and outcomes of purulent meningitis in children. MATERIAL AND METHODS: Fifty children with purulent meningitis, aged from 5 to 17 years 11 month, were studied. Thirty patients of the treatment group (n=30; mean age 6,8 ± 2,2 years) received Cytoflavin (0,6 mcg/kg once a day) during 5 days with the following treatment with Sulodexide (250 LSU/day in children 5-12 years, 500 LSU/day in children above 12 years). Patients of the comparison group (n=20), aged 5,9±1,8 years, received standard antibacterial treatment. Duration and persistent of fever, cerebral, meningeal symptoms, the recovery period of CSF, the normalization of the number of desquamated epithelial cells (DEC), D-dimer were estimated. Outcomes of purulent meningitis were assessed using a working scale representing a modification of Rankin's, Fisher's, and Glasgow scales. RESULTS AND CONCLUSION: The combination of drugs reduces the duration of cerebral and meningeal symptoms, leads to the normalization of hematological parameters (the level of leukocytes, desquamous epithelial cells, D-dimer) and improves outcomes.

[Cytoflavin efficacy in the treatment of disseminated encephalomyelitis in children]. / Éffektivnost' tsitoflavina pri disseminirovannykh éntsefalomielitakh u detei.

AIM: To evaluate the efficacy of cytoflavin in the complex therapy of disseminated encephalomyelitis in children. MATERIAL AND METHODS: A blind, placebo - controlled, randomized study was carried out. Thirty-two patients, aged form 1 to 17 years, received cytoflavin from the first day after admission in intravenous drips in 5% glucose solution during 10 days. The control group consisted of 30 children who received a standard infusion therapy. Clinical and laboratory evaluation was carried out on the 11th and 30th days, MRT was performed before hospitalization and on the 30th day. RESULTS AND CONCLUSION: Cytoflavin had a positive effect on the rate of recovery of the majority of neurological symptoms. The average EDSS score decreased by 1.5 times to the 30th day compared with the control group. The complete regression of clinical symptoms and focal changes on MRI on the 30th day was observed in 25% of children of the main group and in 3.3% in the control group (р=0.001). The drug exerted the endothelium protective and antioxidant effects, improved blood rheology and restored the content of circulating endothelial cells, the level of D-dimer and indicators of free radical oxidation to the 30th day of treatment.

Association analysis of ACE, ACTN3 and PPARGC1A gene polymorphisms in two cohorts of European strength and power athletes.

The performance of professional strength and power athletes is influenced, at least partly, by genetic components. The main aim of this study was to investigate individually and in combination the association of ACE (I/D), ACTN3 (R577X) and PPARGC1A (Gly482Ser) gene polymorphisms with strength/power-oriented athletes' status in two cohorts of European athletes. A cohort of European Caucasians from Russia and Lithuania (161 athletes: by groups - weightlifters (87), powerlifters (60), throwers (14); by elite status - 'elite' (104), 'sub-elite' (57); and 1,202 controls) were genotyped for ACE, ACTN3 and PPARGC1A polymorphisms. Genotyping was performed by polymerase chain reaction and/or restriction fragment length polymorphism analysis. Statistically significant differences in ACTN3 (R577X) allele/genotype distribution were not observed in the whole cohort of athletes or between analysed groups separately when compared with controls. The odds ratio for athletes compared to controls of the ACE I/I genotype was 1.71 (95% CI 1.01-2.92) in the Russian cohort and for the ACE I/D genotype it was 2.35 (95% CI 1.10-5.06) in the Lithuanian cohort. The odds ratio of being a powerlifter in PPARGC1A Ser/Ser genotype carriers was 2.11 (95% CI: 1.09-4.09, P = 0.026). The ACTN3 (R577X) polymorphism is not associated with strength/power athletic status in two cohorts of European athletes. The ACE I/I genotype is probably the 'preferable genotype' for Russian athletes and the ACE I/D genotype for Lithuanian strength/power athletes. We found that the PPARGC1A (Gly482Ser) polymorphism is associated with strength/power athlete status. Specifically, the PPARGC1A Ser/Ser genotype is more favourable for powerlifters compared to controls.

Cancer of the vulva: modern methods of diagnostics and surgical treatment.

Over the last 15 years in the Novgorod Region the incidence of cancer of the vulva, with some fluctuations, increased almost 3 times and had a definite tendency to increase including HRV positive variants in younger persons. It was found that the use of new technologies in particular cryoapplication and expanded surgery with subsequent reconstructive plastic for cancer of the vulva, allowed reducing blood loss and the death rate to 0.58 per lOO thousand of female population.

[Modifying effect of physical activity on genetic predisposition to obesity].

AIM: To evaluate the modifying effect of physical activity on the association of ADRB3, CLOCK, FABP2, FTO, PPARA, PPARD, PPARG, PPARGC1A, SHBG, UCP2 and UCP3 gene polymorphisms with body mass index (BMI), body fat mass, and risk of obesity. SUBJECTS AND METHODS: The investigation enrolled 582 students and 215 athletes who showed moderate and high physical activities, respectively. The students' body composition was estimated with a DIAMANT-AST bioimpedance analyzer. Gene polymorphisms were determined by polymerase chain reaction (PCR) or real-time PCR. RESULTS: No differences in the rate of obesity risk alleles were found between normal-weight, and overweight or obese students. Correlation analysis in the total group of students revealed an association of the A allele of the FTO gene with BMI (p=0.0011) and body fat mass (p=0.0031). Comprehensive analysis summarizing the total number of obesity risk alleles for 7 polymorphisms of the PPARA, PPARD, PPARG, PPARGCIA, FTO, FABP2, and UCP2) genes in each individual showed that a subgroup of male students having a large number of obesity risk alleles (4-9) had higher BMI (22.6 ± 2.73 kg/m2) than that of students having a small number of obesity risk alleles (20.8 ± 2.81 kg/m2; p=0.0209). This pattern was not observed in the group of athletes regardless of gender and sports specialization. CONCLUSION: This investigation has demonstrated that physical activity has modifying effects on individuals who are genetically predisposed to obesity. Moderate and high physical activity considerably reduces the risk of obesity even in the presence of genetic risk factors.

[Cytoflavin in the complex treatment of neuroinfections in children].

The results of using cytoflavin in the complex treatment of bacterial purulent meningitis and viral encephalitis in 60 children, aged from 1 month to 18 years, are presented. Clinical efficacy of the drug revealed by the decrease in the frequency of residual presentations and reduction of recovery time was demonstrated. The drug had an effect on the endothelial dysfunction, rheologic blood properties, coagulation blood system as a whole and vascular tone as well. Cytoflavin can be recommended in complex pathogenetic treatment of neuroinfections in children.

[The microlocalization of natural uranium in bone tissue]. / Mikrolokalizatsiia estestvennogo urana v kostnoi tkani.

The author experimentally confirms the presence of a large share of uranium within the organic matrix of bone tissue and its uniform distribution within the bone mineral. It was shown in the powder-typed stratum bone cuts that the bone uranium is uniformly distributed within the bone mineral. The same is with the organic fraction of bone where uranium is uniformly distributed as well. This conclusion simplifies the calculation of the dose rate of irradiation of bone cells and red bone marrow cells with alpha-particles from the incorporated uranium, the event that these cells are plunged into a "cloud" of alpha-particles being proposed.

[Natural distribution of uranium in skeletal bones and bone tissue fractions]. / Estestvennoe raspredelenie urana po kostiam skeleta i fraktsiiam kostnoi tkani.

It was shown that uranium is deposited in the mineral and the organic matrix of bones, and approximately 50% of uranium is bound with the latter. In the bone mineral, uranium is deposited not on the surface of hydroxyl apatite crystals but distributed uniformly within them.