The Comparison of Methods for Bone Reconstruction in the Anterior Wall of the Maxillary Sinus (an Experimental Study).

The aim of the study was to compare various methods used for the bone reconstruction in the anterior wall of the maxillary sinus during sinus lift surgery; in addition, we aimed to study the effect of maxillary sinus membrane perforation on the healing process. Materials and Methods: The experiments were carried out using the North Caucasian sheep. Maxillary sinus lift surgery was performed on the animals under general anesthesia. The skin and muscle fascia were dissected layer-by-layer providing the optimal conditions for bone preparation; then, three bone windows were made on each side of the head. Two windows were sawn out with a spherical bur, the third window - with a hollow bur and part of the anterior wall was taken out. On one side, the mucous membrane of the maxillary sinus was pulled and perforated; on the other side, the sinus lift was performed with no membrane perforation. On each side, one window was left uncovered, the second was closed with a collagen membrane, and the third was closed with a bone cover. After 30 and 60 days, the sheep were taken out of the experiment in groups of three; samples were collected from the operated areas and examined using computed microtomography and histology. Results: According to the histological study, the bone repair process developed normally regardless of the surgery technique. The process started with the appearance of granulation tissue and connective tissue cords; in the final stages, cellular differentiation, pronounced osteoblastic activity, and inter-beam formation were seen.The most active regeneration was observed in the areas where the bone defects were closed with a collagen membrane, and especially in the windows made with no perforation of the maxillary sinus membrane. The microtomographic and histological tests proved that perforation of the mucous membrane during the sinus lift operation impaired bone tissue regeneration. Conclusion: The obtained results suggest that the most promising way to close a bone defect in the anterior wall of the maxillary sinus is the use of a collagen membrane; therefore, we recommend choosing this approach for sinus lift surgery.

Scaffolds Based on Poly(3-Hydroxybutyrate) and Its Copolymers for Bone Tissue Engineering (Review).

Biodegradable and biocompatible polymers are actively used in tissue engineering to manufacture scaffolds. Biomedical properties of polymer scaffolds depend on the physical and chemical characteristics and biodegradation kinetics of the polymer material, 3D microstructure and topography of the scaffold surface, as well as availability of minerals, medicinal agents, and growth factors loaded into the scaffold. However, in addition to the above, the intrinsic biological activity of the polymer and its biodegradation products can also become evident. This review provides studies demonstrating that scaffolds made of poly(3-hydroxybutyrate) (PHB) and its copolymers have their own biological activity, and namely, osteoinductive properties. PHB can induce differentiation of mesenchymal stem cells in the osteogenic direction in vitro and stimulates bone tissue regeneration during the simulation of critical and non-critical bone defects in vivo.

Genetic Diversity of Cattle Bred in Territory of the Tyumen Region, Russia.

Improving the genetic potential of animals using genomic technologies is an effective way to solve problems in domestic breeding of dairy breeds. The aim of the current study is to analyze the genetic diversity of Holstein cattle bred in the Tyumen Region using microsatellite markers. The blood samples of 241 Holstein cow were collected for genomic analysis. Genetic identification was performed using COrDIS kits. The resulting data indicated the presence of genetic diversity in the studied sample of dairy cattle bred at the Tyumen Region for a number of indicators. The number of alleles at 15 microsatellite loci in the tested breeds varied from 5 to 14. Eighteen unique allelic variants can be breed-specific markers for genetic identification of dairy cattle. The recorded data showed a high level of animal genetic variability. A high level of polymorphism (Ае 3.32) was detected in 47% of the loci under research. High values of the observed heterozygosity up to 0.91 at the Eth3 locus and of the polymorphism up to 0.77 at the Tgla53 locus were detected. In the results, 7% erroneous entries in the progeny pedigree was detected. The results of the current study contribute to the knowledge of genetic diversity of dairy cattle in the Tyumen region, Russia, and also paved the way to seek new relationships between allelic variants of microsatellite loci with the productive traits of animals.

Determination of adenine nucleotides by the modified method of high-performance liquid chromatography.

Adenine nucleotides (ATP, ADP and AMP) play a central role in the regulation of metabolism and energy: they provide the energy balance of the cell, determine its redox state, act as allosteric effectors of a number of enzymes, modulate signaling and transcription factors and activate oxidation or biosynthesis substrates. A large number of methods have been developed to determine the level of ATP, ADP and AMP, but the most universal and effective method for the separation and analysis of complex mixtures is the reversed-phase high-performance liquid chromatography method (RP-HPLC). The aim of this study is to determine the optimal conditions for the qualitative separation and quantitative determination of standard solutions of ATP (1 mmol/l), ADP (0,5 mmol/l) and AMP (0,1 mmol/l) by RP-HPLC. The degree of separation of adenine nucleotides was estimated by the time of peak output in the chromatogram. To achieve the goal, the following tasks were set: assess the effect of the temperature of the analysis on the separation and change of the release time of the analytes in the chromatogram; determine the most optimal composition of the mobile phase for the separation of ATP, ADP and AMP in the chromatogram (the content of the organic solvent in the solution); to identify the effect of pH of the mobile phase on the separation of standard solutions of adenine nucleotides; set the optimal molarity of the mobile phase for the separation of ATP, ADP and AMP in the chromatogram. It was found that the temperature of the analysis does not affect the quality of peak separation, while the composition and pH of the mobile phase have a significant effect on the complete and clear separation of the studied nucleotides in the chromatogram. It was determined that the analysis temperature of 37°C and the mobile phase of 0.05 M KH2PO4 (pH 6.0) are optimal for separating the peaks of adenine nucleotides.

[Clinical observation experience of a pediatric patient with primary progressive multiple sclerosis in the Moscow office for the treatment of children and adolescents with multiple sclerosis]. / Opyt kuratsii pediatricheskogo patsienta s pervichno-progressiruyushchim rasseyannym sklerozom v usloviyakh kabineta po lecheniyu detei i podrostkov s rasseyannym sklerozom Departamenta zdravookhraneniya goroda Moskvy.

OBJECTIVE: To demonstrate the experience of a personalized approach to the treatment of pediatric patients with multiple sclerosis using the example of the Moscow patient population. MATERIALS AND METHODS: The authors describe the clinical follow-up of 79 pediatric patients with demyelinating diseases of the nervous system during 2019, including 39 patients with multiple sclerosis, including one patient with a primary progressive course of the disease (clinical case). RESULTS: The experience of the Moscow office for the treatment of multiple sclerosis in children and adolescents demonstrates the effectiveness of the personalized approach to the treatment of pediatric cases confirmed by the case report of biological therapy by recombinant humanized monoclonal antibody directed against CD20-expressing B-cells for early treatment of the adolescent patient with primary progressive multiple sclerosis. CONCLUSION: The identification of patient's groups with different levels of disease activity and different risks of disability progression is highly relevant in the pediatric population of patients with multiple sclerosis, especially in the context of expanding therapeutic opportunities.

[The efficacy of active physical exercises in comprehensive cognitive rehabilitation of pediatric and adult patients with multiple sclerosis]. / Effektivnost' aktivnykh fizicheskikh uprazhnenii v kompleksnoi kognitivnoi reabilitatsii vzroslykh i detei s rasseyannym sklerozom.

Cognitive dysfunction in multiple sclerosis (MS) is a disabling factor and extends to the processes of memory, attention, verbal and logical thinking, visual-spatial, and motor skills. 40-70% of patients have a decrease in the rate of information processing, dysfunction of executive functions, and decrease in the quality of training. Cognitive dysfunction is also often reduced quality of life with MS. The most common methods of non-drug cognitive function correction are cognitive rehabilitation and exercise. This article reviews current research on the positive effects of regular physical activity on the cognitive functions of adults and children with MS.

[Vitamin D and pregnancy: current state of the problem in the central regions of the Russian Federation].

BACKGROUND: It has been proven that vitamin D plays an important role in pregnancy. Deficiency of this element may be associated with the risk of developing gestational diabetes mellitus, preeclampsia, placentar insufficiency, low birth weight and premature birth. AIMS: To conduct an epidemiological analysis of vitamin D supply in women at different stages of pregnancy, living in Russia. MATERIALS AND METHODS: We included 1198 pregnant women living in 3 regions of Russia in the observational, multicenter, cross-sectional, continuous study. All pregnant women were tested for serum 25(OH)D levels. We collected biomaterial from August 2018 to December 2019. The end point of the study was the indicator of vitamin D supply in pregnant women and its level depending on the trimester of pregnancy and region of Russia. Statistical analysis included counting and grouping according to vitamin D levels, and calculating the median vitamin D concentration in each region. RESULTS: We confirmed vitamin D deficiency in all regions. The optimum level of this element is present in less than 7% of women. Insufficiency of this element is present in 20,62% of all women. The largest percentage of them is in a deficit of this element - 46,66%. We found that the lowest rates are in Smolensk, where the median was 12,75 ng/ml. In addition, we found changes in vitamin D concentration: with an increase in gestational age revealed a decrease in its level. CONCLUSIONS: In our study, we confirmed the presence of a 25(OH)D deficiency in most of the examined pregnant women, which is consistent with international epidemiological data. We should remember about these both at the stage of pre-gravid preparation and at the stage of pregnancy itself in order to achieve the optimal level of vitamin D.

[The efficacy of alimemazine (solution for intramuscular injection) in complex with antidepressants in the treatment of anxiety and depressive disorders]. / Otsenka éffektivnosti preparata Alimemazin (rastvor dlia vnutrimyshechnogo vvedeniia) v lechenii trevozhno-depressivnykh rasstroistv.

AIM: To evaluate the efficacy of alimemazine in the form of a solution for intramuscular injections in the treatment of anxiety and depressive disorders. MATERIAL AND METHODS: Twenty patients, who met ICD-10 criteria for anxiety and depressive disorders, participated in the clinical observation. Alimemazine was used in the form of a solution for intramuscular injection (5 mg/ml) along with SSRIs and SNRIs. RESULTS: The significant positive dynamics in the reduction of anxiety-depressive disorders, sleep disorders and vegetative symptoms was observed in patients treated with alimemazine (solution) and antidepressants from the group of SSRIs and SSRIs. CONCLUSION: The drug has demonstrated efficacy and a favorable tolerability profile.

Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes.

BACKGROUND: Patients undergoing amputation of the lower extremity for the complications of peripheral artery disease and/or diabetes are at risk of treatment failure and the need for reamputation at a higher level. The aim of this study was to develop a patient-specific reamputation risk prediction model. METHODS: Patients with incident unilateral transmetatarsal, transtibial or transfemoral amputation between 2004 and 2014 secondary to diabetes and/or peripheral artery disease, and who survived 12 months after amputation, were identified using Veterans Health Administration databases. Procedure codes and natural language processing were used to define subsequent ipsilateral reamputation at the same or higher level. Stepdown logistic regression was used to develop the prediction model. It was then evaluated for calibration and discrimination by evaluating the goodness of fit, area under the receiver operating characteristic curve (AUC) and discrimination slope. RESULTS: Some 5260 patients were identified, of whom 1283 (24·4 per cent) underwent ipsilateral reamputation in the 12 months after initial amputation. Crude reamputation risks were 40·3, 25·9 and 9·7 per cent in the transmetatarsal, transtibial and transfemoral groups respectively. The final prediction model included 11 predictors (amputation level, sex, smoking, alcohol, rest pain, use of outpatient anticoagulants, diabetes, chronic obstructive pulmonary disease, white blood cell count, kidney failure and previous revascularization), along with four interaction terms. Evaluation of the prediction characteristics indicated good model calibration with goodness-of-fit testing, good discrimination (AUC 0·72) and a discrimination slope of 11·2 per cent. CONCLUSION: A prediction model was developed to calculate individual risk of primary healing failure and the need for reamputation surgery at each amputation level. This model may assist clinical decision-making regarding amputation-level selection.

Mortality prediction following non-traumatic amputation of the lower extremity.

BACKGROUND: Patients who undergo lower extremity amputation secondary to the complications of diabetes or peripheral artery disease have poor long-term survival. Providing patients and surgeons with individual-patient, rather than population, survival estimates provides them with important information to make individualized treatment decisions. METHODS: Patients with peripheral artery disease and/or diabetes undergoing their first unilateral transmetatarsal, transtibial or transfemoral amputation were identified in the Veterans Affairs Surgical Quality Improvement Program (VASQIP) database. Stepdown logistic regression was used to develop a 1-year mortality risk prediction model from a list of 33 candidate predictors using data from three of five Department of Veterans Affairs national geographical regions. External geographical validation was performed using data from the remaining two regions. Calibration and discrimination were assessed in the development and validation samples. RESULTS: The development sample included 5028 patients and the validation sample 2140. The final mortality prediction model (AMPREDICT-Mortality) included amputation level, age, BMI, race, functional status, congestive heart failure, dialysis, blood urea nitrogen level, and white blood cell and platelet counts. The model fit in the validation sample was good. The area under the receiver operating characteristic (ROC) curve for the validation sample was 0·76 and Cox calibration regression indicated excellent calibration (slope 0·96, 95 per cent c.i. 0·85 to 1·06; intercept 0·02, 95 per cent c.i. -0·12 to 0·17). Given the external validation characteristics, the development and validation samples were combined, giving a total sample of 7168. CONCLUSION: The AMPREDICT-Mortality prediction model is a validated parsimonious model that can be used to inform the 1-year mortality risk following non-traumatic lower extremity amputation of patients with peripheral artery disease or diabetes.

The Priming of Potato Plants Induced by Brassinosteroids Reduces Oxidative Stress and Increases Salt Tolerance.

This is the first study to show that brief pretreatment of potato plants with two brassinosteroids differing in structure causes in plants the ability to react to delayed salt stress by accumulation of compounds with antioxidant activity and by increased salt tolerance.

[Features of changes in levels of humoral factors regulating the system of hemostasis, in the late stages of pregnancy.]

The influence of humoral factors on the state of hemostasis in nonpregnant and pregnant women. There were 70 women aged from 22 to 32 years, of which the 1st group consisted of 50 patients with physiological pregnancy at term gestation 38-40 weeks, the 2nd group - 20 healthy non-pregnant women. All women was measured in the plasma levels of e-NOS, cGMP, PF4, ß-TG, adrenaline and noradrenaline by ELISA, in serum NOx, indicators of gemostaziogramma. The results showed a significant decrease in the blood e-NOS, NOx, cGMP, PF4, as well as increased levels of adrenaline and noradrenaline in the blood of pregnant women in 38-40 weeks of gestation in comparison with nonpregnant women.

Epidemiology of inflammatory bowel disease among participants of the Millennium Cohort: incidence, deployment-related risk factors, and antecedent episodes of infectious gastroenteritis.

BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC) are two pathotypes of inflammatory bowel disease (IBD) with unique pathology, risk factors and significant morbidity. AIM: To estimate incidence and identify IBD risk factors in a US military population, a healthy subset of the US population, using information from the Millennium Cohort Study. METHODS: Incident IBD was identified from medical encounters from 2001 to 2009 or by self-report. Our primary risk factor of interest, infectious gastroenteritis, was identified from medical encounters and self-reported post-deployment health assessments. Other potential risk factors were assessed using self-reported survey responses and military personnel files. Hazard ratios were estimated using Cox proportional hazards analysis. RESULTS: We estimated 23.2 and 21.9 diagnoses per 100 000 person-years, respectively, for CD and UC. For CD, significant risk factors included [adjusted hazard ratio (aHR), 95% confidence interval]: current smoking (aHR: 2.7, 1.4-5.1), two life stressors (aHR: 2.8, 1.4-5.6) and prior irritable bowel syndrome (aHR: 4.7, 1.5-15.2). There was no significant association with prior infectious gastroenteritis. There was an apparent dose-response relationship between UC risk and an increasing number of life stressors. In addition, antecedent infectious gastroenteritis was associated with almost a three-fold increase in UC risk (aHR: 2.9, 1.4-6.0). Moderate alcohol consumption (aHR: 0.4, 0.2-0.6) was associated with lower UC risk. CONCLUSIONS: Stressful conditions and the high risk of infectious gastroenteritis in deployment operations may play a role in the development of IBD in military populations. However, observed differences in risk factors for UC and CD warrant further investigation.

[Annual blood pressure dynamics and weather sensitivity in women]. / Godovaia dinamika arterial'nogo davleniia i meteochuvstvitel'nost' u zhenshchin.

AIM: To study the annual cycle of blood pressure (BP) and weather sensitivity in normotensive women aged 20-59 years. SUBJECTS AND METHODS: The same group of 25 non-smoking women who had been living in the European North of Russia (62° N, 51° E) almost since their birth and were engaged in moderate-intensity mental labor was daily examined. During a year, there were 11823 blood pressure measurements using the Korotkoff technique; heart rate was calculated by palpation. These meteorological parameters were taken at the websites: http://meteo.infospace.ru and ftp://ftp.ngdc.noaa.gov/stp/geomagnetic_data/indices/kp_ap. The statistical significance of differences in the indicators was determined using the Fisher's test and the Newman-Keuls test. The study used a correlation analysis with the calculation of the Spearman's rank correlation coefficient. RESULTS: The maximum systolic and diastolic BP values were revealed in February and January, respectively. The minimum values of systolic BP were detected in July; those of diastolic BP were in August. An individual-based analysis of sensitivity to environmental variations showed that about 88% of the women responded to atmospheric temperature; nearly 44% did to geomagnetic activity; almost 24% were sensitive to relative air humidity, and about 16% of the women were to atmospheric pressure. CONCLUSION: The dynamics of systolic and diastolic BP in the annual cycle of women depends on meteorological factors and suggests that there is a change in the priorities of its control in different periods of a year.

[Medical terminology. Blepharorhaphy]. / O meditsinskoi terminologii. Blefarorafiya.

Ophthalmic literature currently lacks definiteness in classifying surgeries aimed at eyelid closure. In Western countries the term tarsorrhaphy is most commonly used, while in Russia another term - blepharorhaphy - is widely accepted. The latter seems more appropriate as the sutures are passed through all palpebral layers, not just the cartilage. It has also been suggested that temporary blepharorhaphy, which implies that we use only sutures to bring the eyelids together, and therefore, the procedure cannot be permanent, should be called simple blepharorhaphy. As to a procedure (temporary or permanent), of which the goal is ankyloblepharon, it is recommended to be called ankylosing blepharorhaphy, instead of permanent. CONCLUSION: Blepharorhaphy is a more appropriate name for eyelid closure surgery than tarsorrhaphy. Blepharorhaphy can be simple or ankylosing and only the latter can be either temporary or permanent. The authors suggest reconsidering classification of this type of surgical procedures.

Longitudinal Associations Among Posttraumatic Stress Disorder, Disordered Eating, and Weight Gain in Military Men and Women.

Obesity is a major health problem in the United States and a growing concern among members of the military. Posttraumatic stress disorder (PTSD) has been associated with overweight and obesity and may increase the risk of those conditions among military service members. Disordered eating behaviors have also been associated with PTSD and weight gain. However, eating disorders remain understudied in military samples. We investigated longitudinal associations among PTSD, disordered eating, and weight gain in the Millennium Cohort Study, which includes a nationally representative sample of male (n = 27,741) and female (n = 6,196) service members. PTSD at baseline (time 1; 2001-2003) was associated with disordered eating behaviors at time 2 (2004-2006), as well as weight change from time 2 to time 3 (2007-2008). Structural equation modeling results revealed that the association between PTSD and weight change from time 2 to time 3 was mediated by disordered eating symptoms. The association between PTSD and weight gain resulting from compensatory behaviors (vomiting, laxative use, fasting, overexercise) was significant for white participants only and for men but not women. PTSD was both directly and indirectly (through disordered eating) associated with weight change. These results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military service members.

[About the formation of legislation in the field of chemical and biological safety of the Russian Federation].

The realization of the package of measures directed at the consecutive decrease of the negative effect of hazardous chemical and biological factors on the population and environment to the acceptable risk level stipulates the development of standard legal regulation in the field of ensuring the chemical and biological safety. For this purpose article presents substantiation and conceptual approaches to the creation of legislation in the field of the chemical and biological security of the Russian Federation within the pursued state policy. In determination of conceptual approaches, in the article there are reported: the main idea, the purpose, a subject of legal regulation, the circle of people who will be subjected to the laws, the place offuture laws in the system of current legislation, the provisions of the Constitution of the Russian Federation, the Federal backbone laws of the Russian Federation to realization of which laws are directed, there is given the general characteristic and an assessment of a condition of legal regulation in this field, results of the analysis of the information on the need for correspondence of Russian laws to provision of international treaties, concerning prohibitions of the biological and chemical weapon, safe handling with biological agents and chemicals, and also the development of uniform procedures of ensuring chemical and biological safety. The major aspect in the shaping of the legislation is the global character ofproblems of chemical and biological safety in this connection in article there is indicated the need of rapprochement of rules of law for this area with partners in economic cooperation and integration. Taking into account an orientation of future laws on the decrease in the level of the negative impact of dangerous chemical and biological factors on the population and environment, there are designated medical, social, economic and political consequences of their implementation. There are presented the proposed structure for bills: "About biological safety", "On Chemical Safety" and "On the National collection of pathogens.

Interventions in the management of infection in the foot in diabetes: a systematic review.

The expert panel on diabetic foot infection (DFI) of the International Working Group on the Diabetic Foot conducted a systematic review seeking all published reports relating to any type of treatment for infection of the foot in persons with diabetes published as of 30 June 2014. This review, conducted with both PubMed and EMBASE, was used to update an earlier one undertaken on 30 June 2010 using the same search string. Eligible publications included those that had outcome measures reported for both a treated and a control population that were managed either at the same time, or as part of a before-and-after case design. We did not include studies that contained only information related to definition or diagnosis, but not treatment, of DFI. The current search identified just seven new articles meeting our criteria that were published since the 33 identified with the previous search, making a total of 40 articles from the world literature. The identified articles included 37 randomised controlled trials (RCTs) and three cohort studies with concurrent controls, and included studies on the use of surgical procedures, topical antiseptics, negative pressure wound therapy and hyperbaric oxygen. Among the studies were 15 RCTs that compared outcomes of treatment with new antibiotic preparations compared with a conventional therapy in the management of skin and soft tissue infection. In addition, 10 RCTs and 1 cohort study compared different treatments for osteomyelitis in the diabetic foot. Results of comparisons of different antibiotic regimens generally demonstrated that newly introduced antibiotic regimens appeared to be as effective as conventional therapy (and also more cost-effective in one study), but one study failed to demonstrate non-inferiority of a new antibiotic compared with that of a standard agent. Overall, the available literature was both limited in both the number of studies and the quality of their design. Thus, our systematic review revealed little evidence upon which to make recommendations for treatment of DFIs. There is a great need for further well-designed trials that will provide robust data upon which to make decisions about the most appropriate treatment of both skin and soft tissue infection and osteomyelitis in diabetic patients.

[En face' optical coherence tomography guided focal navigated laser photocoagulation]. / Fokal'naia navigatsionnaia lazernaia koaguliatsiia setchatki s pomoshch'iu OKT-kartirovaniia.

Aim - to prove the feasibility of focal navigated laser photocoagulation (LP) for central serous chorioretinopathy (CSC) that relies only on the data provided by optical coherence tomography (OCT) without considering fluorescein angiography (FA). MATERIAL AND METHODS: Two patients with CSC were treated with focal navigated LP (NAVILAS laser system) basing on macular OCT findings (RTVue 100). Before the procedure, FA was not performed. RESULTS: In both cases the leaking point was recognized by a solitary focal detachment of the pigment epithelium in 'en face' OCT scans. OCT images were then imported into the laser photocoagulator unit and superimposed on the basic image of the fundus, thus, enabling accurate focal LP. In both cases the serous retinal detachment resolved completely within 9-14 days. CONCLUSION: In some CSC patients, 'en face' OCT data allow focal navigated laser photocoagulation without prior fluorescein angiography.