Li4GeO4-Li2CaGeО4 phase equilibria and Li2+xCa1-xGeO4 solid solutions.

Detailed studies of the Li4GeО4-Li2CaGeО4 system by solid-phase syntheses of various compositions from pure Li4GeО4 to pure Li2CaGeО4 in the temperature range from 25 to 1125 °C is investigated for a first time. Solid state synthesis powders are characterized by X-ray and DSC/TG methods. Concentration and temperature two-phase regions of Li4GeО4 and Li2CaGeО4 as well as two-phase regions of Li2CaGeО4 and Li2+2xCa1-xGeO4 are established. Region of pure Li2+2xCa1-xGeO4 solid solution are detected too and it structure is investigated. Being structural analog to Li2+2xZn1-xGeO4 and Li2+2xMg1-xGeO4, Li2+2xCa1-xGeO4 has own specific local environment of the metal ions. The obtained results are compared with those for Li4GeО4-Li2ZnGeО4 system and for Li2+2xZn1-xGeO4 solid solution. The differences of the phase diagrams and structural features of the solid solutions are discussed.

Acute Management of Deep Periorbital Burns: A 10-Year Review of Experience.

Deep periorbital burns are an important issue mainly due to the presence of the eyes in the region, and the crucial importance of preservation of vision. There is no consensus regarding their treatment. A retrospective analysis of the treatment and outcome of 446 patients with deep burns of the periorbital region admitted to the Department of Burns and Plastic Surgery of St George's University Hospital in Plovdiv, Bulgaria over 10 years was conducted. The study covers 446 patients, 162 female (36.5%) and 284 male (63.5%) aged from 5 months to 92 years. Deep periorbital burns accounted for 74.8% of hospitalized deep facial burns. Most frequent burn agents were hot liquids and flames. The mean total body surface area affected was 19.6% (min 0.5%, max 80.0%). Concomitant ocular pathology was diagnosed in 14% (n=63) of the patients. An early, staged and precise surgical approach was preferred, aimed at fast wound closure without sacrificing survived tissues. Follow up time ranged from 3 months to 5 years, median 37 months. Late ocular sequelae occurred in 7.4% (n=33) of the patients. There was no incidence of secondary corneal perforation or definitive loss of vision. Timely and adequate treatment during the acute period can minimize initial damage and late sequelae. Favor is given to the early, balanced surgical approach aimed at rapid wound closure between day 2 and 10 post burn. Preservation of vision is a determining factor for the significance of trauma and the effectiveness of treatment.

La gravité des brûlures péri- orbitaires profondes tient à la nécessité de préserver la vision. Il n'existe pas de consensus quant à leur prise en charge. Nous avons revu les dossiers de 446 patients victimes de brûlure péri- orbitaire profonde traités dans le CTB du CHU St Georges de Plovdiv (Bulgarie) sur une période de 10 ans. On comptait 284 hommes (63,5%) et 162 femmes (36,5%) âgés de 5 mois à 92 ans. Un atteinte péri- orbitaire était présente dans 74,8% des brûlures faciales profondes dans le cadre d'une brûlure touchant en moyenne 19,6% SCT (0,5 à 80%), dues dans la plupart des cas à une flamme ou à un ébouillantement. Une atteinte oculaire était objectivée dans 14% des cas (63 patients). Une excision précoce et soigneuse, visant à recouvrir les lésions tout en préservant le maximum de tissu était la stratégie habituelle. La durée de suivi médiane était de 37 mois (3 mois à 5 ans). Trente- trois patients (7,4%) ont souffert de séquelles oculaires, sans toutefois de perforation cornéenne ni perte de vision. Un traitement adapté techniquement et temporellement permet de limiter les dégâts initiaux et la survenue de séquelles. Nous préconisons une première intervention chirurgicale entre J2 et J10, la préservation de la fonction visuelle étant le marqueur d'une prise en charge adaptée.

Anti-Inflammatory Effect of Technologically Processed Antibodies to the Molecules of the Major Histocompatibility Complex in a Model of Acute Inflammation In Vivo.

The anti-inflammatory effect of technologically processed antibodies (TPA) to immune targets (MHC I and MHC II) was assessed in the carrageenan-induced rat paw edema model. The parameters "increase in edema" and "suppression of edema" significantly decreased (p<0.05) against the background of treatment with TPA and the reference drug indomethacin compared to the placebo group. The tested TPA produced an anti-inflammatory effect.

[Sexual dysfunction on the background of antidepressant therapy]. / Seksual'nye disfunktsii na fone antidepressivnoi terapii.

The review is devoted to the problem of sexual dysfunction caused by taking antidepressants. Sexual dysfunction is widespread, but it is not reported, and its impact on the quality of life and compliance of patients is underestimated. Partly because of its bidirectional association with depression, sexual dysfunction is difficult to diagnose. Possible mechanisms and risk factors associated with sexual dysfunction in patients with depression are considered. The data on the frequency of sexual dysfunction with the use of various antidepressants are given. Therapeutic strategies for sexual dysfunction associated with taking antidepressants are described. The advantages of agomelatin as an antidepressant associated with a low risk of sexual side effects are emphasized.

Antiallergic Effects of Technologically Processed Antibodies to MHC II.

The risk of developing anaphylactic reactions to medications introduces additional difficulties for effective pharmacotherapy. Using a model of systemic anaphylaxis in mice, we showed that preventive administration of a preparation containing technologically processed antibodies (TPA) to MHC II induces an anti-anaphylactic effect comparable to that of dexamethasone (when assessing the severity of systemic anaphylaxis 30 and 60 min after challenge injection of the model antigen ovalbumin). The revealed activity may be related to the ability of TPA to MHC II to regulate the antigen presentation system and shift the immune response towards the production of IgG instead of IgE typical of anaphylactic reaction.

Efficacy of Raphamin against Pneumococcal Infection: a Preclinical Study.

The aim of the study was to evaluate the activity of Raphamin in a model of non-lethal pneumococcal infection caused by Streptococcus pneumoniae 3 in BALB/c mice. The drug or placebo was administered intragastrically 3 days prior to infection, 2 h before and 2 h post infection, and then for 3 full days, alone or in combination with antibiotic (amoxicil-lin/clavulanic acid). Raphamin monotherapy significantly decreased bacterial load in the lungs in comparison with placebo (p<0.05) which was comparable to the effect in antibiotic alone or combined with Raphamin. Raphamin prevented reproduction of Streptococcus pneumoniae in the lower respiratory tract and its combination with the antibiotic was safe and did not reduce the efficacy of amoxicillin/clavulanic acid.

[Prescription of psychotropic drugs off label]. / Naznachenie psikhotropnykh preparatov vne zaregistrirovannykh pokazanii.

The review was written based on the analysis of available publications (Pubmed, other Internet resources) on the problem of off-label use of drugs. It reveals the concept of off-label prescribing and discusses modern approaches to the use of off-label drugs in domestic psychiatric and addiction practice. The problems of normative substantiation of prescribing off-label drugs are discussed. It has been established that, despite some progress in this matter, for patients in adult psychiatric practice, the use of off-label therapy is carried out only by decision of the medical commission. The issue of substantiating the prescription of off-label drugs on the basis of scientific and clinical studies and experience in the use of drugs at the legislative level remains relevant.

Combined Drug with Antibacterial Effect Supports the Normal Intestinal Microflora.

Widespread use of antibiotics leads to an imbalance of normal intestinal microflora and to the development of multidrug resistance. The problem can be solved by administration of the antibiotics in combination with the drugs that have an immunotropic effect. We studied the effect of the drug containing technologically processed affinity purified antibodies to IFNγ, CD4 receptor, ß2-microglobulin of MHC class I, and ß2-domain of MHC II combined with antibiotics on the composition of intestinal microflora of pigs and the total number of microbiome resistance genes. Using the methods of NGS sequencing and quantitative PCR, we found that the drug contributes to the maintenance of normal microflora and, consequently, to the symbiotic relationship of the host with microflora, and prevents the reproduction of pathogenic bacterial species. Analysis for the presence of the resistance genes of gastrointestinal microorganisms showed that the drug does not affect the qualitative and quantitative composition of these genes of the intestinal microbiome.

[Molecular genetics in diagnosis of Coats disease: combination of oligogenic variants associated with different forms of hereditary retinal dystrophy]. / Molekulyarno-geneticheskie nakhodki pri diagnostike bolezni Koatsa: sochetanie oligolokusnykh izmenenii, svyazannykh s raznymi nozologicheskimi formami nasledstvennoi retinopatii.

Coats disease (OMIM 300216) is a form of hereditary retinal dystrophy, which occurs due to congenital abnormality of retinal vessels and features unilateral exudative vitreoretinopathy. Coats disease mostly occurs sporadically; its genetic cause is still undetermined. Molecular genetic research including whole exome sequencing by the NGS method was used to define a genetic cause of the observed phenotype. Two heterozygous variants in different genomic loci associated with other forms of hereditary retinal dystrophy were detected, a rare variant in the HMCN1 gene c.9571C>T, p.(Arg3191Cys), and a known pathogenic variant in the NPHP4 gene c.2930C>T, p.(Thr977Met). The HMCN1 gene is responsible for dominant age-related macular degeneration (OMIM 603075), pathogenic variants in the NPHP4 gene cause recessive Senior-Løken syndrome 4 (OMIM 266900). These genes encode the proteins that are involved in the regulation of integrity of the blood-retinal barrier in the vascular endothelium (NPHP4) and retinal pigment epithelium (HMCN1). The identified mutation in the NPHP4 gene could lead to decreased function of the NPHP4 protein and contribute to the development of retinal degeneration, potentially of oligogenic nature.

Nootropic Activity of Prospekta in a Blind Placebo-Controlled Study in a Model of Focal Cerebral Ischemia in Rats.

Analysis of the pharmacological activity of the original drug Prospekta in a rat model of focal cerebral ischemia revealed its nootropic effect: course treatment in the post-ischemic period led to recovery of the neurological status of animals at the peak of neurological deficit. Evaluation of the therapeutic potential of the drug in morphological and functional CNS disorders allowed us to conclude that it is advisable to carry out further studies of its biological activity at the preclinical stage (the results obtained in animals were successfully confirmed in a clinical trial of drug efficacy in the treatment of moderate cognitive disorders in the early recovery period after ischemic stroke). Studies of the nootropic activity in other pathologies of the nervous system are also promising.

[Borderline personality disorder in clinical outpatient practice]. / Pogranichnoe rasstroistvo lichnosti v klinicheskoi vnebol'nichnoi praktike.

OBJECTIVE: To investigate Borderline Personality Disorder (BPD) and associated psychiatric disorders in real clinical practice. MATERIAL AND METHODS: Fifty patients (72% female; n=36; 28% male; n=14, aged 22.4±4.3 years) with ICD-10 diagnosis F60.31 «Emotionally Unstable Personality Disorder, Borderline Type¼ were examined. Research methods included a clinical follow-up method and psychometric assessment. RESULTS: The majority of patients were female (72%). Asocial environment and low social status were typical for the patients with BPD. The vast majority of patients (86%; n=43) were not diagnosed with BPD when they first consulted a psychiatrist. In 24% of patients comorbid psychiatric disorders were diagnosed, of which affective spectrum disorders were predominant. Depressive (94%) and anxiety (80%) syndromes were leading in the clinical presentation. BPD patients were characterized by the absence of somatic components of depression, vitality of affect. CONCLUSIONS: Women are predominant among patients with BPD in outpatient practice. Impairment of interpersonal interaction and antisocial environment were typical for them. Comorbidity of BPD and affective disorders, mostly anxious-depressive, was confirmed. Low diagnosability of BPD at the initial psychiatric examination was established.

[New goals for depression therapy]. / Novye tseli terapii depressii.

The review is devoted to the consideration of the effectiveness of treatment of depression, the ratio of symptomatic and functional remission, factors associated with the achievement of high-quality remission and recovery of patients. Currently, between 29 and 66% of patients do not fully recover from antidepressant therapy and have residual symptoms of depression. Persistent depressive symptoms, neurocognitive deficits predict increased risk of relapse, social disability, impair interpersonal relationships, and represent a barrier to functional recovery. The results of a comparative analysis of antidepressants in terms of their effect on the restoration of the functioning of patients with depression are presented. It has been established that the positive impact on the social functioning of patients should be an important criterion when choosing an antidepressant for supporting therapy. Effective therapeutic approaches that maintain symptomatic remission increase the potential for functional recovery.

[The problem of suicide in depression in the modern world]. / Problema suitsida pri depressii v sovremennom mire.

OBJECIVE: To analyze the literature data on the relationship between antidepressant therapy and suicide risk and the ways to prevent suicidal behavior in patients on antidepressant therapy. MATERIAL AND METHODS: A non-systematic review of publications was conducted using keywords in the following databases: ELibrary.ru, PubMed, Cochrane Database of Systematic Reviews. Inclusion criteria were meta-analyses, Cochrane reviews, epidemiological and original studies. RESULTS: Data from original studies are inconsistent, but more evidence-based epidemiologic studies support the preventive role of antidepressant therapy with regard to suicide. An increased risk of suicide with antidepressant therapy is seen in younger patients, especially in the first 2 weeks of treatment, in the absence of a therapeutic response. The initial dosage of antidepressants, possibly the type of antidepressant, is of some importance. The group at risk of committing suicide is those who have received psychotropic therapy in the previous year. CONCLUSION: There is no generally accepted model of prevention, but it is recommended that patients be observed during the first 4 weeks of treatment for depression, as well as during the period of antidepressant dose modification.

[Mechanisms of action and clinical effects of vortioxetine]. / Vortioksetin: ot mekhanizmov deistviya k klinike.

The opinion article is devoted to the analysis of a large-scale comprehensive systematic review of relevant and practically oriented studies of vortioxetine use in depression for the period to 2020. The mechanisms of multimodal action, issues of efficacy and safety of the drug, including direct procognitive effects, effects on anhedonia, anxiety, sleep disorders, analgesic and anti-inflammatory effects are highlighted. An increase in the efficacy of vortioxetine when the dose is increased to 20 mg/day is emphasized. Prospective directions for antidepressant research are outlined.

[Second-generation long-acting injectable antipsychotics in clinical practice]. / In"ektsionnye antipsikhotiki-prolongi vtoroi generatsii v klinicheskoi praktike.

On the example of 5 clinical cases of paranoid schizophrenia at different stages of the development of the disease, the therapeutic tactics of using drugs from the group of second-generation injectable prolong antipsychotics to solve problems that arise during anti-relapse therapy are shown. The research data substantiating these approaches are presented. Various combination therapy options are discussed, including at the stage of drug replacement and the appointment of a second-generation long-acting injectable antipsychotic.

[On the treatment of bipolar affective disorder]. / K voprosu o terapii bipolyarnogo affektivnogo rasstroistva.

In the scientific review, in order to highlight the problem of bipolar affective disorder, a systematic review of the literature in PubMed and Google was conducted, epidemiological data were presented, issues of systematization and pharmacotherapy were considered, including modern meta-analyses and recommendations, including the effectiveness and safety of antipsychotic therapy. Special attention is paid to the place of quetiapine in the treatment of both manic and depressive symptoms of bipolar disorder. Relevant full-text articles, systematic reviews, meta-analyses identified by keywords were analyzed. The review did not include publication of clinical trial results.

Antiviral Activity of Technologically Processed Antibodies to CD4 Receptor against Influenza Infection.

The antiviral activity of technologically processed antibodies to CD4 receptor was evaluated a model of sublethal A/California/04/2009 (H1N1)pdm09-induced influenza infection in female BALB/c mice. The technologically processed antibodies increased animal survival rate by 50% in comparison with the placebo group (p<0.05), which correlated with significant inhibition of virus replication in the lungs (p<0.05). The reference drug Tamiflu increased mouse survival rate (by 47%), decreased the virus titer in the lungs, and prevented body weight loss (p<0.05 in comparison with the placebo group by all parameters). The intrinsic protective activity of technologically processed antibodies to CD4 receptor was demonstrated, which manifested in a decrease in viral load in the lower respiratory tract and an increase in the survival rate.

[Depression in the structure of schizophrenia: clinical and biochemical characteristics]. / Depressiya v strukture shizofrenii: kliniko-biokhimicheskaya kharakteristika.

THE AIM OF THE STUDY: Was to investigate clinical and biochemical correlates of depression in the structure of schizophrenia to improve its diagnosis and differential diagnosis and to deepen understanding of mechanisms of schizophrenia development. Material and Methods. Forty-two inpatients at the stabilization stage of paranoid schizophrenia, aged 29.5±5.9 years, of whom 64.3% were women, were examined. The duration of the disease was 5.6±6.3 years. We used clinical and psychopathological methods, clinical scales (PANSS, SANS, BACS, Calgary Scale), catamnestic and clinic-laboratory methods (determination of brain-derived neurotrophic factor BDNF, proinflammatory cytokine interleukin-6, C-reactive protein). Results. At the stabilization stage, depression in patients with paranoid schizophrenia occurred in 19% of cases, more frequently in women. Female patients were more severely depressed, which was associated with an increased concentration of C-reactive protein, while negative symptoms predominated in male patients as compared to females. The presence of depression correlates with a lower severity of psychopathological, primarily positive symptoms and with a greater severity of neurocognitive deficit in schizophrenic patients. BDNF level directly correlates with the severity of positive and negative symptoms, and the level of interleukin 6 at the stage of remission formation does not differ from that in healthy individuals. C-reactive protein levels are associated with the characteristics of the course of schizophrenia.

[Prevention of impulsive suicide with antidepressants in outpatients]. / Preventsiya impul'sivnogo suitsida s primeneniem antidepressantov u ambulatornykh patsientov.

Self-poisoning is a common method of suicide, for which various medications are used, including antidepressants. A non-systematic review of Russian-language and English-language publications, by keywords, in the databases: ELibrary.ru, PubMed, Cochrane Database of Systematic Reviews. The purpose of the review was to analyze the literature on new risk factors and methods of their reduction in suicides with self-poisoning with antidepressants. Every fifth (20%) self-poisoning performed with antidepressants. In self-poisoning attempts, one drug used in 55% of cases, and more than one drug was used in 45% of cases. Impulsive suicides account for up to half of all suicide cases. Risk factors for impulsive suicides include the presence of impulsive character traits, female gender, young age, and the use of psychostimulants. The WHO Regional Office for Europe's mhGAP-IG guidelines recommend limiting access to a patient at risk of suicide to a weekly dose of an antidepressant. Preferably, the use of antidepressants from the group of SSRIs in small forms of release.