Terahertz beam with radial or orthogonal to laser polarization from a single-color femtosecond filament.

At the selected frequencies from 0.3 to 10 THz we measured the two-dimensional (2D) distributions of fluence and polarization of terahertz (THz) emission from a single-color femtosecond filament. At the majority of frequencies studied, the THz beam has a donut-like shape with azimuthal modulations and radial polarization. At the maximal modulation, THz beam takes the form of the two lobes and polarization of the THz field degenerates into orthogonal to the laser pulse polarization direction. Violation of the radially polarized donut beam shape is due to destructive interference of THz waves driven by light pressure directed along the laser beam propagation axis and ponderomotive force parallel to the laser polarization.

Observation of conical emission from DC-biased filament at 10 THz.

The terahertz (THz) radiation emitted by an air-based femtosecond filament biased by a static electric field is known to have on-axis shape and relatively low frequency spectrum in contrast to the unbiased single-color and two-color schemes. Here, we measure the THz emission of a 15-kV/cm-biased filament in air produced by a 740-nm, 1.8-mJ, 90-fs pulse and demonstrate that a flat-top on-axis THz angular distribution of the emission at 0.5-1 THz transforms into a contrast ring-shaped one at 10 THz.

[The effect of etiopathogenetic therapy of COVID-19 on the severity of the disease: results of a multicenter double-blind placebo-controlled randomized trial].

AIM: The search for etiopathogenetic agents to prevent the development of severe and extremely severe COVID-19 remains relevant. A placebo-controlled randomized clinical trial was conducted to evaluate the efficacy and safety of the antibody-based biological drug (Raphamin). MATERIALS AND METHODS: 785 outpatients 18-75 y.o. with laboratory confirmed mild COVID-19 were included within 24 hours from the disease onset. 771 patients were randomized to the group Raphamin (n=382) and the Placebo group (n=389). The study drug/placebo was prescribed for 5 days. The rate of progression to a more severe degree of COVID-19 by day 28 as well as the time to sustained clinical recovery and the frequency of hospitalization were evaluated. Safety was assessed taking into account adverse events, vital signs and laboratory parameters. RESULTS: The number of cases of progression to a more severe degree of COVID-19 in participants receiving Raphamin was 59 (15.5%) [52 (14.6%)] versus placebo - 89 (22.9%) [85 (23.7%)], ITT and [PP] analysis data are presented. The odds ratio between groups was OR=0.6157 [OR=0.5494], 95% confidence interval 0.4276-0.8866 [0.3750-0.8048], which meant a reduction in the chance of progression to a more severe degree by 38.4% [45.1%] or 1.48 [1.62] times; p=0.0088 [p=0.0019]. The time to sustained recovery in the Raphamin group was 4.5±2.4 [4.6±2.4] days, versus placebo - 5.8±4.7 [6.0±4.8] days; p=0.0025 [p=0.0036]. No adverse events with a certain relationship were registered. CONCLUSION: Raphamin reduces the risk of progression to a more severe degree of the COVID-19 and significantly shortens the duration of clinical symptoms.

Flat-top THz directional diagram of a DC-biased filament.

In the experiment, the laser pulse (744 nm, 0.5 mJ, 90 fs) focused into the air gap between the plane electrodes biased by a 10 kV/cm field (DC-biased filament) produced terahertz (THz) radiation. At the selected frequencies of ν=0.3, 0.5, 1 THz, a wide flat-top angular distribution was measured by a bolometer rotating in the plane of the electrodes. The simulations based on the unidirectional pulse propagation equation with fine 0.01 THz resolution and 3 PHz frequency domain showed the transition of the THz directional diagram from the flat-top at ν≲1THz to the conical one at ν>8THz due to the destructive interference of THz waves from the ionization front propagating with the superluminal velocity. Refraction on the plasma is not the major factor in ring formation.

Postfilament supercontinuum on 100 m path in air.

Pulses at 744 nm with 90 fs duration, 6 mJ energy, and a weakly divergent wavefront propagate for more than 100 m and generate a filament followed by an unprecedently long high intensity (≥1TW/cm2) light channel. Over a 20 m long sub-section of this channel, the pulse energy is transferred continuously to the infrared wing, forming spectral humps that extend up to 850 nm. From 3D+time carrier-resolved simulations of 100 m pulse propagation, we show that spectral humps indicate the formation of a train of femtosecond pulses appearing at a predictable position in the propagation path.

[Pharmacoepidemiological research of COVID-19 in the Russian Federation EGIDA-2020].

AIM: An analysis of coronavirus infection in Russia and evaluation of different AVT regimens effectiveness. MATERIALS AND METHODS: The study involved a retrospective analysis of 1082 patient records with laboratory-confirmed COVID-19 in 17 regions of Russia. The number of men and women was equal, mean age 48.718.1 (median 50). Patients with moderate COVID-19 (85%) versus mild COVID-19 (15%) were characterized by higher age (median 54 vs 21 years; p0.001), higher body mass index (27.8 vs 23.4; p0.001), prevalence of chronic diseases (75.3% vs 8.5%; p0.001), including circulatory system diseases (37.8%). Moderate COVID-19 characterized higher intoxication (10.86.1 vs 4.22.7 days; p0.001) and catarrhal symptoms duration (10.25.4 vs 6.14.1 days; p0.001). RESULTS: During hospitalization 92% of the patients received AVT, 77% antibiotics, and 16% corticosteroids. Umifenovir therapy resulted in a significant reduction of intoxication (8.75.5 vs 11.75.5 days; p0.001) and catarrhal symptoms duration (8.85.1 vs 12.04.9 days; p0.001) compared to the group without AVT. The usage of INF reduced intoxication symptoms compared with the group without AVT (8.97.5 vs 11.75.5; p0.05). Therapy with hydroxychloroquine, imidazolylethanamide pentandioic acid, and lopinavir + ritonavir combination did not affect the course of COVID-19. Most of adverse reactions were related to antibiotics. CONCLUSION: Umifenovir therapy and inclusion of interferon in AVT regimens was associated improvement in the clinical manifestation of the disease among patients.

[The experience of reforming primary health care in conditions of demographic trends of average population age increasing].

The article presents experience of reforming of primary health care in the Belgorod Oblast in 2016-2019. In the course of reforming the original organizational model of interaction between doctors and patients developed and implemented. The measures were applied to strengthen the material-technical base and personnel potential of primary medical care. The offices of General Practitioners were arranged within step accessibility for patients. The continuous training of family physicians was organized at the workplace. The unified regional medical information system was developed and implemented enabling corporate conference communication, remote consultations, population feedback and remote arrangement of making appointment with physician. The differentiated approach to medical personnel remuneration of labor was brought on the basis of key performance indices that permitted to increase their salary and quality of work. As a result of the reforms, the percentage of people covered by family physicians dispensary observation increased by 13%, number of emergency calls decreased by 3.3% and number of calls because of illness reduced by 17%. The mortality rate of people older than able-bodied age began to decrease and population life expectancy reached prognosticated numbers of 74 years in 2019.

[The experience of reforming primary health care in conditions of increasing of population average age].

The article presents the experience of reforming primary health care in Belgorod Oblast in 2016-2019. In the process of reforming, the original organizational model of new interaction pattern "family doctor - patient - family members", was developed and implemented. The measures were taken to strengthen material-technical base and manpower potential of primary medical care. The general practitioners offices were positioned within "step accessibility" for patients. The continuous training of family doctors was organized at the workplace. The unified regional medical information system was developed and implemented enabling corporate conference communications, remote consultations, public feedback and remote arrangement of visits of patients to physician. The differentiated approach to remuneration of medical personnel was implemented using key performance indices that permitted to increase salaries and work quality. As a result of the reforms, the percentage of patients under supervision of family doctors increased up to 13%, the number of medical emergency calls decreased up to 3.3% and the number of calls because of illness decreased up to 17%. The mortality of population older than able-bodied age began to decrease and life expectancy reached relevant 74 years in 2019.

[Decision-making while implantation of biodegradable vascular scaffolds ABSORB based on methods of intravascular visualization]. / Priniatie reshenii pri implantatsii biodegradiruemykh sosudistykh karkasov ABSORB na osnove metodov vnutrisosudistoi vizualizatsii.

A series of studies demonstrated comparability of the incidence rate of major adverse cardiac events (MACE) in the middle-term postoperative period following implantation of last-generation drug-coated stents and biodegradable intravascular scaffolds. It was noted observed that these complications may be associated with malposition and inadequate inappropriate preparation of the lesion. We carried out a total of 16 percutaneous coronary interventions (PCI) with implantation of absorbable vascular scaffolds (Absorb, Abbott Vascular) under the guidance of optical coherent tomography. Besides, a further 16 PCIs were performed without intravascular visualization (control group). As experience was gathered, the algorithm of carrying out optical coherent tomography was subjected to changes, resulting in proposal of an optimal algorithm for choice of intraoperative policy based on the findings obtained in optical coherent tomography.

[ANALYSIS OF THE POSTOPERATIVE COURSE OF COMPLEX CONGENITAL HEART DISEASES SIMULTANEOUS CORRECTION WITH AN OPEN STERNOTOMY IN CHILDREN DURING THE FIRST MONTHS OF LIFE].

UNLABELLED: In children during the first months of life delayed sternum closure is one of the few techniques increasing cardiac output after simultaneous correction of complex congenital heart defects (CHD). The aim of study was evaluating mortality, predictors of adverse outcome and frequency noncardial complications at of delayed sternum closure after correction of CHD. METHODS: Study design: a prospective, uncontrolled, cohort. 22 children were studied 6 children died. Anesthesia was carried out on the basis ofpropofol (3 mg/kg/h) and fentanyl (5 pg/kg/h) infusion with sevoflurane inhalation in a dose of 1-1.5 WT, including during perfusion. Cardiopulmonary bypass (IR) was carried out by the "Stockert S50" using oxygenators ("Medtronic"). After IR in all cases the use of arterio--venous modified ultrafiltration. Sternum closure was performed on average 2.7 ± 1.4 days after surgery. RESULTS: The odds ratio (OR) of death development at the mean arterial pressure (MAP) < 35 Hg was 3.7, the OR for the risk of death development if SVO2 < 40% was 0.94. OR for risk of death when blood lactate level > 10 mmol/l during the first three days ofpostoperative intensive care was 2.1. CONCLUSIONS: The technique of delayed sternum closure is an acceptable method of maintaining cardiac output in children during the first months of life with CHD in the postoperative period. High blood lactate level (> 10 mmol/l) and especially its further growth and the MAP < 35 mm Hg can be predictors of adverse outcomes of surgical interventions with an open sternotomy.

[ENTEROTOXIGENICITY OF STAPHYLOCOCCUS AUREUS STRAINS, ISOLATED FROM BREAST MILK OF WOMEN, FEEDING CHILDREN WITH INFECTIOUS PATHOLOGY].

AIM: Determination of enterotoxigenicity and ability to synthesize TSST-1 in S. aureus strains, isolated from breast milk of women, feeding children with infectious pathology. MATERIALS AND METHODS: 35 S. aureus strains, isolated from breast milk of women feeding children with varying infectious pathology in hospitals and as outpatients were studied for the presence of staphylococci enterotoxins (SE) of types A and B and toxic shock syndrome toxin (TSST-1). Determination of SEA, SEB and TSST-1 was carried out by enzyme immunoassay. RESULTS: Toxins were detected in 94.2% of S. aureus strains. SEB was synthesized by 86.7%, SEA--34.3%, TSST-1--42.8% of S. aureus strains. Toxins were detected with equal frequencies in healthy women and women with inflammatory diseases of breasts. Differences in frequency of colonization of intestines of children receiving breast milk, infected with toxigenic and non-toxigenic staphylococci strains was not detected. CONCLUSION: A high frequency of occurrence of enterotoxins and TSST-1 in S. aureus, isolated from breast milk of the mother during infectious pathology in the child was discovered. Enterotoxigenic strains can be detected in breast milk in healthy women. Study of the role of breast milk, infected with S. aureus, producing SEA, SEB And TSST-1 in development of child pathology is necessary.

[INFLUENCE OF LIPOSUCTION OF LARGE VOLUME ON SYSTEMIC AND LUNG CIRCULATION, OXIGENATED LUNG FUNCTION].

The authors measured the changes of hemodynamics in 72 patients. It was also estimated a blood oxygenation and volume of liquid sectors of the organism in different degree of obesity before and after liposuction of the large volume. It was shown, that this operation facilitated to an improvement of respiratory lung function due to changes of pulmonary circulation.

Upregulation of IFN-γ and IL-12 is associated with a milder form of hantavirus hemorrhagic fever with renal syndrome.

Hantavirus hemorrhagic fever with renal syndrome (HFRS) is a zoonotic disease characterized by acute onset, fever, malaise, and back pain. As the disease progresses, hemorrhagic disturbances and kidney dysfunctions predominate. The examination of tissue collected postmortem supports the premise that virus replication is not responsible for this pathology; therefore, it is widely believed that virus-induced immune responses lead to the clinical manifestations associated with HFRS. The overproduction of inflammatory cytokines is commonly reported in subjects with HFRS and has given rise to the hypothesis that a so-called "cytokine storm" may play a pivotal role in the pathogenesis of this disease. Currently, supportive care remains the only effective treatment for HFRS. Our data show that serum levels of interferon (IFN)-γ, interleukin (IL)-10, CCL2, and IL-12 are upregulated in HFRS cases when compared to healthy controls and the level of upregulation is dependent on the phase and severity of the disease. Furthermore, we observed an association between the mild form of the disease and elevated serum levels of IFN-γ and IL-12. Collectively, these observations suggest that the administration of exogenous IFN-γ and IL-12 may provide antiviral benefits for the treatment of HFRS and, thus, warrants further investigations.

[Association between inflanummatory gene polymorphisms and the risk of myocardial infarction].

Allele and genotype frequency distributions of polymorphism rs2076059 (3832T>C) within the SELE gene rs6131 (S290N), within the SELP gene, rs1131498 (F206L), within the SELL gene, rs5498 (K469E) within the ICAM1 gene, rs35569394 (-2549(18)I/D) within the VEGFA gene, and rs1024611 (-2518A>G) within the CCL2 gene were examined in a group of patients after myocardial infarction (MI)(280 individuals) and in a control group (312 individuals). An implementation of the Markov chain and Monte-Carlo method (AP- Sampler) revealed the allele combinations associated with decreased and increased risk of MI. Among these the most important allele combinations were SELE*C + SELP*S + CCL2*A (FDR = 0.0005; OR = 0.42) SELP*S + CCL2*A (FDR = 0.0009; OR= 0.36}, SELL*F + VEGFA*I+ CCL2*G/G(FDR = 0.0009; OR = 4.17) VEGFA*I+ CCL2*G/G (FDR = 0.0009; OR = 3.76), SELE*C + CCL2*A (FDR = 0.0023; OR = 0.47), and SELL*I+ CCL2*G/G (FDR = 0.003; OR = 3.15).

[Combinations of cytokine gene network polymorphic markers as potential predictors of myocardial infarction].

With the intent to identify informative predictors of myocardial infarction (MI) development in an ethnically homogenous group of Russian men after MI (255 subjects) and in a corresponding control group (257 subjects), an analysis of genotype frequency distribution for polymorphic DNA markers (SNP) rs16944 (-511C>T, IL1B gene), rs1800796 (-572G>C, IL6 gene), rs1800872 (-592C>A, IL10 gene), rs3212227 (1159AA, TNF), rs909253 (252A>C, LTA), rs767455 (36A>G, TNFRSF1A) was conducted. Using the Monte Carlo method and a Markov chain (APSampler), allele combinations associated both with decreased and increased MI risk were revealed. The most significant results were obtained for IL6*C/C (P = 3 x 10(-4), OR = 6.3 CI 2.37-16.75 10(-4)), LTA*A+IL6*G/G (FDR = 2.3, OR = 0.25 CI 0.14-0.46), LTA*G/G + IL12B*A/A (FDR = 0.0053, OR = 4.92 CI 1.8-13.33), TNF*G + LTA*G/G + TNFRSF1A*A (FDR = 0.013, OR = 4.38, CI 1.6-12.01), TNFRSF1A*G + IL10*A/A + IL12B*C (FDR = 0.016, OR = 8.79, CI 2.17-35.63), TNF*G + LTA*G?G + IL10*C (FDR = 0.0105, OR = 3.54 CI 1.55-8.09).

[Frequency of occurrence of ivyC and pliC lysozyme inhibitors genes in clinical klebsiella strains].

AIM: Chromosomal ivyC and plasmid pliC lysozyme inhibitor genes frequency of occurrence detection in klebsiella strains of various origins. MATERIALS AND METHODS: 129 strains were studied including K. pneumoniae (n= 115) and K. oxytoca (n=14). Klebsiella strains were divided into 2 groups: group 1 - 62 strains (39 isolated in Kazan and 23 strains isolated from children with klebsiella infection in Moscow). Kazan strains were presented by isolates from young children receiving in-patient treatment regarding klebsiella (n=8), respiratory (n= 17), rotavirus (n=5) and purulent-inflammation infection ofnewborns (n=9). Group 2 (n=67) was composed of strains isolated from children that had received outpatient treatment regarding intestine dysbacteriosis in Kazan (n=37) and Moscow (n=30). ivyC and pliC gene detection was carried out by PCR (N.B. Perunova et al., 2012). RESULTS: Chromosomal ivyC gene determinants were isolated in 40.3% of cases (52 strains of 129), plasmid pliC gene - 6.9% (9 of 129). ivyC gene frequency of occurrence in klebsiella strains isolated from 39 ill children of Kazan was 46.6% of cases (18 of 39), in Moscow clinical strains - 95.5% (22 of 23) cases, wherein 6 strains had ivyC and pliC genes at the same time. Dysbiosis intestine strains had chromosomal ivyC gene at the frequency of 61.2% (41 of 67), 1 strain additionally had pliC gene. CONCLUSION: . The presence of ivyC and pliC lysozyme inhibitor genes in klebsiella clinical strains provides bacteria with selective advantages in various biotopes in the process of bacterial colonization of mucous membrane.

[Opsoclonus-myoclonus syndrome associated with West Nile virus]. / Opsoklonus-mioklonus sindrom, obuslovlennyi likhoradkoi Zapadnogo Nila.

Opsoclonus is oculomotor dyskinesia characterized by rapid, repetitive conjugate eye movements that are involuntary, arrhythmic, chaotic, and multidirectional (horizontal, vertical, and torsional components). Most common cause of the symptom is paraneoplastic process. It is combined with myoclonus usually with the development of opsoclonus-myoclonus syndrome. Viral etiology is one of the possible causes of the of this syndrome, which is presented in the following case. A 26-year-old man was admitted to an infectious hospital suspected by encephalitis. After a 2-day febrile fever the patient developed balance problem, nausea, vomiting, tremors in the limbs and head, sensations of jerking of eyeballs. The neurological examination revealed opsoclonus, myoclonic jerking in the limbs, neck and trunk muscles, severe static and dynamic ataxia, there was no consciousness changes or altered mental stature. Cerebrospinal fluid examination revealed a pleocytosis (24 cells), increased protein levels (1.1 g/l). MRI of the brain was normal. After excluding of typical neuroinfections the patient was tested for West Nile fever. Elevated titers of IgG and IgM for West Nile fever virus were detected, as well as positive PCR for virus RNA in the cerebrospinal fluid. Patient was treated by acyclovir, an antibiotic and dexamethasone but severe neurological symptoms were persisted for 2 weeks with inability of sitting and walking. Then the symptoms gradually began to improve, rehabilitation was included with total recovery during the next 2 months. The doctors should be aware for possibility of neuroinvasive form of West Nile fever as the etiology of opsoclonus-myoclonus syndrome.

[Prophylactic use of VFS in patients with coronary artery disease in the perioperative coronary artery bypass grafting].

Tachyarrhythmias (TA) - dangerous postoperative complications of coronary artery bypass grafting, threatening the lives of patients and found, according to different authors, in 13-40% of cases. VFS - an antiarrhythmic drug that belongs to a class 1C, is effective in the treatment and prevention of a variety of cardiac arrhythmias. The aim of the work was to study the clinical efficacy of VFS CHD patients with a history of tachyarrhythmias during the perioperative period of coronary bypass surgery, as well as its comparison with other antiarrhythmic drug (amiodarone). Clinical efficacy was evaluated in 218 patients with coronary heart disease at baseline with a history of tachyarrhythmia (paroxysmal atrial fibrillation or premature ventricular high grade (IV and V class on classification of Lown B. and Wolf M. in the modification of Ryan M.). Shown that the VFS is more effective than amiodarone, both in paroxysmal atrial fibrillation and ventricular arrhythmias when high gradation.

[Effect of cytoflavin on some physiological values in patients with toxicohypoxic encephalopathy].

The effect of cytoflavin upon bolus intravenous administration on the state of hemodynamic values and liquid sectors of the organism was studied in patients with toxicohypoxic encephalopathy caused by heavy acute poisoning. It is established that the bolus administration of cytoflavin is less effective than dropwise intravenous injection.

[Association of polymorphic markers of CCL2 gene with essential hypertension].

Chemokine CCL2, or monocytic chemoatractant protein 1 (CCL2/MCP-1) plays an important role in the development of cardiovascular diseases. In the present study, genotypes of four polymorphic markers (rs1860190, rs1024611, rs3917887, and rs991804) of the CCL2gene were identified in the population of Tatars (residents of the Republic of Bashkortostan). Analysis of associations of these markers with essential hypertension (EH) was carried out. It was demonstrated that haplotype CCL2*A*G*D*T was associated with the increased risk of EH (P = 0.01; OR = 1.53).