Репозиторий Университета

© 2018, Springer Science+Business Media, LLC, part of Springer Nature. The pharmacokinetics, bioequivalence, and safety of Femorix®(Valenta Pharm Co., Russia) and Aubagio®(SanofiWinthrop Industrie, France) film-coated tablets (14 mg) were compared in a double-blind randomized investigation in parallel groups of healthy volunteers. The bioavailabilities of Femorix®film-coated tablets (14 mg, Valenta Pharm Co., Russia) were 96.18% [87.92 – 105.22%] for ln(Cmax) and 96.24% [88.67 – 104.44%] for ln(AUC0–72) of those for Aubagio®film-coated tablets (14 mg, Sanofi Winthrop Industrie, France), which fell in the commonly accepted range (80 – 125%) for proving the bioequivalence of the tested products.

Symptoms of sleep disruption are widely prevalent in general population, but they are not necessarily form the full clinical presentation of insomnia. Diagnostic process should consider somatic diseases usually accompanied by sleep disruption. This review presents the data on insomnia symptoms in gynecological diseases: menstrual cycle related disorders, endometriosis, peri- and postmenopausal symptoms.

© 2018, Dynasty Publishing House. All rights reserved. The objective. To specify the frequency and species composition of vaginal bacterial carriage in pregnant women at the term of gestation 35–37 wks. Patients and methods. We examined 800 pregnant women, who were followed-up on an outpatient basis at terms of gestation 35–37 wks. Cultural examination of the content of the posterior vaginal fornix was performed. Species identification of microorganisms was performed by the method of direct protein profiling with the help of MALDI-TOF mass spectrometry, FLEX series, Bruker Daltonic GmbH, Germany. Results. The growth of flora was obtained in 761 patients (95%). Bacterial vaginosis (n = 71), Candida vulvovaginitis (n = 83) were diagnosed in 154 patients (19%). Lactobacillus spp. were found in 80% (n = 637) of examined women, of them in 161 (20%) in monoculture. Bacterial carriage was diagnosed in 55.8% of cases. The prevalence of Enterococcus faecalis, Escherichia coli, Streptococcus agalactiae, Staphylococcus epidermidis and Staphylococcus haemoliticus was noted. They were much more rarely detected in monoculture: E. faecalis (1%), S. agalactiae (0.1%), S. epidermidis (0.1%), Candida albicans (0.1%). In 39 (5%) patients, no growth of flora was found. In 17 patients we found extended-spectrum B-lactamase-producing bacteria: E. coli (n = 15), Klebsiella pneumoniae (n = 2). Conclusion. Taking into account a high prevalence of vaginal bacterial carriage in pregnant women in the 3rd trimester, it might be expedient to consider inclusion of microbiological examination of vaginal discharge in the basic spectrum of antenatal observation and screening examination of pregnant in the Russian Federation.

© 2018 Authors. The authors substantiate the need to develop a scientific and methodical approach to modernizing business processes of a pharmacy using information technologies. IK FARM LLC pharmacy has been chosen as a model object of the study. The IDEF0 (Integrated Definition Function Modeling) method adopted as a state standard in the US and recommendations of the State Standard of Russia R 50.1.028-2001 have been used for the analysis, systematization and reorganization of business processes. The article offers methodology for optimizing the pharmacy's activities, which includes the building of two models for managing business processes - before and after modernization (AS-IS and AS-WILL). The structure of the AS-WILL model includes new functions: "Plan the pharmacy's activities" (set the goals and objectives of the organization, plan target sales for the next period) and "Monitor the pharmacy's activities" (control the compliance with the rules of drugs' storage and layout, sanitary regime, and rules of property operation). The complex automation of the pharmacy's trading activities ensures these functions through the Magister software. Estimated efficiency of business processes' modernization based on the net present value has indicated that automation of processes will increase net unreduced profit.

© 2018, Dynasty Publishing House. All rights reserved. A clinical observation of the patient (26 years) is presented, for whom prolene (a non-absorbable monofilament suture material with a perfectly smooth surface) was used for the recovery of the wound in the uterus during Caesarean section. Numerous prolene sutures were hanging free in the uterine cavity and performed a peculiar function of intrauterine contraceptive. After excision of sutures by the resectoscope loop, fertility was restored.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: To develop a technique for conducting of complex radiology diagnostics in combination with dynamic MSCT-cystureterography in patients with reconstruction of the urogenital area and to study the possibilities of its application in clinical practice. Materials and methods: At the pre and postoperative stages 8 patients were examined by MSCT, from whom all men were presented with such acquired and congenital diseases of the urogenital area as followings: stricture or obliteration of the urethra, as well as hypoplasia of the penis. The age of the patients varied from 33 to 58 years with the average of 43.8 years. The studies were performed by a multispiral computer tomograph Toshiba Aquilion One. This 640-slice computer tomograph has 320 rows of detectors with 0.5 mm wide, which allows the detector to cover the scan zone at 16 cm by one rotation of the X-ray tube. Results: By studying the data obtained in five cases, hypoplasia of the penis was revealed. In three cases urethral obstruction was diagnosed, its cause and localization were determined. At the pre and postoperative stages the anatomy of the donor and recipient vessels was assessed, surgical intervention was planned, and the dynamic MSCT-cystureterography method allowed avoiding invasive examination of the urethra. The MSCT method with intravenous contrasting in combination with dynamic MSCT-cystureterography surpasses the standard X-ray examination, ultrasound method and endoscopic urethroscopy at terms of accuracy and informativeness. In addition, these methods are separated in time and in the implementation techniques and most of them are not physiological. Conclusions: Analyzing the obtained data, we can confidently state that MSCT with intravenous contrast showed its high informative value in the study of donor and recipient vessels, and the combination with dynamic MSCT-cystureterography in order to assess the patient's urethra further increases the informativeness and value of this study. The proven effectiveness of the developed method suggests that it can become routine in examining patients with diseases of the urogenital area.

© 2018 Inderscience Enterprises Ltd. Increase in academic performance of medical universities' students is one of the most significant tasks of the modern education and healthcare systems as a factor contributing to high quality of the future doctors' qualification. Increased level of anxiety and depression negatively correlate with the level of the students' academic performance. Such a method of physiotherapy as mesodiencephalic modulation takes a stabilising effect on psychoemotional state of a person. The paper contains the analysis of emotional state of the students from the Faculty of Dentistry, defines the level of anxiety and depression, and notes their correlational interconnection with the level of academic performance in their study. The authors have practically stated positive influence of the mesodiencephalic modulation sessions on psychoemotional state of the students and indirectly on the level of their educational academic performance.

© Bionika Media Ltd. The author has carried out a systems analysis of the data available in the current literature on the participation of vitamin D in the physiology of bone metabolism, the pathogenesis of osteoporosis, and the possibilities of osteoporosis therapy with active vitamin D metabolites. The paper describes the mechanisms of vitamin D participation in the processes of bone metabolism and calcium homeostasis. It presents the effects of vitamin D on connective and muscle tissues. Its deficiency is shown to play a role in the pathogenesis of osteoporosis and in the increased risk of low-trauma fractures. There are clinical trial findings that confirm the possibility of using active vitamin D metabolites for the therapy of osteoporosis and for the prevention of low-trauma fractures. Active vitamin D metabolites used alone or in combination with antiresorptive therapy for osteoporosis is an effective measure to prevent low-trauma fractures and can be prescribed for menopausal osteoporosis.

© 2018 Dynasty Publishing House. All rights reserved. Replication of Francisella and Shigella in cytosole of host cell is correlated with their ability to escape from phagosome (containing bacteria vacuole) and to modulate innate immunity of host. Francisella T6CC and some undeterminated products of pathogenicity island's genes take part in such processes. Shigella T3CC and autotransporter protein IscA provide this processes together with spreading bacteria intra colonic epithelium.

© Ivan M. Chizh, Igor V. Karpenko, Maria S. Sergeeva, Ilya V. Fedoseikin. The article covers a little-known episode from World War I, concerning the work of one of the foreign detachments (hospitals) in the Russian Tsarist army. The large-scale sanitary losses and epidemics of infectious diseases, which accompanied the war, required special efforts from the medical service of the Russian army. The Russian Red Cross Society (RRCS), which had monopoly rights to organize medical care during the war, did not cope with the problems that arose. In connection with this, the international community, primarily the medical personnel of neutral and allied states, in particular, England and America, played a big role in the provision of medical care to the wounded Russian army. The activities of foreign doctors, nurses and hospitals were carried out under the auspices of the RRCS in the framework of the humanitarian assistance that allies provided to Russia during World War I. Based on archival documents and materials from RRCS periodicals for 1914–1917, the activities of the medical unit of the North American United States in the Caucasian theater of military operations and the American hospital organized by it on the territory of Persia (the town of Khoy) are investigated. The materials under review single out a number of problems in the provision of medical assistance to the troops of the Caucasian Front, requiring special urgency and unprecedented work from the American specialists in Khoy. Throughout the period under review, anti-epidemic, clinical, evacuation and charitable activities predominated the detachment’s work. Doctors and nurses of the detachment risked their lives in performing their duties during typhus epidemics. It is noted that in addition to American doctors and nurses, Russian doctors and nurses worked at the hospital.

© 2018 Dynasty Publishing House. All rights reserved. The objective: To enhance the efficacy of diagnosis and treatment of various kinds of intrauterine pathology in women with infertility using minimally invasive hospital-substitute methods. Patients and methods: We made a complex examination and treatment of 226 female patients with infertility and various intrauterine pathologies aged 22 to 45 years. Minimally invasive interventions were performed using an office hysteroscope, without cervical fixation or dilation of the cervical canal, and in some cases without anaesthesia, which permitted to reduce traumatization of patients during highly informative diagnostic screening and surgical treatment of the diagnosed intrauterine pathology. Results: According to the findings of office hysteroscopy, all patients were divided into 3 groups: group 1 included 110 (49%) women with endometrial polyps, group 2 - 30 (13%) women with polyps of the cervical canal, group 3 - 86 (38%) women with intrauterine synechiae. All women were treated in outpatient settings, laser destruction of intrauterine synechiae and polypectomy of the cervical canal and uterine cavity were performed. 22 (10%) patients with complete or almost complete obliteration of the uterine cavity by fibrinous adhesions and 12 (5%) women with multiple small endometrial polyps were hospitalised. 148 (65%) patients 3-6 months after intervention underwent control office hysteroscopy. No pathology was found in 129 of them, in 5 patients single adhesions were found after complete obliteration, in 2 - endocervical polyps and in 12 - endometrial polyps. Pregnancy occurred in 51 (22%) patients from group 1, in 19 (9%) and 34 (15%) from groups 2 and 3, including pregnancies after assisted reproductive technologies. Conclusion: Office hysteroscopy as a hospital-substitute method of examination and treatment of female patients with infertility conditioned by intauterine pathology has demonstrated its high efficacy.

© 2018 Publishing House of the Union of Pediatricians. All rights reserved. This lecture for the system of postgraduate medical education analyzes causes, types, key links of pathogenesis, and manifestations of the main typical forms of liver pathology-liver failure, hepatic coma, jaundice, cholemia, acholia, cholelithiasis, and their complications in children. To control the retention of the lecture material, case problems and multiple-choice tests are given.

© 2018 Izdatel'stvo Meditsina. All rights reserved. Background: The widespread prevalence of infertility, the low effectiveness of assisted reproductive technologies (ART), and the high incidence of chronic endometritis (CE) in infertile women determine the relevance of the considered problem. The aim of the study was to determine the clinical and anamnestic, laboratory, and instrumental features of CE associated with infertility and unsuccessful IVF cycles in women of reproductive age. Materials and methods: The study enrollred 150 women of reproductive age with morphologically established CE (main group, n=120) and without CE (control group, n=30). A subgroup I of the main group included 64 patients with infertility and IVF failures, a subgroup II - 56 fertile women. In addition to anamnesis collection and identification of CE clinical features, all patients underwent infectious screening, immunological and immunohistochemical analysis, ultrasound examination of pelvic organs with dopplerometry, and office hysteroscopy. A comparative analysis of the data obtained from subgroups of the main group was conducted. Results: Histological study of endometrial pipelle-biopsy specimens on the 7-10th day of the cycle revealed CE in all patients of the main group. We found prevalence of mean duration of CE in the subgroup I relative to subgroup II - 5.5±0.06 years and 2.4±0.07 years, respectively (p<0.001). Infectious screening showed that 58 (90.6%) patients of the I subgroup had sterile endometrial seeding which was 16.9 times higher than in subgroup II (p<0.0001). Immunological analysis determined the presence of AEAT in all patients of the subgroup I, 43 of which (67.2%) were above 265 U/ml, while 51 (91.1%) of subgroup II had no AEAT (p<0.001). Immunohistochemical analysis of the endometrium on the 18th-24th day of the cycle established high expression of CD16, CD20, CD56, and HLADRII in 58 (90.6%) patients of the subgroup I, whereas in 54 patients (96.4%) of II subgroup high expression of CD16 and CD20 with low amount of CD56- and HLA-DRII-positive cells was registered (p<0.001). We determined prognostically significant clinical and anamnestic risk factors predisposing to the development of infertility in patients with CE (p<0, 05). We revealed certain echographic, dopplerometric, and hysteroscopic criteria of CE demonstrating the critical disruption of endometrial receptivity in infertile women. Conclusion: Most patients (90.6%) with infertility had autoimmune component of CE characterized by prolonged (more than 5 years) course, high serum level of AEAT, sterile endometrial crops, and high expression of inflammation markers CD16, CD20, CD56 and HLA-DRII .

© 2018, Silicea-Poligraf. All rights reserved. Aim. Study of efficacy and safety of taurin in management of stable angina patients with postinfarction cardiosclerosis. Material and methods. Totally, 95 postinfarction cardiosclerosis patients included, with stable angina of II and III functional class. The patients that were included, had refused revascularization. To the main group, 48 were included with added taurin (Dibicor, “PIK-Pharma”, Russia, 750 mg daily), and to comparison group — 47 patients that were taking standard treatment and placebo. Treatment duration 3 months. Results. Clinical efficacy of taurin in postinfarction cardiosclerosis and stable angina is confirmed by significant improvement of the following parameters: subjective state (decreased fatigue, less complaints on palpitation, less severity of dyspnea and rarer angina attacks), of the life quality parameters by Seattle questionnaire; echocardiographic parameters, normalized cardiac rhythm. Postive changes achieved on the basis therapy with taurin, remained for 3 months after drug discontinuation. Conclusion. Positive influence of taurin on clinical and instrumental parameters of patients make it to recommend its prescription for stable angina treatment in postinfarction cardiosclerosis patients.

© 2018 Russian Electronic Journal of Radiology. All Rights Reserved. Purpose. Post-mortem MRI characteristics of the distribution and severity of nonimmune fetal hydrops (NFH). Materials and methods. The analysis of autopsy material of 2 stillborn and 22 newborns, divided into three groups was carried out. Group I consisted of the bodies of the dead due to NFH, group II - the bodies of newborns who died with the presence of general edema syndrome in the absence of NFH, group III (control) - the bodies of deceased newborns in the absence of NFH and general edema syndrome. Before autopsy, MRI was performed. On T1- and T2-weighted images was determined by the thickness and signal intensity of the skin with subcuta-neous tissue and the subsequent calculation of the tissue hydration index. The volume of fluid in the pericardial cavity, pleural and abdominal cavities determined when using three-dimensional processing of the obtained tomograms and calculated their specific volume in the corresponding cavities. Results. The values of the specific volume of free fluid in the pleural cavities and abdominal cavity less than 8% should be considered a natural postmortem sign, rather than the life-time accumulation of transudate, when examining the bodies of deceased newborns on the first day after death. The mean values of absolute and specific volumes of pleural fluid had the maxi-mum values in the NFH observations, exceeding the values of the control group by 6.3 and 5.1 times, respectively. The highest values of the absolute amount of ascites were observed in the group with general edema syndrome. In the NFH group, all cases had hydrothorax, 85.7% of cases had ascites, and 42.9% had hydropericardium. In the group of newborns with general ede-ma syndrome, hydrothorax was detected in 57.1%, ascites - in 85.7%, and hydropericardium - in 42.9% of cases. The thickness of the skin with subcutaneous tissue depended on the localization and group of research. The most pronounced deviations from the control level were recorded for the average values of the skin thickness of the anterior chest wall in group I and the scalp of the fronto-parietal region in group II. The mean values of the tissue hydration index were higher in the group with NFH, and the lowest in the control group. Conclusion. Postmortem MRI performing, allows an objective assessment of the nature and severity of anasarca and pathological fluid accumulations in the serous cavities of dead fe-tuses and newborns. In this regard, postmortem MRI is recommended as a mandatory component of the autopsy of the bodies of fetuses and newborns that died as a result of nonimmune fetal hydrops.

© 2018 S. Karger AG.All right reserved. Therapeutic plasma exchange (PE) is a procedure of removing and replacing a large volume of plasma with various biologically active substances that have a pathological effect on the patient. Plasma exchange in some diseases is one of the components of pathogenetic therapy (ANCA-associated systemic vasculitis, antiphospholipid syndrome, Goodpasture's syndrome, thrombotic microangiopathy, etc.). PE removes circulating immune complexes damaging tissues and organs and restores the coagulation system. In the practical recommendations of the American Apheresis Society (2016) leading experts in the field of apheresis therapy, based on an analysis of numerous clinical studies, gave clear recommendations to use the apheresis technologies for extracorporeal detoxification. Also 4 categories of indications and contraindications, assessing the benefits of carrying out apheresis procedures for a specific nosology were specified. A number of new diseases have been introduced, such as atopic (neuro) dermatitis (atopic eczema), cardiac neonatal lupus, Hashimoto encephalopathy, HELLP syndrome, in which PE is one of the leading therapeutic approaches as well as cytotoxic and glucocorticosteroid therapy. However, the use of plasma exchange in the treatment of some diseases remains controversial, for example, sepsis. So further research is needed.

© 2018, Media Sphera Publishing Group. All rights reserved. Inflammasomes are macromolecular complexes that contain many copies of receptors recognizing molecular patterns of pathogenic agents (PAMP) and damage-associated structures (DAMP), and also include molecules of adapter protein ASC and procaspase- 1. Activation of inflammasomes leads to the formation of active caspase-1 that, in turn, provides the maturation of pro-IL-1β and pro-IL-18 to IL-1β and IL-18. The latter cytokines play an important role in control of neuroinlfammation in the central nervous system contributing to the pathogenesis of a series of neurological, neurodegenerative and mental disorders. The review discusses the involvement of NLRP3 inflammasome and other their types in the development of the traumatic brain injury, ischemic and hemorrhagic stroke, brain tumors, CNS infections, Alzheimer’s and Parkinson’s diseases, epilepsy, amyotrophic lateral sclerosis, depressiver, and consequences of alcohol abuse. The elucidation of molecular mechanisms and signaling pathways controlled by inflammasomes will allow the development of new therapeutic measures for diseases, in which neuroinflammation plays a leading pathogenetic role.

The article reviews the results of using optical coherence tomography (OCT) - a non-invasive non-contact examination method for obtaining a tomographic slice image of the site of glaucoma surgery. The method helped reveal the functional relationships between the newly created outflow pathways and various parameters of the filtering bleb such as its linear dimensions, wall structure, presence of microcysts, position of drainage, etc. Due to its high resolution and noninvasiveness, OCT can be reliably used to examine the structure of aqueous outflow pathways in different postoperative periods with accuracy close to morphometric. The amount of data that had been obtained with the method has allowed the creation of new classifications and clarification of OCT-relevant prognostic signs for glaucoma surgery site.

© 2018, Media Sfera. All rights reserved. At present, phacoemulsification and trabeculectomy are the most widespread surgery methods in cataract and glaucoma treatment, generally recognized as the gold standard. Among elderly patients, comorbid glaucoma and cataract are extremely prevalent, so the order of the two surgeries and the time interval between them are pivotal choices when planning treatment strategy. The reason for it is that almost any eye surgery is considered a risk factor for long-term trabeculectomy effectiveness. In attempts to solve this problem, numerous studies have been conducted on the impact of cataract surgery on filtration bleb scarring. The problem of determining the time interval between surgeries, as well as other treatment nuances, remains relevant despite the long history of research and publications. Some results are cited as general recommendations on treatment tactics (increasing the time interval between operations, using antimetabolite and anti-inflammatory therapy, minimizing intraoperative traumatism). However, currently there are no specific recommendations for one of the most important factors - the time interval between cataract extraction and trabeculectomy.