Репозиторий Университета

© 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. Background: Elevated levels of C-reactive protein (CRP), a sensitive marker of inflammation, have been consistently reported in chronic spontaneous urticaria (CSU). Here, we retrospectively analyzed data from 1253 CSU patients from 2 centers to answer the following questions: (i) What is the prevalence of elevated levels of CRP in CSU? (ii) Why do CSU patients show elevated levels of CRP? (iii) Are elevated CRP levels relevant?. Methods: Serum levels of CRP were measured by the nephelometric method. We collected information regarding various laboratory tests including ESR, CBC with differential, D-dimer, fibrinogen, C3, C4, IL-6, etc. For most patients, we also collected data on age, gender, duration of CSU, presence of angioedema, activity (UAS at the time of blood sampling and for 7 days), quality of life (CU-Q2oL and/or DLQI), comorbidities and possible causes of CSU, and autologous serum skin test (ASST) response. The efficacy of second-generation antihistamines was evaluated on the day of blood collecting. Results: One-third of CSU patients had elevated levels of CRP. Higher levels of CRP were associated with ASST positivity (P =.009) and arterial hypertension (P =.005), but not with other possible causes or comorbidities of CSU. C-reactive protein correlated with urticaria activity (P <.001), quality of life impairment (P =.026), and inflammatory and coagulation markers (P <.001). C-reactive protein levels were significantly higher in nonresponders to antihistamines as compared to responders (P <.001). Conclusion: Elevated levels of CRP are common and relevant in CSU patients. The assessment of CRP levels may help to optimize the management of patients with CSU.

© 2018, Pleiades Publishing, Ltd.  The uptake of NO 3 on a pyrene coating at [NO 3 ] = 2.5 × 10 12 –1.2 × 10 13 cm −3 is studied using a coated-insert flow tube reactor coupled to a mass spectrometer. It is established that, in this concentration range, the uptake occurs by the impact recombination mechanism, whereas the consumption of surface sites involves the unimolecular decomposition of stabilized surface complexes. Several hundreds of NO 3 radicals are consumed per surface site destroyed. The uptake coefficient depends on the exposure time, being described by the expression γ(t) = γ 0 exp(−t/τ), where γ 0 and τ are parameters dependent on the NO 3 concentration. Based on the Langmuir adsorption concept, the following elementary parameters determining the uptake process are estimated: the Langmuir coefficient, K L = 7.1 × 10 −13 cm 3 ; the desorption rate constant, k d = 44 s −1 ; and the rate constant for the unimolecular heterogeneous conversion of surface complexes, k r = 6.6 × 10 −2 s −1 . Gas chromatography–mass spectrometry measurements showed that the main products of the reaction are phthalates. The nitropyrene yield is found to be ~0.6%.

© 2018  The antioxidant activity of Ge-132 (2-carboxyethylgermanium sesquioxide, [(O 0.5 ) 3 GeCH 2 CH 2 COOH] n ), a widely used organic germanium dietary supplement, was assessed by cyclic voltammetry and through its interaction with a stable radical 2,2,-diphenyl-1-picrylhydrazyl (DPPH) monitored by UV-Vis and EPR spectroscopy in water, CH 3 CN, DMF, MeOH, and their mixtures with water. The results obtained by these methods are coherent in that Ge-132 can manifest its antioxidant activity only in the absence of water because the latter hydrolyses its Ge-O-Ge fragment responsible for quenching free radicals. Thus, contrary to a common use of Ge-132 as a water-soluble agent, it can act as an antioxidant solely in a lipid environment, which is important for understanding the mechanism of its biological activity.

© 2018, Pediatria Ltd. All rights reserved. Materials and methods: the study assessed safety and clinical efficacy of combined use of vaccine preparations against S. pneumoniae and H. influenzae type b, leading pathogens in bronchopulmonary diseases exacerbations development, in previously unvaccinated 38 children aged 2–17 years with chronic bronchopulmonary diseases: 19 with malformations of the bronchi and lungs (MBL); 10 with malformations of bronchi and lungs in combination with bronchial asthma (MBL+BA); 9 with bronchial asthma (BA). The control group consisted of 19 unvaccinated children of the same age with a similar pathology. Combined vaccination against these infections, as well as their separate administration, did not cause adverse effects. Results: a year after the introduction of Pneumo-23 vaccine, the incidence of acute respiratory infections (ARI) and exacerbations of the main disease decreased by 2,3 times; Act-HIB by 2,3 and 2,1 times respectively; by 1,7 and 1,5 times respectively with simultaneous administration of these preparations. In children with BA the duration of one exacerbation decreased by 3,4 times, the average duration of temperature reaction by 1,9 times and the systemic antibiotic therapy of one exacerbation episode by 2,4 times. In the group of children with MBL+BA these indicators decreased by 2,1, 1,8 and 1,6 times, respectively, and in patients with MBL by 1,6, 1,5 and 1,4 times, respectively. Conclusion: vaccination against pneumococcal and hemophilic type b infections using one or both vaccines in patients with MBL and with MBL+BA is safe and positively affects the clinical course of the main disease.

© 2017 Elsevier Inc. A wide range of methods are known to increase the prokaryotic intracellular recombinant proteins solubility, for instance, growth at low temperature, supplementation of culture media with “chemical chaperones” (proline, glycine-betaine, and trehalose), co-expression with chaperones or highly soluble fusion partners. As an alternative, we have introduced the polyglutamate tag, which, as it has been shown, increased the protein solubility and facilitated folding. In this study we evaluated the minimal quantity of high density negatively charged EEEEVE amino acid repeats (pGlu) necessary to switch the recombinant receptor-binding domain of human alpha-fetoprotein (rbdAFP) expression almost entirely from the inclusion bodies to the soluble cytoplasmic fraction in E. coli. For this purpose, genetic constructs based on pET vectors coding rbdAFP and containing from 1 to 4 additional EEEEVE repeats at the C-terminus have been prepared. It was found that 3 pGlu repeats is the minimal number, that leads to a complete shift of the expression to the soluble cytoplasmic fraction in E. coli SHuffle Express T7 while 4 repeats were required for that in E. coli BL21(DE3). The rbdAFP contained 4 pGlu repeats was purified making use of ion-exchange chromatography and characterized by circular dichroism and ability to bind and accumulate in AFP receptor positive cancer cells in order to check for the structural and specific activity alterations related to the additional polyanionic sequence introduction.

© 2017 Informa UK Limited, trading as Taylor  &  Francis Group. A number of concepts exist which reveal an interaction between endogenous and psychogenic factors in stress-induced disorders in patients with schizophrenia. These concepts relate to psychological, pathophysiological, and sociological aspects of the problem. In this study we look at the respective states described within the clinical concept of reactive schizophrenia. Materials: Fifty clinical cases were included: 32 females and 18 males, mean age 38.6 ± 12.5. Thirty-three patients (66%) had a diagnosis of ‘schizophrenia’, 17 patients (34%) were diagnosed with ‘schizotypal personality disorder’ according to DSM-5 criteria. The performed examination included a clinical interview, analysis of the current clinical state, analysis of the medical history. Results: From the perspective of concept of ‘reactive schizophrenia’, the subjects of our study can be split into two groups based on their mechanism of development and psychogenic vs. endogenous contributions. These two groups may be characterized as ‘psychogenic provocation of a schizophreniform disorder’ and ‘endogenous provocation of a psychogenic disorder’ respectively. Conclusions: The results observed made it possible to re-establish the hypothesis of ‘reactive schizophrenia’. The principal feature is the specific interaction between endogenous and psychogenic factors, i.e. the psychogenic provocation of endogenous disorders.

© 2018 Ima-Press Publishing House. All Rights Reserved. The brain is a natural target organ in hypertension and, as shown by some clinical observations, it is affected earlier than other organs and systems. Due to the specific features of the anatomy of cerebral circulation, hypertensive microangiopathy leads primarily to damage to the sub-cortical basal ganglia and deep white matter. Clinically, this is manifested by a concuirence of predominantly subcortical cognitive impairment and emotional and behavioral disorders as depression, emotional lability, and apathy. Some features of depression, such as the prevalence of anhedonia and fatigue and the significant severity of cognitive and somatic symptoms in an elderly person with vascular disease, suggest its organic nature (vascular depression).

The tendency to anxiety is a characteristic feature of alcohol abusers, and anxiety can be a symptom of alcohol withdrawal as well as comorbid disorder. The frequent comorbidity of alcohol use disorders and anxiety is due to a number of reasons including general hereditary predisposition, mutual conditioning and similar pathogenesis. Pharmacological therapy of anxiety disorders in alcohol-dependent patients is carried out on the basis of general principles of anxiety treatment and involves the use of benzodiazepines, antidepressants and, in some cases, antipsychotics as second-line medicines.

© 2018, Dynasty Publishing House. All rights reserved. The objective. A comparative study of the dose uniformity, dose reproducibility, imprint areas on a planar simulation model as indicators of dispersion of spray-aerosol pharmaceutical forms of various trademarks for treatment of diseases of the mouth cavity and throat. Materials and methods. As objects of study we selected 10 drugs manufactured in the «aerosol» and «spray» forms. Test for dose uniformity was performed in accordance with articles of the State Pharmacopoeia of the Russian Federation «Aerosols and sprays», comparison of dose reproducibility was performed by comparing average dose mass dispersions according to Fisher. The test for the width of dispersion was performed by imprints obtained of a single release of drugs on filter paper with Dragendorff’s reagent and plates for thin-layer chromatography. Results. All metered-dose sprays successfully passed the test for dose mass uniformity. The test for dose mass reproducibility showed a high enough stability of dosage in all the examined drugs: the percentage error of the average dose mass was at the level 1–3%. The test for dispersion width performed on planar simulation models showed significant differences in the character of drug dispersion. For comparing the width of dispersion we calculated imprint areas from a single-dose release on PSM, which permitted to determine drugs with wide and fine dispersion as the most effective with respect to the way of drug delivery to the focus of inflammation – on the mucous membranes of the throat and mouth cavity. Conclusion. The optimal combination of the examined spray characteristics was found in the spray Tantum® Verde, which permits to recommend it as a drug of choice in paediatrics for local therapy of inflammatory diseases of the throat in children beginning from the age of 3 years.

© 2018, Media Sphera Publishing Group. All rights reserved. Antidepressants are among the most commonly prescribed drugs due to their effectivenes in treating depression and anxiety disorders. One of the reasons for early discontinuation of taking antidepressants are side-effects. Agomelatine is a relatively novel antidepressant with high efficacy and good tolerance. Clinical effects of agomelatine include a reduction in symptoms of depression, anti-anxiety and hypnotic effects, as well as the rapid elimination of anhedonia, which determines high adherence to therapy, restoration of normal social functioning, and complete remission of disease.

© 2018, Media Sphera Publishing Group. All rights reserved. Objective. To study clinical characteristics of depression in women and men. Material and methods. One hundred and twenty women, aged from 18 to 65 years, and 67 age-matched men with the diagnosis of recurrent depressive disorder (RDD) (ICD-10 F33) were examined using a specially developed survey. Results. Differences in the clinical picture and course of RDD in women and men were found. RDD in women develops at an earlier age, the number of attacks is greater but remissions are longer. However, complete remission is achieved more frequently in men. Most typical effect in the structure of depression in women is anxiety whereas melancholy prevails in men. Daily mood fluctuations and suicidal thoughts are characteristic of women. Motor retardation and decreased motivation are more frequent in men. Ideas of self-blame, avoidance of contacts with other people, adynamia, persistent sense of fatigue are more common in women. Sleep disorders are equally common in men and women but falling asleep disturbance and lack of sleep feeling are more common in women. Somatic symptoms of depression are generally more common in men as well as concomitant diseases of cardiovascular, respiratory and genitourinary systems. Men are more likely to abuse alcohol and other psychoactive substances. Conclusion. The identified characteristics of depression in women and men allow more accurate diagnosis and treatment recommendations.

© 2018, © 2018 Informa UK Limited, trading as Taylor  &  Francis Group. Background: Antiphospholipid antibodies (aPL) have a multifaceted effect on the hemostatic system, damaging all its protective links. Aim: To study the effect of APA on outcomes of assisted reproductive technologies (ART). Study design: We examined 267 women with infertility, who planned pregnancy using ART. They included 178 women with IVF failure (I group) and 89 women with pregnancy after the IVF program (II group). The comparison group consisted of 80 pregnant women after IVF (male factor); a control group included 80 pregnant women with physiological pregnancy. Results of study demonstrated a high frequency of aPL circulation in a group of women with IVF failures. Overall, the proportion of aPL among all 267 women who planned pregnancy with ART was 32.6%. Elevated levels of aPL in the structure of causes of IVF failures (group I) were observed in 42.1% of them. Among women whose pregnancy occurred with ART (II group) the rate of APA was 19.1%. In the comparison group, in 6.3% of cases, aPL circulation was observed. In the control group, the rate was 3.4%. Conclusion: Considering the high percentage of aPL circulation in the case of IVF failures, authors think that high titers of aPL are a temporary contraindication for IVF. Patients with a history of aPL circulation are required to receive anticoagulant therapy from the first days of the hormonal protocol. The drug of choice is a group of low molecular weight heparins (LMWH). An individual approach is extremely important with the possible identification of causes of IVF failures and selective therapy, which leads to a significant improvement in the outcomes of the IVF program.

© 2018, Dynasty Publishing House. All rights reserved. The article analyzes a favourable outcome of multiple pregnancy achieved after using assisted reproductive technologies and donor egg in a patient with recurrent pregnancy loss and combined thrombophilia.

© 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.

© 2018, Media Sphera Publishing Group. All rights reserved. The authors describe manifestations of chronic cerebral ischemia (CCI) and present the cases of a combination of primary headache and CCI. Management of patients with CCI and headache and the use of vazobral and its efficacy in treatment of such patients are discussed.

© 2018, Media Sphera Publishing Group. All rights reserved.  Objective. To assess the prognostic significance of biological rhythms in depression on the example of the individual chronotype. Material and methods. One hundred patients (women 68%), aged 18—77 years, mean age 48±16, were examined before and after 8 weeks of treatment. The Morningness-Eveningness Questionnaire (MEQ) was used. Treatment response (a decrease of 50% in total MADRS scores to the 8 th week of treatment) and dynamics of depression severity (dMADRS; R) were assessed. Results and conclusion. Evening chronotype was found to be associated with poor prognosis. TCAs and SSRIs were more effective in eveningness, other antidepressants—in morningness. MEQ changes during and after treatment may reflect the resynchronizing activity of antidepressants.

© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The problem of drug interactions is increasingly important today because they may induce serious adverse events as well as interfere with efficacy of pharmacotherapy. Combinations of drugs are most often prescribed to patients presenting with comorbid pathology. The incidence of a combination of arterial hypertension (AH) and acid-dependent diseases (ADDs) varies widely ranging from 11.6 to 50%. One of combinations of drugs prescribed to such patients is a combination of calcium channel blocker amlodipine and proton pump inhibitor omeprazole. The latter in the human body undergoes biotransformation mediated at the level of cytochrome P450 by isoenzymes CYP2C19 and CYP3A4. Amlodipine is a substrate of the isoenzyme CYP3A4, which increases the probability of the development of interaction between these drugs. The purpose of our study was to investigate antihypertensive efficacy of amlodipine in patients suffering from arterial hypertension combined with acid-dependent diseases and additionally taking omeprazole. Method: Study included a total of 150 patients with AH and ADD. Antihypertensive therapy was evaluated by means of office measuring of arterial pressure (AP) and circadian monitoring of AP (CMAP). The followed-up patients with AH and ADD were divided into 2 groups. Group One was composed of hypertensive patients undergoing pharmacotherapy with 10 mg amlodipine, whose condition required due to exacerbation of ADD administration of omeprazole at a dose of 20 mg for a period from 3 to 4 weeks. Group Two comprised hypertensive patients receiving antihypertensive therapy consisting of 10 mg amlodipine, who were found to have remission of acid-dependent diseases, with no additional medication taken. Results: The obtained findings demonstrated that one of the commonly used drug combinations in treatment of patients with AH and ADD in ambulatory conditions was a combination of omeprazole and amlodipine, accounting for 7.1%. The results of office measurement of arterial pressure (AP) 2 weeks after initiating pharmacotherapy with omeprazole in patients with AH and ADD demonstrated that the patients receiving omeprazole in addition to antihypertensive therapy were found to have a statistically significant decrease in systolic arterial pressure (SAP) and statistically significantly more pronounced dynamics of a decrease in diastolic arterial pressure (SAP) (p<0.05) compared with those not receiving therapy with omeprazole. Also, in the group of patients taking omeprazole, the findings of circadian monitoring of blood pressure (CMAP) showed a statistically significant decrease in average circadian SAP, average circadian DAP, mean value of daytime SAP and mean value of nighttime SAP (p<0.05). Conclusion: The obtained findings demonstrated that simultaneous prescription of amlodipine and omeprazole to patients with concomitant pathology, i.e., AH and ADD, turned out to enhance the antihypertensive affect of amlodipine, which probably resulted from substrate competition of amlodipine and omeprazole at the level isoenzyme CYP 3A4 of cytochrome P450.

© 2018 Dynasty Publishing House. All rights reserved. The lecture deals with treatment of patients with CIN associated with papillomavirus infection (HPVI). The issues of epidemiology, diagnosis and treatment of CIN are discussed. Emphasis is put on a complex approach to treating patients with HPVI-associated CIN. Special attention is paid to studying the mechanisms of dysregulation of immune response during the period of human papillomavirus virus (HPV) persistence, which promotes immune suppression and is considered to be a necessary precondition for progression of HPV-associated cancer. Based on analysis of literature sources, the authors show that high oncogenic risk E6 and E7 HPV types interact with key proteins of interferon signalling pathway, inhibiting its production. This accounts for insufficient effectiveness of preparations of pure interferons and their inductors for treatment of HPV infection. From the pathogenetic positions, the use of inosine pranobex as a medication in complex therapy would be appropriate, since it ensures complete elimination of HPV and reduces the frequency of HPV infection recurrences.

© N.N. IVANETS E.N. EFREMOVA, 2018. Objective. To explore psychopathological features of affective disorders in the structure of schizotypal disorder. Material and methods. The study included 102 patients with schizotypal disorder, aged from 18 to 60 years. Assessment was done using clinical/ psychopathological method and psychometric scales — Calgary depression scale in patients with schizophrenia (CDSS), General Clinical Impression scale (CGI), Yang’s mania scale (YMRS). Results and conclusion. Affective disorders are noted in the majority of inpatients with schizotypal disorder. They are represented by depressive disorders of variable severity, and mixed depressive states. A group of patients with schizotypal disorder was identified in whom the symptoms of the affective disorder constituted the main clinical picture of the disease, whereas concomitant neurosis-like disorders were formed solely during the exacerbation of depression, correlated with its severity and reduced on antidepressant therapy along with depressive symptoms. Observed reversibility of productive disorders allowed us to consider the dynamic of these states as similar to the atypical affective phase, and the natural course of the disorder as close to the paroxysmal type in the form of distinct depressive phases. In patients with persistent neurosis-like disorders, affective disorders accompanied axial symptoms of the disease and made a large impact on the structure of the exacerbation of the endogenous process. A reduction of depressive symptoms in these patients was accompanied by a decrease in the intensity of axial symptoms of the disease, however the complete reduction of axial symptoms and remission was not observed.

© 2018, Media Sphera Publishing Group. All Rights Reserved. Objective. To develop therapeutic programs for treatment of depression with panic attacks on the basis of their clinical and psychopathological features. Material and methods. A total of 100 in-and outpatients, aged from 18 to 60 years, with depression of mild and moderate severity with panic attacks were studied. The investigation was carried out using clinical, psychopathological and psychometric (the Atypical Depression Diagnostic Scale (ADDS), the Montgomery—Asberg Depression Rating Scales (MADRS), and the Sheehan Anxiety Rating Scale (ShARS)) methods. The patients were assessed on admission, on the 1st, 2nd, 4th and 8th weeks with subsequent processing and defining standard indicators. Three therapeutic groups were formed: the 1st group received therapy combining an antidepressant and a tranquilizer; the 2nd group an antidepressant, a tranquilizer and a mood stabilizer; and the 3rd group an antidepressant, a tranquilizer and an antipsychotic agent. The time course of expression of the signs of depression, anxiety and frequency of panic attacks was analyzed. Results. The highest efficacy in the form of reduced signs of depression and anxiety was observed in the 3rd group on the 1st week of therapy. No significant differences in reduction of depression and anxiety were found between the 1st and 2nd groups. In the 1st therapeutic group, there was an increase in the frequency of panic attacks together with the reduction in their expression and decrease in the severity of depression as compared to the 2nd and 3rd groups. At the same time the 3rd therapeutic group was characterized by a maximally expressed decrease in the frequency of panic attacks already on the 1st week of therapy. Conclusion. The study has shown that the use of antipsychotic drugs in addition to therapy with antidepressants and tranquilizers is the most effective way to stop depression.