Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early S
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01.12.2021 |
Duss S.B.
Brill A.K.
Baillieul S.
Horvath T.
Zubler F.
Flügel D.
Kägi G.
Benz G.
Bernasconi C.
Ott S.R.
Korostovtseva L.
Sviryaev Y.
Salih F.
Endres M.
Tamisier R.
Gouveris H.
Winter Y.
Denier N.
Wiest R.
Arnold M.
Schmidt M.H.
Pépin J.L.
Bassetti C.L.A.
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Trials |
10.1186/s13063-020-04977-w |
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Ссылка
© 2021, The Author(s). Background: Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods: eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion: The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration: ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).
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Effect of early sleep apnoea treatment with adaptive servo-ventilation in acute stroke patients on cerebral lesion evolution and neurological outcomes: study protocol for a multicentre, randomized controlled, rater-blinded, clinical trial (eSATIS: early S
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01.12.2021 |
Duss S.B.
Brill A.K.
Baillieul S.
Horvath T.
Zubler F.
Flügel D.
Kägi G.
Benz G.
Bernasconi C.
Ott S.R.
Korostovtseva L.
Sviryaev Y.
Salih F.
Endres M.
Tamisier R.
Gouveris H.
Winter Y.
Denier N.
Wiest R.
Arnold M.
Schmidt M.H.
Pépin J.L.
Bassetti C.L.A.
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Trials |
10.1186/s13063-020-04977-w |
0 |
Ссылка
© 2021, The Author(s). Background: Sleep-disordered breathing (SDB) is highly prevalent in acute ischaemic stroke and is associated with worse functional outcome and increased risk of recurrence. Recent meta-analyses suggest the possibility of beneficial effects of nocturnal ventilatory treatments (continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV)) in stroke patients with SDB. The evidence for a favourable effect of early SDB treatment in acute stroke patients remains, however, uncertain. Methods: eSATIS is an open-label, multicentre (6 centres in 4 countries), interventional, randomized controlled trial in patients with acute ischaemic stroke and significant SDB. Primary outcome of the study is the impact of immediate SDB treatment with non-invasive ASV on infarct progression measured with magnetic resonance imaging in the first 3 months after stroke. Secondary outcomes are the effects of immediate SDB treatment vs non-treatment on clinical outcome (independence in daily functioning, new cardio-/cerebrovascular events including death, cognition) and physiological parameters (blood pressure, endothelial functioning/arterial stiffness). After respiratory polygraphy in the first night after stroke, patients are classified as having significant SDB (apnoea-hypopnoea index (AHI) > 20/h) or no SDB (AHI < 5/h). Patients with significant SDB are randomized to treatment (ASV+ group) or no treatment (ASV− group) from the second night after stroke. In all patients, clinical, physiological and magnetic resonance imaging studies are performed between day 1 (visit 1) and days 4–7 (visit 4) and repeated at day 90 ± 7 (visit 6) after stroke. Discussion: The trial will give information on the feasibility and efficacy of ASV treatment in patients with acute stroke and SDB and allows assessing the impact of SDB on stroke outcome. Diagnosing and treating SDB during the acute phase of stroke is not yet current medical practice. Evidence in favour of ASV treatment from a randomized multicentre trial may lead to a change in stroke care and to improved outcomes. Trial registration: ClinicalTrials.gov NCT02554487, retrospectively registered on 16 September 2015 (actual study start date, 13 August 2015), and www.kofam.ch (SNCTP000001521).
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InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers
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01.12.2021 |
Gago-Veiga A.
Huhn J.I.
Latysheva N.
Vieira Campos A.
Torres-Ferrus M.
Alpuente Ruiz A.
Sacco S.
Frattale I.
Ornello R.
Ruscheweyh R.
Marques I.
Gryglas-Dworak A.
Stark C.
Gallardo V.
Pozo-Rosich P.
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Journal of Headache and Pain |
10.1186/s10194-021-01258-y |
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Background: There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries. Methods: This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months. Results: A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments. Conclusions: There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.
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Determining the sex-specific distributions of average daily alcohol consumption using cluster analysis: is there a separate distribution for people with alcohol dependence?
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01.12.2021 |
Jiang H.
Lange S.
Tran A.
Imtiaz S.
Rehm J.
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Population Health Metrics |
10.1186/s12963-021-00261-4 |
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Background: It remains unclear whether alcohol use disorders (AUDs) can be characterized by specific levels of average daily alcohol consumption. The aim of the current study was to model the distributions of average daily alcohol consumption among those who consume alcohol and those with alcohol dependence, the most severe AUD, using various clustering techniques. Methods: Data from Wave 1 and Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions were used in the current analyses. Clustering algorithms were applied in order to group a set of data points that represent the average daily amount of alcohol consumed. Gaussian Mixture Models (GMMs) were then used to estimate the likelihood of a data point belonging to one of the mixture distributions. Individuals were assigned to the clusters which had the highest posterior probabilities from the GMMs, and their treatment utilization rate was examined for each of the clusters. Results: Modeling alcohol consumption via clustering techniques was feasible. The clusters identified did not point to alcohol dependence as a separate cluster characterized by a higher level of alcohol consumption. Among both females and males with alcohol dependence, daily alcohol consumption was relatively low. Conclusions: Overall, we found little evidence for clusters of people with the same drinking distribution, which could be characterized as clinically relevant for people with alcohol use disorders as currently defined.
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The potential role of emicizumab prophylaxis in severe von Willebrand disease
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01.03.2021 |
Barg A.A.
Avishai E.
Budnik I.
Brutman T.B.
Tamarin I.
Dardik R.
Bashari D.
Misgav M.
Lubetsky A.
Lalezari S.
Livnat T.
Kenet G.
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Blood Cells, Molecules, and Diseases |
10.1016/j.bcmd.2020.102530 |
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Ссылка
© 2020 Elsevier Inc. Background: Severe von Willebrand disease (VWD) may be associated with chronic joint damage and may require prophylactic therapy. Emicizumab is a humanized bispecific antibody, which mimics the function of coagulation factor VIII (FVIII), and it has been approved for prophylaxis in hemophilia A. Methods: This is the first study assessing the potential future role of emicizumab as an alternative prophylactic treatment in patients with severe VWD, based upon a thrombin generation (TG) ex vivo analysis. We report 51 weeks of successful off label emicizumab prophylaxis in a child with severe VWD and recurrent hemarthroses and progressive arthropathy despite adherence to previous prophylaxis with replacement therapy. Results and conclusions: Our work demonstrated that ex vivo spiking with emicizumab increased TG in plasma from patients with type 3 VWD. Similar TG results were observed in our treated patient, whose therapy was well tolerated without any adverse events. Both in vitro and ex vivo TG data support sufficient hemostasis without exceeding the range seen in healthy volunteers. Further collaborative studies on the efficacy and safety of emicizumab prophylaxis in severe VWD is warranted.
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The potential role of emicizumab prophylaxis in severe von Willebrand disease
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01.03.2021 |
Barg A.A.
Avishai E.
Budnik I.
Brutman T.B.
Tamarin I.
Dardik R.
Bashari D.
Misgav M.
Lubetsky A.
Lalezari S.
Livnat T.
Kenet G.
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Blood Cells, Molecules, and Diseases |
10.1016/j.bcmd.2020.102530 |
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Ссылка
© 2020 Elsevier Inc. Background: Severe von Willebrand disease (VWD) may be associated with chronic joint damage and may require prophylactic therapy. Emicizumab is a humanized bispecific antibody, which mimics the function of coagulation factor VIII (FVIII), and it has been approved for prophylaxis in hemophilia A. Methods: This is the first study assessing the potential future role of emicizumab as an alternative prophylactic treatment in patients with severe VWD, based upon a thrombin generation (TG) ex vivo analysis. We report 51 weeks of successful off label emicizumab prophylaxis in a child with severe VWD and recurrent hemarthroses and progressive arthropathy despite adherence to previous prophylaxis with replacement therapy. Results and conclusions: Our work demonstrated that ex vivo spiking with emicizumab increased TG in plasma from patients with type 3 VWD. Similar TG results were observed in our treated patient, whose therapy was well tolerated without any adverse events. Both in vitro and ex vivo TG data support sufficient hemostasis without exceeding the range seen in healthy volunteers. Further collaborative studies on the efficacy and safety of emicizumab prophylaxis in severe VWD is warranted.
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A microwave-triggered opening of the multifunctional polyelectrolyte capsules with nanodiamonds in the shell composition
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06.01.2021 |
Borodina T.
Yurina D.
Sokovikov A.
Karimov D.
Bukreeva T.
Khaydukov E.
Shchukin D.
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Polymer |
10.1016/j.polymer.2020.123299 |
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© 2020 Microcapsules are ideal cargo platform for variety of applications such as drug delivery, sensing and imaging due to the combination of a simplicity fabrication and flexibility in the design. We developed remotely collapsing polymer capsules to response to external microwave treatment. The multilayer structure of the capsules was designed to create a polyfunctional system intercalating with nanodiamonds (NDs) and upconversion nanoparticles (UCNPs) into the polyelectrolyte shell. NDs empower local overheating to the microcapsules, while UCNPs provide opportunity to luminescent thermal sensing. UCNPs consist of inorganic crystalline host matrix - hexagonal β-phase NaYF4, doped with pairs of trivalent lanthanide ions, which play role of sensitizer (Yb3+) and activator (Er3+). The microwave triggering followed by the capsule heating results in the controlled destruction of the polyelectrolyte shell with subsequent cargo release. UCNPs luminescence was utilized to determine the local temperature of the capsule shell at nanoscale under GHz ultrasonic treatment. Our novel approach provides on demand microcapsule system destruction, which can be used in the development of nanotheranostic platform for the unification of diagnosis and treatment of various diseases.
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Flow-mode water treatment under simultaneous hydrodynamic cavitation and plasma
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01.01.2021 |
Abramov V.O.
Abramova A.V.
Cravotto G.
Nikonov R.V.
Fedulov I.S.
Ivanov V.K.
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Ultrasonics Sonochemistry |
10.1016/j.ultsonch.2020.105323 |
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© 2020 Elsevier B.V. Over the last two decades, the scientific community and industry have made huge efforts to develop environmental protection technologies. In particular, the scarcity of drinking water has prompted the investigation of several physico-chemical treatments, and synergistic effects have been observed in hyphenated techniques. Herein, we report the first example of water treatment under simultaneous hydrodynamic cavitation and plasma discharge with the intense generation of radicals, UV light, shock waves and charged particles. This highly reactive environment is well suited to the bulk treatment of polluted water (i.e. E. coli disinfection and organic pollutant degradation). We have developed a new prototype and have efficiently applied this hybrid technology to water disinfection and the complete degradation of methanol in water with the aim of demonstrating its scalability. We have analyzed the mechanisms of water disinfection under the abovementioned conditions and verified them by measuring cavitation noise spectra and plasma emission spectra. We have also used the degradation of textile dyes and methanol solutions as an indicator for the formation of radicals.
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Flow-mode water treatment under simultaneous hydrodynamic cavitation and plasma
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01.01.2021 |
Abramov V.O.
Abramova A.V.
Cravotto G.
Nikonov R.V.
Fedulov I.S.
Ivanov V.K.
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Ultrasonics Sonochemistry |
10.1016/j.ultsonch.2020.105323 |
0 |
Ссылка
© 2020 Elsevier B.V. Over the last two decades, the scientific community and industry have made huge efforts to develop environmental protection technologies. In particular, the scarcity of drinking water has prompted the investigation of several physico-chemical treatments, and synergistic effects have been observed in hyphenated techniques. Herein, we report the first example of water treatment under simultaneous hydrodynamic cavitation and plasma discharge with the intense generation of radicals, UV light, shock waves and charged particles. This highly reactive environment is well suited to the bulk treatment of polluted water (i.e. E. coli disinfection and organic pollutant degradation). We have developed a new prototype and have efficiently applied this hybrid technology to water disinfection and the complete degradation of methanol in water with the aim of demonstrating its scalability. We have analyzed the mechanisms of water disinfection under the abovementioned conditions and verified them by measuring cavitation noise spectra and plasma emission spectra. We have also used the degradation of textile dyes and methanol solutions as an indicator for the formation of radicals.
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Flow-mode water treatment under simultaneous hydrodynamic cavitation and plasma
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01.01.2021 |
Abramov V.O.
Abramova A.V.
Cravotto G.
Nikonov R.V.
Fedulov I.S.
Ivanov V.K.
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Ultrasonics Sonochemistry |
10.1016/j.ultsonch.2020.105323 |
0 |
Ссылка
© 2020 Elsevier B.V. Over the last two decades, the scientific community and industry have made huge efforts to develop environmental protection technologies. In particular, the scarcity of drinking water has prompted the investigation of several physico-chemical treatments, and synergistic effects have been observed in hyphenated techniques. Herein, we report the first example of water treatment under simultaneous hydrodynamic cavitation and plasma discharge with the intense generation of radicals, UV light, shock waves and charged particles. This highly reactive environment is well suited to the bulk treatment of polluted water (i.e. E. coli disinfection and organic pollutant degradation). We have developed a new prototype and have efficiently applied this hybrid technology to water disinfection and the complete degradation of methanol in water with the aim of demonstrating its scalability. We have analyzed the mechanisms of water disinfection under the abovementioned conditions and verified them by measuring cavitation noise spectra and plasma emission spectra. We have also used the degradation of textile dyes and methanol solutions as an indicator for the formation of radicals.
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Effect of Perindopril/Indapamide on Cerebral Blood Flow in Middle-Aged, Treatment-Naïve Patients with Hypertension
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01.12.2020 |
Ostroumova T.M.
Ostroumova O.D.
Parfenov V.A.
Perepelova E.M.
Perepelov V.A.
Kochetkov A.I.
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Advances in Therapy |
10.1007/s12325-020-01515-7 |
0 |
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© 2020, Springer Healthcare Ltd., part of Springer Nature. Introduction: The relationship between blood pressure (BP) and cerebral blood flow (CBF) is not fully understood. This study evaluated the impact of a perindopril arginine/indapamide (Pa/I) single-pill combination (SPC) on CBF in middle-aged patients. Methods: A total of 22 treatment-naïve patients with essential hypertension and at least one hypertension-mediated organ damage and 41 healthy controls were enrolled. At baseline, all participants underwent brain magnetic resonance imaging (MRI); patients with hypertension underwent an additional MRI at end of follow-up. Arterial spin labeling (ASL) was used to calculate CBF in the frontal lobe cortical plate. Patients with hypertension received once-daily Pa/I 5 mg/1.25 mg SPC, which could be increased to Pa/I 10 mg/2.5 mg at 2 weeks if necessary. Patients with hypertension underwent 24-h ambulatory BP monitoring (ABPM) at baseline and end of follow-up. Results: Mean baseline BP values were 146.2/93.1 and 119.1/76.1 mmHg in the hypertension and control groups, respectively. Patients with hypertension had significantly (p < 0.001) lower CBF in the cortical plate of both left (36.2 ± 8.3 vs. 45.3 ± 3.5 ml/100 g/min) and right (37.9 ± 7.9 vs. 45.8 ± 3.2 ml/100 g/min) frontal lobes compared to normotensive controls. At the end of follow-up, there was a statistically significant (p < 0.001) increase in CBF in the cortical plate of both left (from 36.2 ± 8.3 to 47.5 ± 9.8 ml/100 g/min) and right frontal lobes (from 37.9 ± 7.9 to 47.4 ± 10.1 ml/100 g/min) compared to baseline. No significant difference was found between end of follow-up CBF levels in frontal lobes of patients with hypertension and those of healthy controls at baseline. Office BP decreased by 24.2/15.5 mmHg and 24-h ABPM from 145.5/95.3 to 120.8/79.3 mmHg. Conclusion: In middle-aged, treatment-naïve patients with hypertension, Pa/I SPC was associated with increased CBF in the cortical plate of the frontal lobes, which achieved levels of normotensive controls. The increase in CBF had no clear association with observed BP changes. Registration number: ISRCTN67799751.
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Differences in the local structure and composition of anodic TiO<inf>2</inf> nanotubes annealed in vacuum and air
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30.06.2020 |
Gavrilin I.
Dronov A.
Volkov R.
Savchuk T.
Dronova D.
Borgardt N.
Pavlikov A.
Gavrilov S.
Gromov D.
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Applied Surface Science |
10.1016/j.apsusc.2020.146120 |
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© 2020 This work is dedicated to the influence of thermal treatment procedures in vacuum and air atmosphere on the structural features of multiwalled TiO2 anodic nanotubes (NTs) formed in fluorine-containing ethylene glycol (EG) based electrolyte investigated by high-resolution transmission electron microscopy (HRTEM) in conjunction with EDX and electronic nanodiffraction (STEM nanodiffraction), IR and Raman spectroscopy, XPS and ToF SIMS. Using electron nanodiffraction technique, there were estimated TiO2 nanocrystallite sizes for the inner layer of the NTs after annealing in air and vacuum for the first time. The differences in carbon distribution profiles in TiO2 nanotube crosscut after thermal treatments in air and vacuum were discussed. It was found that thermal treatment in vacuum leads to different phase composition of TiO2 NTs IL comparing to annealing in air. A sequential thermal treatment (firstly in vacuum and then in air) enables to remove carbon from TiO2 NTs surface and partly from TiO2 NTs IL and prevent detachment of IL from OL at the same time. The obtained data will be useful for understanding the mechanisms of structural modifications during thermal treatments as well as for functional properties optimization of such nanostructures.
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Universal Library Preparation Protocol for Efficient High-Throughput Sequencing of Double-Stranded RNA Viruses
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01.01.2020 |
Dolgova A.
Safonova M.
Dedkov V.
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Methods in Molecular Biology |
10.1007/978-1-0716-0138-9_14 |
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© Springer Science+Business Media, LLC, part of Springer Nature 2020. This chapter reports a library preparation protocol for efficient high-throughput sequencing of double-stranded RNA viruses. The protocol consists of four main steps, viz., enzyme treatment, precipitation using lithium chloride, full-length amplification of cDNAs, and tailing adapters for high-throughput sequencing. This protocol will be useful for all double-stranded RNA viruses and for all of the high-throughput sequencing platforms.
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Salvage surgery for recurrent larynx cancer
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01.11.2019 |
Mimica X.
Hanson M.
Patel S.
McGill M.
McBride S.
Lee N.
Dunn L.
Cracchiolo J.
Shah J.
Wong R.
Ganly I.
Cohen M.
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Head and Neck |
10.1002/hed.25925 |
1 |
Ссылка
© 2019 Wiley Periodicals, Inc. Background: Despite advances in treatment, the recurrence rates for laryngeal cancer range from 16% to 40%. Methods: Patients with recurrent laryngeal cancer treated at Memorial Sloan Kettering (MSK) from 1999 to 2016 were reviewed. Survival outcomes were analyzed. Results: Of 241 patients, 88% were male; the median age was 67 years; 71% had primary glottic tumors. At initial treatment, 72% of patients were seen with early stage disease; primary treatment was radiation (68%), chemoradiation (29%), and surgery (3%). The most common salvage surgery was total laryngectomy (74%). Forty-seven percentage were upstaged at salvage surgery. The 2- and 5-year disease-specific survival (DSS) was 74% and 57%, respectively. Patients with cT4 disease treated with nonsurgical primary management had a 0% 5-year DSS. Independent predictors of DSS were tumor location, perineural invasion, margin, and stage. Conclusions: Salvage surgery results in acceptable oncologic outcomes. Stage, disease site, perineural invasion, and margins are associated with inferior DSS.
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Dynamics of concomitant therapy in children with juvenile idiopathic arthritis treated with etanercept and methotrexate
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01.10.2019 |
Alexeeva E.
Dvoryakovskaya T.
Denisova R.
Sleptsova T.
Isaeva K.
Chomahidze A.
Fetisova A.
Mamutova A.
Alshevskaya A.
Gladkikh V.
Moskalev A.
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Pediatrics and Neonatology |
10.1016/j.pedneo.2019.02.003 |
2 |
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© 2019 Background: Both the steroid- and NSAID-sparing effects of biologics in juvenile idiopathic arthritis (JIA) treatment are key aspects of the dynamics of patient's condition. The proper selection of biologics enables maximum treatment effectiveness and reduction of the dosage of concomitant therapy. Our aim was to study the dynamics of concomitant therapy during etanercept (ETA) and methotrexate (MTX) treatment in patients with JIA. Methods: This analysis included 215 JIA patients (63.3% females) showing sufficient response to main therapy. One hundred patients received MTX as main therapy, 24 received ETA monotherapy, and 91 received ETA þ MTX combination therapy. The dynamics of concomitant therapy were analyzed after 1 month, every 3 months during the first year, and every 6 months during the long-term follow-up (up to 5 years). Results: At the baseline, 24 (11.2%) patients received concomitant oral glucocorticoids (orGCs) and NSAIDs; the remaining 191 (88.8%) patients were treated with concomitant NSAIDs only. Within 1-year treatment, NSAIDs were discontinued in 162 (75.3%) patients. There were no significant differences in the dynamics of withdrawal of NSAIDs in patients who received and did not receive concomitant MTX. However, the percentage of treatment discontinuation in the MTX group was significantly lower compared to the other two groups (p < 0.001). Oral GCs were discontinued completely in 4 children (16.7%), and the dose of oral GCs was reduced in another 4 patients (16.7%). By the end of the follow-up period, 44 of 115 patients (38.3%) treated with ETA in combination with any concomitant therapy could switch to ETA monotherapy. Conclusion: Therapy with ETA makes it possible to reduce the dosage or completely discontinue most concomitant medications (orGCs, NSAIDs, MTX) in a significant percentage of patients. This reduces the risk of development of NSAID- and GC-induced pathological conditions, while the effectiveness of therapy of the underlying condition remains high.
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Prevalence and treatment of vitamin D deficiency in young male Russian soccer players in winter
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01.10.2019 |
Bezuglov E.
Tikhonova A.
Zueva A.
Khaitin V.
Waśkiewicz Z.
Gerasimuk D.
Żebrowska A.
Rosemann T.
Nikolaidis P.
Knechtle B.
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Nutrients |
10.3390/nu11102405 |
0 |
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© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Vitamin D (25(OH)D) insufficiency and deficiency are highly prevalent in adult soccer players and can exceed 80% even in regions with high insolation; however, the treatment of this condition is often complicated. The aim of the present study was to examine the prevalence of vitamin D insufficiency and deficiency in youth Russian soccer players and the efficacy of its treatment. Participants were 131 young male football players (age 15.6 ± 2.4 years). Low vitamin D levels (below 30 ng/mL) were observed in 42.8% of the analyzed participants. These athletes were split in two groups composed of persons with vitamin D deficiency (serum vitamin D below 21 ng/mL) and insufficiency (serum vitamin D in range of 21-29 ng/mL). A dietary supplement of 5000 IU cholecalciferol per day was administered for two months. After the treatment, an average 92% increase in vitamin D concentration was observed (before treatment—19.7 ± 5.4 ng/mL, after treatment—34.7 ± 8.6 ng/mL, p < 0.001) and 74% of the post-treatment values were within the reference range (30-60 ng/mL). Serum concentration of vitamin D increased by 200% ± 98% (p < 0.001) during the first month of treatment with vitamin D deficiency and insufficiency being successfully treated in 83% of the football players. In summary, the prevalence of vitamin D insufficiency and deficiency was high in young Russian soccer players. Furthermore, it was indicated that the daily usage of cholecalciferol in a dose 5000 IU was an effective and well-tolerated treatment for vitamin D insufficiency. No linear dependency between the duration of treatment and increase in vitamin 25(OH) D concentration was observed.
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Modern approaches to diagnosis and treatment of attention deficit hyperactivity disorder
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01.09.2019 |
Korabelnikova E.
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Pediatriya - Zhurnal im G.N. Speranskogo |
10.24110/0031-403X-2019-98-5-114-122 |
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© 2019, Pediatria Ltd. All rights reserved. Attention deficit hyperactivity disorder (ADHD) is an urgent problem due to the high incidence rate, reaching 3–5% in the child population. The article discusses diagnostic criteria for ADHD and manifestation peculiarities in different age periods. It also duscusses etiopathogenesis of ADHD as a multifactorial developmental disorder; reviews main groups of drugs used for the pharmacological correction of the disease, among which nootropics, in particular aminophenylbutyric acid («Anvifen»), occupy a special place. Author discusses and justifies the need for an integrated approach to ADHD treatment, which should combine pharmacotherapy, neuropsychological correction and psychotherapy with a child, parents and teachers.
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Modern ideas about juvenile dermatomyositis part 2: Activity assessment and treatment
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01.09.2019 |
Podchernyaeva N.
Konevina M.
Tikhaya M.
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Pediatriya - Zhurnal im G.N. Speranskogo |
10.24110/0031-403X-2019-98-5-135-146 |
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© 2019, Pediatria Ltd. All rights reserved. In the article the authors present relevant information on the criteria for assessing the activity of juvenile dermatomyositis (JDM) and modern approaches to its treatment. In clinical practice, various scales are currently used to assess the overall JDM activity and severity of damage to various organs, primarily muscles and skin. The article provides modern recommendations for JDM treatment: The use of glucocorticosteroids, disease-modifying antirheumatic drugs (methotrexate, calcineurin inhibitors, cyclophosphamide, mycophenolate mofetil, azathioprine, hydroxychloroquine, intravenous immunoglobulin), genetically engineered drugs (rituximab, infliximab, adalimumab, golimumab, certolizumab, etanercept), as well as promising new drugs and methods of maintenance therapy. The modern JDM treatment algorithm is described.
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Osteosynthesis of intra-and periarticular fractures of the distal humerus
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01.09.2019 |
Al Abdullah M.
Solod E.
Zagorodniy N.
Lazarev A.
Abdulkhabirov M.
Dzhanibekov M.
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International Journal of Pharmaceutical Research |
10.31838/ijpr/2019.11.03.063 |
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© 2019, Advanced Scientific Research. All rights reserved. Intra - and periarticular fractures of the distal humerus comprise from 0.5% to 15.3% of all fractures of the humerus and 3.5 - 5% of all fractures in adults. In recent years, the growing injury, including the localization. Treatment of fractures of the elbow joint is complex and not fully resolved problem of modern traumatology and orthopedics. This is due to the peculiarities of the structure and biomechanics of the elbow joint, predisposition to the occurrence of heterotopic ossification and the development of posttraumatic contractures. Incorrect healing of fractures leads to complications, so you need the exact matching of fragments. Treatment of intra - and periarticular fractures of the distal humerus remains a topical problem in traumatology. Common, both domestic and foreign authors, is the tactics of surgical treatment of such damage. This article presents one of methods of osteosynthesis of the lower third of the humerus is subcutaneous-subfascialosteosynthesis.
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The dependence of running speed and muscle strength on the serum concentration of Vitamin D in young male professional football players residing in the Russian Federation
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01.09.2019 |
Bezuglov E.
Tikhonova A.
Zueva A.
Khaitin V.
Lyubushkina A.
Achkasov E.
Waśkiewicz Z.
Gerasimuk D.
Zebrowska A.
Nikolaidis P.
Rosemann T.
Knechtle B.
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Nutrients |
10.3390/nu11091960 |
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© 2019 by the authors. Background: Vitamin D insuffciency is prevalent among athletes, and it can negatively affect physical performance. At the same time, most of the available data were obtained from untrained individuals of various ages, and published studies performed in athletes led to contradictory conclusions. Methods: This cohort prospective study examined the serum concentration of 25-hydroxycalciferol (25(OH)D) and its association with running speed and muscle power in 131 young football players (mean age 15.6 ± 2.4 years). Results: 25(OH)D levels were below reference in 42.8% (serum 25(OH)D <30 ng/mL) and above reference in 30.5% of the participants (serum 25(OH)D 61-130 ng/mL). A comparison of the results of 5, 15, and 30 m sprint tests and the standing long jump test found no statistically significant differences between the two groups. Athletes from the 25(OH)D-insuffcient group were treated with 5000 IU cholecalciferol supplement daily for 60 days. After the treatment, the 25(OH)D concentration increased by 79.2% and was within reference in 84% of the treated athletes (serum 25(OH)D 30-60 ng/mL). Testing was repeated after the end of treatment, and a statistically significant increase in the results of the 5, 15, and 30 m sprint tests was observed (Cohen’s d was 0.46, 0.33, and 0.34, respectively), while the results of the standing long jump test remained unchanged. Body height, body weight, and lean body mass of the football players also increased. Conclusions: These findings indicate that there is likely no correlation between serum levels of 25(OH)D, muscle power, and running speed in young professional football players, and the changes observed post-treatment might have been caused by changes in the anthropometric parameters. During the study, all the anthropometric parameters changed, but the amount of lean body mass only correlated with the results of the 5 m sprint.
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