Репозиторий Университета

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.

© 2019 Elsevier Inc. The paper studies an approximate static condensation method for the diffusion problem with discontinuous diffusion coefficients. The method allows for a general polygonal mesh which is unfitted to the material interfaces. Moreover, the interfaces can be discontinuous across the mesh edges as typical for numerical reconstructions using the volume or moment-of-fluid methods. We apply a mimetic finite difference method to solve local diffusion problems and use P1 (mortar) edge elements to couple local problems into the global system. The condensation process and the properties of the resulting algebraic system are discussed. It is demonstrated that the method is second order accurate on smooth solutions and performs well for problems with high contrast in diffusion coefficients. Experiments also show the robustness with respect to position of the material interfaces against the underlying mesh.

© 2018 John Wiley  &  Sons A/S. Published by John Wiley  &  Sons Ltd Background: The essential physical role, visibility and social importance of the hands place a major psychological burden on patients with hand eczema. Objectives: The aim of this study was to identify the psychological, social and clinical characteristics of patients with hand eczema, in particular the prevalences of depression, anxiety, suicidal ideation, and comorbidities. Materials and methods: Data on patients with hand eczema were analysed from a large European multicentre study conducted with dermatology outpatients from 13 countries. Groups of patients and controls were compared to analyse the psychological burden of hand eczema. Results: Female patients with hand eczema had higher Hospital Anxiety and Depression Scale (HADS) scores for anxiety (n = 86, median = 7.0) than controls (n = 900, median = 5.0, P =.02), and for depression (median = 4.0) than controls (3.0, P <.001). Patients with high suicidal ideation, with low socioeconomic status and who were widowed or divorced were more likely to fulfil the HADS criteria for anxiety [odds ratio (OR) > 1, P =.038, P <.001, and P <.001, respectively]. The median Dermatology Life Quality Index score was 7.0 (n = 68). Discussion: This study identifies a specific psychological burden experienced by hand eczema patients, highlighting the need for focused psychosocial interventions. Physicians in particular should be aware of the need to identify anxiety and depression in female patients.

© 2018, © 2018 Informa UK Limited, trading as Taylor  &  Francis Group. Children growth and development may be affected by metal exposure. The objective of the present study was to investigate the interactive effects of age and gender on children hair toxic metal levels in urban environment of two Russian cities. A total of 2021 children living in Moscow and Novosibirsk aged 1–18 years old were examined. Hair Al, As, Cd, Hg, Ni, Pb and Sn levels were assessed using inductively-coupled plasma mass-spectrometry in dynamic reaction cell mode. Children from Novosibirsk were characterised by higher hair Al (37%), As (385%), Cd (127%), Hg (11%), Ni (23%), Pb (72%) and Sn (25%) in comparison to Moscow values. In the general cohort, boys had higher Al (13%), As (51%), Cd (65%), Pb (63%) and Sn (18%) levels, whereas hair Ni was higher in girls (17%). Further analysis demonstrated age-specific gender differences. In particular, only hair Ni and Cd levels were higher in male toddlers and pre-schoolers from Novosibirsk as compared to females. No gender difference was detected in Moscow. Maximal gender differences in hair metal levels were detected in adolescents for both locations. International Union of Pure and Applied Chemistry (IUPAC) reference values for all groups were also calculated. The overall reference limits for the studied children population were Al (1.335–3.340 µg/g), As (0.021–0.384 µg/g), Cd (0.000–1.389 µg/g), Hg (0.024–0.722 µg/g), Ni (0.076–0.701 µg/g), Pb (0.050–1.490 µg/g) and Sn (0.070–1.026 µg/g). Two-way ANOVA demonstrated significant effects of age, gender and age*gender interaction on hair metals in both cities. At the same time, the age-specific changes in hair metal content were more expressed in children from Novosibirsk, being exposed to higher metal pollution. The obtained data demonstrate that age, gender as well as the particular rate of pollution in each location should be taken into account during interpretation of hair test results.

© 2018, Pleiades Publishing, Inc. The article presents empirical data on the possible use of transcranial Doppler sonography as a method for the identification of functional specialization of hemispheres. We investigated intrahemispheric differences in the increase in blood flow velocity indicators during the performance of cognitive tasks with verbal and nonverbal stimuli in 20 healthy right-handed participants and 20 right-handed patients with local unilateral vascular brain lesions. We observed interhemispheric and intrahemispheric differences in blood flow velocity indicators between arteries during the performance of cognitive tasks with different variants of verbal stimuli in all participants. It has been found that one of the hemispheres plays a dominant role in verbal and nonverbal stimulus processing.

© 2018 Media Sphera Publishing Group.All rights reserved.  Contribution of diseases of the circulatory system to total mortality of the population remains high. Therefore it is necessary to study factors with most substantial impact on regional morbidity and mortality for elaboration of targeted programs of preventive measures aimed at definite population groups. Purpose of this study was to perform analysis of differences of mortality from cardiovascular diseases (VVD) of Moscow region inhabitants of various gender and age. Materials and methods. Data on 2016 mortality of Federal Service of State Statistics (Rosstat) and territorial service of state statistics of the Moscow Region were used in this analysis. Analysis was conducted for men and women divided in age groups ≤50, 50-59, 60-69, and ≥50 years. Diseases were classified in accordance with 10 th Revision of International Statistical Classification of Diseases (ICD10). Results. Population of the Moscow Region territory on January 1, 2016, amounted 7 318 647 (men 46.2, women 53.8%, persons of working age 58.9%). Contribution in the mortality structure of chronic ischemic heart disease (IHD) and cerebro-vascular diseases in women was greater than in men (80 vs. 68%, respectively, р<0.0001). Contribution of acute IHD, IHD unrelated heart diseases, and vascular diseases in men was significantly greater than in women (30 vs. 18%, respectively, р<0.0001). In the age group over working age mortality indexes were substantially higher compared with those in working age. In men these indexes became 10-20 times while in women - 30-130 times higher. Conclusion. Despite positive dynamics of mortality from diseases of the circulatory system (45.3% lowering from 2008 to 2016) it is necessary to strengthen efforts directed to correction risk factors of IHD and implementation of timely diagnostics and correction of IHD unrelated diseases.

© 2018 Media Sphera Publishing Group. All rights reserved. Stroke is now one of the leading causes of morbidity and mortality worldwide, in this connection, various programs are being implemented to prevention this disease and to improve diagnostic and therapeutic measures. Female gender is a proven unmodifiable risk factor for stroke. Objective - to analyze literature data on the risk factors of stroke in women and to identify the epidemiological features of the disease in women in the Tyumen Region. Material and methods. To achieve literature was sought in the databases Pubmed and Library the 2007 - 2016 statistical materials of the Healthcare Department of the Tyumen Region were used. Results. The review of the literature demonstrated significant differences in the epidemiological parameters of stroke and analyzed in detail its age-related characteristics in women, the possible biological mechanisms of differences, and the role of hormone replacement therapy. The authors' own study did not reveal a higher incidence of stroke in women than that in men even in the oldest age groups. Conclusion. For personalized stroke prevention and treatment, there is a need for further investigations with a thorough analysis of the burden of gender-related risk factors.

© 2018 Izdatel'stvo Meditsina. All rights reserved. The purpose of the study was to investigate gender features of abnormalities of blood serum lipid composition and their relationship with clinical and functional manifestations in patients with chronic kidney disease (CKD). The study covered patients with CKD at pre-dialysis stage of disease, aged 17-71 years (average age 37.3±13.0 years). All patients underwent complex clinical and laboratory examination. Depending on gender, the sample (n = 417) was divided into 2 groups: group I - males (n = 277) and group II-females (n = 140). Blood sampling was implemented using venipuncture of ulnar vein after 12-14 hours of fasting in morning time. The lipid analysis of blood serum was performed using the auto-analyzer "Respons 920" (Germany), including detection of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). The atherogenic index (AI) was calculated according formula: AI = (TC - HDL-C)/HDL-C. At analysis of the results of lipidogram, the levels of TC (hypercholesterolemia), LDL-C (hyper-beta-cholesterolemia) and TG (hypertriglyceridemia) were considered as increased when their values were ≥5.0 mmol/L, ≥3.0 mmol/L and > 1.7 mmol/L respectively. The level of HDL cholesterol (hypo-alpha-cholesterolemia) was considered as decreased when its concentration was ≤1.0 mmol/L in males and ≤1.2 mmol/L in females. In the group of male patients, hypo-alpha-cholesterolemia was detected in 135 patients (48.7%), hypertriglyceridemia - in 162 (58.4%), and average value of atherogenic index was significantly higher - 3.49 (2.43-5.08) as compared with 3.12 (2.12-3.74) in female patients (p=0.001). The laboratory signs of anemia were significantly more frequent in group of females - 53 (37.8%) as compared with 63 (22.7%) than in males (p = 0.001). In males, average values of HDL cholesterol and total serum protein were significantly lower (1.07 ± 0.44 mmol/L vs. 1.23 ± 0.42, p = 0.000 and 53.3 ± 14.6 g/L vs. 57.4 ± 11.9 g/L. p = 0.007, respectively. The levels of TG - 1.92 (1.23-2.74) mmol/L vs. 1.85 (1.04-2.37);p = 0.034], sodium (140.3 ± 6.20 mmol/L vs. 138.3 ± 6.01 mmol/L, p = 0.010) and uric acid in blood serum were significantly higher (0.38 ± 0,09 mmol/L vs. 0.34 ± 0.01 mmol/L, p = 0.003) as compared with females. In the group II (females), a noticeable slowing of the glomerular filtration rate (GFR) - 68,4 (43,6-98,1) ml/min vs. 87,6 (55,0-117,6) ml/min; (p = 0.001) was detected as compared with group I (males). Among male patients, a reliably significant positive relationship was established between TC and BMI, level of diastolic blood pressure and proteinuria; LDL cholesterol level and proteinuria; concentration of TG - and BMI, level of diastolic blood pressure and level of proteinuria. No correlation was established between the concentration of HDL-cholesterol and aforementioned laboratory markers of CKD. In contrast with males, in females, TC demonstrated an inverse relationship with the concentration of Hb, values of GFR and proteinuria, and level of HDL cholesterol - with indices of BMI, thrombocytes and uric acid of blood serum. In females a positive relationship was established between LDL cholesterol and level of diastolic blood pressure, GFR and daily proteinuria, and also between concentration of serum TG and volume of daily proteinuria and BMI. In general group, a reliable positive relationship was detected between TC and BMI and proteinuria, between LDL-C level and proteinuria, and between TG concentration and BMI, level of diastolic blood pressure, sodium content and proteinuria. The negative relationship was established between concentration of HDL cholesterol and BMI and uric acid in blood plasma, and TG level with Hb concentration. In male patients with CKD at pre-dialysis stage of disease, decreasing of level of HDL cholesterol was established as an increased concentration of TG and increasing atherogenic index. The content of triglyceride of blood serum is closely related to body mass index, level of diastolic blood pressure and proteinuria. In females, slowing of glomerular filtration rate is accompanied by development of anemia and atherogenic dyslipidemia.