Репозиторий Университета

© 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.

The atherosclerosis is considered among the most prevalent diseases. In Russia, N. N. Anitchkov and A. L. Miasnikov are founders of atherosclerosis studies. Valentina Iosifovna Miasnikova, doctor of medical sciences, professor of the Chair of Faculty Therapy #2 of the Sechenov University is one the numerous followers of A. L. Miasnikov. From the early 1960s, Valentina Iosifovna, proceeding with ideas of N. N. Anitchkov and A. L. Miasnikov, actively investigated pathogenesis of atherosclerosis. The professor V. I. Kalmykova, one of the first in Russia presented pathogenesis of atherosclerosis as a multi-factorial process and, combining theories existed at that moment, described effect of peroxidation of lipids on all stages of development of atherosclerotic plaque. She carried out a unique scientific investigation concerning studying intensity of peroxidation of lipids and antioxidant activity of lipids in patients with various degree of expression of ischemic heart disease. The gender characteristics of content of peroxides and antioxidant activity of lipids of blood serum were established. The research works of professor V. I. Kalmykova made an invaluable contribution into comprehension of pathogenesis of atherosclerosis and obtained an international approval. The scientific data obtained by V. I. Kalmykova were confirmed by studies of national and international researchers. Nowadays, the role of oxidation process in pathogenesis of atherosclerosis and ischemic heart disease is generally acknowledged.

© 2018 American Society for Microbiology.  The discovery of highly diverse nonprimate hepatoviruses illuminated the evolutionary origins of hepatitis A virus (HAV) ancestors in mammals other than primates. Marsupials are ancient mammals that diverged from other Eutheria during the Jurassic. Viruses from marsupials may thus provide important insight into virus evolution. To investigate Hepatovirus macroevolutionary patterns, we sampled 112 opossums in northeastern Brazil. A novel marsupial HAV (MHAV) in the Brazilian common opossum (Didelphis aurita) was detected by nested reverse transcription- PCR (RT-PCR). MHAV concentration in the liver was high, at 2.5 × 10 9 RNA copies/g, and at least 300-fold higher than those in other solid organs, suggesting hepatotropism. Hepatovirus seroprevalence in D. aurita was 26.6% as determined using an enzyme-linked immunosorbent assay (ELISA). Endpoint titers in confirmatory immunofluorescence assays were high, and marsupial antibodies colocalized with anti- HAV control sera, suggesting specificity of serological detection and considerable antigenic relatedness between HAV and MHAV. MHAV showed all genomic hallmarks defining hepatoviruses, including late-domain motifs likely involved in quasienvelope acquisition, a predicted C-terminal pX extension of VP1, strong avoidance of CpG dinucleotides, and a type 3 internal ribosomal entry site. Translated polyprotein gene sequence distances of at least 23.7% from other hepatoviruses suggested that MHAV represents a novel Hepatovirus species. Conserved predicted cleavage sites suggested similarities in polyprotein processing between HAV and MHAV. MHAV was nested within rodent hepatoviruses in phylogenetic reconstructions, suggesting an ancestral hepatovirus host switch from rodents into marsupials. Cophylogenetic reconciliations of host and hepatovirus phylogenies confirmed that hostindependent macroevolutionary patterns shaped the phylogenetic relationships of extant hepatoviruses. Although marsupials are synanthropic and consumed as wild game in Brazil, HAV community protective immunity may limit the zoonotic potential of MHAV.

© 2018 Paediatrician Publishers, LLC. All Rights Reserved. The article provides the characteristic of a tumor from cells of cartilaginous tissue - chondroblastoma. Current data on etiology, key links of pathogenesis, types of tumor, General clinical manifestations, approaches to diagnosis and treatment in children are analyzed.

© 2018 Voprosy Sovremennoi Pediatrii - Current Pediatrics. All rights reserved. The lecture analyzes modern knowledge about etiology, key mechanisms of pathogenesis, clinical manifestations, types, diagnostic methods and treatment strategy of chordoma (tumor from notochordal cells). To assess the retention of the lecture material, a case problem and multiple-choice test questions are given.

© 2018 Media Sphera Publishing Group.All right reserved. Aim. To estimate association between disorders of salt-water homeostasis on admision and the remote one-year prognosis for patients hospitalized with decompensated CHF NYHA FC III-IV. Materials and methods. This prospective study was based on clinical amnestic data and results of one-year follow-up of 111 consecutive patients admitted for decompensation of CHF to the State Clinical Hospital No. 24 in January 2015-February 2016. Results. The relative risk of death within one year for patients hospitalized for decompensated CHF with disorders of water and salt homeostasis increased 1.43 times by the end of one-year follow-up compared to patients with normal blood levels of sodium and potassium on admission (RR=1.43; 95 % CI: 1.10-1.87; p<0.01). Furthermore, the relative risk of death within one year was significantly increased 1.4 times in the subgroup of patients with hypernatremia (RR=1.41; 95 % CI: 0.99-2.01; p<0.05, respectively) and 1.4 and 2.3 times in subgroups with hypo-/hyperkalemia respectively (RR=1.39; 95 % CI: 0.93-2.07; p<0.05 and RR=2.23; 95 % CI: 1.04-4.78; p<0.01) compared to patients with normal blood levels of sodium and potassium on admission. Conclusion. Disturbed water and salt homeostasis on admission of patients hospitalized for decompensated NYHA FC III-IV CHF is a predictor for an unfavorable remote prognosis.

© Group of authors, 2018. The article presents literature data on the methods of correction of linear atrophy of the skin (striae). This pathology is widespread in both sexes. The decline in the quality of life in this disease occurs largely due to the presence of a cosmetic defect. To date, there is no universal therapeutic approach for the correction of stretch marks. In this article available literature data on the problem of linear atrophy of the skin has been summarized.

© 2018, Media Sphera Publishing Group. All rights reserved. The review of the literature deals with the participation of Clara cells now called club cells (CCs) of the epithelium in the respiratory and terminal bronchioles in the pathogenesis and morphogenesis of chronic inflammatory diseases, precancer, and cancer of the lung, which develop in the respiratory segments. The review summarizes data on the histophysiology of CCs and their participation in the pathogenesis and morphogenesis of chronic interstitial lung diseases, pneumoconiosis, chronic obstructive diseases, adenomatosis, and adenocarcinoma of the lung. In this area, there is a bronchioloalveolar junction area (BAJA), one of the most important stem cell niches. CCs are located in the BAJA; they are progenitor tissue stem cells and play an important role in the regeneration of the epithelium of the respiratory bronchioles and alveoli. Pathology of CCs in the BAJA leads to the maintenance of chronic inflammation, to the destruction of the lung elastic frame, and to impaired epithelial regeneration, interstitial fibrosis, and adenomatosis. In this case, decompensated inflammation, pathological regeneration, and fibrosis develop, which, along with the action of carcinogenic agents, can contribute to the accumulation of mutations and epigenetic rearrangements in the CCs, which subsequently results in atypical adenomatous hyperplasia and adenocarcinoma of the lung.

Traditionally, Parkinson's disease (PD) is associated with the lesion of the substantia nigra and dopamine system dysfunction. However, current studies show the involvement of other CNS regions, which extend far beyond the substantia nigra, in the pathogenesis of PD. The prevalence of altered α-synuclein in PD leads to the dysfunction of several neurotransmitter systems including the orexin system located in the hypothalamus. The involvement of this system in the neurodegenerative process explains some symptoms of PD including daily drowsiness and eating disorders. The authors consider the pathophysiology of the orexin system and its role in the pathogenesis of PD.

© 2018 Stolichnaya Izdatelskaya Kompaniya. Синдром такоцубо - это остро развивающаяся и, как правило, обратимая дисфункция миокарда левого желудочка. Наиболее часто синдром такоцубо проявляется локальной гипокинезией апикальных сегментов миокарда левого желудочка в ответ на эмоциональные или физические триггеры. Синдром такоцубо составляет около 2% от всех госпитализаций с подозрением на острый коронарный синдром. Диагностика синдрома такоцубо остается затруднительной. Клиническая картина острой фазы синдрома такоцубо зачастую не отличима от симптомов острого коронарного синдрома с подъемом или без подъема сегмента ST. Заболевание также сопровождается повышением маркеров по- вреждения миокарда, которое, однако, отличается от такового у пациентов с инфарктом миокарда с подъемом сегмента ST. Наиболее рас- пространенными для постановки диагноза являются модифицированные критерии клиники Mayo. Патогенез заболевания также мало изучен и представлен различными теориями, в которых главную роль играют катехоламины и их воздействие на миокард. На основании описанных семейных случаев синдрома такоцубо нельзя исключить генетическую предрасположенность к развитию заболевания. Несмотря на обратимую дисфункцию миокарда, почти в половине случаев синдром такоцубо осложняется развитием острой сердечной недостаточности, а госпитальная летальность сопоставима с таковой при инфаркте миокарда с подъемом сегмента ST. Вопрос о лечении синдрома такоцубо на сегодняшний день малоизучен. Проспективных клинических исследований каких-либо препаратов не проводилось. Считается, что тактика ведения пациентов с синдромом такоцубо, госпитализированных с подозрением на острый коронарный синдром, должна соответ- ствовать протоколу ведения больных с инфарктом миокарда, пока острая коронарная патология не исключена. На сегодняшний день забо- левание требует дальнейшего изучения.

© Bionika Media Ltd. Objective. To carry out a systems analysis of the data available in the current literature on the pathogenesis, therapy, and prevention of vaginal infections caused by the pathogens of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The paper highlights the main pathways of pathogenesis and the causes of recurrent vaginal coinfection. It describes methods for the treatment of women with BV and VVC and presents the optimal therapy and prevention schemes for recurrent vaginal infectious diseases, which have evidence-based effectiveness. Conclusion. The features of a microbial portrait and immune status predispose to recurrent BV and VVC, the presence of which results in coinfection. The cause of the latter is also repeated therapy for recurrent monoinfection. First-line therapy for BV is recognized to include metronidazole and clindamycin; the advantages of the latter are a wider spectrum of activity against the microorganisms that are difficult to identify. To treat coinfection and to prevent VVC in patients with BV, it is advisable to use fluconazole that also remains a first-line treatment option for vaginal infection caused by Candida albicans.

© 2018 Media Sfera. All rights reserved. The article reviews development mechanisms of different refractive errors accompanied by marked defocus of light rays reaching the retina. Terminology used for such ametropias includes terms extreme, ultra-high and complicated. Justification of their usage for primary ametropias, whose symptom complex is based on changes in axial eye length, is an ongoing discussion. To comply with thesaurus definitions of «diagnosis» and «pathogenesis», to characterize refractive and anatomical-functional disorders in patients with primary ametropias it is proposed to use the terms «hyperaxial and hypoaxial syndromes» with elaboration of specific symptoms instead of such expressions as extreme (ultra-high) myopia and hypermetropia.

© 2018 Ima-Press Publishing House. All rights reserved. Cranial dystonia is a common disease of the extrapyramidal nervous system. The clinical manifestations of dystonia are extremely variable; many of its forms are often undiagnosed. Dystonia is a sensorimotor disorder of the nervous system. Damage affects not only one structure, but also a network of the nodes interacting with each other in the somatosensory cortex and associative sensory and motor fields, which play a role in the integration of various sensory modalities coming from both outside the body and from the receptors within it. Botulinum toxin preparations show the highest efficacy in treating cranial dystonia. If their administration cannot achieve a positive result, oral drugs and surgical treatments should be used.

© Bionika Media Ltd. Objective. To carry out a systematic analysis of the data available in the current literature on the modern view on Trousseau’s syndrome Material and methods. The review included the data of foreign and Russian articles published in the past 10 years and found in e-Library and PubMed on this topic. Results. This paper provides a pathogenetic explanation for the increased thrombotic potential in cancer patients, which underlies tumor growth and metastasis. In addition to direct thrombotic events, the paper also describes hemorrhagic complications resulting from systemic coagulopathy, including disseminated intravascular coagulation, hemolytic thrombotic microangiopathy, and excessive fibrinolysis. Conclusion. At present, any manifestation of thrombohemorrhagic complications in patients with malignant tumors can be classified as a paraneoplastic syndrome (Trousseau’s syndrome). In addition to Virchow’s classic triad, hyperproduction of tissue factor (TF), the main initiator of the extrinsic coagulation pathway, underlies the pathophysiology of Trousseau’s syndrome. At the same time, the substantial release of microparticles from TF-bearing tumor cells is critical not only for clot formation, but also for the progression of tumor growth.

© Ima-Press Publishing House. All rights reserved. Peripheral nervous system involvement may be a main manifestation of systemic amyloidosis or occur in the later stages of the disease in the presence of multiple organ pathology. Focal, multiple mononeuropathy, radiculopathy, polyneuropathy, autonomic nervous system dysfunction, and myopathy develop depending on the localization of amyloid deposits in the peripheral nervous system. The most characteristic symptom in systemic amyloidosis is sensorimotor polyneuropathy accompanied in most cases by the involvement of autonomic nerve fibers in the pathological process. In cases of systemic amyloidosis, peripheral nervous system involvement is progressive, leading to disability, which makes the early diagnosis of the disease and its neurological manifestations and subsequent pathogenetic therapy relevant.

© 2018 Media Sphera Publishing Group. All rights reserved. The review considers modern ideas about the clinic and pathogenesis of minimal hepatic encephalopathy (MHE). It is discussed the present of cognitive impairment in this category of patients. The data of functional MRI are analyzed, and these results allow taking a fresh look at the origin of clinical disorders in this condition. The importance of cerebral connections disruption is emphasized. It is focused on the fact that in the functioning of the central nervous system the spontaneous activity of the brain has a significant importance. Separately is analyzed "the resting state". It is concluded that MHE, despite its minimal manifestations, is a clinically significant condition requiring attention of a specialists. With that, it is often not diagnosed on time in clinical practice, which could lead to more severe damage of the cerebral functions. As evidenced by the data obtained at the present time, quite extensive changes in the neuronal activity are underlid of the cognitive deficit.