ANALYSIS OF EPIDEMIOLOGICAL FEATURES OF THE INCIDENCE OF DIPHYLLOBOTHRIASIS IN SIBERIAN FEDERAL DISTRICT AND IRKUTSK REGION

The article presents the comparative analysis of the incidence of diphyllobothriasis in the Siberian Federal District and the Irkutsk  Region, and the peculiarities of its epidemiology in the Irkutsk  Region. On the basis of in-depth study of the structure of  diphyllobothriasis foci functioning on the territory of Irkutsk Region,  the zoning of the territory was carried out according to the degree of risk of contamination with diphyllobothriidae. The categories of the  population of various age groups exposed to invasion is defined, and  dynamics of morbidity within groups is analyzed. The analysis  revealed a distinctive feature of the Irkutsk Region, which is  expressed in a greater proportion of children among the sick people compared to other regions of the Siberian Federal District and the lowest incidence reduction rates among this group. The question  of reorientation of preventive and explanatory work with the  population, taking into account the identified data, is raised. The  cases are also considered on the basis of belonging to the rural or  urban population; among the rural population, the incidence is  almost twice as high. The analysis of morbidity in some territories of  the Irkutsk Region was carried out on the basis of an integral  indicator, which was carried out by ranking individual territories  according to the degree of infection of the population, areas with low, medium, high and very high levels of morbidity were allocated

Contribution of <i>AGTR</i> 1 Promoter Region Polymorphism to the Progression and Outcome of Sepsis in Patients with Various Comorbidities

Blood pressure dysregulation and circulatory failure are major contributors to the progression of sepsis and especially septic shock. One of the genes affecting the vascular endothelium and arteriolar tone is the angiotensin II receptor 1 gene (AGTR1). The AGTR1 rs275651 single-nucleotide polymorphism is associated with the development of angina, high altitude pulmonary edema, and hypertension. The significance of the AGTR1 rs275651 polymorphism in sepsis, particularly in patients with significant comorbidity, has not been studied previously.The aim of the study was to determine the impact of AGTR1 functional polymorphism on sepsis outcome in patients with various comorbidities, including cardiovascular disease and type 2 diabetes mellitus.Material and methods. A prospective study included 144 ICU patients of two clinical hospitals in Moscow, aged 18-75 years with clinical signs of sepsis (Sepsis-3, 2016).Results. In the group of patients with cardiovascular diseases, carriers of the TT AGTR1 rs275651 genotype had a lower mortality rate compared with carriers of the A allele (25 deaths out of 33 versus 16 out of 16, respectively, P=0.041, Fisher's exact test; P=0.0019, log-rank test). In the group of patients with diabetes mellitus (n=62), we also found significant differences in sepsis outcome based on the AGTR1 rs275651 genotype variant. The subgroup of TT AGTR1 rs275651 genotype carriers demonstrated significantly lower mortality compared with TA, AA genotypes carriers (27 deaths out of 41 and 20 out of 21, respectively, P=0.012, Fisher's exact test; OR=10.37; 95% CI: 1.26 to 85.5; P&lt;0.0001, log-rank test).Conclusion. We found an association of the functional polymorphism AGTR1 -777 T&gt;A (rs275651) with sepsis outcome in ICU patients with high-value baseline comorbidity: carriers of the more common TT genotype had lower mortality compared to carriers of the minor A allele

COVID-19 after emergency coronary artery bypass grafting: features of the postoperative course and prognosis

Introduction Coronavirus disease (COVID-19) caused by SARS-CoV-2 virus identified in 2019, forces cardiology departments to quickly adapt existing clinical guidelines to the new reality, and this is particularly relevant for scheduling patients with acute coronary syndrome (ACS). The article demonstrates how COVID-19 has affected emergency cardiac surgery care.Objective To analyze the features of completed cases of emergency coronary artery bypass grafting (ECABG) and COVID-19 diagnosed during the postoperative period at the Research Institute – Ochapovsky Regional Hospital no. 1 for the period from May 1, 2020 to February 1, 2021. Material and Methods Completed cases of ECABG have been retrospectively studied. EACS was performed in 145 patients: in 79 people with unstable angina pectoris (NS), in 40 with Q-negative myocardial infarction (MI), in 14 cases with primary Q-positive MI, in 12 patients with recurrent MI. The condition for ECABG was a negative SARS-Cov-2 PCR result and the absence of viral pneumonia by CT. The patients were divided into 2 subgroups. The first one included people with ECABG that were not diagnosed with COVID-19 during postoperative follow-up in the hospital. Subgroup II had patients with ECABG and COVID-19 diagnosed during the hospitalization.Results Contingency tables showed a statistically significant interaction between group membership and mortality, 2.3% (n = 3) in subgroup 1 and 20% (n = 3) in subgroup 2, Pearson’s test χ2 = 10.6, p &lt; 0.05. When analyzing survival rate in the EACS + COVID-19 subgroup, it is worth paying attention to the cumulative proportion of survivors, considering the severity of the course of viral pneumonia. The proportion of such patients with CT-4 by the 32nd day of hospital stay was 0.3.Conclusions Mortality rate in the postoperative course after ECABG with COVID-19 is significantly higher. In patients who underwent ECABG and died in the early and late postoperative period from COVID-19, a new coronavirus infection was diagnosed at a later date. In these cases, a considerably longer duration of CPB and a higher level of ferritin were revealed at the time of transference to the observation department. Survival rate in ECABG patients due to primary Q-negative MI is significantly lower in comparison with patients hospitalized for unstable angina

Dynamics of the Epidemic Process of Tick-Borne Encephalitis in Irkutsk Region in 2001–2021

The aim of this work was to analyze the spatial and temporal features of the epidemic process dynamics of tick-borne encephalitis (TBE) in Irkutsk Region in 2001–2021.Materials and methods. The data of the Rospotrebnadzor Administration for the Irkutsk Region, the Reference Center of the Irkutsk Research Anti-Plague Institute, the materials of the state statistical reporting form No. 2 “Information on infectious and parasitic diseases”, and scientific publications were analyzed. The chronological and chorological features of the change in the incidence of TVE have been traced. In the latter case, the administrative-territorial formations (ATF) of the subject were differentiated by epidemiological risk groups over two ten-year periods: 2001–2010 and 2011–2020. At each time interval, the grouping of areas according to the level of TBE incidence was carried out using the calculation of 95% confidence interval. Time sequences of observations were analyzed using the construction of regression equations. Standard methods of variation statistics in the Microsoft Excel were deployed.Results and discussion. Over the course of the 21st century, the incidence of TBE in Irkutsk Region has been declining. Based on 2001–2010 data, there were no cases of TBE in six ATF, and endemic areas were divided into three groups: with low (15 districts), medium (6) and high (8) incidence of TBE. A separate assessment of morbidity rates was conducted in the administrative center of the entity, the city of Irkutsk. In 2011–2020, the structure of ATF with varying epidemiological risk of TBE underwent a change. Six non-endemic areas, groups of low (12 ATFs), medium (9), high (6) and very high (2) epidemiological risk were identified. The spatial arrangement of high epidemiological risk zones changed, and their area increased. Each ATF cluster with different TBE incidence in 2011–2020 is characterized by the number of TBE cases and the volume of measures to prevent the infection. It is concluded that preventive measures were insufficient in ATF groups of high and very high epidemiological risk

Sex Differences in Cognitive Flexibility and Resting Brain Networks in Middle-Aged Marmosets

Sex differences in human cognitive performance are well characterized. However, the neural correlates of these differences remain elusive. This issue may be clarified using nonhuman primates, for which sociocultural influences are minimized. We used the marmoset (Callithrix jacchus) to investigate sex differences in two aspects of executive function: reversal learning and intradimensional/extradimensional (ID/ED) set shifting. Stress reactivity and motor function were also assessed. In agreement with human literature, females needed more trials than males to acquire the reversals. No sex differences in ED set shifting or motivational measures were observed. The findings suggest enhanced habit formation in females, perhaps due to striatal estrogenic effects. Both sexes showed increased urinary cortisol during social separation stressor, but females showed an earlier increase in cortisol and a greater increase in agitated locomotion, possibly indicating enhanced stress reactivity. Independent of sex, basal cortisol predicted cognitive performance. No sex differences were found in motor performance. Associations between brain networks and reversal learning performance were investigated using resting state fMRI. Resting state functional connectivity (rsFC) analyses revealed sex differences in cognitive networks, with differences in overall neural network metrics and specific regions, including the prefrontal cortex, caudate, putamen, and nucleus accumbens. Correlations between cognitive flexibility and neural connectivity indicate that sex differences in cognitive flexibility are related to sex-dependent patterns of resting brain networks. Overall, our findings reveal sex differences in reversal learning, brain networks, and their relationship in the marmoset, positioning this species as an excellent model to investigate the biological basis of cognitive sex differences

Dextran-Polyacrylamide as Matrices for Creation of Anticancer Nanocomposite

Drug targeting to specific organs and tissues is one of the crucial endeavors of modern pharmacotherapy. Controlled targeting at the site of action and reduced time of exposure of nontargeted tissues increase the efficacy of the treatment and reduce toxicity and side effects, improving compliance and convenience. Nanocarriers based on the branched copolymers dextran-graft-polyacrylamide were synthesized and characterized and were tested on phagocytic cells. It was shown that these nanoparticles are actively captured by phagocytic cells and that they are not cytotoxic. The polymer nanoparticles loaded with cisplatin at different concentrations from 0.1 to 10 μg/mL yielded dose-dependent decrease in viability of chronic myelogenous leukemia and histiocytic lymphoma cells. The lowest percentage of viable cells was observed for lymphoma cells (22%). Taking into account the fact that our nanoparticles will act mainly on malignant phagocytic cells and do not affect healthy cells, they can thus potentially be used for the therapeutic treatment of tumor cells having phagocytic activity. The effect of nanosilver on cell viability was lower than the one of polymer/cisplatin composite. The data from the cytotoxic studies indicate that nanosilver induces toxicity in cells. However, when the copolymers were conjugated to both nanosilver and cisplatin, such a nanosystem displayed less cytotoxic effect compared to the conjugates of dextran-polyacrylamide and cisplatin

АЛЛЕЛЬНЫЕ ВАРИАНТЫ ГЕНОВ NRF2 И TLR9 ПРИ КРИТИЧЕСКИХ СОСТОЯНИЯХ

Aim of the study. To elucidate the association of allelic variants of single nucleotide polymorphism in NRF2 (rs6726395, 177238501A&gt;G) and TLR9 (rs352162, 52218953T&gt;C) genes, each gene separately and in their combination, with peculiarities of the course of critical conditions during lung infection. Materials and methods. DNA from 86 post#operative patients and oncologic patients was genotyped in an allelespecific fashion using tetra#primer polymerase chain reaction followed by gel electrophoresis analysis of products.Results. It has been found that septic shock patients with NRF2 177238501A&gt;G GG genotype had increased mortality and higher APACHE II score and developed non#responsive edema more frequently. Patients with NRF2 177238501A&gt;G GG/TLR9 52218953T&gt;C CC genotype combination developed septic shock and nosocomialpneumonia more rarely.Conclusion. The homozygous NRF2 177238501A&gt;G (GG) allele combination is unfavorable for the course and outcome of critical conditions only in combination with TLR9 52218953T&gt;C СT or TLR9 52218953T&gt;C TT alleles in septic shock patients. At the same time, the combination of TLR9 52218953T&gt;C СС alleles in the same patients with 'unfavorable' NRF2 177238501A&gt;G GG protects against development of septic shock and nosocomial pneumonia.Цель исследования. Выявить связь аллельных вариантов сайтов однонуклеотидного полиморфизма генов NRF2 (rs6726395, 177238501A&gt;G) и TLR9 (rs352162, 52218953T&gt;C) — изолированно и в комплексе — с особенностями течения критических состояний при инфекции легких. Материалы и методы. Аллель#специфически генотипирована ДНК от 86 больных, перенесших хирургическое вмешательство, и онкологических больных.Результаты. Обнаружено, что у больных генотипа NRF2 177238501A&gt;G GG с септическим шоком повышена летальность и более высокие баллы по шкале APACHE II, чаще развивался отек легких, резистентный к лечению. У больных с комбинацией генотипов NRF2 177238501A&gt;G GG/TLR9 52218953T&gt;C CC реже развивался септический шок и нозокомиальная пневмония.Заключение. Комбинация аллеля NRF2 177238501A&gt;G в гомозиготном состоянии (GG) является неблагоприятной для течения и исхода критических состояний только в сочетании с аллелями TLR9 52218953T&gt;C СT или TLR9 52218953T&gt;C TT у больных с септическим шоком. При этом комбинация аллелей TLR9 52218953T&gt;C СС с «неблагоприятными» NRF2 177238501A&gt;G GG защищает от развития септи#ческого шока и нозокомиальной пневмонии

Прогностическое значение генетического полиморфизма промоторной области AQP5 при сепсисе с различными очагами

Aquaporins represent proteins contributed to water transport through cell membrane. They are involved in formation and resolution of edema, cell migration and inflammatory reaction. There are only few studies linking the genetic polymorphism of aquaporin 5 (rs3759129 AQP5) and sepsis. At the same time, the apparent heterogeneity of patients along the foci of infection may limit finding the most significant association of AQP5 genotypes with the course of infectious complications of critical conditions and restrict further development of rs3759129 AQP5 as a potentially strong marker of sepsis outcome.The purpose of the study was to determine whether the preferential localization of the infection affects the prognostic value of the genetic marker AQP5 (1364A/C, rs3759129) in outcome prediction in sepsis (SEPSIS-3, 2016) patients.Materials and methods. Study groups (n=339) included ICU patients with abdominal sepsis (AS, including pancreatitits, peritonitis, cholecystitis, appendicitis; n=94) sepsis patients with other sources of infections  (n=65) and ICU patients without sepsis (n=180). AQP5 polymorphism was studied by analyzing PCR products in a 2% agarose gel using a AQP5 1364A/C specific tetra primer set.Result. Distribution of alleles (A and C) and genotypes (AA, AC and CC) AQP5 1364A/C in patients with  sepsis or sepsis subgroups (sepsis with no septic shock and sepsis shock patients) versus control group (healthy  volunteers) did not differ. Although there was a trend to preferential survival of sepsis patients with genotype C AQP5 despite the source of infection, only patients with AQP5 CC or AC genotype and abdominal sepsis (Sepsis-3), or a subgroup of the same AQP5 genotype experiencing septic shock, demonstrated increased 30day survival versus AA homozygotic patients (P=0.002).Conclusion. The informative value of detecting the AQP5 CC or AC genotype for prognosis of 30-day survival versus AA homozygotic patients is most significant only in abdominal sepsis patients.Аквапорины — мембранные белки, играющие роль в транспорте молекул воды через клеточную мембрану и участвующие в формировании и разрешении отеков, миграции клеток, воспалительных реакциях. Имеются единичные исследования, свидетельствующие о связи генетического полиморфизма аквапорина 5 (rs3759129 AQP5) с течением сепсиса. Вместе с тем, очевидная гетерогенность пациентов по очагам инфекции может затруднить поиск наиболее выраженной ассоциации генотипов AQP5 с течением инфекционных осложнений критических состояний и дальнейшую разработку rs3759129 AQP5 как потенциально сильного маркера исхода сепсиса.Цель исследования: выяснить связь аллельных вариантов сайта однонуклеотидного полиморфизма гена AQP5 (1364A/C, rs3759129) с исходами сепсиса (СЕПСИС-3, 2016) в зависимости от вероятного первичного очага инфекции.Материалы и методы. С помощью тетрапраймерной полимеразной цепной реакции с последующей электрофоретической визуализацией продуктов проведено аллель-специфическое генотипирование ДНК, выделенной из образцов крови 339 пациентов отделений реанимации и интенсивной терапии двух лечебных учреждений.Результаты. Выявлена тенденция к преимущественному выживанию пациентов с сепсисом с генотипами AQP5 «С+» (AС и CC) вне зависимости от источника инфекции (p&gt;0,050). Однако только в группе пациентов с генотипами AQP5 AC или CC и абдоминальным сепсисом (Sepsis-3, 2016) было выявлено значительное увеличение 30-дневной выживаемости по сравнению с гомозиготными пациентами генотипа AQP5 АА (p=0,002).Заключение. Информативная ценность выявления генотипов CC или AC AQP5 для прогноза 30дневной выживаемости по сравнению с гомозиготными пациентами с генотипом AA может быть выше у пациентов с абдоминальным сепсисом

MODERN EPIDEMIOLOGY OF VECTOR-BORNE TICK-BORNE INFECTIONS IN NORTHERN DISTRICTS OF THE IRKUTSK REGION

Проведен вирусолого-микробиологический мониторинг семи северных районов Иркутской области. Полученные в ходе исследования данные свидетельствуют об изменении эпидемиологической ситуации в отношении клещевых инфекций на территории данных районов. Отмечается продвижение природных очагов на север. На территории северных районов выявлены сочетанные очаги, клещевых инфекций, в том числе обнаружена циркуляция новых для Восточной Сибири патогенов - E. muris, A. phagocytophilum, B. miyamotoi

БЕЗОПИАТНАЯ АНЕСТЕЗИЯ ПРИ ВМЕШАТЕЛЬСТВАХ НА ЭКСТРАКРАНИАЛЬНЫХ АРТЕРИЯХ У ПАЦИЕНТОВ С МУЛЬТИФОКАЛЬНЫМ АТЕРОСКЛЕРОЗОМ

Aim. To assess safety and effectiveness of opioid-free anesthesia in patients with polyvascular disease undergoing carotid endarterectomy for early mobilization and hemodynamic stability in the perioperative period.Methods. 28 consecutive male patients with polyvascular disease and internal carotid artery stenoses were included in a single-center, randomized observational study. The control group (n = 12) received conventional intravenous anesthesia of fentanyl 0.1 mg bolus every 20 minutes with continuous sedation with propofol at a rate of 4 mg / kg / h. The study group (n = 16) received conventional anesthesia followed by introvenous nefopam 20 mg with continuous infusion of 40 mg/h. Invasive monitoring of blood pressure, sedation depth, and the analgesia nociception index were measured. The marker of brain damage, S100 protein, was measured in blood plasma. All patients underwent neuropsychological testing in the perioperative period.Results. There were no reliable hemodynamic derangements during anesthesia in both study groups. There were no cases with worsening of the initial coronary circulation according to the ECG. No alterations in the initial neurological status were registered. BIS values were maintained at 56±19 in both groups without increasing the dose of propofol. All patients in the study group versus 5 patients (41.7%) in the control group were extubated in the OR unit.Conclusion. Opioid-free anesthesia in patients with polyvascular disease undergoing CEA allows achieving adequate pain management in the perioperative period, ensuring early extubation in the OR unit and postoperative mobilization while maintaining stable hemodynamic parameters and ensuring safe cognitive status.Цель. Оценить безопасность и эффективность безопиатной анестезии при каротидной эндартерэктомии у больных с мультифокальным атеросклерозом для обеспечения ранней активизации и гемодинамической стабильности в периоперационном периоде.Материалы и методы. В одноцентровое рандомизированное наблюдательное исследование было включено 28 мужчин с мультифокальным атеросклерозом и стенозами внутренних сонных артерий. В группе сравнения (n = 12) базовая анестезия обеспечивалась сочетанием внутривенного введения фентанила 0,1 мг болюсно каждые 20 мин и пропофола 4 мг/кг/ч, в исследуемой группе (n = 16) после вводного наркоза – в/в введением 20 мг нефопама с последующей его непрерывной инфузией со скоростью 40 мг/ч. Использовали мониторинг инвазивного артериального давления, глубины седации, индекса ноцицепции и аналгезии; определяли маркер повреждения головного мозга в сыворотке крови (белок S100); нейропсихологическое тестирование проводили в периоперационном периоде.Результаты. В обеих группах в течение анестезии не отмечено достоверных расстройств гемодинамики, по данным электрокардиографии не регистрировалось ухудшения исходного коронарного кровообращения; отсутствовали отклонения по сравнению с исходным неврологическим статусом. Седация на уровне 56±19 баллов по BIS-мониторингу наблюдалась в обеих группах в течение всего вмешательства, что не требовало увеличения дозы пропофола. В исследуемой группе все пациенты экстубированы по окончании операции, в группе сравнения экстубированы в операционной 5 (41,7%) пациентов.Заключение. Безопиатная анестезия при каротидной эндартерэктомии у пациентов с мультифокальным атеросклерозом позволяет осуществлять адекватное обезболивание в течение всего периоперационного периода, обеспечивая раннюю послеоперационную активизацию и экстубацию при сохранении стабильности гемодинамических показателей и комфорта пациента