47 research outputs found
FEATURES OF POSTOPERATIVE PERIOD IN PATIENTS AFTER BRAIN REVASCULARIZATION
The aim of the research was to compare incidence of small complications after carotid endarterectomy (CEA) versus carotid artery stenting, as well as to evaluate its application in specific clinical situations. The outcomes of1826 patients who underwent surgery for stenosis of the internal carotid artery (ICA) were analyzed. There were two groups: 1018 patients who underwent CEA and 808 patients who carried the stenting. Age of patients was greater and coronary heart disease, diabetes, chronic obstructive pulmonary disease occurs more often in group with endovascular treatment, and they had rife stroke anamnesis. The mortality rate, uncontrolled hypertension and transient ischemic attacks were similar in early postoperative period. Stroke frequency was higher in patients with carotid artery stenting (35 (4,3 %) versus 27 patients (2,6 %) with CEA (p = 0,02)), and myocardial infarction took place more often after CEA (38 (3,7 %) versus 13 (1,6 %) patients with endovascular treatment (p = 0,008)). There was no statistically significant difference in security between CEA and stenting. However, treatment of carotid stenosis should be chosen according to individual characteristics, including individual anatomy
CEREBRAL REVASCULIZATION IN PATIENTS OF 70 YEARS AND OLDER
The aim of the work was to evaluate the perioperative management of aged patients after elective surgical cerebral revascularization. We analyzed the outcomes of 813 patients of 70 years and older who had surgery for stenosis of the internal carotid artery [ΠΠ‘Π]. There were two groups: 392 patients who had carotid endarterectomy [CEA] and 421 patients who had the stenting. Age of the patients, severity of disease and comorbidity were similar in both groups In aged patients, the incidence of acute disorders of cerebral circulation (stroke] after CEA was significantly lower than the one after stenting (p = 0,04]. Frequency of perioperative myocardial infarction [MI] was 3 times higher in cases with CEA (p = 0,03]. in patients of 70 years and older, CEA shown lower incidence of stroke, however, there is increase of perioperative MI while using this method. Endovascular treatment could be chosen in patients with severe cardiac disease according to atherosclerotic plaques with no risk of embolism. In addition, the individual approach and assessment of social aspect are necessary
Development of a technology for the preparation of a dry nutrient medium for anthrax vaccine production
Currently, submerged cultivation of the Bacillus anthracis STI-1 strain for live anthrax vaccine production requires liquid nutrient media, which have disadvantages of a short shelf life (no more than one month) and a narrow range of storage temperatures (2β8 Β°Π‘). Dry media, in contrast, have a number of indisputable advantages: such media are transportable and easy to use, have a standard capability to retain properties, and can be stored without preservatives at 2β30 Β°Π‘ for 2β5 years. The aim of this work was to develop a technology for the preparation of a dry nutrient medium for anthrax vaccine production. Materials and methods: The study used the Bacillus anthracis STI-1 vaccine strain and a nutrient medium for its cultivation, containing a 70:30 mixture of an enzymatic digest of casein and a pre-processed corn extract solution. Drying of the nutrient medium was carried out on a spray-drying unit. The authors evaluated physicochemical parameters of experimental medium batches. The shelf life was determined by an accelerated stability study. The dry nutrient medium was used to produce a live anthrax vaccine. Quality attributes of the vaccine were assessed for compliance with regulatory requirements. Results: The authors developed the dry media production technology. According to it, the liquid nutrient medium is fed to the drying unit at a rate of 20β25 dm3/h. The spray air pressure is 0.02 MPa. Temperatures at the drying chamber inlet and outlet are 118β122 Β°Π‘ and 85β90 Β°Π‘, respectively. The technology was used to obtain 3 experimental batches of the dry medium. The study results demonstrate that the technology is reproducible, and the tested quality attributes of experimental medium batches are consistent with the requirements. According to the accelerated stability study, the shelf life of the dry nutrient medium at 2β30 Β°Π‘ is at least 3 years. Experiments demonstrated the possibility of using the dry nutrient medium for live anthrax vaccine production. Critical quality attributes of the vaccine obtained with the medium met regulatory requirements. Conclusions: The developed technology allows for the production of a standard dry nutrient medium with a prolonged shelf life, which is convenient for live anthrax vaccine production
ΠΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΠΈ ΠΠ’-Π°Π½Π³ΠΈΠΎΠ³ΡΠ°ΡΠΈΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Π±ΡΡΠΆΠ΅Π΅ΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ ΠΏΡΠΈ ΠΏΠ»Π°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΠΈ ΡΠ΅Π·Π΅ΠΊΡΠΈΠΉ Π»Π΅Π²ΠΎΠΉ ΠΏΠΎΠ»ΠΎΠ²ΠΈΠ½Ρ ΡΠΎΠ»ΡΡΠΎΠΉ ΠΊΠΈΡΠΊΠΈ Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ
During laparoscopic surgery for colorectal cancer, vascular structures may be incorrectly identified and damaged due to ignorance of the variant anatomy of the inferior mesenteric artery (IMA), lack of tactile sensations, narrowed field of vision, which leads to complications such as massive bleeding and intestinal ischemia. Therefore, the preoperative study of the variant anatomy of the IMA is of paramount importance. Knowing the variant anatomy of the vessels before surgery, you can make an operation plan in advance, which will ensure fast and safe vascular ligation at the required level and lymph dissection.Aim: To develop a classification of IMA variability for practical use in operations for colorectal cancer. Optimize the standard abdominal scanning protocol to improve the accuracy of MSCT and the best visualization of the IMA and its branches.Material and methods. From February 2013 to March 2022, 214 computed tomograms (CT) of abdominal organs with intravenous contrast were analyzed. We studied the variant anatomy of the IMA. The abdominal cavity scanning protocol was optimized using a 100 kV tube voltage, the contrast density of the NBA and its branches was compared using standard and optimized scanning protocols during a retrospective analysis of 105 CT studies of abdominal organs.Results. We proposed the classification of structure of the IMA and its branches. This is especially important when the safe lymph node dissection along the IMA is necessary. I type β several colonic branches derivate from the IMA by independent trunks (54%); II type β all colon branches derivate from the IMA in one point like a βgoose pawβ (25%); III type β one colon branch departs from the IMA by a single trunk; then it divides into colonic branches (21%).The accuracy of MSCT of the abdominal organs with intravenous contrast, which was determined by comparing the results of studies with intraoperative data, was 97.9%. The sensitivity of the method is 95.8%, the specificity of the method is 100%.The use of a scanning protocol with a tube voltage of 100 kV makes it possible to simplify and speed up the determination of the anatomical type of structure, improve the visualization of the IMA and its branches.Conclusion. CT with 3D-reconstruction of vessels allows the surgeon to perform an extended LND for colorectal cancer with a minimal risk of complications.ΠΠΎ Π²ΡΠ΅ΠΌΡ Π»Π°ΠΏΠ°ΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° ΡΠΎΡΡΠ΄ΠΈΡΡΡΠ΅ ΡΡΡΡΠΊΡΡΡΡ ΠΌΠΎΠ³ΡΡ Π±ΡΡΡ Π½Π΅ΠΏΡΠ°Π²ΠΈΠ»ΡΠ½ΠΎ ΠΈΠ΄Π΅Π½ΡΠΈΡΠΈΡΠΈΡΠΎΠ²Π°Π½Ρ ΠΈ ΠΏΠΎΠ²ΡΠ΅ΠΆΠ΄Π΅Π½Ρ ΠΈΠ·-Π·Π° Π½Π΅Π·Π½Π°Π½ΠΈΡ Π²Π°ΡΠΈΠ°Π½ΡΠ½ΠΎΠΉ Π°Π½Π°ΡΠΎΠΌΠΈΠΈ Π½ΠΈΠΆΠ½Π΅ΠΉ Π±ΡΡΠΆΠ΅Π΅ΡΠ½ΠΎΠΉ Π°ΡΡΠ΅ΡΠΈΠΈ (ΠΠΠ), ΠΎΡΡΡΡΡΡΠ²ΠΈΡ ΡΠ°ΠΊΡΠΈΠ»ΡΠ½ΡΡ
ΠΎΡΡΡΠ΅Π½ΠΈΠΉ, ΡΡΠΆΠ΅Π½Π½ΠΎΠ³ΠΎ ΠΏΠΎΠ»Ρ Π·ΡΠ΅Π½ΠΈΡ, ΡΡΠΎ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ°ΠΊΠΈΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΡΠΌ, ΠΊΠ°ΠΊ ΠΌΠ°ΡΡΠΈΠ²Π½ΠΎΠ΅ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΈ ΠΈΡΠ΅ΠΌΠΈΡ ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°. Π‘Π»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΡΠ½ΠΎ, ΠΏΡΠ΅Π΄ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ΅ ΠΈΠ·ΡΡΠ΅Π½ΠΈΠ΅ Π²Π°ΡΠΈΠ°Π½ΡΠ½ΠΎΠΉ Π°Π½Π°ΡΠΎΠΌΠΈΠΈ ΠΠΠ ΠΈΠΌΠ΅Π΅Ρ ΠΏΠ΅ΡΠ²ΠΎΡΡΠ΅ΠΏΠ΅Π½Π½ΠΎΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΠ΅. ΠΠ½Π°Ρ Π²Π°ΡΠΈΠ°Π½ΡΠ½ΡΡ Π°Π½Π°ΡΠΎΠΌΠΈΡ ΡΠΎΡΡΠ΄ΠΎΠ² ΠΏΠ΅ΡΠ΅Π΄ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ΅ΠΉ, ΠΌΠΎΠΆΠ½ΠΎ Π·Π°ΡΠ°Π½Π΅Π΅ ΡΠΎΡΡΠ°Π²ΠΈΡΡ ΠΏΠ»Π°Π½ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ, ΡΡΠΎ ΠΎΠ±Π΅ΡΠΏΠ΅ΡΠΈΡ Π±ΡΡΡΡΡΡ ΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΡ ΠΏΠ΅ΡΠ΅Π²ΡΠ·ΠΊΡ ΡΠΎΡΡΠ΄ΠΎΠ² Π½Π° ΡΡΠ΅Π±ΡΠ΅ΠΌΠΎΠΌ ΡΡΠΎΠ²Π½Π΅ ΠΈ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΡ.Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°ΡΡ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ Π²Π°ΡΠΈΠ°Π±Π΅Π»ΡΠ½ΠΎΡΡΠΈ ΠΠΠ Π΄Π»Ρ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ ΠΏΡΠΈ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΡΡ
ΠΏΠΎ ΠΏΠΎΠ²ΠΎΠ΄Ρ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ°. ΠΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°ΡΡ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΠΉ ΠΏΡΠΎΡΠΎΠΊΠΎΠ» ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Π΄Π»Ρ ΠΏΠΎΠ²ΡΡΠ΅Π½ΠΈΡ ΡΠΎΡΠ½ΠΎΡΡΠΈ ΠΠ‘ΠΠ’ ΠΈ Π½Π°ΠΈΠ»ΡΡΡΠ΅ΠΉ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΠΠ ΠΈ Π΅Π΅ Π²Π΅ΡΠ²Π΅ΠΉ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π‘ ΡΠ΅Π²ΡΠ°Π»Ρ 2013 Π³. ΠΏΠΎ ΠΌΠ°ΡΡ 2022 Π³. ΠΏΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½ΠΎ 214 ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½ΡΡ
ΡΠΎΠΌΠΎΠ³ΡΠ°ΠΌΠΌ ΠΎΡΠ³Π°Π½ΠΎΠ² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ Π²Π½ΡΡΡΠΈΠ²Π΅Π½Π½ΡΠΌ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ. ΠΠ·ΡΡΠΈΠ»ΠΈ Π²Π°ΡΠΈΠ°Π½ΡΠ½ΡΡ Π°Π½Π°ΡΠΎΠΌΠΈΡ ΠΠΠ. ΠΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΏΡΠΎΡΠΎΠΊΠΎΠ» ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΎΡΠ³Π°Π½ΠΎΠ² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π½Π°ΠΏΡΡΠΆΠ΅Π½ΠΈΡ ΡΡΡΠ±ΠΊΠΈ 100 ΠΊΠ, ΡΡΠ°Π²Π½ΠΈΠ»ΠΈ ΠΏΠ»ΠΎΡΠ½ΠΎΡΡΡ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΠΠ ΠΈ Π΅Π΅ Π²Π΅ΡΠ²Π΅ΠΉ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΠΎΠ³ΠΎ ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»ΠΎΠ² ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΡΠ΅ΡΡΠΎΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΌ Π°Π½Π°Π»ΠΈΠ·Π΅ 105 ΠΠ’-ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΠΎΡΠ³Π°Π½ΠΎΠ² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°Ρ. ΠΠ°ΠΌΠΈ Π±ΡΠ»Π° ΠΏΡΠ΅Π΄Π»ΠΎΠΆΠ΅Π½Π° ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΡΡΡΠΎΠ΅Π½ΠΈΡ ΠΠΠ ΠΈ Π΅Π΅ Π²Π΅ΡΠ²Π΅ΠΉ. ΠΠ°Π½Π½Π°Ρ ΠΊΠ»Π°ΡΡΠΈΡΠΈΠΊΠ°ΡΠΈΡ ΠΎΡΠ΅Π½Ρ Π²Π°ΠΆΠ½Π° ΠΏΡΠΈ Π²ΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΠΈ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠΈ Π²Π΄ΠΎΠ»Ρ ΠΎΡΠ½ΠΎΠ²Π½ΠΎΠ³ΠΎ ΡΡΠ²ΠΎΠ»Π° ΠΠΠ. Π’ΠΈΠΏ I β Π½Π΅ΡΠΊΠΎΠ»ΡΠΊΠΎ ΡΠΎΠ»ΡΡΠΎΠΊΠΈΡΠ΅ΡΠ½ΡΡ
Π²Π΅ΡΠ²Π΅ΠΉ ΠΎΡΡ
ΠΎΠ΄ΠΈΠ»ΠΈ ΠΎΡ ΠΠΠ ΠΎΡΠ΄Π΅Π»ΡΠ½ΡΠΌΠΈ ΡΡΠ²ΠΎΠ»Π°ΠΌΠΈ (54%); ΡΠΈΠΏ II β Π²ΡΠ΅ ΡΠΎΠ»ΡΡΠΎΠΊΠΈΡΠ΅ΡΠ½ΡΠ΅ Π²Π΅ΡΠ²ΠΈ ΠΎΡΡ
ΠΎΠ΄ΡΡ ΠΎΡ ΠΠΠ ΠΈΠ· ΠΎΠ΄Π½ΠΎΠΉ ΡΠΎΡΠΊΠΈ Π² Π²ΠΈΠ΄Π΅ βΠ³ΡΡΠΈΠ½ΠΎΠΉ Π»Π°ΠΏΠΊΠΈβ (25%); ΡΠΈΠΏ III β ΠΎΡ ΠΠΠ ΠΎΡΡ
ΠΎΠ΄ΠΈΡ Π΅Π΄ΠΈΠ½ΡΡΠ²Π΅Π½Π½ΡΠΉ ΡΡΠ²ΠΎΠ», ΠΊΠΎΡΠΎΡΡΠΉ Π½Π° ΡΠ²ΠΎΠ΅ΠΌ ΠΏΡΠΎΡΡΠΆΠ΅Π½ΠΈΠΈ Π΄Π΅Π»ΠΈΡΡΡ Π½Π° ΡΠΎΠ»ΡΡΠΎΠΊΠΈΡΠ΅ΡΠ½ΡΠ΅ Π²Π΅ΡΠ²ΠΈ (21%).Π’ΠΎΡΠ½ΠΎΡΡΡ ΠΠ‘ΠΠ’ ΠΎΡΠ³Π°Π½ΠΎΠ² Π±ΡΡΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ Ρ Π²Π½ΡΡΡΠΈΠ²Π΅Π½Π½ΡΠΌ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ, ΠΊΠΎΡΠΎΡΠ°Ρ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»Π°ΡΡ ΠΏΡΡΠ΅ΠΌ ΡΡΠ°Π²Π½Π΅Π½ΠΈΡ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ Ρ ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΌΠΈ Π΄Π°Π½Π½ΡΠΌΠΈ, ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 97,9%, ΡΡΠ²ΡΡΠ²ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΡ ΠΌΠ΅ΡΠΎΠ΄Π° β 95,8%, ΡΠΏΠ΅ΡΠΈΡΠΈΡΠ½ΠΎΡΡΡ β 100%.ΠΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΡΠΎΠΊΠΎΠ»Π° ΡΠΊΠ°Π½ΠΈΡΠΎΠ²Π°Π½ΠΈΡ Ρ Π½Π°ΠΏΡΡΠΆΠ΅Π½ΠΈΠ΅ΠΌ ΡΡΡΠ±ΠΊΠΈ 100 ΠΊΠ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΡΠΏΡΠΎΡΡΠΈΡΡ ΠΈ ΡΡΠΊΠΎΡΠΈΡΡ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΡΡΡΠΎΠ΅Π½ΠΈΡ, ΡΠ»ΡΡΡΠΈΡΡ Π²ΠΈΠ·ΡΠ°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΠΠ ΠΈ Π΅Π΅ Π²Π΅ΡΠ²Π΅ΠΉ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ’ Ρ 3D-ΡΠ΅ΠΊΠΎΠ½ΡΡΡΡΠΊΡΠΈΠ΅ΠΉ ΡΠΎΡΡΠ΄ΠΎΠ² ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Ρ
ΠΈΡΡΡΠ³Ρ Π²ΡΠΏΠΎΠ»Π½ΠΈΡΡ ΡΠ°ΡΡΠΈΡΠ΅Π½Π½ΡΡ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΡ ΠΏΡΠΈ ΠΊΠΎΠ»ΠΎΡΠ΅ΠΊΡΠ°Π»ΡΠ½ΠΎΠΌ ΡΠ°ΠΊΠ΅ Ρ ΠΌΠΈΠ½ΠΈΠΌΠ°Π»ΡΠ½ΡΠΌ ΡΠΈΡΠΊΠΎΠΌ ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
Π Π°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΡΠ΅Ρ Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΡΠΈΠ³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΡΡ ΠΎΠΉ ΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΠΎΠΉ ΡΡΠ΅Π΄Ρ Π΄Π»Ρ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ Π²Π°ΠΊΡΠΈΠ½Ρ
Currently, submerged cultivation of the Bacillus anthracis STI-1 strain for live anthrax vaccine production requires liquid nutrient media, which have disadvantages of a short shelf life (no more than one month) and a narrow range of storage temperatures (2β8 Β°Π‘). Dry media, in contrast, have a number of indisputable advantages: such media are transportable and easy to use, have a standard capability to retain properties, and can be stored without preservatives at 2β30 Β°Π‘ for 2β5 years. The aim of this work was to develop a technology for the preparation of a dry nutrient medium for anthrax vaccine production. Materials and methods: The study used the Bacillus anthracis STI-1 vaccine strain and a nutrient medium for its cultivation, containing a 70:30 mixture of an enzymatic digest of casein and a pre-processed corn extract solution. Drying of the nutrient medium was carried out on a spray-drying unit. The authors evaluated physicochemical parameters of experimental medium batches. The shelf life was determined by an accelerated stability study. The dry nutrient medium was used to produce a live anthrax vaccine. Quality attributes of the vaccine were assessed for compliance with regulatory requirements. Results: The authors developed the dry media production technology. According to it, the liquid nutrient medium is fed to the drying unit at a rate of 20β25 dm3/h. The spray air pressure is 0.02 MPa. Temperatures at the drying chamber inlet and outlet are 118β122 Β°Π‘ and 85β90 Β°Π‘, respectively. The technology was used to obtain 3 experimental batches of the dry medium. The study results demonstrate that the technology is reproducible, and the tested quality attributes of experimental medium batches are consistent with the requirements. According to the accelerated stability study, the shelf life of the dry nutrient medium at 2β30 Β°Π‘ is at least 3 years. Experiments demonstrated the possibility of using the dry nutrient medium for live anthrax vaccine production. Critical quality attributes of the vaccine obtained with the medium met regulatory requirements. Conclusions: The developed technology allows for the production of a standard dry nutrient medium with a prolonged shelf life, which is convenient for live anthrax vaccine production.Π Π½Π°ΡΡΠΎΡΡΠ΅Π΅ Π²ΡΠ΅ΠΌΡ ΠΏΡΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ Π²Π°ΠΊΡΠΈΠ½Ρ ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ ΠΆΠΈΠ²ΠΎΠΉ Π΄Π»Ρ Π³Π»ΡΠ±ΠΈΠ½Π½ΠΎΠ³ΠΎ Π²ΡΡΠ°ΡΠΈΠ²Π°Π½ΠΈΡ ΡΡΠ°ΠΌΠΌΠ° Bacillus anthracis Π‘Π’Π-1 ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΡΡΡ ΠΆΠΈΠ΄ΠΊΠ°Ρ ΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½Π°Ρ ΡΡΠ΅Π΄Π°, Π½Π΅Π΄ΠΎΡΡΠ°ΡΠΊΠ°ΠΌΠΈ ΠΊΠΎΡΠΎΡΠΎΠΉ ΡΠ²Π»ΡΡΡΡΡ ΠΌΠ°Π»ΡΠΉ ΡΡΠΎΠΊ Π³ΠΎΠ΄Π½ΠΎΡΡΠΈ β Π½Π΅ Π±ΠΎΠ»Π΅Π΅ ΠΎΠ΄Π½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΡΡΠ° ΠΈ ΡΠ·ΠΊΠΈΠΉ Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½ ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΡ Π΅Π΅ Ρ
ΡΠ°Π½Π΅Π½ΠΈΡ: ΠΎΡ 2 Π΄ΠΎ 8 Β°Π‘. Π‘ΡΡ
ΠΈΠ΅ ΠΏΠΈΡΠ°ΡΠ΅Π»ΡΠ½ΡΠ΅ ΡΡΠ΅Π΄Ρ (ΠΠ‘) ΠΎΠ±Π»Π°Π΄Π°ΡΡ ΡΡΠ΄ΠΎΠΌ Π½Π΅ΠΎΡΠΏΠΎΡΠΈΠΌΡΡ
ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²: ΠΈΡ
ΠΌΠΎΠΆΠ½ΠΎ Ρ
ΡΠ°Π½ΠΈΡΡ ΠΎΡ 2 Π΄ΠΎ 5 Π»Π΅Ρ ΠΏΡΠΈ ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ΅ ΠΎΡ 2 Π΄ΠΎ 30 Β°Π‘ Π±Π΅Π· ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°Π½ΡΠΎΠ²; ΠΎΠ½ΠΈ ΡΡΠ°Π½ΡΠΏΠΎΡΡΠ°Π±Π΅Π»ΡΠ½Ρ, ΡΠ΄ΠΎΠ±Π½Ρ Π² ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΠΈ ΡΡΠ°Π½Π΄Π°ΡΡΠ½Ρ Π² ΡΠΎΡ
ΡΠ°Π½Π΅Π½ΠΈΠΈ ΡΠ²ΠΎΠΉΡΡΠ². Π¦Π΅Π»Ρ ΡΠ°Π±ΠΎΡΡ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠΊΠ° ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΡΠΈΠ³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΡΡ
ΠΎΠΉ ΠΠ‘ Π΄Π»Ρ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ Π²Π°ΠΊΡΠΈΠ½Ρ. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ: Π² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡΡ
ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π»ΠΈ Π²Π°ΠΊΡΠΈΠ½Π½ΡΠΉ ΡΡΠ°ΠΌΠΌ B. anthracis Π‘Π’Π-1 ΠΈ ΠΠ‘, ΡΠΎΡΡΠΎΡΡΡΡ ΠΈΠ· ΡΠΌΠ΅ΡΠΈ ΡΠ΅ΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π³ΠΈΠ΄ΡΠΎΠ»ΠΈΠ·Π°ΡΠ° ΠΊΠ°Π·Π΅ΠΈΠ½Π° ΠΈ ΡΠ°ΡΡΠ²ΠΎΡΠ° ΠΎΠ±ΡΠ°Π±ΠΎΡΠ°Π½Π½ΠΎΠ³ΠΎ ΠΊΡΠΊΡΡΡΠ·Π½ΠΎΠ³ΠΎ ΡΠΊΡΡΡΠ°ΠΊΡΠ° Π² ΡΠΎΠΎΡΠ½ΠΎΡΠ΅Π½ΠΈΠΈ 70 ΠΈ 30%, Π΄Π»Ρ ΠΊΡΠ»ΡΡΠΈΠ²ΠΈΡΠΎΠ²Π°Π½ΠΈΡ ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠΈΠΊΡΠΎΠ±Π°. ΠΠ±Π΅Π·Π²ΠΎΠΆΠΈΠ²Π°Π½ΠΈΠ΅ ΠΠ‘ ΠΎΡΡΡΠ΅ΡΡΠ²Π»ΡΠ»ΠΈ Π½Π° ΡΡΡΠ°Π½ΠΎΠ²ΠΊΠ΅ ΡΠ°ΡΠΏΡΠ»ΠΈΡΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΡΠΈΠΏΠ°. ΠΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠ΅ ΡΠ΅ΡΠΈΠΈ ΡΡΡ
ΠΎΠΉ ΠΠ‘ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈ ΠΏΠΎ ΡΠΈΠ·ΠΈΠΊΠΎ-Ρ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ Π½Π° ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠ΅ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡΠΌ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠΈ. Π‘ΡΠΎΠΊ Π³ΠΎΠ΄Π½ΠΎΡΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ Β«ΡΡΠΊΠΎΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠ΅Π½ΠΈΡΒ». Π‘ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΡΡ
ΠΎΠΉ ΠΠ‘ Π³ΠΎΡΠΎΠ²ΠΈΠ»ΠΈ Π²Π°ΠΊΡΠΈΠ½Ρ ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΡΡ ΠΆΠΈΠ²ΡΡ ΠΈ ΠΏΡΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΈ ΠΎΡΠ΅Π½ΠΊΡ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Π΅ΠΉ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠ° Π½Π° ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠ΅ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡΠΌ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠΈ. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΡΠΈΠ³ΠΎΡΠΎΠ²Π»Π΅Π½ΠΈΡ ΡΡΡ
ΠΎΠΉ ΠΠ‘ (ΡΠΊΠΎΡΠΎΡΡΡ ΠΏΠΎΠ΄Π°ΡΠΈ ΠΠ‘ Π½Π° ΡΡΡΠΊΡ ΠΎΡ 20 Π΄ΠΎ 25 Π΄ΠΌ3/Ρ, Π΄Π°Π²Π»Π΅Π½ΠΈΠ΅ ΡΠΆΠ°ΡΠΎΠ³ΠΎ Π²ΠΎΠ·Π΄ΡΡ
Π° Π² ΡΠ°ΡΠΏΡΠ»ΠΈΡΠ΅Π»Π΅ 0,02 ΠΠΠ°, ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ° Π²ΠΎΠ·Π΄ΡΡ
Π° Π½Π° Π²Ρ
ΠΎΠ΄Π΅ Π² ΡΡΡΠΈΠ»ΡΠ½ΡΡ ΠΊΠ°ΠΌΠ΅ΡΡ ΠΎΡ 118 Π΄ΠΎ 122 Β°Π‘, ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ° Π²ΠΎΠ·Π΄ΡΡ
Π° Π½Π° Π²ΡΡ
ΠΎΠ΄Π΅ β ΠΎΡ 85 Π΄ΠΎ 90 Β°Π‘). ΠΠΎ ΡΡΠΎΠΉ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΠΎΠ»ΡΡΠ΅Π½Ρ 3 ΡΠ΅ΡΠΈΠΈ ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎΠΉ ΡΡΡ
ΠΎΠΉ ΠΠ‘. ΠΠΎΠΊΠ°Π·Π°Π½ΠΎ, ΡΡΠΎ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½Π°Ρ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ Π²ΠΎΡΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΠΌΠ°, Π° ΡΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΡΠ΅ ΡΠ΅ΡΠΈΠΈ ΡΡΡ
ΠΎΠΉ ΠΠ‘ ΠΏΠΎ ΠΈΠ·ΡΡΠ΅Π½Π½ΡΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΠΎΡΠ²Π΅ΡΠ°ΡΡ ΠΏΡΠ΅Π΄ΡΡΠ²Π»ΡΠ΅ΠΌΡΠΌ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡΠΌ. Π‘ΡΠΎΠΊ Π³ΠΎΠ΄Π½ΠΎΡΡΠΈ ΡΡΡ
ΠΎΠΉ ΠΠ‘, ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½Π½ΡΠΉ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ΅ΡΠΎΠ΄Π° Β«ΡΡΠΊΠΎΡΠ΅Π½Π½ΠΎΠ³ΠΎ ΡΡΠ°ΡΠ΅Π½ΠΈΡΒ», Π½Π΅ ΠΌΠ΅Π½Π΅Π΅ 3 Π»Π΅Ρ ΠΏΡΠΈ ΡΠ΅ΠΌΠΏΠ΅ΡΠ°ΡΡΡΠ΅ Ρ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΎΡ 2 Π΄ΠΎ 30 Β°Π‘. ΠΠΊΡΠΏΠ΅ΡΠΈΠΌΠ΅Π½ΡΠ°Π»ΡΠ½ΠΎ ΠΏΠΎΠ΄ΡΠ²Π΅ΡΠΆΠ΄Π΅Π½Π° Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎΡΡΡ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΡ ΡΡΡ
ΠΎΠΉ ΠΠ‘ Π² ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΈ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π° ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ Π²Π°ΠΊΡΠΈΠ½Ρ. ΠΡΠΈΠ³ΠΎΡΠΎΠ²Π»Π΅Π½Π½ΡΠΉ ΠΏΡΠ΅ΠΏΠ°ΡΠ°Ρ ΠΏΠΎ ΠΎΡΠ½ΠΎΠ²Π½ΡΠΌ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΠΊΠ°ΡΠ΅ΡΡΠ²Π° ΠΎΡΠ²Π΅ΡΠ°Π΅Ρ ΡΡΠ΅Π±ΠΎΠ²Π°Π½ΠΈΡΠΌ Π½ΠΎΡΠΌΠ°ΡΠΈΠ²Π½ΠΎΠΉ Π΄ΠΎΠΊΡΠΌΠ΅Π½ΡΠ°ΡΠΈΠΈ. ΠΡΠ²ΠΎΠ΄Ρ: ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π½Π°Ρ ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΡ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ ΠΏΠΎΠ»ΡΡΠΈΡΡ ΡΡΡ
ΡΡ ΠΠ‘ ΡΡΠ°Π½Π΄Π°ΡΡΠ½ΡΡ Ρ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½Π½ΡΠΌ ΡΡΠΎΠΊΠΎΠΌ Ρ
ΡΠ°Π½Π΅Π½ΠΈΡ ΠΈ ΡΠ΄ΠΎΠ±Π½ΡΡ ΠΏΡΠΈ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠΈ Π² ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΡΡΠ²Π΅ Π²Π°ΠΊΡΠΈΠ½Ρ ΡΠΈΠ±ΠΈΡΠ΅ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ ΠΆΠΈΠ²ΠΎΠΉ
Energy Barrier Reduction for the Double Proton-Transfer Reaction in GuanineβCytosine DNA Base Pair on a Gold Surface
Efficient Molecular Dynamics Simulations of Multiple Radical Center Systems Based on the Fragment Molecular Orbital Method
INVESTIGATION OF CO-TRIMOXAZOLE EFFICIENCY USING THE EXPERIMENTAL TUBERCULOSIS MODEL IN MICE CAUSED BY TUBERCULOUS MYCOBACTERIA WITHΒ EXTENSIVE DRUG RESISTANCE
The efficiency of using co-trimoxazole for treatment of mice infected with tuberculous mycobacteria with extensive drug resistance and supposed sensitivity to co-trimoxazole have been investigated.The study of 78 clinical cultures of tuberculous mycobacteria has demonstrated that drug resistance to first line drugs (cases with multiple drug resistance β MDR) can be accompanied by the expansion of polymorphism in the part of drug susceptibility to co-trimoxazole, thus this drug can be used as an additional drug in the treatment of M/XDR tuberculosis patients. Using co-trimoxazole as an additional drug to isoniazid in the model of generalized tuberculosis in mice infected with Beijing strain with XDR reduced the bacterial load of the lungs by 10 times.Detail evaluation of drug susceptibility/resistance of tuberculous mycobacteria to the additional drug of co-trimoxazole and investigation of the interaction of this drug with other agents included into treatment regimens IV and V can form the basis for improvement of treatment regimens for M/XDR tuberculosis patients with specification of doses and frequency of drug in-takes for each specific case
Adding cystatin C to the GRACE scale improves the prediction of bleeding complications in non-invasively treated patients with acute coronary syndrome
Aim. To assess the prognostic performance of the GRACE scale extended by cystatin C levels in the prediction of ischemic and hemorrhagic in-hospital complications among patients with acute coronary syndrome (ACS). Material and methods. In 160 ACS patients, admitted to the Moscow City Clinical Hospital No. 29 and included in the hospital register, blood levels of cystatin C were measured within the first 24 hours from admission. All patients were treated conservatively. The in-hospital risk of mortality and bleeding was assessed. The cut-off level of cystatin C was 1,53 mg/l. Results. High levels of cystatin C, high GRACE scale risk, and their combination were associated with a significant increase in the in-hospital risk of hemorrhagic and ischemic complications. Independent mortality predictors included GRACE levels (odds ratio, OR, 1,05; 95% confidence interval (CI) 1,02-1,08; p=0,002) and cystatin C levels (OR 1,01; 95% CI 1,00-1,02: p=0,025). Major and moderate bleeding complications were independently predicted by fibrinolysis (OR 9,86; 95% CI 1,74-55,20; p=0,01), leukocyte levels (OR 1,34; 95% CI 1,11-1,62: p=0,002), and haemoglobin levels (OR 0,96; 95% CI 0,91-0,99; p=0,043), as well as the combination of high GRACE risk levels and elevated cystatin C levels (OR 11,78; 95% CI 1,95-71,06; p=0,007). Adding cystatin C to the high GRACE risk improved the prognostic specificity by approximately 20% and did not affect the prognostic sensitivity in the prediction of in-hospital risk of major and moderate bleeding complications. Conclusion. The combination of high GRACE risk levels and elevated cystatin C levels was an independent predictor of major and moderate in-hospital bleeding complications, but not in-hospital death. Adding cystatin C to the GRACE scale by approximately 20% increased its specificity for the prediction of in-hospital risk of major and moderate bleeding complications