Dynamics of Stroke Incidence and Mortality Indicators over Eight-Year Period in the Territories Included into the Federal Program of Reorganization of Care for Patients with Stroke

Background. Stroke is a severe medical, social and economic burden for all countries of the world. The leading indicators characterizing the “epidemiological picture” of stroke are the incidence and mortality rates from stroke.Aims. Analyze the dynamics of stroke incidence and mortality rates in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke for the period from 2009 to 2016.Material and methods. The study was based on the data of the territorial-population register for seven study areas in the regions of Russia that were included in the federal program for reorganizing care for patients with stroke (Republic of Bashkortostan, Sverdlovsk region, Republic of Tatarstan, Sakhalin region, Stavropol Territory, Ivanovo Region and Irkutsk Region). The age of the examined persons was 25 years and older.Results. In the period from 2009 to 2016, in the studied territories, there was a consistent stable decrease in the value of the stroke incidence rate. Stroke mortality rates fluctuated with a single increase in 2012. When comparing the average incidence of stroke and mortality from it between 2009 and 2016, we discovered a statistically significant decrease in the incidence of stroke – by 1.4 times and in the rate of mortality from stroke – by 2.3 times. According to the results of the cluster analysis, we revealed a significant conformity (similarity) of mortality rates between regions by 2016 and the absence of monotony (stability) of the rate of stroke incidence.Conclusion. In all the regions under study, an almost systematic annual decrease in the incidence and mortality rates from stroke among the adult population was revealed in seven studied territories. The results of cluster analysis of the “picture” of stroke incidence and mortality from it also demonstrate a positive trend by 2016 in all studied territories. Only one of the studied territories – the Republic of Tatarstan – despite the presence of a positive dynamics of stroke incidence over an eight-year period, in 2016 belonged to the rank with a high integral incidence rate

Prognostic value of molecules of average mass in patients with chronic obstructive pulmonary disease

Background. Chronic obstructive pulmonary disease is a socially significant disease affecting patient’s quality of life. Assessment of endogenous intoxication in patients with chronic obstructive pulmonary disease will allow to understand pathogenetic features of different phenotypes of this disease, which can be taken into account when predicting its course.The aim of the study. To determine the prognostic value of levels of mediumand low-molecular-weight substances and oligopeptides in patients with chronic obstructive pulmonary disease.Materials and methods. One hundred and four patients with chronic obstructive pulmonary disease (COPD) and 110 somatically healthy individuals were examined. Molecular weight medium and low molecular weight substances (LMWSM) and oligopeptides (OP) were determined in blood plasma, erythrocytes and urine. Based on these indicators mathematically calculated indices of endogenous intoxication and coefficient of elimination were defined. Statistical processing of the data was performed using the SPSS 26.0 software package (IBM Corp., USA).Results. In all biological fluids, the levels of average molecules and calculated indices in the COPD patients’ group were statistically significantly different from those in the control group. The indices characterizing endotoxin accumulation were statistically significantly higher, while those characterizing toxin elimination were lower. The level of endotoxemia was correlated with the frequency of exacerbations, clinical manifestations severity, quality of life, COPD group and phenotype.Conclusions. Frequent exacerbations, groups C and D, bronchitic and mixed COPD phenotypes are characterized by more severe endotoxicosis manifested by high levels of LMWSM, OP and calculated indices

EVALUATION METHODS OF ESTIMATION OF YOUNG APPLE TREES LEAF AREA

The analysis of the three measurement methods of leaf blade area of young bi-axis apple trees on rootstock 54-118 was made. High accuracy of the measurement results by a method of area calculation within a leaf contour on millimeter graph paper (31, 21 cm2) and with help of a method of computer sight using application “Petiole” on Smartphone with operational system Android (31, 28 cm2) was established. The gravimetric method and the use of mobile application “Petiole” appeared to be the most productive as to time consumption to carry out the operatio

Drug Agranulocytosis

The paper covers the problem associated with the wide availability and uncontrolled use of over-the-counter medicines, particularly analgesics, antipyretics, and anticatarrhal agents, which lead to the occurrence of adverse drug reactions and poisonings and to considerable economic and human losses. The mechanisms of the pathogenesis of drug agranu-locytosis due to the intake of nonsteroidal analgesics and the diagnosis and treatment of this disease are described in detail. The case presented by the authors clearly demonstrates that the possible development of life-threatening complications due to the use of even submaximal permitted doses of widely spread and available anticatarrhal drugs. Key words: antipyretics, analgesics, nonsteroidal anti-inflammatory drugs, drug agranulocytosis, trepanobiopsy, myelo-gram, intensive care unit

The influence of evening walks on the emotional state and sleep quality of medical university students

Received: 10.11.2022. Accepted: 12.12.2022.Рукопись поступила в редакцию: 10.11.2022. Принята к публикации: 12.12.2022.The problem of creating harmony in relation to the mental and physical health of students at the present time is quite serious. Modern universities of medical specialization are characterized by an increased intellectual load in conditions of insufficient physical activity, which necessitates increasing the stress resistance of the students’ organism. The means of physical culture used to reduce stress vary for different groups of people. The relevance of the choice of topic is due to the fact that evening walks are suitable for people of any age, including students, and have no contraindications. The purpose of the study: to compare the indicators of the emotional state and quality of sleep of students who take daily evening walks in the fresh air, and the indicators of their peers who prefer spending time at home. It is assumed that students who combine physical activity in the process of implementing elective disciplines in physical culture and sports with daily walks have higher rates of emotional state and sleep quality than their peers who do not use physical culture in their free time. The study involved 180 students of the Northern State Medical University. The analysis of the emotional state of students was carried out according to the method of L.A. Kurgansky and T.A. Nemchina. According to the results of the survey, students who take evening walks have higher indicators of emotional state than those who prefer spending time at home. To study sleep indicators, a questionnaire for scoring the quality of sleep by Y.I. Levin. According to the results of the survey, students who take evening walks have higher rates of sleep quality. The conducted studies have shown that the means of physical education can optimize the emotional state of students, reduce anxiety, tension and discomfort. Walking improves the quality of sleep. Thus, the studies obtained state the importance of systematic exercise, even the simplest and most accessible to everyone, such as evening walks in the fresh air.Проблема создания гармонии в отношении психического и физического здоровья студентов в нынешнее время достаточно серьезна. Современные вузы медицинской специализации характеризует повышенная интеллектуальная нагрузка в условиях недостаточной двигательной активности, что обуславливает необходимость повышения стрессоустойчивости организма студентов. Средства физической культуры, используемые для уменьшения стресса, для различных групп людей различаются. Актуальность выбора темы обусловлена тем, что вечерние прогулки подходят людям любого возраста, в том числе студентам, и не имеют противопоказаний. Цель исследования: сравнить показатели эмоционального состояния и качества сна студентов, совершающих ежедневные вечерние прогулки на свежем воздухе, и показатели их сверстников, предпочитающих домашнее времяпрепровождение. Предполагается, что студенты, совмещающие физическую деятельность в процессе реализации элективных дисциплин по физической культуре и спорту с ежедневными прогулками, имеют более высокие показатели эмоционального состояния и качества сна, нежели их сверстники, не использующие средства физической культуры в свободное от учебы время. В исследовании приняло участие 180 студентов Северного государственного медицинского университета. Анализ эмоционального состояния студентов осуществлялся по методике Л. А. Курганского и Т. А. Немчина. По результатам опроса студенты, которые совершают вечерние прогулки, имеют более высокие показатели эмоционального состояния, нежели, те, кто предпочитает домашнее времяпрепровождение. Для исследования показателей сна использовалась анкета балльной оценки качества сна Я. И. Левина. По результатам анкетирования студенты, которые совершают вечерние прогулки, имеют более высокие показатели качества сна. Проведенные исследования показали, что средствами физического воспитания можно оптимизировать эмоциональное состояние у студентов, снизить состояние тревоги, напряжение и дискомфорт. Во время прогулок улучшается качество сна. Таким образом, полученные исследования констатируют важность систематического выполнения физических нагрузок, даже самых простых и доступных каждому, таких как вечерние прогулки на свежем воздухе

Estimating Hemodynamic Significant Deformations of Brachiocephalic Arteries Using CT Perfusion

Background and Aim: The cause of most strokes is associated with the pathology of the carotid arteries. Many modern researchers suggest preventive surgery in the presence of arterial deformity to prevent strokes. The hemodynamic significance of carotid deformities is determined by morphological and functional disorders at the level of tortuosity, the reaction of cerebral blood flow is not often considered. Here, we assume that cerebral autoregulation in tortuosity can be different. Methods and Materials/Patients: A total of 64 patients (31-75 years old) with 110 carotid deformities were analyzed. Duplex color mapping, computed tomography angiography of carotid arteries, and computed tomography perfusion were performed by estimating the absolute and average values of cerebral blood flow (mL/100 g/min), cerebral blood volume (mL/100 g), Mean transit time (MTT) (s) in similar areas of the cortex. In 6 patients, the acetazolamide challenge test was used to evaluate the autoregulatory disturbances. Results: According to computed tomography angiography and duplex color mapping, 18(28.1%) patients had unilateral tortuosity, and 46(71.9%) patients had bilateral tortuo s ity. Hemodynamically significant deformities were detected in 33 cases (30% of tortuosity). In 54 cases (49% of tortuosity), the deformities were accompanied by carotid stenosis. Perfusion disorders were detected in 23 of 64 patients (35.9%). In the majority of cases (75% of all perfusion disorders), hypoperfusion was diagnosed on the side corresponding to the maximum degree of stenosis, regardless of the location of the tortuosity. Neurologically significant hypoperfusion, compensated by collateral blood flow revealed only in 7.8% of cases of hemodynamic significant internal carotid artery deformity without concomitant atherosclerosis. Conclusion: The decision on surgical correction of carotid artery tortuosity should be made while considering both local changes in hemodynamics and proven violations of autoregulation of cerebral blood flow, especially in patients with concomitant carotid stenosis

Construction of Recombinant Escherichia coli Strain – Producer of Basic Subunit of Toxin-Coregulated Pilus of Adhesion (TCPA) of Vibrio cholerae Biovar El Tor

Objective of the study is to construct recombinant E. coli strain – producer of TcpA protein of cholera agent El Tor, carrying tcpACIRS gene in its genome, and use the strains for antigen production. Materials and methods. Utilized was non-toxigenic genovariant strain of Vibrio cholerae biovar El Tor from the “State Collection of Pathogenic Bacteria” at the premises of RusRAPI “Microbe”, as well as commercial E. coli strains and plasmids for cloning (Invitrogen, USA). Chromosomal DNA from V. cholerae cells was extracted using Charge Smitch gDNA Mini Bacteria Kit applying nucleo-sorption. To extract plasmid DNA from E. coli cells PureLink Quick Plasmid DNA MiniprepKits were used. The presence of tcpACIRS gene was assayed by PCR, using designed through our own efforts primers. DNA fragments were isolated from agarose gel with the help of PCR Clear-Up-System panel. SDS-PAGE was performed according to U.K.Laemmli method. Protein content of samples was measured by M.M.Bradford method. The panel for affinity chromatography was applied for recombinant TcpA protein purification. Results and conclusions. Constructed safe strain of E. coli is the producer of recombinant TcpA protein, basic subunit of toxin-coregulated pilus of adhesion of cholera agent biovar El Tor. The region of tcpA gene of Vibrio cholerae biovar El Tor was cloned as part of vector plasmid pET302 by the restriction sites XhoI-BamHI in E. coli strain BL21(DE3)Star. In the stated design protein biosynthesis is under transcriptional control of phage promoter T7 and induced by isopropyl-ß-thiogalactoside (IPTG). Tested were the conditions for optimum TcpA protein production and the layout of its purification using affinity chromatography. It was demonstrated that TcpA is present in cells of intestinal bacterium, both in native form and as inclusion bodies. Overall TcpA protein production amounted to 60 mcg/ml. Obtained purified TcpA protein can be used for studies of its immunogenic and physical-chemical properties, as well as development of immune-diagnostic preparations to evaluate the level of TcpA production in various V. cholerae strains, and identification of antigen composition of cholera vaccine preparations

Газоразделительные свойства мембран с диффузионными слоями из N-алкилированного поливинилпиридина и его комплексов с додецилсульфатом натрия.

O2 and N2 permeability of membranes with diffusive layers from quaternary poly(vinyl pyridine) and its complexes with sodium dodecyl sulfate was studied. The influence of a layer's chemical structure on these gases selectivity separation was shown.Изучены проницаемость O2 и N2 мембран с диффузионными слоями из кватернизованного поливинилпиридина и его комплексов с додецилсульфатом натрия. Показано влияние химической структуры слоя на селективность разделения этих газов

ХАРАКТЕРИСТИКА КОРОТКОЛАТЕНТНЫХ СЛУХОВЫХ ВЫЗВАННЫХ ПОТЕНЦИАЛОВ МОЗГА (ВОЗДУШНОЕ И КОСТНОЕ ЗВУКОПРОВЕДЕНИЕ) У ДЕТЕЙ С НОРМАЛЬНЫМ СЛУХОМ

Diagnosis of hearing level in small children with conductive hearing loss associated with congenital craniofacial abnormalities, particularly with agenesis of external ear and external auditory meatus is a pressing issue. Conventional methods of assessing hearing in the first years of life, i. e. registration of brainstem auditory evoked responses to acoustic stimuli in the event of air conduction, does not give an indication of the auditory analyzer’s condition due to potential conductive hearing loss in these patients. This study was aimed at assessing potential of diagnosing the auditory analyzer’s function with registering brainstem auditory evoked responses (BAERs) to acoustic stimuli transmitted by means of a bone vibrator. The study involved 17 children aged 3–10 years with normal hearing. We compared parameters of registering brainstem auditory evoked responses (peak V) depending on the type of stimulus transmission (air/bone) in children with normal hearing. The data on thresholds of the BAERs registered to acoustic stimuli in the event of air and bone conduction obtained in this study are comparable; hearing thresholds in the event of acoustic stimulation by means of a bone vibrator correlates with the results of the BAERs registered to the stimuli transmitted by means of air conduction earphones (r = 0.9). High correlation of thresholds of BAERs to the stimuli transmitted by means of a bone vibrator with thresholds of BAERs registered when air conduction earphones were used helps to assess auditory analyzer’s condition in patients with any form of conductive hearing loss.  Диагностика уровня слуха у детей младшего возраста с кондуктивной тугоухостью, связанной с пороками развития челюстно-лицевой области, в частности с агенезией слуховой раковины и наружного слухового прохода, является актуальной проблемой. Традиционная методика оценки слуха в первые годы жизни, а именно регистрация слуховых вызванных потенциалов мозга на акустические стимулы при воздушном звукопроведении, не дает представления о состоянии слухового анализатора за счет кондуктивного компонента тугоухости у этой когорты пациентов. Целью данного исследования стала оценка возможности диагностики функции слухового анализатора методом регистрации коротколатентных слуховых вызванных потенциалов (КСВП) при использовании акустического стимула, подаваемого через костный вибратор. В исследование были включены 17 детей с нормальным слухом в возрасте 3−10 лет. Проводили сравнение параметров регистрации коротколатентных слуховых вызванных потенциалов (V пик) в зависимости от типа передачи стимула (воздух/кость) у нормально слышащих детей. Полученные в исследовании данные порогов КСВП, зарегистрированных на акустические стимулы воздушного и костного звукопроведения, сопоставимы, а значения порогов слуха при акустической стимуляции через костный вибратор соответствуют результатам регистрации КСВП на стимулы, подаваемые через воздушные телефоны (r = 0,9). Высокая корреляция порогов КСВП на стимулы, подаваемые через костный вибратор, и порогов КСВП, зарегистрированных через воздушные телефоны, позволяет оценивать состояние слухового анализатора у пациентов с любыми формами кондуктивной тугоухости.