Polypharmacy problem in treatment of children in outpatient practice

The drug load that children receive is often superfluous and unreasonable. A typical example is the appointment of antibacterial drugs and immunomodulators in acute respiratory infections (ARI). In this work, there were analyzed 714 appeals to primary care physicians due to ARI in children under five years of age. The morbidity structure and frequency of use of drugs of various groups in this age period are presented. Unjustified use of antibacterial drugs has been noted in 59 % of cases. The average total number of drugs received by a child due to ARIs in his first five years of life was 44, some of which did not have proven effectiveness and safety

CLUSTER ANALYSIS OF THE PATHOGENETIC RELATIONSHIPS OF METABOLIC PARAMETERS IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE ON THE BACKGROUND OF HYPERTENSION

The aim of the study was to conduct a cluster analysis of pathogenetic relationships between metabolic parameters, endothelial lipase levels, the severity of steatosis, and clinical parameters in patients with non-alcoholic fatty liver disease with hypertension. To analyze pathogenetic relationships, a cluster analysis was performed with the distribution of parameters into 4 clusters using the Ward's method. The most dense metabolic link by cluster analysis endothelial lipase forms with NAFLD liver fat score (2.639 cu), HbA1C (2.084 cu), total cholesterol (2.272 cu), and alcohol units (2.797 cu).The aim of the study was to conduct a cluster analysis of pathogenetic relationships between metabolic parameters, endothelial lipase levels, the severity of steatosis, and clinical parameters in patients with non-alcoholic fatty liver disease with hypertension. To analyze pathogenetic relationships, a cluster analysis was performed with the distribution of parameters into 4 clusters using the Ward's method. The most dense metabolic link by cluster analysis endothelial lipase forms with NAFLD liver fat score (2.639 cu), HbA1C (2.084 cu), total cholesterol (2.272 cu), and alcohol units (2.797 cu)

Sensitivity of bronchial receptors under the effect of tobacco smoke in the conditions of various activity of the thyroid gland in children.

The role of the initial hormonal profile disorders of the system “pituitary – thyroid” in the emergence of a bronchospasm in response to exogenic stimuli has not been finally determined. The aim of our research was to investigate the character and degree of the relationship between bronchial hypersensitivity in children exposed to smoking and the functional activity of the thyroid gland. The research involved 74 patients aged 10 to 17 years. Sixteen children were not exposed to tobacco smoke, 50 children were passive smokers, and 8 of the children surveyed smoked actively. To investigate the level of bronchial sensitivity, a bronchial provocation test with a non-specific stimulus – bronchoconstrictor acetylcholine was carried out. We assayed the functional state of the thyroid gland by the level of free triiodothyronine (FT3), free thyroxin 4 (FT4) and thyroid stimulating hormone (TSH), identified by Enzyme-linked Immunosorbent Assay (ELISA) (Alkor Bio, Russia). Indicators of hormones of a thyroid gland in most of the examined children did not differ from standard values for healthy children. Analysis of the results of the inhaled bronchial provocation test with acetylcholin showed that the state of non-specific bronchial hypersensitivity was observed in 2 active smokers and in none of the passive smokers and non-smokers (χ2=15,4>χ201=9,21 або р<0,01). According to our data, in children with hypothyroidism, under the effect of tobacco smoke, changes in the functional state of sensitive bronchial receptors do not occur. Among 2 children who had an increased activity of the thyroid gland (hyperthyroidism), one child from the group of smokers had an increased bronchial sensitivity by the results of the acetylcholine test (p>0.05). According to our data,  changes in the functional status of sensitive bronchial receptors (cholinergic receptors) resulting from exposure to tobacco smoke in children exposed to tobacco smoke, active or passive, do not depend on the functional state of the thyroid gland (Рχ2>0,05)

Extrakranielle stereotaktische Radiotherapie - Indikationen und erste Ergebnisse mit dem Novalis-Beschleuniger

This retrospective study investigated the efficiency and toxicity of the fractionated stereotactic body radiation therapy (SBRT) and the stereotactic body radiosurgery. The medical records of 130 patients, who were treated with SBRT between 2003 and 2007, were reviewed retrospectively. The median survival time in the category “lungs” was 19 months and the local control could achieved in 70.8%. Pain relief was achieved in 80.6%. Acute grade three toxicity occured in case of 6 irradiations (4.8%). There was no chronically grade 3 or higher toxicity. In the category “bones/spinal cord” the median survival time was 12.3 months. The local control of treated lesions was obtained in 75%. For both, neurological deficits and pain, a control rate of 92.9% was achieved. Grade 2 acute toxicity occurred only in one single case (1.8%). The median survival time in the category “abdomen” was 39.2 months. The local tumor control rate was observed in 62.5 %. The symptom control rate of 82.4% could be achieved. No grade 3 or higher toxicity occurred in this category. Excellent local tumor control rates with low toxicity are seen with the SBRT for the lesions in the lungs, bones, spinal cord and abdomen. It allows the reirradiation of the targets in critical localizations.In dieser retrospektiven Untersuchung wurden die fraktionierte stereotaktische Therapie und die stereotaktische Radiochirurgie hinsichtlich ihrer Effektivität und ihres Toxizitätsprofils bei der Therapie von extrakraniell gelegenen Läsionen untersucht. Zwischen 2003 und 2007 wurden 130 Patienten stereotaktisch mit dem Novalis Linearbeschleuniger an den extrakraniellen Läsionen behandelt. In der Gruppe „Lunge“ lag die lokale Kontrollrate bei 70,8%. Eine Schmerzfreiheit oder Schmerzreduktion konnte bei 29 (72,2%) von 36 Läsionen beobachtet werden.Eine akute Toxizität dritten Grades wurde in 6 Fällen (4,8%) beobachtet. Es kam zu keiner chronischen Toxizität dritten Grades oder höher. In der Gruppe Wirbelsäule/Knochen betrug die lokale Tumorkontrollrate 75%. Für Schmerzen und neurologische Symptome konnte eine Kontrollrate von 92,9% erreicht werden. Es kam nur nach einer Bestrahlung zur akuten Toxizität Grad 1 (1,8%). Es trat keine chronische Toxizität Grad 3 oder höher auf. In der Gruppe „Abdomen“ betrug die lokale Tumorkontrollrate 62,5%. Es kam in 82,4% zur Symptomkontrolle (Schmerzfreiheit oder Schmerzreduktion). Es trat keine akute oder chronische Toxizität Grad 3 und höher auf. Die extrakranielle stereotaktische Radiotherapie ist eine effektive und nebenwirkungsarme Methode zur Bestrahlung von Läsionen in der Lunge, in Knochen und der Wirbelsäule und im Abdomen. Sie ermöglicht die Zweitbestrahlung in kritischen Lokalisationen

Образ крепости в составе русских загородных ансамблей середины XVIII века

Статья посвящена утраченным памятникам середины XVIII века, которые находились в составе архитектурно-парковых ансамблей в окрестностях Санкт-Петербурга и Москвы. Все эти сооружения принадлежали к стилю позднего барокко и рококо и являлись парковыми увеселительными павильонами, но их планы и объёмно-пространственные решения воспроизводили облик военной крепости. В статье предпринята попытка рассмотреть эти постройки как целостное явление в истории русской архитектуры Нового времени

Convolutional Neural Networks for Image Steganalysis

© 2016, Springer Science+Business Media New York.Mathematical models based on human neuronal network behavior have recently become extremely popular and arouse interest as a solution of various computer vision problems. One of these models—Convolutional Neural Network—has been proven to be very efficient for object recognition problems and resembles principles of visual processing held by animal visual cortex. In this research, we propose a new approach to performing steganalysis on JPEG images using Convolutional Neural Networks. This approach allows to detect hidden embedding without computing features of an image predefined by empirical observations and obtain results comparable to state of the art methods of JPEG image steganalysis

Gender hormones and non-specificbronchial hypersensitivity in children with bronchial asthma

Bronchial asthma continues to occupy a leading place in thestructure of chronic respiratory diseases in adults and children. Therefore,bronchial asthma remains an actual scientific problem today.One of the main links in the pathogenesis of bronchial asthma is bronchialhyperreactivity (non-specific bronchial hypersensitivity). On the other hand,among the etiological and pathogenetic factors of the development of bronchial asthma,a certain role belongs to violations of the neuroendocrine regulation of the body, whichis performed by the hypothalamic-pituitary-adrenal system. The hormonal defensemechanism of the body is triggered due to a state of stress reaction, which causesincreased activity of the pituitary gland, which in turn activates the adrenal cortex. Themain hormones of the adenohypophysis play a key role in the process of physiologicalmaturation of the body and the establishment of reproductive function. Theendocrine status of children and adolescents is characterized by the immaturity of the"hypothalamus - pituitary gland - gonads and target organs" system. In suchconditions, the negative impact of exo- and endogenous factors during the formationof the reproductive system can cause its functional immaturity. It is a well-known factthat sex hormones are included in the mechanisms of adaptation reactions.It is from the age of 12 that there is a significant restructuring of the functionalactivity of the pituitary-adrenal-gonadal status and a qualitative change in thehypothalamic-pituitary-gonadal relationship in the system of negative and positivefeedback.The purpose of the study: to study the relationship between puberty and the stateof non-specific bronchial sensitivity in children suffering from bronchial asthma

Spatially determined olfactory receptor choice is regulated by Nfi-dependent heterochromatin silencing and genomic compartmentalization

Pattern formation during development is guided by tightly controlled gene regulatory networks that lead to reproducible cell fate outcomes. However, stochastic choices are often employed to further diversify cell fates. These two mechanisms are closely interlinked in the mouse olfactory system, where stochastic expression of one of one out of >1,000 olfactory receptor (OR) genes is restricted to anatomical segments, or “zones”, organized along the dorsoventral axis of the olfactory epithelium (OE). Despite recent progress in understanding the processes underlying OR choice, the mechanism by which the dorsoventral position of an olfactory sensory neuron (OSN) dictates its OR repertoire has remained elusive and is the focus of this thesis. To gain insight into a possible mechanism I compared the transcriptomes, chromatin landscape, and nuclear architecture of cells isolated from ventral and dorsal zonal segments of the OE. I determined the developmental window in which cells become restricted in their zonal OR repertoire and found this coincided with both the deposition of heterochromatic histone marks H3K9me3 and H3K79me3 on OR genes and their coalescence into a multi-chromosomal compartment. Comparing heterochromatin levels and OR compartment composition in OSNs from different zones, I determined in each case OR genes with more dorsal indexes have higher levels of H3K9me3/H3K79me3 and thus become silenced, while OR genes with more ventral indexes have no heterochromatin and consequently are excluded from OR compartments. Thus, ORs that are “competent” for activation are relatively more accessible, while still being recruited into the OR compartment where they can interact with the proximally positioned enhancer hub. I found that this mechanism is regulated by Nfi family transcription factors that are expressed in a ventral (high) to dorsal (low) gradient in the OE. Deletion of Nfi A, B and X transforms the heterochromatin and OR compartmentalization in ventral OSNs to a more dorsal state, and shifts their preferred OR repertoire towards more dorsal ORs. This result implicates Nfi proteins as key regulators of zonal OR expression. Finally, I probed the nuclear architecture in single cells to look for the source of stochastic choice within zonal segments. I found high variability in inter-chromosomal OR compartment and enhancer hub composition between individual OSNs that stemmed from the unpredictable and variable positioning of chromosomes in the interphase nucleus. Overall, this thesis provides evidence for a mechanism of zonal OR choice that combines deterministic restrictions imposed by a gradient of Nfi with random inter-chromosomal contacts