Иммунологические и биохимические особенности патогенеза саркоидоза легких и идиопатического фиброзирующего альвеолита

Immunological and biochemical parameters such as: Interleukin 1 and 2 (IL-1, IL-2), prostaglandin E and F2alfa levels, subpopulations of T-lymphocytes, the activity of elastase and collagenase were studied in patients with cryptogenic fibrosing alveolitis and pulmonary sarcoidosis.It was found that the immunoreactivity of the patients is characterized by high levels of the IL-1 and IL-2 activity and the T-lymphocyte subpopulation disbalance. High levels of elastase and collagenase in bronchoalveolar fluid in these patients were detected.Иммунологические и биохимические параметры, такие как уровни интерлейкина 1 и 2 (IL-1, IL-2), простагландина Е и F2alfa, субпопуляции Т-лимфоцитов, активность эластазы и коллагеназы, исследовались у пациентов с криптогенным фиброзирующим альвеолитом и легочным саркоидозом.Было найдено, что иммунореактивность данных пациентов характеризуется высокими уровнями IL-1 и IL-2 активности и дисбалансом субпопуляций Т-лимфоцитов. Высокие уровни эластазы и коллагеназы были обнаружены в бронхоальвеолярной жидкости у этих пациентов

МЕНИНГОКОККОВАЯ ИНФЕКЦИЯ У ДЕТЕЙ: ФАКТОРЫ, ВЛИЯЮЩИЕ НА ИСХОД

Generalized forms of meningococcal infection are characterized by high risk of complication and fatal outcomes. In Russian Federation, 2016, meningococcal infection was the second most common cause of pediatric deaths (25%) due to infectious diseases after community associated-pneumonia. Mandatory vaccination against meninococcal infection is not regulated, and immunization coverage according to epidemic indications is insufficient. During first 6–8 hours of illness clinical signs of this infection may be non-specific, because of that it is difficult to make correct diagnosis at outpatient department. Aim of the study was to analyze mistakes of diagnostics of meningococcal infection and to assess factors influencing the disease outcome. Material and methods. Retrospective cohort study was performed including 113 pediatric cases of generalized meningococcal infection occurred in Arkhangelsk region (46 cases with fatal outcome and 67 patients, who recovered). Factors influencing the outcome were recognized using Cox regression. Results. Median age of patients was 11 months. Clinical forms were meningitis (13,3%), meningococcemia (40,7%), mixed form (46%). The diagnosis of meningococcal infection was made at outpatient department in 36,9% of cases. The main causes of diagnostic mistakes were the lack of experience among primary care physicians and non-specificic symptoms during the first hours of the disease. Age younger 2 years, septic shock and time between onset of the diseases and admission to the hospital were associated with fatal outcome. Conclusion. To manage meningococcal disease we need to have good compliance with clinical guidelines for outpatient departments and hospitals; to optimize medical students education for prevention of diagnostic mistakes. Vaccination is the most effective method of prevention of deaths associated with meningococcal infection.Генерализованные формы менингококковой инфекции отличаются высоким риском развития осложнений и летальных исходов. В Российской Федерации (РФ) в 2016 г. менингококковая инфекция заняла второе место (25%) после внебольничных пневмоний в структуре причин смерти детей от инфекционных заболеваний. Обязательная вакцинация против менинкогокковой инфекции не регламентирована, а охват иммунизацией по эпидемическим показаниям недостаточный. В первые 6–8 ч симптомы этой инфекции неспецифические, поэтому клиническая диагностика инфекции на догоспитальном этапе представляет сложность. Цель: анализ причин диагностических ошибок при оказании медицинской помощи пациентам с менингококковой инфекцией и оценка факторов, влияющих на исход болезни. Материалы и методы. Проведено ретроспективное когортное исследование 113 случаев генерализованной менингококковой инфекции у детей, проживающих в Архангельской области (46 умерших от менингококковой инфекции детей и 67 пациентов, у которых заболевание закончилось выздоровлением). Для выявления факторов, влияющих на исход заболевания, использовали регрессионный анализа Кокса. Результаты. Средний возраст пациентов составил 11 месяцев. Клинические формы были представлены менингитом в 13,3% случаев, менингококцемией – в 40,7% случаев, смешанной формой – у 46% детей. При направлении в стационар менингококковая инфекция была диагностирована в 36,9% случаев. Главными причинами ошибок диагностики менингококковой инфекции были – отсутствие опыта у врачей первичного звена и неспецифичность симптоматики в первые часы болезни, а факторами, влияющими на исход, – возраст младше 2 лет, наличие септического шока и своевременность госпитализации. Заключение. Для решения проблемы менингококковой инфекции необходимо: соблюдение клинических рекомендаций при оказании медицинской помощи на догоспитальном этапе и в стационаре; оптимизация образовательного процесса для профилактики ошибок диагностики. Наиболее эффективным способом предотвращения летальности от менингококковой инфекции является специфическая профилактика

Nutritional approaches to correction of metabolic syndrome before abdominoplasty

The aim of the study was to highlight modern approaches to the dietary correction of metabolic syndrome in patients who have decided to perform abdominoplasty.Цель работы — освещение современных подходов к диетологической коррекции метаболического синдрома у пациентов, принявших решение о проведении абдоминопластики

Meningococcal infection in children: factors influencing outcome

Generalized forms of meningococcal infection are characterized by high risk of complication and fatal outcomes. In Russian Federation, 2016, meningococcal infection was the second most common cause of pediatric deaths (25%) due to infectious diseases after community associated-pneumonia. Mandatory vaccination against meninococcal infection is not regulated, and immunization coverage according to epidemic indications is insufficient. During first 6–8 hours of illness clinical signs of this infection may be non-specific, because of that it is difficult to make correct diagnosis at outpatient department. Aim of the study was to analyze mistakes of diagnostics of meningococcal infection and to assess factors influencing the disease outcome. Material and methods. Retrospective cohort study was performed including 113 pediatric cases of generalized meningococcal infection occurred in Arkhangelsk region (46 cases with fatal outcome and 67 patients, who recovered). Factors influencing the outcome were recognized using Cox regression. Results. Median age of patients was 11 months. Clinical forms were meningitis (13,3%), meningococcemia (40,7%), mixed form (46%). The diagnosis of meningococcal infection was made at outpatient department in 36,9% of cases. The main causes of diagnostic mistakes were the lack of experience among primary care physicians and non-specificic symptoms during the first hours of the disease. Age younger 2 years, septic shock and time between onset of the diseases and admission to the hospital were associated with fatal outcome. Conclusion. To manage meningococcal disease we need to have good compliance with clinical guidelines for outpatient departments and hospitals; to optimize medical students education for prevention of diagnostic mistakes. Vaccination is the most effective method of prevention of deaths associated with meningococcal infection

A novel method for preparation of HAMLET-like protein complexes

Some natural proteins induce tumor-selective apoptosis. α-Lactalbumin (α-LA), a milk calcium-binding protein, is converted into an antitumor form, called HAMLET/BAMLET, via partial unfolding and association with oleic acid (OA). Besides triggering multiple cell death mechanisms in tumor cells, HAMLET exhibits bactericidal activity against Streptococcus pneumoniae. The existing methods for preparation of active complexes of α-LA with OA employ neutral pH solutions, which greatly limit water solubility of OA. Therefore these methods suffer from low scalability and/or heterogeneity of the resulting α-LA - OA samples. In this study we present a novel method for preparation of α-LA - OA complexes using alkaline conditions that favor aqueous solubility of OA. The unbound OA is removed by precipitation under acidic conditions. The resulting sample, bLA-OA-45, bears 11 OA molecules and exhibits physico-chemical properties similar to those of BAMLET. Cytotoxic activities of bLA-OA-45 against human epidermoid larynx carcinoma and S. pneumoniae D39 cells are close to those of HAMLET. Treatment of S. pneumoniae with bLA-OA-45 or HAMLET induces depolarization and rupture of the membrane. The cells are markedly rescued from death upon pretreatment with an inhibitor of Ca(2+) transport. Hence, the activation mechanisms of S. pneumoniae death are analogous for these two complexes. The developed express method for preparation of active α-LA - OA complex is high-throughput and suited for development of other protein complexes with low-molecular-weight amphiphilic substances possessing valuable cytotoxic properties

Mosaicism in preimplantation human embryos

Since the very first publications on preimplantation genetic testing, researchers have faced a serious problem — a high mosaicism level in the preimplantation human embryos obtained by means of in vitro fertilization cycles. The nature of this mosaicism and its high impact on embryo development draws attention to this issue. In this research we studied the cells from different parts of preimplantation human embryos with mosaicism in the trophectoderm cells detected using Next-generation Sequencing (NGS). Six human blastocysts with mosaicism in their trophectoderm cells were each sectioned in three parts: two containing only trophectoderm cells and one predominantly inner cell mass. These parts were then analyzed individually. Our data indicate that the proportion of aneuploid cells in bioptate taken for preimplantation genetic testing does not necessarily reflect the true chromosomal status of the whole embryo and cannot be extrapolated to that in the embryoblast cells. The results of our study strongly suggest that mosaicism revealed in blastocyst reduces the likelihood of finding the euploid chromosome set in the other parts of the embryo. Karyotypes of cells from different parts of mosaic embryos show low concordance. Chromosomal abnormalities in mosaic embryos are unpredictably diverse, which may lead not only to loss of conception, but also to the development of genetic disease in the offspring. According to our data, the mosaic rate tends to increase in the samples containing trophectoderm adjacent to the embryoblast, which may have physiological significance for the implantation. Comparative studies focused on the concordance of mosaicism level of and the type of chromosomal abnormalities detected in different parts of preimplantation human embryos will improve clinical recommendations regarding the transfer of mosaic embryos