Aneurysm of internal carotid artery, which simulated paratonsillary abscess (clinical case)

This article describes a rare case of paratonsillar abscess imitation among the patients with the aneurysm of ICA. The purpose of the study is to describe the methods of this disease diagnosing using the example of a clinical case, to give a general description of this nosology occurrence frequency, and to recommend a detailed approach to the differential diagnosis among this category of patient

Therapy of Schizoaffective Disorder and Paranoid Schizophrenia with Episodic Course

Background. The use of atypical antipsychotics in schizophrenia contributes to the reduction of psychotic, affective, negative and cognitive disorders.Aims. To evaluate the effectiveness of ziprasidone therapy in patients with schizoaffective disorder and paranoid schizophrenia with episodic course.Materials and methods. In accordance with ICD-10 there were 14 (63.6 %) people with schizoaffective disorder (F25), 8 (36.4 %) people with paranoid schizophrenia, episodic course (F20.x1). Treatment with ziprasidone lasted 42 days. The dose of ziprasidone in 6 patients (27.3 %) was 80 mg, in 10 patients (45.5 %) – 120 mg, in 6 patients (27.3 %) – 160 mg. Evaluation of the effectiveness of ziprasidone therapy was carried out using psychometric scales (PANSS, General clinical impression scale to assess the effectiveness of therapy – CGI-S, CGI-I), adverse events were registered with the UKU scale.Results. The number of respondents was 19 (86.3 %) (reduction of the total score on the PANSS scale > 20 % of the pre-treatment level). Ziprasidone was effective in patients with schizoaffective disorder with a significant decrease in total score on PANSS subscales to the 14 th day of therapy (p < 0.05), with paranoid schizophrenia with episodic course – by the 21st day (p < 0.01). According to the CGI-S scale at the end of therapy, “borderline condition” was observed in 10 patients (52.6 %), mild severity – in 3 (15.8 %), normal condition – in 6 (31.6 %). CGI-I scale showed a significant improvement in 10 patients (52.6 %), marked improvement – in 9 patients (47.4 %). Among the mild adverse events that do not require discontinuation of the drug, we noted: weakness – in 3 patients (15.8 %), drowsiness – in 3 (15.8 %), impaired concentration – in 2 (10.5 %), orthostatic dizziness – in 2 (10.5 %), galactorrhea – in 1 (5.3 %).Conclusions. Ziprasidone is an effective antipsychotic drug that has a safe tolerability profile. It can be used in patients with schizoaffective disorders and paranoid schizophrenia with episodic course

Relationship of the Content of Systemic and Endobronchial Soluble Molecules of CD25, CD38, CD8, and HLA-I-CD8 and Lung Function Parameters in COPD Patients

© 2017 Nailya Kubysheva et al. The definition of new markers of local and systemic inflammation of chronic obstructive pulmonary disease (COPD) is one of the priority directions in the study of pathogenesis and diagnostic methods improvement for this disease. We investigated 91 patients with COPD and 21 healthy nonsmokers. The levels of soluble CD25, CD38, CD8, and HLA-I-CD8 molecules in the blood serum and exhaled breath condensate (EBC) in moderate-to-severe COPD patients during exacerbation and stable phase were studied. An unidirectional change in the content of sCD25, sCD38, and sCD8 molecules with increasing severity of COPD was detected. The correlations between the parameters of lung function and sCD8, sCD25, and sHLA-I-CD8 levels in the blood serum and EBC were discovered in patients with severe COPD. The findings suggest a pathogenetic role of the investigated soluble molecules of the COPD development and allow considering the content of sCD8, sCD25, and sHLA-I-CD8 molecules as additional novel systemic and endobronchial markers of the progression of chronic inflammation of this disease

Body Height of Children with Bronchial Asthma of Various Severities

© 2017 Tatiana I. Eliseeva et al. Influence of bronchial asthma (BA) severity on physical development in children patients was evaluated in comparison with healthy population. Materials and Methods. 1042 children and adolescents (768 boys) with atopic BA were evaluated. All children underwent standard examination in a clinical setting, including anthropometry. The control group included 875 healthy children of a comparable age (423 boys). Results. The fraction of patients with the normal, lower, and increased height among the whole group of patients with BA is close to the corresponding values in the healthy population (χ 2 =3.32, p=0.65). The fraction of BA patients with the reduced physical development is increased monotonically and significantly when the BA severity increases: healthy group, 8.2% (72/875), BA intermittent, 4.2% (6/144), BA mild persistent 9% (47/520), BA moderate persistent, 11.7% (36/308), and BA severe persistent, 24.3% (17/70) (χ 2 =45.6, p=0,0009). Conclusion. The fraction of the children with the reduced height is increased monotonically and significantly in the groups of increasing BA severities. At the same time, the fraction of such children in groups of intermittent and mild persistent BA practically does not differ from the conditionally healthy peers

The significance of soluble molecules of cellular adhesion, nitric oxide metabolites, and endothelin-1 and their associations as markers of progression of inflammation in COPD

© 2017, Nizhny Novgorod State Medical Academy. All rights reserved. The aim of the investigation was to assess the significance of the content of metabolites of the nitric oxide, sICAM-1 and sICAM-3 in blood serum and in exhaled breath condensate, the serum level of endothelin-1 as systemic and topical markers of inflammation in patients with COPD, and their correlations with the parameters of lung ventilation function. Materials and methods. 91 patients with COPD, aged from 46 to 67, and 21 healthy, non-smoking volunteers took part in the study. The material for investigation was blood serum and exhaled breath condensate. Results. The severity of progression of COPD was linked with an increase in the serum content of sCD50, sCD54, ET-1, as well as in the concentrations of metabolites of nitric oxide in blood and in exhaled breath condensate. For the patients with COPD we determined the associations between the function of pulmonary ventilation and the levels of ET-1, sICAM-1, sICAM-3 and the value of ΣNO – 2 /NO – 3 . The resulting correlations between the concentration of soluble adhesion molecules, the values of nitrosative stress, and ET-1 level indicate that they are involved in the genesis of chronic inflammation in COPD patients

Relative body mass index as a new tool for nutritional status assessment in children and adolescents with bronchial asthma

© 2017, Nizhny Novgorod State Medical Academy. All rights reserved.The aim of the investigation was to estimate the possibilities of using relative body mass index (RBMI) for determining age- and gender-specific aspects of nutritional status in children and adolescents with bronchial asthma (BA) of different severity degrees. Materials and Methods. The study involved 887 children and adolescents with BA of different severities, aged 5–17 years (61– 215 months), of them 655 were boys. Their body mass index (BMI) was evaluated based on the Z-score criterion and nutritional status was determined as recommended by the World Health Organization (WHO). To unify nutritional status assessment in patients of different age and gender groups, there was introduced RBMI representing the ratio of the patient’s BMI to gender- and age-specific median BMI value presented in the WHO reference data. Results. Nutritional status and its relation to BA were studied in children and adolescents using two parameters: the standard nutritional status indicator based on BMI Z-scores as recommended by WHO, and a new parameter, RBMI, representing the ratio of the patient’s BMI to gender- and age-specific median BMI value recommended by WHO. No significant nutritional status differences were found in the studied sample of patients with various degrees of BA severity. There was revealed a tendency to a decrease in the proportion of children with normal body weight and an increase in the proportion of overweight children as BA severity increased, χ2=26.82; р=0.08. Conclusion. Using RBMI for assessment of BA patients makes it possible to significantly facilitate clinical data analysis and obtain new data unavailable when standard parameters are applied

Prokaryotic expression, purification and immunogenicity in rabbits of the small antigen of hepatitis delta virus

Funding Information: Expression and purification of HDV antigen was supported by Russian Foundation for Basic Research (grant 16-04-01490a). Evaluation of serum by Western blot and confocal microscopy was supported by Russian Science Foundation (grant 14-14-01021). Experiments in rabbits were supported by the Swedish Institute grants 09272_2013 and 19806_2016. Cross-border collaboration of the partners, exchange of the materials and standard operation procedures used in the study, and dissemination of the data were supported by the EU Twinning project VACTRAIN, contract nr 692293. Publisher Copyright: © 2016 by the authors; licensee MDPI, Basel, Switzerland.Hepatitis delta virus (HDV) is a viroid-like blood-borne human pathogen that accompanies hepatitis B virus infection in 5% patients. HDV has been studied for four decades; however, the knowledge on its life-cycle and pathogenesis is still sparse. The studies are hampered by the absence of the commercially-available HDV-specific antibodies. Here, we describe a set of reproducible methods for the expression in E. coli of His-tagged small antigen of HDV (S-HDAg), its purification, and production of polyclonal anti-S-HDAg antibodies in rabbits. S-HDAg was cloned into a commercial vector guiding expression of the recombinant proteins with the C-terminal His-tag. We optimized S-HDAg protein purification procedure circumventing a low affinity of the His-tagged S-HDAg to the Ni-nitrilotriacetyl agarose (Ni-NTA-agarose) resin. Optimization allowed us to obtain S-HDAg with >90% purity. S-HDAg was used to immunize Shinchilla grey rabbits which received 80 µg of S-HDAg in two subcutaneous primes in the complete, followed by four 40 µg boosts in incomplete Freunds adjuvant. Rabbits were bled two weeks post each boost. Antibody titers determined by indirect ELISA exceeded 107. Anti-S-HDAg antibodies detected the antigen on Western blots in the amounts of up-to 100 pg. They were also successfully used to characterize the expression of S-HDAg in the eukaryotic cells by immunofluorescent staining/confocal microscopy.publishersversionPeer reviewe

Endonasal infrared thermometry for the diagnosis of allergic inflammation of the nasal mucosa in patients with bronchial asthma

© 2017, Nizhny Novgorod State Medical Academy. All rights reserved. Bronchial asthma (BA) is often associated with chronic inflammatory processes in the nasal mucosa; these processes give rise to allergic rhinitis, chronic rhinosinusitis, adenoiditis, and polypous rhinosinusitis. Due to their multiple symptoms, these diseases of the upper respiratory tract, especially allergic rhinitis, are often difficult to verify in patients with asthma. The aim of the study was to evaluate the diagnostic potential of endonasal IR thermometry in BA patients suspected of allergic rhinitis. Materials and Methods. Fifty children diagnosed with both BA and allergic rhinitis and 15 healthy children, matched by gender and age, participated in the study. The endonasal temperature determined with contactless IR thermometry was confronted with the symptoms of allergic rhinitis and sinusitis assessed with the TNSS and SNOT-20 questionnaires. The results were compared with the severity of nasal obstruction as determined through the anterior active rhinomanometry. Results. The nasal temperature in patients with asthma and allergic rhinitis was 33.77 [33.37; 34.17]°С, which was significantly lower than that in the group of healthy children (34.98 [34.57; 35.39] °С; p=0.0006); the body temperature did not differ between the groups (36.55 [36.45; 36.65] and 36.58 [36.40; 36.76] °С, respectively; p=0.5). We found a negative correlation between the values of nasal temperature and the sinusitis symptom scores in patients with BA and allergic rhinitis (R=–0.32; p=0.02). Conclusion. Patients with both BA and allergic rhinitis showed a decreased endonasal temperature in comparison with healthy children; the endonasal temperature can serve an indicator of allergic inflammation of the nasal mucosa

ОЦЕНКА ЭФФЕКТИВНОСТИ И БЕЗОПАСНОСТИ ПЕРОРАЛЬНЫХ АНТИКОАГУЛЯНТОВ У ПАЦИЕНТОВ С ФИБРИЛЛЯЦИЕЙ ПРЕДСЕРДИЙ В ПРОСПЕКТИВНОМ НАБЛЮДЕНИИ

PURPOSE. To evaluate the effectiveness and safety of warfarin therapy using a clinical laboratory model of centralized monitoring of international normalized relationships, and direct oral anticoagulants in patients with atrial fibrillation in real clinical practice.MATERIAL AND METHODS. In a non-interactive prospective study, 661 atrial fibrillation patients were prescribed oral anticoagulants to prevent cardioembolic complications. The study included patients older than 18 years of age, with creatinine clearance at least 50 ml/min. Рatients were divided into 4 groups: 1 group of 120 people who took warfarin was observed in the conditions of centralized monitoring the international normalized ratio (INR), group 2 – 112 people– was taking Rivaroxaban, group 3 – 106 people– was taking Dabigatran, group 4 – 98 people took Apixaban. Formed 4 groups of patients were comparable in age, concomitant diseases, risks of thromboembolic and hemorrhagic complications.The follow-up period was 2 years from the date of prescribing.RESULTS. In patients who were observed in the clinical laboratory model of centralized monitoring of INR, the TTR was 69.4%. The groups did not differ in the number of thromboembolic complications (p>0.05). Warfarin had an advantage in the amount of large bleeding - 0.9% versus 3.6% taking rivaroxaban and 3.8% taking dabigatran (p = 0.044 and p = 0.035, respectively) without statistical significance for apixaban.CONCLUSION. The ratio of efficacy and safety of warfarin therapy can be successfully maintained at a satisfactory level using a centralized monitoring system of international normalized relationships. It allows you to get comparable treatment results with warfarin and direct inhibitors of blood coagulation factors in real clinical practice.ЦЕЛЬ. Оценить эффективность и безопасность терапии варфарином при использовании клинико-лабораторной модели централизованного мониторинга международного нормализованного отношения и прямыми оральными антикоагулянтами у пациентов с фибрилляцией предсердий в условиях реальной клинической практики.МАТЕРИАЛ И МЕТОДЫ. В ходе неинтервенционного проспективного исследования наблюдались 661 пациент с фибрилляцией предсердий старше 18 лет и с клиренсом креатинина не менее 50 мл/мин, получавшие варфарин (n = 120), ривароксабан (n = 112), дабигатран (n = 106) и апиксабан (n = 98). Пациенты, принимавшие варфарин, наблюдались в условиях централизованного мониторинга международного нормализованного отношения (МНО). Сформированные четыре группы пациентов были сопоставимы по возрасту, сопутствующим заболеваниям, рискам тромбоэмболических и геморрагических осложнений. Срок наблюдения составил 2 года от момента назначения препарата. В качестве конечных точек наблюдения рассматривали тромбоэмболические осложнения (ТЭО), большие кровотечения и смерть по любой причине.РЕЗУЛЬТАТЫ. В ходе наблюдения и использования клинико-лабораторной модели централизованного мониторинга МНО для варфарина достигнуто среднее время нахождения пациентов в терапевтическом целевом интервале 69,4%. Сравнение клинических результатов не показало статистически значимых отличий в исследованных группах по частоте ТЭО и некоторое преимущество в группе принимающих варфарин по количеству больших кровотечений – 0,9% против 3,6% принимающих ривароксабан и 3,8% принимающих дабигатран (р = 0,044 и р = 0,035 соответственно) без статистической значимости для апиксабана.ВЫВОД. Соотношение эффективности и безопасности терапии варфарином может с успехом поддерживаться на удовлетворительном уровне с помощью системы централизованного мониторинга международного нормализованного отношения, которая позволяет получать сопоставимые результаты лечения варфарином и прямыми ингибиторами факторов свертывания крови в реальной клинической практике