The relevance of topical drugs endaural use in otosurgical practice

Introduction. Preoperative, in particular, antiseptic, preparation of the external auditory canal (EAC) is an important issue for the otosurgeon to take in mind, especially with endaural approach.The aim of the study is to assess the skin microbiota of the EAC and the effectiveness of antiseptic treatment before endaural intervention.Materials and methods. A prospective study including 19 patients who underwent ear surgery by endaural approach: 10 stapedoplasty; 9 tympanoplasty. Ear swabs culture were taken from all the patients preoperatively and after removing the tamponade. Of the 10 patients with otosclerosis, 5 underwent skin preparation with 10% povidone iodine and a swab culture.Results. According to the microbiological examination results, Staphulacoccus Auricularis prevailed in the first smear - 52.6%. In 5 patients with otosclerosis, in comparison to the 1st swab: one case with absence of microorganisms growth, in the other 4 -decrease in the degree of contamination by half. In the 3rd swab, there was no growth in these patients and in the rest, who didn't undergo antiseptic preparation. Patients, without antiseptic preparation of the ear canal, after tympanoplasty (9 patients) in the second smear, had an increase of contamination (from 105 to 106 CFU/ml).Conclusions. Analysis of the microbiome before and after the operation revealed the growth of predominantly (94.7%) opportunistic microorganisms. Preoperative antiseptic preparation reduces the degree of contamination of the skin, which, in our opinion, prevents complications and improves the healing process

Prevalence of risk factors of HIV contamination in injection drug using women in the Omsk Region

The results of an epidemiological study of risk factors of HIV infection among women, who inject drugs, are presented in this paper. Incidence of HIV among women during the period from 2005 to 2013 had a significant increasing trend from 2,1 to 63,3 per 100000 women. The predominance of parenteral transmission of HIV, as well as a significant prevalence of substance abuse disorders among women, determined a significant risk of morbidity for women with HIV infection (6,3 per 10,000 women). We included 115 women, taking injection drugs, in our study. Most of the women noted patterns of high risk HIV infection behavior, as well as the lack of knowledge about HIV prevention. 45% of women had been using drugs for 6-11 years, most of them have started using drugs at the age of 16-19 years, 40% of participants have used more than one type of drug, used common needles, syringes, together with other persons, including those with HIV infection. 23,8% of the women mentioned having unprotected sex, including sex with casual sex partners

Levilimab clinical efficacy for interleukin-6 receptor inhibition in COVID-19 and its potential for treating cytokine release syndrome of other aetiologies

The COVID-19 mortality is associated with an increase in interleukin-6 (IL-6) levels. Levilimab is an anti–IL-6 receptor antibody with proven clinical efficacy in patients with severe COVID-19.The aim of the study was to assess the association of COVID-19 severity and levilimab effectiveness with IL-6 levels and to explore the potential for using levilimab in other conditions accompanied by cytokine release syndrome.Materials and methods: the subgroup analysis was based on the data of COVID patients with known baseline IL-6 levels from the CORONA clinical study. Subgroups were formed according to baseline IL-6 levels: ≤5 pg/mL (normal) and >5 pg/mL (elevated). The subgroup analysis included descriptive statistics of the patients and time courses of their clinical and laboratory findings (at screening, on the day of investigational product administration, and further until day 14). In order to compare the percentages of patients who had required rescue therapy, the authors used Fisher's exact test.Results: the subgroup analysis included 91 patients (47 from the levilimab group and 44 from the placebo group). At baseline, the authors observed elevated levels of IL-6 in 31/47 (66%) subjects in the levilimab group and 29/44 (48.4%) subjects in the placebo group. The subjects with elevated IL-6 demonstrated more pronounced clinical signs of pneumonia and abnormalities in inflammatory markers. Elevated baseline IL-6 levels were associated with the need for rescue therapy (OR=3.714; 95% CI: 1.317–9.747; p=0.0183); this association was stronger in the placebo group (OR=8.889; 95% CI: 2.098–33.31; p=0.0036). Also, the placebo group showed long-term abnormalities in the clinical and laboratory findings.Conclusions: IL-6 is one of the key elements in the pathogenesis of cytokine release syndrome related to COVID-19 and other conditions. Elevated IL-6 levels are associated with the severity of COVID-19. Inhibition of IL-6 receptors by levilimab leads to clinical improvement in patients with severe COVID-19, suggesting the effectiveness of levilimab in pathogenesis-oriented therapy for cytokine release syndrome of other aetiologies

ЧРЕСКОЖНОЕ ТРАНСФЕМОРАЛЬНОЕ ДРЕНИРОВАНИЕ ЛЕВОГО ПРЕДСЕРДИЯ КАК МЕТОД ОБЪЕМНОЙ РАЗГРУЗКИ ЛЕВОГО ЖЕЛУДОЧКА ПРИ ПРОВЕДЕНИИ ПЕРИФЕРИЧЕСКОЙ ВЕНО-АРТЕРИАЛЬНОЙ МЕМБРАННОЙ ОКСИГЕНАЦИИ У ПОТЕНЦИАЛЬНЫХ РЕЦИПИЕНТОВ СЕРДЦА

Aim. Peripheral VA ECMO is effective method of circulatory support in heart transplant candidates with life th- reatening CHF. However this type of extracorporeal life support may be complicated by pulmonary congestion (“white lung”) as a result of left ventricle (LV) dilatation and volume overload. Difference approach proposed for LV unloading following VA ECMO circulatory support. We report our experience of LV unloading by percutaneous introduced of supplement drainage cannula in the left atrium (LA ) through the femoral vena and interatrial septum. Material and methods. In this study was included 33 heart transplant candidates (6/27 F/M, age 46.2 ± 3.7 yrs) on peripheral VA ECMO support. For LV unloading we used supplement standard venous ECMO-cannula (15–19 F) percutaneous introduced in LA through the femoral vena of conterlateral leg and connected to the venous line of ECMO circuit. Results. To 20 (60.6%) from 33 patients needed of early (n = 10) or delayed (n = 10) LA drainage. After beginning of LV drainage we noted of significant (p < 0.05) decreasing of PAWP from 31 ± 3 to 14 ± 3 mm Hg and resolution of pulmonary edema. Mean blood flow on LA cannula was 1.5 ± 0.2 l/min. To 18 (90%) from 20 patients was successfully bridged to heart transplantation. Duration VA ECMO before OHT was 8.6 ± 1.7 days. 16 (88.9%) recipients were discharged from hospital. Conclusion. Active LA drainage is as effective tool of LV un- loading and protection of pulmonary congestion and edema in patients bridged to heart transplantation by peripheral VA ECMO. Цель работы: оценка эффективности объемной разгрузки левого желудочка (ЛЖ) при проведении периферической ВА ЭКМО путем дополнительного чрескожного трансфеморального дренирования левого предсердия (ЛП). Материалы и методы. Обследовали 33 потенциальных реципиентов сердца – 6 (18,2%) женщин и 27 (81,8%) мужчин в возрасте 46,2 ± 3,7 года, у которых применили периферическую вено-артериальную экстракорпоральную мембранную оксигенацию (ВА ЭКМО) в качестве предтранс- плантационной механической поддержки кровообращения. Показаниями для чрескожного дренирования ЛП считали наличие одного или нескольких клинико-инструментальных проявлений застоя крови в малом круге кровообращения и развитие отека легких, несмотря на адекватную объемную скорость экстракорпорального кровотока и оптимальную разгрузку правых отделов сердца. К разработанному варианту дренирования ЛП при проведении периферической ВА ЭКМО относили установку дополнительной дренажной стандартной венозной ЭКМО-канюли (15, 17 или 19 F), проведенной через бедренную вену в восходящем направлении в правое предсердие и затем непосредственно через межпредсердную перегородку в полость ЛП. Результаты. У 20 (60,6%) из 33 обследованных потребовалось раннее (n = 10; 50%) или отсроченное (n = 10; 50%) трансфеморальное дренирование ЛП. Через 1 ч после начала дренирования ЛП (1,5 ± 0,2 л/мин) выявили уменьшение (p < 0,05) ДЛА ср. и ЗДЛА и снижение дозировок кардиотонических препаратов. Объем дренирования крови из ЛП составил 1,5 ± 0,2 л/мин. У 18 из 20 пациентов выполнили ТС. 16 (88,9%) из 18 реципиентов с предтрансплантационной ВА ЭКМО были выписаны из стационара. У данной категории реципиентов продолжительность послеоперационной ИВЛ составила 1,5–11,0 (7,2 ± 1,5) ч, послеоперационного лечения в условиях ОРИТ – 6,7 ± 0,8 суток. Заключение. Чрескожное трансфеморальное дренирование левого ЛП является эффективным и безопасным методом профилактики возникновения и купирования отека легких, развивающегося на фоне периферической ВА ЭКМО.

Некоторые закономерности жидкофазного каталитического диспропорционирования g-трифторпропилметилдихлорсилана в присутствии этил- и фенилхлорсиланов

γ-Trifluoropropylmethyldichlorosilane interaction with ethyl- and phenylchlorosilanes in aluminum chloride presence was studied. It is demonstrated that besides expected exchange reactions of Cl↔F at silicon, exchange reactions proceed with the participation of γ-trifluoropropyl substituent resulting in the formation of a few new unsaturated allyl-type compounds. There is no intermolecular exchange of organic substituents. It is found that chlorine atoms, which are in γ-position towards silicon in a hydrocarbon chain, are active in dehydrochlorination reactions in aluminum chloride presence in contrast to chlorine atoms in α- and β-positions.Tetraethylsilane has been found to be passive in the studied reactions in contrast to ethylchlorosilanes. A scheme explaining the obtained results is proposed, and quantum-chemical calculations of the basic reactions have been made.Исследовано взаимодействие g-трифторпропилметилдихлорсилана с этил- и фенилхлорсиланами в присутствии хлорида алюминия. Показано, что, помимо ожидаемых реакций обмена Cl«F у атомов кремния, протекают обменные реакции с участием g-трифто-рпропильного заместителя, приводящие к образованию ряда новых непредельных соединений аллильного типа. Проведены квантово-химические расчеты основных стадий протекающих реакций

Stellar structure and compact objects before 1940: Towards relativistic astrophysics

Since the mid-1920s, different strands of research used stars as "physics laboratories" for investigating the nature of matter under extreme densities and pressures, impossible to realize on Earth. To trace this process this paper is following the evolution of the concept of a dense core in stars, which was important both for an understanding of stellar evolution and as a testing ground for the fast-evolving field of nuclear physics. In spite of the divide between physicists and astrophysicists, some key actors working in the cross-fertilized soil of overlapping but different scientific cultures formulated models and tentative theories that gradually evolved into more realistic and structured astrophysical objects. These investigations culminated in the first contact with general relativity in 1939, when J. Robert Oppenheimer and his students George Volkoff and Hartland Snyder systematically applied the theory to the dense core of a collapsing neutron star. This pioneering application of Einstein's theory to an astrophysical compact object can be regarded as a milestone in the path eventually leading to the emergence of relativistic astrophysics in the early 1960s.Comment: 83 pages, 4 figures, submitted to the European Physical Journal

The recombinant fusion protein CFP10–ESAT6–dIFN has protective effect against tuberculosis in guinea pigs

Development of effective vaccine candidates against tuberculosis (TB) is currently the most important challenge in the prevention of this disease since the BCG vaccine fails to guarantee a lifelong protection, while any other approved vaccine with better efficiency is still absent. The protective effect of the recombinant fusion protein CFP10–ESAT6–dIFN produced in a prokaryotic expression system (Escherichia coli) has been assessed in a guinea pig model of acute TB. The tested antigen comprises the Mycobacterium tuberculosis (Mtb) proteins ESAT6 and CFP10 as well as modified human γ-interferon (dIFN) for boosting the immune response. Double intradermal immunization of guinea pigs with the tested fusion protein (2 × 0.5 µg) induces a protective effect against subsequent Mtb infection. The immunized guinea pigs do not develop the symptoms of acute TB and their body weight gain was five times more as compared with the non-immunized infected guinea pigs. The animal group immunized with this dose of antigen displays the minimum morphological changes in the internal organs and insignificant inflammatory lesions in the liver tissue, which complies with a decrease in the bacterial load in the spleen and average Mtb counts in macrophages

Клиническая эффективность ингибирования рецептора интерлейкина-6 при COVID-19 левилимабом и перспективы его применения при синдроме высвобождения цитокинов другой этиологии

The COVID-19 mortality is associated with an increase in interleukin-6 (IL-6) levels. Levilimab is an anti–IL-6 receptor antibody with proven clinical efficacy in patients with severe COVID-19.The aim of the study was to assess the association of COVID-19 severity and levilimab effectiveness with IL-6 levels and to explore the potential for using levilimab in other conditions accompanied by cytokine release syndrome.Materials and methods: the subgroup analysis was based on the data of COVID patients with known baseline IL-6 levels from the CORONA clinical study. Subgroups were formed according to baseline IL-6 levels: ≤5 pg/mL (normal) and >5 pg/mL (elevated). The subgroup analysis included descriptive statistics of the patients and time courses of their clinical and laboratory findings (at screening, on the day of investigational product administration, and further until day 14). In order to compare the percentages of patients who had required rescue therapy, the authors used Fisher's exact test.Results: the subgroup analysis included 91 patients (47 from the levilimab group and 44 from the placebo group). At baseline, the authors observed elevated levels of IL-6 in 31/47 (66%) subjects in the levilimab group and 29/44 (48.4%) subjects in the placebo group. The subjects with elevated IL-6 demonstrated more pronounced clinical signs of pneumonia and abnormalities in inflammatory markers. Elevated baseline IL-6 levels were associated with the need for rescue therapy (OR=3.714; 95% CI: 1.317–9.747; p=0.0183); this association was stronger in the placebo group (OR=8.889; 95% CI: 2.098–33.31; p=0.0036). Also, the placebo group showed long-term abnormalities in the clinical and laboratory findings.Conclusions: IL-6 is one of the key elements in the pathogenesis of cytokine release syndrome related to COVID-19 and other conditions. Elevated IL-6 levels are associated with the severity of COVID-19. Inhibition of IL-6 receptors by levilimab leads to clinical improvement in patients with severe COVID-19, suggesting the effectiveness of levilimab in pathogenesis-oriented therapy for cytokine release syndrome of other aetiologies.Смертность при COVID-19 ассоциирована с повышением уровня интерлейкина-6 (ИЛ-6). Левилимаб – моноклональное антитело к рецептору ИЛ-6 с доказанной клинической эффективностью у пациентов с тяжелым течением COVID-19.Цель работы: уточнить ассоциацию тяжести клинических проявлений COVID-19 и эффективности левилимаба с уровнем ИЛ-6 и определить возможность применения левилимаба при других состояниях, сопровождающихся синдромом высвобождения цитокинов.Материалы и методы: для подгруппового анализа использованы данные пациентов с COVID-19, участников клинического исследования CORONA, у которых был определен исходный уровень ИЛ-6. Подгруппы были сформированы на основании исходных значений уровня ИЛ-6: ≤5 пг/мл (нормальный уровень) и >5 пг/мл (повышенный уровень). Подгрупповой анализ включал описательную статистику и динамику клинико-лабораторных параметров пациентов изучаемых подгрупп на этапе скрининга, в день введения исследуемого препарата и далее до 14 суток. Сравнение долей пациентов, которым потребовалось назначения терапии спасения, было выполнено точным тестом Фишера.Результаты: в анализ включили 91 пациента (47 из группы пациентов, получивших левилимаб, и 44 из группы пациентов, получивших плацебо). Исходно повышенный уровень ИЛ-6 наблюдался у 31 (66%) из 47 в группе пациентов, получивших левилимаб, и 29 (48,4%) из 44 в группе пациентов, получивших плацебо. У пациентов с высоким уровнем ИЛ-6 наблюдались более выраженные клинические проявления пневмонии и отклонения показателей маркеров воспаления. Высокий уровень ИЛ-6 был ассоциирован с необходимостью назначения терапии спасения (ОШ=3,714; 95% ДИ 1,317–9,747; p=0,0183), в большей степени в группе пациентов, получивших плацебо (ОШ=8,889; 95% ДИ 2,098–33,31; p=0,0036), в которой также наблюдались длительно сохраняющиеся отклонения клинико-лабораторных параметров.Выводы: ИЛ-6 является одним из важнейших элементов патогенеза синдрома высвобождения цитокинов при COVID-19 и других состояниях. Повышенный уровень ИЛ-6 ассоциирован с более тяжелым течением COVID-19. Ингибирование рецепторов ИЛ-6 левилимабом приводит к клиническому улучшению у пациентов с тяжелым течением COVID-19, что позволяет предположить эффективность левилимаба в качестве патогенетической терапии синдрома высвобождения цитокинов различной этиологии