Risk factors for unfavorable clinical course of the early recovery period of ischemic stroke in young and middle-aged patients

Background. This study was carried out due to persistent increase in the incidence of ischemic stroke in people of working age and insufficient knowledge of risk factors affecting its clinical course in the early recovery period in young and middle-aged patients.The aim. To identify and to study variants of the clinical course of the early recovery period of ischemic stroke in young and middle-aged patients; to determine the risk factors for its unfavorable course.Materials and methods. We carried out a longitudinal prospective study, which involved 145 patients with ischemic stroke in its early recovery period. The main risk factors for cardiovascular diseases were analyzed. Dynamic observation of these patients allowed us to determine five variants of the clinical course of the ischemic stroke early recovery period – regressive, regressive with residual mild focal neurological symptoms, stable, slowly progressive and rapidly progressive.Results. Regressive course was observed in 58 (40 %) patients; regressive course with residual mild focal neurological symptoms – in 66 (45.5 %) patients; stable course – in 9 (6.2 %) patients; slowly progressive course – in 8 (5.5 %) patients, rapidly progressive course – in 4 (2.8 %) patients. The following risk factors had statistically significant affect on the unfavorable course of the disease: more pronounced motor, sensory and speech disorders at the time of patient’s admission to the hospital and at the end of the ischemic stroke early recovery period; severity of ischemic stroke according to the National Institutes of Health Stroke Scale (NIHSS); damage to the carotid basin of the brain; ischemic heart disease; irregular intake or patient’s refuse of taking prescribed antiplatelet, lipid-lowering, antihypertensive therapy (p < 0.05).Conclusions. Defining the variant of the clinical course of the ischemic stroke early recovery period in young and middle-aged patients and risk factors for its unfavorable course is important in determining tactics and further neurorehabilitation measures

LONG-TERM TRENDS OF CHANGES IN INFESTATION RATE OF THE BAIKAL REGION POPULATION BY IXODIC TICKS

Ixodid ticks are the vectors of many pathogens including tick-borne encephalitis virus and the Lyme disease agent Borrelia burgdorferi sensu lato. In Pribaikalye, Ixodes persulcatus, Dermacentor nuttalli, D. silvarum and Haemaphysalis concinna are regarded as main vectors of the diseases. Recently, significant changes in world tick fauna have been reported and this affects the spread of tick-borne pathogens. We studied the current species diversity, population structure and the number of attacks of hard ticks (Acari:Ixodidae) on humans in Irkutsk region and nearby territories during the season 2015. Long-term trends of changes in attack rate were analyzed as well. In total, 4268 individual ticks were identified and analyzed during the season 2015. The majority (86 %) of victims was bitten by I. persulcatus; 13.55 % of attacks on humans were caused by D. nuttalli and D. silvarum; whereas H. concinna was documented only in 2 cases (~0.05 %). No non-endemic or invasive tick species were documented in 2015. The seasonal activity and the age/gender structure of tick population that bite human hosts were described as well. The comparison of the results of 2015 with previously reported datasets on tick bite ratesfrom 1992-2001 andfrom 2007-2014 indicates that, after the burst of tick bites in 1992-2001, there are no significant increase of attack rate since 2007. Possible implications to human health and epidemiology of tick-borne infections are discussed

ASSESSMENT OF NEUTRALIZING PROPERTIES OF DNA-APTAMERS AND EXTRACTS OF MEDICINAL HERBS AGAINST THE TICK-BORNE ENCEPHALITIS VIRUS

Tick borne encephalitis (TBE) is a dangerous neurological disease that is transmitted to humans through the bite of Ixodid ticks. The disease exhibits an estimated 16 000 cases recorded annually over 30 European and Asian countries. The agent of TBE is the tick borne encephalitis virus (TBEV), belonging to the family Flaviviridae, genus Flavivirus. In spite the significant impact of TBE on human health, there is a serious lack of specific treatment against this disease. The only specific drug available is the human anti-TBEV immunoglobulin from vaccinated blood donors. The drug is produced and used in Russia only, both to prevent and to cure the TBE. In this work, we evaluated the ability of TBEV-specific DNA-aptamers and extracts of traditional medicine plants to neutralize the TBEV Selection of aptamers was performed using SELEX approach. Extracts of the seeds of Momordica cochinchinensis and Terminalia chebula were produced by boiling the ground seeds in water, clarified by centrifugation and filtration steps and filter sterilized. The SELEX had produced two aptamers - My13 and My38. Neither of two was capable to neutralize TBEV in vitro. The ability to shield the antibody binding sites on the surface of TBEV virions was also absent. The extract of M. cochinchinensis exhibited no neutralizing activity as well. Surprisingly, the T. chebula extract completely neutralized the TBEV after 30 min of incubation at 37 °C. The possible explanations and further development of the project are discussed

Antiviral activity of herbal extracts against the tick borne encephalitis virus (literature review)

Tick-borne encephalitis (TBE) is a widely known viral disease that is transmitted through the bites of ixodid ticks. In severe cases, it leads to disability or death of the patient. The causative agent of the TBE is the tick-borne encephalitis virus (TBEV), which belongs to the Flaviviridae family. Despite the great importance of TBE in human pathology, currently the only way to prevent and treat this disease is a donor immunoglobulin, which has a number of significant disadvantages. In this paper, we analyzed modern literature on the detection of antiviral properties of herbal preparations and assessed the possibility of using them to search for new drugs against TBE. In general, the published works can be divided into two areas of research - the study of whole plant extracts and the study of the biological activity of the purified extract components. The most informative results can be obtained under certain conditions; for example, the study of both water extracts of plants and extracts with organic solvents, fractionation of the initial preparations with the detected antiviral activity followed by the concentration of the target substance; identification of an antiviral agent to obtain standardized drugs and preclinical testing in laboratory animals and cell cultures. This approach made it possible to identify three substances - hebulinic acid, panicalagin and baikalein - possessing inhibitory activity against Dengue flavivirus. The article discusses the possibility of using these substances against TBEV and the optimal algorithm for searching for antiviral agents in plant preparations

Hantavirus infection in patients with fever of unknown origin and in small mammals in the Baikal region

Background. Hantavirus infections are one of the most important zoonotic diseases in the Russian Federation. However, the pathogenicity of Hantaviruses circulating in Siberia is still unknown. The aim of the study was to assess the incidence of Hantavirus infection in patients with fever of unknown origin from Irkutsk region and adjacent territories. Materials and methods. Serum samples collected in 2016 from individuals with symptoms of health deterioration were screened by ELISA to investigate possible Hantavirus infection, in addition to tick-borne infections. Depending on date of tick bite specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to tick-borne encephalitis, borreliosis and Hantavirus were tested by ELISA or screened by PCR for tick-borne encephalitis, borreliosis, human granulocytic anaplasmosis and monocytic erlychiosis RNA/DNA. Results. Out of 92 serum samples, 6.5 % were positive for hantavirus-specific antibodies, which is at least twice higher than the seroprevalence among healthy people in the Irkutsk region. IgM and IgM+IgG antibodies were found in 5.4 % of cases, while IgG antibodies - in 1.1 % of cases. The clinical symptoms among sero-positive patients were fever, skin lesion, fatigue syndrome, headache and lymphadenitis. IgM antibodies to borreliosis were found in two hantavirus sero-positive cases. Lung tissues from small mammals captured in 2016 were screened by ELISA for the presence of Hantavirus antigen. Hantaviral antigen was detected in 6.3 % of 48 samples. Conclusions. Thus, present and previous studies demonstrate existence of natural foci of Hantavirus infections in addition to tick-born infections in the territory of the Irkutsk region

Легочная гипертензия, ассоциированная с портальной гипертензией, и легочная гипертензия при саркоидозе органов дыхания: сложные патогенетические взаимоотношения

 In the literature review, modern views on the features of pathogenesis and diagnosis of pulmonary hypertension associated with portal hypertension and sarcoidosis of respiratory organs are presented. A variety of views is due to the lack of a convincing evidence base underlying the algorithm for diagnosis and treatment of this pathology. Pulmonary hypertension is one of the most complex cardiological problems and represents a pathological condition that is based on increasing resistance to blood flow in a small circle of blood circulation at any of site. Unlike the systemic arteries, there is no direct access to the pulmonary artery for measuring blood pressure by non-invasive methods, so the diagnosis of pulmonary hypertension in the early stages, before the formation of a lesion in the target organ, which is the right ventricle of the heart, is practically impossible. In actual clinical practice, pulmonary hypertension is at best diagnosed at the stage of latent right ventricular dysfunction, which is manifested by dilatation of its cavity and / or hypertrophy of its walls, at worst at the stage of right ventricular heart failure. At present, there has been a trend towards an improvement in the diagnosis of pulmonary hypertension (LH) in various diseases. This is the reason for the special interest in this interdisciplinary problem.В обзоре литературе представлены современные взгляды на особенности патогенеза и диагностику легочной гипертензии (ЛГ), ассоциированной с портальной гипертензией и саркоидозом органов дыхания, что обусловлено отсутствием убедительной доказательной базы, лежащей в основе четкого алгоритма диагностики и лечения данной патологии. Легочная гипертензия является одной из самых сложных кардиологических проблем и представляет собой патологическое состояние, в основе которого лежит повышение сопротивления току крови в малом круге кровообращения на любом из его участков. В отличие от системных артерий к легочной артерии нет прямого доступа для измерения артериального давления неинвазивными методами, поэтому диагностика ЛГ на ранних стадиях, до поражения органа-мишени, которым является правый желудочек сердца, практически невозможна. В реальной клинической практике ЛГ в лучшем случае диагностируется на стадии скрытой дисфункции правого желудочка, которая проявляется дилатацией его полости и (или) гипертрофией его стенок, в худшем – на стадии правожелудочковой сердечной недостаточности. В настоящее время отмечена тенденция к улучшению диагностики ЛГ при различных заболеваниях. Именно этим обусловлен особый интерес к данной междисциплинарной проблеме

Forecasting prices of dairy commodities – a comparison of linear and nonlinear models

peer reviewedDairy commodity prices have become more volatile over the last 10–11 yr. The aim of this paper was to produce reliable price forecasts for the most frequently traded dairy commodities. Altogether five linear and nonlinear time series models were applied. The analysis reveals that prices of dairy commodities reached a structural breakpoint in 2006/2007. The results also show that a combination of linear and nonlinear models is useful in forecasting commodity prices. In this study, the price of cheese is the most difficult to forecast, but a simple autoregressive (AR) model performs reasonably well after 12 mo. Similarly, for butter the AR model performs the best, while for skimmed milk powder (Smp), whole milk powder (Wmp) and whey powder (Whp) the nonlinear methods are the most accurate. However, few of the differences between models are significant according to the Diebold–Mariano (DM) test. The findings could be of interest to the whole dairy industry