«CHEST PAIN» AT PRE-HOSPITAL STAGE

The article is devoted to the questions of differential diagnostics in patients with chest pain at pre-hospital stage of medical care. On the basis of literary data the principle of construction of diagnostic algorithm by the physician for this group of patients is defined. Summarized literary data allowed to reveal the tendency of mutually burdening influence of different pathology, that is accompanied with chest pain, on the pathogenesis of basic disease. The principles of medical care for the patients with chest pain at pre-hospital stage are determined

Condition of entomophilic fauna on Hyssopus officinalis L. crops depending on ecotope conditions

Species diversity and number of potential pollinator species on H. officinalis seed crops in various ecotopes of farm fields were studied under the influence of "Bi-58 new" insecticide treatment and without preliminary treatment. The presence of 16 insect species belonging to four families of the genus Hymenoptera (Megachilida, Apidae, Halictidae and Vespidae), two families of the Diptera row (Syrphidae and Stratiomyidae) and one family of the genus Lepidoptera (Lycaenalidae) has been identified on the seed crops of H. officinalis. The insecticidal treatment in general did not significantly affect the total number of pollinators, but changed the species composition of pollinators and their number on the field area. As much as possible, the decrease in the prevalence and number of the Megachilida species was affecte

Connection between the level of anesthesia and hemodynamic and heart rate variability

The work presents the analysis of changes of statistical parameters, hemodynamic and cardiac rhythm variability in dynamics depending on sedation level according to the bispectral index in patients undergone intravenous anaesthesia in painful endoscopic procedures. Heart rate variability is a reliable and sensitive method for evaluation of functions of the autonomic nervous system. Registration and interpretation of heart rate variability reflects the activity of the autonomic nervous system in such diseases as intracranial hypertension, stroke, and brain trauma. As a "gold standard" assessment of the level of anesthesia we used the original methodology for the evaluation of bioelectrical activity of the brain based on electroencephalogram - "Bispectral index" - BISPECTRAL INDEX (BIS], demonstrating the degree of sedation of the patient on a dynamic curve from 100 % to 0 %. Assessment of heart rate variability, hemodynamic profile, and the BIS was carried out in three phases of research: phase 1 - before the introduction of anaesthesia (baseline]; phase 2- after administration of drugs for anesthesia; phase 3 - the end of the procedure, recovery of consciousness (post anesthesia]. Depending on the BIS, values for all patients were allocated to three levels of sedation: the first level corresponded to the patient's state of consciousness or light sedation, the second and third - to deep anesthesia. A mathematical model of light and deep levels of anesthesia based on the discriminant analysis contingency options

LUMBAR DRAINAGE IN CHIASMOSELLAR TUMORS

Lumbar drainage is one of the methods used to prevent the occurrence of intracranial hypertension and treatment of nasal liquorrhea in patients after by endonasal transsphenoidal endoscopic removal of tumors of the chiasmosellar region. The application of this method intraoperatively is a standard procedure to facilitate manipulation of the brain surgeon, but prolonged post-operative drainage is used extremely selectively and depending on the approaches taken in the specific medical organization. The present paper describes different frequency and risks of lumbar drainage after the surgery. Our aim was to assess the efficacy and safety of postoperative drainage of liquor from the surveyed patients. We observed 80 patients in the postoperative period who were conducted passive lumbar drainage. The assessment was performed of the cell count and discharge of the liquor, depending on the size of the tumor. During the study, it was found that the optimal timing of drainage is: 3 days for patients with small and medium-sized pituitary adenomas and 5 days for patients with large and giant adenomas. In all cases, the maximum values of cell count were observed on the first day and they gradually reduced by the 3-5th days due to reorganization of the liquor and reduced inflammatory response. Postoperative meningitis developed in 6 (5.8 %) cases and in 3 cases this complication led to death. It has been found, that prolonged liquor drainage meets the standards of safety and effectiveness for the correction of intracranial hypertension and accelerates the rehabilitation of the CSF

Infectious disease testing of UK-bound refugees: a population-based, cross-sectional study

Background: The UK, like a number of other countries, has a refugee resettlement programme. External factors, such as higher prevalence of infectious diseases in the country of origin and circumstances of travel, are likely to increase the infectious disease risk of refugees, but published data is scarce. The International Organization for Migration carries out and collates data on standardised pre-entry health assessments (HA), including testing for infectious diseases, on all UK refugee applicants as part of the resettlement programme. From this data, we report the yield of selected infectious diseases (tuberculosis (TB), HIV, syphilis, hepatitis B and hepatitis C) and key risk factors with the aim of informing public health policy. Methods: We examined a large cohort of refugees (n = 18,418) who underwent a comprehensive pre-entry HA between March 2013 and August 2017. We calculated yields of infectious diseases stratified by nationality and compared these with published (mostly WHO) estimates. We assessed factors associated with case positivity in univariable and multivariable logistic regression analysis. Results: The number of refugees included in the analysis varied by disease (range 8506–9759). Overall yields were notably high for hepatitis B (188 cases; 2.04%, 95% CI 1.77–2.35%), while yields were below 1% for active TB (9 cases; 92 per 100,000, 48–177), HIV (31 cases; 0.4%, 0.3–0.5%), syphilis (23 cases; 0.24%, 0.15–0.36%) and hepatitis C (38 cases; 0.41%, 0.30–0.57%), and varied widely by nationality. In multivariable analysis, sub-Saharan African nationality was a risk factor for several infections (HIV: OR 51.72, 20.67–129.39; syphilis: OR 4.24, 1.21–24.82; hepatitis B: OR 4.37, 2.91–6.41). Hepatitis B (OR 2.23, 1.05–4.76) and hepatitis C (OR 5.19, 1.70–15.88) were associated with history of blood transfusion. Syphilis (OR 3.27, 1.07–9.95) was associated with history of torture, whereas HIV (OR 1521.54, 342.76–6754.23) and hepatitis B (OR 7.65, 2.33–25.18) were associated with sexually transmitted infection. Syphilis was associated with HIV (OR 10.27, 1.30–81.40). Conclusions: Testing refugees in an overseas setting through a systematic HA identified patients with a range of infectious diseases. Our results reflect similar patterns found in other programmes and indicate that the yields for infectious diseases vary by region and nationality. This information may help in designing a more targeted approach to testing, which has already started in the UK programme. Further work is needed to refine how best to identify infections in refugees, taking these factors into account

Some ways of filling of the vascular bed of domestic animals

In this work the assessment of some methods of filling of the mammals blood channels is presented. As injection masses there were used the gelatine solution of 5%, painted with the ink by Borisevich V.B. technique and the solution consisting of Bustilat-M glue and the water in a proportion of 2:1. The conducted researches showed that the most successful, in terms of simplicity of execution, is filling of vessels with the solution consisting of Bustilat-M glue and water, as it allows with the little effort and with the smallest expenses to fill in both large and average vessel

Features of intra population variability of Medicago varia Mart. with the expressed mf-mutation on a complex qualitative characteristics

The purpose of this work was studying of features of intra population variability of a lucerne with a mf-mutation on a complex of the qualitative signs, valuable as for the forage production as well as for the pharmaceutical industr

Biological resources of natural forage grassland of the cretaceous south of the European Russia

The main objective of the made researches was assessment of territorial confinedness of economic and valuable plant species and also a status and productivity of a natural forage grassland within agrolandscapes of the cretaceous South of the European Russia (the territory of the Belgorod region). Biological and vegetable resources of the natural forage grasslands of the East part of the Belgorod region in a subband of the southern forest-steppe were studie

PLASMA Th1/Th2/Th17 CYTOKINE PROFILE AND CYTOKINE GENE POLYMORPHISMS (IL12B, IL13, IL31, IL33) IN ASTHMATIC CHILDREN: A MAGNETIC MULTIPLEX ASSAY

The study of the bronchial asthma pathogenesis is an urgent problem due to its high prevalence and often developing uncontrolled severe ashma, including in childhood. The first signs of asthma development tend to occur in childhood, which causes deterioration in the patient’s quality of life and early disability. Since BA is a genetically mediated process, the severity of the disease is assumed to depend on the presence of a specific allelic variant in the mediator (e.g. cytokines) genes involved in the BA pathogenesis. The aim of this study was to search for immunogenetic markers of severe asthma in Slavs children living in Krasnoyarsk city. The quantitative indicators of the Th1/Th2/Th17-cytokine profile in children with bronchial asthma (BA) with varying disease severity, depending on the polymorphism of cytokine genes, using the method of multiplex analysis (xMAP), were first determined. Changes in the cytokine background in BA patients fit into the concept that a percentage of neutrophilic endotype, which performs its functions through Th1 and Th17-lymphocytes in severe asthma, increases. In addition, the cytokine profile data depending on concomitant acute respiratory infections were obtained. There was an imbalance when analyzing the cytokine plasma level, with a tendency to maintain the protective functions of the immune system among patients in remission. Distribution of cytokine genes was obtained: allelic variants of IL12B rs321220*G, IL13 rs1800925*C, IL31 rs7977932*C and IL33 rs7044343*T are the most common in the population sampling from Krasnoyarsk. The probability of the genotype association of cytokine genes (IL12B, IL13, IL31, IL33) with the state of the immune system in bronchial asthma with varying disease severity in children was studied: a significant association of the TT genotype IL12B rs3212220 with a low concentration of IL-12B was presented. Our data obtained can be used along with the previously obtained immunogenetic markers of severe and uncontrolled asthma in children for patient-specific prognosis of the disease nature

Analysis of the infectious agent’s structure and antibiotic resistance parameters in patients in intensive care units of a multidisciplinary hospital

Introduction.  Nosocomial infections are a common complication in patients treated in the intensive care unit (ICU). Microorganisms with multidrug resistance are one of the significant risk factors for death in this category of patients. Aim. To study structure of infectious agents in ICU patients and parameters of their antibiotic resistance.  Materials and methods. Retrospective pharmacoepidemiological study of medical records of adult patients with infections diagnosed in ICU who were treated in City Clinical Hospital No. 24 of the Department of Health (Moscow, Russian Federation) in the period 08/20/2022 — 07/31/2023 (n=199). The analysis (gender, age of patients, localization of the infectious process, data on the structure of pathogens and sensitivity to antibacterial drugs) included records with data on bacterial culture ( n=141). Results. In the structure of pathogens detected in ICU patients, gram-negative microflora predominated (54 %). Among the pathogens with a clinically significant growth, leaders were  K. pneumoniae (22 %), Candida spp. (20 %) and  Staphylococcus  spp. (19 %). K. pneumoniae was characterized by resistance to beta-lactams, aminoglycosides, and levofloxacin, the highest susceptibility was reported to colistin, 88.9 %.  Candida  spp. was overwhelmingly susceptible to all drugs used. Among Staphylococ caceae, S. aureus  was the most common (70 % resistance to ampicillin and cefoxitin).  Conclusion.  In the structure of infectious agents detected in ICU patients, a predominance of ESKAPE pathogens (the most prognostically important microorganisms: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) was observed, including K. pneumoniae, S. aureus, A. baumannii, P. aeruginosa.  For all these microorganisms, except for Staphylococcaceae, a high level of antibiotic resistance was demonstrated