Innovative technologies in the treatment of short bowel syndrome

Introdiction. In recent years, many new technologies for the management of patients with short bowel syndrom (SBS), including SBS-IF (short bowel syndrom with intestinal failor), have appeared. The implemented surgical techniques are aimed at slowing down the progress of intestinal contents (antiperistaltic inserts, the creation of artificial valves in the small intestine, loops or pockets from the small intestine, etc.); surgical elongation of the small intestine (the most common STEP, Bianchy technique); intestinal transplantation. At the same time, when the intestine is shortened to 1.5–2,0 m, the adaptive rearrangements are still able to provide (albeit suppressed), but partially preserved absorption processes (in 80% of cases, the surface of the intestine is sufficient for slow transport of nutrients from the intestine to the blood). Therefore, it is important to increase the efficiency of adaptive rearrangements in any conservative way shown.Аim. Тo evaluate the role of hormonal stimulation of adaptive rearrangements in the residual bowel stump.Materials and methods. Рarameters of the well-known alimentary-volemic diagnosis, assessment of adaptive changes in the gastrointestinal tract (performed by determining citruline and GLP-2, as well as by morphological method). To stimulate the regulation of adaptive processes, a hormone preparation GLP-2 (teduglutide) was used in the nutritional support program.Results. It was shown that the length of the intestinal stump up to 1.5–2.0 m allows for digestive and transport processes due to adaptive rearrangements of the intestinal epithelium. With a super-short intestine, it is advisable to choose surgical methods of correction.Conclusion. For conservative correction of adaptive processes in the intestine, it is advisable to use a GLP-2 hormone preparation, in particular, teduglutide

Characteristics of online behavior and structure of consumed content in Abakan adolescents of different age, groups and ethnicity

Background. The study of the prevalence and structure of various types of online behavior, the characteristics of the content consumed by adolescents of different age, sex and ethnic groups is an important area of scientific research.The aim. To study the features of online behavior and the structure of content consumed in Abakan adolescents of various age and sex groups and ethnicity (Russians and Khakasses).Materials and methods. 1400 adolescents of the city of Abakan (Republic of Khakassia) aged 12–18 were examined: 962 (68.7 %) Russians, 438  (31.3  %) Khakasses, 678 (48.4 %) boys and 722 (51.6 %) girls, aged 12–14 years – 39.8 % and 15–18 years – 60.2 %. The type of online behavior was verified using the Chen scale (CIAS). Emotional and behavioral disorders were diagnosed using the SDQ questionnaire. The indicators were compared in groups formed by sex, age and ethnicity. The data were processed using the Statistica 12.0 program (StatSoft Inc., USA).Results. It has been established that the prevalence and structure of online behavior among adolescents in Abakan depends on gender, age and ethnicity. Pathological Internet use (PIU) is more common among Khakasses, more often in the older age group. Regardless of ethnicity, maladaptive online behavior (pathological and maladaptive Internet use) is recorded more often among girls. In the structure of consumed content, gaming addiction prevails, social network addiction is in second place, and the proportion of mixed and undifferentiated Internet addiction is less. Dependence on online games prevails in boys, while dependence on social networks and undifferentiated internet addiction prevail in girls.Conclusion. One of the reasons for the greater prevalence of maladaptive online behavior among Khakasses may be the association of maladaptive Internet use with the presence of emotional disorders and behavioral problems that reach the borderline level and are causally significant factors in the development of Internet addiction. Adolescents with maladaptive online behavior, who have not yet reached the level of formed Internet addiction, are the target group requiring medical and psychological assistance

Functional properties of the Su(Hw) complex are determined by its regulatory environment and multiple interactions on the Su(Hw) protein platform

The Su(Hw) protein was first identified as a DNA-binding component of an insulator complex in Drosophila. Insulators are regulatory elements that can block the enhancer-promoter communication and exhibit boundary activity. Some insulator complexes contribute to the higher-order organization of chromatin in topologically associated domains that are fundamental elements of the eukaryotic genomic structure. The Su(Hw)-dependent protein complex is a unique model for studying the insulator, since its basic structural components affecting its activity are already known. However, the mechanisms involving this complex in various regulatory processes and the precise interaction between the components of the Su(Hw) insulators remain poorly understood. Our recent studies reveal the fine mechanism of formation and function of the Su(Hw) insulator. Our results provide, for the first time, an example of a high complexity of interactions between the insulator proteins that are required to form the (Su(Hw)/Mod(mdg4)-67.2/CP190) complex. All interactions between the proteins are to a greater or lesser extent redundant, which increases the reliability of the complex formation. We conclude that both association with CP190 and Mod(mdg4)-67.2 partners and the proper organization of the DNA binding site are essential for the efficient recruitment of the Su(Hw) complex to chromatin insulators. In this review, we demonstrate the role of multiple interactions between the major components of the Su(Hw) insulator complex (Su(Hw)/Mod(mdg4)-67.2/CP190) in its activity. It was shown that Su(Hw) may regulate the enhancer–promoter communication via the newly described insulator neutralization mechanism. Moreover, Su(Hw) participates in direct regulation of activity of vicinity promoters. Finally, we demonstrate the mechanism of organization of “insulator bodies” and suggest a model describing their role in proper binding of the Su(Hw) complex to chromatin

Gamma Knife stereotactic radiosurgery for intraocular retinoblastoma: a 5-year experience

External beam radiotherapy (EBR) remained for a long time the only method of treatment in children with recurrent and resistant retinoblastoma (RB). This method often leads to serious complications, including the occurrence of secondary malignant tumors. Currently, EBR is used as second-line (salvage) therapy. There is no data in the literature of using Gamma Knife stereotactic radiosurgery (GKRS) in RB treatment.Purpose. To present 5-year experience of using GKRS in patients with RB.Material and methods. 16 children (17 eyes) were treated using GKRS in the period from 2015 to 2019. Mean patient age was 34.7 months (range, 12–114 months). The eyes were classified as group B (n=4), C (n=1), D (n=12). 3 children had the last eye. All patients received systemic and local chemotherapy, all types of local treatment modalities before using GKRS. Recurrent and resistant RB was the indication for GKRS. Marginal 50% mean dose was 22 Gу (range, 20–24 Gу), depending on tumour type and location. Radiation doses were evaluated accounting critical eye structures and the orbit bones.Results. Complete regression was achieved in 11 patients, partial in 2. Four patients underwent enucleation after GKRS. Indications for enucleation were retinoblastoma recurrence (n=2) and vitreous hemorrhage with total retinal detachment (n=2). 13 eyes were salvaged with no signs of keratopathy, uveitis or damage of orbital and surrounding tissues during mean follow-up 30.6 months (range, 7–60 months). Сomplications of different severity occurred in 13 patients, including vitreous hemorrhage in 6 patients, which was successfully treated both conservative (n=3) and using pars plana vitrectomy with simultaneous melphalan irrigation (n=3).Conclusion. The first experience of GKRS as an alternative to enucleation in patients with RB was proved to be reasonable and successful

STUDYING DEVELOPMENT OF POST-VACCINAL CELLULAR IMMUNITY AGAINST BRUCELLOSIS BY MEANS OF LYMPHOCYTE <i>IN VITRO</i> TESTS USING AN EXPERIMENTAL ANTIGENIC COMPLEX

Regulatory framework and methodological approaches to evaluation of immunological effects of vaccination against brucellosis are not established, and the degree of immunological post-vaccinal rearrangement is not yet developed. Due to leading role of cellular immunity in formation of immune protection against brucellosis, evaluation the cellular response in response to antigenic stimulation may be considered the most informative and objective approach to analysis of immune changes in the body during vaccination. In order to develop the most diagnostically informative methods for design of antigen-stimulation cell tests in vitro, a careful selection of a stimulating agent (antigen) is required, which should have a sufficient activating potential, thus providing specificity of reaction under in vitro conditions. The aim of the present study is to study the in vitro specific activity of a protein-polysaccharide antigenic complex from the Brucella abortus 19 BA strain (BrAg), and an opportunity of its application in order to assess the formation of post-vaccinal cellular immunity against brucellosis.The study was performed with white laboratory mice (n = 50) immunized with the Brucella abortus 19 BA strain. The control group (n = 50) consisted of laboratory mice that received a sterile saline solution in a volume of 0.5 ml. Blood samples were taken from immunized and control animals before vaccination, and 7, 14, 21, and 30 days after immunization. By means of flow cytometry, the activation molecules CD25, CD69, MHC II and CD95, expressed on T lymphocytes (CD3+CD69+, CD3+CD25+, CD3+CD95+, CD3+MHC+) were determined. To observe the development of immunity, the intensity of expression of T lymphocyte activation markers was calculated using the stimulation quotient. BrAg was used for specific in vitro stimulation of T lymphocytes. The liquid brucellosis allergen (brucellin) was used as an antigen for comparison, when studying opportunity of BrAg usage for assessing the postvaccinal immunity development.The following results were obtained: BrAg has pronounced specific activity, it did not cause non-specific in vitro reactions (activation) of T lymphocytes, thus enabling its application as a test antigen when evaluating development of adaptive vaccine immunity against brucella.Experimental testing of brucellosis antigen for carrying out the in vitro antigen-stimulated cellular reactions, aiming for evaluation of post-vaccinal immunity development against brucellosis, showed that the usage of BrAg promotes increase in diagnostic sensitivity of cellular reactions under in vitro experimental conditions. The applied experimental antigen is a quite promising tool for development of laboratory algorithms for brucellosis diagnostics, and assessment of actual vaccination efficiency in cohorts previously vaccinated against brucellosis

Using CAST-test to investigate human specific hypersensitivity to the anthrax pathogen

We present the results of applying functional cytometric test of antigen-stimulated activation basophils to assess specific immunological reactivity in the people with anthrax, and immunized with anthrax vaccine. As a criterion for antigen-specific basophil activation, we measured expression of the CD63 membrane receptor, which reflects the process of anaphylactic basophil degranulation. To determine spontaneous and antigen-induced activation of basophils (CCR3+CD63+), a FlowCAST reagent kit (Buhlmann laboratories AG, Switzerland) was used. Anthraxin, an experimental anthrax allergen (a hydrolysate the Bacillus anthracis STI-1 strain), manufactured by the Stavropol Anti-Plague Institute, was used as a specific antigen. As based on clinical and experimental data, a threshold value of &gt; 10% of anthraxin-activated (CCR3+CD63+) basophils was accepted for the in vitro immunodiagnostic CAST test, as a laboratory criterion for the subjects exhibiting specific immune response, i.e., IgE-mediated sensitization. It was shown that, in anthrax patients within one week after onset of the disease (3-7 days), a positive CAST result was obtained in 92.3% cases; the levels of specific basophil activation with anthraxin averaged 37.9% (12.01 ÷ 78.9%). Immunological examination of individuals three weeks (21 days) after vaccination against anthrax revealed CAST-positivity in all the vaccinated persons. Intensity of anthraxin-induced basophil activation the vaccinated subjects was ranged from 10.87 to 30.03%, averaging 17.86%. The overall values of spontaneous and specific activation ranged within 12.39 ÷ 41.46%. The study opens prospectives for implementation of basophil antigenic activation test in the Flow CAST format in diagnostics of anthrax and to identify specific immune rearrangements after vaccination in humans, as an index of actual vaccination rates. Usage of CAST test with anthraxin makes it possible to identify anthrax patients at the early stages (2-4 days after onset of the disease) including, among patients with an increased CCR3+CD63+ background values, evaluation of immunological efficiency in the cohorts at risk for vaccination. At the same time, it was found that a significant decrease in diagnostic sensitivity of CAST test could be observed in the patients immune to anthrax pathogen who received intensive antibacterial and pathogenetic therapy at the early stages of infection, including glucocorticosteroids (anti-inflammatory drugs) and desensitizing agents that inhibit the degree of hypersensitivity development and its expression

Analysis of Epizootiological-Epidemiological Situation on Brucellosis in the Russian Federation in 2018 and Forecast for 2019

Presented is the analysis of brucellosis incidence among humans and animals in the Russian Federation in 2018. Epizootiological situation in the regions of developed animal husbandry remains reasonably tense. In 2018, as in previous years, the foci of bovine cattle and small ruminant brucellosis were registered in the North Caucasian, Southern Federal Districts, Volga and Siberian Federal Districts, the share of which made up to more than 90% of all registered in Russia potentially hazardous as regards brucellosis areas and cases of the disease in animals. Against the background of long-term unfavorable epizootic condition, the incidence of brucellosis over the past three years was, on average, 14 % lower than the average long-term indicators. The greatest number of cases (94.1 % of the overall Russian incidence) is registered in the administrative subjects of the North Caucasus Federal District, Southern Federal District and Siberian Federal District, which have the maximum levels of brucellosis incidence in cattle (88.9 %) and small ruminants (95 %). In 2019, persistence of epidemiological problems in regard to brucellosis in the subjects of the North Caucasus Federal District (primarily the Republic of Dagestan, Stavropol Territory), the Southern Federal District (the Republic of Kalmykia, Volgograd and Astrakhan Regions), and the Siberian Federal District (the Tuva Republic, the Omsk and Tyumen Regions) is predicted. The number of human cases of brucellosis may be within the range of 290–310 cases (intensive incidence rate per 100 thousand population – 0.21)

Brucellosis: Trends in the Development of Situation in the World and Forecast for 2022 in the Russian Federation

An analysis of trends in the development of situation on brucellosis in the world over past decade and the data on the main risk factors for the occurrence of epidemiological complications regarding this infection in various regions of the world are provided in the paper. An expert assessment of the current epizootiological and epidemiological situation on brucellosis, the coverage of population and animals with immunization in the Russian Federation is given. Over 9 months of 2021, 210 potentially hazardous as regards brucellosis in cattle areas and 24 sites – as regards brucellosis in small ruminants – were registered in Russia. Compared to the same period in 2020, there was a decrease in the number of newly identified hazardous sites for bovine brucellosis by 35.8 % (117 areas). However, long-term upward trend in epizootiological adversity for bovine brucellosis in Russia persists. The epidemiological situation on brucellosis in the country for the period of 2012–2021 is characterized as unfavorable. Decrease in the number of newly detected human brucellosis cases (by 25.1 % of long-term average values) is observed against the background of persistent unfavorable epizootic conditions for brucellosis among epidemiologically significant species of small ruminants and cattle in regions with developed animal husbandry. In 2021, clusters of human cases were registered in the Republic of Dagestan and Penza Region. In the Republic of Dagestan, against the background of aggravation of epizootiological and epidemiological situation on brucellosis, there was also an alarming trend towards prevalence of a relatively high incidence among minors. The proportion of cases of brucellosis among children under the age of 17 in the Republic amounted to 60.3 % of the total number of minors with newly diagnosed brucellosis in Russia over the past 10 years. Taking into account current epizootic, epidemic situations and the long-term dynamics of the development of situation on  brucellosis in the Russian Federation, the incidence of brucellosis among the population  is predicted to be 10–15 % lower than the average long-term values – 0.18–0.20 per 100000 of the population – in 2022. The number of human cases of brucellosis can range from 250 to 300