Prevalence and structure of juvenile arthritis in young persons

The purpose of the study: to determine the prevalence and structure of juvenile arthritis (JA) in adolescents, to identify the clinical course in young persons. Materials and methods. A questionnaire in 1550 persons aged 14 to 22 years. Of these, 69 adolescents identified with complaints of pain in the joints and 21 people of young age, address their complaints to the clinic, who received a complete clinical examination. It consisted generally accepted in rheumatology research, including X-ray and ultrasonography (U.S.) of painful joints, as well as phenotypic map for the syndrome of undifferentiated connective tissue dysplasia (UCTD). Results. We examined adolescents the most frequent pain in the knee, at least in the hip joints. In all there were signs UCTD varying degree. When ultrasound revealed changes in the joints due to synovitis and I or periarthritis. According to a detailed clinical, laboratory and instrumental investigations, including ultrasonography of the joints, the diagnosis of JA may have 12 patients with reactive arthritis (ReA) -1 3 , osteoarthritis (OA) - 63, arthralgia - 2 patients, not always coincided with diagnosis with direction. Conclusions. The prevalence of joint pathology in adolescents was 30.39% , among~which were more often diagnosed with early signs of OA (70% ), ReA (14.44% ) and JA (13,33% ). A significant risk factor for articular pathology is UCTD, as the leading causes — upper respiratory tract infection and injuries of musculoskeletal system.Цель исследования: определить распространенность и структуру ювенильных артритов (ЮА) у подростков, выявить особенности клинического течения у лиц молодого возраста.Материалы и методы. Проведено анкетирование 1550 лиц в возрасте от 14 до 22 лет. Из них выявлено 69 подростков с жалобами на боли в суставах и 21 человек молодого возраста, обратившихся с подобными жалобами в поликлинику, которые прошли полное клиническое обследование. Оно включало общепринятые в ревматологии исследования, в т. ч. рентгенологическое и ультразвуковое исследования (УЗИ) болезненных суставов, а также фенотипическую карту по синдрому недифференцированной дисплазии соединительной ткани (НСТД).Результаты. У обследованных подростков наиболее часто встречались боли в коленных, реже в тазобедренных суставах. У всех имелись признаки НСТД различной степени выраженности. При УЗИ были выявлены изменения в суставах, обусловленные синовитом и/или периартритом. По данным детального клинико-лабораторного и инструментального исследований, включая УЗИ суставов, диагноз ЮА выставлен у 12 пациентов, реактивного артрита (РеА) — у 13, остеоартроза (ОА) - у 63, артралгии - у 2 пациентов, что не всегда совпадало с диагнозом при направлении. Выводы. Распространенность патологии суставов у подростков составила 30,39% , среди которой чаще были диагностированы начальные признаки ОА (70% ), РеА (14,44% ) и ЮА (13,33% ). Значимым фактором риска суставной патологии является НСТД, а ведущими причинами - инфекция верхних дыхательных путей и травмы опорно-двигательного аппарата

The Energy Level Shifts, Wave Functions and the Probability Current Distributions for the Bound Scalar and Spinor Particles Moving in a Uniform Magnetic Field

We discuss the equations for the bound one-active electron states based on the analytic solutions of the Schrodinger and Pauli equations for a uniform magnetic field and a single attractive $\delta({\bf r})$-potential. It is vary important that ground electron states in the magnetic field differ essentially from the analogous state of spin-0 particles, whose binding energy was intensively studied more than forty years ago. We show that binding energy equations for spin-1/2 particles can be obtained without using the language of boundary conditions in the $\delta$-potential model developed in pioneering works. We use the obtained equations to calculate the energy level displacements analytically and demonstrate nonlinear dependencies on field intensity. We show that the magnetic field indeed plays a stabilizing role in considered systems in a case of the weak intensity, but the opposite occurs in the case of strong intensity. These properties may be important for real quantum mechanical fermionic systems in two and three dimensions. We also analyze the exact solution of the Pauli equation for an electron moving in the potential field determined by the three-dimensional $\delta$-well in the presence of a strong magnetic field. We obtain asymptotic expressions for this solution for different values of the problem parameters. In addition, we consider electron probability currents and their dependence on the magnetic field. We show that including the spin in the framework of the nonrelativistic approach allows correctly taking the effect of the magnetic field on the electric current into account. The obtained dependencies of the current distribution, which is an experimentally observable quantity, can be manifested directly in scattering processes, for example.Comment: 31 pages, 10 figure

Chronic endometritis and infertility — in vitro fertilization outcomes: systematic review and meta-analysis

Background. The relevance of the problem is related to the high prevalence of chronic endometritis (CE); its role in female infertility, implantation failures during assisted reproductive technology procedures, and recurrent miscarriage; as well as the lack of a unified strategy in the diagnosis and treatment of this pathology. The present systematic review with a meta-analysis focuses on evaluating the impact of CE and its therapy on the outcome of in vitro fertilization. In addition, the effect of CE of various severity on the outcomes of assisted reproductive technologies is analyzed. Objective. To analyze the effect of CE of varying severity and its treatment on the outcomes of in vitro fertilization. Methods. Using PubMed, Medline, Scopus, Embase, ELibrary, Cochrane Central Register of Controlled Trials (CENTRAL), WHO International Clinical Trials Registry, and Russian Science Citation Index, a systematic search was conducted for articles published over the past 12 years that met the following criteria: randomized controlled trial examining the effect of CE of varying severity on fertility and ways to treat it. The following indicators were calculated: ongoing pregnancy/live birth, clinical pregnancy, and miscarriage rates. A total of 4145 patients (from ten studies) were included. A meta-analysis was performed using Stata 11.0 software (The Cochrane Collaboration, Oxford, UK). The heterogeneity was considered low at I2 <30%, moderate at 30–50%, and high at >50%. Results. Women with CE exhibited lower ongoing pregnancy/live birth (OR 1.97; p = 0.02) and clinical pregnancy rates (OR 2.28; p = 0.002) as compared to women without it. CE treatment increased the ongoing pregnancy/live birth (OR 5.33; p < 0.0001) and clinical pregnancy rates (OR 3.64; p = 0.0001). In vitro fertilization outcomes were comparable in women treated for CE and women without CE (ongoing pregnancy/live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Women with severe CE exhibited lower ongoing pregnancy/live birth (OR 0.43; p = 0.003) and clinical pregnancy rates (OR 0.40; p = 0.0007). Mild CE showed no significant effect on in vitro fertilization outcomes (ongoing pregnancy/ live birth rate, clinical pregnancy rate, and miscarriage rate: p = ns). Conclusion. The conducted meta-analysis showed that CE significantly reduces the ongoing pregnancy/live birth and clinical pregnancy rates in infertile women undergoing in vitro fertilization. Noteworthy is that antimicrobial therapy in such patients improves the results of assisted reproductive technologies, which are comparable to those of patients without CE. The negative impact of this pathology on the implantation capacity of the endometrium is most often observed in the severe form, while its mild form has virtually no effect on the in vitro fertilization outcome

Combination therapy for benign prostate hyperplasia-related urinary symptoms

Introduction. Non-neurogenic lower urinary tract symptoms (LUTS) are a serious polyetiologic problem in the male population. The side effects of the medication agents used to treat LUTS significantly reduce treatment compliance. According to the literature data, the frequency of refusal for the proposed treatment during the year varies from 20 to 80%. Several studies have shown the benefits of herbal medicine for LUTS concerning the fewer side effects and increased adherence to treatment. However, to obtain a high-level recommendation base, clinical trials are required.Purpose of the study. To evaluate the effectiveness of Gardaprost® in LUTS combination therapy.Materials and methods. The study included 57 men aged 60 – 70 years with diagnosed medium- or large-volume benign prostatic hyperplasia (BPH) and moderate-to-severe LUTS according to I-PSS, morphologically excluded prostate cancer, without urinary infection signs. The patients were randomized into two follow-up groups. Tamsulosin 0.4 mg q.d. was prescribed to patients in the control group. Patients of the main group received Gardaprost® 0.4 mg q.d. in addition to Tamsulosin. The follow-up period in both groups was one-year. The statistical analysis includes data from 56 men. To evaluate therapy at the screening visit and on days 180 and 360, I-PSS, urination diary, IIEF-5, urinalysis, prostate-specific antigen, uroflowmetry, ultrasound were analyzed. Paired t-test and one-way ANOVA test were used to determine intergroup differences in normally distributed variables. For variables with a distribution other than normal, Friedman's two-way ANOVA for related samples was used. Events with a probability greater than 95% were considered statistically significant.Results. At the time of inclusion in the study, the groups were comparable concerning the control parameters. In the main group, there was a more pronounced positive dynamics in the I-PSS score, maximum urine flow rate, and post-void residual urine volume, which corresponded to 7.9 ± 2.1 points, 18.0 ± 7.3 ml/sec, 23.6 ± 13.6 ml vs 19.7 ± 7.2 points, 10 ± 3.5 ml/sec, 65.9 ± 33.2 ml in the main and control groups, respectively (p < 0.001). Additionally, in the main observation group, a decrease in prostate volume was recorded by 18.8% (p < 0.001) was recorded.Conclusion. We have obtained encouraging long-term results from the use of Gardaprost® in combination therapy of moderate-to-severe LUTS caused by medium- and large-volume BPH

MESH-RELATED COMPLICATIONS AFTER IMPLANTATION OF SYNTHETIC MESHES USING TROCAR AND ANCHORING SYSTEMS

Aim. To reduce incidence of mesh-related complications by comparative analysis of the results of vaginal extraperitoneal mesh-vaginopexy with use of trocar and anchoring systems.Materials and methods. A retrospective analysis of outpatient and hospital charts of 160 patients was performed, who underwent operative treatment of genital prolapse by vaginal extraperitoneal vaginopexy with Prolift, Johnson & Johnson, USA, Pelvix (Lintex, RF), Elevate (AMS, USA) and the Calistar system (Promedon, Argentina). The duration of postoperative follow-up was 3 years. In the 1st group, the patients were operated on using trocar techniques (Prolift, Pelvix). The second group consisted of patients operated on with the use of anchor technologies using the Elevate and Calistar methods. The degree of prolapse of the genitals was determined by the POP-Q system. The index of the influence of genital prolapse on the quality of life (IVQV) was assessed using a validated PD-QL questionnaire. To verify the accuracy of the hypothesis, Chi-square was used. Differences were considered valid for p<0,05.Results. In group 1, the mean time of surgery was 98±26 min. The frequency of erosions of the vaginal mucosa was 10,9%, in 4,1% of cases, a partial excision of the implant was carried out. In 1,4% there was a wrinkling of the implant, accompanied by a pain relief syndrome, in connection with which the implant was partially excised. Chronic pelvic pain was noted in 11,3% of patients. Dyspareunia de novo was noted in 11,0% of patients. Infection of the implant was observed in 2,7%, the implant was removed. Implant protrusion into the bladder occurred in 1 patient, the implant was partially excised. The frequency of recurrence of prolapse of the genitals was 10,4%. In group 2, the mean time of surgery was 79±32 min. The frequency of erosions of the vaginal mucosa was 3.1%, in 1 case, partial excision of the implant was required. Dyspareunia de novo was noted in 6,1% of patients, in 1 of them the implant was partially excised. Chronic pelvic pain was noted in 3,1% of patients − the pain syndrome was treated conservatively. The frequency of recurrence of genital prolapse in the 2nd group was 9,8%.Conclusion. Surgical treatment of genital prolapse with the use of synthetic meshes is highly effective, with both trocar and anchoring systems in use. It is advisable to give preference to anchor technologies, given the lower frequency of meshrelated complications

ОСТРЫЙ ЭПИГЛОТТИТ У МАЛЬЧИКА 3 ЛЕТ (КЛИНИЧЕСКОЕ НАБЛЮДЕНИЕ)

Аarticle describes the case of epiglottitis in a boy 3 years old, who was hospitalized  in a children's infectious disease department of city hospital of Izhevsk. He was hospitalized  in the department with a diagnosis of acute laryngotracheitis constrictive.The diagnosis  was clarified following an anesthetized laryngoscopy. Описан клинический случай эпиглоттита у мальчика 3 лет, находившегося на стационарном лечении в детском инфекционном отделении 7-ой Городской  клинической  больницы г. Ижевска. Госпитализирован в отделение с диагнозом: «острый стенозирующий ларинготрахеит». Диагноз был уточнен после проведенной поднаркозной ларингоскопии

Сравнительное исследование фармакокинетики и биораспределения карбазольного соединения CBL0100 в составе различных топических лекарственных форм на морских свинках

An experimental drug CBL0100 is developed as an antifungal agent for topical application. In order to assess the effect of composition of the formulation on transdermal absorption, a comparative absorption study of its pharmacokinetics and biodistribution after a single topical application on the guinea pigs' skin. Two different formulations of CBL0100 (prototypes of final dosage forms for topical applications) - cream emulsion and polyethylene glycol vehicles with a content of active substance 1, 0,2 and 0,02% mass. in each of these formulations were used in the study. CBL0100 concentration in blood plasma and homogenates of organs and tissues of animals was analyzed by HPLC - MS/MS. During the preliminary blood-to-plasma partitioning in vitro experiment it was determined that CBL0100 is found mostly in the cell fraction of the blood, which, based upon the pharmacokinetic curves shape affects elimination from plasma. It was revealed that after a single topical application active compound enters the systemic circulation and intensively distributed into the spleen, liver, kidneys and lungs of guinea pigs. At the same time, its content in the muscular tissue and the heart is negligible; CBL0100 moderately penetrates into the brain. In general, it was shown that the emulsion composition provides improved bioavailability of CBL0100 compared to the polyethylene glycol composition.Экспериментальный препарат CBL0100 разрабатывается в качестве противогрибкового средства для местного применения. Для оценки влияния состава лекарственной формы на трансдермальное всасывание было проведено сравнительное исследование его фармакокинетики и биораспределения после однократного нанесения на кожу морских свинок. В исследовании использовали две различные прописи CBL0100 (прототипы готовых лекарственных форм для топических аппликаций) - крема на эмульсионной (ЭМ) и полиэтиленгликолевой (ПЭГ) основах с содержанием активного вещества 1, 0,2 и 0,02% по массe. Концентрацию активного вещества в плазме крови и гомогенатах органов и тканей животных определяли методом ВЭЖХ-МС/ МС. В предварительном эксперименте по изучению распределения CBL0100 между плазмой и клеточными компонентами крови in vitro установлено, что исследуемое соединение преимущественно обнаруживается в клеточной фракции крови, что, судя по форме фармакокинетических кривых, влияет на скорость его элиминации из плазмы. Показано, что после однократного накожного нанесения крема CBL0100 проникает в системный кровоток и интенсивно распределяется в селезёнку, печень, почки и лёгкие морских свинок. В то же время его содержание в мышечной ткани и сердце незначительно; в мозг CBL0100 проникает умеренно. Установлено, что пропись на ЭМ основе обеспечивает повышенную по сравнению ПЭГ основой биодоступность CBL0100

АКТУАЛЬНЫЕ ПРИРОДНО-ОЧАГОВЫЕ ИНФЕКЦИИ, ПЕРЕДАВАЕМЫЕ КЛЕЩАМИ, В САНКТ-ПЕТЕРБУРГЕ

Purpose: to conduct a comparative analysis and to identify the epidemiological and clinical features of tick-borne encephalitis (TBE) and Lyme borreliosis as a mono- and coinfections in St. Petersburg. Materials and methods. 718 cases of TBE, 4353 cases of Lyme borreliosis and 127 combined diseases registered by the St. Petersburg epidemiological bureau in 2006-2017 were studied. Identification of combined diseases was carried out by a special software that allows to identify co-morbid diseases from the array of monoinfections. To identify clinical and epidemiological features, 144 cases of TBE, 286 Lyme borreliosis, and 43 cases of co-infection were studied. Age and sex characteristics, places of human contagion, infection rates of ticks, clinical forms of mono- and associated diseases, morbidity dynamics changes and patients’ IgM seropositivity were studied. Results. The long-term dynamics of TBE and Lyme borreliosis incidence had did not have significant upward or downward trends, it was characterized by synchronous fluctuations. The priority of the incidence of men over women is revealed. 61–69% cases of TBE and Lyme borreliosis occurred in Leningrad region, 19–30% – in the adjacent territories of Russia, 5,7–6,7% of cases were imported from other countries. High tick infection rates of TBE virus and Borrelia was revealed. Borrelia аnd virus of TBE and were detected in 81,6–87,5% of the examined ticks removed from patients with a later established diagnosis. Seasonal distribution of Lyme borreliosis was shifted by a month to the right in comparison with TBE. The clinical forms of both diseases did not differ in their structure from the country data, however after 2012 subclinical forms were more common in women. The proportion of non-erythematous forms of Lyme borreliosis in 2011–2015 compared with the 2006–2010 observation period increased almost 1,5-fold mainly forms, including those with co-infection. The IgM seropositivity rate in the dynamics of the disease testifies to the incomplete rehabilitation of patients. Conclusion. The clinical and epidemiological characteristics of TBE, Lyme borreliosis and combined infection in the North-West region of Russia, with the example of St. Petersburg, have certain distinctive features. The reasons for the revealed features need further study.Цель: провести сравнительный эпидемиологический анализ и выявить эпидемиологические и клинические особенности клещевого энцефалита и боррелиоза как моно- , так и одновременного сочетания этих инфекций у больных в Санкт-Петербурге. Материалы и методы: ретроспективно изучено 718 случаев клещевого энцефалита, 4353 случая клещевого боррелиоза и 127 сочетанных заболеваний, зарегистрированных в отделе учета и регистрации инфекционных и паразитарных заболеваний Центра гигиены и эпидемиологии Санкт-Петербурга за 2006–2017 гг. Идентификация сочетанных заболеваний происходила с помощью специальной программы, позволяющей выявлять сочетанные заболевания из массива моноинфекций. Для выявления клинико-эпидемиологических особенностей изучено 144 истории болезни клещевым энцефалитом, 286 – клещевым боррелиозом и 43 истории болезни в случаях сочетания этих инфекций. Проанализированы возрастно-половые характеристики, места заражения людей, вирусо- и борелиафорность клещей, клинические формы моно- и сочетанных заболеваний, изменения, происходящие во времени. Коэффициент серопозитивности IgM у больных оценивался в динамике обследования пациентов. Результаты: многолетняя динамика заболеваемости клещевым энцефалитом и клещевым боррелиозом не имела выраженных тенденций к росту или снижению и характеризовалась синхронными колебаниями. Выявлен приоритет заболеваемости мужчин над женщинами. Заражения клещевым энцефалитом и боррелиозами в 61–69% случаев происходили в Ленинградской области, в 19–30% – на сопредельных территориях России, в 5,7–6,7% – в странах ближнего и дальнего зарубежья. Выявлена высокая инфицированность клещей вирусом клещевого энцефалита и боррелиями. Боррелии и вирус клещевого энцефалита выявлены у 81,6 и 87,5% исследованных переносчиков, снятых с больных с позднее установленным диагнозом. Сезонное распределение заболеваний боррелиозом было сдвинуто на месяц вправо по сравнению с клещевым энцефалитом. Клинические формы как клещевого энцефалита, так и боррелиоза по своей структуре не отличались от литературных данных по стране, однако субклинические формы чаще встречались у женщин в период после 2012 г. Доля безэритемных форм боррелиоза в 2011–2015 гг. по сравнению с 2006–2010 гг. наблюдения увеличилась почти в 1,5 раза, в том числе и при сочетанной инфекции. Коэффициент серопозитивности IgM в динамике болезни свидетельствует о неполном выздоровлении больных. Заключение: клинико-эпидемиологическая картина клещевого энцефалита, клещевого боррелиоза и сочетания этих инфекций в Северо-Западном регионе России на примере Санкт-Петербурга имеет определенные отличительные особенности. Причины выявленных особенностей нуждаются в дальнейшем изучении