21 research outputs found

    A patient tumour-on-a-chip system for personalised investigation of radiotherapy based treatment regimens

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    Development of personalised cancer models to predict response to radiation would benefit patient care; particularly in malignancies where treatment resistance is prevalent. Herein, a robust, easy to use, tumour-on-a-chip platform which maintains precision cut head and neck cancer for the purpose of ex vivo irradiation is described. The device utilises sintered discs to separate the biopsy and medium, mimicking in vivo microvascular flow and diffusion, maintaining tissue viability for 68 h. Integrity of tissues is demonstrated by the low levels of lactate dehydrogenase release and retained histology, accompanied by assessment of cell viability by trypan blue exclusion and flow cytometry; fluid dynamic modelling validates culture conditions. An irradiation jig is described for reproducible delivery of clinically-relevant doses (5 × 2 Gy) to newly-presenting primary tumours (n = 12); the addition of concurrent cisplatin is also investigated (n = 8) with response analysed by immunohistochemistry. Fractionated irradiation reduced proliferation (BrdU, p = 0.0064), increased DNA damage (ƴH2AX, p = 0.0043) and caspase-dependent apoptosis (caspase-cleaved cytokeratin-18) compared to control; caspase-dependent apoptosis was further increased by concurrent cisplatin compared to control (p = 0.0063). This is a proof of principle study showing the response of cancer tissue to irradiation ex vivo in a bespoke system. The novel platform described has the potential to personalise treatment for patients in a cost-effective manner with applicability to any solid tumour

    Течение генерализованной формы менингококковой инфекции у пациента призывного возраста, отказавшегося от специфической профилактики (клинический случай)

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    Meningococcal infection is an acute infectious disease caused by Neisseria meningitidis, characterized by a polymorphism of clinical manifestations from meningococcus carriage to invasive forms. They, in turn, pose a great danger to the patient’s life, since in most cases they have a severe course with the development of complications, fulminant course and high mortality. The success of treatment of invasive meningococcal disease largely depends on the timeliness of diagnosis and the timing of treatment initiation. The article describes a clinical case of a generalized form of severe meningococcal infection with a rapidly developing infectious toxic shock, disseminated intravascular coagulation syndrome in a soldier who had previously refused specific prophylaxis. Despite the mistakes made at the prehospital stage and, accordingly, late hospitalization, this case had a favorable outcome.Менингококковая инфекция — острое инфекционное заболевание, вызываемое Neisseria meningitidis, характеризующееся полиморфизмом клинических проявлений от менингококконосительства до генерализованной формы. Она, в свою очередь, представляет большую опасность для жизни заболевшего, поскольку в большинстве случаев имеет  молниеносное течение с развитием осложнений и высокую летальность. Успех терапии генерализованных форм менингококковой инфекции во многом зависит от своевременности диагностики и срока начала лечения. В статье описан клинический случай генерализованной формы менингококковой инфекции тяжелой степени тяжести со  стремительно развившимся инфекционно-токсическим шоком, синдромом диссеминированного внутрисосудистого свертывания у военнослужащего по призыву, отказавшегося ранее от специфической профилактики. Несмотря на допущенные ошибки на догоспитальном этапе и, соответственно, позднюю госпитализацию, данный случай имел благоприятный исход

    THE ASSESSMENT OF AGROPHYSICAL AND AGROCHEMICAL PROPERTIES OF THE DARK BROWN (CHESTNUT) SOIL OF THE SOUTHERN PART OF THE ROSTOV REGION

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    The article deals with the data of several agrophysical and agrochemical properties of the dark brown (chestnut) soil of the southern arable part of the Rostov region. These properties do not only characterize soil fertility, but also promote the growth and development of the plants, influence on their productivity. The awareness of the soil properties in the agrocenosis allows not only estimating its condition but applying the technologies of its improvement. The article considers the analysis of each 0-10 cm soil layer to the one meter depth that gives a clear understanding about the changes of the indexes in the depth. There have been determined the indexes of grain-size and aggregated composition of soil, density of soil, content and reserves of humus, pH and solid residue

    COMPARISON OF DIRECT COSTS OF DABIGATRAN AND WARFARIN THERAPY IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION DURING PREPARATION FOR ELECTIVE CARDIOVERSION IN THE REAL CLINICAL PRACTICE

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    Aim. To compare direct medical costs of dabigatran and warfarin therapy in patients with non-valvular atrial fibrillation (NVAF) during preparation for elective cardioversion. Material and methods. An open non-randomized study was conducted to evaluate direct medical costs (cost of drug, cost of the international normalized ratio (INR) adjust- ment in outpatient clinic, cost of visits to cardiologist). Patients (n=62) with persistent NVAF (AF paroxysm duration &gt; 48 hours) were enrolled. All of them requested medical as- sistance and were decided to perform an elective cardioversion. The patients received warfarin (n=32) or dabigatran (n=30). The patients of the both groups were similar in the main clinical characteristics and thromboembolic risk levels according to CHA2DS2-VASc scale.Results. Treatment duration before elective cardioversion was 21±2 and 30.5±4.5 days for dabigatran and warfarin groups, respectively (p&lt;0.05). Average costs of visits to cardiologists were 3,720 and 744 RUB in warfarin and dabigatran groups, respectively (p&lt;0.05), and drug costs were 53.63 and 1,172.01 RUB, respectively (p&lt;0.05). The costs of laboratory INR monitoring were 3,058 RUB in warfarin group. Total costs per patient were 6,831.63 and 1,916.01 RUB in warfarin and dabigatran groups, respectively (p&lt;0.05). Conclusion. In the real clinical practice in patients with NVAF dabigatran antithromboembolic therapy substantially reduces direct medical costs in comparison with warfarin ther- apy during preparation for elective cardioversion. Dabigatran therapy reduces time from the decision of elective cardioversion and antithromboembolic therapy start to car- dioversion performance.</p

    RISK OF THROMBOEMBOLIC COMPLICATIONS AND ANTITHROMBOTIC THERAPY IN IN-PATIENTS WITH PERMANENT AND RECURRENT ATRIAL FIBRILLATION IN REAL CLINICAL PRACTICE

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    Aim. Тo evaluate compliance of ongoing antithrombotic therapy (ATT) in various forms of atrial fibrillation (AF) with the risk level of thromboembolic complications (TEC), calculated with the СHADS2 and CHA2DS2–VASc scales in real clinical practice. Material and methods. A retrospective study of hospital records of 308 in-patients admitted to the cardiology departments of two multidisciplinary hospitals during the year because of nonvalvular AF . Risk of thromboembolic complications was estimated with the CHADS2 and CHA2DS2–VASc scales and appointed ATT was analyzed. Results. Patients with high risk of TEC were predominated in the study population: 77.6% and 91.9% according to CHADS2 and CHA2DS2–VASc scales, respectively. Moderate risk was found in  17.6%  and  6.1%  of  patients  according  to  CHADS2 and  CHA2DS2–VASc  scales,  respectively.  Only  32.2%  and  28.6%  28.6%  of  patients  at  high  risk  according  to  CHADS2 and  CHA2DS2–VASc scales, respectively received warfarin in hospital. All patients with permanent AF in this sample had a high risk of TEC according to the both scales. In the group of paroxysmal/persistent AF the high, moderate and low risk of TEC was identified in 87%, 9.9%, and 3.1% of patients, respectively , according to CHA2DS2–VASc scale and in 64.25%, 28.5% and 7.5% of patients, respectively , according to CHADS2 scale. Difference in high-risk patient rate was not significant among patients with permanent AF . In high risk group contraindications for receiving indirect anticoagulants were more frequent in the group with permanent AF (OR 3.1; 95% CI 0.88–10.7; p&gt;0,05). The probability of warfarin prescription in patients with permanent AF was higher than in patients with paroxysmal or persistent AF (OR 1.98, 95% CI 1,18-3,31), and probability of aspirin prescription was lower (OR 0.82; 95% CI 0,51-1,32; p&gt;0,05).  Conclusion. In real clinical practice oral anticoagulants are prescribed insufficiently in patients at high risk. Usage of CHA2DS2–VASc scale compared with usage of CHADS2 scale, leads to significant increase in the proportion of patients at high risk due to reduction in the proportion of patients with moderate risk in persistent or permanent AF . Usage of CHADS2 scale can lead to an underestimation of the TEC risk in patients with persistent or permanent AF .</p

    ANTITHROMBOTIC THERAPY IN ATRIAL FIBRILLATION: RECENT APPROACHES AND NEAR PERSPECTIVES

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    Recent data and perspectives of antithrombotic therapy in patients with atrial fibrillation (AF) are highlighted. The main statements of current Russian and international guidelines about thromboembolic events prevention in AF patients are presented. Special attention paid to new agents for oral anticoagulation therapy , last information about their efficacy , safety and potential of application

    RESPONSE OF SPRING BARLEY VARIETIES ON DIFFERENT CULTIVATION TECHNOLOGIES IN THE SOUTHERN PART OF THE ROSTOV REGION

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    In the southern part of the Rostov region we studied effect of different cultivation technologies on productivity of spring barley varieties ‘Vikont’ (for forage) and ‘Priazovsky 9’ (for brewing) in heavy loamy carbonate chernozem (black soil). The technologies varied in doses of mineral nutrition and protection during vegetation.The technological effect was studied according to three methods of primary tillage, i.e. plowing, combined tillage and surface tillage. The study showed that these factors influenced a lot on productivity, grain quality and economic profitability. The varieties showed the greatest productivity and better grain quality when cultivated by intensive technologies using plowing as a primary tillage. The article gives the assessment of economic profitability of spring barley. The improvement of the variety productivity and an increase of intensive cultivation showed economic efficiency reduce. The receiving of the yield per unit area using intensive technologies with a plowing turned to be the most expensive one with a total expenditure of 13287-13386 rub/ha, a prime cost of 3264-3524 rub/ha and a net income of 6173-7114 rub/ha. The cultivation of barley using extensive technologies with a surface tillage turned to be low-cost (6563-6574 rub/ha). The prime cost was the lowest one (2206-2369 rub/ha) and the net income was the highest one (7287-8326 rub/ha). Among all cultivation technologies an extensive method showed the maximum profitability of 95,1-126,7 %,when an intensive method showed only 43,0-53,1%
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