The role of the ultrasound examination of the brachial plexus in thoracic outlet syndrome

Introduction. Difficulties in determining the compression of the neurovascular bundle with the thoracic outlet syndrome raises the question of finding an accessible and reproducible method for the neuroimaging of the brachial plexus and surrounding tissues.Purpose of the study – to develop an ultrasound diagnostic algorithm using a stress test to determine the level and cause of brachial plexus compression in comparison with the results of a clinical assessment.Materials and methods. 111 patients with verified compression of the brachial plexus at the level of the interstitial (65.7 %) and bone-clavicular space (21.6 %), as well as the tendon of the pectoralis minor muscle (12.6 %) were examined. The study protocol including the Adson ultrasound stress test, the assessment of the lower trunk in the interstitial space, and the test with ultrasound evaluation of the axillary artery at the level of the tendon of the pectoralis minor muscle with passive abduction of the arm back and up was used.Conclusion. An ultrasound study of the brachial plexus demonstrated informativeness in assessing the level and possible cause of compression, which opens up the possibility of using the method in routine neurological practice

Species diversity of Trichoderma in Poland

In the present study, we reinvestigate the diversity of Trichoderma in Poland utilizing a combination of morphological and molecular/phylogenetic methods. A total of 170 isolates were collected from six different substrata at 49 sites in Poland. These were divided among 14 taxa as follows: 110 of 170 Trichoderma isolates were identified to the species level by the analysis of their ITS1, ITS2 rDNA sequences as: T. harzianum (43 isolates), T. aggressivum (35), T. citrinoviride (11), T. hamatum (9), T. virens (6), T. longibrachiatum (4), T. polysporum (1), and T. tomentosum (1); 60 isolates belonging to the Viride clade were identified based on a fragment of the translation-elongation factor 1-alpha (tef1) gene as: T. atroviride (20 isolates), T. gamsii (2), T. koningii (17), T. viridescens (13), T. viride (7), and T. koningiopsis (1). Identifications were made using the BLAST interface in TrichOKEY and TrichoBLAST (http://www.isth.info). The most diverse substrata were soil (nine species per 22 isolates) and decaying wood (nine species per 75 isolates). The most abundant species (25%) isolated from all substrata was T. harzianum

The Trichoderma koningii aggregate species

The morphological concept of Trichoderma koningii is found to include several species that differ from each other in details of phenotype (including conidium morphology, growth rate) and biogeography. Phylogenetic analysis utilizing partial sequences of the translation-elongation factor 1 alpha (tef1), as well as fragments of actin and calmodulin genes, indicate that phenotypic characters typical of T. koningii evolved independently in three well-separated main lineages. Combined molecular and phenotype data lead to the development of a taxonomy with the recognition of twelve taxonomic species and one variety within the three lineages. These lineages include: (1) T. koningii and T. ovalisporum and the new species T. caribbaeum var. caribbaeum, T. caribbaeum var. aequatoriale, T. dorotheae, T. dingleyae, T. intricatum, T. koningiopsis, T. petersenii and T. taiwanense; (2) the new species T. rogersonii and T. austrokoningii, and (3) the new anamorph T. stilbohypoxyli

Hypocrea rufa/Trichoderma viride: a reassessment, and description of five closely related species with and without warted conidia

The type species of the genus Hypocrea (Hypocreaceae, Hypocreales, Ascomycota, Fungi), H. rufa, is re-defined and epitypified using a combination of phenotype (morphology of teleomorphs and anamorphs, and characteristics in culture) and phylogenetic analyses of the translation-elongation factor 1α gene. Its anamorph, T. viride, the type species of Trichoderma, is re-described and epitypified. Eidamia viridescens is combined as Trichoderma viridescens and is recognised as one of the most morphologically and phylogenetically similar relatives of T. viride. Its teleomorph is newly described as Hypocrea viridescens. Contrary to frequent citations of H. rufa and T. viride in the literature, this species is relatively rare. Although both T. viride and T. viridescens have a wide geographic distribution, their greatest genetic diversity appears to be in Europe and North America. Hypocrea vinosa is characterised and its anamorph, T. vinosum sp. nov., is described. Conidia of T. vinosum are subglobose and warted. The new species T. gamsii is proposed. It shares eidamia-like morphology of conidiophores with T. viridescens, but it has smooth, ellipsoidal conidia that have the longest L/W ratio that we have seen in Trichoderma. Trichoderma scalesiae, an endophyte of trunks of Scalesia pedunculata in the Galapagos Islands, is described as new. It only produces conidia on a low-nutrient agar to which filter paper has been added. Additional phylogenetically distinct clades are recognised and provisionally delimited from the species here described. Trichoderma neokoningii, a T. koningii-like species, is described from a collection made in Peru on a fruit of Theobroma cacao infected with Moniliophthora roreri

System Approach to the Development of Intelligent Complexes of Oncological Diagnostics

The system approach to the development of intellectual complexes in cancer diagnosis are discussed in the article. Distinctive features of this approach: the participation of pathologist at the stage of description of recognizable images (the description is based on traditional assessments of quality informative features of tumors); the set of the most similar probabilistic diagnoses is forming on the classification stage of recognition; final histological diagnosis is made by pathologist. The proposed approach has been successfully tested in clinical practice. Keywords: image processing, image description, image classification, pattern recognition, qualitative attributes of tumor images, interactive recognition, cancer diagnosis, decision support syste

Algorithm for determining the authenticity of biomedical cell preparations containing mesenchymal stem cells

The use of mesenchymal stem cells (MSCs), which have a pronounced immunomodulatory activity, is a promising direction in the development of biomedical cell preparations (BMCPs). In oncohematology, the use of BMCPs containing MSCs is aimed at supporting hematopoiesis during cotransplantation with hematopoietic stem cells (HSCs) and suppressing immune conflicts during allogeneic unrelated transplantation and severe autoimmune processes. An obligatory stage of registration of BMCPs is confirmation of the identity of the MSC cell line (CL), which includes the establishment of morphological characteristics, evaluation of the expression of specific markers and proteins, and confirmation of the genetic stability of CL during cultivation. Determination of markers of genetic stability is possible using various methods, however, according to the recommendations of the American National Standardization Institute, the standard is the analysis of short tandem repeats (STR analysis). The purpose of the study is to develop an algorithm for determining the authenticity of BMCPs containing MSCs, including STR analysis. Material and methods. Identification of MSC cells in BMCP was performed according to the criteria of the International Society for Cell Therapy. Viable cells were counted in a Goryaev chamber. Immunophenotypic characteristics of MSCs were determined by flow cytometry. The level of production of specific proteins was assessed using enzyme immunoassay. Genetic stability markers were identified by STR analysis. Results and discussion. The methods were tested in triplicate for ten BMCP samples to confirm the reproducibility and reliability of the results. The developed algorithm for determining the authenticity of BMCP has a high accuracy, as it includes the STR analysis technique, which makes it possible to identify 19 polymorphic STR markers located on different alleles. Using the method will allow BMCP manufacturers to go through the procedure of state registration of drugs

Роль ультразвукового исследования плечевого сплетения при синдроме верхней апертуры

Introduction. Difficulties in determining the compression of the neurovascular bundle with the thoracic outlet syndrome raises the question of finding an accessible and reproducible method for the neuroimaging of the brachial plexus and surrounding tissues.Purpose of the study – to develop an ultrasound diagnostic algorithm using a stress test to determine the level and cause of brachial plexus compression in comparison with the results of a clinical assessment.Materials and methods. 111 patients with verified compression of the brachial plexus at the level of the interstitial (65.7 %) and bone-clavicular space (21.6 %), as well as the tendon of the pectoralis minor muscle (12.6 %) were examined. The study protocol including the Adson ultrasound stress test, the assessment of the lower trunk in the interstitial space, and the test with ultrasound evaluation of the axillary artery at the level of the tendon of the pectoralis minor muscle with passive abduction of the arm back and up was used.Conclusion. An ultrasound study of the brachial plexus demonstrated informativeness in assessing the level and possible cause of compression, which opens up the possibility of using the method in routine neurological practice.Введение. Трудности в определении компрессии сосудисто-нервного пучка при синдроме выходного отверстия ставят вопрос о поиске доступного и воспроизводимого метода нейровизуализации плечевого сплетения и окружающих тканей.Цель исследования – модифицировать алгоритм ультразвукового исследования для выявления уровня и причины компрессии плечевого сплетения в сопоставлении с результатами клинической оценки.Материалы и методы. Обследованы 111 пациентов с верифицированной компрессией плечевого сплетения на уровне межлестничного (65,7 %) и косто-клавикулярного промежутка (21,6 %), а также сухожилия малой грудной мышцы (12,6 %). Использован протокол исследования, включающий ультразвуковой стресс-тест Адсона, оценку нижнего ствола в межлестничном промежутке и тест с ультразвуковой оценкой подмышечной артерии на уровне сухожилия малой грудной мышцы при пассивном отведении руки назад и вверх.Результаты. Атрофии коротких мышц кисти чаще обнаружены у пациентов с компрессией на уровне косто-клавикулярного промежутка (p <0,05). Изолированная атрофия мышц в основании большого пальца оказалась характерной для пациентов с увеличенным поперечным отростком С7. Число пациентов, имеющих атрофию мышц предплечья и кисти встречается в 3 раза чаще у лиц с увеличением площади поперечного сечения нижнего ствола плечевого сплетения, но при этом количество больных с увеличенными параметрами площади поперечного сечения и положительным / отрицательным стресс-тестом достоверно не отличалось.Заключение. Ультразвуковое исследование плечевого сплетения продемонстрировало информативность в оценке факта, уровня и возможной причины компрессии, что открывает возможность применения метода в рутинной неврологической практике

Vitamin D (steroid hormone) and the nervous system diseases (literature review)

The present review aims to summarize the activities of vitamin D effects on the nervous system and to clarify a vitamin D role in brain diseases, in the pathogenesis or as a serum biomarker for the disease development and severity. Objective: correlation between chronic nervous system diseases and vitamin D level. Methods: a literature research in PubMed and in Russian electronic resources by keywords: vitamin D, brain diseases, chronic nervous system diseases. Results. Vitamin D as a neurosteroid hormone stimulates cerebral activity in both adult and embryonic brain regulates the activity of neural circuits which are responsible for locomotor, reward-dependent and emotional behavior. Patients with autism spectrum disorders, schizophrenia, Alzheimer disease, multiple sclerosis, Parkinson disease and sleep disorders have been shown to have low level of vitamin D. Discussion. Data are controversial, a further study of vitamin D hypovitaminosis significance is essential for the nervous system chronic diseases manifestation and evaluation of the vitamin D dietary supplement efficiency in patients with the nervous system pathology

Arterial Hypertension and Severe COVID-19 in Hospitalized Patients: Data from a Cohort Study

Aim. To assess the association  of hypertension  with the severe forms and fatal outcomes of Coronavirus disease 2019 (COVID-19).Material and Methods. This retrospective  cohort study involved adult patients (≥18 years old),  admitted to the University  hospital №4 of Sechenov University (Moscow, Russia) between 08 April 2020 and 19 November 2020 with clinically diagnosed or laboratory-confirmed COVID-19. The cohort included 1637 patients. The primary outcome was all-cause in-hospital mortality. The secondary outcomes included intensive care unit admission (ICU) and invasive ventilation. Multiple logistic regression was performed to assess the independent association  between risk factors and endpoints.Results. A total of 1637 patients were included in the study. 51.80% (n=848) of the subjects were males. The median age was 59.0 (48.0; 70.0) years and 55.90% (n=915) had pre-existing diagnosis of hypertension. Patients with hypertension  had significantly more severe lung injury based on chest CT scan findings  as well as lower oxygen saturation  (SрO2). More of them were admitted to ICU  and  placed  on invasive  ventilation.  The hypertension  group  also  had  higher  mortality.  Age,  hypertension, glucose, C-reactive protein and decreased platelet count were independently associated with mortality, hypertension  having the strongest association (OR 1.827, 95% CI 1.174-2.846, p=0.008). Age,  hypertension, neutrophil count, platelet count, glucose, and CRP were independently associated  with ICU  admission, with hypertension  having  the strongest  association  (OR  1.595, 95% CI 1.178-2.158, p=0.002). Age, hypertension, glucose, CRP and decreased platelet count were independently associated with invasive ventilation, with hypertension having the strongest association  (OR  1.703, 95% CI 1.151-2.519, p=0.008).Based on the multiple logistic regression models, odds of death, ICU admission, and invasive ventilation were higher in the hypertension  group as compared  to the group without hypertension.Conclusion. Hypertension can be an independent predictor of severe COVID-19 and adverse outcomes, namely death, ICU admission, and invasive ventilation in hospitalized  patients

Современные подходы к обеспечению качества диагностики в компьютерной томографии

To ensure the quality assurance of CT-examinations, it is necessary to obtain the high-quality diagnostic information and maintain the optimal exposure levels of patients and medical staff. This paper is focused on the requirements and main aspects of quality assurance of CT-examinations, which include quality control of the equipment, methods of CT-image quality control, optimization of radiation protection, as well as management of the unintended and accidental medical exposure. The paper contains recommendations on quality control of diagnostic equipment, methods for monitoring the quality control of CT-images, values of diagnostic reference levels for the detection of abnormally high patient doses and optimization of the radiation protection of patients, as well as the recommendations for management of radiation and non-radiation accidents. All main sections of the paper represent an unified quality assurance system in computed tomography.Обеспечение качества проведения компьютерно-томографических исследований способствует как получению необходимой диагностической информации, так и поддержанию оптимальных уровней облучения пациентов и персонала в этой области лучевой диагностики. В статье рассмотрены требования и основные аспекты обеспечения качества при проведении КТ-исследований, которые включают контроль качества оборудования, методики контроля качества КТ-изображения, методики проведения исследований, вопросы оптимизации радиационной защиты, а также предотвращения и расследования радиационных аварий. Все основные разделы статьи представляют из себя рекомендации по применению единой системы обеспечения качества проведения КТ-исследований