Congenital heart defects in children of Chelyabinsk: regional aspects of the 20-year monitoring

The problem of congenital heart defects (CHD) in children, it is determined not only by a severe course, early development of disability, high-cost methods of treatment, but also by regional peculiarities. On the basis of the register of CHD in children in Chelyabinsk, the monitoring of prevalence and morbidity indicators from 2000 to 2020, calculated per 1000 children’s population, taking into account its average number, was carried out. During the analyzed period, there was an almost 3-fold increase in the total number of children with CHD: from 691 people in 2000 to 1903 people in 2020. A stable growth of this pathology was revealed in the first year of their life: 3.9 % in 2000, 11.0 % in 2012, 12.3 % in 2020.The prevalence and primary incidence of CHD over the past 20 years have been characterized by a steady increase: from3.68 and 0.72 in 2000 to 8.04 and 1.48 in 2020, respectively. Septal defects and open ductus arteriosus occupy leading positions in the structure of all CHD, accounting for 61 % in 2000 and 74 % in 2020. An increase in the number of early surgical interventions, especially during the first year of a child’s life (from 11 % in 2000 up to 31 % in 2020) is associated with a decrease in disability (from 15.7 % in 2000 to 4.8 % in 2020). Monitoring of registry data, especially at the regional level, can be a useful mechanism for assessing the situation of CHD, monitoring the effectiveness of both conservative and cardiac surgical treatment

Distribution of trace elements controlled by sector and growth zonings in zircon from a miaskite pegmatite of the Vishnegorsky massif, the Southern Urals

Data on the content and distribution of trace and rare-earth elements (SIMS method) in sectors and growth zones of a large zircon crystal from miaskite pegmatites of the Vishnegogorsky massif are presented. The morphology of the zircon crystal is a combination of a dipyramid {111} and prism {010}. It has been established that the growth sector of dipyramid {111} is characterized by almost one order of magnitude higher contents of Y, Nb, REE, Th; higher Th/U and Eu/Eu* values; REE distribution spectra are flatter compared to prism {010} growth sector. A regular decrease in the content of trace and rare-earth elements in the direction from the central zone to the marginal zone of crystal growth was revealed. A smooth regression of zircon crystallization temperature of zircon from 960 °C in the central zone to 740 °C in the marginal zone of the dipyramid sector and 700-650 °C in the prism sector has been revealed, which may be a reflection of thermal evolution of the crystallization process. It is assumed that crystallization of the central zone of zircon occurred at early stages from a relatively trace-еlement-rich melt. The crystallization was completed at lower temperatures, probably, simultaneously with the formation of REE-concentrating minerals, which resulted in natural decrease of  content of trace and rare-earth elements in the melt and, consequently, in zircon crystallizing from it

Применение метода дифференциальных неравенств для обоснования решения системы параболических уравнений в виде движущегося фронта

Investigations of initial boundary value problems for parabolic equations solutions are an important component of mathematical modeling. In this regard of special interest for mathematical modeling are the boundary value problem solutions that undergo sharp changes in any area of space. Such areas are called internal transitional layers. In case when the position of a transitional layer changes over time, the solution of a parabolic equation behaves as a moving front. For the purpose of proving the existence of such initial boundary value problem solutions, the method of differential inequalities is very effective. According to this method the so-called upper and lower solutions are to be constructed for the initial boundary value problem. The essence of an asymptotic method of differential inequalities is in receiving the upper and lower solutions as modifications of asymptotic submissions of the solutions of boundary value problems. The existence of the upper and lower solutions is a sufficient condition of existence of a solution of a boundary value problem. While proving the differential inequalities the so-called ”quasimonotony” condition is essential. In the present work it is considered how to construct the upper and lower solutions for the system of the parabolic equations under various conditions of quasimonotony.Исследование решений начально-краевых задач для параболических уравнений является важной составляющей математического моделирования. Особый интерес для математического моделирования представляют краевые задачи, решения которых претерпевают резкое изменение в какой-либо области пространства. Такие области называются внутренними переходными слоями. В том случае, если положение переходного слоя изменяется со временем, решение параболической задачи имеет вид движущегося фронта. При доказательстве существования у начально-краевых задач решений такого вида весьма эффективным оказывается метод дифференциальных неравенств, согласно которому для данной краевой задачи строятся так называемые верхнее и нижнее решения. Суть асимптотического метода дифференциальных неравенств заключается в том, чтобы получать верхнее и нижнее решения как модификации асимптотических представлений решений краевых задач. Существование верхнего и нижнего решений является достаточным условием существования решения краевой задачи. В ходе проверки выполнения дифференциальных неравенств существенным оказывается так называемое условие квазимонотонностии. В настоящей работе рассмотрено, каким образом можно построить верхнее и нижнее решения для системы параболических уравнений при различных условиях квазимонотонности

Асимптотический анализ в задаче моделирования процесса переноса газовой примеси в приповерхностном слое атмосферы

In the present work the model boundary value problem for a stationary singularly perturbed reaction-diffusion-advection equation arising at the description of gas impurity transfer processes in an ecosystem ”forest – swamp” is considered. Application of a boundary functions method and an asymptotic method of differential inequalities allow to construct an asymptotics of the boundary layer type solution, to prove the existence of the solution with such an asymptotics and its asymptotic stability by Lyapunov as the stationary solution of the corresponding parabolic problem with the definition of local area of boundary layer type solution formation. The latter has a certain importance for applications, since it allows to reveal the solution describing one of the most probable conditions of the ecosystem. In the final part of the work sufficient conditions for existence of solutions with interior transitional layers (contrast structures) are discussed.Рассматривается модельная краевая задача для стационарного сингулярно возмущенного уравнения реакция-диффузия-адвекция, возникающая при описании процессов переноса газовой примеси в экосистеме 컈лес–болотоо. Применение метода пограничных функций иасимптотического метода дифференциальных неравенств позволяет построить асимптотику решения погранслойного типа, доказать существование решения с такой асимптотикой и его асимптотическую устойчивость по Ляпунову, как стационарного решения соответствующей параболической задачи с определением локальной области формирования решения погранслойного типа. Последнее имеет определенное прикладное значение, т.к. позволяет выявить решение, описывающее одно из наиболее вероятных состояний экосистемы. В заключительной части работы обсуждаются достаточные условия существования решений с внутренними переходными слоями (контрастных структур)

Methodology of comprehensive assessment of the athlete's adaptive potential to the load

The review summarizes the current data on the methods of assessment of adaptation and disadaptation (fatigue, overreaching, overtraining, OT) of athlete during training; special attention is paid to the diagnostic value of biochemical and immunological markers of adaptation potential (AP). Their diagnostic significance was analyzed. Hypotheses and possible mechanisms of OT development were considered. Based on the results of recent studies published by domestic and foreign authors, both the diversity and the number of proposed adaptation markers have been established, and a lack of unity of approaches in the assessment of AP and OT has been revealed. Large amount of biochemical, immunological and other tests proposed for the evaluation of AP was summed up. The most significant AP and OT markers are protein metabolism factors, enzymes, lactate, urea. The role of immune factors, besides leukocytes and lymphocytes, is intensively studied: these are leukocyte toxicity index, level of neutrophils, cytokines, natural antibodies to AP bioregulators. The prospects of using an integrated test system for determining the e-At panel to AP bioregulators is shown for monitoring the athlete's condition, and especially for early diagnosis of OT

Comparative Pharmacoepidemiological Assessment of Antihypertensive Drugs Administration Structure in Pregnant Women in Routine Medical Practice in Kursk and Chisinau

Aim. To study the structure of antihypertensive drugs prescription in pregnant women in routine practice in Kursk and Chisinau.Material and methods. The study design was observational descriptive cross-sectional. Authors conducted a survey of doctors in medical organizations in Kursk and Chisinau in 2017-2018.Results. Respondents from Kursk and Chisinau preferred methyldopa in prescriptions of central alpha-adrenergic receptor agonists. Doctors from Chisinau used clonidine in 14.3% of cases. The leading place in the group of calcium channel blockers belonged to short-acting nifedipine. Among beta-blockers in Kursk, doctors most often prescribed bisoprolol (43.3%), metoprolol (21.7%) and nebivolol (13.3%), while in Chisinau the preference was given to metoprolol (32.1%), atenolol (19.6%) and bisoprolol (16.1%). From the group of diuretics, Kursk doctors mainly prescribed hydrochlorothiazide (10%), indapamide (6.7%); in Chisinau, indapamide was the leader (19.6%), hydrochlorothiazide was used less frequently (7,1%). From the class of alpha-blockers, prazosin occupied the leading position among respondents in Kursk, and terazosin in Chisinau.Conclusion. The priority drug classes in both regions were calcium channel blockers, central alpha-adrenergic receptor agonists and beta-blockers. A small number of not recommended drugs prescriptions have been registered. In general, the prescribed treatment corresponded to the current guidelines and protocols for the management of patients with arterial hypertension during pregnancy

Диагностические и прогностические лабораторные критерии развития сепсиса при гнойно-воспалительных заболеваниях мягких тканей

Objective. Identification of laboratory parameters that are used in routine practice and can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulent-inflammatory diseases of soft tissues.Materials and methods. The study included 48 patients with purulent-inflammatory diseases of soft tissues. Recorded the occurrence of such clinical events as the development of sepsis or septic shock, intensive therapy, death or recovery and discharge from the hospital. For the diagnosis of sepsis, a SOFA (Sepsis-related organ failure assessment score) ³ 2 points was used. Patients were divided into subgroups according to the number of points according to the SOFA scale, intensive care and depending on the outcome of the disease: Subgroup 1 – 26 patients with sepsis (SOFA ³ 2 points) and 22 patients with systemic inflammatory response syndrome (SIRS) and SOFA <2 points; 2nd subgroup – 12 people who underwent intensive therapy and 36 people without it; 3rd subgroup – 7 patients with a fatal outcome and 41 patients with a favorable outcome.Results. In patients with sepsis, albumin concentration was 24,07 g / l in median versus 34,65 g / l in the control group of patients with SOFA <2 points (p <0,01); glucose -7,82 mmol / l and 5,15 mmol / l (p <0,01); sodium concentration of 133 mmol / li 139 mmol / l (p <0,01). The values of the international normalized ratio (INR) amounted to a median of 1,29 and 1,04 (p <0,01); activated partial thromboplastin time -36,20 seconds and 31,50 seconds (p <0,01). In the subgroup of patients for whom intensive therapy was required, the concentration of albumin was 22,34 g / l by median versus 30,10 g / l (p <0,01); urea – 15,50 mmol / l versus 6,00 mmol / l (p <0,05), glucose – 9,61 mmol / l against 5,80 mmol / l (p <0,05), lactate dehydrogenase-644,00 U / l and 426,00 U / l (p <0,05); INR – 1,35 against 1,05 (p <0,05). The aver-age total protein concentration is 47,80 g / l versus 57,90 g / l (p <0,01). The average albumin is 22,34 g / l versus 28,50 g / l (p <0,05). The glucose concentration among patients with a fatal outcome was 12,00 mmol / l in median versus 5,95 mmol / l (p <0,01); urea – 23,22 mmol / l versus 6,00 mmol / l (p <0,01). The incidence of lethal disease was statistically significantly higher in patients with a total protein level of less than 52 g / l 5,96 times (RR = 5,96, 95% CI 1,32 – 26,89), glucose more than 11 mmol / l – 7,00 times (OR = 7,00, 95% CI 1,25 – 39,15), urea more than 20 mmol / l – 7,05 times (RR = 7,05, 95% CI 2,00 – 24,85).Conclusion. Routine laboratory indicators as the level of total protein, albumin, glucose, sodium and urea, as well as indicators of the blood coagulation system (INR and APTT), can serve as diagnostic and prognostic criteria for the development of sepsis and its outcomes in patients with purulentinflammatory diseases. soft tissue.Цель: выявление лабораторных показателей, которые используются в рутинной практике и могут служить диагностическими и прогностическими критериями развития сепсиса и его исходов у пациентов с гнойно-воспалительными заболеваниями мягких тканей.Материалы и методы. В исследование включено 48 пациентов с гнойно-воспалительными заболеваниями мягких тканей. Проводили учет наступления таких клинических событий, как развитие сепсиса или септического шока, проведение интенсивной терапии, летальный исход или выздоровление и выписка из стационара. Для постановки диагноза «сепсис» применяли шкалу SOFA (Sepsis-related organ failure assessment score) ³ 2 баллов. Пациенты были распределены в подгруппы по количеству баллов по шкале SOFA, проведения интенсивной терапии и в зависимости от исхода заболевания: 1-я подгруппа – 26 больных сепсисом (SOFA ³ 2 баллов) и 22 пациента с синдромом системного воспалительного ответа (ССВР) и SOFA < 2 баллов; 2-я подгруппа – 12 человек, которым проводилась интенсивная терапия, и 36 человек без нее; 3-я подгруппа – 7 больных с летальным исходом и 41 пациент с благоприятным исходом.Результаты. У пациентов с сепсисом концентрация альбумина составила по медиане 24,07 г/л против 34,65 г/л в контрольной группе больных с SOFA < 2 баллов (p< 0,01); глюкозы – 7,82 ммоль/л и 5,15 ммоль/л (p< 0,01); концентрация натрия 133 ммоль/л и 139 ммоль/л (p< 0,01). Значения международного нормализованного отношения (МНО) составили по медиане 1,29 и1,04 (p< 0,01); активированного частичного тромбопластинового времени – 36,20 с и 31,50 с (p< 0,01). В подгруппе пациентов, которым потребовалось проведение интенсивной терапии, концентрации альбумина составили по медиане 22,34 г/л против 30,10 г/л (p< 0,01); мочевины – 15,50 ммоль/л против 6,00 ммоль/л (p< 0,05), глюкозы– 9,61 ммоль/лпротив 5,80 ммоль/л(p< 0,05), лактатдегидрогеназы – 644,00 Ед/л и 426,00 Ед/л (p< 0,05); МНО – 1,35 против 1,05 (p< 0,05). Средняя концентрация общего белка – 47,80 г/л против 57,90 г/л (p < 0,01). Средние показатели альбумина – 22,34 г/л против 28,50 г/л (p < 0,05). Концентрация глюкозы среди пациентов с летальным исходом составила по медиане 12,00 ммоль/л против 5,95 ммоль/л (p< 0,01); мочевины – 23,22 ммоль/л против 6,00 ммоль/л (p < 0,01). Частота наступления летального исхода болезни была статистически значимо выше у пациентов с уровнем общего белка менее 52 г/л в 5,96 раз (ОР = 5,96, 95 % ДИ 1,32 – 26,89), глюкозы более 11 ммоль/л – в 7,00 раз (ОР = 7,00, 95 % ДИ 1,25 – 39,15), мочевины более 20 ммоль/л – в 7,05 раз (ОР = 7,05, 95 % ДИ 2,00 – 24,85).Заключение. Такие рутинные лабораторные показатели, как уровень общего белка, альбумина, глюкозы, натрия и мочевины, а также показатели свертывающей системы крови (МНО и АЧТВ) могут служить диагностическими и прогностическими критериями развития сепсиса и его исходов у пациентов с гнойно-воспалительными заболеваниями мягких тканей

‘In vivo’ optical approaches to angiogenesis imaging

In recent years, molecular imaging gained significant importance in biomedical research. Optical imaging developed into a modality which enables the visualization and quantification of all kinds of cellular processes and cancerous cell growth in small animals. Novel gene reporter mice and cell lines and the development of targeted and cleavable fluorescent “smart” probes form a powerful imaging toolbox. The development of systems collecting tomographic bioluminescence and fluorescence data enabled even more spatial accuracy and more quantitative measurements. Here we describe various bioluminescent and fluorescent gene reporter models and probes that can be used to specifically image and quantify neovascularization or the angiogenic process itself