Проект протокола ведения больных нозокомиальной пневмонией у взрослых в условиях стационара

The nosocomial pneumonia is one of the most (or just “is a”) common hospital infections complicating the disease course and resulting in a fatal outcome. In 2016 the revised version of “Russian national recommendations for Nosocomial pneumonia in adults” was published. The new methods of diagnostics, preventative measures and hospital pneumonia treatment were systematized there. The international association of clinical pharmacologists and pharmacists introduced the new information on the epidemiology of hospital infections as well as their sensitivity to antibacterial therapy, dosage and introduction regime.  The current management guidelines of the patients with nosocomial pneumonia is based on these actual internationally recognized recommendations. It consists of an action algorithm to be used when the nosocomial pneumonia diagnosis is suspected and as tables which provide the tactics of treatment. It also helps to systematize the details of the anamneses, the data of functional and microbiological diagnostics and to develop an optimal scheme of empirical introduction of therapy and its further correction when necessary after receiving the results of microbiological diagnostics. The project is intended for physicians of internal medicine departments, emergency rooms in hospitals, as well as for resident medical practitioners. The quick introduction of management guideline algorithm of the patients with nosocomial pneumonia and the precise indication of the dose regime into clinical practice will allow doctors to decrease the death rate and improve the quality of medical service. Нозокомиальная (госпитальная) пневмония является одной из наиболее распространенных внутрибольничных инфекций, утяжеляющих течение основного заболевания и приводящих к летальному исходу. В 2016 г. издана переработанная и дополненная версия Российских национальных рекомендаций «Нозокомиальная пневмония у взрослых», в которой систематизированы новые методы диагностики, профилактики и лечения госпитальной пневмонии. Международная ассоциация клинических фармакологов и фармацевтов представила новые сведения по эпидемиологии госпитальных инфекций, их чувствительности к антибактериальной терапии, дозам и режимам введения. Настоящий протокол ведения больных с нозокомиальной пневмонией основан на этих современных рекомендациях, признанных на международном уровне. Он представлен в виде алгоритмов действия врача при подозрении на нозокомиальную пневмонию и таблиц по тактике лечения, позволяющих систематизировать данные анамнеза, клинико-функционального обследования, микробиологических исследований, разработать оптимальную схему эмпирической стартовой терапии, а при необходимости провести ее коррекцию после получения результатов микробиологического исследования. Проект предназначен для врачей терапевтических отделений, отделений реанимации и терапии, ординаторов и интернов. Скорейшее внедрение в практику алгоритма ведения больных нозокомиальной пневмонией с указанием доз вводимых препаратов позволит врачам снизить смертность и повысить качество медицинской помощи.

Multiple Alignment of Promoter Sequences from the Arabidopsis thaliana L. Genome

In this study, we developed a new mathematical method for performing multiple alignment of highly divergent sequences (MAHDS), i.e., sequences that have on average more than 2.5 substitutions per position (x). We generated sets of artificial DNA sequences with x ranging from 0 to 4.4 and applied MAHDS as well as currently used multiple sequence alignment algorithms, including ClustalW, MAFFT, T-Coffee, Kalign, and Muscle to these sets. The results indicated that most of the existing methods could produce statistically significant alignments only for the sets with x < 2.5, whereas MAHDS could operate on sequences with x = 4.4. We also used MAHDS to analyze a set of promoter sequences from the Arabidopsis thaliana genome and discovered many conserved regions upstream of the transcription initiation site (from −499 to +1 bp); a part of the downstream region (from +1 to +70 bp) also significantly contributed to the obtained alignments. The possibilities of applying the newly developed method for the identification of promoter sequences in any genome are discussed. A server for multiple alignment of nucleotide sequences has been created

Forming universal competencies in the course of teaching a foreign language at a nonlinguistic university

The labor market modernization and the transition to the digital economy have led to a revision of the requirements for a contemporary specialist, who, in addition to professional competencies, possesses a broad range of universal skills and personal qualities. The development of leadership skills can become a universal pedagogical basis for implementing the concept of continuous nationally oriented independent education at all stages starting from the preparation of applicants, secondary vocational education, bachelor’s and master’s degree programs, to postgraduate studies, including advanced training and additional education. The study aimed to identify efficient educational technologies aimed at forming universal competencies in the framework of disciplines “Foreign Language” and “Business Foreign Language” at various stages of training, both in academic and extracurricular activities. The basis for identifying efficient educational technologies was theoretical methods (literature analysis (active teaching methods, and mixed learning technologies), documentation analysis (Federal State Education Standard, FSES 3+++)), as well as empirical methods (observation, study, and generalization). The practical significance of the work consists in the presented model of forming universal competencies, which can be considered as a component of the professional education of a future graduate of a nonlinguistic university. The universal competencies formed within the framework of the disciplines “Foreign Language” and “Business Foreign Language” will allow the graduate to become a competitive specialist in the international labor market

Current project of management guidelines of the patients with nosocomial pneumonia in adults

The nosocomial pneumonia is one of the most (or just “is a”) common hospital infections complicating the disease course and resulting in a fatal outcome. In 2016 the revised version of “Russian national recommendations for Nosocomial pneumonia in adults” was published. The new methods of diagnostics, preventative measures and hospital pneumonia treatment were systematized there. The international association of clinical pharmacologists and pharmacists introduced the new information on the epidemiology of hospital infections as well as their sensitivity to antibacterial therapy, dosage and introduction regime.  The current management guidelines of the patients with nosocomial pneumonia is based on these actual internationally recognized recommendations. It consists of an action algorithm to be used when the nosocomial pneumonia diagnosis is suspected and as tables which provide the tactics of treatment. It also helps to systematize the details of the anamneses, the data of functional and microbiological diagnostics and to develop an optimal scheme of empirical introduction of therapy and its further correction when necessary after receiving the results of microbiological diagnostics. The project is intended for physicians of internal medicine departments, emergency rooms in hospitals, as well as for resident medical practitioners. The quick introduction of management guideline algorithm of the patients with nosocomial pneumonia and the precise indication of the dose regime into clinical practice will allow doctors to decrease the death rate and improve the quality of medical service

Ocular injectable formulation assessment for oxidized dextran-based hydrogels

Initiator-free injectable hydrogels are very interesting for drug and/or cell delivery applications, since they can be administered in a minimally invasive way, and avoid the use of potentially harmful chemical initiators. In the current work, oxidized dextran crosslinked with adipic acid dihydrazide hydrogels were further characterized and tuned to produce formulations, with the aim of producing an injectable formulation for the possible treatment of posterior eye diseases. The gelation rate and the hydrogel dissolution profile were shown to be dependent on the balance between the degree of dextran oxidation, and the concentration of both components. For the in vitro studies, rabbit corneal endothelial cells were seeded on the hydrogels to assess cytotoxicity. Hydrogels prepared with low oxidized dextrans were able to promote cell adhesion and proliferation to confluence in just 24 h, while more highly oxidized samples promoted cell adhesion and proliferation, but without achieving confluence. Cell viability studies were performed using MTS assays to verify the non-cytotoxicity of hydrogels and their degradation byproducts, rendering these formulations attractive for further in vivo studies.Instituto de Investigação Interdisciplinar (financial support of JM – III/BIO/20/2005); Portuguese Foundation for Science and Technology (in the form of fellowship to IJC - SFRH/BPD/19776/2004

Predictors of Progression and Mortality in Patients with Chronic Hypersensitivity Pneumonitis: Retrospective Analysis of Registry of Fibrosing Interstitial Lung Diseases

Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) resulting from an immune-mediated response in susceptible and sensitized individuals to a large variety of inhaled antigens. Chronic HP with a fibrotic phenotype is characterized by disease progression and a dismal prognosis. The aim of this study was to identify predictors of progression and mortality in patients with chronic HP in real clinical practice. Materials and methods: This retrospective, multicenter, observational study used data from a registry of 1355 patients with fibrosing ILDs. The study included 292 patients diagnosed with chronic HP based on the conclusion of a multidisciplinary discussion (MDD). Results: The patients were divided into groups with progressive (92 (30.3%) patients) and nonprogressive pulmonary fibrosis (200 (69.7%) patients). The most significant predictors of adverse outcomes were a DLco < 50% predicted, an SpO2 at the end of a six-minute walk test (6-MWT) < 85%, and a GAP score ≥ 4 points. Conclusion: Pulmonary fibrosis and a progressive fibrotic phenotype are common in patients with chronic HP. Early detection of the predictors of an adverse prognosis of chronic HP is necessary for the timely initiation of antifibrotic therapy

De Novo Variant in the <i>KCNJ9</i> Gene as a Possible Cause of Neonatal Seizures

Background: The reduction in next-generation sequencing (NGS) costs allows for using this method for newborn screening for monogenic diseases (MDs). In this report, we describe a clinical case of a newborn participating in the EXAMEN project (ClinicalTrials.gov Identifier: NCT05325749). Methods: The child presented with convulsive syndrome on the third day of life. Generalized convulsive seizures were accompanied by electroencephalographic patterns corresponding to epileptiform activity. Proband WES expanded to trio sequencing was performed. Results: A differential diagnosis was made between symptomatic (dysmetabolic, structural, infectious) neonatal seizures and benign neonatal seizures. There were no data in favor of the dysmetabolic, structural, or infectious nature of seizures. Molecular karyotyping and whole exome sequencing were not informative. Trio WES revealed a de novo variant in the KCNJ9 gene (1:160087612T > C, p.Phe326Ser, NM_004983), for which, according to the OMIM database, no association with the disease has been described to date. Three-dimensional modeling was used to predict the structure of the KCNJ9 protein using the known structure of its homologs. According to the predictions, Phe326Ser change possibly disrupts the hydrophobic contacts with the valine side chain. Destabilization of the neighboring structures may undermine the formation of GIRK2/GIRK3 tetramers necessary for their proper functioning. Conclusions: We believe that the identified variant may be the cause of the disease in this patient but further studies, including the search for other patients with the KCNJ9 variants, are needed