New methods to detect early manifestations of adverse side effects of glucocorticosteroids in children

The article focuses on the early manifestations of adverse side effects in children with nephrotic syndrome receiving glucocorticosteroids. The search for criteria of early side effect manifestations is a real challenge nowadays. The authors developed new diagnostic criteria for early detection of pharmacotherapeutical side effects in children with nephrotic syndrom

Characteristics of adverse side effects of corticosteroid therapy in children with nephrotic syndrome and methods of pharmacological correction

The article discusses the issues of the long-term glucocorticosteroid therapy in children with nephrotic syndrome that results in severe adverse side effect

КОНЦЕПТУАЛЬНІ ПІДХОДИ ДО ЗАБЕЗПЕЧЕННЯ ЗДОРОВОГО СПОСОБУ ЖИТТЯ СТУДЕНТСЬКОЇ МОЛОДІ

Purpose: to develop and assess the conceptual approaches to ensuring a healthy lifestyle of student’s youth. Materials and Methods. The following research methods were applied in the course of study: bibliosemantic, structural and logical analysis, descriptive modeling, expert assessments, statistical. Systematic approach was applied as the methodological basis of the study. The results of previous research and the questionnaires of the assessment of conceptual approaches to providing healthy lifestyle of student’s youth by 25 independent experts. The assessment of independent competent experts’ answers was carried out in 10 scores system, with the subsequent medical and statistical analysis of the obtained results. Results. The proposed conceptual approaches to ensuring a healthy lifestyle of student youth consist of the following sections: problems, causes of problems and ways to solve them. There are eight main problems: students do not lead a healthy lifestyle, lack of state policy to ensure healthy living conditions and student education, insufficient range of health and health-forming services, insufficient development of individual and collective services that ensure a healthy lifestyle, non-systematic work on the formation of a healthy lifestyle, the lack of a healthy lifestyle strategy, the lack of public funding for advocacy, the formation and maintenance of a healthy lifestyle of students, the underdevelopment of the system of return to a healthy lifestyle. The main causes of these problems are identified and ways to eliminate the causes of problems are developed. These ways are comprehensive and relate to management decisions and the implementation of practical measures at all levels of government from the country’s leadership to the level of student government of the educational institution. In order to create conditions for maintaining and strengthening the health of students, we proposed to involve future employers and use the mechanisms of public-private partnership. Conclusions. The conceptual approaches to providing a healthy lifestyle of students are developed and recommended for practical implementation in the fields of health care and higher education in Ukraine.Мета: розробити та оцінити концептуальні підходи до забезпечення здорового способу життя студентської молоді. Матеріали і методи. Під час проведення дослідження використано такі методи: бібліосемантичний, структурно-логічного аналізу, описового моделювання, експертних оцінок, статистичний. Методичною основою дослідження став системний підхід. Матеріалами дослідження є результати попередніх досліджень та анкети оцінки концептуальних підходів до забезпечення здорового способу життя студентської молоді 25 незалежними експертами. Оцінку відповідей незалежних компетентних експертів проводили за 10-бальною системою з наступним медико-статистичним аналізом отриманих результатів. Результати. Запропоновані концептуальні підходи до забезпечення здорового способу життя студентської молоді складаються із таких розділів: проблем, причин виникнення проблем та шляхів їх вирішення. Виділено вісім основних проблем: студенти не ведуть здоровий спосіб життя, відсутність державної політики із забезпечення здорових умов життя та навчання студентів, недостатній спектр здоров’язбережувальних та здоров’яформувальних послуг, недостатня розвиненість системи надання індивідуальних та колективних послуг, які забезпечують здоровий спосіб життя, несистемна робота з формування здорового способу життя, відсутність стратегії здорового способу життя, відсутність державного фінансування пропаганди, формування та забезпечення здорового способу життя студентів, нерозвиненість системи повернення до здорового способу життя. Визначено основні причини виникнення даних проблем та розроблено шляхи усунення причин виникнення проблем. Дані шляхи є комплексними і стосуються прийняття управлінських рішень та запровадження практичних заходів на всіх рівнях управління від керівництва країною до рівня студентського самоврядування закладу освіти. До створення умов для збереження та зміцнення під час навчання здоров’я студентами нами запропоновано залучати майбутніх роботодавців та використовувати механізми державно-приватного партнерства. Концептуальні підходи позитивно оцінено незалежними експертами. Висновки. Розроблені концептуальні підходи до забезпечення здорового способу життя студентської молоді, які рекомендують до практичного впровадження в галузі охорони здоров’я та сфері вищої освіти України

Adverse reactions of high-osmolar and low-osmolar radiographic contrast media in clinical practice

Introduction. Adverse drug reactions (ADR) to administration of radiographic contrast media (RCM) are observed in 10–20 % of patients. Individual tolerability of drugs is affected by RCM properties (ionicity, osmolarity). Aim. Evaluation of ADR in patients during diagnostic studies using high- and low-osmolar RCM. Methods. Analysis of 52 reports of adverse reactions to RCM registered in medical organizations of Voronezh region in 2014–2021 was performed. Group 1 included 21 patients with ADR to high-osmolar RCM (sodium amidotrizoate, yoxitalamic acid), group 2–31 patients with ADR to low-osmolar drugs (yogexol, yopromide, yopamidol, yoversol). Results. Age of patients is 6–82 years, median 48.5 years, children — 8 persons (15.4 %), women — 31 patients (59.6 %), serious reactions — 28 (53.8 %). Since 2017 there has been an increase in the number of ADRs with constant frequency of serious reactions. In 2020–2021 ADRs to low-osmolar drugs were mainly registered. Life-threatening conditions (anaphylactic shock, arterial hypotension, arrhythmia) were observed in 70.2 % of group 2, in 28.6 % of group 1 (p=0.007). One patient with initial renal dysfunction and comorbid pathology was reported to develop nephrotoxicity to yogexol. Pharmacological correction was performed in 92.3 % of cases. In 57.7 % of the patients ADR ended in recovery, in the  other cases — state improvement. Conclusion. Side effects of high-osmolar and low-osmolar RCM mainly had form of hyperergic reactions of immediate type and were reversible. High frequency of serious reactions to lowosmolar RCM against an increase in their use requires a more careful selection of patients for X-ray contrast studies

Long-term variability of the optical spectra of NGC 4151: I. Light curves and flux correlations

Results of a long-term spectral monitoring of the active galactic nucleus of NGC 4151 are presented (11 years, from 1996 to 2006). High quality spectra (S/N>50 in the continuum near Halpha and Hbeta) were obtained in the spectral range ~4000 to 7500 \AA, with a resolution between 5 and 15 A, using the 6-m and the 1-m SAO's telescopes (Russia), the GHAO's 2.1-m telescope (Cananea, Mexico), and the OAN-SPM's 2.1-m telescope (San-Pedro, Mexico). The observed fluxes of the Halpha, Hbeta, Hgamma and HeII emission lines and of the continuum at the observed wavelength 5117 A, were corrected for the position angle, the seeing and the aperture effects. We found that the continuum and line fluxes varied strongly (up to a factor 6) during the monitoring period. The emission was maximum in 1996-1998, and there were two minima, in 2001 and in 2005. The Halpha, Hgamma and He II fluxes were well correlated with the Hbeta flux. We considered three characteristic periods during which the Hbeta and Halpha profiles were similar: 1996-1999, 2000-2001 and 2002-2006. The line to continuum flux ratios were different; in particular during the first period, the lines were not correlated with the continuum and saturated at high fluxes. In the second and third period, where the continuum flux was small, the Halpha and Hbeta fluxes were well correlated to the continuum flux, meaning that the ionizing continuum was a good extrapolation of the optical continuum. The CCFs are often asymmetrical and the time lags between the lines and the continuum are badly defined indicating the presence of a complex BLR, with dimensions from 1 to 50 light-days.Comment: A&A, accepte

The effect of humic substances on test-objects

The complex study of a number of humic substances was conducted with help of bioassay methods using invertebrates (Daphnia, paramecium, earthworms), terrestrial (wheat seeds) and aquatic plants (elodea, duckweed) and algae (Scenedesmus quadricauda). The ranges of concentrations of humates that have a negative and a stimulating effect on biological objects were identified. The efficiency of biological testing methods to evaluate the effect of humic substances on biological objects is shown

Genetic structure and drug resistance of <i>Mycobacterium tuberculosis</i> strains in the Kemerovo Region — Kuzbass

Background. Kemerovo Region has a high burden of tuberculosis (TB) with incidence rates twice the national average. The circulating variants of Mycobacterium tuberculosis significantly influence the TB epidemic process. Screening of epidemically significant variants of the pathogen in areas with a high burden of TB underlies epidemiological diagnosis and is necessary for the development of effective prevention measures. However, the population structure of M. tuberculosis in the Kemerovo Region — Kuzbass is poorly understood. Aims: to study genetic heterogeneity and phenotypic resistance to anti-tuberculosis drugs of M. tuberculosis strains in the Kemerovo Region. Materials and methods. The MIRU-VNTR genotyping of 163 M. tuberculosis strains isolated from TB patients in the Kemerovo Region in March–October 2022 was carried out. Cultivation of M. tuberculosis, drug susceptibility testing, and isolation of genomic DNA were carried out by standard methods. Genotypic identification was performed using MIRU-VNTR (24 loci) typing. In parallel, express genotyping was carried out: identification of isolates of the Beijing genotype (by RD105/207) and non-Beijing; subtyping Beijing using real-time PCR tests for detection of Central Asian Russian and B0/W148; identification of the non-Beijing group by real-tine PCR RT tests for LAM, S, Ural. Results. The isolates of the Beijing genotype (67.5%) were found to dominate both among newly diagnosed (64.4%) and previously treated patients (88.5%). MIRU-VNTR typing revealed 75 profiles, of which 94-32 (35.3%) and 100-32 (15.7%) were the most abundant and belonged to the Beijing genotype. Overall, 39.9% and 20.9% of isolates, respectively, were assigned to the Beijing Central Asian Russian and B0/W148 epidemic clusters, which differed significantly in MDR levels (50.8% and 85.3%, respectively; p = 0.005). The second most common were strains of the genetic family of the Euro-American lineage (L4) (31.9%): LAM (6.7%) Ural (7.4%) Haarlem (4.9%) and L4-unclassified (12.9%), MDR among of these minor genotypes was significantly lower than among Beijing genotype strains, and amounted to 11.5% (p 0.001). Strains from HIV-TB patients (56.4% of the total sample) carried an MDR profile more often (54.8%) compared to TB cases without HIV infection (35.2%) (p = 0.005), which may be due to higher proportion of Beijing genotype strains in the HIV-TB group (75.0% vs. 57.7%; p = 0.026). Complete comparability of the SNP analysis (in-house tests) to identify the main genotypes and epidemically significant Beijing subtypes was shown, which made it possible to characterize 75.5% of the sample by the express method. Conclusions. The molecular genetic screening carried out in the Kemerovo Region revealed the heterogeneity of the M. tuberculosis population, which was dominated by strains of the Beijing genotype, with the frequency of subtypes comparable with other territories of the Siberian Federal District

Finite-size scaling from self-consistent theory of localization

Accepting validity of self-consistent theory of localization by Vollhardt and Woelfle, we derive the finite-size scaling procedure used for studies of the critical behavior in d-dimensional case and based on the use of auxiliary quasi-1D systems. The obtained scaling functions for d=2 and d=3 are in good agreement with numerical results: it signifies the absence of essential contradictions with the Vollhardt and Woelfle theory on the level of raw data. The results \nu=1.3-1.6, usually obtained at d=3 for the critical exponent of the correlation length, are explained by the fact that dependence L+L_0 with L_0>0 (L is the transversal size of the system) is interpreted as L^{1/\nu} with \nu>1. For dimensions d\ge 4, the modified scaling relations are derived; it demonstrates incorrectness of the conventional treatment of data for d=4 and d=5, but establishes the constructive procedure for such a treatment. Consequences for other variants of finite-size scaling are discussed.Comment: Latex, 23 pages, figures included; additional Fig.8 is added with high precision data by Kramer et a

Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety

&lt;p&gt;Background: Melatonin is extensively used in the USA in a non-regulated manner for sleep disorders. Prolonged release melatonin (PRM) is licensed in Europe and other countries for the short term treatment of primary insomnia in patients aged 55 years and over. However, a clear definition of the target patient population and well-controlled studies of long-term efficacy and safety are lacking. It is known that melatonin production declines with age. Some young insomnia patients also may have low melatonin levels. The study investigated whether older age or low melatonin excretion is a better predictor of response to PRM, whether the efficacy observed in short-term studies is sustained during continued treatment and the long term safety of such treatment.&lt;/p&gt; &lt;p&gt;Methods: Adult outpatients (791, aged 18-80 years) with primary insomnia, were treated with placebo (2 weeks) and then randomized, double-blind to 3 weeks with PRM or placebo nightly. PRM patients continued whereas placebo completers were re-randomized 1:1 to PRM or placebo for 26 weeks with 2 weeks of single-blind placebo run-out. Main outcome measures were sleep latency derived from a sleep diary, Pittsburgh Sleep Quality Index (PSQI), Quality of Life (World Health Organzaton-5) Clinical Global Impression of Improvement (CGI-I) and adverse effects and vital signs recorded at each visit.&lt;/p&gt; &lt;p&gt;Results: On the primary efficacy variable, sleep latency, the effects of PRM (3 weeks) in patients with low endogenous melatonin (6-sulphatoxymelatonin [6-SMT] ≤8 μg/night) regardless of age did not differ from the placebo, whereas PRM significantly reduced sleep latency compared to the placebo in elderly patients regardless of melatonin levels (-19.1 versus -1.7 min; P = 0.002). The effects on sleep latency and additional sleep and daytime parameters that improved with PRM were maintained or enhanced over the 6-month period with no signs of tolerance. Most adverse events were mild in severity with no clinically relevant differences between PRM and placebo for any safety outcome.&lt;/p&gt; &lt;p&gt;Conclusions: The results demonstrate short- and long-term efficacy and safety of PRM in elderly insomnia patients. Low melatonin production regardless of age is not useful in predicting responses to melatonin therapy in insomnia. The age cut-off for response warrants further investigation.&lt;/p&gt