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Клинико-лабораторные характеристики, лечение и прогноз синдрома Гийена-Барре у детей

A retrospective study of 42 cases of acute flaccid paralysis (AFP) in children aged between 7 months and 15 years, registered at the Municipal Clinical Hospital №1 throughout a 7 year period (2007—2014), was performed to investigate the features of pediatric Guillian-Barre Syndrome (GBS). GBS has shown to be the most common cause of AFP in children, with prevalence of 74% of all 31 cases. Clinical manifestations, functional status, laboratory and electrodiagnostic data were evaluated in group of 31 children in order to highlight particular features of childhood GBS in Russia. The highest frequency of GBS was observed in children aged between 1 to 3 with the median 6 [3; 11] years. Boys with GBS outnumbered girls by a 2,1:1 ratio. No seasonal dependence has been observed, with children equally suffering from this disease without a seasonal pattern throughout the year. According to the electrophysiological and clinical data, 24 children were diagnosed with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) (77%), 5 with acute motor axonal neuropathy (AMAN) (16%) and 2 with аcute motor-sensory axonal neuropathy (AMSAN) in a total of cases (7%). Several exclusive features of GBS in children for Russia were discovered. The most common initial symptom was limb pain, with the impartial sensory disturbance found only in 13% of the patients observed, 10% of which were paresthesias and the remaining 3% belonging to hypostesias. Children reached the nadir state rapidly, the median time from onset to nadir was 9.5 [6,25; 12,5] days. Cranial nerve dysfunction at nadir was observed in a greater percentage of patients (51%) compared to that of 23% cases at the onset, with the facial palsy increasing from 10 to 32% and the bulbar palsy from 12 to 19%. The patients were given intravenous immunoglobulin in various doses: from 0.2 to 1.75 mg/kg per course (0.5 [0.5; 0.8] g/kg) and/or plasmapheresis with a median volume of 93 [81; 100] ml/kg per course. The treatment has shown to be effective for the majority of patients, but three children was resistant to the intravenous immunoglobulin. An important feature of pediatric GBS is a nonthreatening prognosis at the point of discharge, with the length of hospitalization numbering in with a median of 28 [20,5; 38] days.В работе были проанализированы 42 случая острых вялых параличей (ОВП) у детей в возрасте от 7 месяцев до 15 лет, зарегистрированных в ИКБ №1 г. Москвы в период с 2007 по 2014 гг. Согласно ретроспективному анализу, ведущей причиной ОВП среди детей является Синдром Гийена-Барре (СГБ), доля которого составила 74% (31 пациент). Изучена клиническая картина и данные лабораторных и электрофизиологических исследований для выявления особенностей течения и диагностики СГБ у детей. СГБ чаще всего встречается в возрастной группе от 1 до 3 лет, медиана 6 [3;11] лет. Мальчики болеют чаще (2,1:1). Небыло выявлено сезонной зависимости СГБ: дети переносят заболевание в разные месяцы на протяжении всего года. Острая воспалительная демиелинизирующая полирадикулонейропатия (ОВДП) диагностирована у 24 детей (77%), острая моторная аксональная невропатия (ОМАН) — в 5 случаях (16%) и острая моторно-сенсорная аксональная невропатия (ОМСАН) — в 2 случаях (7%). Выявлен ряд особенностей клинической картины СГБ у детей. Ведущим симптомом в дебюте заболевания является интенсивная боль в конечностях, при этом объективные сенсорные нарушения выявляются редко (13%): в виде парестезий (10%) или гипостезий (3%). Темп нарастания параличей достаточно высокий: медиана достижения пика заболевания 9,5 [6,25; 12,5] суток от начала заболевания. На пике заболевания доля поражения ЧМН увеличивается с 23 до 51%: частота парезов VII пары возрастает с 10 до 32%, а частота бульбарного синдрома с 12 до 19% случаев. Проведено лечение внутривенным иммуноглобулином в дозе от 0,2 до 1,75 г/кг за курс (медиана 0,5 [0,5; 0,8] г/кг) и/или плазмаферезом в объёме 93 [81; 100] мл/кг за курс. В подавляющем большинстве случаев был достигнут положительный результат, но три ребёнка оказались рефрактерны к внутривенной иммунотерапии. Важной особенностью СГБ у детей является благоприятный прогноз исхода к моменту выписки из стационара, при сроках госпитализации 28 [20,5; 38] суток

Exciton/Charge-transfer Electronic Couplings in Organic Semiconductors

Charge transfer (CT) states and excitons are important in energy conversion processes that occur in organic light emitting devices (OLEDS) and organic solar cells. An ab initio density functional theory (DFT) method for obtaining CT−exciton electronic couplings between CT states and excitons is presented. This method is applied to two organic heterodimers to obtain their CT−exciton coupling and adiabatic energy surfaces near their CT−exciton diabatic surface crossings. The results show that the new method provides a new window into the role of CT states in exciton−exciton transitions within organic semiconductors.United States. Dept. of Energy (DEFG02- 07ER46474)David & Lucile Packard Foundation (Fellowship

Modeling and Evaluation of Co-Evolution in Collective Web Memories

The constantly evolving Web reects the evolution of society in the cyberspace. Projects like the Open Directory Project (dmoz.org) can be understood as a collective memory of society on the Web. The main assumption is that such collective Web memories evolve when a certain cognition level about a concept has been exceeded. In the scope of our work we analyse the New York Times archive for concept detection. There are several approaches to the concept modelling. We introduce an alternative model for concepts, which does not make any additional assumptions about types of contained entities or the number of entities in the corpus. Moreover, the proposed distributed concept computation algorithm enables the large scale archive analysis. We also introduce a model of cognition level and explain how it can be employed to predict changes in the category system of DMOZ

Modeling and Evaluation of Co-Evolution in Collective Web Memories

The constantly evolving Web reects the evolution of society in the cyberspace. Projects like the Open Directory Project (dmoz.org) can be understood as a collective memory of society on the Web. The main assumption is that such collective Web memories evolve when a certain cognition level about a concept has been exceeded. In the scope of our work we analyse the New York Times archive for concept detection. There are several approaches to the concept modelling. We introduce an alternative model for concepts, which does not make any additional assumptions about types of contained entities or the number of entities in the corpus. Moreover, the proposed distributed concept computation algorithm enables the large scale archive analysis. We also introduce a model of cognition level and explain how it can be employed to predict changes in the category system of DMOZ

Photoselected electron transfer pathways in DNA photolyase

Cyclobutane dimer photolyases are proteins that bind to UV-damaged DNA containing cyclobutane pyrimidine dimer lesions. They repair these lesions by photo-induced electron transfer. The electron donor cofactor of a photolyase is a two-electron-reduced flavin adenine dinucleotide (FADH(−)). When FADH(−) is photo-excited, it transfers an electron from an excited π → π* singlet state to the pyrimidine dimer lesion of DNA. We compute the lowest excited singlet states of FADH(−) using ab initio (time-dependent density functional theory and time-dependent Hartree–Fock), and semiempirical (INDO/S configuration interaction) methods. The calculations show that the two lowest π → π* singlet states of FADH(−) are localized on the side of the flavin ring that is proximal to the dimer lesion of DNA. For the lowest-energy donor excited state of FADH(−), we compute the conformationally averaged electronic coupling to acceptor states of the thymine dimer. The coupling calculations are performed at the INDO/S level, on donor–acceptor cofactor conformations obtained from molecular dynamics simulations of the solvated protein with a thymine dimer docked in its active site. These calculations demonstrate that the localization of the (1)FADH(−)* donor state on the flavin ring enhances the electronic coupling between the flavin and the dimer by permitting shorter electron-transfer pathways to the dimer that have single through-space jumps. Therefore, in photolyase, the photo-excitation itself enhances the electron transfer rate by moving the electron towards the dimer