ADULT-ONSET STILL'S DISEASE: DIAGNOSIS AND TREATMENT

The paper describes adult-onset Still's disease (AOSD), a rare multisystemic disease of unknown etiology that is referred to as seronegative rheumatoid arthritis. It presents the major manifestations of AOSD: long-term fever, arthritis or persistent arthralgias, maculopapular eruption, seronegativity for rheumatoid factor, neutrophilic leukocytosis, and disease onset after 16 years of age, as well as additional signs: lymphadenopathy, hepatosplenomegaly, polyserositis, nasopharyngeal infection. It is noted that particular difficulties in the diagnosis of AOSD emerge when it is complicated by the hematophagocytic syndrome (HPS). The distinctive features of AOSD are the development of cutaneous and articular symptoms in practically 80% of patients and their absence in HPS. It is stated that of greater value in the diagnosis of HPS is examination of aspirate of the bone marrow than its biopsy. Most patients develop refractoriness to glucocorticoids and essential anti-inflammatory drugs. The positive results of using anakinra, rituximab, and tocilizumab are promising

The using of orthogonal basis for the steganographic coding of information in multimedia

This article discusses methods for steganographic encoding additional information using three different orthogonal bases. The bases are represented by the functions, which occupies a different bandwidth in the spectrum. There are comparison of the approach to the definition of DCT- coefficients with the approaches used in the methods of the spread spectrum and subband projections. The approaches of the coefficients of the implementation to ensure secrecy by adaptive determination of their value are considere

Estimation of Innovative Activity of the University

On the basis of Belgorod region innovation activity analysis, positive relationship between shipped innovation items and domestic research and development costs was found. Semantic differential was used for multiple estimation of BelSU innovation activity and competiveness. BelSU integrated index showed high-enough innovation activity of this universityyesBelgorod State Universit

Genesis of the Russia’s economy innovative development

The innovative development of economy in Russia is possible only if the way of development will be based on the objective basic components, i.e. the corresponding system of premises and factors determining the innovative process. Namely the latter ensure a transformation of the fundamental processes into the application ones, as well as the dynamic development of the economy under the new trends and patterns influenceyesBelgorod State Universit

Gender features of depressive disorders in women

The authors give the data available in the literature and the results of their investigations of the gender features of depressive disorders in women. They analyze the results of studies relating to gender differences in the neurohormonal system from the embryonic period, as well as those in the lateralization of neuromorphofunctional provision of emotions. Based on their clinical observations, the authors discuss the varying roles of menopause in the etiopathogenesis of climacteric, psychogenic, and endogenous depression; in these forms of depression, menopause may be a cause, ground, or trigger, respectively. The influence of endocrine and sociopsychological factors on the development of postpartum depression is considered. The authors unveil the diagnostic and predictive value of premenopausal syndrome with depressive disorders at different stages of a depressive episode: the prediction of depression when depressive symptoms appear in the premenopausal period, as well as the reduction of premenopausal depressive disorders as evidence of intermission. Based on the data available in the literature, the authors consider the clinical features of depression in women: earlier onset; more frequent depressive episodes; greater presentation of atypical symptoms (anxiety, fatigue, increased appetite, weight gain, hypersomnia, and signs of somatization), as well as rarer suicidal tendencies as comparedto men. It is concluded that the gender features of depression in women are due to the whole complex of gender factors, such as neurophysiological, neuroendocrine, and sociopsychological ones

Перспективы применения мелоксикама у больных старшей возрастной группы с ревматическими заболеваниями

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used in complex therapy for pain syndrome in rheumatology. The paper describes the pathophysiological mechanisms responsible for the development of chronic and acute pain. It details the action of cyclooxygenase types 1 and 2 (COG 1 and COG 2), shows the key role of COG 2 in pain induction and transmission. The data of clinical trials of meloxicam that inhibits mainly COG 2 are given. The drug is highly effective in treating rheumatic diseases, particularly in old-age group patients with osteoporosis. The combined use of different meloxicam formulations makes it possible to choose adequate, maximally individualized treatment and to relieve the pain syndrome in the shortest possible time. Among NSAIDs, meloxicam shows an optimum efficacy-safety ratio.Нестероидные противовоспалительные препараты (НПВП) широко применяются в комплексной терапии болевого синдрома в ревматологии. В статье представлены патофизиологические механизмы развития острой и хронической боли. Подробно описаны функции циклооксигеназы 1-го и 2-го типов - ЦОГ 1 и ЦОГ 2, показана ключевая роль ЦОГ 2 в индукции и трансмиссии боли. Приведены данные клинических исследований мелоксикама - НПВП, ингибирующего преимущественно ЦОГ 2. Мелоксикам высокоэффективен в терапии ревматических болезней, особенно при остеоартрозе у больных старшей возрастной группы. Комбинированное использование различных лекарственных форм мелоксикама позволяет подобрать адекватное, максимально индивидуализированное лечение, и в кратчайшие сроки купировать болевой синдром. Среди НПВП мелоксикам выделяется оптимальным соотношением эффективности и безопасности

Синдром Стилла у взрослых: диагностика и лечение

The paper describes adult-onset Still's disease (AOSD), a rare multisystemic disease of unknown etiology that is referred to as seronegative rheumatoid arthritis. It presents the major manifestations of AOSD: long-term fever, arthritis or persistent arthralgias, maculopapular eruption, seronegativity for rheumatoid factor, neutrophilic leukocytosis, and disease onset after 16 years of age, as well as additional signs: lymphadenopathy, hepatosplenomegaly, polyserositis, nasopharyngeal infection. It is noted that particular difficulties in the diagnosis of AOSD emerge when it is complicated by the hematophagocytic syndrome (HPS). The distinctive features of AOSD are the development of cutaneous and articular symptoms in practically 80% of patients and their absence in HPS. It is stated that of greater value in the diagnosis of HPS is examination of aspirate of the bone marrow than its biopsy. Most patients develop refractoriness to glucocorticoids and essential anti-inflammatory drugs. The positive results of using anakinra, rituximab, and tocilizumab are promising.Описан синдром Стилла у взрослых (ССВ) - редкое мультисистемное заболевание неизвестной этиологии, относящееся к сероне-гативному ревматоидному артриту. Приводятся основные проявления ССВ - длительная лихорадка, артрит или стойкие артралгии, макулопапулезная сыпь, серонегативность по ревматоидному фактору, нейтрофильный лейкоцитоз, развитие болезни после 16 лет, а также дополнительные признаки - лимфаденопатия, гепатоспленомегалия, полисерозит, носоглоточная инфекция. Отмечено, что особые трудности при диагностике ССВ возникают в случае его осложнения гематофагоцитарным синдромом (ГФС). Отличительными чертами ССВ являются развитие кожной и суставной симптоматики практически у 80% больных и отсутcтвие таковых при ГФС. Указано, что для диагностики ГФС большее значение имеет исследование аспирата костного мозга, чем его биопсия. У большинства пациентов развивается рефрактерность к глюкокортикоидам и базисным противовоспалительным препаратам. Надежду вселяют положительные результаты использования анакинры, ритуксимаба, тоцилизумаба

Detection of rifampicin and izoniazid resistance in Mycobacterium tuberculosis strains from Samara Region (Central Russia)

Recently high rates of tuberculosis incidence and prevalence are observed in civilian and prisons sectors in Russia. One of the main reasons for high morbidity levels and ineffectiveness of treatment is wide spreading of drug resistant Mycobacterium tuberculosis strains, but accurate and comprehensive information on levels of drug resistance among strains circulating in Central Russia is unavailable. Rifampicin and izoniazid resistance detection in TB isolates from Samara (Central Russia) civilian and prison TB hospitals and dispensaries in 2000–2002 by revealing mutations in rpoB, katG and inhA genes using Macroarray technique. Methods: A total of 342 M. tuberculosis isolates were tested using Macroarray method. It is based on multiplex amplification of rpoB, katG and inhA genes fragments (with three pairs of biotin labeled primers) following by dothybridization with normal and mutant oligonucleotide probes (fragments of rpoB, katG and inhA genes in which mutations occur) immobilized on nylon membrane strips. Mycobacterial DNA was extracted by heating of cell suspensions following by chloroform extraction. Streptavidin-alkaline phosphatase color development system was used for visualization of results

Microevolution of extensively drug-resistant tuberculosis in Russia.

Extensively drug-resistant (XDR) tuberculosis (TB), which is resistant to both first- and second-line antibiotics, is an escalating problem, particularly in the Russian Federation. Molecular fingerprinting of 2348 Mycobacterium tuberculosis isolates collected in Samara Oblast, Russia, revealed that 72%belonged to the Beijing lineage, a genotype associated with enhanced acquisition of drug resistance and increased virulence. Whole-genome sequencing of 34 Samaran isolates, plus 25 isolates representing global M. tuberculosis complex diversity, revealed that Beijing isolates originating in Eastern Europe formed a monophyletic group. Homoplasic polymorphisms within this clade were almost invariably associated with antibiotic resistance, indicating that the evolution of this population is primarily driven by drug therapy. Resistance genotypes showed a strong correlation with drug susceptibility phenotypes. A novel homoplasic mutation in rpoC, found only in isolates carrying a common rpoB rifampicin-resistance mutation, may play a role in fitness compensation. Most multidrug-resistant (MDR) isolates also had mutations in the promoter of a virulence gene, eis, which increase its expression and confer kanamycin resistance. Kanamycin therapy may thus select for mutants with increased virulence, helping preserve bacterial fitness and promoting transmission of drug-resistant TB strains. The East European clade was dominated by two MDR clusters, each disseminated across Samara. Polymorphisms conferring fluoroquinolone resistance were independently acquired multiple times within each cluster, indicating that XDR TB is currently not widely transmitted. © 2012 by Cold Spring Harbor Laboratory Press

Роль герпес-вирусной инфекции при болезни (синдроме) Шегрена

The etiology of Sjц gren's disease (syndrome) - SD, SS - is unknown; however, its frequent development in patients with hepatitis B or C or AIDS in infection with human lymphotropic virus type (HLTV-1) suggests the viral nature of the disease. A large body of data available in the literature shows the promise of studying the implication of viral infection in the development of SD and SS, at the early stages of the development in particular.Этиология болезни (синдрома) Шегрена (БШ,СШ) неизвестна, однако частое ее развитие у больных гепатитом В, С, СПИДом при инфицированности человеческим лимфотропным вирусом 1-го типа (HLTV 1) предполагает вирусную природу болезни. Многочисленные данные литературы свидетельствуют о перспективности изучения роли вирусной инфекции в развитии БШ и СШ, особенно на ранних стадиях заболевания