Local Self-Government and Traditional Institutions: Problems of the Influence of Historical and Cultural Heritage in Post-Reform Russia

This paper presents, drawing on archival records and published sources, problems in the local governments functioning that have emerged as a result of the Great Reforms. Theoretical and methodological background of the work are ideas of B. N. Mironov, A. Ribera, M. de Certeau. The authors emphasize that the responsibilities of the municipal government bodies had not been clearly defined, therefore, in practice, there were conflicts between them and the provincial administration or the estates bodies. Often the personal authority of powerful officials had precedence over the formal laws. Duma did not come into open conflict, but it used a variety of delays, which had a negative effect on the possibilities of dialogue between the local government and the previous government authorities. A work of self-government bodies was complicated by the fact that they almost did not have any material resources; new social and political institutions could not earn social respect without a demonstration of its concrete and practical effectiveness, which could not be achieved without public backing. Thus, it is possible to state a lack of independence of public self-governance in the analyzed period, as well as difficulties in the practical implementation of its activities. The reason is the fact that the modernized socio-political institutions have been functioning and interacting with each other in an environment of mainly traditional concepts. Copyright © 2022 by Cherkas Global University

Outcome prediction of the measles vaccination in healthcare employees

Vaccination is the only guarantee for elimination of measles infection. Healthcare workers have a 13- to 19-fold higher risk for contracting measles than the general population. The number of individuals in the population who did not respond to vaccination is up to 10%, and their accumulation may lead to an outbreak of the infection. The aim of our research was to find potential predictors of arising post-vaccination measles antibodies in the panel of biochemical and immunological serum markers in healthcare workers. The group of healthcare workers (n = 76) aged from 19 to 51 years, with proven absence of pre-existing anti-measles antibodies were twice vaccinated 3 months apart with live measles culture vaccine (SPA “Microgen”, Russia). Measles-specific IgG, total IgG, IgM, IgA, IFNγ, IL-6, CRP, total protein, ALT, AST, total bilirubin, urea, creatinine, protein fractions were determined before vaccination, 1 month after vaccination, 1 month following revaccination, 1 year after revaccination. ROC analysis was used to gain access to the diagnostic performance of quantitative variables in predicting a categorical outcome. Development of a predictive probability model for the binary outcome was carried out using logistic regression. IFNγ, total IgG, IgM, total bilirubin, ALT activity at various post-immunization stages may be considered potential laboratory predictors of measles vaccination failures in healthcare workers. Meanwhile, the contents of pre-vaccination IFNγ, and IgG to measles virus after first vaccination proved to be most informative indexes, which formed the basis for the development of regression models predicting the risk of both primary and secondary vaccination failures. These models allowed to develop algorithm for predicting failures of the measles vaccination in healthcare workers that can be used for detection of persons at risk for non-forming specific humoral immunity. This algorithm is primarily focused on search for the persons who have not responded to measles vaccination, including subjects with probable immunodeficiency conditions. We do not exclude that, on the basis of revealed predictors following measles vaccination, it would be possible to build prognostic models of vaccination efficiency for other vaccinemanaged infections

Use of Levosimendan in Cardiac Anesthesiology

The authors consider the main aspects of the rational use of the novel inotropic drug levosimendan in cardiosurgical patients on the basis of the results of the trials described in the literature and on their own findings in this review. The purpose of the analysis made was to provide a rationale for the effective use of this drug. The review shows the role of the ultrasound indicator left ventricular ejection fraction, the prognostic scale EuroSCORE, and the natriuretic peptides NT-proBNP and BNP in defining indications for levosimendan administration for preoperative preparation. There are original data on the lower level of the natriuretic peptides due to levosimendan therapy. The target hemodynamic monitoring values indicating that it is essential to use levosimendan in postperfusion heart failure are discussed. It is shown that it is expedient to use levosimendan simultaneously with traditional medical measures, by taking into account the pharmacokinetic features of a calcium sensitizer. The problem of levosimendan readministration in patients operated on the heart as well is stated. That there are no clear algorithms for repeated use of the drug is shown. At the same time, possible options of this therapy in different clinical situations are given. Key words: levosimendan, cardiosurgery, heart failure

Using Both Sides of Your Brain: The Case for Rapid Interhemispheric Switching

Individual brain hemispheres are often specialized for specific aspects of a behavior. How both sides of the brain coordinate their output to produce a perfectly seamless behavior is not known. Songbirds appear to achieve this by rapidly switching back and forth between hemispheres

РЕДКИЕ ОСЛОЖНЕНИЯ ТЕРАПИИ МУКОВИСЦИДОЗА: CLOSTRIDIUM DIFFICILE-АССОЦИИРОВАННЫЙ КОЛИТ

 The aim of this study was to determine a rate of Clostridium difficileassociated colitis in patients with cystic fibrosis (CF). Methods. Qualitative and quantitative bacteriological examination with identification of C. difficile toxins A and B production was done in 61 intestinal contents samples from CF patients who previously received antibiotics. Results. Various disorders of qualitative and quantitative composition of the intestinal microflora were found in 100% of patients. Testing for C. difficile toxins A and B production was positive in 5 (15.2%) of patients. Conclusion. These patients could have a high risk of pseudomembranous colitis development.  Цель. Определение группы риска по развитию Clostridium difficileассоциированного колита. Материалы и методы. Проведено исследование 61 образца кала на дисбактериоз кишечника у больных муковисцидозом (n = 33). Определен качественный и количественный состав кишечной микрофлоры. В образцах оценена продукция токсинов А и В C. difficile. Результаты. У 100 % пациентов установлены различные нарушения качественного и количественного состава микрофлоры. Тест на продукцию токсинов А и В C. difficile оказался положительным у 5 (15,2 %) больных. Заключение. Показано, что данные пациенты могут быть отнесены к группе риска по развитию псевдомембранозного колита. Приведен клинический пример развития C. difficile ассоциированного колита у пациентки с муковисцидозом.

Respiratory diseases in children: assessment of the stage of emergency medical care

The aim of the study to analyze the frequency and structure of respiratory system diseases in children, the clinical picture at the stage of emergency medical care.Цель исследования – проанализировать частоту, структуру заболеваний дыхательной системы у детей, особенность клинической картины на этапе скорой медицинской помощи

Применение левосимендана в кардиоанестезиологии

The authors consider the main aspects of the rational use of the novel inotropic drug levosimendan in cardiosurgical patients on the basis of the results of the trials described in the literature and on their own findings in this review. The purpose of the analysis made was to provide a rationale for the effective use of this drug. The review shows the role of the ultrasound indicator left ventricular ejection fraction, the prognostic scale EuroSCORE, and the natriuretic peptides NT-proBNP and BNP in defining indications for levosimendan administration for preoperative preparation. There are original data on the lower level of the natriuretic peptides due to levosimendan therapy. The target hemodynamic monitoring values indicating that it is essential to use levosimendan in postperfusion heart failure are discussed. It is shown that it is expedient to use levosimendan simultaneously with traditional medical measures, by taking into account the pharmacokinetic features of a calcium sensitizer. The problem of levosimendan readministration in patients operated on the heart as well is stated. That there are no clear algorithms for repeated use of the drug is shown. At the same time, possible options of this therapy in different clinical situations are given. Key words: levosimendan, cardiosurgery, heart failure.В настоящем обзоре на основе литературных и собственных исследований рассмотрены основные аспекты рационального использования нового инотропного препарата — левосимендана у кардиохирургических больных. Цель проведенного анализа — обоснование принципов эффективного назначения этого лекарственного средства. Обозначена роль ультразвукового параметра — фракции изгнания левого желудочка, прогностической шкалы EuroSCORE, натрийуретических пептидов (NT-proBNP и BNP) для определения показаний к введению левоси-мендана с целью предоперационной подготовки. Продемонстрированы оригинальные данные о снижении уровня натрийуретических пептидов (НУП) в связи с терапией левосименданом. Обсуждены «целевые» показатели ге-модинамического мониторинга, указывающие на необходимость назначения препарата при постперфузионной сердечной недостаточности. Показана целесообразность назначения левосимендана одновременно с проведением традиционных лечебных мер, учитывая фармакокинетические особенности «кальциевого сенситайзера». Сформулирована проблема повторного введения левосимендана, в том числе у больных, оперированных на сердце. Констатировано отсутствие четких алгоритмов неоднократного назначения препарата. Вместе с тем, приведены возможные варианты такой терапии в различных клинических ситуациях. Ключевые слова: левосимендан, кардиохирургия, сердечная недостаточность