System Approach to the Development of Intelligent Complexes of Oncological Diagnostics

The system approach to the development of intellectual complexes in cancer diagnosis are discussed in the article. Distinctive features of this approach: the participation of pathologist at the stage of description of recognizable images (the description is based on traditional assessments of quality informative features of tumors); the set of the most similar probabilistic diagnoses is forming on the classification stage of recognition; final histological diagnosis is made by pathologist. The proposed approach has been successfully tested in clinical practice. Keywords: image processing, image description, image classification, pattern recognition, qualitative attributes of tumor images, interactive recognition, cancer diagnosis, decision support syste

Taxonomic structure of bacterial communities in sourdoughs of spontaneous fermentation

The article is devoted to the study of the microbiome of spontaneously fermented sourdoughs. The aim of the work was to study the influence of the technological parameters of sourdough propagations on the taxonomic structure of the microbiome of spontaneously fermented sourdoughs. Two spontaneously fermented sourdoughs were studied: dense rye sourdough and liquid rye sourdough, both prepared using the same batch of peeled rye flour. To study the taxonomic structure of the sourdough microbiome in dynamics, the method of high-throughput sequencing of 16S rRNA gene fragments of microorganisms was used. It was shown that the technological parameters of sourdough (humidity, temperature) do not affect the taxonomic composition of the microbiome of dense rye or liquid rye sourdough at the phylum/class/genus level. It was found that during the first three days of propagations, bacteria from the phyla Proteobacteria and Firmicutes dominated in the microbial community. In the phylum Proteobacteria, microorganisms from the order Enterobacterales took a large share, which persisted for three days of backslopping. The phylum Firmicutes was represented by lactic acid bacteria of the genera Weissella, Lactobacillus, Leuconostoc, Pediococcus, Lactococcus. It was established by classical microbiological methods that after a day of fermentation, the number of lactic acid bacteria cells was significantly higher in liquid rye sourdough compared to dense one. However, with further propagation of sourdoughs, the number of cells was comparable, while significant changes occurred at the level of genera and species. It was shown that as the relative number of lactic acid bacteria of the genus Lactobacillus increased, a gradual displacement of the coccal forms of Lactococcus, Leuconostoc, Weissella, Pediococcus happened. With further propagation of sourdough after 10 days, the position of the dominant groups of bacteria was occupied by representatives of the phylum Firmicutes, lactic acid bacteria of the genus Lactobacillus. The influence of the mode and parameters of the sourdough on the species composition of lactobacilli, which demonstrated a low bacterial diversity, is shown. In the first three days of propagations, lactobacilli L. curvatus, L. brevis, and Lactiplantibacillus sp. dominated in both sourdoughs. After a month of backslopping, Fructilactobacillus sanfranciscensis and Companilactobacillus sp. dominated in dense rye sourdough, and L. pontis dominated in liquid rye sourdough

Shifting attention in viewer- and object-based reference frames after unilateral brain injury

The aims of the present study were to investigate the respective roles that object- and viewer-based reference frames play in reorienting visual attention, and to assess their influence after unilateral brain injury. To do so, we studied 16 right hemisphere injured (RHI) and 13 left hemisphere injured (LHI) patients. We used a cueing design that manipulates the location of cues and targets relative to a display comprised of two rectangles (i.e., objects). Unlike previous studies with patients, we presented all cues at midline rather than in the left or right visual fields. Thus, in the critical conditions in which targets were presented laterally, reorienting of attention was always from a midline cue. Performance was measured for lateralized target detection as a function of viewer-based (contra- and ipsilesional sides) and object-based (requiring reorienting within or between objects) reference frames. As expected, contralesional detection was slower than ipsilesional detection for the patients. More importantly, objects influenced target detection differently in the contralesional and ipsilesional fields. Contralesionally, reorienting to a target within the cued object took longer than reorienting to a target in the same location but in the uncued object. This finding is consistent with object-based neglect. Ipsilesionally, the means were in the opposite direction. Furthermore, no significant difference was found in object-based influences between the patient groups (RHI vs. LHI). These findings are discussed in the context of reference frames used in reorienting attention for target detection

Diagnosis of IgG4 - related ophthalmic disease in a group of patients with various lesions of the eye and orbits

Purpose of the study. To provide demographic, clinical, laboratory, ultrasound, radiological, morphological/ immunomorphological phenotype of IgG4-related ophthalmic diseases, which allowsmaking a differential diagnosis with granulomatous, autoimmune, inflammatory, endocrine and hematologic diseases affecting the eye and orbits. Materials and methods. From 2004 to 2016 108 (78.2%) of the 138 patients were diagnosed with non-tumoral lesions of eye and orbits. In 48 patients (35%) at admission and 5 patients in the follow were diagnosed IgG4-related ophthalmic disease. In the analysis of 82 (f-44, m-38) patients with IgG4-related disease, localization of lesions in orbit observed in 53 (f-36, m-17) and it was the most frequent involvement in patients with IgG4-related disease (64.5%). Only 7 patients had isolated IgG4-related ophthalmic disease, whereas 46 patients (87%) had involvement of 2-7 locations, as a manifestation of IgG4-related systemic disease.During the examination, the average age of patients with IgG4-related ophthalmic disease was 47.5 years (19-73 years). Median time to diagnosis was 52.8 months before 2004 and 36 months 2004-2016. Results. We noted the predominance of females in the ratio 2: 1 inthe group of patients with IgG4-related ophthalmic disease. Edema of the eyelids, nasal congestion (55-60%), tumor-like formations of the upper eyelids and increased lacrimation prevailed at the onset of the disease, whereas such functional impairment like limited mobility and pain in eyeballs, exophthalmos, ptosis and diplopia appeared later at 15-38% with a loss visual acuity in one case. Bilateral lesion (86%), mainly affecting the lacrimal glands (93.5%), infiltration of the extraocular muscles (83.5%) and retrobulbar tissue with a thickening of the optic nerve in one third of patients were the main localizations IgG4-related ophthalmic disease. Clinical symptoms were accompanied by the appearance of moderate inflammatory activity (38%), increased levels IgG (44%), IgG4(88%) and IgE (61%). Indicators of autoimmune disorders observed in 6-22% of patients, most often in patients with simultaneous involvement of the salivary glands. Significant lymphoplasmacytic infiltration (94%) with a ratio of plasma cells (IgG4/IgG) secreting IgG4> 40% (90%) with fibrosis formation (94%) and follicle formation (71%) with a moderate amount of eosinophils (34%) were the major morphological / immunomorphological manifestations of IgG4-related ophthalmic disease. Signs of vasculitis and obliterative phlebitis were found in a small amount of patients. Conclusion. Determination of elevated levels of IgG-4 / IgE in patients with edema, pseudotumor of the eyelid, sinusitis and increase of the palpebral lobe of the lacrimal gland suggests the presence of IgG4-related ophthalmic disease. Minimally invasive incisional biopsy of lacrimal glands and salivary glands followed by morphological / immunomorphological research is needed for the correct diagnosis. Diagnostic orbitotomy in ophthalmic hospitals in such cases is inexpedient, since it leads to the development of dry eye. Massive lymphoplasmacytic infiltration with IgG4 / IgG ratio more than 40%, advanced fibrosis in biopsiesof the orbits tissue or salivary glands when combined lesions are required for the making the diagnosis of IgG4-related ophthalmic disease

The stages of rendering of medical aid to patients with disorders of the veins

The article presents the results of analysis of organization of medical aid to patients with disorders of the veins in the Orenburg region. The insufficient provision of population with physicians, surgeons (10 thousand to 1,37) and cardiovascular surgeons (0,15 per 10 thousand), which is lower than the national average and, as a consequence of the low staffing data specialists in the departments of vascular surgery. Among the organizational problems of medical care are leading to the absence of a day hospital for surgical treatment of this disease; not enough widespread introduction of less traumatic methods of surgical treatment and the low percentage of patients in the departments of vascular surgery on the background of their high average duration of hospital stay. For changes and improvements suggested are the stages of rendering of medical aid to this category of patients.В статье представлены результаты анализа состояния организации медицинской помощи пациентам с патологией вен в Оренбургской области. Установлена недостаточная обеспеченность населения врачами-хирургами (1,37 на 10 тыс.) и сердечно-сосудистыми хирургами (0,15 на 10 тыс.), что привело к низкой укомплектованности отделений сосудистой хирургии данными специалистами. Среди организационных проблем оказания медицинской помощи пациентам с патологией вен ведущими являются: отсутствие в регионе дневного стационара для хирургического лечения данной патологии; недостаточно широкое внедрение малотравматичных методов хирургического лечения; низкая доля пациентов с венозной патологией в отделениях сосудистой хирургии. Для изменения и улучшения ситуации разработаны этапы оказания медицинской помощи данной категории пациентов

Рак желудка у пациентов моложе и старше 50 лет: характеристики опухолевого процесса, анализ выживаемости

Objective. To study clinical and pathological characteristics of gastric cancer in patients aged younger and older than 50 years, who received anticancer treatment including surgery, as well as to identify prognostic factors for overall survival of these patients.Material and methods. A retrospective study of surgical treatment outcomes was conducted in 350 gastric cancer patients, who were divided into 2 groups. The study group included 34 (9.71 %) patients aged 50 years and younger and the control group consisted of 316 (90.29 %) patients aged 51 years and older.Results. The analysis of treatment outcomes and survival rates was carried out. The diffuse-type gastric cancer was more frequently diagnosed in younger than in older patients (p<0.001), and asymptomatic disease often present in younger patients (p<0.001). There were no differences in the extent of surgery between the groups (p=0.613). The overall survival rate was lower in the control group than in the study group (p=0.002). The multivariate analysis revealed that a worse prognosis was observed in patients of the control group (hr=12.71), with regional lymph node metastases (hr=2.64), distant metastases (hr=1.83), iii/iv stage of the disease (hr=2.01), lymphovascular (hr=3.15) and perineural invasion (hr=2.46), as well as with postoperative complications (hr=2.12). Adjuvant chemotherapy improved the disease prognosis (hr=0.35).Conclusion. Specific clinical and pathological features predicted survival of gastric cancer patients aged younger and older 50 years.Цель исследования – изучить особенности рака желудка у больных моложе и старше 50 лет, получивших противоопухолевое лечение с хирургическим компонентом, и установить предикторы прогноза общей выживаемости для каждой из групп.Материал и методы. Проведено ретроспективное исследование непосредственных и отдаленных результатов хирургического лечения пациентов с раком желудка в ООХМЛ 5 ГБУЗ «ВОКОД» за три года. Выборка разделена на две группы: основную (50 лет и моложе) и контрольную (51 год и старше).Результаты. Из 350 пациентов, вошедших в анализ, 34 (9,71 %) были отнесены к основной группе и 316 (90,29 %) к контрольной. Заболевание у более молодых пациентов чаще протекало бессимптомно (p<0,001), они чаще имели опухоли с диффузным типом роста (p=0,001). Различий в объеме хирургического лечения между группами не отмечено (p=0,613). Общая выживаемость была ниже в контрольной группе (p=0,002). Многофакторный анализ позволил установить, что прогноз для всей совокупности пациентов ухудшается при принадлежности пациентов к контрольной группе (HR=12,71), метастазах в регионарные лимфатические узлы (HR=2,64), отдаленных метастазах (HR=1,83), iii/iV стадии заболевания (HR=2,01), лимфоваскулярной (HR=3,15) и периневральной инвазии (HR=2,46), а также осложнениях после хирургического лечения (HR=2,12). Фактором, улучшающим прогноз, явилось проведение адъювантной химиотерапии (HR=0,35).Выводы. Пациенты с раком желудка моложе и старше 50 лет имеют ряд клинико-патологических особенностей, обусловливающих прогноз выживаемости

НЕЙРОЭНДОКРИННЫЙ РАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ (ОПИСАНИЕ КЛИНИЧЕСКОГО СЛУЧАЯ)

Neuroendocrine carcinoma of the prostate belongs to the so-called small-cell neuroendocrine carcinomas and amounts to 1–2 % of all prostate malignancies. With allowance made for the low incidence of this pathology, the paper describes a case of high-grade neuroendocrine (small-cell) prostate cancer with an aggressive course.Нейроэндокринный рак предстательной железы (РПЖ) относится к так называемым мелкоклеточным нейроэндокринным формам рака и составляет 1–2 % всех злокачественных опухолей предстательной железы. С учетом низкой встречаемости этой патологии приводится описание низкодифференцированного нейроэндокринного (мелкоклеточного) РПЖ с крайне агрессивным течением

Nanoscale engineering of hybrid magnetite–carbon nanofibre materials for magnetic resonance imaging contrast agents

Magnetic nanomaterials show significant promise as contrast agents for magnetic resonance imaging (MRI). We have developed a new highly efficient one-step procedure for the synthesis of magnetically- functionalised hollow carbon nanofibres, where (i) the carbon nanofibres act as both a template and a support for the nucleation and growth of magnetite nanoparticles and (ii) the structural (size, dispersity and morphology) and functional (magnetisation and coercivity) properties of the magnetic nanoparticles formed on nanofibres are strictly controlled by the mass ratio of the magnetite precursor to the nanofibres and the solvent employed during synthesis. We have shown that our magnetite-nanofibre materials are effectively solubilised in water resulting in a stable suspension that has been employed as a ‘‘negative’’ MRI contrast agent with an excellent transverse relaxivity (r2) of (268 13) mM s 1, surpassing current commercial materials and state-of-the-art magnetic nanoscale platforms in performance for MRI contrast at high magnetic fields. The preparation and evaluation of this unique hybrid nanomaterial represents a critical step towards the realisation of a highly efficient ‘‘smart’’ MRI theranostic agent – a material that allows for the combined diagnosis (with MRI), treatment (with magnetic targeting) and follow-up of a disease (with MRI) – currently in high demand for various clinical applications, including stratified nanomedicine

Особенности микробиоты у новорожденных в критическом состоянии при поступлении в ОРИТ специализированного стационара

Clarification of etiology and identification of infectious agents in critically ill newborns is a very urgent problem of neonatal resuscitation.The objective. To study the characteristics of microbiota in critically ill newborns at admission to the intensive care unit (ICU) of a specialized hospital.Subjects and Methods. 165 critically ill newborns were examined, and bacteriological tests of blood, feces, and saliva were performed.Results. Positive culture results were obtained in 40 (24%) patients. The most frequent causative agent was S. epidermidis (47.5%). The detection rate of E. faecalis amounted to 15%, S. haemolyticus ‒ 15%, C. albicans – 12.5%, and K. pneumoniae ‒ 10%. Microorganisms were isolated from feces in 70% of cases, from the oral cavity in 62.5%, and from blood in 12.5%. E. faecalis was equally frequent at all three sites (5%).Conclusion. In 76% of patients, no neonatal infectious agent was isolated at admission to ICU of a specialized hospital that is most likely associated with the early administration of antibacterial drugs in the first hours of life of the newborn.Уточнение этиологии и идентификация возбудителей инфекций у новорожденных, находящихся в критическом состоянии, является крайне актуальной проблемой неонатальной реаниматологии.Цель: изучить особенности микробиоты у новорожденных, находящихся в критическом состоянии, при поступлении в отделение реанимации и интенсивной терапии (ОРИТ) специализированного стационара. Материал и методы. Обследовано 165 новорожденных в критическом состоянии, проведено бактериологическое исследование крови, фекалий и слюны.Результаты. Положительные результаты бактериологического исследования получены у 40 (24%) пациентов. Наиболее частыми микроорганизмами были S. epidermidis (47,5%). Частота выявления E. faecalis составила 15%, S. haemolyticus ‒ 15%, C. albicans – 12,5% и K. pneumoniae – 10%. Из фекалий микроорганизмы были выделены в 70% случаев, из ротовой полости – в 62,5%, а из крови – в 12,5%. E. faecalis одинаково часто встречался во всех трех локусах (5%).Заключение. У 76% пациентов возбудитель инфекций неонатального периода при поступлении в ОРИТ специализированного стационара выделен не был, что, вероятнее всего, ассоциируется с ранним назначением антибактериальных препаратов в первые часы жизни ребенка