Splenic morphometric characteristics in infectious mononucleosis (ultrasonic study)

The spleen is a secondary immune and the largest organ of the reticuloendothelial system, actively involved during infectious mononucleosis. Clinically, assessing a degree of organ involvement in the pathological process seems unlikely. As a rule, only palpation and percussion are used to determine the size of the spleen, which represents a late and subjective sign of potential splenomegaly. Ultrasound examination provides ample opportunities to estimate the spleen size during infectious mononucleosis. Our study was aimed at identifying morphometric and Doppler ultrasound changes in the spleen in patients with infectious mononucleosis. Materials and methods. There were enrolled 24 patients with infectious mononucleosis to be compared with 30 healthy medical institute students in control group. All participants underwent splenic ultrasound examination. Spleen echotexture and contour clarity together with measuring linear dimensions: length, width, and thickness were analyzed. Splenic artery and vein velocity parameters were measured at the gates of the spleen. Elastographic window for fibroelastometry was positioned within the window for standard grayscale examination. Measurements were performed at 5 or more points of the spleen parenchyma at least 4—5 mm away from the capsular zone and the zone of large vessels. Based on the morphometric measurements obtained, the mass, spleen mass coefficient (SMC), as well as the spleen mass/body height ratio and spleen mass/body surface area ratio were calculated. Results. We found that patients with infectious mononucleosis had the length, thickness and weight of the spleen significantly greater than those observed in control group. However, the mass of the spleen varies widely and justified to calculate the CMS as an objective criterion to assess the size of the spleen. It was revealed that infectious mononucleosis may proceed in one of the three variants of the splenic response: decreased size, CMR < 1.5; normal size, CMR ranged from 1.5 to 4; splenomegaly, CMR > 4. Splenomegaly is associated with increased organ stiffness, peak blood flow velocity and pressure in v. lienalis, as well as periportal lymphadenopathy. Identified changes are characteristics of young patients. Conclusion. Ultrasound examination of the spleen is of high diagnostic value for patients with infectious mononucleosis allowing highly accurate assessment state of the immune organs in the acute disease period. At the preclinical stage, gradation of splenomegaly is possible depending on its intensity, assessed hemodynamics and organ stiffness

Congenital hyperinsulinism in newborns and young children: the state of the problem and the results of surgical treatment

Congenital hyperinsulinism causes irreversible damage to the cerebral cortex with subsequent disability in children. The article presents the features of etiopathogenesis, clinical picture of the disease. The histological variants of pancreatic lesions are analyzed in detail. The principles of correct diagnosis are formulated. A new in Russia method for the preoperative determination of the histological form of the disease, which is carried out at the y, Almazov National Medical Research Centre since 2017, – PET/ CT with 18F-DOPA, explained the biochemical basis of its clinical application and the examination technique. The principles of the selection of drug therapy with possible complications, the need for an adequate assessment of its effectiveness are described. If it is impossible to achieve a stable target euglycemia without the need for intravenous glucose infusion, surgical correction of the disease is indicated. In schematic drawings and intraoperative photographs, approaches to surgical treatment are described, the stages of operations and possible complications are clearly disassembled. The results of surgical interventions at the N.N. V.A. Almazov for 01.2017–02.2021, where 39 children with congenital hyperinsulinism were operated on. According to PET/CT with 18F-DOPA, 15 diffuse and 24 focal forms were diagnosed. After surgery, in 12 (31%) patients, a diffuse lesion of the gland was confirmed, in 23 (59%) – a focal nature of the lesion, in 4 (10%) – an atypical form was diagnosed intraoperatively. Of 39 children, 36 (92%) have complete relief of hyperinsulinism, a significant improvement in psychomotor development, of which 9 (23%) need insulin replacement therapy with minimal dosages, these are 8 children with a diffuse form of the disease and 1 child with an atypical one. Intraand postoperative complications were not observed. Thus, partial pancreatectomy for focal forms, subtotal for atypical and near total for diffuse forms, can cope with hypoglycemia due to congenital hyperinsulinism and prevent damage to the central nervous system of newborns and infants

Methods of physical activity for students with disabilities with cardiovascular diseases

The article deals with the question of ways of physical activity for students with disabilities in practical classes in the discipline «Physical culture».В статье рассматривается вопрос о способах физической активности для студентов-инвалидов на практических занятиях по дисциплине «Физическая культура»

Hormonal parameters and embryological outcomes of in vitro fertilisation/intra cytoplasmic sperm injection cycles in women using dydrogesterone for the prevention of premature luteinizing hormone surge during ovarian stimulation

Aim. To evaluate the hormonal parameters and embryological outcomes of an ovarian stimulation protocol using dydrogesterone to prevent the premature LH surge in IVF/ICSI programmes. Materials and methods. A prospective study randomised, including 79 women with normal ovarian reserve undergoing ovarian stimulation for IVF/ICSI with recombinant FSH (rFSH) from Day 2 or 3 of the menstrual cycle. To prevent the premature LH surge, participants in Group 1 (n=38) received oral dydrogesterone 20 mg/day from the start of ovarian stimulation until the day of ovulation trigger administration. Participants in Group 2 (n=41) received a GnRH antagonist. We evaluated the starting and total dose of gonadotropins, duration of stimulation, serum levels of LH, oestradiol and progesterone on Day 1 and 6 of stimulation and the day of trigger administration, number of retrieved and mature oocytes, fertilization rate, and the number of blastocysts and cryopreserved embryos. Results. There were no significant differences in most hormonal parameters, characteristics of the ovarian stimulation and embryological outcomes between the two groups. Serum levels of progesterone in the dydrogesterone arm were higher than in the GnRH antagonist arm (2.3 nmol/l [2.03.4] vs 1.5 [1.02.4] nmol/l; p=0.026), but without any impact on the embryological outcomes. Conclusion. Prevention of premature LH surge in ovarian stimulation cycles using oral dydrogesterone may represent a convenient alternative to the conventional use of GnRH antagonists, reducing the number of required injections and potentially increasing the convenience in patients who are not planning a fresh embryo transfer

Working conditions and health status of workers employed in electric steelmaking (on the example of JSC Seversky pipe plant)

The purpose of the study– to study the working conditions and health status of workers employed in the electric smelting industry, according to periodic medical examinations.Цель исследования – изучить условия труда и состояние здоровья рабочих, занятых в электроплавильном производстве, по данным периодических медицинских осмотров

Влияние гуминовых веществ угля и биокомпозиций с наночастицами серебра на их основе на баланс аргинина в перитонеальных макрофагах интактных мышей

Background. Antigen-presenting cells (APCs), especially macrophages, play an important role in the body defense against various pathogens. Their dysfunction and polarization are associated with most inflammatory and autoimmune diseases. The inflammatory process is regulated by activation and / or inhibition of genes differentially expressed by macrophages. Successful correction of inflammation leads firstly to elimination of inflammatory stimuli and then to remodeling and restoration of tissues and organs. It was experimentally confirmed that silvercontaining bionanocomposites based on natural humic substances (HS) obtained from coal of different origin, as well as initial matrices of these HS, are capable of activating pro- and anti-inflammatory properties of macrophages.Aim. To study cytotoxic, pyrogenic, and immunomodulatory properties (arginine balance) of initial HS samples and samples of silver nanoparticles ultradispersed in these HS matrices (HS-AgNPs) in the cell culture of peritoneal macrophages, as well as their effect on pro- and anti-inflammatory properties of APCs.Materials and methods. Cultural and biochemical methods were used in the study.Results. The study showed that the samples CHE-K, CHE-AgNPs, CHS-K, and CHP-K increased M1 macrophage polarization due to stimulation of the NO-synthase activity and inhibition of arginase. The samples CHI-K, CHIAgNPs, CHP-AgNPs, and CHS-AgNPs modulated an alternative M2 or M2-like state of macrophage activation. At the same time, HS are not cytotoxic at effective concentrations, and three out of four studied samples did not contain pyrogenic impurities.Conclusion. The use of HS and their silver-containing bionanocomposites, which have the ability to greatly affect the polarization of antigen-presenting cells, is a promising research area in correction of the inflammatory response for solving an important social and medical problem of treating chronic wounds. Введение. Антигенпрезентирующие клетки, особенно макрофаги, играют важную роль в защите организма от различных патогенов, их дисфункции, и поляризация связана с большинством воспалительных и аутоиммунных заболеваний. Воспалительный процесс жестко регулируется активацией и (или) ингибированием дифференциально экспрессируемых макрофагами генов. Успешная коррекция воспалительного процесса приводит к устранению воспалительных стимулов и далее ремоделированию и восстановлению тканей и органов. Экспериментально доказано, что биокомпозиции с наночастицами серебра на основе природных гуминовых веществ (ГВ) угля различного генеза, а также исходные матрицы данных ГВ способны активировать про- и противовоспалительные свойства макрофагов.Цель. Исследование в культуре клеток перитонеальных макрофагов цитотоксических, пирогенных и иммуномодулирующих свойств (баланс аргинина) исходных образцов ГВ и образцов наночастиц серебра, ультрадиспергированных в данных матрицах гуминовых веществ (ГВ-AgNPs),а также их влияния на про- и противовоспалительные свойства антигенпрезентирующих клеток. Материалы и методы. Использовались культуральные и биохимические методы.Результаты. Показано, что образцы CHE-K, CHE-AgNPs, CHS-K, CHP-K за счет усиления активности NOсинтазы и ингибиции аргиназы способствуют поляризации перитонеальных макрофагов по классическому типу (М1). Образцы CHI-K, CHI-AgNPs, CHP-AgNPs и CHS-AgNPs модулируют альтернативный М2 или M2-подобный тип (M2-like state) активации макрофагов. При этом ГВ не цитотоксичны в эффективных концентрациях, а также три из четырех исследуемых образцов не содержат пирогенных примесей.Заключение. Применение ГВ и серебросодержащих бионанокомпозиций на основе ГВ, обладающих способностью широко влиять на поляризацию антигенпрезентирующих клеток, является перспективным направлением исследований коррекции воспалительной реакции и, в частности, для решения острой социальной и медицинской проблемы – лечения хронических ран.

КЛИНИЧЕСКИЙ СЛУЧАЙ БРЮШНОГО ТИФА В КАЛИНИНГРАДСКОЙ ОБЛАСТИ

Currently, on the territory of the Russian Federation, typhoid fever is registered in the form of sporadic cases, primarily due to imported cases when Russians visit epidemiologically unfavorable for typhoid fever in foreign countries. A clinical case of a woman from Kaliningrad, who returned from a tourist trip to India, is given. The erased picture of the disease requires the doctors’ alertness and knowledge of the main clinical variants of the disease course. The study of epidemics and the follow-up to normative documents made it possible to establish the correct diagnosis. The treatment was carried out with a positive result.В настоящее время на территории Российской Федерации брюшной тиф регистрируется в виде единичных спорадических случаев. Прежде всего это связано с завозными случаями при посещении россиянами неблагополучных по брюшному тифу зарубежных стран. Приведен клинический случай заболевания у жительницы г. Калининграда, вернувшейся из туристической поездки в Индию. Стертая картина заболевания требует настороженности врачей и знания основных клинических вариантов течения болезни. Изучение эпидемиологического анамнеза и следование нормативным документам позволили поставить правильный диагноз. Лечение проведено с положительным результатом

Prevalence of eating disorders among USMU students

The aim of the study – to assess the prevalence of eating disorders among female students of USMU and to identify the relationship between eating disorders and the nutritional status of female students.Цель исследования – оценить распространённость нарушений пищевого поведения среди студенток УГМУ и выявить связь между пищевыми расстройствами и пищевым статусо