Cleaning of aquatic ecosystems from oil new effective sorbent

Is devoted to the production of particles of amorphous silica, the study of the nature of the interaction of the silica nanoparticles with surfactants to the water surface and the assessment of their absorption capacity in relation to petroleum productsРабота посвящена получению частиц аморфного кремнезема, исследованию природы взаимодействия наночастиц кремнезема с поверхностно-активными веществами на водных поверхностях и оценка их адсорбционной способности по отношению к нефтепродукта

Diagnostics of Central and Autonomic Nervous System Dysfunction in Patients with Sepsis-Associated Encephalopathy

This chapter is devoted to monitoring of central and autonomic nervous system (ANS) in patients with verified sepsis to recognize the specific functional and anatomic changes in the brain and its important autonomic centers which is named sepsis-associated encephalopathy (SAE). Fluctuation of conscience level from agitation to delirium and coma, muscle tone, and severity of pain syndrome is evaluated with different scales (SOFA, SAPS II, RASS, CAM-ICU, FOUR, PBSS, BPS, MRC, MAS, CNS). Multimodal neuromonitoring includes EEG, EPs, ENMG, cerebral oxymetry, saturation in the bulb of the jugular vein, TCD, and neuroimaging (MRI, PET). Dysfunction of autonomic brainstem structures is detected with variational cardiointervalometry, pupillometry, thermometry (peripheral and central), photoplethysmography assessment of perfusion index, quantitative assessment of muscle strength on the MRC scale and MAS, and diagnostics of the severity of the PSH syndrome. Monitoring data help clinicians to make decisions on SAE patient management tactics

CSF Bypass Surgery in Children with Hydrocephalus: Modern Possibilities, Prospects and Ways of Solving the Correction of Complications

The chapter discusses modern and promising approaches to the use of CSF shunting operations in children. CSF shunting operations remain the only effective method for correcting persistent CSF circulation disorders in CSF resorption disorders with the development of intracranial hypertension and hydrocephalus. The chapter is devoted to general ideas about CSF dynamics and biomechanical properties of the craniospinal system that affect CSF dynamics, and gives a pathogenetic assessment of CSF dynamics in the development of intracranial hypertension and hydrocephalus. Aspects of genetics and genomics of anomalies in hydrocephalus are touched upon. Pathological changes in the brain around old ventricular shunts are described. The authors consider the types of CSF shunting operations for hydrocephalus in children. Possible complications of CSF shunting operations are analyzed with the algorithm for their correction and management tactics for this group of patients

Risk factors for cardiovascular diseases in patients received complex treatment for cranial and craniospinal tumors in childhood

Aim. To study the traditional risk factors for cardiovascular disease (CVD), indicators of endothelial function and exercise tolerance in patients received complex treatment for cranial and craniospinal tumors in childhood, including radiation therapy.Material and methods. We compared examination data of 48 patients who underwent treatment for brain tumors using cranial and craniospinal irradiation in childhood (mean age, 21,7±4,3 years, mean period after the end of treatment, 6,9±5,4 years), and 20 healthy volunteers. Examination methods included assessment of lipid profile, vascular stiffness and endothelial function using the Photoplethysmography and occlusion test, cardiopulmonary test, and in patients who underwent craniospinal irradiation, also echocardiography and duplex ultrasound of extracranial arteries.Results. Compared to healthy individuals, patients after a brain tumor were found to have lower blood pressure, higher heart rate (HR), significantly lower exercise performance (peak oxygen consumption, 19,8±6,4 ml×min-1×kg vs 30,3±5,8 ml×min-1×kg, p<0,0001) and a higher prevalence of dyslipidemia (56% vs 5%, p<0,0001), as well as an increase in the augmentation index, indicating higher stiffness of large vessels (-7,3±16,3 vs -20,3±7,9, p=0,001), and a trend towards a decrease in the occlusion index (p=0,051). Echocardiography and duplex ultrasound revealed no radiation-associated abnormalities.Conclusion. Determining the mechanisms and prognostic significance of the identified risk factors for CVD (dyslipidemia, decreased exercise tolerance, increased heart rate and vascular stiffness) in this category of patients requires further research. Regular monitoring of risk factors, primarily the lipid profile, and the use of preventive measures for individuals with an increased risk of CVD should be recommended

Частота инфекционных осложнений и особенности системного воспалительного ответа у больных с длительным нарушением сознания

Objective: investigate epidemiology of infectious complications, intensity of antibacterial therapy, and features of the systemic inflammatory response in patients with prolonged disorders of consciousness.Materials and methods: retrospective case histories analysis of 102 patients with prolonged disorders of consciousness who were treated in the department of anesthesiology and intensive care of Polenov Neurosurgical Institute from 2010 to 2019.Results: during hospitalization all patients (100%) had signs of tracheobronchitis, 86 patients (84,3%) had urinary tract infection, 34 (33,3%) pneumonia, 10 patients (9,8%) meningoventriculitis, and in 9 (8,8%) cases sepsis was diagnosed. Identified bacterial complications required systemic antibacterial therapy. With an average length of hospital stay of 51±42 days, duration of antibiotic therapy was 37±41 days. One-component therapy was applied in half of the cases (54%), slightly less often (43,2%) treatment consisted of two antibiotics, in some cases patient’s condition required prescription of three antibiotics (2,8%). Even in the absence of a focus of infection, temperature and laboratory markers of inflammation in blood samples of patients with prolonged disorders of consciousness were higher than the reference values. CRP was increased with addition of any bacterial complications. Count of white blood cells significantly increased only in case of pneumonia and sepsis. Procalcitonin test was positive in 16,6% observations of urinary tract infection, 30,4% of pneumonia, and 28% of meningoventriculitis.Conclusion: most informative proinflammatory marker of bacterial complications in patients with prolonged disorders of consciousness was CRP. Mild leukocyte response can be explained by immunosuppression in long-term ill patients. Limited value of procalcitonin test may be due to the insufficiency of the semi-quantitative method sensitivity with a threshold level of 0,5 ng/ml, as well as reduced proinflammatory response to local infection in patients with prolonged disorders of consciousness as a result of massive antibacterial therapy, colonization of opportunistic microflora and presence of sympathicotonia (non-infectious systemic inflammatory reaction). Цель: изучить эпидемиологию инфекционных осложнений, интенсивность антибактериальной терапии и особенности системного воспалительного ответа у больных с длительным нарушением сознания.Материалы и методы: проведен ретроспективный анализ историй болезни 102 пациентов с длительным нарушением сознания, проходивших лечение в отделении анестезиологии-реанимации Российского научноисследовательского нейрохирургического института им. профессора А.Л. Поленова с 2010 по 2019 г.Результаты: у всех пациентов (100%) за время госпитализации присутствовали признаки трахеобронхита, у 86 больных (84,3%) была обнаружена инфекция мочевыводящих путей, у 34 (33,3%) – пневмония, у 10 (9,8%) – менинговентрикулит, у 9 (8,8%) – сепсис. Выявленные бактериальные осложнения потребовали назначения интенсивной антибактериальной терапии. При продолжительности пребывания больного в стационаре в среднем 51±42 дня продолжительность антибактериальной терапии составила в среднем 37±41 день. Однокомпонентная терапия проводилась в половине случаев (54%), чуть реже (43,2%) лечение состояло из двух антибактериальных препаратов, в отдельных случаях состояние больного требовало назначения трех антибактериальных препаратов (2,8%). Даже в отсутствие очага инфекции температура и лабораторные маркеры воспаления в крови у больных с длительным нарушением сознания были выше референсных показателей. СРБ увеличивался при присоединении всех бактериальных осложнений. Количество лейкоцитов достоверно повышалось только с развитием пневмонии и сепсиса. Прокальцитониновый тест был положительным в 16,6% случаев инфекций мочевыводящих путей, 30,4% пневмоний и 28% менинговентрикулитов.Заключение: наиболее информативным провоспалительным маркером в диагностике бактериальных осложнений у больных с длительным нарушением сознания оказался С-реактивный белок. Слабо выраженная лейкоцитарная реакция может объясняться иммуносупрессией у длительно болеющих пациентов. Ограниченная ценность прокальцитонина обусловлена недостаточной чувствительностью полуколичественного метода с пороговым уровнем 0,5 нг/мл, а также сниженным провоспалительным ответом на локальную инфекцию у пациентов с длительным нарушением сознания в результате массивной антибактериальной терапии, колонизации условно-патогенной флоры, наличия симпатикотонии (неинфекционной системной воспалительной реакции).

Constraining modern day silicon cycling in Lake Baikal

Constraining the continental silicon cycle is a key requirement in attempts to understand both nutrient fluxes to the ocean and linkages between silicon and carbon cycling over different timescales. Silicon isotope data of dissolved silica (δ30SiDSi) are presented here from Lake Baikal and its catchment in central Siberia. As well as being the world's oldest and voluminous lake, Lake Baikal lies within the seventh largest drainage basin in the world and exports significant amounts of freshwater into the Arctic Ocean. Data from river waters accounting for c. 92% of annual river inflow to the lake suggest no seasonal alteration or anthropogenic impact on river δ30SiDSi composition. The absence of a change in δ30SiDSi within the Selenga Delta, through which 62% of riverine flow passes, suggest a net balance between biogenic uptake and dissolution in this system. A key feature of this study is the use of δ30SiDSi to examine seasonal and spatial variations in DSi utilisation and export across the lake. Using an open system model against deep water δ30SiDSi values from the lake, we estimate that 20-24% of DSi entering Lake Baikal is exported into the sediment record. Whilst highlighting the impact that lakes may have upon the sequestration of continental DSi, mixed layer δ30SiDSi values from 2003 and 2013 show significant spatial variability in the magnitude of spring bloom nutrient utilisation with lower rates in the north relative to south basin

ХАРАКТЕРИСТИКА ГЛОМЕРУЛЯРНОЙ ГЕМАТУРИИ У ДЕТЕЙ

Hematuria is a significant manifestation, which can reflect both renal disorders and other urinary tract diseases and also be a symptom of systemic illnesses. High prevalence, diversity of etiological and trigger factors, latent course of hematuria and phenotypic resemblance of a number of underlying nephropathies symptoms cause increased interest and urgency of further investigations of such diseases features. The examination of 56 children showed that the most common cause of glomerular hematuria was hereditary kidney diseases, associated with collagen IV type mutations — 64% (Alport syndrome — 56%, thin basement membrane disease — 44%) and IgA-nephropathy — 36%. Comparative analysis of these conditions is presented in this study.Гематурия — важный признак, отражающий патологическое состояние почек и других органов мочевой системы, служит также проявлением системных заболеваний. Частая встречаемость, многообразие причин, способствующих возникновению гематурии, латентное течение и фенотипическое сходство проявлений ряда нефропатий, вследствие которых она возникает, обусловливают повышенный интерес к дальнейшему изучению особенностей заболевания. В результате обследования 56 детей показано, что наиболее частой причиной гломерулярной гематурии выступают наследственные заболевания почек, связанные с мутацией коллагена IV типа, составляя 64% случаев (из них с синдромом Альпорта — 56%, болезнью тонких базальных мембран — 44%), а также IgA-нефропатия — 36%

Використання низькоінтенсивного лазерного випромінення та імуномодуляторів в комплексному лікуванні хронічного тонзиліту

При лечении хронического тонзиллита во время обострения использовали комплексную терапию, включающую использование иммуномодуляторов «Имупрет» и «Лимфомиозот», а также лазерного облучения миндалин и подчелюстных лимфоузлов. Применение комплексной терапии позволило уменьшить частоту осложнений и достичь быстрого обратного регресса симптомов заболевания.Complex therapy was used in treatment of chronic tonsillitis in worsening. The therapy included laser radiation low intensity and immunomodulator medications such as “Imupret”® and “Limphomyosot”®. Using of complex therapy reduced quantity of complications and brought to quick regress of the clinical manifestations.При лікуванні хронічного тонзиліту під час загострення використовувалась комплексна терапія, що включала використання імуномодуляторів «Імупрет» та «Лімфоміозот», а також лазерного опромінення мигдаликів та підщелепних лімфовузлів. Застосування комплексної терапії дозволило зменшити частоту ускладнень та досягти швидкого зворотнього регресу симптомів захворювання

Severe neurological outcomes after very early bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD)

To test the association between bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD) and long-term clinical outcome and to identify risk factors for severe outcomes, a dataset comprising 504 patients from the international registry study ARegPKD was analyzed for characteristics and complications of patients with very early (� 3 months; VEBNE) and early (4�15 months; EBNE) bilateral nephrectomies. Patients with very early dialysis (VED, onset � 3 months) without bilateral nephrectomies and patients with total kidney volumes (TKV) comparable to VEBNE infants served as additional control groups. We identified 19 children with VEBNE, 9 with EBNE, 12 with VED and 11 in the TKV control group. VEBNE patients suffered more frequently from severe neurological complications in comparison to all control patients. Very early bilateral nephrectomies and documentation of severe hypotensive episodes were independent risk factors for severe neurological complications. Bilateral nephrectomies within the first 3 months of life are associated with a risk of severe neurological complications later in life. Our data support a very cautious indication of very early bilateral nephrectomies in ARPKD, especially in patients with residual kidney function, and emphasize the importance of avoiding severe hypotensive episodes in this at-risk cohort. © 2020, The Author(s)