51 research outputs found

    Comparison of efficacy of laser and radio-wave methods of surgical treatment of patients with chronic rhinitis

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    Introduction. Chronic rhinitis occurs more often in patients; it’s symptoms deteriorate their quality of life, affect sleeping, daily activity, and sometimes cause complications. The treatment depends on the clinical symptoms. In case of inefficiency of conservative therapy, surgery is indicated. Choosing an exact surgical instrument is still controversial.Objective. The aim of our study is to compare using semiconductor laser (wavelength 1.56 mkm) and radiofrequency (4 MHz) in patients with chronic rhinitis.Materials and methods. 60 patients with chronic drug-induced rhinitis aged 19–80 years were recruited and divided into two equal groups. All patients underwent surgical procedures: semiconductor laser (IRE-Polus) and radiofrequency (Ellman Surgitron) inferior nasal turbinate reduction. To assess and compare the healing process in two groups we used endoscopy and active anterior rhinomanometry. All patients filled out the SNOT-20 questionnaire. For the mucociliary clearance evaluation saccharin test was used. We observed patients during 12 months.Conclusion. Both, laser and radiofrequency, techniques are effective in patients with chronic rhinitis. In laser group shorter healing period was observed, what leads to rehabilitation shortening and life quality improvement

    Isolation and whole genome sequencing of a lipophilic anaerobic bacterium, a representative of the species complex <i>Corynebacterium tuberculostearicum</i>, from a tuberculosis focus

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    Background. The study of the lower respiratory tract microbiome has been actively developed inrecent years with the help of whole genome sequencing (WGS) methods. Due to this, it became clear that the nature of the lungs microbiota is very different from other microbial communities inhabiting the human body. One of the important directions in the study of pathological lungs biocenosis is the study of the role of the satellite microbiota of the tuberculosis focus. The aim of the work. To isolate and characterize oxygen-tolerant anaerobes from the necrotic contents of tuberculomas. Materials and methods. Biopsy material from 5 patients with pulmonary tuberculosis was obtained during a planned surgical treatment of tuberculoma. A pure culture was isolated from one sample during anaerobic cultivation. Lipase activity of strain was determined by plating on brain heart infusion agar (HIMEDIA, India) supplemented with 0.1 % Tween-80 and 10 mM of CaCl2. Antibiotic susceptibility was determined by RAPMYCO and SLOWMYCO of TREK Diagnostic Systems (Thermo Fisher Scientific, USA). DNA from the sediment of the broth culture was isolated by the CTAB chloroform method. Whole genome sequencing was performed on a DNBSeq-G400 NGS sequencer by Genomed (Russia). Results. Based on WGS results and phylogenetic analysis, the strain was identified as Corynebacterium kefirresidentii. The strain was characterized by high lipase activity and resistance only to Isoniazid, Ethionamide and Trimethoprim/Sulfamethoxazolin. Conclusion. The isolation of a lipophilic anaerobic representative of the Corynebacterium tuberculostearicum species complex from a tuberculous focus indicates a  possible role of the non-tuberculous microbiota in the liquefaction of caseous necrosis. We assumed that in some cases, favorable conditions are created inside the tuberculous focus for the development of satellite anaerobic lipophilic microbiota

    АНТИКОАГУЛЯНТНОЕ СОПРОВОЖДЕНИЕ ЧРЕСКОЖНЫХ КОРОНАРНЫХ ВМЕШАТЕЛЬСТВ С ИСПОЛЬЗОВАНИЕМ БИВАЛИРУДИНА ИЛИ НЕФРАКЦИОНИРОВАННОГО ГЕПАРИНА ПРИ РАЗЛИЧНЫХ СОСУДИСТЫХ ДОСТУПАХ

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    Purpose. Nowadays it is proved that the use of bivalirudin instead of unfractionated heparin (UFH) during primary percutaneous coronary intervention (PCI) allows to reduce the number of bleeding complications. But at the same time there is no conclusive data on the clinical advantage of the use of bivalirudin over UFH during planned PCI. The purpose of the work was a comparison of shortterm and longterm results of PCI in subjects with stable coronary artery disease (CAD) associated with the infusion of bivalirudin and heparin, depending on the type of vascular access (transradial and transfemoral).Materials and methods. The study included 127 stable CAD subjects who underwent a planned PCI. By the method of simple randomization the subjects were divided into two groups: «Bivalirudin + transfemoral access» group (n=65) – bivalirudin was used as an anticoagulant during the intervention by femoral access and «Heparin + transradial access» group (n=62). The groups were comparable on major clinical and demographic indicators and risk factors for bleeding complications (14±7 vs. 13±6 scores on «Mehran Score», p=0,451). Endpoints were death, myocardial infarction (MI), repeated myocardial revascularization (RMR), episodes of bleeding during hospitalization and the total number of adverse cardiovascular events during hospitalization and in 1 year after randomization.Results. After 30 days of observation, the group «bivalirudin» (transfemoral access, n=65) and the group «UFH» (transradial access, n=62) did not differ in the number of fatal outcomes (no cases in both groups), the frequency of RMR (1,5% vs 1,6%, correspondingly, p=0,998), MI (3,1% vs. 1,6%, correspondingly, p=0,899), bleeding episodes during the hospital stay (4,6%, vs. 3,2%, correspondingly, p=0,899). The total number of cardiovascular complications was 4,6% and 3,2%, correspondingly, p=0,675. The results of one year follow-up in both groups also did not differ in the number of fatal outcomes (0% vs. 1,6%, correspondingly, p=0,946), MI (7,7% vs. 6,5%, correspondingly, p=0,656), RMR (7,7% vs. 4,8%, correspondingly, p=0,785), MACE (15,3% vs. 11,3%, correspondingly, p=0,677).Conclusion. Short-term and long-term results of planned PCI performed by transradial access with UFH anticoagulant support and PCI performed by transfemoral access ) associated with administration of bivalirudin are comparable both in the number of postoperative bleeding complications and in the number of adverse cardiovascular events.Цель. В настоящее время доказано, что использование бивалирудина вместо нефракционированного гепарина (НФГ) во время первичного чрескожного коронарного вмешательства (ЧКВ) позволяет уменьшить количество геморрагических осложнений. Но в то же время нет убедительных данных о клиническом преимуществе использования бивалирудина над НФГ во время планового ЧКВ. Целью работы являлось сопоставление ближайших и отдаленных результатов ЧКВ у больных со стабильным течением ишемической болезни сердца (ИБС) на фоне инфузии бивалирудина и гепарина в зависимости от вида сосудистого доступа (трансрадиальный и трансфеморальный).Материалы и методы . В исследование включено 127 больных со стабильной ИБС, которым было проведено плановое ЧКВ. Методом простой рандомизации пациенты были разделены на две группы: «Бивалирудин + трансфеморальный доступ» (n=65) – в качестве антикоагулянта во время проведения вмешательства трансфеморальным доступом использовался бивалирудин, и «Гепарин + трансрадиальный доступ» (n=62). Группы были сопоставимы по основным клинико-демографическим показателям и факторам риска геморрагических осложнений (14±7 против 13±6 баллов по «Mehran Score», р=0,451). Конечными точками являлись смерть, инфаркт миокарда (ИМ), повторная реваскуляризации миокарда (ПРМ), эпизоды кровотечений во время госпитализации и общее количество неблагоприятных сердечно-сосудистых событий в течение госпитализации и через год после рандомизации. Результаты. Через 30 дней наблюдения группа бивалирудина (трансфеморальный доступ, n=65) и группа НФГ (трансрадиальный доступ, n=62) не различались по количеству летальных исходов (ни одного случая в обеих группах), частоте ПРМ (1,5 % против 1,6 % соответственно, р=0,998), ИМ (3,1 % против 1,6 %, соответственно р=0,899), эпизодов кровотечений за время пребывания в стационаре (4,6 % против 3,2 % соответственно, р=0,899). Общее количество сердечно-сосудистых осложнений составило 4,6 и 3,2 % соответственно, р=0,675. Результаты одного года наблюдения в обеих группах также не различались по количеству летальных исходов (0 % против 1,6 % соответственно, р=0,946), ИМ (7,7 % против 6,5 % соответственно, р=0,656), ПРМ (7,7 % против 4,8 % соответственно, р=0,785), МАСЕ (15,3 % против 11,3 % соответственно, р=0,677).Выводы. Ближайшие и отдаленные результаты планового ЧКВ, выполненного трансрадиальным доступом на фоне антикоагулянтного сопровождения НФГ и ЧКВ, выполненного трансфеморальным доступом на фоне введения бивалирудина, сопоставимы как по количеству послеоперационных геморрагических осложнений, так и по числу неблагоприятных сердечно-сосудистых событий

    Viral Load in COVID-19: Underestimated Clinical and Epidemiological Marker

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    Background. The viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the new coronavirus infection, is becoming increasingly important in clinical and epidemiological contexts. Despite this, there are significant complexities in the implementation of viral load quantitative measurement into clinical practice due to the limited approaches to its assessment.The aim of this work was to develop an approach for SARS-CoV-2 viral load analysis by the value of sample threshold cycles (Ct) relative to the Ct of the internal control sample obtained in routine PCR diagnostics of the COVID-19, and to use this approach for quantitative monitoring of viral load in patients with first positive SARS-CoV-2 test from the Irkutsk region.Materials and methods. Using regression models based on the least squares method, an approach to determine the number of copies of SARS-CoV-2 RNA in 1 ml of nasopharyngeal secretion was developed. The viral load of SARS-CoV-2 was assessed in nasopharyngeal and pharyngeal samples obtained from 1370 patients from Irkutsk and Angarsk with primary diagnosed positive PCR result in the period from July 1 to November 10, 2020.Results. A tenfold increase in the average monthly viral load among patients in September-October 2020 was revealed. We assume that the change in the epidemiological pattern of the spread of the new coronavirus infection during this period is associated with an increase in the number of contacts in the population due to the school year beginning. Higher viral loads are observed in populations at risk for COVID-19 – among healthcare workers and adults/elderly patients. Conclusion. The development of a standardized quantification of SARS-CoV-2 viral load in the nasopharyngeal samples can be a predictive clinical marker and a reliable tool for improving COVID-19 surveillance using the proposed approach to assess average viral load in a local population
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