Complications after BCG vaccination in a big city

Complications after specific prevention of tuberculosis for the last 10 years have been analyzed using the example of a big city. The frequency of severe complications (BCG-ostitis) made 0.004% and the frequency of minor complications (lymphadenitis) made 0.005% and cold abscesses made 0.01% per 100 000 vaccinated children. Often complications were caused by mistakes in the vaccine administration related to premature discharge from maternity hospital and administration of the vaccine in the polyclinic and also concurrent prenatal disorder. The issue of complications caused by anti-tuberculosis vaccination makes no grounds to review the policy of the primary BCG vaccination

Совмещенный процесс синтеза циклогексилциклогексанкарбоксилата из циклогексанола и CO, катализируемый системой Pd(OAc)2–PPh3–п-толуолсульфокислота

Objectives. To study the possibility of combining acid-catalytic cyclohexanol dehydration and alkoxycarbonylation of the formed cyclohexene with cyclohexanol and carbon(II) oxide in a single reactor in order to achieve high yields of the target cyclohexyl cyclohexanecarboxylate product under mild conditions using the Pd(OAc)2–PPh3–p-toluenesulfonic acid catalytic system.Methods. The combined process took place in a toluene medium in a periodic steel reactor designed to operate at elevated pressure, equipped with a glass insert, a magnetic stirrer, and a sampler, as well as gas input and discharge devices. The reaction mass with the components of the catalytic system was placed in a glass reactor inside a steel autoclave. The reaction mass samples obtained during the combined process were analyzed by gas–liquid chromatography with a flame ionization detector.Results. The possibility of combining cyclohexanol dehydration catalyzed by p-toluenesulfonic acid monohydrate and formed cyclohexene alkoxycarbonylation with cyclohexanol and CO during catalysis by the Pd(OAc)2–PPh3–p-toluenesulfonic acid system in a single reactor was demonstrated. Under mild conditions (temperature 110°C; CO pressure 2.1 MPa), the target product yield reached 64.8% in 5 h. However, the combined process is complicated by the formation of a cyclohexanecarboxylic acid by-product formed as a result of the cyclohexyl cyclohexanecarboxylate hydrolysis and the cyclohexene hydroxycarbonylation.Conclusions. The reactions of intramolecular acid-catalytic cyclohexanol dehydration and formed cyclohexene alkoxycarbonylation catalyzed by the Pd(OAc)2–PPh3–p-toluenesulfonic acid system can be combined in a single reactor. p-Toluenesulfonic acid can simultaneously act as a catalyst for the cyclohexanol dehydration and a co-catalyst of the palladium–phosphine system of cyclohexene alkoxycarbonylation. The involvement of cyclohexene, representing a product of reversible cyclohexanol dehydration, in the alkoxycarbonylation reaction is a factor in shifting the dehydration reaction equilibrium towards the formation of cyclohexene. Cyclohexanecarboxylic acid is a by-product of the proposed combined process. A factor in the reduction of target product yield is water formed as a result of cyclohexanol dehydration due to the involvement of the latter in the hydrolysis reaction and the course of the cyclohexene hydroxycarbonylation.Цели. Изучение возможности совмещения в одном реакторе реакций кислотнокаталитической дегидратации циклогексанола и алкоксикарбонилирования образующегося циклогексена циклогексанолом и оксидом углерода (II). Установление возможности достижения высоких выходов целевого продукта – циклогексилциклогексанкарбоксилата – в мягких условиях при катализе системой Pd(OAc)2–PPh3–п-толуолсульфокислота.Методы. Совмещенный процесс изучался в среде толуола в периодическом стальном реакторе, рассчитанном на работу при повышенном давлении, снабженном стеклянной вставкой, магнитной мешалкой, пробоотборником, устройствами ввода и сброса газов. Реакционная масса с компонентами каталитической системы помещалась в стеклянный реактор внутри стального автоклава. Отбираемые в ходе совмещенного процесса пробы реакционной массы анализировали методом газо-жидкостной хроматографии с пламенно-ионизационным детектором.Результаты. Показана возможность совмещения в одном реакторе дегидратации циклогексанола, катализируемой моногидратом п-толуолсульфокислоты, и алкоксикарбонилирования образующегося циклогексена циклогексанолом и СО при катализе системой Pd(OAc)2–PPh3–п-толуолсульфокислота. В мягких условиях (температура 110 °С, давление СО 2.1 МПа) выход целевого продукта достигал 64.8% за 5 ч. Установлено, что совмещенный процесс осложняется образованием побочного продукта – циклогексанкарбоновой кислоты – в результате гидролиза циклогексилового эфира циклогексанкарбоновой кислоты и гидроксикарбонилирования циклогексена

Prognostic value of molecules of average mass in patients with chronic obstructive pulmonary disease

Background. Chronic obstructive pulmonary disease is a socially significant disease affecting patient’s quality of life. Assessment of endogenous intoxication in patients with chronic obstructive pulmonary disease will allow to understand pathogenetic features of different phenotypes of this disease, which can be taken into account when predicting its course.The aim of the study. To determine the prognostic value of levels of mediumand low-molecular-weight substances and oligopeptides in patients with chronic obstructive pulmonary disease.Materials and methods. One hundred and four patients with chronic obstructive pulmonary disease (COPD) and 110 somatically healthy individuals were examined. Molecular weight medium and low molecular weight substances (LMWSM) and oligopeptides (OP) were determined in blood plasma, erythrocytes and urine. Based on these indicators mathematically calculated indices of endogenous intoxication and coefficient of elimination were defined. Statistical processing of the data was performed using the SPSS 26.0 software package (IBM Corp., USA).Results. In all biological fluids, the levels of average molecules and calculated indices in the COPD patients’ group were statistically significantly different from those in the control group. The indices characterizing endotoxin accumulation were statistically significantly higher, while those characterizing toxin elimination were lower. The level of endotoxemia was correlated with the frequency of exacerbations, clinical manifestations severity, quality of life, COPD group and phenotype.Conclusions. Frequent exacerbations, groups C and D, bronchitic and mixed COPD phenotypes are characterized by more severe endotoxicosis manifested by high levels of LMWSM, OP and calculated indices

Clinical speciality of reproductive age women with uterine myoma

In spite of multifactory development reasons of uterine myoma the main method of treatment of reproductive age patients is surgical one. The choise of managment of young women isn't simple, because it's nessesary to make prognosis of growth and character of tumour. Data of reaserch of reproductive age women with uterine myoma are represented in this article. The study group includes 190 patients of the age from 18 to 35 years. The main features are infertility, miscarrige in anamnesis and bad(proliferative) hystological type of myomaНесмотря на мультифакторную природу миомы матки, хирургический метод в комплексном лечении больных репродуктивного возраста является определяющим. Выбор тактики ведения молодых женщин с миомой матки является сложной клинической задачей, решение которой связано с необходимосью прогнозировать темп роста и характер опухоли. Проведено исследование 190 пациенток репродуктивного возраста с миомой матки. Для женщин оптимального ре­продуктивного возраста (от 18 до 35 лет) характерным является наличие бесплодия или невынашивания в анамнезе, отсутствие выраженных симптомов заболевания, пролиферирующий вариант миомы матки

Осложнения после вакцинации БЦЖ/БЦЖ-М в мегаполисе

Complications after specific prevention of tuberculosis for the last 10 years have been analyzed using the example of a big city. The frequency of severe complications (BCG-ostitis) made 0.004% and the frequency of minor complications (lymphadenitis) made 0.005% and cold abscesses made 0.01% per 100 000 vaccinated children. Often complications were caused by mistakes in the vaccine administration related to premature discharge from maternity hospital and administration of the vaccine in the polyclinic and also concurrent prenatal disorder. The issue of complications caused by anti-tuberculosis vaccination makes no grounds to review the policy of the primary BCG vaccination.Цель исследования: изучить структуру, частоту, факторы риска и причины возникновения осложнений на вакцинацию БЦЖ/БЦЖ-М в г. Москве за 2004-2014 гг.Результаты. Частота тяжелых осложнений (БЦЖ-оститы) составила 0,004%, а частота легких осложнений (лимфадениты) - 0,005%; холодных абсцессов - 0,01% на 100 тыс. вакцинированных детей. Причиной возникновения осложнений наиболее часто являлись: нарушение техники введения вакцины, связанное с ранней выпиской из родильного дома и введением вакцины в условиях поликлиники; наличие сопутствующей перинатальной патологии. Проблема осложнений при вакцинопрофилактике туберкулеза не является поводом для пересмотра политики в области пер- вичной вакцинации БЦЖ

Diagnostic significance of lung ultrasound in new coronavirus infection in children

The purpose of the study is to assess the reliability of the ultrasound picture of changes in the lungs and correlation with the clinical manifestations of a new coronavirus infection in children.Цель исследования - оценка достоверности ультразвуковой картины изменений в лёгких и корреляция с клиническими проявлениями новой коронавирусной инфекции у детей

IN SITU VASCULAR TISSUE REMODELING USING BIODEGRADABLE TUBULAR SCAFFOLDS WITH INCORPORATED GROWTH FACTORS AND CHEMOATTRACTANT MOLECULES

Background Currently, the search for the bioactive molecules capable of promoting formation of the vascular tissue is still ongoing. We have previously demonstrated that incorporation of the growth factors and chemoattractant molecules into the biodegradable tubular scaffolds can increase their primary patency upon the implantation into rat abdominal aorta. However, further studies are required to investigate tissue remodeling using functionalized vascular grafts with the same diameter as a replaced native vessel. Aim To investigate the specific aspects of de novo vascular tissue formation and calcification employing rat abdominal aorta interposition model and vascular grafts with 1.5 mm diameter with incorporated vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and stromal cell-derived factor (SDF)-1α. Methods Tubular grafts with a diameter of 1.5 mm were blended of poly(3-hydroxybutyrateco-3-hydroxyvalerate) and poly(ε-caprolactone) (PHBV/PCL). Grafts without growth factors were fabricated using standard electrospinning technique whilst grafts with incorporated growth factors were prepared utilizing emulsion electrospinning. VEGF was incorporated into the inner third, whereas bFGF and SDF-1α were incorporated into the outer two-thirds of the graft. Grafts were implanted into the abdominal aortas of Wistar rats for 1, 3, 6, and 12 months following scanning electron microscopy along with histological and immunofluorescent examination. Results Primary patency of the grafts with VEGF, bFGF, and SDF-1α reached 93% indicative of structural integrity of the vascular tissue. Neither signs of inflammation nor severe calcification was detected. Conclusion As in 2 mm diameter vascular grafts, incorporation of bioactive factors into 1.5 mm diameter grafts increased their long-term primary patency and improved vascular tissue formation in comparison with non-modified grafts.  Background Currently, the search for the bioactive molecules capable of promoting formation of the vascular tissue is still ongoing. We have previously demonstrated that incorporation of the growth factors and chemoattractant molecules into the biodegradable tubular scaffolds can increase their primary patency upon the implantation into rat abdominal aorta. However, further studies are required to investigate tissue remodeling using functionalized vascular grafts with the same diameter as a replaced native vessel. Aim To investigate the specific aspects of de novo vascular tissue formation and calcification employing rat abdominal aorta interposition model and vascular grafts with 1.5 mm diameter with incorporated vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and stromal cell-derived factor (SDF)-1α. Methods Tubular grafts with a diameter of 1.5 mm were blended of poly(3-hydroxybutyrateco-3-hydroxyvalerate) and poly(ε-caprolactone) (PHBV/PCL). Grafts without growth factors were fabricated using standard electrospinning technique whilst grafts with incorporated growth factors were prepared utilizing emulsion electrospinning. VEGF was incorporated into the inner third, whereas bFGF and SDF-1α were incorporated into the outer two-thirds of the graft. Grafts were implanted into the abdominal aortas of Wistar rats for 1, 3, 6, and 12 months following scanning electron microscopy along with histological and immunofluorescent examination. Results Primary patency of the grafts with VEGF, bFGF, and SDF-1α reached 93% indicative of structural integrity of the vascular tissue. Neither signs of inflammation nor severe calcification was detected. Conclusion As in 2 mm diameter vascular grafts, incorporation of bioactive factors into 1.5 mm diameter grafts increased their long-term primary patency and improved vascular tissue formation in comparison with non-modified grafts

BIOMECHANICAL REMODELING OF BIODEGRADABLE SMALL-DIAMETER VASCULAR GRAFTS IN SITU

Aim: to evaluate the biomechanical remodeling of polymer grafts modified with vascular endothelial growth factor (VEGF) after implantation into rat abdominal aorta.Materials and methods. Vascular grafts of2 mmdiameter were fabricated by electrospinning from polycaprolactone (PCL) and a mixture of poly (3-hydroxybutyrate-co-3-hydroxyvalerate) and PCL. The grafts were modified with VEGF by biphasic electrospinning. Morphology of the grafts was assessed by scanning electron microscopy. Physico-mechanical properties of PCL and PHBV/PCL grafts were estimated using uniaxial tensile test and physiological circulating system equipped with state-of-theart ultrasound vascular wall tracking system. Physico-mechanical testing of PCL/VEGF and PHBV/PCL/VEGF was performed before and after implantation into rat abdominal aorta for 6 months. The modeling of coronary artery bypass grafting (CABG) was performed by finite element analysis for modified grafts.Results. Durability of PCL and PHBV/PCL grafts did not differ from that of human internal mammary artery; however, elasticity and stiffness of these grafts were higher compared to internal mammary artery. Viscoelastic properties of the grafts were comparable to those of native blood vessels. Modification of the grafts with VEGF reduced material stiffness. Six months postimplantation, PCL/VEGF and PHBV/PCL/VEGF were integrated with aortic tissue that induced changes in the physico-mechanical properties of the grafts similar to the native vessel. Biomechanical modeling confirmed the functioning of modified grafts in bypass position for CABG.Conclusion. PCL/VEGF and PHBV/PCL/VEGF grafts have satisfactory physico-mechanical properties and can be potentially used in the reconstruction of blood vessels

Эффективность скрининга туберкулезной инфекции у детей и подростков в г. Москве в 2019 г. на основе нового алгоритма применения внутрикожной пробы с аллергеном туберкулезным рекомбинантным (ESAT-6/CFP-10)

The objective of the study: to compare two approaches to mass screening for tuberculosis infection in children and adolescents in Moscow.Subjects and methods. Two periods have been assessed. Period 1 (2014), when a pilot screening project was implemented in two stages: Stage 1 -all children and adolescents had Mantoux test with 2 TU PPD-L (1,429,395 people were tested), Stage 2 - a skin test with TRA (tuberculosis recombinant allergen - ESAT protein-6/CFP-10) was used in those with increasing induration as a response to Mantoux test (219,888 people were tested). Period 2 (2019): children from 0 to 7 years old (711,869 children were tested) were screened by the same two-stage scheme, and those 8-17 years old (904,757 people were tested) had the test with TRA only.Results. It has been demonstrated that the test with TRA can be used as a screening tool and effectively identify patients with a high risk of tuberculosis development. At the same time, the rate of detection of tuberculosis patients, persons with post-tuberculosis changes and latent infection is tens times higher among persons with positive reactions to TRA test versus Mantoux test. The preventive therapy received by those positively responding to TRA test resulted in almost no disease in them. Over the past 7 years, the number of people newly diagnosed with tuberculosis, latent tuberculosis infection (LTBI) and post-tuberculosis changes has decreased. Preventive therapy in those with a positive result of TRA test helps to stop the progression of tuberculosis infection and reduce the pool of LTBI among children and adolescents.TRA test versus Mantoux test, allows more effective selection patients with a high risk of developing tuberculosis, thus it is possible to carry out additional examination only of this target group and save resources.Цель исследования: сравнение двух подходов к проведению массового скрининга туберкулезной инфекции у детей и подростков в г. Москве.Материалы и методы. Оценены два периода. I период (2014 г.), когда проводился пилотный проект скрининга по двухэтапной схеме: 1-й этап - всем детям и подросткам выполнялась проба Манту с 2 ТЕ ППД-Л (обследовано 1 429 395 человек), 2-й этап - лицам с нарастанием реакции на пробу Манту проводилась кожная проба с АТР (аллергеном туберкулезным рекомбинантным - белок ESAT-6/CFP-10) (обследовано 219 888 человек). II период (2019 г.): детям от 0 до 7 лет (обследовано 711 869) - та же двухэтапная схема, а лицам 8-17 лет (обследовано 904 757) - только проба с АТР.Результаты. Показано, что проба с АТР при скрининге позволяет эффективно выявлять пациентов с высоким риском развития туберкулеза. При этом показатель выявляемости больных туберкулезом, лиц с посттуберкулезными изменениями и латентной инфекцией в десятки раз выше среди лиц с положительными реакциями на пробу с АТР по сравнению с пробой Манту. Проведение превентивной терапии лицам с положительной реакцией на АТР привело практически к отсутствию заболевания у них. За последние 7 лет снизилась численность лиц, впервые выявленных с туберкулезом, латентной туберкулезной инфекцией (ЛТИ) и c посттуберкулезными изменениями. Проведение превентивной терапии лицам с положительной реакцией на АТР способствует остановке развития туберкулезной инфекции и снижению пула ЛТИ среди детей и подростков.Проба с АТР, по сравнению с пробой Манту, позволяет более эффективно отбирать пациентов с высоким риском развития туберкулеза, что дает возможность проводить дообследование лишь этой целевой группы, экономя ресурсы