Multifocal atherosclerosis: focus on the prevention of ischemic events

In patients with atherosclerotic lesions of two or more systems or multifocal atherosclerosis (MFA), the risks of ischemic events are extremely high. MFA leads not only to cardiovascular outcomes, but also to a decrease in the patient’s quality of life, life expectancy, and in most cases to disability. The prevalence of this pathology and the importance of preventing adverse outcomes are often underestimated. This literature review examines the problem of MFA in the context of key studies on the prevalence, course of multivessel disease and the reduction of the risk of cardiovascular events in this group of patients, with an emphasis on antiplatelet and anticoagulant therapy

Diagnostic value of capillary electrophoresis of blood serum proteins and urine in patients with multiple myeloma

The authors state that capillary electrophoresis of blood and urine proteins is one of the defining method in revealing and confirmation of the presence of paraprotein at multiple myeloma. Simplicity and availability of this method as well as the advantages which it provides at the performing of measurements allow to hope for dynamic development of methodic supplying and the nearest including of capillary electrophoresis in mandatory list of biochemical methods of analysis, the mostfrequently used by clinical physicians in everyday laboratory practice

Bactericide, Immunomodulating, and Wound Healing Properties of Transgenic Kalanchoe pinnata Synergize with Antimicrobial Peptide Cecropin P1 In Vivo

Procedure of manufacturing K. pinnata water extracts containing cecropin P1 (CecP1) from the formerly described transgenic plants is established. It included incubation of leaves at +4°C for 7 days, mechanical homogenization of leaves using water as extraction solvent, and heating at +70°C for inactivating plant enzymes. Yield of CecP1 (after heating and sterilizing filtration) was 0.3% of total protein in the extract. The water extract of K. pinnata + CecP1 exhibits favorable effect on healing of wounds infected with S. aureus (equal to Cefazolin) and with a combination of S. aureus with P. aeruginosa (better than Cefazolin). Wild-type K. pinnata extract exhibited evident microbicide activity against S. aureus with P. aeruginosa but it was substantially strengthened in K. pinnata + CecP1 extract. K. pinnata extracts (both wild-type and transgenic) did not exhibit general toxicity and accelerated wound recovery. Due to immunomodulating activity, wild-type K. pinnata extract accelerated granulation of the wound bed and marginal epithelialization even better than K. pinnata + CecP1 extract. Immunomodulating and microbicide activity of K. pinnata synergizes with microbicide activity of CecP1 accelerating elimination of bacteria

Challenges in measuring nitrogen isotope signatures in inorganic nitrogen forms: An interlaboratory comparison of three common measurement approaches

Rationale Stable isotope approaches are increasingly applied to better understand the cycling of inorganic nitrogen (Ni) forms, key limiting nutrients in terrestrial and aquatic ecosystems. A systematic comparison of the accuracy and precision of the most commonly used methods to analyze δ15N in NO3− and NH4+ and interlaboratory comparison tests to evaluate the comparability of isotope results between laboratories are, however, still lacking. Methods Here, we conducted an interlaboratory comparison involving 10 European laboratories to compare different methods and laboratory performance to measure δ15N in NO3− and NH4+. The approaches tested were (a) microdiffusion (MD), (b) chemical conversion (CM), which transforms Ni to either N2O (CM-N2O) or N2 (CM-N2), and (c) the denitrifier (DN) methods. Results The study showed that standards in their single forms were reasonably replicated by the different methods and laboratories, with laboratories applying CM-N2O performing superior for both NO3− and NH4+, followed by DN. Laboratories using MD significantly underestimated the “true” values due to incomplete recovery and also those using CM-N2 showed issues with isotope fractionation. Most methods and laboratories underestimated the at%15N of Ni of labeled standards in their single forms, but relative errors were within maximal 6% deviation from the real value and therefore acceptable. The results showed further that MD is strongly biased by nonspecificity. The results of the environmental samples were generally highly variable, with standard deviations (SD) of up to ± 8.4‰ for NO3− and ± 32.9‰ for NH4+; SDs within laboratories were found to be considerably lower (on average 3.1‰). The variability could not be connected to any single factor but next to errors due to blank contamination, isotope normalization, and fractionation, and also matrix effects and analytical errors have to be considered

СРАВНИТЕЛЬНЫЙ АНАЛИЗ ДАННЫХ ДВУХЭНЕРГЕТИЧЕСКОГО КОМПЬЮТЕРНОГО ТОМОГРАФА И РЕЗУЛЬТАТОВ МИНЕРАЛОГИЧЕСКОГО ИССЛЕДОВАНИЯ МОЧЕВЫХ КАМНЕЙ ПРИ УРОЛИТИАЗЕ

Introduction. The idea of using dual-energy computed tomography (DECT) originated in the early development of computed tomography (CT). However, only recently, advances in radiation diagnosis have made it possible to use dual-energy CT for routine clinical use. We describes the characteristic features of dual-energy CT scanners, as well as the results of a study of 245 patients with urolithiasis, the identification of urinary stones in vivo and the subsequent comparative characteristics with mineralogical studies of uroliths. Purpose. Evaluate the possibility of using DECT in the diagnosis of urolithiasis with the determination of the chemical composition of urinary stones in vivo. Materials and methods. A group of patients (n=245) aged 18 to 84 years was examined. All patients with the established diagnosis-urolithiasis-were treated with DECT (Somatom Definition, Siemens, Forchheim, Germany) with data processing, then in-vitro infrared spectrometry (IR-Alpha-P spectrometer) to determine the true composition of the calcu lus. Results. After conducting the DECT and then ROC analysis and comparing the results with the IR-spectrometry data, it was established that stones with an average density of less than 500 HU according to DECT can be attributed to urate, with a uric acid content of more than 50% with a sensitivity of 91,1% (34 stones of 35) and specificity of 100% — the content of uric acid is also determined in polymineral calculi with a content of less than 50%. The knowledge gained on the composition and structure of the stone in vivo can subsequently be used in pathogenetic treatment and prevention of complications in patients with urolithiasis, and influence the choice of the tactics of removing the uroliths. Conclusions. The obtained results give the right to apply DECT in the diagnosis of urolithiasis, and with high sensitivity to identify urate stones in vivo, thereby influencing the choice of the tactics of removal of uroliths and pathogenetic treatment, as well as the prevention of complications in patients with urolithiasis.Идея применения двухэнергетической компьютерной томографии (ДЭКТ) возникла в раннем развитии компьютерной томографии (КТ). Однако только в последнее время достижения в лучевой диагностике сделали возможным использование ДЭКТ для повседневного клинического применения. В статье описываются характерные особенности двухэнергетических КТ-сканеров, а также результаты обследования 245 пациентов с мочекаменной болезнью, идентификация мочевых камней in vivo и последующая сравнительная характеристика с минералогическим исследованием уролитов. Цель работы: оценить возможность применения ДЭКТ в диагностике мочекаменной болезни с  определением химического состава мочевых камней in vivo. Обследована группа пациентов (n=245) в  возрасте от  18 до  84 лет. Всем пациентам с  установленным диагнозом мочекаменной болезни выполнялась ДЭКТ (Somatom Definition, Siemens, Forchheim, Germany) с обработкой данных, затем производилась in vitro ИК-спектрометрия (спектрометр ИК-Фурье Alpha-P) для установления истинного состава конкремента. После проведения ДЭКТ, а затем ROC-анализа и сопоставлении результатов с данными ИК-спектрометрии установлено, что конкременты средней плотностью менее 500 HU по данным ДЭКТ могут быть отнесены к уратам, при содержании мочевой кислоты более 50% с чувствительностью 91,1% (34 конкремента из 35) и специфичностью 100% — содержание мочевой кислоты определено также и в полиминеральных конкрементах при содержании ее менее 50%. Полученные знания о составе и структуре камня in vivo в последующем могут быть использованы в  патогенетическом лечении и  профилактики осложнений у  пациентов с МКБ, а также влиять на выбор тактики удаления уролитов. Полученные результаты дают право применять ДЭКТ в диагностике мочекаменной болезни, а также с высокой чувствительностью идентифицировать уратные камни in vivo, тем самым влиять на выбор тактики удаления уролитов и патогенетического лечения, а также профилактики осложнений у больных уролитиазом

НЕЙРОПСИХОЛОГИЧЕСКИЙ СТАТУС ПАЦИЕНТОВ СО СТАБИЛЬНОЙ ИШЕМИЧЕСКОЙ БОЛЕЗНЬЮ СЕРДЦА И ФАКТОРЫ, НА НЕГО ВЛИЯЮЩИЕ

The purpose. To assess neuropsychological status of patients with stable coronary artery disease (CAD) and to determine the factors affecting it.Material and methods. 272 male patients aged 45-69 years were included in the study. Neuropsychological status of patients with coronary artery disease was assessed and presented as an integrated index.Results. The integrated index of neuropsychological status was reported to be 2 times less than those in healthy subjects matched for age (0.47 [0.35; 0.59] vs. 0.8 [0.72; 0.87, (p <0.0001)). The most significant factors affecting neuropsychological status of patients with coronary artery disease were as follows: age (p = 0.00271), number of years of education (p = 0.033), left ventricular ejection fraction (LVEF) (p = 0.018), as well as plasma triglyceride levels (TG) (p = 0.003). Conclusion. The integrated approach to the assessment of neuropsychological status in patients with CAD allows not only presenting it as a single index, but also determining the extent to which the index deviate from neuropsychological status of healthy subjects. The factors affecting neuropsychological status in patients with coronary artery disease were as follows: age, number of years of education, LVEF and plasma triglyceride levels.Цель. Оценить состояние нейропсихологического статуса пациентов со стабильной ишемической болезнью сердца (ИБС) и определить факторы, на него влияющие.Материал и методы. Обследовано 272 мужчины в возрасте 45-69 лет. Нейропсихологический статус пациента с ИБС комплексным способом был представлен в виде его интегрального показателя.Результаты. Выявлено, что интегральный показатель нейропсихологического статуса почти в 2 раза ниже данного показателя здоровых лиц того же возраста (0,47 [0,35; 0,59] и 0,8 [0,72; 0,87, (p<0,0001)). Установлено, что наиболее значимыми факторами, влияющими на нейропсихологический статус пациента с ИБС, являются возраст (p=0,00271), количество лет обучения (p=0,033), фракции выброса левого желудочка (p=0,018), а также концентрация в плазме триглицеридов (ТГ) (p=0,003).Выводы. Комплексный способ оценки нейропсихологического статуса у пациентов с ИБС позволяет оценить и представить его в виде единого показателя, а также определить степень его отклонения от статуса здоровых лиц. Факторами, негативно влияющими на состояние нейропсихологического статуса у пациентов с ИБС, являются возраст, количество лет образования, ФВ ЛЖ и концентрация в плазме крови ТГ

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

ANALYSIS OF A NEW DIAFILTRATION METHOD OF CLEANING BUTTERMILK FROM LACTOSE WITH MINERAL COMPOSITION PRESERVED

Removing lactose from buttermilk and other dairy products is a topical problem, as there is a significant increase in morbidity rates due to lactose intolerance. In many cases, milk and dairy products containing lactose can not be completely excluded from the diet. These products have a number of valuable components. There are several ways to remove lactose from milk or other dairy products. They are based on separation methods of processing and on the use of enzymes. Among the separation methods, membrane treatment, including diafiltration, is of particular importance. A technique of engineering calculation of cleaning an ultrafiltration buttermilk concentrate is suggested. As a solvent that reduces the concentration of lactose, a nanofiltrate permeate of buttermilk ultrafiltration is used. This method allows preserving the chemical composition of the concentrate with lactose effectively removed. Basing on the experimental data of membrane productivity and their selectivity for lactose, the main characteristics of diafiltration are calculated for various practical applications. For practical purposes, it is advisable to use a buttermilk permeate nanofiltrate using highly selective lactose membranes. Selectivity for salts should be minimal. When comparing the different diafiltration variants, the most suitable is a periodic method, with continuous dilution, and a continuous method with a crossflow and reverse flow of the nanofiltrate. The smallest аmount of a nanofiltrate is observed in the case of a continuous countercurrent. The time for diafiltration treatment depends on the membrane’s specific parameters, process operating parameters, and the selected lactose purification variant. The most cost-effective is the continuous variant with a countercurrent nanofiltrate. However, it can not be recommended because of the considerable duration of the process. The suggested technique for calculating diafiltration allows quick evaluation of possible options of purifying the product from lactose, and concludes which one is optimal.</p

Processing of Dairy Raw Materials in Healthy Food Products

The object of research is whey-based beverages. The most problematic areas are the limited shelf life of beverages and the risk of product stratification during storage.In the course of the study, whey pasteurization regimes are used: 84±2 °C, waiting time 15–20 s, so the shelf life of beverages is limited, since sterilization of whey beverages is impossible due to loss of biologically active substances. To prevent delamination of the beverages during the storage of the formulation, pectin is added and an additional operation – homogenization is introduced.Whey beverages with functional properties for individuals controlling body weight are obtained with improvement of organoleptic characteristics of the product. The resulting beverage is suitable, as a result of the introduction of plant components, to improve the metabolism in the body, block the synthesis of fat in adipose tissue, reduce the absorption of carbohydrates and fats in the digestive tract and remove excess fluid, accelerate the cleavage of fat molecules and transform fat into free energy. This is confirmed by the activation of pancreatic lipase. The activity of pancreatic lipase increases in 3.8...4.0 times in comparison with the control (whey).Components of the whey, as the basis of beverages, have low energy value and high biological value. L-carnitine, α-lipoic acid, stevia, gingerol and bromelain stimulate the breakdown of fats. Cinnamon increases metabolism in the body. This helps to accelerate the breakdown of fat.To increase the nutritional value and biological activity to the beverages, the introduction of fruit and berry juices (lemon, cranberry, orange, pumpkin, yostaberry juice). Biologically active substances of juices show antisclerotic, antistress, tonic, immunostimulating, antioxidant effect. Antisclerotic action of juices is associated with the antioxidant properties of vitamins C, E, β-carotene. Juices reduce the oxidation degree of the most dangerous fraction of lipoproteins, thereby slowing the growth process of atherosclerotic plaques in the vessels. Antistress, tonic, immunostimulating and antioxidant effects of juices are due to the content of polysaccharides, sulfur-containing proteins, minerals, vitamins A, E, C, group B, bioflavonoids.Whey beverages for people who control body weight are not toxic, their frequent consumption does not lead to addiction. Beverages do not contain substances prohibited by the Ministry of Health of Ukraine. Shelf life of beverages is 14 days. Beverages can be made on traditional equipment using traditional technology

Outcomes of in vitro fertilization as a multifactorial clinical problem or reproductive medicine

The study was conducted during the years 2013--2014 by the assisted reproductive technology (ART) department of the Moscow Regional Perinatal Center in Balashikha. We analyzed 384 IVF and ET cases using clinical and embryological criteria. It was found that the outcome of induced pregnancy is associated with such factors as patient age, body mass index, polycystic ovary syndrome, hyperandrogenism, congenital thrombophilia, endometrial pathology, miscarriage history, total dose of HT per COS cycle, number of best quality embryos in ovarian cohort, level of serum hCG on day 14 after embryo transfer. "Best quality embryo in ovarian cohort" factor is of great interest due to high reliability and few studies in this area. Quality distribution of embryos does not occur randomly or as part of an isolated in vitro process; it follows a certain pattern that directly affects the outcome of pregnancy