ИТОГИ РЕАЛИЗАЦИИ МЕРОПРИЯТИЙ, НАПРАВЛЕННЫХ НА СОВЕРШЕНСТВОВАНИЕ ОКАЗАНИЯ МЕДИЦИНСКОЙ ПОМОЩИ БОЛЬНЫМ С СОСУДИСТЫМИ ЗАБОЛЕВАНИЯМИ НА ТЕРРИТОРИИ ТОМСКОЙ ОБЛАСТИ В 2012 г.

Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department), decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients.Острые нарушения мозгового кровообращения (ОНМК) остаются актуальной медицинской и социальной проблемой с высокими показателями смертности и инвалидизации населения. С 2011 Томская область вошла в число участников мероприятий, направленных на совершенствование оказания медицинской помощи больным с сосудистыми заболеваниями. Анализ предварительных результатов реализации данных мероприятий за 2012 показал улучшение большинства показателей, характеризующих состояние медицинской помощи больным с ОНМК: повысился процент пациентов, госпитализированных в специализированные отделения (региональный сосудистый центр и первичные сосудистые отделения), снизилась летальность от инсультов, особенно от геморрагических типов. Строгое выполнение утвержденных порядков помощи больным с ОНМК и использование современных методик лечения инсульта в сосудистых отделениях позволило снизить госпитальную летальность в первичных сосудистых отделениях и раннюю летальность в региональном сосудистом центре. Активное применение нейрореабилитационных мероприятий привело к повышению доли пациентов, не зависимых от окружающих при выписке. Анализ показателей работы отделений позволил обозначить существующие проблемы и перспективы дальнейшего развития специализированной медицинской помощи данной категории больных.

Polymorphism of viral dsRNA in Xanthophyllomyces dendrorhous strains isolated from different geographic areas

<p>Abstract</p> <p>Background</p> <p>Strains of the astaxanthin producing yeast <it>Xanthophyllomyces dendrorhous </it>have been isolated from different cold regions around the earth, and the presence of double stranded RNA (dsRNA) elements was described in some isolates. This kind of viruses is widely distributed among yeasts and filamentous fungi and, although generally are cryptic in function, their studies have been a key factor in the knowledge of important fungi. In this work, the characterization and genetic relationships among dsRNA elements were determined in strains representatives of almost all regions of the earth where <it>X. dendrorhous </it>have been isolated.</p> <p>Results</p> <p>Almost all strains of <it>X. dendrorhous </it>analyzed carry one, two or four dsRNA elements, of molecular sizes in the range from 0.8 to 5.0 kb. Different dsRNA-patterns were observed in strains with different geographic origin, being L1 (5.0 kb) the common dsRNA element. By hybridization assays a high genomic polymorphism was observed among L1 dsRNAs of different <it>X. dendrorhous </it>strains. Contrary, hybridization was observed between L1 and L2 dsRNAs of strains from same or different regions, while the dsRNA elements of minor sizes (M, S1, and S2) present in several strains did not show hybridization with neither L1 or L2 dsRNAs. Along the growth curve of UCD 67-385 (harboring four dsRNAs) an increase of L2 relative to L1 dsRNA was observed, whiles the S1/L1 ratio remains constant, as well as the M/L1 ratio of Patagonian strain. Strains cured of S2 dsRNA were obtained by treatment with anisomycin, and comparison of its dsRNA contents with uncured strain, revealed an increase of L1 dsRNA while the L2 and S1 dsRNA remain unaltered.</p> <p>Conclusion</p> <p>The dsRNA elements of <it>X. dendrorhous </it>are highly variable in size and sequence, and the dsRNA pattern is specific to the geographic region of isolation. Each L1 and L2 dsRNA are viral elements able to self replicate and to coexist into a cell, and L1 and S2 dsRNAs elements could be part of a helper/satellite virus system in <it>X. dendrorhous</it>.</p

Nodular mastocytosis: a case study

A case study of nodular mastocytosis is described. Tacrolimus was used to treat skin manifestations of mastocytosis

ACTIVITIES RESULTS AIMED AT IMPROVED MEDICAL ASSISTANCE TO THE VASCULAR PATIENTS IN TOMSK REGION

Acute disorders of cerebral circulation remain serious medical and social problem associated with high disability and mortality rates. Since 2011 Tomsk oblast is a participating member of the medical campaign aimed at improved medical services to the vascular patients. The preliminary implementation data analysis for 2012 revealed improvement of most of the indices of medical support to patients suffering from acute cerebral circulation; increased number of the in-patient cases (Regional Vascular Center and primary vascular department), decreased lethality rates from strokes, specifically hemorrhagic cases. Strict observance of the Regulations on Medical Assistance for stroke patients and the using of modern methods of therapy allowed to decrease hospital mortality in the Primary Vascular Departments and early mortality in the Regional Vascular Center. The active implementation of neurorehabilitation approaches resulted in the increased number of patients who do not require third parties’ assistance. Analysis of the work of the departments helped to identifying current problems and perspectives of further development of special medical care for stroke patients

A SHORT COURSE OF TRIPLE TELAPREVIR-BASED ANTIVIRAL THERAPY: THE PRINCIPLES OF PATIENTS SELECTION

Background: The beginning of a new era of direct acting antivirals sets up its own rules, that is, to achieve the highest efficacy with the shortest duration of treatment. It is assumed that the use of the first generation of direct acting antivirals, similarly to interferon-free regimens, would allow for personalization of approaches to their prescriptions.Aim: To identify the most important parameters that can predict the greatest efficacy of triple antiviral therapy of 12 week duration in patients with chronic hepatitis C genotype 1.Materials and methods: The study included 204 patients with chronic hepatitis C virus (HCV) genotype 1 at an early stage of liver disease (METAVIR score F0-F2), who were either treatment-naive or had a history of relapse after standard of care antiviral therapy. In addition to routine work-up, all patients were screened for IL28B polymorphism; in the course of the treatment viral kinetics was assessed by an ultrasensitive polymerase chain reaction (PCR) (with lower limit of quantification of 12 IU/ml). Duration of the triple therapy (pegylated interferon-α2a, ribavirin and telaprevir) was reduced to 12 weeks if a rapid virological response was achieved; otherwise the patients continued their treatment in according with guidelines. Results: A complete rapid virological response was achieved in 174 patients (81.6%), in whom the duration of triple therapy was 12 weeks. According to the protocol, 25 patients with a partial rapid virological response continued their standard antiviral therapy for 12 weeks more. In those who achieved a rapid virological response, there was an association between IL28B-CC genotype at rs12979860 and maintenance of zero viremia at 12 weeks after termination of antiviral therapy (r = 0.38, p &lt; 0.001). In all such patients there was a stable virological response at 12 weeks of the follow-up. Monitoring of viral load after 14 days of antiviral treatment was not predictive of its success. The preliminary results of a shortened (12 week) course of triple telaprevir-based viral therapy allowed to identify the most significant parameters of 100% efficacy, i.e., absence of the virus in blood at 12 weeks after termination of antiviral therapy. Conclusion: A 12 week course of triple telaprevir-based combination therapy is an optimal regimen for achievement of a stable virological response after 12 weeks of the follow-up in treatment-naïve patients with HCV genotype 1 or with a relapse after previous conventional antiviral treatment, who have IL28B – CC polymorphism, are at an early stage of liver disease and who achieve a rapid complete virological response confirmed by a highly sensitive PCR