Сенсорные фенотипы хронической боли у пациентов, переживших критическое состояние: проспективное наблюдательное исследование

АКТУАЛЬНОСТЬ: Определение сенсорных фенотипов, которые отражают лежащие в их основе болевые механизмы, актуально для пациентов с хронической болью, переживших критическое состояние. ЦЕЛЬ ИССЛЕДОВАНИЯ: Оценить интенсивность, локализацию и сенсорные фенотипы хронической боли у пациентов, перенесших критическое состояние. МАТЕРИАЛЫ И МЕТОДЫ: В исследование было включено 99 пациентов, перенесших критическое состояние. Критериями включения являлись: возраст 18–75 лет, длительность пребывания в отделении реанимации и интенсивной терапии (ОРИТ) > 3 дней, длительность искусственной вентиляции легких (ИВЛ) > 48 ч, оценка на момент поступления по шкале Acute Physiology And Chronic Health Evaluation II (APACHE II) ≥ 7 баллов, получение информированного согласия. Локализацию, интенсивность и качественные характеристики длительной (6 мес.) боли, связанной с пребыванием в ОРИТ, оценивали при помощи краткого опросника боли, опросника PainDetect, выраженность тревоги и депрессии — по шкале Hospital Anxiety and Depression Scale (HADS). Всем пациентам перед выпиской выполнено термальное количественное сенсорное тестирование (КСТ) с оценкой порогов обнаружения холода и обнаружения тепла, парадоксальных тепловых ощущений, порогов холодовой и тепловой боли, условной модуляции боли. РЕЗУЛЬТАТЫ: Через 6 мес. хронический болевой синдром сформировался у 59 % пациентов. Были получены данные об интенсивности, о локализации, степени выраженности нейропатического и дисфункционального компонента боли. При оценке термальных показателей КСТ с помощью иерархического кластерного анализа выявлены статистически достоверная связь изменений статических и динамических показателей термального сенсорного тестирования, формирование «раздраженного» и «деафферентационного» сенсорного фенотипа в зависимости от длительности ИВЛ, пребывания в отделении интенсивной терапии и оценки по шкале Sequential Organ Failure Assessment (SOFA). ВЫВОДЫ: Выявление сенсорных фенотипов позволяет определить пациентов с дисфункцией волокон малого диаметра, нарушением эндогенных механизмов контроля боли, что позволит подобрать индивидуальную программу облегчения боли

Антибактериальная активность полифенолов, полученных механохимическим путем из природного сырья

This study focuses on bactericidal activity of a number of biomass-derived polyphenols (humic substances and melanins) obtained by mechanochemical activation of the brown coal and husk of buckwheat mixed with a solid oxidizing or reducing agents against opportunistic pathogens relevant to the poultry industry: Salmonella typhimurium, Shigella sonnei, Escherichia coli, Pasteurella multocida, Yersinia pseudotuberculosis, Streptococcus pyogenes, Staphylococcus aureus, and Staphylococcus epidermidis. The studied polyphenols are active against bacteria belonging to the family Enterobacteriaceae (Salmonella typhimurium, Shigella sonnei, Escherichia coli, and Yersinia pseudotuberculosis) after being subjected to mechanochemical activation in the presence of sodium percarbonate. Almost all the studied samples, except for those exposed to treatment with zinc, were active against bacteria Pasteurella multocida (the family Pasteurellacеae) and Staphylococcus epidermidis (the family Staphylococcаcеae). The samples active against bacteria Streptococcus pyogenes (the family Streptococcacеae) and Staphylococcus aureus (the family Staphylococcacеae) can be obtained by mechanochemical interaction with sodium percarbonate under certain conditionsПроведено исследование бактерицидного действия ряда полифенолов (гуминовых веществ и меланинов) из природного сырья, полученных в результате механохимической обработки смесей сырья с твердым окислителем – перкарбонатом натрия и восстановителем – цинком в отношении условно-патогенных бактерий, важных для птицеводства: Salmonella typhimurium, Shigella sonnei, Esherichia coli, Pasteurella multocida, Yersinia pseudotuberculosis, Streptococcus pyogenes, Staphylococcus aureus, Staphylococcus epidermidis. Исследованные гуминовые полифенолы проявляют активность в отношении бактерий семейства Enterobacteriaceae (Salmonella typhimurium, Shigella sonnei, Esherichia coli, Yersinia pseudotuberculosis) после механохимического взаимодействия с перкарбонатом натрия. Образцы после взаимодействия с цинком активности не проявляют. В отношении бактерий Pasteurella multocida (семейство Pasteurellacеae) Staphylococcus epidermidis (семейство Staphylococcаcеae) активны практически все исследованные гуминовые и меланиновые препараты за исключением препаратов после взаимодействия с цинком. Активные в отношении бактерий Streptococcus pyogenes (семейство Streptococcacеae), Staphylococcus aureus (семейство Staphylococcacеae) могут быть получены механохимическим взаимодействием с перкарбонатом натрия в определенных условия

LIPOPROTEIN(A) MEANING AS AN ADDITIONAL MARKER OF CARDIOVASCULAR RISK IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA

Aim. To analyze the relation of Lp(a) and atherosclerosis development in familial hypercholesterolemia (FHCE).Material and methods. Totally, 81 patient with definite FHCE studied, mean age 39,1±0,4 y. o. The participants were selected to two groups: first — with increased level of Lp(a) >0,3 g/L (n=34); mean age — 44,5±0,3; second — with normal Lp(a) <0,3 g/L (n=47, 58,1%); mean age — 37,5±0,3 y. o.Results. Mean level of Lp(a) in various age persons did not differ significantly. In both subgroups in about a half of all participants there was arterial hypertension (AH) revealed (50,8% and 42,6%, respectively), obesity was diagnosed in one third of both groups, number of smokers was higher in higher Lp(а) group (11,8% and 8,5%). IHD had 25,9% of participants. Revalence of IHD in IHD group was 44, 4%, in non-smoker group — 25,8% (RR 1,72 (0,75; 3,99)), acute myocardial infarction prevalence (MI) in smoking subgroup was — 44,6% versus 13,5% (RR 3,26 (1,26; 8,43)). Among lipid profile parameters LDL level was definitive for IHD development (p=0,012). Presence of obesity increased MI risk 2,54 times in FHCE (OR 2,4 (1,05; 5,63)). With increase of Lp(a) IHD was diagnosed more commonly: 32,4% versus 19%, non-significant (p=0,47). Prevalence of MI in the first group was higher than in the second: 8 (23,5%) and 4 (8,5%), respectively, (OR 3,3 (1,1; 9,8), р=0,03).Conclusion. In FHCE, the risk of IHD was influenced by traditional RF (smoking, obesity, LDL level)

ANALYSIS OF THE TRADITIONAL RISK FACTORS INFLUENCE ON DEVELOPMENT OF ISCHEMIC HEART DISEASE IN FAMILIAL HYPERCHOLESTEROLEMIA

Familial hypercholesterolemia (FH) is inherited pathology with increased level of cholesterol, and predisposes for early development of atherosclerosis, but prevalence of cardiovascular pathology in FH patients varies, and demands for more precise definition of additional factors of risk of ischemic heart disease (IHD).Aim. To evaluate in FH patients an association of IHD and classical risk factors (sex, age, arterial hypertension (AH), smoking, obesity, cholesterol of low density lipoproteides (LDL-C) and high density (HDL-C), complicated heredity for cardiovascular disorders), mutation of LDL receptors.Material and methods. Totally, 253 patients studied, age 18 and older, with heterozygous FCHE, diagnoses according to Dutch Lipid Clinic Network, (mean age — 51±3,4 y. o.). 109 patients (43%) underwent genetic test. IHD was diagnosed in 106 (41,8%), anamnesis of acute myocardial infarction (MI) had 63 (24,9%) patients.Results. In FH, IHD was associated with the following risk factors: AH, age older 40 y., complicated inheritance for cardiovascular pathology. An increase of LDL-C level by every1 mM increased the prevalence of CHD in heterozygous FCHE patients by 4,5% up to LDL-C 8,5 mM/L. In higher LDL-C values IHD prevalence increases by 1-2%. In patients with mutation of LDL receptor, IHD develops 5 years earlier. There was no association revealed for the type of mutation and IHD.Conclusion. The main risk factors associated with CHD in heterozygous FH are AH, age more than 40 y. o., complicated inheritance for cardiovascular diseases. The relation of LDL-C and IHD prevalence in FH patients is not linear

Colloid-chemical effects in the oxidative destruction of isononylphenol ethoxylate

The possibility of the oxidative destruction of isononylphenol ethoxylates in micellar solutions with critical micellization concentrations of up to 3.5 by the Ruff system is established in principle. It is shown that iron hydroxocomplex polymerization, which leads to the formation of large colloid particles but does not lower the efficiency of a surfactant oxidation, can proceed in a solution at pH 3-5ye

Colloid-chemical effects in the oxidative destruction of isononylphenol ethoxylate

yesThe possibility of the oxidative destruction of isononylphenol ethoxylates in micellar solutions with critical micellization concentrations of up to 3.5 by the Ruff system is established in principle. It is shown that iron hydroxocomplex polymerization, which leads to the formation of large colloid particles but does not lower the efficiency of a surfactant oxidation, can proceed in a solution at pH 3-

Carbocyclic functionalization of quinoxalines, their chalcogen congeners 2,1,3-benzothia/selenadiazoles, and related 1,2-diaminobenzenes based on nucleophilic substitution of fluorine

Previously unknown mono-, di- and in some cases tri- and tetra- carbocycle-substituted quinoxalines (2–8), 2,1,3-benzothiadiazoles (11, 12, 14–17) and 2,1,3-benzoselenadiazoles (20-25) were synthesized by nucleophilic substitution of fluorine in 5,6,7,8-tetrafluoroquinoxaline (1) and 4,5,6,7-tetrafluoro-2,1,3-benzothia/selenadiazoles (10 and 19, respectively) with methoxide and dimethylamine. In the 1:1 reactions, the nucleophiles attacked selectively the position 6 of 1 or the position 5 of 10 and 19. The regioselective nature of the 1:1 reactions was confirmed by the DFT calculations at the M06-2X/6-31+G(d,p) level of theory. Disubstituted quinoxaline (28), thia- (29) and selena- (30) diazoles bearing two different substituents, i.e. MeO- and Me2N-, were synthesized in a similar way. New substituted 1,2-diaminobenzenes (31–33) were prepared by reduction of corresponding thiadiazoles (12, 14, 15) and isolated in the form of hydrochlorides. Compound 33 was converted into a new quinoxaline (34) by reaction with (PhCO)2. Compounds 5, 7 and 14 were studied for cytotoxicity toward the human cancer cells and effects on the cytochrome P450 mRNA expression. They did not cause any significant modulations in the expression of several cytochrome P450 genes, and 7 was weakly toxic for the Hep2 (carcinoma) and U937 (leukemia) cells, particularly, apoptosis was observed

Carbocyclic functionalization of quinoxalines, their chalcogen congeners 2,1,3-benzothia/selenadiazoles, and related 1,2-diaminobenzenes based on nucleophilic substitution of fluorine

Previously unknown mono-, di- and in some cases tri- and tetra- carbocycle-substituted quinoxalines (2–8), 2,1,3-benzothiadiazoles (11, 12, 14–17) and 2,1,3-benzoselenadiazoles (20-25) were synthesized by nucleophilic substitution of fluorine in 5,6,7,8-tetrafluoroquinoxaline (1) and 4,5,6,7-tetrafluoro-2,1,3-benzothia/selenadiazoles (10 and 19, respectively) with methoxide and dimethylamine. In the 1:1 reactions, the nucleophiles attacked selectively the position 6 of 1 or the position 5 of 10 and 19. The regioselective nature of the 1:1 reactions was confirmed by the DFT calculations at the M06-2X/6-31+G(d,p) level of theory. Disubstituted quinoxaline (28), thia- (29) and selena- (30) diazoles bearing two different substituents, i.e. MeO- and Me2N-, were synthesized in a similar way. New substituted 1,2-diaminobenzenes (31–33) were prepared by reduction of corresponding thiadiazoles (12, 14, 15) and isolated in the form of hydrochlorides. Compound 33 was converted into a new quinoxaline (34) by reaction with (PhCO)2. Compounds 5, 7 and 14 were studied for cytotoxicity toward the human cancer cells and effects on the cytochrome P450 mRNA expression. They did not cause any significant modulations in the expression of several cytochrome P450 genes, and 7 was weakly toxic for the Hep2 (carcinoma) and U937 (leukemia) cells, particularly, apoptosis was observed

Evaluation of distribution coefficients and concentration ratios of 90Sr and 137Cs in the Techa River and the Miass River

Empirical data on the behavior of radionuclides in aquatic ecosystems are needed for radioecological modeling, which is commonly used for predicting transfer of radionuclides, estimating doses, and assessing possible adverse effects on species and communities. Preliminary studies of radioecological parameters including distribution coefficients and concentration ratios, for 90Sr and 137Cs were not in full agreement with the default values used in the ERICA Tool and the RESRAD BIOTA codes. The unique radiation situation in the Techa River, which was contaminated by long-lived radionuclides (90Sr and 137Cs) in the middle of the last century allows improved knowledge about these parameters for river systems. Therefore, the study was focused on the evaluation of radioecological parameters (distribution coefficients and concentration ratios for 90Sr and 137Cs) for the Techa River and the Miass River, which is assumed as a comparison waterbody. To achieve the aim the current contamination of biotic and abiotic components of the river ecosystems was studied; distribution coefficients for 90Sr and 137Cs were calculated; concentration ratios of 90Sr and 137Cs for three fish species (roach, perch and pike), gastropods and filamentous algae were evaluated. Study results were then compared with default values available for use in the well-known computer codes ERICA Tool and RESRAD BIOTA (when site-specific data are not available). We show that the concentration ratios of 137Cs in whole fish bodies depend on the predominant type of nutrition (carnivores and phytophagous). The results presented here are useful in the context of improving of tools for assessing concentrations of radionuclides in biota, which could rely on a wider range of ecosystem information compared with the process limited the current versions of ERICA and RESRAD codes. Further, the concentration ratios of 90Sr are species-specific and strongly dependent on Ca2+ concentration in water. The universal characteristic allows us to combine the data of fish caught in the water with different mineralization by multiplying the concentration of Ca2+. The concentration ratios for fishes were well-fitted by Generalized Logistic Distribution function (GLD). In conclusion, the GLD can be used for probabilistic modeling of the concentration ratios in freshwater fishes to improve the confidence in the modeling results. This is important in the context of risk assessment and regulatory