Application of optical non-invasive methods to diagnose the state of the lower limb tissues in patients with diabetes mellitus

The paper shows the possibility of assessing the functional state of microcirculatory-tissue systems of patients with diabetes mellitus by laser Doppler flowmetry (LDF), diffuse reflectance spectroscopy (DRS) and fluorescence spectroscopy (FS) methods. A review of the existing non-invasive optical technologies used to assess the state of microcirculation and oxygen metabolism in tissues of patients with diabetes is conducted. A series of experimental studies involving 76 patients with diabetes and 46 healthy volunteers was carried out. A wavelet analysis of LDF-grams was used to evaluate the adaptive changes of microcirculation during the temperature tests. The obtained data revealed that the proposed methodology in the form of combined use of several diagnostic technologies (LDF, FS and DRS) allows us to detect the presence or absence of trophic disorders and to evaluate adaptation processes during thermal tests

Studies of age-related changes in blood perfusion coherence using wearable blood perfusion sensor system

Laser Doppler flowmetry (LDF) was used for detection of age-related changes in the blood microcirculation. The LDF signal was simultaneously recorded from the 3rd fingers' pads of both hands. Amplitudes of the blood flow oscillations and wavelet coherence of the signals were used for the data analysis. A statistical difference in the synchronisation of myogenic oscillations was found between the two studied age groups. Myogenic oscillations of blood perfusion in the younger group had a higher wavelet coherence parameter than in the older group. Observed site-specific and age-related differences in blood perfusion can be used in the future in the design of experimental studies of the blood microcirculation system in patients with different pathologies

Wearable sensor system for multipoint measurements of blood perfusion: pilot studies in patients with diabetes mellitus

The growing interest in the development of new wearable electronic devices for mobile healthcare provides great opportunities for the development of methods for assessing blood perfusion in this direction. Laser Doppler flowmetry (LDF) is one of the promising methods. A fine analysis of capillary blood ow structure and rhythm in the time and frequency domains, coupled with a new possibility of round-the-clock monitoring can provide valuable diagnostic information about the state of microvascular blood ow. In this study, wearable implementation of laser Doppler flowmetry was utilised for microcirculatory function assessment in patients with diabetes and healthy controls of two distinct age groups. Four wearable laser Doppler flowmetry monitors were used for the analysis of blood microcirculation. Thirty-seven healthy volunteers and 18 patients with type 2 diabetes mellitus participated in the study. The results of the studies have shown that the average perfusion differs between healthy volunteers of distinct age groups and between healthy volunteers of the younger age group and patients with diabetes mellitus. It was noted that the average level of perfusion measured on the wrist in the two groups of healthy volunteers has no statistically significant differences found in similar measurements on the fingertips. The wearable implementation of LDF can become a truly new diagnostic interface to monitor cardiovascular parameters, which could be of interest for diagnostics of conditions associated with microvascular disorders

Multimodal optical measurement for study of lower limb tissue viability in patients with diabetes mellitus

According to the International Diabetes Federation, the challenge of early stage diagnosis and treatment effectiveness monitoring in diabetes is currently one of the highest priorities in modern healthcare. The potential of combined measurements of skin fluorescence and blood perfusion by the laser Doppler flowmetry method in diagnostics of low limb diabetes complications was evaluated. Using Monte Carlo probabilistic modeling, the diagnostic volume and depth of the diagnosis were evaluated. The experimental study involved 76 patients with type 2 diabetes mellitus. These patients were divided into two groups depending on the degree of complications. The control group consisted of 48 healthy volunteers. The local thermal stimulation was selected as a stimulus on the blood microcirculation system. The experimental studies have shown that diabetic patients have elevated values of normalized fluorescence amplitudes, as well as a lower perfusion response to local heating. In the group of people with diabetes with trophic ulcers, these parameters also significantly differ from the control and diabetes only groups. Thus, the intensity of skin fluorescence and level of tissue blood perfusion can act as markers for various degrees of complications from the beginning of diabetes to the formation of trophic ulcers

Data incongruence and the problem of avian louse phylogeny

Recent studies based on different types of data (i.e. morphological and molecular) have supported conflicting phylogenies for the genera of avian feather lice (Ischnocera: Phthiraptera). We analyse new and published data from morphology and from mitochondrial (12S rRNA and COI) and nuclear (EF1-) genes to explore the sources of this incongruence and explain these conflicts. Character convergence, multiple substitutions at high divergences, and ancient radiation over a short period of time have contributed to the problem of resolving louse phylogeny with the data currently available. We show that apparent incongruence between the molecular datasets is largely attributable to rate variation and nonstationarity of base composition. In contrast, highly significant character incongruence leads to topological incongruence between the molecular and morphological data. We consider ways in which biases in the sequence data could be misleading, using several maximum likelihood models and LogDet corrections. The hierarchical structure of the data is explored using likelihood mapping and SplitsTree methods. Ultimately, we concede there is strong discordance between the molecular and morphological data and apply the conditional combination approach in this case. We conclude that higher level phylogenetic relationships within avian Ischnocera remain extremely problematic. However, consensus between datasets is beginning to converge on a stable phylogeny for avian lice, at and below the familial rank

Resolving the Evolutionary History of Campanula (Campanulaceae) in Western North America

Recent phylogenetic works have begun to address long-standing questions regarding the systematics of Campanula (Campanulaceae). Yet, aspects of the evolutionary history, particularly in northwestern North America, remain unresolved. Thus, our primary goal in this study was to infer the phylogenetic positions of northwestern Campanula species within the greater Campanuloideae tree. We combined new sequence data from 5 markers (atpB, rbcL, matK, and trnL-F regions of the chloroplast and the nuclear ITS) representing 12 species of Campanula with previously published datasets for worldwide campanuloids, allowing us to include approximately 75% of North American Campanuleae in a phylogenetic analysis of the Campanuloideae. Because all but one of North American Campanula species are nested within a single campanuloid subclade (the Rapunculus clade), we conducted a separate set of analyses focused specifically on this group. Our findings show that i) the campanuloids have colonized North America at least 6 times, 4 of which led to radiations, ii) all but one North American campanuloid are nested within the Rapunculus clade, iii) in northwestern North America, a C. piperi – C. lasiocarpa ancestor gave rise to a monophyletic Cordilleran clade that is sister to a clade containing C. rotundifolia, iv) within the Cordilleran clade, C. parryi var. parryi and C. parryi var. idahoensis exhibit a deep, species-level genetic divergence, and v) C. rotundifolia is genetically diverse across its range and polyphyletic. Potential causes of diversification and endemism in northwestern North America are discussed

Рroblem of miscarriage in multiple pregnancies

A multiple pregnancy (MP) remains one of the most thorny problems of modern obstetrics [1]. According to data of world statistics only 15-30% women with multiple gestations have a physiological process of pregnancy [13]. Therefore on the amount of obstetric and perinatal complications MP indisputably belongs to gestation with the high degree of risk. For the last three decades the increase of frequency of MP [3] fixed. Only in a period from 2000 to 2010 in Ukraine frequency of MP increased on 30%, almost 95% - twins and other 5% were gestations of higher-order [3]. This problem acquires the special actuality because of annual increase of number of the MP, conditioned by wide introduction of assisted reproductive technologies in treatment of sterility [1]. It is presently well-proven that one of major factors qualificatory perinatal ends at MP is not zygocity, but chorionicity [4]. A monochorionic (MC) type of placentation at MP is most unfavorable in regard to perinatal ends, as a mortinatality at MC twins in 3-4 times exceeds such at dichorionic (DC) twins [11]. Touching the process of MB, firstly it is necessary to underline appearance of threat symptoms of pregnancy breaking (75%) [9]. It should be noted that at spontaneous MP this symptomatology is less expressed and has another mechanisms [9]. For example, the threat of pregnancy unmaturing at spontaneous twins is more often related to uterus overdistension and releasing of prostaglandins, which raise myometrium tone [9]. Thus this symptomatology appears in later gestational terms (26-28 weeks) [9]. In induced MP (IVF) it is necessary to detect presence of infection and endocrine disbalance, that determines the features of therapeutic approach [9]. The aim of this research was to study the features of pregnancy process, structure and frequency of obstetric and antenatal complications in women and newborn. Materials and methods of research From data of medical documentation, namely: exchange pregnancy cards (form №113/o), case histories (form №096/o), conclusions of pathohistology research (form №014/o) we have done the retrospective analysis of multigestational process and twins labor in 80 women hospitalized and afterwards delivered on the base of the Clinical maternity hospital №5 Zaporozhye for period from 2008 to 2010 years. We analysed labor histories of women with a spontaneous MP. All patients were divided into 2 groups depending on chorionicity: Ist group – 37(46,2%) patients with monochorionic diamniotic twins; IInd group – 43(53,8%) patients with dichorionic diamniotic twins. Category of pregnancy after IVF – 5 women: 2(MC) and 3(DC) excluded from research. Results and conclusions Women with a multigestation are included in a high-risk group of development of pregnancy miscarriage. Among complications of gestational process more often meet: premature labor (61,3±21,92%), threat of pregnancy breaking (32,5±38,18%), threat of premature labor (22,5±43,84%), premature rupture of amniotic membranes (20,0±45,25%). Clinical experience shows that monochorionic type of placentation is accompanied by greater frequency of such specific complications multiple pregnancy as discordant fetal growth (18,9±21,21%), fetofetal transfusion syndrome (2,7±5,45%), twin reversed arterial perfusion (2,7±5,45%), fetal growth retardation syndrome (2,7±5,45%). Thus, chorionicity exactly determines the process of multiple pregnancy and its ends. It’s extremely important to use modern uninvasive and safe methods of fetus state function analysis for early diagnostics, prevention of multiple pregnancy miscarriage

ANALYSIS OF CURRENT THERAPEUTIC APPROACHES TO CHRONIC RHINITIS ACCORDING TO THE POLYCLINIC DATA OF AMBULATORY SERVICE OF MOSCOW

The term «rhinitis» comprises a large heterogeneous group of diseases with different etiology and pathophysiological mechanisms. The latest consensual documents recommend that all rhinitis be classified into 3 main types: infectious, allergic (AR) and non-infectious and non-allergic with subsequent subdivision of each type into separate subtypes. In the Russian Federation, standards and clinical guidelines have been developed only for allergic rhinitis. The therapeutic agement of 779 patients with chronic rhinitis in outpatient settings have been analysed. When formulating the diagnosis, codes J31.0 and J30.0 and the terms «Hypertrophic rhinitis» and «Vasomotor rhinitis» were used for non-allergic rhinitis, while code J30.4 and the terms «Allergic rhinitis» or «Vasomotor-allergic rhinitis» were used for allergic genesis. The diagnosis «Intermittent AR» was indicated once, and severity was mentioned only in 2 patients. In AR group  (216 people), a comprehensive study was performed in 6.5% of cases, the diagnosis was established empirically in 52.7% of cases. Antihistamines were prescribed in 27.3% of cases, intranasal corticosteroids in 77.8%, montelukast in 9.7%, allergen-specific immunotherapy was performed in 1.9%. In non-allergic rhinitis (563 patients), 77.4% intranasal received corticosteroids, 7.5% received antihistamines, 3.7% – montelukast, 4.8% underwent surgical treatment. In both groups, original methods of therapy in the form of local antibiotics, homeopathic drugs, bacterial lysates were reported. In the AR group, a violation of the step-by-step therapy regimen was identified