Retrospective Analysis of Lipid-Lowering and Antiplatelet Therapy Regimen by Clinical Decision Support Service Based on Real-World Data from Electronic Medical Records "Intellect 3 Study".

Aim      To evaluate prescription of lipid-lowering and antithrombotic therapy in clinical practice and to compare differences in recommendations using the clinical decision support service (CDSS).Material and methods  Electronic medical records (EMR) of 300 patients from the Chazov National Medical Research Center of Cardiology, as well as from medical organizations controlled by the Department of Health of the Lipetsk Region and the Ministry of Health of the Voronezh Region, were analyzed for the period of August - December 2022, during the pilot implementation of CDSS. Retrospective information about the prescription of lipid-lowering and antithrombotic therapy from the EMR was compared with the CDSS guidelines under the expert supervision based on digitized clinical and laboratory profiles of patients. The study primary endpoint was a change in the initially prescribed lipid-lowering and / or antithrombotic therapy as per CDSS guidelines.Results Overall 292 patients were included in the final analysis; 46 (15.7 %) were from the primary prevention group and 246 (84.3 %) from the secondary prevention group. In group 1, the lipid-lowering therapy recommended by the CDSS differed by 50 % (p<0.001) from the baseline therapy recorded in the EMR. In the secondary prevention group, 78.9 % (p<0.001) differences were found in the lipid-lowering therapy recommended in the CDSS guidelines compared to the prescriptions in the EMR. In 76.8 % (p<0.001) of patients, antithrombotic therapy was significantly different from the baseline therapy in the EMR.Conclusion      The use of CDSS may improve the practice of choosing lipid-lowering and antithrombotic therapy for prevention of cardiovascular complications.

[The typology of social predictors as a research tool of studying personnel crisis in Russian health care: The publications review].

In conditions of societal transformations, social institutions undergo significant alterations that are manifested by institutional inconsistency and dysfunctionality. The transformation of social professional structure of health care system resulted in change of status and trends of social mobility of social professional groups. The purpose of the study is to typologize social predictors of professional activity of physicians in health care of the Russian Federation. The social economic transformation and reforms of the National health care system of recent decades initiated trends of deprofessionalization in medicine, status inflation and marginalization of professional groups. The phenomenon of professional marginalization of physicians is discussed from perspective of the "concept of status inconsistency" by G. Lensky. In aurhoring typology low income of physicians, financial deprivation, reducing of prestige and relative status inflation of medical profession, professional stress, social frustrations and professional burnout are considered as social predictors of professional activity of physicians. The destructive consequences of status inflation are considered as social threat to preservation of manpower potential of health care of the Russian Federation.

[Modern approaches to the formation of antidote stocks at medical institutions in Russia and foreign countries].

This article analyses the approaches to the formation of specific treatment of acute poisoning in the various countries. The authors present a systematic review of scientific publications about the formation of reserves of antidote agents at medical institutions of the Russian Federation, the US, Canada, France, Spain, Greece, Norway, Czech Republic, Taiwan and Poland. A search for a variety of databases, as well as by reviewing reference lists of publications on the subject of "stockpiling antidote means". It is concluded that the antidote provision at health care institutions in different countries is insufficient. State of affairs with the formation of antidote stocks is better at hospitals of Czech Republic, France and Spain. To determine the range and volume of the stock of fixed assets necessary antidote coordination and approval of the list and the number of mandatory for every medical institution antidotes.

Hippocampal microRNA-132 mediates stress-inducible cognitive deficits through its acetylcholinesterase target.

Diverse stress stimuli induce long-lasting cognitive deficits, but the underlying molecular mechanisms are still incompletely understood. Here, we report three different stress models demonstrating that stress-inducible increases in microRNA-132 (miR-132) and consequent decreases in its acetylcholinesterase (AChE) target are causally involved. In a mild model of predator scent-induced anxiety, we demonstrate long-lasting hippocampal elevation of miR-132, accompanied by and associated with reduced AChE activity. Using lentiviral-mediated suppression of "synaptic" AChE-S mRNA, we quantified footshock stress-inducible changes in miR-132 and AChE and its corresponding cognitive damages. Stressed mice showed long-lasting impairments in the Morris water maze. In contrast, pre-stress injected AChE-suppressing lentivirus, but not a control virus, reduced hippocampal levels of both miR-132 and AChE and maintained similar cognitive performance to that of naïve, non-stressed mice. To dissociate between miR-132 and synaptic AChE-S as potential causes for stress-inducible cognitive deficits, we further used engineered TgR mice with enforced over-expression of the soluble "readthrough" AChE-R variant without the 3'-untranslated region binding site for miR-132. TgR mice displayed excess AChE-R in hippocampal neurons, enhanced c-fos labeling and correspondingly intensified reaction to the cholinergic agonist pilocarpine. They further showed excessive hippocampal expression of miR-132, accompanied by reduced host AChE-S mRNA and the GTPase activator p250GAP target of miR-132. At the behavioral level, TgR mice showed abnormal nocturnal locomotion patterns and serial maze mal-performance in spite of their reduced AChE-S levels. Our findings attribute stress-inducible cognitive impairments to cholinergic-mediated induction of miR-132 and consequently suppressed ACHE-S, opening venues for intercepting these miR-132-mediated damages.

[The sanitary and parasitological characteristics of environmental objects in the south of Russia. Wastewaters and their precipitations].

The relative uniformity of helminthic eggs has been noted in the wastewaters of the Rostov Region, Krasnodar Territory, and the Republic ofAdygea. An ovogram is mainly presented by the eggs of Ascaris, Toxocaras, and whipworms. By taking into account incomplete dehelmintization during waste treatment, 5,000 to 1,080,000 helminth eggs may annually come into the water reservoirs where purified wastewaters are discharged, 33% remaining viable. Irrespective of the efficiency of dehelmintization, wastewaters and their precipitations continue to remain epidemiologically dangerous substrates and to create prerequisites for the spread of an invasive source in the environment, by risking the infection of the population with parasitic diseases.

Intracerebroventricular injection of streptozotocin causes neurotoxicity to myelin that contributes to spatial memory deficits in rats.

It has been reported that intracerebroventricular (icv) injection of streptozotocin (STZ) impairs spatial memory by disrupting glucose utilization through an insulin-dependent mechanism in the cerebral cortex and hippocampus. However, evidence of septal damage and microglosis induced by icv STZ suggested that its neurotoxic effects could contribute to the memory impairment. The present study examined the histopathological changes in adult rats following three icv STZ injections (0.25 mg into each lateral ventricle) and their effects on spatial memory in a Morris water maze task. STZ retarded acquisition of reference learning (progressive reduction in escape latency) and disrupted working memory (difference in escape latency between the two swims within a daily session). STZ caused selective injury to myelin and axons in the fornix and hippocampus in association with activation of microglia. The 3rd ventricle was enlarged by 100-150% because of a loss of ependymal cells and damage to hypothalamic periventricular myelin but the process involved in these changes is unclear. Our findings provide an alternative explanation for the decrease in glucose utilization in the hippocampus and cortex and the impairment of spatial memory induced by STZ. These could result from a disruption of the communication through myelinated axons in the fornix connecting the septum and the hippocampus, and through other myelinated axons adjacent to the ventricles. The selective damage to myelin may well result from oxidative stress.

An alternative route for Carboni-Lindsey reaction: N,N cycloaddition of an alkene to s-tetrazine.

Quantum mechanical calculations show that N,N cycloaddition of alkenes and alkynes to s-tetrazines is possible as an alternative to the well-known C,C cycloaddition (Carboni-Lindsey reaction). Formation of 1,2,4-triazole derivatives (formal product of N,N cycloaddition) along with the pyrazole (formal product of C,C cycloaddition) corroborates this theoretical prediction.

[Crimean-Congo hemorrhagic fever in Rostov Province: the epidemiological characteristics of an outbreak]. / Krymskaia-Kongo gemorragicheskaia likhoradka v Rostovskoi oblasti: épidemiologicheskie osobennosti vspyshki.

The results of the epidemiological analysis of the outbreak of hemorrhagic fever which was caused by Crimean-Congo hemorrhagic fever virus and occurred during the period of July 3-19, 1999, in the Oblivskaya district of Rostov Province are presented. The specific epidemiological features of the outbreak have been determined. The possible versions of the appearance of the focus of infection and the role of Ixodes ticks in the circulation of the infective agent are discussed.

[Biochemical and ultrastructural changes in the periodontium during the chronic administration of pro-oxidant xenobiotics]. / Biokhimicheskie i ul'trastrukturnye izmeneniia v parodonte pri khronicheskom vvedenii ksenobiotikov-prooksidantov.

Effects of chronic administration of xenobiotics pro-oxidants on the state of periodontal tissues, level of free-radical oxidation of lipids, and antioxidant provision were studied. Diphenin and delagil were found to promote biochemical and morphological changes similar to the manifestations observed in periodontitis. A conclusion is made about an important role of nonenzymatic free-radical oxidation of lipids and biopolymers in the pathogenesis of periodontitis. The principal stages of contribution of autooxidation to the parodontogenesis are presented.

Life-span of irradiated mammals. Mathematical modelling.

A mathematical model of the mortality dynamics of irradiated mammals is developed. It relates the statistical biometrical functions with the statistical and kinetical characteristics of the critical systems in the organism. This model can be used for predicting the life shortening of irradiated mammals.

Multiplicities of secondaries in nuclear interactions, induced by 20Ne, 40Ar and 56Fe nuclei at 0.1-0.5 GeV/nucleon.

Multiplicities of various species of charged secondaries produced in inelastic interactions of 20Ne, 40Ar and 56Fe nuclei with emulsion nuclei at 0.1-0.5 GeV/nucleon have been measured. The data obtained are compared with the results for interactions of higher energy nuclei with emulsion nuclei. The dependences of the nucleus-nucleus interaction parameters on masses and energies of colliding nuclei are examined.

[The diagnosis of campylobacteriosis]. / Diagnostika kampilobakteroza.

Results of assays for Campylobacter in patients with intestinal dysfunction are presented for the period from 1984 to 1991. 4147 cases were analyzed in 144 of which (3%) Campylobacter was detected in feces. Children constituted 12% of this group. They were distributed by age in the following way: 1 year and younger--1%, from 1 to 2 years--4.2%, from 3 to 6 years--3.8%, from 7 to 16 years--2.3%. 15 Campylobacter-positive patients were established to discharge other enteropathogenic microorganisms. 4% of children suffered from severe form of campylobacteriosis associated with exsicosis, 80% had moderate form of the disease. In order to study reservoirs of the infection 102 samples of intestinal content in livestock were analyzed for Campylobacter 57.1% of which proved to be positive.

Dependence of the multiplicities of secondary particles on the impact parameter in collisions of high-energy neon and iron nuclei with photoemulsion nuclei.

A method is proposed for finding the dependence of mean multiplicities of secondaries on the nucleus-collision impact parameter from the data on the total interaction ensemble. The impact parameter has been shown to completely define the mean characteristics of an individual interaction event. A difference has been found between experimental results and the data calculated in terms of the cascade-evaporation model at impact-parameter values below 3 fm.

Quality factor and dose equivalent investigations aboard the Soviet space station MIR.

Since Dec 1988, date of the French-Soviet joint space mission "ARAGATZ", the CIRCE device (Compteur Intégrateur de Rayonnement Complexe dans l'Espace) had recorded dose equivalent and quality factor inside the MIR station (380-410 km, 51.5 degrees). After the initial gas filling two years ago, the low pressure tissue equivalent proportional counter is still in good working conditions. Some results of three periods, viz Dec 1988, Mar-Apr 1989 and Jan-Feb 1990 are presented. The average dose equivalent rates measured are respectively 0.6, 0.8 and 0.6 mSv/day with a quality factor equal to 1.9. Some detailed measurements show the increasing of the dose equivalent rates through the SAA and near polar horns. The real time determination of the quality factors allows to point out high LET (Linear Energy Transfer) events with quality factors in the range 10-20.

Cosmic ray LET spectra and doses on board Cosmos-2044 biosatellite.

Results of the experiments on board Cosmos-2044 (Biosatellite 9) are presented. Various nuclear track detectors (NTD) (dielectric, AgCl-based, nuclear emulsions) were used to obtain the LET spectra inside and outside the satellite. The spectra from the different NTDs have proved to be in general agreement. The results of LET spectra calculations using two different models are also presented. The resultant LET distributions are used to calculate the absorbed and equivalent doses and the orbit-averaged quality factors (QF) of the cosmic rays (CR). Absorbed dose rates inside (approximately 20 g cm-2 shielding) and outside (1 g cm-2) the spacecraft, omitting electrons, were found to be 4.8 and 8.6 mrad d-1, respectively, while the corresponding equivalent doses were 8.8 and 19.7 mrem d-1. The effects of the flight parameters on the total fluence of, and on the dose from, the CR particles are analyzed. Integral dose distributions of the detected particles are also determined. The LET values which separate absorbed and equivalent doses into 50% intervals are estimated. The CR-39 dielectric NTD is shown to detect 20-30% of the absorbed dose and 60-70% of the equivalent dose in the Cosmos-2044 orbit. The influence of solar activity phase on the magnitude of CR flux is discussed.

Radiation shielding estimates for manned Mars space flight.

In the analysis of the required radiation shielding protection of spacecraft during a Mars flight, specific effects of solar activity (SA) on the intensity of galactic and solar cosmic rays were taken into consideration. Three spaceflight periods were considered: (1) maximum SA; (2) minimum SA; and (3) intermediate SA, when intensities of both galactic and solar cosmic rays are moderately high. Scenarios of spaceflights utilizing liquid-propellant rocket engines, low- and intermediate-thrust nuclear electrojet engines, and nuclear rocket engines, all of which have been designed in the Soviet Union, are reviewed. Calculations were performed on the basis of a set of standards for radiation protection approved by the U.S.S.R. State Committee for Standards. It was found that the lowest estimated mass of a Mars spacecraft, including the radiation shielding mass, obtained using a combination of a liquid propellant engine with low and intermediate thrust nuclear electrojet engines, would be 500-550 metric tons.

Real time quality factor and dose equivalent meter "CIRCE" and its use on-board the Soviet orbital station "MIR".

During the French-Soviet space mission "Aragatz," the experiment CIRCE (Compteur Integrateur de Rayonnement Complexe dans l'Espace) recorded the dose rate and quality factor values inside the MIR station. This paper presents results obtained with a new active dose equivalent meter based on microdosimetric techniques and using a low pressure tissue equivalent proportional counter. In terms of lineal energy CIRCE device works in the 0.2-1200 keV micrometer-1 range in tissue. Preliminary studies were performed in photon, neutron and heavy ion beams, and in the real stratosphere cosmic radiation field. Long term measurements on-board MIR station from December 1988 to April 1989 gave an average quality factor value equal to 1.9 +/- 0.3. Through the South Atlantic Anomaly (SAA), the quality factor was equal to 1.4. The temporal orbital variations of the dose rates and quality factors have been established in space dosimetry for the first time.

Target fragments in collisions of 1.8 GeV/nucleon 56Fe nuclei with photoemulsion nuclei, and the cascade-evaporation model.

Nuclear photographic emulsion is used to study the dependence of the characteristics of target-nucleus fragments on the masses and impact parameters of interacting nuclei. The data obtained are compared in all details with the calculation results made in terms of the Dubna version of the cascade-evaporation model (DCM).

[The effect of low-intensity laser radiation on spermatogenesis in men]. / Vliianie nizkointensivnogo lazernogo izlucheniia na spermatogenez u muzhchin.

Fifty-three males suffering from aspermatogenic sterility were exposed to low-intensity laser irradiation. The results suggest a conclusion on a stimulating effect of He-Ne laser on testicular function. Relevant laser stimulation is thought to hold promise for clinical purposes.