Efficiency of an algorithm for the prevention of sternal infection after cardiac surgery in children under 1 year of age: A single-center retrospective study.

Background: Sternal infection is one of the most challenging complications to manage after heart surgery. The aim of our study is to evaluate the effectiveness of a developed algorithm for preventing sternal infection in pediatric patients after surgery for congenital heart disease (CHD). Methods: We conducted a single-center study examining the treatment of 478 children with CHD. Patients were divided into 2 groups, taking into account the application of a developed management algorithm. A multivariate logistic regression analysis was used to identify the factors influencing the development of sternal infection following heart surgery using median sternotomy. Results: A developed algorithm was applied in 308 children. In total, there were 16 cases of sternal infection (3.34 %) across both groups. Deep wound infection developed in 6 patients (1.26 %). Sternal infection developed in 2 children (0.65 %) in the first group (in which the algorithm was applied) and 14 children (8.2 %) in the second group. Deep sternal infection developed in 1 patient in the first group (0.33 %) and in 5 patients in the second group (2.94 %). As a result, perioperative risk factors as postoperative resternotomy (OR 23.315; p < 0.001), delayed sternal closure (OR 9.087; p = 0.003), development of acute renal failure (OR 5.322; p = 0.018) were associated with increased risk of infection and application of the developed algorithm resulted in a significant reduction in risk (OR 0.032; p < 0.001). Conclusion: The suggested method for the prevention of sternal infection has significantly reduced the incidence of sternal infection after cardiac surgery in children less than 1 year of age. In patients with moderate to high risk for surgical site infection, surgeons can enhance wound healing and prevent wound infections with simple, inexpensive, and readily available tools and techniques. Surgical aspects, topical use of antibiotics, prevention of peripheral vasoconstriction, maintenance of normal oxygen delivery rates, and an individual approach to intensive care are essential.

Quantification of attenuation and speckle features from endoscopic OCT images for the diagnosis of human brain glioma.

Application of optical coherence tomography (OCT) in neurosurgery mostly includes the discrimination between intact and malignant tissues aimed at the detection of brain tumor margins. For particular tissue types, the existing approaches demonstrate low performance, which stimulates the further research for their improvement. The analysis of speckle patterns of brain OCT images is proposed to be taken into account for the discrimination between human brain glioma tissue and intact cortex and white matter. The speckle properties provide additional information of tissue structure, which could help to increase the efficiency of tissue differentiation. The wavelet analysis of OCT speckle patterns was applied to extract the power of local brightness fluctuations in speckle and its standard deviation. The speckle properties are analysed together with attenuation ones using a set of ex vivo brain tissue samples, including glioma of different grades. Various combinations of these features are considered to perform linear discriminant analysis for tissue differentiation. The results reveal that it is reasonable to include the local brightness fluctuations at first two wavelet decomposition levels in the analysis of OCT brain images aimed at neurosurgical diagnosis.

[Possibilities of tissue perfusion assessment in abdominal surgery: integration into the intraoperative system of safety control points]. / Vozmozhnosti otsenki perfuzii tkanei v abdominal'noi khirurgii: integratsiya v sistemu intraoperatsionnykh kontrol'nykh tochek bezopasnosti.

OBJECTIVE: To evaluate the possibility of integrating tissue perfusion assessment techniques (ICG perfusion and imaging photoplethysmography - iPPG) into the system of intraoperative control points of laparoscopic interventions with a reconstructive component. MATERIALS AND METHODS: Quantitative assessment of ICG fluorescence and iPPG were used during 8 laparoscopically assisted interventions: gastrectomy for gastric cancer (total - 2 and distal - 1) and colorectal resections (left-sided colorectal resections - 4 and right hemicolectomy - 1). RESULTS: Four stages are presented for the assessment of tissue perfusion: initial assessment, before intestine transection, before anastomosis formation, and evaluation of anastomosis. From the point of view of the significance of clinical decision-making, the «before intestine transection¼ stage is of great importance, due to the ease of transferring the resection level to the optimal tissue perfusion zone. CONCLUSION: Integration of tissue perfusion assessment techniques into the system of intraoperative checkpoints is possible and promising.

A rare case of diagnosed absent aortic valve and severely hypoplastic pulmonary valve with double outlet right ventricle: A case report.

Agenesis of the aortic and pulmonary valves is a very rare congenital malformation of the semilunar valves. The literature describes no more than thirty cases of such anomaly in combination with congenital heart disease. Most descriptions include aplasia of either the aortic or pulmonic valve. The combination of such defect in both valves has been described in a much smaller number of scientific papers. In this article, we present a clinical case of the treatment of a patient with agenesis of aortic valve and severely hypoplastic pulmonary valve. As a result circulatory arrest occurred immediately after birth, which required the implementation of cardiopulmonary resuscitation. The child was resuscitated and transferred to the intensive care unit for further examination and treatment.

Application of Magnetic Particles for Fast Determination of Immunoreactive Fraction of 68Ga-Labelled VHH Antibodies to PD-L1.

Quantification of the immunoreactive fraction (IRF) of radioactive isotope-labeled antibodies or their fragments is necessary to assess the specific activity of radiopharmaceuticals. Traditionally, cells expressing the target molecules on their surface are used to determine IRF, but such analysis is time-consuming and has difficulties with standardization. The aim of the study was to develop a fast and reliable method for quantitative determination of IRF by 68Ga-labeled VHH antibodies to PD-L1 based on the use of magnetic particles coated with antigen molecules. Materials and Methods: Commercially available magnetic particles coated with protein A have been used in our study. The antigen conjugated with the Fc fragment (PD-L1-Fc) was immobilized on the particles. The IRF value of 68Ga radionuclide-labeled nanobodies (VHH) against PD-L1 (68Ga-VHH-PD-L1) was determined using magnetic particles coated with antigen molecules and cells expressing the antigen on their surface. When VHH antibodies were conjugated to 68Ga radionuclide, protein molecules were modified using bifunctional chelating agents: tetraazacyclododecanetetraacetic acid (DOTA) or deferoxamine (DFO). The magnitude of IRF was defined as the ratio of radioactivity specifically bound to particles or cells to the total radioactivity added to the sample. Results: The specificity of the 68Ga-VHH-PD-L1 radioimmunoconjugate binding to the antigen-coated magnetic particles has been proved. Some special aspects, which should be taken into consideration when using this method, have been established. The comparison of the IRF estimates using the antigen-expressing cells and magnetic particles has not revealed any significant differences in the results obtained in our study. Nevertheless, the presented method based on magnetic particles with immobilized antigen molecules requires only 15 min to determine the radioimmunoconjugate IRF, which is of fundamental importance for the routine assessment of the specificity of radiopharmaceuticals containing short-lived isotopes.

Fitting the determined impedance in the guinea pig inner ear to Randles circuit using square error minimization in the range of 100 Hz to 50 kHz.

Objective. Several lumped and distributed parameter models of the inner ear have been proposed to improve vestibular implant stimulation. The models should account for all significant physical phenomena that influence the current propagation, such as the electrical double layer (EDL) and medium polarization. The electrical properties of the medium are reflected in the electrical impedance; therefore, the study aimed to measure the impedance in the guinea pig inner ear and construct its equivalent circuit.Approach. The electrical impedance was measured from 100 Hz to 50 kHz between a pair of platinum electrodes immersed in 0.9% NaCl saline solution using sinusoidal voltage signals. The Randles circuit was fitted to the measured impedance in the saline solution in order to estimate the EDL parameters (C,W,andRct) of the electrode interface in saline. Then, the electrical impedance was measured between all combinations of the electrodes located in the semicircular canal ampullae and the vestibular nerve in the guinea pigin vitro. The extended Randles circuit considering the medium polarization (Ri,Re,Cm) together with EDL parameters (C,Rct) obtained from the saline solution was fitted to the measured impedance of the guinea pig inner ear. The Warburg element was assumed negligible and was not considered in the guinea pig model.Main results. For the set-up used, the obtained EDL parameters were:C=27.09*10-8F,Rct=18.75kΩ.The average values of intra-, extracellular resistances, and membrane capacitance wereRi=4.74kΩ,Re=45.05kΩ,Cm=9.69*10-8F,respectively.Significance. The obtained values of the model parameters can serve as a good estimation of the EDL for modelling work. The EDL, together with medium polarization, plays a significant role in the electrical impedance of the guinea pig inner ear, therefore, they should be considered in electrical conductivity models to increase the credibility of the simulations.

Multimodal Optical Coherence Tomography for Intraoperative Evaluation of Tumor Margins and Surgical Margins in Breast-Conserving Surgery.

The aim of the study: We compare the effectiveness of multimodal optical coherence tomography (MM OCT) in the traditional structural OCT mode and the OCT elastography (OCE) mode in addressing two clinically important tasks: (1) detecting groups of tumor cells at surgical margins during breast-сonserving surgery (BСS) in breast cancer (BC) and (2) identifying breast tumor margins. The obtained results were correlated with corresponding histological sections. Materials and Methods: The study was performed on 100 surgical margin samples (top, bottom, medial, and lateral - four samples from each patient in total) obtained from 25 patients with BC who underwent BCS (lumpectomy), and on 25 postoperative tumor samples (to determine tumor margins). With MM OCT method, we visually and numerically assessed the scattering (level and depth of OCT signal penetration) and elastic (stiffness values, or Young's modulus (kPa)) properties of the tumor and non-tumor breast tissue and the obtained values were compared with the results of postoperative histological examination. Results: In 4 surgical margin samples (out of 100), with the OCE method we identified groups of histologically confirmed tumor cells ("positive" resection margins) at the distance of about 5 mm from the visible tumor margin. The identified zones were larger than 0.5 mm with stiffness of more than 400 kPa in all these cases. However, the structural OCT could not identify these groups of tumors and they were not distinguishable from the surrounding fibrous tissue.In the areas of tumor into non-tumor tissue transition, structural OCT images detected tumor margins only if they were adjacent to adipose tissue and did not detect them if there were adjacent to non-tumor fibrous tissue. OCE images with high stiffness values (more than 400 kPa) and high contrast showed a clear tumor margin with both adipose and fibrous tissue. Conclusion: The study demonstarets the potential of MM OCT, particularly its OCE mode, as a real-time method for intraoperative tumor margin and surgical margin assessment in BCS. OCE images compared to structural OCT images visualize higher contrast between different types of breast tissue (adipose tissue, fibrous stroma, hyalinized stroma, tumor cell clusters), as well as more accurate identification of the tumor border and detection of small groups of tumor cells at surgical margins. An algorithm for intraoperative MM OCT examination of the state of the resection margin is proposed in accordance with standard clinical guidelines for achieving clean surgical margins in breast cancer patients.

[Analysis of healthcare for patients with cardiovascular diseases in Russian Federation in comparison with the practice of Europe and USA].

The medical community, researchers and healthcare organizers are constantly challenged by comparing key indexes reflecting the effectiveness of cardiovascular care, primarily for the dynamic assessment and implementation of the world's best practices to reduce cardiovascular mortality. The analysis of health care for patients with cardiovascular diseases (CVD) is a complex, multicomponent process, the structure and key tools of which differ from country to country. Using different data sources, methodological and analytical approaches creates certain limitations and barriers to the assessment. In order to update the ideas about the modern coordinate system and tools for assessing cardiovascular care, the authors presented practices for analyzing major indexes in Russia, European countries, and the United States. The review presents sources of statistical data, principles for assessing risk factors, cardiovascular morbidity and mortality, and specific features of monitoring the availability and quality of cardiovascular care.

[Clinical significance of different assesment methods of myocardial fibrosis in patients with hypertrophic cardiomyopathy.]

Objective To evaluate prospects for clinical use of circulating biomarkers for characterizing fibrotic changes in the myocardium of patients with hypertrophic cardiomyopathy (HCMP) with left ventricular (LV) outflow tract obstruction.Materials and Methods This was a prospective study with a 12-month follow-up period. The study included 47 patients (29 females and 18 males) with obstructive HCMP who were selected for septal reduction. Echocardiography (EchoCG), cardiac magnetic resonance imaging (MRI) and measurements of serum C-reactive protein, N-terminal pro-brain natriuretic peptide, and relevant circulating markers of fibrosis (TGF-ß1, MMP-2,-9, TIMP-1, galectin-3, sST2, CITP, PICP, and PIIINP) were performed for all patients. All patients were evaluated at baseline and at 7 days, 6 and 12 months following surgical treatment. Morphometrical analysis of intraoperative biopsy samples was performed for evaluation of the degree of fibrotic changes. Patients received beta-blockers (95.7%), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (34%), loop diuretics (68.1%), aldosterone antagonists (34%), and statins (66%).Results Women with HCMP were older and more frequently had additional risk factors (arterial hypertension). Men had a higher risk of sudden cardiac death. Histological study of intraoperative myocardial biopsy samples showed that the area of fibrotic changes was 13.9±6.9%. According to cardiac MRI mean area of delayed contrast enhancement was 8.7±3.3% of LV myocardial mass. No association was established between traditional cardiovascular risk factors and severity of myocardial fibrotic changes or levels of circulating fibrosis markers. Perhaps that was due to the modifying effect of the drug therapy received by HCMP patients. According to EchoCG maximum pressure gradient in the LV outflow tract before the surgical treatment was 88 (55; 192) mm Hg, and interventricular septal thickness was 22 (16; 32) mm. A considerable decrease (p=0.0002) in the LV outflow tract gradient was observed after myectomy in all patients. At the same time, the left ventricular dimension, which tended to decrease in the early postoperative period, returned to baseline values by the 6th month of follow-up.Conclusion The study confirmed the increase in relevant circulating markers of fibrosis in patients with obstructive HCMP. At the same time, no correlation was observed between levels of circulating biomarkers and severity of fibrosis according to data of histology and cardiac MRI, which was probably due to the modifying effect of drug therapy and limited sampling.

Optical coherence angiography for pre-treatment assessment and treatment monitoring following photodynamic therapy: a basal cell carcinoma patient study.

Microvascular networks of human basal cell carcinomas (BCC) and surrounding skin were assessed with optical coherence angiography (OCA) in conjunction with photodynamic therapy (PDT). OCA images were collected and analyzed in 31 lesions pre-treatment, and immediately/24 hours/3-12 months post-treatment. Pre-treatment OCA enabled differentiation between prevalent subtypes of BCC (nodular and superficial) and nodular-with-necrotic-core BCC subtypes with a diagnostic accuracy of 78%; this can facilitate more accurate biopsy reducing sampling error and better therapy regimen selection. Post-treatment OCA images at 24 hours were 98% predictive of eventual outcome. Additional findings highlight the importance of pre-treatment necrotic core, vascular metrics associated with hypertrophic scar formation, and early microvascular changes necessary in both tumorous and peri-tumorous regions to ensure treatment success.

Accurate early prediction of tumour response to PDT using optical coherence angiography.

Prediction of tumour treatment response may play a crucial role in therapy selection and optimization of its delivery parameters. Here we use optical coherence angiography (OCA) as a minimally-invasive, label-free, real-time bioimaging method to visualize normal and pathological perfused vessels and monitor treatment response following vascular-targeted photodynamic therapy (PDT). Preclinical results are reported in a convenient experimental model (CT-26 colon tumour inoculated in murine ear), enabling controlled PDT and post-treatment OCA monitoring. To accurately predict long-term treatment outcome, a robust and simple microvascular metric is proposed. It is based on perfused vessels density (PVD) at t = 24 hours post PDT, calculated for both tumour and peri-tumour regions. Histological validation in the examined experimental cohort (n = 31 animals) enabled further insight into the excellent predictive power of the derived early-response OCA microvascular metric. The results underscore the key role of peri-tumour microvasculature in determining the long-term PDT response.

[The effectiveness of autogenic training in the psycho-corrective treatment of the patients presenting with chronic somatic diseases]. / Autogennaia trenirovka v psikhokorrektsii patsientov s khronicheskimi somaticheskimi zabolevaniiami: éffektivnost' i ee prediktory.

BACKGROUND: The autogenic training (AT) is one of the most widely used methods for psychotherapy of patients suffering from chronic somatic diseases (CSD). A number of studies have demonstrated the improvement of the psychological status in the patients under the influence of autogenic training. However, up to the present time, both the mechanisms underlying the therapeutic effectiveness and the predictors of the AT effectiveness have remained to be poorly studied which hampers the development of differentiated indications for the application of this technique. AIM: The objective of the present study was to estimate the effectiveness of AT and to identify the predictors of the outcomes of the treatment of patients presenting with chronic somatic diseases. MATERIAL AND METHODS: The study included 325 patients with CSD who were examined with the use of the shortened multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomized into two groups. Group 1 (main) was comprised of 163 patients who underwent AT-based psychotherapy, group 2 (control) consisted of 162 patients who did not receive the psychotherapy. In order to identify the predictors of AT effectiveness, the patients of the main group were subdivided into two subgroups at the end of the study period: (a) including 128 patients whose psychologic status was normalized under psychotherapy and (b) containing 35 patients showing the improvement of their health status. The comparative analysis of the baseline characteristics of the patients belonging to each group was performed. RESULTS: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of scales 1, 2, and 7 indicators, an increase of the SMPI scale 9 indicators, and a decrease of STAI and BDI indicators. The positive impact of autogenic training on the psychological status of the patients was mostly attributable to the reduction of anxiety, tension, fixation on negative sensations, and sensitivity to the stress factors as well as to the increased activity and the improved mood. The study of AT predictors revealed that the increase of scales 4 and 6 of SMPI and BDI indicators fairly well predicts the lack of the effectiveness of the method under consideration. CONCLUSIONS: The beneficial influence of the autogenic training on the psychological status of the patients presenting with chronic somatic diseases is mainly mediated through the decrease of anxiety, tension, fixation on negative feelings, sensitivity to stressful influences, increased activity, and improved mood of the patients. A study of AT effectiveness predictors revealed that an increased level of rigidity reduces the effectiveness of this method because of the tendency of the patients toward making excessive efforts to achieve the state of relaxation. The predictors of the high effectiveness of AT the development of which requires regular training proved to be a moderate decrease of the psychological adaptation level together with such characteristics as the ability of the patients to control their behavior, purposefulness, and perseverance in achieving the goal.

PREVALENCE OF DISEASES AMONG ADOLESCENT POPULATION IN DNEPROPETROVSK REGION (UKRAINE), CORRELATED WITH DRINKING WATER QUALITY DETERIORATION.

Purpose of research was to study dynamics prevalence of diseases among children' population in the separate rural tacsons of Dnepropetrovsk region; to carry out correlation analysis between some indicators of drinking water quality and prevalence of diseases. Research indicators of prevalence of diseases was carried out in the 6 types of tacsons of Dnipropetrovsk region (Ukraine) during 2008 - 2013 years (totally 522720 indicators). It was proved that (I, II, III, XI, XIII, XIV) classes of diseases takes the first place by the prevalence of diseases in the majority of rural tacsons. Correlation between higher salt content of the potable water taking from decentralized sources and content of some heavy metals (Zn, Cu, Mn) and some substances (pH, F, Al, nitrogen ammonia, nitrites, nitrates, oxidability) and the prevalence of diseases among children: tumors (r=0.87); diseases of blood and hematopoetic organs (r=0.74-0.95); anemia (r=0.79-0.87); diseases of genitourinary system (r=0.79-0.82); congenital anomalies (r=0.87), including circulatory system (r=0.74-0.95) was revealed in the separate tacsons of Dnepropetrovsk region (p<0.001).

In-vivo longitudinal imaging of microvascular changes in irradiated oral mucosa of radiotherapy cancer patients using optical coherence tomography.

Mucositis is the limiting toxicity of radio(chemo)therapy of head and neck cancer. Diagnostics, prophylaxis and correction of this condition demand new accurate and objective approaches. Here we report on an in vivo longitudinal monitoring of the oral mucosa dynamics in 25 patients during the course of radiotherapy of oropharyngeal and nasopharyngeal cancer using multifunctional optical coherence tomography (OCT). A spectral domain OCT system with a specially-designed oral imaging probe was used. Microvasculature visualization was based on temporal speckle variations of the full complex signal evaluated by high-pass filtering of 3D data along the slow scan axis. Angiographic image quantification demonstrated an increase of the vascular density and total length of capillary-like-vessels before visual signs or clinical symptoms of mucositis occur. Especially significant microvascular changes compared to their initial levels occurred when grade two and three mucositis developed. Further, microvascular reaction was seen to be dose-level dependent. OCT monitoring in radiotherapy offers a non-invasive, convenient, label-free quantifiable structural and functional volumetric imaging method suitable for longitudinal human patient studies, furnishing fundamental radiobiological insights and potentially providing useful feedback data to enable adaptive radiotherapy (ART).

[The specific features of the psycho-emotional status and the application of psychotherapy for the rehabilitative treatment of the patients presenting with rheumatoid arthritis]. / Osobennosti psikhoémotsional'nogo sostoianiia i psikhoterapiia v reabilitatsii bol'nykh revmatoidnym artritom.

The relevance of the problem of rheumatoid arthritis arises from the influence of such factors as its prevalence rate, unpredictability, tendency towards the transition to the chronic form, severe pain syndrome, high levels of disability, and long-term loss of working ability, as well as the accompanying psycho-emotional disorders. The present reviews article was designed to analyze the premorbid personality characteristics, the specifics features of mental health, and the response to the disease in the patients presenting with rheumatoid arthritis. Special emphasis is placed on the discusses of the relationship between the intensity of the pain syndrome and psycho-emotional disorders. The factors responsible for the development of the depressive states associated with rheumatoid arthritis are distinguished; they are shown to be related to both pathogenesis and the clinical symptoms of the underlying pathology as well as the general course of the disease and the specific features of the patients' psychological condition. The most extensively applied psychodiagnostics techniques are described, and the commonest psychotherapeutic approaches to the combined therapy and rehabilitation of the patients presenting with rheumatoid arthritis are overviewed.

Photodynamic therapy monitoring with optical coherence angiography.

Photodynamic therapy (PDT) is a promising modern approach for cancer therapy with low normal tissue toxicity. This study was focused on a vascular-targeting Chlorine E6 mediated PDT. A new angiographic imaging approach known as M-mode-like optical coherence angiography (MML-OCA) was able to sensitively detect PDT-induced microvascular alterations in the mouse ear tumour model CT26. Histological analysis showed that the main mechanisms of vascular PDT was thrombosis of blood vessels and hemorrhage, which agrees with angiographic imaging by MML-OCA. Relationship between MML-OCA-detected early microvascular damage post PDT (within 24 hours) and tumour regression/regrowth was confirmed by histology. The advantages of MML-OCA such as direct image acquisition, fast processing, robust and affordable system opto-electronics, and label-free high contrast 3D visualization of the microvasculature suggest attractive possibilities of this method in practical clinical monitoring of cancer therapies with microvascular involvement.

[The application of the biological feedback technique for the treatment of the patients presenting with chronic somatic diseases]. / Primenenie metoda biologicheskoi obratnoi svyazi pri lechenii patsientov s khronicheskimi somaticheskimi zabolevaniyami.

The objective of the present work was to study the influence of the application of the biological feedback (BFB) technique on the dynamics of the psychological and clinical status of the patients presenting with various chronic somatic diseases (CSD) and to identify the predictors of the effectiveness of the treatment by this method. PATIENTS AND METHODS: The study included 337 patients suffering from CSD who were interviewed with the use of the concise standardized multifactorial personality inventory (SMPI), the Spielberger State-Trait Anxiety Inventory (STAI), and the Beck depression inventory (BDI) scales. The patients were randomly distributed into two groups. Group 1 (main) was comprised of 168 patients who underwent psychotherapeutic treatment based on the BFB method, group 2 (control) consisted of 169 patients who did not receive the psychotherapeutic treatment. In order to identify the predictors of the effectiveness of the treatment by the biological feedback technique, the patients of the main group were subdivided into two subgroups at the end of the study period. Subgroup A contained 112 (67%) patients whose health status was normalized under the influence of psychotherapy, subgroup B included 56 (33%) patients who experienced the improvement of the somatic conditions. We undertook the comparative analysis of the background characteristics of the patients belonging to each group. RESULTS AND DISCUSSION: The study has demonstrated that by the end of the observation period the patients of the main group showed a significantly more pronounced (compared with controls) decrease of the parameters estimated based on the scales 1, 2, and 7 and an increase of those evaluated based on the (SMPI) scale 9. Simultaneously, the levels of state and trait anxiety estimated based on the Spielberger и Beck inventory scales decreased. These findings give evidence of the improvement of psychological adaptation of the patients, decrease of the anxiety level and emotional stress under the influence of the treatment with the use of the biological feedback technique; these changes were concomitant with the enhancement of the general activity of the patients, the improvement of their working capacity, mood, and feelings of optimism. The study of the predictors of the effectiveness of the BFB method revealed the significantly higher background values estimated based on the SMPI scales 1, 4, and 6 in the patients with the improvement of the health status compared with those exhibiting normalized conditions (p<0,01). In 12% of the patients in the former subgroup (but in none of the patients of the latter subgroup), the values obtained based on the Beck scale were higher than 20 scores which suggested either the moderate or high level of depression. These data give reason to conclude that the patients that exhibited a relatively weak response to the treatment with the application of the biological feedback technique were initially predisposed to the un-necessary excessive fixation of attention on their sensations in the combination with enhanced impulsivity, rigidity of attitudes, and the presence of depressive disorders.

[The application of the system of «reminder stickers¼ for the rehabilitation programs with the use of behavioural therapy for the patients presenting with anxiety disorders]. / Sistema stikernykh napominanii v programmakh reabilitatsii s primeneniem povedencheskoi terapii u patsientov s trevozhnymi rasstroistvami.

UNLABELLED: This article was designed to report the results of research on the effectiveness of the new original «reminder stickers¼ technique proposed by the authors for the management of the patients undergoing rehabilitation based on behavioral therapy. The essence of this technique consists of providing the patients with systematic reminders of the need to implement skills aimed at coping with maladaptive sensations that accompany anxiety disorders. AIM: The objective of the present study was to evaluate the effectiveness of using the «reminder stickers¼ technique for the formation of stable responses to the correction of the target clinical symptoms. PATIENTS AND METHODS: The study involved 118 patients suffering from anxiety disorders allocated to two groups for comparison. Group 1 was comprised of the patients (n=76) given the reminders while group 2 contained those (n=42) not included in the system of «reminder stickers¼. The difference between the parameters of interest in the two groups was estimated with the use of Mann-Whitney and Kolmogorov-Smirnov tests. RESULTS: The analysis of diary records of the patients was used to evaluate the frequency of occurrence of maladaptive sensations that required the application of the appropriate behavioural skills and the frequency of the missed or delayed responses as well as the level of subjective satisfaction of the patients with the stability of the acquired skills. It was shown that the patients given «reminder stickers¼ significantly more frequently reported situations that required the application of the appropriate skills within the first week after the initiation of monitoring than the patients of group 2 (р<0,0001). The frequency of the missed or delayed responses in these patients was significantly lower than in group 2 (р<0,0001) whereas the degree of subjective satisfaction with the stability of the acquired skills was much higher (р<0,0001). These differences persisted during week 2 after the onset of monitoring when the frequency of maladaptive sensations that required the application of the previously formed behavioural skills of therapeutic significance in the patients given «reminder stickers¼ remained lower than in the patients to whom no such «remainders¼ were provided (р=0,001). The frequency of the missed or delayed responses in these patients decreased significantly in comparison with that in group 2 (р<0,0001),) while the degree of subjective satisfaction of the patients with the stability of the acquired skills further increased (р<0,0001). CONCLUSION: The results of the study indicate that inclusion of «reminder stickers¼ in the structure of cognitive-behavioral therapy at the stages of formation of the skills needed to cope with maladaptive sensations enhances the ability of the patients presenting with anxiety disorders to much more often timely identify situations that require the use of the appropriate behavioural skills and to apply them. It is concluded that the application of the original «reminder stickers¼ technique ensures an adequate response of the patients to maladaptive sensations that accompany anxiety disorders.

[Genetic stability of the HA, NA, and NS genes of the recombinant vector virus Flu-NS1-124-Omp16 (H5N1) expressing the brucellar gene].

The recombinant strain Flu-NS1-124-Omp16 (H5N1) of the influenza virus expressing the brucellar Omp16 gene was constructed on the basis of the technology of reverse genetics for the purpose of developing vector anti-brucellosis vaccine. The obtained recombinant strain is a genetically stable construction. This stability is confirmed by the comparative analysis of the nucleotide sequences of the HA, NA, and NS genes of the recombinant vector virus Flu-NS1-124-Omp16 (H5N1) expressing the Omp16 gene of the Brucella abortus (GenBank: AAA59360.1). The comparative analysis showed that the nucleotide sequence of the NS gene of the first and the fifth passage level of the Flu-NS1-124-Omp16 (H5N1) virus corresponded for 100% to the initial part of 12AAS2TC_124 Omp16g containing the chimera NS1-124-Omp16 in the composition of DNA (deoxyribonucleic acid) plasmids pHW2000. Total identity with HA and NA genes of the strain A/AstanaRG/6:2/2009 (H5N1) was shown by the comparative analysis of the nucleotide sequences of HA and NA genes of the first and the fifth passage level of the recombinant strain Flu-NS1-124-Omp16 (H5N1). The recombinant vector virus Flu-NS1-124-Omp16 (H5N1) expressing the brucella Omp16 gene maintains the genetic stability during 5 passages in 10-day developing chicken embryos.

[The role of the respiratory and relaxation training in the treatment of the patients after the surgical treatment of non-specific pulmonary diseases].

The present study included 62 patients who had undergone the surgical intervention for the treatment of non-specific pulmonary diseases. All the patients were subjected to the psychological and spirometric examination. The study has demonstrated the relationship between the characteristics of the external respiration function on the one hand and the ability to handle stress, the levels of anxiety, tension, emotional instability and hypochondriacal mood on the other hand. It was shown that the respiratory and relaxation training improves the effectiveness of the treatment of the patients presenting with such symptoms due to the correction of their psychological status and optimization of the external respiration function. The highest effectiveness of the respiratory and relaxation training was documented in the patients suffering moderate neurotic disorders.