[The role of ω-3 polyunsaturated fatty acids in child development].

ω-3 polyunsaturated fatty acids (PUFAs) are incorporated in cell membranes and play an important role in the development and functioning of organs. Consolidation of data on the role of ω-3 PUFAs in child development may increase the professional's awareness, help to plan clinical studies, and develop recommendations for supplementation. The aim of the research was to analyze literature data on the effect of ω-3 PUFAs on the central nervous system, immune system, and vision in children. Material and methods. 86 literature sources have been analyzed, a keyword search was carried out in the PubMed, Scopus, Elsevier, eLibrary and Google Scholar databases. Results. ω-3 PUFAs (alpha-linolenic, docosahexaenoic and eicosapentaenoic acids) are not synthesized in the human organism, and should be obtained from food. The need for ω-3 PUFAs is especially high during periods of rapid growth (the first years of life and adolescence). ω-3 PUFAs play an important role in the anatomical and functional development of the brain, affecting the maturation and functioning of neurons, participating in the processes of neurogenesis, migration, synaptogenesis, and neurotransmission. The results of clinical studies on the effect of ω-3 PUFAs on the cognitive functions of healthy children and patients with attention deficit hyperactivity disorder are contradictory, which requ ires further research. PUFAs are substrates for the synthesis of bioactive compounds and take part in the control of acute and chronic inflammation, and also have a regulatory effect on immune cells. ω-3 PUFAs supplementation decreases the frequency and duration of acute respiratory viral infections in children. This indicates the potential effectiveness of ω-3 PUFAs in the prevention of acute respiratory viral infections. Сlinical studies demonstrated positive effects of ω-3 PUFAs on retinal development in premature infants. Conclusion. Adequate intake of ω-3 PUFAs is essential for the development and functioning of the central nervous system, immune system and vision in children. The body content of ω-3 PUFAs is closely related to the nutrition. In the Russian Federation, consumption of fish and other products containing ω-3 PUFAs is traditionally low. The majority of the Russian population has a deficiency in ω-3 PUFA consumption. With an unbalanced diet, supplementation of ω-3 PUFAs is necessary.

[The problem of comorbid disorders in attention deficit hyperactivity disorder in children and adolescents: clinical cases]. / Problema komorbidnykh rasstroistv pri sindrome defitsita vnimaniya s giperaktivnost'yu u detei i podrostkov i ikh korrektsiya: klinicheskie nablyudeniya.

The problem of comorbid disorders in attention deficit hyperactivity disorder (ADHD) is considered, which occur in at least 60% of patients and lead to additional difficulties in intra-family, school and social adaptation. Children and adolescents with ADHD have a wide range of neurological and somatic disorders caused by complex polygenic pathogenetic mechanisms. Among the pathologies associated with ADHD in this cohort of children, neurotic and anxiety manifestations, motor disorders: dyspraxia, discoordination, impaired gross and fine motor skills, tics, behavioral disorders, enuresis, tension cephalgia are common disorders. Treatment of ADHD should be pathogenetic, taking into account the main symptoms of ADHD and manifestations of comorbid disorders, since it is quite long. When choosing pharmacotherapy, it is preferable to use drugs with verified efficacy not only in the correction of ADHD, but also concomitant behavioral, motor and emotional disorders. Also an important aspect in the pediatric clinic is the use of drugs with a reliable safety profile.

[Plastic surgery and fighting: Our experience during Nagorno-Karabakh war in 2020]. / Chirurgie plastique et conflit armé : notre expérience lors du conflit au Haut-Karabakh en 2020.

INTRODUCTION: This work relates the experience of three French surgical missions in the care of the war wounded during the armed conflict in Nagorno Karabakh which took place from September 27 to November 10, 2020. MATERIALS AND METHODS: Three surgical missions were carried out in Armenia between October 2020 and January 2021. Surgeons intervened in different hospitals, at different times of the conflict and on various war wounds. RESULTS: The presence of a plastic surgeon proved to be essential in the care of war wounded, especially in delayed emergency and secondary care. The ortho-plastic treatment offered during these missions has proven to be effective in the reconstruction of limbs. These missions made it possible to introduce the induced membrane technique of Masquelet AC in Armenia. During our visit to the Yerevan burn center, we mentioned the very probable use of white phosphorus as an etiology in several of the cases analyzed. CONCLUSION: We relate the particular experience of civilian surgeons in the context of a modern armed conflict. The presence of a plastic surgeon proved to be indispensable in the care of war wounded and especially in their secondary reconstructions.

A patient with extensive neck defects Management of this unusual clinical situation.

Among all thermal burn injuries, electrical burns are the most unpredictable and are characterized by the damage of depressing and functionally important anatomical structures, as well as an extensive volume of tissue damage. The tactics of treating such post-burn defects require always an individual and non-standard approach. In this article, a clinical example of the plastic closure of a neck defect is presented, as a result of a high-voltage electric burn received, with counter skin-muscular flaps based on m. platysma. Considering the major role of the lymphatic system in microcirculation, in the pathogenesis of inflammatory processes and the immune response of the body, during the planning of the operation anatomical features of the lymphatic vessels of the anterior surface of the neck were studied. The result of the operation was a primary, full-fledged closure of the defect with two opposing cutaneous muscle flaps with unilateral lymph node preservation as well as a full functional restoration of the neck motion. KEY WORDS: Electrical burns, Flaps lymph flow, Lymphatic system, Lymph nodes, Neck defect, Nonstandard clinical situations, Reconstruction.

The role of nelarabine in the treatment of T-cell acute lymphoblastic leukemia: literature review and own experience.

AIM: The analysis of experience of nelarabine use in refractory/relapsed T-cell acute lymphoblastic leukemia (T-ALL) depending on the immunophenotype and the line of therapy. MATERIALS AND METHODS: All the patients with relapsed or refractory T-ALL aged from 0 to 18 years who received treatment with nelarabine as a part of the therapeutic element R6 were included in the study. For all patients a detailed immunological analysis of leukemia cells with discrimination of immunological variants TI, TII, TIII or TIV was performed. Patients administered with nelarabine as a first therapeutic element were referred to the first-line therapy group, other patients were referred to the second-line therapy group. Nelarabine was ad- ministered as intravenous infusion at a dose of 650 mg/m2, on days 1-5. Allogeneic hematopoietic stem cells transplantation (allo-HSCT) was considered for all patients. RESULTS: From 2009 to 2017, 54 patients with refractory/relapsed T-ALL were treated with nelarabine. Five-year event-free survival (EFS) and overall survival (OS) was 28% for all patients, cumulative risk of relapse (CIR) was 27%. EFS was significantly higher in nelarabine first-line therapy group in comparison with second-line therapy group (34±8% vs 8±8%, p=0,05). In patients after allo-HSCT EFS, OS and CIR were 51±10%, 50±10% and 39,1±9,5% accordingly. The best results were achieved in patients with TI immunophenotype. No toxicity-related mortality as well as severe neurologic complications or discontinuation of therapy associated with use of nelarabine were reported. CONCLUSION: The use of nelarabine is an effective strategy for the treatment of relapsed and refractory T-ALL. The best treatment outcomes were obtained in patients with TI immunophenotype and in the first-line therapy group. Optimal dosage regimens can be established dur- ing controlled clinical trials.

Molecular products and radicals from pyrolysis of lignin.

Thermal degradation of lignin under two reaction regimes (pyrolysis in N(2) and oxidative pyrolysis in 4% O(2) in N(2)) has been investigated in a tubular, isothermal, flow-reactor over the temperature range 200-900 °C at a residence time of 0.2 s. Two experimental protocols were adopted: (1) Partial pyrolysis in which the same lignin sample was continuously pyrolyzed at each temperature and (2) conventional pyrolysis, in which new lignin samples were pyrolyzed at each pyrolysis temperature. The results identified common relationships between the two modes of experiments, as well as some differences. The majority of products from partial pyrolysis peaked between 300 and 500 °C, whereas for conventional pyrolysis reaction products peaked between 400 and 500 °C. The principal products were syringol (2,6-dimethoxy phenol), guaiacol (2-methoxy phenol), phenol, and catechol. Of the classes of compounds analyzed, the phenolic compounds were the most abundant, contributing over 40% of the total compounds detected. Benzene, styrene, and p-xylene were formed in significant amounts throughout the entire temperature range. Interestingly, six ringed polycyclic aromatic hydrocarbons were formed during partial pyrolysis. Oxidative pyrolysis did not result in large differences from pyrolysis; the main products still were syringol, guaiacol, phenol, the only significant difference being the product distribution peaked between 200 and 400 °C. For the first time, low temperature matrix isolation electron paramagnetic resonance was successfully interfaced with the pyrolysis reactor to elucidate the structures of the labile reaction intermediates. The EPR results suggested the presence of methoxyl, phenoxy, and substituted phenoxy radicals as precursors for formation of major products; syringol, guaiacol, phenols, and substituted phenols.

Molecular modeling studies of the reactions of phenoxy radical dimers: pathways to dibenzofurans.

The B3LYP hybrid density functional computational technique was applied to describe the sequence of phenoxy radicals coupling reactions leading to the formation of dibenzofurans. Reaction kinetic parameters were estimated for key reactions. Aromatization of bis-keto dimers of phenoxy radicals followed by intermediate dehydration or dehydroxylation was demonstrated to be a strongly stereoselective process. While the S,S-diastereomer of the ortho-C//ortho-C keto dimer forms (o,o')-dihydroxybiphenyl, a known dibenzofuran intermediate, via inter-ring hydrogen transfer reaction, the less stable R,S-stereoisomer can easily be transformed into another 5-hydroxyl-4,5-cyclohexadiene-2,3-benzofuran intermediate that provides an energetically more favorable pathway for formation of dibenzofuran. The possible channels of radical-chain processes that convert these intermediates to dibenzofuran and polychlorinated dibenzofurans are discussed.

Development of expanded and core kinetic models for the gas phase formation of dioxins from chlorinated phenols.

Expanded, 45 reaction, and core, 12 reaction, kinetic models have been developed that account for the major features in the homogeneous formation of polychlorinated dibenzo-p-dioxins (PCDD) from the oxidation of 2,4,6-trichlorophenol (P). The expanded and core schemes provide good agreement between experimental and calculated yields of PCDDs using the CHEMKIN combustion package or the React kinetic program, respectively. Steady-state approximations of the reaction kinetic models including radical-molecule and radical-radical formation pathways of PCDD, as well as oxidative destruction pathways of chlorinated phenoxyl radicals, reveal a competition between reactions of chlorinated phenoxyl radicals with chlorinated phenols, recombination reactions of chlorinated phenoxyl mesomers, and destruction/decomposition of phenoxyl radicals.