[Hydrogen sulfide balneotherapy in comprehensive sanatorium-resort treatment of post-burn scars in children]. / Serovodorodnaya bal'neoterapiya v kompleksnom sanatorno-kurortnom lechenii posleozhogovykh rubtsov u detei.

Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy is an integral part of rehabilitation measures in such patients. OBJECTIVE: To analyze the results of hydrogen sulfide balneotherapy in children with consequences of thermal injury. MATERIAL AND METHODS: A single-center observational retrospective non-controlled study was carried out, in which sanatorium-resort treatment concerning post-burn scars in 812 children aged 5-17 years was analyzed. Hydrogen sulfide balneotherapy was prescribed to patients depending on the age in mild (5-6 years) or moderate-to-high (7-17 years) exposure modes. The imported hydrogen sulfide mineral water from the T-2000 well of the Matsesta field with the H2S total concentration of 410-420 mg/l was used for treatment. The applications were performed to children alternate days, 8 procedures of balneotherapy per course. RESULTS: Lightening of the affected areas of the skin, reduction of the sensation of contraction and tension of the scars, which became softer, more elastic and more mobile with regard to the subjacent tissues have been noted in patients after the course of balneotherapy. The head mobility increased after applications in the presence of scars. The large joints' range of motion grew up. In addition, an increase in the mobility of the fingers of wrists and feet, a decrease in the stiffness of movements, increase or recovery of the affected skin's tactile sensitivity have been observed. Children well tolerated procedures, adverse events were seen in 0.7% of cases in the form of mild reactions at the beginning of the applications' course, namely of balneological (0.6%) and toxico-allergic (0.1%) nature. CONCLUSION: Hydrogen sulfide balneotherapy in combination with rehabilitation exercises and other sanatorium-resort factors is an effective mean of post-burn scars correction in children.

[Transcranial magnetic stimulation in the treatment of depressive disorder in Parkinson's disease]. / Primenenie transkranial'noi magnitnoi stimulyatsii v lechenii depressivnogo rasstroistva pri bolezni Parkinsona.

The prevalence of affective disorders in patients with Parkinson's disease (PD) is significantly higher than in the general population of people of the same age. It is known that the effectiveness of antidepressants in PD with depressive disorder is lower than in patients with primary depression. For depression resistant to standard treatments, other therapeutic strategies are available. Transcranial magnetic stimulation (TMS) is one of the most popular and safe brain stimulation methods that has been successfully used to treat primary depression. The accumulation of experience in the use of TMS has made it possible to expand the application of the method to other diseases, including PD. The article provides literature data on the use of different TMS protocols for the treatment of depressive disorder in patients with PD.

[Artificial intelligence in the diagnosis of prostate cancer]. / Iskusstvennyi intellekt v diagnostike raka predstatel'noi zhelezy.

OBJECTIVE: To discuss the possibilities and prospects of using artificial intelligence (AI) in the diagnosis of prostate cancer (PC). The laboratory diagnosis of PC is considered and prostate images are analyzed according to transrectal ultrasound and magnetic resonance imaging using AI algorithms. Particular emphasis is placed on prostate histologic evaluation.

An analysis of missed cases with surgical emergencies admitted in non-surgical departments. Case series and а review of the literature.

INTRODUCTION: The delayed diagnosis in emergency surgery can be associated with significant morbidity and mortality and often lead to litigations. The aim of the present work is to analyse the outcome in cases with non-trauma surgical emergencies wrongly admitted in non-surgical departments. METHODS: A retrospective trial in two independent University hospitals was conducted. The first group encompassed the patients worked-up in the Surgical unit of Emergency department (2014-2018). The second one included all cases visited Emergency department (2018). Only cases with acute abdomen and delayed diagnosis and operation were included. The analysis included the proportion of the delayed diagnosis, time between admission and operation, intraoperative diagnosis, complications and mortality rate. RESULTS: In the first group there were 30 194 visits in the surgical unit with 15 836 hospitalizations (52.4%). Twenty patients of the last (0.13%) were admitted in the Clinic of Infectious disease and subsequently operated. The mean delay between hospitalization and operation was 3 days (1-10). Seventeen patients (85%) were operated with mortality of 10%. In the second group, there were a total of 22 760 visits with 11 562 discharged cases. Of the last, 1.7% (n=192) were re-admitted in a surgical ward, 25 of which underwent urgent surgery (0.2%). CONCLUSIONS: The missed surgical cases represent only a small proportion of the patients in emergency department. The causes for wrong initial admissions in our series were misinterpretation of the symptoms, insufficient clinical examination and underuse of US and CT. The careful clinical assessment, point-of care US and CT may decrease the rate of the delayed diagnosis.

Giant-cell arteritis without cranial manifestations presenting as fever of unknown origin: a diagnostic value of 18F-FDG PET/CT.

We present a case of 68-year-old female with four months history of fever, fatigue, and weight loss. She was classified as case of fever of unknown origin. The physical examination was normal, the laboratory tests showed anemia, elevation of C-reactive protein, erythrocyte sedimentation rate and fibrinogen. The diagnosis was unclear and 18F-FDG PET/CT was performed. Images showed high glucose uptake in the wall of the ascending and descending aorta, in the walls of the subclavian arteries, abdominal aorta and proximal part of both iliac arteries. The diagnosis of GCA appeared most likely and steroid treatment was initiated. After the therapy, clinical signs disappeared, laboratory parameters normalized and follow-up 18F-FDG PET/CT demonstrated lack of glucose uptake in the vessels' walls. We observed remission. 18F-FDG PET/CT offers a possibility for early detection of inflammation in the vessels and could be used for assessment of therapy response. Performing this nuclear imaging method in a clinical setting, where there is suspicion of large-vessel vasculitis is of great benefit for the final outcome.

[Development and assessment of efficacy of L-polylactide matrix for creation of a tissue-engineered vascular graft]. / Razrabotka i otsenka éffektivnosti matritsy iz L-polilaktida dlia sozdaniia tkaneinzhenernogo sosudistogo implantata.

In order to create a tissue-engineered vascular graft we elaborated a matrix consisting of nanofibres of biodegradable polymer L-polylactide. We worked out the methodology of crystallization of the matrix on a rod, making it possible to manufacture specimens possessing strength and deformity characteristics superior to those of native vessels. This was followed by a series of chronic experiments on implanting the elaborated matrix into the abdominal aorta of rats for the duration of up to 16 months. We obtained satisfactory parameters of the patency of the matrices (71%). According to the findings of histological examination, in the course of time there occurred biodegradation of the matrix and formation of a new vascular wall, with no evidence of either inflammation or neointimal hyperplasia in the zone of the anastomoses. Resorption of the polymeric fibres commenced 12 weeks after exposure and completely terminated after 64 weeks. By that time, both neointima and neoadventitia were formed, whose composition and structure were close to those of the native vessel. Insufficiently high mechanical properties of the zone of reconstruction turned out to be the cause of the formation of aneurysms.

Tissue-Engineered Vascular Graft of Small Diameter Based on Electrospun Polylactide Microfibers.

Tubular vascular grafts 1.1 mm in diameter based on poly(L-lactide) microfibers were obtained by electrospinning. X-ray diffraction and scanning electron microscopy data demonstrated that the samples treated at T = 70°C for 1 h in the fixed state on a cylindrical mandrel possessed dense fibrous structure; their degree of crystallinity was approximately 44%. Strength and deformation stability of these samples were higher than those of the native blood vessels; thus, it was possible to use them in tissue engineering as bioresorbable vascular grafts. The experiments on including implantation into rat abdominal aorta demonstrated that the obtained vascular grafts did not cause pathological reactions in the rats; in four weeks, inner side of the grafts became completely covered with endothelial cells, and fibroblasts grew throughout the wall. After exposure for 12 weeks, resorption of PLLA fibers started, and this process was completed in 64 weeks. Resorbed synthetic fibers were replaced by collagen and fibroblasts. At that time, the blood vessel was formed; its neointima and neoadventitia were close to those of the native vessel in structure and composition.

Vascular Prostheses Based on Nanofibers from Aliphatic Copolyamide.

Tubular grafts based on nanofibers of copolymer of ε-caprolactam and hexamethylendiaminadipate were obtained by the electrospinning method. The strength of materials based on the dry nanofibers was 6.2 MPa with elongation at break of 133%, or 7.5 MPa and 299% in saline, respectively. The pressure value at which liquid started seeping through the tube wall was P = 10 kPa. Absence of cytotoxicity was proved, as well as adhesion and proliferation of mesenchymal stem cells on the surface. Tubes with inner diameter of 1 mm were tested in vivo in rat abdominal aorta. A layer of endothelial cells was shown to form on the inner side of the prosthesis after 30 days. There was no evidence of stenosis or dilatation of the prosthesis after 14 months with observation of endothelial and subendothelial layers.

[The Specific Effects of Magnetic Stimulation Depending on the Specialization of Sportsmen].

The article presents data on the effect of magnetic stimulation of quadriceps muscle in the professional sportsmen: cyclists and long jumpers (Magstim Rapid 2 magnetic stimulator was used). In the experiments involving 3 cyclists and 4 long jumpers, both male and female, we observed an increase in the effect of FR muscle fibers (Burke classification) on the process of muscle tension during magnetic stimulation in the frequency range of the activity of motor units. We found some differences between these two types of sportsmen, which result from the characteristics of muscle tension during typical muscle activity.

[PROSPECTS FOR THE TREATMENT OF IDIOPATHIC AND NEUROGENIC OVERACTIVE BLADDER].

Overactive bladder (OAB) is a common problem in modern population. The main line of medical treatment of this condition is the use of M-cholinoblockers. Solifenacin has shown high selectivity for the bladder in preclinical studies. Data on the efficacy and safety of high-dose (10 mg/day) of solifenacin are insufficient. The study was aimed to the comparative evaluation of the effectiveness and safety of solifenacin at a dose of 5 and 10 mg/day. The study included 28 patients (17 women and 11 men), mean age was 41.3±6.7 years. All patients were divided into two groups. In Group 1 included 12 patients with idiopathic overactive bladder, the Group 2 (n=16) - with neurogenic overactive bladder. Depending on the effect obtained, in some patients the dose was increased to 10 mg/day 1 month after starting treatment. The duration of treatment was 12 weeks. Application of solifenacin at a dose of 5 mg in patients with overactive bladder significantly reduces the severity of symptoms. Increasing the dose was required in 3 (25%) patients with idiopathic OAB and in 10 (62.5%) - with neurogenic OAB. Patients unsatisfied by therapy with solifenacin 5 mg/ day initially had more severe symptoms of the disease - significantly more urgency frequency, incontinence episodes, and nocturia. The use of high doses of solifenacin increased the effectiveness of treatment. Statistical significance was achieved for all parameters evaluated. Against the background of increasing doses, the number ofadverse effects may increase, but within a month of therapy in most cases they are reduced.

[Apathy in the structure of mental and neurological disorders of the old age].

The studies on apathy, a common phenomenon in psychiatry, are summarized. The definitions of this term suggested by different authors are presented. The difference between apathy as a symptom and apathy as a syndrome is described. Main pathogenetic mechanisms of the development and epidemiology of this disorder, the results on the differential diagnosis of apathy and depression in patients with neurological and mental diseases as well as methods of treatment are presented.

In vitro study of the role of lenticular epithelial calcium channels and aquaporins in the development of cataract.

The role of calcium and water channels (aquaporins) in the pathogenesis of cataract was studied in vitro. Aquaporin blockade caused opacity of the lens sooner than changes in calcium ion concentration in culture medium.

[Clinical and pharmacoeconomic peculiarities of the treatment with cerebrolysin in the period of rehabilitation of is ischemic stroke.].

The results of the clinical and pharmacoeconomic study of cerebrolysin in the rehabilitative therapy of ischemic stroke presented in the paper revealed the statistically significant regress of neurological disturbances in patients receiving cerebrolysin in daily dosages of 10 and 20 ml as compared to the control group. The rehabilitation of motor functions was more rapid than sensitive ones in patients receiving cerebrolysin comparing to those switched to the basic antihypertensive and antiaggregate therapy. The positive dynamics of speech rehabilitation was observed, the regress of aphatic disturbances being more significant for daily dosage of 20 ml. Rehabilitation rate in the period of treatment with cerebrolysin was higher for daily dosage of 20 ml than that of 10 ml. A prolonged effect of the drug during the long period after its withdrawal was found that resulted in higher rates of rehabilitation to the 11th week in patients receiving cerebrolysin as compared to the control group. Average total cost of direct medical expenses per a patient estimated in the pharmacoeconomic analysis for the groups receiving cerebrolysin and the control group was higher in the former groups, in particular in that with 20 ml dosage of cerebrolysin. A cost-efficacy analysis revealed that the cost of cerebrolysin treatment per effective unit (a cost of one score on the Lindmark scale and the Barthel scale) was less or comparable in patients receiving cerebrolysin comparing to the control group. The study suggests clinical and pharmacoeconomic expediency of cerebrolysin treatment in rehabilitative period of ischemic stroke.

Effect of low-intensity laser radiation on peripheral blood eosinophils.

The study was performed on peripheral blood eosinophils isolated on a Ficoll-Verografin continuous-density gradient. Low-intensity laser radiation (lambda=0.89 mu, 25-30 mW power, 8 min exposure) induced degranulation of peripheral blood eosinophils. The effect of low-intensity laser radiation was realized via activation of calcium channels.

[Pathophysiologic mechanisms of tissue revascularization using high intensity laser exposure]. / Patofiziologicheskii mekhanizm revaskuliarizatsii tkanei s pomoshch'iu vozdeistviia vysokointensivnogo lazernogo izlucheniia.

Satellite cellular populations (mast cells, blood platelets and fibroblasts) were found to be the promoters in forming the new vessels. When irradiated by laser, the mentioned cells act as the main source for the angiogenic growth factors and matrix metalloproteinases, which comprehensively stimulate the proliferation and migration of endothelial and smooth-muscle vascular cells. Neo-angiogenesis, in response to the laser impact, is a stereotype, adaptive reaction of tissues to laser damage irrespective of a tissue type.

Expression of vascular endothelial growth factor during neoangiogenesis stimulated by exposure to high-intensity laser radiation.

Expression of vascular endothelial growth factor was studied during neoangiogenesis stimulated by exposure of ischemic tissues in the limb muscles, liver, and myocardium and normal myocardial tissue to high-intensity laser radiation. Changes in expression were related to cell reactions during the inflammatory and reparative process and did not differ in the studied tissues.

[Expression of endometrial proteins in the uterine glands in physiological and non-developing pregnancy]. / Ekspressiia éndometrial'nykh belkov v matochnykh zhelezakh pri fiziologicheskoi i nerazvivaiushcheisia beremennosti.

It is established that at the 1st trimester of the progressing pregnancy uterine glands produce both endometrial proteins (placental al-microglobulin--PAMG) and alpha 2-fertility microglobulin (AFMB) but with different intensity: maximum level of PAMG is at early periods (4-5 weeks) but 8-9 weeks of gestation for AFMB. Production deficiency of PAMG and AFMB in the glands epithelium is found in 90% cases of non-developing pregnancy (4-7 weeks) and this is obviously one of the causes of early pregnancy interruption.

[Mechanism of laser radiation action at tissue and cellular levels]. / Mekhanizm deistviia lazernogo oblucheniia na tkanevom i kletochnom urovniakh.

The paper describes the action of low-intensity laser radiation (LILR) and high-intensity one (HILR) on biological tissues. LILR produces its action on cells by changing the membranous formations-receptors and ion channels. At cardiac surgery, HILR stimulates uncontractile myocardial elements, by inducing the secretion of biologically active substances and the activation of enzyme systems that ensure the implementation of neoangiogenesis in the ischemic myocardium.