Impulsive Reaction-Diffusion Delayed Models in Biology: Integral Manifolds Approach

In this paper we study an impulsive delayed reaction-diffusion model applied in biology. The introduced model generalizes existing reaction-diffusion delayed epidemic models to the impulsive case. The integral manifolds notion has been introduced to the model under consideration. This notion extends the single state notion and has important applications in the study of multi-stable systems. By means of an extension of the Lyapunov method integral manifolds’ existence, results are established. Based on the Lyapunov functions technique combined with a Poincarè-type inequality qualitative criteria related to boundedness, permanence, and stability of the integral manifolds are also presented. The application of the proposed impulsive control model is closely related to a most important problems in the mathematical biology—the problem of optimal control of epidemic models. The considered impulsive effects can be used by epidemiologists as a very effective therapy control strategy. In addition, since the integral manifolds approach is relevant in various contexts, our results can be applied in the qualitative investigations of many problems in the epidemiology of diverse interest.

Comparative Effectiveness of Riamilovir and Umifenovir for Treating Influenza

The present study focuses on the comparative assessment of the therapeutic efficacy of the antiviral drugs riamilovir and umifenovir in the treatment of patients diagnosed with influenza. The aim of the study was to compare the clinical efficacy and safety, as well as the incidence of complications, of the use of antiviral drugs riamilovir and umifenovir and the use of only symptomatic therapy in patients with a confirmed diagnosis of influenza. All patients were hospitalized at the Regional Clinical Hospital No. 2 in Vladivostok. The study included 150 patients, who were divided into 3 groups (50 patients in each group), comparable in gender, age, and admission to the hospital. Patients of the first group received riamilovir, the second group received uminofenovir, patients of the third group received only symptomatic therapy (control group). The duration of clinical manifestations of the disease, hematological disorders, as well as the content of cytokines TNF-α and IL-10 in blood serum were assessed. The incidence of complications in each group was taken into account. As a result of the study, it was found that the inclusion of the antiviral drugs riamilovir and umifenovir in the therapy of influenza decreases the amount of the pro-inflammatory cytokine TNF-α after 5 days of treatment; and in case of symptomatic therapy its level significantly exceeded the reference values. The level of anti-inflammatory cytokine IL-10 on the 5th day of treatment in the main group was three times lower than in the control group. Thus, riamilovir and umifenovir effectively relieve the main symptoms of the disease, reduce the incidence of complications, and reduce the severity of the inflammatory response by the 5th day of treatment.

PET/CT in therapy control of infective native aortic aneurysms

Infective native aortic aneurysms (INAA) are aneurysms arising from infection of the aortic wall. Treatment is demanding with 5-year survival rates between 53 and 55%. The aim of our study was to evaluate the usefulness of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in the long-term monitoring of patients with proven INAA. Fifty-three PET/CT were performed in 15 patients with INAA in this single-center retrospective cohort study and retrospective analysis of prospectively collected Vascular Graft Cohort Study (VASGRA) data. Median metabolic activity (as measured by maximum standardized uptake value, SUVmax) of the aneurysms at the initial PET/CT was high (6.8 (IQR 5.7–21.8)), and lower at the last PET/CT prior to the end of antimicrobial therapy (3.9 (IQR 2.7–6.8); n = 11) as well as in the first PET/CT after the end of the treatment (3.9 (IQR 3.0–4.4);n = 6). Compared to the course of C-reactive protein alone, PET/CT provided different (> 20% difference in trend) or altering (opposed trend) information on the course of disease in at least 14 comparisons (56%) in 11 patients (73%). The one-year and five-year freedom from all-cause lethality was 92% (95% confidence interval 57%-99%). As compared to the course of C-reactive protein, PET/CT provides different and occasionally altering information in therapy control of INAA.

CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

Review of Medical Thermometry: From the Advent to Modern Applications

The article describes the first and modern devices for the study of temperature, their principles of operation and the prospects for the development of medical thermometry in clinical practice, along with the use of information technologies, their advantages and disadvantages. The prospects for the use of thermometry using remote methods of recording temperature, wearable devices, the Internet of medical things, telemedicine, big data for patients in rehabilitation at home as part of continuous monitoring of the state of health are considered. The article emphasizes the importance of measuring body temperature by remote thermometry as one of the main diagnostic markers of infection during the pandemic of the novel SARS-CoV-2 virus infection. Also, the importance of thermometry for the timely appointment of antipyretic therapy, control over the course of various diseases and the effectiveness of the prescribed treatment is considered.

Evaluation of the Effectiveness of the Use of the Diode Laser in the Reduction of the Volume of the Edematous Gingival Tissue after Causal Therapy

Aim: The aim of this study was to evaluate and compare two different techniques for the treatment of plaque-induced gingivitis, demonstrating whether the causal therapy supported by diode laser can allow a resolution of the edema caused by gingivitis in less time compared to the single traditional causal therapy. Materials and methods: Twenty-five patients between 20 and 60 years of age with a specific diagnosis of gingivitis were evaluated at the CLID-HSR oral hygiene department. Once the clinical parameters (bleeding index, plaque index, recession, and clinical attack level) were recorded, each of them was subjected to a professional oral hygiene session and instructed in correct home hygiene procedures. Through a split-mouth protocol for each individual patient, hemi-arches were treated by simple randomization to be treated with causal therapy supported by the action of the diode laser (experimental therapy) and which with traditional causal therapy (control therapy). A first intraoral scan was performed before therapy (T0), which was repeated 20 min after rinsing with CHX. The intraoral scans were repeated at a control 7 (T1) and 14 days (T2) after the session. For each intraoral scan, a volumetric value was calculated, proportional to the edema of the gingival tissues, using special digital software. The operator who carried out the volumetric measurements on the software was not aware of the therapy implemented on each half-arch. The operator who carried out the statistical analysis was not aware of the therapy applied to each group. The collected data were statistically compared in order to detect any differences between the volumetric variations between the two therapy groups and within the therapy groups over time. After evaluating the distribution of data by means of the Kolmogorov-Smirnov statistical test, the appropriate nonparametric tests were chosen to carry out the statistical comparisons. Results: Based on the analysis of the gingival-periodontal health parameters and the volumetric value of the treated areas, no statistically significant differences were detected between the areas treated with the adjuvant action of the diode laser compared to those treated with causal therapy alone. Conclusions: With the limitations of this study, in accordance with the statistical results obtained, diode laser therapy does not allow a faster resolution of gingival edema compared to traditional therapy; the two treatment techniques for plaque-induced gingivitis, therefore, have the same efficacy.

The best practices of the Russian Federation in the organization of anticoagulant therapy in patients with high risk of thromboembolic events

Organization of anticoagulant therapy control plays a key role in ensuring the effectiveness and safety of anticoagulant use. Currently, several models of organization are successfully used in the Russian Federation, which cover more than 23000 patients at high risk for thromboembolic events. There are following common features of the models used: the maximum reduction in the time from the moment of international normalized ratio (INR) testing with a quick communication with a patient for the need to adjust the dose, the ability to sort patients depending on the degree of hypocoagulation and the risks of events with the creation of a personalized approach to treatment, the organization of a shared information space and maintaining a register of patients.

Gestationsdiabetes – aktuelle Entwicklungen

Gestational diabetes is asymptomatic. Screening in Germany has been part of the maternity guidelines since 2012. Uncovering the glucose tolerance disorder and intensive treatment reduce maternal and child risks. The aim of treatment for diabetic pregnant women is to align the results for mother and child with the results of metabolically healthy pregnant women. In addition to the diabetological therapy control through blood glucose measurements and weight control in the mother, a qualified sonographic growth control of the fetus can be used as a support. In 70–90 % of GDM cases, non-pharmacological basic therapy is sufficient; the gold standard in pharmacotherapy is insulin. Maternity clinics with a spatially connected children’s clinic offer the best security for mother and child at birth. Breastfeeding should be recommended and encouraged because of its long-term protective effects