Prediction of osteoporosis severity in patients with rheumatoid arthritis via evaluation of the fetuin-A level

Aim of study. To investigate the level of dependence of osteoporosis (OP) progression severity on the level of fetuin-A (FA) in order to predict the OP progression severity in RA patients. Material and methods. We have examined a total of 110 RA patients (mean age 54.2+11.97). Th e diagnosis was established based on ACR/EULAR criteria 2010. A total of 30 conventionally healthy subjects were enrolled serving as a control group. Evaluation of bone mineral density (BMD) was performed using DXA (Lunar DPX-NT GE densitometer). The FA level was determined through indirect enzyme-linked immunoassay (Human Fetuin-A ELISA test-system). Results. Mean serum FA in healthy subjects amounted to 653.55-972.19μg/ml. We formed 2 groups of RA patients: with blood serum FA levels <653.55μg/ml (23 patients) and with normal FA values: 653.55μg/ml or higher (87 patients). A lowered FA level was revealed in 20 (86.96 %) subjects in the group of OP patients and only in 3 (13.04 %) patients with RA without OP (р<0.001). Osteoporotic bone fractures were diagnosed in 12 (13.79 %) patients in the group with normal FA levels and were absent in 75 (86.21 %) patients (р<0.001). Apart from that, RA patients with lowered FA had reliably lower mean BMD in the area of femoral neck and vertebral column as well as lower BMD total value (р<0.001). In order to determine the diagnostic accuracy of laboratory tests, the characteristic curve (ROC curve) was applied. Th e area under the ROC-curve was 0.663 with the cut-off point matching the FA level of 660.3μg/ml. Th is value corresponds with 84.72 % specifi city and 47.37 % sensitivity. Conclusion. We have revealed reliable correlations between the serum FA level in RA patients, the frequency of OP development, osteoporotic bone fractures and BMD values (p<0.001). Laboratory evaluation of FA for OP progression severity prediction for RA patients has good quality with the specifi city of 84.72 % and the sensitivity of 47.37 %.

Serum vitamin D content in children with SARS-CoV-2 infection

Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and мethods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22; 28.07] ng/ml) as compared with the control group (36.43 [32.05; 44.08] ng/ml; p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.

Historical development of estimated fetal weight calculation

Accurate calculation of the estimated fetal weight is necessary for the choice of a correct approach to management of labour. Th e existing methods are not universal and require complex application. Th is article presents a review of literatures published in PubMed and Google Scholar databases in 1955-2021 and devoted to historical aspects in development of the existing clinical and instrumental approaches to calculation of estimated fetal weight. The paper presents existing methods for calculation of estimated fetal weight at diff erent gestational ages as well as methods making it possible to predict fetal weight before gestation onset. Data on their informative value during the third trimester and alterations in their accuracy depending on the pregnant patient’s BMI are presented. Th e topic of application of magnet-resonance imaging for fetometry is considered with comparison of this approach to a more common method of ultrasonography.

Selection of the optimal type of the stapler cassette for distal pancreas resection

Aim of study. Investigation of risk factors in development of postoperative pancreatic fi stula (POPF) in patients aft er distal pancreatectomy (DP) involving application of a cutting stapler device (CS) as well as determination of the criteria for selection of the optimal cassette type for such devices making it possible to reduce the POPF development frequency. Material and methods. A two-centre retrospective/prospective controlled study was performed. A total of 46 patients (19 (41.3 %) male and 27 (58.7 %) female) were enrolled. All patients included in the study underwent DP surgery using CS for excision of the pancreas with closure of its stump. In all cases, measurement of the pancreas thickness in the resection area based on the data of preoperative computed tomography and calculation of the difference between the pancreatic parenchymal thickness in the resection area and the staple closure height (SCH). Th e patients were distributed between two groups: 1) without POPF of with biochemical leakage (BL); 2) with clinically relevant POPF (CR-POPF). Results. CR-POPF developed in 15 (32.6 %) cases (type-B POPF: 14 (93.3 %) cases, type-С: 1 (6.7 %) case). Statistically signifi cant diff erence in mean pancreatic parenchymal thickness in the resection area as well as mean SCH between the group without POPF or with BL and the group with CR-POPF (15.4±4.3mm versus 12.3±3.5mm, р=0.01 and 12.8±2.3mm versus 16.4±3.1mm, р<0.01, respectively). Th e frequency of CR-POPF development was reliably lower at the SCH varying from 8 to 14mm (9.5 %) as compared to cases with SCH below 8mm (55.6 %, p<0.01) and above 14mm (50.0 %, p<0.01). Conclusion. Upon analysis of risk factors in POPF development aft er DP, it has been established that a greater pancreatic parenchymal thickness in the resection area as well as SCH are statistically significant risk factors for this complication. Th e optimal SCH making it possible to achieve the minimal frequency of POPF aft er pancreatic stump closure using a CS is within the range of 8-14mm.

A technology for prediction of preterm discharge of amniotic fluid

Aim of study. To create a technology for prediction of preterm discharge of amniotic fl uid based on universally accessible methods of laboratory and instrumental evaluation. Material and methods. A retrospective analysis of 200 birth cases dated 2018-2021 at the premises of obstetric facilities in Chita and Ufa cities featuring patients admitted to the inpatient unit shortly before term labour (1-2 days). In the course of the study, 2 groups were distinguished: Group 1 included 128 female patients with term discharge of amniotic fluid and Group 2 was constituted by 72 female patients with preterm discharge of amniotic fluid. The groups were comparable in age, anthropomorphic parameters and extragenital pathology. On admission, all women underwent general medical examination and ultrasonography. Statistical processing of the results was performed via the IBM SPSS Statistics Version 25.0 soft ware. Results. The technology for prediction of preterm discharge of amniotic fluid was based on multilayer perceptron learning. The structure of the learning neural network included 5 input neurons: body mass index, fundal height, the total bilirubin level, activated partial thromboplastin time and the amniotic fluid index. Th e percentage of incorrect predictions of the neural network totalled 28.5 %. Conclusion. A complex approach based on integration of universally accessible methods for laboratory and instrumental tests shortly before the labour based on a neural network makes it possible to predict possible preterm discharge of amniotic fl uid with an accuracy of up to 75 %. Application of this technology in clinical practice will make it possible not only to perform timely preparation of the parturient canal but also to reduce the frequency of adverse obstetric and perinatal outcomes

Estimation of the efficiency of using interferon inducer in children with Epstein-Barr viral infection

The aim of the research. To evaluate the effectiveness of synthetic low-molecular interferon inducers in children with Epstein-Barr viral infection. Material and methods. The study included 68 children aged 7 to 17 years with primary Epstein-Barr viral infection: 38 children in the main group received basic therapy against the primary form of Epstein-Barr viral infection in age-specific dosages in combination with a synthetic low-molecular interferon inducer; 30 children of the control group received the conventional basic therapy with age-specific dosages. Results. It has been established that clinical manifestation of Epstein-Barr viral infection is based on immunopathological inflammation mediated by the factors of cellular immunity. As a result of the therapy, 78.95 % of children in the main group had a normal rate of functional recovery of the liver. In the control group, however, the recovery was delayed in 60.00 % of children: rapid recovery was only noted in the main group. Administration of synthetic lowmolecular weight interferon inducers in addition to basic symptomatic therapy facilitated the reduction of intoxication symptoms duration by 4.7±1.9 days (p < 0.05) and the duration of the icteric period by 5.3±0.9 days (p < 0.05), as well as 5.1±1.3 days earlier normalisation of liver size (p < 0.05). Conclusion. Thus, the use of synthetic low molecular weight interferon inducers in combination with basic therapy against the primary form of Epstein-Barr viral infection in children contributes to a faster restoration of the functional state of the liver. The conducted clinical and biochemical studies indicate high efficiency of synthetic low molecular weight interferon inducers in the complex therapy of Epstein-Barr viral infection in children.

Minimally invasive surgery for spine osteomyelitis treatment

The aim of the research is to study the results of minimally invasive surgery for the treatment of nonspecifi c infectious spine lesions, and to present personal experience. Material and methods. Three patients with purulent nonspecifi c spondylodiscitis of lumbar spine got minimally invasive surgical treatment. The essence of surgical intervention included X-ray-assisted placement of tubular retractors in the area of intervertebral disc aff ected by purulent process; debridement and irrigation with antiseptic solution of interbody space, and setting a drain tube. All patients were treated during the period from December 2016 to February 2019. They were examined before surgery and in 3 months aft er the discharge. Laboratory parameters (CBT, C-reactive protein, bacteriological analysis of intervertebral disc contents) and instrumental research methods (computer tomography, magnetic resonance imaging) were evaluated. ODI, VAS, SF-36 questionnaires helped to assess pain syndrome and life quality of patients. Results. In 100 % of studied cases infection was caused by Staphylococcus aureus. The result of treatment in all cases was assessed as good, because pain syndrome, neurological disorders and inflammatory process were arrested; there were no signs of disease progression. In all cases, life quality of patients was restored. In one case, additional surgical intervention was required (posterior instrumental fi xation of spine) because of instability signs. Conclusion. Minimally invasive surgical treatment of purulent single-level spondylodiscites can be recommended for practical use. The use of such approache allows to verify purulent infection agent, to damage soft tissues less getting proper sanitation of interbody space. It also allows to stop the infection and restore life quality of a patient

Study of the anti-infl ammatory activity of the Potentilla anserina L on burn wounds in mice

The aim of the research. To investigate the anti-infl ammatory eff ect of Cinquefoil on a model of a thermal wound. Material and methods. A liquid extract in 70 % ethyl alcohol was obtained from dry crushed goose cinquefoil by the percolation method. Th e resulting extracts were evaporated under vacuum at a temperature of 50 °C. Th e dry residue was dissolved in water immediately before treatment at a dose of 250 mg / kg. Th e evaluation of anti-infl ammatory activity was carried out in an experiment on 20 white male mice. Th ermal skin burns were simulated in all animals. Th e burns were healed in an open way. During the entire experiment, the general condition of the experimental animals was assessed, body weight and temperature were determined, the appearance of wounds, appetite, and activity were assessed. For histological examination, a section of the skin was taken, including the burn zones and intact tissues. Paraffi n sections were stained with hematoxylin and eosin. Results. An analysis of the results of the experimental study showed that all experimental animals, under the infl uence of high temperatures, developed a third degree thermal burn of the skin, characterized by damage to the entire thickness of the skin with complete death of hair follicles, sweat and sebaceous glands. At the site of the burn, the skin was dense, motionless and insensitive to painful stimuli. Th e appearance of the wounds did not diff er between groups of animals. Comparative microscopy of the control and experimental groups showed that the depth of damage to the epidermis and dermis was more pronounced in the experimental group. In addition, in the same group, lymphocytic infi ltration of the dermis, hypodermis, the presence of a pronounced vascular reaction and edema of the dermis are more pronounced, which indicates a more pronounced infl ammatory. Conclusion. Th e analysis of the results obtained shows that in the treatment of burn wounds, the local application of the preparation Potentilla goose on the 4th day in the experiment does not lead to a pronounced anti-infl ammatory eff ect. However, the revealed lymphocytic infi ltration of the dermis and other histological parameters indicate more active processes in the tissues, which may subsequently lead to more accelerated wound cleansing and faster regeneration

20-years dynamics of tuberculosis and HIV mortality and of their contribution to life expectancy reduction in the population of Krasnoyarsk

Aim of the study. To study the dynamics of mortality from tuberculosis and HIV as well as their contribution to life expectancy reduction in Krasnoyarsk Krai population over a period of 20 years. Material and methods. We used primary databases of Krasnoyarsk Krai population mortality for the period from 1999 to 2018. The direct method of standardisation according to the European standard of population age structure was applied for calculation of the standardised population mortality ratio. In order to analyse mortality in the population of the WHO European region and the CIS, the data of the European health information gateway were used (https://gateway.euro.who.int). Results. It has been established that female mortality from certain infectious and parasitic diseases has increased signifi cantly (from 13.2 to 22.7 per 100,000 of female population) in the cause of death structure of Krasnoyarsk Krai within the 20-years period. Analysis of Krasnoyarsk Krai mortality from such specifi c conditions as tuberculosis and HIV has shown signifi cant decrease in tuberculosis mortality rate which complies with the global trend in the dynamics of mortality from this disease, while the rate of reduction for this index surpasses that of CIS countries. Th e analysis has established signifi cant growth of HIV mortality in Krasnoyarsk Krai population, especially female (up to 11.6 per 100,000 of female population). Conclusion. There has been a change of the leading mortality cause in the structure of population mortality from certain infectious and parasitic diseases over the period of 2016-2017. From that moment, the leading role in the cause of death structure of Krasnoyarsk Krai in this class of causes belongs to HIV

Structure approaches to study of DNA aptamers in solution

The high potential of aptamers – specifi c molecular agents based on short single-stranded nucleic acids – makes high demands on the molecules under development for the effi ciency of interaction with target biomolecules. In this work, approaches are considered for studying the spatial structure of DNA aptamers in solution using various complementary methods, which make it possible to obtain a more complete picture of the formation of the structure and conformational changes, to track the interaction with the target protein, the tendency to oligomerization, and to characterize the spatial structure of both individual molecules and complexes.