Vol 70, No 3 (2015)

CARDIOLOGY: CURRENT ISSUES

EFFICACY OF STATIN THERAPY IN THE PREVENTION OF ATRIAL FIBRILLATION IN EARLY POSTOPERATIVE PERIOD AFTER CORONARY ARTERY BYPASS GRAFTING

Bokeriya O.L., Akhobekov A.A., Shvarts V.A., Kudzoeva Z.F.

Abstract

Background: The incidence of the postoperative atrial fibrillation (POAF) after open heart surgery is up to 65%. Statin therapy has shown conflicting data in the prevention of the POAF. Objective: Our aim was еo evaluate the role of statin therapy in the primary prevention of AF after CABG. Methods: Group 1 (n =84) included those patients who received no statin therapy and the Group 2 (n =124) included those patients who did receive statin therapy for at least three days prior to the operation and for all days in the postoperative period. WBC count in different periods after surgery and rate of AF were evaluated. The risk of occurrence of postoperative AF was evaluated using the Cox-regression model and odds ratio. Results: A retrospective analysis of 206 medical records of the patients without pre-existing AF after CABG was performed. The rate of AF was 26% in Group 1 and 6.5 % in Group 2 (p =0.0001). On Day 4 after surgery, WBC count was 11 (9;13) in the first group and 9 (7,6;10,2)×109 e/L in the second group (p =0.000001). «Statin use» and «number of grafts» and were found to be statistically meaningful: p =0.002 and p =0.0125 respectively (χ2=28,3; p <0.001). In accordance with the Cox model of regression, the risk of AF was 0.201 for «statin use»; and 2.099 for «number of grafts». Odds ratio was 0.2 (95% CI 0.08–0.5). Conclusion: Statin therapy prior to and after GABG was found to be an effective method of primary prevention of AF in the early postoperative period.

 

 

Annals of the Russian academy of medical sciences. 2015;70(3):273–278
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ONE-STAGE APPLICATION OF MITRAL VALVE CORRECTION, SURGICAL RADIOFREQUENCY ABLATION AND LEFT ATRIAL ATRIOPLASTY

Joshibayev S.D., Bolatbekov B.A.

Abstract

Objective: Our aim was to evaluate sinus rhythm restoration and its failure predictors after one-stage application of surgical radiofrequency ablation, left atrial reduction and mitral valve correction. Methods: This is a prospective longitudinal cohort study with historical controls. Patients were divided into 2 groups according to the performed type of operation — the main group included patients undergone one-stage mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty (n =47); and the control group consisted of patients undergone only mitral valve correction (n =76). Surgical radiofrequency ablation was performed under the scheme Maze-IV. Left atrial atrioplasty procedure was performed according to echocardiography data: if in women LA antero-posterior dimensions were more than 4.7 cm and in men more than 5.2 cm. Results: The study included 123 patients. In the main group (age of the patients 61.0±9.1 years, 55% male) sinus rhythm restoration was observed in 32 (68%) patients during the early postoperative period, but at the time of discharge it reduced to 19 (40%), but in 6 months it increased up to 37 (78%), and in 36 months sinus rhythm already was detected in 40 (85%) patients. At the same time, during the early postoperative period in the control group (patients aged 59.0±11.0 years, 61% male) only 31 (40%) of patients had sinus rhythm, in 6 months it was detected in 11 (14%) cases, and in 36 months sinus rhythm – only in 28 (37%) patients. Predictors of atrial fibrillation recurrence were revealed: valve disease continuance <4 years (p =0.017) and atrial fibrillation history <3 years (p =0.029). Conclusion: One-stage performing of mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty restores and maintains more regular sinus rhythm, even in presence of atrial fibrillation recurrence predictors.

 

 

Annals of the Russian academy of medical sciences. 2015;70(3):279–285
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CARDIOVASCULAR DISEASES IN THE CONTEXT OF RUSSIA’S LONG-TERM SOCIO-ECONOMIC DEVELOPMENT PRIORITIES

Saygitov R.T., Chulok A.A.

Abstract

The paper presents results of a comprehensive analysis of the cardiovascular diseases (CVD) situation, both in the global and Russian contexts. It introduces original data illustrating the declining mortality rate from CVD, and the diminishing contribution of these diseases to overall mortality rate — globally and, to a larger extent, in developed countries. The paper also analyses the reasons for continuing CVD epidemic in Russia. Based on factual evidence, it argues that those include insufficient expenditures on treating CVD patients, and critically inadequate funding of prevention programmes. Unsatisfactory use of these funds to subsidise Russian regions (without taking into account their actual needs determined by the CVD mortality rate) only makes the problem worse. Through modelling, «average» efficiency of the Russian health care system in reducing CVD mortality was revealed. The paper describes various scenarios for future development of the Russian CVD situation. In the context of innovation-based scenario, the advantages of technological foresight are analysed; specifically, the authors summarise major S&T development trends in the health sector (using data of the Russian S&T Foresight 2030), which could significantly contribute to stopping the CVD epidemic in Russia.

 

 

Annals of the Russian academy of medical sciences. 2015;70(3):286–299
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RESULTS OF PERCUTANEOUS CORONARY INTERVENTION IN ELDERLY DIABETIC PATIENTS

Sigaev I.Y., Yarbekov R.R., Chigogidze N.A., Enokyan L.G., Keren M.A., Starostin M.V.

Abstract

Objective: Our aim was to compare results of the percutaneous coronary intervention (PCI) with drug eluting stent (DES) and bare metal stent (BMS) in older patients with coronary heart disease (CHD) and diabetes mellitus (DM) type 2. Methods: Patients (>65 years) with DM type 2 were divided into two groups: the 1st group — 58 patients after PCI with DES, the 2nd group — 62 patients after PCI with BMS. The average follow-up period was 32.6±8.0 months. The end-points of the study were death, non-fatal myocardial infarction and restenosis of the target stenosis. Results: Endovascular treatment of patients older than 65 years with DM is highly effective and safe despite the complexity of coronary lesions. There are no significant differences in the rate of early (hospital) complications in two groups. Also, we did not find differences in three-year mortality between the groups. But the incidence of myocardial infarction in the groups with DES and BMS was 9% and 18% respectively (р =0.039). Major adverse cardiovascular events (death, myocardial infarction and restenosis of the target stenosis) frequency was also lower in the group with DES compared to BMS (36% and 61% respectively, p =0.001). Conclusion: Endovascular treatment of patients older than 65 years with DM type 2 is a highly effective and safe method despite the complexity of coronary lesions. PCI with DES compared to BMS in older patients with DM is associated with improvement of medium-term results and decreases the number of cardiovascular events.

 

Annals of the Russian academy of medical sciences. 2015;70(3):300–306
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PEDIATRICS: CURRENT ISSUES

MEDICAL AND SOCIAL PROBLEMS OF ASSISTED REPRODUCTIVE TECHNOLOGIES FROM THE PERSPECTIVE OF PEDIATRICS

Baranov A.A., Namazova-Baranova L.S., Belyaeva I.A., Bombardirova E.P., Smirnov E.P.

Abstract

The article presents a literature review over the last few years devoted to the health status and development peculiarities of children born using assisted reproductive technologies (ART) procedures. The statistics shows an explosive increase in the frequency of ART application as a fertility treatment method. The presented data analysis reflects the perinatal outcomes after ART in children, the frequency of congenital malformations and genetic diseases in this population, possible long-term malconditions and pathologies in children born using ART. The overwhelming majority of investigators consider the adverse effect of ART on a child’s body to be the result of prematurity and multiple pregnancy (transfer multiple embryos followed by partial reduction). It is stated that the widespread introduction of ART may contribute to the vertical transmission of parental infertility factors in the population. The application of ART procedures in some cases is associated with controversial ethical and legal issues (surrogacy, oocyte donation). Further improvements in ART procedures (preimplantation training, medical and genetic diagnosis, reducing the frequency of multiple pregnancy) cannot be stated as an alternative to the general medical and social prevention of reproductive disorders in adolescents and youth.

 

Annals of the Russian academy of medical sciences. 2015;70(3):307–314
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CHILD AND ADOLESCENT INTEREPYDEMIC IMMUNITY TO INFLUENZA VIRUSES

Lyapunov A.V., Kolesnikova S.I., Khasnatinov M.A., Manzarova E.L., Petrova I.V., Dolgikh V.V., Danchinova G.A.

Abstract

Objective: Our aim was to evaluate the child and adolescent population immunity to influenza A viruses (IAV) and influenza B virus (IBV). Methods: The concentration and specificity of antiviral antibodies was evaluated by hemagglutination inhibition assay (HAI) that was performed using commercial HAI diagnostic kits.  Results: The serum samples of 254 clinically healthy children and adolescents were examined in this study. 245 participants had the antibodies to IAV, 199 — to IAV and IBV, and only 4 children aged between 1 and 4 years and a 12-year-old boy had no immunity to IAV or IBV. The number of children with specific immunity increased in elder groups by 43% (from 81 to 116) for N0N1 and H3N2 subtypes and by 110% (from 38 to 80) for H1N1 subtype of IAV. In children younger than 4 years the titer of specific antibodies against the H1N1pdm09 was 1:210 and against the H3N2 — 1:270, whereas in adolescents of 10–14 years these figures were by 1.6 and 2.4 times lower (1:130 and 1:120) respectively. Antibodies to the subtypes H2N2 and H5N1 were not detected. Conclusion: The results indicate that 98.4% of child and adolescent population in interepidemic influenza season are immune to the various IAV (H3N2, H1N1, H0N1) as well as to the IBV. More than half of children and adolescents (57.4%) are immune to H1N1pdm09 subtype of IAV. The strength of immune response to the recent pathogens (H3N2 и H1N1 pdm09) is higher in infants than in teenagers.


 

Annals of the Russian academy of medical sciences. 2015;70(3):315–319
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РATHOPHYSIOLOGY: CURRENT ISSUES

PARATHYREOIDECTOMY IN RATS USING MICROSURGERY AND MEDICAL ADHESIVE SULFACRYLATE

Ausheeva A.V., Lepekhova S.A., Gol'dberg O.A., Il'icheva E.A., Andaeva T.M., Koryakina L.B., Kurganskii I.S., Zaritskaya L.V.

Abstract

Background: One of the main difficulties in assessing the effectiveness of etiologic treatment of hypoparathyroidism is absence of its standardized model. Objective: The aim of the study was to develop a method of hypoparathyroidism modeling. Methods: Controlled nonrandomized study was performed on female Wistar rats aged 10 month. Group 1 (n =14) was performed with destruction of parathyroid glands with electrocoagulation; group 2 (n =12) — parathyroidectomy by the developed method. In 3 and 14 days after the surgery the levels of ionized calcium, parathyroid hormone, number of white blood cells, blood leukocyte formula, indicators of immunological tests, histological examination of organs in the area of operations were performed. Statistical analysis was performed using the nonparametric Mann–Whitney-Wilcoxon test. Results: Selection of animals by sex and age criteria, angular skin incision, use of the operating microscope, microsurgical techniques, extirpation of parathyroid glands via resection of thyroid gland with the closure of the wound defect glue appeared to be the distinctive features of the developed method. In 14 days the group 2 showed decrease in ionized calcium (p =0.016), PTH (p =0.094), leucocytes (p =0.004), PI (р =0.003), spontaneous NBT test (р =0,004), induced NBT test (р =0.003) compared with group 1. Histological examination in the group 2 revealed no changes in thyroid gland, thin connective tissue capsule, cavity with a small amount of glue, however, there were determined foci of necrosis with perifocal inflammation in the group 1. Conclusion: Combination of several techniques allowed to simulate metabolic disorders with persistent hypocalcemia as well as lack of mortality in early postoperative period.

 

Annals of the Russian academy of medical sciences. 2015;70(3):320-327
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INTERACTION OF THE HUMORAL AGONIST DURING THE PLATELETS ACTIVATION IN PATIENTS WITH CHRONIC CEREBRAL ISCHEMIA

Barinov E.F., Mamedalieva S., Tverdokhleb T.A.

Abstract

Objective: The aim of the study was to determine the effect of the standard drug therapy of 95 patients with chronic cerebral ischemia (CCI) on the functional status of platelets as possible participants of microcirculation of the brain. Methods: Platelets were isolated from peripheral blood by centrifugation and examined at 24 hours after initiation of standard medical therapy including aspirin (100 mg). The cells were stimulated in vitro using adenosine diphosphate (ADP), epinephrine, platelet activating factor (PAF) and serotonin in an effective concentration (EC50) inducing in healthy individuals platelet aggregation in the range of 50±5%. A study of platelet aggregation was carried out on aggregometer Chrono-Log (USA). Results: Research included 82 patients with CCI 1–2 Stage — 76 patients taking antiplatelet and antihypertensive drugs before hospitalization (main group), 6 — did not receive these drugs during 7 days prior to hospitalization (comparison group). After start conservative treatment, only ADP induced platelet aggregation, which was similar (p >0.05) with values in healthy individuals. The pharmacological inhibition of the functional activity of platelets other investigated agonists reproduced hyporesponsiveness of platelets. Against this background, in 34 (44.7%) patients at 24 hours after initiation of therapy occurred potentiation effects of PAF and epinephrine in the test in vitro; whereas the summation of the effects of serotonin and epinephrine on platelets was detected in 12 (15.8%) patients. The basis of this phenomenon may be strengthening effect of ADP secreted from dense-granules, additional stimulation by Gi-protein signaling system by epinephrine and Gq-protein by the action of PAF and serotonin. Conclusion: Response to the combined action of platelet agonists may be predictor of the risk of thrombogenesis at CCI.

 

Annals of the Russian academy of medical sciences. 2015;70(3):328–333
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REPARATIVE OSTEOGENESIS AND ANGIOGENESIS IN LOW INTENSITY ELECTROMAGNETIC RADIATION OF ULTRA-HIGH FREQUENCY

Iryanov Y.M., Kiryanov N.A.

Abstract

Background: Non-drug correction of reparative bone tissue regeneration in different pathological states — one of the most actual problems of modern medicine. Objective: Our aim was to conduct morphological analysis of the influence of electromagnetic radiation of ultra-high frequency and low intensity on reparative osteogenesis and angiogenesis in fracture treatment under transosseous osteosynthesis. Methods: In the experiment conducted on rats we modeled tibial fracture with reposition and fixation of the bone fragments both in control and experimental groups. In the animals of the experimental group the fracture zone was exposed to low intensity electromagnetic radiation of ultra-high frequency. Exposure simulation was performed in the control group. The operated bones were examined using radiography, light and electronic microscopy, X-ray electronic probe microanalysis. Results: It has been established that electromagnetic radiation of ultra-high frequency sessions in fracture treatment stimulate secretory activity and degranulation of mast cells, produce microcirculatory bed vascular permeability increase, endotheliocyte migration phenotype expression, provide endovascular endothelial outgrowth formation, activate reparative osteogenesis and angiogenesis while fracture reparation becomes the one of the primary type. The full periosteal, intermediary and intraosteal bone union was defined in 28 days. Conclusion: Among the therapeutic benefits of electromagnetic radiation of ultra-high frequency in fracture treatment we can detect mast cell secretory activity stimulation and endovascular angiogenesis activation.

 

Annals of the Russian academy of medical sciences. 2015;70(3):334–340
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HEALTH CARE MANAGEMENT

DIAGNOSTICS OF REGIONAL HEALTHCARE MANAGEMENT SYSTEM IN RUSSIA BASING ON MODELING AND FORECASTING OF HEALTH AND DEMOGRAPHIC INDICATORS

Gnezdova Y.V., Idilov I.I., Bataev S.M., Bataev S.S.

Abstract

Background: Justification of the study direction of public health improving is quite general. But the identification of the most effective indicators of the healthcare system improvement remains unexplored. Objective: Our aim was to determine the interaction between the basic demographic indicators of the region (Smolensk region) and efficacy endpoints of the Healthcare management identified in the study. Methods: The study reviewed the demographic changes of the Smolensk region at present and the forecast for 2015, 2016, 2017. The forecast of demographic and health indicators was based on exponential smoothing models and autoregressive model. Results: The study identified the most appropriate medical and demographic indicators. 1) The ratio of physicians (per 10,000 people in population, the rate maximum was 62 in 2004, in 2015 this figure has fallen to 52, and it is supposed to decrease to 49 by 2017). 2) The overall mortality rate (per 1000 people in population). Reduction of the resident population of the Smolensk region is 8.2 thousand people in annual average. This fact shows a stable depopulation of the region. 3) The average load on the ambulance. It has been found that the increase and decrease of these parameters directly affect the population rate. Conclusion: The study revealed a stable downtrend of average resident population number which confirms the long regional depopulation. It is associated in particular with the lack of stimulation of the health and demographic indicators’ increase including but not limited to inefficient healthcare management arrangements.

 

Annals of the Russian academy of medical sciences. 2015;70(3):341–347
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DEMOGRAPHIC AGEING IN RUSSIA AT THE PRESENT STAGE

Grinin V.M., Shestemirova E.I.

Abstract

In the article data of the article describes the findings of modern demographic indicators in Russia and foreign countries for the period 2010–2013. As a result of monitoring was defined Russia's status by demographics such as: proportion of population aged 65 years and older; total (men and women) life expectancy at birth; the rate of natural increase of population; mortality; fertility rate; the coefficient of migration growth and the dependency ratio. This article was presented analogy age-sex structure disclosed negative and positive aspects of the ageing of the population in Russia and foreign countries.

 

Annals of the Russian academy of medical sciences. 2015;70(3):348–354
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SHORT MESSAGES

PECULIARITIES OF PLATELET ACTIVATION CHANGES IN PATIENTS WITH CHRONIC SCHIZOPHRENIA, DEPENDING ON THE SEVERITY OF POSITIVE AND NEGATIVE SYMPTOMS DURING THE REMISSION FORMATION

Brusov O.S., Zlobina G.P.

Abstract

Objective: The aim of our study was to compare the changes in the severity of positive, negative and psychopathological PANSS symptoms which occur as an outcome of an attack in schizophrenic patients along with remission formation and the degree of platelet activation in these patients. Methods: Psychometric scale of the Positive and Negative Syndrome Scale (PANSS) and the method of estimation of platelet activation based on the calculation of cells number after elution from the column with sepharose CL-2B were used. Results: The changes in the severity of the disease were estimated using the PANSS scale of chronic schizophrenic patients in remission formation. An increase in platelet activation was determined on the basis of the above described quantitative parameter. Comparison of changes in platelet activation parameter with changes in the disease severity rating detected similar statistically indistinguishable (p >0.05) changes in the severity of positive symptoms and quantitative variable of platelet activation between the 1st and the 3rd visits in the period of remission formation. Platelet number after elution from the column during the 3rd visit was approximately two times less than during the 1st visit (p =0.002). PANSS positive subscale shows a decrease of the severity of the syndrome by 1.6 times (p <0.0002). In addition the difference between the platelet activation parameter and severity of the negative syndrome was fixed during the 3rd visit (p <0.034). Conclusion: Similar changes in the severity of positive syndrome and platelet activation parameter were presented from 1st to 3rd visit in the remission formation. A distinction was also made between the platelet activation parameter and severity of the negative syndrome was fixed during the 3rd visit.


 

Annals of the Russian academy of medical sciences. 2015;70(3):355-359
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NEW RADIOPHARMACEUTICALS BASED ON PROSTATE-SPECIFIC INHIBITORS OF MEMBRANE ANTIGEN FOR DIAGNOSTICS AND THERAPY OF METASTATIC PROSTATE CANCER

Vlasova O.P., German K.E., Krylov V.V., Petriev V.M., Epshtein N.B.

Abstract

About 10.7% cases of prostate cancer were registered in Russia in 2011 (40 000 patients). More than half of cancer cases were revealed in advanced (III–IV) stages when metastases inevitably developed quickly. Clinical problem of early diagnostics and treatment of metastatic prostate cancer is still not solved. Anatomical imaging techniques have low sensitivity and specificity for the detection of this disease. Metabolic visualization methods which use prostate specific antigen (PSA) as a marker are also ineffective. This article describes prostate-specific membrane antigens (PSMA) that are proposed as a marker for diagnostics and therapy of prostate cancer. The most promising PSMA-based radiopharmaceutical agent for diagnostics has been developed and clinically tested in the European countries. These pharmaceuticals are based on small peptide molecules modified with urea, and have the highest affinity to PSMA. Favorable pharmacokinetics, rapid accumulation in the tumor and rapid excretion from the body are beneficial features of these pharmaceuticals.

 

 

Annals of the Russian academy of medical sciences. 2015;70(3):360–365
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BIODISTRIBUTION OF RIFABUTIN POLYMERIC TRANSPORT FORM

Kuznetsova I.G., Dubovik E.G., Dubovik N.S., Komarov T.N., Medvedev Y.V., Men'shchikova L.A., Severin S.E., Shokhin I.E., Yarushok T.A.

Abstract

Background: One way to increase drug efficacy is to provide a drug delivery transport system to the target organ. A widely used method is to incorporate the drug in a biodegradable polymer composition with forming nanosized drug’s transport forms. Objective: Our aim was to investigate the tissue biodistribution of antibiotic rifabutin transport system based on lactic and glycolic acids copolymer, and to compare it with the pure substance of rifabutin. Methods: These substances were administered to two groups of rats intragastrically in the doses of 10 mg/kg. After a certain period of time, the animals were sacrificed by cervical dislocation. Samples preparation for analysis was carried out of the liquid-liquid extraction. Active substance’s concentrations were measured by high performance liquid chromatography method. Results: The study included 8-week-aged Wistar rats of both sexes weighing 0.22±0.02 kg. Animals were divided into 2 groups. The study group received polymer form of antibiotic, and the comparison group received substance of rifabutin. In intervals of 10 min, 30 min, 1 h, 2 h, 4 h, 7 h, 15 h, 24 h after drug administration liver, lung, spleen, kidney, intestines, stomach, heart and brain were resected respectively. Organs were measured by their weight. The drug was not detected in the brain. Rifabutin was determined in other examined tissues within 10 minutes and the maximum drug concentration in organs was fixed in 1.5–3.5 hours after administration. The rifabutin concentrations defined in the lungs were significantly higher in polymer form (p <0.05). The polymer form’s distribution coefficient was higher in the liver and lungs (15.83 and 10.14 μg/g respectively) in comparison with the substance one. The minimum amount of the active ingredient was observed in the heart (0.02 μg/g). Conclusion: It is shown that the inclusion of the drug in a polymeric form substantially alters its localization in organs and tissues. Extensive biodistribution nanorifabutin in lung tissue, liver and spleen is established.

 

 

Annals of the Russian academy of medical sciences. 2015;70(3):366–371
pages 366–371 views

TRANSPALPEBRAL TETRAPOLAR REOOPHTALMOGRAPHY IN THE ASSESSMENT OF PARAMETERS OF THE EYE BLOOD CIRCULATORY SYSTEM

Luzhnov P.V., Shamaev D.M., Iomdina E.N., Tarutta E.P., Markosyan G.A., Shamkina L.A., Sianosyan A.A.

Abstract

Background: Quantitative assessment of hemodynamic parameters is an important element of ophthalmic diagnostics especially in early detection of myopia, glaucoma, diabetic retinopathy. The assessment of hemodynamic changes is essential in evaluating of the efficiency of treatment. Objective: Our aim was to determine the adequate of eye hemodynamics assessment using reoophtalmography in patients with various clinical refractions. Methods:  A controlled study was carried out. All tests were performed using transpalpebral tetrapolar method. Signal registration lasted for 20 seconds in the supine position, and then the diagnostic parameters were calculated. Results: We present the results of examination of 76 patients aged 5 to 22 years (average age 13.0±1.1). 32 patients had low myopia (62 reoophtalmography records), 23 patients had moderate myopia (42 records) and 5 patients had high myopia (12 records). The control group was composed of 16 patients. The main differences were found in the rheographic index, which is equal to 58.1±4.1 mOhm in the control group. It is significantly reducing with refraction increase, from 47.8±3.2 mOhm in low myopia to 34.0±2.5 mOhm in high myopia (p =0.050). This is an evidence of blood supply deficiency in the myopic eyes. Conclusion: Rheographic index was shown to differ in different breathing phases, which agrees with the known physiological regularities. The proposed method is highly informative and sufficiently accurate what allows assessing the eye blood supply state objectively. It is easy to apply and requires no contact with the eye surface, which is especially important in pediatric practice.

 

Annals of the Russian academy of medical sciences. 2015;70(3):372–377
pages 372–377 views

CLINICAL AND LABORATORY PREDICTORS FOR FORECASTING THE OUTCOMES OF IXODES TICK-BORNE BORRELIOSIS

Minoranskaya N.S., Sarap P.V., Andronova N.V., Minoranskaya E.I.

Abstract

Objective: Our aim was to identify the most informative clinical and laboratory predictors of chronicity of Ixodes tick-borne borreliosis in the acute phase of the disease based on the «optimal cut-off values» (COV) and the predicted probability of the outcomes. Methods: A retrospective cohort controlled study was carried out. We used the technique of ROC-analysis to estimate the information content of the clinical and laboratory indicators in patients with Ixodes tick-borne borreliosis in the acute phase of the disease with erythemal (n =16), non-erythemal (n =77) forms of Ixodes tickborne borreliosis and co-infection with the tick-borne encephalitis (n =68) for the prediction of the outcomes: recovery or chronization. Results: A retrospective analysis of clinical and laboratory parameters recorded in the acute phase of the disease in 161 patients with chronic Ixodes tick-borne borreliosis. The calculations were performed for the informative clinical and laboratory prognostic predictors of the outcomes for the intervals above and below the COV values are defined probabilities of recovery or chronization of Ixodes tick-borne borreliosis. A general predictor of outcomes for all clinical forms of the disease — the interleukin 8 — was established: the probability of chronization after erythemal form is 100.0% at the level of its production over 107.89 pg/ml (AUC =1.0), after non-erythemal form is 54.63±0.23% at serum concentrations above 94.64 pg/ml (AUC =0.770), after co-infection with the tick-borne encephalitis is 52.69±0.27% at the level of interleukin 8 above 84.96 pg/ml (AUC =0.780). Conclusion: The  results of the study suggest the possibility of predicting the outcomes of infection in the acute phase, which allows to optimize the etiopathogenic therapy of the disease in a timely manner.

 

Annals of the Russian academy of medical sciences. 2015;70(3):378–385
pages 378–385 views

GUIDE FOR AUTHORS

GENERAL GUIDELINES FOR SUBMISSION OF ORIGINAL RESEARCH PAPERS

Saygitov R.T.

Abstract

First published on the website of the journal "Current Pediatrics". Available at: http://www.spr-journal.ru/ojs/index.php/VSP/about/submissions#authorGuidelines.

You can flook through the full version of the Author's Guideline for original articles and other types of manuscripts.

Annals of the Russian academy of medical sciences. 2015;70(3):390-392
pages 390-392 views

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