Aim. To investigate the effects of serotonin on duodenal motor activity. Materials and Methods. Experiments were performed on Wistar rats (n=83) which received nembutal anesthesia. We further conducted electromyography and measured hydrostatic pressure in the duodenum. Results. Intraarterial administration of 0.05 mg/kg, 0.1 mg/kg, and 0.15 mg/kg serotonin induced inhibitory responses in 29%, 8.3%, and 6.3% of rats, respectively. Other rats, however, showed stimulatory responses or no specific response. Intravenous administration of serotonin did not enhance bowel contractions. Conclusion. Inhibitory responses occurred at low doses of serotonin due to the activation of presynaptic5-hydroxytryptamine (5-HT, serotonin) receptors while stimulatory responses were induced by high doses of serotonin through muscular 5-HT receptors.

Aim. To investigate the proteomic profile of calcium phosphate bions (CPB) derived from atherosclerotic plaques of large human arteries. Materials and Methods. CPB were extracted from femoral atherosclerotic plaques of two patients with coronary artery disease and significant peripheral atherosclerosis utilizing an original protocol. After sodium dodecyl sulfate polyacrylamide gel electrophoresis, we performed tryptic hydrolysis followed by matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Mass spectra were identified using the Mascot search engine. Results. Plaque-derived CPB contained bovine and human serum albumin, bovine alpha-2-macroglobulin, and human cytoplasmic actin 1. Hence, we showed that CPB adsorb proteins from both fetal bovine serum and atherosclerotic plaques. Conclusion. Plaque-derived CPB have similar proteomic profile to artificially synthesized CPB, yet adsorbing plaque proteins in addition to those characteristic for the serum.

Aim. To study histochemistry and ultrastructure of vitellocytes providing the development of Opisthorchis felineus eggs. Materials and Methods. Opisthorchis felineus eggs were collected from cats with opisthorchiasis. Tissue were examined utilizing toluidine blue and bromphenol blue for nuclei staining, and Coomassie brilliant blue G-250 for protein staining. We further conducted ferric ferricyanide test (Chevremont and Frederic) to identify sulfur-containing amino acids, Feulgen staining to detect DNA, periodic acid-Schiff staining for polysaccharides and mucosubstances, and Sudan Black B for lipids. Electron microscopic examination was carried out after ultrathin sectioning with the following staining with uranyl acetate and counterstaining with lead citrate. Results. Ultrastructure of Opisthorchis felineus vitellocytes was defined by the stage of vitellogenesis. Vitellocytes were positively stained for proteins, SS- and SH-containing amino acids, and also contained small amount of glycogen and lipids. These substances were involved in the formation of vitelline granules aggregating in clusters within the endoplasmic reticulum and representing precursors of vitelline membrane. Conclusion. At sequential stages of their development, vitellocytes produce protein- and lipid-rich granules that ultimately consitute vitelline membrane of Opisthorchis felineus eggs.

Aim. To evaluate effects of triclabendazole on the egg production by Fasciola hepatica. Materials and Methods. Fasciola hepatica were isolated from the liver of spontaneously invaded sheep after the administration of triclabendazole (10 mg/kg). Control animals did not receive anthelmintics. Efficacy of triclabendazole was assessed using the morphometric analysis of the eggs (n = 50). Results. Administration of triclabendazole led to the increase in total egg size as compared to control animals (9.15∙10^-8 ± 0,06 mm³ and 8,1∙10^-8 ± 0,71 mm³, respectively, p = 0,002) and their content (6.98∙10^-8±0,04 mm³ and 5,3∙10^-8±0,12 mm³, respectively, p = 0,0001) suggestive of increased permeability of the shell and swelling of the eggs. Total size of eggs to size of their contents was 1:0,77 compared to 1:0,65 in control animals (p = 0,0001) that indicated egg degeneration. Conclusion. Triclabendazole at a dose of 10 mg/kg causes degeneration of Fasciola hepatics eggs and leads to cessation of their development.

Aim. To test whether a combination of pessary and micronized progesterone improves pregnancy management and delivery outcomes in pregnant women with large uterine fibroids. Materials and Methods. We collected the data on pregnancy course and birth outcome of 102 patients with large uterine fibroids who were further stratified into two groups: 1) those having 5-7 cm diameter uteroids (n = 45); 2) those having 8-10 cm diameter uteroids (n = 57). All patients underwent uterine myomectomy during pregnancy with the following administration of both pessary and micronized progesterone (200 mg/day vaginally). Results. The risk of abortion was 73.5% (75/102). Pain was documented in 91.0% (91/100) of patients while 39.0% (39/100) of patients had impaired blood supply of the fibroid. Preterm birth occurred in 10.0% (10/100) cases that is 1.9-fold less as compared to the average rate for Russia in patients with uterine fibroids (18.6%). Conclusion. A combination of pessary with micronized progesterone can significantly reduce the incidence of preterm birth.

Aim. To identify risk factors for «near miss» ectopic pregnancy. Materials and Methods. We recruited 720 consecutive women with ectopic pregnancy who were admitted to the gynecology unit of a large multidisciplinary hospital from 2007 to 2017. All patients were divided into two groups: without «near miss» (n = 666) and with «near miss» ectopic pregnancy (n = 54) defined by potentially life-threatening conditions such as massive (> 1500 mL) intraabdominal bleeding, multiple organ failure syndrome, or sepsis. Short-term outcomes were evaluated on the 6th day postoperation. Results. Certain risk factors for «near miss» were uncontrollable such as cardiovascular disease (OR = 3.2, 95% CI = 1.0-9.8, p = 0.004) and past medical history of obstetric or gynecological disorders, in particular spontaneous miscarriage (OR = 15.6, 95% CI = 7.7-31.7, p = 0.001). Controllable risk factors included rare types of ectopic pregnancy (OR = 3757.4, 95% CI = 625-30567, p = 0.001) such as interstitial pregnancy (OR= 896.3, 95% CI = 121.3-1864.4, p = 0.001). Conclusion. Rare types of ectopic pregnancy represent a valuable predictor of «near miss» condition.

Aim. To investigate whether contact route is involved in transmission of healthcare-associated invasive candidiasis in HIV-infected patients. Materials and Methods. We performed a prospective epidemiological study to assess the colonization of HIV-infected patients by C. albicans in the hospital environment in candidiasis-free and candidiasis-affected locations. We examined 921 clinical samples and 227 samples from hospital facilities. In total, we carried out a microbiology and molecular genetic screening of 70 C. albicans strains. Results. We detected a number of risk factors for invasive candidiasis in HIV-infected patients admitted to the hospital facilities: high level of C. albicans colonization (up to 100%), contamination of the hospital environment (47.3 ± 2.06%), augmented colonization of genitourinary system and gut, increased number of patients with massive colonization of ≥ 2 foci (19.1 ± 1.96% - 57.1 ± 10.8%), and circulation of C. albicans strains with high phospholipase activity. C. albicans strains isolated from these patients shared a similar genetic profile indicative of nosocomial infection. The leading factors of transmission were door and bedside handles, bedside tables and patients’ hands. Conclusion. Contact route is implicated in transmission of nosocomial invasive candidiasis in HIV-positive patients.

The prevalence of chronic heart failure (CHF) in Russian Federation remains unacceptably high (7%) compared to United States and Europe (1-3%). Annual case fatality rate among patients with CHF reaches 12%, which is equal to 300,000 deaths worldwide. Implantation of antiarrhythmic devices is able to significantly improve both survival rates and quality of life of such patients. Currently, CHF progression can be reliably detected by a measurement of intrathoracic impedance. Here we summarize the data on measurement of intrathoracic impedance in implantable antiarrhythmic devices for proper and timely diagnosis of CHF progression. We particularly focus on combination of this technique with remote monitoring of antiarrhythmic devices.

Bacteriophages are highly efficient in treatment of intestinal and respiratory infections caused by community-acquired antibiotic-resistant pathogens. However, mass production of bacteriophages does not consider a rapid turnover of circulating strains causing healthcare-associated infections, formation of anti-phage immunity, the focus of infection in human body, phage pharmacokinetics, and a number of other issues. Therefore, we developed an original algorithm for personalized phage therapy which includes three consecutive stages: 1) determination of bacterium sensitivity to a number of widely applied bacteriophage strains using spot test and modified Gratia’s assay; 2) measurement of neutralizing anti-phage IgG in the patients’ serum utilizing enzyme-linked immunosorbent assay and neutralization test; 3) personalized selection of the phage strain for therapy including assessment of the optimal route of delivery and phage pharmacokinetic properties. Implementation of aforementioned algorithm for patients with healthcare-associated infections in intensive care units resulted in 40% increase in efficiency of phage therapy (up to 72 per cent).

Here I analyze current knowledge and prospects regarding the concept of epidemic process. Aim. To systematize our understanding on epidemic process, to perform the synopsis, and to denote the prospects in the field. Materials and Methods. To apply a critical analysis, I employed Frege’s semiotic triangle (sign - concept - denotation). Publications on epidemic process were utilized as the research material. Results. Epidemic process considers diseases at the population level that demands understanding principles of research object definition and determination of the research subject, representing a concept content. I structured the concept content, logical models of epidemic process, and mechanisms of its development. The new theory of epidemic process formation should be based on the social organization. To classify types of incidence, I annotate types of social relationships. In turn, development of epidemic process is defined by distinct incidence types.

Here I briefly review anatomy and physiology of bile system, epidemiology, classification, development, signs and symptoms, diagnosis, and treatment of cholestasis and obstructive jaundice. Among the causes of obstructive jaundice, cholestasis-induced benign diseases have the highest prevalence (80%) and are followed by malignant tumors, mainly pancreatic cancer. Bile hypertension entails movement of the bile components to lymph and blood increasing level of bilirubin, cholesterol, and bile acids. Restriction or termination of the release of bile into the duodenum disturbs the digestion of fats with the further development of steatorrhea. Stagnant bile disrupts enterohepatic circulation and activates lipid peroxidation ultimately resulting in a significant hepatotoxicity. A number of cell death subroutines provoke inflammation and liver fibrosis. Cholelithiasis is also associated with the development of cholangitis. Early diagnosis of obstructive jaundice requires non-invasive examination (blood test, ultrasonography, magnetic resonance cholangiography, and computed tomography) and can demand invasive methods to evaluate biliary tract patency (endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography). Surgical treatment of cholestasis includes intitial transpapillary or percutaneous biliary decompression with the following invasive intervention. Surgery should be accompanied by hepatoprotective therapy; in severe cases, plasmapheresis or liver dialysis are expedient.