Aim: To study the management of patients with ST-segment elevation acute coronary syndrome (STE-ACS) in interventional cardiology units according to RECORD-3 registry data. Materials and Methods: RECORD-3 study included 47 hospitals among 37 Russian cities. From March to April 2015, 714 patients were admitted to interventional cardiology units with STE-ACS. Results: Coronary angiography at the admission was not performed in 17% (n=122) of patients, mainly due to the late admission. Primary percutaneous coronary intervention (pPCI) was performed in 335 (57%) patients. In general, treatment was consistent with the current recommendations excepting administration of ticagrelor, a new antiplatelet agent, to 19.6% of patients. Conclusions: Late admission to the hospital is still a significant problem in management of patient with STE-ACS, which limits efficiency of endovascular myocardial revascularization. In addition, the proportion of the patients receiving ticagrelor is low.

Aim: To analyze the efficacy of hypothermia in intensive care patients to prevent multiple organ failure (MOF). Materials and Methods: We conducted a prospective, non-randomized study during 2014-2016. Patients (n = 14) with acute coronary syndrome and cardiogenic shock underwent therapeutic hypothermia (THT), with target temperature of 34°C and duration of 52 (38-84) hours. Patients (n = 10) with the same clinical diagnosis but without THT were considered as a control group. We examined: (1) severity of MOF (SOFA score); (2) central hemodynamic parameters; (3) basal metabolic rate (BMR); (4) serum biochemical markers (S100beta protein, intestinal fatty acid-binding protein (i-FABP), surfactant protein A). Results: We detected a significant increase in severity of MOF from the 2 nd day in the control group compared to the patients who underwent THT. In addition, THT group had significantly decreased BMR and markers of organ damage in comparison with the controls. Conclusion: THT can prevent MOF in critically ill patients.

Aim: To determine the diagnostic value of microcirculatory disorders in patients with acute coronary syndrome (ACS). Materials and Methods: We recruited 174 consecutive patients with ACS during 2014-2015. Patients were divided into three groups: 1) those with Killip class I (n = 120); 2) Killip class II-III (n = 38); Killip class IV (n = 16).Day of the admission, 1st, and 2nd day in the intensive care unit (ICU) were selected as observation points. For the assessment, we measured central hemodynamic parameters and parameters of microcirculation using Doppler laser flowmetry. Results: Patients with Killip class IV had significantly depressed microcirculation at the 1st and 2nd day after admission to ICU compared to those with Killip class I-III. Coefficient of variation was significantly higher in patients with Killip class II-IV compared to those with Killip class I at the 1st and 2nd day after admission to ICU. Bypass ratio was significantly higher in patients with Killip class IV compared to those with Killip class I-III at all the time points. Patients with multiple organ failure had significantly depressed microcirculation and higher bypass ratio compared to those without at the 1st day after admission to ICU. Area under the ROC curve was0.75, 0.56, and 0.67 for microcirculation index, coefficient of variation, and bypass ratio, respectively. Conclusions: Microcirculation parameters can be included in the diagnostic algorithm for ACS in patients with low cardiac output in order to predict cardiogenic shock and multiple organ failure. Moreover, they can be used as a therapeutic target during intensive therapy of ACS.

Aim: To test whether the cytogenetic techniques can be used for detection of infectious agents in ixodid ticks. Materials and Methods: Suspensions of ixodid ticks were tested for encephalitis virus (TBEV) and pathogenic Borrelia (PB) using enzymelinked immunosorbent assay and then added to the lymphocytes isolated from donor peripheral blood. Results: Suspensions of ixodid ticks with either TBEV or ITBB induced clastogenic and aneugenic effects, with the synergistic action of these two agents. However, one-third of samples negative for both TBEV and PB did still provoke mutagenic effects. To test whether other infectious agents may be responsible for this, we conducted polymerase chain reaction, with the successful identification of West Nile Fever virus (WNFV). Conclusion: Cytogenetic techniques can be used for the detection of TBEV, ITBB, or WNFV in ixodid ticks.

Aim: To assess the reproductive system in preterm and full-term newborn girls. Materials and Methods: We recruited full-term and preterm newborn girls (58 and 42, respectively) and collected umbilical cord serum samples. Results: We measured the indicators of physical development, somatic health, vulvar anatomy, and ovarian reserve. Expectedly, we noted statistically significant differences between the preterm and full-term newborn girls. Conclusion: Premature birthaffects the reproductive system in the antenatal period.

Aim: To develop a software for evaluation of lumbar spine computed tomography densitometry to predict the risk of osteoporotic fractures in postmenopausal women. Materials and Methods: We evaluated the lumbar spine computed tomography densitometry data in 282 postmenopausal women following a computerized modeling Results: The sensitivity and specificity of the model were 77.8% and 86.7%, respectively, with the area under the ROC curve of 0.894 (95% confidence interval 0.855-0.932). We have also developed an original software for prediction of osteoporotic fractures in postmenopausal women. Conclusion: Our software can assist the clinicians in predicting the risk of osteoporotic fractures in postmenopausal women.

Aim: To study blood rheological properties in the immediate postoperative period after the surgery due to ascending colon cancer. Materials and Methods: We recruited 145 consecutive patients (50-75 years of age) who underwent surgery due to ascending colon cancer. All patients were divided into three groups: 1) T1N0M0 disease stage (n = 45); 2) T2N0M0 (n = 38); 3) T3N1M0 (n = 62). To determine blood rheological properties, we measured viscosity, deformation and aggregation of red blood cells. Results: We found that 1-3 days postoperation blood rheological properties, i.e. deformation and aggregation of red blood cells, hematocrit, and oxygen delivery to tissues, were increased in all groups with the further decline 5-7 and particularly 11-13 days postoperation. However, in patients with T2N0M0 and T3N1M0 stages, rheological properties did not return to the reference values. Conclusion: Alterations of rheological properties may have clinical significance in immediate postoperative period.

Aim: To determine the prevalence of depression in patients with myocardial infarction (MI) and its association with adverse annual outcome in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: We recruited 198 patients and divided them into two equal (99 patients) age-, gender-, and MI severity-matched groups: with and without T2DM. The follow-up duration was one year. Upon one year, we assessed the prevalence of all-cause mortality, myocardial infarction, and repeated admissions due to unstable angina, which all were considered as adverse outcomes. Results: Patients with T2DMhad higher prevalence of depression compared to those without (p = 0.004). Furthermore, we found significant associations of depression with severe MI, low left ventricular ejection fraction, ventricular arrhythmia, and recurrent MI during in-hospital period, particularly in patients with T2DM. Patients with depression, particularly those with T2DM, had significantly higher risk of an adverse outcome. One-year mortality rate in diabetic patients with and without depression was 50% and 18%, respectively. Conclusions: Depression is a significant factor of an adverse outcome, particularly in patients with T2DM.

Aim: To study the features of retinoblastoma (Rb) diagnosis in patients with different signs and symptoms. Materials and Methods: We investigated case histories of 58 patients (77 eyes) with Rb (1984-2013). Results: Average delay in diagnosis of Rb was 3.4 (95% CI 2.13-4.70) months. Average age of patients at diagnosis was 1.4-fold higher than at onset of symptoms (p = 0.001).The majority of patients (64%) had T3 and T4 stages according to the TNM classification. Conclusions: The results confirm the need in the measures aimed at early diagnosis of Rb within the first days of life. We suggest clinical and diagnostic algorithm for early detection of Rb.

Aim: To develop a method for prediction of adverse perinatal outcomes (severe asphyxia, intrauterine infection) in women with high risk of intrauterine infection. Materials and Methods: We recruited 375 pregnant women and divided them into two groups: 239 patients with high risk of intrauterine infection and 136 non-infected women. Out of 239 infected patients, 56 had transplacental infection, 98 suffered from exacerbations of chronic infections, and 85 had latent infections during the pregnancy. Upon the collection of clinical and laboratory data, we performed a stepwise logistic regression analysis. Results: We revealed energy deficiency of mother or fetus as independent predictive factors of pregnancy outcomes in the cases with intrauterine infection. Placental insufficiency was common for all patients with intrauterine infection. Conclusion: Energy deficiency should be considered as a significant predictive factor of adverse perinatal outcome in patients with intrauterine infection

Maternal mortality is now established as a key health indicator in women of reproductive age. Moreover, it can be recognized as an indicator of the country healthcare system since it reflects both the availability and quality of prenatal and obstetric care. The high rate of obstetric hemorrhage (OH)-related mortality reflects the poor quality of medical care and indicates the possibility to reduce maternal deaths. OH, particularly postpartum hemorrhages, remain a significant cause of maternal mortality worldwide. OH may cause critical conditions accompanied with massive blood loss and altered hemostasis. In recent years, a «near miss» conception became widely applied in obstetrics, particularly in regard to OH. This provides additional advantages and increases potential for decreasing maternal mortality. World Health Organization systematic review indicated three distinct approaches for identifying severe maternal morbidity: 1) the definition of criteria for clinical complications such as severe pre-eclampsia and hemorrhage; 2) admission of the patient in the intensive care unit, performance of hysterectomy or massive blood transfusion; 3) correction of organ dysfunction (shock or respiratory distress). It is important to develop standardized criteria for determining «near miss» cases to apply this principle as a research tool and improve the quality of obstetric care.

Sterile and nonspecific neuroinflammation can be detected in all critical care conditions as a part of systemic inflammatory response. A large number of prognostic and diagnostic candidate markers of severe neuroinflammation have been suggested for stroke, severe trauma and sepsis. Expression of inflammatory genes, glial activation, release of pro- and anti-inflammatory cytokines, and activation of cell adhesion molecules can be induced by both focal and diffuse brain injury. Therapeutic hypothermia is now considered as an efficient way to control neuroinflammation, normalize neurovascular units, reduce expression of cell adhesion molecules, stabilize extracellular matrix, and adjust cytokine response. Therefore, therapeutic hypothermia can be used for the treatment of systemic inflammatory response in intensive care units.

Here we present two clinical cases of shaken baby syndrome (SBS) ocular manifestations. SBS, being life-threatening condition, is important for providing an adequate treatment for violated children. An information about SBS can assist parents in avoiding traumas