Vaccination is an effective means of preventing pertussis infection. The purpose of this work was to improve vaccines available in the Russian Federation in general and actualize vaccine strains used for the production thereof in particular. We studied B. pertussis strains isolated in Moscow, Voronezh, Novosibirsk, Ulyanovsk and Chelyabinsk regions, and eight production strains part of the adsorbed diphtheria-pertussis-tetanus (DPT) vaccine. Multilocus antigenic sequence typing (MAST) and whole genome multilocus sequence typing (wgMLST) were used for genotyping. We studied cultural morphological, enzymatic, serological, and genotypic properties of the candidate B. pertussis strains, and compared their genotypic properties to those of B. pertussis vaccine strains from the current composition of the DPT vaccine. Candidate strains belong to four genotypes: ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn2, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-2/prn9, ptxА1/ptxВ2/ptxС2/ptxР3/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС2/ptxР3/fim2-2/fim3-1/prn2. Current vaccine strains were from other six genotypes: ptxА2/ptxВ1/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА4/ptxВ1/ptxС1/ptxР2/fim2-1/fim3-1/prn1, ptxА2/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1, ptxА4/ptxВ2/ptxС1/ptxР2/fim2-1/fim3-1/prn1 and ptxА1/ptxВ2/ptxС1/ptxР1/fim2-1/fim3-1/prn1. With the help of wgMLST, we established affiliation of all candidate strains of B. pertussis to ST2.
VIEWS 1931
The POPI criteria (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions) for assessment of treatment of comorbidities, complications and underlying conditions in children that are accepted as the only existing instrument for detection of potentially inappropriate prescriptions, make it possible to evaluate prescriptions in children at the inpatient and outpatients stages of care provision, similar to the Beers criteria for adults. The study was aimed to assess the structure and rate of potentially inappropriate prescribing in the pediatric anesthesiology and resuscitation department of the multidisciplinary children's hospital based on the adapted version of  POPI criteria for non-antibiotic concomitant therapy of nosocomial infections. We analyzed 305 cases of non-antibiotic medication prescription per 100 patients included. The rate of potentially inappropriate prescribing was 31 cases (10.5%), among which potentially inappropriate medication was prescribed in 29 cases (9.5%), and potentially missed medication took place in three cases (1%). The highest rate of potentially inappropriate prescribing was reported for respiratory diseases. Assessment of concomitant therapy in the critically ill children with infections revealed no significant effects on the rate of adverse reactions to antibiotics in children. In the context of implementing medical information systems (MIS) and prescription sheets, integration of the adapted POPI criteria is topical in terms of maintaining the quality and safety of drug therapy for treatment of concomitant diseases, conditions, and complications in children.
VIEWS 1850
Functional assessment of higher mental functions in case of intoxication or during treatment will make it possible to identify predictors of the symptoms of hepatic encephalopathy associated with portal hypertension. The study was aimed to determine the diagnostic predictors of the emergence of the earliest symptoms of hepatic encephalopathy in adolescents with portal hypertension. The study involved 60 adolescents aged 13–17 years: 28 males, 32 females. The experimental group included 30 adolescents with the diagnosis К76.6 Portal hypertension, unspecified form. The control group included 30 adolescents with normal somatic status, who had no mental disorders, traumatic brain injuries or severe infectious diseases of the brain (based on the records of the annual check-up). The studied groups were matched by sex, age, and social status. The proprietary method, Tobii EyeX hardware and software system (GazeControl software), and Cambridge Face Memory Test for Children (CFMT-C) were used. It has been found that recognition of single face images, multiple face images, and multiple face images camouflaged with noise by adolescents with portal hypertension is associated with the greater efforts (manifested in the increased number and duration of gaze fixations), than recognition of the above by adolescents with normal somatic status. The accuracy of recognition of single face images, multiple face images, and multiple face images camouflaged with noise shown by adolescents with portal hypertension experiencing the toxic effects associated with manifestations of hepatic encephalopathy is significantly reduced compared to that shown by adolescents with normal somatic status. The results obtained can be considered as the diagnostic predictors allowing one to trace the changes in the hepatic encephalopathy severity at various stages of treatment (including after surgical intervention).
VIEWS 1756
Injections of platelet-rich plasma are considered to be a promising treatment. Medicines acting on the subchondral bone can improve tissue's structure and slow down destruction of the articular cartilage. This study aimed to analyze the results of intraarticular and intraosseous administration of platelet-rich plasma (PRP) in gonarthrosis cases. One hundred and eighty-seven participants (gonarthrosis stages 1 through 3) were divided into three groups. Group 1 (treatment group) received intraarticular PRP injections, group 2 (comparison group) — intraosseous PRP injections. For assessment purposes, we used the SF-36 survey and visual analog scale. Three months after the treatment, initial pain level decreased in both groups 1 and 2. In group 1, the prevalence of synovitis went down after 3 months, in group 2 — after 6 months (21.9 and 31.3%, respectively; p < 0.05). Six months after the treatment, soft tissue swelling around the joint was registered less often in groups 1 and 2 (8.2 and 8.3%, respectively). As for the physical component of the quality of life, it improved in group 1 after 3 months (70.40%), in group 2 — after 6 months (69.80%); as for the mental component, the dynamics was acknowledged positive 3 months after the treatment in groups 1 and 2 (64.30 and 65.10%, respectively), and 6 months after the treatment (65.10 and 66.40%, respectively). Thus, administration of PRP in gonarthrosis cases attenuate pain and improves the quality of life. In terms of alleviation of the clinical symptoms and improvement of the physical component of patients' lives, intraosseous PRP injections performed significantly better.
VIEWS 1614
The cellular response to various types of stress underlying placental vascular dysfunction is under the sumoylation control. Consequently, SUMO homeostasis is closely related to the maintenance of angiogenic balance, the disruption of which is a feature of preeclampsia (PE). The goal of the research is to search for exosomal markers of such a disorder. The expression and prognostic potential of exosomal SUMO 1–4, UBC9 and hnRNPA2/B1 were evalueted in 39 pregnant women (cohort I) in the first trimester using Western blotting technology. The expression of these proteins in the placenta (cohort II, 27 pregnant women) at the time of delivery was also assessed. The expression of their conjugated forms was significantly changed in pregnant women with early-onset (SUMO 1, p = 0.03; SUMO 2/3/4, p = 0.03) and late-onset PE (SUMO 1, p = 0.03; SUMO 2/3/4, p = 0.04; UBC9 and hnRNPA2/B1, p < 0.0001, respectively). This change may be due to the functional specificity of SUMO isoforms in the context of their subcellular targets upon exposure to stressful stimuli. Significant changes in the expression of these proteins were also found in the placenta. Significant correlations were established between the expression of exosomal SUMO 2/3/4 (r = –0.59; p = 0.01) and UBC9 (r = –0.88; p = 0.0001) with PlGF in early-onset PE. In late-onset PE, hnRNPA2/B1 (r = –0.48; p = 0.03) and UBC9 (r = –0.48; p = 0.03) was correlated with β-hCG, and SUMO 2/3/4 with PAPP-A (r = –0.60; p = 0.006) in the blood serum of pregnant women. The analyzed proteins also significantly correlated with uterine artery pulsation index (SUMO 1 (r = 0.59; p = 0.01), SUMO 2/3/4 (r = 0.54; p = 0.02), hnRNPA2/B1 (r = 0.75; p = 0.0001)) and mean arterial pressure (UBC9 (r = 0.53; p = 0.03)). Based on the data the logistic models have been created to predict the risk of developing early-onset (UBC9 (AUC = 0.88; Se-0.72; Sp-1)) and late-onset PE (SUMO 1 (AUC = 0.79; Se-0.8; Sp-0.77)) at 11–14 weeks of pregnancy.
VIEWS 1639