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COMPREHENSIVE ASSESSMENT OF POSTURAL CONTROL AS A CONCEPTUAL BASIS FOR OPTIMIZING REHABILITATION AND RECOVERY PROGRAMS IN SPORTS
стр.5-11
Andreev D.A., Karmazin V.V., Parastaev S.A.
This literature-based review focuses on the basic physiological aspects of proprioception. Below, we describe and compare a number of biomechanical platforms used to measure postural control in high-class athletes. We define the primary goals of biomechanical assessment of postural problems, paying special attention to the functional performance of proprioceptors and proprioceptive control. We also provide a list of clinical and biomechanical indicators of proprioceptive damage and propose a diagnostic algorithm for assessing static and dynamic impairments in high-class athletes.
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AN UPDATE ON DEHYDRATION IN ATHLETES
стр.12-17
Parastaev S.A., Miroshnikova Yu.V., Pushkina T.A., Kurashvili V.A., Yashin T.A., Vykhodets I.T., Kupeev M.V., Didur M.D.
Fluid and electrolyte imbalances can compromise physical performance of professional athletes. We have conducted a study to understand how aware athletes are of their hydration status and how they deal with dehydration. First, we surveyed 51 athletes (mean age of 20.4 years) specializing in different sports, including ice hockey, water polo, tennis and figure skating, using a questionnaire. Next, we analyzed the anonymized results of the laboratory tests run on the samples of 30 athletes specializing in futsal. We focused on hemotocrit and sodium levels and urine specific gravity as indirect indicators of hydration status. Survey results demonstrated that 86 % of the participants lacked knowledge of wise approaches to replenishing fluid or electrolytes after physical exercise, did not adequately control fluid intake and developed various degrees of dehydration. We noticed that awareness of hydration status negatively correlated with professional qualifications of the participants. Retrospective analysis of laboratory tests showed that hypohydration prevailed among high-class athletes: at least 73 % of them showed signs of dehydration. We emphasize the need for elaborating unified clinical recommendations on rehydration for Russian athletes that should be further approved by doctors and coaches.
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CAN SPORTS BE SAFE? REALITY, CONCEPTS AND REGULATIONS
стр.18-21
Didur M.D., Vykhodets I.T., Khokhlina N.K., Zhuravleva A.I., Polyaev B.A.
A safe sport is a bit of an oxymoron: competition puts a severe strain on the vital systems of the organism that may be dangerous or uncontrollable, does not come in small doses and entails unpredictable results. Sports injury surveillance aims to estimate the impact of different factors that increase the risk of injuries and to elaborate wise and efficient measures to curb this risk. Accurate data on mortality rates in athletes help to improve approaches to health screening. Injury surveillance systems that also report injury-related deaths in athletes exist in many developed countries. This article talks about sports injuries in Russia and provides rationale for creating a nation-wide system of sports injury surveillance.
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DRUG-FREE TREATMENTS OF TENSION HEADACHES IN SCHOOL-AGE CHILDREN
стр.22-27
Polunina V.V., Sergeenko E.Yu., Yarustovskaya O.V., Polunin V.S.
Nowadays headaches are common among teenagers and children. This study aimed to assess effectiveness of reflexology, kinesiology taping and myofascial trigger point therapy in children with tension headaches and to compare these treatments with traditional drug-based modalities. The study recruited 37 children (19 boys and 18 girls) aged 9 to 14 years. The main group (n = 25) received 2 series of reflexology treatments separated by a month interval, kinesiology taping and trigger point massage, which was also taught to the patients and their parents. The control group (n = 12) received Ibuprofen and Mydocalm (the daily doses did not exceed 30 mg/kg and 2-4 mg/kg, respectively). Treatment duration in both groups was 4 months. Treatment effectiveness was assessed based on the evolution of patients’ complaints and the impact of headache on children’s daily activities, using the visual analog pain scale and the HIT-6 method, respectively. Within a month, headaches became 1.2 times less frequent and the attacks became 1.2 times shorter in the control group, while in the main group headaches became 2.5 times less frequent and the attacks became twice as short as they had been before Headache intensity did not change significantly in the control group, while in the main group it decreased 1.5 times (p < 0.05). The number of controls who experienced a severe impact of headache on their daily activities decreased 1.2 times after the treatment, while the main group reported no such impact at all. In the main group the number of patients who experienced only a slight impact of headaches on their daily activities increased 4.7 times, from 12 % to 56 %. Our findings demonstrate that drug-free treatments for tension headaches are more effective than drug-based regimens. Moreover, children benefit from drug-free regimens as they are not exposed to the negative effects of analgesics and muscle relaxants.
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DEPENDENCE OF MUSCLE STRENGTH ON BIOLOGICAL MATURATION RATES AND KEY VARIABLES OF PHYSICAL DEVELOPMENT IN TEENAGE BOYS
стр.28-33
Milushkina O.Yu., Skoblina N.A., Prusov P.K., Bokareva N.A., Tatarinchik A.A., Kozyreva F.U., Moiseev A.B.
Functional abilities of school-age children are affected by a variety of factors, including endogenous. Over the course of a few years, we studied physical development of 182 boys who underwent annual physical examination from the age of 11 to 17. We took basic anthropometric measurements, such as height and weight, tested hand muscle strength and assessed biological maturation and body build. Our study showed that muscle strength in school-age boys suffers a negative influence of such endogenous factors as delayed physical development, body mass deficit, short stature, and asthenic build. Excess weight and low skeletal weight also contribute to decreased muscle strength in teenage boys. Our results can be used to identify teenagers at risk who should be given special attention during PE classes at school or during training sessions before the GTO fitness test.
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WORKPLACE HYGIENE IN CORRECTIONAL FACILITIES: PROBLEMS AND SOLUTIONS
стр.34-39
Polunina N.V., Timerzyanov M.I., Milushkina O.Yu., Pivovarov Yu.P., Polunin V.S., Al Sabunchi A.A, Kozyreva F.U., Korolik V.V.
The state takes the responsibility of protecting the life, health and working ability of inmates of penitentiary institutions. This study aimed to explore working conditions at a correctional facility located in Tatarstan. Among the most significant workplace hazards were high noise and vibration levels, poor lighting, exposure to increased concentrations of harmful substances in the air, physical distress, constrained posture, sensory stress, and monotonous work. Health evaluation of 5,009 incarcerated individuals exposed to poor working conditions revealed that they were more likely to develop work-related diseases than their counterparts who worked in the office. Among the former skin and subcutaneous tissue diseases, hearing impairment, respiratory conditions and cardiovascular disorders were 2.1, 1.7, 1.5 and 1.3 times more frequent, respectively. Our study revealed the lack of medical examinations on admission, as well as regular medical checkups, and the reluctance of the inmates to use personal protection at work. Based on the study results, adequate measures were taken to improve working conditions, raise awareness of hygiene problems among the inmates and initiate routine medical checkups. The number of incarcerated individuals working under bad conditions plunged from 68 % to 19 %. Also, up to 82 % of inmates started to use personal protection.
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DEVELOPING AN ARTIFICIAL INTELLIGENCE-BASED SYSTEM FOR MEDICAL PREDICTION
стр.40-44
Sakhibgareeva M.V., Zaozersky A.Yu.
Diagnostic accuracy remains one of the central problems of medical care. In this work we attempt to apply artificial intelligence to solve this challenge. We propose an approach to medical prediction based on the intelligent analysis of patients’ data from 200 different laboratory tests. The initial sample included 7, 918 cases falling into 4 nosological categories: D50 (iron deficiency anemia), E11 (non-insulin-dependent diabetes mellitus), E74 (other disorders of carbohydrate metabolism), and E78 (disorders of lipoprotein metabolism and other lipidemias), and was further divided into the training and testing datasets. Using gradient boosting, we constructed a machine learning model. The model demonstrated a recognition rate of 89 % (AUC-ROC) and a mean certainty in the diagnosis of 92 %. Our study proves feasibility of using machine learning in the analysis of this type of medical data. We are currently implementing a web-service for medical prediction as part of our Healthcare platform aiming at automation of clinical practice.
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A FEW ASPECTS OF PLASTIC SURGEONS’ PERFORMANCE
стр.45-48
Manturova N.E., Kochubey V.V., Kochubey A.V.
In spite of accreditation programs, levels of professional skills vary among plastic surgeons: there are no requirements for the diversity and number of performed surgical interventions that a surgeon can specify in his/her portfolio. Rationale for elaborating such requirements can be explored by studying service reports of private medical practices certified to provide plastic surgery services to their in- and outpatients. In the course of out study we analyzed such reports using different statistical tools, including the variation coefficient, the Kolmogorov-Smironov, Mann-Whitney U and Kruskal-Wallis tests, and Spearman’s correlation coefficient. Differences were considered statistically significant at p < 0.05. Surgical interventions were divided into 9 categories: skin/soft tissue plasty, rhinoplasty, breast plasty, blepharoplasty, otoplasty, lip and palate repair, craniofacial plasty, repair of urogenital defects, and hand surgery. On average, each surgeon performed a total of 112.3 ± 326.4 surgeries (Мо = 1). About 30.4 % of surgeons performed 1 to 10 interventions a year. None of the surgeons performed all types of interventions and hand surgery. We found that the diversity and number of interventions performed by a surgeon does not depend on the qualification or academic title (r = -0.8, р = 0.2 and r = -0.2, р = 0.8, respectively). Skin/soft tissue repair accounted for 51.1 % of all services provided by private medical practices. The number of post-operative treatment services was 0.017 per surgery.
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BREAST CANCER: ANALYSIS OF DRIVER SOMATIC MUTATIONS DETECTED BY NEXT-GENERATION SEQUENCING
стр.49-54
Tsukanov K.Yu., Krasnenko A.Yu., Korostin D.O., Churov A.V., Stetsenko I.F., Plotnikov N.A., Zarubina S.A., Belova V.A., Kovyrshina A.V., Vorotnikov I.K., Mescheryakov A.A., Ilyinsky V.V.
Breast cancer (BC) is one of the most common malignancies. There is a need for novel approaches to screening for genetic mutations in patients with BC that will help to reduce high mortality rates caused by this disease and improve treatment outcomes. In this study we employed next generation sequencing to screen a few key genes associated with the risk of breast cancer for mutations. We also evaluated their pathogenicity using the previously proposed bioinformatics-based algorithm and analyzed the associations between some of the detected mutations and the clinical manifestations of the disease. Our study recruited 16 female patients with BC (mean age was 50.7 ± 11.3 years). A total of 58 mutations were detected in the oncogenes , , , , and . Bioinformatic analysis of the sequencing data revealed 14 mutations that affect the sequence of the encoded proteins. Most deleterious mutations were harbored by the genes , and .
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ANALYSIS OF THE APOPTOTIC EFFECT OF ULTRAHIGH GAMMA DOSE RATES ON HUMAN PERIPHERAL BLOOD LYMPHOCYTES
стр.55-61
Grabovsky E.V., Oleynik G.M., Krastelev E.G., Smirnov V.P., Khmelevsky E.V., Bozhenko V.K., Shishkin A.M., Ivanov A.V., Kulinich T.M.
Relative biological effectiveness of ionizing radiation is determined by a number of factors, including a dose rate. Radiotherapy equipment employs low dose rates of up to a few Gy per minute. But very little is known about the biological effect of high and ultrahigh (≥ 10 Gy/min) dose rate radiation. Our study aimed to investigate the apoptotic effect of ultrahigh gamma dose rates on human peripheral blood lymphocytes. Blood samples were collected from seemingly healthy donors. Lymphocytes were isolated by density gradient separation. Lymphocyte suspensions were irradiated with low-rate doses on the Rokus-AM gamma-ray machine for clinical use (Russia) and with 10 Gy/s doses on the experimental pulse generators Angara-5-1 and Mir-M (Russia). Apoptosis was measured by flow cytometry using annexin V and propidium iodide double staining. We established that in comparison with low dose rates, ultrahigh gamma dose rates (with doses ranging from 1 to 6 Gy) induced significantly more pronounced apoptosis in peripheral blood lymphocytes (p < 0.05) with fewer necrotic cells. Total radiation-induced cell death did not differ significantly between the therapeutic gamma machine and the experimental pulse generators. Further research is needed to assess biological and medical significance of our findings.
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THE CHOICE OF ANESTHETIC TYPE AND CONDITIONS FOR 2,3,5-TRIPHENYLTETRAZOLIUM CHLORIDE STAINING OF BRAIN SLICES IS IMPORTANT IN THE ASSESSMENT OF ISCHEMIC INJURY IN RATS IN THE EARLY STAGES OF PATHOLOGY
стр.62-68
Bilan D.S., Kelmanson I.V., Belousov V.V.
Studies of ischemic brain injury are an important area of modern biomedical research. So far, a lot of ischemic stroke models have been proposed, along with different imaging and staining modalities aimed to visualize the damaged tissue. In this work we use a rat model to investigate how the experimental setup affects the interpretation of experimental data obtained in the acute phase of ischemic stroke (5 hours after the occlusion of the middle cerebral artery). We show the association between the choice of the type of anesthesia and the severity of ischemic injury: in our experiments brain damage was the most pronounced in the animals anesthetized with a combination of chloral hydrate and Rometar; the least damage was observed for isoflurane. Staining was performed using the popular dye 2,3,5-triphenyltetrazolium chloride (TTC). We demonstrate that parameters of brain slices incubation in TTC also need to be accounted for when interpreting the results obtained during the acute phase of stroke, the optimum incubation time being 30 min and temperature 37 °С.
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TEMPORAL DYNAMICS OF CYTOKINES IN THE BLOOD OF RATS WITH EXPERIMENTALLY INDUCED AUTOIMMUNE ENCEPHALOMYELITIS
стр.69-77
Pozdniakova N.V., Turobov V.I., Garanina E.E., Ryabaya O.A., Biryukova Yu.K., Minkevich N.I., Trubnikova E.V., Shevelev A.B., Kuznetsova T.V., Belyakova A.V., Udovichenko I.P.
In this work we explore the temporal dynamics of cytokines in Dark Agouti rats with experimentally induced autoimmune encephalomyelitis (EAE). The main group consisted of 11 animals who were injected with 100 μl (per leg) of spinal cord homogenate obtained from random-bred rats and combined with incomplete Freund’s adjuvant to the hind footpads. The control group included 7 animals who received 100 μl of normal saline mixed with incomplete Freund’s adjuvant. Blood samples (500 μl) were collected daily, starting from day 1 through day 7. We ran a Bio-Plex-based multiplex cytokine assay on the samples using the Bio-Plex Pro Rat Cytokine 24-plex Assay kit. EAE in rats was shown to simulate progression of multiple sclerosis in humans in terms of temporal dynamics of lymphoproliferative and hematopoietic factors IL-1b, IL-2, IL-4, IL-5, IL-6, and IL-7. The studied model satisfactory imitates the dynamics of factors stimulating migration of lymphocytes, monocytes and other immune cells, including IL-17, RANTES (CCL-5) and MCP-1 (CCL-2) but excluding GRO/KC (CXCL1), which shows a different dynamics. The model also resembles patterns of human multiple sclerosis in terms of factors affecting cytotoxic and apoptotic reactions, including IFNγ, IL-6 and IL-17, but excluding TNFα.
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