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Statkevich D.,Belarusian Medical Academy of Post Graduate Education
Psychiatry, Psychotherapy and Clinical Psychology | Year: 2016

This study explores the influence of various factors on the efficacy of inpatient opioid detoxification - retention rate of patients, who completed the treatment program. The paper presents a model and the scale predicting the early drop-out of patients from inpatient opioid detoxification.

Tabolina A.,Belarusian Medical Academy of Post Graduate Education | Baikova I.,Belarusian Medical Academy of Post Graduate Education
Psychiatry, Psychotherapy and Clinical Psychology | Year: 2016

Analysis of 25 women of perimenopausal period was conducted in order to reveal their hormonal parameters, the degree of severity of menopausal disorders and psycho-emotional state. Women with anxiety and depressive disorders had more severe course of menopausal syndrome and estradiol level in their blood was significantly lower than in blood of patients without the psycho- emotional disorders. The interrelation of the presence of psycho-emotional disorders (PED), the level of estradiol and modified menopausal index was dependent on the duration of menopause. For women in perimenopause confirmed diagnosis of PED and estradiol levels were associated with the number of hot flashes and degree of their severity. Strong dependence was revealed between PED and the increase of prolactin concentration in blood. Patients with PED showed a decrease in concentration of serotonin in blood in the dynamic observation, which was associated with decrease of estradiol level, which confirms the positive rate of correlation of dynamic indices of these hormones.

Statkevich D.,Belarusian Medical Academy of Post Graduate Education
Psychiatry, Psychotherapy and Clinical Psychology | Year: 2016

Leaving hospital against medical advice (AMA) remains a major healthcare challenge, which often leads to negative health consequences and related costs. However, there is lack of information on the prevalence and factors associated with leaving AMA among users of illegal opioids. This study demonstrated that substantial proportion of users of illegal opioids from inpatient opioid detoxification left AMA, and diff erent factors were associated with this phenomenon.

Lasyi E.,Belarusian Medical Academy of Post Graduate Education
Psychiatry, Psychotherapy and Clinical Psychology | Year: 2016

The review presents the data on suicide frequency among hospitalized psychiatric and somatic patients. Risk factors connected to the availability of means of suicide, quality of surveillance and communicative ability of medical personnel are analyzed. Authors propose data on suicide and death due external causes among hospitalized patients in Belarus. Authors underline that quality of suicide prevention in hospital depends on the evaluation of patient's suicide risk as well as the improving surveillance and control over the suicide means in hospital and quality of interpersonal communication with patients.

Leifeld L.,Evangelisches Krankenhaus Kalk | Pfutzer R.,Evangelisches Krankenhaus Kalk | Morgenstern J.,Evangelisches Krankenhaus Kalk | Gibson P.R.,Monash University | And 4 more authors.
Alimentary Pharmacology and Therapeutics | Year: 2011

Background Different oral formulations of 'mesalazine (mesalamine)' may have different efficacy in distal ulcerative colitis. Aim To evaluate the efficacy of mesalazine granules (Salofalk granules) vs. mesalazine tablets (Salofalk tablets) as induction therapy in patients with distinct extensions of ulcerative colitis. Methods A pooled analysis of 705 patients from four prospective, randomised, double-blind phase III trials was performed. The efficacy of 8 weeks' induction with 3 g/day mesalazine granules [3 g once daily (o.d.) or 1 g three times daily (t.d.s)] vs. 3 g/day mesalazine tablets (1 g t.d.s.) was compared in terms of clinical remission (CR: CAI ≤ 4) and endoscopic remission (ER: EI ≤ 3) (both according to Rachmilewitz) in subgroups with pancolitis, left-sided colitis, or proctosigmoiditis. Results Mesalazine granules were equipotent to mesalazine tablets in pancolitis regarding CR (72% vs. 71%, P = 0.909) and ER (58% vs. 49%, P = 0.338). In left-sided colitis, both mesalazine formulations were equipotent regarding CR (66% vs. 67%; P = 0.843) but mesalazine granules were superior regarding ER (56% vs. 37%; P = 0.025). In proctosigmoiditis, mesalazine granules were significantly more effective than mesalazine tablets regarding CR (78% vs. 55%P < 0.001) and ER (67% vs. 43%P < 0.001). Furthermore, o.d. application of mesalazine granules was more effective than t.d.s. dosing in left-sided colitis (CR 73% vs. 62%, P = 0.181; ER 71% vs. 48%P = 0.005) and proctosigmoiditis (CR 86% vs. 73%, P = 0.020; ER 75% vs. 61%, P = 0.021), but not in pancolitis. Conclusion This pooled analysis supports the hypothesis that mesalazine granules are superior to mesalazine tablets in induction of remission in distal colitis and should be taken once daily. © 2011 Blackwell Publishing Ltd.

Zafranskaya M.M.,Belarusian Medical Academy of Post Graduate Education | Nizheharodova D.B.,Belarusian Medical Academy of Post Graduate Education | Yurkevich M.Y.,Belarusian Medical Academy of Post Graduate Education | Lamouskaya N.V.,Belarusian Medical Academy of Post Graduate Education | And 6 more authors.
Immunology Letters | Year: 2013

Mesenchymal stem cells (MSC) are promising for multiple sclerosis (MS) treatment. However, clinical results remain controversial, and no criteria are available for predicting the efficiency of MSC therapy. Using an in vitro model of lymphocytes and MSC cocultivation we revealed that the Index of MSC Suppression of myelin-induced memory T cells proliferation was stronger than that of PHA-stimulated proliferation and inversely correlated with patients' EDSS score. In vitro expression of CD119 (IFNGR1) in mitogen/myelin-stimulated T cells increased in the presence of MSC being inversely correlated with T-lymphocytes proliferation. The Index of MSC Suppression and CD119 expression in T-lymphocytes may be useful when assessing MSC immunosuppressive potential in MS patients. © 2012 Elsevier B.V.

Zafranskaya M.,Belarusian Medical Academy of Post Graduate Education | Nizheharodava D.,Belarusian Medical Academy of Post Graduate Education | Yurkevich M.,Belarusian Medical Academy of Post Graduate Education | Ivanchik G.,Belarusian Medical Academy of Post Graduate Education | And 3 more authors.
Scandinavian Journal of Immunology | Year: 2013

Current theories of multiple sclerosis (MS) induction and progression place autoreactive T cells in the focus of the pathogenesis. Mesenchymal/stromal stem cells (MSC) have become a promising alternative approach for pathogenic therapy of MS due to their immunomodulatory properties, underlying mechanisms of which are intensive study. The objective of the research was to investigate the contribution of PGE2 to MSC-mediated suppression in patients with MS using in vitro model of mitogen- and myelin-stimulated T cell cocultivation with autologous/allogeneic MSC. We have showed that PGE2 production depends on cell-to-cell contact of MSC and lymphocytes. The antigenic stimulation did not affect PGE2 production following cocultivation of MSC and PBMC, and it is the presence of MSC in cell culture that significantly increases PGE2 production irrespective of antigenic cultivation conditions. Simultaneously, PGE2 synthesis correlated with indexes of MSC-mediated suppression of mitogen- and myelin-stimulated T cell proliferation in patients with MS. No significant differences in PGE2 production by autologous and allogeneic MSC have been established. These results have demonstrated that in patients with MS, PGE2 is one of the possible factors of MSC immunosuppression. The interrelation between PGE2 concentrations and T cell proliferation suppression mediated by MSC may explain one of the immune mechanisms of cell therapy, which is crucial for the further proper use of MSC in MS research and pathogenic treatment. © 2013 John Wiley & Sons Ltd.

PubMed | National Academy of Sciences of Belarus, Belarusian State Medical University and Belarusian Medical Academy of Post Graduate Education
Type: Journal Article | Journal: Advances in clinical and experimental medicine : official organ Wroclaw Medical University | Year: 2016

Clinical and experimental results show that repetitive transcranial magnetic stimulation (rTMS) is effective and safe in the treatment of epilepsy. The characteristics of the impulse magnetic field (IMF) are empirical in these studies, making impossible to compare their effectiveness.The article presents the results of a study of the anticonvulsive effects of different modes of IMF on the picrotoxin seizure model, which is important for studying GABAergic brain mechanisms activated by rTMS.The experiments were performed on outbred male mice (n = 597; 450 in the experimental group and 147 in the control group). The picrotoxin was injected in a dose of 2.5 mg/kg subcutaneously after either rTMS or a placebo. The rTMS regimes varied in frequency (0.1, 0.3, 0.5, 1.0 and 10 Hz), intensity (10, 20 and 40% of maximal magnetic induction [MMI] of the big ring coil) and the number of procedures (1, 3, 10). The dependence of the criterial characteristics on the TMS parameters was shown in this convulsive model.The analysis of the data obtained showed that 10 rTMS sessions at an intensity of 20% of MMI in the range of frequencies from 0.5 to 1.0 Hz had the most stable and significant effect in terms of reducing the convulsive readiness of the brain, evaluated by the latent period of the myoclonuses in the picrotoxin test. In all the regimes of exposure, rTMS decreased the number of seizures in the picrotoxin model by 1.5-2 points; the most significant effect was obtained with 10 rTMS sessions in the 0.5-1.0 Hz frequency range and an intensity of 20% of the MMI ( < 0.01).The study results support the use of IMF as therapy for blocking convulsive attacks.

Reiners C.,University of Würzburg | Biko J.,University of Würzburg | Haenscheid H.,University of Würzburg | Hebestreit H.,University of Würzburg | And 6 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013

Context: After severe reactor emergencies with release of radioactive iodine, elevated thyroid cancer risk in children and adolescents is considered the main health consequence for the population exposed. Design: We studied thyroid cancer outcome after 11.3 years' median follow-up in a selected, very high-risk cohort, 234 Chernobyl-exposed Belarusian children and adolescents undergoing post-surgical radioiodine therapy (RIT) in Germany. Interventions: Cumulatively 100 children with or (without; n = 134) distant metastasis received a median 4 (2) RITs and 16.9 (6.6) GBq, corresponding to 368 (141) MBq/kg iodine-131. Main Outcome Measures: Outcomes were response to therapy and disease status, mortality, and treatment toxicity. Results: Of 229 patients evaluable for outcome, 147 (64.2%) attained complete remission [negative iodine-131 whole-body scan and TSH-stimulated serum thyroglobulin (Tg) < 1 μg /L], 69 (30.1%) showed nearly complete remission (complete response, except stimulated Tg 1-10 μg/L), and 11 (4.8%) had partial remission (Tg >10 μg/L, decrease from baseline in radioiodine uptake intensity in ≥ 1 focus, in tumor volume or in Tg). Except for 2 recurrences (0.9%) after partial remission, no recurrences, progression, or disease-specific mortality were noted. One patient died of lung fibrosis 17.5 years after therapy, 2 of apparently thyroid cancer-unrelated causes. The only RIT side effect observed was pulmonary fibrosis in 5 of 69 patients (7.2%) with disseminated lung metastases undergoing intensive pulmonary surveillance. Conclusions: Experience of a large, very high-risk pediatric cohort with radiation-induced differentiated thyroid carcinoma suggests that even when such disease is advanced and initially suboptimally treated, response to subsequent RIT and final outcomes are mostly favorable. Copyright © 2013 by The Endocrine Society.

PubMed | Belarusian Medical Academy of Post Graduate Education, Central City Hospital and 23, Ural Federal University, Children City Clinical Hospital and 9 and Children City Hospital and 10
Type: Journal Article | Journal: Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova | Year: 2016

To determine clinical/instrumental predictors of symptomatic epilepsy after ischemic stroke in children.One hundred and thirty-six patients, aged 0-15 years, with the diagnosis of ischemic stroke (ICD-10 I63.0-I63.9) were examined. The duration of the study was 18 months - 12 years. Patients were stratified into post-stroke (n=22) and control (n=114) groups, the latter included patients without epilepsy regardless of the presence of convulsive seizures in the acute stage of stroke. Predictors were determined based on EEG and characteristics of convulsive syndrome in the acute stage of stroke.The following prognostic criteria were found: generalized type of seizures, focal type of seizures with secondary generalization, epileptiform (peak and/or peak-wave) activity, focal character of epileptiform activity, generalized type of seizures in the combination with slow wave background activity on EEG, generalized type of seizures in the combination with slow wave activity and disorganized activity on EEG.

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