The prevalence of post-COVID syndrome in patients treated on an outpatient basis ranges from 10 to 35 %; it can reach 80 % in patients with severe coronavirus infection. It is currently hypothesized that long-COVID may be due to both the direct effects of the SARS-CoV-2 virus and the biopsychosocial effects of COVID-19.The aim. To study the characteristics of damage to the central nervous system and mental sphere in patients with comorbid post-COVID syndrome.Materials and methods. To study the clinical features of the course of post-COVID syndrome, 98 patients who had suffered COVID-19 were examined. Of these, 18 (18.4 %) were men, 80 (81.6 %) were women. The mean age in the group was 56.05 ± 1.27 years. The examination program included a questionnaire, clinical examination, pulse oximetry, and assessment of exercise tolerance using the Borg scale. Statistical processing was carried out using the Statistica software package, version 6 (StatSoft Inc., USA). The results of the study are presented as a median, upper and lower quartiles. After analyzing the compliance of the studied indicators with the law of normal distribution (Shapiro – Wilk test), the groups were compared using the Wilcoxon test for pairwise comparison of related samples. Differences were considered statistically significant at p < 0.05.Results. Our studies of comorbidity and complications after COVID-19 infection revealed the most frequent involvement of three systems in the pathological process: cardiovascular, nervous and endocrine. Metabolic syndrome was detected in 67 % and involvement of the cardiovascular system was detected in 48.8 % of those examined.One of the main manifestations of post-COVID syndrome is damage to the central nervous system and mental sphere in the form of mild cognitive and emotional-volitional disorders with asthenodepressive and anxiety-depressive disorders.Conclusion. The health status of patients after COVID-19 is significantly lower than that of the general population. The study results indicate an urgent need to study the pathogenesis of long COVID and develop effective interventions to reduce the risk of its development.

Summary. Through the skin fine-needle aspiration biopsy of parapancreatic fiber under ultrasound control with microbiological study of the biomaterial to verify purulent-septic complications of pancreatonecrosis, 46 patients with acute necrotizing pancreatitis were performed. Using the developed method for diagnosing infected pancreatic necrosis, it was possible to achieve timely detection of infectious complications of pancreatonecrosis, which would lead to a reduction in untimely (early) operations, the number of cases of systemic complications.

Summary. The predominance of people of working age (21-60 years) among patients with pancreatic necrosis, the occurrence of permanent disability in a significant part of patients, high overall and postoperative mortality (20-85 %), due to various complications, turns the treatment of pancreatic necrosis into an important social problem. The frequency of formation of false cysts in acute pancreatitis is 5-16 %, and in destructive forms it increases to 60-80 %. Materials and methods. The scope of endoscopic interventions in the treatment of 16 patients with pancreatic cysts of the pancreas directly depended on the preoperative findings and, first of all, on the presence of the connection of the cyst with the pancreatic ducts. Favorable conditions for endoscopic correction in the treatment of pancreatic pseudocysts were a small (less than 10 mm) distance between their cavity and the lumen of the gastrointestinal tract, minimal thickness of the capsule (no more than 2 mm), large dimensions (over 6 cm), as well as localization in the projection body and isthmus of the pancreas. Research results. When analyzing the results of the treatment of complications of pancreatic necrosis, we formulated an algorithm for the rational choice of operative interventions. We believe that rational treatment is based on early diagnosis of PN complications, including hemorrhagic ones. Conclusions. The use of the developed algorithm allowed us to reliably reduce postoperative mortality among patients of this category.

Abstract—The aim of this study was to identify the relationship between the changes in certain immune system parameters (cytokines and neuronal antibodies) and the distribution of the level of constant brain potential (LCP) in patients with occupational neurosensory hearing loss (NHL). We examined 55 males with occupational NHL formed under the influence of aviation noise and 34 relatively healthy males of comparable ages. As a result of correlation analysis, we found that the higher the concentration is of proinflammatory IL-1β, which is the first to be involved in the body’s reaction by regulating the nonspecific and specific immune response, the higher the LCP of the inter-hemisphere frontal asymmetry of energy metabolism (Fd–Fs) is. In contrast, an increase in TNF-α concentration was accompanied by a decrease in the LCP in the left frontal lead (Fs). These results can indicate the important role of IL-1β and TNF-α in the regulation of interhemispheric activity during hyperpolarization of neuronal membranes in the frontal parts of the brain and activation in the frontal parts of the brain; they also confirm that cytokine regulation of the immune response occurs at the level of entire body. We also showed the deficiency of some relationships and the appearance of new negative relationships between the level of antibodies (AB) to proteins: V-gated Ca-channel, Chol-R, Ser-R, and the LCP in the right and left parietal regions (Pd, Ps), AB to GABA-R, Glu-R, and the LCP in the left parietal region (Ps), ABs to Glu-R with parameters of inter-hemisphere frontal asymmetry of the LCP (Fd–Fs), which indicates an important role of neuroautoimmune reactions in the development of brain energy metabolism disorders. The LCP characteristics that correlate with immunochemical parameters reflect not only neurophysiological mechanisms but also characterize the functional state of the adaptive systems of the body in general. In the future, this can be used in practice to develop new methods for diagnosing various conditions.

The development of vibration disease (VD) is based on the stagnant excitation response that arises mainly in the sympathetic part of the autonomic nervous system, the hypothalamic region, and cortical areas of the brain and leads imbalanced endocrine regulation and metabolic insufficiency. VD is due to a combined effect of local and general vibration and is thought to be a membrane-associated pathological process, membranes of the vascular endothelium being the most vulnerable. It is therefore of importance to study the relationship between topography of direct current (DC) potentials, which integrally reflect the membrane potentials of neurons, glia, and the blood–brain barrier, and serum concentrations of pro- and anti-inflammatory cytokines. The aim of the study was to compare the changes in serum cytokine concentrations and the brain DC potential distribution in patients with VD due to local and general vibrations. The study involved 28 patients who were diagnosed with stage II VD due to occupational exposure to vibration, lacked exposure to vibration at the time of the study, and had no comorbid pathology that could affect cytokine metabolism. A control group included 15 men without occupational exposure to vibration. The serum concentrations of IL-2, IL-4, IL-8, and IFN-γ were determined by the enzyme-linked immunosorbent assay (ELISA). The DC-potential level was recorded using neuro-energy mapping. Statistical analyses included the Shapiro–Wilk W-test, Mann–Whitney U-test, and Spearman’s rank correlation. The VD patients compared with the controls showed a moderately elevated DC-potential level in the central (p = 0.04), left central (p = 0.02), and right temporal (p = 0.03) leads. The IL-2 concentration was found to correlate with the DC potential in the left central (rs = 0.47), right parietal (rs = 0.37), and occipital (rs = 0.38) regions of the brain. The IL-4 concentration correlated with the DC potential in the right (rs = 0.41) and left (rs = 0.45) frontal regions and the temporal (rs = 0.39) and central (rs = 0.51) interhemispheric gradients. The IL-8 concentration correlated with the DC potential in the right (rs = 0.41) and left (rs = 0.43) frontal regions and the central (rs = 0.38) interhemispheric gradient. IFN-γ correlated with the DC potential of the left frontal (rs = 0.41) region and the central (rs = 0.42) interhemispheric gradient. An increase in DC potential in the frontal (right and left), right temporal, occipital, central, and right parietal regions of the brain was associated with IL-8 and IFN-γ overproduction in VD. Based on the correlations, higher energy metabolism in the anterior brain regions was associated with activation of the neuroinflammatory process due to overproduction of IL-4 and IL-8. An increase in IL-2 concentrations was associated with a higher CD-potential level in the posterior regions of the brain.

We have studied the structure, lattice dynamics, and dielectric properties (terahertz spectroscopy) of heteroepitaxial Sr0.5Ba0.5Nb2O6 films grown on MgO (001) substrates by rf cathode sputtering in an oxygen atmosphere. The results demonstrate that the films are heteroepitaxial and homogeneous and have high structural perfection. According to analysis of Raman spectra of the films measured at various temperatures in the range 299–433 K, the behavior of individual vibrational modes shows anomalies at T ≃ 390 ± 10 K, related to the phase transition. The unit cell of barium strontium niobate films 2.4–2.5 μm in thickness is shown to undergo strain both along and across the plane of the interface. Presumably, this is responsible for the increase in the width of the ferroelectric phase transition according to Raman spectroscopy data and also for the observed variations in the dielectric properties of the films in the terahertz frequency range.

The aim . To identify neuropsychological signs of a decrease in higher mental functions associated with professional exposure to physical factors. Materials and methods . The study involved 40 patients with vibration disease caused by local vibration (Group 1), 50 patients with vibration disease caused by combined exposure to local and general vibration (Group 2), 71 civil aviation pilots with an established diagnosis of occupational sensorineural hearing loss (Group 3), and 38 healthy men (Group 4, control group). Methods of neuropsychological testing were used. Results . In Groups 1–3 the state of functioning of the cognitive sphere is represented by a mildly pronounced nature of impairments. The results of MMSE and FAB tests in patients of Groups 1–2, when compared with Group 4, determine a decrease in the functional activity of the frontal lobes and subcortical structures (25 (24–27), 25 (22–26), 15 (14–16) and 15 (13–16) points respectively). The most informative feature associated with the fact of occupational exposure to local vibration is the indicator of long-term memory (F = 9.41; р = 0.003); with combined impact of local and general vibration – short-term memory (F = 11.0; р = 0.001); with aircraft noise – objective gnosis (F = 8.48; р = 0.001). The obtained features make it possible to track with a high degree of accuracy the development of a decrease in cognitive functions in this contingent (86.1 %, 84.8 % and 72.1 % respectively). Conclusion . Common signs of changes in the cognitive sphere and lesions of the brain structures in patients with vibration disease are a decrease in praxis, impressive speech, for occupational sensorineural hearing loss – the lack of analytical-synthetic and conceptual thinking, object and finger gnosis, characterizing the inferiority of the functioning of the frontal and parietal regions of the left hemisphere.

Особый интерес для инженерии устройств прикладной оптики в ТГц диапазоне частот представляет разработка эффективных детекторов излучения методами нелинейной оптики. Цель данной работы заключается в исследовании одного из таких детекторов – кристаллов Ga50%Se50-x%Sx%, где x принимает значения: 0, 1.5, 6, 8, 11, на эффективность детектирования ТГц волн в телекоммуникационном диапазоне (1550 нм). Образцы для исследований были изготовлены в ИГиМ СО РАН. Атомное вхождение серы определялось методом ЭДС СЭМ. Также, на базе ИАиЭ СО РАН был собран ТГц спектрометр с генерацией лазерного излучения на длине волны 1550 нм. В работе проведено сравнение эффективности детектирования терагерцового поля в вышеупомянутом ряде кристаллов и приведено сравнение с наиболее распространенным детектором для длин волн 1550 нм – кристаллом GaAs. Предварительные результаты демонстрируют, что наибольшей чувствительностью обладает кристалл детектора GaSe с процентным содержанием серы в количестве 6%, а также падение чувствительности детектора на основе Ga50%Se44%S6% относительно GaAs на 25 % с учетом потерь на переотражение. Впервые произведена оценка электрооптического коэффициента для кристаллов GaSe (для длин волн 1550 нм), для наиболее чувствительного кристалла r33=2,36 пм/В.

In this work, we study Ga 50% Se 50-x% S x crystals (where x = 0, 1.5, 6, 8, 11) as an electrooptic detector of terahertz pulses using probing femtosecond laser radiation with the wavelength of 1.55 μm. It was found that the sample with x = 6 provides the highest detection efficiency. The efficient value of the electrooptic coefficient of GaSe:S crystals is estimated to be about twice higher than those of GaAs in the same conditions.

The aim of the study was to identify the peculiarities of neuropsychological indices disorders depending on changes in the level of constant potential in patients with occupational diseases as a result of physical factors.Materials and methods. The study involved 60 patients with vibration disease caused by local vibration (group I), 106 patients with vibration disease caused by combined exposure to local and general vibration (group II), 101 civil aviation pilots with an established diagnosis of professional sensorineural hearing loss (group III), and 50 healthy men (group IV, comparison group) who were not exposed to vibration and noise due to the specifics of their professional activities. Methods of neuro-energy mapping and neuropsychological testing were used.Results. In groups I–II, compared with group IV, an increase in local levels of constant potential (DC-potential level) in the central, right temporal, and central frontal parts of the brain (2.3 (6.5–3.8) mV; –0.3 (–2.1–2.1); 2.1 (–3.4–6.8) and –0.3 (–3.1–4.3); –2.24 (–6.4–3.8); 0.9 (–3.1–8.5) mV at p = 0.005, 0.007 and 0.004 respectively). Differences in the values of DC-potential level gradients in individuals of group III when compared with group IV reached the level of significance in the central, temporal, occipital leads relative to the central frontal (–5.0 (–13.1–3.8); –4.1 (–9.4–5.1); –2.1 (–10.9–6.6); –6.3 (–15.3–1.8) and 2.9 (–3.0–10.6); 2.2 (–4.5–13.8); 5.6 (–7.6–14.1); –1.4 (–7.5–3.9) mV at p = 0.008; 0.009; 0.009, and 0.007 respectively). Cognitive disorders in patients of groups I–III when compared with group IV correspond to a mild disorder of dynamic, constructive praxis and expressive speech (1.40 (0–1,6); 1.43 (0–1,7); 1.2 (0–1,5) and 0.3 (0–1); 0.2 (0–1); 0.06 (0–1) points at p = 0.008, 0.008 and 0.009 respectively).Conclusions. A common neurofunctional sign of a mild impairment of the cognitive sphere in occupational diseases caused by physical factors is an increase in direct current potential level in the frontal-central and parieto-occipital regions, predominantly of the left hemisphere of the brain.

The aim of the study was to assess changes in serum concentrations of pro- and anti-inflammatory cytokines in patients with vibration disease (VD). Methods. In total, 28 patients with VD associated with the combined effects of local and general vibration comprised the study group while 24 men were included in the reference group with no exposure to vibration in their professional activities. Serum concentrations of IL-2, IL-4, IL-8, IFN-y) were measured by enzyme-linked immunosorbent assay. The severity of neuroenergy exchange was assessed using the neuroenergy mapping method based on measuring the levels of constant potential (DC-potential level). Data were analyzed using Shapiro-Wilk test, Student test, Mann-Whitney test, Fisher's angular transformation method and Spearman's rank correlation. Results. The proportion of study participants with increased brain DC-potential level was greater (67.9 %) among patients with VD (p = 0.001). The concentration of IL-8 was 24.29 (14.42-65.16) pg / ml in the VD-group vs. 14.35 (6.24-19.14) pg / ml. in the comparison group. Concentration of IFN-y - was 21.38 (1.68-94.28) pg / ml. in the VD-group vs. 0.01 (0.01-0.28) pg / ml in the reference group. We observed significant correlations between the levels of IL-4, IL-8, TNF-γ and DC-potential (rs = 0.61; 0.55; 0.57, respectively) suggesting their role in disruption of the processes of neuroenergy exchange. Conclusions. More than two thirds of patients with VD have an increased DC-potential level and greater concentrations of IL-8 and TNF-y. Disrupted functioning of the mechanisms of cytokine regulation seems to be associated with neuuroenergy exchange and may activate neuroinflammatory processes.

The aim of the study was to identify the characteristics of energy metabolism of the brain according to neuroenergy mapping in patients with hand-arm vibration syndrome (HAVS) and occupational sensorineural hearing loss (SNHL). Methods. 45 patients with HAVS associated with the combined effects of local and general vibration, and 71 patients with SNHL of professional origin were examined. The comparison group was represented by 38 men who were not exposed to the studied factors in their professional activities. The method of neuroenergy mapping was used, based on measuring of constant potential level. Results. Increased values of level of constant potential were observed in 62 % of patients with HAVS, 39 % of patients with SNHL, 31 and 52 % of patients, respectively, had a normal average level of neurometabolism, 7 and 9 % had reduced values of the constant potential level. An increase in metabolic intensity in relation to the average constant potential level in patients with HAVS was determined in the central (p = 0.027), right temporal (p = 0.043) regions. Patients with SNHL demonstrated an increase in bipolar indices in the central lead (Fpz-Cz = -5.0 (-13.1...3.8) mV) (p = 0.003), temporal right (Fpz -Td = -2.1 (-10.9...6.6) mV) (p = 0.014), temporal left (Fpz-Ts = -6.3 (-15.3...1.8) mV) (p = 0.031), occipital (Pz-Oz = -4.2 (-9.4...5.1) mV) (p = 0.022) regions of the brain associated with a decrease in constant potential level in frontal areas. According to the results of a discriminative analysis, the most informative neurometabolic signs in patients with HAVS were the indicators of constant potential level in the central lead (Cz, F = 9.672), in patients with SNHL - in the central parietal (Pz, F = 12.816). Conclusions. Functional disorders of the brain were observed in 69 % of the examined with HAVS and 48 % with SNHL; they were represented by increased energy exchange mainly in the central and temporal sections. Neurometabolic signs peculiar to HAVS were an increase in constant potential level of centralized lead and a decrease in the Td-Ts interhemispheric ratio; for SNHL, an increase in the left parietal, central parietal, and occipital divisions.

Objective. To identify the features of cognitive impairments (CI) in patients with alcoholic (AE) and dyscirculatory (DE) encephalopathies. Materials and methods. The study included 32 patients with DE and 30 with AE. Along with clinical observations, patients underwent computerized electroencephalography (EEG), recording of cognitive event-related potentials, and neuropsychological testing. Results and conclusions. The pathologies studied here showed both common and distinct signs in the clinical picture, in the emotional-personality domain, and impairments to cognitive processes. Common features of encephalopathies of different etiologies were CI and asthenic syndrome; AE was characterized by hyposthenic and DE by mixed (hyper- and hyposthenic) syndromes. The EEG showed that changes in bioelectrical activity in DE were predominantly located in the occipital-parietal areas of the cortex, while in AE they were located in the temporal and occipital-parietal areas. CI in DE and AE consisted of disorders to categorial thinking, long-term memory, reciprocal coordination, and digital gnosis, pointing to dysfunction of the frontal and parietal lobes of the left hemisphere, hippocampus, and corpus callosum. The indexes of the δ, β1, and β2 rhythms were discriminating features of CI in AE and DE.

Research objective identification of the peculiarities of indicators of audiological examination, registration of somatosensory induced potentials (SSSP), level of constant potential (LCP) and neuropsychological testing in persons of flight composition (LLS) of civil aviation exposed to intra-cabin noise, depending on the degree of expression of professional neurosensory noise (ONIHL).PATIENTS AND METHODS:Thresholds of acoustical sensitivity, levels of perception of shepotny, informal conversation, UPP, characteristic of SSVP, neuropsychological features at 45 patients with easy degree of PNST (LONIHL) and at 50 - with moderate degree of ONIHL (UONIHL) are studied.RESULTS:LCP in the left frontal (Fs), central dark (Pz) leads increased in persons with ONIHL, and the inter-peak interval of the N13-N20 characterizing the central conduct time increased. The FAB, unlike the LONIHL, is characterized by deterioration of cognitive activity in the form of easily pronounced decrease of visual memory functions, expressive speech, FAB scale value indicating priority dysfunction of frontal, dark-occipital lobes, subcortical cerebral structures.CONCLUSION:Neurofunctional markers in UONIHL are the reduction of the indicators of the interfamily relations on the frontal department, conceptual thinking, visual image memory, expressive speech, MMSE and FAB tests, the increase of LCP in the left temporal, central dark, occipital right central N13-N20, inter-peak N25.

Pragmatic clinical trials (PCTs) allow combining the advantages of observational trials in real-world evidence with the scientific rigor of randomized clinical trials (RCTs), and thereby provide more effective answers to questions of real-world evidence.Aim. Assessment of differences in conducting RCTs and PCTs, as well as analysis of the features related to conducting PCTs at different stages.Methods. An analysis of publications in the period from 1999 to 2017 was conducted to identify data on PCTs.Results. There are significant differences in conducting classic RCTs and PCTs. First, PCTs use more flexible inclusion criteria and differ in the approach to choosing an investigator’s site. Also, the procedure for obtaining informed consent has significant differences from that of classical RCTs; alternative options are proposed but a unified approach has not yet been developed. When conducting PCTs, monitor intervention should be minimal in order not to interfere in the routine therapy, which, however, can lead to a violation of reporting. A possible solution may be remote data collection.Conclusion. PCTs represent a huge potential for studying the effectiveness of drugs in real-world evidence. However, despite a significant increase in the number of such trials, there are still a sufficient number of points that need to be resolved.

The results of neuroenergical mapping of patients with vibration disease associated with the combined effects of local and general vibration before and after the training with biological feedback on the support reaction are presented.

Abstract—The aim of the study was to identify changes in serum concentrations of pro- and anti-inflammatory cytokines in workers exposed to metallic mercury vapors and in patients with chronic mercury intoxication (CMI), depending on the level of depression. We found unidirectional changes in the cytokine profile in workers with moderate and severe depression chronically exposed to vapors of metallic mercury, which include an increase in the production of proinflammatory IL-6 and TNF-α, and a decrease in IL-2. The most pronounced activity of inflammatory reactions was observed in subjects with moderate depression. In patients with severe depression associated with CMI, we found IL-4 overproduction associated with a decrease in the activation of pro-inflammatory reactions (IL-6, TNF-α) and an increase in IL-2 concentrations relative to subjects with moderate depression, which may reflect disturbance of the adequate functioning of the mechanisms cytokine regulation of the immune response. The revealed changes in the cytokine profile may be due to the comorbidity of depression with organic disorders of the nervous system characteristic of CMI, which can alter the state of the immune system. Further analysis of the role of inflammatory mediators in the pathophysiological mechanisms of the formation and development of depressive disorders will make it possible to more accurately determine objective risk criteria and develop preventive measures that will help to reduce the contribution of depression to the overall picture of neurointoxication.