Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564

IntroductionThere are many studies supporting the efficacy of trauma focused EMDR in the treatment of PTSD and other anxiety disorders. But most of them included only people younger than 70 years. Older people often suffer from intellectual decline. Been proved that EMDR is effective in people with intellectual impairment (Mevissen. L et all, 2012), but the people who participated in these studies did not relate to the older age group.ObjectivesOld people are often faced with loss, death of a spouse, friends, relatives. Inaddition, the known so-called 'domino effect' when a new trauma can reactivate old traumatic experiences, and the fact that older people inrelation to the characteristics of their memory can suddenly reactivate traumatic experiences related to the events of their youth.AimsExplore the possibility of using EMDR in the treatment of elderly people with a history of psychological trauma.MethodsThe study involved 26 women aged 70-85 years who received treatment in the in-patient department of our hospital. They had cognitive impairment from mild to moderate (for MoCA-test) and a history of psychological trauma. The Doctor used bilateral stimulation (mainly tapping) and 8-phase EMDR protocol, developed by F. Shapiro.ResultsAll patients showed a decrease anxiety, improve sleep, and decrease in the number of somatic complaints.ConclusionEMDR is highly effective in the elderly.

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The aim of the study was to evaluate the levels of mediators of the immune response, cellular immunity, and phagocytic activity in patients with chickenpox with various values of the clinical and laboratory parameters and propose criteria for predicting the severity and complications of the disease. Materials and Methods. The blood levels of pro-inflammatory mediators were evaluated by ELISA using monoclonal antibodies (Protein Contour, Russia). Results. The inflammatory mediators and neutrophil chemiluminescence were studied in patients with either presence or absence of Varicella zoster DNA. We found that in patients with positive viral DNA, the levels of IFN-α and IFN-γ were significantly lower compared to patients with negative DNA results. Thus, complications of chickenpox, in particular secondary viral-bacterial pneumonia, can be predicted based on low (less than double-normal) levels of IL-6 and IFN-γ, induced chemiluminescence, CD16, and CD20. This type of immune response indicates the state of immune deficiency with prevailing suppression of the T-effector and phagocytic mechanisms in these patients. Conclusion. Prognosis of the development of severe and complicated forms of chickenpox can be based on the insufficiently increased (less than two normal values) levels of IL-6 and IFN-γ, induced chemiluminescence, CD16, and CD20. These relatively low levels are indicative of reduced immune response to the infection, which may require additional immune correcting therapy.

Introduction. At the initiative of the Russian Hematology Society, the research group for the study of idiopathic aplastic anemia has developed clinical recommendations for the diagnosis and treatment of idiopathic aplastic anemia.Aim: to standardize diagnostic and therapeutic approaches for the treatment of acquired aplastic anemia in Russia.Methods. The methodological approaches used are based on the principles of evidence-based medicine, based on the recommendations of the Russian council of experts on the diagnosis and treatment of patients with idiopathic aplastic anemia, Russian and international experience in managing patients, and the recommendations of the European group for the study of aplastic anemia.Results. A new revised and updated version of the national clinical guidelines is presented.Conclusion. These recommendations are intended for doctors of various specialties, health administrators, and medical school students.Conflict of interest: the authors declare no conflict of interest.Financial disclosure: this study did not have sponsorship.

Роботу виконано згідно з науковою тематикою ДУ «Інститут охорони здоров'я дітей та підлітків НАМН України» «Розробити технологію підтримки довгострокової мотивації до самоконтролю цукрового діабету 1 типу у дітей та підлітків», (державний реєстраційний № 0115U001021).Установою, що фінансує дослідження є НАМН України. Автори гарантують відповідальність за все, що опубліковано в статті. Автори гарантують відсутність конфлікту інтересів та власної фінансової зацікавленості при виконанні роботи та написанні статті.Рукопис надійшов до редакції 1.04.2020.

The modern Wilms tumor treatment protocols used all over the world can cure up to 90 % of children. Such successes make it possible to actively introduce risk-adapted therapy methods aimed at de-escalating the chemotherapy regimen and radiation therapy impact to the tumor. The most conservative was the stage of surgical treatment, implying the organ-depleting nature of the surgery. Nevertheless, over the past decade, a lot of experience has been accumulated with both nephron-sparing and minimally invasive interventions in patients with both bilateral and unilateral Wilms tumor.We presented the experience of laparoscopic kidney resection with intraoperative ultrasound control in a child with unilateral Wilms tumor, receiving treatment at the N.N. Petrov National Medical Research Center of Oncology.

Depressive disorders (DD) are among the most common worldwide mental problems in children. One of the major causes are genetic factors.The main objective:was to estimate the level of spontaneous mutagenesis in children with DD.Patients and methods:Cytogenetic analysis has been carried out in 24 children of both genders with mental disorders (MD) in their family history, aged 9 to 17 years, examined in SI ‘ICAHC NAMS’. Control group I consisted of 23 children with DD and with no family history of MD; control group II consisted of 52 healthy peers. Statistical treatment: Excel, SPSS Statistics 17,0.Results:The level of chromosomal abnormalities in the patients with DD was 13,2%, being 7-fold as frequent as in healthy children (1,9%); the most prevailing were single fragments (7,3 and 0,9%) and paired fragments (3,7 and 0,8%); less frequent were polyploidy (0,7% and 0,1%) and premature centromere division (0,7% and 0,03%). The level of spontaneous mutagenesis in the lymphocytes of peripheral blood in the patients with and without family history of MD was more frequent than in healthy children (13,2; 12,9 versus 1,9%). Regardless of their family history of MD, the patients with DD had more significantly frequent occurrence of chromatid, chromosomal and genomic aberrations as compared to healthy children; nevertheless, the significant difference between the patients with DD and control group I was only found for the occurrence of premature centromere division.