[Readiness for intersectoral cooperation to preserve health of megalopolis population].

INTRODUCTION: For a better understanding of issues related to health-preserving activities for the benefit of city population, theoretical knowledge about the attitude and readiness of all interested parties for intersectoral cooperation is needed. The purpose of the study is to analyze readiness of the participants of health-preserving activities for intersectoral cooperation in Moscow. MATERIAL AND METHODS: In 2023, a one-time, one-time study of intersectoral responsibility, commitment and awareness, as well as satisfaction with individual health care (original test cards) was conducted among different participants in the health care of the population of the city of Moscow (n = 1007). From among them, participants were identified -workers of «medical¼ infrastructure facilities of urban space, participants-workers of other facilities (sports, culture, industry, waste disposal, transport, food, trade, education and others) and the population as a participant in intersectoral health saving. RESULTS: The research based on the original integrated assessment methodology shows insufficient readiness for intersectoral cooperation to implement health-saving activities for the benefit of Moscow population. Immature intersectoral responsibility, literacy, motivation for teamwork noted among the participants of the unified health-preserving city space determines the lack of internal conviction that it is necessary to deal with both own health, and health of other members of the urban community. CONCLUSION: The data obtained can form basis for new methodological approaches to prioritize control measures to improve intersectoral cooperation between the participants of health-preserving activities in the metropolis.

[Epithelial protective therapy in comorbid diseases. Practical Guidelines for Physicians].

This document was produced with the support of the National Medical Association for the Study of Comorbidities (NASС). In 2021 the first multidisciplinary National Consensus on the pathophysiological and clinical aspects of Increased Epithelial Permeability Syndrome was published. The proposed guidelines are developed on the basis of this Consensus, by the same team of experts. Twenty-eight Practical Guidelines for Physicians statements were adopted by the Expert Council using the "delphic" method. Such main groups of epithelial protective drugs as proton pump inhibitors, bismuth drugs and probiotics are discussed in these Guidelines from the positions of evidence-based medicine. The clinical and pharmacological characteristics of such a universal epithelial protector as rebamipide, acting at the preepithelial, epithelial and subepithelial levels, throughout gastrointestinal tract, are presented in detail.

[Anxiety and Depression in Chronic Heart Failure. What Can a Cardiologist Do?]

AIM: To reveal the probability and duration of the onset of remission of anxiety-depressive symptoms in patients with CHF III-IV receiving optimal medicine treatment (OMT) or (OMT), supplemented with the education program and active outpatient monitoring (OMT + A). MATERIALS AND METHODS: A secondary analysis of the results of RCT CHANCE, which studied the impact of the training program and active outpatient control (further additional exposure (DV) plus optimal medication (OMT) on mortality and cardiovascular hospitalization in patients with CHF III-IV FC. Therapeutic training and outpatient control performed by the cardiologist after discharge from the hospital (weekly in the first month, every 2 weeks for the next 2 months, and then On the basis of the results of the telephone contact, an additional visit could be scheduled, the CHANCE study control group was made up of patients on OMT who were observed as practiced in regular health care setting. Control group had 4 visits to the cardiologist during the 1 year observation. The present analysis included patients on OMT and OMT + DV who had a clinically significant anxiety at the 0 week of the CHANCE program using the Hospital Anxiety and Depression Scale (HADS) (the sum of scores on the anxiety subscale ≥11), depression (the sum of scores on the depression subscale ≥11), or a combination of anxiety and depressive symptoms (scores on anxiety and depression subscales ≥11). Patients who did not pass HADS or SHOCK testing at 0.24 and 48 weeks were excluded from the analyses. A total of 237 patients were included. Severity of HF symptoms were assessed by "Scale of Heart failure Optimizing Clinical Status (SHOCS)" and compared it with the shares of patients who reached remission (HADS scores.

[Between depression and fibroniyalgia: the fate of the antidepressant].

The authors present the information about one of the least studied antidepressants- milnacipran. Recommendations of its clinical use have been long based on incorrect conceptions of its pharmacological properties. Currently, milnacipran is considered as ancirepinephrine and serotonin (to a lesser degree) reuptake inhibitor and NMDA receptor blocker. Milnacipran can be successfully used in apatic, asthenic, adynamic and anhedonic depressions as well as in fibromyalgia in patients with marked fatigability and pain. However the recommendations for the latter are not registered in Russia (maybe due to the differences in the diagnosis of fibromyalgia which is traditionally more often diagnosed as neurasthenia).

[Pharmacotherapy and dementia]. / Farmakoterapiia i dementsiia.

The review considers treatment aspects of dementia in Alzheimer's disease (DAD), vascular dementia (VD) and some other forms of dementia. Pathogenetic pharmacotherapy of DAD aims to maintain the activity of cholinergic neurons with anticholinesterase drugs including donepezil, which is used most often. The main objective of VD treatment is prevention of new cerebral infarctions using cardiotropic medications, antiaggregants, anticoagulants, hypotensive drugs and statins. In Russia, patients with DAD and VD receive polymodal drugs as well. These drugs have been included in the list of antidementia medications due to their wide use in treatment of discirculatory encephalopathy and chronic brain ischemia.

Long- and Short-Range Electrostatic Fields in GFP Mutants: Implications for Spectral Tuning.

The majority of protein functions are governed by their internal local electrostatics. Quantitative information about these interactions can shed light on how proteins work and allow for improving/altering their performance. Green fluorescent protein (GFP) and its mutation variants provide unique optical windows for interrogation of internal electric fields, thanks to the intrinsic fluorophore group formed inside them. Here we use an all-optical method, based on the independent measurements of transition frequency and one- and two-photon absorption cross sections in a number of GFP mutants to evaluate these internal electric fields. Two physical models based on the quadratic Stark effect, either with or without taking into account structural (bond-length) changes of the chromophore in varying field, allow us to separately evaluate the long-range and the total effective (short- and long-range) fields. Both types of the field quantitatively agree with the results of independent molecular dynamic simulations, justifying our method of measurement.

[Rationale for the choice of medication based on the conception of the pathogenesis of mental disorder and mechanism of drug action]. / Ratsional'nyi vybor preparata na osnove predstavlenii o patogeneze psikhicheskogo rasstroistva i mekhanizme ego deistviia.

In modern medicine, when prescribing drugs it is customary to take into account the pathogenesis of the disease and the mechanism of action of drugs. On the example of buspirone, authors have shown that in psychiatry recommendations for administration of drugs should also consider the pathogenesis of diseases (disorders) and the mechanism of drug action. These data will contribute to the rapprochement of neurology and psychiatry with other medical specialties.

Describing two-photon absorptivity of fluorescent proteins with a new vibronic coupling mechanism.

Fluorescent proteins (FPs) are widely used in two-photon microscopy as genetically encoded probes. Understanding the physical basics of their two-photon absorption (2PA) properties is therefore crucial for creation of two-photon brighter mutants. On the other hand, it can give us better insight into molecular interactions of the FP chromophore with a complex protein environment. It is known that, compared to the one-photon absorption spectrum, where the pure electronic transition is the strongest, the 2PA spectrum of a number of FPs is dominated by a vibronic transition. The physical mechanism of such intensity redistribution is not understood. Here, we present a new physical model that explains this effect through the "Herzberg-Teller"-type vibronic coupling of the difference between the permanent dipole moments in the ground and excited states (Δµ) to the bond-length-alternating coordinate. This model also enables us to quantitatively describe a large variability of the 2PA peak intensity in a series of red FPs with the same chromophore through the interference between the "Herzberg-Teller" and Franck-Condon terms.

All-Optical Sensing of the Components of the Internal Local Electric Field in Proteins.

Here, we present a new all-optical method of interrogation of the internal electric field vector inside proteins. The method is based on experimental evaluation of the permanent dipole moment change upon excitation and the pure electronic transition frequency of a fluorophore embedded in a protein matrix. The permanent dipole moment change can be obtained from two-photon absorption measurements. In addition, permanent dipole moment change, tensor of polarizability change, and transition frequency for the free chromophore should be calculated quantum-mechanically. This allows obtaining the components of the electric field by considering the second-order Stark shift. We use the fluorescent protein mCherry as an example to demonstrate the applicability of the method.

Absolute two-photon absorption spectra and two-photon brightness of orange and red fluorescent proteins.

Fluorescent proteins with long emission wavelengths are particularly attractive for deep tissue two-photon microscopy. Surprisingly, little is known about their two-photon absorption (2PA) properties. We present absolute 2PA spectra of a number of orange and red fluorescent proteins, including DsRed2, mRFP, TagRFP, and several mFruit proteins, in a wide range of excitation wavelengths (640-1400 nm). To evaluate 2PA cross section (sigma(2)), we use a new method relying only on the optical properties of the intact mature chromophore. In the tuning range of a mode-locked Ti:sapphire laser, 700-1000 nm, TagRFP possesses the highest two-photon cross section, sigma(2) = 315 GM, and brightness, sigma(2)phi = 130 GM, where phi is the fluorescence quantum yield. At longer wavelengths, 1000-1100 nm, tdTomato has the largest values, sigma(2) = 216 GM and sigma(2)phi = 120 GM, per protein chain. Compared to the benchmark EGFP, these proteins present 3-4 times improvement in two-photon brightness.

[Clinical and psychosomatic peculiarities of essential hypertension under the conditions of chronic stress].

The investigation was dedicated to associations between anxious or depressive conditions and clinical features of essential hypertension (EH) on a model of in-patients undergoing treatment in Groznyy Municipal Hospital No 1. The study found a high frequency of depressive and anxious disturbances in this group of patients (36.4% and 41.6%, respectively). Comparison of patients with mental disorders with mentally healthy controls showed that anxious (to a greater degree) and depressive disorders were in a strong association with crises within the course of EH as well as high prevalence of left ventricular hypertrophy and elevated level of blood catecholamines.

[Nonspecific pains and depression in neurology].

Nonspecific pains (NP) are considered as general symptoms in different pathologies. They occurred in most patients with depression. A data analysis using a program "PARUS" allowed to specify clinical characteristics related to depression. It has been found that the clinically significant depressive state amplified the pains characteristic of somatic and neurological pathology. Therefore, treatment of such patients must be complex and include a therapy of somatic disease and antidepressants. A choice of the latter is depended on its thymoanaleptic and, in case of NP, antinociceptive activity.

[First generation antidepressants in the current treatment of depression].

An aim of the present retrospective (based on medical hystories) study, was to specify the choice of different antidepressants of first generations (AFG) by practical physicians for treatment of different types of depressions. Three hundreds and thirty-four cases (201 female, 133 male) have been studied. The sample included the following types of depression: vital (16 patients), anxious (64), hypochondriac (74), apathic (71), asthenic (13), anesthetic (17), anankastic (19), hysteric (51) and with somatic equivalents (9). It has been found that amitryptiline and imipramine are prescribed in the various depressive states, clomipramine is more often used in anankastic depressions and maprotiline - in anesthetic depressions. When choosing an antidepressant, practical physicians follow the current empiric scheme corresponding to general ideas on the correlation between psychopathological presentations and action of psychotropic drugs on the level of cell metabolism (deficit) of monoamines (dopamine, serotonin, noradrenalin). Moreover, physicians consider clomipramine and maprotiline as more selective antidepressants as they really are; the use of maprotiline is not enough. In conclusion, the author emphasizes the necessity of increasing the knowledge of physicians about possibilities of using AFG taking into account mechanisms of their action.

Resonance enhancement of two-photon absorption in fluorescent proteins.

We measure two-photon absorption (2PA) spectra of wild-type green fluorescent protein, cyan fluorescent protein, and monomeric red fluorescent protein in absolute cross section values in a wide spectral range (lambda2PA = 550 - 1300 nm), and find, for the first time to our knowledge, a new S0 --> Sn 2PA transition in all three proteins in the short-wavelength region. This transition is strongly resonantly enhanced, showing 2PA cross section values of approximately 20-160 GM, which are at least 2-4 times higher than those measured in the lowest energy (S0 --> S1) transition of corresponding proteins. We also show that the change of permanent dipole moment upon S0 --> S1 excitation (|Deltamu10|) can be deduced from 2PA cross section, providing a new tool for fast evaluation of |Deltamu10| in physiological conditions.

[The clinical features of the course of coronary artery disease in patients with schizophrenia].

Thirty-nine patients suffering from coronary artery disease (CAD) and schizophrenia (main group) and 32 mentally healthy CAD patients (control group) were included in the study. Cardiological examination including complaint and anamnesis analysis, ECG, EchoCG, stress-EchoCG with dobutamine, 24-hour Holter ECG monitoring was performed; coronaroangiography was carried out in 15 patients. Acute circulatory insufficiency, early post-infarction stenocardia, and chronic left ventricular aneurism were found to be more frequent in patients with schizophrenia vs. controls. Certain differences in CAD risk factors between the groups were revealed. Hyperlipidemia and type 2 diabetes were found in 14 (36%) and 1 (3%) patients in the main group vs. 20 (62%) and 6 (19%) patients in the control group (p = 0.03; p = 0.04), respectively. Glucose intolerance was found in no schizophrenia patients, while it was revealed in 5 (16%) controls (p = 0.02). Patients with schizophrenia sought medical aid later than controls. The number of main group patients who sought medical aid during the first hour, the first 4 hours, the first 4 to 12 hours, or the first 12 to 24 hours was 2 (3%), 3 (5%), 16 (27%), and 38 (64%), respectively; in the control groups these numbers were 12 (30%), 21 (54%), 3 (8%), and 3 (8%), respectively (p < 0.001, p < 0.001, p = 0.02, p < 0.001, respectively).

[Ischemic heart disease in patients with schizophrenia (clinico-epidemiological study)].

We carried out a multicenter controlled study of case histories of patients with schizophrenia and acute myocardial infarction (AMI) or postinfarction cardiosclerosis (PIC) from cardiological (n=44), psychosomatic (n=19) and psychiatric (n=23) hospitals was. In hospital mortality, ischemic heart disease (IHD) risk factors, peculiarities of IHD course, antipsychotic therapy were analyzed. Elevation of in hospital mortality related to PIC and its complications was revealed in somatopsychiatric (21% vs 1.26%; p<0.05) and psychiatric (29% vs 1.26%; p<0.05) hospitals. Hypercholesterolemia, excess weight in patients with schizophrenia were met more rarely (36, 32, 9, 21%, 16, 0% vs 61, 45%, respectively; p<0.05) while diabetes mellitus (5, 5, 9% vs 15%, respectively; p>0.05), arterial hypertension (89, 84, 45% vs 77%, respectively; p>0.05) - with same frequency as in comparison group. Patients with schizophrenia do not differ from persons not suffering from this psychiatric disease by proportion of patients with AMI (39, 47, 49% vs 43%; p>0.05) and PIC (73, 74, 61% vs 73%; p>0.05). Probability of effect of inadequate body weight and psychotherapy with phenothiazine derivatives and antiparkinsonian cholinolytic medications on elevation of mortality of patients with IHD and schizophrenia is discussed.

[Pain in diabetic neuropathy: psychosomatic aspects].

Diabetic neuropathy (DN) is one of the most common complications of diabetes mellitus (DM). Most clinical and population studies indicate that its prevailing form is distal symmetric, affecting about 30% of patients with diabetes. The main clinical manifestation of this form of DN is a decrease (up to a complete loss) of sensitivity, which is either not recognized by the patient or is perceived as numbness, loss of any sensations in the lower extremities. At the same time, in a relative minority of patients, the leading symptom in the DN clinical presentation is pain, which, in some cases, reaches high intensity, disrupts working ability, daily activity, and sleep.

Near-infrared two-photon absorption in phthalocyanines: enhancement of lowest gerade-gerade transition by symmetrical electron-accepting substitution.

This paper presents, to the best of our knowledge, the first study of two-photon absorption (2PA) spectra of a number of symmetrically substituted phthalocyanines in the excitation wavelength region from lambda(ex)=800 to 1600 nm. The selected molecules vary by position of substitution (alpha or beta), number of substituent groups (4, 8, or 16), and presence or absence of metal (Zn or Al) in the center. For all phthalocyanines we find a moderately strong (sigma(2) approximately 100-200 GM), pure electronic, gerade-gerade (g-g) 2PA transition, which shows up as a well-resolved relatively narrow peak in the energy region between Q and B bands (lambda(ex)=870-1100 nm). In metallophthalocyanines (MPcs) this lowest g-g transition is followed by the onset of other higher-frequency 2PA transitions. In some metal-free phthalocyanines (H(2)Pcs) we also reveal a second, broader 2PA transition at slightly higher frequency. In both MPcs and H(2)Pcs, we find a strong monotonic increase of integrated strength of the lowest g-g transition as a function of electron-accepting ability of peripheral substituents, expressed as their aggregated Hammett constant. By using few essential states models (three states for MPcs and four states for H(2)Pcs) we demonstrate the primary role of excited-state transition dipole moment in this effect.