[Stroke Prevention in Patients with Atrial Fibrillation in Real Clinical Practice, Emphasis on Efficacy and Safety of Anticoagulant Therapy].

Aim To evaluate frequency of administration of anticoagulant therapy (ACT) for atrial fibrillation and to study the effect of chronic antithrombotic therapy (ATT) on kidney function.Material and methods Due to a high medical and social significance of AF, much attention is presently paid to appropriate administration of ACT for AF in clinical practice. The study retrospectively analyzed 776 case reports of hospitalized patients with AF. The effect of chronic ATT on kidney function was studied in 70 patients who were rehospitalized, including 25 patients treated with warfarin, 25 patients treated with direct oral anticoagulants (DOAC), and 20 patients treated with acetylsalicylic acid (ASA).Results In January 2014, at the prehospital stage, 74.3 % of patients did not receive ATT, 14.7 % of patients received antiplatelet therapy, and only 11 % received anticoagulants. In the hospital in January 2014, ACTs were administered to 74.3 % of patients (warfarin, 58.6 %; DOAC, 15.7 %), 20.6 % of patients received antiplatelet drugs, and 5.1 % of patients were discharged without ATT. In January 2019, the number of patients receiving ACT at the prehospital stage increased to 58.1 % (warfarin, 13.8 %; DOAC, 44.3 %); 12 % of patients received antiplatelet drugs; and 29.9 % of patients did not receive ATT. The number of patients treated with warfarin and DOAC in the hospital increased to 14.8 % and 70.6 % (rivaroxaban, 33.4 %; apixaban, 25.5 %, and dabigatran, 11.7 %), respectively. The number of patients taking antiplatelet drugs decreased to 3.7 %, and the number of patients without ATT decreased to 10.9 %. There were no statistically significant differences in glomerular filtration rate (GFR) between these three groups at baseline. Only in the warfarin treatment group, GFR was significantly decreased from baseline during the follow-up period. Comparison of GFR in three study groups at the finale stage of the study showed significant differences between mean GFRs in the warfarin treatment group and the DOAC treatment group and between the warfarin treatment group and the ASA treatment group.Conclusion Among the prescribed and taken anticoagulants, DOACs are presently in the first place. Among DOACs, the most frequently prescribed drug is rivaroxaban. GFR decreases with the DOAC treatment slower than with the warfarin treatment. Despite the slower decrease in GFR with the ASA treatment compared to warfarin, ASA is not indicated for prevention of stroke in AF due to its low efficacy.

[Novel Genes Associated with the Development of Carotid Paragangliomas].

Carotid paragangliomas (CPGLs) are rare neuroendocrine tumors of the head and neck. "Germline" and somatic mutations in a number of genes were shown to be associated with the development of CPGLs; however, molecular mechanisms of the tumor pathogenesis have not been fully understood. In the work, we have used whole exome sequencing data of 52 CPGLs obtained earlier. Using MutSigCV, the search for genes with high mutation rate was performed. Thirty four genes (MADCAM1, SARM1, ZFPM1, CTDSP2, DSPP, POTED, ANP32B, FRG2B, BAGE3, CCDC89, ACOT2, KRTAP10-1, ATXN1, GXYLT1, MUC2, AQP7, TMPRSS13, KRTAP4-3, PRR21, PSPH, PLBD1, ZNF595, IGSF3, PRR16, FAM157A, KCNJ12, HYDIN, IGFBP2, KIAA1671, DISC1, MUC6, XKR3, HRNR, and MUC4) potentially associated with the CPGL initiation and progression were revealed. The involvement of these genes in the pathogenesis of CPGLs was first shown, and possible mechanisms of their participation in that were discussed.

Selection of stable expressed reference genes in native and vitrified/thawed human ovarian tissue for analysis by qRT-PCR and Western blot.

PURPOSE: To select reference genes with stable messenger RNA (mRNA) expression for quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR) analysis of vitrified/thawed human ovarian tissue and to evaluate in human ovarian tissue the levels of key proteins which are commonly used as reference proteins. METHODS: Pieces of ovarian tissue were obtained during laparoscopy from patients (n = 10, 24-36 years old) who suffered from types of cancer that does not affect reproductive system. Tissue strips from the intact group were immediately placed into liquid nitrogen. Tissue strips from the second group were successively placed into solutions with cryoprotective agents. Then, these strips were rapidly placed into liquid nitrogen. After thawing, ovarian tissue strips were cultured during 2 h in complete growth medium. Gene expression levels were measured using quantitative RT-PCR. Also, protein levels of three key reference genes were measured using Western blot. Statistical analysis of obtained data was performed by BestKeeper, NormFinder, and geNorm software utilities; correlation coefficients were also calculated. RESULTS: The most suitable reference genes for qRT-PCR analysis of human cortical ovarian tissue after cryopreservation by vitrification are genes of ribosomal proteins RPL4, RPLP0, RPS18, and heat shock protein HSP90AB1. The protein levels of three commonly used reference genes (ACTB, GAPDH, and HSP90) were measured in two groups of samples of human ovarian tissue: intact and vitrified/thawed. The levels of ACTB, GAPDH, and HSP90 proteins were similar in native and vitrified/thawed samples. CONCLUSION: Selection of suitable reference genes is the first aim of any research dedicated to the investigation of gene expression, because the interpretation of obtained results largely depends on selection of appropriate reference genes. Nowadays, there are many mathematical approaches allowing to select not only single reference gene but also a group of the most stably expressed reference genes. The use of mathematical models which take into account multiple reference genes will allow to obtain more accurate data on the expression of target genes.

Effect of Vitrification on Functional Morphology and Viability of the Ovarian Tissue.

The results of a complex morphofunctional study with markers of proliferation (PCNA and Ki-67), angiogenesis (CD31 and CD34), and structural integrity of mesenchymal cells (vimentin) suggest that the pool of primordial follicles was well preserved in vitrified ovarian tissue and that viability of its cellular components can be rapidly restored during incubation at 37°C within 4 h after thawing.

Female fertility preservation strategies: cryopreservation and ovarian tissue in vitro culture, current state of the art and future perspectives.

In the present review, the main strategies of female fertility preservation are covered. Procedures of fertility preservation are necessary for women who suffer from diseases whose treatment requires the use of aggressive therapies, such as chemotherapy and radiotherapy. These kinds of therapy negatively influence the health of gametes and their progenitors. The most commonly used method of female fertility preservation is ovarian tissue cryopreservation, followed by the retransplantation of thawed tissue. Another approach to female fertility preservation that has been actively developed lately is the ovarian tissue in vitro culture. The principal methods, advantages and drawbacks of these two strategies are discussed in this article.

[Comparison of effectiveness of treatment for cervical carcinoma using different brachytherapy equipment]. / Sravnitel'naia otsenka éffektivnosti oblucheniia raka sheiki matki na razlichnykh brakhiterapevticheskikh apparatakh.

The immediate and end results of combined radiotherapy for cervical carcinoma stages I-III conducted at the N.N. Blokhin Center's Clinic (1982-1996) were compared. Intracavitary irradiation was carried out using the following radiation sources: 60Co-AGAT-V (208); 137Cs-Selectron (96) and 252Cf-ANET-V and ANET-VA (115). Remote-control irradiation procedure was identical in all groups. Five-year survival for stage I was 85.1% +/- 6.2; 85.7% +/- 13.1 and 87.8% +/- 1.2; stage II--67.5% +/- 4.0; 61% +/- 8.5 and 76.6 +/- 3.2; stage III--43.6% +/- 6.8; 57.7% +/- 9.6 and 70.9% +/- 5.4, respectively. Ten-year survival for stage I was 56.9% +/- 15.1; 85.4% +/- 13.1 and 80.1% +/- 1.5; stage II--65% +/- 5.2; 46.5% +/- 8.7 and 70.7% +/- 3.5; stage III--42% +/- 8.8; 51.3 +/- 9.9 and 64.6% +/- 6.2, respectively.

[Structural and functional changes of bone marrow stroma in chronic lymphocytic leukemia]. / Strukturnaia i funktsional'naia perestroika stromy kostnogo mozga pri khronicheskom limfotsitarnom lekoze.

Marrow stroma was investigated in 20 patients with chronic lymphocytic leukemia (CLL). Such morphological and functional features as adipose tissue reduction, sinusoid pattern obliteration and increased number of reticular cells were identified as typical of marrow stroma in such patients. Foci of fibrosis, nuclear bodies in stromal cell nuclei and heightened proliferation of stromal precursors in organ cultures were recorded in the subendostal and perivascular areas in 60% of patients with diffuse lesions of bone marrow. Bone marrow stroma was shown to suffer morphological and functional changes which were particularly pronounced in diffuse lesions of the bone marrow. Such changes may be traced both to the malignant clone of lymphoid cells and stromal lesions.

[Morphologic and functional features of hemopoietic microenvironment in acute lymphoblastic leukemia]. / Morfofunktsional'nye osobennosti krovetvornogo mikrookruzheniia pri ostrykh limfoblastnykh leikozakh.

Data of the histological, ultrastructural and culture cell investigations of bone marrow microenvironment in 20 patients with acute lymphoblastic leukemia (ALL) are presented. Morphological and functional peculiarities of the patients' bone marrow stroma different from that in healthy subjects were identified. They included distorted histotopographic patterns of stroma-hemopoietic cell-to-cell interaction, obliteration of sinusoid counts, resorption on the sites of internal bone support structures, a changed stromal cells ratio, formation of reticular cell clusters in the subendosteal and perivascular bone marrow areas, fibroid centers, the presence of nuclear bodies in stromal cell nuclei and an intensified proliferation of stromal cell precursors in organ tissue cultures. Morphological and functional changes in bone marrow microenvironment were detected in ALL patients, which could have been caused both by malignant cell clones and stromal defects.

[Ultrasonic diagnosis of radiation injuries of the urinary system]. / Ul'trazvukovaia diagnostika luchevykh povrezhdenii mochevyvodiashchei sistemy.

The paper is concerned with the results of ultrasound investigation of the kidneys and bladder in 78 patients with radiation injuries of pelvic tissues and organs. Comparison of the results of USI, isotope renography and excretory urography has shown that with an increase in the gravity of injury of the urinary system, the frequency of ultrasound findings rises from 60.8% in renal dysfunction of a mean gravity up to 91.2% in severe disorders. Echography data on the presence of hydronephrosis, pyelocaliectasis, a granular kidney, pyelonephritis, and nephroptosis usually coincided with the results of excretory urography in these patients. A combined use of echography and renography permits obtaining in most cases necessary data on structural and functional disorders of the urinary tracts. Echographic semiotics of radiation cystitis was studied in detail versus cystoscopy data. The informative value of ultrasound scanning of the bladder was observed in patients with radiation cystitis.

[Intrapelvic radiation fibrosis]. / Vnutritazovyi luchevoi fibroz.

The paper presents the results of diagnosis and treatment of 155 patients with intrapelvic radiation fibrosis (IRF). IRF mainly manifests itself as a disorder of the urinary function. The use of presacral disorders in complex treatment increases the efficacy of therapeutic measures.

[Late radiation injuries of the urinary tract]. / Pozdnie luchevye povrezhdeniia mochevyvodiashchikh putei.

A total of 400 patients with radiation injuries of the organs of the small pelvis were examined. Urinary dysfunction was found in 115 of them. Radionuclide renography with 131I-hippurane, excretory urography and ultrasound scanning were employed for their investigation. The principal cause of urinary dysfunction was the development of intrapelvic radiation fibrosis with ureteral compression and direct radiation injury of the ureter.