[The relationship of vascular complications with cerebrovascular reactivity and endothelial dysfunction in patients with obstructive sleep apnea]. / Svyaz' sosudistykh oslozhnenii s tserebrovaskulyarnoi reaktivnost'yu i endotelial'noi disfunktsiei u patsientov s obstruktivnym apnoe sna.

OBJECTIVE: To assess the relationship of vascular complications with cerebrovascular reactivity (CVR) and endothelial dysfunction in patients with obstructive sleep apnea (OSA). MATERIAL AND METHODS: One hundred and twelve patients were examined. The patients were stratified into the main group with moderate and severe OSA and the control group without apnea. All patients underwent anthropometry, polysomnography, transcranial dopplerography and duplex scanning of the brachial artery. RESULTS: Patients with OSA showed a more frequent decrease in post-occlusive vascular dilatation. The CVR indices in the hypercapnic test in the main group were in the range of 0.91-0.97 and significantly lower after 1 minute on the left, after 5 minutes on both sides and after 10 minutes on the left. A positive correlation during a hypercapnic test between the CVR on the left after 10 minutes and the desaturation index (r=0.287, p=0.021), between the CVR on the left after 5 and 10 minutes and acute cerebrovascular accident (r=0.248, p=0.048 and r=0.285, p=0.022, respectively), as well as a negative correlation between the indicators of the middle cerebral artery and chronic cerebral ischemia were established in patients with apnea. CONCLUSION: Timely assessment of pathological changes in central and peripheral hemodynamics in patients with OSA will allow diagnosing early signs of vascular complications, which will further improve the personalized strategy for the prevention of stroke and chronic cerebral ischemia.

The problem of the risk of development of infection of surgical obstetric wound after cesarian section in women of the Kirov region.

Over the past decade, the frequency of abdominal delivery in Russia has increased to an average of 25 %. The widespread use of abdominal delivery has not been without an increase in the incidence of complications. Among them is an infectious complication of a surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after a caesarean section, which in some regions reaches 43 %. The development of complications is facilitated by various clinical and laboratory risk factors, the analysis of which in women of the Kirov region is the subject of this article. The analysis of clinical and laboratory risk factors was carried out on the basis of the data presented in the case histories of women hospitalized in the gynecological departments of the city of Kirov. Statistical data processing was carried out on a personal computer using the R-4.0.2 statistical program and Excel spreadsheets. When assessing the relevance of the problem for the Kirov region, it was found that the frequency of caesarean section over the past 10 years from 2011 to 2021 increased from 27,0 % to 34,0 %. The incidence of infectious complications in the Kirov region can be presented as follows: infection of the surgical obstetric wound (ICD O86.1) on the anterior abdominal wall after caesarean section - 27,0 %; peritonitis after caesarean section - 0,94 %-1,01 %; diffuse sepsis - 0,93 %-0,97 %. An important role, according to reports, in the addition of an infection of a surgical obstetric wound after cesarean section is played by the general morbidity and obstetric history in women with abdominal delivery, a detailed statistical analysis of which is presented in the materials of the article. The results of the study substantiated the problem of the development of an infection of a surgical obstetric wound after a caesarean section for the healthcare of the Kirov region, comparable to that for the healthcare of the entire Russian Federation. The analysis of clinical and laboratory risk factors showed the feasibility of using a comprehensive analysis of infection of a surgical wound after cesarean section at an early stage of its development to quickly resolve complications, reduce the duration of hospitalization of women after cesarean section, and subsequently preserve the reproductive function of a woman.

Fragmented QRS as a marker of coronary atherosclerosis severity evaluated by the Gensini score.

BACKGROUND: QRS fragmentation (fQRS) represents a marker of local myocardial fibrosis, especially in patients with CAD (coronary artery disease). However, little is known about the association between fQRS and the severity of coronary atherosclerosis as defined by the Gensini score. OBJECTIVE: To identify the angiographic and echocardiographic characteristics of patients with suspected CAD depending on the location and extent of fQRS. METHODS: A total of 178 patients who underwent coronary angiography were included in the study. fQRS was defined as the presence of RSR' and/or notching of the R/S wave (if QRS<120ms) or≥2 notches of the R/S wave (if QRS≥120ms). All patients were divided into three groups: non-fQRS; fQRS in 1-2 and≥3 leads. RESULTS: Statistically significant differences in the LVEF (left ventricular ejection fraction, P=0.009) and the degree of coronary atherosclerosis severity (P=0.008) were found among 3 groups. The median Gensini score was 7 in non-fQRS group (minimal CAD) and >20 in other groups (severe CAD). Both the anterior and lateral fQRS groups had a lower LVEF compared to no fQRS (P=0.039 and P=0.01, respectively). The median Gensini score was significantly higher in case of the lateral fQRS (P=0.037). fQRS in≥1 lead was associated with coronary occlusion (OR 2.1, 95% CI: 1.1-4.1, P=0.038). CONCLUSIONS: The presence of fQRS, particularly in lateral leads, can be a useful noninvasive marker of severe coronary atherosclerosis. Patients with≥1 fragmented lead have a lower LVEF, a higher Gensini score and a two-fold increased risk of occlusion.

[Cognitive impairment in patients with arterial hypertension depending on the presence of risk factors for chronic kidney disease at the sanatorium stage]. / Kognitivnye narusheniya u patsientov s arterial'noi gipertenziei v zavisimosti ot nalichiya faktorov riska khronicheskoi bolezni pochek na sanatornom etape.

Vascular cognitive disturbances are widespread in patients with arterial hypertension, especially when attached to arterial hypertension of chronic kidney disease. Each of these diseases has a negative impact on brain vessels and may contribute to cognitive deficits. THE PURPOSE OF THE STUDY: To evaluate the neuropsychological profile and determine the risk of cognitive impairment in patients with arterial hypertension depending on the presence or absence of risk factors for chronic renal disease at the sanatorium stage. MATERIAL AND METHODS: 200 patients with arterial hypertension of 1st-2nd degree, stage II, risk 2-3 were examined. The level of microalbuminuria, creatinine in blood serum was investigated, the rate of glomerular filtration was calculated. Cognitive functions were evaluated using neuropsychological tests of 10 words, 5 figures, counting down, tables Shulte, MMSE, FAB. RESULTS AND CONCLUSION: Risk factors for chronic kidney disease were first discovered in 48% of patients. It was revealed that in patients with arterial hypertension and risk factors of chronic kidney disease the risk of occurrence and development of cognitive disorders is 1.46 times higher, the degree of reduction in indicators of arbitrary attention, speed of mental performance, auditory memory is more expressed than in patients with arterial hypertension alone. It was shown that in patients with arterial hypertension and risk factors of chronic kidney disease a moderate degree of multifunctional variant of cognitive disturbances with memory decrease and neurodynamic disturbances is observed.

Parkinson's Disease-Associated Changes in the Expression of Neurotrophic Factors and their Receptors upon Neuronal Differentiation of Human Induced Pluripotent Stem Cells.

Parkinson's disease (PD) is a neurodegenerative pathology resulting from the degeneration of dopaminergic (DA) neurons in the substantia nigra (SN). Neurotrophic factors (NTFs) and their receptors are key regulators of the survival, differentiation, and development of neurons. However, the role of these factors in the pathogenesis of PD is still unclear. Here, we analyzed the expression of NTFs and their receptors in human induced pluripotent stem cells (iPSCs) derived from the fibroblasts of patients with PD and healthy donors (HDs). Four PD-derived iPSC lines with different mutations and three cell lines from HDs at different stages of neuronal differentiation were used for RT-qPCR analysis and ELISA. We found that the mRNA levels of most analyzed genes were altered in PD-derived cells compared with those in HD-derived cells at all stages. Importantly, irrespective of PD-associated mutations, the mRNA levels of the BDNF and GDNF genes were mostly increased or unchanged in predominantly DA terminally differentiated neurons (TDNs) compared with those in HD-derived cells. Strikingly, in contrast to BDNF and GDNF mRNA levels, BDNF and GDNF protein levels were lower in almost all PD-derived TDNs than in HD-derived cells, thus indicating the dysregulation of NTF expression at the post-transcriptional level. We suggest that this dysregulation is one of the important signs of PD development.

[Radical cystectomy: therapeutic aspects of preoperative and early postoperative management].

AIM: to improve the results of radical cystectomy by optimization of patient preparation for surgery and early postoperative care. MATERIALS AND METHODS: A total of 136 patients who underwent radical cystectomy and either orthotopic ileal neobladder or ileal conduit formation were included in the study. Brikkers operation was performed in 92 patients (76% men and 24% women) aged from 39 to 83 years, while in 44 patients (97.7% men, 2.3% women) aged from 32 to 75 years the Studer ileal neobladder was created. All patients underwent preoperative comprehensive examinations in order to determine type and extent of surgical treatment. RESULTS: A complication rate after radical cystectomy with urine derivation using bowel segment was 49.2%. Mortality rate in early postoperative period was 3.9%. CONCLUSION: An algorithm of postoperative care after radical cystectomy with formation of either orthotopic neobladder or ileal conduit and consideration of comorbid status and preparation which we have used in clinical practice was developed. According to the results, after implementation of algorithm of management in preoperative and early postoperative period a decrease in complications and mortality rate has been found.

[Depressive disorders and diabetes mellitus in children and adolescents]. / Depressivnye rasstroistva i sakharnyi diabet u detei i podrostkov.

AIM: To clarify the role of depressive disorders and personality traits in the pathogenesis of diabetes mellitus type I in children and adolescents. MATERIAL AND METHODS: One hundred and three patients with diabetes, aged from one year nine months to 17 years, mean 9.7±0.7), with diabetes mellitus and depressive disorders were studied using clinical-psychopathological, psychometric, paraclinical and statistical methods. RESULTS: Biological and psychosocial risk factors of a somatic disorder have been identified. Mental disorders are represented by affective disorders and personality features of the patients. Affective disorders include mild psychogenic anxiety and asthenic-anxiety depression, personality features are represented by hysterical signs and emotional lability. Clinical variants of these mental disorders and their diagnostic assessment according to ICD-10 are presented. CONCLUSION: The dynamics of diabetes mellitus correlate with characteristics of depressive disorders. This result can be used to optimize the therapy of diabetes mellitus.

[Cognitive therapy of depressive rumination]. / Kognitivnaia terapiia depressivnykh ruminatsii.

Modern approaches to the therapy of depressive ruminations are reviewed. Depressive ruminations are thought to underlie and maintain depression. The authors describe different forms of ruminations and present the analysis of depressive ruminations and the role of childhood experience in their development as well as cognitive-behavioral techniques used for their correction.

[Emotional disorders in patients with controlled hypertension]. / Émotsional'nyi status patsientov s kontroliruemoi gipertonicheskoi bolezn'iu.

AIM: To conduct a comprehensive examination of patients with controlled hypertension, including assessment of the functional state of the cardiovascular system, vegetative and psycho-emotional status. MATERIAL AND METHODS: The study involved 80 patients (51 men, 29 women) divided into 2 groups: 60 patients with essential hypertension (EH) without concomitant severe pathology and normal blood pressure during the preceding 3 months (group 1) and 20 healthy patients without EH (group 2). Anthropometric parameters (height, weight, body mass index), parameters of central hemodynamic (heart rate, systolic and diastolic blood pressure), vegetative status (vegetative Kerdo index), mental and emotional status (SCL-90R, Leonhard questionnaire, HADS, SF-36, MPQ) were assessed. RESULTS AND CONCLUSION: There were significant differences in the psycho-emotional status between patients with hypertension and patients with normal blood pressure. Significant correlations between anthropometric indicators, the state of the autonomic nervous system and psycho-emotional status of patients with hypertension were shown.

Effect of cationic substitution on the double-well hydrogen-bond potential in [K1-x(NH4)x]3H(SO4)2 proton conductors: a single-crystal neutron diffraction study.

The structure of the mixed crystal [K1-x(NH4)x]3H(SO4)2 as obtained from single-crystal neutron diffraction is compared with the previously reported room-temperature neutron structure of crystalline K3H(SO4)2. The two structures are very similar, as indicated by the high value of their isostructurality index (94.8%). It was found that the replacement of even a small amount (3%) of K+ with NH4+ has a significant influence on the short strong hydrogen bond connecting the two SO42- ions. Earlier optical measurements had revealed that the kinetics of the superionic transition in the solid solution [K1-x(NH4)x]3H(SO4)2 are much faster than in K3H(SO4)2; this reported difference in the kinetics of the superionic phase transition in this class of crystal is explained on the basis of the difference in strength of the hydrogen-bond interactions in the two structures.

The Transcriptional Changes of trim Genes Associated with Parkinson's Disease on a Model of Human Induced Pluripotent Stem Cells.

Over the last few years, in vitro models, based on patient-derived induced pluripotent stem cells (iPSCs), have received considerable attention for modeling different neurodegenerative disorders. Using this model, we analyzed transcription of 15 tripartite motif (trim) genes in iPSCs, derived from the different groups: Parkinson's disease (PD) patients bearing mutations in different genes, patient with the sporadic form of PD, and the healthy individuals. The transcription was observed during neuronal differentiation of the cells in vitro into neuronal stem cells and terminally differentiated neurons. The transcription of over 50 % of these genes, belonging to different sub-groups of the TRIM family, varied between PD patients and healthy individuals during the reprogramming of fibroblasts into iPSCs and the following neuronal differentiation. Moreover, the transcription of the trim6 and trim24 genes was different between cells, derived from PD patients, and control cells at all stages. The transcription of the four trim genes (trim5α, 26, 27, 31) remained unchanged during almost all investigated stages, compared with the controls. We suppose that the revealed changes in the transcription of several trim genes reflect their possible role in neurodegenerative processes at the early stages of PD. These genes may act as a gear unit between the PD progression and the deregulation of the immune system.

[THE PROGRAM OF PHYSICAL REHABILITATION FOR PATIENTS WITH CORONARY HEART DISEASE AND HYPERTENSIVE DISEASE].

The authors demonstrate the importance of individual criteria for the choice of dosed physical load for the patients with cardiological problems during hospitalization. The analysis of the functional state and hemodynamic parameters included 68 patients with various cardiovascular diseases before and after performance of the special program of physical rehabilitation. The results suggest high efficiency of the proposed treatment and good prospects for further studies in this field.

[The importance of muscular disbalance in physical therapy of the patients presenting with pneumonia].

UNLABELLED: Thematic justification. Pneumonia holds a leading position among the pathological conditions responsible for temporary disability. AIM: The objective of the present study was to develop a rationale for the system of therapeutic physical exercises designed to treat the patients presenting with pneumonia taking into consideration the myofascial disorders and to elucidate its advantages, if any, over the conventional approaches. MATERIAL AND METHODS: A total of 134 patients the patients presenting were examined and treated after they were randomly divided into two groups. The study group was comprised of 73 patients at the mean age of 48.0 ± 4.0 years while the control group consisted of 61 patients (mean age 48.0 ± 4.0 years). The standard clinical and laboratory examination and the chest X-ray study of all the patients were supplemented by the evaluation of the external respiration function and the assessment of the state of myofascial structure with the use of the methods for testing the muscular function. RESULTS: The complete resolution of pneumonia documented by X-ray investigations in the patients of the study group was achieved 20.6% more frequently than in controls (p < 0.05). Chest excursion in the study and control groups increased by 36.63% (p < 0.01) and 7.46% (p < 0.05) respectively. The number of the patients with the unaltered vital lung capacity (VLC) (up to more than 90% of the normal value) increased in the study group by 35.6% (p < 0.01). Simultaneously, the number of the patients with moderate and severe disorders decreased in the study group by 21.9% (p < 0.01) and 12.3% (p < 0.05) respectively. The results of the testing of the muscular function suggest that it was most frequently altered in the erector muscle of the spine, gluteus maximus and gluteus medius muscles, musculus quadriceps femoris, iliopsoas muscle, rectus abdominis muscle and oblique abdominal muscle, deep cervical flexor muscles, pectoralis major and pectoralis minor muscles on the side of the affected lung. After the treatment, these changes in the patients of the study group were observed significantly less frequently than in those of the control one. CONCLUSION: The patients with pneumonia developed the signs of muscular disbalance as a result of pathological myofascial disorders in the muscles of the neck, thoracic cage, abdominal wall, paravertebral region, thigh, and the ilio-lumbar region. The program for the combined treatment of the patients presenting with pneumonia based at a hospital facility including the newly proposed method of physical rehabilitation promoted the accelerated resolution of the inflammatory process as is apparent from the results of the X-ray examination. The respiratory exercises prescribed with due regard for the localization of the inflammatory process and specific changes of spirographic measurements together with microcorrection procedures exerted a more pronounced positive influence on the external respiration function and the state of the locomotor system in the patients of the study group in comparison with the control subjects prescribed a complex of conventional therapeutic physical exercises.

[Effect of Ultrasmall Gold Nanoparticles on the Murine Native Sperm Chromatin].

The effects of ultrasmall (2-3 nm) gold nanoparticles on native epididymal sperm chromatin of CBAxC57BL/6 hybrid mice and 129/IMG mice with a mutation in the DNA-polymerase iota gene were studied. It is shown that for both mouse strains after sperm incubation in a solution containing Au nanoparticles, at 23, 37 and 60 degrees C for 30 min followed by 1 hour treatment in dithiothreitol solution, a decrease in the number of nuclei with fully decondensed chromatin was observed compared with the control. Though, the manifestation of this effect in the population of 129/IMG mice mature sperm, was weaker. Also we have demonstrated that sperm of both strains that were incubated in a sol of Au nanoparticles at 60 degrees C behave differently under the action of dithiothreitol. A considerable part (-80%) of sperm of CBAxC57BL/6 hybrid mice treated with Au nanoparticles showed high resistance to the action of dithiothreitol, whereas in the case of 129/IMG mice only -30% did, and a partial or complete chromatin decondensation takes place in the remaining sperm. In general, using the method of nuclear chromatin decondensation in vitro for the native sperm, the patterns that we have identified in earlier studies on previously demembranized sperm are confirmed.

[The risk of atherosclerosis and osteoporosis development in post-ovariectomy syndrome women during hormone replacement therapy].

AIM: To study the formation of and trends in risk factors (RFs) for cardiovascular disease (CVD), their influence on the occurrence of early (preclinical) atherosclerotic lesions, a combination of these changes with osteoporosis (OP) in women following bilateral oophorectomy depending on whether hormone replacement therapy (HRT) is performed. SUBJECTS AND METHODS: The investigation enrolled 50 women with surgical menopause after bilateral oophorectomy in combination with hysterectomy who received estrogen monotherapy (a study group) and 37 patients who underwent the same operation, but had no HRT (a control group). The study group patients were examined twice (before and 10 years after HRT); the comparison group was examined once in the same period postsurgery. The investigators conducted Doppler study of the great arteries of the head and neck and measured pulse wave velocity, as well as they made dual-energy X-ray densitometry to estimate bone mineral density and a detailed analysis of the most common RFs for CVD. RESULTS: There was an increase in the prevalence of RFs for CVD and a change in their structure, which were particularly marked in the women who received no HRT, their impact on the development of early atherosclerotic changes naturally progressing with the number of RFs. The similar trend was observed for bone tissue changes: a higher incidence of osteopenia and OP during the follow-up. CONCLUSION: The high percentage of a concurrence of osteoporosis and atherosclerosis argues for that there are common pathogenic mechanisms.

[Effect of Mn(II) on the error-prone DNA polymerase iota activity in extracts from human normal and tumor cells].

The DNA polymerase iota (Pol iota), which has some peculiar features and is characterized by an extremely error-prone DNA synthesis, belongs to the group of enzymes preferentially activated by Mn2+ instead of Mg2+. In this work, the effect of Mn2+ on DNA synthesis in cell extracts from a) normal human and murine tissues, b) human tumor (uveal melanoma), and c) cultured human tumor cell lines SKOV-3 and HL-60 was tested. Each group displayed characteristic features of Mn-dependent DNA synthesis. The changes in the Mn-dependent DNA synthesis caused by malignant transformation of normal tissues are described. It was also shown that the error-prone DNA synthesis catalyzed by Pol iota in extracts of all cell types was efficiently suppressed by an RNA aptamer (IKL5) against Pol iota obtained in our work earlier. The obtained results suggest that IKL5 might be used to suppress the enhanced activity of Pol iota in tumor cells.

[Efficacy of catalin eyed drops in age-related cataract agents].

The present investigation studied the efficacy of Catalin eye drops (Senju Pharmaceutical Co, Osaka, Japan) in patients with early senile cataract. An objective procedure for the densitometric analysis of lens transparency images with a Pentacam apparatus (Oculus GmbH, Germany) was used to assess the results of the investigation. Unlike the control group, the patients using Catalin had a lower optical density in the anterior and posterior cortical lens layers and beneath the posterior capsule in the first months of therapy. In the other lens layers, the transparency remained unchanged whereas in the controls it was increased throughout the follow-up.

[Activity of error-prone DNA polymerase iota in different periods of house mouse Mus musculus ontogeny].

Analysis of incorrect activity of error-prone DNA polymerase iota in M. musculus ontogeny demonstrated considerable changes in its activity, which peaks in most organs during prenatal development and decreases in the adult body. We propose that the capacity of error-prone DNA polymerases to synthesize on damaged DNA regions is critical for the realization of rapidly changing genetic program in mammalian embryogenesis, which relieves the replication block and prevents cell death.