[Nutritional factors of bone health in athletes].

The importance of proper nutrition when playing sports is difficult to overestimate. Athletes of any age need to consume a sufficient amount of macro- and micronutrients for bone health. High-quality and balanced nutrition in terms of quantity and composition is important for optimal recovery after training, adaptation to intense physical activity and prevention of sports injuries. The aim of the study was to summarize the current data of domestic and foreign literature on the factors affecting bone mineral density (BMD) in athletes, as well as to consider the key points of nutritional support necessary for the prevention and treatment of osteoporosis. Material and methods. The search was conducted using the Google Academy search engine and electronic databases PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY for the period from 2008 to 2022. For the search, we used keywords and their combinations: "athletes", "osteoporosis", "stress fractures", "calcium" and "vitamin D". Results and discussion. Bone health is influenced by many factors, the most significant of which are lifestyle and the nature of a person's physical activity. Despite strong evidence for the benefits of exercise for bone health, there are sports that predispose to low BMD and increase the risk of osteoporosis. First of all, athletes involved in aerobic and aesthetic disciplines (long-distance running, cycling, swimming, rhythmic gymnastics, dancing, etc.) are at risk. In addition, factors that predispose to a decrease in BMD include female gender, low intake of energy substrates, protein, vitamin D and calcium, and certain medications. Of great importance for the regulation of bone metabolism and maintaining optimal BMD are the genetic characteristics of the athlete. The main adverse consequences for athletes with reduced BMD are fractures of various localization. At the same time, the problem of a high risk of developing stress injuries of bones is especially relevant. Calcium and vitamin D are key nutritional factors needed to maintain bone health. Optimal intake of carbohydrates, proteins, and polyunsaturated fatty acids is also important. There is evidence of a positive effect on the skeletal system of such nutritional factors as potassium, magnesium, sodium, vitamins K, C, B12 and folic acid. The specific mechanisms of the influence of these micronutrients on bone metabolism and the relationship of their consumption level with BMD need further research. Conclusion. Thus, athletes of all ages and specializations need to pay great attention to the state of the skeletal system. Given the association between the risk of osteoporosis and malnutrition, it is essential for athletes to maintain an optimal nutritional status and consume adequate amounts of vitamins and minerals.

[Relative energy deficiency in sport: modern approaches to diagnostics, treatment and prevention].

In recent years, close attention has been paid to energy deficiency in professional athletes. More and more studies confirm the widespread prevalence of relative energy deficiency syndrome in sports and its relationship with various pathological conditions that lead to a decrease in the level of athletic performance. Nowadays the possibilities of early diagnosis and treatment of this syndrome are being carefully studied, and clinical protocols are being actively developed to facilitate the early detection of energy deficiency. The aim of the study was to summarize the modern data on the influence of the syndrome of relative energy deficiency in sports on the health and performance of athletes, as well as to consider effective methods for the diagnosis, treatment and prevention of this syndrome. Material and methods. The search was carried out using the Google Academy engine and electronic databases PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY for the period from 2017 to 2021. For the search, we used keywords and their combinations: "relative energy deficit in sports", "female athlete triad", "menstrual dysfunction", "osteoporosis". Results. Based on our analysis, we can conclude that the syndrome of relative energy deficit in sports has a multicomponent negative effect on the athlete's organism and negatively affects his performance, well-being and sports results. Diagnosis of this condition is challenging due to the nonspecificity and variety of symptoms. Key diagnostic methods include physical examination, anamnesis gaining, dual energy X-ray absorptiometry, bioimpedance body composition analysis, and hormonal profile studies. Additional methods include: electrocardiography, study of the basal metabolic rate, hematological examination (hemoglobin, ferritin, etc.), determining the level of energy consumption using diaries of food and physical activity, determining blood vitamin level, etc. To facilitate the screening, diagnosis and follow-up of athletes, it is possible to use specially developed clinical protocols. Non-drug nutritional correction and optimal training plan are the main methods of treatment and prevention of energy deficiency. If this type of treatment is ineffective, hormone therapy should be considered. It is recommended to use transdermal estrogen therapy in combination with shortterm progestin therapy. In some cases, when very low bone mineral density or delayed fracture consolidation is detected, it is possible to use recombinant parathyroid hormone. Conclusion. Due to the relatively high prevalence of relative energy deficiency syndrome in athletes of both sexes and its long-term negative impact on athlete health and performance, further research is needed to improve the effectiveness of early diagnosis, prevention and treatment of pathological conditions associated with malnutrition.

[The use of rehabilitation programs for patients in the early recovery period after total knee arthroplasty]. / Primenenie reabilitatsionnykh programm dlya patsientov v rannem vosstanovitel'nom periode posle total'nogo endoprotezirovaniya kolennogo sustava.

Rehabilitation of patients after total knee arthroplasty is still a challenge for modern medicine. At the same time, there are few publications in the medical literature on rehabilitation programs for patients after total knee arthroplasty. Available scientific studies have proven the effectiveness of low-intensity laser therapy and a pulsed low-frequency electrostatic field (PLFEF) in tissue repair by modulating the inflammatory process and relieving pain. OBJECTIVE: Scientific substantiation of the feasibility of the combined use of low-intensity laser radiation (LILR) and PLFEF in patients after total knee arthroplasty. MATERIAL AND METHODS: 90 patients aged from 55 to 80 years after total knee arthroplasty were examined. All patients were randomly assigned to three groups. Patients of the 1st group underwent therapeutic exercises with an instructor and low-intensity laser exposure; in the 2nd group, therapeutic exercises with an instructor, low-intensity laser therapy, and PLFEF were performed without a time interval; patients of the 3rd group received only therapeutic exercises with an instructor. RESULTS: After the course of treatment, a positive dynamics of the state of microcirculation was noted in all patients, which correlated with a significant regression of the pain syndrome and an improvement in the performance of the 10-meter walk test with external support on crutches. However, a more significant decrease in pain intensity after the first procedures and at the end of the course of treatment was found in the group of patients who received complex therapy, which included LILR, PLFEF, and therapeutic exercises. CONCLUSION: Thus, based on the data of this study, it is possible to recommend the combined use of LILR and PLFEF for the treatment of patients after total knee arthroplasty.

DNA Damage in Splenocytes of Mice Exposed to Secondary Radiation Created by 650 MeV Protons Bombarding a Concrete Shielding Barrier.

The proportion of splenocytes with a high level of DNA double-strand breaks was determined in mice exposed to primary and secondary radiation created by bombarding of a concrete barrier (thickness 20, 40, and 80 cm) by 650 MeV protons. The proportion of splenocytes with a high level of DNA double-strand breaks was assessed by flow cytometric analysis of γH2AX+ and TUNEL+ cells. It is shown that concrete barrier can significantly reduce primary proton radiation; the severity of negative biological effects in mice irradiated in the center of the proton beam decreased with increasing the thickness of this barrier. However, the spectrum of secondary radiation changes significantly with increasing the barrier thickness from 20 to 80 cm and the distance from central axis of the beam from 0 to 20 cm, and the proportion of the neutron component increases, which also causes negative biological effects manifesting in a significant (p<0.05) increase in the percentage of splenocytes with a high level of DNA damage in mice irradiated at a distance of 20 cm from the center of the proton beam and receiving relatively low doses (0.10-0.17 Gy).

The Role of Radiobiology and Nuclear Medicine in Protection from the Effects of Ionizing Radiation (Domestic Experience).

This article presents the domestic experience in nuclear medicine, radiobiology, radiotoxicology, radiation protection, and health maintenance of nuclear industry workers and residents of the region of location of radiation hazardous facilities of the Russian Federation. In addition, the authors address the history and stages in the establishment of nuclear medicine and radiobiology in Russia, as well as modern projects and the prospects of further development of healthcare provision for workers in the nuclear industry.

[The history of development of doctrine of somatotypes: the publications review].

The study required o apply various modes of corresponding publications search through such international databases as RussiaScopus, Web of Science, Medline, The Cochrane Library, EMBASE, Global Health, CyberLeninka, RISC, eLIBRARY.RU. Actually, there are not less than one hundred definitions of constitution of individual. For the first time, constitutional differences were mentioned in Ayurveda. The following mentioning about constitutional types is found in the teachings of Hippocrates. The Ancient Greek philosopher Aristotle supplemented the teachings of Hippocrates. In the 18th century the somatic predispositions of the psyche were mentioned for the first time by J.-A. de La Mettrie. However, the systemic study of constitutional characteristics begins only in the 19th century. In the 20th century, the constitutional characters of human began to be associated with such clinical science as psychiatry. In the mid-30s of the 20th century acquires significance the classification of types approved by I. P. Pavlov. After Pavlov's theory, numerous works begin to appear where attempts are made to determine the main somatotypic reactions of individuals (V. B. Shtefko, A. D. Ostrovsky, V. N. Shevkunenko). In 1929, V. N. Shevkunenko, the outstanding Leningrad scientist, developed the classification that was lead as foundation of the theory of W. H. Sheldon (1940, 1942). Approximately in the same time period (1941) the Russian researcher V. V. Bunak develops criterion estimated indices of classification for males. In the end of 20th century classifications by B. Heath and L. Carter, V. P. Chtetsov, R. N. Dorokhov, V. G. Petrukhin, A. V. Kondrashov acquire great reputation. In the 21st century, the methods directed to biologically differential indices lined up with consideration of medical individual indices of body mass and body length are developed. Nowadays, despite of enormous number of methods, the universal criteria for somatotyping are to be developed.

[Identification of genetic polymorphisms associated with overweight in athletes of winter sports].

The identification of polymorphisms rs9939609 gene FTO, Trp64Arg ADRB3 and gene -866G> A UCP2 gene using multiplex allele-specific PCR hybridization-fluorescence detection in real time has been carried out in highly skilled athletes under the age of 30 years engaged in biathlon (n = 25) and bobsleigh (n = 28). The data on the frequency of allele risk of obesity has been obtained. The study of polymorphism rs9939609 of the FTO gene in biathletes found that 30% of them are carriers of the risk allele of obesity (A). Among the bobsledder the frequency of allele A is slightly higher than in European populations and is 55.4%. The study of gene polymorphism Trp64Arg ADRB3 shored that the frequency of risk allele of obesity 64Arg in biathletes (14%) was slightly higher than in the European population and biathletes (5.4%). The results of the identification of polymorphism -866G> A gene UCP2 in biathletes and bobsledders, found the incidence of obesity risk allele, respectively, 52 and 58.7%.