[The social economic indices of regions and population morbidity of myocardium infarction].

In Russia, in recent decades, there were regional gapping in terms of social inequality and high level of morbidity and mortality in comparison with European countries. The high morbidity and mortality of population in the Russian Federation from diseases of circulatory system on one hand, and regional differences in terms of social economic status on the other hand, determined the purpose of the study. In order to evaluate relationship between social economic status of regions of the Russian Federation and incidence rate of myocardial infarction, the analysis was applied to standardized data of adult morbidity in classes of acute myocardial infarction and repeated myocardial infarction. Also was evaluated a number of social economic indices that reflect state and conditions of life of population. The statistical analysis was applied using MS Excel and Statistica 6 software. The critical significance level of null statistical hypothesis was established as p=0.05. When analyzing morbidity of adult population of Russia with acute and repeated myocardial infarction, significant regional differences were established. The seven factors were identified that statistically significantly affect morbidity rate of the adult population with myocardial infarction, which made it possible to divide the regions into four clusters, between which differences in morbidity rate of acute myocardial infarction were revealed. The analysis of morbidity of acute and repeated myocardial infarction established significant regional differences such as in 2017 7.7 times for acute myocardium infarction and 61 times for repeated myocardium infarction. The allocation of regional clusters depending on their social economic status allows to supplement regional and federal projects with risk-oriented technologies with purpose of decreasing morbidity of diseases of circulatory system.

[The Morbidity of Myocardium Infarction in the Russian Federation, the Siberian Federal District and the Omsk Region].

The study was organized to analyze myocardium infarction morbidity in the Russian Federation, the Siberian Federal District and the Omsk Region of the Russian Federation. In the Omsk Region, in 2014 myocardium infarction morbidity amounted to 175.6 cases per 100 000 of population that is 1.4 times higher tan in the Siberian Federal District and in the Russian Federation. The morbidity of recurrent myocardium infarction amounted to 56.9 cases per 100 000 of population. During thirteenth years period, in Russia, level of acute myocardium infarction morbidity decreased up to 12%, in the Siberian Federal District up to 10% and in the Omsk Region up to 25%. The morbidity of recurrent myocardium infarction in Russia increased up to 32%, in the Omsk Region up to 68%. The increasing of morbidity of recurrent myocardium infarction in Russia resulted in increasing of percentage of recurrent myocardium infarction up to 1.3 times, in the Siberian Federal District up to 1.4 times and in the Omsk Region up to 1.8 times. The high myocardium infarction morbidity in the Omsk Region is determined by high social and economic losses in the Region. The Regional health care has an important task of optimization of activities targeted to achievement of the all-Russian level of myocardium infarction morbidity.

[Effect of Bisoprolol on Heart Rate Variability in Patients With Coronary Atherosclerosis: Dependence on Polymorphisms of -1 Adrenergic Receptor Gene].

PURPOSE: To assess effectiveness of a -blocker bisoprolol basing on a study of variability of cardiac rhythm and polymorphism of -1 adrenergic receptor gene (ADRB1). MATERIAL AND METHODS: We examined 99 patients with coronary atherosclerosis either with stable angina without history of vascular events or more than 6 month after myocardial infarction and/or coronary intervention. RESULTS AND CONCLUSION: Patients with coronary atherosclerosis including those after myocardial infarction had signs of autonomic dysfunction regardless of the presence of genetic polymorphism Gly389Arg ADRB1. Sympathetic influences at orthostatic test performed during taking bisoprolol were more pronounced in patients with Gly389Gly ADRB1 genotype than in patients with Gly389Arg ADRB1 genotype. Basing on this observation we conclude that the control by bisoprolol of heart rate regulation in patients with Gly389Gly ADRB1 genotype should be considered inadequate.

[Healthy eating: implementation of a practice-oriented training program].

Health professionals need to have current knowledge and skills in nutrition. The knowledge and skills have to be acquired in programs of continuing medical education, but also in undergraduate medical education. The main purpose of this work was to develop and implement a practice-oriented training program in nutrition and healthy eating for medical students. The subject named "Nutrition" was implemented into second-year medical curriculum. We defined a theoretical framework and terms such as nutrition, healthy eating, and evidence-based nutrition. In order to get learning outcomes we constructed a method of patients counseling and training "Individual food pyramid". The making of "Individual food pyramid" is a key integrate element of the program. It helps to memorize, understand and apply the basic principles of healthy eating in real life contexts. The final program consists of two sections: "General Nutrition" and "Special Nutrition". The most important intended learning outcome is student's lifestyle improvement. The program is practice-oriented and outcome-based.

[Effect of a vascular event on drug regimen compliance in patients with coronary atherosclerosis].

In order to assess the effect of a vascular event on adherence to treatment we examined a total of 68 patients presenting with coronary atherosclerosis. The patients' age varied from 31 to 84 years (mean 57.1±8.7). There were 55 (81.1%) men and 13 (18.9%) women. Drug regimen compliance was evaluated by means of the Morisky-Green Medication Adherence Questionnaire before and after the vascular event. Of the 68 examined patients, 15 (22.1%) had not taken any therapeutic agents before the vascular event occurred, despite existing arterial hypertension. Drug regimen compliance prior to the vascular event was low in 82.4% of cases. The number of patients with coronary atherosclerosis and low compliance to treatment before the vascular event decreased significantly thereafter (p=0.0012). After the vascular event, the number of patients adhering to the doctor's recommendations on medicamentous therapy increases considerably. At the same time, a sufficiently great number of patients [about 30% of patients after endured myocardial infarction (MI) and 18% after transcutaneous coronary intervention (TCI)] still remain in the category of those "having low drug regimen compliance" and, accordingly, have high risk for the development of recurrent vascular events. Endured TCI increases patient compliance more significantly than MI, which requires additional study of a psychological component of the given fact.

Paraoxonase cluster polymorphisms are associated with sporadic ALS.

BACKGROUND: Paraoxonases (PONs) are involved in the detoxification of organophosphate pesticides and chemical nerve agents. Due to a reported possible twofold increased risk of ALS in Gulf War veterans and the associations of PON1 polymorphisms with the neurologic symptom complex of the Gulf War syndrome, the authors investigated the association between sporadic ALS (SALS) and PON gene cluster variants in a large North American Caucasian family-based and case-control cohort (N = 1,891). METHODS: Clinically definite and probable ALS was diagnosed according to the revised El Escorial criteria, exclusion of family history of ALS, and SOD1 mutation analysis. Single nucleotide polymorphism (SNP) genotyping was done using TaqMan assays on ABI7900HT. Data were analyzed using SPSS, Haploview, FBAT, and THESIAS. RESULTS: A haploblock of high linkage disequilibrium (LD) spanning PON2 and PON3 was associated with SALS. The SNPs rs10487132 and rs11981433 were in strong LD and associated with SALS in the trio (parents-affected child triad) model. The association of rs10487132 was replicated in 450 nuclear pedigrees comprising trios and discordant sibpairs. No association was found in case-control models, and their haplostructure was different from that of the trios with overall reduced LD. Resequencing identified an intronic variant (rs17876088) that differentiated between detrimental and protective SALS haplotypes. CONCLUSION: This study demonstrates evidence of significant association of variants in the Paraoxonase gene cluster with sporadic ALS and is compatible with the hypothesis that environmental toxicity in a susceptible host may precipitate ALS.

[Use of ketogenic diet in treatment of pharmacoresistant epilepsy]. / Primenenie ketogennoi diety v lechenii farmakorezistentnykh épilepsii.

Ketogenic diet (KD) is one of the most effective methods of epilepsy non-drug therapy. Ten patients with pharmacoresistant epilepsy, aged 1.5-18 years, were treated with individually matched and strictly controlled KD with high fat content and restricted amount of proteins and carbohydrates. After 1 year, only 4 patients kept the diet. Factors of efficacy, causes of withdrawal and side effects of KD are discussed.

[Gelastic seizures: etiology, semiology, therapeutic perspectives]. / Gelasticheskie pripadki: étiologiia, semiologiia, terapevticheskie perspektivy.

Gelastic seizures (laughing seizures) are a rare type of epileptic seizure in which laugh in a main and dominating manifestation of the seizure. As a rule, the seizures are caused by organic cerebral pathology and are often reported as a specific epilepsy marker related to hypothalamic hamartoma. The interictal EEG frequently shows a focal activity. Based on examination of 2 patients with gelastic seizures and hypothalamic hamartoma, clinical features, EEG characteristics and therapeutic perspectives for the disorder are discussed.

A new PCR-based approach to a fast search of a wide spectrum of cry genes from Bacillus thuringiensis strains.

A pair of highly degenerated primers was adapted to carry out a single-step PCR-detection of any known and probably unknown cry genes of classes cry1, cry4 and cry9 encoding for 130 kDa protein delta-endotoxins in the natural Bacillus thuringiensis (BT) strains. The Southern hybridization of the product has demonstrated that essentially remote cry-genes like cry1Aa and cry9A (cryIG) could be represented in the single amplificate if they are simultaneously present in the genome of the analyzed strain. Four genes were detected by the proposed scheme in the BT ssp. galleriae 11-67. One of them, gene cry1Ga1 was originally found and cloned using the PCR-amplification product obtained from the genomic DNA of this strain as a probe. The new gene was completely identical to one cloned by B. Lambert (unpublished, EMBL accession number Z22510) and essentially related to cryIM (EMBL accession number Y09326), renamed according to the new nomenclature as cry1Ga2.

The interactions of anti-MLI monoclonal antibodies with isoforms of the lectin from Viscum album.

Monoclonal antibodies (mAb) reacting with native (TA5, TB12) and denatured (T33, T35) plant toxin mistletoe lectin I (MLI) from Viscum album have been obtained. The interaction between mAbs and native toxin with ML isoforms (MLII, MLIII) has been investigated. An immunological cross-reaction has been shown to take place for mAb TA5 (anti-A-chain of MLI) between MLII and MLIII isoforms of toxin. TA5 has not inhibited enzyme activity of the A-chain in a rabbit reticulocyte cell-free system. TB12 has been shown to react with the galactose-binding site of the B-chain. TA5 and TB12 have shown no cross-reaction with plant toxin ricin. The association constants for mAbs have been determined. The nature of heterogeneity of the lectins from Viscum album is discussed.