[The effectiveness of tele-rehabilitation for patients with multiple sclerosis during the COVID-19 pandemic in 2020-2021 was evaluated in this study]. / Effektivnost' telereabilitatsii patsientov s rasseyannym sklerozom v usloviyakh pandemii koronavirusnoi infektsii v 2020­2021 gg.

OBJECTIVE: To evaluate the effectiveness of telerehabilitation (TELEREBT) of patients with multiple sclerosis (MS) in the context of the coronavirus pandemic 2020-2021. MATERIAL AND METHODS: The study included 37 patients with MS who underwent a course of teleRBT. The course included 10 classes of 60 minutes for 10 days with a two-day break. Various questionnaires and scales were used to assess the effectiveness, as well as an assessment of the neurological status. RESULTS: 19 patients refused to participate in the program. The level of disability on the EDSS scale decreased from 4.86±1.19 at the initial level to 4.73±1.12 after the course of teleRBT, while no statistically significant changes were found. CONCLUSION: TeleRPT in patients can be an effective way to correct existing disorders. Further research is required to establish the effectiveness of teleRBT.

[Assessment of the efficacy and safety of alemtuzumab in patients with highly active relapsing-remitting multiple sclerosis in Russian population]. / Otsenka effektivnosti i bezopasnosti alemtuzumaba u patsientov s vysokoaktivnym techeniem rasseyannogo skleroza v rossiiskoi populyatsii.

OBJECTIVE: To evaluate the severity and frequency of infusion reactions (IR) in patients with highly active relapsing-remitting multiple sclerosis (MS) In Russian population receiving alemtuzumab therapy. MATERIAL AND METHODS: In retrospective study, we analyzed data from 50 patients with highly active relapsing-remitting multiple sclerosis (MS) from six Regional MS Centers in the Russian Federation who received two courses of alemtuzumab between 2018 and 2022. RESULTS: Among all IRs, the most frequently reported were hives-like rashes, which were registered in 27 people, mostly of mild severity (70.6%). Headaches were the second most common IR, observed in 17 patients (34%). When comparing the group of patients who underwent music therapy (MT) with those who received alemtuzumab therapy without MT, no statistically significant difference was found in the frequency and severity of IRs. CONCLUSION: All patients experienced IRs of varying degrees of severity. A decrease in the score on the EDSS disability scale was noted. MT did not affect the occurrence or severity of IRs.

Hard Wear-Resistant Ti-Si-C Coatings for Cu-Cr Electrical Contacts.

In this study, hard wear-resistant Ti-Si-C coatings were deposited on Cu-Cr materials to improve their performance as sliding electrical contact materials. A ceramic disk composed of Ti3SiC2 and TiC phases was used as a target for DC magnetron sputtering to deposit the coatings. The influence of the power supplied to the magnetron on the chemical composition, structure, and friction coefficient of the coatings was examined. The coatings demonstrated high hardness (23-25 GPa), low wear rate (1-3 × 10-5 mm3/N/m) and electrical resistance (300 µOhm·cm), and fair resistance to electroerosion. The coating deposited at 450 W for 30 min displayed optimal properties for protecting the Cu-Cr alloy from the arc effect.

Crystal chemistry criteria of the existence of spin liquids on the kagome lattice.

The structural-magnetic models of 25 antiferromagnetic kagome cuprates similar to herbertsmithite (ZnCu3(OH)6Cl2)-a perspective spin liquid-have been calculated and analyzed. Main correlations between the structure and magnetic properties of these compounds were revealed. It has been demonstrated that, in all AFM kagome cuprates, including herbertsmithite, there exists the competition between the exchange interaction and the antisymmetric anisotropic exchange one (the Dzyaloshinskii-Moriya interaction), as magnetic ions are not linked to the center of inversion in the kagome lattice. This competition is strengthened in all the kagome AFM, except herbertsmithite, by one more type of the anisotropy (duality) of the third in lengthJ3 magnetic couplings (strongJ3(J12) next-to-nearest-neighbor couplings in linear chains along the triangle edges and very weak FM or AFMJ3(Jd) couplings along the hexagon diagonals). The above couplings are crystallographically identical, but are divided to two types of different in strength magnetic interactions. The existence of duality ofJ3 couplings originated from the structure of the kagome lattice itself. Only combined contributions of dualJ3 couplings with anisotropic Dzyaloshinskii-Moriya interactions are capable to suppress frustration of kagome antiferromagnetics. It has been demonstrated that the possibility of elimination of such a duality in herbertsmithite, which made it a spin liquid, constitutes a rare lucky event in the kagome system. Three crystal chemistry criteria of the existence of spin liquids on the kagome lattice have been identified: first, the presence of frustrated kagome lattices with strong dominant antiferromagnetic nearest-neighborJ1 couplings competing only with each other in small triangles; second, magnetic isolation of these frustrated kagome lattices; and third, the absence of duality of the third in lengthJ3 magnetic couplings.

[Efficacy, tolerability and safety of the treatment with teberif: the results of a 2-year randomized clinical trial of treatment naïve patients with remitting multiple sclerosis, who have not received DMT, after switching from other interferon ß-1a]. / Éffektivnost', perenosimost' i bezopasnost' terapii preparatom teberif: rezul'taty dvukhletnego klinicheskogo issledovaniia u patsientov s remittiruiushchim rasseiannym sklerozom, ranee ne poluchavshikh PITRS, i pri perekliuchenii s drugogo interferona ß-1a.

OBJECTIVES: To evaluate efficacy, safety, and tolerability of the treatment with teberif/interferon ß-1a, to analyze safety, tolerability and dynamics of key efficacy variables after switching from referent drug rebif to biosimilar teberif in patients with remitting multiple sclerosis (RMS). MATERIAL AND METHODS: During the main period of the international multicenter randomized study patients were randomized to receive treatment with teberif for 52 weeks, or rebif for 52 weeks, or placebo for 16 weeks to evaluate efficacy and safety of treatment. After the main study period, patients were group-independently switched to take open-label teberif treatment during the next 48 weeks. RESULTS AND CONCLUSION: The analysis of multiple evaluation parameters of the efficiency during the 1st study period (blinded) and the 2nd study period (open-label) has shown that teberif and rebif demonstrate equivalent efficacy and stable 2-year efficacy of teberif was proven. There were no significant differences between teberif and rebif for all safety, and tolerability parameters. Switching from rebif to teberif didn't influence treatment efficacy. The 2-year study results confirmed a biosimilar teberif's benign tolerability and expected safety profile to other interferons ß-1a in patients with RMS.

[Factors governing development of nonalcoholic fatty liver disease and insulin resistance in obesity]. / Faktory, sposobstvuiushchie razvitiiu nealkogol'noi zhirovoi bolezni pecheni i insulinorezistentnosti pri ozhirenii.

The factors promoting development of non-alcoholic fatty liver disease in patients with obesity and different state of carbohydrate metabolism have been studied. 43 patients were examined; these included 26 patients with abdominal obesity (BMI=52.9±7.9 kg/m2). The control group consisted of 17 conditionally healthy donors without obesity (BMI=18.9-24.9 kg/m2), seven of them formed a comparison group that was included to compare the results of study on the levels of tissue-specific expression of HSP70 mRNA. The study of mRNA expression was performed by real-time PCR. The concentration of IL-6 and TNF-a was measured in blood serum by the ELISA method. In patients with obesity with diabetes mellitus type 2 (DM2), a significant increase in the serum level of proinflammatory cytokines was found in comparison with the group of patients without DM2 and control. The results of histological examination of liver biopsy specimens in obese patients revealed the most pronounced changes in the group of DM2 patients. Regardless of the stage of nonalcoholic fatty liver disease in obese DM2 patients, an increase in the area of fatty inclusions (relative to the group without type 2 diabetes) was recorded. The study of the HSP70 gene expression in peripheral blood mononuclear cells allowed its significant increase relative to the comparison group. The relationship between the level of expression of the HSP70 gene in metabolically active tissues (visceral, subcutaneous adipose tissue and liver) established in all obese patients with the serum content of proinflammatory cytokines (IL-6 and TNF-a) may indicate suppression of HSP70 expression in these tissues, background of systemic and local inflammation in obesity.

Antiferromagnetic spin-frustrated layers of corner-sharing Cu4 tetrahedra on the kagome lattice in volcanic minerals Cu5O2(VO4)2(CuCl), NaCu5O2(SeO3)2Cl3, and K2Cu5Cl8(OH)4·2H2O.

The objective of the present work was to analyze the possibility of realization of quantum spin liquids in three volcanic minerals-averievite (Cu5O2(VO4)2(CuCl)), ilinskite (NaCu5O2(SeO3)2Cl3), and avdononite (K2Cu5Cl8(OH)4·2H2O)-from the crystal chemistry point of view. Based on the structural data, the sign and strength of magnetic interactions have been calculated and the geometric frustrations serving as the main reason of the existence of spin liquids have been investigated. According to our calculations, the magnetic structures of averievite and ilinskite are composed of antiferromagnetic (AFM) spin-frustrated layers of corner-sharing Cu4 tetrahedra on the kagome lattice. However, the direction of nonshared corners of tetrahedra is different in them. The oxygen ions centering the OCu4 tetrahedra in averievite and ilinskite provide the main contribution to the formation of AFM interactions along the tetrahedra edges. The local electric polarization in averievite and the possibility of spin configuration fluctuations due to vibrations of tetrahedra-centering oxygen ions have been discussed. The existence of structural phase transitions accompanied with magnetic transitions was assumed in ilinskite because of the effect of a lone electron pair by Se4+ ions. As was demonstrated through comparison of averievite and avdoninite, at the removal of centering oxygen ions from tetrahedra, the magnetic structure of the pyrochlore layer present in averievite transformed into an openwork curled net with large cells woven from corner-sharing open AFM spin-frustrated tetrahedra ('butterflies') in avdoninite.

[Sensitivity and specificity of urinary and serum neurotrophins in the diagnosis of neurogenic detrusor overactivity in multiple sclerosis].

Lower urinary tract dysfunction is common among neurological patients. Traditionally, the basic method of diagnosis is a complex urodynamic study. In recent years, many studies have focused on the search for new non-invasive diagnostic modalities. In particular, neurotrophins are considered as potential biological markers of a neurogenic bladder. AIM: To estimate the sensitivity and specificity of the serum and urinary nerve growth factor (NGF) and brain neurotrophic factor (BDNF) in MS patients as markers of detrusor overactivity. MATERIALS AND METHODS: The study comprised 20 patients with multiple sclerosis, who complained of voiding problems. The control group consisted of 20 people without neurological diseases, lower urinary tract symptoms and detrusor overactivity estimated by filling cystometry. Apart from standard laboratory tests, diagnostic evaluation included a complex urodynamic study, ultrasound of the urinary tract, cystoscopy, testing serum and urinary NGF and BDNF using the enzyme immunoassay. The diagnostic significance of neurotrophins was evaluated using ROC analysis. RESULTS: According to the ROC analysis, the diagnostic sensitivity and specificity of serum NGF as a marker of detrusor hyperactivity was 57% and 93%, respectively (for serum NGF more or equal 26 pg/ml). The quality of the test according to the expert scale of AUC values was "very good" (AUC=0.806). Detecting NGF in patients urine was less effective. The sensitivity and specificity were 52% and 40%, respectively (for NGF more or equal 6 pg/ml). The quality of the test according to the expert scale of AUC values was "average" (AUC=0.64). The serum BDNF demonstrated high sensitivity (90%) and low specificity (23%), AUC=0.56. The urinary BDNF was more informative, (AUC=0.65). The combination of all four markers provides a sensitivity of 85.7% and a specificity of 66.7% (AUC=0.824). CONCLUSIONS: Testing serum and urinary neurotrophins in patients with multiple sclerosis can be used to diagnose detrusor overactivity. The NGF is a highly specific biomarker, while the BDNF is highly sensitive. Combined testing for serum NGF and BDNF is most informative.

[Russian version of the neurogenic bladder symptom score (NBSS)].

AIM: The Neurogenic Bladder Symptom Score (NBSS) is widely used now for the bladder symptoms assessment in neurogenic low urinary tract dysfunction. It is suitable for all patients, regardless of a bladder management method. NBSS contains 24 questions, which focus on incontinence, storage and voiding symptoms, urinary complicationsand life quality.With the permission of the authors (Dr.Welk et al.), NBSS had been translated into Russian according to the cultural and lingual adaptation algorithm. OBJECTIVES: Validate the Russian version of NBSS for multiple sclerosis patients. DESIGN, SETTING, AND PARTICIPANTS: The study included 80respondents: group A - 40 multiple sclerosis (MS) patients with neurogenic bladder, group B - 40 multiple sclerosis (MS) patients without bladder dysfunction, group C - healthy controls. All participants filled out the NBSS two times with an interval of two weeks. They also completed other measurement tools (IPSS,OAB Awareness Tool, WHOQOL BREF).Data were used to determine the internal consistency (Cronbachs alfa), external validity (Pearson correlation), and test-re-test reliability with interclass correlation coefficient. RESULTS: The mean of the NBSS total in the group A was 22.56+/-12.6, which significantly (p<0.001) exceeded score in comparable groups B (6.42+/-2.3) and C (5.31+/-1.9). The Cronbachs alfa of the total and the in continence, storage/voiding, and consequences domains was 0.939, 0,965, 0,801 and 0.712 respectively, which confirms the high internal consistency of the Russian version of the NBSS. External validity was verified by the relevant correlations with other questionnaires. Test-retest reliability was excellent. The interclass correlation coefficients were >0.85 (p<0.001) for all subdomains and the overall score. CONCLUSION: The Russian version of the NBSS demonstrated good validity and reliability and may be recommended for use in clinical practice.

[Polymorphic variants of the immune response genes as risk factors for primary progressive multiple sclerosis]. / Polimorfnye varianty genov immunnogo otveta kak faktory riska razvitiia pervichno-progressiruiushchego rasseiannogo skleroza.

AIM: To analyze the involvement of immune response genes in the pathogenesis of primary progressive multiple sclerosis (PPMS). MATERIAL AND METHODS: This multicenter study included 111 patients with PPMS from the Russian ethnic group. The association of PPMS with genes of immune system was analyzed by the study of polymorphic variants of genes of cytokines and genes of antigen-presenting cells. RESULTS AND CONCLUSION: The genotypes of IL-4 (rs2243250)*C/C and CLEC16A (rs6498169)*G/G were associated with PPMS in Russians. The association between the HLA-DRB1*15 and PPMS found out in other populations was confirmed in Russians.

[A comparative placebo-controlled clinical study on the efficacy and safety of interferon beta-1a for subcutaneous injections in patients with remitting multiple sclerosis: results of the first year of observations]. / Sravnitel'noe platsebo-kontroliruemoe klinicheskoe issledovanie éffektivnosti i bezopasnosti preparatov interferona beta-1a dlia podkozhnogo vvedeniia u patsientov s remittiruiushchim rasseiannym sklerozom: rezul'taty pervogo goda nabliudeniia.

AIM: To prove the equivalent efficacy of teberif (BCD-033, interferon beta-1) and rebif (interferon beta-1a) in patients with remitting multiple sclerosis (RMS). MATERIAL AND METHODS: A multicenter double blind placebo-controlled comparative randomized III phase study included 163 patients with RMS. Patients were randomized into three equal groups (teberif, rebif or placebo). RESULTS AND CONCLUSION: After 52 weeks, the equivalent efficacy of teberif and the brand drug rebif was shown. The result of assessment of the primary endpoint, which was combined unique active (CUA) lesion (the total of MRI T1-weighted lesions and new or newly enlarging T2-weighted lesions, without double counting of lesions with both activities), showed no significant differences (0.727±1.042 and 0.652±1.059 (p=0.7354, t-Student test) in the teberif and rebif groups, respectively. No between-group differences were found for other MRI indices and clinical parameters related with relapses. Teberif was shown to have a favorable safety and tolerability profile comparable to that of rebif. The results suggest the therapeutic equivalency of the drugs and form the basis for using the bioanalogue of interferon-beta 1 in patients with RMS.

[Primary progressive multiple sclerosis: current issues of timely diagnosis]. / Pervichno-progressiruiushchii rasseiannyi skleroz: sovremennoe sostoianie problemy svoevremennoi postanovki diagnoza.

This article presents a review of international data on primary progressive multiple sclerosis (PPMS) and an analysis of factors influencing timely diagnosis of PPMS in a number of regions of the Russian Federation.

PHYSIOLOGICAL, CYTOLOGICAL AND BIOCHEMICAL STABILITY OF Medicago sativa L. CELL CULTURE AFTER 27 YEARS OF CRYOGENIC STORAGE.

BACKGROUND: The efficiency of long-term cryogenic storage to prevent somaclonal variations in plant cell cultures and retain their major cytogenetic and biochemical traits remains under debate. In particular, it is not clear how stress conditions associated with cryopreservation, such as low temperature, dehydration and toxic action of some cryoprotectants (DMSO in particular), affect post-storage regrowth and genetic integrity of cell samples. OBJECTIVE: We assessed growth, cytogenetic and biochemical characteristics of the peroxidase-producing strain of Medicago sativa L. cell culture recovered after 27 years of cryogenic storage as compared to the same culture before cryopreservation. MATERIALS AND METHODS: In 1984, M. sativa L. cell culture was cryopreserved using programmed freezing and 7% DMSO as a cryoprotectant. In 2011, after rewarming in a water bath at 40 degree C for 90 s, cell culture was recovered and proliferated. Viability, growth profile, mitotic index, ploidy level, peroxidase activity and cell response to hypothermia and osmotic stress were compared between the recovered and the initial cell cultures using the records available from 1984. RESULTS: Viability of alfalfa cell culture after rewarming was below 20% but it increased to 80% by the 27th subculture cycle. Recovered culture showed higher mitotic activity and increased number of haploid and diploid cells compared to the initial cell line. Both peroxidase activity and response to abiotic stress in the recovered cell culture were similar to that of the initial culture. CONCLUSION: Cryopreservation by programmed freezing was effective at retaining the main characteristics of M. sativa undifferentiated cell culture after 27 years of storage. According to available data, this is longest period of successful cryopreservation of plant cell cultures reported so far. After storage, there was no evidence that DMSO had any detrimental effect on cell viability, growth or cytogenetics.

[Health state in women engaged in professional military service in European North].

The authors analysed health state and morbidity of women engaged into professional navy service in North Fleet, age features of health state in these servicewomen, and results of medical stationary examination and checkup results, regular medical examination results and the servicewomen morbidity over 12 years (about 15.5 thousand cases), and 697 reports on the servicewomen diseases according to military medical (navy) commission. The article covers causes of changes in navy fitness category for the servicewomen, analysis of comorbidity, suggestions of new approaches to comorbidity analysis.

[The results of the multicenter pharmaco-epidemiological observational project on the use of mydocalm in the treatment of pain syndromes with the muscle spasm].

The prospective multicenter open noncomparative pharmaco-epidemiological observational project on the use of mydocalm in real clinical practice has been completed in 2013. The project has been performed in 2090 clinical/rehabilitation settings in 284 cities of 13 countries using the results of 35,383 patients. The project aimed to assess the safety of treatment (percentage of patients with adverse-effects) and pain relieving efficacy as well as patient's satisfaction with the treatment. In total, 6603 (19%) adverse-effects were recorded. Their severity was evaluated as mild in 84,48%, no serious adverse-effects were noted. The high efficacy of mydocalm in the treatment of pain syndromes with the muscle spasm has been demonstrated. The high level of tolerability and absence of the clinically significant increase of adverse effects in the combination with nonsteroidal anti-inflammatory drugs have been confirmed.

Effect of diets containing whole white lupin seeds on rabbit doe milk yield and milk fatty acid composition as well as the growth and health of their litters.

The effect of dietary inclusion of white lupin seed (WLS) on the milk composition and yield of rabbit does as well as the performance of their litters was studied. Two lactation diets having identical digestible protein (DP):DE ratio and two weaning diets having identical DP:DE ratio were formulated. The first lactation diet (SL) contained soybean meal (SBM; 13.0%) and sunflower meal (5.0%) as the main CP sources, whereas the second lactation diet (LL) was based on WLS (25.0%). As a result, the LL diet had a greater ether extract (EE) content than did the SL diet. The first weaning diet (SW) included SBM (7.0%) as the main CP source, whereas the second weaning diet (LW) diet was based on WLS (12.0%). No additional fat was added to any of the diets. A total of 32 (16 per treatment) Hyplus PS 19 does (4,225 ± 607 g BW, at the second parturition) were fed 1 of the 2 lactation diets. The litters were standardized to 9 kits (564 ± 81 g BW) on the day of birth and were fed 1 of the 2 weaning diets from d 17 to 69 of age. At d 30 of age (weaning), 66 rabbits on each weaning diet (689 ± 71 g BW; 3 per cage) were used to evaluate performance. Feed intake and doe BW were not affected by the dietary treatments. Milk yield tended to be higher between d 1 and 30 of lactation in does fed the LL diet (P = 0.094), a finding that is related to the higher dietary EE content and intake in the LL diet. When expressed per kilogram of metabolic weight, milk output (P < 0.05) and fat output (P < 0.05) were greater in these does. Improved G:F (P < 0.05) between d 1 and 21 of lactation and greater ADG (P = 0.072) and milk efficiency (P < 0.05) of litters was observed in does fed the LL diet. The milk of does fed the LL diet contained less linoleic acid (P < 0.05) and arachidonic acid (C 20:4n-6; P < 0.05) and more oleic acid (P < 0.05), α-linolenic acid (P < 0.05), and eicosapentaenic acid (P < 0.05), with a corresponding increase in the total PUFA n-3:C 20:4n-6 ratio (P < 0.05). The performance of fattening rabbits was not affected by dietary treatment. The number of ill plus dead rabbits caused by digestive disease was lower (P < 0.05) in rabbits fed the LW diet. Therefore, WLS is a suitable dietary CP source for lactating does that can replace traditionally used CP sources without adverse effects on feed intake and milk yield or on the growth and viability of their litters. Due to its fatty acid (FA) composition, the use of WLS in the lactation diet has the potential to improve the milk FA composition of does.

[Ormond's disease complicated by infectious endocarditis].

A case of retroperitoneal fibrosis (Ormond's disease) is reported. It is known to be usually diagnosed at the late stages of renal complications Urinary infection ended in infectious endocarditis caused by E. faecium showing multiple resistance to antibiotics. Moderate immunosuppressive and modern antibacterial (daptomycin) therapy ensured remission of both Ormond's diseases and endocarditis.

[Health status of female soldiers serving in the Northern Fleet].

Authors analyzed the health status and morbidity among female soldiers serving under the contract in the Northern Fleet, age peculiarities, results of medical in-patient examination and expert assessment, put in medical records in accordance with prophylactic medical examination service and medical examination. Annual data about military troops, morbidity and medical examination among female soldiers in the period 2002-2010 (n-14,5 thousand of people) are included into analysis. 502 medical records of female soldiers approved by military physician board were analyzed. Authors presented statistic data about primary diseases and chronic pathology and considered causes of changing of the category of fitness for military service and its gender peculiarities. Authors suggest changing the recruiting concept for female soldiers and the system of medical in-patient examination.

[Features of organization of nutrition for young athletes].

Organization of nutrition for young athletes implied a regime, which includes the distribution of meals throughout the day, the multiplicity of power an nutrients that must be strictly consistent with the mode of the training process. Athletes' requirements in energy and nutrients vary considerably depending on the sport discipline and the amount of intense of physical activity. In the Institute of Nutrition of Russian Academy of Medical Sciences the recommended average daily sets of products, which are based on daily energy expenditure of young athletes, depending on the duration and intensity of physical activity in diverse kinds sports has been developed, these kits provide young athletes the necessary nutrients and micronutrients. In precompetitive period athletes must be given high physical activity and the diet should be mainly protein and fat-containing, with a high level of fiber. The training process should be intense for three days, then the athlete is advised to transfer to the carbohydrate-rich diet that is combined with a significant reduction in the intensity of trainings--glycogen super compensation. During competition period meal should be well digestible and low-volume. It must contain proteins of high biological values and carbohydrates in the required quantity. During this period the inclusion of new dishes and products in the menu for athletes is not desirable. During marathon the main aim is to recover the energy, water, mineral resources, and to maintain normal blood glucose concentrations. This is achieved in the following ways: carbohydrate intake with a relatively small amount of liquid, high product content of vitamins and minerals that helps to maintain the water-salt metabolism at the appropriate level, taking food in liquid form, in small portions. In the recovery period adequate nutrition should achieve the following objectives: to restore the acid-base and fluid and electrolyte balance, eliminate the effect of metabolic products (urea, lactic acid, ammonia, etc) associated with high physical activity; restore carbohydrate stores, provide plastic exchange, synthesis processes. The article also contains the basic sanitary and epidemiological requirements for the catering departments, selection of products and sports doctors.