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Based on the literature review, the authors describe current situation of the new coronavirus infection COVID-19 spread, which is a common problem for the entire world community. The COVID-19 infection caused by the SARS-CoV-2 coronavirus has rapidly spread to all countries and continents. All segments of the population are sensitive to it, regardless of gender, age, belonging to various social groups. This virus creates certain difficulties in detecting and treating the disease. It is associated with the risks of developing critical clinical conditions of infected people. There are several versions regarding the origin of the coronavirus. The first theory is the natural origin of the virus. The second theory is the artificial origin of the virus. Currently, the evidence for both the artificial origin of the coronavirus and its natural origin is indirect, so it is impossible to reject both hypotheses yet. Reducing the incidence of coronavirus infection can be achieved only through vaccination and compliance with appropriate safety measures.

Стаття присвячена огляду історичних та сучасних даних щодо становлення рефлексотерапії, яка веде своє походження від традиційної східної медицини і 40 років тому була впроваджена в Україні.

Background: Despite advances in surgery and pharmacotherapy, there remains significant residual ischemic risk after coronary artery bypass grafting surgery. Methods: In REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial), a multicenter, placebo-controlled, double-blind trial, statin-treated patients with controlled low-density lipoprotein cholesterol and mild to moderate hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or placebo. They experienced a 25% reduction in risk of a primary efficacy end point (composite of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina) and a 26% reduction in risk of a key secondary efficacy end point (composite of cardiovascular death, myocardial infarction, or stroke) when compared with placebo. The current analysis reports on the subgroup of patients from the trial with a history of coronary artery bypass grafting. Results: Of the 8179 patients randomized in REDUCE-IT, a total of 1837 (22.5%) had a history of coronary artery bypass grafting, with 897 patients randomized to icosapent ethyl and 940 to placebo. Baseline characteristics were similar between treatment groups. Randomization to icosapent ethyl was associated with a significant reduction in the primary end point (hazard ratio [HR], 0.76 [95% CI, 0.63–0.92]; P =0.004), in the key secondary end point (HR, 0.69 [95% CI, 0.56–0.87]; P =0.001), and in total (first plus subsequent or recurrent) ischemic events (rate ratio, 0.64 [95% CI, 0.50–0.81]; P =0.0002) compared with placebo. This yielded an absolute risk reduction of 6.2% (95% CI, 2.3%–10.2%) in first events, with a number needed to treat of 16 (95% CI, 10–44) during a median follow-up time of 4.8 years. Safety findings were similar to the overall study: beyond an increased rate of atrial fibrillation/flutter requiring hospitalization for at least 24 hours (5.0% vs 3.1%; P =0.03) and a nonsignificant increase in bleeding, occurrences of adverse events were comparable between groups. Conclusions: In REDUCE-IT patients with a history of coronary artery bypass grafting, treatment with icosapent ethyl was associated with significant reductions in first and recurrent ischemic events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01492361.

In 3-month bone marrow transplants of CBA mice from bone marrow donors receiving single injections of TLR-4 ligand (LPS) or NOD-2 ligand (muramyl dipeptide, MDP) 24 h before transplantation, an increase in the total number of MSCs (by 2.6 and 1.9 times, respectively), as well as a slight increase in the number of nuclear cells and the mass of bone capsules (by 1.3 and 1.2 times) were observed. After combined administration of MDР and LPS to donors, the total content of MSCs in the grafts was higher by 1.6 times in comparison with the total result of their isolated administration (and by 7.2 times in comparison with the control). At the same time, the concentration of osteogenic MSCs in the grafts of all groups was almost the same and corresponded to the control level. The number of nuclear cells and the mass of bone capsules of the grafts after combined administration of LPS and MDP were close (~80%) to the sum of the results of their isolated administration. These findings suggest that activation of the stromal tissue and the success of bone marrow transplantation depend on the intensity of innate immune responses. These data can be useful for the development of optimal methods of tissue transplantation.

AimTo investigate whether the American Joint Committee on Cancer (AJCC) clinical category cT2b needs to be subclassified by the type and distribution of retinoblastoma (RB) seeding.MethodsMulticentre, international registry-based data were collected from RB centres enrolled between January 2001 and December 2013. 1054 RB eyes with vitreous or subretinal seeds from 18 ophthalmic oncology centres, in 13 countries within six continents were analysed. Local treatment failure was defined as the use of secondary enucleation or external beam radiation therapy (EBRT) and was estimated with the Kaplan-Meier method.ResultsClinical category cT2b included 1054 eyes. Median age at presentation was 16.0 months. Of these, 428 (40.6%) eyes were salvaged, and 430 (40.8%) were treated with primary and 196 (18.6%) with secondary enucleation. Of the 592 eyes that had complete data for globe salvage analysis, the distribution of seeds was focal in 143 (24.2%) and diffuse in 449 (75.8%). The 5-year Kaplan-Meier cumulative globe-salvage (without EBRT) was 78% and 49% for eyes with focal and diffuse RB seeding, respectively. Cox proportional hazards regression analysis confirmed a higher local treatment failure risk with diffuse seeds as compared with focal seeds (hazard rate: 2.8; pConclusionThis international, multicentre, registry-based analysis of RB eyes affirmed that eyes with diffuse intraocular distribution of RB seeds at diagnosis had a higher risk of local treatment failure when compared with focal seeds. Subclassification of AJCC RB category cT2b into focal vs diffuse seeds will improve prognostication for eye salvage.

The bacterial archetypal adaptive immune system, CRISPR-Cas, is thought to be repressed in the best-studied bacterium,Escherichia coliK-12. We show here that theE. coliCRISPR-Cas system is active and serves to inhibit its nine defective (i.e., cryptic) prophages. Specifically, compared to the wild-type strain, reducing the amounts of specific interfering RNAs (crRNA) decreases growth by 40%, increases cell death by 700%, and prevents persister cell resuscitation. Similar results were obtained by inactivating CRISPR-Cas by deleting the entire 13 spacer region (CRISPR array); hence, CRISPR-Cas serves to inhibit the remaining deleterious effects of these cryptic prophages, most likely through CRISPR array-derived crRNA binding to cryptic prophage mRNA, rather than through cleavage of cryptic prophage DNA; i.e., self-targeting. Consistently, four of the 13E. colispacers contain complementary regions to the mRNA sequences of seven cryptic prophages, and inactivation of CRISPR-Cas increases the level of mRNA for lysis protein YdfD of cryptic prophage Qin and lysis protein RzoD of cryptic prophage DLP-12. Also, lysis is clearly seen via transmission electron microscopy when the whole CRISPR-Cas array is deleted, and eliminating spacer #12, which encodes crRNA with complementary regions for DLP-12 (includingrzoD), Rac, Qin (includingydfD), and CP4-57 cryptic prophages, also results in growth inhibition and cell lysis. Therefore, we report the novel results that (i) CRISPR-Cas is active inE. coliand (ii) CRISPR-Cas is used to tame cryptic prophages, likely through RNAi; i.e., unlike with active lysogens, active CRISPR-Cas and cryptic prophages may stably co-exist.

The issue of radiation exposure as a potential cause of cerebrovascular disease raises many concerns. The aim of the present study was to investigate the epidemiology of stroke and transient ischemic attacks (TIA) along with the associated risk factors among the population of East Kazakhstan exposed to ionising radiation from the former Semipalatinsk Nuclear Test Site (SNTS) in comparison with the unexposed population of the same region. This 5-year retrospective cross-sectional study included the data on 10,970 patients, of whom the majority (62.3%) suffered from ischemic stroke, 11.7% had hemorrhagic stroke and the remaining 26.0% had TIA. At the moment when stroke/TIA happened, exposed patients were younger than the unexposed (mean age 63 years versus 64 years, p

Lung cancer has the highest morbidity rate among all malignant tumors in men and the highest mortality rate in men and women in Russia. In total, 49 145 new cases of lung cancer were registered (diagnosed) in Russia in 2019. The majority of cases are related to exogenic carcinogens and mainly tobacco smoke. For several decades surgical resection with preoperative cytotoxic therapy was an optimal approach for maximal cure rate. This year recommendations were updated with new strategies including adjuvant anti-PD-L1 atezolizumab following completion of chemotherapy in PD-L1 positive patients and osimertinib for EGFR mutated cases. For this moment available data suggest the increase in disease free survival. Strategic approach to treatment for inoperable patients varies according to the status of driver mutations. New approach includes pretreatment option of testing for a wide spectrum of alterations with NGS based panels. Significant changes were incorporated into treatment of ALK mutated NSCLC with two new options of brigatinib for TKI naive patients and lorlatinib for those who progress on second generation drugs. Treatment strategy for patients without activating mutations is based on PD-L1 status. Tsis year recommendations included atezolizumab as a new monotherapy option for patients with high depression of PD-L1. Also treatment options for pembrolizumab, nivolumab and atezolizimab were widened with prolonged treatment schedules.

Purpose Circulating testosterone levels are a heritable trait with anabolic properties in various tissues, including skeletal muscle. So far, hundreds of single nucleotide polymorphisms (SNPs) associated with testosterone levels have been identified in nonathletic populations. The aim of the present study was to test the association of 822 testosterone-increasing SNPs with muscle-related traits (muscle fiber size, fat-free mass and handgrip strength) and to validate the identified SNPs in independent cohorts of strength and power athletes. Methods One hundred and forty-eight physically active individuals (47 females, 101 males) were assessed for cross-sectional area (CSA) of fast-twitch muscle fibers. Significant SNPs were further assessed for fat-free mass and handgrip strength in > 354,000 participants from the UK Biobank cohort. The validation cohorts included Russian elite athletes. Results From an initial panel of 822 SNPs, we identified five testosterone-increasing alleles (DOCK3 rs77031559 G, ESR1 rs190930099 G, GLIS3 rs34706136 TG, GRAMD1B rs850294 T, TRAIP rs62260729 C) nominally associated (P P = 0.048) and greater strength performance in weightlifters (P = 0.017). Moreover, the proportion of participants with ≥ 2 testosterone-increasing alleles was higher in power athletes compared to controls (68.9 vs. 55.6%; P = 0.012). Conclusion Testosterone-related SNPs are associated with muscle fiber size, fat-free mass and strength, which combined can partially contribute to a greater predisposition to strength/power sports.

The article is devoted to the memory of the outstan-ding person and coincide with the 90th anniversary of the birth of Macheret Yevheniia Leonidivna — MD, PhD, Professor, Corresponding Member of the Academy of Medical Sciences of Ukraine, Academician of the Academy of Sciences of the Higher School of Ukraine, Recipient of the State Prize of Ukraine, Honoured worker of science and technology of Ukraine, Holder of the Order of Princess Olga grade III, recipient of the republican award named after V.K. Seminskyi, President of the European Association for Laser Therapy, Vice-President of the World Acupuncture Association, Professor of the Tianjin Traditional Chinese Medicine College, President of the Ukrainian Academy of Traditional Oriental Medicine and Culture, President of the Ukrainian Association of Acupuncture and Laser Therapy (renamed as the Ukrainian Association of Reflexotherapy and Medical Acupuncture), until 2011 — the Head of the Department of Neurology and Reflexology of Shupyk National Medical Academy of Postgraduate Education. The path of life of Professor Ye.L. Macheret and her professional achievements are described. The scientific and practical achievements of her students and followers from public organization “Ukrainian Association of Reflexotherapy and Medical Acupuncture” founded by professor Ye.L. Macheret, which is currently headed by professor O.Ye. Kovalenko, are covered.

Introduction. In MRI, the difference in sensitivity between tissues is used to obtain images weighted by the inhomogeneity of the magnetic field termed susceptibility-weighted imaging (SWI) and a high-resolution 3D radiofrequency gradient echo scan with full speed compensation is applied. The aim was to determine the features of lesions caused by traumatic brain injury in children using the SWI sequence. Materials and methods. 535 TBI children aged two months up to 18 years old (average age 9.58 ± 1.5) were studied. There were 325 boys (60.7%), 210 girls (39.3%). MRI was performed without and with intravenous contrast on a Phillips Achieva 3 T scanner with T1- and T2WI, 2D and 3D images, FLAIR, magnetic resonance angiography (TOF MRA), SWI, and DW/DTI, MRS and fMRI, SWI were used for visualization of DAI. Results. Patients included children with severe TBI - 178 (33.3%), moderate TBI - 172 (32.1%) and mild TBI - 185 (34.6%). Of the 535 injured children, 129 (24.1%) had MRI performed within the first 24 hours from the moment of injury, up to 48 hours - at 91 (17.0%), up to 72 hours - in 78 (14.6%) and up to 13 days - in 237 (44.3%). DAI foci at all degrees of TBI were detected in 422 (78.9%) children out of 535 children. Conclusion. SWI is a sensitive method for diagnosing brain lesions in TBI and significantly contributes to predicting outcomes in the early stages after trauma. The amount of brain lesions diagnosed by SWI correlates with the degree of injury according to the Glasgo Coma Scale. The study of the brain functional connections can inform about possible relationships between the localization of the SWI lesion and cognitive deficits, potentially providing an opportunity to use SWI in the hyperacute phase.

Aim. Study the effect of a study video, which was created by researchers and devoted to the atherosclerosis development and the effect of statin therapy on atherosclerotic plaque, on adherence to long-term therapy in patients with high or very high risk of cardiovascular complications.Material and methods. 120 patients admitted to hospital with cardiovascular diseases were included in the study. Patients were randomized into 2 groups: in the main group (n=60), the information video edited by the researchers was shown to patients on the eve of discharge, in addition to a printed brochure on lifestyle and diet modification, and in the control group (n=60), patients were given only a standard brochure. The motivating video shows the damage to the cardiovascular system by the atherosclerotic process and the beneficial effect on the body of constant intake of statins. After 1 and 3 months after discharge from the hospital, telephone calls were made, after which the patients had to visit the center for an objective examination by a researcher and control of laboratory parameters. After 1 month, 110 patients visited the center, after 3 months, 98 respondents visited the center.Results. The group with the information video demonstration noted more frequent adherence to medical recommendations compared to the control: after 1 month, 52 (96%) patients continued treatment versus 48 (86%) patients, 3 months after discharge 48 (96%) patients continued treatment versus 38 (79%) patients (pConclusion. Demonstration of a motivating video about the effect of statins on the atherosclerosis course increases patient adherence to medicinal therapy, including adherence to statins.

Overweight and obesity are among the main factors of cardiovascular risk, but the prospective studies on the dependence between high-fat diets and weight gain yielded contradictory results. Different types of fats exert varying metabolic effects, and this fact leads to a difference in the risk associated with increasing body weight. The effects of fat quality in the daily diet on immunological status and resistance of myocardium to ischemic-reperfusion damage should be studied experimentally in biomedical models. The purpose of this work was to assess the effect of the qualitative composition of a high-fat diet used for induction of primary visceral obesity (PVO) in rats with systemic inflammatory response syndrome (SIRS) upon myocardial resistance to ischemic-reperfusion injury, and levels of pro- and anti-inflammatory cytokines.The experiments were performed on adult male Wistar rats with PVO caused by 28-day consumption of any fat types: hydrogenated fats (HF), vegetable oils (VO), animal fats (AF) or milk fat (MF). The SIRS model included a combination of chemically induced colitis (CIC) and intragastric injection of a broad-spectrum antimicrobial agent (AMA) for three days. Five days later, immunological and biochemical studies were conducted, as well as composition of intestinal microbiota in faecal samples, morphological changes in the structure of the large intestine, hemodynamic parameters and myocardial resistance to ischemic-reperfusion injury were studied in the model of isolated heart perfusion, by Langendorff technique.There was a significant increase in the concentration of anti-inflammatory cytokines in animals with SIRS, i.e., TNFα, IL-1α, IL-2, IL-8, as well as a decrease in TGF-1β, an anti-inflammatory cytokine. SIRS was accompanied by severe dietary disorders and evacuatory function of the gastrointestinal tract. Minimal changes in the intestinal microbiota composition, as well as the most pronounced regeneration signs of intestinal epithelium was observed in rats in the group with MF injection. There was a trend for increasing size of infarction in all the groups as compared with control, directly correlating with increase in BDNF and IL-2 production. However, a significant increase in the infarction size was found only in the group receiving milkfat, thus suggesting a decrease in myocardial resistance to ischemic reperfusion injury (IRI).Thus, the presence of SIRS in the primary obesity model is characterized by controllable change of inflammation markers and depends on the quality of dietary fats. The degree of morphofunctional deterioration of isolated heart, including a decrease in resistance to ischemia-reperfusion injury, correlates with the concentration of BDNF and IL-2 during the studied observation terms.

The development of mycological gerontology requires effective methods for assessing the biological age of fungal cells. This assessment is based on the analysis of a complex of aging and oxidative stress markers. One of the most powerful such markers is the protein carbonylation. In this study, the already known method of dry immune dot blotting is adapted for mycological studies of the content of protein carbonyl groups. After testing the method on a number of filamentous fungi species, some features of the accumulation of carbonylated proteins in mycelium were established. Among these features: (i) a weak effect of exogenous oxidative stress on the accumulation of carbonyls in a number of fungi, (ii) reversibility of the carbonyl accumulation, (iii) possibility of arbitrary regulation of carbonyl content by fungus itself and (iv) the influence of hormesis. In addition, two polar strategies for the accumulation of carbonyl modification were revealed, named Id-strategy (Indifferent) and Cn-strategy (Concern). Thus, even the analysis of one marker allows making some preliminary general assumptions and conclusions. For example, the idea that fungi can freely regulate their biological age is confirmed. This feature makes fungi very flexible in terms of responding to environmental influences and promising objects for gerontology.

Introduction. Osteoporosis is one of the most common diseases of the musculoskeletal system in modern clinical practice. Its prevention and treatment requires a diet with a sufficient intake of calcium, vitamins, and connective tissue proteins that regenerate cartilage and bone tissue. We aimed to formulate a functional product based on collagen fermentolysate to prevent osteoporosis and prove its effects in experiments on laboratory rats. Study objects and methods. Our study objects were collagen fermentolysate obtained from pork ears and legs (1:1) and the functional product based on it. The biological experiment was carried out on Wistar female rats exposed to osteoporosis through complete ovariectomy. Their femurs were analyzed for the contents of phosphorus, magnesium, and calcium, as well as cytometric and biochemical blood parameters. Results and discussion. The formulated functional product based on collagen fermentolysate contained 41% of the most easily assimilable peptide fractions with a low molecular weight of 10 to 20 kDa. Other components included pumpkin powder, dietary fiber, calcium, chondroprotectors, and vitamins E, C, and D3. Compared to the control, the experimental rats that received the functional product had increased contents of calcium and magnesium in the bone tissue (by 25.0 and 3.0%, respectively), a decreased content of phosphorus (by 7.0%), a calcium-to-phosphorus ratio restored to 2.4:1.0, and a higher concentration of osteocalcin in the blood serum (by 15%). Conclusion. The developed functional product based on collagen fermentolysate can be used as an additional source of connective tissue protein, calcium, vitamins C, E, and D3, dietary fiber, and chondroprotectors to prevent osteoporosis.

The aim of the study was to assess the level of NAD+ in the brain of mice treated with beta-amyloid (Aβ), as well as to determine the activity of ADP-ribosyl cyclase/CD38 and the number of CD38-immunopositive neurons, astrocytes and endothelial cells. Material and methods. The Alzheimer’s disease model was reproduced by intrahippocampal administration of Aβ to C57BL/6 mice. Determination of the NAD+ level in the extracellular fluid of the brain and in the hippocampal tissue was carried out by spectrophotometric analysis. Evaluation of the enzymatic activity of ADP-ribosyl cyclase / CD38 was carried out by the fluorimetric method, determination of the number of CD38-immunopositive cells by the immunohistochemistry method. Results and discussion. The level of NAD+ was significantly increased in the hippocampal tissue in mice after administration of Aβ, while the level of extracellular NAD+ did not change. The activity of ADP-ribosyl cyclase / CD38 in the hippocampal tissue did not change, but the number of CD38-immunopositive neurons decreased, and the number of CD38+ endothelial cells increased in the hippocampus of mice after administration of Aβ. Conclusion. Opposite changes in the expression of ADP-ribosyl cyclase / CD38 in neurons and endotheliocytes correspond to different metabolic states of these types of cells and, along with an increased intracellular pool of NAD+ in experimental Alzheimer’s disease, reflect an adaptive stress response to Aβ administration.

Introduction The high prevalence of obstructive sleep apnea (OSA), which impairs quality of life for numerous patients and leads to various OSA complications, has contributed to the continued interest in this disorder. The role of serotonin (5-HT) in many physiological processes, studies on its connection with the circadian system, and relationship to changes in sleep architecture are insufficient to assess the interaction of this neurotransmitter with nocturnal hypoxia. The aim of this study was to determine changes in sleep patterns and serum serotonin levels before and after positive airway pressure (PAP) therapy in patients with OSA. Methods The study involved 30 OSA patients (27 men and 3 women) who were treated with PAP for 3 months. Polysomnography using the GRASS TELEFACTOR (USA) and blood collection were conducted before and after PAP courses. Determination of serum serotonin was performed by high-performance liquid chromatography (HPLC). PAP therapy was performed using an automatic Prisma 20A (Germany) continuous positive airway pressure (CPAP) device. Results The use of PAP for 3 months revealed a significant improvement as measured by sleep data and serotonin levels (before: apnea index [AI] 17.2 eV/h, after: 2.4 eV/h p = 0.001; SpO2

AOS enzymes can be biochemical indicators of abnormal xylogenesis in Karelian birch. The elevation of enzymatic activity correlates with the increase in wood figure intensity. The different biochemical strategies of the antioxidant system (AOS) enzymes (superoxide dismutase (SOD), catalase (CAT), peroxidase (POD), polyphenol oxidase (PPO)) are described for the first time for various xylogenesis scenarios in Karelian birch (Betula pendula Roth var. carelica (Mercl.) Hamet-Ahti). Studies have shown that figured wood formation is closely associated with the secondary metabolism processes in this woody plant, as reflected in the elevation of the activity of AOS enzymes. Our results demonstrate that AOS enzymes can be used as biochemical markers of figured wood formation during active cambial growth.

One of the important components of the antioxidant defense system is the glutathione system, the activity of which, when overweight, changes direction depending on gender and ethnicity. The results of studies involving overweight menopausal women are mixed. The study involved 61 postmenopausal women, who, after clinical and anamnestic examination, were divided into 2 groups: control (BMI = 19-24.9 kg / m2) and overweight group (BMI = 25-29.9 kg/m2). The use of hormone replacement therapy; the use of antioxidant drugs; diseases of endocrine genesis; exacerbation of chronic diseases; premature early menopause; surgical menopause was the exclusion criteria for women from the study. The lipid profile parameters with the calculation of the atherogenic coefficient; reduced and oxidized glutathione levels with the calculation of their ratio, the glutathione S-transferase and glutathione reductase activities were determined in the blood. Overweight women showed an increase in the triacylglycerols (p = 0.041) and cholesterol in very low density lipoproteins levels (p = 0.044). When assessing the glutathione system activity in women of the main group, compared with the control, an increase in the glutathione-S-transferase (p = 0.023) and glutathione reductase (p = 0.022) activities was noted, however, the reduced and oxidized glutathione levels, as well as their ratio did not differ from the control values. The results obtained indicate the activation of the glutathione system enzymatic link in response to changes in lipid status in postmenopausal women with overweight.

The retinoblastoma tumor suppressor (RB) is a critical regulator of E2F-dependent transcription, controlling a multitude of protumorigenic networks including but not limited to cell-cycle control. Here, genome-wide assessment of E2F1 function after RB loss in isogenic models of prostate cancer revealed unexpected repositioning and cooperation with oncogenic transcription factors, including the major driver of disease progression, the androgen receptor (AR). Further investigation revealed that observed AR/E2F1 cooperation elicited novel transcriptional networks that promote cancer phenotypes, especially as related to evasion of cell death. These observations were reflected in assessment of human disease, indicating the clinical relevance of the AR/E2F1 cooperome in prostate cancer. Together, these studies reveal new mechanisms by which RB loss induces cancer progression and highlight the importance of understanding the targets of E2F1 function. Significance: This study identifies that RB loss in prostate cancer drives cooperation between AR and E2F1 as coregulators of transcription, which is linked to the progression of advanced disease.

Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior CV–TV axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.

The content of carbonyl compounds (methylglyoxal and TBA-reactive substances) and components of the glutathione system (activities of glutathione-dependent enzymes, content of oxidized and reduced glutathione) and their interrelationships were studied in men of young reproductive age with type 1 diabetes mellitus at the stages of normo- and microalbuminuria. In patients with normoalbuminuria, the level of methylglyoxal, reduced and oxidized glutathione, and glutathione reductase activity were increased and the content of TBA-reactive substances was decreased. In the group with microalbuminuria, an increase in content of methylglyoxal and activity of glutathione-dependent enzymes relative to the control values were observed; the content of TBA-reactive substances was increased and glutathione reductase activity was decreased relative to the group with normoalbuminuria. In patients with microalbuminuria, a strong correlation between the mean glomerular filtration rate and the blood level of methylglyoxal was revealed.

BACKGROUND: Diabetic retinopathy (DR) is the leading complication of diabetes mellitus (DM) which is reported to affect more than one-third of the global diabetic population. Optical coherence tomography angiography (OCT-A) can help to reveal early biomarkers of DR to improve current diagnostic approach.AIMS: To evaluate early visual functions deficiency and OCT-A changes in patients with type 1 DM (T1DM) without clinical signs of DR.MATERIALS AND METHODS. 74 eyes of 40 T1DM patients with no apparent DR and 49 eyes of 28 healthy volunteers were included in the study. The mean duration of DM was 11,7 ± 6,1 years. All participants underwent standard ophthalmological examination, low-luminance visual acuity (LLVA) assessment, 7-field fundus photography, OCT and OCT-A. We analyzed LLVA deficit as a marker of visual function. For OCT-A scans we evaluated foveal avascular zone (FAZ) area (mm2), acircularity index (AI), vessel density (VD), skeletonized density (SD) and vessel diameter index (VDI) in superficial vascular plexus (SVP), intermediate capillary plexus (ICP) and deep capillary plexus (DCP).RESULTS: LLVA deficit was significantly higher in T1DM patients (0,16±0,05 vs 0,10±0,04, pCONCLUSIONS: Our results demonstrate early visual functions deficiency and OCT-A changes at the preclinical stage of DR. The prognostic value of these findings will be studied during longitudinal observation.

The paper provides a comparison of properties of cryopreserved fetal murine multipotent stromal cells (MSCs) of skin-muscular origin and those derived from adult thymus in culture in vitro. Fetal MSCs showed a 30% higher number of average population doublings within 24 hrs, and 41% lower average population doubling time. It was found that the fetal MSCs of the 4th passage had a 39% higher clonogenic activity than the adult thymus-derived ones. Fetal MSCs and those derived from adult thymus differentiated in osteogenic and adipogenic lineages with equal efficiency in special culture media. Fetal and thymus-derived MSCs were characterized by almost the same high ability of contact interaction with thymocytes, and the fibroblast-lymphocyte rosette (FLR) formation. They were far less active in FLR formation with lymph node cells. This indicated the presence of membrane affinity for immature lymphoid cells in both MSC subpopulations. The results showed the fetal MSCs to be significantly different from the adult thymus-derived MSCs by more active kinetics of growth and clonogenic potential. However, both cell subpopulations had virtually the same ability for linear differentiation and showed high activity during contact with immature lymphoid cells. Linear differentiation and the ability to interact with lymphocytes were found to be quite stable properties of MSCs, but a proliferative activity and in vitro colony formation distinguished significantly in different types of MSCs. This can be taken into account when choosing the cells for therapy, research and results assessment. Probl Cryobiol Cryomed 2021; 31(3): 249–257

Aim. To determine the level of SARS-CoV-2 seroprevalence among the Novosibirsk Region population against the background of the COVID-19 pandemic.Material and methods. The work was carried out in 2 phases: 1) a cross-sectional cohort study performed 28.06– 15.07.2020; 2) longitudinal cohort 3-stage seromonitoring: 1st stage 28.06–15.07.2020; 2nd 14.09–04.10.2020; 3rd 10–30.12.2020 The work was carried out according to a unified methodology developed by Rospotrebnadzor with the participation of St-Petersburg Pasteur Institute, taking into account the recommendations of the WHO. IgG antibodies to the SARS-CoV-2 nucleocapsid protein were detected by ELISA using a kit of reagents produced by the SRCMSB (Obolensk) according to the manufacturer’s instructions. Statistical analysis was performed using Microsoft Excel 2010 and other programs.Results. The seroprevalence in the region’s population was 9.1% (95% CI 8.0–10.2): maximum in children 14–17 years old (17.6%, 95% CI 12.3–23.9) and persons over 75 years (14.8%, 95% CI 11.4–18.8), minimum among persons 30–39 years old (4.9%, 95% CI 3.0–8.0). Increased rate was noted among the unemployed (15.4%, 95% CI 9.9–17.1) and other individuals (13.0%, 95% CI 8.6–18.5). Seroprevalence was 33.3% (95% CI 16.3–59.0) in COVID-19 convalescents and 19.0% (95% CI 13.9-25.0) in contact persons. More than 94.7% (95% CI 91.2–97.2) of seropositive individuals were asymptomatic. During the serological monitoring, seroprevalence increased from 7.4% (95% CI 6.2–8.9) at 1st stage 1 to 12.4% (95% CI 10.6–14.3) at 2nd , and 31% (95% CI 28.8–33.3) at 3rd stage.Conclusion. SARS-CoV-2 herd immunity has not reached the threshold level, this does not exclude exacerbation of the epidemic process.

The article highlights in detail the features of the periodic accreditation of specialists in 2021, gives detailed recommendations to doctors on the formation of an educational trajectory and on the preparation of documents for accreditation. The authors present the rules of operation of the Federal Accreditation Center, listed regulatory legal documents. Keywords: primary accreditation of specialists, professional development programs, portfolio, Department of Parasitology and Disinfection.

The invention of OCT angiography (OCTA) was a milestone in studying the early stages of diabetic retinopathy (DR). The latest findings show significant changes in foveal avascular zone (FAZ) parameters (FAZ area, FAZ perimeter, acirculatory index, axis ratio, FAZ angle) in diabetes mellitus patients with no ophthalmoscopic signs of DR. Many studies evaluate vessel density in superficial and deep plexuses in these patients using different methods of image processing and different qualitative and quantitative parameters. Nonperfusion areas (NA) are very important findings at the preclinical stage of DR, which can be detected in superficial and deep layers. With OCT-A it is possible not only to reveal them but also to calculate their area. Vascular tortuosity (VT) was described earlier using fundus photography. Nowadays VT can be assessed at the microcirculation level in OCT-A scans. Microaneurysms are the earliest clinical sign of DR. They can be missed in fundus photos, but easily detected with OCT-A. The aim of the current review is to analyze the latest OCT-A findings at the preclinical stage of DR and to discuss the future diagnostic value of OCT-A in DR.

Objective To determine if differences in patient characteristics, treatments, and outcomes exist between children with sepsis who arrive by emergency medical services (EMS) versus their own mode of transport (self-transport). Methods Retrospective cohort study of patients who presented to the Emergency Department (ED) of two large children's hospitals and treated for sepsis from November 2013 to June 2017. Presentation, ED treatment, and outcomes, primarily time to first bolus and first parental antibiotic, were compared between those transported via EMS versus patients who were self-transported. Results Of the 1813 children treated in the ED for sepsis, 1452 were self-transported and 361 were transported via EMS. The EMS group were more frequently male, of black race, and publicly insured than the self-transport group. The EMS group was more likely to have a critical triage category, receive initial care in the resuscitation suite (51.9 vs. 22%), have hypotension at ED presentation (14.4 vs. 5.4%), lactate >2.0 mmol/L (60.6 vs. 40.8%), vasoactive agents initiated in the ED (8.9 vs. 4.9%), and to be intubated in the ED (14.4 vs. 2.8%). The median time to first IV fluid bolus was faster in the EMS group (36 vs. 57 min). Using Cox LASSO to adjust for potential covariates, time to fluids remained faster for the EMS group (HR 1.26, 95% CI 1.12, 1.42). Time to antibiotics, ICU LOS, 3- or 30-day mortality rates did not differ, yet median hospital LOS was significantly longer in those transported by EMS versus self-transported (6.5 vs. 5.3 days). Conclusions Children with sepsis transported by EMS are a sicker population of children than those self-transported on arrival and had longer hospital stays. EMS transport was associated with earlier in-hospital fluid resuscitation but no difference in time to first antibiotic. Improved prehospital recognition and care is needed to promote adherence to both prehospital and hospital-based sepsis resuscitation benchmarks.

Background. Representatives of complex coordination sports are most susceptible to psychoemotional stress, since they demonstrate high sports results already at a young age. The tightening of anti-doping control has significantly reduced the possibility of using pharmacological and biologically active drugs to speed up the recovery of athletes. Against this background, in sports medicine, more attention is paid to the use of non-drug methods to improve performance and recovery in athletes. Aim – to study the efficiency of the introduction of whole-body cryotherapy in the training process of female athletes of complex coordination sports (for example, group gymnastics) to increase stress resistance and reduce violations of adaptation processes as a result of neuropsychiatric overstrain. Materials and methods. During the academic-training year, 22 gymnasts received six ten-day courses of whole-body cryotherapy in the ICEQUEEN cryosauna. 19 athletes were included in the control group. The studies were conducted 3 times: before the start of the procedures, after the first course of procedures, at the end of the training year. The diagnosis of nocturnal bruxism and the definition of the “psychological component of health” were carried out. Total and effective albumin concentrations were determined in the blood serum with the calculation of the albumin binding reserve, helper T-lymphocytes and killer T-lymphocytes with the calculation of the immunoregulatory index. Results. After one course, there was an increase in the functional activity of serum albumins, a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night, and an increase in the “psychological component of health” according to SF-36. After six courses of cryotherapy, the functional activity of serum albumins and the initial values of the immunoregulatory index were preserved by the end of the season, and the “psychological component of health” according to SF-36 was increased, while these indicators decreased in the control group. There was also a decrease in the number of episodes of involuntary contractions of the masticatory muscles at night with an increase in their number in the control group of female athletes. Conclusions. Considering the obtained results, it is possible to recommend the use of whole-body cryotherapy in gymnasts during the preparatory and recovery periods of the annual training cycle in order to increase stress tolerance and prevent psychoemotional overstrain.

The article describes a clinical case of balantidiasis, an invasive protozoal zoonotic disease that is relatively rarely diagnosed in humans. The development of invasion is accompanied by serious risks of penetration of the pathogen into the tissues, as a rule, an erosive and ulcerative process develops in the large intestine. The relevance of invasion remains in modern civilization both in terms of the clinic and treatment, and the epidemiology of balantidiasis. Key words: infusoria, balantidium, infusory dysentery, protozoosis, human parasitic disease.

The purpose of this work is to study the peculiarities of external influence, namely osmotic pressure, on cancer cells. Methods. For this purpose, spatially distributed systems describing the dynamics of a three-dimensional cell lattice, a cell spheroid, and a cell surface have been considered. The studied models are based on the basic principles of hydrodynamics, and their numerical simulation has been performed using a modified Euler method. Results. The paper proposes three-dimensional models to study the dynamics of cancer cells in the epidermal layer of the skin; the models include the possibility of adding additional pressure and changing it with a single parameter. It is shown that it is possible to achieve a slowdown of cancer cell growth in all considered models at certain values of osmotic pressure.

Bariatric surgery is an effective option for managing obesity and has gained general acceptance among patients in recent years. Generally, despite the high caloric intake, a bad nutritional habit of obese people results in the deficiency of several vitamins, minerals, and trace elements essential for body metabolism and normal physiological processes. Additionally, the current bariatric surgical approaches such as sleeve gastrectomy (SG), Roux-en-Y-gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB), and jejunoileal bypass (JIB) can cause or exacerbate these deficiencies. Based on several reports, it appears that the various bariatric surgical procedures affect nutrient absorption differently. Being purely restrictive, LAGB and SG affect the absorption of iron, selenium, and vitamin B12, while RYGB, JIB, and biliopancreatic diversion have a more profound impact on the absorption of essential vitamins, minerals, and trace elements. Nutritional deficiencies in vitamins, minerals, and trace elements may follow bariatric surgery and are associated with clinical manifestations and diseases, including anemia, ataxia, hair loss, and Wernicke encephalopathy. The present review summarizes some of the major vitamin and micronutrient deficiencies associated with bariatric surgery, particularly those presented post-surgically. To avoid any adverse consequences of vitamin and trace element deficiency, proper monitoring and tests are recommended at any stage, from pre- to post-surgery (periodical check-up), followed by specific and individual nutritional supplementation treatments and a proper healthy diet.

Despite the vitrectomy performed for diabetic macular edema (DME), some patients still have symptoms of the disease due to overproduction of VEGF by the ischemic retina, which requires regular administration of an antiangiogenic drug. Studies of the pharmacokinetics of antiangiogenic drugs after vitrectomy in humans have not been carried out. Data from the DRCR.net (Post-Hawk Protocol I) study and real-life clinical practice studies show similar results for anti-VEGF DMO therapy in vitreous eyes and after vitrectomy (2, 7). Purpose. To assess the effectiveness of antiangiogenic therapy with aflibercept for DMO in avitreal eyes in real clinical practice. Methods. The initial and after vitrectomy best corrected visual acuity (BCVA) and central retinal thickness (CRT) were determined according to OCT data, then these parameters were monitored by 1, 3, 6 and 12 months after the start of antiangiogenic therapy with aflibercept. 14 patients (14 eyes) with persistent DME underwent vitrectomy with removal of the internal limiting membrane, in 5 of them the epiretinal fibrosis was removed and 3 of them with a traction retinal detachment that was also removed with air tamponade. Results. Aflibercept intravitreal injections were started with 5 loading doses by 1-11 months after vitrectomy. On average, after 12 months, patients received 7.2 injections, while there was no need for laser surgery of the macular zone. By the end of the study, the CRT decreased by 255 ±86 µm, the BCVA was 0.35 ± 0.2 in comparison with the initial 0.07±0.03 (on a decimal scale). Conclusions. The effectiveness of the anti-VEGF therapy with aflibercept for DME in avitreal eyes was confirmed by an increase in functional (BCVA) and normalization of morphological (CRT on OCT) parameters after the first injections during the period of loading doses. Previous vitrectomies in patients with DMO do not affect the long-term favorable clinical outcomes of anti-VEGF therapy with aflibercept. Key words: vitrectomy, diabetic macular edema, aflibercept, anti-VEGF, OCT, best corrected visual acuity, central retinal thickness.

The article presents clinical data and the results of a detailed pathology changes in a 2-month-old infant who died from a coronavirus infection, confirmed by the results of in vivo PCR and morphological examination, which included the detection of the SARS-Cov-2 spike antigen. Histological examination in the lungs, as well as in the brain revealed cytoproliferative and cytopathic changes similar to those described in coronavirus infection in adults, while other characteristic for them lesions were not determined. The unfavorable course of COVID-19 was facilitated by an activated intrauterine infection, mycoplasmosis or chlamydiosis according to morphological data.

Despite the great interest of the scientific community in the behavior of the human body after contact with the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), long‐term (more than 6 months) monitoring of the immunological status of patients with coronavirus disease 2019 (COVID‐19) having varying severity degrees and of the people with a low SARS‐CoV‐2 viral load is practically absent. The aim of this study is a 9‐month monitoring of SARS‐CoV‐2 infection immune response development and extinction using quantitative assessment of IgA and IgG levels in the blood of healthy donors living in the context of the coronavirus pandemic and of the patients who have undergone COVID‐19. The project involved 180 volunteers, of whom 51 persons (28.33%) fell ill with COVID‐19 during the observation period. All people who underwent COVID‐19 developed a stable humoral immune response but their individual immune status had a number of features. Approximately 39.22% (20 of 51 people) of project participants diagnosed with COVID‐19 showed an unusual change in plasma anti‐SARS‐CoV‐2 IgA levels. Relatively high levels of IgA (ratio ~ 3) after recovery persisted for a long time (more than 6 months). In one‐third (17 of 51 people) of patients with COVID‐19, the IgA level exceeded the IgG level. IgA antibodies appeared earlier and showed a stronger and more robust response to the SARS‐CoV‐2 virus than IgG. Increased levels of anti‐SARS‐CoV‐2 IgA (ratio from 0.8 to 2.36) throughout the observation period were recorded in 28 of 180 project participants (15.56%) of whom only one person fell ill with COVID‐19., Highlights For SARS‐CoV‐2 coronavirus unlike other viruses IgA remains in the blood for a long time.In some patients who recovered from COVID‐19 the IgA immune response was stronger and more stable than IgG.Some healthy people have elevated blood levels of IgA to SARS‐CoV‐2.

We performed comparative analysis of 8-hydroxy-2’-deoxyguanosine in women in different climax stages with and without insomnia. The study involved 90 women aged 45 to 60 years divided into perimenopausal (n=30) and postmenopausal (n=60) groups. After questioning using special sleep questionnaires (Insomnia Severity Index, Epworth Sleepiness Scale, Munich Chronotype Questionnaire), the groups were divided into subgroups with insomnia and without it (control). 8-Hydroxy-2’-deoxyguanosine was assayed in blood serum by ELISA. The higher levels of 8-hydroxy-2’-deoxyguanosine in postmenopausal women with insomnia in comparison with the control and perimenopausal patients (p

The issue of comorbid pathology is the most relevant and requested in recent years. The combined course of gastroesophageal reflux disease (GERD) and chronic obstructive pulmonary disease (COPD) serves as obstacle to successful and rapid recovery of patients in the practice of both general practitioners and other specialists. The aim is to study the change in laboratory tests — Complete Blood Count (CBC), clinical analysis of sputum (CAS) and biochemical analysis at the level of C Reactive Protein and alpha-1-acid glycoprotein (AGP) in patients with mild to moderate GERD with concomitant mild to moderate COPD without risk of adverse events and LF 0–1. Female, male, young and middle-aged patients were examined. Patients were divided into 3 groups: the first group — patients with exacerbation of COPD and existing GERD in remission, the second group — patients with acute GERD and concomitant COPD in remission, the control group with a combination of GERD and COPD without exacerbation, in remission. The study revealed that in the clinical analysis of blood there are increases in hemoglobin, erythrocytes, hematocrit, leukocytes, neutrophils and erythrocyte sedimentation rate in the group of patients with acute COPD. Changes in the level of acute phase parameters were observed in groups of patients with exacerbation. It was found that simple generally accepted laboratory methods are indispensable for differential diagnosis in the presence and exacerbation of the studied comorbid conditions.

Electroencephalogram (EEG) and electromyogram (EMG) traces were made in ten adult subjects in the resting state (eyes open) and on execution of real and imaginary rhythmically repeating movements. Vector autoregression modeling was used to evaluate the directed transfer function (DTF) for six bilaterally symmetrical EEG channels (F1/2, C3/4, and P5/6) and two EMG channels (flexor carpi radialis in the left and right upper limbs). Subjects executed real and imaginary repetitive opening and clenching of the right and left hands. Statistical analysis of DTF averaged in the α and γ ranges, corresponding to top-down and bottom-up corticomuscular influences, showed (1) top-down influences changed in different ways in the α and γ frequency ranges on transition from resting to imaginary and real movements. In the α range, these influences increased on performance of real movements while in imaginary movements they were no different from the resting state. In the γ range, the top-down influence of signals from the left frontal lead on the EMG channel of the right arm increased as compared with the resting state on performance of both real and imaginary movements; (2) that bottom-up influences showed a tendency to change: in real movements, these influences in both frequency ranges were slightly greater than at rest; (3) that bottom-up influences in both the α and γ ranges on imaginary movements displayed a tendency to take up a lower level than in controls; (4) that top-down influences in both frequency ranges were significantly greater than bottom-up influences; (5) that the greatest top-down influences in the α range in both real and imaginary movements were seen in the frontal rather than the central areas.

Introduction. Participation in the sports movement is an effective tool for the full-fledged socialization of people with disabilities. In this regard, one of the socially significant tasks of the state is to ensure the availability of conditions for practicing various sports and adaptive physical culture (APhC) for people with disabilities. Materials and methods. To study the socio-psychological readiness of the family to include a disabled child in APhC classes, a survey was conducted on 67 parents of children with cerebral palsy (CP). CP patients were observed at the National Medical Research Center of Children’s Health of the Ministry of Health of Russia in 2019-2020. The criteria for the inclusion of participants in the group of subjects were the informed consent of the parents, the presence of medical indications, and the absence of contraindications for the child to engage in APhC training. Results. There is presented objective data indicating a positive attitude of respondents to APhC as one of the most effective tools for the development of movements in children. The factors that determine the socio-psychological readiness of parents for this type of rehabilitation are awareness of the child’s health, emotional stability and focus on achieving positive results in the child’s socialization, sufficient adherence to treatment. Socio-psychological factors reducing the likelihood of including children in APhC classes include a pessimistic assessment of the child’s health and social prospects, insufficient awareness of the positive impact of APhC classes on the physical development of a CP child, an incomplete awareness of the institutions in which this type of assistance can be obtained, the place of residence, the low physical activity of parents. Conclusion. The study of the socio-psychological profiles of parents with different motivations for the participation of a CP child in APhC classes proves the need for a differentiated approach to the management of psychological and pedagogical work with parents.

The syndrome of the ectopic production of the adrenocorticotropic hormone (ACTH) presents a version of endogenous hypercorticism which is the most challenging one for diagnostics and treatment. The paper discusses a clinical case of the ACTH-ectopic syndrome diagnosed in an elderly female patient. Advanced age and ongoing long-term treatment may obscure the typical manifestations of a disease. At the same time, it is common for doctors to be less focused on identifying rare diseases when working with elderly patients. A combination of clinical signs (resistance to the antihypertensive therapy; poorly controlled glycemia; increasing weakness; hypokalemia and severe skin pigmentation) allowed for suspecting symptomatic hypertension. Doctors need to be alert and to identify rare diseases among patients of any age group. This case also demonstrates the productivity of a multidisciplinary approach (a team including cardiologists, endocrinologists, radiology specialists and surgeons).