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Summary. In connection with the growing volume of scientific data on the genetic problems of generalized epilepsy in recent decades, the ambiguity of the therapeutic tactics and prognosis of this cohort of patients has become obvious based solely on the phenotypic characteristics of the patient. It is known that epilepsies with similar phenotypes show a different genetic nature, different pathogenesis of the development of epileptogenesis and response to therapy. The outcomes also differ, both in terms of seizure control and in terms of cognitive functions.The article presents an overview of the factors that must be taken into account when manifesting childhood absentee epilepsy: the child’s gender, types of seizures, cognitive profile, results of electroencephalography and neuroimaging. Attention is paid to the genes that determine the development of these forms of epilepsy in children.

Abstract Background Captive wild animals in zoos infected with Cryptosporidium spp., Giardia duodenalis, Enterocytozoon bieneusi, and Blastocystis sp. can be sources of zoonotic infections and diseases. Therefore, to investigate the distribution of these pathogens in captive wild animals of zoos in Henan, China, a total of 429 fresh fecal samples were collected from six zoos in Henan, China. The infection rates of Cryptosporidium spp., G. duodenalis, E. bieneusi, and Blastocystis sp. were determined by PCR analysis of corresponding loci. Positive results for Cryptosporidium (C. parvum and C. hominis) were subtyped based on the (gp60) gene. Results The overall prevalence was 43.1% (185/429), and the prevalence of Cryptosporidium, Giardia duodenalis, Enterocytozoon bieneusi, and Blastocystis sp. were 2.8% (12/429), 0.5% (2/429), 20.8% (89/429), and 19.1% (82/429), respectively. Five Cryptosporidium species, namely, C. hominis, C. parvum, C. muris, C. andersoni, and C. macropodum, were identified in this study. Cryptosporidium parvum was further subtyped as IIdA19G1. Two Giardia duodenalis assemblages (A and E) were also identified. A total of 20 Enterocytozoon bieneusi genotypes were detected, including 18 known (BEB6, D, HND-1, CD7, SDD1, Henan-IV, KIN-1, CHK1, Peru8, Henan-V, CHG11, CHG-1, CHS9, CHG21, Type-IV, CHC9, CM5, and CHB1) and 2 novel genotypes (CHWD1 and CHPM1). A total of nine subtypes of Blastocystis sp. (ST1, ST2, ST3, ST5, ST6, ST7, ST10, ST13, and ST14) were identified in captive wild animals in zoos in the present study. Cryptosporidium andersoni, nine Enterocytozoon bieneusi genotypes, and five Blastocystis subtypes were here first identified in new hosts. Conclusions Our study has expanded the host ranges of these four pathogens. The data indicate that animals in zoos can commonly be infected with these four zoonotic pathogens, and animals in zoos are potential sources of zoonotic infections in humans.

Purpose — to analyze the literature data on the benefits of preservative-free medication therapy for glaucoma.Materials and methods. 482 articles in the Pubmed database published from 1975 to 2020 were analyzed using the terms: “glaucoma”, “preservatives”, “preservative-free therapy”, “benzalkonium chloride”. The review includes 78 articles. Inclusion criteria: studies that examined the effect of local antihypertensive therapy on the condition of the ocular surface in comparison with preservative-free drugs.Discussion. BAC is the most common preservative used in ophthalmology, accounting for 70 % of eye drop formulations. But it has a pronounced toxic effect on the ocular surface, so other classes of preservatives have been developed. These include polyquaternium-1 detergent; oxidizing preservatives — stabilized oxychlorocomplex and sodium perborate; ionic buffer preservative. However, most of the publications are devoted to BAC, as it is considered the most toxic and, at the same time, the most commonly used preservative. There is a large number of switching studies from preservative therapy to preservative-free, in which almost all groups of drugs used for the treatment of glaucoma were studied, but the use of antihypertensive drugs is associated not only with the action of preservatives, but also with the active substance, excipients and buffers. However, most switching studies demonstrate the benefits of preservative-free drugs. Other studies compared preservative and preservative-free drugs with the same active ingredients, in which a comparable hypotensive effect and safety profile was revealed, which indicates that BAC is not required for adequate penetration of the active substance to the point of application. At the same time, statistically significant advantages in the tolerability of preservativefree therapy were also revealed.Conclusion. Glaucoma preservative therapy has a toxic effect on the ocular surface, which leads to a decrease in the quality of life and compliance. Switching to preservative-free drugs can help reduce iatrogenic complications during long-term treatment of patients with glaucoma

Abstract Water‐soluble, stable nanoparticles of elemental sulphur with a size of 9‐52 nm have been synthesised using the stabilising potential of starch. Sulphide anions were used as sulphur precursors that were generated earlier from the bulk powder sulphur in the base‐reduction system NaOH‐N2H4·H2O followed by their oxidation with molecular oxygen to element sulphur atoms. Using a set of modern spectral and microscopic methods (XRD, optical spectroscopy, DLS, TEM), the phase state, elemental composition of the nanocomposites and their nanomorphological characteristics have been investigated. It was found that nanocomposites are formed as sulphur particles with the shape which is nearly spherical dispersed in the polysaccharide starch matrix with a pronounced tendency to cluster into ring formations. Water solubility and stability of the obtained nanoparticles is ensured by sorption of starch macromolecules on the surface of sulphur nanoparticles, with the thickness of the stabilising shell in a range of 10‐171 nm. In vitro experiments were carried out to study the anti‐microbial activity of the obtained sulphur nanocomposite (1.6% S) using the propidium iodide fluorescent dye staining method and the diffusion method. It showed that the water solution of the starch‐capped sulphur nanoparticles at the concentration of 6.25 µg/ml had a pronounced anti‐phytopathogenic activity against the potato ring rot pathogen Clavibacter michiganensis subsp. sepedonicus.

The review analyzes current literature data on the relationship between gender and glaucoma incidence, and assesses the demographic and behavioral factors that may contribute to gender differences. Potential risks for the development and progression of glaucoma in men and women have been identified in numerous studies, the main ones being age, gender, and race. The prevalence of glaucoma in the world among people aged 40 to 80 years is higher than in other age groups and will grow steadily. Women are more likely to suffer from closed-angle glaucoma, while primary open-angle glaucoma is more common in men. Further genetic studies of this disease will provide a better understanding of the underlying pathomorphic mechanisms and may improve therapeutic approaches in the future. Individuals with the highest risk of developing glaucoma should be checked by an ophthalmologist in time for early detection and slowing the progression of the disease.

The results of the diagnosis of cognitive impairments in patients with endocrinological and cardiological profiles are presented. The Montreal MoCA test was used to assess cognitive functions.

E.A. Egorov1, V.E. Korelina2, D.V. Cherednichenko3, I.R. Gazizova3 1Pirogov Russian National Research Medical University, Moscow, Russian Federation 2LLC "American Medical Clinic", St. Petersburg, Russian Federation 3N.P. Bekhtereva Institute of the Human Brain, St. Petersburg, Russian Federation This article reviews recent studies on the etiology and pathogenesis of primary open-angle glaucoma (POAG). POAG is now considered a neurodegenerative disease associated with neuroinflammation. Neuroglia plays a key role in the development of neuroinflammation. In impaired homeostasis, microglia is activated to prevent retinal alterations triggered by glutamate excitotoxicity. Macrophages, being still active, release cytokines in the extracellular space and produce matrix metalloproteinases. The result is an increased degradation of collagen fibers of the lamina cribrosa and development of glaucomatous optic neuropathy. Macroglia (astrocytes and Muller cells) are also involved in retinal immunoregulation. Astrocytes produce neurotrophic brain factor which promote the survival of damaged neurons. Additionally, these cells secrete fibrillar proteins that regenerate the extracellular matrix but form a glial scar, thereby inhibiting axonal transport and limiting t he regeneration of damaged axons. The activation of microglia and macroglia in glaucoma precedes the loss of retinal ganglion cells. Determining the activity of retinal ganglion cells helps identify specific biomarkers of early glaucoma. Early diagnosis of POAG prevents irreversible damage. The authors discuss potential ways to regulate the activity of glia by stimulating the release of neurotrophic factors and suppressing glia hyperactivity. Keywords: primary open-angle glaucoma, neurodegenerative disease, neuroinflammation, macroglia, microglia, neurotrophic factors. For citation: Egorov E.A., Korelina V.E., Cherednichenko D.V., Gazizova I.R. Role of neuroinflammation in the pathogenesis of glaucomatous optic neuropathy. Russian Journal of Clinical Ophthalmology. 2022;22(2):116–121 (in Russ.). DOI: 10.32364/2311-7729-2022-22-2-116-121.

Objective: To evaluate the effectiveness of ozone therapy in the combination of arterial hypertension (AH) and gastropathy in miners. Methods: Two groups of male miners with AH and gastropathy were analyzed: group I – 43 miners aged 47.4±1.3 years with work experience of 27.9±1.9 years and group II – 42 miners aged 46.9±1.4 years with work experience of 27.1±1.8 years. Group II received drug treatment only, and group I, in addition, received ozone therapy. An ozone-oxygen mixture was administered intravenously in an amount of 200-400 ml with an ozone concentration in a solution of 1-1.5 mg/l five times every other day. To assess the effectiveness of the ozone therapy, the lipid profile was studied, the level of blood pressure was monitored, and fibrogastroduodenoscopy was performed. Patients were examined before the start of the course of ozone therapy, control examinations were carried out on the 12th day from the moment of treatment. Results: In both groups, individuals with grade I AH showed a statistically significant (p

NEET (not in employment, education, or training) unemployment is one of the newer, most relevant, and least studied modern features of the youth labor market, making it an urgent problem to be solved. The purpose of this study is to identify the barriers to creating productive employment in the youth labor market, with a view to reducing the NEET youth segment in Kazakhstan. Our aim is to identify the impact of employment and unemployment parameters in the youth labor market in order to reduce the NEET youth segment in Kazakhstan. The article analyzes the indicators of youth participation in the labor force, defines the features of the youth labor market based on segmentation by age, and identifies the dynamics of youth employment, including the type of economic activity. Particular attention is paid to the NEET youth category in Kazakhstan, providing a comprehensive analysis of the dynamics of the youth labor market for the period 2001–2021. The portrait of Kazakhstani youth in the category of NEET unemployment was determined based on an analysis of labor market indicators. Our study identifies the barriers to generating productive youth employment, allowing policymakers to reduce the NEET youth segment in Kazakhstan.

Autoimmune polyglandular syndrome type 3 (APS type 3) is a combination of autoimmune thyroid damage in combination with one or more autoimmune endocrine or non-endocrine diseases. It is represented by three subtypes: APS 3A (graves ‘ Disease, or Hashimoto’s thyroiditis and type 1 diabetes mellitus), APS 3B (autoimmune thyroid disease and pernicious anemia), APS 3C (autoimmune thyroid disease and vitiligo, alopecia, and/or other organ-specific autoimmune diseases). Clinical observations of patients with type 3 APS are presented: characteristic clinical syndromes and clinical and laboratory characteristics of patients. These clinical examples demonstrate the importance of thorough examination, alertness and knowledge of endocrinologists about the possibility of developing polyglandular lesions of the endocrine system, the importance of timely prescribed treatment and interdisciplinary interaction of doctors.

The paper presents findings from psycholinguistic research with normally developing preschool Tatar-Russian bilingual children between the age of 4;0 to 6;0 years old. Forty children in total- twenty children between the age of 4;0 -5;0, and twenty children between the age of 5;0-6;0 were tested. Children with language impairment and mental disabilities were excluded from the study. All children attend a polylingual kindergarten, where the children learn in organized way the following three languages: their mother tongue - the state language of the Tatarstan - the Tatar language, Russian - the official language of the Russian Federation to which Tatarstan belongs, and English. The children were tested with two types of language tests: Syntactic test (wh-complement tests) and mix Tatar-Russian vocabulary test (comprehension and production). They were also tested with a psychological non-verbal Knock Tap test. All children were tested individually in a separate room by a native Tatar speaking and Russian speaking researcher. In order to avoid the influence of the language of testing on the results half of the children were tested with part of the tests in Tatar language and the other part in Russian language. The next day they were changing the languages and the tests. The research question we try to answer is: Do the children develop balanced bilingualism in the kindergarten age having in mind the educational system they are involved in or they are dominant in one of the two languages. The results of the children are analyzed with the ANOVA and SPSS Statistics. They show that the older children are better in all tests. Regarding the language the younger children show poor results in Tatar and better results in Russian. The older children show equally good results in both languages. The paper discusses the classical theory of Skutnabb-Kangas (1981) and newest findings of Bialystok (2020) regarding the bilingualism and bilingual education from early ages and which factors play important role in successful development of balanced bilingualism from early age.

As known, there are changes in the biomechanical properties of the fibrous tunic in glaucoma. This is also due to the imbalance between the formation and loss of collagen fibers. The cornea is a highly sensitive tunic of the eyeball, endothelium is one of the target organs in the formation of pathological changes in primary open-angle glaucoma, and endothelial dysfunction, according to many authors, plays a significant role in its pathogenesis. The unintended consequences of glaucoma surgery lead to a progressive loss of corneal endothelial cells, which can lead to corneal decompensation. In the proposed literature review, we analyzed more than 30 publications by authors representing the results of multicenter studies of the pathological effects of antiglaucoma operations on the corneal endothelium in patients with various types of uncompensated glaucoma. The analysis of both classic fistulizing type operations and modern, so-called micro-invasive techniques (MIGS), including the use of various drains and devices, is presented. Thus, the smallest decrease in the density of endothelial cells was noted during deep sclerectomy and trabeculectomy. The use of mitomycin C in glaucoma surgery significantly improving the prognosis, but increases the loss of endothelial cells in both high and low concentrations. The highest rates of loss of corneal endothelial cells are noted during using valves and shunts. Ex-PRESS shunt implantation is associated with a significant loss of corneal endothelial cell density in the immediate area to the drainage tube, and therefore, shunt implantation should not be considered as an option for eyes with corneal dysfunction. In addition, the authors prove that the drainage device changes its position in the anterior chamber, especially when performing massage and self-massage of filtration bleb, which leads to a greater loss of density of corneal endothelial cells.

Abstract Background Triphalangeal thumb-polysyndactyly syndrome (TPT-PS) is a rare well-defined autosomal dominant disorder characterized by long thumbs with three phalanges combined with pre- and postaxial polydactyly/syndactyly of limbs. By now, the syndrome has been reported in several large families from different ethnic backgrounds, with a high degree of inter- and intrafamilial variability. The genome locus responsible for TPT-PS has been mapped to the 7q36.3 region harboring a long-range sonic hedgehog (SHH) regulatory sequence (ZRS). Both single-nucleotide variants and complete duplications of ZRS were shown to cause TPT-PS and similar limb phenotypes. TPT-PS usually forms as isolated limb pathology not associated with additional malformations, in particular, with cardiovascular abnormalities. Case presentation Here we report on a rare Russian neonatal case of TPT-PS combined with severe congenital heart disease, namely double outlet right ventricle, and microphthalmia with optic disc coloboma. Pedigree analysis revealed TPT-PS of various expressivity in 10 family members throughout five generations, while the cardiac defect and the eye pathology were detected only in the proband. To extend the knowledge on genotype–phenotype spectrum of TPT-PS, the careful clinical and genomic analysis of the family was performed. High-resolution array-based comparative genomic hybridization (array-CGH) revealed a ~ 300 kb microduplication of 7q36.3 locus (arr[GRCh37] 7q36.3(156385810_156684811) × 3) that co-segregated with TPT-PS in the proband and her mother. The duplication encompassed three genes including LMBR1, the intron 5 of which is known to harbor ZRS. Based on whole-exome sequencing data, no additional pathogenic mutations or variants of uncertain clinical significance were found in morbid cardiac genes or genes associated with a microphthalmia/anophthalmia/coloboma spectrum of ocular malformations. Conclusions The results support the previous data, indicating that complete ZRS duplication underlies TPT-PS, and suggest a broader phenotypic impact of the 7q36.3 microduplication. Potential involvement of the 7q36.3 microduplication in the patient’s cardiac and eye malformations is discussed. However, the contribution of some additional genetic/epigenetic factors to the complex patient`s phenotype cannot be excluded entirely. Further comprehensive functional studies are needed to prove the possible involvement of the 7q36.3 locus in congenital heart disease and eye pathology.

Application of genetically encoded biosensors of redox-active compounds promotes the elaboration of new methods for investigation of intracellular redox activities. Previously, we have developed a method to measure quantitatively the intracellular concentration of hydrogen peroxide (H2O2) in living cells using genetically encoded biosensor HyPer. In the present study, we refined the method and applied it for comparing the antioxidant system potency in human cells of different phenotypes by measuring the gradient between the extracellular and cytoplasmic H2O2 concentrations under conditions of H2O2-induced external oxidative stress. The measurements were performed using cancer cell lines (K-562 and HeLa), as well as normal human cells – all expressing HyPer in the cell cytoplasm. As normal cells, we used three isogenic lines of different phenotypes – mesenchymal stem/stromal cells (MSCs), induced pluripotent stem cells (iPSCs) derived from MSCs by reprogramming, and differentiated iPSC progenies with the phenotype resembling precursory MSCs. When exposing cells to exogenous H2O2, we showed that at low oxidative loads (50 μM of H2O2), which caused the exhaustion of thioredoxin activity in the cell cytoplasm, the gradient stabilized, pointing out that it is the functional status of the thioredoxin-depended enzymatic system that drives the dependence of the H2O2 gradient on the oxidative load in human cells. At high H2O2 concentrations, the cytoplasmic H2O2 level in cancer cells was found to be several hundred times lower than the extracellular one. At the same time, in normal cells, extracellular-to-intracellular gradient amounted to thousands of times. Upon reprogramming, the potency of cellular antioxidant defense increased. In contrast, differentiation of iPSCs did not result in the changes in antioxidant system activity in the cell cytoplasm, assuming that intensification of the H2O2-detoxification processes is inherent to a period of early human development.

Despite the large amount of information, the WHO-announced pandemic of the new coronavirus infection (COVID-19) remains poorly understood. Discussions are continuing about the possibility of transmission of the infection through the eye, about methods of protecting medical personnel and patients, clinical manifestations, methods of diagnosis, prevention and treatment, and organization of ophthalmic medical care under epidemiological restrictions. The proposed literature review is an attempt to provide new data on the problem of COVID-19 in ophthalmology.

A clinical observation of a patient with Swyer's syndrome is presented. The article presents anamnesis data, phenotypic signs, clinical symptoms and objective data of the patient, the results of instrumental and hormonal studies, on the basis of which doctors of different specialties may suspect a violation of sex formation with XY gonadal dysgenesis.

Purpose. To study the influence of personal protective equipment (PPE) of the respiratory and visual systems on the development and progression of dry eye syndrome (DES) and its relationship with other risk factors for medical workers.Patients and methods. The data of 243 people (male — 22.2 %, female — 77.8 %) were analyzed as part of a multi-center analytical scientific one-step study. Total tear production (Schirmer I test) was studied at the beginning and the end of the working day in persons used PPE of respiratory system (disposable medical face mask, gauze masks or different types of respirators), as well as PPE of the eyes (protective half-closed/closed glasses or protective screens). Risk factors for the development and progression of DES were registered (age, smoking, systemic hormones intake, soft contact lenses), as well as the use of artificial tears.Results. A decrease in the Schirmer I test score at the end of a 7–8 hour work shift was found by an average of 3 mm (from 13 (9; 16) mm to 10 (6; 15) mm, p < 0.001). Statistically significant changes were typical mainly for medical personnel (p < 0.001) with the maximum severity in persons working in outpatient sector. The presence of at least one DES risk factor was found in 30.5 % of patients, two factors — in 3.0 %, and three or more — in 7.0 %. There was no influence of risk factors on the degree of changes in total tear production. Reduced tear production is typical for some PPE of respiratory system (disposable masks and respirators) and the eye (screens and half-closed glasses) (p < 0.001). In people who do not use PPE of the eye, significant changes were detected only in the presence of risk factors.Conclusion. The negative influence of various PPE of the respiratory system and eye on the total tear production was established. The decrease in the results of the Schirmer I test by the end of the working day was 20–25 % of the basic level, regardless of the presence of traditional risk factors for DES. The severity of changes depended on the type of PPE used. The data obtained are particularly relevant during the new COVID-19 coronavirus pandemic and justify the need to establish specific prophylactic measures. One of the possible methods is the preventive use of artificial tears.

Modern multicenter studies of psychological features proper to glaucoma patients reveal the presence of physiological and psychological issues associated with the condition. A high level of anxiety causes a clinically significant increase of intraocular pressure. The incidence of depression and anxiety in older people with visual impairments is twice as high as in older people in general. Damaged visual field has an even more adverse effect on the quality of life than deterioration in visual acuity, especially when the visual field defect is localized in the lower hemisphere. The failure to comply with the prescribed antihypertensive regimen may be due to patients' disbelief in a successful outcome of the disease, a low level of trust towards the doctor, poor education, low monthly income, side effects of local antihypertensive therapy, the type of drugs used and their amount.

Relevance. All technological processes occurring in the reservoir, wellbore and in the system for collecting and preparing oil, gas and gas condensate require knowledge of the physicochemical properties of the well production. These parameters are associated with hydrocarbon reserves, changes in composition of the reservoir mixture, the rate of water intrusion into the reservoir, partial pressure of individual components, well construction, hydraulic losses, selection of the optimal operation mode, etc. All technological processes of extraction, collection, preparation and transportation are accompanied by continuous changes in pressure and temperature, which directly affect the properties of products, «PVT-properties». The lack of ideas about the physicochemical properties and phase transformations occurring when the temperature and pressure conditions change in multicomponent systems leads to adoption of incorrect technological decisions, occurrence of complications during the well operation and, consequently, decrease in the efficiency of field development. Therefore, it is important to be able to predict the change in pressure and temperature and calculate the PVT-properties along the fluid flow path. The aim of this work is to calculate and analyze changes in the PVT-properties of the produced products and the temperature along the well length. Methods. The Standing method, developed in the USA as a result of numerous studies of oil and gas samples, was used to calculate oil density and viscosity, oil volume factor, solubility, and supercompressibility factor; the Alves method was used to calculate the temperature change curve over the well depth. Findings. The solubility of gas increases linearly with increasing pressure, which also leads to increase in gas content and, accordingly, the volume factor. The increase in oil gas content results in its turn in density gradual decrease. Temperature increase along the wellbore leads to decrease of oil viscosity. The development of analytical methods for predicting temperature in a well over depth is complicated by the need to take into account the thermophysical properties of rocks, reservoir fluids, which have to be neglected, as is the case with the Alves method. This inevitably results in discrepancies between actual and theoretical temperature values.

Abstract Background Enterocytozoon bieneusi is a parasite that infects humans and a wide range of other animals. The large migratory waterfowl, the whooper swan (Cygnus cygnus), travels through many cities during its migration and can spread parasites. Despite receiving increasing attention worldwide, there have been no reports of E. bieneusi infection occurring in C. cygnus. Therefore, this study aims to assess the prevalence and genetic characteristics of E. bieneusi in C. cygnus in Sanmenxia, China. Methods Altogether, 467 fresh fecal samples were collected in the Swan Wetland Park in Sanmenxia, China. Genomic DNA was extracted from fresh fecal samples (n = 467) and E. bieneusi was identified by nested PCR amplification of the internal transcribed spacer (ITS) region. ITS-positive sequences were aligned and phylogenetically analyzed to determine the genotypes of E. bieneusi. Results The overall prevalence of E. bieneusi in C. cygnus was 7.49% (35/467). Sequencing of the 35 positive samples revealed eight known genotypes (EbpA, EbpC, Henan-III, Henan-IV, BEB6, CD9, Peru6 and PtEb IX) and three novel genotypes (CSW1, CSW2 and CSW3). The phylogenetic tree constructed from the ITS sequences showed that seven genotypes (Peru6, EbpA, EbpC, Henan-III, CSW3, Henan-IV and CSW1) clustered within the zoonotic Group 1 while the remaining novel genotype CSW2 clustered within Group 5. Conclusions To our knowledge, this is the first report of E. bieneusi in C. cygnus. Of public health significance, our results suggest that migratory C. cygnus might play an important role in the water-borne transmission of E. bieneusi. Effective strategies will be necessary to control E. bieneusi infection in C. cygnus, other animals and humans.

Aim: to work out an approach of preoperative drug preparation for CAD patients with low LVEF and varying degrees of compensation for CHF, to study the possibility of using levosimendan (L) in this preparation. Materials and methods. We studied 82 patients with severe angina pectoris, multivascular coronary disease, extensive postinfarction zone, LVEF ≤35%, chronic heart failure and proven viable myocardium, which performed CABG. All patients received long - term standard CHF therapy before surgery: loop diuretic, ACE/ARA, beta - blocker, aldosterone antagonist. In the first, retrospective part of the study (39 pts), it was determined which factors could be associated with perioperative AHF. In the second, prospective part (43 pts), the course of the operation and the early postoperative period in patients with compensated and uncompensated heart failure were compared; uncompensated pts received L 2 days before surgery in addition to standard therapy. The third, retro - prospective part of the study (37 pts) was the assessment of operation outcome in patients only with uncompensated pre - operative CHF, but with different preoperative drug preparation. Results. Statistically significant direct influence on the perioperative AHF development was provided by the combined clinical sign - venous pulmonary congestion+orthopnea (p

The main purpose of glaucoma treatment is to reduce the intraocular pressure (IOP) to a target level. One of the pathogenetically justified method of treatment for various types of glaucoma, first of all its refractory forms, is the surgery on the ciliary body. A purpose of such manipulations is to suppress excessive formation of aqueous humor. Previously, diode laser cyclophotocoagulation was widely used, which is mainly applied in terminal glaucoma. Technological innovations have led to the development of perspective, more safe, and less destructive methods of cyclodestructive anti-glaucomatous operations, such as micro-pulse diode cyclophotocoagulation, endoscopic cyclophotocoagulation, and ultrasound cyclodestruction. During micro-pulse cyclophotocoagulation, the effect of laser energy occurs by short pulses at rest intervals, which significantly reduces the absorption of energy by surrounding tissues and their associated damage. With endoscopic cyclophotocoagulation, the epithelium of the ciliary processes is directly coagulated, which makes it possible to dose laser energy under visual control. Ultrasonic cyclodestruction causes a coagulation necrosis of the ciliary processes with a very insignificant collateral damage of surrounding tissues. Today these surgical techniques are becoming more relevant in the treatment of refractory glaucoma in order to preserve visual functions. This review is an analysis of modern literature, reflecting the efficacy and safety of cyclodestructive operations with sufficiently high visual functions.

The younger generation, as an integral part of any society, is the future of our country. The living conditions of people completely depend on the preferences of young people. Therefore, the question of the values and orientations of modern youth is becoming increasingly important in order to preserve the ecological balance in nature. The solution of the environmental problem is impossible without the awareness of the importance of this problem by the younger generation. In order to accurately define the role and significance of ecological consciousness in overcoming modern global environmental problems, it is necessary to first determine what is meant by ecological consciousness.

Currently, the mitochondrial component is becoming increasingly significant in the development and progression of glaucoma optic neuropathy. Since mitochondria have their own genetic apparatus, the study of qualitative and quantitative changes in mitochondrial DNA (mtDNA) becomes part of the disease diagnosis, in addition to studying the functional characteristics of the organelles alone. Moreover, the inability to explain the nature of the disease by known mutations of nuclear DNA contributes to the the study of mtDNA. In this review, we briefly discuss the mitochondrial genetics and the role of mitochondrial haplogroups in the diseases manifestation. We summarize the accumulated data on the qualitative and quantitative changes in mtDNA in patients with glaucoma. We discuss the approach to prevent the inheritance of mutant mtDNA as a part of assisted reproductive technologies, as well as the first steps towards the mtDNA heteroplasmy level manipulation and direct mtDNA editing.

V.E. Korelina1, I.R. Gazizova2, A.V. Kuroyedov3,4, M.D. Didur2 1LLC “American Medical Clinic”, St. Petersburg, Russian Federation 2N.P. Bekhtereva Institute of the Human Brain, St. Petersburg, Russian Federation 3P.V. Mandryka Military Clinical Hospital, Moscow, Russian Federation 4Pirogov Russian National Research Medical University, Moscow, Russian Federation The novel coronavirus infection (COVID-19) provides powerful effects on all pathogenic aspects of the primary open-angle glaucoma (POAG). The property of this virus to initiate disseminated intravascular coagulation, damage endotheliocytes, and impair coagulation result in numerous severe complications affecting all organs and systems. This disorder provokes retinal ischemia and hypoxia and spurs apoptosis of ganglionic cells. Cytokine storm and oxidative stress resulting from the COVID-19 potentially contribute to the progression of glaucomatous optic neuropathy. Distressing effect of the pandemic, a growing number of patients with depressive and anxiety disorders increase the risk of POAG and ocular hypertension, reduce treatment compliance, and exacerbate glaucoma course. Ophthalmic patients should be informed on potential risks and consequences of the COVID-19 and educated on the safety and efficacy of vaccination and the need for these preventive measures for elderly patients (in particular, with glaucoma). A year of the COVID-19 pandemic has radically changed the attitude to many processes of doctor-patient relationships. There is a need for the development of the technologies of distant monitoring of patients with glaucoma. Keywords: primary open-angle glaucoma, COVID-19, telemedicine, pandemic, SARS-CoV-2, cytokine storm, oxidative stress, intraocular pressure, apoptosis of ganglionic cells, glaucomatous optic neuropathy, post-COVID-19 syndrome. For citation: Korelina V.E., Gazizova I.R., Kuroyedov A.V., Didur M.D. Glaucoma progression during the COVID-19 pandemics. Russian Journal of Clinical Ophthalmology. 2021;21(3):147–152 (in Russ.). DOI: 10.32364/2311-7729-2021-21-3-147-152.

O.S. Myakonkaya1, A.S. Sarkisyan1, A.V. Seleznev2, A.V. Kuroyedov3,4, I.R. Gazizova5 1Volgograd Branch of the S.N. Fedorov NMRC “MNTK “Eye Microsurgery”, Volgograd, Russian Federation 2Ivanovo State Medical Academy, Ivanovo, Russian Federation 3P.V. Mandryka Military Clinical Hospital, Moscow, Russian Federation 4Pirogov Russian National Research Medical University, Moscow, Russian Federation 5N.P. Bekhtereva Institute of the Human Brain, St. Petersburg, Russian Federation Prevention of blindness and low vision resulting fr om the progression of glaucomatous optic neuropathy (GON) depends mainly on the early diagnosis of glaucoma. Loading and unloading tests which create conditions for intraocular pressure (IOP) fluctuations are important for the early diagnosis of glaucoma. Stress tests for glaucoma lead to a short-term IOP rise and help identify symptoms that are questionable under normal conditions. Stress tests include water-drinking test, position test, dark room test, dentation test, pharmacological mydriasis, corticosteroid provocative test, etc. Unloading tests are reasonable if the IOP level is the upper normal lim it or slightly higher. Unloading tests include glyceryl ascorbate test, test with acetazolamide, and instillations of IOP-lowering medications (e.g., M-cholinomimetic or prostaglandin analog). Visual changes accompanying loading and unloading tests are recorded by visual acuity measurement, IOP measurement (tono metry and tonography, visual field testing (campimetry, angioscotometry), adaptometry, retinal tomography, and electrophysiology (visually evoked potentials). Studies are currently underway to develop novel modifications of diagnostic tests using modern high-tech controlling tools. These advances increase the informative value of these tests which are relevant for both early diagnosis and stabilization of glaucoma course. This review article summarizes currently available data on the informative value of loading and unloading tests. Keywords: glaucoma, intraocular pressure, loading tests, unloading tests, early diagnosis of glaucoma. For citation: Myakonkaya O.S., Sarkisyan A.S., Seleznev A.V. et al. State-of-the-art of loading and unloading tests for glaucoma: potentialities and informative value. Russian Journal of Clinical Ophthalmology. 2021;21(3):153–158 (in Russ.). DOI: 10.32364/2311-7729-2021-21-3-153-158.

This article presents a clinical case in a woman with a full two-legged uterus. This pathology in the patient was revealed by ultrasound examination in 2013. There is one spontaneous miscarriage in the anamnesis; later, the patient did not become pregnant with regular sexual activity without contraception. A comprehensive examination of the patient was carried out. It was decided to conduct a hysteroscopy, during which one cervical canal was identified, in the area of the internal pharynx, a division into two hemipolostas was visualized. In the future, the patient underwent Strassmanns reconstructive plastic surgery, which is the gold standard for this pathology. Laparatomic metroplasty is a safe and effective procedure for women with a bicornuate uterine malformation. The postoperative period was uneventful. A year later, the patient became pregnant in the natural cycle. Pregnancy proceeded without complications, culminating in the birth of a healthy child.