Vol 73, No 4 (2018)

OBSTETRICS AND GYNAECOLOGY: CURRENT ISSUES
MOLECULAR MECHANISMS OF FORMATION OF CHRONIC PELVIC PAIN SYNDROME IN PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS: MARKERS AND TARGETS FOR DIAGNOSIS AND THERAPY (REVIEW)
Nikiforova D.E., Makarenko T.A., Salmina A.B.
Abstract

This article systematizes the results of studies on the pathogenetic mechanisms of CPPS formation in patients with EGE. Pain is one of the severe clinical manifestations and complications of endometriosis. To ease the pain in patients with EGE is complex but urgent task. Long diagnostic search (mean period 5−8 years) leads to the formation of a persistent Autonomous pain syndrome associated with relapses of pain even after a com-prehensive treatment of patients (surgical and/or long-term hormonal). Patients with endometriosis suffer from mixed pain including neuropathic and nociceptive components which is proved by the example of expression in ectopic foci of specific biomarkers. Therefore, the question of early non-invasive diagnosis of endometriosis is very vital and can be solved by the development of a diagnostic panel consisting of biomarkers expressed by ectopic foci at the initial stage of the disease.

Annals of the Russian academy of medical sciences. 2018;73(4):221-228
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BIOCHEMISTRY: CURRENT ISSUES
THE INTENSITY OF LIPID PEROXIDATION PROCESSES IN WOMEN WITH PRIMARY VARICOSE VEINS OF THE PELVIC DEPENDING ON THE STAGE OF THE DISEASE
Kolesnikova, L.I., Semendyaev A.A., Stupin D.A., Darenskaya M.A., Grebenkina [.A., Natyaganova L.V., Danusevich I.N., Cherepanova M.A., Kolesnikov S.I.
Abstract

Background: Information about involvement of general nonspecific reactions, in particular lipid peroxidation processes, in the progression of varicose veins of the pelvic (VVP) in women is still too scarce. Aims: To study the intensity of processes of lipid peroxidation and the activity of components of the antioxidant system in women with primary varicose veins of the pelvic at different stages of the disease. Materials and methods: 167 women of reproductive age were examined ― 137 with VVP and 30 made up a control group. All patients with VVP were divided into 3 groups depending on stages of the disease. Spectrophotometric and fluorometric methods of investigation were used. The study was conducted during 2012−2017. Results: It was revealed that the level of primary products of lipid peroxidation, diene conjugates, increased statistically significantly according to the stage of the disease by 1.25 times (in the 1st stage), 1.51 times (in the II stage) and 1.59 times (in the III stage) values. Changes in the content of final TBA-active products showed similar changes-an increase in the mean values for all stages of the disease relative to control (in 1.24, 1.17, and 1.77 times, respectively). Activity of glutathione peroxidase increased in stage 2 of VVP (1.19 times), with the maximum increase in stage III (1.42 times); activity of glutathione-S-transferase increased 1.18 times in the II stage of the disease. The concentration of GSH in the clinical groups was characterized by lower values with respect to the control (by 1.22 times in the 1st stage, in 1.64 times in the II stage), with the maximum decrease of this parameter in the III stage of VVP (3.67 times). The level of catalase activity increased in the I stage of VVP ― by 1.18 times and decreased in the III stage ― by 1.14 times with respect to the control. The activity of SOD showed similar changes with catalase ― in the form of increased activity at the 1st stage (1.35 times higher) and decreased values for II (1.35 times lower) and III (1.65 times lower) for the stages of VVP to the values of control. Conclusions: At progression of primary VVP in women (from the initial stage to the 3rd stage of the disease), there is an increase in imbalance in the lipid peroxidation − antioxidant defense system. Moreover, if the compensatory increase in activity of antioxidant enzymes is registered at stage 1 of the disease, then the most of the antioxidant defense factors decreases as relative to control values, and the initial stages of the disease.

Annals of the Russian academy of medical sciences. 2018;73(4):229-235
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CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUES
DISTURBANCES OF CARDIOVASCULAR SYSTEM IN PERSONS WITH CHRONIC SPINAL CORD INJURY DURING EXERCISE AND PARTICIPATION IN PARALYMPIC SPORTS
Krassioukov A.V., Mashkovskiy E.V., Achkasov E.E., Kashchenko E.M.
Abstract

Spinal cord injury (SCI) is a devastating condition that affects mostly young and active individuals but also impacts their family members and results in significant challenges for medical care and social integration. In addition to obvious motor impairment (tetraplegia/paraplegia), these individuals also suffer from a variety of less obvious but devastating autonomic nervous system dysfunctions that negatively impact their health and affect various aspects of daily living. Physical training and sports are essential components of rehabilitation and leaser activities for people with disabilities. Number of individuals with SCI who run an active lifestyle is increasing. Physical activity puts an additional stress on various organs and body systems. The presented manuscript describes in detail cardiovascular dysfunctions in physically active individuals with a SCI, including those engaged in Paralympic sports: low resting blood pressure, orthostatic hypotension, arrhythmias, and the phenomenon of «autonomic dysreflexia». We also address issues related to self-induced episodes of autonomic dysreflexia in order to improve athletic performance ― a phenomenon known as «boosting». Boosting may improve sports performance in short term but is associated with the risk of serious cardiovascular disorders and even sudden death. This practice is considered as anti-doping rule violation by the International Paralympic Committee and thus prohibited. Understanding of the changes occurring in the body of a physically active individual after SCI is necessary for general practitioners, neurologists, rehabilitation specialists, sports medicine physicians, as well as for specialists of adapted physical education and sports.

Annals of the Russian academy of medical sciences. 2018;73(4):236-243
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MICROBIOLOGY: CURRENT ISSUES
MOLECULAR REGULATION OF PSEUDOMONAS AERUGINOSA BIOFILMS
Manzenyuk O.Y., Firstova V.V., Mukhina T.N., Shemyakin I.G.
Abstract

Nowadays healthcare-associated infections caused Pseudomonas aeruginosa remain actual problem due to P. aeruginosa resistance to a wide range of antimicrobials and its ability to form biofilms that are 1000 times more resistant to antibiotics than free-living (plankton) cultures. P. aeruginosa biofilms forming is regulated by Quorum Sensing (QS) communication system which is controlled by inhibitors (Quorum sensing inhibitors, QSIs). An essential role in stabilization of biofilms belongs to extracellular DNA (eDNA) as a structural polyanionic polymer whereas its genetic function is not applicable. In addition, internal signal molecules c-di-GMP, cascade Gac/Rsm also participate in formation of P. aeruginosa biofilms. A review provides a detailed description of the biofilm molecular regulation by means of QS inhibitors and QS modulators of signaling molecules QS.

Annals of the Russian academy of medical sciences. 2018;73(4):244-251
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PSYCHOLOGY AND PSYCHIATRY: CURRENT ISSUES
ACTUAL METHODICAL PROBLEMS OF THE ASSESSMENT OF NEGATIVE CONSEQUENCES OF ALCOHOL CONSUMPTION AND WAYS TO SOLVE THEM
Mordovsky E.A., Soloviev A.G., Sannikov A.L.
Abstract

Alcohol consumption enters the list of risk factors for the global population health. It determines the nature of social relations and achieved level of public welfare. Authors of the article claim that some unsolved methodological problems complicate the process of interdisciplinary research on various negative consequences of alcohol consumption. The absence of generally approved interpretation of the nature of the risk factor («alcohol consumption» by an individual or «alcohol abuse»), negative consequences of alcohol consumption, and logical contradictions in theories describing the mechanism of their interaction can be indicated among these problems. The use of alternative approaches to the quantitative assessment of the scale of the negative consequences of alcohol consumption (even within the same scientific discipline) does not provide opportunities to perform a comparative analysis of research results. Basing on a review of methods and results of series of clinical, epidemiological, social, and economic studies, the authors systematize and explain the methodological problems of assessing the scale of the alcohol consumption negative consequences, formulate the principles of solutions. The review results can be used for methodological rationalization of new mono- and interdisciplinary studies on negative consequences of alcohol consumption, critical analysis of previous study results, and correction of activities implemented within the government policies aimed to reduce the alcohol abuse and alcoholism prevention. The presented academic review can be used in planning the new activities implemented within the government policy on alleviation of alcohol abuse and prevention of alcoholism.

Annals of the Russian academy of medical sciences. 2018;73(4):252-261
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ONCOLOGY: CURRENT ISSUES
PROMISING TARGETED THERAPIES GENES AND PROGNOSTIC BIOMARKERS OF GASTRIC CANCER
Kipkeeva F.M., Muzaffarova T.A., Nikulin M.P., Apanovich P.V., Karpukhin A.V.
Abstract

Understanding the molecular genetic features of gastric cancer (GC) and principally the functioning of signaling cascades involved in its occurrence and development is determining for identifying the most promising genes for targeted therapy. On this basis, development and consequent implementation of effective drugs and treatment regimens is conducted. The inductors of signaling paths, the main one of which is the mTOR pathway, and the functioning of the pathway are considered in details. mTOR inductors (angiogenesis factors, epidermal growth factor and their receptors) are most actively studied as therapeutic targets. Particular attention is paid to the consideration of stimulation and development of lymphangiogenesis where not all genes are discovered and examined yet. The possibility of achieving a significant therapeutic effect with simultaneous inhibition of the action of genes of angio- and lymphangiogenesis is considered. The review covers the administered target drugs and pharmaceuticals under investigation for GC therapy, including immunotherapy. The review provides details on the simultaneous activation of several genes ― potential targets of therapy and possible interactions in the development of the tumor process. As a result the combined effect of the simultaneous action of two or more factors can be detected. The possibility of maintaining the activated signaling cascade when one of the activated receptors is blocked in consequence of the action of another expressed receptor is also considered. The article presents information on development of drugs affecting several targets and on effectiveness of combined therapy with different targeted drugs. Essential effectiveness of GC therapy can be achieved by personified treatment including application of molecular classification. The review discusses the prognostic value of target and other genes expression, as well as GC subtypes according molecular classification.

Annals of the Russian academy of medical sciences. 2018;73(4):262-272
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PEDIATRICS: CURRENT ISSUES
MECHANISMS OF NEPHROSCLEROSIS DEVELOPMENT IN CHILDREN WITH VESICOURETERAL REFLUX
Morozova O.L., Litvitskiy P.F., Morozov D.A., Maltseva L.D.
Abstract

The review discusses the issue of reflux nephropathy for specialists of the system of higher medical education: the article provides the definition, characterizes the epidemiology, risk factors for disease development in children with vesicoureteral reflux, causes and molecular mechanisms of renal fibrosis formation and progression in reflux nephropathy, markers for diagnosing and predicting the disease course.

Annals of the Russian academy of medical sciences. 2018;73(4):273-278
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ENDOCRINOLOGY: CURRENT ISSUES
THE ROLE OF HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY − TANDEM MASS SPECTROMETRY IN OPTIMIZING DIAGNOSIS AND TREATMENT OF THYROID DISEASES
Mikhina M.S., Ioutsi V.A., Troshina E.A.
Abstract

Thyroid hormones play an integral role in growth, homeostasis, and maintenance of physiological functions and are necessary for normal development. Therefore, an accurate assessment of thyroid function is important for both diagnosis and treatment of thyroid disorders. Thyroid function is assessed by measuring thyroid-stimulating hormone (TSH) and thyroid hormones: thyroxine (T4), triiodothyronine (T3), total and free fractions. The concentration of thyroid hormones in patients without pathology of the thyroid gland remains constant and correlates with the level of hormones in tissues and their biological effects. However, most circulating hormones are bound to plasma proteins and only a small part is in free form, the most commonly used methods of immunoassay in this connection have limitations. The method of high performance liquid chromatography − tandem mass spectrometry (HPLC-MS/MS) successfully copes with this problem, which allows improving the specificity and accuracy of measurement of thyroid hormones. High performance liquid chromatography − tandem mass spectrometry allows to achieve specificity, accuracy for reliable determination of the level of thyroid hormones, increasing diagnostic capabilities. This method is especially important in the presence of thyroid gland pathology and factors affecting the binding of hormones to the protein.

Annals of the Russian academy of medical sciences. 2018;73(4):279-284
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