Building a dictionary of Russian legal terminology

The work presented in this article aims towards a description of the contemporary lexicon of Russian jurisprudence in the 21st century. Legal concepts and terms in the current Russian legal terminology tend to shift within the discursive field, which makes it difficult to systematize legal vocabulary. The lexicon presented in the current study is selected based on the principle of frequency. It is presented as a polylinguistic thesaurus which displays semantics as well as possible use cases in different spheres within the legal field. The terminological system of contemporary Russian law is based in Latin, and this base is still significant for today’s complex world of legal education. The work presented in this article gives educators a tool for quickly correcting terminological errors

Multiagonists of the “incretin axis” as a promising tool for managing cardiometabolic risk in visceral obesity

Currently, the world experiences an increase in obesity prevalence, resulting in an increase in the incidence of diseases in which it is one of the leading factors, primarily type 2 diabetes and cardiovascular disease. This limits the effectiveness of preventive measures and determines the need to introduce more effective approaches. Evidence of the key role of intestinal peptide hormones (incretins) in the normalization of body weight and metabolic processes after bariatric interventions became the basis for studying pharmacological methods for treating obesity and related complications aimed at the “incretin axis”. In order to achieve greater efficacy compared to monotherapy with glucagon-like peptide-1 (GLP-1) agonists, studies are performed on unimolecular multiagonists developing on the basis of GLP-1 agonists and effecting on various components of the “incretin axis” by competitive activation of numerous receptors, in first of all, receptors for glucose-dependent insulinotropic polypeptide and glucagon. This review analyzes the results of clinical trials and discusses the prospects for introduction of “incretin axis” multi-agonists for patients with visceral obesity syndrome

ЭПИКАРДИАЛЬНОЕ ОЖИРЕНИЕ КАК ОДИН ИЗ ОСНОВНЫХ КРИТЕРИЕВ МЕТАБОЛИЧЕСКИ ТУЧНОГО ФЕНОТИПА ОЖИРЕНИЯ И ПРЕДИКТОРОВ СУБКЛИНИЧЕСКОГО АТЕРОСКЛЕРОЗА

Aim. To assess the effect of epicardial obesity on the development of dyslipidemia and polyvascular subclinical atherosclerosis, and to assess the prognostic significance of various obesity criteria in the development of cardiovascular risk.Methods. Male patients with arterial hypertension and without clinical symptoms of atherosclerosis of any localization and type 2 diabetes were included in the study. All the patients were enrolled into two groups, depending on the metabolic phenotypes of obesity assessed by epicardial fat thickness and body mass index. Both groups were comparable in waist circumference. All patients in both groups had abdominal obesity (AO≥94 cm). The study groups underwent a comparative assessment of parameters of lipid metabolism and levels of Apo-proteins. Coronary atherosclerosis was measured with multispiral computed tomography. Atherosclerotic lesions of brachiocephalic arteries were assessed by duplex scanning was performed. Epicardial fat thickness was measured by echocardiography.Results. Significant relationships between epicardial obesity and the development of dyslipidemia and polyvascular subclinical atherosclerosis have been determined. Waist circumference and body mass index have low prognostic significance for developing cardiovascular risk. Conclusion. Epicardial obesity significantly affects the development of subclinical atherosclerosis of the coronary and brachiocephalic arteries. The assessment of cardiovascular risk in patients with arterial hypertension and without other diagnosed cardiovascular diseases reported that it is necessary to measure epicardial fat thickness along with traditional risk factors. Epicardial fat thickness is considered to be a criterion for visceral obesity, contributing to the development of cardiometabolic disorders. Цель. Изучить влияние эпикардиального ожирения (ЭО) на развитие дислипидемии и мультифокального субклинического атеросклероза, а также оценить прогностическую значимость различных критериев ожирения в формировании сердечно-сосудистого риска (ССР).Материалы и методы. В исследование вошли мужчины с артериальной гипертензией (АГ) и отсутствием клинических проявлений атеросклероза любых локализаций, сахарным диабетом 2 типа. Обследуемые были разделены на две группы в зависимости от метаболических фенотипов ожирения по показателям толщины эпикардиальной жировой ткани (ЭЖТ) и индекса массы тела (ИМТ). Обе группы были сопоставимы по величине окружности талии (ОТ) и имели абдоминальное ожирение (ОТ ≥94см). В группах проводилась сравнительная оценка показателей липидного обмена, Апо-белков, а также оценка атеросклероза коронарных артерий методом мультиспиральной компьютерной томографии и брахиоцефальных артерий при помощи дуплексного сканирования. Толщина ЭЖТ определялась методом эхокардиографии.Результаты. Выявлена значимая взаимосвязь ЭО с развитием дислипидемии и мультифокального субклинического атеросклероза. Установлена низкая прогностическая значимость ОТ и ИМТ в формировании ССР.Заключение. ЭО оказывает значимое влияние на формирование субклинического атеросклероза коронарных и брахиоцефальных артерий. При оценке ССР у пациентов с АГ без других установленных сердечнососудистых заболеваний наряду с традиционными факторами риска необходимо измерять толщину ЭЖТ как критерий висцерального ожирения, вносящий важный вклад в формирование кардиометаболических нарушений.

RISK ASSESSMENT MODEL FOR CORONARY ATHEROSCLEROSIS IN PATIENTS WITH VISCERAL OBESITY

Aim. To invent a model for coronary atherosclerosis risk prediction in patients with visceral obesity and to conduct comparison research for this model with the other known Framingham and PROCAM.Material and methods. Totally 67 men included, of the age 40-65 (50,95±6,54 y.o.) without angina pectoris and clinical signs of another localization atherosclerosis. Patients had general obesity of I-III grade with BMI 35,16±3,32 kg/m , and visceral obesity by the thickness of epicaridal fat >7 mm. After coronary arteriography or multidetector computed tomography of coronary arteries we selected 2 comparison groups: group I (n=25) — patients with coronary atherosclerosis, group II (n=42) — without. For the invention of the prognostic score we used regression model with regression and optimal scaling.Results. Potential predictors of coronary atherosclerosis riskas a result of two groups comparison were: arterial hypertension, carbohydrate metabolism disorders, triglycerides, leptin, adiponectin and C-rective protein. As the result of regression analysis each predictor got its own significance mark. The rate of correctclassifications reached 79,1% that shows good prognostic value of this regression model. While using Framingham and PROCAM model the prognostic value of subclinical coronary atherosclerosis was 24,6% and 21,6% lower, resp., than the new risk assessment. Conclusion. The model invented of the risk assessment in visceral obesity patients makes it possible to take into account the main pathogenetic mechanisms that connect obesity and coronary atherosclerosis

Predicting the risk of left ventricular diastolic dysfunction in obesity

Obesity may develop heart failure with preserved ejection fraction, which is based on left ventricular diastolic dysfunction (LV DD). Currently, the search for effective predictors of LV DD is extremely relevant.Aim. To assess the prognostic value of key and additional metabolic risk factors (RFs), neurohumoral and profibrotic factors in the development of LV DD in obese patients.Material and methods. The study included 149 men with general obesity. The mean age was 49,7±7,9 years. The inclusion criteria was the presence of class I-III general obesity. The average body mass index was 32,9±3,6 kg/m2. The exclusion criteria were hypertension, coronary atherosclerosis, type 2 diabetes, as well as LV DD according to transthoracic echocardiography. Depending on the presence of epicardial adiposity, patients were divided into two groups: group 1 — epicardial adipose tissue (EAT) thickness ≥7 mm (n=70), group 2 — EAT <7 mm (n=31). In all patients, the following laboratory parameters were determined in blood serum using enzyme immunoassay: type I and III collagen, Procollagen I C-Terminal Propeptide (PICP), matrix metalloproteinase-3 (MMP-3), transforming growth factor β1, vascular endothelial growth factor, tumor necrosis factor-α (TNF-α), interleukin (IL)-6, IL-10, C-reactive protein (CRP), adiponectin, soluble leptin receptor, leptin, lipid parameters and free fatty acids (FFA). After 4,7±0,3 years, echocardiography was repeated in order to assess LV diastolic function.Results.  Comparative analysis of metabolic risk factors revealed a significant increase in the level of total cholesterol (p=0,001), low-density lipoprotein cholesterol (LDL-C) (p<0,0001), triglycerides (TGs) (p<0,0001). These groups had no differences in such parameters as high-density lipoprotein cholesterol (p=0,09) and glucose (p=0,12). An increase in the level of such pro-inflammatory cytokines as TNF-α (p<0,0001), CRP (p<0,0001), IL-6 (p<0,0001) in group 1 was revealed, while differences in IL-10 (p=0,34) levels were not significant. In group 1, there was a significant increase in leptin levels (p<0,0001), a decrease in levels of adiponectin (p<0,0001) and leptin receptor (p=0,001). In group 1, an increase in the level of all studied profibrotic factors was revealed. After 4,7±0,3 years, repeated echocardiography revealed that selected groups were comparable in such parameters as A, E, E/A, E/e’, e’, and the peak tricuspid regurgitation velocity. There was a significant difference in left atrial volume index (p=0,0003). LV DD was detected in 20 patients. Binary logistic regression revealed the following most significant predictors of LV DD in obese patients: glucose, LDL-C, triglycerides, leptin receptor, leptin, MMP-3, FFA, PICP, and EAT thickness.Conclusion. Thus, the following most significant predictors of LV DD in obese patients were identified glucose, LDL-C, triglycerides, leptin receptor, leptin, MMP-3, FFA, PICP, and EAT thickness

НЕЙРОКОГНИТИВНЫЕ НАРУШЕНИЯ У ПАЦИЕНТОВ С ВИСЦЕРАЛЬНЫМ ОЖИРЕНИЕМ В ПЕРИОПЕРАЦИОННОМ ПЕРИОДЕ КОРОНАРНОГО ШУНТИРОВАНИЯ

Visceral obesity (VO) is a predictor of complications after coronary artery bypass grafting (CABG), and a risk factor for cognitive and psychological disorders.Purpose. Of our study was to investigate features of neurocognitive disorders and their interactions in patients with VO in a perioperative period of CABG.Materials and methods. 90 patients with a body mass index from 25 to 35 kg/m2 were included in the study, they had indications for CABG. VO was assessed in terms of «waist circumference/hip circumference» (WC/HC). Group 1 included patients with VO (WC/HC >0.9 for men and WC/HC >0.85 for women), Group 2 – patients without VO (WC/HC ≤0,9 for men and WC/HC ≤0,85 for women). Cognitive functions were evaluated with the use of the automated complex software Status PF (Kemerovo,Russia). The Spielberger State-Trait Anxiety Inventory (STAI-T, STAI-S) was used for an estimation of anxiety.Results. Group 1 showed statistically lower rates of attention and neurodynamics and higher levels of depression and anxiety in the perioperative period of CABG. Group 1 demonstrated the decrease in memory and neurodynamics scores as STAI-T levels were higher in the perioperative period of CABG; the growth of STAI-T levels in Group 2 did not always lead to the derangements of attention and neurodynamics scores. Moreover, in Group 2 higher attention and neurodynamics scores were at higher STAI-T levels in 6 months after CABG. High STAI-S levels in both groups negatively affected the performance of attention and neurodynamics in the perioperative period of CABG.Conclusion. Patients with VO have a higher risk of developing neurocognitive disorders in the perioperative period of CABG. Висцеральное ожирение (ВО) является предиктором осложнений после коронарного шунтирования (КШ) и фактором риска когнитивных и психологических нарушений.Цель. Изучение особенности нейрокогнитивных нарушений и их взаимосвязей у пациентов с ВО в периоперационном периоде КШ.Материалы и методы. В исследование включено 90 пациентов с индексом массы тела от 25 до 35 кг/м2 и определенными показаниями к КШ. Наличие ВО оценивалось по показателю «окружность талии/окружность бедер» (ОТ/ОБ). Группу 1 составили пациенты с ВО при ОТ/ОБ >0,9 для мужчин и ОТ/ОБ >0,85 для женщин, группу 2 – пациенты без ВО при ОТ/ОБ ≤0,9 для мужчин и ОТ/ОБ ≤0,85 для женщин. Для оценки когнитивных функций использована программа Status PF (Кемерово, Россия), тревога оценивалась по шкале реактивной тревожности (РТ) и личностной тревожности (ЛТ) Спилбергера – Ханина.Результаты. В группе 1 отмечались статистически значимо более низкие показатели внимания и нейродинамики и более высокие уровни депрессии и тревоги в периоперационном периоде КШ. В группе 1 при более высоких уровнях ЛТ отмечалось снижение памяти и нейродинамики в периоперацонном периоде КШ; а в группе 2 повышение уровня ЛТ не всегда приводило к нарушению внимания и нейродинамики. Более того, в группе 2 при высоких уровнях ЛТ через 6 месяцев после КШ наблюдались более высокие показатели внимания и нейродинамики. Высокий уровень РТ в обеих группах негативно отражался на показателях нейродинамических процессов и внимания в периоперационном периоде КШ.Выводы. Пациенты с ВО имеют высокий риск развития психокогнитивных нарушений в периоперационном периоде КШ.

Profibrotic genetic polymorphisms as possible risk factors for the development of diastolic dysfunction in patients with epicardial adiposity

Aim. To determine the associations of variable sites of fibrogenesis genes with the risk of left ventricular (LV) diastolic dysfunction (DD) in patients with epicardial adiposity (EA).Material and methods. The study included 101 men with general obesity (Altai Territory) without cardiovascular diseases, diabetes and documented LVDD, of which, after determining the epicardial fat thickness (EFT), 2 groups were formed: group 1 — with EA (EA+), EFT ≥7 mm or more (n=70); group 2 — without EA (EA-), EFT <7 mm (n=31). The control group was formed from Kemerovo region residents of the corresponding sex and age and without a history of cardiovascular diseases and general obesity. Polymorphisms of the MMP9 rs17576, TGFB1 rs1800469, MMP3 rs6796620, MMP3 rs626750, MMP1 rs514921, LOC101927143 rs4290029, TIMP2 rs2277698 genes were determined in all patients using the polymerase chain reaction. After 4,7±0,3 years, all patients with general obesity underwent repeated echocardiography to assess LVDD.Results. We found that in the group with EA for rs626750 MMP3, the carriage of the homozygous T allele is 2 times more common (recessive inheritance, p=0,0022). After 4,7±0,3 years, LVDD was registered in 18 patients in the EA+ group and in 2 patients in the EA- group. When analyzing inheritance patterns, as well as comparing genotypes in groups of patients with EA with developed LVDD (n=20) and without LVDD (n=78), we found that patients with EA and LVDD are 3,4 times more likely to be a carrier of the homozygous T allele (recessive inheritance, p=0,02) for rs1800469 TGFB1.Conclusion. In patients with EA and LVDD, the carriage of the T rs1800469 TGFB1 allele is more common, which probably contributes to cardiac fibrosis and LVDD according to a recessive inheritance

Сывороточные биомаркеры сердечной недостаточности и параметры механики левого желудочка в ранней диагностике диастолической дисфункции у пациентов с эпикардиальным ожирением

Highlights. Patients with epicardial obesity develop myocardial fibrosis (the underlying mechanism of left ventricular diastolic dysfunction) the preclinical diagnosis of which is difficult to perform. In this regard, the search for non-invasive methods for diagnosing diastolic dysfunction at an early stage, including the methods of determining the serum level of biomarkers of heart failure and studying the parameters of left ventricular mechanics using speckle-tracking echocardiography, seems quite relevant.Background. Currently, the search for serum biomarkers and non-invasive methods for diagnosing diastolic dysfunction (DD) of the left ventricle (LV) at the preclinical stage in obese patients is relevant.Aim. To study the levels of heart failure biomarkers and their association with profibrotic factors and LV mechanics in patients depending on the presence of epicardial obesity (EO).Methods. Out of 143 men with general obesity, depending on the severity of EO, determined by the thickness of epicardial adipose tissue (tEАT), 2 groups of patients were identified: the EO (+) group with tEАT 7 mm or more (n = 70), and the EO (–) group with tEАT less than 7 mm (n = 40). The exclusion criteria from the study were: arterial hypertension, type 2 diabetes mellitus, coronary artery disease, and the presence of LVDD detected by echocardiography (echo). Levels of profibrotic factors (type I and type III collagen, procollagen type I C-terminal propeptide (PICP), matrix metalloproteinase-3 (MMP-3), transforming growth factor-β (TGF-β), vascular endothelial growth factor A (VEGF-A), sST2, and NT-proBNP were determined in all patients using enzyme immunoassay. With the help of speckle-tracking echocardiography, the mechanics of LV were analyzed.Results. The EO (+) group presented with increased sST2 level (22.11±7.36 ng/mL) compared to the EO (–) group (sST2 level 9.79±3.14 ng/mL (p<0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover, in the EO (+) group, a statistically significant relationship between sST2 and type III collagen was revealed (p = 0.01). When comparing the parameters of speckle-tracking echo, the EO group (+) presented with increased LV untwisting rate of –128.31 (–142.0; –118.0) deg/s-1 (p = 0.002), and increased time to LV peak untwisting rate of – 476.44 (510.0; 411.0) msec compared with the EO group (–) (p = 0.03). Moreover, a significant association between LV untwisting rate and sST2 level was revealed in the EO (+) group (r = 0.35; p = 0.02).>˂0.0001). In the EO (+) group, a significant influence of tEAT on sST2 level was identified (F = 8.57; p = 0.005). In the EO (+) group, an increase in the level of MMP-3, type I collagen, type III collagen, PICP, transforming growth factor-β, and VEGF-A was revealed. Moreover, in the EO (+) group, a statistically significant relationship between sST2 and type III collagen was revealed (p = 0.01). When comparing the parameters of speckle-tracking echo, the EO group (+) presented with increased LV untwisting rate of –128.31 (–142.0; –118.0) deg/s-1 (p = 0.002), and increased time to LV peak untwisting rate of – 476.44 (510.0; 411.0) msec compared with the EO group (–) (p = 0.03). Moreover, a significant association between LV untwisting rate and sST2 level was revealed in the EO (+) group (r = 0.35; p = 0.02).Conclusion. The data obtained indicate that patients with EO have LVDD, which could not be detected using echo criteria for LVDD, and the determination of serum levels of the heart failure biomarker - sST2 can be used for the diagnosis of LVDD at the early stage.Основные положения. У пациентов с эпикардиальным ожирением развивается фиброз миокарда, лежащий в основе нарушения диастолической функции левого желудочка, доклиническая диагностика которого затруднительна. В связи с этим крайне актуален поиск неинвазивных методов диагностики диастолической дисфункции на ранней стадии, в том числе с помощью определения сывороточного уровня биомаркеров сердечной недостаточности и изучения параметров механики левого желудочка с применением speckle-tracking эхокардиографии.Актуальность. В настоящее время актуален поиск неинвазивных методов диагностики диастолической дисфункции (ДД) левого желудочка (ЛЖ) на доклиническом этапе, в том числе у пациентов с ожирением.Цель. Изучить уровни биомаркеров сердечной недостаточности и их ассоциацию с профибротическими факторами и параметрами механики ЛЖ у пациентов в зависимости от наличия эпикардиального ожирения (ЭО).Материалы и методы. Из 143 мужчин с общим ожирением в зависимости от степени выраженности ЭО, определенного по толщине эпикардиальной жировой ткани (тЭЖТ), выделены две группы: ЭО(+) – тЭЖТ 7 и более мм (n = 70), ЭО(–) – тЭЖТ менее 7 мм (n = 40). Критерии исключения из исследования: артериальная гипертензия, сахарный диабет 2-го типа, ишемическая болезнь сердца, а также наличие ДД ЛЖ, выявленной по данным эхокардиографии (ЭхоКГ). Всем пациентам определяли уровень профибротических факторов (коллаген I и III типов, проколлаген I C-концевого пропептида (PICP), матриксная металлопротеиназа-3 (MMП-3), трансформирующий фактор роста-β (TGF-β), сосудистый эндотелиальный фактор рост (VEGFA)), sST2 и NT-proBNP исследовали с использованием иммуноферментного анализа. С помощью speckle-tracking ЭхоКГ изучена механика ЛЖ.Результаты. В группе ЭО(+) выявлено повышение уровня sST2 до 22,11±7,36 нг/мл в сравнении с группой ЭО(–), где уровень sST2 составил 9,79±3,14 нг/мл (р<0,0001). В группе ЭО(+) определено значимое влияние тЭЖТ на уровень sST2 (F = 8,57; p = 0,005). Также в группе ЭО(+) зарегистрировано увеличение уровня ММП-3, коллагена I и III типов, PICP, TGF-β, VEGFA; определена статистически значимая взаимосвязь sST2 и коллагена III типа (p = 0,01). При сравнении показателей speckle-tracking ЭхоКГ в группе ЭО(+) в сравнении с группой ЭО(–) отмечено повышение скорости раскручивания ЛЖ до –128,31 (–142,0; –118,0) градуса/с–1 (p = 0,002) и времени до пика раскручивания ЛЖ до 476,44 (510,0; 411,0) мсек (p = 0,03). В данной группе выявлена взаимосвязь скорости раскручивания ЛЖ и уровня sST2 (r = 0,35; p = 0,02). >˂0,0001). В группе ЭО(+) определено значимое влияние тЭЖТ на уровень sST2 (F = 8,57; p = 0,005). Также в группе ЭО(+) зарегистрировано увеличение уровня ММП-3, коллагена I и III типов, PICP, TGF-β, VEGFA; определена статистически значимая взаимосвязь sST2 и коллагена III типа (p = 0,01). При сравнении показателей speckle-tracking ЭхоКГ в группе ЭО(+) в сравнении с группой ЭО(–) отмечено повышение скорости раскручивания ЛЖ до –128,31 (–142,0; –118,0) градуса/с–1 (p = 0,002) и времени до пика раскручивания ЛЖ до 476,44 (510,0; 411,0) мсек (p = 0,03). В данной группе выявлена взаимосвязь скорости раскручивания ЛЖ и уровня sST2 (r = 0,35; p = 0,02).Заключение. Полученные данные позволяют предположить, что у пациентов с ЭО может быть ДД ЛЖ, не выявленная с помощью ЭхоКГ-критериев нарушения диастолической функции ЛЖ, а определение уровня сывороточного биомаркера сердечной недостаточности sST2 возможно для диагностики ДД на ранней стадии

Expression of CD80 and HLA-DR molecules on blood monocytes in patients with pulmonary tuberculosis

We examined expression pattern of CD80 and HLA-DR pro-inflammatory molecules on the monocytes in patients with pulmonary tuberculosis (TB), depending on the clinical form of the disease and susceptibility of the pathogen to anti-tuberculosis drugs. The study involved forty-five patients with newly diagnosed pulmonary TB (25 men and 20 women aged 18 to 55 years, average age — 44.0±12.4 years). The control group included 15 healthy donors with similar socio-demographic characteristics as in TB patients. Venous blood was used as biomaterial for assays. Studies of the monocyte immunophenotype were carried out by flow cytometry of whole blood cells using Cytoflex flow cytometer (Beckman Coulter, USA) with specific monoclonal antibodies (eBioscience, USA). We determined the content of cells expressing surface markers of monocytes, i.e., CD14, CD45, CD80, and HLA-DR. The results of this study were evaluated using SPSS Statistics 17.0 standard software package and Microsoft Excel. In the course of the study, we have suggested a working hypothesis that the monocytes in TB patients, still being in circulation, can express activation markers during their migration to inflammation focus, especially CD80 and HLA-DR molecules. Analysis of the total CD14+ monocyte number showed its decrease in all forms and variants of clinical course of pulmonary tuberculosis compared with the control group. Assessment of pro-inflammatory markers expressed on CD14 positive monocytes, i.e., HLA-DR activation marker and CD80 co-stimulatory molecule, showed that the number of monocytes with HLA-DR expression in all TB patients was higher than in healthy donors. HLA- DR expression on CD14+ monocytes in the group of patients with infiltrative TB proved to be 15% higher than in patients with disseminated TB. The expression of CD80 on CD14+ monocytes in TB patients showed no differences between the groups and varied within the normal range. Hence, an imbalance within monocyte population in patients with pulmonary tuberculosis, regardless of its clinical form and drug sensitivity of the pathogen is developed, due to decrease in total number of CD14+ cells, along with increased relative number of monocytes expressing HLA-DR activation marker (pro-inflammatory phenotype). Meanwhile, expression of the CD80 co-stimulatory molecule on monocytes was within normal values