Clinical and social portrait of patients with Keratoconus, living in the southern regions of Russia

For the southern regions of Russia, the problem of Keratoconus is of particular importance due to the high incidence of the disease.Purpose. To examine the clinical and social characteristics of patients with Keratoconus and get a portrait of the disease.Material and metods. Comprehensively surveyed 74 patients with Keratoconus at all stages (136 eyes). Depending on the stage of the process formed 4 clinical groups: I stage Keratoconus was 55 eyes (40.4%), stage II-36 eyes (26.5%), stage III-38 eyes (27.9%) and IV-7 eyes (5.2%). Applied traditional and modern ophthalmic techniques.Results. On the basis of the received data was compiled clinical social portrait of patient with Keratoconus. Patient with Keratoconus is a young man aged about 28 years, I Keratoconus stage, resident in the city, often by nationality Russian or Armenian, has working specialty, diagnosed with Keratoconus, installed this year, having a high enough risk of Keratoconus, with complaints of reduced Visual acuity, in having Visual acuity is about 0.4, correction to almost 0.6 with myopic correction with spherical myopic component of about 3.7D and cylindrical myopic component of about 3.2D. Eye size and level of true intraocular pressure while correspond to normal values, in contrast to the thickness of the central part of the cornea, which reliably thinner norms.Conclusion. Submitted by clinical and social portrait is a «slice», reflecting the most characteristic manifestation of Keratoconus in the southern regions of Russia according to the principle of «here and now»

The Structure of Polyvinyl Alcohol Adsorption Layers at Interfaces with Benzene in Connection with Stability of Concentrated Emulsions

Determination of PV A adsorbtion on interfaces between PV A and benzene was performed. Adsorbed layers are formed under dynamic conditions emulsions were prepared by vibrocomminution and ultrasonic dispergation). Adsorbtion data are used in calculation of the area per adsorbed molecule and the thickness of interfacial adsorpbtion layers. Adsorption isotherms are compared with rheological parameters of adsorbed layers. On the basis of reported data on the distribution of adsorbed segments of PV A molecules, the interfacial thickness of the adsorbed layer is estimated to be several hundreds of A in a fo rm of gel. The formation of the gel is a result of condensation and phase deemulgation which is in agreement with a similar mechanism of gel formation in solution with diffuse distribution of polymer segments in the adsorbed layer. It is shown that at least one monolayer must cover drops of benzene in order to obtain stable emulsions. Kinetic parameters and the energy of activation of coalescence are dependent on PV A adsorption

Hyperuricemia: Features of the Diet

The association of hyperuricemia (HU) with cardiovascular disease (CVD), diabetes, metabolic syndrome, and kidney disease has been demonstrated in numerous studies. НU is the main pathogenetic factor in the development of gout and is associated with an increase in overall and cardiovascular mortality. НU is included in the list of factors determining cardiovascular risk. According to epidemiological studies, there is a high prevalence of HU in the world and its increase in recent decades. A number of factors have been identified that contribute to the increased risk of НU. Non-modifiable factors include gender, age, genetic factors, and modifiable factors include diet and lifestyle. Nutritional unbalances, increased life expectancy, increased prevalence of obesity, and increased use of drugs (especially diuretics) are seen as contributing factors to the rise in НU. The review was carried out to summarize the available information on the effect of dietary habits, individual foods and nutrients on serum uric acid (SUA) levels and the risk of developing HU. The review presents the results of scientific studies demonstrating the relationship of НU with the consumption of foods rich in purines (offal, red meat, fish, seafood, legumes), alcohol consumption, drinks sweetened with fructose, coffee, dairy products, vegetables and fruits. Diet correction is an important and necessary step in the prevention and treatment of НU. The article reviews the basic principles of dietary management in HU and provides dietary recommendations for patients. For effective prevention and treatment of НU, a mandatory correction of the diet is required

Healthy Eating in Population Models of Nutrition: Asian Diet Style Summary

The population of Japan and Okinawa is known for the longest life expectancy, which many researchers rightly associate with the nature of nutrition existing in these territories. The Japanese diet and Okinawan diet, along with other traditional diets, are real examples of historically established sustainable patterns of healthy eating. Asian eating styles have marked differences from European eating patterns, not only in differences in food sources, but also in eating habits. The article presents the historical, climatic and cultural features of these diets; the issues of food composition, energy and nutritional value of these models of nutrition are considered in detail with an analysis of the differences existing between them; highlights the benefits of products grown mainly in Japan, which are ration-forming for the population of this country; as well as the results of scientific studies on the protective effect of the Japanese and Okinawan diets on human health and disease prevention

Состояние водных ресурсов озер Арктической зоны Российской Федерации

Regions of the Russian Federation classified among Arctic zone estimated to 22% of Russian territory. Arctic is characterized by the richest reserves of natural resources, and its phased, balanced development is the most important strategic task of Russia’s socioeconomic development. Production and household activities of the population of Russia living and working in the far North is associated with difficult climatic and geographical conditions. In this case, the constant cold and consumption of contaminated water can lead to aggravation of various human disease. The Arctic zone of the Russian Federation is characterized by the richness of water resources as rapidly renewable (river runoff and its underground component), and static one to which are assigned the waters of lakes, underground waters, waters (ice) of mountain and polar glaciers. A characteristic feature of water consumption in the Arctic regions is the active use of lake water, which in a number of settlements is the main source of drinking water supply. In this regard, the assessment of the lake’s fund of Arctic zone and its ecological status is extremely topical.According to the assessments, more than 2.5 million water bodies, that is a ~2/3 of all water bodies of the country, are decoded in the Arctic zone of the Russian Federation on satellite images. Mainly, these are small water bodies, only about 975 thousand of them exceed 1 ha. The total area of the water surface of Arctic lakes is ~160 thousand km2 (slightly less than a half of the total water surface of all natural water bodies of the Russian Federation), and the total volume of water enclosed in them is ~760 km3.Even in the middle of the 20th century, the lakes of the Russian Arctic, with rare exceptions, were characterized by the highest quality of their waters, but by now the ecological status of many water bodies has deteriorated significantly. The vulnerability of Arctic lakes to pollution is enhanced both by virtue of the peculiarities of their orometry and by the simplicity of the biological communities of northern ecosystems characterized by a low degree of stability. The poor knowledge of Arctic water bodies does not allow taking the necessary preventive measures for their protection and rational use. In this connection, attention to the expansion of works on the integrated study of limnology of water bodies included in the lake fund of the Arctic zone should be paid.An estimation of water resources of lakes of the Arctic zone of Russia, their ecological status and the questions of etiology of diseases on the territories of the Far North are given in this article. The morbidity of the population of the Arctic regions of Russia today is much higher than the national average. Further development of the territory and the observed warming of the climate will lead to increasing pollution of freshwater resources with toxic substances, pathogenic microorganisms and viruses. This will exacerbate the issue of ensuring environmental safety and meeting the needs of the population in quality drinking water. The situation is further aggravated by the fact that the most affordable technologies for water treatment and wastewater treatment in conditions of low temperatures and high content of humic substances in the initial water cannot ensure the proper level of disinfection. In this regard, one of the topical issues is the creation of innovative technologies for water purification that are more adequate to the conditions of the Arctic zone of Russia.Производственно-бытовая деятельность населения России, проживающего и работающего в районах Крайнего Севера, связана со сложными климатическими и географическими условиями. При этом фактически постоянный холод и потребление некачественной воды может приводить к обострению различных заболеваний. Особенностью арктических регионов России является наличие значительного количества озер и рек. Во многих северных регионах озерные воды являются важнейшим источником водоснабжения. В этой связи в настоящей работе дана оценка водных ресурсов озер Арктической зоны России, проанализировано их экологическое состояние и рассмотрены вопросы этиологии заболеваний на территориях Крайнего Севера

HLA-B5/51 GENOTYPE: AN ASSOCIATION WITH THE CLINICAL MANIFESTATIONS OF BEHCET’S DISEASE

Objective: to estimate the contribution of HLA-B5/51 genotype to the clinical manifestations and risk of Behcet’s disease (BD) in two ethnic groups.Subjects and methods. 146 BD patients fulfilling the International Criteria for BD (ICBD) were divided into two ethnic groups: 1) 86 patients from Dagestan (representatives of 8 ethnic nationalities in this region) with mean age 30.7±9.6 years; disease duration – 8.8±10.1 years; 2) 60 ethnic Russian patients, nonresidents of Dagestan with mean age 32.9±11.1 years; disease duration – 11.2±10.1 years. All patients were examined at the V.A. Nasonova Research Institute of Rheumatology in 1990 to 2014. HLA class I antigens were typed by a microlymphocytotoxic technique using a Gisans anti-leukocyte sera kit (Saint Petersburg).Results. HLA-B5/51 was detected in 87 (59.6%) patients, much more often in men than in women (70 and 38%, respectively; p<0.01). Genital ulcers and erythema nodosum were significantly more common in HLA-B5/51-positive Dagestani (87.3 and 57%) than in HLA-B5/51-negative ones (56.5 and 26%; p=0.0019 and р=0.01; respectively). There were no significant differences in these signs in the Russian group of patients with BD depending on the presence of this allele. In HLA-B5/51-positive male Dagestani patients with BD, the risk of erythema nodosum was twice as high as that in HLA-B5/51-negative patients (p=0.054). In HLA-B5/51 female Dagestani carriers, the risk of genital ulcers and generalized uveitis proved to be 3.5 (p=0.057) and 2.7 times higher than that in HLA-B5/51 noncarriers. Frequency of HLA-B5/51 was 73.2% among the Dagestanis and 40% among the Russians. Furthermore, this investigation revealed HLA-B5/51 carriage mainly in the male BD patients. Therefore, in addition to ethnicity, gender should be borne in mind when analyzing the clinical associations with HLA-B5/51

Маркеры прогноза лимфогенного метастазирования рака мочевого пузыря

Treatment results (2005—2009) for patients with invasive (N=104) urinary bladder carcinoma were analyzed. Molecular genetic analysis of cytochrome gene P450 polymorphous locus carried out: CYP1А1 (A2455G), СYP1A2 (T-2464delT), Glutathione S-transferase: GSTM1 (del), GSTP1 (A313G); DNA reparation: XRCC1 (G28152A) for patients with invasive urine bladder carcinoma with and without lymphogenic metastases was carried out. Genotypes associated with lyphogenic metastasis risk were identified.Проанализированы результаты лечения 104 пациентов с инвазивным раком мочевого пузыря за период с 2005 по 2009 г. Проведен молекулярно-генетический анализ полиморфных локусов генов цитохромов P450: CYP1А1 (A2455G), СYP1A2 (T-2464delT), глутатион S-трансферазы: GSTM1 (del), GSTP1 (A313G); репарации ДНК: XRCC1 (G28152A) у пациентов с инвазивным раком мочевого пузыря с лимфогенными метастазами и без них. Выявлены генотипы, ассоциированные с риском лимфогенного метастазирования

Genetic prognostic markers of urinary bladder cancer recurrence

Treatment results (2005-2009) for patients with surface (N=104) urinary bladder carcinoma were analyzed. Molecular genetic analysis of cytochrome gene P450 polymorphous locus carried out: CYP1A1 (A2455G), CYP1A2 (T-2464delT), Glutathione S-transferase: GSTM1 (del), GSTP1 (A313G); DNA reparation: XRCC1 (G28152A) for patients with surface urine bladder carcinoma recurrence, which took place within a year, and for patients with surface urine bladder carcinoma without recurrence within a year. Genotypes associated with surface urine bladder carcinoma one-year recurrence were identified.Проанализированы результаты лечения пациентов с поверхностным (N=104) раком мочевого пузыря за период с 2005 по 2009 гг. Проведен молекулярно - генетический анализ полиморфных локусов генов цитохромов Р450: CYP1А1 (A2455G), CYP1А2 (T-2464delT), глутатион S-трансферазы: GSTM1 (del), GSTP1 (A313G); репарации ДНК: XRCC1 (G28152A) у пациентов с рецидивами поверхностного рака мочевого пузыря, возникшими в течении одно года, и у пациентов с поверхностным раком мочевого пузыря без рецидива в течении одного года. Выявлены генотипы ассоциированные с появлением рецидива поверхностного рака мочевого пузыря в течении одного года

Тромботическая окклюзия у пациентов с острым ишемическим инсультом

Currently, reperfusion therapy is the main method of treating patients with ischemic stroke (IS). The safety and efficacy of systemic thrombolytic therapy with a recombinant tissue plasminogen activator in patients with IS within 3 hours, and then 4.5 hours after the onset of symptoms of the disease was demonstrated in the NINDS (1995) and ECASS III (2008) studies. In 2018, based on the results of five studies, clear indications were formulated for performing thrombectomy (TE) in patients with IS, which involve the detection of thrombosis of a large stroke-associated artery. Given the continuous growth in the number of the adult population, which constitutes the bulk of patients with IS, information on the prevalence of patients with thrombotic occlusion of cerebral arteries, who are potential candidates for TE, may be important for regional vascular centers.Aim of study. To describe IS patients admitted within the 6-hour “therapeutic window”.Materials and methods. The study included 145 patients with cerebral IS who were admitted within the first 6 hours after the onset of symptoms of the disease. All patients underwent computed tomographic (CT) angiography in order to verify the occlusion of the cerebral artery.Results. In our study, a correlation was established between the NIHSS severity of IS and the likelihood of verification of stroke-related artery thrombosis by CT angiography, but in 32.6% of patients with severe stroke (NIHSS at least score 14), no thrombotic occlusion was detected, and in 13% of patients with a clinic of mild acute cerebrovascular accident (NIHSS no more than 6), on the contrary, thrombotic occlusion was detected. Mortality in patients with verified thrombotic occlusion of the cerebral artery was higher than in patients without it (38% versus 10.5%, p<0.001). Such a significant difference in the mortality rate was due to the initially more severe stroke (NIHSS at admission 17 [10; 23] versus 5 [2; 10], p><0.001) in patients with thrombotic occlusion of a stroke-related artery, as well as a higher incidence of severe swallowing disorders (30% versus 9.5%, p ><0.002), which are a risk factor for pneumonia, as well as a higher frequency of such a comorbid background as chronic kidney disease and atrial fibrillation (30% versus 13.7%, p=0.018% and 58% versus 29.5%, p=0.001, respectively). CONCLUSION 1. Thrombosis of the cerebral stroke-associated artery was detected in 34.5% of patients with ischemic stroke who were admitted within the first 6 hours from the onset of the disease. 2. The main reason for the failure to perform thrombectomy in patients with ischemic stroke admitted within the 6-hour therapeutic window is the lack of verification of stroke-related artery thrombosis using computed tomographic angiography. Due to thrombosis at a different location (other than thrombosis of the internal carotid artery and / or M1 segment of the middle cerebral artery), 10% of patients with verified thrombosis did not meet the currently existing selection criteria for thrombectomy. Keywords: ischemic stroke, reperfusion therapy, cerebral artery thrombosis, cryptogenic stroke>˂0.001). Such a significant difference in the mortality rate was due to the initially more severe stroke (NIHSS at admission 17 [10; 23] versus 5 [2; 10], p˂0.001) in patients with thrombotic occlusion of a stroke-related artery, as well as a higher incidence of severe swallowing disorders (30% versus 9.5%, p˂0.002), which are a risk factor for pneumonia, as well as a higher frequency of such a comorbid background as chronic kidney disease and atrial fibrillation (30% versus 13.7%, p=0.018% and 58% versus 29.5%, p=0.001, respectively).Conclusion. 1. Thrombosis of the cerebral stroke-associated artery was detected in 34.5% of patients with ischemic stroke who were admitted within the first 6 hours from the onset of the disease. 2. The main reason for the failure to perform thrombectomy in patients with ischemic stroke admitted within the 6-hour therapeutic window is the lack of verification of stroke-related artery thrombosis using computed tomographic angiography. Due to thrombosis at a different location (other than thrombosis of the internal carotid artery and / or M1 segment of the middle cerebral artery), 10% of patients with verified thrombosis did not meet the currently existing selection criteria for thrombectomy. В настоящее время реперфузионная терапия является основным методом лечения пациентов с ишемическим инсультом (ИИ). Безопасность и эффективность системной тромболитической терапии при помощи рекомбинантного тканевого активатора плазминогена у пациентов с ИИ в пределах 3 часов, а в последующем 4,5 часа от начала симптомов заболевания была продемонстрирована в исследованиях NINDS (1995) и ECASS III (2008). В 2018 году, основываясь на результатах пяти исследований, были сформулированы четкие показания для выполнения тромбэктомии (ТЭ) у пациентов с ИИ, которые подразумевают выявление тромбоза крупной инсульт-связанной артерии. В условиях непрерывного роста числа взрослого населения, составляющего основную массу пациентов с ИИ, информация о распространенности больных с тромботической окклюзией церебральных артерий, являющихся потенциальными претендентами для выполнения ТЭ, может быть важной для региональных сосудистых центров.Цель исследования. Охарактеризовать пациентов с ИИ, поступающих в 6-часовом «терапевтическом окне».Материал и методы. В исследование включены 145 пациентов с церебральным ИИ, поступивших в первые 6 часов от начала развития симптомов заболевания. Всем пациентам с целью верификации окклюзии церебральной артерии выполняли компьютерную томографическую (КТ) ангиографию.Результаты. В нашем исследовании была установлена корреляция между тяжестью ИИ по шкале NIHSS и вероятностью верификации при помощи КТ-ангиографии тромбоза инсульт-связанной артерии, но у 32,6% пациентов с клиникой тяжелого инсульта (NIHSS не менее 14 баллов) не было выявлено тромботической окклюзии, а у 13% пациентов с клиникой легко протекающего острого нарушения мозгового кровообращения (NIHSS не более 6 баллов), напротив, тромботическая окклюзия была выявлена. Летальность у пациентов с верифицированной тромботической окклюзией церебральной артерии была статистически значимо выше, чем у пациентов без таковой (38% против 10,5%, р<0,001). Столь значительная разница между показателями летальности была обусловлена исходно более тяжелым инсультом (оценка по NIHSS при поступлении 17 [10; 23] против 5 [2; 10], p><0,001, статистически значимо) у больных с тромботической окклюзией инсульт-связанной артерии, а также большей частотой статистически значимых грубых расстройств глотания (30% против 9,5%, p><0,002, статистически значимо), являющихся фактором риска развития пневмонии и такого коморбидного фона, как хроническая болезнь почек и фибрилляция предсердий (30% против 13,7%, р=0,018 и 58% против 29,5%, р=0,001 соответственно). Выводы 1. Тромбоз церебральной инсульт-связанной артерии выявлен у 34,5% пациентов с ишемическим инсультом, поступающих в первые 6 часов от начала заболевания. 2. Основной причиной невыполнения тромбэктомии у пациентов с ишемическим инсультом, поступивших в 6-часовом «терапевтическом окне», является отсутствие верификации тромбоза инсульт-связанной артерии при помощи компьютерной томографической ангиографии. По причине тромбоза другой локализации (отличной от тромбоза внутренней сонной артерии и/или М1 сегмента средней мозговой артерии) 10% пациентов с верифицированным тромбозом не соответствовали существующим в настоящее время критериям отбора для выполнения тромбэктомии. Ключевые слова: ишемический инсульт, реперфузионная терапия, тромбоз мозговой артерии, криптогенный инсульт>˂ 0,001). Столь значительная разница между показателями летальности была обусловлена исходно более тяжелым инсультом (оценка по NIHSS при поступлении 17 [10; 23] против 5 [2; 10], p˂ 0,001, статистически значимо) у больных с тромботической окклюзией инсульт-связанной артерии, а также большей частотой статистически значимых грубых расстройств глотания (30% против 9,5%, p˂ 0,002, статистически значимо), являющихся фактором риска развития пневмонии и такого коморбидного фона, как хроническая болезнь почек и фибрилляция предсердий (30% против 13,7%, р=0,018 и 58% против 29,5%, р=0,001 соответственно).Выводы. 1. Тромбоз церебральной инсульт-связанной артерии выявлен у 34,5% пациентов с ишемическим инсультом, поступающих в первые 6 часов от начала заболевания. 2. Основной причиной невыполнения тромбэктомии у пациентов с ишемическим инсультом, поступивших в 6-часовом «терапевтическом окне», является отсутствие верификации тромбоза инсульт-связанной артерии при помощи компьютерной томографической ангиографии. По причине тромбоза другой локализации (отличной от тромбоза внутренней сонной артерии и/или М1 сегмента средней мозговой артерии) 10% пациентов с верифицированным тромбозом не соответствовали существующим в настоящее время критериям отбора для выполнения тромбэктомии.

ГЕНЕТИЧЕСКИЕ МАРКЕРЫ РИСКА РАЗВИТИЯ ПОВЕРХНОСТНОГО И ИНВАЗИВНОГО РАКА МОЧЕВОГО ПУЗЫРЯ

To reveal possible associations of the polymorphic variants of the cytochrome P450 and enzymes glutathione-S-transferase genes with the risk for bladder cancer (BC), the authors analyzed the frequency of genotypes and alleles at the polymorphic loci of the CYP1A1 (A2454G), GSTM1 (del), and GSTP1 (A313G) genes in 208 patients diagnosed as having BC (104 patients with invasive BC and 104 with superficial BC) and in 367 patients without identified oncopathology. The *1A*2C (OR = 3.42) and *2C*2С (OR = 6.98) genotypes, *2C (OR = 3.73) allele of the CYP1A1 gene and the GG (OR = 2.53) genotype of the GSTP1 gene were ascertained to be genetic markers for a risk for BC. The presence of the *2C (OR = 1.69) allele of the CYP1A1 gene, the G (OR = 2.40) allele and the AG genotype (OR = 2.40) of the GSTP1 gene was associated with the invasive forms of BC. There were no substantial differences in the distribution of the frequency of genotypes of the GSTM1 gene between the samples of patients and healthy individuals.С целью выявления возможных ассоциаций полиморфных вариантов генов цитохрома P450 и ферментов глутатион-S-трансферазы с риском развития рака мочевого пузыря (РМП) нами проведен анализ частот встречаемости генотипов и аллелей полиморфных локусов генов CYP1A1 (A2454G), GSTM1 (del), GSTP1 (A313G) у 208 больных с диагнозом РМП (104 пациента с инвазивным и 104 – с поверхностным раком) и у 367 пациентов без выявленной онкопатологии. Установлено, что генетическими маркерами риска развития РМП являются генотипы *1A*2C (ОP 3,42) и *2C*2С (ОР 6,98), аллель *2C (ОР 3,73) гена CYP1A1, генотип GG (ОР 2,53) гена GSTP1. Наличие аллеля *2C (ОР 1,69) гена CYP1A1, аллеля G (ОР 2,40) и генотипа AG (ОР 2,40) гена GSTP1 ассоциировано с инвазивными формами РМП. Существенных различий в распределении частот встречаемости генотипов гена GSTM1 между выборками больных и здоровых не выявлено