Penile rehabilitation in patients following surgical treatment of Peyronie’s disease

Peyronie's disease (PD) is an acquired disease, which is based on a violation of the wound healing process, which results in the formation of fibrous plaques in the tunica albuginea of the cavernous bodies. The prevalence of erectile dysfunction (ED) among patients with PD ranges from 22% to 54%, according to various studies. Surgical treatment remains the "gold standard" for correcting penile curvature in PD. It is important to note that the existing methods of PD surgery (techniques with shortening or lengthening of the tunica albuginea) carry the risks of developing ED or aggravating its severity. At the same time, the absence of adequate sexual rehabilitation following PD surgery is associated with a significant deterioration in functional outcomes. In view of the above, the article is aimed to systematise information on penile rehabilitation methods in patients following PD surgery, which showed that the problem remains relevant to the present day. Most existing penile rehabilitation methods are currently not sufficiently investigated, and it is therefore impossible to give clear recommendations on the use of any method. The small number of well-designed and randomised studies on this problem is noteworthy, most likely due to the relative rarity of the disease

Association of angiotensinogen and angiotensin II receptor type I polymorphisms with biomarkers of carbohydrate and lipid metabolism in Dagestan residents with type 2 diabetes and hypertension

Aim. To study the associations of angiotensinogen (AGT) (s4762(С521Т), rs699(Т704C)) and angiotensin II receptor type I (AGTR1) (rs5186(A1166C)) genetic polymorphisms with serum levels of insulin, glucagon, C-peptide, leptin, as well as with dyslipidemia and glycemic levels in Dagestan residents with combination of type 2 diabetes (T2D) and hypertension (HTN), as well as with isolated T2D/HTN.Material and methods. We examined 16 patients with isolated T2D, 59 patients with T2D+HTN and 51 patients with isolated HTN from Dagestan. Genetic polymorphisms of the AGT and AGTR1 genes were studied. The levels of insulin, glucagon, C-peptide, and leptin were studied by enzyme-linked immunosorbent assay (ELISA), while lipid and carbohydrate metabolism — by biochemical methods.Results. In patients with T2D, the association of CC genotype of AGT gene rs4762(С521Т) polymorphism with a leptin decrease was determined, while its CT genotype was associated with an increase in serum level of triglycerides. The TC genotype of AGT gene rs699(Т704C) polymorphism was associated with an increase in leptin, triglyceride and glucose levels. The AA genotype of AGTR1 gene rs5186(A1166C) polymorphism was associated with an increase in insulin and glucose levels, as well as a decrease in leptin level. In patients with a combination of T2D and HTN, CC and CT genotypes of AGT gene rs4762(С521Т) polymorphism was associated with a decrease in glucagon level. The TT genotype of AGT gene rs699(Т704C) polymorphism was associated with an increase in insulin, triglyceride, glucose and body mass index (BMI) levels. In isolated HTN, the CC and CT genotypes of AGT gene rs4762(С521Т) polymorphism were associated ith a decrease in glucagon level. The TT genotype of AGT gene rs699(Т704C) polymorphism was associated with increased levels of insulin, low density lipoproteins, and BMI.Conclusion. Associations of AGT (s4762(С521Т), rs699(Т704C)) and AGTR1 (rs5186(A1166C)) genetic polymorphisms with carbohydrate and lipid metabolism changes are an important pathogenetic link of T2D and HTN, which allows developing an individual prognosis of these diseases in Dagestan residents

The effect of ivabradine as part of standard therapy on vascular endothelial function and cardiac electrical instability in patients with post-infarction cardiosclerosis and heart failure

Aim. To reveal the equivalence of nebivolol replacement with ivabradine in the prevention of endothelial dysfunction and cardiac electrical instability in patients with heart failure with reduced ejection fraction (HFrEF).Material and methods. In current observational study, 126 patients with HFrEF in the postinfarction period were randomized into two groups for six-month treatment: group 1 (n=62) — standard therapy (acetylsalicylic acid 0,1 g/day, clopidogrel 75 mg/day, veroshpiron 50 mg/day, nebivolol 5 mg/day, perindopril 5 mg/day and rosuvastatin 20 mg/day; group 2 (n=66) — the same therapy with nebivolol replacement with ivabradine 10 mg/day. Initially and after 6 months, 24-hour Holter monitoring was performed, heart rate variability was determined. We also investigated endothelial dysfunction using the photoplethysmographic technique with post-occlusive reactive hyperemia (PORH) test.Results. The heart rate, the number of episodes and the duration of symptomatic and silent myocardial ischemia, total myocardial ischemia were significantly decreased in both groups (p<0,001). The decrease of supraventricular extrasystole frequency in both groups had not statistical significance (p>0,05). In both groups, after therapy, parameters of heart rate variability were improved with the parasympathetic predominance (p<0,01). In both groups, the PORH test revealed the increase of brachial artery diameter (group 1 — 5,90Ѓ}3,15% and group 2 — 5,88Ѓ}1,82%) and pulse wave amplitude (group 1 — 1,81Ѓ}0,78 and group 2 — 1,73Ѓ}0,90 times), which indicates a trend towards an improvement in endothelial function. Intergroup comparisons did not reveal significant differences.Conclusion. Ivabradine is equivalent to nebivolol in preventing ventricular extrasystole and reducing heart rate, number of episodes of symptomatic and silent ischemia and the duration of total myocardial ischemia in patients with HFrEF. Ivabradine equivalently to nebivolol improves endothelial function and heart rate variability with reducing the sympathetic activity

ANALYSIS OF POLYMORPHISMS OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM AND RELATION TO VASOPRESSORS IN ESSENTIAL SYSTEMIC HYPERTENSION WITH THE LEFT VENTRICLE HYPERTROPHY IN DAGESTAN REPUBLIC

Aim. To assess the prevalences of genotypes and alleles polymorphisms of reninangiotensin-aldosterone  system,  and  β2-adrenoreceptors,  and  to  evaluate  the results  in regard   to  vasopressor  levels  in blood  serum  in essential   systemic hypertension  (ESH) with the  left ventricle hypertrophy  (LVH)  and  with none,  in Dagestan  Republic population.Material and methods. To the assessment, 98 patients included with the diagnosis “essential systemic hypertension  with or none LVH”. Genotypes  were assessed, of polymorphism A1166C gene AGTR1 and polymorphism Arg16Gly gene ADRB2. The testing of the polymorphisms was performed  with allele-specific polymerase  chain reaction.  Level of angiotensin  (At) II, endothelin (et) 1-21 and aldosterone (AS) in blood serum was measured by the hard-phase IeA. Level of ACe was measured by enzymatic method. Statistics was done with the software statistica (version 6.0) and “Biostat 4.03”.Results.  In EAH  patients   with LVH  the  prevalence   of  Arg/Arg polymorphism Arg16Gly gene  ADRB2  was  lower than  in control.  In EAH  with no LVH  there  is significant decline  of AC genotype  prevalences of polymorphism  A1166C gene AGTR1 and genotype  Arg/Arg polymorphism Arg16Gly gene ADRB2. Level of EТ1-21  and АТ II in the group of EAH with no LVH patients was significantly higher than in controls. Level of AT II in EAH with LVH was significantly higher than none LVH group. Increase of the levels of these mediators of AH was followed by a decline of AS level in the groups  of patients  comparing  to controls. In EAH group with LVH significant increase of et 1-21 was associated with the carriage of As polymorphism A1166C gene AGTR1, and genotypes АА and СС of the same polymorphism were associated with the decrease of levels of EТ1-21. In EAH with no LVH a significant decrease of At  II  level was found in the  carriers  of AA  and  AC genotypes of polymorphism A1166C  gene   AGTR1.  Also, the  association   was  found  of  all  genotypes  of polymorphism Arg16Gly gene ADRB2  with the decrease of АТ II.Conclusion. In Dagestan  population, in EAH with and with no LVH, most significant are  genotypes  AA,  AC and  CC  of  polymorphism  A1166C gene   AGTR1,  and genotypes Arg/Arg, Arg/Gly, Gly/Gly and alleles Arg and Gly polymorphism Arg16Gly gene ADRB2. Pathogenic  significance of the mentioned  polymorphisms is emphasized by the presence of polymorphism ET1-12, АТ II, Аs in blood serum

MICROSTRUCTURE OF THE MID-INTESTINE OF CERTAIN CARP FISH (CIPRINIDAE) IN THE WESTERN PART OF THE MIDDLE CASPIAN SEA

Aim. The aim of the study was an attempt to expand on the findings about the structure of the anterior part of the mid-intestine of three species of carp fish: Rutelus frisii kutum (Kamenski), Abramis brama orientalis and Ciprinus caprio (Linne) in connection with the feeding habits in the changed conditions of the western coast of the Middle Caspian sea. Studies of the digestive tract can extend the idea of the specifics of the mid-intestine structure due to the feeding of fish in certain environmental conditions of habitat.Methods. Investigations of the digestive tract were carried out, guided by the "Methodological manual" by I.V. Verigina.Findings and discussion. It is shown that in the anatomical and histological structure of the middle intestine was affected by the feeding habits of these types of fish; feeding upon small and soft invertebrates leads to a relatively simple structure of the intestinal wall: mucous layer covers a small part of the total thickness of the wall; there are no collagen structures that perform the function of the mechanical frame and capsules around blood vessels.Conclusion. Simplification of the digestive system emphasizes adaptive capacity appearing in periodic fluctuation of sea water level. The absence of food of a bigger size in the diet of fish results in a relatively simple anatomical and histological structure of the mid-intestine wall. None of the species under study has a differentiated stomach; instead its role is taken by an expanded portion of the fore intestine, similar is the microstructure of the middle part of the intestines of all three species