Eating Habits, Anxiety and Depression in Patients with Irritable Bowel Syndrome: Clinical and Laboratory Comparisons

Aim: to assess the level of stress hormones (cortisol in saliva), neurotransmitters (serotonin in blood serum, dopamine in blood plasma) in relation to eating habits, anxiety and depression levels in patients with IBS.Materials and methods. An open cohort prospective study was conducted with the inclusion of 263 patients with an established diagnosis of IBS, among them 189 (71.9 %) women and 74 (28.1 %) men. The average age of patients with IBS was 29 [25; 35] years. The control group included 40 healthy volunteers. All individuals included in the study were assessed for diet and eating habits using the WHO CINDI program questionnaire, “Information on Nutrition and Eating Behavior”, the severity of anxiety and depression according to the HADS questionnaire, the level of specific anxiety in relation to gastrointestinal symptoms according to the VSI questionnaire, quality of life according to the IBS-QoL questionnaire. In addition, the enzyme immunoassay method was used to assess the levels of cortisol in the morning and evening portions of saliva, serotonin in the blood serum and dopamine in the blood plasma.Results. Among patients with IBS there is a statistically significantly higher level of cortisol in the morning and evening portions of saliva (U = 19.5, p < 0.001 and U = 111.5, p < 0.001, respectively), serotonin in blood serum (U = 269.0, p = 0.042) and lower plasma dopamine levels (U = 93.5, p = 0.0002) compared with controls. The mean salivary cortisol level among patients with IBS was 45.39 [29.86; 70.10] ng/ml in the morning and 19.21 [13.98; 23.50] ng/ml in the evening, while in the group of healthy individuals it was 19.0 [16.5; 21.7] and 9.7 [8.5; 10.5] ng/ml, respectively. The average content of serotonin in blood serum in patients with IBS was 188.78 [150.41; 230.32] ng/ml, among healthy individuals — 142.80 [130.52; 154.15] ng/ml. The average content of dopamine in blood plasma in patients with IBS was 28.83 [20.08; 41.54] ng/ml, in healthy individuals — 58.20 [48.15; 66.62] ng/ml.Conclusion. In patients with IBS the secretion of the stress hormone (cortisol) and neurotransmitters (serotonin, dopamine) is closely related to the nature of nutrition, the level of anxiety and depression, and is also associated with the clinical variant and severity of the course of the disease

Abdominal Pain in Young Adults

Aim. A study of abdominal pain incidence in young adults in relation to dietary habits and psychological profile for advancement of health-promoting technologies.Materials and methods. An anonymous quiz survey covered 3,634 students enrolled at Omsk State Medical University in higher and secondary vocational education programmes via online use of the GSRS and WHO CINDI programme questionnaires to assess eating patterns and dietary preferences, as well as a brief multifactor personality inventory scale. Respondents with abdominal pain were divided into subcohorts by pain severity according to GSRS scores (mild, moderate or severe pain).Results. Abdominal pain was reported by 2,300 (63.29%) respondents, of whom 1,243 (54.0%) rated symptoms as mild, 996 (43.3%) and 61 (2.7%) — as moderate to severe. Abdominal pain complaints were more frequent in women (2I = 33.96, p <0.001), but gender had no effect on pain intensity. Pain associated with abdominal bloating and distention (57.65%), gastroesophageal reflux symptoms (38.75%), constipation (30.54%) or diarrhoea (28.4%). The presence and severity of abdominal pain was distinctive of individuals spending the most of average monthly income on food purchase and those actively consuming tea, coffee, added sugar, extra salt in cooked food, while having low intake of fruit and vegetables. A typical personality in severe abdominal pain is hypothymic depressive, hypochondriac in moderate and psychasthenic in mild pain.Conclusion. Abdominal pain is common among medical students predominating in females, associates with the eating pattern, dietary habits and psychological profile

Редкое клиническое наблюдение аденокарциномы толстой кишки с метастазами в легкие у пациентки средних лет

A rare case of colonic adenocarcinoma with metastatic lung lesion in a female patient of 43 years old is reported in the article. The diagnostic difficulty of this case was due to absolute lack of both respiratory and gastrointestinal clinical symptoms and signs. Timely scheduled chest fluorographic examination was the starting point of the diagnostic work-up resulted in diagnosis of colon cancer with metastasis to the lungs.Представленное клиническое наблюдение является редким казуистическим случаем метастатического поражения легких аденокарциномой ободочной кишки у пациентки 43 лет. Диагностическая сложность данного клинического случая обусловлена практически полным отсутствием у пациентки клинических симптомов со стороны бронхолегочной системы и желудочно-кишечного тракта, а также отсутствием каких-либо физикальных проявлений, указывающих на вовлечение данных органов и систем, что не позволяло даже заподозрить наличие патологического процесса.Своевременное плановое проведение флюорографического обследования органов грудной клетки явилось отправным пунктом диагностического процесса, по результатам которого был диагностирован рак толстой кишки с метастазами в легкие

ВОЗМОЖНОСТИ МУЛЬТИСПИРАЛЬНОЙ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ В ОБОСНОВАНИИ ВЫБОРА ХИРУРГИЧЕСКОЙ ТАКТИКИ ЛЕЧЕНИЯ ПЕРИТОНИТА У БОЛЬНЫХ С ТЕРМИНАЛЬНОЙ СТАДИЕЙ ВИЧ-ИНФЕКЦИИ

Research is devoted to the development of criteria for surgical treatment of peritonitis in 32 patients with end-stage HIV infection on the basis of the characteristics of the course of the inflammatory process according to multislice computed tomography (MSCT) of the abdominal cavity. Particular attention was paid to topical localization of the inflammatory process, its prevalence, the involvement of other organs and systems. In the analysis of morphological data tuberculous infection of the abdominal cavity was present in all patients. Studies have shown the need for MSCT in all patients with suspected acute abdominal surgical pathology on the background of the terminal stage of HIV infection for the objectification of the indications for the choice of optimal primary surgical approach, as well as - to assess the dynamics of the inflammatory process in the abdominal cavity, a characteristic feature of which is unpredictable and atypical course in the postoperative period.Исследование посвящено разработке хирургических критериев лечения перитонитов у 32 больных с терминальной стадией ВИЧ-инфекции на основании особенностей течения воспалительного процесса по данным мульти-спиральной компьютерной томографии (МСКТ) брюшной полости. Особое внимание уделяли топической локализации воспалительного процесса, его распространенности, вовлечению других органов и систем. Туберкулезная инфекция брюшной полости присутствовала у всех пациентов. Выполненная работа показала необходимость использования МСКТ у всех больных при подозрении на острую абдоминальную хирургическую патологию на фоне терминальной стадии ВИЧ-инфекции для объективизации показаний к выбору оптимальной первичной хирургической тактики, а также для оценки динамики воспалительного процесса в брюшной полости, характерной особенностью которого является непредсказуемость и атипичность течения в послеоперационном периоде

ОСОБЕННОСТИ ТЕЧЕНИЯ ПАНКРЕОНЕКРОЗА У БОЛЬНЫХ С ТЕРМИНАЛЬНОЙ СТАДИЕЙ ВИЧ-ИНФЕКЦИИ ПО ДАННЫМ МСКТ И МРТ

The purpose of this retrospective study was to explore peculiarities of pancreatic necrosis in patients with end-stage HIV infection using MDCT and MRI. Comparisons with subsequent pathological studies revealed features of the pancreatonecrosis course: protracted persistent course, with a tendency to relapse, delimitation of exudative processes, depending on the predominance of one or another AIDS-related infections. Pancreatonecrosis on a background of generalized toxoplasmosis was observed in 2 patients (18%) and was accompanied by formation of specific cysts secondary to the presence of hemorrhage and calcination, mesenteric lymphadenopathy, without the presence of additional inflammatory fluid streaks. Pancreatonecrosis on a background of generalized tuberculosis was observed in 4 patients (36%). It noted the severe and widespread destruction of pancreas with miliary parenchymal and mesenteric dissimination, mesenteric lymphadenopathy, the presence of additional inflammatory fluid streaks in the abdominal cavity and retroperitoneal space. The density of inflammatory fluid streaks was relatively high, at 15-30 HU. Out of 5 (46%) evaluable patients with pancreatic necrosis on the background of generalized mycosis 2 had revealed candidiasis, in 1 - cryptococcosis, in 2 - actinomycosis. Destruction of the pancreas on the background of different fungal infection accompanied by the appearance of multiple focal formations (microabscesses) due to rapidly emerging adhesions in exudative changes mild abdominal and mesenteric lymphadenopathy and had no significant differences depending on the pathogen.Целью настоящего исследования явилось ретроспективное комплексное (с использованием мультиспиральной компьютерной томографии и магнитно-резонансной томографии) изучение особенностей течения панкреонекроза у больных с терминальной стадией ВИЧ-инфекции. Сопоставление с данными последующих патоморфологических исследований позволило выявить особенности течения панкреонекроза, заключающиеся в затяжном персистирующем течении, со склонностью к рецидивированию и отграничению экссудативных процессов, в зависимости от преобладания той или иной СПИД-ассоциированной инфекции. Панкреонекроз на фоне генерализованного токсоплазмоза отмечен у 2 больных (18%) и сопровождался формированием специфических кист с наличием вторичного кровоизлияния и кальцинации, мезентериальной лимфаденопатией, без наличия дополнительных затеков воспалительной жидкости. Панкреонекроз на фоне генерализованного туберкулеза наблюдали у 4 пациентов (36%). При этом отмечена выраженная и распространенная деструкция железы с милиарной паренхиматозной и мезентериальной диссеминацией, мезентериальной лимфаденопатией, наличием дополнительных затеков воспалительной жидкости в брюшной полости и забрюшинном пространстве. Денситометрическая плотность воспалительной жидкости затеков была достаточно высокая и составляла 15-30 HU. Из 5 (46%) обследованных пациентов с панкреонекрозом на фоне генерализованного микоза у 2 выявлен кандидоз, у одного - криптококкоз, у 2 - актиномикоз. Деструкция поджелудочной железы на фоне различной грибковой инфекции не имела значимых отличий в зависимости от возбудителя, сопровождалась появлением множественных очаговых образований (микроабсцессов) на фоне быстро формирующегося спаечного процесса при слабовыраженых экссудативных изменениях брюшной полости и мезентериальной лимфаденопатии

Опыт применения препарата нинтеданиб у пациентки с идиопатическим легочным фиброзом

Idiopathic pulmonary fibrosis (IPF) is the most common clinical variant of idiopathic interstitial pneumonia. Pathophysiology of IPF involves recurrent damage of the alveolar epithelium with fibroblast excessive proliferation as aberrant reparative activity of the lung interstitium. Currently, a treatment approach to this disease has been revised. Given new knowledge on pathogenesis of IPF, an international evidencebased clinical guideline published in 2015 recommends antifibrotic agents as the basic therapy of IPF. The only antifibrotic agent registered in Russia is niintedanib. A clinical case of IPF with the first experience of therapy with nintedanib in Omsk region has been reported in the article.Идиопатический легочный фиброз (ИЛФ) – наиболее распространенный вариант идиопатических интерстициальных пневмоний. Патофизиология заболевания включает рецидивирующее повреждение альвеолярного эпителия и абберантную репаративную активность интерстиция в виде избыточной пролиферации фибробластов. В настоящее время пересмотрены подходы к диагностике и лечению данной категории пациентов. В Международном доказательнообоснованном клиническом руководстве (2015) по лечению ИЛФ с учетом появившихся новых сведений о патогенезе заболевания рекомендуется применение врачамиклиницистами антифибротических препаратов. Представленное клиническое наблюдение является первым опытом применения в регионе единственного на сегодняшний день в России антифибротического препарата нинтеданиб у пациентки с ИЛФ

Initial Steps of Thermal Decomposition of Dihydroxylammonium 5,5′-bistetrazole-1,1′-diolate Crystals from Quantum Mechanics

Dihydroxylammonium 5,5?-bistetrazole-1,1?-diolate (TKX-50) is a recently synthesized energetic material (EM) with most promising performance, including high energy content, high density, low sensitivity, and low toxicity. TKX-50 forms an ionic crystal in which the unit cell contains two bistetrazole dianions {c-((NO)N3C)-[c-(CN3(NO)], formal charge of ?2} and four hydroxylammonium (NH3OH)+ cations (formal charge of +1). We report here quantum mechanics (QM)-based reaction studies to determine the atomistic reaction mechanisms for the initial decompositions of this system. First we carried out molecular dynamics simulations on the periodic TKX-50 crystal using forces from density functional based tight binding calculations (DFTB-MD), which finds that the chemistry is initiated by proton transfer from the cation to the dianion. Continuous heating of this periodic system leads eventually to dissociation of the protonated or diprotonated bistetrazole to release N2 and N2O. To refine the mechanisms observed in the periodic DFTB-MD, we carried out finite cluster quantum mechanics studies (B3LYP) for the unimolecular decomposition of the bistetrazole. We find that for the bistetrazole dianion, the reaction barrier for release of N2 is 45.1 kcal/mol, while release of N2O is 72.2 kcal/mol. However, transferring one proton to the bistetrazole dianion decreases the reaction barriers to 37.2 kcal/mol for N2 release and 59.5 kcal/mol for N2O release. Thus, we predict that the initial decompositions in TKX-50 lead to N2 release, which in turn provides the energy to drive further decompositions. On the basis of this mechanism, we suggest changes to make the system less sensitive while retaining the large energy release. This may help improve the synthesis strategy of developing high nitrogen explosives with further improved performance

Fatty Acid and Peptide Profiles in Plasma Membrane and Membrane Rafts of PUFA Supplemented RAW264.7 Macrophages

The eukaryotic cell membrane possesses numerous complex functions, which are essential for life. At this, the composition and the structure of the lipid bilayer are of particular importance. Polyunsaturated fatty acids may modulate the physical properties of biological membranes via alteration of membrane lipid composition affecting numerous physiological processes, e.g. in the immune system. In this systematic study we present fatty acid and peptide profiles of cell membrane and membrane rafts of murine macrophages that have been supplemented with saturated fatty acids as well as PUFAs from the n-3, the n-6 and the n-9 family. Using fatty acid composition analysis and mass spectrometry-based peptidome profiling we found that PUFAs from both the n-3 and the n-6 family have an impact on lipid and protein composition of plasma membrane and membrane rafts in a similar manner. In addition, we found a relation between the number of bis-allyl-methylene positions of the PUFA added and the unsaturation index of plasma membrane as well as membrane rafts of supplemented cells. With regard to the proposed significance of lipid microdomains for disease development and treatment our study will help to achieve a targeted dietary modulation of immune cell lipid bilayers

Tyrosine-Phosphorylated Caveolin-1 Blocks Bacterial Uptake by Inducing Vav2-RhoA-Mediated Cytoskeletal Rearrangements

During the early stages of infection, Neisseria gonorrhoeae triggers a phosphotyrosine-dependent Cav1-Vav2-RhoA signaling cascade that promotes the pathogen's extracellular state

Circuit-based interrogation of sleep control.

Sleep is a fundamental biological process observed widely in the animal kingdom, but the neural circuits generating sleep remain poorly understood. Understanding the brain mechanisms controlling sleep requires the identification of key neurons in the control circuits and mapping of their synaptic connections. Technical innovations over the past decade have greatly facilitated dissection of the sleep circuits. This has set the stage for understanding how a variety of environmental and physiological factors influence sleep. The ability to initiate and terminate sleep on command will also help us to elucidate its functions within and beyond the brain