Stress and arterial hypertension: ISIAH rat strain

The main views of the issue of stress and hypertension are briefly reviewed. It is well known that stress is one of the major risk factors for cardiovascular disease development. Increase in blood pressure is a typical manifestation of the acute stress response. This fact is the reason to hypothesize that chronic stress causes the development of hypertensive disease. An association of hypertension with psychological stress in humans was shown in several works. In addition, it was demonstrated that hypertension was accompanied by an increase in sympathetic tone. On the other hand, there were many population studies in which no association was found between different types of chronic stress and arterial hyper­tension. Thus, the question is far from being answered. Even in the cases when one managed to obtain a signi­ficant hypertensive effect in experimental studies with emotional stress, it was difficult to explain the mechanisms mediating the formation of stressinduced hypertension. To clarify the situation, one of the authors of this review decided to begin the breeding of a rat strain with increased blood pressure response to emotional stress. This breeding gave rise to inbred rats with persistent stress-induced arterial hypertension. A brief history of the development of the genetic model ofstress-induced arterial hypertension, the ISIAH rat strain, is given. A retrospective review of the studies performed with ISIAH rats is presented. The contribution of genotype changes in the neuroendocrine systems involved in stress and blood pressure regulation to the development ofstress-dependent hypertension in the ISIAH rat strain is shown

Metabolic profile of blood serum in experimental arterial hypertension

The etiology of essential hypertension is intricate, since it employs simultaneously various body systems related to the regulation of blood pressure in one way or another: the sympathetic nervous system, renin-angiotensin-aldosterone and hypothalamic-pituitary-adrenal systems, renal and endothelial mechanisms. The pathogenesis of hypertension is influenced by a variety of both genetic and environmental factors, which determines the heterogeneity of the disease in human population. Hence, there is a need to perform research on experimental models – inbred animal strains, one of them being ISIAH rat strain, which is designed to simulate inherited stress-induced arterial hypertension as close as possible to primary (or essential) hypertension in humans. To determine specific markers of diseases, various omics technologies are applied, including metabolomics, which makes it possible to evaluate the content of low-molecular compounds – amino acids, lipids, carbohydrates, nucleic acids fragments – in biological samples available for clinical analysis (blood and urine). We analyzed the metabolic profile of the blood serum of male ISIAH rats with a genetic stress-dependent form of arterial hypertension in comparison with the normotensive WAG rats. Using the method of nuclear magnetic resonance spectroscopy (NMR spectroscopy), 56 metabolites in blood serum samples were identified, 18 of which were shown to have significant interstrain differences in serum concentrations. Statistical analysis of the data obtained showed that the hypertensive status of ISIAH rats is characterized by increased concentrations of leucine, isoleucine, valine, myo-inositol, isobutyrate, glutamate, glutamine, ornithine and creatine phosphate, and reduced concentrations of 2-hydroxyisobutyrate, betaine, tyrosine and tryptophan. Such a ratio of the metabolite concentrations is associated with changes in the regulation of glucose metabolism (metabolic markers – leucine, isoleucine, valine, myoinositol), of nitric oxide synthesis (ornithine) and catecholamine pathway (tyrosine), and with inflammatory processes (metabolic markers – betaine, tryptophan), all of these changes being typical for hypertensive status. Thus, metabolic profiling of the stress-dependent form of arterial hypertension seems to be an important result for a personalized approach to the prevention and treatment of hypertensive disease

Обзор зарубежного опыта внедрения электронного здравоохранения

A review of studies, presentations and reports of the Regional Office for Europe of the World Health Organization (WHO) devoted to the experience of European countries in the formation of cross-border eHealth and the use of quality management tools for medical activities to reduce risks when introducing innovative solutions in health systems was carried out. In order to comprehensively assess the information received, a SWOT analysis was fulfilled – an analysis of strengths (S), weaknesses (W), opportunities (O) and threats (T), internal and external factors that influenced the development of cross-border eHealth in the European Union. It is shown that in European countries with a developed health care system, the leading direction in building cross-border e-Health are innovative technologies and advanced solutions aimed at improving the interaction of medical systems: Electronic Health Record (EHR), Health Information Exchange (HIE), Telemedicine Technologies (Telehealth), and Personal Health Records (PHR). The analysis of the strengths and weaknesses of this technologies, as well as the main problems that have affected the transition to eHealth and the implementation of information and communication technologies in medical organizations of European countries has revealed common factors and patterns that can be taken into account for the digital transformation of the health system in the Russian Federation.Проведен обзор исследований, докладов и отчетов Европейского регионального бюро Всемирной организации здравоохранения (ВОЗ), посвященных опыту европейских стран в формировании трансграничного электронного здравоохранения и применении инструментов менеджмента качества медицинской деятельности для снижения рисков при внедрении инновационных решений в системы здравоохранения. С целью комплексной оценки полученной информации проводился SWOT-анализ – анализ сильных (S), слабых (W) сторон, возможностей (O) и угроз (T), внутренних и внешних факторов, повлиявших на развитие трансграничного электронного здравоохранения в Евросоюзе. Показано, что в европейских странах с развитой системой здравоохранения ведущим направлением в построении трансграничного электронного здравоохранения являются инновационные технологии и передовые решения, направленные на усовершенствование взаимодействия медицинских систем: Электронная медицинская карта (англ. Electronic Health Record, EHR), Обмен медицинской информацией (англ. Health Information Exchange, HIE), Телемедицинские технологии (англ. Telehealth) и Личные медицинские записи (англ. Personal Health Record, PHR). При анализе сильных и слабых сторон указанных технологий, а также основных проблем, которые повлияли на переход к электронному здравоохранению и внедрение информационно-коммуникационных технологий в медицинских организациях европейских стран, выявлены общие факторы и закономерности, которые могут быть учтены при цифровой трансформации системы здравоохранения в Российской Федерации

БЛИЖАЙШИЕ РЕЗУЛЬТАТЫ МУЛЬТИМОДАЛЬНОГО ЛЕЧЕНИЯ АДЕНОКАРЦИНОМЫ ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫ В НОВОСИБИРСКОЙ ОБЛАСТИ

The short-term performance criteria (PSA blood level and prostate volume) were analyzed concerning the complex (hormonal and radiation) treatment of 57 patients with prostate adenocarcinoma, stratified into three disease progression risk groups. Two treatment regimens were differed in the duration of neoadjuvant hormone therapy: 9 or 32 ± 13 months in combination with external beam radiation therapy with a total dose 76–80 Gy. Statistical analysis of the multimodal treatment efficiency criteria of patients with high risk of prostate adenocarcinoma showed the best result (significant decrease of PSA blood level) using a single 9-month course of hormone therapy and subsequent external beam radiation therapy. The prostate volume indicator in the applicable mode of radiation therapy has mixed dynamics, and requires further study as a multimodal treatment effectiveness criterion.Изучены ближайшие критерии эффективности – уровень простатспецифического антигена (ПСА) и объем предстательной железы (ПЖ) – комплексного (гормонального и лучевого) лечения 57 пациентов с аденокарциномой ПЖ, стратифицированных по 3 группам риска прогрессирования заболевания. Использованы 2 схемы лечения, различающиеся по длительности неоадъювантной гормонотерапии: 9 мес или 32 ± 13 мес в сочетании с дистанционной лучевой терапией с суммарной дозой 76–80 Гр. У пациентов с высоким риском прогрессирования опухолевого процесса продемонстрирована достоверно высокая эффективность комбинированного метода лечения с наилучшими показателями снижения уровня ПСА в группе 9-месячного курса гормонотерапии. Показатель объема органа в применяемом режиме лучевой терапии имеет разнонаправленную динамику и требует дальнейшего изучения в качестве критерия эффективности мультимодального лечения