THE CHANGE IN STRESS RESISTANCE OF THE STUDENTS WHEN APPLYING TRANSCRANIAL ELECTROSTIMULATION

Aim.To determine the transcranial electrostimulation effect on stress resistance of students, according to N.V. Kirsheva, N.V. Ryabchikova test.Materials and methods. 127 medical students (50 boys and 77 girls aged from 19 to 22) were observed. All the students were practically healthy. They were divided into the main group (78 people) and the comparison group (49 people). The students of the main group underwent transcranial electrostimulation (TES): 22 people got 2 sessions a week, 56 people got 5 sessions a week. The level of stress resistance in the main group was determined according to N.V. Kirsheva, N.V. Ryabchikova test before and after TES. In the comparison group, the level of stress resistance was determined the same way. TESs were conducted with the Transair-03 apparatus. The results of the study were determined for the normal distribution using the computer program "STATISTIKA 6.0" and processed with parametric methods.Results. In the comparison group subjects had moderate and low levels of stress resistance. There were no significant changes in the levels of stress resistance in the initial state and a week later. After two TES sessions the number of students with average level of stress-resistance decreased by 3 people, and the number of students with high level of stress resistance increased by 3 people. There were no statistically significant differences in the level of stress resistance. During five TES sessions the level of stress resistance in 26 people increased from medium to high. Number of points after TES decreased by 10.3%, which indicated an increase in the level of stress resistance. No gender differences were taken into account. The interpretation of the test results by NV. Kirsheva, N.V. Ryabchikova showed high level of stress resistance in 13 subjects at a level "above average", "high" in 2 subjects. After 5 TES sessions, 15 subjects had "higher than average" level, 19 subjects had "high" level, 7 subjects had "very high" level.Conclusion. Thus, there is a reliable increase in stress resistance in practically healthy medical students of both sex at the end of the academic year after 5 TES sessions a week. Subjects who had medium and high levels of stress resistance before TES got high level of stress resistance after TESs, which also changed qualitatively: "proper high level" increased and "very high level" of stress resistance appeared

Age-dependent changes of coagulation system parameters in pediatric patients of cardiosurgical profile

Objective. Estimate baseline coagulation profile values in patients scheduled for cardiosurgical intervention in age groups of pediatric population.Material and Methods. The coagulation profile was analyzed in a complete selection of patients admitted to the intensive care department of Scientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1 for the period from January to December 2018. The study includes 842 patients planned for cardiac surgery.Results. This study demonstrates the dependence of the basic parameters of the hemostasis system on age characteristics, mainly during the period of the first year of life. APPT values were similar in all age groups, whereas extended PV was recorded in patients less than one year.Conclusion. Evaluation of coagulation system parameters should be based on age-specific reference values. Understanding the concept of developing hemostasis is extremely important in conditions of optimal prevention, diagnosis and treatment of hemorrhagic and thrombotic conditions in the pediatric population

Lipofilling. The review of the technique. Modern opportunities and prospects for dermal scar correction

Since of the invention lipofilling, there was a significant change in ideas of the role used autologous fat tissue (Auto Fat) from natural filler of defects to the product for stimulating regeneration. There was a considerable evolution in technology of liposuction and Auto Fat processing, material and methodical providing of the procedure was improved. Opening and studying role of the stromal-vascular fraction (SVF) of the adipose tissue, in particular mesenchymal stem cells of the adipose tissue (MSC FT), promoted considerable extension of indications while using this method in aesthetic medicine. During experience accumulation of lipofilling application new concepts of application of Auto Fat in combination with MSC FT, platelet-enriched plasma (PRP) and growth factors were developed for scar correction. Understanding of a key role recipient area in succesful engrafting Auto Fat on scars resulted in development of transcutaneous aponeurotomy in a combination with a lipofilling (riggotomy). The procedure of a nanolipofilling which can be considered an attempt of the isolated use of lipofilling for regeneration stimulation and remodeling of cicatricial tissue was developed. However, despite the achieved success, carrying out further researches which would allow to confirm this method efficacy from the point of view evidence-based medicine and develop clear clinical guidelines about its application for treatment of dermal scars would be necessary

Antiatherogenic Potential of Transcranial Electrical Stimulation in a High-Fructose/High-Fat Diet: Experimental Randomized Trial

Background. Transcranial electrical stimulation is a promising method for correction of malnutrition-induced hyperlipidemia, in the absence of indications for drug hypolipidemic therapy in young and middle-aged patients with low and moderate cardiovascular risk. Objectives — to study the effect of transcranial electrical stimulation on lipid metabolism in a high-fructose/high-fat (HFHF) diet in rats.Methods. An experimental randomized trial was performed to study the effect of transcranial electrical stimulation on lipid metabolism in a high-calorie diet enriched with fructose and saturated animal fat in rats. The experiments involved 180 outbred male rats and were carried out on the basis of the vivarium of Kuban State Medical University. The animals were divided into three groups: group 1 (control group, n = 60) — followed a standard diet; group 2 (comparison group, n = 60) — followed a HFHF diet; group 3 (experimental group, n = 60) — underwent transcranial electrical stimulation against the background of a HFHF diet. According to the target reference point of the study, the groups were divided into three equal subgroups of 20 rats each: subgroup A — day 30, subgroup B — day 60, and subgroup C — day 90 (biomaterial sampling and euthanasia were carried out on those days). In the obtained blood samples, the following lipid metabolism parameters were evaluated: total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and atherogenic index. Statistical analysis was performed using Microsoft Office Excel 2021 (Microsoft, USA), GraphPadPrism 9 (GraphPad Software, USA) and Statistica 13.3 (StatSoft, USA).Results. On the 30th day of the study, it was noted that in group 3, the concentration of low-density lipoprotein cholesterol was 14.9% lower and the atherogenic index was 30.8% lower (p < 0.05) than in group 2, while total cholesterol concentration, triglycerides, and high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05). On the 60th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 18.7% lower, low-density lipoprotein cholesterol was 42.9% lower, high-density lipoprotein cholesterol was 16.7% higher, and the atherogenic index was 56.3% lower (p < 0.05), while triglycerides had no statistically significant differences (p > 0.05). On the 90th day of the study, in group 3, when compared to group 2, the concentration of total cholesterol was 29.2% lower, the concentration of triglycerides was 36.0% lower, low-density lipoprotein cholesterol was 42.8% lower, and the atherogenic index was 57.0% lower (p < 0.05), while the concentration of high-density lipoprotein cholesterol had no statistically significant differences (p > 0.05).Conclusion. High-fructose/high-fat diet leads to a progressive increase in the serum concentration of low-density lipoprotein cholesterol, total cholesterol, triglycerides, as well as to a moderate decrease in high-density lipoprotein cholesterol and a growth in the atherogenic index. Transcranial electrical stimulation has a moderate lipid-lowering effect, manifested in the form of a decrease in the serum concentration of low-density lipoprotein cholesterol, total cholesterol and atherogenic index, while the effect on the concentration of triglycerides and high-density lipoprotein cholesterol is insignificant

The Pathogenetic Basis of the Action of Bempedoic Acid

The modern cardiology has a wide range of medications which affect various pathogenetic links of atherosclerosis, but even the best of them still obtain disadvantages causing intolerance and medicine discontinuation. The development of new hypolipidemic medications will allow not only to introduce alternative therapies into the cardiology practice, but also to completely execute the strategy of residual risk reduction by utilizing rational combinations of medications. One of such alternatives could be bempedoic acid, which can have a positive effect on a number of endpoints as the results of third phase trials have shown. These effects are also confirmed in Mendelian randomization studies. The mechanism of action of bempedoic acid is presumably associated with inhibition of the activity of ATP citrate lyase – the enzyme responsible for the breakdown of citrate into acetyl-CoA and oxaloacetate. Acetyl-CoA, in turn, is used by the cell to synthesize cholesterol and fatty acids. Thus, bempedoic acid affects in the same metabolic pathway as statins, but at an earlier stage. According to this, it is possible that medications of these classes will have similar side effects and pleiotropic effects associated with modulation of the mevalonic pathway, such as prenylation regulatory proteins (small GTPases) or reduction of coenzyme Q synthesis. However, there are also some specific features of the pharmacodynamics and pharmacokinetics of bempedoic acid to be considered. In particular, once entered the body, it must be activated via esterification by very long-chain acyl-CoA synthetase-1. The enzyme isoform required for this process is expressed in a tissue-specific manner and, for example, is absent in skeletal myocytes. In addition, citrate, oxaloacetate, and acetyl-CoA are important regulators of many intracellular processes: metabolism, growth and proliferation, mechanotransduction, posttranslational modifications of histones and other proteins. The levels of all three substances are altered by bempedoic acid, although no firm conclusions about the effects of these changes can be drawn at this time. The mentioned features probably have a significant impact on the clinical profile of bempedoic acid and underlie the differences from statins already observed in third phase trials, including, for example, a reduced risk of the onset or worsening of diabetes mellitus while taking bempedoic acid

Cognitive neural prosthetics – the way from experiment to clinical application

Accepted: September 3, 2021. Objective of this review is to highlight some aspects of the development and use of cognitive neuroprostheses, such as the technological background for their developing and key modern projects in this field. The literature sources were analyzed and the place of neuroprostheses among other artificial organs and tissues, which are under development or already used in clinical practice, was defined. The main principles of their implementation, structural elements and operating conditions were described. Also, this review presents some examples of diseases which can be corrected by cognitive neuroprostheses. The mechanisms of compensation for the functions of the damaged brain structures when using neuroprostheses are described on the basis of the principles of their interaction with biological neural networks. Descriptions of advanced developments that are currently relevant are given. Moreover, information is provided on the protocols and results of tests on animals and humans of the artificial hippocampus, as well as the results of testing a prosthesis that allows restoring the functions of the prefrontal cortex in animals. The examples considered in the review allow us to conclude that cognitive neuroprostheses are not just a hypothetic concept. They are implemented as specialized experimental solutions for practical clinical issues. Currently, the greatest success has been achieved in restoring the hippocampus functions

tPCS as a method for correcting cardiac arrhythmias after percutaneous transluminal coronary angioplasty with stenting in patients with myocardial infarction

Objective: To study the effect of transcranial pulsed current stimulation (tPCS) therapy on cardiac arrhythmias developed after percutaneous transluminal coronary angioplasty (PTCA) with stenting in patients with myocardial infarction (MI).Material and methods: Characteristics of patient groups: the comparison group (n = 17) – with myocardial infarction, after PTCA with stenting, standard treatment; the main group (n = 21) – the same and tPCS therapy. Control points of the study: 1st day – Electrocardiography (ECG), Echocardiography (ECHO), Creatine phosphokinase (CPK), Creatine phosphokinase-MB (CPK-MB), Troponin-I, potassium, β-endorphin; 5th day – the same without ECHO; 10th day – the same and ECG with the determination of harmony and quantum of the electromagnetic flux of the cardiac cycle. PTCA was performed using drug-eluting stents. tPCS therapy was performed in pulsed bipolar mode, current strength 2 mA, current frequency 77.5 Hz, session duration 45 min.Results: In patients of the main group (against the background of tPCS therapy), the studied parameters of the cardiac cycle approached the optimal values. It was shown that intergroup differences in harmony (p = 0.002) and the size of the electromagnetic flux quantum of the cardiac cycle (p = 0.001) are statistically significant. Also, against the background of the tPCS therapy, the concentration of highly sensitive troponin-I is statistically significantly (p = 0.0042) lower by 109%. On the 5th and 10th days of the study, the serum concentration of β-endorphin in the main group was higher by 38.3 and 35.0% than in the comparison group (p < 0.05).Conclusion: The results of the study clearly demonstrate the cardioprotective and antiarrhythmic potential of tPCS therapy in patients with myocardial infarction and cardiac arrhythmias after PTCA with stenting

Molecular mechanisms of long-chain fatty acids absorption

The article presents about the role of several lipid-binding proteins expressed by the small intestine brush border membrane in the main steps of intestinal absorption of long-chain fatty acids and about changes in lipid profile caused by failed absorbtion. The system literature search is performed on Scopus databases, Web of Science, MedLine

Hypercatecholaminaemia in stress urinary incontinence and its pathogenetic treatment perspectives: an experimental non-randomised study

Background. Urinary incontinence is associated with chronic psycho-emotional stress. Stress management should be part of a comprehensive treatment for urinary incontinence.Objectives. An assessment of hypercatecholaminaemia severity and dynamics in repeated courses of TES therapy for stress urinary incontinence.Methods. A total of 100 stress urinary incontinence patients were divided between a comparison and two main cohorts. Main cohort 1 (n = 30) received a modern standard treatment in combination with TES therapy. TES therapy was performed in three courses (1 session per day for 7 days): course 1 on admission, course 2 in 3 months after course 1, course 3 in 6 months after course 1. Main cohort 2 (n = 40) received a modern standard treatment in combination with two short courses of TES-therapy (2 sessions per day for 7 days): course 1 on admission, course 2 in 6 months after course 1. The comparison cohort (n = 30) only had standard treatment. Catecholamine concentrations were assessed over time in each cohort.Results. Catecholamine concentrations were >2 times higher before treatment in all cohorts vs. healthy volunteers. The comparison cohort revealed adrenaline and noradrenaline concentrations 71.2% (p < 0.05) and 84.0% (p < 0.05) higher vs. healthy volunteers, respectively, by month 6 of the trial. Main cohort 1 had the concentrations of adrenaline and noradrenaline 2.1 (p < 0.05) and 1.5 (p < 0.05) times higher, respectively, vs. healthy volunteers. Main cohort 2 showed an adrenaline concentration 12.5% (p < 0.05) and noradrenaline — 2.4% higher (p = 0.15) vs. healthy volunteers.Conclusion. TES therapy affects urinary incontinence hypercatecholaminaemia, demonstrating a favourable homeostatic impact on neuroimmunoendocrine regulation

Capsule Endoscopy for the Diagnosis of Suspected Small Bowel Bleeding

This review discusses the role of capsule endoscopy in diagnosing suspected small bowel bleeding and compares guidelines of the European Society of Gastrointestinal Endoscopy (ESGE), the American College of Gastroenterology (ACG), the American Society for Gastrointestinal Endoscopy (ASGE), the Canadian Association of Gastroenterology (CAG), and the consensus document of 4 Japanese medical societies. European and North American experts recommend capsule endoscopy as a first-line diagnostic modality for suspected small bowel bleeding without life-threatening signs in adult patients when ileocolonoscopy and esophagogastroduodenoscopy failed to be informative. Japanese experts, on the contrary, prefer cross-sectional imaging “from the chest to the pelvis” and consider capsule endoscopy as an alternative