Peer-reviewed journal "Acta Biomedica Scientifica"
Scientific Centre for Family Health and Human Reproduction Problems
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Deputy editor-in-chief’s preface to Issue 4, 2025
Predicting the risk of developing infiltrative forms of genital endometriosis with involvement of adjacent organs
Backgorund. Women with endometriosis suffer from pelvic pain, dysmenorrhea, infertility. Deep infiltrating endometriosis (DIE) is diagnosed with a delay from 6 to 10 years after the first symptoms manifest. The aim. To improve early diagnosis of DIE with adjacent organ involvement by identifying predictors based on a risk prediction model. Methods. This retrospective comparative study included 67 patients with DIE stage III-IV according to the rASRM classification who were divided into 2 groups: group A – 32 patients with involvement of adjacent organs, group B – 35 patients without involvement of adjacent organs by endometriosis. Results. Patients from Group A had a greater severity of pelvic pain (p < 0.001) when assessed via the VAS scale. Patients in Group A had a longer duration of complaints (p < 0.001). Dyspareunia was more common in patients in Group A (p = 0.011). According to the ultrasound data, patients in Group A more often had signs of adenomyosis (p < 0.001), retroflexion of the uterus (p = 0.005), retrocervical or prevesical infiltration (p < 0.001). According to MRI data, Group A more often showed signs of colon (p = 0.001) and vaginal infiltration (p = 0.015). Conclusions. The main predictive signs of DIE with involvement of adjacent organs were identified: severity of pelvic pain of 5 points (VAS) or more (p = 0.003), retrocervical or prevesical infiltration according to pelvic ultrasound (p = 0.001), duration of symptoms for 22 months or more (p = 0.002), dyspareunia (p = 0.015). We created a predictive model of DIE with involvement of adjacent organs (sensitivity 93.7 %, specificity 82.9 %) that was approved via ROC-analysis.
The state of vaginal microbiocenosis of adolescent girls with urinary tract and gastrointestinal diseases
Justification. Changes in the microbiocenosis of the vagina of adolescent girls with diseases of the urinary tract and gastrointestinal tract may be a marker of future diseases of the reproductive system. Currently, more than 20 types of vaginal lactobacilli have been identified, the relationship of which among themselves and with other microorganisms can be a predictor of vulvovaginitis. These issues are relevant and poorly understood among adolescent girls. The aim of this study. To determine the features of vaginal microbiocenosis and to establish factors preventing the vulvovaginitis in adolescent girls of the hospital sample. Materials and methods. The analysis of the vaginal microbiocenosis of 60 adolescent girls in a hospital sample with urinary tract and gastrointestinal diseases was performed using microscopic, bacteriological, and molecular genetic research methods (species typing of lactobacilli). Results. In 53.4 % and 46.6 % of cases of urinary tract and gastrointestinal diseases in adolescent girls had vulvovaginitis, regardless of the reason for hospitalization (p = 0.82). Moderate vulvovaginitis (5–6 points on the ISSVD score) is associated with microorganisms such as Escherichia coli (103–106 CFU/ml) and Staphylococcus aureus (103–104 CFU/ml) and the absence of lactobacilli (OR = 10.4 95% CI [0.90; 120.2], p = 0.03; OR = 7.5, 95% CI [0.61; 91.8], p = 0.18). In adolescent girls without vulvovaginitis, vaginal microbiocenosis is characterized by the dominance of lactobacilli (88.3 %); L. crispatus (46.0 %) and L. gasseri (30.7 %). In adolescent girls with urinary tract diseases, the number of lactobacilli greater than 105 CFU/ml reduces the risk of developing vulvovaginitis by 7.7 times, in adolescent girls with gastrointestinal diseases – by 8.3 times (OR = 0.13, 95% CI [0.03; 0.65] and OR = 0.12, 95% CI [0.02; 0.63]). Conclusion. Vulvovaginitis is often associated with diseases of the urinary tract and gastrointestinal tract in adolescent girls. The number of lactobacilli exceeding 105 CFU/ml and the dominance of L. crispatus are a significant protective factor against the development of vulvovaginitis (p = 0.002).
Lysyl oxidase in the pathology of the heart
Cardiovascular pathology is currently one of the main causes of disability and mortality of the able-bodied population. Fibrosis, an overgrowth of connective tissue, occupies one of the main places among the diseases of this pathology. The formation of fibrous tissue is determined by the excessive accumulation of extracellular matrix components and is an important phase of the reparative process. The lysyl oxidase and lysyl oxidase-like proteins enzyme play an important role in the remodeling of the extracellular matrix, controlling its formation by binding collagen or elastin fibers. It is known that in the heart, in addition to cardiomyocytes, fibroblasts represent the largest population of cells, among which the synthetically active are fibroblasts and myofibroblasts, which produce fibrous structures of the extracellular matrix, among which collagen in the heart is considered predominant. Of all the types of collagen, the most common are type I and type III collagens, which are responsible for the strength and elasticity of the matrix network. Lysyl oxidase includes 5 representatives: the enzyme itself and 4 lysyl oxidase-like proteins. The enzyme and its proteins are copper-containing amino oxidases that catalyze the oxidation of lysine, forming strong cross-links between lysine fragments of fibrous structures of the extracellular matrix, regulating its homeostasis and remodeling. The functional state of the heart directly depends on the composition and structure of the extracellular matrix. Dynamic changes in protein expression occur in various cardiovascular pathologies; It is believed that these changes play a key role in the associated tissue fibrosis. Therapeutic effects on enzymes of the lysyl oxidase family have shown promising results in animal models, but are at an early stage of development and require further study. The PubMed and eLibrary databases for the period 1968–2024 were analyzed using the following keywords: lysyl oxidase, fibrosis, connective tissue, heart pathology.
Effect of obstructive sleep apnea on the effectiveness of cognitive-motor training in patients with mild vascular cognitive impairment: a prospective comparative study
Background. Cognitive rehabilitation in patients with vascular cognitive impairment (VCI) remains challenging, particularly in the presence of comorbid conditions. obstructive sleep apnea syndrome (OSAS) is one of underestimated factor potentially limiting the effectiveness of cognitive interventions. Cognitive-motor training (CMT), including nondominant hand writing, is considered a promising non-pharmacological intervention; however, its efficacy in patients with combined VCI and OSAS has not been adequately studied. The aim. To compare cognitive performance dynamics in patients with moderate VCI depending on the presence of moderate to severe OSAS after a one-month course of nondominant hand writing training. Methods. A prospective non-randomized comparative interventional study was conducted from May 2024 to February 2025. The study included 34 patients aged 50–74 years with moderate VCI, divided into two groups based on the presence of moderate/ severe OSAS (AHI ≥ 15 events/hour). The intervention consisted of a 4-week CMT course (14 days inpatient, 14 days home-based). Cognitive performance was assessed before and after the intervention using the MoCA, FAB, FCSRT-IR, TMT, Stroop, and SDMT scales. Results. The study group included 16 patients with AHI ≥ 15 events/hour; the control group consisted of 18 patients with AHI < 15. The groups were comparable in age, sex, and comorbidities (p > 0,05). Both groups showed cognitive improvement post-intervention, but changes were more pronounced in the control group. Between-group comparisons of change scores revealed significant differences in Stroop 3 (p < 0,001; d = -1,18), TMT-B (p = 0,004; d = 1,08), SDMT (p = 0,160; d = -0,50), and FCSRT-IR FR (p < 0.001; d = -1,54). No adverse events were observed. Conclusion. The presence of moderate to severe OSAS reduces the effectiveness of nondominant hand writing training in patients with moderate VCI. These findings highlight the importance of accounting for sleep-disordered breathing when planning cognitive rehabilitation strategies.
The influence of bone metabolism gene polymorphism on the level of encoded proteins in patients with long bone fractures
Introduction. Polymorphism of bone metabolism genes makes an important contribution to the course of reparative processes in fractures and can contribute to the disruption of consolidation. The aim of the study. To identify the level of encoded proteins (OPG, IL6, TGFβ1, EGF) in patients with limb bone fractures depending on the carriage of bone metabolism gene polymorphisms (TNFRSF11B-1181G>C, IL6-174C>G, TGFβ1-25Arg>Pro, EGFR-2073A>T). Materials and methods. The case-control study was performed in 108 patients: Group 1 (n = 64) with uncomplicated course; Group 2 (n = 46) – delayed consolidation. The analyzed groups of patients are comparable in clinical and epidemiological parameters and treatment. The control group was represented by 92 practically healthy individuals of the same sex and age. Two months after the injury, the levels of OPG, IL-6, TGFβ1, EGF were determined by ELISA, and gene polymorphism (TNFRSF11B-1181G>C, IL6174C>G, TGFβ1-25Arg>Pro, EGFR-2073A>T) was determined using standard primer sets “Litech” (Moscow). Statistical processing was performed by the IBM SPSS Statistics Version 25.0 program. Results. The highest level of OPG was recorded in carriers of the CC genotype of the TN-FRSF11BG1181C gene in all studied groups, including the control group. In the group of patients with bone tissue repair disorders, the OPG content increased 1.1-fold relative to carriers of the GC genotype and 1.7-fold compared to carriers of the GG genotype. Analysis of the effects of SNP of the IL6C174G gene, the TGFb1Arg25Pro gene, and the EGFRA2073T gene showed opposite results: carriers of the GG, ProPro, and TT genotypes, respectively, had significantly lower concentrations of encoded proteins (IL-6, TGFb1, and EGF). Conclusion. The content of OPG, IL-6, TGFβ1, EGF decreases in the carriage of the geno-types: -1181G/Gofthe TNFRSF11Bgene,-174G/Gofthe IL6 gene, -25Pro/Pro of the TGFβ1 gene, -2073T/T of the EGFR gene, respectively. The SNPs in question can be used to predict delayed consolidation in patients with limb bone fractures.
Orphan disease: features of difficult to diagnose and genetically verified muscular dystrophy based on DNA sequencing results (clinical case)
Currently, orphan diseases are rarely diagnosed due to low patient awareness, heterogeneity of symptoms, low publication activity of specialists who may encounter orphan pathology, and limited availability of molecular genetic technologies for verifying the human genome/exome. The clinical case is presented in the form of a detailed interdisciplinary examination of the patient within the framework of the genetic, neurological, radiological and neurophysiological profiles. At the same time, the work shows the clinical and laboratory-instrumental diversity of signs of a hereditary pathological process with neurogenic and myogenic manifestations. The peculiarity of the clinical case of the orphan disease is the rarity of its occurrence, as a consequence of the impossibility of diagnosing it by routine methods. The patient was diagnosed with myofibrillar myopathy (type 1) taking into account the identified criteria: onset at theageof 20-40, burdenedgenealogical history onthefather’s side, progressive muscle weakness, distal muscle group of the legs, hypotrophy, paresis, initial cardiosclerosis, incomplete right bundle branch block, supraventricular extrasystoles, ischemic episodes (according to Holter), significant restructuring of motor unit potentials according to the myogenic type, a decrease in the average duration to 50 % of the norm in the calf muscles, myotonic discharges according to electroneuromyography, signs of myofibrillar muscular dystrophy of the legs with manifestation of a defect in the proteins desmin and αB-crystallin. During the work, a patient was found to have a pathogenic variant of the nucleotide sequence of the DES gene, encoding the desmin protein, is a structural protein of the cytoskeleton, and forming intermediate filaments of muscle cells. Due to the fact that in most cases there is insufficient information about myofibrillar myopathy and the diagnosis of the disease is untimely without the use of specific methods, including medical genetic ones, the diagnosis is established several years later. The effective use of medical genetic technologies and the correct interpretation of the results depend on the coordinated work of a team of professionals.
Clinical and electrocardiographic features and results of genetic testing of children with tachy-bradycardia syndrome
Background. Tachy-bradycardia syndrome in adults is often a result of ischemic changes and is detected in 50 % of cases among all patients with sick sinus syndrome. Tachy-bradycardia syndrome has not been studied in children, the genetic mechanisms have not been studied, and the definition of treatment tactics is difficult due to the need to treat both life-threatening bradycardia and tachyarrhythmias in patients. The aim. To determine the frequency of occurrence of syncope, palpitations and electrocardiographic markers and to study the frequency and representation of genetic mutation associated with the cardiac channelopathies and cardiomyopathies in children with tachy-bradycardia syndrome. Materials and methods. Eighteen patients with tachy-bradycardia syndrome aged 1 to 17 years (on average 11.3 + 4.97) without structural heart diseases were examined, who underwent a complete cardiological examination with genetic analysis. Results. 67 % of children in clinical status had syncope, 56 % had palpitations, 39 % had low tolerance of physical activity. A combination of sinus node dysfunction with atrioventricular block I was detected in 56 % of cases, one child had atrioventricular block of I–II degrees. Antiarrhythmic devices were implanted in 6 children, radiofrequency catheter ablation was performed in one, and 7 patients were treated with antiarrhythmic drugs. Variants in various genes associated with channelopathies, arrhythmias or cardiomyopathies were identified in 78 % of patients. Conclusion. Only 17 % of children with tachy-bradycardia syndrome have not complains. Tachy-bradycardia syndrome with supraventricular tachyarrhythmias may be the first manifestation of a structural pathology of the heart. A genetic study should be included in the examination of children with tachy-bradycardia syndrome, as it allows to diagnose the genetic mechanisms of progressive cardiac conduction diseases, cardiomyopathies, the early manifestations of which are not always detected in children during a standard examination.
Features of meldonium effect on the cells viability and mitochondria of blood leucocytes in patients with angina pectoris
Background. The ambiguous effectiveness of cardiocytoprotectors and the low level of evidence for their use in coronary heart disease (CHD) necessitate the study of their direct effect on cell viability for assessing cytoprotective activity. The aim. To determine the specific effects of meldonium on the cells viability and mitochondria of blood leukocytes in patients with angina pectoris. Materials and methods. Thirty-one patients with stable angina were examined. The lipid profile; antioxidant protection; and respiratory control of blood plasma were determined using biochemical methods. The viability of blood leukocytes and the fluorescence intensity of their mitochondria were studied using fluorescence microscopy. Meldonium was tested in vitro. Statistical data processing was performed. Results. Two variants of changes in cell viability under the influence of meldonium were found: in the form of an increase or decrease in this indicator. An increase in cell viability occurred due to an increase in the number of living cells in patients with normal values of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C); provided that the activity of antioxidant cell protection enzymes (catalase; superoxide dismutase) was maintained; with the prevalence of anabolism processes. A decrease in cell viability under the influence of meldonium occurred due to an increase in the number of dead cells in patients with elevated values of total cholesterol and LDL-C; provided that the enzymatic activity of the antioxidant system was depleted and catabolism processes prevailed. The value of mitochondrial fluorescence of blood leukocytes in both cases changed towards an increase; but in the first case only by 3 %; and in the second – by 6 %. Conclusion. According to in vitro studies; meldonium can have a dual effect on cell viability – either increasing or decreasing it by increasing the number of living or dead cells. The resulting effect of meldonium depends on the individual metabolic characteristics of a particular patient; the state of their energy metabolism and antioxidant protection of cells.
Peculiarities of the temporal dynamics of biofilm formation of bacteria of the genus Staphylococcus
Justification. Bacteria of the genus Staphylococcus are conditionally pathogenic microorganisms capable of causing purulent-septic diseases. Testing for biofilm (BF) formation can be a useful marker of staphylococcal pathogenicity and have great clinical significance; especially in the chronic course of staphylococcal infections. The aim. To study the kinetics of growth and the dynamics of BF formation by bacterial strains of the genus Staphylococcus. Materials and methods. Ten Staphylococcus strains from the working collection of the Microbiome and Microecology Laboratory of the Scientific Сentre for Family Health and Human Reproduction Problems were used. The measurement of optical density (OD); growth rate; determination of the total microbial number; and assessment of the morphological structure of BFs were carried out for three clinically significant species: Staphylococcus aureus (three strains); S. epidermidis (two strains); and S. haemolyticus (five strains). Sampling was carried out after 2; 4; 8; 10; and 24 h of cultivation. Results. The OD of the starting culture for all tested strains was 0.08 optical units. All tested strains showed comparable growth and a general tendency toward biofilm formation. The stationary phase was achieved after 8 h of cultivation with a total microbial number of more than 8 lg CFU/mL and an OD of 0.216–0.329 units. Cell adhesion to the surface was recorded after 4–6 h of incubation; and after 8 h; the formation of an inhomogeneous BFs was observed. After 10 h; the biofilm structure was reorganized; and after 20 h of incubation; the BFs were completely destroyed; while the total microbial number decreased with a simultaneous increase in OD from 0.288 to 0.562 units due to the transition of the destroyed cells to a suspended state. Conclusion. The features identified in real time expand the understanding of the dynamics of the BF formation of gram-positive bacteria and can be applied in clinical microbiology to prevent recurrent infections caused by staphylococci.
A pilot in vitro study of the antagonistic properties of Lactiplantibacillus plantarum isolates derived from the intestines of healthy adolescents in the Irkutsk region
Background. The growing antibiotic resistance; complicating the treatment of intestinal dysbiosis and related diseases; makes the development of probiotics for microbiota correction increasingly relevant. Lactiplantibacillus plantarum exhibits probiotic potential due to its antagonistic activity. Considering the strain-specific nature of this property; studying local isolates of L. plantarum is necessary for creating new; more effective probiotic preparations. The aim. To evaluate the in vitro antagonistic properties of five isolates of L. plantarum isolated from the intestines of healthy adolescents in the Irkutsk region against multidrug-resistant isolates of opportunistic bacteria and Escherichia coli. Materials and methods. Five isolates of L. plantarum 43p; 45p; 46p; 52p; and 57p were used; 25 multidrug-resistant isolates of opportunistic bacteria representing the species Enterobacter hormaechei; E. cloacae; Klebsiella pneumoniaе; K. oxytoca; K. variicola; Pseudomonas aeruginosa; Staphylococcus aureus; Citrobacter amalonaticus; and 23 isolates of E. coli with different characteristics. Antagonistic activity was evaluated by methods of perpendicular strokes and the well diffusion method. Results. L. plantarum isolates showed statistically significant variations in antagonistic activity; and these variations were also dependent on the testing method. A lot more activity was seen with the perpendicular strokes method. Statistically significant differences (p < 0.05) indicated that isolates 43p; 45p; and 46p were more effective antagonists than 52p and 57p; irrespective of the method. A marked antagonistic effect of L. plantarum isolates 43p; 45p; and 46p was observed against P. aeruginosa. Conclusion. This pilot study confirmed the strain-specific antagonistic potential of L. plantarum against multidrug-resistant opportunistic bacteria and E. coli; identifying L. plantarum isolates 43p; 45p; and 46p as the most promising candidates. These findings support the need for further screening of L. plantarum isolates; as well as other Lactobacillus species; cultured from the normal microbiota of healthy adolescents in the Irkutsk region. Furthermore; investigation of the mechanisms of antagonism is warranted to develop novel; effective probiotics based on local isolates.
State of the parietietal-luminal microbiota of the distal colon of Wistar rats during experimental acute cerebral ischemia
The “microbiota-gut-brain” axis plays a significant role in the pathogenesis of ischemic stroke. However; changes in the composition of the intestinal microbiota in the acute period of ischemic stroke remain insufficiently studied; which determines the need for experimental research. The aim. To study the changes in the composition of the parietal-luminal microbiota of the distal colon of Wistar rats in experimental acute cerebral ischemia. Materials and methods. The study was performed on 20 sexually mature male Wistar rats; divided into 2 groups: group I (n = 10) – intact animals; group II (n = 10) – animals with experimental acute cerebral ischemia (EACI); modeled by the method of Chen S.T. Composition of the parietal luminal microbiota of the distal colon. The intestines of the animals were evaluated on day 3 by real-time polymerase chain reaction. The total bacterial mass (GE/ml); the frequency of detection of microorganisms (n (%)); and the quantitative structure of the parietal-luminal microbiota (lg GE/ml) were determined. Results. On the 3 day from the start of the experiment; the total bacterial mass in animals of the EACI group (10 GE/ml) did not differ from the same indicator in animals of the intact group (p = 1.000). The dominant microorganisms in both groups were Lacticaseibacillus spp.; Bifidobacterium spp.; Escherichia coli; Bacteroides spp.; while the spectrum of the accompanying parietal-luminal microbiota was different. Thus; Enterobacter spp. was not detected in animals with EACI and Klebsiella pneumoniae; but Clostridioides difficile and Fusobacterium nucleatum were recorded; in contrast to similar indicators of the group of intact animals. Faecalibacterium prausnitzii and Staphylococcus aureus were found in both groups. Conclusions. On day 3; EACI in Wistar rats was accompanied by selective restructuring of the parietal luminal microbiota of the distal colon; associated with the appearance of C. difficile; F. nucleatum and the disappearance of Enterobacter spp.; K. pneumoniae; which may indicate an imbalance of the autochthonous microbiota; while maintaining the total bacterial mass and dominant symbiotic populations (Lacticaseibacillus spp.; Bifidobacterium spp.; E. coli; Bacteroides spp.) reflects the stability of the basic microbial profile in cerebral ischemia.
Young “athlete’s hearts” and isolated systolic hypertension: can “athlete’s genes” underlie their relationship? Results from the pilot study
Introduction. Engaging in intense aerobic exercises can lead to a specific; nonpathological condition known as isolated systolic hypertension or “athlete’s heart”; characterized by elevated systolic blood pressure. The side effects of the heart’s response to intense training can be attributed to individual genetic factors. The aim. To analyze a minimal set of polymorphic gene variants in relation to personal differences in hemodynamic parameters among athletes and a control group of untrained individuals. Methods. The study cohort comprised 98 participants who met the specified inclusion criteria. All subjects were male individuals aged between 18 and 30 years; actively engaged in professional sports for a minimum of four years and free from serious medical conditions. Individuals were examined at Republican Autonomous Healthcare Institution of Karelia “Medical and Physical Education Dispensary” and grouped according to sports disciplines. Comprehensive measurements of key anthropometric parameters were conducted; along with an assessment of the functional state of the cardiovascular system at rest. The genetic analysis was performed using DNA extracted from blood samples. ACTN3; ACE; PPARA and BDKRB2 gene variants associated with heart development and functioning were studied by PCR. Statistical analysis was performed using the statistical package SPSS version 22.0 (IBM; Armonk; USA). Results. I/D ACE gene variant was distinctly associated with power-oriented training compared to speed-oriented and endurance-oriented athletes. The combination of dominant alleles from studied genes occurred to be predictor of higher systolic blood pressure in power-oriented athletes. Conclusion. We found that genetic variants may affect to the development of training-specific and mostly disadvantageous characteristics of body composition. Three polymorphic gene variants could independently predict heart remodeling and future health complications in young athletes.
Functional role of gangliosides in cell membranes: from physiology to pathogenesis
Gangliosides are complex glycosphingolipids that constitute essential components of cell membranes and actively participate in the regulation of numerous biological processes. Although their biochemical properties have been extensively documented; the mechanisms by which they contribute to disease pathogenesis – and the opportunities they offer for therapeutic intervention – remain incompletely understood. This review outlines the biochemical characteristics of gangliosides; the principles of their clustering within membrane microdomains; and the distinctive features of their interactions with proteins and pathogens. Particular attention is given to how perturbations in ganglioside metabolism are linked to major disorders such as Alzheimer’s; Parkinson’s; Huntington’s diseases; and amyotrophic lateral sclerosis. In addition; many viruses; including SARS-CoV-2; exploit ganglioside receptors during initial cell attachment. The prospects of employing gangliosides and their derivatives as biomarkers and therapeutic targets are critically analyzed; and contemporary strategies aimed at modulating ganglioside-dependent pathological processes are discussed. Drawing on recent advances in neurobiology; immunology; and infectious disease research; this interdisciplinary review highlights the unique role of gangliosides as universal regulators of cellular responses to diverse stressors. The conclusions presented here may guide future studies of molecular pathogenesis and foster the development of innovative diagnostic and therapeutic approaches for ganglioside-associated diseases. The aim. To synthesize current knowledge on the structure and functions of ganglio- sides; their influence on cellular activity and their involvement in neurodegenerative; infectious and autoimmune disorders.
Associations between geriatric status and eye diseases among residents of the arkhangelsk region
Introduction. Visual impairment represents a significant geriatric syndrome that markedly diminishes the quality of life in elderly patients. As a potentially modifiable risk factor for loss of autonomy; vision disorders may adversely affect both the clinical status and prognosis of aging individuals. The aim. To investigate the correlations between ophthalmic pathologies and geriatric syndromes could enhance the comprehensive assessment of health status in this patient population. Materials and methods. A cross-sectional study was conducted involving 481 patients aged 80.96 ± 0.24 years; hospitalized at the Arkhangelsk Veterans Hospital between 2020 and 2022. The data collection methods included medical record analysis; ophthalmological examination; and assessment of geriatric syndromes using screening diagnostic methods employed in comprehensive geriatric evaluations. Results. Glaucoma was detected in 35.2 % of cases; cataracts in 25.2 %; optic disc pathology in 10.5 %; age-related macular degeneration in 75.5 %; refractive errors in 16.8 %; and secondary retinopathy in 16.8 %. Regression analysis revealed that glaucoma was associated with malnutrition (OR = 1.82; 95% CI: 1.21–2.74). Secondary retinopathies showed a correlation with malnutrition (OR = 1.84; 95% CI: 1.07–3.16). Refractive errors were associated with cognitive impairment (OR = 1.87; 95% CI: 1.68–3.00). Conclusions. Glaucoma; cataracts; secondary retinopathies; and refractive errors were associated with geriatric syndromes such as decreased walking speed; malnutrition; balance disorders; cognitive impairment; and depression. The study findings may be used for early diagnosis of geriatric syndromes and the development of personalized rehabilitation programs for elderly patients with ophthalmic conditions.
Screen time duration and risk factors for non-communicable diseases in adolescents
Introduction. Risk factors (RF) for chronic non-communicable diseases (NCDs) require great attention to reduce mortality from NCDs in the population worldwide. The severity of excessive screen time (ST) and its association with behavioral RFs of NCDs in adolescents haven’t been sufficiently studied. The aims. To assess the duration of ST in adolescents; to establish RFs of NCDs associated with the duration of ST. Materials and methods. A cross-sectional study of 1125 adolescents aged 11; 13; and 15 years from 5 schools was conducted in Irkutsk in 2023. Participants were divided into groups depending on the duration of ST. Socio-demographic and behavioral factors (physical activity; nutrition); some aspects of mental well-being (satisfaction with body; appearance; anxiety and life satisfaction) were assessed using a structured validated questionnaire “Health Behavior in School-aged Children” (HBSC). Body mass index was calculated using the AnthroPlus calculator. Material wealth was calculated using the Family Wealth Scale; which is used in HBSC studies. Results. The recommended duration of screen time comply 9.1 % of adolescents. Adolescents with ST more than 5 hours are more often brought up in single-parent families (p = 0.004); rare eat breakfast; often consume carbonated and energy drinks (p = 0.003 and p < 0.001); compared to those who don’t exceed the ST norm. Adolescents with ST less than 2 hours consider themselves less committed to a sedentary lifestyle and better physically prepared (p < 0.001); refuse snacks; sweets and fast food (p < 0.001); are satisfied with their appearance (p < 0.001) and find everyday life interesting (p = 0.007); compared to adolescents whose ST is more than 2 hours per day. Conclusion. Excessive ST is associated with such behavior as consumption of high-calorie foods; skipping breakfast; commitment to a sedentary lifestyle; decreased interest in everyday life and dissatisfaction with own body.
Predicting the risk of the formation of mixed anxiety and depressive disorders in women
Background. In case of unfavorable dynamics of events and/or untimely treatment; adjustment disorders may develop into more severe conditions with aggravated clinical manifestations. The reaction to stress becomes prolonged and goes beyond the adjustment disorders; leading to the formation of stable psychopathological disorders with a predominance of vegetative symptoms. A mixed anxiety and depressive reaction due to adjustment disorders may transform into a clinically formalized mixed anxiety and depressive disorder. The aim. Construction of a mathematical model for predicting the risk of developing the mixed anxiety and depressive disorder in women with mixed anxiety and depressive reaction due to adjustment disorders; using hormonal parameters. Materials and methods. Two groups of women were examined: group 1 (n = 53) with the diagnosis of “Adjustment disorders: mixed anxiety and depressive reaction” (F43.22); group 2 (n = 48) – “Mixed anxiety and depressive disorder” (F41.2). The level of anxiety was determined using the Spielberger – Khanin Personality and Reactive Anxiety subscale. Anxiety and depression levels were assessed using the Hospital Anxiety and Depression Scale (HADS). The body mass index (BMI) was calculated. The laboratory study included the determination of hormonal parameters using the ELISA method. All data were processed statistically. Results. A model for predicting the risk of developing mixed anxiety and depressive disorder in women with mixed anxiety and depressive reaction due to adjustment disorder had been developed. The model included the level of cortisol; prolactin; and BMI. The criterion variable was calculated; and if its value was ≥ 1.5; the risk of developing mixed anxiety and depressive disorder was predicted; and if the value was < 1.5; a favorable course of adjustment disorder was predicted with 83.0 % sensitivity – 81.3 % specificity. Conclusion. We propose a mathematical model that provides the possibility of early recognition of conditions with a high risk of developing mixed anxiety and depressive disorder. This will allow timely carrying out the preventive and therapeutic activities aimed at increasing the stress resistance and restoring the normal neuroendocrine regulation.
The link between inflammation and hemostasis in patients with schizotypic disorder
Background. A current research on mental disorders ethiopathology is about to attract a special attention towards a possible role of inflammation/neuroinflammation related metabolic pathways. It has been shown that there is a close link between immunoinflammation and hemostasis. It might be assumed that the interrelated processes of inflammation and blood coagulation are the important elements in pathogenesis of psychiatric diseases. However; this problem remains rather obscure so far. The aim. Identification of significant parameters characterizing the hemostasis system and markers of systemic inflammation; as well as an assessment of their possible relationship in patients with schizotypal disorder. Materials and Methods. Eighteen female patients; aged 16–41 (median age [Q1;Q2] – 20 years [17.0; 26.0]); were hospitalized to the Mental Health Research Center (MHRC) clinic; all in clinically acute conditions. The blood plasma analysis based on evaluation of immune status was performed according to a special «Neuroimmunotest» technology developed and proposed earlier by the above mentioned research center (MHRC). A «Fibrinodynamics» technique was employed to elucidate the hemostasis system functioning in vivo simulating; method is also a product of our research team. Results. It has been shown that the inborn immunity patters (leucocyte elastase catalytic activity and its specific inhibitor – which is an acute phase alfa-1 protein – functional activity) are significantly increased in patients studied. Indicators of acquired immunity (S100B and the basic myelin protein antibodies level values); do not differ from the reference values. A number of «Fibrinodynamics» detected parameters were found of being significantly higher as compared to the referent values. Thus; the values of potentials of coagulation; fibrinolysis and hemostasis are essentially increased; while the hemostasis system equilibrity patterns are the same in patients as in controls. A correlation analysis results are in a favor to the existence of a link between inflammation and hemostasis parameters. Conclusion. The results of a present study reflect an interdependence between immu- noinflammatory and hemostatic systems in schizotypal disorder.
Results of surgical treatment of patients with Freiberg – Kohler disease by original method
Background. The relevance of the problem of treating patients with Freiberg – Kohler disease is due to high morbidity; gender and age characteristics of patients; as well as the unproven effectiveness of individual treatment methods. The aim. To evaluate the clinical effectiveness of surgical treatment of patients with Freiberg – Kohler disease by the original method of osteochondroplasty of the metatarsal head. Materials and methods. A retrospective analysis of the treatment results of 35 patients suffering from Freiberg – Kohler disease and receiving surgical treatment at the Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivian in 2010– 2020 was conducted. Results. The analysis of the results showed good clinical outcomes of surgical treatment. Positive dynamics of pain syndrome indices VAS preOP – 59.1 ± 13.7; VAS postOP – 31.4 ± 9.0 (p < 0.001) and functional index for the forefoot AOFAS preOP – 62.3 ± 11.6; AOFAS postOP – 76.9 ± 8.6 (p < 0.001) were noted. The structure of complications and adverse events included contracture of the metatarsophalangeal joint; partial lysis of the graft; painful donor site syndrome and superficial infection. Conclusion. The results of treatment of patients with Freiberg – Kohler disease by osteochondroplasty of the head of the affected metatarsal bone are good. However; there is a need for further study of the effectiveness of the method.
Imaging modalities for necrotizing pancreatitis: what’s new (literature review)
Pancreatic necrosis is the most severe form of acute pancreatitis; which is accompanied by a high risk of developing serious complications such as sepsis; peritonitis; multiple organ failure; etc. The mortality rate of pancreatic necrosis reaches 60–80 %; according to many authors; representing a huge problem of emergency abdominal surgery. Pancreatic necrosis most often develops in young and middle-aged people; which makes it an important social problem. Despite recent advances in pancreatology; improvement of diagnostic methods; and the emergence of new treatment methods; difficulties in choosing the optimal treatment and diagnostic tactics for pancreatic necrosis remain. In this review article; we analyzed new studies presented in open sources devoted to the diagnosis and treatment of acute pancreatitis. The search for scientific publications was conducted in the electronic database of the Scientific Library of Russia (eLibrary.ru) and the US National Library of Medicine (PubMed.org) in Russian and English. The following keywords were used as search queries: acute pancreatitis; pancreatic necrosis; ultrasound; CT; MRI; EUS; as well as their combinations in order to narrow the search for the problem. The article examines in detail the methods of radiation diagnostics of pancreatic necrosis (ultrasound; CT; MRI; EUS); which allow us to identify necrosis of the pancreatic parenchyma; the presence of “local” complications of acute pancreatitis and assess the severity. The authors analyze the advantages and limitations of each method; and discuss the features of interpreting the results. In particular; the role of radiological examination methods for assessing the severity of acute pancreatitis was studied in comparison with generally accepted scales: MCTSI; BISAP; APACHE-II; SOFA; Ranson and the C-reactive protein index. Data on diagnostic criteria for pancreatic duct disconnection syndrome were also systematized. The article will be useful for specialists in the field of radiation diagnostics; surgeons and other medical workers in related specialties involved in the treatment of acute diseases of the pancreas.
Simultaneous fixation of rib and clavicle fractures in patients with multiple thoracic trauma
Background. The combination of multiple rib fractures with a clavicle fracture can lead to severe chest deformities; respiratory dysfunction; and loss of shoulder function. In this regard; the study of the effectiveness and results of simultaneous surgical stabilization of injuries to the rib cage and upper limb girdle seems to be a relevant and scientifically sound direction. The aim. To investigate the epidemiology and treatment features of patients with combined chest injuries and clavicle fractures. Materials and methods. The epidemiological and clinical-topographic characteristics of combined chest injuries and clavicle fractures are studied. The experience of introducing the developed method of surgical stabilization of rib fractures into clinical practice is presented using the example of a 40-year-old victim with multiple thoracic trauma. An unsystematic review of the literature on the topic of the study is performed. Results. Among closed chest injuries; rib fractures occurred in 75 % (n = 490) of the total number of hospitalized patients (n = 654). The vast majority of patients with rib fractures; 76.9 % (n = 377); were men. A combination of musculoskeletal injuries and chest trauma was detected in 22.5 % of patients (n = 110). According to our data; a combination of rib and clavicle fractures occurred in 12.1 % of cases (n = 59). The treatment outcome of a 40-year-old patient hospitalized with multiple rib fractures and a clavicle fracture was analyzed after simultaneous fixation of the injuries. No complications were observed during the treatment. Conclusions. Studying the mutual influence of thoracic trauma and injuries to the upper limb girdle; as well as the possibilities of surgical treatment of fractures of the designated anatomical areas seems relevant. The presented clinical case clearly confirms the effectiveness of simultaneous surgical stabilization of the chest frame and clavicle fracture.
Experimental study of the effectiveness of a nafion-coated polypropylene endoprosthesis in plastic surgery of the anterior abdominal wall
Justification. The search for various materials in hernia repair is an urgent task of herniology. The aim of the study was to study the effectiveness of using polypropylene endoprostheses with a nafion coating in the plastic of the anterior abdominal wall in experimental animals. Materials and methods. A prospective non-randomized study in the vivarium of Kabardino-Balkarian University was used 16 mongrel rabbits divided into 2 equal groups. The first group underwent implantation of a polypropylene mesh using the “on-lay” technique; the second group underwent a similar operation; but using a nafion-coated endoprosthesis. On the 7th; 14th; 21st; and 30th days; 4 individuals were removed from the experiment; followed by tissue sampling from the anterior abdominal wall using an endoprosthesis and the production of paraffin blocks and slides for histological examination and morphometry. The clinical and laboratory dynamics were evaluated. The tissues in the endoprosthetics area were subjected to a tear strength test. The SPSS 17.0 program was used for statistical processing. Results. In the control group; the fibers of the newly formed connective tissue were chaotic with a large number of cellular infiltrates. In the experimental group; the fiber flow was orderly and corrugated. Morphometric parameters of fibrillogenesis were statistically significantly higher in the experimental group. According to the results of a clinical blood test in the control group; there was a statistically significant increase in leukocytes and C-reactive protein. In individuals of this group; an increase in blood creatinine was noted against the background of a systemic inflammatory reaction. Suppuration in the control group was 50 % more than in the experimental group. The force required to rupture the anterior abdominal wall tissue with an endoprosthesis was statistically significantly greater in the experimental group than in the experimental group. Conclusion. The use of a polypropylene endoprosthesis with a nafion coating leads to an improvement in regeneration processes in the area of its implantation on the anterior abdominal wall in rabbits.
The dynamics of oxidoreductase expression in the liver during experimental peritonitis and the role of p38 MAPK inhibition
Background. Oxidative stress is crucial in the pathogenesis of endogenous intoxication syndrome in acute surgical abdominal pathology. The enzyme systems of oxidative phosphorylation and cytochrome reductase are vital for hepatocyte energy potential. This study aimed to investigate the effects of a p38 MAPK inhibitor on cytochrome b5 reductase 3 (CYB5R3); cytochrome c oxidase; and microsomal oxidation in experimental peritonitis. Methods. A model of peritonitis was used with two groups: a control group without treatment (n = 15) and a main group treated with adezmapimod conjugate on endof-surgery (n = 15). Immunomorphological staining was employed to evaluate CYB5R3 and cytochrome oxidase expression on days 3; 7; and 14. The intensity of staining was scored from 0 to 4; and differences were assessed using multiple comparison tests and the Mann-Whitney criterion. Results. In the control group; CYB5R3 intensity decreased from 2.5 [2.0;3.0] on day 3 to 1.0 [1.0;1.0] on day 14. Conversely; in the main group; the inhibitor maintained high enzyme expression throughout the study. On day 3; cytochrome oxidase levels differed significantly between groups: 1.0 [1.0;2.0] in the control and 4.0 [3.0;4.0] in the main group (p < 0.05). Conclusion. The findings suggest that adezmapimod conjugate positively affects the integrity of enzyme systems; maintaining redox balance and oxidative phosphorylation in hepatocytes during peritonitis.
Integral Assessment of the Epidemiological Risk of Genetic Lineages of Mycobacterium tuberculosis within the Genomic Epidemiological Surveillance System
Introduction. The spread of drug-resistant tuberculosis necessitates the implementation of novel analytical approaches for assessing epidemiological risks using wholegenome sequencing (WGS) data. Objective. To develop an Integrated Epidemiological Risk Index (IERI) that accounts for regional patterns of strain distribution as well as biological and genetic characteristics of Mycobacterium tuberculosis (MTB) associated with the development of drug resistance. Materials and Methods. The study included 5538 MTB genomes representing a wide range of genotypes from countries of the post-Soviet region. For each strain; the mutational burden in resistance-associated genes and the relative frequency of the genotype in the population were calculated. Logarithmic transformation; normalization; and aggregation methods were applied to construct a unified Integrated Epidemiological Risk Index (IERI). The predictive value of the index was evaluated using ROC analysis. Results. This study presents an Integrated Epidemiological Risk Index (IERI) that simultaneously incorporates the population prevalence of MTB genotypes and their mutational burden in genes associated with resistance to anti-tuberculosis drugs. ROC analysis confirmed the high predictive value of the IERI (AUC = 0.867) and the robustness of the method when applied to heterogeneous population datasets. Conclusion. The findings demonstrate the practical utility of the IERI for early identification of high-risk strains in the context of genomic epidemiological surveillance.
Paradigms and scientific revolutions in epidemiology
The article analyses the philosophical ideas of the American historian and philosopher of science Thomas Kuhn; who introduced such key concepts as “paradigm” and “paradigm shift” into scientific usage. These concepts underpin his approach to the development of science. Kuhn’s ideas and his work “The Structure of Scientific Revolutions” (1962); which outlines the main provisions of his doctrine; remain one of the most quoted in world science. However; in the Russian language literature; especially in the context of medical science; they are not sufficiently covered. According to Kuhn; the accumulation of knowledge occurs gradually only in periods of “normal science”; the main development of science occurs abruptly; through scientific revolutions; which are associated with the change of paradigms. Under the paradigm; Kuhn understands “recognized scientific achievements that for a time provide model problems and solutions to a community of practitioner”. At the same time; the term “scientific revolutions” used by Kuhn covers all transformations in science – from minor changes to large-scale transformations; which is not always logically justified. Russian philosopher V.S. Styopin identifies four major scientific revolutions; covering the period of formation of modern science from the 17th century to the present day. The article proposes to interpret global scientific changes through V.S. Styopin’s classification; considering the change of paradigms (according to Kuhn); occurring within these main stages; as “discrete transformations”. The article attempts to familiarize domestic specialists with the development of science as a process of paradigm shift; considered in the context of epidemiological studies.