[Overactive bladder pathogenetic features and choice of drug therapy].

The information about the founders of studies of the bladder function in our country, the features of the nervous and humoral regulation of the lower urinary tract activity, the cholinergic and adrenergic effects of mediators are presented in the article in the form of a clinical lecture. The pathogenetic features of detrusor dysfunction in overactive bladder and the principles of choosing drug therapy are described. Special attention is paid to the comparative characteristics of modern M-anticholinergics.

[A decrease in male reproductive potential in Russia: causes, diagnosis, possibilities for correction].

The causes, some pathogenetic mechanisms and possibilities for correcting the decrease in male reproductive potential in Russia are discussed in the lecture. Particular attention is paid to oxidative stress as one of the main causes for subfertility and male infertility, as well as the role of trace elements (zinc, selenium) and antioxidants (vitamins A, E and C) in the pathogenesis of male infertility and opportunities for the correction of fertility issues. Some aspects of COVID-19 influence on the problems of reproductive medicine, andrology and urology are highlighted.

[Combination of 1-blockers and phosphodiesterase type 5 inhibitor in patients with benign prostatic hyperplasia and erectile dysfunction: results of observatory prospective multicenter study].

AIM: To evaluate the efficacy and safety of combination therapy with 1-blocker and phosphodiesterase type 5 inhibitor (PDE5) in patients with benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). MATERIALS AND METHODS: The observational multicenter program involving 18 medical institutions in Moscow included 315 men aged 40-65 years with BPH and ED. The inclusion criteria were a total IPSS score more than 8 points, QoL score of more than 3 points and clinical manifestations of ED ( less or equal 20 points on the IIEF-5 score). All patients received combined pharmacotherapy with Alfuprost MP 10 mg/day and Viatail 50 mg/day (if necessary, the dose was increased to 100 mg/day) for 3 months. RESULTS: The combination therapy showed a high clinical efficiency and a favorable safety profile. Lower urinary tract symptoms improved by more than 60%, QoL increased by 64% and erectile function improved in more than 80% of patients. At the end of treatment, the average patient satisfaction score on the Likert scale was 4.2 (high and very high satisfaction), while doctors satisfaction with the clinical response of patients to the treatment was 4.35 points, which also corresponds to high and very high efficacy of therapy. CONCLUSION: Combination of Alfuprost MP 10 mg/day and Viatail 50 mg/day (100 mg, if necessary) can be considered as one of the best options for non-surgical treatment of patients with BPH and ED.

Diseño de Sonrisa Digital / Digital Smile Desinge

Nowadays, a lot of people need in reconstruction of the teeth in connection with their loss. Before prosthetics or any other manipulations, a person wants to quickly see the aesthetic appearance of his future tooth. At the moment, many dentists use the option of verbal explanation to the patient, what will look like a smile or a front row of teeth after treatment, but the visual representation of the person remains aside. But now this can be achieved with the help of "Digital smile design", which shows the person the final result of the dentition. This technology has a number of advantages. Some of them are the rapid creation of a prototype model and high accuracy in the manufacture of work. Thanks to these technologies, communication between the specialist and the patient has been facilitated. The digital smile design has simplified the doctor's work process and reduced patient data processing time. From now on, achieving aesthetic results in the reconstruction of teeth for the dentist is not a problem.

[Results of analysis of the structural and functional state of the kidneys by the method of mathematical processing of contrast-enhancing MD-CT data in patients with urolithiasis].

INTRODUCTION: and Objectives: to date there have been several hypotheses on the causes of kidney stone formation. Compromised intrarenal blood flow might play one of major roles in stone formation. Advances in software and 3D technologies have unveiled the nature of contrast medium flow in the intrarenal structures. Mathematical analysis and 3D rendering of computed tomography (CT) scans was utilized for inrarenal contrast medium flow assessment in patients with stone kidney disease. This study aimed at assessing split glomerular filtration rate (sGFR) in patients at the initial stage of stone kidney disease (SKD). sGFR was measured by means of mathematical analysis of 3D rendering abdominal contrast enhanced CT scans. As well as that, possible correlations between irregular inrarenal contrast medium flow and causes of stone formation were considered. MATERIALS AND METHODS: 23 patients of both sexes with stone kidney disease (SKD) were recruited. They underwent US/Dopler investigation of the kidneys and the bladder, plain X-ray, histopathological evaluation of the tissues (those patients who were operated on), spectroscopic analysis of the stone(s). Mathematical analysis of 3D rendering of CT scans was utilized for sGFR assessment (sGFR reference value: 0,55% of contrast medium per second). Inclusion criteria are as follows: 1) newly diagnosed SKD; 2) stone size less than 1,5-2,0 cm 3) stones that do not block urine flow 4) non-operated young patients; 5) patients free of comorbidities. Inclusion criteria were set to mitigate the effects of other factors that might influence on intrarenal blood flow and conduct the study per se. RESULTS: Mathematical analysis of 3D rendering of CT scans allowed to elucidate changes in sGFR in 22 (95,6%) patients out of 23. HypErfiltration (hyperF) was detected in 10 (43,5%) patients, hypOfiltration (hypoF) was detected in 11(47,8%) patients. sGFR values were statistically significantly different in these groups both on the left (p=0,000142) and on the right (p=0,00068). No significant gender differences were observed (hypoF group aged 25-67 years with the mean age of 43,5 years; hyperF group aged 17-57 years with the mean age of 39 years (p=0,563). Ultrasound Doppler renal resistive index in renal arteries was within the normal range in both groups with no statistically significant difference between the groups. However, 1 patient demonstrated no sGFR changes. Another patient had hyporfiltration on the left (0,48%) and hyperfiltration on the right (0,62%) Conclusions: sGFR alterations (hypo- or hyperfiltration) were detected in the majority of the patients with SKD (95,6%). This in turn might be suggestive of compromised intrarenal blood flow. Further studies are needed to elucidate the optimal management of these patients.

[The features of course of chronic abacterial prostatitis with inflammatory compoment in men of the first period of mature age depending on the somatotype. Part 2: laboratory and imaging characteristics].

AIM: to study the course of chronic abacterial prostatitis with the inflammatory component (CAPIC) depending on the somatotype in men of the first period of mature age taking complex treatment with a use of local and systemic ozone therapy. MATERIALS AND METHODS: A total of 306 men of asthenic, normostenic and pyknic somatotypes with CAPIC were followed-up. Along with standard therapy, all patients received systemic and local ozone therapy. Clinical, laboratory and imaging characteristics were recorded before and after treatment. In addition, hemodynamic parameters in the prostate, prostatic part of the urethra and skin projection of the prostate were evaluated. RESULTS: In patients with pyknic somatotype (from 34.12+/-0.51 cm3 to 29.08+/-0.64 cm3) the most significant reduction in prostate size during the treatment with CAPIC was observed, while the improvement of microcirculation parameters were seen in patients with asthenic somatotype. Changes in the microcirculation in the mucous membrane of the prostatic part of the urethra and skin projection of the prostate during the treatment of CAPIC are somatotype-dependent. The highest values of tissue perfusion were found in patients of the normostenic somatotype, while pyknic patients had the smallest values. Along with somatotyping, this allows to use in clinical practice the abovementioned methods for early diagnosis and subsequent monitoring of the effectiveness of CAPIC therapy.

[A new method of evaluation of split renal function based on contrast-enhanced multislice spiral computed tomography].

INTRODUCTION: Traditionally, evaluation of the split renal function is performed using nephroscintigraphy. However, as shown in several studies, there might be quite significant inaccuracy in the interpretation of dynamic nephroscintigraphy results. But due to the lack of alternative methods for evaluation of split renal function, nephroscintigraphy remains the method of choice. AIM: To investigate the feasibility of digital analysis of contrast-enhanced MSCT imaging for evaluation of the split renal function. MATERIALS AND METHODS: This is a prospective study conducted at the R.M. Fronshteyn Clinic of Urology from November 2015 to February 2017. The study comprised 31 patients with urolithiasis (n=7), hydronephrosis (n=9), kidney cancer (n=14) and urinary bladder tumor (n=1). During the preoperative period, the patients underwent contrast-enhanced MSCT, 3D-reconstruction, and digital analysis. The obtained data were compared with the results of dynamic nephroscintigraphy. RESULTS: Contrast-enhanced MSCT findings were not inferior to data obtained with dynamic nephroscintigraphy regarding information content (p<0.004). CONCLUSIONS: The new method of digital processing of three-dimensional contrast-enhanced MSCT allows for concomitant assessment of both the anatomical features of the kidney and renal function that may help to improve the accuracy of surgical planning to choose the optimal extension of the intervention.

[The features of course of chronic abacterial prostatitis with inflammatory compoment in men of the first period of mature age depending on the somatotype. Part 1: the clinical characteristics].

AIM: to study the course of chronic abacterial prostatitis with the inflammatory component (CAPIC) depending on the somatotype in men of the first period of mature age taking complex treatment with a use of local and systemic ozone therapy. MATERIALS AND METHODS: A total of 306 men of asthenic, normostenic and pyknic somatotypes with CAPIC were followed-up. Along with standard therapy, all patients received systemic and local ozone therapy. Patients complaints were recorded before and after treatment. Questionnaires for total assessment of the symptoms of CAPIC and male sexual function were used for monitoring of clinical manifestations. RESULTS: Sexual disturbances before and after treatment were less pronounced in patients with normostenic somatotype in comparison to patients with asthenic and pyknic somatotypes. Pain syndrome was less common in normostenic patients (0.83+/-0.09 points). The most severe dysuric symptoms (<0.03) was noted in patients with pyknic somatotype, such as weak urine stream, interrupted stream and incomplete bladder emptying (1.33+/-0.14 points), increased frequency of urination (0.91+/-0.11 points), dribbling (1.22+/-0.14 points). In addition, they had a maximum influence of the symptoms of CAPIC on the professional activity (1.50+/-0.08 points; <0.02). After treatment, a clinical index (CI) of CAPIC in the severity of clinical manifestations in patients of the normostenic somatotype was insignificant (9.29+/-0.55 points), while in patients with asthenic and pyknic somatotype it was moderate, almost insignificant (11.71+/-0.62 and 13.62+/-0.61 points, respectively). Overall, CAPIC was the most severe in patients with a pyknic somatotype, which was objectively confirmed by the of CI of CAPIC. However, standard therapy with a using of regional and local ozone therapy in these patients were more efficient in comparison with patients with other somatotypes and was accompanied by an almost twice decrease in CI of CAPIC (from 24.32+/-0.73 to 13.62+/-0.61 points).

[General clinical and laboratory and instrumental characteristics of the chronic nonbapterial prostatite with the inflammatory component in men of the first period of mature age].

AIM: To investigate the course of CNPIC in young men treated with general and local ozone therapy. MATERIALS AND METHODS: 306 patients underwent standard treatment concurrently with local and systemic ozone therapy. Clinical-laboratory and instrumental parameters were evaluated before and after treatment. In addition, the blood flow of the prostate, prostatic urethra and skin at the projection point of the prostate was studied. RESULTS: Standard treatment of CNPIC with the concurrent use of general and local ozone therapy resulted in a reduction of pain intensity and severity of dysuria, improvement of the sexual function and quality of life of men. There was an increase in blood flow in the arteries and veins of the prostate, a decrease in the prostate size and volume. The study findings showed an almost twofold decrease of the mean values of the CNPIC clinical index during treatment. In the prostate secretion, the leukocyte count decreased from 29.29+/-0.67 to 4.75+/-0.15. A statistically significant (p<0.001) decrease in all sizes of the prostate was observed: height (upper) from 40.99+/-0.22 to 39.13+/-0.21 mm, width (transverse dimension) from 41.94+/-0.21 to 39.94+/-0.22 mm, and thickness (anteroposterior size) from 30.52+/-0.20 to 29.15+/-0.18 mm. Prostate volume also decreased from 27.78+/-0.42 to 24.10+/-0.36 cm (p<0.001).

Biocompatibility and Structural Features of Biodegradable Polymer Scaffolds.

We performed a comparative analysis of physicochemical properties and biocompatibility of scaffolds of different composition on the basis of biodegradable polymers fabricated by casting and electrospinning methods. For production of polyhydroxyalkanoate-based scaffolds by electrospinning method, the optimal concentration of the polymer was 8-10%. Fiber diameter and properties of the scaffold produced by electrospinning method depended on polymer composition. Addition of polycaprolactone increased elasticity of the scaffolds. Bio- and hemocompatibility of the scaffolds largely depended on the composition formulation and method of scaffold fabrication. Polylactide introduced into the composition of polyhydroxybutyrate-oxyvalerate scaffolds accelerated degradation and increased adhesive properties of the scaffolds.

Use of polycaprolactone grafts for small-diameter blood vessels.

Current trends are toward actively developing approaches of tissue engineering, aimed at creating vascular grafts of small diameter. This is due to the existing in cardiovascular surgery demand for prostheses to be used in coronary artery bypass grafting. The present work was undertaken in order to assess possibilities of using smalldiameter vascular grafts made of biodegradable polymer polycaprolactone by means of electrospinning. The authors studied physico-mechanical properties and structure of polycaprolactone grafts, as well as their thromboresistance and patency after implantation into the vascular bed of rats. The obtained results demonstrated optimal physicomechanical properties of the vascular grafts, their biocompatibility, endothelialisation of the internal surface, and infiltration of the graft's wall by cells with the formation of new tissue, accompanied and followed by the development of an extensive intimal layer in the zones of the anastomoses. Hence, the study showed possibilities of using polycaprolactone grafts as vascular prostheses, however requiring their further modification which would promote and contribute to a decrease in hyperplasia of connective tissue in the graft's lumen.

[Effect of polyoxyalkanoate -based cover on properties of suture material].

The results of a surgical intervention and, in particular, reconstructive operations on arteries are largely influenced by suture material. Despite a wide range of choice, the market concerned lacks suture material which would make it possible to decrease the risk of thrombosis in the area of the vascular anastomosis. In order to increase bio- and haemocompatibility, the surface of a polypropylene thread was covered with a layer based on polyoxyalkanoates - polyhydroxybutyrate and copolymer polyhydroxybutyrate-oxyvaleriate (PHBV). The strongest and most uniformly distributed coating of the polypropylene thread was provided by PHBV. We assessed the bio- and haemocompatibility properties of suture material modified by PHBV, revealing that this modification does not exert negative effect on the main components of blood - thrombocytes and erythrocytes. Treatment of the thread's surface with PHBV promoted a significant (p<0.05) decrease in the amount of absorbed proteins in the area of the vascular anastomosis in experiment: the amount of IgM decreased by 26%, that of fibrinogen by 29%, and that of D-Dimer by 281%, being on the whole indicative of bio- and haemocompatibility of the modified suture material.

[Ozone therapy and tamsulosin in the treatment of cystitis].

Treatment of cystitis remains an urgent problem in urology due to its prevalence, physical and social disadaptation of patients, and not always satisfactory treatment results. The article presents the results of treatment of 40 women aged 41.5 +/- 12.4 years with chronic cystitis. 20 patients received ozone therapy, 20 patients--ozone therapy in combination with alpha-adrenoblocker tamsulosin. Effectiveness of the treatment was evaluated using clinical data, data of bladder diaries, IPSS score, and uroflowmetry data. Dynamics of all the parameters in patients treated with ozone therapy in combination with tamsulosin was significantly higher in comparison with that in patients treated with ozone therapy only. As a result of the treatment, increased urine flow rate was accompanied by an increase in urination. Combination therapy with the use of ozone therapy and tamsulosin can be successfully and safely used in the treatment of patients with cystitis.

[The role of dysfunction of the autonomic nervous system in idiopathic overactive urinary bladder in women].

A complex urological and neurological examination of female patients with idiopathic overactive bladder (IOAB) has detected clinical signs and neurophysiological correlates of vegetative dysfunction in the form of disturbed sympatho-parasympathic interrelations, failure of segmental and compensatory enhancement of suprasegmental mechanisms of regulation of lower urinary tract activity. The treatment with selective inhibitors of serotonin re-entry reduced severity ofpsychovegetative syndrome and symptoms of the lower urinary tract. This confirms an essential role of the autonomic nervous system in pathogenetic mechanisms of IOAB development and gives grounds for recommending selective inhibitors of serotonin re-entry for combined treatment of IOAB patients.

Foot and mouth disease virus polyepitope protein produced in bacteria and plants induces protective immunity in guinea pigs.

The goal of this project was to develop an alternative foot and mouth disease (FMD) vaccine candidate based on a recombinant protein consisting of efficient viral epitopes. A recombinant gene was designed that encodes B-cell epitopes of proteins VP1 and VP4 and T-cell epitopes of proteins 2C and 3D. The polyepitope protein (H-PE) was produced in E. coli bacteria or in N. benthamiana plants using a phytovirus expression system. The methods of extraction and purification of H-PE proteins from bacteria and plants were developed. Immunization of guinea pigs with the purified H-PE proteins induced an efficient immune response against foot and mouth disease virus (FMDV) serotype O/Taiwan/99 and protection against the disease. The polyepitope protein H-PE can be used as a basis for developing a new recombinant vaccine against FMD.

[Molecular genetic characteristics of the newcastle disease virus velogenic strains isolated in Russia, Ukraine, Kazakhstan, and Kirghizia].

The F gene fragment of 79 Newcastle disease virus (NDV) strains isolated from domestic and synanthropic birds in Kazakhstan, Kirghizia, Ukraine, and Russia in 1993 to 2007 was comparatively analyzed. Phylogenetic analysis of test isolates and reference NDV strains obtained from the GenBank was carried out by polymerase chain reaction with subsequent sequencing and comparative analysis of 154-bp nucleotide sequences in the main functional region of the F gene. All newly characterized isolates belong to three NDV genotype VII subgroups: VIIa, VIIb, VIId. The results show it necessary to monitor of NDV strains isolated in the CIS countries since the spread of NDV among migratory and synanthropic birds (pigeons, crows, and jackdaws) poses a serious threat to commercial poultry industry.