[Cardiovascular effects of omega-3 polyunsaturated fatty acids: position of omega-3 polyunsaturated fatty acids in Russian and international guidelines. Council of Experts].

This Expert Council focuses on the meta-analysis of studies on the risk of atrial fibrillation (AF) in patients taking omega-3 polyunsaturated fatty acids (PUFA) and of data on the omega-3 PUFA treatment in patients with cardiovascular and kidney diseases.The major statements of the Expert Council: the meta-analysis of AF risk in patients taking omega-3 PUFA showed an increased risk of this arrhythmia. However, it should be taken into account that the risk of complications was low, and there was no significant increase in the risk of AF when omega-3 PUFA was used at a dose of ≤1 g and a standard dose of the only omega-3 PUFA drug registered in the Russian Federation, considering all AF episodes in the ASCEND study.At the present time, according to Russian and international clinical guidelines, the use of omega-3 PUFA can be considered in the following cases: • for patients with chronic heart failure (CHF) with reduced left ventricular ejection fraction as a supplement to the basic therapy (2B class of recommendations according to the 2020 Russian Society of Cardiology guidelines (RSC) and the 2022 AHA / ACC / HFSA guidelines); • for patients with hypertriglyceridemia (>1.5 mmol/l) as a part of combination therapy (IIb class of recommendations and B level of evidence according to the 2021 European guidelines on cardiovascular disease prevention, etc.); • for adult patients with stage 3-4 chronic kidney disease (CKD), long-chain omega-3 PUFA 2 g/day is recommended for reducing the level of triglycerides (2C class of recommendations). Data on the use of omega-3 PUFA for other indications are heterogenous, which can be partially explained by using different form and doses of the drugs.

[Integral tests of the hemostasis system in assessing the efficiency of acetylsalicylic acid in patients with ischemic heart disease]. / Integral'nye testy sistemy gemostaza v otsenke éffektivnosti atsetilsalitsilovoi kisloty u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Despite the fact that acetylsalicylic acid (ASA) is the "gold" standard for the prevention of cardiovascular complications in patients with coronary heart disease (CAD), a number of patients still have risks of atherothrombosis. In the present study, the antithrombotic effect of ASA in patients with CAD was assessed in platelet-rich plasma (PRP) using integral tests of the hemostasis study: the T-TAS system (Total Thrombus-formation Analysis System) and the thrombin generation test (TGT). The study involved 34 patients with stable CAD (11 women, 23 men) and people (15 women, 18 men) in the control group. As a result of assessing the activity of thrombus formation using the T-TAS system, a significant decrease in the area under the curve (AUC10) was found in the group with CAD patients compared with the control (135.6 [88.0-222.3] and 260.5 [217.3-301.9], respectively, p.

[Surgical treatment of mega aorta syndrome: a single-center experience]. / Khirurgicheskoe lechenie sindroma megaaorty: opyt odnogo tsentra.

OBJECTIVE: To present our experience in the treatment of severe patients with mega aorta syndrome. MATERIAL AND METHODS: There were 49 patients with mega aorta syndrome for the period from May 2015 to March 2021. All patients underwent total aortic replacement from sinotubular junction (with staged aortic root repair, if necessary) to abdominal aorta bifurcation. All surgeries were elective. All patients were divided into two groups: group I (n=33; 67.3%) - staged replacement, group II (n=16; 32.7%) - one-staged replacement of the aorta via thoracophrenolumbotomy. The primary endpoints were mortality, perioperative parameters and complications. We also analyzed long-term freedom from aortic redo surgery and survival rate. RESULTS: Both groups were comparable by pre-, intra- and postoperative parameters. The interval between surgeries for staged approach was 7.1±2.3 months. Rehabilitation time considering two stages was longer in group I (13±2 vs. 5.5±1.1 months, p=0.0001). Between-stage mortality rate was 12% (n=4). Intraoperative mortality was absent in both groups. In-hospital mortality was 3% and 12% (p=0.25), overall mortality with between-stage interval - 10.2% and 12% (p=1.000), respectively. The follow-up period was similar (18±22.7 (range 1-71) and 23.3±19.1 (range 1-51) months, respectively (p=0.63)). In group I, 1-year, 3-year and 5-year survival rate considering between-stage mortality was 89% (95% CI 78-100%), 77.1% (95% CI 60.1-98.8%), 77.1% (95% CI 60.1-98.8%), respectively. In group II, 1-year and 3-year survival rate was 86.5% (95% CI 70.5-100%), plog-rank=0.88. Overall freedom from redo surgery was 92.9% (95% CI 80.3-100%) vs. 90.9% (95% CI 75.4-100%), plog-rank=0.072. CONCLUSION: One-stage total aortic replacement via thoracophrenolumbotomy is safe surgical treatment for mega aorta syndrome, especially in young patients with low surgical risk. Favorable outcomes may be expected in specialized centers with extensive experience in aortic surgery. Compared to staged approach, total aortic replacement eliminates the risks of between-stage aortic rupture. Therefore, it is a worthy alternative to other methods.

[Disulfiram inhibites the development of cataract in OXYS rats].

Surgical treatment remains the only way to restore vision in patients with cataract; this disorder is the most common reason for vision decline and vision loss in people older than 65 years. It is estimated that a 10-year delay in the development of cataract will reduce the need for surgery twofold. In 2012, Nagai and colleagues reported an anticataract effect of an inhibitor of acetaldehyde dehydrogenase-a widely used antialcoholism drug disulfiram (DSF) - in ICR/f rats with hereditary cataracts. Accordingly, the goal of the present study was to evaluate the influence of DSF on the cataract in OXYS rats, which develop lens alterations similar to senile cataract in humans. Instillation of DSF from age 1,5 to 3,5 months did not prevent but significantly slowed the development of cataracts in OXYS rats. At concentrations of 0,25 % and 0,5 %, DSF reduced the severity of pathological changes in the lens 1,8-fold and was more effective than at the concentration 1 %. These data were consistent with the results of ophthalmoscopic histomorphological examination: the pharmacotherapy strongly reduced the (typical of cataract) structural damage to the capsule of the lens epithelium and to organization of its fibers. Thus, disulfiram is a promising drug for the prevention of senile cataract in humans.

[Radiological Aspects of Transition of Russian Areas Affected by the Chernobyl Accident to Normal Activities].

Dynamics of radiation situation in settlements, agriculture and forestry on the Russian Federation areas af- fected by the Chernobyl accident is presented. A set of challenging problems on public radiation protection and rehabilitation of territories was determined. The main objective at a long-term period after the accident is a stage-wise return of the affected areas to normal activity without any radiological criteria restrictions. For practical realization of this process it is necessary to change the national statutes and regulations consid- ering the contemporary international approaches, to pass to the current exposure situation and to establish reference levels, to define criteria of transition of the areas affected after the Chernobyl accident to normal activity. The change of conceptual approaches will allow one to revise the boundaries of settlement zoning and to develop the regulatory framework on procedures of changing their status from radioactively contami- nated zone to normal activity zone; to develop the regulatory framework on the procedures of transition of agricultural and forest lands classified as radioactively contaminated zones to territories where the traditional husbandry is possible. The Russian Federation has positive experience of transition of areas contaminated as a result of the Chernobyl accident to normal activity.

[Rosuvastatin in Coronary Bypass Surgery: Whether Only Secondary Prevention?]

BACKGROUND AND AIM: The increasing number of coronary artery bypass grafting (CABG) is associated with a need for active introduction of methods improving immediate and long-term results of these interventions. Results of a number of studies conducted during recent years allow to consider high dose statin therapy one of such methods. In this article we present results of rosuvastatin administration to patients with ischemic heart disease (IHD) prior to surgery. METHODS: Rosuvastatin (40 mg/day) was given for 4 weeks before CABG to patients who had previously taken simvastatin (20 mg/day). RESULTS: This regimen was assocaed with reduction of desquamation of endothelium of the intima, reduction of the number of smooth muscle cells in the media, as well as the proliferation index according to the immunohistochemical analysis in sections of the great saphenous vein selected for the coronary anastomosis. CONCLUSION: It is assumed that the antiproliferative effects of high-dose rosuvastatin therapy may have a positive impact in relation to the viability of a remote arterio-venous grafts.

[The Antihypertensive Effect of the Fixed Combination of Lisinopril and Amlodipine in Patients With Coronary Heart Disease After Coronary Artery Bypass Grafting].

Literature data and results of our own register have indicate that hypertension is one of the most common risk factor in patients with ischemic heart disease (IHD) who have undergone coronary artery bypass grafting (CABG). But despite proven benefits of control of hypertension after CABG adherence of patients to corresponding recommendations remains low. Fixed combinations of antihypertensive drugs are associated with better compliance. In 30 IHD patients after CABG we studied effects of fixed lisinoprillamlodipine combination. This combination was safe and had high antihypertensive activity. Practically all patients responded to therapy and achieved target level of arterial pressure.

[The Antihypertensive Effect of the Fixed Combination of Amlodipine and Lisinopril in Patients With Coronary Heart Disease After Coronary Artery Bypass Grafting].

Literature data and results of our own register have indicate that hypertension is one of the most common risk factor in patients with ischemic heart disease (IHD) who have undergone coronary artery bypass grafting (CABG). But despite proven benefits of control of hypertension after CABG adherence of patients to corresponding recommendations remains low. Fixed combinations of antihypertensive drugs are associated with better compliance. In 30 IHD patients after CABG we studied effects of fixed lisinopril/amlodipine combination. This combination was safe and had high antihypertensive activity. Practically all patients responded to therapy and achieved target level of arterial pressure.

[IncP-7 plasmids' classification based on structural diversity of their basic replicons].

The structural diversity of basic replicons and repB gene of the IncP-7 plasmids' collection was firstly assessed on the basis of PCR, restriction analysis and partial sequencing. It has been revealed that DNA fragment containing gene for UvrD-like helicase RepB is a part of all known P-7 replicons, but often serves as hot place for diverse IS-elements invasion. The first system of P-7 plasmids' classification has been worked out on the basis of determined repA-oriV-par WABC nucleotide divergency. Most degradation plasmids established to be belonging to large beta-subgroup, streptomycin resistance plasmid Rms148 (IncP-7 archetype)--to alpha-subgroup, carbazole degradation plasmid pCAR1 and NAH/SAL-plasmids from pY-line (Yamal oil deposits)--to gamma-subgroup and CAP-plasmid pBS270 with potentially reduced P-7 replicon--to delta-subgroup. It has been observed that the type of IncP-7 basic replicon molecular organization does not correlate with fixed phenotypic character in most cases, that is plasmids encoding different phenotypic markers could be members of the same P-7 subgroup.

[The new gene encoding TrfA-type replication initiator has been found on caprolactam/salicylate degradation plasmid pBS270].

The mini-replicon of pseudomonads' caprolactam/salicylate degradation plasmid pBS270 (105 kb, contains incompatibility determinants of P-7 group) has been obtained and its nucleotide sequence has been determined. The new gene encoding TrfA-like replication initiator has been found on this replicon. Poor homology of this replication initiator with known proteins of TrfA-family allows us to classify obtained replicon as IncP-1-like. The pBS270mini reveals chimeric nature.

[scpA the new salicylate hydroxylase gene localized on salicylate/caprolactam degradation plasmids].

Both caprolactam and salicylate biodegradation by Pseudomonas salicylate/caprolactam degraders is controlled by large conjugative plasmids (SAL/CAP). Some of these plasmids determined to be the members of IncP-7 group. The new salicylate 1-hydroxylase gene (scpA) on SAL/CAP-plasmids has been detected and partially sequenced. Gene scpA was equally related to closest homologs nahG (NAH7), salA (P. reinekei MT1) and nahU (pND6-1), but identity of scpA to these genes did not exceed 72-74%. Synthesis of salicylate 1-hydroxylase ScpA was not induced by salicylate. This enzyme had wide substrate specificity and exhibited highest specific activity with 4-methylsalicylate and nonsubstituted salicylate. Besides pseudomonad's salicylate degradative conjugative plasmids without "classical" nah2-operon and harboring only salicylate 1-hydroxylase gene nahU have been firstly described.

[Effectiveness and safety of losartan and its combination with amlodipine in therapy of arterial hypertension].

AIM: To estimate effectiveness and safety of losartan and its combination with amlodipine in therapy of arterial hypertension. MATERIALS AND METHODS: The study based at 6 clinical centres was conducted in two stages. All 160 patients with grade I-II AH (103 women and 57 men aged 54 ± 12 yr) participated in stage 1 of the study and patients of centre No 1 (n = 100) in stage 2. Losartan was used at a dose of 50-100 mg/24 h for 8 weeks (stage 1) and thereafter from week 9 to 26 (stage 2) in combination with amlodipine (5-10 mg/24 hr) if the desired AP level (< 140/90 mmHg) was not achieved. The following parameters were measured: systolic and diastolic AP (SAP and DAP) (office measurement and 24-hr monitoring), pulse wave propagation rate (PWPR), left ventricle mass index (LVMI), thickness of intima-media complex (IMT), blood biochemistry, tolerability of therapy and its side effects. RESULTS: Losartan alone decreased SAP and DAP from 150 ± 11/91 ± 7 to 132 ± 12/81 ± 8 mm Hg (office measurement) and from 144 ± 10/86 ± 9 to 128 ± 12/76 ± 10 mm Hg (24-hr monitoring); heart rate decreased fom 74 ± 8 to 70 ± 8/min (p < 0.05). SAP and DAP in 66 patients who completed stage 2 was 122 ± 6/73 ± 6 mm Hg or significantly lower than before therapy (147 ± 9/87 ± 9) (p < 0.001). Mean daily decrease of SAP and DAP according to 24-hr monitoring decreased from 144 ± 10 to 128 ± 12 and from 86 ± 9 to 76 ± 10 mm Hg respectively (p < 0.001). The target AP value was reached in 73% of the cases (99 out of 136 patients) after stage 1 and in 95% cases (63 out of 66) after stage 2. The values of LVMI (105 ± 23 and 98 ± 26 g/m2), PWPR from 16 ± 2.1 to 13 ± 3.5 m/s (p < 0.05), IMT (0.76 ± 0.16 and 0.80 ± 42 mm), and microalbuminuria (11.0 ± 1.7 and 8.6 ± 0.7 mg/24 hr) before and after completion of stage 2 were not significantly different in 66 patients (p > 0.05). Biochemical parameters of blood did not appreciably change. The safety profiles of both drugs were on the whole positive. Deaths and adverse reactions were absent barring clinically insignificant side effects in 28 of the 160 patients (17.5%). CONCLUSION: Losartan and amlodipine are effective and safe agents for AH therapy.

[The change in efficiency of protective measures for reduction of 137Cs accumulation by agricultural plants in various periods after the Chernobyl accident].

Dynamics of 137Cs transfer factors to plants and the effects of protective measures on this radionuclide accumulation in the agricultural production is estimated on the example of the south-western regions of Bryansk District. Three periods in decreasing the 137Cs content in plants during 20 years after the Chernobyl accident are identified. The contribution of radionuclide decay, natural biogeochemical processes and protective measures aimed at reduction of the 137Cs accumulation in agricultural plants during various periods after radioactive fallout is shown. Maximum permissible levels of 137Cs contamination of cultivated lands, where crop products meeting current standards may be obtained, at different scopes of protective measures on radioactive-contaminated territories are forecasted. Periods after radioactive fallout, when crop and forage products meeting radiological standards are obtained, are assessed.

Effect of bovine serum albumin on mitochondrial respiration in the brain and liver of mice and rats.

We studied the effect of BSA (in the isolation medium) on the oxidation rate of succinate, glutamate, pyruvate, and α-ketoglutarate by mitochondria of the brain and liver from C57Bl/6g mice and Taconic Sprague Dawley rats. BSA had no effect on liver mitochondrial respiration, but increased oxidation of substrates (particularly of succinate) in brain mitochondria. Therefore, the major effect of BSA on brain mitochondria is manifested in activation of SDH. The improvement of mitochondrial properties in the brain after treatment with BSA is associated with antioxidant activity of this agent. Our results confirm the hypothesis that inhibition of SDH in brain mitochondria is not the artifact. This process serves as a mechanism protecting neurons from free oxygen radicals during succinate oxidation.

Chernobyl radionuclide distribution, migration, and environmental and agricultural impacts.

The distribution and migration of radionuclides released into the environment following the Chernobyl accident in 1986 are described. The Chernobyl disaster resulted in the consumption of farm products containing radionuclides as a source of irradiation of the population due to the prevalence of a rural type of human nutrition in the affected region. Economic and radiologic importance of countermeasures for reducing the impacts of the accident are described. The basic radioecological problem is described in which the area where direct radiation contamination of biota was observed is considerably smaller than the zone where concentrations of radionuclides through the food chain exceeded the permissible standards. The radiation-induced effects in biota in the affected area are described. In the long-term post-accident period, the radionuclide distribution between components of ecosystems (including humans) and doses are considered in comparison to a technologically normal situation of nuclear power plant operation. This analysis demonstrates that if radiation standards protect humans, then biota are also adequately protected against ionizing radiation.

[The radioecological situation in the agricultural sphere in the contaminated regions of russia during the long-term after the Chernobyl accident].

The results of the contamination monitoring of the agricultural land and products in 2000-2005 in the regions of Russia affected by the Chernobyl accident are presented. The contribution is assessed of foodstuffs to the formation of internal exposure doses to the population during the long-term after the accident. Prediction is made of the change in the radioecological situation in radioactively contaminated areas.

[Radiological assessment of protective countermeasures in the private sector of rural settlements in the Chernobyl nuclear power plant accident area].

The effectiveness of countermeasures on private farms in rural settlements of the Russian Federation affected by the Chernobyl accident for the period of 1986-2005 was assessed. The averted collective doses to the residents of these settlements and the contribution of restrictive and agricultural countermeasures to dose reduction in the rural population have been estimated.