[Floating structure of the carotid artery as a cause of microembolism in the basin of cerebral arteries]. / Flotiruiushchaia struktura sonnoi arterii kak prichina mikroémbolii v basseine mozgovykh arterii.

This article describes a rare clinical and diagnostic case report regarding a female patient presenting with frequent transitory attacks in the basin of both middle cerebral arteries. Based on the findings of duplex scanning of the cervical arteries we revealed floating structures with the presence of pronounced slow turbulent blood flow. After excluding all known causes of cerebral artery microembolism, associated with heart pathology or with the presence of unstable atherosclerotic plaques, the leading hypothesis of transitory ischaemic attacks in the woman concerned was the formation of microthrombi in the zone of motility of the structures revealed. The results of bitemporal transcranial Doppler monitoring carried out during 30 minutes detected more than 10 microembolic signals in the middle cerebral artery, thus confirming the embolic nature of transitory ischaemic attacks.

FEATURES OF EJACULATE MICROBIOCENOSIS IN MEN WITH IMPAIRED FERTILITY, DEPENDING ON THE TYPE OF CONSUMED ALCOHOLIC BEVERAGES.

Due to the lack of both common conception concerning etiology of male infertility and data about disorders of immune homeostasis concomitant with dysbiosis of urogenital tract in men with damages of reproductive function depending on features of alcoholic anamnesis, the aim of our research is studying influence of microbiocenoses in ejaculate on nonspecific immune factors in males suffering from fertile function damages depending on kind and amount of alcohol used. This article deals with findings concerning condition of semen analysis, cellular agents in innate immunity, bacteriological investigation of ejaculate in 73 males divided in 5 groups, depending on amount and kind of alcohol. According to data obtained it was established that all patients in groups under research suffered from incomplete phagocytosis in neutrophils links secondary to retaining functional and metabolic reserve in using strong alcoholic drinks and in its exhaustion in drinking excess bear and mixed alcohol. Studying microflora in ejaculate has shown presence only G+ flora (Staphylococcus haemolyticus, Staphylococcus epidermidis, Enterococcus faecalis) in drinking excess strong alcohol but in drinking excess bear and mixed alcohol both G+ microflora (Staphylococcus epidermidis, Enterococcus faecalis) and G- microflora (Escherichia coli, Klebsiella pneumoniae) have been observed. Associations of microorganisms have been revealed in males of all groups under research, in this case the most number of them has been revealed in drinking excess bear. In turn, the semen analysis showed that the most evident changes in ejaculate fertile properties were being observed at middle and high risk in consumption of beer and alcohol mixed, as astenoteratozoospermia. Proceeding from the data obtained one may suppose that drinking alcohol mixed is the factor causing development of incompetence for nonspecific protection, because it might lead to damages of microbiocenoses in ejaculate and male fertility reduced consequently.

[MENTAL DERANGEMENT AS A MANDATORY MEDICAL CRITERION OF LIMITED SANTY].

The aim of the article is scientific conceptualization of the problem of mental derangement as a mandatory medical criterion of limited sanity according to criminal legislation by experience of Ukraine and some foreign countries and development of new approaches to such status assessment. Empirical study base of the problem consists of judgments of conviction taken from Unified State Register of Court Rulings of Ukraine and carried out on persons who commit crimes in the state of limited sanity from March 1st, 2014, till August 1st, 2020. Results of some foreign researchers' studies of the problem in question have been used as well. A combination of general and special scientific methods (comparative method, system structural method, method of statistical analysis, method of legal phenomenon system analysis etc.) has been applied to reach the aim in view. In conclusion: medical criterion of limited sanity ("mental derangement") used by lawmaker does not allow defining clearly types of illnesses, represent all possible types of psychiatric pathology and also causes complications in law enforcement practice. It has been proved that increase of quantity of people having mental derangements and quantity of crimes committed by such people shows that non-application of compulsory measures of medical care, correlational programs leads to repeated crimes commitment. Taking into account absence of duration of compulsory measures of medical care application, it has been suggested to stipulate this by Ukrainian legislation and to develop classification of mental derangements and criteria of their division into severe and non-severe.

[PREVENTION OF CORRUPTION OFFENCES IN THE HEALTHСARE: THE EXPERIENCE OF UKRAINE AND GEORGIA].

The aim of the article is a comparative and legal study of corruption and measures to combat corruption in health care in Ukraine, using the experience of Georgia and the European Union. The materials of the research are the legislation of the European Union, Georgia, Ukraine, statistical information. The authors of the research have used the systematization method, comparative and legal method, analysis and generalization of statistical data. Corruption and corruption offences in the health system may lead to unpredictable consequences impacting accessibility, equity and health outcomes. Fighting against corruption in the health sector consists of the identification of specific forms of corruption and the implementation of effective anti-corruption measures, which must be designed to fit the context of a country's health system. A study of the experience of Georgia and the EU countries shows that, changes in the organization and management of the health system, financing of health care, provision of health services, increase access to medical services, reducing inequalities, financial risks reduction regarding expenditures on medical services, changing public opinion of the perception of corruption, transparency and accountability in the funding of medicine, the anti-corruption examination of legislative acts regulating the activity of healthcare in Ukraine, the formation of anti-corruption behaviour in society, active cooperation with civil society institutions are therefore of primary importance for Ukraine during the period of medical reform. Elimination of the reasons and conditions promoting the commission of corruption offences in the health system and the introduction of an effective anti-corruption strategy based on good governance, transparency and zero tolerance are among the priority areas for improving the current legislation of Ukraine in fighting against corruption in the field of healthcare.

Applying Patient-Specific Induced Pluripotent Stem Cells to Create a Model of Hypertrophic Cardiomyopathy.

Generation of patient-specific induced pluripotent stem cells (iPSCs) and their subsequent differentiation into cardiomyocytes opened new opportunities for studying pathogenesis of inherited cardiovascular diseases. One of these diseases is hypertrophic cardiomyopathy (HCM) for which no efficient therapy methods have been developed so far. In this study, the approach based on patient-specific iPSCs was applied to create a model of the disease. Genetic analysis of a hypertrophic cardiomyopathy patient revealed R326Q mutation in the MYBPC3 gene. iPSCs of the patient were generated and characterized. The cells were differentiated into cardiomyocytes together with the control iPSCs from a healthy donor. The patient's iPSC-derived cardiomyocytes exhibited early HCM features, such as abnormal calcium handling and increased intracellular calcium concentration. Therefore, cardiomyocytes obtained by directed differentiation of iPSCs from the HCM patient can be used as a model system to study HCM pathogenesis.

Formation of Alcohol Motivation in Monkeys (Macaca mulatta) Kept in Isolation.

The effects of environmental factors (flavors, different ethanol concentration, alcoholic deprivation, and food reinforcement) on the formation of alcohol motivation was studied in rhesus macaques (Macaca mulatta, n=6). Motivation for alcohol intake was induced in two stages: initiation (sessions 1-160) and formation of motivation (sessions 161-516). Monkeys preferred multifruit flavor and 4% ethanol solution, while ethanol deprivation did not stimulate alcohol consumption. The pronounced individual differences in the pattern of alcohol motivation were revealed: the intake of 4% ethanol solution ranged from 0.21±0.03 to 0.43±0.06 g/kg without food reinforcement and increased from 0.78±0.03 to 1.22±0.09 g/kg with food reinforcement. The results suggest that the proposed method is valid and can be used as an experimental model of alcohol dependence in non-human primates.

[Preventability of perinatal losses by the example of the large industrial cities Chelyabinsk and Novosibirsk]. / Predotvratimost' perinatal'nykh poter' v Cheliabinske i Novosibirske.

Perinatal mortality rate is an indicator that characterizes the quality of medical care, as well as the social and economic situation in the region. OBJECTIVE: to audit perinatal losses in large regional centers of the Russian Federation with a population of over 1 million inhabitants, such as Chelyabinsk and Novosibirsk. MATERIAL AND METHODS: A comprehensive postmortem examination of 309 cases of perinatal losses in 2016 was made, which was supplemented with an assessment of preventability according to the Scandinavian-Baltic classification. RESULTS: The rate of preventable deaths in Chelyabinsk and Novosibirsk amounted to 91 and 81.5% of cases, respectively; the deaths were due to stillbirths at more than 28 weeks' gestation and to dead newborns in almost half of cases. The proportion of intranatal deaths was shown to increase in Chelyabinsk; the number of neonatal deaths at more than 33 weeks' gestation rose in Novosibirsk. CONCLUSION: Supplementing the traditional clinical and postmortem analysis with an assessment of the preventability of perinatal loss makes it possible to ensure a unified approach to evaluating these conditions and the comparability of autopsy results in different subjects of the Russian Federation and to determine regional reserves for reducing perinatal mortality rates.

Search for Neutrinoless Quadruple-ß Decay of

We report the results of a first experimental search for lepton number violation by four units in the neutrinoless quadruple-ß decay of ^{150}Nd using a total exposure of 0.19 kg yr recorded with the NEMO-3 detector at the Modane Underground Laboratory. We find no evidence of this decay and set lower limits on the half-life in the range T_{1/2}>(1.1-3.2)×10^{21} yr at the 90% C.L., depending on the model used for the kinematic distributions of the emitted electrons.

[SURGICAL TREATMENT OF THE INJURED PERSONS WITH SPLENIC TRAUMA IN THE CLOSED COMBINED ABDOMINAL TRAUMA].

The results of treatment of the injured persons, suffering splenic injury, in closed com- bined abdominal trauma, depending on its severity and the splenic injury degree, are presented.

[Postradial sialozoadenitis in patients with papillary carcinoma of the thyroid gland].

The authors present the results of investigation of 42 patients with salivary gland dysfunction after radioactive iodine-131 ablation therapy concerning papillary thyroid carcinoma. Clinical manifestations of postradial sialodenitis with secretory insufficiency of different degree were revealed. These side effects required an application of the special therapy.

[Diagnosis and causes of death in diabetes mellitus].

In the pandemic of diabetes mellitus (DM), there is no unified approach to making the final clinical and postmortem diagnoses of deaths caused by coronary heart disease (CHD), cerebrovascular diseases (CVD), and some other vascular catastrophes. The acute and chronic forms of CHD and CVD and acute and chronic ischemic lesions in other vascular basins, which result in death in DM, should be regard as its complications. Moreover, DM is a peripheral vascular disease.

[Development of targeted indicators of quality in postmortem examination].

The indicators of quality for impartial quantitative assessment of postmortem examination have been suggested. These indicators were based on ratio of achievement and target indexes of pathologicoanatomic activity. The indicators are necessary for decision making for enhancement of pathologicoanatomic service quality in the health-care agencies.

[Metabolic disturbances as a factor of the pathogenesis of hypertensive disease and its clinical outcomes].

AIM: To identify and determine the mechanisms of an association between arterial hypertension (AH) and proatherogenic systemic metabolic disturbances in hypertensive disease (HD), as well as the possibility of eliminating these disturbances by antihypertensivetherapy. SUBJECTS AND METHODS: Fifty-four patients with HD and 64 persons randomly selected from an unorganized urban population were examined. Systolic and diastolic blood pressure (BP), insulin sensitivity, the most important metabolic parameters of lipids, lipoproteins, and glucose, the degree of systemic inflammation and oxidative stress, and the rate of lipoprotein proatherogenic and immunogenic modification were determined. RESULTS: All the patients with HD were found to have a regular concurrence of AH with systemic inflammation and activated free-radical reactions, metabolic abnormalities, such as atherogenic dyslipidemia, insulin resistance, atherogenic and immunogenic modified lipoproteins. Antihypertensive treatment failed to eliminate metabolic disturbances even when BP control was fully restored. CONCLUSION: AH and systemic metabolic disturbances in HD have a common pathogenetic basis and the treatment of hypertensive patients should provide the normalization of not only BP, but also inflammatory and oxidative status and systemic metabolism.

Measurement of the ßß decay half-life of 130Te with the NEMO-3 detector.

We report results from the NEMO-3 experiment based on an exposure of 1275 days with 661 g of (130)Te in the form of enriched and natural tellurium foils. The ßß decay rate of (130)Te is found to be greater than zero with a significance of 7.7 standard deviations and the half-life is measured to be T(½)(2ν) = [7.0 ± 0.9(stat) ± 1.1(syst)] × 10(20) yr. This represents the most precise measurement of this half-life yet published and the first real-time observation of this decay.

[Thyroid morphology in a children population living in the environmentally polluted area].

Comprehensive study of the "normal" thyroid gland in fetuses and children of different age groups in the Chelyabinsk region revealed a number of changes characteristic of the so-called dysregulation pathology. The role of ecological factors and outcome of resuscitation and intensive therapy in these changes is discussed. It is shown that the development and manifestation of tumoral and non-tumoral diseases of thyroid gland prone to a combination of various diseases are delayed till the school age.

[Uterine mucosal morphofunctional characteristics in women with early miscarriages of infectious genesis].

Eighty-two reproductive-aged patients who had early miscarriages of infectious genesis were examined. Group I comprised 56 women who had a history of one spontaneous miscarriage; Group 2 included 26 patients with a history of 2 spontaneous miscarriages or more. The examination used a set of diagnostic tools for the identification of genital infections and histological, histochemical, and statistical studies. Group 2 patients were ascertained to have more frequently infectious inflammatory genital diseases. In the women of both groups, chronic endometritis of mainly Ureaplasma, Mycoplasma, and viral etiologies was recorded in 100% of cases while that of mixed etiology was observed in 57%. Moreover, the signs of endometrial stromal fibrosis and atrophy, receptor apparatus lesion, and suppressed tissue protective immune reactions were significantly more evident in Group 2 patients.

Study of p-(3-carboxy-1-adamantyl)-calix[4]arene with hydrogen bonds along the upper and lower rim by IR spectroscopy and DFT.

The IR spectra of p-(3-carboxy-1-adamantyl)-calix[4]arene (AdC4A) were studied. Using IR spectroscopy, it has been shown that in calixarene in dilute solution in CCl4, there was no free hydroxyl absorption band. The hydroxyl group band was characterized by a very low frequency, which indicates a strong intramolecular hydrogen bond on the lower rim of the calixarene molecules. On the upper rim of the calixarene, the carboxyl groups form cyclic dimer or tetramer complexes via intermolecular hydrogen bonds. The cone conformation persists, but there is a mutual influence of the hydrogen bonds along the top and bottom rims of the calixarene molecule. The structure with dimeric hydrogen bonds between the carboxyl groups is 16.5 KJ/mol more preferable than the structure with tetrameric cyclic hydrogen bonds for AdC4A. The reactivity depends on the type of association on the upper rim, whether these are hydrogen-bonded dimers or cyclic tetrameric association. Graphical abstract .

Generation of two clonal iPSC lines, ICGi019-A and ICGi019-B, by reprogramming peripheral blood mononuclear cells of a patient suffering from hypertrophic cardiomyopathy and carrying a heterozygous p.M659I mutation in MYH7.

Hypertrophic cardiomyopathy (HCM) is one of the most frequent cardiovascular diseases but no methods to prevent its progression have been developed. Cardiomyocytes derived from patient-specific induced pluripotent stem cells can become a platform to study pathogenesis of the disease and to search for more effective therapy methods. We generated two iPSC lines from peripheral blood mononuclear cells of an HCM patient with heterozygous p.M659I mutation in MYH7 using episomal vectors. The iPSC lines expressed pluripotency markers, demonstrated ability to spontaneously differentiate into derivatives of three germ layers, and retained the mutation.

Synthesis, structure-activity relationship and biological evaluation of tetracationic gemini Dabco-surfactants for transdermal liposomal formulations.

In this study, we report the relationship between structure, self-assembly behavior and antimicrobial activity of multicationic gemini surfactants and their successful use as stabilizers of a new liposomal formulation for transdermal drug delivery. New surfactants containing natural moiety 1,4-diazabicyclo[2.2.2]octane with four charges and two hydrophobic chains (n-Dabco-s-Dabco-n, where s = 2, 6, 12 and n = 12, 14, 16, 18) were synthesized. A linear dependence of the CMC decrease, with the increase of the number of carbon atoms in alkyl groups (slope 0.23) was shown. The aggregation numbers of n-Dabco-2-Dabco-n are smaller than 30 and they decrease with increasing alkyl chain length. This is in compliance with the larger surface area per n-Dabco-2-Dabco-n molecule. New liposomal formulations loading Rhodamine B phosphatidylcholine (with mean size about 100 nm and increased zeta potential from -7 ± 2 mV to +55 ± 2 mV) have been successfully stabilized by n-Dabco-s-Dabco-n surfactants. These formulations were designed to improve the bioavailability and skin permeation of loaded compound. The antibacterial activity of Dabco-surfactants was shown to be strongly affected by their structure (alkyl chain length and number of charged nitrogen). 12-Dabco-2-Dabco-12 was the most active (MIC = 0.48, 0.98 and 15.6 µg/mL against S. aureus, B. cereus and E. coli, respectively) without hemolytic activity at 3.1 µg/mL concentration. PC/14-Dabco-2-Dabco-14-liposomes were shown to be the best formulation, with the highest antibacterial activity against Sa (MIC = 7.8 µg‧mL-1) and lowest cytotoxicity (IC50 > 125). The modification of liposomes by Dabco-surfactants stabilizes the membrane of the vesicles, preventing the release of rhodamine B and impairing the penetration of the dye across Strat-M® membrane. Cellular uptake of rhodamine B-loaded PC/12-Dabco-2-Dabco-12-liposomes was also reported. This is the first example of cationic mixed liposomes containing Dabco-surfactants of potential interest for transdermal drug delivery.

IR spectroscopy investigation using DFT analysis on the structure of P(1) phosphorus dendrimer built from octasubstituted metal-free phthalocyanine core.

The IR spectra of P(1) phosphorus dendrimer built from an octasubstituted metal-free phthalocyanine core have been recorded in the region 4000-400cm(-1). Besides the phthalocyanine core, P(1) possess also eight C(6)H(4)-CHN-N(CH(3))-P(S) arms and terminal P-Cl groups. The optimized molecular geometry, frequency and intensity of the IR bands have been calculated using density functional theory (DFT). The P(1) molecules exist in a stable conformation with planar C(6)H(4)-CHN-N(CH(3))- fragments and phthalocyanine core. The calculated geometrical parameters and harmonic vibrational frequencies are predicted in a good agreement with the experimental data. The experimental IR spectrum of P(1) dendrimer was interpreted by means of potential energy distributions. Relying on DFT calculations a complete vibrational assignment is proposed. The difference IR spectra of molecules built from the thiophosphoryl, cyclotriphosphazene, and phthalocyanine cores with the same repeated units and terminal groups were studied in order to undermine the role of the core functionality on the dendrimer architecture.