[Therapy of mental disorders in patients with hematological malignancies]. / Terapiya nepsikhoticheskikh psikhicheskikh rasstroistv u bol'nykh s zabolevaniyami sistemy krovi.

OBJECTIVE: To assess the possibilities of therapy with minimal effective doses (MED) of psychotropic drugs for mental disorders (MD) that manifest during the treatment of hematological malignancies (HM). MATERIAL AND METHODS: A prospective study was conducted at the National Medical Research Center for Hematology of the Russian Ministry of Health (Moscow), which included 204 (39.4%) men and 314 (60.6%) women (518 patients in total), aged 17 to 83 years (median 45 years), with various HM, in which the manifestation of MD occurred during the treatment of the underlying disease. To minimize the side-effects of psychotropic drugs and given the relatively mild level of MD, psychopharmacotherapy of patients was carried out mainly at MED. The severity of MD, manifested in patients, was assessed by the illness severity scale of the Clinical Global Impression (CGI) scale, and the effectiveness of the treatment was assessed by the improvement scale (CGI-I). RESULTS: Mainly mild (188, 36%) and moderately pronounced (270, 52%) MD were noted in patients with HM during the treatment of the underlying disease. Severe psychopathological disorders (60, 12%) were observed much less often. Because of psychopharmacotherapy with MED, patients experienced a very significant (97, 19%) and significant improvement (354, 68%) of their mental state, less often the improvement was regarded as minimal (67, 13%). Therefore, almost all patients showed a stable relief of MD; in 87% (95% CI 84-90) of patients, this improvement was significant. CONCLUSION: The tactics of treatment MD that manifest in patients with HM with MED of psychotropic drugs turned out to be therapeutically effective according to the results of the assessment on CGI scales.

A novel preliminary metabolomic panel for IHD diagnostics and pathogenesis.

Cardiovascular disease (CVD) represents one of the main causes of mortality worldwide and nearly a half of it is related to ischemic heart disease (IHD). The article represents a comprehensive study on the diagnostics of IHD through the targeted metabolomic profiling and machine learning techniques. A total of 112 subjects were enrolled in the study, consisting of 76 IHD patients and 36 non-CVD subjects. Metabolomic profiling was conducted, involving the quantitative analysis of 87 endogenous metabolites in plasma. A novel regression method of age-adjustment correction of metabolomics data was developed. We identified 36 significantly changed metabolites which included increased cystathionine and dimethylglycine and the decreased ADMA and arginine. Tryptophan catabolism pathways showed significant alterations with increased levels of serotonin, intermediates of the kynurenine pathway and decreased intermediates of indole pathway. Amino acid profiles indicated elevated branched-chain amino acids and increased amino acid ratios. Short-chain acylcarnitines were reduced, while long-chain acylcarnitines were elevated. Based on these metabolites data, machine learning algorithms: logistic regression, support vector machine, decision trees, random forest, and gradient boosting, were used for IHD diagnostic models. Random forest demonstrated the highest accuracy with an AUC of 0.98. The metabolites Norepinephrine; Xanthurenic acid; Anthranilic acid; Serotonin; C6-DC; C14-OH; C16; C16-OH; GSG; Phenylalanine and Methionine were found to be significant and may serve as a novel preliminary panel for IHD diagnostics. Further studies are needed to confirm these findings.

[The relationship between penile hemodynamic parameters in cavernous rteries and penile rigidity].

INTRODUCTION: Blood flow parameters in cavernous arteries during full-erection phase on Doppler ultrasonography are associated with intracavernosal pressure and, consequently, with penile rigidity. AIM: To examine the relationship between blood flow parameters in cavernous arteries and the penile rigidity. MATERIALS AND METHODS: A total of 54 healthy men and patients with erectile dysfunction of various degrees of severity, with mean age of 43,0 +/- 2,2 years ranging from 18 to 74 years, were included in the study. Erectile function was examined and 81 Doppler ultrasonography were performed after intracavernosal injection of alprostadil (10 mcg). In full-erection phase, peak systolic velocity (PSV) and systolic acceleration (SA) were measured, as well as resistive index (RI). Mean values were calculated for both cavernous arteries. Penile rigidity was assessed in three ways: clinical evaluation according to I. Goldstein, measurement of surface rigidity and evaluation of longitudinal rigidity. RESULTS: During Doppler ultrasonography a strong correlation of penile rigidity with RI (0,71-0,85) and SA (0,63-0,69) was found. Indirect assessment of penile rigidity using PSV values was less precise. With RI values close to 1,0, SA is a more reliable method for indirect rigidity assessment. CONCLUSION: Penile blood flow parameters, RI and SA, allow to evaluate a degree of rigidity and to eliminate subjectivity of the specialist performing the examination, as well as to obtain a range of penile rigidity values.

[Chemotherapy-associated clinical dynamics of nosogenic reactions in breast and ovarian cancer model]. / Assotsiirovannaya s khimioterapiei klinicheskaya dinamika nozogennykh reaktsii na modeli raka molochnoi zhelezy i yaichnikov.

OBJECTIVE: To study the clinical features, dynamics and factors of nosogenic reactions (NR) development in patients with breast and ovarian cancers at the stage of chemotherapy. MATERIAL AND METHODS: The study involved 35 patients who underwent chemotherapy. Clinical-psychopathological and psychometric methods were used to assess the mental state. RESULTS: We distinguished 3 clinical types of nosogenic reactions: anxiety-phobic (n=14, 40%), anxiety-depression (n=13, 37%) and dissociative reaction (n=8, 23%). It was discovered that nosogenic reactions reflect the dynamics of psychopathological disorders associated with chemotherapy and they are connected with premorbid personality structure of the patients. When compared on the Mini-mult scales, differences were found between patients of the anxiety-phobic and dissociative groups: the score on the Anxiety and Depressive Tendencies scale was significantly higher in the group of patients with anxious-phobic NR (p<0.01), as was the score on the scale «Anxiety fixation and restrictive behavior¼, which was correlated with such personality traits as sensitivity, self-doubt, low self-esteem, obsessive fears (p<0.05). According to the results of the Spielberger-Khanin anxiety scale, in general, the sample was characterized by an increased level of anxiety compared to the norm: the average scores were 49.7 for trait anxiety and 47.7 for state anxiety. CONCLUSION: Nosogenic reactions can undergo dynamic changes at various stages of treatment. The proposed typology of nosogenies in a more detailed study can have not only scientific, but also practical significance for determining the personalized tactics of psychiatric care for cancer patients at different stages of the disease.

[Development of a Series of Neutralizing Nanobodies against SARS-CoV-2 Spike Protein].

Countering the spread of new respiratory infections and reducing the damage they cause to society requires efficient strategies for rapidly developing of targeted therapeutics, such as monoclonal antibodies. Nanobodies, defined as variable fragments of heavy-chain camelid antibodies, have a set of characteristics that make them particularly convenient for this purpose. The speed at which the SARS-CoV-2 pandemic spread confirmed that the key factor in the development of therapeutics is obtaining highly effective blocking agents as soon as possible, as well as the diversity of epitopes to which these agents bind. We have optimized the selection process of blocking nanobodies from the genetic material of camelids and obtained a panel of nanobody structures with affinity to Spike protein in the lower nanomolar and picomolar ranges and with high binding specificity. The subset of nanobodies that demonstrate the ability to block the interaction between the Spike protein and the cellular ACE2 receptor was selected in experiments in vitro and in vivo. It has been established that the epitopes bound by the nanobodies are located in the RBD domain of the Spike protein and have little overlap. The diversity of binding regions may allow a mixture of nanobodies to retain potential therapeutic efficacy towards new Spike protein variants. Furthermore, the structural features of nanobodies, particularly their compact size and high stability, indicate the possibility of their utilization in the form of aerosols.

[Immune mechanisms of complicity of somatic pathology in the pathogenesis of mental disorders]. / Immunnye mekhanizmy souchastiya somaticheskoi patologii v patogeneze psikhicheskikh rasstroistv.

Understanding the mechanisms of the relationship between the nervous and immune systems within the framework of the concept of the key role of inflammation, taking into account the involved genetic factors in the development of a wide range of combined forms of somatic and mental diseases, is of interest for research as well as for the development of new approaches to early diagnosis and more effective treatment of these diseases. This review analyzes the immune mechanisms of the development of mental disorders in patients with somatic diseases, in particular, the transmission of an inflammatory signal from the periphery to the CNS and the implementation of the influence of inflammatory factors on neurochemical systems that determine the characteristics of mental functioning. Particular attention is paid to the processes underlying the disruption of the blood-brain barrier caused by peripheral inflammation. Modulation of neurotransmission, changes in neuroplasticity, changes in regional activity of the brain in areas associated with the functions of threat recognition, cognitive processes and memory function, the effect of cytokines on the hypothalamic-pituitary-adrenal system are considered as mechanisms of action of inflammatory factors in the brain. The need to take into account variations in the genes of pro-inflammatory cytokines, which may be the cause of increased genetic vulnerability associated with the risk mental disorders in patients suffering from a certain somatic disease, is emphasized.

[Psychopharmacotherapy of mental disorders in hematological patients: security concerns]. / Psikhofarmakoterapiya psikhicheskikh rasstroistv u gematologicheskikh bol'nykh: problemy bezopasnosti.

OBJECTIVE: Evaluation of the safety of psychopharmacotherapy (PFT) of mental disorders in modern protocols for the treatment of patients with blood disorders. MATERIAL AND METHODS: The data of medical records of 552 patients with blood disorders who received PFT during treatment at the clinic of the National Medical Research Center for Hematology were analyzed. Any adverse events recorded while taking PFT were taken into account. Statistical analysis included descriptive statistics, frequency analysis, and assessment (Student's t-test) of changes in blood parameters (before and after taking psychotropic drugs). RESULTS: Signs of hematotoxicity were found only in 7.1% (n=37) patients, in all cases while taking benzodiazepines (n=12) in combination with hematotoxic drugs for the treatment of blood disorders. Other significant adverse events (which caused premature discontinuation or dose reduction) were detected in 4.8% (n=25) cases, of which 9 were associated with the appointment of anxiolytics (hydroxyzine, zopiclone), 11 with antidepressants (clomipramine, amitriptyline, duloxetine, trazodone, ademethionine) and 5 with antipsychotics (risperidone, alimemazine, haloperidol). CONCLUSION: Most psychotropic drugs are effective in relation to psychopathological disorders that develop in hematological patients and are safe when used at minimum/average therapeutic doses within the daily dosage ranges established by the official instructions for use.

Low-Molecular-Weight Perorally Active Nerve Growth Factor Mimetic Reduces Manifestations of Diabetic Neuropathy in Wistar Rats.

A low-molecular-weight nerve growth factor mimetic, compound GK-2 (bis-(N-monosuccinyl- L-glutamyl-L-lysine)hexamethylenediamide) that previously demonstrated antidiabetic activity in rats with streptozotocin-induced type 2 diabetes mellitus was studied on the model of diabetic neuropathy. It was found that in 8 weeks after diabetes mellitus development, untreated diabetic rats demonstrated impaired tactile sensitivity in von Frey test, while GK-2 therapy (7.5 mg/kg orally for 28 days) restored this parameter. The decrease of tactile sensitivity in diabetic neuropathy closely correlated with the severity of hyperglycemia (r=0.76). Our findings are consistent with the concept on the role of glucose toxicity and nerve growth factor deficiency in the pathogenesis of diabetic neuropathy and attest to feasibility of further studies of nerve growth factor mimetic GK-2 as a potential treatment for diabetes and diabetic neuropathy.

[The newer antipsychotic cariprazine (reagila): perspectives for use in different stages of schizophrenia therapy]. / Noveishii antipsikhotik Kariprazin (Reagila): vozmozhnosti primeneniya na raznykh etapakh terapii shizofrenii.

Cariprazine is a newer 3rd generation antipsychotic acting as partial agonist for dopamine receptors with unique higher affinity for D3 than D2 receptors. This review article summarizes key data from preclinical and clinical studies of cariprazine including pharmacodynamics, pharmacokinetics, clinical efficacy and safety/acceptability in acute short-term and long-term maintenance and relapse prevention therapy in patients with schizophrenia. Efficacy and safety of cariprazine in patients schizophrenia with predominantly negative symptoms resistant to previous antipsychotic therapy is discussed as well.

[Depression therapy for somatic diseases]. / Terapiya depressii pri somaticheskikh zabolevaniyakh.

A review of works devoted to the problem of psychopharmacotherapy of depression in general medical practice is presented. The issues of its comorbidity with somatic and neurological diseases, as well as multimorbidity are discussed. Both direct and side-effects of antidepressants, which are important for effective therapy of not only affective disorders proper, but also the symptoms of the leading pathology, are considered in detail for individual organs and systems. The analysis of the preferred pharmacological classes of antidepressants, which are drugs of first choice, taking into account the somatic condition of the patient, is carried out, and drugs are indicated, the appointment of which is undesirable for the treatment of a patient with a certain disease. The presented results are aimed both at increasing the efficiency of therapy for patients with general medical level of health care, and at increasing the safety of treatment of psychiatric patients with concomitant somatic disorders.

[Coronary artery bypass grafting in myocardial infarction and unstable angina pectoris: in-hospital outcomes. Part 2]. / Koronarnoe shuntirovanie pri infarkte miokarda i nestabil'noi stenokardii: gospital'nye iskhody. Chast' 2.

AIM: To assess in-hospital outcomes of coronary artery bypass grafting in patients with acute coronary syndrome, depending on the presence or absence of myocardial infarction. PATIENTS AND METHODS: Over the period from 2017 to 2018 within the framework of a single-centre register, the study enrolled a total of 166 consecutive patients admitted with non-ST segment elevation acute coronary syndrome and subjected to coronary artery bypass grafting. Depending on the outcome of acute coronary syndrome, the patients were divided into 2 groups: Group One included 98 (59%) patients with unstable angina pectoris and Group Two comprised 68 (41%) patients with myocardial infarction, who underwent surgery at an average of 16 (11; 20) days after manifestation of the clinical signs of myocardial infarction. The endpoints of the study were major adverse cardiovascular events during the in-hospital period: death, myocardial infarction, acute cerebral circulation impairment/transitory ischaemic attack, repeat revascularization, septic complications, multiple organ failure syndrome, wound infectious complications, requirement for repeated surgical debridement, remediastinotomy due to haemorrhage, the frequency of extracorporeal membrane oxygenation and renal replacement therapy. RESULTS: The mortality rate in the compared groups was similar: 3% (n=3) and 3% (n=2), respectively. Perioperative myocardial infarction occurred in 1 (1%) patient of the first group, with no cases of this complication observed in the second group. The frequency of reoperations due to haemorrhage in the early postoperative period in the group of unstable angina pectoris amounted to 3% (n=3) and was associated with administration of dual antithrombotic therapy, with no cases of this complication in the group of myocardial infarction. Wound complication in the second group were observed in 7.6% (n=5) and in the first group in 4% (n=4) (p=0.33). The differences turned out to be statistically insignificant for such postoperative complications as multiple organ failure syndrome, requirement for repeated surgical debridement, renal replacement therapy, and extracorporeal membrane oxygenation. The residual SYNTAX Score in the group of myocardial infarction amounted to 2.3±2.8, whereas in the group of unstable angina pectoris to 2.3±3, thus suggesting complete revascularization in the total sample of patients with acute coronary syndrome. The average length of hospital stay (including the postoperative period) in the first group amounted to 26.3±6.6 days and in the second group to 27.4±7.2 days (p=0.53). The postoperative bed-day in the group with unstable angina pectoris was 12.6±3.2 and in the myocardial infarction group - 14.9±5.3 (p=0.06). CONCLUSION: The obtained in-hospital outcomes suggest that coronary artery bypass grafting may be an efficient and safe method of complete revascularization for patients with non-ST-elevation acute coronary syndrome, including that resulting in myocardial infarction, performed averagely on day 16 (11; 20) after the onset of clinical manifestations of myocardial infarction.

[Asthenic disorders in schizophrenia (schizoasthenia) on the model of hypochondriac schizophrenia]. / Astenicheskie rasstroistva pri shizofrenii (shizoasteniya) na modeli ipokhondricheskoi shizofrenii.

OBJECTIVE: To determine the structure and mechanisms of interaction of asthenic disorders with negative and positive psychopathological symptoms in hypochondriac schizophrenia. MATERIAL AND METHODS: The study included male and female patients, aged 17-69 years, with a diagnosis of hypochondriac schizophrenia (F20.80 according to ICD-10) and asthenia symptoms. The main research method was clinical, which was supplemented by pathopsychological examination and the use of psychometric scales (PANSS, SANS, MFI-20,VAS asthenia). RESULTS AND CONCLUSION: Asthenia in case of hypochondriac schizophrenia (schizoasthenia) integrates two unrelated phenomena: «weakness¼ and «exhaustion¼ (intolerance to stress), and also acts within the framework of three psychopathological syndromes: neurotic, senestopathic/hypochondriac and overvalued hypochondria. Asthenia with hypochondriac schizophrenia is a predictor of an unfavorable social and clinical prognosis. Integrating into the structure of the clinical manifestations of hypochondriac schizophrenia, asthenia forms close relationships with positive and negative disorders of the type of «general syndromes¼, but remains outside the categories of both positive and negative symptoms of the disease, thus forming a separate «dimension¼ in the psychopathological space of schizophrenia.

[Coronary artery bypass grafting in myocardial infarction and unstable angina pectoris: analysis of perioperative factors. Part 1]. / Koronarnoe shuntirovanie pri infarkte miokarda i nestabil'noi stenokardii: analiz perioperatsionnykh faktorov. Chast' 1.

AIM: The purpose of this study was to assess the perioperative clinical, demographic and anatomo-angiographic factors in patients presenting with non-ST-segment elevation acute coronary syndrome and being candidates for coronary artery bypass grafting, depending on the presence or absence of myocardial infarction. PATIENTS AND METHODS: Over the period from 2017 to 2018 within the framework of a single-centre register, the study enrolled a total of 166 consecutive patients admitted with non-ST segment elevation acute coronary syndrome and recommended by the cardiosurgical team to undergo coronary artery bypass grafting. Depending on the outcome of acute coronary syndrome, the patients were divided into 2 groups: Group One included 98 (59%) patients with unstable angina pectoris and Group Two comprised 68 (41%) patients with myocardial infarction. A lethal outcome occurred in 2 (3%) Group Two patients prior to revascularization, hence they were not included into the analysis comparing the results of surgery in both groups, however these data were taken into consideration, being analysed separately. RESULTS: The group of patients with myocardial infarction appeared to include significantly more female patients (20 (30.3%) versus 15 (15.3%) in the group of patients with unstable angina pectoris, p=0.02). However, by such parameters as the average age, left ventricular ejection fraction, and the frequency of diabetes mellitus the compared groups did not differ. The group with myocardial infarction was characterised by a severe clinico-angiographic status: more frequently encountered was stage II obesity (3%, n=3 in the first group and 10.6% n=7 in the second group, p=0.04). On the whole, the majority of patients were at intermediate and high risk (44.7% in the group with unstable angina pectoris versus 81.8% in the group of myocardial infarction, p<0.05). Group Two patients significantly more often presented with three-vessel lesions of the coronary bed (40 (40.8%) and 39 (59%), p=0.02). The level of low-density lipoproteins appeared to be significantly higher in patients with myocardial infarction (3.3±1 mmol/l and 2.9±0.9, p=0.04). In the same group more often encountered were peripheral artery lesions (28 (21%) and 12 (11.3%), p=0.04). In its turn, in the group of unstable angina pectoris, there were significantly more patients having received dual antithrombotic therapy prior to surgery (44 (44.9%) and 17 (25%), p=0.01). Approximately half of the patients in the first group (53%, n=52) had a history of myocardial infarction (p=0.001). CONCLUSION: The obtained findings suggested that amongst the patients with non-ST-elevation acute coronary syndrome resulting in myocardial infarction prevailing were those of female gender, with obesity, as a consequence, hyperholesterolaemia and triple-vessel disease. At the same time, postinfarction cardiosclerosis, renal dysfunction, and haemodynamically significant lesions of lower-extremity arteries were encountered in the group of unstable angina pectoris.

Analysis of Cytoprotective Properties of Afobazole in Streptozotocin Model of Diabetes.

Previous in vitro and in vivo studies revealed the neuroprotective effect of anxiolytic Afobazole. Based on similarities in the regulation of functions of neurons and ß cells, we studied the effect of Afobazole on streptozotocin (STZ) model of type 2 diabetes in Wistar rats. Immunohistochemical analysis showed that the decrease in the number of ß cells and a violation of their morphological structure caused by STZ were significantly alleviated by Afobazole administration (10 mg/kg orally for 28 days) to diabetic animals. A correlation between morphometric data and blood glucose level was revealed. A possible role of σ1-receptors in the cytoprotective effects of Afobazole in respect to pancreatic ß cells is discussed.

[Peculiarities of the development of acute coronary syndrome in patients after coronary artery bypass grafting]. / Osobennosti razvitiia ostrogo koronarnogo sindroma u patsientov posle koronarnogo shuntirovaniia.

AIM: The purpose of the study was to analyse clinical peculiarities of the development of acute coronary syndrome in patients after coronary artery bypass grafting procedures and to evaluate the in-hospital results of treatment PATIENTS AND METHODS: Within the frameworks of a single-centre register over the period from 2006 to 2016 the study included 81 patients (with a total of more than 5000 coronary artery bypass grafting operations performed during this period). We examined the preoperative, intraoperative, and in-hospital periods, as well as the patients' status at the moment of the development of the clinical course of acute coronary syndrome, its structure and terms of manifestation, the dynamics of the coronary bed condition, also carrying out the analysis of treatment strategies and the in-hospital outcomes thereof. RESULTS: The development of acute coronary syndrome after coronary artery bypass grafting procedures was revealed in patients with a mean age of 58 (52; 63) years, with a history of postinfarction cardiosclerosis (70.37%), arterial hypertension (92.59%), dyslipidemia (51.83%), obesity (77.78%) and a multiple-vessel lesion of the coronary bed (67.90%) of intermediate risk according to the SYNTAX score estimated as an average of 26 (22; 32) points. In the structure of acute coronary syndrome having developed in patients with previously endured coronary artery bypass grafting operations, prevailing was its form of non-ST-segment elevation (87.65%), predominantly of a low risk (61.73%) which manifested itself averagely 24 (12; 35) months after the operation. The main factor of the development of acute coronary syndrome was progression of atherosclerosis (60.49%). The dominating strategy of treatment was medicamentous therapy (55.56%). The in-hospital mortality rate amounted to 2.47%. In the dynamics of the clinical status of the patients prior to coronary artery bypass grafting by the moment of the manifestation of acute cardiac ischaemia there took place a significant decrease in the left ventricular ejection fraction (p=0.01) and progression of atherosclerosis to the multifocal status (p=0.004). CONCLUSION: Patients with acute coronary syndrome, having previously endured coronary artery bypass grafting procedures appear to belong to a special cohort presenting with a series of clinical peculiarities and despite satisfactory in-hospital results do require special attention, with the development of appropriate algorithms for risk stratification and optimal therapeutic decision-making.

[Cariprazine in schizophrenia with predominantly negative symptoms: early effects of therapy (observational study)]. / Kariprazin v terapii shizofrenii s preobladaniem negativnykh simptomov: initsial'nye effekty lecheniya (observatsionnoe issledovanie).

BACKGROUND: Currently available antipsychotics have limited efficacy in the treatment of negative symptoms in schizophrenia and new drugs with wider spectrums of clinical efficacy are very desirable. Cariprazine is a newer antipsychotic acting as dopamine D3- and in lesser extent D2-receptor partial agonist found to be effective in the treatment of negative symptoms in schizophrenia. OBJECTIVES: To evaluate cariprazine early effects at the first stage of therapy of schizophrenia patients with predominantly negative symptoms. DESIGN AND PATIENTS: Open-lable observational assessment of 60 adult schizophrenia patients (F20 on ICD-10, 49% males) with predominantly negative symptoms (PANSS-FSNS ≥15, PANSS-FSPS <19) treated by cariprazine (starting daily dose 1.5 mg followed by upward titration by 1.5 mg weekly up to 6 mg if needed) were assessed with PANSS, CAINS, CDSS and SAS scales at baseline and on week 1, 2, and 4. Efficacy criteria were. RESULTS: Most patients (75%) improved during 28 days of cariprazine treatment. Negative symptoms mean total scores on PANSS-NS and CAINS significantly (p<0.05) reduced by 4.3 and 4.9 respectively at the end of assessment (day 28). Cariprazine tolerability was good, only 4 patients discontinued because of TEAEs (akathisia, insomnia). CONCLUSIONS: The study results preliminary suggest initial effect of cariprazine on negative symptoms at least in some schizophrenia patients with predominantly negative symptoms starting from 1-2 weeks of treatment and available for observation and assessment and could be useful for determination of early clinical predictors for efficacy. Considering limitations of observational open-lable design with no control groups these data need to be confirmed.

Strongly Confined Excitons in GaN/AlN Nanostructures with Atomically Thin GaN Layers for Efficient Light Emission in Deep-Ultraviolet.

Fascinating optical properties governed by extremely confined excitons have been so far observed in 2D crystals like monolayers of transition metal dichalcogenides. These materials, however, are limited for production by epitaxial methods. Besides, they are not suitable for the development of optoelectronics for the challenging deep-ultraviolet spectral range. Here, we present a single monolayer of GaN in AlN as a heterostructure fabricated by molecular beam epitaxy, which provides extreme 2D confinement of excitons, being ideally suited for light generation in the deep-ultraviolet. Optical studies in the samples, supplemented by a group-theory analysis and first-principle calculations, make evident a giant enhancement of the splitting between the dark and bright excitons due to short-range electron-hole exchange interaction that is a fingerprint of the strongly confined excitons. The practical significance of our results is in the observation of the internal quantum yield of the room-temperature excitonic emission as high as ∼75% at 235 nm.

[Polymorbidity in elderly patients needing myocardial revascularization (a review article).]

In the present review, the main attention is focused on the problem of polymorbidity and age-related conditions in elderly patients with CAD who need myocardial revascularization. In addition to a high risk of mortality, elderly patients with polymorbidity are characterized reduced functional activity, cognitive impairment, low quality of life and frequent seeking medical help. There is evidence of the presence of common mechanisms that affect the aging process and the development of a number of associated diseases associated with age. Accordingly, the study of polymorbidity will allow us to develop strategies for the prevention it and understand the aging process and significantly reduce the risks of surgical intervention. In this regard, there is a necessity for research aimed at studying the causal relationship between coronary artery disease and polymorbidity in elderly patients with an additional assessment of functional and cognitive status for the development of specific prognostic tools and treatment strategies.

[Long-term outcomes of coronary artery bypass surgery in young patients]. / Otdalennye iskhody koronarnogo shuntirovaniia u patsientov molodogo vozrasta.

OBJECTIVE: To analyze long-term outcomes of CABG in young patients, incidence and structure of adverse cardiovascular events depending on patients' age. MATERIAL AND METHODS: There were 175 young patients (up to 44 years old in accordance with WHO classification) who underwent CABG for the period from 2006 to 2016. The control group included 175 patients aged 45 years and older who were randomly selected among patients operated in the same period. Overall long-term follow-up period was 81.9±15.75 months (≈ 6.8 years). Data on long-term survival and adverse cardiovascular events were available in 86.3% of patients in general sample and 72.6% of young patients. RESULTS: Young patients undergoing CABG were usually characterized by the absence of severe concomitant diseases, moderate coronary atherosclerosis by SYNTAX Score scale, high percentage of left ventricular aneurysm and previous PCI. Incidence and structure of in-hospital and long-term adverse cardiovascular events in young and older patients confirmed satisfactory results of CABG regardless age.

[The use of the concentrate of nucleus containing cells of umbilical cord blood for treatment of asthenic disorders (schizoasthenia) in patients with schizophrenia with negative symptoms]. / Primenenie kontsentrata iadrosoderzhashchikh kletok pupovinnoi krovi u bol'nykh s astenicheskimi rasstroistvami (shizoasteniia) v ramkakh shizofrenii, protekaiushchei s preobladaniem negativnykh rasstroistv.

AIM: To assess the safety and efficacy of umbilical cord blood (UCB) cells in the treatment of schizoasthenia and comorbid negative disorders. MATERIAL AND METHODS: The study was conducted in men (n=15) with remission of schizophrenia with a predominance of asthenic disorders (ICD-10 items F20.6 and F21.5). Patients received intravenous infusions of UCB cells at the average dose of 250 mln viable cells per infusion (4 injections at 2 week intervals). The efficacy and safety were assessed using the Positive and Negative Symptoms of Schizophrenia (PANSS), the General Clinical Impression Scale (CGI), Asthenia Scale MFI-20 3, the MATRIX Consensus Cognitive Battery (MCCB), the Clinical evaluation of adverse events (side effects). RESULTS AND CONCLUSION: The infusions of UCB cells have a positive effect on asthenic disorders, increase the level of general activity and minimize cognitive impairments. The authors assume that UCB cells potentiate the activity of typical and atypical antipsychotics.