[The influence of diet therapy and regular physical trainings on monocyte chemoattractant protein-1 (MCP-1) secretion by monocytes among obese patients with coronary heart disease].

Chronic systemic inflammation is one of the leading pathogenetic pathways for the development of atherosclerosis in obese patients. In this regard, it seems promising to evaluate the effect of the diet and physical exertion on the proinflammatory activity of monocytes. The purpose of this research was to evaluate the effect of the diet and regular physical trainings on the secretion of monocyte chemotactic factor 1 (MCP-1) by monocytes in obese patients with coronary artery disease. Material and methods. 27 obese participants (body mass index >30 kg/m2) with a confirmed diagnosis of coronary heart disease were recruited. All participants were prescribed with 12 weeks of a specialized diet with a restriction of simple carbohydrates and salt, a 500-kcal daily energy deficit, and with inclusion of cruciferous (200 g per day), seasonal dark berries (70 g per day) and green tea (200 ml per day). The regular assisted physical trainings were also administered. The body composition, blood biochemical parameters and MCP-1 secretion rates in the primary culture of monocytes isolated from blood samples via the immunomagnetic separation method were assessed before and after the intervention. Results. As a result, after the 12-weeks intervention the reliable body weight loss (-4.0%), waist circumference (-4.2%), visceral fat (-5.4%), total cholesterol (-9.8%), LDL-cholesterol (-16.6%) and triglycerides (-26.0%), an improvement in the results of the 6-minute walk test (+10.33%) was achieved, as well as an LPS-stimulated monocytes secretion of MCP-1 decreased by 2.8 times (p=0.005). Conclusion. Overall, the results suggest that diet and regular physical activity in patients with obesity and coronary heart disease may decrease the functional "proinflammatory" activity of monocytes.

[The oral microbiome in the context of systemic disease].

The oral microbiome is a community of symbiotic, commensal and opportunistic microorganisms, usually present in the form of biofilm, that plays a critical role in maintaining the homeostasis and protective function of the oral cavity. Recently, the study of the human oral microbiome to develop new diagnostic and therapeutic approaches has become a promising new area of the research in the field of personalized medicine. The aim of this review was to generalise and analyse the accumulated data on the relationship between the oral microbiome characteristics and the course of systemic diseases. Material and methods. Literature searches were performed using RSCI, PubMed, Google Scholar, and included original research data published mainly in the last 5 years. Results. The review summarized data on the role of the oral microbiome in the development of a number of systemic diseases, including alimentary diseases. The importance of the major exogenous and endogenous factors that lead to changes in the oral microbiome, including diet, macro- and micronutrient composition of foods, was highlighted. Data were provided on the main types of microorganisms associated with the development and c ourse of a number of somatic diseases, represented mainly by obligate anaerobic periodontal pathogens (Tannerella forsythia, Treponema denticola, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans). The role of the systemic inflammatory response as the main pathogenetic factor of oral dysbiosis has been described. The benefits of periodontal therapy in metabolic disorders such as diabetes mellitus, obesity, and dyslipidemia have been discussed. Promising approaches to correct oral dysbiosis have been presented. Conclusion. The knowledge of the relationships between the oral microbiome composition, the development and characteristics of the course of somatic disease can contribute to the development of new technologies for its prevention and treatment. The change in the structure of the oral microbiome observed in systemic diseases is usually accompanied by a decrease in bacterial diversity and an increase in the number of pathogenic bacteria. Lifestyle modification, dietary therapy, smoking cessation, rational use of antibacterial drugs and treatment of periodontitis play an important role in normalising the structure of the oral microbiome.

[Physical activity in sarcopenia: rehabilitation approaches in prevention and treatment of age-related muscle disorders]. / Fizicheskaya aktivnost' pri sarkopenii: reabilitatsionnye podkhody v profilaktike i lechenii vozrastnoi patologii myshechnoi tkani.

Sarcopenia is a widespread condition in the elderly people, that occurs as a result of impaired muscle structure and function and is significantly associated with reduced quality and time of life. This review represents current approaches to the diagnosis of sarcopenia with reference to recent European and Asian consensus. They include rules for the evaluation of the main muscle strength and function tests (hand dynamometry, sit-to-stand test, 6-minute walk test, physical performance battery tests, etc.), physical and instrumental methods of muscle mass analysis (densitometry, bioimpedance analysis, magnetic resonance imaging). Furthermore, the pathogenetic relationship between the lack of physical activity and muscle dysfunction in elderly people is broached, including in particular the role of myostatin, interleukin-6, somatotropin and insulin resistance. The article represents possibilities of impact of aerobic, strength and neuromuscular physical exercises on prevention and correction of sarcopenic changes in different age groups based on the analysis of current clinical studies.

[COVID-19-associated diarrhea].

In addition to the typical clinical picture of respiratory symptoms and intoxication, the SARS-CoV-2 virus is also characterized by a gastroenterotropic effect. Diarrhea is one of the most common gastroenterological symptoms of COVID-19 and is detected, according to the various authors, in 2-49.5% of cases, including children. The presence of diarrhea aggravates the patient's clinical condition, limits the possibility of carrying out the necessary diagnostic manipulations, and complicates the selection of therapy. The article provides an overview of the scientific literature on the formation of diarrheal syndrome in patients with COVID-19. Objective. Analysis of scientific publications studying the pathogenesis, incidence, clinical features, aspects of diagnosis and therapy of diarrhea in patients with COVID-19. Material and methods. A search was made for scientific publications on the electronic resources PubMed, Google Scholar and eLIBRARY.ru. Results. The pathogenesis of diarrhea in a new coronavirus infection is complex and includes, among other things, the effect of the virus on the angiotensin-converting enzyme 2 receptors, inducing an inflammatory process in the gastrointestinal tract mucosa, neurotropic effect on the autonomic regulation of intestinal motor activity, disturbance of the colon microbiota, liver and pancreas damage. Another important pathogenetic aspect of diarrhea in COVID-19 is iatrogenic one, i.e. a side effect of drugs used in the treatment of a new coronavirus infection and its complications, and the activation of opportunistic clostridial intestinal flora against the background of antibiotic therapy. The variety of pathogenetic mechanisms of diarrheal syndrome formation allows us to speak of "COVID-associated diarrhea" as an independent clinical phenomenon characteristic for the new coronavirus infection. Mandatory diagnostic algorithm of a patient with COVID-19 and diarrhea is the fecal analysis test for toxins Cl. difficile, while the possibility of endoscopic examinations during the pandemic is limited. Compliance with the hygiene measures, diet correction and nutritional support, rational antibiotic therapy of COVID-19 complications, careful use of antiperistaltic antidiarrheal drugs, nonspecific therapy (antiviral, rehydration, adsorbents) are considered as the main therapeutic approaches for diarrheal syndrome against the background of COVID-19. The administration of probiotics and antibacterials should be considered in case of confirmed clostridial co-infection. Conclusion. Diarrhea is a frequent clinical manifestation of COVID-19 and can affect the course of the disease. The complex genesis of diarrheal syndrome requires further study of therapeutic strategies and nutritional support for patients after COVID-19.

[Cardiovascular nutrition: disease management and prevention as major public health problem nowadays].

Cardiovascular disease (CVD) is the leading cause of death in many developed countries. At the same time, nutrition is the basis of preventive cardiology. Earlier researches were focused on the importance of individual nutrients, including saturated fats, sodium, and dietary fiber, or certain foods, such as fruits, vegetables, fish, and olive oil, in the development of СVD. Recently, however, an analysis of nutritional patterns has been preferred to take into account the heterogeneity of the diet and the interaction of foods and nutrients. Besides, studies of the cardioprotective potential of bioactive compounds, e.g. polyphenols, peptides, oligosaccharides, vitamins, mono- and polyunsaturated fatty acids, are of particular interest. This paper covers dietary patterns that are associated with improved cardiovascular outcomes, including the Mediterranean diet. The use of a pattern-based approach will help practitioners make optimal and meaningful changes to the patients' diet. Personalized diet therapy is also very important, which implies flexibility and tailoring guidelines to patient needs and comorbidities.

[COVID-19: new challenges for medical science and practical health].

Currently, due to the wide spread of the new coronavirus infection COVID-19 and the need for anti-epidemic measures, medical science should integrate all efforts to ensure, on the one hand, at the global level - the fight against the spread of infection, on the other hand, at the individual level - increasing the adaptive capacity and immune response of the organism to protect against COVID-19. Nutrition is the most important factor determining human health and the functioning of all mechanisms to protect a person from negative environmental factors. For the prevention and treatment of new coronavirus infection COVID-19, a significant role is played by the correction of eating disorders, including vitamin and micronutrient deficiency. Federal Research Centre of Nutrition and Biotechnology, together with Russian Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor), prepared Recommendations on nutrition for children and adults, requiring a self-isolation regime or quarantine at home in connection with COVID-19. In order to promptly inform and advise the population on nutrition optimization in the early days of anti-epidemic measures, an information reference Contact Center was created and is continuously functioning on the basis of the Federal Research Centre of Nutrition and Biotechnology. Equally important is the implementation of measures aimed at the prevention of food contamination with COVID-19 agent. In this regard, the Federal Research Centre of Nutrition and Biotechnology, together with Rospotrebnadzor prepared guidelines on measures to prevent the transmission of a new coronavirus infection through foods. Another aspect that the medical community has faced in connection with the pandemic is the need to reorient specialized medical organizations that have not previously worked with patients with infectious diseases in order to create Clinical centers for the treatment of the new coronavirus infection COVID-19. Thus, in the context of the spread of the new coronavirus infection COVID-19, many areas of medicine are involved in the process of providing anti-epidemic measures. Successful completion of the tasks will significantly reduce the negative consequences of the COVID-19 pandemic for the state and citizens.

[Non-pharmaceutical treatment of dyslipidemia: review of current methods of diet and nutraceuticals].

The role of nutrition in the development and progression of atherosclerosis is well known. The correction of diet in patients with dyslipidemia is important as an independent intervention (in the group of patients with low and, partially, moderate cardiovascular risk), and as an addition to drug therapy in patients with at higher risk of cardiovascular events. The current review describes the effect of modern methods of diet therapy, as well as the use of a number of nutraceutical agents in terms of evidence-based medicine.

[The effectiveness of preventive counseling with the use of remote technologies on medical awareness of cardiovascular risk factors in patients with high and very high cardiovascular risk].

Purpos. To assess the effectiveness of preventive counseling with focus on diet modification followed by remote support via telephone on awareness of cardiovascular (CV) risk factors (RFs) in patients (pts) with high/very high CV risk. Material and methods. This is a prospective randomized controlled study of 100 pts with high/very high CV risk (5-9% and ≥10% according to the SCORE scale) and any 2 criteria for metabolic syndrome.  Pts were randomized into 2 groups in 1:1 ratio - the intervention group (n=50) and the control group (n=50). The intervention group received comprehensive preventive counseling with focus on diet modification followed by remote preventive counseling by phone every two weeks for the first 3 months after enrollment (a total of 6 sessions). The control group received usual care in Health centers which also included basic preventive counseling. A specially designed questionnaire was used to evaluate the awareness of the basic CV RFs, including open questions. The awareness was assessed at baseline, 6 and 12 months. Results. The groups were well balanced according to demographic and clinical features. The results of the study revealed an extremely low awareness of major CV RFs of pts in both groups at baseline: practically none of them indicated as RFs for cardiovascular disease elevated cholesterol (8,0% and 4,0%, respectively) and blood pressure (14.0% and 4.0%). At 6 month the level of awareness of CV RFs has increased significantly. Moreover, pts of the intervention group were more informed about elevated cholesterol (58,0% vs. 28,0%; p<0,01) and unhealthy diet (76,0% vs. 52,0%; p<0,05). At 12 month the level of awareness of CV RFs was significantly higher in both groups  to compare from baseline. Conclusion. Preventive counseling with focus on diet modification followed by 3 months  remote support via phone provided a significant improvement of awareness of CV RFs in pts with high/very high CV risk.

[Problems of optimal nutrition of elderly and senile patients with comorbidities against obesity].

AIM: To analyze the effectiveness of the main and low - calorie standard diets in elderly and senile patients with comorbidities against obesity. MATERIALS AND METHODS: Retrospective analysis of the inpatient data. Patients received the main or low - calorie standard diet at the Nutrition clinic. The analysis included clinical, laboratory, body composition (bioimpedance) parameters and the results of indirect calorimetry. The primary endpoint was anthropometric and body composition data. Statistical analysis was performed using Statistica 10.0 for Windows 6.1 (StatSoft Inc., USA). RESULTS AND DISCUSSION: 46 patients were included in the analysis. The average age was 65 years (95% CI 63.63-66.37 years). All patients had abdominal obesity. 44 patients (97.78%) had hypertension, 32 (71.11%) - osteoarthrosis, 28 (60.87%) - dyslipidemia, 16 (35.56%) - diabetes mellitus; and сoronary artery disease was detected in 9 patients (20%). Diet therapy caused a statistically significant decrease in body weight, waist and hip circumferences, fat mass, lean mass, total body fluid and muscle mass (in particular, 25.35% weight loss was due to muscle mass loss), as well as the improvement of lipid profile. CONCLUSION: Dietary interventions, such as main and low - calorie standard diets, routinely used for inpatient settings allow us to reduce body weight and improve anthropometric parameters in elderly and senile obese patients with comorbidities, which is accompanied by positive changes in lipid and carbohydrate metabolism even in a short - term follow - up. However, the protein content for standard diets is insufficient for this target group and leads to the loss of both fat and muscle mass.

[Cognitive Disorders and Dementia in Old Patients With Arterial Hypertension].

The article describes the definition of dementia, its diagnostic criteria, classification. Differences in the pathogenesis and clinical manifestations of different types of dementia are considered. The issues of interrelation of arterial hypertension and the risk of development of cognitive disorders and dementia in old and very old people are discussed in detail. Data on the effect of antihypertensive drugs of different groups on the risk of dementia and the state of cognitive functions are presented. The evidence base of dihydropyridine calcium antagonist amlodipine and thiazide-like diuretic indapamide-retard is discussed with respect to the prevention of dementia and cognitive decline and their beneficial effect on cognitive function in patients with arterial hypertension.

[Characteristics of lipid metabolism and the cardiovascular system in glycogenosis types I and III]. / Kharakteristika lipidnogo obmena i sostoianie serdechno-sosudistoi sistemy pri glikogenozakh I i III tipov.

Glycogen storage disease (GSD) is an inherited metabolic disorder characterized by early childhood lipid metabolic disturbances with potentially proatherogenic effects. The review outlines the characteristics of impaired lipid composition and other changes in the cardiovascular system in GSD types I and III. It analyzes the factors enabling and inhibiting the development of atherosclerosis in patients with GSD. The review describes the paradox of vascular resistance to the development of early atherosclerosis despite the proatherogenic composition of lipids in the patients of this group.

[Mantle dentin as biomodel of materials for structural teeth restoration]. / Plashchevoi dentin kak biomodel' materialov dlia strukturnoi restavratsii zubov.

The article describes a structural element of natural teeth - mantle dentin. It has been shown that the presence of this element in the structure of a natural tooth largely ensures its strength under the influence of repeated loads in a functional oral environment and arrests crack growth at the enamel/dentine interface. This later effect is explained by the influence of a thin layer of mantle dentine, which has physical and mechanical characteristics different from that of the main dentin.

[Pulse wave velocity and pulse pressure in patients with arterial hypertension].

The article is devoted to assessment of pulse pressure (PP) in female postmenopausal patients and patients with arterial hypertension (AH) older than 55 years. It is shown that in postmenopausal women even aged 55 years or less PP is one of most important parameters associated with target organ damage. Conclusion about presence of elevated vascular wall stiffness in these women as in elderly patients can be made at PP more or equal 60 mm Hg. In elderly patients both with isolated systolic AP and 1-2 degree systolic-diastolic monotherapy with indapamide 1,5 mg retard allows not only to achieve clear-cut hypotensive effect but in both variants of AH to lower PP. This can substantially decrease degree of cardiovascular risk without crossing bottom borders of diastolic AP lowering. The latter is especially important for elderly patients with isolated systolic AH.

[Insulin resistance and carbohydrate metabolism indexes in women of reproductive age depending on the type of their breast-feeding in infancy].

Determine what in women in early age exceptionally on artificial nutrition risk beginning insulin resistance and breach carbohydrate metabolism more high than in women receive in pectoral age naturally nutrition. This relation especially distinctly reveals in women with obesity.

[Modern presentation of role of nutrition and genetic factors in the development of metabolic syndrome].

The role of dietary and hereditary factors in the development of metabolic syndrome is discussed in this review.