[Soy protein as part of a low-protein diet is a new direction in cardio- and nephroprotection in patients with 3B-4 stages of chronic kidney disease: prospective, randomized, controlled clinical study].

BACKGROUND: It has been established that the use of a low-protein diet (LPD) in combination with ketoanalogues (KA) of essential amino acids can contribute to cardio- and nephroprotection in chronic kidney disease (CKD). Moreover, it has been shown that replacing part of the animal protein with soy protein (SP) in the diet contributed to more pronounced nephro- and cardioprotection in CKD, however, the data, available in the literature, are mainly represented by experimental studies. AIM: To compare the effects of 2 types of diets on the main parameters of nephro- and cardioprotection in patients with CKD. MATERIALS AND METHODS: We have conducted a prospective, randomized, controlled clinical study which included 85 patients with 3B4 stages of CKD, compliant to LPD (0.6 g of protein/kg body weight) + KA (1 tablet/5 kg body weight). 43 patients (Group 1) received LPD with replacing animal protein with soy (60% soy protein + 40% another vegetable proteins) + KA, and 42 patients (control group, Group 2) received LPD (60% animal protein + 40% vegetable protein) + KA, within 12 months. RESULTS: The dietary substitution of animal protein with SP to a greater extent delayed the decrease in glomerular filtration rate (-5.9% vs -13.3%; p=0.048), the increase in left ventricular hypertrophy (+4.7% vs +12.3%; p=0.042), as well as the increase in central systolic blood pressure (+2.6% vs +13.0%; p=0.021), augmentation index (+7.6% vs +23.3%; p=0.010), slowed down the decrease in lean body mass in men (+0.9% vs -11.2%; p=0.017) and women (-1.8% vs -10.3%; p=0.024), increase in phosphorus (-10.3% vs +13.0%; p=0.029), cholesterol (-10.7% vs -3.4%; p=0.047) and urea (+6.3% vs +19.6%; p=0.035) serum levels. CONCLUSION: The use of LPD with substitution of animal protein with soy protein + KA provides a more pronounced effect on nephro- and cardioprotection as well as maintenance of nutritional status, than conventional LPD + KA in patients with 3B4 stages of CKD.

Bilateral thalamic stroke in patient with patent foramen ovale and hereditary thrombophilia.

Patent foramen ovale and hereditary thrombophilia are both known risk factors for ischemic stroke. Artery of Percheron is a rare anatomical variant in which vast areas of the midbrain and thalamus have a single source of blood supply. This case report presents a 45-years old female patient with bilateral thalamic stroke due to Percheron artery occlusion, with a combination of hereditary thrombophilia and patent foramen ovale as the risk factors. Modern approaches to the diagnosis and secondary prevention of this pathology are also discussed herein.

[Action of neuropeptides on the status of neuronal populations in the post-resuscitation period: structural-functional correlation]. / Deistvie neiropeptidov na sostoianie neironal'nykh populiatsii v postreanimatsionnom periode: strukturno-funktsional'nye korreliatsii.

Effects of some neuropeptides and hormones (oxytocin, melanostatin, oxytocin in combination with estradiol, somatostatin) on neurons of the V cortical layer, Purkinje cells of medial and lateral regions of rat cerebellum were studied in rats after 15 minutes of cardiac arrest. A single administration of the peptides after successful cardiopulmonary resuscitation improved the condition of neuronal populations (prevented dystrophy and cell death), accelerated neurological recovery. One of the mechanisms of action of oxytocin, melanostatin and oxytocin in combination with estradiol is elevated number of satellite glial elements of the nervous tissue. Responses of varying neuronal populations to neuropeptide action are different. These data are essential for design of pathogenetic methods of prevention and treatment of posthypoxic encephalopathies.

[The effect of succinic acid on postresuscitation pathology of the CNS and of the body as a whole]. / Vliianie iantarnoi kisloty na postreanimatsionnuiu patologiiu TsNS i organizma v tselom.

The effect of oral succinic acid was studied in rats exposed to 10-min heart arrest followed by resuscitation. The drug was administered for 5 days in a dose of 30 mg/kg starting from day 3 up to day 7 after resuscitation. Succinic acid was found to normalize the orientation and exploration behavior of rats in the "open field" test, decreased the intensity of response to stress (electric shock), and normalized the radical formation in the brain tissue and blood serum, thus reducing the morphological changes in the brain. In addition, succinic acid prevented the development of risk factors of atherogenesis, namely, increase of the levels of blood cholesterol, triglycerides, and low and very low density lipoproteins. Further studies are needed to validate the addition of succinic acid to the armory of drugs preventing the development of postresuscitation encephalopathies in remote (3 months) periods.

[The potentials for therapy of the postresuscitation process using regulatory peptides after 10 and 15 minutes of heart arrest]. / Vozmozhnosti terapii postreanimatsionnogo protsessa s pomoshch'iu reguliatornykh peptidov posle 10 i 15 minut ostanovki serdtsa.

The therapeutic effect of a single systemic injection of regulatory peptides was assessed in experiments oil white rats exposed to 10- and 15-min heart arrest. The effect of regulatory peptides was found to depend on the initial body resistance to hypoxia and on the duration of heart arrest. Positive effects of thyrotropin-releasing factor, ACTH4-10 and substance P on the recovery of cerebral function grew weaker as the duration of heart arrest increased, whereas the effects of oxitocin and somatostatin were unchanged, and that of taftsin even increased. In animals nonresistant to hypoxia cardiopulmonary resuscitation and survival of 50% of animals after 15-min heart arrest was provided by injection of thyrotropin-releasing factor at the beginning of resuscitation and of somatostatin 30 min later.

[The mouse paw edema test for titrating Shigella toxin and antitoxin and for determining the safety of the anatoxin]. / Test oteka lapy myshi dlia titrovaniia shigelleznogo toksina, antitoksina i opredeleniia bezvrednosti anatoksina.

The method for the titration of Shigella dysenteriae I neurotoxin, toxoid prepared from this toxin and different antitoxic preparations in the mouse paw edema test has been developed. The quantitative determination of antitoxin is based on the neutralization test. The conditions of titration (the dilutions of the neurotoxin and the neutralization doses of the antitoxin), as well as criteria for the evaluation of the positive or negative results, have been established.