[The population satisfaction with medical care quality according National monitoring of public health in the Russian Federation].

The article presents updated information concerning satisfaction of patients with quality of medical care in public and private health care institutions in Russia. The purpose of the study is to explore satisfaction with medical services in different groups of Russian population using representative sampling and considering various aspects of medical care quality. The statistical analysis on the basis of data of telephone survey "The National Monitoring of Public Health" (2022) was applied. The respondents were asked about four aspects of medical care quality: explanation of health condition and treatment, involvement into desision making concerning treatment, trust to medical workers, readiness for another visit. The most patients of public and private medical institutions were satisfied with all aspects of medical care quality. The level of satisfaction varies in different groups: it was lower in less healthy patients and patients with unmet demands in medical care. No significant differences in satisfaction of patients were established in relation to socio-demographic characteristics (except place of residence). Most patients were satisfied with two aspects of medical care quality at once. However, 1-9% and 8-14% of patients of private and public clinics were satisfied with one aspect and dissatisfied with another. Despite dominance of patient satisfaction nation-wide, behaviors in some patient groups requires more detailed study to develop measures promoting their further involvement into health care system.

Brief but enough: 45-min maternal separation elicits behavioral and physiological responses in neonatal mice and changes in dam maternal behavior.

Currently, two gaps exist in the study of early stress response caused by maternal separation (MS) in rodents. Firstly, the influence of brief maternal separation (less than 1 hour) on physiological and behavioral development of offspring is still largely unexplored despite its fundamental and applied value. Secondly, little information is available on the social context of pups' ultrasonic vocalizations (USVs), one marker of stress response to MS, with a virtual absence of studies 1) comparing pups' USV rates during MS (absence of social interaction) with that of home cage (presence of social interaction) and 2) analysing the relationship between pup call composition and maternal behavior. After maternal separation (45 min/day) on postnatal days (PND) 3-7 we showed greater corticosterone levels on PND 7 and USV rates on PNDs 3 and 6 compared to home cage levels. Returning the pups to the dams led to a decrease in these measures. Dams' licking and grooming and pup investigation behaviors during the post-reunion period were higher on PND 3 and nursing levels were lower on PND 6 compared to control and MS baseline conditions. The pups' call composition also differed between these three conditions. Each type of dam behavior was characterized by a unique pattern of pup calls. Our previous research has demonstrated the numerous short- and long-term effects of repeated 45-min MS on development of 129Sv mice. Results presented here suggest the hormonal and behavioral responses described above might be early-life predictors of such effects.

[Effects of histone deacetylase inhibitor sodium valproate on the physical and behavioral development of 129SV mice].

Sodium valproate is a widely used antiepileptic drug at high dosage levels, but it has been shown to produce a variety of toxic side-effects when used during perinatal period. These effects include increased risk of congenital anomalies and autism. For this reason, valproate is commonly employed in animal model of autism. Sodium valproate has multiple molecular targets including histone deacetylases. Therefore valproate can be utilized as a tool for the modulation of epigenetic modifications of the genome via inhibition of histone deacetylases. It is known that administration of sodium valproate at a dose of 50 mg/kg during early postnatal period leads to increase of the histone H3 acetylation level in the brain. The aim of the present study was to evaluate the effects of multiple valproate injections from 3rd to 6th postnatal day (50 mg/kg s.c.) on physical and sensorimotor development of 129Sv mice. The standard battery of tests was used. Our results show that valproate have no negative effect on physical development, sensorimotor function, and social behavior. The obtained results support the applicability of sodium valproate in our dosing schedule for further experimental modulation of histone acetulation level in the developing brain.

Administration of histone deacetylase inhibitor during neonatal period changes emotionality of adult male 129Sv mice.

Environmental factors acting during the neonatal period affected the formation of phenotype of adult animals via epigenetic modifications of the genome, e.g. histone acetylation. We studied the effects of blockage of histone deacetylases with sodium valproate on week 1 of life on the behavioral pattern of adult male 129Sv mice. The results of behavioral tests attest to long-term changes in emotional, but not cognitive pattern of adult animals after sodium valproate administration, which manifested in increased anxiety of animals.

[Sleep disorders in the structure of cerebrovascular diseases].

The literature on the place and role of insomnia in cerebral blood circulation disturbances is reviewed. It is emphasized that insomnia is a modifying risk factor of cerebrovascular pathology. The syndrome of obstructive sleep apnea may be a cause of arterial hypertension. The diagnostic relevance of the complex examination of patients with sleep pathology, including polysomnographic technology, and its role in the choice of corrective measures and treatment of insomnia in whole are shown.

[Systemic manifestations of primary sclerosing cholangitis].

Primary sclerosing cholangitis (PSC) is a chronic slowly developing cholestatic diseases of liver characterized by non-purulent destructive inflammation and fibrosis of bile ducts leading to secondary biliary cirrhosis. PSC etiology remains unknown and the disease is regarded as an autoimmune pathology. In 60-80% of the patients PSC combines with other autoimmune diseases (over 40 nosological forms). This paper deals with the diversity and prevalence of systemic manifestations of PSC in a group of 93 patients admitted to Tareev Nephrology Clinic. Autoimmune diseases were diagnosed in 79.6% of the patients. PSC was most frequently associated with ulcerative colitis (49.5%), Crohn's disease (17.2%), hemorrhagic vasculitis (8.6%) and autoimmune thyroiditis (7.59%). Nervous system, kidneys, lungs and eyes were affected less frequently. 20.3% of the patients had more than one (2-5) manifestations of PSC in different combinations. It is concluded that the knowledge of extrahepatic PSC symptoms will promote its early diagnosis in patients with cholestasis of uncertain origin.

[Gender-dependent effects of histone deacetylase inhibitor sodium valproate on early olfactory learning in 129Sv mice].

In the brain, histone acetylation underlies both learning and the maintenance of long-term sustained effects of early experience which is further epigenetically inherited. However, the role of acetylation in learning previously has only been studied in adult animals: high level of learning could be dependent on high levels of histone H3 acetylation in the brain. The role of acetylation in the mechanisms of early learning has not been studied. In the present work, we were interested whether histone deacetylase inhibitor sodium valproate which increases the level of histone H3 acetylation will affect early olfactory discrimination learning in 8-day-old pups of 129Sv mice that are characterized by low efficiency of learning with imitation of maternal grooming. Multiple valproate injections from 3rd to 6th postnatal day had a gender-dependent effect: learning was selectively improved in male but not in female pups. In the female pups, learning improvement was observed after multiple injections of saline. Possible epigenetic mechanisms underlying these sex differences are discussed.

Maternal deprivation in early ontogeny impairs olfactory learning with mother's grooming imitation in 129Sv mice.

Early experience, mediated by mother's care, exerts long-term effects on the formation of behavioral phenotype. However, there are no published data on the effects of such experience on the results of early learning. We investigated the effects of maternal deprivation associated with handling in 129Sv mice during postnatal days 3-6 on the results of olfactory learning with mother's grooming imitation used as the reinforcement on postnatal day 8. Mother deprivation and handling procedure are shown to impair early olfactory learning.

[Primary sclerosing cholangitis: present views of its pathogenesis, diagnosis and treatment].

Primary sclerosing cholangitis (PSC) is a chronic slowly progressive cholestatic liver disease characterized by non-purulent destructive inflammation and sclerosis of the extra- and intrahepatic bile ducts, leading to secondary biliary cirrhosis. The etiology of the disease is unknown; however, bacterial and genetic factors are presumed to be implicated. In 66-84% of cases, PSC is accompanied by inflammatory bowel diseases, such as ulcerative colitis and Crohn's disease. The diagnosis of PSC is based on the clinical presentation of the disease and on the data of magnetic resonance imaging or endoscopic retrograde cholangiography. The treatment of PSC has not been developed; there is evidence that ursodeoxycholic acid reduces cholestasis. Orthotopic liver transplantation is indicated at the stage of decompensated liver cirrhosis.

[The features of defensive behavior of early postnatal C57BL/6 mice in response to the predator odor].

The ontogeny of defensive behavior of laboratory rodents underlying many experimental models has been still poorly understood. In this study, we investigated the age-related features of behavior of 8- and 12-day-old laboratory mice in response to presentation of the predator odor using olfactory discrimination method and determination of sleep and wakefulness states. Transcription factor c-Fos was used as a molecular marker to map the activity of the reticular formation. Neither preference nor avoidance of the predator odor was detected, as assessed by the proportion of time spent in the compartment with this odor. However, a reduction of locomotor activity and an increase in the proportion of sleep were found in 8-day-old mice, which corresponded to the c-Fos expression in the oral pontine reticular nucleus. The increase in the proportion of passive wakefulness was found in 12-day-old mice, it could be regarded as an early form of freezing. Thus, we identified age-specific features of the defensive behavior of early postnatal mice as well as the dynamics of its formation.

[Cytologic features of bronchoalveolar lavage in evaluation of course of exogenous allergic alveolitis].

Application of complex of modern cytologic methods of research bronchoalveolar lavage allowed to allocate most characteristics of development of lymphocytic and macrophagic reaction of bronchial tree in different course of exogenous allergic alveolitis. The most indicative in assessment of origin of exogenous allergic alveolitis development is the characteristics of macrophagic population. In acute course of exogenous allergic alveolitis the considerable number of young activated and non-activated macrophages, increased number of mature phagocytes is observed. Even more significant increase of phagocytic macrophages is observed at dissemination which is primarily is connected with participation of these cells in lymphocytic apoptosis which takes place in high percentage of lymphocytes (up to 49%). Increased number of mature phagocytes is observed at chronic course of exogenous allergic alveolitis that is an important diagnostic pattern of this option of development of exogenous allergic alveolitis in association with the lowest T-helpers/T-supressors index.

[Optimization of parodontitis treatment of patients with tuberculosis].

For the purpose to determine the clinic-pathogenetic efficacy of Cycloferon liniment in the combined therapy of parodontitis of patients with focal tuberculosis medical examination and treatment of 40 patients is carried out. It is established, that use of liniment Cycloferon in the combined treatment of patients with focal tuberculosis allows to accelerate process of normalization of lipid peroxidation parameters and antioxidant potential of blood, to decrease infection load (Herpes symplex virus I, Candida albicans, Staphylococcus aureus) in parodontal recess and evidence of local inflammation with reduction of activity of the tumours necrosis factor and interleukin 1beta, that provides acceleration of recuperation processes, lowering the frequency of parodontitis relapses.

[Clinical laboratory approaches to parodontitis treatment optimization].

In order to determine cycloferon liniment clinical-pathogenetic efficacy in comprehensive parodontitis therapy examination and treatment of 80 patients was done. It was determined that the cycloferon liniment use in comprehensive treatment of patients with parodontitis let to reduce infectious load in parodontal pockets and local inflammation intensity, to normalize the secretory immunoglobulin level and immune status indices that provided speed up of healing process and reduction relapse frequency.

[Postoperative recurrence of a nodular goiter].

Long-term results were followed up from 3 to 15 years in 649 patients with different morphological forms of the nodular goiter. Postoperative recurrent nodular goiter was diagnosed in 26.8% of the patients. The greater part of recurrences (87.4%) was nodular colloid goiter that was shown morphologically. Main part of the recurrences (69.1%) appeared after operations if the greater part of the thyroid gland was left--resection of a lobe and enucleation of the nodes. No recurrences were registered after thyroidectomy. The results of the investigation suggest that such operations as enucleation of a node and resection of a lobe with a node are thought to be inadequate.

[In vitro development of rifampicin resistance in the epithelial cells].

It has been first in vitro demonstrated on a model of epithelial cells that rifampicin may develop not only at the level of Mycobacterium tuberculosis, but also at the level of somatic cells. The mechanism of this phenomenon, its specificity (whether cross resistance to other antituberculous agents will occur), the way it puts into effect under the conditions of a microorganism, and how promptly it may be gone after discontinuation of the drug remain unknown. The effect of rifampicin on the functional activity of Pgp is an important factor that influences as a result not only the absorbability of drugs, but also normal transport processes in the body. These aspects seem to be topical and are the subject for further studies. The authors have obtained an epithelial cell line that resides in the presence of 100 microg/ml of rifampicin and that is 2-2.5 times more resistant to the drug as compared with the parental line. The cells of this line are 2-2.5 times more active in discharging the substrate rhodamine-123 for P-glycoprotein than those of the parental line, which suggests the enhanced functional activity of P-glycoprotein. The presence of P-glycoprotein in this line is confirmed by the action of this protein-specific blocker verapamil. At the same time rifampicin is not a substract for P-glycoprotein. Therefore, the mechanism of rifampicin resistance is unassociated with the functional activity of P-glycoprotein. The mechanism of the resistance remains open. At the same concentration (100 microg/ml), rifampicin can block the functional activity of P-glycoprotein. These results suggest the double mechanism of rifampicin in its long presence in the culture medium: as an inductor and a blocker of P-glycoprotein functional activity. The findings point to the fact that the pharmacokinetics of rifampicin and co-administered dtugs may change during their long use.

Analysis of antioxidant properties of chitosan and its oligomers.

Oral treatment with chitosan with a molecular weight approximately 105, but not its oligomer, reduced plasma content of free-radical oxidation products in normal rats and animals treated for the bone marrow form of radiation sickness and stimulated the recovery processes in involved bone marrow and peripheral blood.

[Sneddon's syndrome and systemic lupus erythematosus with cerebrovascular disturbances and widespread livedo].

A comparative clinical and instrumental analysis of 97 patients with Sneddon's syndrome (SS), a combination of cerebrovascular ischemic disturbances with widespread livedo, and 12 patients with systemic lupus erythematosus (SLE) with the same combination, has been conducted. Despite the presence of similar features related to antiphospholipid syndrome (APS)--cerebrovascular disturbances, livedo, fetal loss, peripheral venous thrombosis, thrombocytopenia, antibodies to phospholipids, etc--there were distinct differences between SS and SLE. In SS, no skin lesions ("butterfly", discoid lupus, photosensibilization) typical for SLE as well as sores of mucous oral cavity, polyarthritis, serosity, diagnostically significant titers of antinuclear factor and antibodies to DNA were observed. SS emerged with livedo (44%), cerebrovascular disturbances (24%) and systemic APS appearances (32%). SLE in 75% cases began with its classical symptoms and in 25% with systemic APS signs and never with livedo or cerebrovascular disturbances. For 10.5 +/- 8.0 years, no cases of SS were featured by typical SLE symptoms. Pathomorphological study indicated that SS and SLE were independent diseases. Their similarity was due to development of secondary APS, including cerebrovascular disturbances and livedo, in some patients with SLE.

[Induction of apoptosis in FAF28 cells by the protein synthesis inhibitor cycloheximide]. / Induktsiia apoptoza v kletkakh FAF28 ingibitorom belkovogo sinteza tsiklogeksimidom.

We have studied the influence of translation of inhibitor cycloheximide (CHI) on the Chinese hamster fibroblast line FAF28. This treatment inhibited the cell cycle and induced apoptosis. A short-term treatment and the following removal of CHI reduced the number of apoptotic cells up to the normal level. Under changed conditions (change in CO2 proportion and pH of cultural medium), the ability of CHI to induce apoptosis increases. The study of cell ultrastructure demonstrates three groups of apoptotic cells differing from each other in the state of cytoplasmic organelles: 1) cells with many well-identified organelles; 2) cells with a scanty number of cytoplasmic organelles; 3) cells lacking any recognizable organelles in the cytoplasm. Presumable causes of this morphological variety of apoptotic cells are discussed.

[Calcium-transporting systems and calcium regulation in cardiomyocytes]. / Kal'tsiitransportiruiushchie sistemy i reguliatsiia kontsentratsii kal'tsiia v kardiomiotsitakh.

The review systematizes and analyzes recent data about the role of different Ca(2+)-transport mechanisms in the regulation of Ca2+ metabolism and functional activity of the cardiomyocytes. During the cardiac action potential, Ca2+ enters the cardiomyocytes through sarcolemmal L-type calcium channels and via the Na+/Ca2+ exchange. This Ca2+ activates the release of additional Ca2+ from the sarcoplasmic reticulum. The sum of calcium from sarcolemmal influxes and sarcoplasmic release produces contractile effect. For the occurrence of relaxation, Ca2+ remove from the cytoplasm by three mechanisms, namely, sarcoplasmic Ca2+ pump, Na+/Ca2+ exchange and sarcolemmal Ca2+ pump. In this review, the structural and functional properties of the Ca2+ transport systems in the sarcolemmal membranes, sarcoplasmic reticulum and mitochondria are discussed. In addition alterations in regulation of intracellular calcium by activation of beta- and alpha-adrenergic receptors are consider.