[Effect of Combined Antihypertensive Therapy With Perindopril and Indapamide on Morpho-Functional Parameters of The Heart, Blood Vessels of Small and Medium Caliber in Patients With Essential Hypertension].

AIM: to study effect of therapy with fixed combination of angiotensin-converting enzyme infibitor and diuretic on structural-functional parameters of the heart and vessels and cognitive function. MATERIAL AND METHODS: We included into this study 30 patients (20 women) with mean age 60.06+/-10.19 years, duration of hypertensive disease 14.7 (3; 32) years, body mass index 31.19+/-3.93 kg/m2, and without history of cerebrovascular diseases. Methods of investigation included clinical examination, measurement of parameters of hemodynamics, electro- and echocardiography. Vascular endothelial function and structural - functional state of finger skin capillary network was studied by photopletismography and video capillaroscopy, respectively. The state of cognitive sphere was evaluated with the help of the Montreal Cognitive Assessment (MoCA) test. RESULTS: We noted improvement of endothelial function of middle caliber arteries and microcirculatory vascular bed (MCVB) (increase of occlusion index at the level of MCVB from 1.4 to 1.8, p<0.00005; increase of density of skin capillary network at rest from 45 to 52 kap/2, p<0.00007); improvement of cognitive function according to changes of MoCA test results (from 23 to 27, p<0,0001). There were no changes of lipid and carbohydrate metabolism, and electrolyte balance. Conclision. The use of fixed of perindopril+indopamide is combination characterized by good tolerability and high results.

[Stigmatization and social adaptation of patients with epilepsy].

The results of previous studies carried out in different countries on the problem of stigmatization of epileptic patients indicate the deficit of knowledge about epilepsy, negative attitude in the society towards the possible mutual activity with epileptic patients, difficulty in choosing an occupation and possibilities of finding a job. These issues remain understudied. The extension of knowledge that demands additional research is needed to get a more full conception of acceptance of the disease by society and non-medical population.

Relationship between osteoinductive characteristics of biocomposite material and physicochemical characteristics of coating.

The osteoinductive characteristics of hydroxylapatite-based coating with different physicochemical characteristics were studied. The formation of the bone tissue on the studied types of the implant coating differed by the pattern and rate of formation of structural elements of the bone. Clear-cut phase-wise osteogenesis was seen on combined calcium phosphate coating: intense formation of the fibrous interstitial substance (due to cellular structure of hydroxylapatite) and slow maturing of cell elements. Bilayer composite coating provided (during the same period) the formation of more mature connective tissue. This phenomenon can be explained by better bioavailability of the coating material. The properties of combined calcium phosphate coating can be evaluated as mainly osteoconductive, while those of bilayer composite coating as osteoinductive.

[Use of atomic force microscopy for estimation of the morphometric indices of blood cells].

The possibility of using the atomic-force microscopy for the evaluation of the geometrical characteristics of blood cells has been shown. It has been found by comparing the hemocyte morphometric indices obtained at different modes of scanning that noncontact and semicontact methods are adequate for the estimation of the size and geometry of biological objects. The scanning of cells in the semicontact mode leads to the irreversible deformation of samples.

[Clinical and pharmacoeconomic peculiarities of the treatment with cerebrolysin in the period of rehabilitation of is ischemic stroke.].

The results of the clinical and pharmacoeconomic study of cerebrolysin in the rehabilitative therapy of ischemic stroke presented in the paper revealed the statistically significant regress of neurological disturbances in patients receiving cerebrolysin in daily dosages of 10 and 20 ml as compared to the control group. The rehabilitation of motor functions was more rapid than sensitive ones in patients receiving cerebrolysin comparing to those switched to the basic antihypertensive and antiaggregate therapy. The positive dynamics of speech rehabilitation was observed, the regress of aphatic disturbances being more significant for daily dosage of 20 ml. Rehabilitation rate in the period of treatment with cerebrolysin was higher for daily dosage of 20 ml than that of 10 ml. A prolonged effect of the drug during the long period after its withdrawal was found that resulted in higher rates of rehabilitation to the 11th week in patients receiving cerebrolysin as compared to the control group. Average total cost of direct medical expenses per a patient estimated in the pharmacoeconomic analysis for the groups receiving cerebrolysin and the control group was higher in the former groups, in particular in that with 20 ml dosage of cerebrolysin. A cost-efficacy analysis revealed that the cost of cerebrolysin treatment per effective unit (a cost of one score on the Lindmark scale and the Barthel scale) was less or comparable in patients receiving cerebrolysin comparing to the control group. The study suggests clinical and pharmacoeconomic expediency of cerebrolysin treatment in rehabilitative period of ischemic stroke.

[Possibilities and perspectives of berlition usage in the treatment of alcohol polyneuropathy]. / Vozmozhnosti i perspektivy primeneniia berlitiona dlia lecheniia alkogol'noi polinevropatii.

A comparison study of efficacy and tolerability of the drug berlition 300 oral and berliton 300 U and vitamin B1 has been conducted in 56 patients with alcohol polyneuropathy (15 female, 41 male, mean age 42.6 years). The key mechanisms of berlition action are increasing of endoneural blood flow, strengthening of antioxidant system functioning and reduction of "oxidative stress" intensity; improvement of glucose consumption and restoring of nerve energetic balance as well as intensification of nerve growth factor releasing and nerve growth acceleration after its experiment cutting or squeezing. Usage of berlition in the cohort studied was accompanied by a positive dynamics of both subjective and objective clinical symptoms. Comparing to vitamin B1, the drug was significantly more effective by clinical and electrophysiological indices. Berlition therapy is tolerable and safe. The results of the study confirm an assumption of berlition efficacy in alcohol polyneuropathy and allow to recommend the drug for a wide clinical application.

[Role of polymerase chain reaction in diagnosing tuberculosis of the bladder and male sex organs]. / Rol' polimeraznoi tseppnoi reaktsii v diagnostike tuberkuleza mochevykh i muzhskikh polovykh organov.

Detection of M. tuberculosis DNA by polymerase chain reaction (PCR) and standard technique was compared in 76 new cases of urogenital tuberculosis. In the urinary test PCR confirmed tuberculous etiology of the disease and corresponded to M. tuberculosis detection in 27 (60%) of 45 patients with urinary tuberculosis. M. tuberculosis DNA detection rose significantly in patients with mycobacteriuria (71%) and in examination of aspirates from isolated renal cavern, blocked kidney, epididymis, prostate and seminal vesicles. Treatment for 1 month and longer transforms the positive result into the negative one. Of 16 patients with tuberculosis of male sexual organs M. tuberculosis DNA were detected by PCR in prostatic secretion in 43.7%, in ejaculate in 93%. This did not correlate with detection of M. tuberculosis. Thus, PCR is recommended for instant diagnosis and screening before further examination and cannot be the only method in identification of urogenital tuberculosis.

[Clinical and neurophysiological aspects of somatosensory afferentation system in patients with hemispheric ischemic stroke]. / Klinicheskie i neirofiziologicheskie kharakteristiki sostoianiia sistemy somatosensornoi afferentatsii u bol'nykh s polusharnym ishemicheskim insul'tom.

Method of somatosensory evoked potentials (SSEP) was applied for examination of 36 patients in early restorative period of ischemic stroke located in internal capsule, in cortical-subcortical area of parieto-temporal cerebral regions or in cortical-subcortical areas of frontal areas. 15 healthy individuals formed a control group. Electrophysiologic SSEP pattern was not homogeneous and depended on the location of a damage focus in cerebral hemispheres. Peculiarities of generatory mechanisms of SSEP components' forming in ischemic stroke, are presented.

[Epilepsy in patients with ischemic brain disease]. / Epilepsiia u bol'nykh s ishemicheskoi bolezn'iu golovnogo mozga.

The paper presents the results of follow-up study of 610 patients with ischemic stroke. In 52 patients (8.6%) there was observed symptomatic epilepsy conditioned by local causes (2 and more epileptic fits in anamnesis). The age of the onset of epileptic seizures was in the range 50-69 years, and men prevailed. From all 52 patients with episyndrome 36 had only one stroke, 16 patients-two and more strokes. 14 patients had fits before the stroke development. Meanwhile in 10 patients the fits were the first stroke symptoms (early) and in 28 individuals the fits arose 7 days after the stroke development (late). Significantly more severe disorders of dynamic praxis were revealed in psychologic examination of the patients with secondary generalized fits than of ones with partial seizures. Pathogenetic and clinical aspects of vascular epilepsy, interactions between transitory ischemic attacks and the fits which developed before the stroke are considered.

Mutational analysis of human prothymosin alpha reveals a bipartite nuclear localization signal.

Mutants of human prothymosin alpha with impaired ability to inhibit yeast Saccharomyces cerevisiae. cerevisiae cell growth were characterized. Two types of prothymosin alpha-inactivating mutations were observed. Mutations that belong to the first type compromised the nuclear entry of prothymosin alpha by affecting its nuclear localization signal. Analysis of subcellular distribution of GFP-prothymosin alpha fusions revealed a bipartite nuclear localization signal that is both necessary and sufficient for nuclear import of the protein in human cells. Mutations of the second type abrogated the inhibitory action of prothymosin alpha through an unknown mechanism, without influencing the nuclear import of the protein.

[The metabolic therapy of ischemic stroke: the use of nootropil]. / Metabolicheskaia terapiia ishemicheskogo insul'ta: primenenie nootropila.

54 patients were treated by notropil (pyracetam). The results of therapy were evaluated statistically according to a number of clinical scales and neurophysiologic indices (EEG and evoked potentials with mapping of bioelectric activity). The results were compared with the data about 56 patients of the control group which were treated by traditional method without application of notropil. Notropil was applied by two ways: small doses (4-12 g daily) during 5 days or high doses (10-12 g daily) during 30 days from the moment when the patient admitted to the hospital. Intravenous injections of the drug were used in all cases as well as its internal administration. It was showed either efficiency of the drug, especially in high doses, in early beginning of the treatment and its duration for at least 30 days or good tolerance of the drug. Authors supposed that application of pyracetam is not adequate in strokes with severe disorders of consciousness and cerebral edema.

[X-ray morphology of coronary artery restenosis]. / Rentgenomorfologiia restenozov koronarnykh arterii.

The data on 36 patients who had undergone coronary angiography (CAG) and/or transluminal balloon angioplasty (TBAP) again after successful TBAP were analyzed. Twenty four patients were found to develop restenosis (n = 26), 80 and 92% of patients having them within the first 6 and 12 months after successful TBAP, respectively. Restenosis were demonstrated to be of almost the same degree and extent as the baseline stenoses; however, after repeated TBAP there was a slight reduction in the extent of residual stenosis as compared with the first TBAP (15.9 +/- 16.1% and 30.8 +/- 16.6%, respectively), though this difference was insignificant. At baseline, 42% of dilated stenoses were complicated and/or eccentric, while restenosis were eccentric in 16% of cases (p < 0.05) and complicated in 21% (p < 0.05). Thus, restenoses are X-ray morphologically more favourable for TBAP.

[The use of a Russian software-hardware package for the quantitative analysis of coronary angiograms]. / Primenenie otechestvennogo programmno-apparatnogo kompleksa dlia kolichestvennogo analiza koronaroangiogramm.

The software and hardware complex developed by the Cardiology Research Center, Russian Academy of Medical Sciences, jointly with the Technomash Research Production Association on the basis of a IBM 386DX personal computer equipped with a VS-100 video controller and a DS P31 VS signal processor board. Testing has indicated that it provides a qualitative image and a quantitative analysis both of phantoms and real images of coronarograms, but more accurately in the analysis of the image obtained from a film projector. Valid results are yielded when lenses more than 1 mm in diameter are used. Clinical tests have shown that the software and hardware complex may yield a rather qualitative image and calculate the required diameter of a vessel, virtually without prolonging the time of intervention, which is particularly important while making intervention procedures and implementing research programmes.

[The manifestations of IHD and the status of the coronary arteries in patients with the antiphospholipid syndrome]. / Proiavleniia IBS i sostoianie koronarnykh aterii u bol'nykh s antifosfolipidnym sindromom.

Of 20 patients with antiphospholipid syndrome 6 were found clinically and upon special tests to have signs of ischemic heart disease. All the 6 had shifts in lipid spectrum of plasma. It is important to study coronary pathology in antiphospholipid syndrome to elucidate mechanisms underlying thrombosis and vascular atherosclerosis in human diseases.

[Clinical and angiographic predictors of initial success of percutaneous transluminal balloon coronary angioplasty in patients with ischemic heart disease]. / Klinicheskie i angiograficheskie prediktory pervichnogo uspekha transliuminal'noi ballonnoi koronarnoi angioplastiki u bol'nykh IBS.

162 patients were investigated to find out the relationship between pre-PTCA clinical and angiographic characteristics and initial PTCA success. There was no relationship between patients pre-PTCA clinical characteristics and procedural success. PTCA in patients with unstable angina (n = 48) was performed after the clinical stabilization (in average on 19th day of hospitalization) and was not followed by reduction in initial procedural success or increase in intra-procedural or post-procedural complications. When coronary angiographic characteristics were considered, the distal coronary artery lesions and coronary artery stenosis 90-99% were associated with statistically significant reduction in procedural success (p = 0.03 for both factors). Complicated lesion morphology was associated with increased overall complication rate of up to 13.5% (p = 0.006 in comparison with non-complicated stenosis) and was the only predictor of poor PTCA results (prognosis).

[Comparison of the tolerance of ionic and nonionic contrast media in coronary angiography]. / Sravnenie perenosimosti ionnykh i neionnykh rentgenokontrastnykh preparatov pri koronarnoi angiografii.

To evaluate the tolerance of ionic versus nonionic CM, a double-blind randomized study was performed in 90 pts undergoing cardiac angiography. Nonionic CM caused fewer adverse reactions. These were no different in tolerance of two nonionic CM. Selective injections of urografin induced significant prolongation of RR, QT, PQ intervals on standard ECG of A-H and H-V intervals on intracardiac ECG. Nonionic CM induced the minimal electrophysiological disturbances. During left ventriculography urografin induced a significant decreased in left ventricular systolic pressure, -dp/dt value and increase in both end-diastolic pressure and heart rate. Nonionic CM produced less hemodynamics adverse effects. Urografin administration produced insignificant increasing of creatinine and urea blood levels. Minimal hemodynamics and ECG alterations caused by nonionic CM and low risk of complications determine the preferable using of nonionic CM in cardiac angiography.