[The social hygienic aspects of reproductive behavior of women aged 40-45 years].

In the context of forecasted decreasing of natality, actuality of studying its causes for organizational decision-making increases. The purpose of the study was to determine factors affecting reproductive behavior of women aged 40-45 years residing in areas with different natality levels in 2020-2021. The cohort, analytical, sociological methods were applied. The results of study demonstrated that in areas with high natality level most of urban women with higher education and high income resides in conditions of dormitory or mortgage flat and working in profile of their specialty. They are characterized by belated marriage that results in postponed child-bearing. The areas with low natality are characterized by dwelling of rural women with secondary or secondary specialized education. They reside in their own homes and work in other occupations than their specialty. The analysis of social status of women of different age groups will permit more selective approach in developing measures of increasing natality in modern conditions.

[Is vTAPP for small ventral hernias a potential «gold standard¼ for less than 24 hours hospitalization?] / Operatsiya vTAPP pri nebol'shikh ventral'nykh gryzhakh ­ potentsial'nyi «zolotoi standart¼ dlya dosutochnoi gospitalizatsii?

OBJECTIVE: To evaluate clinical efficacy and cost-effectiveness of vTAPP for small/M3W1 hernias compared to IPOM. MATERIAL AND METHODS: We retrospectively analyzed a prospectively recruited group of patients. Study objects were patients undergoing ventral laparoscopic transabdominal preperitoneal hernia repair (vTAPP) for primary Midline/Lateral Small hernias up to 2 cm. The control group comprised patients after IPOM procedure. RESULTS: We analyzed 179 patients: vTAPP (n=132) and IPOM groups (n=47). The vTAPP group was characterized by significantly shorter hospitals-stay (Q1-Q3: 8-70 hours, p<0.001), fewer relapses (n=2, p=0.047) and slightly longer surgery (Q1-Q3: 40-80 min, p=0.037). Cost-effectiveness analysis revealed 3.39 times more profitable vTAPP compared to IPOM. CONCLUSION: Laparoscopic preperitoneal hernia repair is a safe and effective method not requiring special tools and consumables. This approach is applicable as an outpatient (or <24h hospital-stay) method.

[The functioning of call-center in conditions of COVID-19 pandemic].

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic. MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed. THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 - 128339 calls, in 2022 - 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 - 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol. CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

[Early predictor of bronchial suture failure after pneumonectomy]. / Rannii prediktor nesostoyatel'nosti bronkhial'nogo shva posle pnevmonektomii.

OBJECTIVE: To identify the relationship between serum CRP/albumin and bronchial suture failure after pneumonectomy. MATERIAL AND METHODS: A retrospective analysis included 100 patients who underwent pneumonectomy with extended lymph node dissection for lung cancer. Patients were divided into 2 groups depending on postoperative complications: group 1 - bronchial stump failure, group 2 - no similar complications. In all patients, we analyzed markers of inflammation (C-reactive protein and albumin) in preoperative period and after 24 postoperative hours. Bronchial stump failure was found in 20 patients (10 patients (14.7%) after left-sided pneumonectomy and 10 (31%) patients after right-sided pneumonectomy). We found a significant relationship between serum CRP/albumin and bronchial stump failure after pneumonectomy (p<0.05). A prognostic formula was based on the ratio of serum C-reactive protein and albumin: PC = CRP/Alb, where PC - prognostic coefficient, CRP - serum C-reactive protein (mg/l) 24 hours after surgery, Alb - serum albumin (g/l) 24 hours after surgery. PC >2.6 determines high risk of bronchial stump failure after pneumonectomy, PC <2.6 - low risk. Sensitivity of this method is 90%, specificity - 97.5%.

[The common morbidity of children population in conditions of propagation of new coronavirus infection COVID-19 in 2017-2019].

The health of children population is one of the indicators of the social and epidemiological well-being of society. The purpose of the study was to study main trends of propagation of various classes of diseases in children population in conditions of propagation of the new coronavirus infection. The data of Rosstat for the Udmurt Republic covering the pre-COVID period (2017-2019) and the period of COVID-19 propagation (2020-2021). The analytical method, descriptive statistics technique, the calculation of intensive and extensive indicators were applied. It is established that in 2017-2019, general morbidity of the children population aged 0-7 years decreased by 8.7%, while in conditions of higher propagation of COVID-19 (2020-2021) there was an increase by 11.0 %. In the children population aged 0-14 years, general morbidity decreased by 10%, and hereinafter it increased on 12.1%. At that, in the pre-COVID period in children population aged from 0 to 17 years, morbidity rate decreased for 14 classes of diseases, for 15 classes in children population aged from 0 to 14 years. During the period of higher propagation of COVID-19 morbidity rate for only 5 classes of diseases decreased in both age groups of children population.

[A tool to assess functional communication skills and its correspondence with traditional language testing in patients with brain tumors]. / Instrument izmereniya funktsional'nykh kommunikativnykh navykov i sopostavlenie ego s traditsionnym rechevym testirovaniem u patsientov s opukholyami golovnogo mozga.

OBJECTIVE: To identify the relationship between speech impairment as measured by the Russian Aphasia Test (RAT) and functional communication as assessed by the Communicative Effectiveness Index (CETI). MATERIAL AND METHODS: RAT and CETI were administered to 87 patients at two time points, before surgery and in 3 months after brain tumor resection surgery. RESULTS: There were significant correlations between CETI and the total scores on RAT subtests for speech comprehension and production before surgery but not in the follow-up period. CONCLUSION: The present research is the first to present the Russian version of CETI and to confirm the relationship between speech disorders measured by the comprehensive standardized battery for evaluating speech function RAT and functional communication as measured by CETI.

[Enteral nutrition in postoperative rehabilitation after reconstructive esophageal and gastric surgery]. / Rol' enteral'nogo pitaniya v reabilitatsii patsientov posle rekonstruktivnykh vmeshatel'stv na pishchevode i zheludke.

OBJECTIVE: To investigate enteral nutrition as a component of postoperative rehabilitation after reconstructive esophageal and gastric surgeries. MATERIAL AND METHODS: The study included 217 patients who underwent reconstructive esophageal and gastric surgeries between 2010 and 2020. In the main group (n=121), patients underwent postoperative enhanced recovery program (ERAS). Early enteral feeding including micro-jejunostomy and early oral feeding was essential for postoperative management. The control group included 96 patients who were treated in traditional fashion. The primary endpoint was length of hospital-stay (LOS) and ICU-stay. Restoration of gastrointestinal function (peristalsis, stool, oral nutrition), anastomotic leakage rate and other complications comprised secondary endpoints. RESULTS: Both groups did not differ by sex, age, body mass index, diagnosis and comorbidities. There was significant reduction in postoperative LOS in the ERAS group (14 (12; 15.8) and 9 (6.3; 12) days, p<0.0001). In the same group, we observed less in ICU-stay (4.7 (3.6; 5.6) and to 3.5 (2; 4) days, p<0.001), earlier recovery of peristalsis and X-ray control of anastomosis in patients with and without anastomotic leakage. Incidence of respiratory complications was lower in the ERAS group (p=0.034). Overall postoperative morbidity and mortality were similar. CONCLUSION: Early enteral and oral feeding after esophageal and gastric reconstructive surgery reduces hospital-stay and accelerates postoperative rehabilitation.

[The essential changes of demographic processes in the Vologda Oblast].

The demographic situation is one of markers of well-being of society. The purpose of the study was to establish main trends in demographic process in the Vologda Oblast. The Rosstat data on the Vologda Oblast for 2008-2019 were analyzed using analytical, parametric and non-parametric statistics, descriptive statistics and prognostic estimate, calculation of intensive and extensive indicators. It is demonstrated that demographic situation in the Vologda Oblast is characterized by decreasing of fertility coefficient (-20.0%) and increasing of negative natural growth of population. In rural areas, at low fertility, high mortality of population is registered and its related mostly to suicides. The relationship of random drowning with suicides and murders (R = +0.66 and R = +0.78, respectively), random alcohol poisoning with suicides (R = +0.57) and suicides with murders (R = +0.76) is established. The strong feedback between murder and random alcohol poisoning was revealed too.

[Clinical and morphological characteristics of corneal epithelial dystrophy (clinical observations)]. / Kliniko-morfologicheskie kharakteristiki epitelial'noi distrofii rogovitsy (klinicheskie nablyudeniya).

This paper presents clinical observations that can be regarded as degeneration of the basement membrane of the corneal epithelium. Difficulties in identifying such forms of corneal dystrophies, on the one hand, are associated with limitation and polymorphism of the clinical picture, and, on the other hand, with insufficient information content of the basic diagnostic methods (i.e. the methods used during the initial examination). The presented clinical cases allow singling out the alarming and pathognomonic signs of the disease in the diagnostic algorithm. In the first case, attention should be paid to biomicroscopic changes in the superficial layers of the cornea and the optical defects, which can be regarded as a manifestation of an irregularity of corneal refraction. Identification of pathognomonic signs of the disease is possible on the basis of a detailed, close-to-morphological study of the structure of superficial corneal layers using confocal microscopy and optical coherence tomography. At the same time, the localization of the detected changes at the level of epithelial basement membrane and its basal sections is of crucial significance for substantiating the diagnosis. In addition, according to the literature data, recurrent erosions of the cornea of unclear etiology should be attributed to presumptive signs of degenerative changes in the basement membrane of the epithelium.

Older adult psychopathology: international comparisons of self-reports, collateral reports, and cross-informant agreement.

OBJECTIVES: To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology. PARTICIPANTS: We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60-102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies. MEASUREMENTS: Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., ). RESULTS: Cronbach's alphas were .76 (OASR) and .80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and the OABCL. Q correlations between the means of the 0-1-2 ratings for the 113 problem items averaged across all pairs of societies yielded means of .77 (OASR) and .78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were .68 for Total Problems and .58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%). CONCLUSIONS: The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.

Multiple Sclerosis Is Associated with Immunoglobulin Germline Gene Variation of Transitional B Cells.

The regulatory functions of the B-cell compartment play an important role in the development and suppression of the immune response. Disruption of their anti-inflammatory functions may lead to the acceleration of immunopathological processes, and to autoimmune diseases, in particular. Unfortunately, the exact mechanism underlying the functioning and development of regulatory B cells (Breg) has not yet been fully elucidated. Almost nothing is known about their specificity and the structure of their B-cell receptors (BCRs). In this research, we analyzed the BCR repertoire of the transitional Breg (tBreg) subpopulation with the CD19+CD24highCD38high phenotype in patients with multiple sclerosis (MS), using next-generation sequencing (NGS). We show, for the first time, that the immunoglobulin germline distribution in the tBreg subpopulation is different between MS patients and healthy donors. The registered variation was more significant in patients with a more severe form of the disease, highly active MS (HAMS), compared to those with benign MS (BMS). Our data suggest that during MS development, deviations in the immunoglobulin Breg repertoire occur already at the early stage of B-cell maturation, namely at the stage of tBregs: between immature B cells in the bone marrow and mature peripheral B cells.

Baseline brain function in the preadolescents of the ABCD Study.

The Adolescent Brain Cognitive Development (ABCD) Study® is a 10-year longitudinal study of children recruited at ages 9 and 10. A battery of neuroimaging tasks are administered biennially to track neurodevelopment and identify individual differences in brain function. This study reports activation patterns from functional MRI (fMRI) tasks completed at baseline, which were designed to measure cognitive impulse control with a stop signal task (SST; N = 5,547), reward anticipation and receipt with a monetary incentive delay (MID) task (N = 6,657) and working memory and emotion reactivity with an emotional N-back (EN-back) task (N = 6,009). Further, we report the spatial reproducibility of activation patterns by assessing between-group vertex/voxelwise correlations of blood oxygen level-dependent (BOLD) activation. Analyses reveal robust brain activations that are consistent with the published literature, vary across fMRI tasks/contrasts and slightly correlate with individual behavioral performance on the tasks. These results establish the preadolescent brain function baseline, guide interpretation of cross-sectional analyses and will enable the investigation of longitudinal changes during adolescent development.

Electrophilic and Drug-Induced Stimulation of NOTCH3 N-terminal Fragment Oligomerization in Cerebrovascular Pathology.

Small vessel disease is a prevalent age-related condition linked to increased risk of dementia and stroke. We investigate the most commonly inherited form, CADASIL, caused by cysteine-involving mutations in NOTCH3. Recent studies highlight accumulation of NOTCH3 N-terminal fragmentation product (NTF) in disease. In vitro, NTF is capable of both spontaneous and catecholamine-enhanced cysteine-mediated oligomerization. Despite well-characterized genetic influence on CADASIL, environmental effects, including medication usage, on disease remain unclear. We studied effects of assorted electrophilic compounds and drugs on NTF oligomerization by SDS-PAGE and dynamic light scattering. We then examined direct proton pump inhibitor-NTF binding with antibodies designed against proton pump inhibitor-labeled proteins and mass spectrometry. Finally, we used monoclonal NTF antibodies with Proximity Ligation Assay to identify NTF oligomers in 3 CADASIL and 2 age-matched control brains. We identified enhancement of NTF oligomerization by two electrophilic cysteine-modifying compounds, N-ethylmaleimide and iodoacetamide, and an electrophilic compound capable of oxidizing cysteines, ferric chloride. Electrophilic clinical drugs (fenoldopam, omeprazole, tenatoprazole, lansoprazole, and rabeprazole) also promoted oligomerization, and we identified direct omeprazole-NTF and tenatoprazole-NTF complexes. Additionally, we provide novel evidence of NTF multimers in human CADASIL brains. A broad array of electrophilic chemicals, including clinically relevant drugs, influences oligomerization of a pathological CADASIL protein, providing mechanistic insight into disease protein oligomerization. We posit that environmental influences, which may include usage of electrophilic drugs, may affect CADASIL presentations.

Investigation of Taurine Derivative Magnesium-Bis-(2-Aminoethanesulfonic)-Butadioateon Alleviation of Neurological Defects in Simulated Hemorrhagic Stroke in Rats.

Stroke or ischemia is caused by a blockage in a specific blood vessel that partially or completely reduces the blood flow to the brain. Nutritional factors such as antioxidants and healthy eating patterns are important variables in preventing stroke. Molecular composition properties such as molecular binding and screening can be used to evaluate the specific activity and morphological changes. The present study aimed to evaluate the effectiveness of pharmacological correction of the consequences of a hemorrhagic stroke in rats with a new derivative of taurine magnesium-bis-(2-aminoethanesulfonic)-butadioate. The animals (n=170) were divided into four groups as follows: 1) control group (n=20), 2) group 2 suffered a hemorrhagic stroke without pharmacological correction (n=50), 3) group 3 (n=50) underwent simulation of hemorrhagic stroke received Taurine at the dose of 50 mg/kg, 4) Group 4 underwent simulation of hemorrhagic stroke with correction of hemorrhagic stroke with magnesium-bis-(2-aminoethanesulfonic)-butadioate at the dose of 150 mg/kg (LKHT 3-17) (n=50). Hemorrhagic stroke was induced by transfusing autologous blood into the parietal lobe of the right hemisphere of the brain. Lethality, neurological status, locomotor, and exploratory behavior, as well as the morphological pattern of the brain damage, were assessed on the 1st, 3rd, and 7th days after the pathology simulation. Neurological deficit was determined in animals by the McGrow stroke index scale. The locomotor and exploratory behavior was evaluated using the Acti-track software and hardware complex. Two criteria were considered when assessing morphological changes in the brain: the average thickness of the cerebral cortex (in micrometers) and the number of neurons without degenerative changes. LKHT 3-17 (150 mg/kg) and taurine (50 mg/kg) reduced lethality by 1.7 and 1.36 times, respectively, on the 3rd day after stroke compared to that of the control (p<0.05). In parallel, a neurological deficit was effectively corrected LKHT 3-17 and taurine to 5.3±0.8 and 6.5±0.9, respectively, on the 1st day in contrast to the control of 8.1±0.7 points. The locomotor and exploratory behavior was significantly different on the 7th day and was accompanied by a significant increase in total activity under the influence of LKHT 3-17 to 491 conventional units (CU) compared to the control of 110 conventional units. On the 1st day, the thickness of the cortex was 1943.7±44.08 µm, and 1491.0±38.61 µm in the control and LKHT 3-17 groups, respectively. The number of neurons without neurodegenerative changes prevailed in LKHT 3-17 group (18.7±4.32), and the lowest number was observed in the group without pharmacological correction of the pathology (14.3±3.78). The taurine derivative magnesium-bis-(2-aminoethanesulfonic)-butadioate, which is a combination of the amino acid, magnesium ion, and succinic acid, decreases the neurological deficits, lethality, and enhances the locomotor and exploratory behavior in experimental hemorrhagic stroke in rats. The effect of the studied medication on the dynamics of molecular pathophysiological mechanisms occurring in the cell requires additional research.

Infectious Plant Diseases: Etiology, Current Status, Problems and Prospects in Plant Protection.

In recent years, there has been an increase in the number of diseases caused by bacterial, fungal, and viral infections. Infections affect plants at different stages of agricultural production. Depending on weather conditions and the phytosanitary condition of crops, the prevalence of diseases can reach 70-80% of the total plant population, and the yield can decrease in some cases down to 80-98%. Plants have innate cellular immunity, but specific phytopathogens have an ability to evade that immunity. This article examined phytopathogens of viral, fungal, and bacterial nature and explored the concepts of modern plant protection, methods of chemical, biological, and agrotechnical control, as well as modern methods used for identifying phytopathogens.

[Difficulties in diagnosing sacroiliitis in young patients]. / Trudnosti diagnostiki sakroileita u patsientov molodogo vozrasta.

In real clinical practice, back pain in young patients is associated with neurological manifestations of degenerative changes in the lumbosacral spine. However, such complaints may be a manifestation of a lesion of the sacroiliac joint-sacroiliitis, and degenerative changes in the spine may accompany it, but not cause pain. Sacroiliitis is an inflammatory lesion of the sacroiliac joint, which can develop as an independent disease or as a symptom of another nosology. The causes of this pathology are diverse: injuries, long-term overloading of the joint, congenital abnormalities of the joints, infectious or systemic diseases, and tumors. In neurological practice, sacroiliitis is similar to myofascial syndromes and can disguise as degenerative diseases of the spine, so early diagnosis and proper therapy are of particular importance. Awareness of doctors about the features of examination of young patients, the use of neuroimaging techniques (CT, MRI), laboratory diagnostics, will help to improve the results of therapy. Prescription of NSAIDs with a pronounced anti-inflammatory potential will slow down the progression of the inflammatory process.

Application of Focal Photoinduced Thrombosis for Modeling Spinal Cord Ischemia.

Typical ischemic damage to neurons were detected in the focus of experimental photothrombosis and in the transition zone. They were associated with symptoms of impaired motor functions and dysfunction of pelvic organs. The applied method of focal photothrombosis can be used for simulation of spinal cord ischemia for the development of methods for pharmacological correction and restoration of impaired sensorimotor functions.

[Creativity in patients with Parkinson's disease]. / Tvorcheskie sposobnosti u patsientov s bolezn'iu Parkinsona.

In some cases, a variety of creative abilities appear in patients with Parkinson's disease receiving dopaminergic therapy. These are the creativity of thinking, unusual motivation and efficiency, which are not inherent to the patients before. The author considers a spectrum of these changes, as well as their possible pathobiochemical and pathophysiological basis. The connection between creativity in art and impulsive-compulsive disorders is discussed. Specific personality traits, type of temperament and emotional stability can play a significant role in the development of creative abilities. It is important to recognize and control the severity of the creative potential of patients with Parkinson's disease, improving the quality of life, and to increase self-esteem, psychological attitude and social adaptation among these patients preventing the excesses of this process.

[The general and primarily diagnosed morbidity of diseases of skin and subcutaneous cellular tissue in the Stavropol kraii].

Atopic dermatitis and contact dermatitis are most common in all age groups of the population. In this regard, the study of the epidemiological situation of these nosological forms is highly relevant. The aim of the study was to study the indicators of general and primary morbidity in diseases of the skin and subcutaneous tissue and their structure. Material and methods. The data of official statistics on the general and primary incidence of diseases of the skin and subcutaneous tissue in the Stavropol Territory for the period from 2010 to 2017 have been studied. Results. Analysis of the incidence of diseases of the skin and subcutaneous tissue taken into account in official statistics showed an increase in the overall incidence of diseases of the skin and subcutaneous tissue by 21.5%, including contact dermatitis, other dermatitis, psoriasis and psoriatic arthritis. The overall incidence of lupus erythematosus and localized scleroderma has decreased. The highest rates of newly detected incidence of contact and atopic dermatitis were noted. Contact and atopic dermatitis prevailed in the structure of both the general and newly diagnosed diseases of the skin and subcutaneous tissue. Conclusion Despite the decrease in newly detected incidence, during the analyzed period there was an increase in the overall incidence of diseases of the skin and subcutaneous tissue. In the structure of both the general and newly detected incidence of diseases of the skin and subcutaneous tissue, the main part is occupied by contact and atopic dermatitis.

Differential Diagnostics of Active Progressing Multiple Sclerosis Using a Fluorescent Biomarker with Resonance Energy Transfer.

Previous data showed that myelin-reactive autoantibodies found in patients with multiple sclerosis and mice with experimental autoimmune encephalomyelitis recognize and hydrolyze various fragments of myelin basic protein (MBP). Moreover, antibody-mediated cleavage of the encephalithogenic fragment MBP81-103 flanked with two fluorescent proteins can serve as a new biomarker of multiple sclerosis. Here we describe creation of the next generation of this biomarker based on antibody-dependent degradation of a new chemically synthesized fluorescent substrate with resonance energy transfer that contains fluorophore Cy5 and quencher QXL680 separated by MBP81-99 protein (Cy5-MBP81-99-QXL680). This substrate is degraded during incubation with purified antibodies and B cells from patients with multiple sclerosis, but not healthy volunteers.