Comparing the Anti-Depressive Effect of Electroconvulsive Therapy (ECT) Versus Transcranial Magnetic Stimulation (TMS) in the Treatment of Patients with Depression.

BACKGROUND: Electroconvulsive therapy (ECT) is one of the most effective treatments for depressive disorders. However, ECT has a number of limitations, such as significant side effects in the neurocognitive domain and the requirement for general anesthesia. Transcranial magnetic stimulation (TMS) is an intervention that applies electric stimulation to the brain without causing convulsions, thus representing an attractive alternative to ECT. The aim of our study is to review systematic reports of the effectiveness of ECT and TMS in the treatment of depressive spectrum disorders. SUBJECTS AND METHODS: We performed search queries in PubMed and eLibrary databases, which retrieved 391 articles, of which 14 met our inclusion criteria for the analysis. The articles comprised three comparisons: TMS vs SHAM, ECT vs sham ECT (SECT), and ECT vs PHARM. The protocol parameters analyzed for TMS were coil type, targeted brain area, amplitude of resting motor threshold, duration of session, number of sessions in total and per week, number and pulses per session and inter-train pause. For ECT, we evaluated the type of ECT device, targeted brain area, type of stimuli, and for ECT vs PHARM we recorded types of anesthesia and antidepressant medication. RESULTS: Three of 6 studies showed a therapeutic effect of TMS compared to placebo; efficacy was greater for TMS frequency exceeding 10 Hz, and with stimulation of two areas of cerebral cortex rather than a single area. There was insufficient data to identify a relationship between the success of TMS and intertrain pause (IP). Three of four studies showed a therapeutic effect of ECT compared to placebo. Three studies of bilateral ECT showed a significant reduction in depression scores compared to the SECT groups. ECT protocols with brief pulses were generally of lesser efficacy. Four of 5 ECT vs PHARM studies showed superior efficacy of ECT compared to PHARM. Among several antidepressants, only the ketamine study showed greater efficacy compared to ECT. CONCLUSIONS: There of six TMS studies and 7 of 9 ECT studies showed efficacy in reducing depressive symptoms. A prospective study of crossover design might reveal the relative efficacies of ECT and TMS.

Perceived Psychological Well-Being in Patients with Hemodynamically Insignificant Carotid Arteries Stenosis.

BACKGROUND: Analysis of the perception of the disease in borderline stenosis of the orifice of the internal carotid artery (ICA) (up to 69% in diameter) in asymptomatic patients. SUBJECTS AND METHODS: 48 patients (28 men and 20 women). Group 1: stenosis up to 49% - 23 people (13 men, 10 women), mean age 50.4±16.1 y.o. Group 2: stenosis 50-59% - 18 people (10 men, 8 women), mean age 57.3±16 y.o. Group 3: stenosis 60-69% - 7 people (5 men, 2 women), mean age 61±12.3 y.o. All patients underwent ultrasound Doppler of brachiocephalic arteries, examination with Brief Illness Perception Questionnaire E. Broadbent (Russian version). RESULTS: According to the results of examination of patients with ICA stenosis, patients with more pronounced lesions (60-69%) more often have a type of reaction "negative attitude to the consequences of the disease". CONCLUSIONS: The majority of patients (54.2%) have a "negative type of attitude towards the consequences of the disease". This type of attitude to the disease is most pronounced in women and patients with stenosis of the ICA 60-69%. It is necessary to perform the psychological work with patients with carotid stenosis in order to form in them more adaptive types of perception of the disease, understanding of the disease and a positive attitude towards treatment.

Application of SF-36 Health Status Survey in Patients with Arterial Hypertension.

BACKGROUND: To estimate quality of life (QOL) in patients with arterial hypertension (AH) using SF-36 Health Status Survey. SUBJECTS AND METHODS: We included 268 patients (144 men, 124 women) with grade 1-3 AH (subgroup 1 - with coronary stenosis less than 50% (n=158), subgroup 2 - with coronary artery stenosis of 50% or more (n=110)). In the control group - 80 people (47 men, 33 women) without AH. Laboratory and instrumental methods included total cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, creatinine, electrocardiography, echocardiography, Doppler ultrasound of brachiocephalic arteries, stress echocardiography with physical exercises and coronary angiography. For QOL evaluation we used SF-36 Health Status Survey. RESULTS: According to the results of the SF-36 Health Status Survey, when assessing physical (PH) and mental (MH) among the groups, there was a significant decrease in summary points in patients of subgroup 2, in whom, according to coronary angiography, it was revealed stenosis of the carotid arteries 50% and more. Anxiety and depression predominated in men. Patients with corrected cholesterol and LDL-cholesterol levels, as well as after coronary angioplasty, were assessed for QOL with limited physical activity, but with high social functioning. CONCLUSIONS: AH, especially with hemodynamically significant atherosclerosis of the coronary arteries are the predictors for QOL worsening in cardiological patients, mostly in men. Using of the international questionnaire "SF-36 Health Status Survey" is advisable to assess the QOL in patients with cardiovascular diseases. In this sense, the interaction of a cardiologist and a psychotherapist is appropriate and justified for the most optimal management of a patient with this pathology.

PPARG stimulation restored lung mRNA expression of core clock, inflammation- and metabolism-related genes disrupted by reversed feeding in male mice.

The circadian rhythm system regulates lung function as well as local and systemic inflammations. The alteration of this rhythm might be induced by a change in the eating rhythm. Peroxisome proliferator-activated receptor gamma (PPARG) is a key molecule involved in circadian rhythm regulation, lung functions, and metabolic processes. We described the effect of the PPARG agonist pioglitazone (PZ) on the diurnal mRNA expression profile of core circadian clock genes (Arntl, Clock, Nr1d1, Cry1, Cry2, Per1, and Per2) and metabolism- and inflammation-related genes (Nfe2l2, Pparg, Rela, and Cxcl5) in the male murine lung disrupted by reversed feeding (RF). In mice, RF disrupted the diurnal expression pattern of core clock genes. It decreased Nfe2l2 and Pparg and increased Rela and Cxcl5 expression in lung tissue. There were elevated levels of IL-6, TNF-alpha, total cells, macrophages, and lymphocyte counts in bronchoalveolar lavage (BAL) with a significant increase in vascular congestion and cellular infiltrates in male mouse lung tissue. Administration of PZ regained the diurnal clock gene expression, increased Nfe2l2 and Pparg expression, and reduced Rela, Cxcl5 expression and IL-6, TNF-alpha, and cellularity in BAL. PZ administration at 7 p.m. was more efficient than at 7 a.m.

Expression of periferal core molecular clock genes in oral mucosa depends on the chronotype in patients with maxillofacial cellulitis.

Introduction: Accurate determination of the patient's chronotype is one of the problems of personalized medicine. Recent studies have shown that determining of the expression of timing genes is a valuable method that can help gain molecular insight into a patient's intrinsic circadian timing. Odontogenic cellulitis is very common pathology. Since acute inflammatory diseases are an urgent pathology, the time of surgical intervention can correspond depend on the time of the patient's hospitalization. Materials and methods: The level of mRNA expression of peripheral circadian clock genes clock and bmal1, per1, cry1 in buccal epithelial cells in patients with odontogenic purulent inflammatory diseases of maxillofacial area in the morning and evening was investigated. Results: During analyzing the results of the mRNA expression study of the genes of the negative regulatory link of the peripheral molecular clock, per1 and cry1, in patients with Cellulitis of the maxillofacial area, a significant decrease (P = 0.0003) in the mRNA expression level of the cry1 gene by 2.61 times in the evening compared to its morning mRNA expression values. Conclusion: The obtained data indicate that in patients with odontogenic purulent inflammatory diseases of the maxillofacial area with an evening chronotype, a violation of the expression profile of the per1 gene in the cells of the buccal epithelium is noted, which is manifested by an increase in its evening expression in comparison with patients with a morning chronotype.

Polymorphism of tmprss2 (rs12329760) and severity of COVID-19 in the Ukrainian population: Response.

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Polymorphism of tmprss2 (rs12329760) but not ace2 (rs4240157), tmprss11a (rs353163) and cd147 (rs8259) is associated with the severity of COVID-19 in the Ukrainian population.

BACKGROUND AND AIM: Angiotensin-converting enzyme 2 (ACE2), transmembrane serine 2 and serine 11A proteases (TMPRSS2, TMPRSS11A), and a cell surface cluster of differentiation 147 (CD147) might be a gene candidate that exerts the susceptibility to and mortality from coronavirus disease 19 (COVID-19). The aim of this study was to investigate the associations between ace2, tmprss2, tmprss11a, and cd147 polymorphic variants and the severity of COVID-19 in the Ukrainian population. METHODS: The study population consisted of the Ukrainian population with COVID-19: patients without oxygen therapy (n=62), with non-invasive (n=92) and invasive (n=35) oxygen therapy, as well as control subjects (n=92). Allelic polymorphisms of ace2 rs4240157, tmprss2 rs12329760, and tmprss11a rs353163 were determined by real-time PCR, and cd147 rs8259 polymorphism was detected by PCR with subsequent restrictase analysis. We compared investigated polymorphisms distribution with other populations by meta-analysis. RESULTS: Our study is the first to obtain data about the distribution of investigated gene polymorphisms in the Ukrainian population: tmprss2 rs12329760 - CC 60.9%, CT 35.9%, TT 3.2%; tmprss11a rs353163 - CC 46.7%, CT 40.2%, TT 13.1%; ace2 rs4240157 - CC 7.6%, C 18.5%, CT 22.8%, TT 19.6%, T 31.5%; cd147 rs8259 - TT 60.9%, AT 32.6%, AA 6.5%. This distribution was similar to the Northern, Western and Southern European populations. There was a statistically significant difference in the frequency of tmprss2 polymorphic genotypes CC 57.1%, CT 28.6%, and TT 14.3% (P<0.05) in COVID-19 patients with invasive oxygen therapy in comparison with non-invasive oxygen therapy. This tmprss2 mutation occurs in the scavenger receptor cysteine-rich (SRCR) domain and might be important for protein-protein interaction in a calcium-dependent manner. CONCLUSIONS: Our study indicated the presence of an association between the tmprss2 rs12329760 polymorphism and the severity of COVID-19 in the Ukrainian population.

PPARG agonist pioglitazone influences diurnal kidney medulla mRNA expression of core clock, inflammation-, and metabolism-related genes disrupted by reverse feeding in mice.

This study examined the influence of PPARG activation by pioglitazone (PG) on the mRNA of core clock, inflammation- and metabolism-related genes in the mouse kidney medulla as well as urinary sodium/potassium excretion rhythms disrupted by reverse feeding. Mice were assigned to daytime feeding and nighttime feeding groups. PG 20 mg/kg was administered at 7 am or 7 pm. On day 8 of the feeding intervention, mice were killed at noon and midnight. Kidney medulla expression of Arntl, Clock, Nr1d1, Cry1, Cry2, Per1, Per2, Nfe2l2, Pparg, and Scnn1g was determined by qRT PCR. We measured urinary K+ , Na+ , urine volume, food, and H2 O intake. The reverse feeding uncoupled the peripheral clock gene rhythm in mouse kidney tissues. It was accompanied by a decreased expression of Nfe2l2 and Pparg as well as an increased expression of Rela and Scnn1g. These changes in gene expressions concurred with an increase in urinary Na+ , K+ , water excretion, microcirculation disorders, and cell loss, especially in distal tubules. PG induced the restoration of diurnal core clock gene expression as well as Nfe2l2, Pparg, Scnn1g mRNA, and decreased Rela expressions, stimulating Na+ reabsorption and inhibiting K+ excretion. PG intake at 7 pm was more effective than at 7 am.

WAYS OF OPTIMIZING THE DIAGNOSTICS OF FOOD ALLERGIES IN CHILDREN BASED ON THE CLINICAL AND IMMUNOLOGICAL CRITERIA.

OBJECTIVE: The aim of the research was to investigate the spectrum of food sensitization, followed by the determination of the main clinical criteria and immunological markers of food allergy in children with gastroduodenal pathology and atopic dermatitis. PATIENTS AND METHODS: Materials and methods: We conducted a comprehensive clinical and immunological examination of 120 children aged from 6 to 15 years with gastroduodenal pathology (group 1; n = 64) and atopic dermatitis (group 2; n = 56), who had a history of adverse allergic reactions to food. The control group consisted of 22 apparently healthy children. RESULTS: Results: In the group of children with gastroduodenal pathology, the spectrum of the most common significant food allergens was represented by legumes, the reaction to which was observed in 25 (39.1%) subjects, eggs (25.0%) and fish (23.4%), which were found in every fourth child. Among patients with atopic dermatitis, the leading positions were occupied by fruits, which were registered in 20 (35.7%) children, nuts - in 15 (26.8%), honey and vegetables - in 11 (19.6%) children, respectively. The study of immunological status in comparison with the control group revealed reliable increases in pro-inflammatory T-helper-2 cytokines - interleukin-4 and chemokine TARC/CCL-17 and a simultaneous decrease in anti-inflammatory interleukin-10 in children of the 1st and 2nd groups who had gastrointestinal and skin manifestations of allergic reactions when eating food products. CONCLUSION: Conclusions: The study of peculiarities of adverse reactions to food in the examined children allowed us to identify specific clinical criteria and immunological markers of food allergy, which had certain features depending on the skin or gastrointestinal manifestations.

Use of the Communication Checklist - Self Report (Cc-Sr) in Schizophrenia: Language Impairments Correlate with Poor Premorbid Social Adjustment.

BACKGROUND: The present study reports preliminary results from the multicentre project on the approbation of the Russian language version of the "The Communication Checklist-Self Report" (RL-CC-SR) and its first use in schizophrenia (SZ), aiming to evaluate the contribution of language disturbances in the pathogenesis of this heterogeneous disorder. SUBJECTS AND METHODS: The study evaluated patients' clinical state with the Diagnostic Interview for Psychoses (DIP), and assessed language and communication disturbances (LCD) with the RL-CC-SR in all participants (213 healthy controls (HC), 83 SZ patients, 31 SZ first-degree relatives). Data from the current sample of SZ (n=50), and HC (n=213) was analysed to calculate the relationships between LCD, social and clinical variables using descriptive statistics methods, T-test and Pearson's correlations (SPSS-26, 2019). RESULTS: The quotient scores (<6) and raw scores on all three CC-SR subscales demonstrated prominent LCD in SZ: (i) language structure (LS) (SZ:11.92±8.01, HC:7.54±5.91; p<0.001), (ii) pragmatic skills (PS) (SZ:11.30±10.07, HC:8.71±7.39; p=0.040), (iii) social engagement (SE) (SZ:31.94±11.76, HC:19.42±10.35; p<0.001). In SZ, Pearson correlations of LS scores were significant for the DIP-items Odd Speech (p=0.033), and Social Engagement - Blunted Affect (p=0.042). PS was related to early disease onset (p=0.027), poor premorbid work adjustment (p=0.003), along with LS (p=0.005), and was also linked to poor premorbid social adjustment (p=0.005). CONCLUSIONS: SZ patients are aware of their LCD at all levels of language structure, pragmatics, and nonverbal communication, but are unable to compensate. Disturbances of LS and PS in SZ patients relate to their poor social adjustment and functioning, and may prove to be associated with the primary negative symptoms domain of the disorder and its generally poor outcome.