[Current approaches to the treatment of patients with dyslipidemia in the real practice in the outpatient stage].

Aim    To evaluate the frequency and structure of lipid-lowering therapy and of achieving the goal of low-density lipoprotein cholesterol (LDL-C) in patients with very high cardiovascular risk (CVR) who were monitored at the outpatient stage. Material and methods    A retrospective snapshot analysis was performed by continuous sampling method for 136 medical records of outpatient patients (71 men, 65 women) aged 42 to 91 years [median, 68 years; 25th and 75th percentiles (59; 78)].Results    134 (98,53 %) patients took statins; 8 (5.88 %) patients took a combination of statin and ezetimibe; 2 (1.47 %) patients took proprotein convertase subtilisin/kexin type 9 enzyme inhibitors (PCSK9): 2 (1.47 %) patients took evolocumab and 1 (0.74%) of 2 PCSK9-treated patients took a combination of PCSK9 inhibitor and statin. Atorvastatin at a dose of 20 (20; 40) mg as recommended at the hospital was the most frequently prescribed statin. 5 (3.68%) patients achieved the goal LDL-C of ≤1.4 mmol/l.Conclusion    Statins prevail in the structure of lipid-lowering therapy in patients with very high CVR. The frequency of combination therapy (statin/ezetimibe, 5.88%; PCSK9 inhibitor/statin, 0.74%) and PCSK9 inhibitors was noted to be low. Only 3.68% of patients achieved the goal LDL-C during the lipid-lowering treatment.

Antihypertensive therapy in male and female: are there sex differences in choice of drugs?

Tis review presents data on prevalence, control, and effectiveness of treatment of hypertension in male and female. Te features of protective action and manifestations of undesirable effects of antihypertensive therapy in male and female, as well as situations influencing the choice of a drug depending on sex are discussed.

[Evaluation of inflammatory and endothelial dysfunction's biomarkers in patients with hypertension at achieving the target blood pressure.]

The target organs damage in hypertension is mainly realized through an endothelial dysfunction. The present study investigated the inflammatory and endothelial dysfunction's biomarkers in patients with hypertension before and after the achieving the target level of blood pressure. We've performed clinical and laboratory study of 44 patients (17 men, 27 women, mean age 58.59 ± 10.57 years) with the hypertension stage II, degrees2-3, high and very high risk of cardiovascular complications, not reaching the target level of blood pressure at the previous therapy. All patients received standardized therapy with a fixed combination of amlodipine / indapamide / perindopril in an individually selected dosage. The duration of the follow-up was 6 months. The levels of pro-inflammatory interleukin-6 (IL-6), anti-inflammatory interleukin-10 (IL-10), vascular cell adhesion molecule-1 (sVCAM-1) and vasculoendothelial growth factor (VEGF) were measured. All patients achieved the target blood pressure level at the end of the study (systolic blood pressure was 125.1 ± 6.9 mm Hg, diastolic - 82.2 ± 5 mm Hg, p < 0.001). After 6 months, there was no significant dynamics of inflammatory biomarkers. The level of sVCAM-1, as an indicator of endothelial dysfunction, decreased (898.67 ± 433.5 ng / ml vs. 1063.5 ± 442.4 ng / ml at the start of treatment, p < 0.001). Thus, it is possible to use vascular cell adhesion molecule-1 as a biomarker of endothelial dysfunction in patients with hypertension. Adequate therapy of hypertension with achievement of target blood pressure levels improves vascular endothelial function, significantly reducing sVCAM-1 expression.

[The Characteristics of Personnel Resources of Medical Care System of the Tver Region].

The article presents results of analysis of physicians' personnel of the Tver region according the data of official reports. In the Tver region, at January 1, 2015 there were 40 physicians per 10 000 of population. The staffing made up to 85% in average. The study established certain feminization of personnel and prevalence of individuals of pre-retirement and retirement age. The number of vacancies in state medical organizations of the Tver region made up to 540 physicians (11%). This data factually complies with results of calculation of need in medical personnel in the Tver oblast carried out according technology approved by Ministry of Health of Russia and according which deficiency of medical personnel comes to 557 physicians.

The cryogenic storage ring CSR.

An electrostatic cryogenic storage ring, CSR, for beams of anions and cations with up to 300 keV kinetic energy per unit charge has been designed, constructed, and put into operation. With a circumference of 35 m, the ion-beam vacuum chambers and all beam optics are in a cryostat and cooled by a closed-cycle liquid helium system. At temperatures as low as (5.5 ± 1) K inside the ring, storage time constants of several minutes up to almost an hour were observed for atomic and molecular, anion and cation beams at an energy of 60 keV. The ion-beam intensity, energy-dependent closed-orbit shifts (dispersion), and the focusing properties of the machine were studied by a system of capacitive pickups. The Schottky-noise spectrum of the stored ions revealed a broadening of the momentum distribution on a time scale of 1000 s. Photodetachment of stored anions was used in the beam lifetime measurements. The detachment rate by anion collisions with residual-gas molecules was found to be extremely low. A residual-gas density below 140 cm(-3) is derived, equivalent to a room-temperature pressure below 10(-14) mbar. Fast atomic, molecular, and cluster ion beams stored for long periods of time in a cryogenic environment will allow experiments on collision- and radiation-induced fragmentation processes of ions in known internal quantum states with merged and crossed photon and particle beams.

[THE SELF-ASSESSMENT OF PHYSICIANS THEIR QUALIFICATION AND SOCIAL STATUS].

The 103 medical organizations of the Tverskaia oblast were involved as study base to carry out questionnaire survey of physicians of different specialties concerning issues of self-assessment of qualification and social status. The most of the respondents (66.8 ± 1.98%) assessed themselves as good specialists, 20.8 ± 1.71% as fair specialists and 11.9 ± 1.36%--as perfect specialists. The own social status respondents assessed in general as not too high. So, 53.1 ± 2.10% of physicians refer themselves to middle class of society and 30 ± 1.93%--to below middle class of society. Among respondents, 3 ± 0.71% referred themselves to high class of society and 3.2 ± 0.74%--to the lowest class of society. The low incomes and overwork were noted by respondents as main problems of their life. The study results testify the necessity of correction of programs of medical education at all levels, actuality of activities of increasing social status of physician and development of benevolent conditions of work and rest.

Hot water molecules from dissociative recombination of D3O+ with cold electrons.

Individual product channels in the dissociative recombination of deuterated hydronium ions and cold electrons are studied in an ion storage ring by velocity imaging using spatial and mass-sensitive detection of the neutral reaction fragments. Initial and final molecular excitation are analyzed, finding the outgoing water molecules to carry internal excitation of more than 3 eV in 90% of the recombination events. Initial rotation is found to be substantial and in three-body breakup strongly asymmetric energy repartition among the deuterium products is enhanced for hot parent ions.

A cryogenic electrostatic trap for long-time storage of keV ion beams.

We report on the realization and operation of a fast ion beam trap of the linear electrostatic type employing liquid helium cooling to reach extremely low blackbody radiation temperature and residual gas density and, hence, long storage times of more than 5 min which are unprecedented for keV ion beams. Inside a beam pipe that can be cooled to temperatures <15 K, with 1.8 K reached in some locations, an ion beam pulse can be stored at kinetic energies of 2-20 keV between two electrostatic mirrors. Along with an overview of the cryogenic trap design, we present a measurement of the residual gas density inside the trap resulting in only 2 x 10(3) cm(-3), which for a room temperature environment corresponds to a pressure in the 10(-14) mbar range. The device, called the cryogenic trap for fast ion beams, is now being used to investigate molecules and clusters at low temperatures, but has also served as a design prototype for the cryogenic heavy-ion storage ring currently under construction at the Max-Planck Institute for Nuclear Physics.

Ultraviolet and visible light photodissociation of H3+ in an ion storage ring.

Ultraviolet and visible photodissociation of a vibrationally excited H(3)(+) ion beam, as produced by standard ion sources, was successfully implemented in an ion storage ring with the aim of investigating the decay of the excited molecular levels. A collinear beams configuration was used to measure the photodissociation of H(3)(+) into H(2)(+) + H fragments by transitions into the first excited singlet state with 266 and 532 nm laser beams. A clear signal could be observed up to 5 ms of storage, indicating that enough highly excited rovibrational states survive on the millisecond time scale of the experiment. The decay into H(2)(+) + H shows an effective time constant between about 1 and 1.5 ms. The initial photodissociating states are estimated to lie roughly 1 eV below the dissociation limit of 4.4 eV. The expected low population of these levels gives rise to an effective cross section of several 10(-20) cm(2) for ultraviolet and some 10(-21) cm(2) for visible light. For using multistep resonant dissociation schemes to monitor rotational populations of cold H(3)(+) in low-density environments, these measurements open promising perspectives.

Anisotropy and molecular rotation in resonant low-energy dissociative recombination.

Angular fragment distributions from the dissociative recombination (DR) of HD(+) were measured with well directed monochromatic low-energy electrons over a dense grid of collision energies from 7 to 35 meV, where pronounced rovibrational Feshbach resonances occur. Significant higher-order anisotropies are found in the distributions, whose size varies along energy in a partial correlation with the relative DR rate from fast-rotating molecules. This may indicate a breakdown of the nonrotation assumption so far applied to predict angular DR fragment distributions.

Screened radiative corrections from hyperfine-split dielectronic resonances in lithiumlike scandium.

Term energies for dielectronic-recombination Rydberg resonances below 0.07 eV are determined for Sc18+ with absolute accuracies below 0.0002 eV by electron collision spectroscopy in an ion storage ring, using the twin-electron-beam technique and a cryogenic photocathode. The lithiumlike 2s_{1/2}-2p_{3/2} transition energy for Z=21 is determined to 4.6 ppm, less than 1% of the few-body effects on radiative corrections. Features from the hyperfine structure of the 2s state could be resolved in the dielectronic-recombination spectrum.

Storage-ring measurement of the hyperfine induced 47Ti18+(2s2p 3P0 --> 2s2 1S0) transition rate.

The hyperfine induced 2s2p (3)P(0) --> 2s(2) (1)S(0) transition rate A(HFI) in berylliumlike (47)Ti(18+) is measured. Resonant electron-ion recombination in a heavy-ion storage ring is employed to monitor the time dependent population of the (3)P(0) state. The experimental value A(HFI)=0.56(3) s(-1) is almost 60% larger than theoretically predicted.

Effects of molecular rotation in low-energy electron collisions of H3+.

Measurements on the energetic structure of the dissociative recombination rate coefficient in the millielectronvolt range are described for H3+ ions produced in the lowest rotational levels by collisional cooling and stored as a fast beam in the magnetic storage ring TSR (Test Storage Ring). The observed resonant structure is consistent with that found previously at the storage ring facility CRYRING in Stockholm, Sweden; theoretical predictions yield good agreement on the overall size of the rate coefficient, but do not reproduce the detailed structure. First studies on the nuclear spin symmetry influencing the lowest level populations show a small effect different from the theoretical predictions. Heating processes in the residual gas and by collisions with energetic electrons, as well as cooling owing to interaction with cold electrons, were observed in long-time storage experiments, using the low-energy dissociative recombination rate coefficient as a probe, and their consistency with the recent cold H3+ measurements is discussed.

Study of regular intracellular and membrane processes in neurons by laser interference microscopy.

Regular fluctuations in the height of phase profile of isolated neuron were studied by laser interference microscopy. The resultant spectra of frequencies of changes in the phase profile height indicate regular local changes in the optical density and/or geometry of neurons. The frequency spectra for the central and pri-membrane regions of the cells are different.

High-resolution dissociative recombination of cold H3+and first evidence for nuclear spin effects.

The energy-resolved rate coefficient for the dissociative recombination (DR) of H(3)(+) with slow electrons has been measured by the storage-ring method using an ion beam produced from a radiofrequency multipole ion trap, employing buffer-gas cooling at 13 K. The electron energy spread of the merged-beams measurement is reduced to 500 microeV by using a cryogenic GaAs photocathode. This and a previous cold- measurement jointly confirm the capability of ion storage rings, with suitable ion sources, to store and investigate H(3)(+) in the two lowest, (J,G) = (1,1) and (1,0) rotational states prevailing also in cold interstellar matter. The use of para-H(2) in the ion source, expected to enhance para-H(3)(+) in the stored ion beam, is found to increase the DR rate coefficient at meV electron energies.

[Cooperation of the Russian Academy of Medical Sciences with the World Health Organization]. / Sotrudnichestvo Rossiiskoi Akademii Meditsinskikh nauk i VOZ.

The paper presents a brief review of successful cooperation of the Russian Academy of Medical Sciences (RAMS) with the World Health Organization (WHO) in developing biomedical research and promoting the scientific bases of public health. This cooperation is effected in different forms. The work of 30 WHO collaborating centers on the basis of 18 RAMS Research Institutions plays the leading part in this cooperation. The paper contains specific data on the activities of these centers in the field of medical research, scientific publications, education, and training of medical staff for Russia and other countries. The financial support given by the WHO to its collaborating centers is now very limited, but scientific information, medicaments, and equipment which can be received by the centers from this Organization are very valuable.