[Trends in the incidence of mental and behavioral disorders during the COVID-19 pandemic in Penza Oblast]. / Dinamika zabolevaemosti psikhicheskimi rasstroistvami i rasstroistvami povedeniya v period pandemii COVID-19 v Penzenskoi oblasti.

OBJECTIVE: An analysis of the trend of overall and primary incidence of mental and behavioral disorders, including those caused by the use of psychoactive substances, in different age groups during the COVID-19 pandemic in Penza Oblast. MATERIAL AND METHODS: The data were obtained from statistical report №12 for Penza Oblast. These included the overall and primary incidence of mental and behavioral disorders (MBD), as well as substance use-related MBD (MBDSUR), as calculated per 100.000 people for the period 2015 to 2022. The period 2015 to 2019 was the reference period and 2020 to 2022 was the pandemic period. The calculation was carried out by age groups: children (0-14 years), adolescents (15-17 years), adults (over 18 years), adults over working age (from 55 years for women and from 60 years for men). Statistical processing of the results included regression analysis, calculation of incidence forecast for 2023-2025, and assessment of the significance of the changes using the t-criterion. RESULTS: The decrease in the overall incidence of MBD in adults was highly deterministic (R2=0.82; p=0.012) and significant between 2017-2018 (p=0.009), 2018-2019 (p=0.001) and 2019-2020 (p=0.004). High determination with a logarithmic trend line was characteristic of almost all models, except for the primary incidence of MBD in children and overall incidence of MBDSUR in adults over working age, including after 2020. Among adolescents, the overall incidence of MBDSUR decreased significantly from 2015 to 2022 (p=0.042). CONCLUSION: There was no significant increase in the incidence of MBD, including MBDURS, during the pandemic. At the same time, there was a trend towards the decrease in adults, as well as the increase in the primary incidence of MBD in children and the overall incidence of MBDSUR in adults over working age, which determines the need for further identification of risk factors and development of specific rehabilitation measures for patients in these groups.

A METHOD FOR IMPROVING THE PROFESSIONAL PERFORMANCE AND RELIABILITY OF PERSONS DRIVING HIGH-SPEED VEHICLES.

Recently, due to the emergence of a variety of modifications of air, land, water vehicles and an increase in their speed and maneuverability, the number of people with severe manifestations of motion sickness has also increased. The relevance of this problem is dictated by the fact that, despite significant achievements in the field of preventive medicine, a significant number of people prone to motion sickness have been observed to date. Thus, among persons using land modes of transport, the percentage of sick people reaches 15.0%, air modes 20.0%, while using water modes of transport, the number of sick people reaches 30.0%. The significance of this problem is dictated by the fact that the psycho-physiological capabilities of our body do not keep pace with the rapidly increasing speed-maneuvering characteristics of vehicles.

[Analgesic and opioid-sparing effects of a fixed combination of diclofenac and orphenadrine in the early postoperative period in cardiac surgery patients]. / Anal'geticheskii i opioidsberegayushchii effekty fiksirovannoi kombinatsii diklofenaka i orfenadrina v rannem posleoperatsionnom periode u kardiokhirurgicheskikh bol'nykh.

OBJECTIVE: Evaluation of the effectiveness of a multimodal scheme of postoperative analgesia based on a fixed combination of orphenadrine and diclofenac against the background of patient-controlled analgesia with morphine in the early postoperative period in cardiac surgery patients. MATERIAL AND METHODS: A prospective, randomized, comparative study evaluated two analgesic regimens. In 20 patients (group 1), «Neodolpasse¼ (a fixed combination of 30 mg Orphenadrine and 75 mg Diclofenac) was administered immediately after trachea extubation. The second injection was performed at VAS>50 mm not earlier than 12 hours after the first one. Patient-controlled analgesia (PCA) with morphine was started 2 hours after extubation, 20 patients of group 2 who were used PCA with Morphine as monotherapy. The intensity of pain taking into account the motor activity of patients was assessed a 100 mm visual-analog scale (VAS), as an additional objective criterion for the effectiveness of analgesia, the method of incentive spirometry was used. RESULTS: A decrease in the severity of pain according to VAS from an average of 41 to 19 mm (p=0.036) was achieved already by the 1st hour from the start of Neodolpasse infusion, and in 80% of patients this effect persisted for 24 hours. 2 patients (10%) needed the administration of the 2nd dose after 12 hours. The infusion of Morphine was started 2 hours after extubation, a significant decrease in pain intensity was noted only at 4th hour, a significant decrease in pain intensity was noted only by 4 hours, and significant differences in the severity of pain in the comparison groups persisted at almost all stages of the study. The analgesic effect of the combination of orphenadrine and diclofenac had a positive effect on the function of respiration system with an increase in MILC by 1.5 times from the beginning of the study. In group 2, the observed adverse effects were associated with the use of Morphine and depended on its dose. No adverse effects of Neodolpasse were noted. The total 24 hour consumption of Morphine at PCA averaged 22.6 mg, and in the Neodolpasse group - 9.35 mg (p<0.001). CONCLUSION: There were demonstrated high analgesic efficacy, safety and significant opioid-sparing effect of a fixed combination of orphenadrine and diclofenac in the early postoperative period of cardiac surgery patients.

[The combined use of peptide bioregulators and self-massage in order to improve the psychophysiological state and increase the professional performance of the elderly.]

The development of modern society is characterized by an increase in the volume and changing forms of information presentation. In the works of Russian and foreign gerontologists, it is noted that the perception and analysis of the flow of relevant data today causes difficulties for a significant part of citizens of older age groups, which is due, among other things, to the deterioration of their psychophysiological state. The lack of the ability to use the necessary information negatively affects the quality of life, the level of social adaptation and professional competence. This problem is particularly significant for population groups and professional communities, whose life and activities require the actualization of certain sectors of the information field. Typical examples of such groups are citizens of retirement age who continue professional activities related to the mobilization of intellectual and creative potential, in particular, university teachers. The use of gerontotechnologies contributes to solving the problem, which provides for the development of effective methods for correcting the functional state of elderly citizens, in particular, increasing the ability to perceive information and the level of vital activity. This publication presents the results of an experimental study of the effectiveness of the combined use of peptide bioregulators and massage on the level of professional performance of elderly teachers of a pedagogical university.

[Accelerated aging as a risk of the education digitalization: possibilities for prevention.]

The work is devoted to the analysis of the education digitalization negative effects and the possibilities of their prevention consideration. The urgency of this problem in the modern conditions of combating the pandemic of the new coronavirus infection and moving a significant part of education and leisure to the virtual space is noted. Against the background of a deficit in physical activity and an increase in the information consumption duration, the participants in the experiment showed a significant increase in the frequency of mental and physical maladjustment symptoms occurrence, a decrease in performance indicators and a deterioration in the biological age parameters. The geroprotective effect of correcting the student lifestyle with an emphasis on information hygiene, optimizing sleep, rest, motor and nutritional regimen in terms of qualitative and quantitative indicators is shown.

[Efficiency and safety of a fixed combination of Orphenadrine and Diclofenac for postoperative analgesia in cardiac surgery patients]. / Effektivnost' i bezopasnost' ispol'zovaniya fiksirovannoi kombinatsii orfenadrina i diklofenaka dlya posleoperatsionnoi analgezii u kardiokhirurgicheskikh bol'nykh.

OBJECTIVE: Evaluation of the safety and effectiveness of the use of a fixed combination of orphenadrine and diclofenac for analgesia in the early postoperative period of cardiac surgery patients. MATERIAL AND METHODS: There were two analgesia regimens evaluated in a retrospective comparative study. In 23 patients (group 1), Neodolpasse (a fixed combination of 30 mg orphenadrine and 75 mg diclofenac) was administered immediately after trachea extubation. When the severity of pain in VAS increased to more than 50 mm, so 20 mg trimeperidine was administered. In group 2 of 20 patients analgesia in group 2 was performed with patient-controlled analgesia (PCA) with Promedol (trimeperidine) as monotherapy. The intensity of pain was assessed a 100 mm visual-analog scale (VAS) and 5-channel verbal scale (VS) for assessment the severity of the pain syndrome during the patient's moving activity. RESULTS: A decrease in the severity of the pain syndrome according to VAS from 68.31 to 21.96 mm (p<0.001) was achieved by the first hour after the start of the infusion of Neodolpasse persisted for 24 hours of 65% patients. 4 patients (35%) needed the administration of the 2nd dose after 12 hours. The infusion of trimeperidine was started 2 hours after extubation, a significant decrease in pain intensity was noted only at 6th hour, and further differences in the severity of pain in the comparative groups did not significantly differ. In group 2, the observed adverse effects were associated with the use of trimeperidine and depended on its dose. No adverse effects of Neodolpasse were noted. In the Neodolpasse group no adverse effects of the treatment was noted. The total 24 hour consumption of trimeperidine at PCA averaged 72.3 mg, and in the Neodolpasse group - 6.96 mg (p=0.00042). CONCLUSION: There were demonstrated safety, high analgesic efficacy and significant opioid-sparing effect of a fixed combination of Orphenadrine and Diclofenac in the early postoperative period of cardiac surgery patients within the framework of the inclusion and exclusion criteria accepted in the study.

[The place of scales and questionnaires in assessing the disease's severity and the long-term prophylaxis's prescribing in patients with hereditary angioedema].

Hereditary angioedema is a hereditary life-threatening disease characterized by recurrent angioedema of various strength and localization. To date, definite diseases severity criteria have not been developed. There are many different factors to consider not only the frequency of episodes, but also their duration, strength, influence on the patient's appearance, the severity of the pain syndrome. Disease related quality of life, the number of work disability days, and the patient's satisfaction with the prescribed treatment are important. In addition, there are no criteria for prescribing long-term prophylaxis, and no parameters for choosing a specific drug. The introduction of specific scales and questionnaires developed to assess such characteristics as disease activity, disease control, quality of life in patients with recurrent angioedema into clinical practice seems to be the best solution for both questions. The comprehensive understanding of the diseases severity in a particular patient can be carried out with the combined use of assessment tools.

[Change in the expression of gene transcription negative regulator SOCS1 in the patients with bronchial asthma and metabolic disorders].

AIM: Comprehensive study of the negative regulation components of cell signaling in the bronchial asthma (BA) patients with metabolic disorders. MATERIALS AND METHODS: 113 people were examined: 63 patients with allergic BA (ABA), 50 patients with a non-allergic variant of the disease (NABA). SOCS1 mRNA expression was evaluated by reverse transcription PCR (RT-PCR). SOCS1 protein expression was investigated by immunoblotting. The determination of cytokine levels was carried out according to the standard protocol on a Bio-Plex flow fluorimeter. RESULTS: A significant and multidirectional change in the expression of SOCS1 mRNA was found at a body mass index 25 (greater than normal) in ABA and NABA. The positive correlations between SOCS1 mRNA expression and body mass index indicate the regulatory role of SOCS1 in leptin signaling. The spectra of correlations in ABA and NABA are different, it indicates the probable existence of specificity in the pathogenesis of these variants of the diseases. CONCLUSION: The obtained data allow us to consider the complexity of regulation disorders occurring at different levels of cell signaling. The multifunctionality of the SOCS1 regulator provides complex control of cytokine signaling simultaneously in different signaling pathways in the BA with metabolic disorders.

[Working ability of elderly university teachers under the combined influence of breathing exercises and peptide bioregulator «Cortexin¼.]

The two-week use of special breathing exercises in combination with the Cortexin peptide bioregulator optimizes the functional state and increases the professional performance of older teachers more effectively compared to the single use of a pharmacological preparation. The maximum effect is noted immediately after the end of the course use of special breathing exercises and the peptide bioregulator and lasts for two months. The results obtained open up prospects for the use of breathing exercises to enhance and prolong the nootropic drugs and antihypoxants antistress and geroprotective effects.

[The influence of self-massage combined with drug Noopept on the professional performance of teachers older.]

It is shown that the two-week use of self-massage of the head and neck in combination with the pharmacological drug Noopept improves the functional state and increases the professional performance of elderly teachers compared to single use of nootropic drug. The greatest increase in the functional state and professional performance was noted immediately after the course of self-massage of the head and neck in combination with the pharmacological drug Noopept. The combined effect of self-massage and nootropic drug on the functional state and professional performance indicators are maintained for 1-2 months, and by the end of the third month they are approaching the initial values.

[Prevention and correction of cognitive dysfunction after general anesthesia]. / Profilaktika i korrektsiia kognitivnykh narushenii posle obshchei anestezii.

AIM: To evaluate clinical efficacy of intraoperative use of cytoflavin in the prevention and correction of cognitive functions in surgical patients with no history of neurological and psychosomatic disorders. MATERIAL AND METHODS: The study included 60 female patients who underwent surgery on the thyroid gland. Patients were stratified into two equal groups matched for main indices. Patients of the main group received infusions of cytoflavin (20 ml in 200 ml of 5% glucose solution). Patients underwent thyroidectomy with general inhalation anesthesia using desflurane. Cognitive testing was performed one day before operation and 6, 24 and 48 h after. Waking time after stopping desflurane administration and time prior tracheal extubation were recorded. RESULTS AND CONCLUSION: The use of cytoflavin promoted the early post anesthesia adaptation and more rapid recovery of initial cognitive status of the patients.

[Role of negative regulators of SOCS1, SOCS3, and SOCS5 gene transcription in the negative cell signaling regulation system in asthma]. / Rol' negativnykh regulyatorov transkriptsii genov SOCS1, SOCS3 i SOCS5 v sisteme negativnoi regulyatsii kletochnoi signalizatsii pri bronkhial'noi astme.

AIM: To conduct a comprehensive study of the components of negative cell signaling regulation in different types of asthma. SUBJECTS AND METHODS: A total of 171 people, including 80 patients with allergic asthma (AA), 60 patients with non-allergic asthma (NAA), and 31 apparently healthy individuals, were examined. SOCS5 mRNA expression was assessed by reverse-transcription polymerase chain reaction. The expression of SOCS1 and SOCS3 proteins was investigated by immunoblotting. The concentration of total serum IgE was determined by enzyme immunoassay; the level of cytokines was measured according to the standard protocol using a Bio-Plex fluorometer. RESULTS: The findings show that the patients with AA generally display more marked changes in the expression of all three investigated SOCSes (SOCS1, SOCS3, and SOCS5) at baseline and when interleukin 4 (IL-4) acts. In NAA, there are pronounced changes in the expression of SOCS3 only and, to a lesser extent, SOCS5. The results of investigating the concentrations of IL-4 in the examined groups demonstrate its significant decrease in the AA group, whereas in the NAA group, it is similar to those in healthy individuals. On the contrary, IL-10 concentrations in AA tend towards those in the control group, but much exceed in NAA. CONCLUSION: The findings allow one to consider the complexity of regulatory disorders arising at various levels of cell signaling in the context of the multifunctional nature of the molecules from the family of negative regulators of transcription of the SOCS1, SOCS3, and SOCS5 genes, which provide the comprehensive control of cytokine signaling simultaneously in different signal pathways.

[COGNITIVE ABNORMALITIES IN POSTOPERATIVE PERIOD OF THYROID SURGERY].

An evaluation of cognitive functions was presented in 90 patients undergoing thyroid surgery. An attention deterioration, shot-term memory impairment and degradation were revealed after operation. It was shown that reduction of manifestations of cognitive dysfunction and stabilization of the haemodynamics indices were allowed due to application of cytoflavin during operation and in early postoperative period.

[REPROGRAMMING OF MITOCHONDRIAL ENERGY METABOLISM IN MALIGNANT NEOPLASMS].

The novel ideas of fundamental role of mitochondria in the maintenance of viability of malignant cells have been reviewed. The modern state of research is considered in detail, including: mitochondrial control of the cellular redox state, sites of reactive oxygen species (ROS) production in inner mitochondrial membrane and antioxidant protection systems. Specificities of the structural-functional mitochondrial remodelling in malignant tumors, the mechanisms of the energy metabolism reprogramming, enhancement of the ROS production and adaptation to the hypoxic conditions and metabolic stress are analyzed. The available data including our research on transplanted tumors indicate that cytotoxic action of sodium dichloroacetate (the inhibitor of pyruvate dehydrogenase kinase) depends on biological properties of tumors and intensity of structural-functional mitochondrial rearrangement. Dichloroacetate turned out to be effective for sarcoma 37, but not for Lewis lung carcinoma.

Dynamics of changes of antioxidant system indexes during the growth of two Lewis lung carcinoma variants.

AIM: To study an intensity of prooxidant processes and activity of antioxidant enzymes in tumor tissue of two Lewis lung carcinoma variants (LLC and LLC/R9) differing by their proliferative, metastatic, and angiogenic potential (LLC/R9 as compared to LLC is characterized by lower metastatic activity, higher proliferative and angiogenic potential). MATERIALS AND METHODS: The in vitro study was carried out using cultured LLC and LLC/R9 cell lines, and in vivo on 50 female С57/BL6 mice. The indexes of prooxidant processes and activity of antioxidant enzymes have been studied using the methods of experimental oncology, optical spectroscopy, fluorescent spectroscopy, electron paramagnetic resonance, statistical analysis. RESULTS: There has been determined the coherence of results on 1.5 fold higher (p < 0.01) level of spontaneous generation of reactive oxygen species (ROS) by LLC cells in vitro compared to LLC/R9 cells, and twice (p < 0.05) higher content of secondary products of lipid peroxidation at 14(th) and 17(th) day of tumor growth in LLC compared to that in LLC/R9. It has been shown that deficiency of nutrient substrates determines an increase (p < 0.01) of ROS production in LLC/R9 cells what is in congruence with the data on accumulation of nitrosyl complexes of heme iron in mitochondria of LLC/R9 during tumor growth. Activity of superoxide dismutase during tumor growth has altered in unmonotonous way: starting from 14(th) day of growth it sharply increased by 147% (17(th) day, LLC) and 217% (20(th) day, LLC/R9), and then decreased to the level registered at 14(th) day. Progressive decrease of activity of glutathione peroxidase (GP) and glutathione-S-transferase (GST) during LLC growth has been accompanied with the decrease of the level of reduced glutathione (GSH) by 70% (p < 0.05). In the case of LLC/R9 the decrease of GP activity at initial stages of tumor growth correlated with significant increase of GSH level in the tumor--by 250% (p < 0.01). It has been shown that in LLC/R9 tumors (unlike to LLC), GSH utilization is mostly provided by GST, its significantly higher activity has been detected in LLC/R9 tumors compared to LLC. CONCLUSION: We have revealed a number of peculiarities of antioxidant system functioning in LLC and LLC/R9 tumors and have shown a relation between an activity of antioxidant system and some biological properties of studied tumor variants.

Functional and dynamic state of inner mitochondrial membrane of sarcoma 37 in mice under administration of sodium dichloroacetate.

The activity of enzymes of the respiratory chain and structural-dynamic properties of the inner mitochondrial membrane (IMM) of sarcoma 37 (S37) in mice under sodium dichloroacetate (SDA) administration in a daily dose of 86 mg/kg of body weight starting from the 2nd day after tumor transplantation were investigated. The dynamic and structural state of the IMM components was determined using the fluorescent probes. With S37 growth the intensification of glycolytic metabolism occurred on the background of suppressed functional capacity of mitochondrial respiratory chain enzymes. The changes of conformational properties of protein molecules and the increase of IMM lipid phase microviscosity were shown. The administration of SDA promotes the decrease of lactate content and the increase of pyruvate dehydrogenase activity in S37. This was accompanied by further suppression of the functional activity of the respiratory chain complexes and H+-ATPase coupled with conformational modification ofprotein molecules and changes of the structural orderliness of the IMM lipid phase, possibly due to intensification of reactive oxygen species generation.

[The use of central acting analgesic nefopam in postoperative analgesia in cardiac surgery patients].

A prospective, randomized, comparative study was conducted. 3 analgesia protocols were used: 1) patient controlled analgesia (PCA) with trimeperidine in combination with a nefopam constant infusion; 2) PCA with trimeperidine in combination with a nefopam bolus; 3) PCA with trimeperidine separately during early postoperative period in cardiac surgery patients. The study included 60 patients agedf rom 40 to 65 years of age (20 patients in each group). The analgesia efficacy was evaluated with a 5-point verbal rating scale (VRS) for pain intensity and inspiratory lung capacity (ILC), measured with incentive spirometer. The safety of nefopam during early postoperative period in cardiac surgery patients was shown. The combination of nefopam and trimeperidine led to a more pronounced analgetic effect. Trimeperidine consumption was significantly lower in nefopam groups than in the group of isolated PCA. Wholly adverse effects were associated with trimeperidine and were dose-related The incidence of nausea, vomiting, dizziness, weakness, bowel paresis was significantly higher in isolated PCA group than in the other two groups.

[Ketoprophen and nefopam combination for postoperative analgesia with minimal use of narcotic analgesics in cardio-surgical patients].

4 combinations of analgesia were studied: 1) Nefopam and patient-controlled analgesia (PCA) with Trimeperidine; 2) Ketoprofen (100 microg each 12 hours intramuscular) and PCA with Trimeperidine; 3) Nefopam, Ketoprofen and PCA with Trimeperidine; 4) PCA with Trimeperidine as monotherapy in early postoperative period in cardio-surgical patients. 80 patients (age from 40 to 70) were divided into 4 groups, 20 patients in each group. Administration of Nefopam and Ketoprofen before extubation reduced the intensity of pain syndrome (in average on 90%) and promoted the early stirring up of patients. Combination of Nefopam and Ketoprofen provided the most expressed analgesic and opioids-saving effects. In this group average amount of Trimeperidine per 24 hours was 14.7 microg that was 4.9 times less than in group of PCA with Trimeperidine as monotherapy. Dynamics of maximal inspiratory capacity of the lungs in the first three groups was better than in group of PCA with Trimeperidine as monotherapy beginning from 6th hour of study. In common undesirable effects was connected with Trimeperidine administration and depended on its dose. The frequency of nausea, vomit, dizziness and weakness was authentically higher in the group of PCA with Trimeperidine as monotherapy than in other groups.

[The pathogenetic approach to the development of tools and methods for the improvement of statokinetic stability in the operators of aerospace systems].

The objective of the present study was to estimate the efficacy of the tools and methods for the optimization of the activity of the central nervous system (CNS) and analyzers involved in the maintenance of the statokinetic (SK) stability in man. To this effect, we evaluated the outcome of bemitil treatment during 10 days with and without A.I. Yarotsky test and the influence of these procedures on the pathophysiological characteristics of selected elements of the work of operators of aerospace systems. Based on the data obtained in the study, the tools and methods have been developed that allow the efficacy and quality of certain aspects of the operators' activity to be improved, viz. general working capacity under conditions requiring enhanced statokinetic stability, self-confidence, emotional and somatic comfort.

The influence of sodium dichloroacetate on the oxidative processes in sarcoma 37.

AIM: to study the activity of antioxidant enzymes and to evaluate an intensity of prooxidant processes in sarcoma 37 (S37) cells during tumor development and under influence of sodium dichloroacetate (SDA). METHODS: Activity of total superoxide dismutase (SOD), SOD isoforms, catalase (Cat), glutathione peroxidase (GP), and glutathione reductase (GR), as well as content of reduced glutathione (GSH) and lipid peroxidation (LP) secondary byproducts were determined in S37 homogenated tissues of untreated mice and animals treated with SDA at daily dose of 86 mg/kg. RESULTS: SDA treatment of S37-bearing mice resulted in the reduced activities of total SOD, SOD isoforms (especially Mn-SOD), Cat, GP and significantly decreased GSH content on the background of LP intensification in tumor tissue. CONCLUSION: The observed changes of oxidative homeostasis in S37-bearing animals treated with SDA could be considered as an element of antitumor action of SDA.