High antioxidant activity of gadolinium-yttrium orthovanadate nanoparticles in cell-free and biological milieu.

Oxidative stress caused by an overproduction of reactive oxygen species (ROS) is the key factor in developing a variety of pathological conditions. Recently various nanomaterials have attracted growing interest as nanoantioxidants with ROS-regulating ability. Here, for the first time, we report on high antioxidant behavior (enzyme-like activity) of GdYVO4:Eu3+nanoparticles (GdYVO NPs) revealed by spectroscopic methods both in cell-free and biological milieu using various ROS sensors. It was revealed that GdYVO NPs (d= 2 nm) effectively scavenge hydroxyl radicals·OH,superoxide anionsO2·-,hydrogen peroxideH2O2,peroxyl radicalsROO·,and remarkably reduce the lipopolysaccharide-induced ROS generation in rat leukocytes. The antioxidant activity of GdYVO NPs is ascribed to high amount of V4+and V3+ions in the structure of the NPs and the reversible switchingV3+↔V4+andV4+↔V5+vanadium oxidation states.

[Initial combination therapy for primary open-angle glaucoma]. / 'Startovaia' kombinirovannaia terapiia pervichnoi otkrytougol'noi glaukomy.

PURPOSE: To study the efficacy and safety of initial combination therapy in patients with primary open-angle glaucoma (POAG). MATERIAL AND METHODS: The study included 111 patients (161 eyes) with stages II-III b-c of POAG aged 46 to 89 years (mean age 70.8±8.5 years). In the test group, therapy began with a fixed combination of prostaglandin (PG) (latanoprost) and beta-blocker (BB) (timolol). In patients of the control group, POAG therapy began with administration of the analogue of prostaglandin (latanoprost). When the target IOP was not achieved, a second drug was added to the treatment - instillations of 0.5% solution of timolol maleate 2 times a day. RESULTS: In patients of the test group the treatment started with a combination of BB + PG, the target IOP in the 'worst' eyes was achieved in 33 cases (64%) in 1.5±0.6 visits, and in the 'best' eyes - in 17 cases (81%), in 1.2±0.4 visits. In the control group with a 'step-by-step' selection of antihypertensive therapy, the target IOP in the 'worst' eyes was achieved in 35 cases (59%), in 2.5±0.7 visits, and in the 'best' eyes - in 22 cases (76%), in 2.2±0.5 visits (p<0.05). In both study groups, there were no cases of drug withdrawal attributed to their side effects. Patients noted conjunctival hyperemia in 5% (4 eyes) and 7% (6 eyes) of cases in the test group and the control group, respectively (p>0.05). Hyperemia decreased significantly in 2 weeks of latanoprost administration or fixed combination and did not cause withdrawal. CONCLUSION: Initial combination therapy is possible in patients with newly diagnosed POAG in some clinical situations, namely in stages II-III POAG with high IOP, unavailability of regular observation of patients for various social and economic reasons, absence of somatic and local contraindications to individual components of the combined treatment, etc.

[Ocular hypotensive effect of systemic beta-blockers in patients with primary glaucoma and arterial hypertension]. / Oftal'mogipotenzivnyĭ éffekt sistemnogo primeneniia beta-blokatorov pri pervichnoĭ glaukome i arterial'noĭ gipertenzii.

AIM: to evaluate the ocular hypotensive efficacy of systemic beta-blockers in primary glaucoma patients suffering from arterial hypertension (AH). MATERIAL AND METHODS: The study included 29 patients with POAG (58 eyes) aged from 47 to 83 years. Patients with stage I-III POAG received instillations of prostaglandin analogs and carbonic anhydrase inhibitors. All POAG patients also suffered from arterial hypertension and were prescribed selective beta-blockers (metoprolol, bisoprolol, or nebivalol) as monotherapy or as part of combination therapy (if the target arterial pressure had not been achieved under the initial treatment). After the start of oral beta-blockers therapy, the patients were re-examined at 2 and 4 weeks, 3 months, 6 months, and 1 year. RESULTS: A clinically significant reduction of IOP in the most seriously affected eye - by 3.3 mmHg (p<0.05), or 14% - occurred four weeks after the start of selective beta-blockers. Over three months of combination therapy, IOP in the 'worst' eye decreased by 4.4 mmHg (18.5%). At 1 year, IOP in the 'worst' eye was 6.2 mmHg (26%) lower than at baseline (p<0.05). CONCLUSION: Aged and senile patients with primary glaucoma usually suffer from polypathy (on average, they have 6.3±0.6 concurrent somatic diseases). To reduce the risk of polypharmacy and the frequency of side effects in the treatment of POAG and AH patients, it is advised that the treatment includes oral selective beta-blockers able to provide target levels of arterial pressure and IOP. In this study, oral beta-blockers in POAG and AH patients enabled IOP reduction as great as 18.5%-26% of baseline values over a 1-year follow-up period.

[Temporary biokeratoprostheses in total destruction of the cornea].

The paper presents an original method for temporary biokeratoprothetics in total destruction of the cornea, which consists of the following. In the operating room a 12-mm disc is cut out of patient's conchal cartilage by a trephine and then thinned down to 1 mm with a blade. The prepared autograft is placed in front of the iris completely overlapping corneal defect and sutured to the sclera with 10--12 U-shaped interrupted stitches using a 7/0 suture. Between the stitches 0.2--0.3 ml of viscoelastic are injected into the anterior chamber. Temporary blepharorrhaphy is done within the temporal one-third of the eyelids with a U-shaped suture 6/0. The authors present an own clinical observation of patient D., aged 46, with purulent corneal ulcer and total destruction of the cornea. In ophthalmic emergency, if no donor cornea is available, the described method allows to save the eyeball from its anatomical and functional loss. Further routine keratoplasty or optical keratoprosthetics may bring some functional improvement.

[Reasons for intraocular pressure to resist hypotensive therapy in glaucoma patients]. / Prichiny rezistentnosti VGD k gipotenzivnoi terapii u bol'nykh s glaukomoi.

AIM: To study the reasons of intraocular pressure (IOP) resistance to therapy in patients with glaucoma. MATERIAL AND METHODS: During the period 2011-2013 we examined 72 primary glaucoma patients (stage I-III), 44 women and 28 men, aged 49-87 years (65.2±2.5 years on average) referred by local ophthalmologists due to poor response to hypotensive therapy. RESULTS: We suggest that glaucoma should be regarded as resistant if, despite combination therapy with three antihypertensive drugs at optimal doses, IOP stays above the target. In the present study, the treatment was found suboptimal in 19.4% of cases. About 45% of all patients (33 patients) demonstrated poor compliance to the prescribed treatment. Resistant glaucoma, as we have defined it, was diagnosed in 33% of cases (pigmentary glaucoma, pseudoexfoliation glaucoma, secondary unrecognized glaucoma, etc.). This group also included patients, in whom b-blockers were initially effective, but then seemed to lose their power. CONCLUSION: 1. The reasons for intraocular pressure to resist hypotensive therapy are often associated with medical inertia (inaccurate diagnosis, inadequate treatment, etc.) and lack of patient compliance. 2. Resistant glaucoma in its true sense accounts for about 35% of cases of IOP being above the target despite conservative treatment. 3. It is advisable that at the time of first presentation, any patient who fails to reach the target IOP is treated as an «uncontrolled glaucoma¼ case, until the reasons for his/her resistance are clear.

[Experimental study on ocular hypotensive efficacy of parenteral metoprolol].

AIM: to evaluate ocular hypotensive efficacy of parenteral metoprolol in an experiment. MATERIAL AND METHODS: A total of 3 series of experiments on 24 rabbits were performed. The first series involved a single subconjunctival injection of 0.3 mg of metoprolol in the right eye, while the left served as a control. During the second series the rabbits received 0.5 mg of metoprolol intramuscularly. The third series also implied a subconjunctival injection of 0.3 mg of metoprolol in the right eye, however, supplemented with timolol 0.5% instilled in the left. In all rabbits tonometry was performed before the injection and then in 30 min, 1, 2, 3, 6, 8, and 24 hours. Biomicroscopy and ophthalmoscopy were also performed before and 1, 3, and 7 days after the injection. CONCLUSIONS: The maximum reduction (down to 30% from the baseline) of intraocular pressure (IOP) was registered in intramuscular metoprolol rabbits. Subconjunctival metoprolol was associated with a faster and more pronounced decrease in IOP as compared to timolol instillations. In case of local or systemic parenteral administration the hypotensive effect of metoprolol lasts for more than a day.

[Ophthalmic pathology in tubalars of the Altai Republic].

PURPOSE: To study the prevalence and structure of ophthalmic pathology in Tubalars, rural indigenes of the Altai Republic, for the benefit of the eye care system. MATERIAL AND METHODS: A total of 673 indigenes (67% of the whole population) aged from 1 month to 88 years, 521 Russians and 316 people of mixed parentage were examined. RESULTS: The general prevalence of eye diseases appeared to be higher in Russian newcomers (2481.75 per thousand) than in Tubalars (1965.82 per thousand), while the lowest proportion was found in the group of mixed parentage (1319.62 per thousand). The structure of ophthalmic pathology in Tubalars was as follows: refractive errors and accommodative disorders (799.40 per thousand), diseases of the conjunctiva (390.79 per thousand), retinal diseases (212.48 per thousand), lens diseases (164.93 per thousand), other ocular pathology and tumors of the auxiliary structures (124.81 per thousand), disorders of the lacrimal system (112.93 per thousand), corneal diseases (87.67 per thousand), strabismus (20.80 per thousand), congenital ocular anomalies (10.40 per thousand), glaucoma (8.91 per thousand), diseases of the vascular tract (8.91 per thousand), and eye injury (2.97 per thousand). CONCLUSION: The prevalence of eye diseases in the three ethnic groups proves interethnic differences. Tubalars demonstrated intermediate results between Russians (higher rates) and the group of mixed parentage (lower rates), which indicates unequal adaptation of these populations to harsh climatic conditions of the area. The obtained data are fundamental for informed management decision-making on rational distribution of health institutions and allocation of medical personnel and funds among the regions of the country.

[Urgent therapeutic penetrating autokeratoplasty for a purulent corneal ulcer in the only functional eye].

The article presents a case of severe purulent corneal ulcer in the only functional eye of a young patient with Frank-Kamenetsky glaucoma and high-degree myopia. Combination therapy was ineffective and the patient developed a descemetocele. Due to the absence of cadaver corneas and small size of the only available conserved Alloplant cornea, the contralateral cornea (of the blind eye, which was enucleated under general anesthesia) was used for urgent therapeutic penetrating autokeratoplasty. Postoperative period was complicated with ocular hypertension, which was surgically resolved. To overcome the critical situation around keratoplasty, with results from Russian regulation gaps, the authors suggest creating interregional eye banks in large cities that would provide sampling, conservation and storage control of donor material in accordance with the existing legislation.

[Retinal detachment in HIV-infected patients with cytomegalovirus retinitis].

The authors present their own clinical experience in three HIV-infected patients with cytomegalovirus retinitis aged from 8 to 36 years. Detailed analysis of the results of physical and laboratory examinations is provided. Given short life expectancy for these patients, the authors pose a deontological question as to whether or not active treatment of retinal detachment in patients with AIDS and CMV retinitis is reasonable.

[Life expectancy of patients with primary glaucoma, residents of a large industrial city of Siberia].

PURPOSE: To investigate life expectancy and the structure of causes of death in patients with primary glaucoma, residents of a large industrial city of Siberia. MATERIAL AND METHODS: The database of the Novokuznetsk Public Health Department information analysis center on registration forms 025 (outpatients) and 066 (inpatients) for 2004-2011 was analyzed. RESULTS: A total of 5424 primary glaucoma patients were registered during 2004-2011, of whom 441 (8.1%) subsequently died. Age at death of patients with primary glaucoma was 69.0 +/- 7.2 years. The difference between age at death and at diagnosis of glaucoma was 2.6 +/- 1.8 years. CONCLUSION: The correlation suggests that primary glaucoma is a predicting factor for vascular events, such as stroke or myocardial infarction. The authors assume that topical administration of beta blockers without consulting a physician and/or a cardiologist may lead to ischemic stroke.

Relationship between Ra-226 activity concentration in building materials and indoor radon concentration: An example of Russian high-rise residential buildings.

The worldwide trend toward the construction of high-rise buildings with high energy efficiency highlights the role of building materials as a source of indoor radon in the modern urban environment. The aim of the study is to analyze the relationship between the Ra-226 activity concentration in building materials and indoor radon concentration using the example of multi-story buildings in Ekaterinburg. Measurements of the activity concentration of natural radionuclides in building materials were carried out using a new non-destructive method. A radon survey conducted early provided the data on indoor radon concentrations in the same apartments. The obtained Ra-226 activity concentrations in building materials in high-rise buildings were found to be relatively low, ranging from 9.1 to 51 Bq/kg. The typical radon entry rate by diffusion from building materials for modern Russian multi-story buildings can be accepted as equal to 0.5 Bq/(m3∙h) per 1 Bq/kg of Ra-226 activity concentration. Ra-226 in building materials has been shown to be a primary source of indoor radon in modern high-rise buildings, where this factor can cause indoor radon concentrations above the reference level of 100 Bq/m3 at low air exchange rates. The activity concentration of Ra-226 in building materials should be considered a separate parameter for regulation within the national radiation protection systems.

Ra-226 in building materials as a source of indoor radon in high-rise residential buildings in Russian cities.

The problem of indoor radon in high-rise buildings is mostly associated with exhalation from building materials. Characterization of the radon entry from building materials by diffusion is required to provide a proper control of the population indoor radon exposure. To analyze the relationship between the content of Ra-226 in building materials and the indoor radon concentration the results of the following surveys in high-rise buildings in Russian cities were used: 1) indoor radon (>1000 apartments), 2) natural radionuclides in the building materials in existing buildings by means of non-destructive field gamma spectrometry (100 apartments). The surveys were carried out in nine large cities in different climatic zones. The radon entry rate due to diffusion from building materials, D, normalized to Ra-226 activity concentration, Ra, is in the range of 0.2-0.6 (Bq/m3/h)/(Bq/kg), depending on the type of building materials and building construction. In new multi-story buildings, the typical D/Ra ratio can be assumed to be 0.4 (Bq/m3/h)/(Bq/kg). In new energy-efficient buildings, the ratio of the radon concentration to Ra-226 activity concentration is on average 2.1 times higher than in multi-story buildings of lower energy efficiency built before 2000. The average radon exhalation rate from the building materials, normalized to Ra-226 activity concentration, is estimated to be 0.25 Bq/m2/h.

Establishing a regional reference indoor radon level on the basis of radon survey data.

The establishment of national reference levels is a new requirement of the ICRP radiological protection system. For protection against indoor radon exposure measures based on a common national reference level tend to be less effective in regions where the probability of high indoor radon concentrations is relatively low in comparison with the national average. Therefore it makes sense to establish individual indoor radon reference levels for large sub-national regions as well as for urban agglomerations separately. Analysis of indoor radon surveys of the territory, taking into account the type of building, year of construction, building material, floor and other factors influencing indoor radon concentration, provides essential and important data for defining the reference level. For Ekaterinburg, Russia it is suggested to set the reference indoor radon concentration to a level of 70 Bq m(-3) which corresponds to the 90th percentile of radon concentration in a representative group of buildings constructed in the period 1970-89, in which the lowest average indoor radon concentration was observed.

[Incidence, structure and features of eye diseases in steelworkers].

Incidence and structure of eye diseases was studied in workers of Novokouznetsk Steelworks who have occupational hazards. High incidence of inflammatory and dystrophic diseases of eyelids and conjunctiva as well as cataract was revealed in steelworkers. The incidence of eye diseases was showed to rise with the increase of work period in hazardous environment.

[Study on causes of ophthalmologists' inertia in glaucoma treatment].

The problem of inertia in ophthalmological practice, which implies the absence of any adjustment of the given treatment, even if an adjustment is objectively necessary or clinically indicated, was studied. According to the authors, the problem is most pressing when multifactorial diseases, including primary glaucoma, are concerned. An anonymous survey of 147 ophthalmologists from different West Siberian regions (Altai Krai, Kemerovo region, and Republic of Khakassia) was conducted. The set of causes for ophthalmologists' inertia was identified. The leading cause appeared to be psychological reluctance to achieve target intraocular pressure and overestimation of therapeutic success. Other causes, although less significant, include lack of professional awareness and economic barriers to decision making.

[Regarding the method of the total tear production assessment].

Different Schirmer test I techniques presented in the literature have been reviewed and a comparative study of Schirmer test I results obtained with the eyes opened and closed has been conducted. The total tear production with the eyes opened vs. closed averaged 17.1+/-1.1 mm and 12-1.2 correspondingly (p=0.001; Mann-Whitney U test). In 22% of patients values were higher with the eyes closed rather than opened. The authors recommend to specify the conditions of the performed test when entering the results into the patient's chart.

[Population-based study of tear production in healthy individuals and patients with dry eye syndrome in Altai Republic].

For the first time population-based study of tear production was performed, prevalence and risk factors of dry eye syndrome (DES) were determined in native ethnic group of Altai Republic--tubalars. Authors examined 673 people, representing 44% of the whole tubalar population. The mean total tear production (Shirmer test I) was 13,3 +/- 0,3 mm in healthy (without DES signs) tubalars. It ranges in 22,6% of healthy tubalars from 0 to 5 mm, in 20,8%--6 to 11 mm, in 20,5%--12 to 17 mm, in 34,5%-- > 17 mm. Prevalence of DES in tubalar population is 86,18 per thousand. Total tear production (Shirmer test I) in tubalars with DES ranges from 0 to 5 mm in 34%, 6-11 mm in 31,5%, 12-17 mm in 21% and > 17 mm in 13% of eyes. This results showed Shirmer test I to be nonspecific in diagnosis of DES. In author's opinion this test may be useful for follow-up and for assessment of treatment efficacy.

[Chronic inflammatory and dystrophic diseases of the eye anterior segment and their association with genetic polymorphisms in workers of metallurgic industry].

The ophthalmologic investigation of workers of the two metallurgical enterprises has shown that 1045 persons (55%) from 1911 observed workers suffer chronic diseases of a forward piece of eyes. Chronic inflammatory diseases (blepharitis, conjunctivitis and blepharoconjunctivitis) are found at 28,9% of them, and dystrophic diseases (pinguecula/pterygium)--at 25,8%. Among metallurgists (1801 persons) ophthalmopathy was found in 2, 2 times more often than at persons in control group (110 observed engineers and managers). Two polymorphisms of cytochrome P450 1A1 (CYP1A1) and P-450 2E1 (CYP2E1) genes were defined in 91 workers, by the method of allele-specific polymerase chain reaction. It is revealed that CYP1A1 Ile462Val polymorphism associates with pinguecula/pterygium, raising risk of their development almost in 3 times, unlike CYP 2E1 -1293G/C polymorphism. Development of chronic inflammatory diseases is not connected with tested polymorphisms.

[The value of neopterin in etiological diagnosis of endogenous uveitis].

Neopterin concentration in blood serum and tear fluid was estimated in 94 patients with endogenous uveitis and 28 healthy subjects. Neopterin concentration was found to be elevated in blood serum of patients with herpetic (12,31+1,1 micromol/L), tubercular uveitis (17,77+4,18 18 micromol/L) and uveitis associated with systemic conditions (12,31+1,1 micromol/L). Neopterin concentration in blood serum of healthy subjects was 8,45+0,61 micromol/L. Dynamics of neopterin concentration in blood serum of patients with uveitis varies depending on etiology. Neopterin concentration in tear fluid of healthy subjects appeared to be higher as compared with blood serum and was as high as 14,52+1,61 micromol/L (p < 0.05). Due to wide range of neopterin concentration in tear fluid, absence of significant correlation with blood serum concentration, apparently because of additional "local" production, authors propose to use only blood serum neopterin concentration for etiologocal diagnosis and control of treatment efficacy.

[Plasmapheresis combined with cell mass ozonation in endogenous uveitis treatment].

Authors propose a new method of uveitis treatment based on plasmapheresis in combination with cell mass ozonation. Analysis of treatment results of 3 patient groups (179 patients, 209 eyes) showed advantage of this original modification of plasmapheresis. In our opinion the effectiveness of proposed treatment option is associated with immunomodulatory effect of plasmapheresis and ozone therapy as well as bactericidal, antiviral and fungicidal effects of ozone therapy. Some sanogenetic mechanisms of the new treatment are disclosed in the study such as correction of T-cell immunodeficiency, decrease of circulating immune complexes and others.