Kazan medical journal

BACKGROUND: Anemia is a common problem with atrial fibrillation. There is a limited number of studies examining the role of iron deficiency anemia in the course of atrial fibrillation.

AIM: To evaluate the association of iron deficiency anemia with the development of recurrent atrial fibrillation within 12 months in patients after pharmacological cardioversion with amiodarone.

MATERIAL AND METHODS: The study included 198 patients over 18 years of age [120 (60.6%) men and 78 (39.4%) women, median age 71 (63.2; 77) years] with paroxysmal non-valvular atrial fibrillation and duration of paroxysm <48 h, after successful pharmacological cardioversion with amiodarone. The group with anemia included 99 patients (all had iron deficiency anemia), the group without anemia included 99 people. Patients with anemia were older; the groups were comparable in other main indicators. The development of recurrent atrial fibrillation over 1 year of follow-up was assessed by the Kaplan–Meier method and the Cox proportional hazards model. Differences were considered statistically significant at a p value <0.05.

RESULTS: In the iron deficiency anemia group, symptomatic relapses of atrial fibrillation developed in 40.4% of patients during 1 year of observation; in the group without anemia — in 25.3% of patients (p=0.003). Kaplan–Meier analysis showed that iron deficiency anemia is associated with an increased risk of developing recurrent atrial fibrillation within 1 year after pharmacological cardioversion with amiodarone, relative risk 1.87 (p=0.014). Comparison of the risks associated with iron deficiency anemia and iron deficiency (regardless of the presence of anemia) showed a greater risk of recurrent atrial fibrillation associated with iron deficiency than with anemia (for interaction p=0.014).

CONCLUSION: A comparison of the risks of developing recurrent atrial fibrillation in patients with iron deficiency itself and in patients with iron deficiency anemia showed a greater influence on the prognosis of recurrent atrial fibrillation by the presence of iron deficiency.

BACKGROUND: Psychosocial risk factors influence the development and progression of chronic heart failure. Early identification and correction of psychosocial risk factors can reduce their negative impact on the severity of heart failure.

AIM: To determine a set of clinical characteristics, socio-demographic indicators, personal and psychological characteristics of patients with coronary heart disease depending on the level of psychosocial adaptation to chronic heart failure.

MATERIAL AND METHODS: The study involved 120 patients with coronary heart disease and chronic heart failure. The “Questionnaire for assessing psychosocial adaptation of patients with coronary heart disease to chronic heart failure” developed by the authors was used. Based on the testing results, patients were divided into three groups: adapted, conditionally adapted and maladapted. The first group included 40 patients, the second — 65, and the third — 15. The severity of the clinical course of heart failure, adherence to therapy and the presence of comorbid pathology were assessed. The characteristics of personal response, the severity of neurotic states, a tendency toward type D personality, quality of life, level of social support, and cognitive functions were studied. The socio-demographic characteristics of the patients (age, gender, level of education, position held, level of earnings, nature of alcohol consumption) were analyzed. Statistical and correlation data analysis was performed using the statistical computing environment R 4.2.1. The critical level of significance was considered to be p=0.05.

RESULTS: The severity of heart failure decreased (τ=0.38, 95% confidence interval 0.25–0.50, p <0.0001); indicators of left ventricular ejection fraction (ρ=–0.46, 95% confidence interval from –0.59 to –0.30, p <0.0001) and quality of life (ρ=0.63, 95% confidence interval 0.51–0.73, p <0.0001) increased as the level of psychosocial adaptation increased. Adapted and maladapted patients differed in age (p=0.0411), level of education (p=0.0179), position (p=0.0217), personal (p <0.0001) and family (p=0.015) financial well-being, characteristics of personal response, severity of neurotic disorders, as well as the level of social support (p <0.05), adherence to treatment (p=0.0004). Type D personality was registered in 100% of maladapted patients. Adapted patients had higher values of cognitive functions (26.5±4.2 points) and lower comorbidity index scores (5.8±2.7 points) than maladapted patients (23.6±2.3 points, p=0.003; 8.7±3.6 points, p=0.0033).

CONCLUSION: Differences in the severity of the clinical course of the disease, socio-demographic characteristics, personal and psychological characteristics of patients with coronary heart disease were found as the level of psychosocial adaptation to heart failure decreased.

BACKGROUND: The phenotypic and pathophysiological heterogeneity of patients with chronic heart failure increases the interest of researchers in grouping according to similar clinical and genetic characteristics based on cluster analysis.

AIM: To identify phenotypic subgroups in a multivariate cohort of patients with chronic heart failure secondary to coronary artery disease using uncontrolled cluster analysis of clinical, instrumental and genetic components.

MATERIAL AND METHODS: 470 patients with chronic heart failure of functional class I–IV, stable course, ischemic etiology of both sexes at the age of 66.4±10.4 years were examined. A clinical study was conducted, genotyping single nucleotide polymorphisms rs10927875 of the ZBTB17 gene, rs247616 of the CETP gene, rs1143634 of the IL-1β gene, rs1800629 of the TNF gene, rs1800795 of the IL-6 gene was carried out, and patient outcomes were assessed for 5 years. Quantitative data were presented as mean and standard deviation or median and interquartile range; categorical — as frequencies and percentages. Categorical intergroup differences were tested using the χ² test, and quantitative differences were tested using the Student/Mann–Whitney test. Hierarchical clustering was carried out according to 44 demographic, clinical, genetic variables, time to event was analyzed by the Kaplan–Meier method, risk ratio — by Cox regression. Statistical processing was carried out in the R4.3.1 program.

RESULTS: Two clusters of patients with heart failure were identified. Cluster 1 (66%) included older patients of both sexes, predominantly functional class III–IV chronic heart failure, with enlarged heart chambers, reduced left ventricular ejection fraction, higher heart rate, atrial fibrillation and left ventricular hypertrophy. In this cluster, more carriers of the GG genotype of the rs1800795 polymorphism of the IL-6 gene (p <0.001) and the CT genotype of the rs247616 polymorphism of the CETP gene (p=0.014) were identified. Cluster 2 (34%) was represented predominantly by younger women, with a higher metabolic index, a history of myocardial infarction and coronary intervention, smokers, and a larger proportion of the TT genotype of the rs247616 polymorphism of the CETP gene (p=0.029).

CONCLUSION: 2 clusters of patients with chronic heart failure, characterized by a different set of 44 variables that determine the risk of death from all causes, were identified.

BACKGROUND: The chemokine CXCL8 and its receptor are involved in the activation and transport of inflammatory mediators and regulate the proliferation and renewal of cancer stem cells in colon cancer. It is believed that CXC signaling may be associated with poor prognosis in colorectal cancer.

AIM: To study the possibilities of using CXCL8-CXCR1/2 pathway indicators as markers in colorectal cancer.

MATERIAL AND METHODS: Isolation of ribonucleic acid (RNA) from histological sections of tumors obtained intraoperatively from 59 patients diagnosed with colorectal cancer was carried out using magnetic particles, and quantitative polymerase chain reaction in real time was performed. Calculation of the normalized expression of the CXCL8 and CXCR1 genes relative to the referee gene was done using special software. Statistical data processing was performed using Statistica 3.0, BioStat v. 7.1 programs. Comparisons of characteristics were performed using the Mann–Whitney U test. Cox and Kaplan–Meier criteria were used to analyze overall and disease-free survival.

RESULTS: The expression of CXCL8 in intestinal adenocarcinoma cells with low differentiation [Me (Q1–Q3) — 8.770 (1.127–1.114)] was significantly higher than in the groups of moderately and well differentiated tumors (p=0.004 and p=0.012, respectively); and in tumor tissue refractory to chemotherapy, it was significantly higher [4.374 (2.052–7.045)] compared to resistant [2.200 (1.388–5.037); p=0.008] and sensitive [1.624 (0.739–2.586); p=0.042]. The level of CXCR1 messenger RNA in tumor tissue was increased in the presence of BRAF mutation [3.645 (0.801–1.090); p=0.009] and low tumor differentiation [6.965 (3.938–12.225); p=0.002], as well as in tumor tissue refractory to FOLFOX/XELOX chemotherapy [46.224 (27.580–83.570); p=0.0009].

CONCLUSION: Expression of components of the CXCL8-CXCR1/2 signaling pathway in tumor tissue may be a marker of sensitivity to FOLFOX/XELOX chemotherapy in colorectal cancer.

BACKGROUND: To achieve the number of potential bone marrow donors in Russian registries to a level sufficient for effective selection of recipients in need of transplantation, it is important to find the most effective ways to recruit Russians as potential bone marrow donors.

AIM: To identify areas for improving methods of recruiting potential bone marrow donors in the Russian population.

MATERIAL AND METHODS: An electronic survey was conducted: the questionnaire included 27 questions, the respondents were participants in the register of potential bone marrow donors of the Vasya Perevoshchikov National Register of Bone Marrow Donors Charitable Foundation, expert validation and a preliminary pilot survey were used. The focus was on factors that determine the population’s readiness to donate, preferred methods of donating biomaterial and territorial accessibility of recruitment centers, opportunities and obstacles to recruiting bone marrow donors. 6,314 people took part in the survey. The work used frequency analysis methods and the Pearson χ² statistical criterion; the data was processed in the SPSS Statistics program.

RESULTS: The most common channels of information about bone marrow donation in the process of involving potential registry participants were mass media (33.6%), social media (18.9%) and the social environment (18.4%). Among the respondents, 30% had experience in human blood donation. The social environment of donors included people who had experience in donating blood: among those surveyed, 48.5% indicated that their relatives served as blood donors; 67.7% noted that their friends were blood donors. For 40% of the registry participants, the method of submitting biospecimens was important. The majority (87%) of respondents indicated that submitting biospecimens at medical centers was the most convenient mechanism for joining the registry.

CONCLUSION: The media serve as an effective channel for informing the population; the role of new social media (Internet resources, social networks) is increasing. A significant factor in involvement in the register is the social environment, including people who have experience in donating blood.

BACKGROUND: With optic nerve degeneration of various origins, retinal neurons are the most vulnerable, and their state under these conditions has been studied in sufficient detail. At the same time, the retinal pigment epithelium plays a very important role, realizing the synthesis of melanin and performing antioxidant, phagocytic, transport, protective, and homeostatic functions. Tyrosinase serves as a key enzyme in melanogenesis by cells of this epithelium. The development of methods for early diagnosis of optic nerve atrophy is extremely important due to the fact that functional visual impairments appear later than structural ones, at more advanced stages of the disease. The retinal pigment epithelium cannot be insensitive to the processes that occur during optic nerve degeneration. That is why its study in experimental degeneration of the optic nerve is necessary for a more complete understanding of the processes occurring in the visual analyzer under these conditions.

AIM: To study changes in the level of tyrosinase expression in the retinal pigment epithelium at different development stages of experimental optic nerve degeneration based on morphological data.

MATERIAL AND METHODS: The subjects of the study were 40 rat eyes after creating a model of optic nerve atrophy using methanol. The animals were divided into five groups: the first group — control; the second to fifth groups included animals whose eyes were enucleated 1, 3, 6 and 9 weeks after the creation of the aminophylline-methanol model of optic nerve atrophy, respectively. The retinal pigment epithelium was studied using fluorescent antibodies to tyrosinase Tyrosinase Mouse Monoclonal. Immunofluorescence staining was performed on fixed transverse sections of the eyeball. Statistical analysis and visualization of the obtained data were carried out using the environment for statistical computing R 4.2.2.

RESULTS: A comparative analysis of the results obtained revealed that the level of tyrosinase expression in the fifth group was on average 4.21 times [95% confidence interval (CI) 2.49–7.13, p=0.00076], 9.31 times (95% CI 5.47–15.85, p=0.00033), 2.63 times (95% CI 1.51–4.58, p=0.0009) and 3.44 times (95% CI 1.96–6.03, p=0.00055) higher compared to the first, second, third and fourth groups, respectively. The level of tyrosinase in experimental samples in the first, third and fourth groups was statistically higher compared to the level of tyrosinase in the second group by an average of 2.21 times (95% CI 1.33–3.66, p=0.0003), 3.53 times (95% CI 2.08–6.02, p=0.00069) and 2.71 times (95% CI 1.58–4.65, p=0.00022), respectively.

CONCLUSION: As degenerative processes develop in the optic nerve fibers under these conditions, the integrity of the retinal pigment epithelium is disrupted, which is characterized by an increase in antibodies to tyrosinase in the retinal pigment epithelium of experimental animals.

The main goal of medicine has been and remains the desire to preserve the health of the population, increase human life expectancy and its quality. For those purposes, it is necessary to constantly improve treatment measures, create and introduce into medical practice new methods of therapy, innovative medicines, guided by strict rules of evidence of their high effectiveness and safety, study the mechanisms of physiological processes of a living organism in normal conditions and in pathology, the possibilities of correction and prevention of disease processes, and this means the need to conduct research, including those involving animals. The modern ethical and legal framework for research involving animals contains a requirement for mandatory examination of a research project by an ethical committee, monitoring its implementation, and analysis of the results. An ethics committee is a structure implemented into the research process to help researchers navigate the complex network of guidelines, rules and best practices, as well as the existing legal framework for conducting scientific research that guarantees quality results of work that do not violate these principles and restrictions. The local ethics committee is responsible for ensuring that research conducted in the territory under its supervision complies with modern ethical standards. This article presents the experience of the local ethics committee of the Kazan State Medical University in the ethical review of research projects involving animals, and substantiates the list and content of the requirements for documents submitted by the researcher for ethical review. The shortcomings identified in the preclinical research protocols submitted for examination were separately analyzed, and references were provided to the ethical and legal framework existing in the Russian Federation.

Retroelements (retrotransposons and endogenous retroviruses) are a class of mobile genetic elements that move in the genome by inserting their own reverse transcribed transcripts. They serve as drivers of epigenetic regulation; therefore, individual characteristics of the distribution of retroelements in the genome influence the development of multifactorial diseases. Type 1 diabetes mellitus is a multifactorial disease with an immune response against pancreatic β cells. The role of heredity in the development of the disease is estimated at 88%, and the role of allelic variants of various genes is determined. There are also other specific types of diabetes mellitus, which account for more than 2% of cases of diabetes mellitus and are monogenic diseases with an autosomal dominant mode of inheritance due to germline mutations in the MODY genes, including HNF4A, GCK, HNF1A, HNF1B. Most patients with type 1 diabetes have the protein product and ribonucleic acid (RNA) of the insulin inhibitor HERV-W-Env, which is caused by abnormal expression of the human endogenous retrovirus (HERV). An assumption has been made about the role of retroelements in the development of type 1 diabetes mellitus. This is due to their involvement in the phylogenetic formation of the endocrine system, since in evolution retroelements turned out to be sources of regulatory sequences of hormone genes, nuclear hormone receptors and binding sites for them. Type 1 diabetes mellitus is associated with the integration of HERV into the HLA-DQ gene region, with allelic variants and sizes of VNTR variable tandem repeats (part of the SVA retroelements), which regulate the expression of the insulin gene and other hormones. For this reason, it is likely that the development of type 1 diabetes mellitus may be based on individual characteristics of the distribution of HERVs in the human genome and their dynamic changes in ontogenesis. HERVs also play a role in the etiopathogenesis of diabetes mellitus through the activation of an autoimmune response, the triggering factors of which are exogenous viral infections and stress. Thus, retroelements are involved in various mechanisms of the development of type 1 diabetes mellitus, which reflects their global regulatory influence on endocrine regulation.

The article is devoted to the analysis of the first clinical application of alloplant biomaterial in cardiac surgery for the treatment of congenital heart defects. Alloplant technology — processing of cadaver material — was developed by Professor E.R. Muldashev in the late 1970s for the needs of ophthalmic surgery and has proven itself to be the best. Taking into account the extensive positive experience in ophthalmic surgery, we jointly created an alloplant from the pulmonary artery, aorta, and then from the vena cava for use in the surgical treatment of congenital heart defects, including in children of the first year of life. The article presents the results of treatment of a small group of patients with similar diagnoses and a long follow-up period.

In Kazan, training in the “midwifery art” has been carried out for more than 200 years. Scattered publications contain information about the influence of the St. Petersburg school of obstetricians and gynecologists on the formation of the Kazan school of obstetricians and gynecologists. It is of interest to establish connections, continuity and development of the Kazan school with the St. Petersburg school of obstetricians and gynecologists. The study of primary sources showed that from the moment the obstetric clinic was created in Kazan in 1833, its first leaders communicated with St. Petersburg colleagues, adopting their experience (Lentovsky A.E., Kozlov A.I.). Subsequently, obstetrics and gynecology department and clinic of the medical faculty of the Kazan Imperial University were led by students of the St. Petersburg Military Medical Academy (Slavyansky K.F., Florinsky V.M., Fenomenov N.N., Gruzdev V.S.). All of them at the end of the 19th and beginning of the 20th centuries made a lot of efforts for the scientific and practical development of obstetrics and gynecology in Kazan. A particularly noticeable mark was left by Professor V.S. Gruzdev, creating an independent scientific and practical school of Kazan obstetricians and gynecologists. Later his work was continued by student of V.S. Gruzdev — Professor P.V. Manenkov with his students.

The article is dedicated to a world-famous scientist, a major clinician, teacher and public figure, one of the founders of the Kazan neurological school, Professor Liverii Osipovich Darkshevich, who occupies a prominent place in the history of Russian medicine. July 17, 2023 marked the 165th anniversary of his birth. Liverii Osipovich was the chairman of the Kazan Society of Doctors and, together with Professor V.M. Bekhterev in 1893 participated in the creation of the society of neuropathologists and psychiatrists in Kazan. On his initiative, in 1901, the “Diary of the Society of Kazan Doctors” was reorganized into the monthly “Kazan Medical Journal”, and Liverii Osipovich became its first editor-in-chief. In Kazan, he organized the first clinic in Russia for people who abuse alcohol, where he often gave popular lectures. The article highlights the main stages of the life and work of Professor L.O. Darkshevich, his significant contribution to the development of neurology and neuromorphology, reflects his professional and personal qualities. The influence of this outstanding doctor and scientist on the development of neurology and neuromorphology in Yekaterinburg has been studied and shown.

The textbook “Oncology 2.0”, prepared by a team of authors under the guidance of Professor Sh.Kh. Gantsev, is a comprehensive presentation of modern approaches and methods in oncology, aimed at training specialized personnel in this field. The textbook uses an integration approach that combines clinical and morphological aspects of oncology. The textbook material complies with the Federal State Educational Standard of Higher Education. The book is written at a high scientific and methodological level. The integration of the latest achievements in scientific research, the latest diagnostic and treatment methods are presented, which makes it an important tool for the education of residents and graduate students. The textbook stands out for its detailed description of the processes of carcinogenesis and cellular mechanisms of malignant transformation. The textbook is intended for residents and graduate students specializing in the field of oncology, oncological radiotherapy, molecular and cellular aspects of cancer and can be used as the main educational literature in the discipline.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Grobbee EJ, Wisse PHA, Schreuders EH, van Roon A, van Dam L, Zauber AG, Lansdorp-Vogelaar I, Bramer W, Berhane S, Deeks JJ, Steyerberg EW, van Leerdam ME, Spaander MCW, Kuipers EJ. Guaiac-based faecal occult blood tests versus faecal immunochemical tests for colorectal cancer screening in average-risk individuals. Cochrane Database of Systematic Reviews. 2022. Issue 6. Art. No.: CD009276. doi: 10.1002/14651858.CD009276.pub2