Vol 32, No 9 (2021)

Age-related foot syndrome is a regional syndrome that manifests itself as biological, functional, social, aesthetic, and other dysfunctions of the foot due to age-related diseases and (or) age-related tissue changes. The paper presents the pathogenesis of this syndrome and changes in the foot bone and joint apparatus in this condition, as well as the basic prevention, treatment, and rehabilitation program for the age-related foot syndrome.

The paper presents an update on the feasibility of a personalized approach and sets forth the criteria for selecting patients with chronic pain for pharmacogenetic testing (PGT). Objective: to improve quality of life in patients with chronic pain through PGT and personalized therapy selection. Genotyping was performed in 22 patients with adverse reactions (ARs) as gastropathies associated with the intake of nonsteroidal anti-inflammatory drugs and hepatotoxicity. The results of CYP2C9*3, CYP2C9*3, and UGT1A1 genotypes were analyzed. According to the results of PGT, the therapy was corrected, causing the ARs to decrease.

The paper gives the results of a study of the efficacy of Phenazalgin as an uroanalgesic in the preoperative period for bladder leukoplakia (BL) in women. The investigation enrolled 38 patients aged 18 to 46 years (mean age, 22 years), who were diagnosed with BL. In the preoperative period, the patients were divided into 2 equivalent groups: 1) 19 patients who received conservative therapy with hyaluronic acid preparations (as instillations and oral administration) and, if necessary, antibacterial therapy, they took Phenazalgin 100 mg (2 tablets thrice daily for 2 days; if necessary, the cycle was repeated at a one-day interval); 2) during the similar conservative therapy, 19 patients took other non-steroidal anti-inflammatory drugs. Preoperative preparation lasted an average of 7-10 days. The effect of the drug was evaluated before and 3 months after surgery prior to control cystoscopy using the O’Leary/Sant questionnaire, an analog scale for painful BL symptoms and the pelvic Pain and Urgency/frequency Patient Symptom Score).

Premature birth (PB) is the main cause of mortality and morbidity in newborns without congenital malformations or chromosomal aberrations. Objective: to evaluate the significance of the ADRB2 gene polymorphism in predicting the efficiency and safety of tocolytic pharmacotherapy with β2-adrenostimulants in pregnant women with PB. Subjects and methods. The investigation involved 120 pregnant women, including 60 women at risk for PB who received tocolytic therapy with hexoprenaline as indicated; and 60 ones at no risk for PB. The Gly16Arg and Gln27Glu polymorphisms in the ADRB2 gene were determined in all the study participants. The findings were compared with the indicators of the efficiency and safety of hexoprenaline therapy. Results. The 16Arg allele of the ADRB2 gene was 1.54 times more common in parturients with a normal pregnancy than in patients at risk for PB (the result was insignificant at the accepted significance level, but close to it: χ2=3.8218; p=0.05059). Hexoprenaline therapy prolonged pregnancy to a period of >37 weeks in 65% of the patients with PB. The efficacy of hexoprenaline was lower in the carriers of the genotypes indicating the high or low expression of ß-adrenoreceptors.

The paper reviews information on the etiology, risk factors, classification, clinical manifestations, diagnosis and treatment of asthenic syndrome (AS) in pediatric patients, as well as the results of the authors’ own studies of the prevalence of AS among Tuvinian schoolchildren. Objective: to study the prevalence of AS in Tuvinian schoolchildren, to comparatively analyze age and gender differences in this contingent with AS. Subjects and methods. In December 2020 to May 2021, cross-sectional screenings were performed in the random samples of 11-18-year-old adolescents of both sexes (pupils from 7 schools in Kyzyl and those from 1 school in the Kyzyl District). The survey involved 1148 teenagers (mean age, 13.7±1.6 years). The presence of AS was assessed using a screening questionnaire. The indicators were generally compared in the entire sample of the surveyed schoolchildren, as well as in the gender (boys and girls) and age (11-14 years and 15-18 years) groups. The data were processed using the Statistica 12 program for Windows. Results. The incidence of AS was found to be 12.2% of the entire sample population of the surveyed Tuvinian schoolchildren; AS was more common in the girls (17.8%) than in the boys (5.8%). There tended to be a higher prevalence of AS in the younger age group (13.3%) than in the older one (9.3%). The incidence of AS in the girls of both age groups was higher than that in the boys of the same age range. The findings suggest that there is a need for further investigation of various aspects of asthenic conditions in pediatric patients.

A myocardial bridge is a congenital anomaly in which a segment of the coronary artery tunnels under the bridge of the overlapping myocardium. This causes the vessel to contract during systole, resulting in hemodynamic changes that can be associated with angina pectoris, myocardial ischemia, acute coronary syndrome, left ventricular dysfunction, arrhythmias, and sudden cardiac death. Beta-adrenoblockers and calcium channel blockers are the first-line therapy to eliminate the symptoms of a tunneled coronary artery. Surgical tactics (myotomy, intracoronary stenting, or aortocoronary bypass surgery) is indicated for refractory symptoms. A method for pharmacological correction of a verified myocardial bridge in the coronary artery is presented in our clinical case.

To understand the pathogenesis of dilated cardiomyopathy (DCM), it is necessary to establish the molecular and cellular mechanisms of myocardial aging, including those associated with melatonin. The latter affects vascular tone, the binding of smooth muscle cells and vascular endothelium to their own receptors (melatonin receptor type 1A (MR1A), melatonin receptor 1B (MR1B)) and acts on the adrenergic and peptidergic (vasointestinal peptide and substance P) endings of perivascular nerves, which allows melatonin to be considered as an important predictor of the development of DCM. The molecular mechanisms of this interaction still remain insufficiently studied. Objective: to study MR1A and MR1V in the cardiomyocytes of patients with DCM in vitro. Methods. Primary dissociated cell cultures and immunofluorescence confocal laser scanning microscopy were used. Passages 3 and 10 cells corresponding to young and old cultures were applied to model cellular senescence. Results. At the molecular level, cardiomyocyte senescence was accompanied by a 3-fold decrease in the level of MR1B expression compared to the old cultures in both the control and the DCM groups (by 1.8 times). Furthermore, there was a 2-fold decrease in MR1A expression in the cell cultures taken from patients with DCM compared with the similar culture of normal cardiomyocytes. The expression of MR1B was significantly lower in the DCM group than that in the control group in passage 3. With aging in the cultures, the level of MR1B expression was significantly lower by 3.9 times in the DCMP group than that in the control group. The similar trends in the studied markers may suggest that both melatonin receptors are involved in the pathogenesis of DCM, which may also be involved in the mechanisms of aging. The findings will be able to expand the concept of DCM and to form its diagnostic panel in people of different ages.

The aim of the study. To study the correlation of expression of p53, type II collagen, VEGF and VEGFR in biopsy specimens of intact myometrium in women of different age groups. Materials and methods. The study included 90 patients aged 23 to 47years, who were randomized into 6 groups. The first three groups included 45 practically healthy patients, the fourth, fifth and sixth groups - women with diagnosed uterine myoma, as a result of which the presence of two diametrically opposite variants of the development of myoma nodes in reproductive age was confirmed -simple myoma and proliferating myoma, with the latter variant predominating. Immunofluorescence and morphometric analysis of p53 proteins, type II collagen, VEGF and VEGFR using Olympus FV1000. Results. The average relative area of the p53 expression level was lower in all three age groups compared to the control group. The VEGF level turned out to be statistically significantly higher in proliferating fibroids in women, which indicated an intensification of the neoangiogenesis process in active uterine fibroids in younger women. The level of type II collagen was higher in all age groups in patients with uterine fibroids. Conclusion. The revealed features of proliferation, apoptosis and neoangiogenesis indicate new aspects of pathogenetically substantiated therapy for uterine fibroids. It becomes possible to develop drugs that contribute to the inhibition of the processes of proliferation, neoangiogenesis and stimulation of apoptosis. Apparently, this group of drugs will occupy an important place in therapeutic agents for conservative treatment at the initial stage of the development of myomatous nodes in young women.

The article presents an analytical and scientific-methodological review devoted to a new stage of development of gerontology and geriatrics in Russia; substantiates the relevance of creating a system of geriatric care as an important component of state policy in the field of improving the quality of life of older citizens; substantiates the use of digital technologies in the process of modernizing social support for older citizens in order to early detect diseases, prolong the period of their life activity and increase life expectancy; the need to change the approach to the examination of older citizens is shown; the relevance of functional ability screening in patients over 65 years of age is considered; the primary screening model is tested using an innovative mobile application developed by who.