Vol 33, No 10 (2022)

Purpose - to study the contribution of diseases of the gastrointestinal tract (GIT) to mortality from all causes, to analyze the nosological structure of mortality associated with the GIT in 52 regions of Russia 2019-2020. Material and methods: Rosstat data on the population and the number of deaths in annual age groups according to the "Brief nomenclature of the causes of death of Rosstat' (KNPSR). All causes associated with lesions of the gastrointestinal tract (total 35 lines for KNPSR) for 2019 and 2020 were selected. in 52 regions of the Russian Federation, the number of which exceeded 1 million people. Standardized mortality rates (SDRs) were calculated using software. When calculating the SDR, the old European population standard for 2015 and 2019 was used. Results: The average regional values of SDR associated with gastrointestinal diseases in 2020 compared to 2019 significantly increased (125.10±23.05 and 120.67±23.51 per 100 thousand population; p=0.018). Their share in the structure of mortality from all causes was 12.47±1.88% in 2019 and 10.97±1.70 in 2020 (p<0.0001). The average regional SDR from malignant neoplasms did not change, from diseases of the digestive system (DDS; class XI) increased (from 57.6±14.0 to 63.0±12.0 per 100 thousand of the population; p=0.001). The contribution to mortality from diseases of the gastrointestinal tract of diseases of the XI class and cancer of the gastrointestinal tract is comparable: 46.89±5.17% and 51.77±4.69 in 2019 and in 2020 49.4±4.5 and 49.36±4.42%, respectively (p=0.001). The proportion of gastrointestinal diseases from the class of infectious diseases was 1.2±1.1 and 1.1±1.0%, and congenital anomalies and malformations were less than 0.5%. The highest SDRs are recorded from diseases of the liver, cancer of the stomach and intestines. In 2020, the average regional values of SDR from non-oncological intestinal diseases requiring surgical operations and their contribution to the structure of mortality increased (compared to 2019). Significant variability and multidirectional dynamics of regional SDR values from individual causes were revealed. Conclusions. Mortality from all diseases of the gastrointestinal tract is twice as high as mortality from DDS (class XI). DDS account for half of all deaths from diseases of the gastrointestinal tract, on average in the regions a quarter of deaths (from the entire gastrointestinal tract) are associated with hepatitis/ fibrosis/cirrhosis of the liver. An increase in mortality from non-oncological bowel diseases requiring surgical operations has been noted.

The paper considers the clinical characteristics of herpes zoster (HZ) and its complications in different patient categories. It gives the pharmacokinetics and pharmacodynamics of unusual nucleoside agents in the treatment of varicella-zoster virus infection. The authors show the advantages of famciclovir in the therapy of HZ, particularly the effect of the drug on the manifestations of acute herpetic neuralgia and its ability to reduce the risk of post-herpetic neuralgia.

Maintaining the balanced gut microbial community is critical to maintaining gut health and preventing chronic inflammation. It is important that the impact of the microbiota on gut function and health depends on its constituent microbes. Dysbiosis (dysbacteriosis) means any changes in the composition of resident commensal communities compared to those found in healthy individuals. Microbial dysbiosis is characterized by a decrease in beneficial microbes, overgrowth of harmful microbes, and loss of microbial diversity. It is important to emphasize that dysbiosis is not a well-defined condition; the dysbiosis indices vary in methodology and clinical context and have been designed for different groups of people to describe many different conditions.

The paper presents information on the use of mobile applications by healthcare workers and patients with cardiovascular diseases in practical healthcare. It provides a detailed description of the mobile application “Warfarin dose calculation" for monitoring anticoagulant therapy.

Key points. S-methylmethionine, better known as vitamin U, is a metabolic substrate that affects many metabolic processes in the human body. It was first discovered in the 50s of the last centuries in cabbage juice. Since then, a large number of pre-clinical and clinical studies have been produced that have demonstrated the safety and effectiveness of vitamin U in various diseases. gastroprotective, hypolipidemic, antioxidant and organoprotective properties of vitamin U. In this review, more attention is paid to the gastroprotective properties of S-methylmethionine. Nevertheless, data are presented demonstrating its hypolipidemic, antioxidant and organoprotective properties, which allow the possibility of expanding the scope of its application in the future. Conclusion. The accumulated data on the effectiveness of vitamin U allow us to consider it as an adjunct to the main therapy of gastritis and ulcers in order to increase efficiency, as well as a means to prevent exacerbations.

Objective. To evaluate the effectiveness of the developed comprehensive personalized rehabilitation program in restoring sexual function in female patients after radical treatment for endometrial cancer (EC). Subjects and methods. The investigation involved 61 reproductive-aged patients with histologically verified endometrioid carcinoma after radical surgery. The women were randomized into 2 groups: 1) 29 patients treated with an active rehabilitation through a comprehensive restorative program; 2) 32 patients treated with a passive rehabilitation, whose management corresponded to clinical recommendations. Follow-ups were performed at 1 week and 3, 6, and 12 months after surgery. Each visit included clinical examination and assessment of sexual function, by using the FSFI questionnaire. Results. Statistically significant differences between the groups were obtained after 6 and 12 months. At the end of the study, the total FSFI score showed an almost complete recovery of sexual function in the active rehabilitation group (a total FSFI score of 24.93±2.86), unlike the comparison group (a total FSFI score of 13.39±2.55; p < 0.001). Conclusion. Comprehensive personalized rehabilitation mitigates the consequences of radical surgery in patients with EC, contributing to the restoration of sexual function within 1 year after surgery.

Sirtuins are among the signaling molecules that may have important prognostic value in dilated cardiomyopathy (DCM). Objective. To study the expression level of sirtuins in the cardiomyocytes of patients with DCM in vitro. Subjects and methods. The study used cardiomyocyte cultures taken during heart biopsy from 3 middle-aged male patients (mean age 52.3±2.6 years) with DCM. A culture of normal human cardiomyocytes served as a control. The investigators applied a primary dissociated cell culturing method and immunofluorescence confocal laser scanning microscopy. To simulate cellular senescence, they employed Passages 3 and 10 cells that corresponded to young and old cultures. Results. At the molecular level, cardiomyocyte aging was accompanied by a decrease in the expression of sirtuins 1, 3, and 6; whereas the expression of sirtuin 2 increased significantly in the old cultures versus the young ones in both the control and DCM groups. The findings suggest may suggest that sirtuins 1,2, 3, and 6 are involved not only in the pathogenesis of DCM, but also in the mechanisms of aging.

The paper presented a scientific review of 19 publications by authors from the Netherlands, the Russian Federation, Great Britain, China, India, South Korea, the United States, Egypt, and Slovakia. We studied: the pharmacological properties of dihydroquercetin. Reflected the antioxidant, anti-inflammatory, antimicrobial, antitumor effects of Dihydroquercetin on the human body. Shown the prospects of using dihydroquercetine in clinical practice: in patients with cardiovascular diseases, with diabetes, in oncology, neurology, surgery, in COVID-19

Objective. To determine the informative value of biological markers of bone and cartilage remodeling in patients with early-stage primary knee osteoarthritis (KOA). Subject and methods. The investigation involved 43 patients (16 men and 27 women) aged 36-50 years with early manifestations of KOA and 21 apparently healthy individuals without locomotor diseases. The markers of bone tissue metabolism were determined in all the study participants: resorptive processes were assessed by the content of C-terminal telopeptides of type I collagen and pyridinoline; the intensity of bone formation processes was estimated by the level of osteocalcin. The concentrations of cartilage oligomeric matrix protein and cartilage glycoprotein were determined as markers of cartilage destruction. Results. The significantly elevated levels of cartilage oligomeric matrix protein and cartilage glycoprotein show evidence of articular cartilage disorganization in the examinees. In addition, there were impaired bone formation (higher osteocalcin levels) and resorption (an increase in the concentrations of C-terminal telopeptides of type I collagen and pyridinoline) processes compared with those in the control group. Conclusion. The patients with early signs of KOA without obvious clinical and radiographic manifestations were observed to have impaired bone remodeling as intensified bone formation and resorption processes, which was accompanied by cartilage matrix restructuring. An indirect assessment of the stability of the collagen network that forms the extracellular framework of the supporting connective tissues displayed a significant increase in serum pyridinoline concentrations, which could be evidence of disruption of intermolecular collagen bonds. The reliably significant changes in the content of pyridinoline suggest that this marker may be used to comprehensively evaluate the health status of patients with early manifestations of KOA when developing diagnostic and therapeutic strategies.