Vol 22, No 3 (2022)

In the review we discussed the clinical and physiological aspects of the use of renal artery denervation as an interventional method of treatment of refractory essential arterial hypertension. The application of radiofrequency denervation may be considered as an additional treatment to drug therapy in patients with arterial hypertension. At the same time, the main emphasis in the performed experimental and clinical studies was made on the assessment of changes in blood pressure, cardiac output and the calculated index of total peripheral resistance. However, there is no satisfactory data in the literature about changes of the venous return, as well as superior and inferior venae cavae flows. To assess the effectiveness of renal artery denervation on arterial and venous vessels resistance shifts, it is necessary to carry out experimental studies with perfusion of isolated organs in the conditions of modeling arterial hypertension in animals. The question of the extent to which denervation of the renal arteries leads to shifts in the reactions of organ venous vessels in response to pressor reflex stimuli also requires further studies on experimental models. There are practically no data in the literature on the degree of influence of renal artery denervation on orthostatic tolerance. To understand the mechanisms of changes in systemic hemodynamics in response to denervation of the renal arteries, it is also necessary to perform further research on the mechanisms of shifts in the capacitive and resistive functions of the pulmonary circulation with an assessment of pulmonary microcirculation.

It is well known that coumarin derivatives are widely distributed in nature and have a wide spectrum of biological activity. At the same time, only a few compounds containing a coumarin fragment are used in the clinics. These compounds include for example the anticoagulant warfarin and the anthelmintic drug haloxon. In the present article is discussed the few examples of biological activity of coumarin derivatives, the mechanisms of action of these compounds and the problems that arise in the development of new drugs, as well as the prospects for using coumarins as leader compounds.

The article highlights the features of the metabolism of fucoglycoproteins in liver homogenates, the wall and mucous membrane of the stomach and small intestine in experimental models: alcoholic liver disease and prolonged alcoholization of rats under immobilization stress. Fucoglycoprotein metabolism was assessed for 90 days by the level of total fucose and fucosidase activity. To evaluate the implementation of the experiments, a biochemical analysis of markers of liver pathology was carried out. In the dynamics of experiments, there was an increase in transaminases and dyslipidemia in the blood serum of rats, as well as an increase in the level of corticosterone, especially in rats against the background of immobilization stress. In the exchange of fucose-containing glycoproteins in the blood serum, in the tissues of the liver, stomach and small intestine of experimental animals, multidirectional metabolic changes were monitored, namely, an increase in catabolism processes in the first days of observations in alcoholized rodents, which may be associated with the cytolytic effect of ethanol in the studied tissues. In these organs, the total amount of fucose is higher in the mucosa layer than in the organ wall. At the same time, in a series of experiments with immobilization stress against the background of ethanol administration, activation of anabolism of oligosaccharide fragments for the synthesis of fucoglycoproteins was noted in the second half of the experiment, associated with compensatory adaptive mechanisms.

BACKGROUND: The possibility of using a diagnostic index based on the use of blood plasma objective indicators to differentiate the diagnosis of type 1 and type 2 diabetes mellitus, autoimmune and non-autoimmune thyroiditis is an urgent task for timely decision-making on the use of a particular type of therapy, taking into account the etiology of a particular pathology. Changing the ratio of blood plasma butyrylcholinesterase isoforms activity makes it possible to identify increased excitability, to separate them among themselves depending on the genesis, and during treatment, to assess the activity of diseases and the effectiveness of therapeutic measures.

AIM: To develop a calculated diagnostic index for the differential diagnosis of diabetes and thyroiditis autoimmune type from symptomatically similar non-autoimmune pathologies, using the ratio of the plasma pseudocholinesterase isoforms activities.

MATERIALS AND METHODS: The study involved 188 people: 45 patients diagnosed with type 1 diabetes; 60 patients diagnosed with type 2 diabetes; 25 patients diagnosed with autoimmune thyroiditis; 25 patients with non-autoimmune thyroiditis; the control group consisted of 33 healthy volunteers. The groups were aligned by gender and age. Patients of all groups were examined by an endocrinologist and a therapeutist. The diagnoses were made in accordance with the Clinical Guidelines of the Russian Endocrinologists Association for the Diagnosis and Treatment of Autoimmune Thyroiditis in Adults, as well as the Clinical Guidelines “Type 1 Diabetes Mellitus in Adults”. In the blood plasma of all patients’ groups, the activity of pseudocholinesterase (butyrylcholinesterase) forms was determined by analysis using a modification of the Ellman’s method in combination with inhibitory analysis. The index was calculated based on the ratio of the studied enzyme typical and atypical forms activities. Based on the results of data analysis for all examined groups, diagnostic intervals were determined that are characteristic for each diagnosis, as well as for conditionally healthy people. Comparison of the patients distribution by categories of diagnosis was carried out using the Χ-square test with Yates correction in the SPSS 22 statistical software package.

RESULTS: The results of the blood plasma analysis determined that in the diagnoses of autoimmune thyroiditis and type 1 diabetes mellitus, there was an increase in the activity of increased activity of the butyrylcholinesterase isoform, while the activity of the atypical form remains more stable. The ratio of these forms was taken as the basis for the development of the calculated diagnostic index. Diagnostic index for the control group in the range of 1–2; for patients with non-autoimmune thyroiditis — 2,1–2,9; autoimmune thyroiditis — 3–3,5; type 1 diabetes mellitus — 3,6–5; type 2 diabetes — 0–1. Statistical analysis of the data showed that the diagnosis based on the index obtained in this way does not inferior to the diagnostic scales in terms of sensitivity and specificity. The findings are consistent with the evolution of data supporting each diagnosis.

CONCLUSIONS: The calculated index on the basis of butyrylcholinesterase activity is a promising, minimally invasive, fast and budgetary method, revealing a pronounced severity of occurrence in terms of symptoms, but different in etiology, type 1 diabetes mellitus and type 2 diabetes mellitus, autoimmune thyroiditis and thyroiditis of a non-autoimmune nature, which is of critical importance when choosing a therapeutic strategy and improving the quality of life of patients.

BACKGROUND: In the formation of scoliotic deformity of the spinal column, the skin of the back on the protruding parts of the body is a vulnerable area. However, the study of the characteristics of the skin condition of the back of adolescents with idiopathic scoliosis has not been given due attention.

AIM: To conduct a comprehensive assessment of the morphological and functional properties of the skin of the back of adolescents with idiopathic scoliosis and to determine the information content of the research methods used.

MATERIALS AND METHODS: In 20 adolescents with idiopathic scoliosis, the skin of the back was examined. The following methods were used: visual clinical examination, local thermometry, laser Doppler flowmetry, esthesiometry, elastometry, histological methods.

RESULTS: Visually, in 70% of cases, a change in the skin was revealed. In the region of the spinal deformity apex, the skin temperature was higher on the convex side than on the concave side. In the skin of the paravertebral region, capillary blood flow from the convex side and in the distal spine was more intense than on the concave side. In the dermatomes corresponding to the apex of the deformity, hyperesthesia, hypesthesia, and the absence of thermal sensitivity were noted. In the paravertebral and scapular projections, in the region of the deformity apex, the lowest indicators of skin elasticity were recorded, compared with the areas located above and below. Histostructural differences in the skin were revealed in the area of the convex and concave sides of the apex of the deformity. On the convex side, a significant decrease in the thickness of the epidermis and dermis, an increase in the thickness of the subcutaneous fat, a greater severity of reactive-destructive changes in the fibrous, vascular and innervating components of the dermis were determined.

CONCLUSIONS: The use of an integrated approach in the study of the skin of the back of adolescents with idiopathic scoliosis made it possible to identify the features of structural and functional changes, which indicates the information content of the selected methods. The results obtained must be taken into account when planning the treatment and rehabilitation process of patients with this pathology.

The evolution of endovascular treatment of cerebral aneurysms has logically developed in the direction from non-constructive methods (treatment of aneurysms using detachable balloons, using liquid embolizing agents, occlusion of aneurysms with detachable coils, occlusion of aneurysms with balloon-assisted coils, implantation of various types of intradaccular devises) to reconstruction of the artery segment carrying the aneurysm (occlusion of aneurysms with stent-assisted coils and the use of flow-diverters). The effectiveness of these methods, including in the treatment of patients in the acute period of aneurysm rupture, in the immediate postoperative period has been proven by a variety of randomized studies, at the same time, in the long-term period, there are cases of aneurysm recurrence, including those accompanied by its rupture and the need for repeated surgical treatment. It should be noted that the development and modernization of various devices for the treatment of cerebral aneurysms is aimed at reducing the risk of operational complications and achieving greater radicality not only in the near, but also in the long-term postoperative period. The purpose of this review is to describe the stages of development of endovascular treatment of cerebral aneurysms. In this work, we describe the most well-known non-constructive methods of treatment.