Vol 19, No 1 (2019)

HIV infection, secondary conditions and comorbidities. Part 2. Concomitant diseases
Rassokhin V.V., Leonova O.N., Boeva E.V., Stepanova E.V., Belyakov N.A., DiClemente R.

Comorbid conditions are typical for many chronic pathological processes, especially at a mature and old age. For several reasons, a special place in the formation of these conditions takes HIV infection in combination with non-communicable diseases. The general characteristics of the secondary athologies, which remain one of the leading causes of severe complications and mortality, are presented. Particular attention is focused on possible concomitant somatic pathology, which may affect the quality of life and the prognosis. Among pathological precosses are lesions of the gastrointestinal and urinary tracts, cardiovascular diseases and malignant neoplasms. A method for the integrated assessment of the severity of a patient’s condition with a combination of comorbidity and HIV infection is presented. This method allows to improve the prediction of the course and outcome of the main and associated diseases, as well as to influence the nature of the diagnostic and therapeutic processes.

Medical academic journal. 2019;19(1):5-16
Modern views on the mechanism of the toxic action of dioxins and their hygienic rationing
Sofronov G.A., Rembovskiy V.R., Radilov A.S., Mogilenkova L.A.

Objective: to assess the genetic and epigenetic predisposing factors for dioxin disease in order to substantiate the mechanism of its development and biomonitoring.

Material and methods. Search was made for polymorphisms of human genes and human epigenome causing reduction of human defense mechanisms in contact with dioxins.

Results. The sensitivity to dioxins may be influenced by target gene polymorphisms, epigenetic modifications, features of non-genomic transgeneration inheritance. Changes in gene expression can occur due to the direct interaction of dioxins with the АhR receptor and the mechanism of cascade regulation through the chain of interacting genes. Along with conventional methods, examination of persons in contact with them, it is advisable to use genetic indicators of individual predisposition to their action (polymorphisms of AhR, CYP1A1, CYP1A2, CYP1B1, GST, and UGT genes, chromosomal aberrations).

Testing methods for detecting mutations in MTHFR genes, cytokines, oncogenes, epigenetic markers of damage, proceeding with search for new markers of exposure (metabolites, dioxins adducts in biological substrates) and sensitivity (geno- and phenotype), as well as detecting difficultly diagnosed prenosological changes and early manifestations of long-term effects of dioxins on the human body, especially low-level exposure, are required.

Conclusion. Dioxins have a modifying effect on the pheno- and genotype of affected people and future generations. It is advisable to search for, develop, and implement molecular diagnostic methods (including genetic and epigenetic) to identify their effects on human health.

Medical academic journal. 2019;19(1):17-28
Minimally invasive treatment of spinal compression fractures in multiple myeloma (review)
Nagajtseva A.A., Zharikov Y.O.

Multiple myeloma is a rare oncohematological disease that affects 70% of the vertebral body, causing its compression fractures. The aim of the article was to analyze the literature data concerning the results of minimally invasive treatment of patients with multiple myeloma complicated by compression fractures of the spine. A small percentage of complications and rapid postoperative recovery contributed to the active introduction of percutaneous vertebroplasty and balloon kyphoplasty in practical medicine. Analysis of literature showed that percutaneous minimally invasive surgery aimed at increasing the height and stability of the vertebral bodies, relief of pain due to the elimination of radiculopathy. In combination with other therapeutic methods it can achieve the best result of complex palliative treatment of patients with multiple myeloma with metastases to the spine which ultimately allows to achieve a better quality of life of this group of patients.

Medical academic journal. 2019;19(1):29-34
Lactoferrin — an endogenous regulator of the protective functions of the organism
Aleshina G.M.

Lactoferrin — multifunctional glycoprotein of the transferrin family with a molecular mass of about 80 kDa. The review presents data on the physicochemical properties and localization of the protein, on antimicrobial properties, antitumor and anti-inflammatory effects, participation in neuroendocrinoimmune interactions, and on possible mechanisms for the realization of its functional manifestations.

Medical academic journal. 2019;19(1):35-44
Lactoferrin as a promising remedy for metabolic syndrome therapy: from molecular mechanisms to clinical trials
Elizarova A.Y., Kostevich V.A., Voynova I.V., Sokolov A.V.

The review summarizes data on the effect of the protein present in exocrine secretions and neutrophils, lactoferrin, on components of metabolic syndrome pathogenesis. The molecular mechanisms of lactoferrin participation in the regulation of carbohydrate and lipid metabolism, such as that of lipoproteins, glycated proteins, fatty and bile acids, are contemplated. The influence of lactoferrin on the development of insulin resistance and hypertension, on proliferation of adipocytes, on inflammatory processes and endocrine control is considered. An analysis of population-based studies on the link between lactoferrin gene expression level and metabolic syndrome evidences is carried out. The results of numerous experiments focused on the effects of lactoferrin in metabolic syndrome and obesity animal models are presented. The results of the first international clinical trials aimed to correct obesity and type 2 diabetes mellitus in volunteers are discussed.

Medical academic journal. 2019;19(1):46-64
Basic studies
The effect methylglyoxal on acute lung injury induced by influenza A(H1N1)PDM09 in mice
Aleksandrov A.G., Savateeva-Lyubimova T.N., Muzhikyan A.A.

The aim of the article. To study of the effect of 2-oxopropanal (methylglyoxal) on virus-induced acute lung injury.

Materials and methods. The study was performed on adult female outbred mice. Methylglyoxal administered subcutaneously at a dose of 50 mg/kg/day to mice for 14 days prior to infection. The pandemic influenza virus A(H1N1)pdm09 was used for modeling viral infection at a dose of 0.75 LD50. Hematology, pathomorphological and histological studies were performed on 4, 7 and 14 days post infection. Level of lung injury was performed by semi-quantitative method.

Results. Methylglyoxal induced 2-fold increase of mortality and lung lesion area (р < 0.05). The structural changes in lung tissue had inflammatory character. These changes had progressive character. The ratio of neutrophiles/lymphocytes was increased by 2.5 times on average in infected animals (р < 0.05 compared to intact animals).

Conclusion. Methylglyoxal aggravated acute lung injury in mice by inducing structural changes in tissue and increased mortality level.

Medical academic journal. 2019;19(1):65-72
The character of pulmonary and venous hemodynamics chahges in the experimental pulmonary thromboembolism and myocardial ischemia models
Evlakhov V.I., Poyassov I.Z., Ovsyannikov V.I.

The pulmonary and venous hemodynamics changes were studied in the experimental pulmonary embolism and myocardial ischemia models in acute experiments on anesthetized rabbits in control and after the blockade of α-adrenoceptors with phentolamine. After 1 min of pulmonary thromboembolism the pulmonary artery pressure and pulmonary vascular resistance increased, the pulmonary flow decreased; the superior vena cava flow decreased to a lesser extent than the inferior vena cava one. During 1 min myocardial ischemia the pulmonary artery pressure and flow decreased, pulmonary vascular resistance did not changed; the superior vena cava flow decreased more than the inferior vena cava one. In case of pulmonary thromboembolism after the blockade of α-adrenoceptors the pulmonary artery pressure increased to the same level, as in control animals, the pulmonary vascular resistance was elevated to a lesser extent. The pulmonary artery flow, the venae cava flows and venous return decreased less than in control. In case of myocardial ischemia after the blockade of α-adrenoceptors the pulmonary artery pressure decreased more, than in control animals, the pulmonary vascular resistance had tendency towards decrease, the venae cava flows and venous return decreased more than in control experiments.The differences of the changes of the pulmonary and venous circulation in cases of pulmonary embolism and myocardial ischemia were caused by activation of the adrenergic mechanisms.

Medical academic journal. 2019;19(1):73-80
Revealing of immunopositive beta-adrenergic structures, using polyclonal antibodies to ADRB2 (GLN247-SER262) in the lungs of rats
Syrczova M.A., Korzhevskii D.E.

The aim of this research was to identify ADRB2-immunopositive structures in the lungs of intact rats.

Materials and methods. The material for the study were the lungs of adult male rats (n = 6) with a verified absence of signs of inflammation. The obtained material was fixed in zinc-ethanol-formaldehyde by a standard procedure. Identification of ADRB2-immunopositive structures was performed using the immunohistochemistry method.

Results. The study revealed the intensive and selective diffuse staining of the apical part of the bronchial airway epithelium, reflecting the preferential distribution of ADRB2-immunopositive structures in the large and medium bronchi and partially in the terminal bronchioles of the intrapulmonary airways. The ADRB2-immunopositive structures were characterized by clear boundaries, with a slightly vague halo, and having a rounded or strongly elongated oval shape. The size of the identified structures varied depending on the caliber of the bronchi, in which they were localized.

Conclusion. This research identified specific ADRB2-immunopositive structures localized in the epithelium of the respiratory tract. In addition, it was demonstrated that polyclonal antibodies used in the research selectively detect ADRB2-immunopositive structures only in the bronchial epithelium, without engaging in immunohistochemically interaction with beta-2 smooth muscle adrenergic receptors, which is apparently due to a higher concentration of the immunoreactive product in epithelial cells compared to smooth muscles.

Medical academic journal. 2019;19(1):81-84
The effect of chronic emotional and physical stress on the neuroendocrine and immune systems
Yankelevich I.A., Filatenkova T.A., Shustov M.V.

The aim of the presented study was to characterize the developed model of chronic stress. Most of the currently existing models of chronic stress are long, laborious, hard to employ, and also difficult to reproduce, which leads to restrictions in their use. Daily swimming in cold water for 10 days model was proposed as a model of chronic stress. The described influence led to a significant involution of the thymus, an increase in the expression of the interleukin-4 (IL-4) and interleukin-6 (IL-6) genes in the thymus, and its decrease in the hypothalamus, a change in behavioral reactions, as well as a multiple increase in the blood concentration of corticosterone in the experimental animals. The data suggest that repeated swimming in cold water in experimental animals causes changes in the activity of the hypothalamic-pituitary-adrenal system, the immune system, and also demonstrate the possibility of using the presented model as a model of chronic stress.

Medical academic journal. 2019;19(1):85-90
Clinical research
Metastatic breast cancer to kidney tumor: case report
Ponomaryeva E.V., Polushin O.G., Kovtun D.P., Karlov A.P.

Aim of the study is to demonstrate a unique case report: synchronous malignant tumors of the breast and kidney with tumor to tumor metastasis.

Materials and methods. The analysis of medical history and the pathology study of surgical material using histological and immunohistochemical methods was carried out.

Results. Clinical observation of metastasis of triple-negative breast cancer in a synchronous renal cell carcinoma of the kidney in a 59-year-old woman has been described. Tumor to tumor metastases are diagnosed by a remote kidney with a neoplasm, hematuria, anemia, and thrombocytopenic syndrome manifested in the clinic.

Conclusions. Lifetime diagnosis of primary multiple tumors and metastatic lesions, including tumor to tumor metastasis, is quite difficult and requires careful clinical and pathology analysis to develop adequate tactics of surgical and conservative treatment.

Medical academic journal. 2019;19(1):91-94

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