Female and Male Phenotypes of Iron Deficiency in CHF. Additional analysis of the «The Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (J-CHF-RF)» study

Aim    To evaluate the incidence of iron deficiency (ID) in men and women with chronic heart failure (CHF) and to compare clinical and functional indexes in patient with and without ID depending on the gender.Material and methods    An additional analysis of the study "Prevalence of Iron Deficiency in Patients With Chronic Heart Failure in the Russian Federation (ID-CHF-RF)" was performed. The study included 498 (198 women, 300 men) patients with CHF, in whom, in addition to iron metabolism, the quality of life and exercise tolerance (ET) were studied. 97 % of patients were enrolled during their stay in a hospital. ID was defined in consistency with the European Society of Cardiology (ESC) Guidelines. Also, and additional analysis was performed according to ID criteria validated by the morphological picture of the bone marrow.Results    ID was detected in 174 (87.9 %) women and 239 (79.8 %) men (p=0.028) according to the ESC criteria, and in 154 (77.8 %) women and 217 (72.3 %) men (p=0.208) according to the criteria validated by the morphological picture of the bone marrow. Men with ID were older and had more severe CHF. They more frequently had HF functional class (FC) III and IV (63.4 % vs. 43.3 % in men without ID); higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) and lower ET. HF FC III increased the probability of ID presence 3.4 times (p=0.02) and the probability of HF FC IV 13.7 times (p=0.003). This clinical picture was characteristic of men when either method of determining ID was used. In women, ID was not associated with more severe CHF.Conclusion    Based on the presented analysis, it is possible to characterize the male and female ID phenotypes. The male ID phenotype is associated with more severe CHF, low ET, and poor quality of life. In females of the study cohort, ID was not associated with either the severity of CHF or with ET.

[Iron deficiency in Russia heart failure patients. Observational cross-sectional multicenter study]

Aim    To evaluate the prevalence of iron deficiency (ID) in Russian patients with heart failure (HF).Material and methods    Iron metabolism variables were studied in 498 (198 women, 300 men) patients with HF. Data were evaluated at admission for HF (97 %) or during an outpatient visit (3 %). ID was determined according to the European Society of Cardiology Guidelines.Results    83.1 % of patients had ID; only 43.5 % of patients with ID had anemia. Patients with ID were older: 70.0 [63.0;79.0] vs. 66.0 years [57.0;75.2] (p=0.009). The number of patients with ID increased in parallel with the increase in HF functional class (FC). Among patients with ID, fewer people were past or current alcohol users (p=0.002), and a greater number of patients had atrial fibrillation (60.1 vs. 45.2 %, p=0.016). A multiple logistic regression showed that more severe HF (HF FC) was associated with a higher incidence of ID detection, whereas past alcohol use was associated with less pronounced ID. An increase in N-terminal pro-brain natriuretic peptide (NT-proBNP) by 100 pg/ml was associated with an increased likelihood of ID (odds ratio, 1.006, 95 % confidence interval: 1.002-1.011, p=0.0152).Conclusion    The incidence rate of HF patients is high in the Russian Federation (83.1 %). Only 43.5 % of these patients had anemia. The prevalence of ID in the study population increased with increases in HF FC and NT-proBNP.

[Prevalence of overweight and obesity in children]

The growing prevalence of overweight and obesity is an urgent problem not only in adults but also in children in both developed and developing countries. The purpose of this study was to analyze the prevalence of overweight and obesity and other forms of nutritional disorders in Russian children. Material and methods. The nutritional status of 17 329 children aged 2-18 years was assessed on the basis of anthropometric data, obtained by the Federal State Statistics Service during the "Sample Survey of the Population's Diet" in 2018. The prevalence of various forms of malnutrition was assessed by the Z-score categories: underweight, stunted growth (short stature), thinness, overweight, obesity. Results. Population mean and median values of Z-scores in all sex-age groups do not exceed ±0.5 in relation to WHO standards, which indicates the applicability of the standards to assessing the nutritional status of Russian children population. High body weight (WAZ>2) occurs in 7.6% of children, underweight in 2.6%. The incidence of short stature in boys and girls is 7.0 and 6.8%, respectively. The prevalence of overweight and obesity in boys is 20.4 and 10.4%, respectively, while in girls, 15.4 and 7.6%. In general, in the population of children 2-18 years old, the prevalence of overweight is 18%, and obesity is 9.1%. The index of malnutrition, including the sum of the frequency of various combinations of low Z-scores (<-2), characterizing underweight, short stature, thinness, and their combinations was 8.0%. The multilevel logistic regression showed that overweight and obesity inversely depend on age; the risk of developing these conditions is lower in the city, but higher in male children compared to female children. Conclusion. The population of children 2-18 years old in the Russian Federation is characterized by a low incidence of forms of malnutrition, such as underweight and thinness. However, the prevalence of overweight and obesity is higher than in European countries.

Epidemiology of atrial fibrillation in a representative sample of the European part of the Russian Federation. Analysis of EPOCH-CHF study

Aim    To study true prevalence of atrial fibrillation (AF) in a representative sample from the European part of the Russian Federation; to describe characteristics of patients with AF; and to provide the frequency of anticoagulant treatment.Material and methods    Cross-sectional data of the EPOCH epidemiological study (2017) were used. Data were collected in 8 constituent entities of the Russian Federation; the sample size was 11 453 people. The sample included all respondents who had given their consent for participation and were older than 10 years. Statistical tests were performed in the R system for statistical data analysis.Results    The prevalence of AF in the representative sample from the European part of the Russian Federation was 2.04 %. The AF prevalence increased with age and reached a maximum value of 9.6% in the age group of 80 to 89 years. The AF prevalence among females was 1.5 times higher than among men. With age standardization, the AF prevalence was 18.95 and 21.33 per 1,000 people for men and women, respectively. The AF prevalence increased in the presence of concurrent cardiovascular diseases (CVDs) or diabetes mellitus as well as with an increased number of comorbidities in the same person and reached 70.3 and 60.0 % in patients with 4 and 5 comorbidities, respectively. Patients with AF had a greater number of comorbidities and higher CHA2DS2VASc scores (5.0 vs. 2.0, p&lt;0.001) compared to patients with CVDs without AF. Only 22.6 % of patients with CVD and AF took anticoagulants. Only 23.9% of patients with absolute indications for the anticoagulant treatment received anticoagulants.Conclusion    The AF prevalence in the European part of the Russian Federation was 2.04 %; it increased with age and in patients with concurrent CVDs or diabetes mellitus. Most of AF patients (93.2 %) required a mandatory treatment with oral anticoagulants.

[Pharmacological modulation of wound healing in glaucoma surgery]

Despite the well-known effectiveness of pharmacological glaucoma therapy, surgical approach remains one of the main treatment options for some forms and stages of the disease. The long-term success of glaucoma surgery depends on the intensity of local wound healing processes at the surgical site. The most common way to influence healing processes in surgical treatment of glaucoma is the use of antimetabolites. However, given the high risk of serious complications associated with their use, the search for new drugs devoid of these disadvantages continues. The aim of this review is to describe the efficacy and safety of both currently used and upcoming pharmacological ways to influence the wound healing process after glaucoma surgery in order to improve the stability of hypotensive effect.

[The prevalence of obesity in various socio-demographic groups of the population of Russia]

The growing prevalence of overweight and obesity has been recognized by WHO as a global obesity pandemic worldwide. The spread of overweight and obesity is also an urgent problem for Russia. The aim of this study was to analyze the nutritional status of the Russian adult population and the prevalence of overweight and obesity depending on a number of socio-demographic factors and family income. Material and methods. The assessment of the nutritional status of adults was carried out on the basis of anthropometric parameters obtained by the Federal State Statistics Service in the course of the "Sample observation of the population's diet" in 2018 based on a random sample of 45 thousand households in all constituent entities of the Russian Federation. 76.960 people aged 19 and over were examined, including 41% of men and 59% of women. The nutritional status of adults was assessed based on the calculation of the body mass index (BMI). According to the WHO classification, BMI values in the range of 18.5-24.9 kg/m² were taken as normal, BMI 25.0-29.9 kg/m² was taken as overweight, and BMI≥30.0 kg/m² indicated obesity. The prevalence of obesity was analyzed depending on socio-demographic variables: gender, age, place of residence (city, village, type of settlement in terms of population, federal district), marital status, educational level, and per capita income. Results. The body weight and height of respondents with a BMI of 18.5-24.9 kg/m² can be considered as the average normal body weight and height of the adult population in Russia, which amounted to 70.6 kg and 175.4 cm for men, and 60.2 kg and 164 cm for women, respectively. The average body weight of all urban men is 1.3 kg more than that of rural men, while the average body weight of urban women is 2.2 kg less than that of rural women. The growth of urban men and women, respectively, is 2.1 cm and 1.1 cm higher than rural ones. The average BMI values of urban and rural men do not differ, while the BMI of rural women is 1.2 kg/m² higher than that of urban ones reflecting higher values of the average body weight. The average BMI values of adult men and women are in the zone of values characteristic of overweight (BMI≥25.0 kg/m²). In general, in 2018, only 34.4% of the adult population (33.2% of men and 35.4% of women) had BMI indices corresponding to normal values. Overweight, including obesity (BMI≥25.0 kg/m²), were detected in 66.1%, men and 63.0% of women, and obesity (BMI≥30.0 kg/m²) in 18.8% of men and 27.4% women. The incidence of obesity among adults of both sexes is significantly higher among rural residents, while the incidence of overweight (BMI 25.0-29.9 kg/m²) does not differ. The prevalence of obesity in urban and rural areas decreases with the increase in their population. The frequency of overweight increases with growth in households' average per capita income with high reliability of differences between the 1st and the 5th quintiles of income (p<0.01). At the same time, the incidence of obesity increases from the 1st to the 3rd quintiles, decreasing in the 4th and the 5th quintiles. For men, the dependence of the average BMI values on household income is almost square with high reliability (p<0.001), while for women, a decrease in BMI was revealed only in the 5th quintile of income. Thus, the incidence of obesity among women in the richest population groups is lower than in the less affluent. The incidence of obesity in men increases linearly with age from 19 to 65, and decreases in the age group over 70 years. In women, the frequency of obesity from 19 to 40 years old increases slowly, then there is a rapid increase up to 65 years, and then, like in men, there is a decrease. In young men, the frequency of overweight, including obesity (BMI≥25.0 kg/m²), is 32.3% at the age of 19-25, and 49.3% at the age of 25-30, which, respectively, by 13.1 and 20.0% higher than among women of the same age. Moreover, the frequency of obesity in these age groups of men and women is the same. The highest incidence of BMI≥25.0 kg/m² in men is observed over 40 (70-76%); in women over 50 (75-83%). The prevalence of obesity (BMI≥30.0 kg/m²) before the age of 50 is approximately the same in men and women, while over the age of 50, the frequency of obesity in women is 12-16% higher than in men. Over the age of 65, there is a decrease of obesity in both sexes, but the incidence remains significantly higher among women than men of a similar age. The prevalence of obesity among urban and rural men in all age groups from 19 to 70 years does not differ significantly. Among rural women the frequency of obesity is significantly higher compared to urban women. Education level affects the prevalence of obesity only in women: the incidence of obesity among women with higher education is considerably lower than among women with less education. Conclusion. Significant differences in the state of nutrition and the prevalence of obesity were revealed depending on the place of residence in urban and rural settlements, the type of settlements in terms of population and the Federal Districts. Noteworthy, there was a significant 10.2% increase in the prevalence of overweight in men in 2018 compared to 2012, while the increase in women was 6.2%. In general, the frequency of overweight increased by 7.8%, amounting to 40.3%. The prevalence of obesity increased in men by 0.9%, while in women decreased by 3.3%. As a result, throughout the adult population, the prevalence of obesity decreased by 1.4%. Based on the available two studies, it is not possible to assert with confidence about the trend of decreasing the prevalence of obesity from 2012 to 2018.

Chronic heart failure in the Russian Federation: what has changed over 20 years of follow-up? Results of the EPOCH-CHF study

Aim    To study the etiology and the dynamics of prevalence and mortality of CHF; to evaluate the treatment coverage of such patients in a representative sample of the European part of the Russian Federation for a 20-year period. Material and methods    A representative sample of the European part of the Russian Federation followed up for 2002 through 2017 (n=19 276); a representative sample of the population of the Nizhny Novgorod region examined in 1998 (n=1922).Results    During the observation period since 2002, the incidence of major CHF symptoms (tachycardia, edema, shortness of breath, weakness) tended to decrease while the prevalence of cardiovascular diseases has statistically significantly increased. During the period from 1998 through 2017, the prevalence of I-IV functional class (FC) CHF increased from 6.1 % to 8.2 % whereas III-IV FC CHF increased from 1.8 % to 3.1 %. The main causes for the development of CHF remained arterial hypertension and ischemic heart disease; the role of myocardial infarction and diabetes mellitus as causes for CHF was noted. For the analyzed period, the number of treatment components and the coverage of basic therapy for patients with CHF increased, which probably accounts for a slower increase in the disease prevalence by 2007-2017. The prognosis of patients was unfavorable: in I-II FC CHF, the median survival was 8.4 (95 % CI: 7.8-9.1) years and in III-IV FC CHF, the median survival was 3.8 (95 % CI: 3.4-4.2) years.

SARS-CoV-2 and Patent Activity

The article provides information on the patent activity of inventors in relation to applications for inventions related to coronaviruses, in particular, to SARS-CoV-2. The presence of a steady interest in this topic for the period 1996–2020 is illustrated. It is indicated what objects of patent law can be inventions related to vaccines.

[Dynamics of innovations in food technologies: from specialization to personalization]

Dynamically changing global trends in the field of innovative foods in recent years are aimed at the development of technologies that ensure the formation of segments of new types of products, positioned as healthy products. Scientific directions of research and development in this area, retrospectively related to the development of nutrition science, are focused on solving an interdisciplinary set of tasks to create new types of foods, the distinctive features of which are the specified compositions and properties that determine the health benefits (functional foods) and directed physiological effectiveness (specialized foods for preventive and therapeutic nutrition). Characteristics of the composition of a specific specialized food are formed in connection with its intended purpose on the basis of medico-biological requirements taking into account specific features of nutrition of the population in total, and its separate groups or individual. Depending on the mentioned specifics, the development of specialized foods provides for different levels of determining human needs: from energy consumption to the metabolome. Taking into account these features, the development tasks, methods of proving the effectiveness and conditions for using specialized foods in order to achieve maximum effect are determined. In studies of prophylactic or therapeutic foods, the subject of evaluating the effectiveness of a specialized product is the clinical effect, so innovative research in this category of products is associated with the creation of a universal approach to the development, use and evaluation of the effectiveness of biologically active substances and containing them specialized foods for the correction of metabolic disorders. The vector of innovative development of technologies for the production of specialized foods is focused today on the direction of personalized nutrition. The basis of scientific justification of the distinctive features of the compositions and properties, as well as technological know-how of the production of personalized foods, is the information about the metabolome directly related to the biological functions of the body.

[To the health of the nation through multi-level educational programs for the population in the field of optimal nutrition]

Healthy nutrition is the most crucial component of the quality of life, which is understood as an integral indicator of mental, physical and social functioning of a person. The diet of Russians doesn't contain enough vegetables and fruits, dairy products, while white sugar, salt, products containing animal fat, and trans fats are in excess. Violations of the structure of nutrition and nutritional status lead to the development of diet related non-communicable diseases (cardiovascular, oncological, diabetes mellitus, obesity, gout, osteoporosis, etc.) that are the leading causes of mortality of the population. All this indicates a low level of knowledge of the people about the principles of healthy nutrition. 49.2% of Russians have almost no idea about the rules of healthy eating. In this regard, it is essential to eliminate the existing gap in the education of the population on healthy nutrition through the introduction of training programs. For this purpose, training (educational) programs on healthy eating have been developed for target groups of the population (preschool and school-age children; adults of all ages, including pregnant and breastfeeding women, people older than working age; people with an increased level of physical activity; persons working in severe and harmful conditions or living in territories with unique features in terms of the impact of environmental factors). Based on scientific institutions of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and Federal Research Centre for Nutrition, Biotechnology and Food Safety, four scientific-methodical centres and one educational centre on the issues of healthy nutrition have been created for the development of training (education) programs. A great deal of work on the implementation of educational programs for the population on healthy nutrition is carried out by the Profile Commission on Dietetics of the Ministry of Health of the Russian Federation, which includes the chief dietitians of Federal districts of the Russian Federation.

[Socio-behavioral factors for of adherence to treatment of patients with mental disorders inclined to socially dangerous behavior]

AIM

To study behavioral factors as a predictor of the adherence to psychopharmacotherapy in patients inclined to socially dangerous actions.

MATERIAL AND METHODS

The total number of people with mental disorders that pose a danger to society in the city of Cherepovets was 148 at the moment of the study. Eighty-three patients were examined. The collection of data was carried out by the method of anonymous sociological survey of patients using a specially developed questionnaire. To interpret the data, quantitative and qualitative indicators were calculated.

RESULTS AND CONCLUSION

Every one in three (28.9%) patients does not follow the doctor's advice. The main reasons for amending the therapy prescribed by the doctor are as follows: high price for the medicines (43.2%), side effects (32.4%) and ineffective treatment (24.4%). Whereby each in two (45.8%) patients considers the most effective medicines to be the natural resource materials (39.8%) or homeopathic medicines (6%), whereas 12% do not believe in the efficacy of any medicine. The reasons for the low adherence to psychopharmacotherapy of patients with mental disorders prone to socially dangerous actions were the insufficient amount of medical information provided by the doctor (51.8%), the insufficient therapeutic relationship between the patient and the doctor (28.9%) and patient dissatisfaction with the quality of treatment (22.9%).

[Physical training in patients with chronic heart failure: level of involvement, as well as psychosocial, anamnestic and iatrogenic factors that determine the motivation to practice]

Introduction Physical exercise (PE) is a necessary part in the treatment of patients with chronic heart failure (CHF), which is stated in the European Society of Cardiology guidelines and the Russian Heart Failure Society guidelines. However, this type of non-drug treatment is still not sufficiently used in HF patients in Russia.Aim To study the current involvement of HF patients in PT and to describe psychosocial factors that influence the patients' willingness to exercise and potential barriers and motivations for PE.Methods This study was designed as an in-moment survey. Patients with CHF who visited clinics in 7 cities of the Russian Federation in 2018 as a part of European Heart Failure Awareness Days were provided with a self-administered questionnaire containing questions about their social and educational status, attitude to PT as a method of treatment, and factors motivating and demotivating them to participation in training sessions. The survey participants were also asked a question about their source of information about exercise in HF. Physicians filled in the items describing HF clinical manifestations (left ventricular ejection fraction (EF) and HF functional class (FC)). Code numbers were used for further identification of the participants and to protect their confidentiality. Statistical analysis was performed with the StatXcat-8 program. Limits of exact confidence intervals (CIs) were provided both for fractions and parameters of polynomial distribution. CI limits for differences and fractions were calculated using MOVER. Age was analyzed using the PAST program.Results The study included 560 patients with HF; 52 % of them were women (mean age, 64; 95 % CI: 63-65 years). Women were 3 years older than men (95 % CI: 1.3-4.9 years). 501 (89.5 %) patients had FC II-III; 265 (49 %) patients had HF with low EF. 350 (62 %) patients had comorbidities: 41.4 % of patients had diabetes mellitus and 25.4 % of patients had arthritis. Only 91 (17 %) patients reported exercising. Patients younger than 65 exercised significantly more frequently than older ones (odds ratio (OR), 1.7, 95 % CI: 1.0-2.7, р&lt;0.001). Patients with higher education had better chances to be involved in PT or were more anxious to start training (OR, 2.7; 95 % CI: 1.6-4.7, р&lt;0.001). The capability for influencing the disease was the major motivation for PT for both sexes. Probability of this answer was 48 % (95 % CI: 33-61) for men and 46 % (95 % CI: 29-63) for women. 62 % of patients indicated poor health as the major barrier for participation in PT. Only 55 % of patients knew that PT could be a method for HF treatment, and only 50 % were informed about that by their physician.Conclusion The factors that positively influence the willingness to exercise include male sex, higher level of education, younger age, and better perception of the own health condition. 62 % of patients indicated poor health as the major barrier for participation in training. On the whole, the awareness of patients about PT benefits for health in HF was low. To our opinion, this was a serious factor of the extremely low involvement of patients in PT. Only 55 % of patients knew that PT could be a method for HF treatment, and, furthermore, only 50 % of patients received this information from their physicians.

[The role of ADRB1 genes polymorphism in examined patients with chronic rheumatic heart disease]

The study purpose is to evaluate effect of ADRB1 gene polymorphism on echocardiography indices and endothelial function in patients with chronic rheumatic heart disease. The sampling consisted of 128 patients with chronic rheumatic heart disease. The echocardiography was performed on Philips Affinity 50 device and evaluation of endothelial function was implemented on "AngioScan01" device. The genetic typing was carried out according polymorphic markers Gly49Ser and Gly389Arg. The nucleotide replacement of glycine with serine resulted in increasing of left sections of heart both at Ser49Ser (left atrium 5.65±0.09 cm; LVED 5.61±0.27 cm; LVES 3.76±0.16 cm), and Gly49Ser (left atrium 5.65±0.09 cm; LVED 5.61±0.27 cm; LVES 3.76±0.16 cm), The similar situation occurred when glycine was replaced with arginine: for Arg389Arg homozygotes (left atrium 5.63±0.12 cm; LVED 5.97±0.20 cm; LVES 3.97±0.16 cm); and heterozygotes Gly389Arg (LVED 5.60±0.08 cm; LVES 3.78±0.07 cm). Homozygosity of Ser49Ser in endothelial function led to low values of index augmentation (5.83±0.80%) and indicators reflecting function of small resistive arteries were the worst (1.30±0.07). Arg389Arg homozygotes had the worst endothelial function in system of large arteries (-20.40±0.68 ms). highest severity of arterial stiffness (23.00±0.68%) as compared with Gly389Gly homozygotes (8.92±0.99% and 62.67±1.41 years). ADRB1 gene polymorphism in subjects with HRBS leads to dilatation of left heart. The effect on endothelial dysfunction is multidirectional: Ser49Ser homozygosity leads to minimal arterial stiffness and changes in small resistive arteries; homozygosity of Arg389Arg leads to maximum changes in large conducting arteries and the highest rates of vascular stiffness.

Jasmonic Acid Induces Endoplasmic Reticulum Stress with Different Outcome in Cultured Normal and Tumor Epidermal Cells

Plant hormones produce cytotoxic effect on human cells and can trigger the processes unrelated to cell death, e.g., biosynthetic system stress. The goal of this study was to investigate activation of the endoplasmic reticulum (ER) stress by jasmonic acid (JA) and to distinguish between the responses of cultured immortalized non-tumorigenic HaCaT cells and epidermoid carcinoma A431 cells to this plant hormone. JA was used in the concentration of 2 mM, as it suppressed cell proliferation in both cell lines. We analyzed expression of genes associated with the activation of ER stress (GRP78, ATF4, CHOP), the structure of the ER and Golgi complex, and synthetic processes in the HaCaT and A431 cell lines. JA induced expression of genes responsible for the activation of ER stress and caused hypertrophic changes in the Golgi complex in both cell lines. However, the patterns of gene expression in the HaCaT and A431 cells were different, and higher levels of involucrin synthesis were observed in A431 but not in HaCaT cells, suggesting that JA activated differentiation of the tumor A431 cells only. Therefore, JA induced ER stress in both cell lines, but the consequences of ER stress were different for the epidermal immortalized non-tumorigenic and tumor cells.

P6370Epidemiology of arterial hypertension in one of the regions of Russia

Aim

To study the dynamics of the prevalence, awareness, risk factors (RF) and treatment of arterial hypertension (AH) among men and women according to a survey of a representative sample of the population of the Ryazan region (RR) in 2007–2016.

Materials and methods

In 2002, as a part of the Russian epidemiological “EPOCH” study, a representative sample of the RR population (2098 people, average age 44.8±18.6 years) was formed and surveyed using step-by-step randomization of medical institutions, medical districts and apartments. A repeated survey of the sample was conducted in 2007 (1,760 people, response 83.9%) and in 2016 (1,497 people, response 85.1%). The AH group included persons with blood pressure ≥140/90 mmHg detected during the double measurement and with normal blood pressure while receiving antihypertensive therapy. In individuals with AH the risk factors were assessed: smoking, alcohol abuse, salt abuse, obesity, burdened family history, low physical activity.

Results

The prevalence of AH over the past 9 years has increased from 39.3% to 43.9%, p<0.001. The age-standardized prevalence of AH among women is higher than among men as in 2007 (42.1% versus 34.8%, p<0.001) and in 2016 (46.9% vs. 41.8%, p<0.05). Women's awareness about having AH increased from 83.9% to 88.9%, p<0.05, in men it decreased (84.0% against 77.4% in 2007, p>0.05). In the group of persons with AH, the more common risk factors are older age (56.8%), hereditary predisposition (58.9%), low physical activity (96.0%) and obesity (34.3%) compared with persons without AH (12.9%, 48.2%, 84.5% and 9.2%, respectively), they smoke less often (10.7% versus 23.2%) and use extra salt less often (29.5% against 38.4%), p<0.001. The number of patients taking antihypertensive drugs reached 91.2% against 84.0% in 2007, p<0.001. There was a decrease in the number of AH patients who: are treated intermittently (from 12.3% to 3.6%, p<0.001), who take drugs only when blood pressure is high (from 16.2% to 6.2%, p<0.001). The most frequently used antihypertensive drugs are still ACE inhibitors (64.8%), beta-blockers (48.9%), diuretics (42.5%), ARBs (29.2%) and calcium channel blockers (21.3%). The ratio of effectively treated AH patients increased in men from 14.6% to 27.8%, p<0.001, in women from 25.0% to 39.5%, p<0.001. A negative influence on the effectiveness of therapy was caused by smoking (RR 1.23; CI 1.11–1.37, p=0.005), salt abuse (RR 1.11; CI 1.06–1.23, p=0.04) and obesity (RR 1.16; CI 1.06–1.27, p=0.003).

Conclusion

Over the past nine years, the prevalence of hypertension in both the men and women has significantly increased in the Ryazan region. Increased treatment coverage and positive changes in drug therapy led to an increase in the number of effectively treated patients (from 21.4% to 35.5%, p<0.001). Obesity, smoking, salt abuse are associated with an increased risk of non-effectiveness of hypertension therapy.

P1949Changes in prevalence patients with arterial hypertension in Russia

Aim

The present study shows the dynamics of the prevalence different grades of AH and treatment coverage over15 years of observation.

Methods

8740 apartments were randomized in 2002 year in eight regions of Russia and 19449 individuals were included. Re-examination was carried out in 2017 year. The representative sample was separated in four groups: Grade 0 – individuals with systolic blood pressure (BP) <140 mm Hg and diastolic blood pressure <90 mm Hg; and three Grades of arterial hypertension (AH) in accordance with European guidelines. Also, we select patient with and without antihypertensive drug treatment (AHDT).

Results

The mean age individuals was 44.4±19.3 years in 2002 year. Grade 0 had 63.3% participants (mean age 36.5±17.1 y.), Grade 1 – 19.5% (mean age 55.2±15.4 y.), Grade 2 – 11.7% (mean age 60.6±13.5 y.) and Grade 3 – 5.6% (mean age 62.4±12.8 y.). 3.0% participants had AHDT and blood pressure meets Grade 0. Patients with AH Grade 1 used drugs in 25.5% cases, with Grade 2 – 49.4% and with Grade 3 – 60.8% patients respectively. The mean age of participants with AHTD was significantly higher than mean age group without AHTD in Grade 0, 1 and 2 (p<0.001). In group Grade 3 mean age was not difference (p=0.16). The mean age individuals (51.3±16.9 y.) in 2017 year was significantly higher on 6.9 years than mean age in 2002 year (p<0.001). The proportion of patients with AHDT in all grades groups in sample 2017 year were significantly higher than in sample 2002 year (Table). The prevalence of AH in 2002 y. amounted to 38.6%. In 2017 y. prevalence of AH was significantly higher – 41.4% (p<0.001).

Structure of samples Grade 2002 2017 AHDT Mean age AHDT P value Mean age 0 63,3% No 35,8±16,8 70,1% 42,6±13,9 Yes 3,0% 57,4±14,5 16,3% <0,001 63,6±12,0 1 19,5% No 53,3±15,7 23,6% 57,3±13,3 Yes 25,5% 60,9±13,0 68,4% <0,001 66,3±11,3 2 11,7% No 58,5±14,2 5,4% 58,0±14,9 Yes 49,4% 62,7±12,3 80,6% <0,001 66,5±11,5 3 5,6% No 61,7±13,9 1,0% 63,6±17,6 Yes 60,8% 62,8±12,0 71,1% 0,03 66,0±12,8 ALL 100% 44,4±19,3 100% 51,3±16,9 AHDT: antihypertensive drug treatment.

Conclusion

Over 15 years follow up period the prevalence of hypertension in Russia increased to 41.4%, but the effectiveness of therapy remains low.

EPOCHA-AH 1998–2017. Dynamics of prevalence, awareness of arterial hypertension, treatment coverage, and effective control of blood pressure in the European part of the Russian Federation

AIM

To perform a repeated epidemiological study of a representative sample in the European part of the Russian Federation in 2017 and to compare the dynamics of arterial hypertension (AH) prevalence with the effectiveness of blood pressure (BP) control in the population compared to 1998, 2002, and 2007.

MATERIALS AND METHODS

A representative sample of the European part of the Russian Federation was created in 2002 and re-examined in 2007 and 2017. In 1998, a pilot project was performed for examining a representative sample for the Nizhniy Novgorod region.

RESULTS

During 19 years of follow-up, the AH prevalence increased from 35.5 to 43.3%. Te awareness and treatment coverage reached 76.9 and 79.3%, respectively, in 2017. Achievement of the target BP with a single measurement also increased among patients receiving antihypertensive medication from 14.3 to 34.9%. For the treatment of AH, medium-acting antihypertensive drugs are used, ofen at suboptimal doses.

CONCLUSION

Epidemiological indices of awareness, treatment coverage, and number of effectively managed patients with AH have improved. However, the AH prevalence has increased by 7.8% for 19 years, which indicates inefciency of the primary prevention of this disease.

New combined topical therapy for refractory rosacea

The main pathogenetic aspects of rosacea, various classifications of dermatosis and the modern clinical classification are presented. The symptoms of different forms of rosacea are described. Contradictory of modern scientific concepts of different researchers, approaches to etiology, pathogenesis and treatment has been noted. The main triggers for the manifestation of rosacea, which should be tak en into account to achieve the maximum effect in the treatment of the disease, are indicated. The first domestic positive experience of authors with 1 % ivermectin cream and 0.03 % tacrolimus ointment is presented. The high efficacy and very good tolerability of this combination, compared to monotherapy of 1 % ivermectin cream and traditional therapy of metronidazole cream and azelaic acid gel as well as the absence of any side effects in patients with moderate to severe rosacea are shown.

[Renal cell carcinoma associated with Xp11 translocation involving the gene]

The paper describes a clinical case of the rare tumor renal cell carcinoma associated with Xp11 translocations involving the TFE3 gene in a 53-year-old male patient. It provides the detailed characteristics of current diagnostic techniques.

[Laryngeal paraganglioma]

The paper describes a clinical case of laryngeal paraganglioma, a rare tumor. It provides the detailed characteristics of current diagnostic techniques.

REORGANIZATION OF INTERPHASE MICROTUBULES IN ROOT CELLS OF MEDICAGO SATIVA L. DURING ACCLIMATION TO OSMOTIC AND SALT STRESS CONDITION

We have investigated the organization of microtubule system in interphase cells of Medicago sativa L. roots during acclimation to salt and osmotic stress at different concentrations of NaCl, Na2SO4 and mannitol. We have identified several morphological changes in tubulin cytoskeleton that appear during the acclimation to salt and osmotic stress in the cells of different root tissues: 1) decreased density of cortical microtubule network, 2) random orientation of cortical microtubule bundles, 3) non-uniform density of the bundles, 4) thickening of the bundles, 5) fragmentation of the bundles, 6) formation of centers of converging microtubule. Reduced density of the microtubule network and thickening of the bundles was detected during osmotic and salt stress, yet random orientation of cortical microtubules was observed under osmotic stress and not found during salt stress. Fragmentation of microtubule bundles was apparent during salt stress and less evident at high concentration of mannitol. Formation of centers of converging microtubule was common under prolonged action of sodium sulfate, less common under sodium chloride and not found after mannitol treatment. Our data show that cortical microtubules in alfalfa root cells rearrange not only in response to different ions, but also to osmotic pressure. Thus, the signaling pathways and molecular mechanisms inducing reorganization of the microtubule system may be triggered not only by sodium cations but also by sulfate and chloride anion at the concentrations that do not cause irreversible cell damage. Our study show that the osmotic and salt stress differently affect the cortical microtubules, and their reorganization in response to stress depends on the salt cations as well as anions might also show additional effect under salt stress.

[EFFECTS OF DIFFERENT CLASSES OF PLANT HORMONES ON MAMMALIAN CELLS]

Plant hormones are signal molecules of different chemical structure, secreted by plant cells and acting at low concentrations as regulators of plant growth and differentiation. Certain plant hormones are similar to animal hormones or can be produced by animal cells. A number of studies show that the effect of biologically active components of plant origin including plant/phytohormones is much wider than was previously thought, but so far there are no objective criteria for assessing the influence of phytohormones on the physiological state of animal cells. Presented in the survey data show that plant hormones, which have different effects on plant growth and development (jasmonic, abscisic and gibberellic acids), are not neutral to the cells of animal origin, and animal cells response to them may be either positive or negative.

[Promising source of micronutrients for specialized foods with modified carbohydrate profile: traditional medicine experience]

Worldwide experience of Traditional medicine (TM) has been successfully applied to the development of modern standardized herbal medicines. Mainly researchers are guided by local sources of medicinal plants and traditional medical systems. TM experience is also used in the search of plants considered as sources of biologically active substances (BAS) and food ingredients. The steady increase in the incidence of type 2 diabetes, makes clear the need for research of domestic plant sources of BAS (with a proven carbohydrate metabolism effect) to create modern specialized foods. This article proves the feasibility of using TM experience of Russia and some neighboring European countries (Belarus, Ukraine) to develop optimized compositions for specialized food products for patients with type 2 diabetes. For reliable identification of the most promising plants, 550 traditional antidiabetic herbal formulations of 66 traditional recipe directories were studied in Russia, Belarus and Ukraine. It revealed 37 species of plants included to more than 20% of all bibliographical sources, and 13 plants included to more than 50% of prescription directories. The 3 most popular are bilberry leaves, leaffruit of common bean, great nettle leaves.

[Antiarrhythmic effect of oligonucleotides accompanied by activation of HSP70 protein in the heart of rats]

The mechanisms of the protective effect of oligonucleotides (OGN) during pathological processes are poorlyunderstood. The goal of this work was to study the effect of OGN on arrhythmias induced by myocardial ischemia and reperfusion, and the HSP70 level in the heart. As a source of OGN was used the drug "Derinat" ("Technomedservis", Russia). In male Wistar rats were pre-treated the drug for 7 days (i/m, 7.5 mg/kg).The intensity of the arrhythmias was assessed by ECG during 10 min occlusion of the left coronary artery and subsequent 5 min of reperfusion. Protein HSP70 determined in the left ventricle of the heart by Western-blot analysis. During ischemia, this drug reduced duration of extrasystolia by 13 times and the incidence of ventricular tachycardia by 1.5 times. During reperfusion the drug reduced the incidence of ventricular fibrillation, a more than 2-fold, as compared with the control (respectively 23% vs 56%) and by 5 times its duration (8,4 ± 2,3 48,1 ± sec vs 18 7 sec). "Derinat" increased the HSP70 level in the heart by 65% compared with control.

CONCLUSION

These data support the fact that the activation of HSP70 synthesis, induced by OGN is one of the mechanisms that increases the heart resistance to the ischemic and reperfusion damages.

Effect of Nitric Oxide Synthesis Blockade on the Morphology of Langerhans Islets in August and Wistar Rats with Acute Alloxan Diabetes

Alloxan diabetes was modeled in August rats with high activity of the NO system and in Wistar rats, and the effects of NO system blockade (by a course treatment with L-NNA) on Langerhans islet β cells were studied in 15 days. The toxic effects of diabetes on the rat β cells and islets were similar: the content of active β cells in the islets decreased to 15-20%, the number of islets to 24-29% of control. A course of L-NNA reduced the β cell and islet death, in August cells greater than in Wistar: the number of islets in August rats was restored to 81%, in Wistar rats to 60% of initial level; the activity of β cells remained at the control level in the former and 2-fold lower than in the control in the latter. It seems that a less pronounced protective effect of L-NNA in Wistar rats was explained by excessive reduction of NO level essential for β cell regeneration.

[Stimulation of DNA molecules association with amphiphilic derivatives of 1,3-diazaadamantane containing hydrophobic side chanins]

Earlier, a new class of compounds--amphiphilic derivatives of 1,3-diazaadamantanes, capable of facilitating the strand exchange in the system of short oligonucleotides was revealed. Longer hydrophobic side chains of 1,3-diazaadamantanes promoted stronger acceleration of the reaction. In this study, interaction with DNA of two 1,3-diazaadamantane derivatives containing different side chains was investigated by use of optical methods. Concentration of the investigated 1,3-diazaadamantans micelles formation were determined by the means of monitoring fluorescence intensity enhancement of 1-anilinonaphtalene-8-sulphonate probe; as well as the ranges of concentrations where the compounds/water mixtures existed as true solutions. 1,3-diazaadamantanes affinity to DNA was determined with Fluorescent Intercalator Displacement (FID) approach. Significant increase in hydrodynamic volume of short DNA hairpins in the complexes with 1,3-diazaadamantanes was revealed by estimation of the fluorescence polarization of ethidium bromide probe bound to the hairpins. Intermolecular association of DNA hairpins upon binding with 1,3-diazaadamantans was confirmed by Förster resonance energy transfer in system of an equimolar mixture of fluorescently labeled with Cy-3 and Cy-5 hairpins. In this study, the number of positive charges at 1,3-diazaadamantane derivatives containing side chains of different lengths was demonstrated to affect their affinity to DNA, whereas longer length of the hydrophobic side chains ensured more efficient interaction between the DNA duplexes that may facilitate, in particular, DNA strand exchange.

[Effect of plant hormones on the components of secretory pathway in human normal and tumor cells]

Plant hormones play a key role in plant growth and differentiation. Many hormones are known as potential antitumor agents, yet others appear to affect the secretory activity and are produced by mammalian cells as pro-inflammatory cytokines. The goal of this research was to study the effect of abscisic and gibberellic acids on the secretory system of human cultured epidermoid carcinoma cells A431 and keratinocytes HaCat. Immunocytochemical and morphometric analysis demonstrated that subtoxic concentration of plant hormones induced the broadening of the ER network and increased the size of Golgi complex. Electron microscopy studies confirmed the hypertrophic changes of the Golgi apparatus, specifically, the swelling of cisternae in the trans-compartment of dictyosomes after exposure to abscisic acid, and swelling of cis- and trans-compartment of dictyosomes after exposure to abscisic acid, and swelling of cis- and trans-compartments of dictyosomes after exposure to gibberellic acid. Using of Click-iT technique allowed to detect the elevation of the total protein synthesis only in A431 cells exposed to abscisic acid. Cumulative data suggests that, under these conditions, the hypertrophy of Golgi apparatus may reflect the enhanced secretory activity of cells. In other experiments, the hypertrophy of Golgi is not related to increased protein synthesis and therefore may suggest the stress-related changes of ER and Golgi apparatus. Our results demonstrate that morphologically similar reaction of cellular organelles, such as hypertrophy of Golgi apparatus, is the result of different functional activities, and that molecular mechanisms underlying the changes induced in cells need further investigations.

[Effect of the alloxane diabetes on the cardio-vascular system function and lipid peroxidation in rats of different genetic strains]

We have previously shown that the innate increased activity of the NO- system, typical for the August rats, increases vulnerability to alloxane diabetes (ALD). The purpose of this study was to investigate the effect of ALD on the cardiovascular system and lipid peroxidation in rats with different activity of NO-system. The August rats and Wistar rats treated with alloxan (125 mg/kg, s/c, once) were studied 3.5 months after. In August-ALD the double production significantly decreased to a greater extent (by 35%) than in Wistar-ALD (by 17%) compared with the control. As in August-ALD and in Wistar-ALD was observed the similar fall of the relaxation (-dp/dt) of the left ventricle (by 45-49%), but not the contraction rate (+dp/dt). LPO activation in the heart and liver, as well as NO-system (level of nitrates and nitrites in the blood plasma) in August rats were more pronounced than in Wistar rats. The hsp32 level in August rats fell significantly more (by 93% ) than in Wistar rats (by 61%). Pathological changes in the microvasculature of the mesostenium were identical in compared rats. Thus, more pronounced cardiac dysfunction in August-ALD, compared with Wistar-ALD, associated with greater activation of lipid peroxidation and NO-system.

[Fat component in the diet and providing with fat-soluble vitamins]

Information about the content of polyunsaturated fats (PUFAs) and vitamin E and D in fish, vegetable oils, trend data on consumption of the main fat products, the consumption of saturated and polyunsaturated fatty acids by patients with diseases which risk factor is the excessive consumption of fat and insufficient content of PUFA omega-3 in the diet. Nutrition of the Russian population is characterized by excessive consumption of fat, including saturated fatty acids. Despite increased consumption of PUFA at the present time the ratio of omega-6 and omega-3 fatty acids in the diet is not optimal. This is due to high consumption of vegetable oils (mainly sunflower oil), that are the major source of alpha-lino- lenic acid, only a small portion of which is converted in the body into DHA and EPA, and insufficient consumption offish and seafood containing a high level of DHA and EPA. Taking into account the data that inadequate intake of PUFA omega-3 is a risk factor for many nutrition-related diseases, there is no doubt necessary to modify the fat component of the diet. But the problems arise how to select the source of PUFA and avoid possible unwanted effects. Enrichment of the diet with PUFA omega-3 by inclusion offish oil and/ or linseed oil in the diet may lead to a deterioration of sufficiency with vitamin E. The way out of this situation is to create a fat module containing several fats and tocopherol, that will prevent the peroxidation of fat components of the product and prevent the deterioration of sufficiency with vitamin E.

[Sensory analysis. Study of influence of assessors training duration on the panel efficiency]

The aim of this study was to evaluate the effectiveness of the assessors group at different stages of training and estimate the influence of the duration of their training on the quality of the data obtained. The optimal training duration to work with descriptive methods, which is necessary and sufficient for reproducible evaluation of sensory properties has been determined. The training was conducted at three stages during 108 hours. It has been demonstrated that statistically significant differences among products can be already determined by assessors after 8 hours of training. By increasing the training duration the effectiveness of assessors was improved. Completion of training course led to a significant reduction in the mean square error for some sensory characteristics of the products and the variability of the scores.

[Effect of NO-synthesis blockade on the free-radical processes in rats of different genetic strains with acute alloxan diabetes]

Previously, we have shown that nitric oxide (NO) plays an important role in the pathogenesis of alloxan diabetes (ALD). In this study in August rats, with the congenital increased activity of NO, and in Wistar rats was induced ALD (130 mg/kg, p/c) and 15 days after were examined the effects of the NO-blockade synthesis, induced by administration of Nω-nitro-L-arginine (L-NNA) cour- se on the activity of lipid peroxidation (LP), HIF-1α level, the degree of NO-system activation. The activation of iNOS, HIF-1a expression and 3-nitrotyrosine accumulation in liver were more pronounced in August-ALD rats than in Wistar-ALD rats. The level of TBA-active products in the heart and liver was increased in both diabetic groups only in the first 3 days ofALD and then this indicator of LP sharply was decreased as compared with the control. This effect was pronounced more in August rats. The inhibition of NO overproduction reduced significantly the severity of ALD and prevented the activation of LP, iNOS and HIF-1a. Thus, these data suggest, that NO plays an important role in the pathogenesis of ALD and in the regulation of oxygen homeostasis.

DYNAMICS OF CARDIOVASCULAR RISK FACTOR PREVALENCE IN RYAZAN REGION

Aim. To investigate the dynamics of the prevalence of cardiovascular disease (CVD) risk factors (RFs) in men and women from a representative sample of the Ryazan Region general population.

Material and methods. As a part of the epidemiological study EPOCH, a cross-sectional standardised screening of a representative sample of the Ryazan Region general population (n=2098) was performed. All respondents underwent a standardised questionnaire survey, anthropometry, and blood pressure (BP) measurement. The examination was repeated 5 years later, in 1760 participants (response rate 83,8%).

Results. Over 5 years, the prevalence of arterial hypertension (AH) in the urban population increased from 34,8% to 39,1% (p<0,05). In the whole sample, AH prevalence remained stable (39,3% and 36,6% at the second and first screening, respectively), similar to the prevalence of diabetes mellitus (DM) (4,5% and 3,4%, respectively). Smoking prevalence in urban women increased from 6,0% to 9,2% (p<0,05) and did not change in men (51,8% in 2002 and 49,6% 5 years later). The prevalence of excessive alcohol consumption decreased from 7,7% to 5,6% (p<0,01), while the prevalence of excessive salt consumption remained the same. Obesity prevalence increased in women (from 23,6% to 28,3%; p<0,001) and only slightly changed in men (11,7% in 2002 and 14,0% 5 years later; p=0,68). Awareness of CVD in family history increased from 46,7% to 59,8% (p<0,001).

Conclusion. In a representative sample of the Ryazan Region general population, the prevalence of CVD RFs remained high over 5 years of the follow-up.

Mitochondrial Pathway of α-Tocopheryl Succinate-Induced Apoptosis in Human Epidermoid Carcinoma A431 Cells

Vitamin E derivatives are known to act as agents exhibiting cytotoxity against tumor cells. The effect of vitamin E succinate on human epidermoid carcinoma cell line A431 was investigated in this study using live imaging, immunocytochemistry, and transmission electron microscopy. -Tocopheryl succinate-induced apoptotic cell death in A431 cells was shown to be both dose- and time-dependent. The hyperproduction of reactive oxygen species, changes in size, shape and ultrastructural characteristics of mitochondria followed by the release of cytochrome c from mitochondria to cytosol were observed. These results suggest that -tocopheryl succinate induces apoptosis that occurs via the mitochondrial pathway. Mitochondria are shown to be crucial targets in -tocopheryl succinate-induced caspase-dependent cell death in human carcinoma A431 cells.