Vol 6, No 4 (2021)

Human Anatomy

Age-related dynamics of morphological changes in the human cortex and corpus callosum: Microgliocytes and neurofilaments as markers of aging

Balandin A.A., Zheleznov L.M., Balandina I.A., Balandin V.A.


Objectives – to analyze the number and sum of diameters of microgliocytes in the precentral gyrus cortex and the corpus callosum of a person in the early adulthood and of an old person and to identify the patterns of neurofilaments expression in these parts of the brain.

Material and methods. The results of a sectional study of the cerebral cortex in the precentral gyrus and corpus callosum using hematoxylin and eosin staining were analyzed, and an immunohistochemical study was performed using antibodies to neurofilaments. The dead were divided into two groups depending on their age. The group I included 23 men and 27 women in their early adulthood, aged from 23 to 28 years; the group II included 19 men and 25 women of the old age – from 75 to 83 years. We examined the number of microgliocytes, the sum of their diameters, and the expression of neurofilament proteins in the tissue.

Results. Morphometric study of autopsy material showed that in the corpus callosum, as well as in the cortex of the precentral gyrus, there was an age-related statistically significant increase in the number of microgliocytes and the sum of their diameters (p < 0.001). We found that the expression of neurofilaments in the cortex of the precentral gyrus is uniform both in the early adulthood and in old age. In the corpus callosum tissue, the age-related neurodegenerative changes are more pronounced: by old age, there is a significant decrease in the expression of neurofilaments with the formation of their rarefaction sites in the areas of microgliocyte clusters.

Conclusion. The results of morphological study of the precentral gyrus cortex and corpus callosum of two age groups testify that the number and sum of diameters of microgliocytes responsible for the utilization of spent myelin have a certain relationship with age and expression of neurofilaments in the nervous tissue.

Science and Innovations in Medicine. 2021;6(4):4-8
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ENT Disorders

Concentration of essential chemical elements in whole blood and in paranasal sinuses mucosa is related to chronic rhinosinusitis severity in children

Alekseenko S.I., Dvoryanchikov V.V., Skalny A.V., Anikin I.A., Isachenko V.S., Tinkov A.A.


Objectives – to evaluate the association between essential chemical element levels in whole blood and in pathologic mucosa and chronic rhinosinusitis severity in children.

Material and methods. A total of 154 children aged from 6 to 17 years were examined. Among them, 88 children had chronic rhinosinusitis (CRS) and underwent functional endoscopic sinus surgery (FESS). The 66 healthy children were included in the control group. Life quality was assessed using SNOT-20 (Sino-Nasal Outcome Test-20). Endoscopic and computer tomography findings were evaluated using Lund – Kennedy and Lund – Mackay scales, respectively. The assessment of essential element levels in whole blood samples was performed using inductively-coupled plasma mass-spectrometry.

Results. The obtained data demonstrate that total SNOT-20 scores in CRS patients were 68% higher than in controls. At the same time, whole blood calcium, selenium, zinc, and magnesium levels were 6%, 28%, 20%, and 3% lower than the respective control values. The analysis of pathologic mucosa demonstrated that the chemical element contents were reducing in the following order: Ca > Mg = Fe > Zn > Cu> Mn > Se. However, only whole blood selenium level correlated significantly with its tissue level. In multiple regression models, the whole blood Se level was inversely associated with SNOT-20 and Lund – Mackay total scores.

Conclusion. Therefore, the obtained data allow to propose the potential role of altered calcium, magnesium, zinc and selenium metabolism in CRS progression.

Science and Innovations in Medicine. 2021;6(4):9-13
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Speech perception in various acoustic environments: Comparison of different sound coding strategies

Kolokolov O.V., Kuznetsov A.O., Machalov A.S., Vladimirova T.Y., Koshel I.V.


Objectives – to compare speech perception in a quiet and noisy environment using a basic audio coding strategy (CIS) and a modern strategy (ACE) over a period of 24 months.

Material and methods. The study involved 30 patients who received hearing rehabilitation in the National Medical Research Center for Otorhinolaryngology of the Federal Medico-Biological Agency in the period of 2018 – 2021. The inclusion criteria were: implantation in the adult age (from 18 to 45 years), speaking fluent Russian, hearing loss after speech skills formation. After initialization and programming of the speech processor, the patients underwent speech audiometry in a free sound field using syllabic and speech tables in silence and noise. The results were collected in the special MS Excel templates and subjected to statistical analysis.

Results. The intelligibility of syllables in patients with CIS and ACE strategies took comparable values and grew with experience within 24 months (from 52 ± 7.00% at the beginning of the study to 72 ± 7.25% at the end), the greatest increase in intelligibility was noted in the first 3 months after connecting the speech processor (from 52 ± 7.00% to 66 ± 7.87%). Using the Greenberg speech table in silence, the groups with the CIS strategy and the ACE strategy obtained similar results with a slight advantage of the ACE strategy up to 6 months of the study. Later, a significantly higher increase in speech perception was observed in the group with the ACE strategy compared to the group with CIS. After 12 months, the perception tests showed 67 ± 8.62% in patients with CIS strategy and 71 ± 7.54% in patients with ACE, after 24 months the results were 68 ± 9.12%, and 72 ± 8.62% respectively. Under noise conditions, we observed an increase of the difference between groups starting from 6 months (41 ± 5.33% in patients with CIS versus 43.3 ± 7.55% with ACE), the largest difference was registered after 24 months (51 ± 5.50% versus 57 ± 8.25% respectively).

Conclusion. When compared to the basic strategy, a modern sound coding strategy with a higher resolution can improve speech perception especially with complex speech patterns and in a noisy environment.

Science and Innovations in Medicine. 2021;6(4):14-18
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Gerontology and geriatrics

Prospects for assessing the biological and immunological age of a person by blood factors

Kurgan N.D., Panova E.I., Silakova L.V., Kaganskii A.M., Rybtsov S.A.


According to the WHO, by 2050 in developed countries, the population over 60 years old will double. This will lead to a further increase in the retirement age and an elevation of burden on the health care system. Therefore, there is an acute issue of maintaining health and prolonging active longevity, as well as the introduction of monitoring for prevention of premature aging and age-related disorders to avoid early disability. The review aims to discuss the aging process and identify critical blood factors affecting or indicating progress in biological aging. The connection of biological age, the regenerative and immune systems aging with the shift in circulating blood factors have been evaluated. The concepts of "health and longevity hygiene" and the concept of "immunological age" are debated. Perspective methods of rapid and multiplex analyzes of blood factors are discussed, as well as the prospects for preliminary analysis of biological and immunological age at home with subsequent processing in high-tech centers to identify risk groups and monitor healthy aging. Approaches to protecting health, slowing aging and rejuvenating the elderly, maintaining healthy aging, and prolonging active life have been defined.

Science and Innovations in Medicine. 2021;6(4):19-39
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Rural population health risks caused by nitrate contamination of locally grown vegetables

Eliseev Y.Y., Berezin I.I., Pichugina N.N., Sergeev A.K.


Objectives – to assess the levels of health risks in the rural population associated with the consumption of local vegetables contaminated with nitrates.

Material and methods. We established the concentration of nitrates in local vegetables, grown on farms and private subsidiary plots of agricultural areas of the region using a retrospective analysis of the statistics from the Office of Federal Service for Surveillance on Consumer Rights Protection and Human Well-being (Rospotrebnadzor) in the Saratov region and our own research results. The health risks in the rural population from exposure to nitrates in local vegetables were assessed according to the Risk Assessment Guidelines (R 2.1.10. 1920-04).

Results. It was revealed that local vegetable products are widely used in the diet of the rural population of the agricultural areas of the Saratov region, amounting to 203.4±22.5 kg/year per adult resident. Significant differences were revealed in the nitrate contamination of vegetables grown by farmers and on private subsidiary plots of agricultural areas of the Saratov region.

Discussion. The high nitrate load detected in vegetable products of farms was determined by a significant amount of fertilizers applied to the soil in the form of ammonium nitrate. On the contrary, the use of special biomass from plants of the legume family by workers of personal subsidiary farms for feeding the growing vegetables, made it possible to obtain vegetable products with a significantly lower quantitative content of nitrates.

Conclusion. The assessment of the hazard coefficients of nitrates in vegetable products of the studied areas testified to the possible effect of the nitrate component on the health of the local population. The individual carcinogenic risk caused by nitrate contamination of local vegetables was assessed as low; the population carcinogenic risk value associated with the presence of nitrates in vegetables had the possibility to contribute from 0.01 to 1.3 additional cases of malignant neoplasms to the general level of oncological morbidity in the population of the surveyed territories.

Science and Innovations in Medicine. 2021;6(4):40-44
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Infectious diseases

Method for predicting the course of peritonsillar abscess in patients with exacerbation of chronic tonsillitis

Konnova T.V., Suzdaltsev A.A., Konstantinov D.Y., Konnova M.P.


Objectives – clinical and laboratory examination of patients with acute tonsillitis for early diagnosis and prognosis of peritonsillar abscess.

Material and methods. The study included 101 patient with lacunar tonsillitis complicated by peritonsillar abscess and 64 donors (control group). Immunological studies were performed according to WHO recommendations, on the basis of the immunological department of the EMB Research Institute and the immunological laboratory of the SamSMU.

Results. Immunological examination of patients with abscess showed an increase in: neutrophil phagocytic activity, CD4+/CD8+, the number of cells expressing HLA-DR+ markers, complement activity, IgA, IgM, IgG plasma concentration, fibronectin level, pro-inflammatory cytokines IL-8, IL-1α, IL-1β and a decrease in: the level of TNF-α, myeloperoxidase activity, number of cells containing CD4+, CD8+, CD16+, CD20+, CD25+ markers. High correlation was registered between total lymphocytes and CD3+ and CD4+ cells (p < 0.01); between CD3+ and CD4+ markers (p < 0.01); as well as high correlation of IL-1β levels with IL-8 and IL-1α (p < 0.01). Cluster analysis revealed different types of immune homeostasis. The first type (cluster) had high values of leukocytes (total), lymphocytes (total), cells with CD3+, CD4+, CD8+, CD16+, CD20+, CD95+ and HLA-DR+ markers; the second type (cluster) was characterized by significantly lower levels of these immune status indicators. 41 patient had the first type of immune response, with an explicit clinical picture and rapid formation of an abscess. The second type of immune response was registered in 60 patients having a torpid course of the disease with delayed development of abscess. Further, to assess the type of immune reactions, it is necessary to substitute the values of indicators into the model and calculate the integral coefficient of the body's reaction (ICTROI and ICTROII).

Science and Innovations in Medicine. 2021;6(4):45-49
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Problems of adherence to treatment with oral anticoagulants in elderly patients with atrial fibrillation in the Kyrgyz Republic

Bazira K.k.


Objectives – assessment of adherence to treatment in elderly patients with nonvalvular atrial fibrillation who were prescribed anticoagulant therapy with vitamin K antagonist, warfarin, and a new oral anticoagulant – rivaroxaban.

Material and methods. During the study, 322 patients with atrial fibrillation of nonvalvular etiology were observed. Depending on the type of anticoagulant taken, the patients were divided into 2 groups: the first group included 253 (78.6%) people who took warfarin, the second group – 69 (21.4%) people, who were prescribed a new oral anticoagulant – rivaroxaban.

Results. By the end of the one-year follow-up from the start of anticoagulant treatment, only 8.7% of patients in the first group followed the doctor's prescription; the second group had 59.4% of adherent patients. The vast majority of patients refused warfarin therapy due to the inability to control INR. In the case of the appointment of rivaroxaban, the reason for the refusal to take was the high cost of the drugs.

Conclusion. Effective prevention of thromboembolic complications in atrial fibrillation requires the development of appropriate measures to improve adherence to treatment.

Science and Innovations in Medicine. 2021;6(4):50-54
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ST2 in heart failure with reduced and mid-range ejection fraction: clinical and instrumental relationships and prognostic value

Kompanets N.V., Aidumova O.Y., Shchukin Y.V.


Objectives – to determine the clinical and instrumental relationships and prognostic value of sST2 in chronic heart failure with reduced and mid-range ejection fraction of ischemic etiology.

Material and methods. The study included examination of 64 patients with heart failure with left ventricular ejection fraction <50% and myocardial infarction in medical history; mean age 55.7 ± 8.7 years.

Results. Higher concentrations sST2 was determined with an increased end-diastolic volume, left ventricular aneurysm, left main coronary artery stenosis, glomerular filtration rate <90 ml/min/1.73 m2 (p < 0.05 for all ). The study confirmed a high predictive significance of increased levels sST2 (p = 0.001); the area under the curve was 0.772; the odds ratio for an adverse outcome with sST2 ≥ 35 ng/ml was 3.93.

Conclusion. sST2 is a predictor of adverse outcome during the first year of follow-up in patients with heart failure with reduced and mid-range ejection fraction of ischemic etiology.

Science and Innovations in Medicine. 2021;6(4):55-58
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Public health, organization and sociology of health

Implementation of preventive care in a fitness center: Medical and social aspects

Valiev A.S., Galikeeva A.S., Pavlov V.V.


Objectives – to evaluate the possibility of organizing a preventive care service in a modern fitness center through the analysis of visitor's motivation to attend the center.

Material and methods. The visitors of three large fitness centers filled in a questionnaire, the results of the survey were further processed using cluster analysis.

Results. In 43.1±1.6% of cases, the main motive for visiting a fitness center was improving health. The goal of "prevention and treatment of diseases" was chosen by 23.4±1.4% of visitors. A motive for weight reduction was registered in 29.4±1.5% of cases. Visitors' ranking of the goals to attend a fitness center showed that in most cases they consider improving health (5.79 points) to be the most important task, in second place – keeping fit (5.69 points). Cluster analysis allowed us to divide visitors into 8 groups, the three largest groups can be the target audience for the prevention of noncommunicable socially significant diseases.

Conclusion. Some categories of fitness center visitors can be the essential target segment for emphasizing preventive activities against non-infectious socially significant diseases.

Science and Innovations in Medicine. 2021;6(4):59-62
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Current approaches in providing medical care for patients with corneal diseases in a large city

Konstantinova P.I., Kochorova L.V., Klyukovkin K.S., Antonova A.V., Kustov I.S.


Objectives – to analyze the aspects of the specialized ophthalmological medical care for patients with corneal diseases on the example of St. Petersburg.

Material and methods. The data of the patients with corneal diseases treated in hospitals of St. Petersburg were copied onto specially developed cards from the official reporting forms and medical records of inpatients for the period of 5-year follow-up. To analyze the characteristics of patients with a continuous method of observation, we studied data on 2200 patients hospitalized in large ophthalmological hospitals in the city. We also interviewed 840 ophthalmologists in order to identify the main problems. The obtained data were statistically processed with the calculation of statistical series, extensive and intensive indicators. To assess the statistical significance of the differences in indicators in individual years of the observation, we used Student's t-test.

Results. The analysis of statistics revealed an increase in the number of patients hospitalized with corneal diseases in the period from 2015 to 2019. The following problems were identified: nonavailability of keratoplasty in the regions (28.6 per 100 respondents), imperfection of the regulatory basis for corneal transplantation (26.2 per 100 respondents), long waiting list for surgery (22.6 per 100 of respondents), lack of modern medical equipment in a medical organization (20.2 per 100 respondents) and an insufficient number of quotas for operations (20.2 per 100 respondents).

Conclusion. The availability of a sufficient amount of donor material will reduce the waiting time for specialized ophthalmic medical care for patients with severe corneal diseases, and will help create conditions for their satisfaction with the medical care provided to them.

Science and Innovations in Medicine. 2021;6(4):63-67
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Diuretic activity of thick extract and flavonoids of fruits of the Filipendula Ulmaria (L.) Maxim.

Kurkin V.A., Sazanova K.N., Sharipova S.K., Zaitceva E.N., Dubishchev A.V., Gladunova E.P.


Objectives – comparative study of the diuretic activity of a thick extract of Filipendula ulmaria (L.) Maxim. fruits and flavonoids spireoside and quercetin isolated from Filipendula ulmaria (L.) Maxim. fruits by column chromatography.

Material and methods. The extractum spissum was obtained by extracting the fruits of Filipendula ulmaria (L.) Maxim. using 70% ethyl alcohol, followed by vacuum evaporation. Spireoside and quercetin were isolated from the fruits of meadowsweet by the method of column chromatography with further purification by recrystallization. The isolated flavonoids were identified using 1H-NMR and 13C-NMR spectroscopy, mass spectrometry, UV spectroscopy, several chemical transformations, and thin-layer chromatography. The thick extract from the fruits of meadowsweet, and also flavonoids spireoside and quercetin were investigated for diuretic activity in albino rats.

Results. The thick extract of the fruits of Filipendula ulmaria (L.) Maxim. at a dose of 50 mg/kg significantly increases diuresis for 4 and 24 hours. At the same time, significant diuretic activity of spireoside was detected only at a dose of 10 mg/kg in the experiment, when diuresis was studied for 4 and 24 hours. Quercetin at a dose of 5 mg/kg increases the daily diuresis of laboratory animals.

Conclusion. A extractum spissum of the fruits of Filipendula ulmaria (L.) Maxim. shows diuretic activity at a dose of 50 mg/kg for 4 and 24 hours of the experiment. Spireoside has diuretic activity at a dose of 10 mg/kg for 4 and 24 hours of the experiment. Quercetin at a dose of 5 mg/kg has the ability to increase diuresis for 24 hours of the experiment. The fruits of Filipendula ulmaria (L.) Maxim. appear to be a promising source of medicines.

Science and Innovations in Medicine. 2021;6(4):68-72
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