No 31 (2014)

Background: Pathogenesis of diabetes complications is due to systemic microcirculatory disturbances, while there is a deficit in instrumental methods of objective assessment of the microvasculature. Aim: To provide diagnostics of microcirculatory disorders in patients with diabetes mellitus (DM) using laser Doppler flowmetry. Materials and methods: The study included 11 patients with decompensated type 1 and type 2 DM (HbA1c level – 9.1±2.2%), the duration of the disease being more than 5 years. The control group consisted of 11 healthy volunteers. Blood microcirculation in skin was measured using LAKK-02 system. We examined the condition of blood microcirculation during the functional testing (occlusion, heat, cold, orthostatic) in different combinations and durations of action. For analysis of the quantitative data, the mean values and standard deviations were calculated (M±SD), the differences between the groups were tested using the double-sided Student’s test. Results: The diagnostic tests using a combination of thermal and orthostatic effects were developed. The said diagnostic functional testing and transformation of perfusion units into the relative values of microcirculation (by dividing perfusion index by the average value of microcirculation during the base period) revealed significant differences in microcirculation levels between diabetic patients and the control group: for foot testing, relative microcirculation indices were 3.2±1.9 in the study group and 6.3±4.6 in the control group (p=0.05), for hand testing, the relative indexes were 3.3±1.4 and 5.3±2.8, respectively (p<0.05). Conclusion: The developed method has demonstrated the efficacy of detection of microcirculatory disorders in patients with diabetes. In future, it can be used for the early diagnosis of diabetic vascular complications and as an additional method for monitoring the effectiveness of DM treatment.

Background: Proteins oxidized by the action of X-rays represent long-lived reactive species, which trigger the secondary generation of reactive oxygen species (ROS). A change in the hydrogen peroxide (H2O2) content induced by various physical impacts may be an important factor of the therapeutic effect and the adaptation of the organism to unfavorable environmental conditions. Moderate hyperthermia and a number of physiotherapeutic procedures leading to a local warming of tissues are widely used in medical practice. However, the biological mechanisms of their curative effect are poorly understood. The prolonged generation of H2O2 long-lived reactive protein species (LRPS) after heating may be one of the mechanisms of activation of protective cellular mechanisms and thus to contribute to overcoming the disease. Aim: To investigate if the serum proteins bovine serum albumin (BSA) and bovine gamma-globulin (BGG) can form LRPS under moderate hyperthermia and show that heat induces LRPS, which in turn continuously generate ROS, in particular H2O2. Materials and methods: LRPS were studied by measuring the heat-induced chemiluminescence of protein solutions using a specially elaborated highly sensitive photon-counting chemiluminometer Biotoks-7 AM. The Results: Here we studied the possibility of formation of long-lived species of the blood serum proteins BSA and BGG in air-saturated solutions under the action of heat. It is shown that heat induces the generation of long-lived protein species, which in turn generate ROS (1O2, О2-•, OH•, H2O2). The formation of the long-lived reactive species of BSA and BGG with a half-life of about 4 h induced by moderate hyperthermia was revealed using the chemiluminescence of protein solutions. It was found that long-lived reactive species of BSA and BGG cause prolonged generation of H2O2. Conclusion: Thus, we found a new fundamental property of serum proteins: by the action of moderate heating, they are able to transform into LRPS that produce H2O2 over a long period of time. Therefore, it cannot be excluded that the heat treatment during physiotherapeutic procedures in clinical practice is accompanied by local heating and the formation of LRPS. H2O2 generated by these species may participate in signaling pathways and induce adaptive response in humans.

Background: Premature aging reduces quality of human life, leads to development of “old age diseases” in younger age, and also shortens life expectancy. Aim: Investigation of premature aging markers in women of reproductive age with central untreated hypogonadism in association with other compensated pituitary deficiencies. Materials and methods: Hormonal and biochemical parameters, body mass index (BMI) and body mineral density (BMD) were investigated in 87 women of reproductive age (median – 24 y.o.) with the central untreated hypogonadism in association with other compensated pituitary deficiencies (hypopituitarism) and in 52 healthy age-matched controls. Results: Low levels of estrogens as well as androgens (total and free testosterone, DHEA-S) were found in women with hypopituitarism as compared to the controls. Such markers of premature aging as increased BMI (р=0,025), high levels of cholesterol (р<0,001) and triglycerides (р><0,001), ionized calcium (р><0,001), alkaline phosphatase (p=0,006), and CTx (p=0,025) were revealed; low BMD was found in 87% of patients with hypopituitarism (mainly ><-2.5 SD in lumbar vertebra). Correlation analysis elucidated that hypoandrogenemia as well as hypoestrogenemia was pathogenetic basis of premature aging in women with hypopituitarism and untreated hypogonadism. Conclusion: Such markers of premature aging as BMI increase, dislipidemia, increased levels of bone metabolism markers, and low BMD were revealed in women of reproductive age with uncured hypogonadism and other compensated types of hypophysial insufficiency. Treatment of hypogonadism in this cohort of patients needs to be considered a prevention of the premature aging.

Background: Ambulatory blood pressure monitoring is one of the main methods for hypertension diagnosis. According to the recommendations of the Russian Medical Society of Hypertension and the All-Russian Society of Cardiology, only devices that passed all of the international protocols requirements can be recommended for ambulatory blood pressure monitoring. Aim: Validation of the MECG-DP-NS-01 upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd., in oscillometry and auscultation modes, for ambulatory blood pressure monitoring, in an adult population at rest according to the ESH International Protocol revision 2010 (ESH-IP2), the BHS protocol revision 1993 and the AAMI standard. Materials and methods: A group of 85 people (50 men and 35 female) aged 19 to 86 years (mean age 47.7±18.0 years) was recruited for the validation study. Expert and device blood pressure measurements were taken for each patient according to the international protocols. Results: The MECG-DP-NS-01 upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd. for ambulatory blood pressure monitoring, was validated in oscillometry and auscultation modes in an adult population at rest according to the BHS protocol revision 1993, the ESH-IP2, and the AAMI standard. The device achieved an A/A grading for the BHS protocol revision 1993 both in the oscillometry and auscultation modes. The device maintained its A/A grading throughout the low-pressure, medium-pressure, and high-pressure ranges. Conclusion: The MECG-DP-NS-01 passed all of the requirements and, fulfilling the standards of the protocols, is recommended for ambulatory blood pressure monitoring according to BHS protocol revision 1993, ESH-IP2, and AAMI standard. According to the Declaration of Blood Pressure Measuring Device Equivalence signed by the manufacturer there are no differences that will affect blood pressure measuring accuracy between the MDP-NS-02s (Voshod) upper arm blood pressure monitor produced by the DMS Advanced Technologies Ltd. and the MECG-DP-NS-01, which passed the ESH-IP2, BHS and AAMI protocols.

Backgroud: There is a high prevalence of vascular diseases of the brain in adult population. One of the most severe complications of the cerebral vascular diseases is an aphasia leading to patient’s disability. An extremely severe and unreversible condition for further rehabilitation is noted in a group of patients which develops an impressive speech impairment as a dominant disturbance associated with aphasia. Aim: To identify the most effective rehabilitation method for patients with complications of cerebral circulation disturbances manifesting as speech impairment in a form of aphasia. Materials and methods: Theoretical aspect of rehabilitation in post-stroke aphasia patients with a dominant impressive speech impairment was studied. All patients underwent neurologic examination, dynamic logopedic observation, and magnetic resonance imaging. The patients of the chosen group underwent rehabilitation with a modified modality of speech restoration. Results: Introduction of the modified rehabilitation methods into the logopedics practice proved their high efficiency. Significant improvement was seen in 64% of patients with acoustic-amnestic aphasia, in 57% of patients with acoustic-gnostic aphasia, and in 60% of those with semantic aphasia. Conclusion: A key moment for achievement of the high rehabilitation outcome is a complex approach needed for rehabilitation of patients with the consequences of the acute impairments of cerebral circulation.

Based on the analysis of the latest scientific data, the paper suggests a synthetic classification of the known bioantioxidants, peculiarities of their structure and functioning. The second part of the review describes the sulfur-containing compounds, chelators
of the metal ions of variable valency, compounds containing hydroxyl or amino group, and nanoparticles.

Currently, an organ rejection is a leading cause of kidney transplants loss. Effective therapy is impossible without a clear understanding of the rejection mechanisms. In this paper, we summarize the views of domestic and foreign authors on the role of T cell activation in kidney transplant rejection.