Vol 106, No 5 (2025)

BACKGROUND: The incidence of newly diagnosed stable angina after a SARS-CoV-2 infection remains high. However, studies on the clinical, functional, and laboratory characteristics of this disease are inadequate. The manifestations of ischemic heart disease (IHD) following SARS-CoV-2 infection require further investigation to elucidate the pathophysiological mechanisms and personalize follow-up care.

AIM: This study aimed to compare the clinical, functional, laboratory, and angiographic characteristics of stable angina in patients diagnosed with IHD following SARS-CoV-2 infection.

METHODS: This cross-sectional study assessed patients’ medical histories, along with clinical, laboratory, and instrumental findings. The study enrolled 428 patients with stable IHD and documented SARS-CoV-2 infection (within 3–18 months of the onset of the disease). Group 1 (n = 195) consisted of patients with newly diagnosed IHD, and group 2 (n = 233) included patients with previously diagnosed IHD, with the infection being documented to have occurred ≥12 weeks prior to study enrollment. IHD was diagnosed through a comprehensive evaluation that included clinical presentation, electrocardiographic analysis, echocardiographic imaging, stress tests, and coronary angiography. Blood chemistry was performed using standardized methods. Statistical analysis was carried out in RStudio. Continuous variables were compared using the Mann–Whitney U test, whereas the comparison of binary and categorical variables was conducted using Fisher’s exact test. The critical significance level was set at p = 0.05.

RESULTS: Group 1 was significantly younger (p = 0.009), had a lower body mass index (p < 0.001), and had a shorter history of hypertension (p < 0.001). These patients exhibited higher prevalence of functional class I angina pectoris (p = 0.006), NYHA class II chronic heart failure (p = 0.005), and lower prevalence of ventricular extrasystole (p = 0.002). Coronary angiography demonstrated that group 1 showed higher prevalence of unchanged coronary arteries (p = 0.003) and hemodynamically insignificant stenoses (p = 0.018), but lower proportion of hemodynamically significant stenoses (p < 0.001). There were no significant differences found in the occurrence of multifocal atherosclerosis (p = 0.132). The treadmill test revealed comparable positive results across both groups (p = 0.479). However, group 1 exhibited a higher frequency of inconclusive results (p = 0.011). The laboratory profile of patients from group 2 showed increased Lp(a) (p = 0.023), triglycerides (p = 0.003), apoB (p = 0.022), NT-proBNP (p = 0.010), D-dimer (p = 0.001), high sensitivity C-reactive protein (p = 0.012), and cystatin C (p = 0.001), as well as higher fasting glucose (p = 0.030), but comparable HbA1c levels (p = 0.750).

CONCLUSION: Patients who develop stable angina following SARS-CoV-2 infection demonstrate a less severe clinical and functional phenotype, less significant coronary atherosclerosis, and more favorable biomarker profile than those with previously diagnosed IHD who had SARS-CoV-2 infection.

BACKGROUND: Stomach cancer is associated with systemic disturbances, including impaired hemostasis, which may result in thrombosis and bleeding, significantly affecting the prognosis, quality of life, and risk of fatal outcome.

AIM: The study aimed to identify risk factors for thrombosis and bleeding in patients with stomach cancer, assess the prognostic value of existing risk scores using a retrospective analysis of our own findings, and propose ways to improve them.

METHODS: The study analyzed medical records of 178 patients with stomach cancer who were treated at Sechenov University in 2021–2023. The medical records were grouped based on two independent variables: the presence of thromboembolic events (25 patients with and 150 patients without thromboembolic events) and the presence of bleeding (23 patients with and 155 patients without bleeding). The outcomes were assessed by examining imaging findings (ultrasound and computed tomography) specified in medical records, which allowed confirming or ruling out thromboembolic events, as well as initial examination findings and discharge summaries following hospitalization for chemotherapy. Qualitative variables are presented as mean ± standard deviation, whereas categorical variables are presented as absolute values and percentages. Intergroup differences were assessed using the Mann–Whitney and Pearson’s chi-squared tests. Significant associations for thromboembolic events and bleeding were identified using multivariate regression analysis. The prognostic value of scores was assessed using ROC analysis (AUC, sensitivity, specificity). SPSS 23.0 was used for statistical analysis.

RESULTS: Patients with chronic heart failure had an 11-fold greater risk of thromboembolic events than patients without chronic heart failure (odds ratio [OR] 11.12; 95% confidence interval [CI] 3.14–38.74; p = 0.001). Chronic kidney disease was associated with more than a 5-fold greater risk (OR 5.07; 95% CI 2.02–12.71; p = 0.002), and varicose veins with more than an 8-fold greater risk (OR 8.12; 95% CI 2.87–22.94; p = 0.001). Adding these factors to the Khorana score improved its prognostic value: in ROC analysis, AUC was 0.823 compared to 0.615 at baseline. This indicates a high discriminatory capability of the modified model (AUC > 0.8). The REACH score showed a high prognostic value for assessing the risk of bleeding (AUC = 0.738).

CONCLUSION: Adding chronic heart failure, chronic kidney disease, and varicose veins to the Khorana score improves its prognostic value for assessing the risk of thromboembolic events. The REACH score was effective in predicting the risk of bleeding.

BACKGROUND: To prevent various diseases and develop personalized treatment strategies, data are required on the immunological and hormonal changes under complex stress in respondents with different temperamental activity.

AIM: To study hormonal and immunological changes in respondents with different temperamental activity under complex stress.

METHODS: A total of 251 volunteers were examined (46% male, mean age 35.80 ± 9.48 years). Experimental groups were created by the ratio of different types of temperamental activity, i.e. psychomotor (n = 75), intellectual (n = 59), and communicative (n = 88). Venous blood samples were drawn before and after a complex stress, including psychomotor, intellectual, and communication tests. We assessed hormone levels (cortisol, epinephrine, norepinephrine, serotonin, and dopamine), genotypes (BDNF, COMT), and cytokines (IL-4, IL-6, IL-10, TNF-α). Statistical tests included Pearson chi-square test, Wilcoxon signed-rank test (W test), Mann–Whitney test (U test), Kruskal–Wallis test (H test), and Spearman’s rank correlation coefficient.

RESULTS: Complex stress in respondents with a predominantly psychomotor temperamental activity is associated with a decrease in serum cortisol (W = 6.187, p < 0.001) and an increase in epinephrine (W = 4.349, p < 0.002) and IL-4 (W = 3.601, p < 0.01). Changes in cortisol correlate with changes in norepinephrine (rs = 0.318, p = 0.006). Changes in serotonin negatively correlate with changes in IL-6 (rs = −0.324, p = 0.005). Changes in IL-6 correlate with changes in TNFα (rs = 0.424, p < 0.001). IL-6 decreases from 21.6 to 2.8 pg/ml (W = 2.525, p = 0.012). Complex stress in respondents with a predominantly intellectual temperamental activity is associated with a decrease in serum cortisol (W = 5.174, p < 0.001) and an increase in norepinephrine (W = 3.049, p < 0.002) and IL-4 (W = 2.582, p < 0.01). Changes in epinephrine correlate with changes in norepinephrine (rs = 0.382, p = 0.003) and dopamine (rs = 0.325, p = 0.012). Changes in serotonin negatively correlate with changes in IL-6 (rs = 0.264, p = 0.044). IL-10 decreases from 6.4 to 5.9 pg/ml (W = 3.313, p < 0.001). Complex stress in respondents with a predominantly communicative temperamental activity is associated with a decrease in cortisol (W = 7.914, p < 0.001) and an increase in norepinephrine (W = 3.318, p < 0.002) and IL-4 (W = 4.238, p < 0.01). Changes in epinephrine is associated with changes in norepinephrine (rs = 0.215, p = 0.045) and cortisol (rs = 0.239, p = 0.026). IL-10 decreases from 7.1 to 6.2 pg/ml (W = 5.449, p < 0.001).

CONCLUSION: We identified special hormonal and immunological changes in the blood serum under complex stress in respondents with different predominant temperamental activity.

BACKGROUND: Phenotypic plasticity and heterogeneity of melanoma cells arising from epigenetic regulation and the activity of transcription factors is pivotal in chemoresistance. Therefore, there it is necessary to explore the molecular mechanisms underlying resistance to alkylating agents, such as dacarbazine.

AIM: This study aimed to analyze transcriptome profiles of B16 melanoma cells after in vivo treatment with dacarbazine to identify key clusters of differentially expressed genes and regulatory transcription factors associated with chemoresistance.

METHODS: The study used a C57Bl/6 mouse model of B16 melanoma. The animals were randomly allocated into a control group and an experimental group, each with 12 mice. The experimental group was treated with dacarbazine at 50 mg/kg. Total RNA was extracted from tumor tissue, before high-throughput sequencing was performed. Data were subjected to bioinformatic processing for gene clustering and prediction of transcription factors for analyzing motifs in RNA sequences.

RESULTS: NGS sequencing and bioinformatic analysis yielded 670 differentially expressed genes, which were organized into 12 functional clusters related to DNA repair, apoptosis, and cell cycle. A comprehensive analysis identified key transcription factors (RELB, IRF5/7/4, NANOG, SOX2, LEF1, and NFKB2) that regulate signaling pathways essential for maintaining pluripotency (p = 0.000001), Wnt (p = 0.000753), TGF-β (p = 0.002631), Toll-like receptors (p = 0.000776), and NF-κB (p = 0.044609) associated with B16 melanoma cell resistance to the alkylating agent dacarbazine in vivo.

CONCLUSION: The findings of this study indicated that the epigenetic and transcription mechanisms of chemoresistance in melanoma cells involves maintenance of the stem cell phenotype, regulation of the immune response, and activation of the epithelial-mesenchymal transition.

Cardiovascular diseases remain the leading cause of worldwide mortality. Recent advancements in microelectronics have created novel opportunities for the development of innovative, intelligent devices that can perform unique electromechanical functions. Microelectromechanical systems are microscopic devices measuring between 20 and 1000 µm and integrated with microelectronics. They are used in the diagnosis and treatment of diseases, monitoring body functions, and in bioprosthetics. They possess the potential to improve the diagnosis, treatment, and prevention of life-threatening conditions. The advent of mobile technologies has led to the development of novel approaches that can enhance the efficiency of healthcare systems. Medical telemetry systems enable the remote measurement of physiological parameters via wireless technology. Implantable medical devices offer a wide range of diagnostic and therapeutic applications. This article provides an overview of current research focusing on implantable microelectromechanical systems with remote signal transmission in cardiology practice, describes in detail their practical operating principles and information transmission mechanisms, and reports the findings of their application in clinical trials. A comprehensive review of relevant publications suggests that this branch of medicine can be widely employed in clinical practice, enabling the personalized monitoring of patients and the prevention of life-threatening complications.

Multipotent stromal (stem) cells are currently the subject of extensive research. Initially, special attention was given to their reparative properties; however, in recent years, the focus switched toward their immunomodulatory effects. Multipotent cells inhibit T cell proliferation (directly and via exosomes), suppress proinflammatory cytokine production, and activate anti-inflammatory cytokine synthesis. Owing to these effects, cell technologies are currently used in the treatment of Huntington disease, multiple sclerosis, autoimmune encephalomyelitis, scleroderma, systemic lupus erythematosus, rheumatoid arthritis, myasthenia gravis, and other disorders. Furthermore, multipotent stromal cells have demonstrated efficacy in acute respiratory distress syndrome models, supporting their potential use in the treatment of COVID-19 complications. They interact with target cells via both paracrine signaling and direct cell–cell interactions. However, multipotent cell-driven immunoregulation and immunosuppression mechanisms are still poorly understood. The use of multipotent cells is highly dependent on the cell source and their functions in vivo; moreover, functional capabilities of stem cells are known to decline with age. It is also essential to consider potential complications of immunomodulatory effects of multipotent stromal cells, including long-term, severe immunosuppression, which may result in prolonged inflammation in infections and facilitate the progression of malignant neoplasms. For the effective use of multipotent cells, changes in gene expression induced by cell culture and various disorders must be taken into account. Further research is warranted into the mechanisms behind the immunomodulatory effect of multipotent stromal cells, as well as indications and contraindications for cell therapy in humans and animals. Moreover, it will be beneficial to investigate ways to control the functions of stem cells in various microenvironments.

BACKGROUND: The preservation and promotion of children’s health remain pivotal aspects of the Russian healthcare.

AIM: The study aimed to identify prevalent health patterns among preschool and school-age children in the Novo-Savinovsky district of Kazan between 2018 and 2022.

METHODS: The analysis included screening reports from 32 preschool education and care facilities and 20 schools in the Novo-Savinovsky district of Kazan. The reports were provided by medical professionals from the regional child health center and detailed laboratory tests and clinical investigations covering the years 2018 through 2022. In 2018 and 2022, the number of preschool-age children (3–7 years old) examined was 7257 and 6362, respectively. The health status of grade 1–11 students was assessed by analyzing medical statistical data collected between 2018 and 2022. A total of 14,917 and 18,141 schoolchildren were examined in 2018 and 2022, respectively. The population included adolescents aged 15–17 years (2775 and 3841, respectively). A comprehensive health assessment included the distribution of health groups and allocation to special medical groups, physical development, and primary and overall incidence (per 1000 age-matched children). The statistical analysis was performed using StatTech software, with the Mann–Whitney U test used for quantitative variables and the χ2 test used for qualitative variables, with a significance level of p = 0.05.

RESULTS: The study period showed a decrease in the proportion of healthy children (p = 0.04) and an increase in the number of preschool children with structural and functional impairments (p = 0.001). The overall incidence demonstrated a 24.3% increase. The most significant increase was observed for respiratory, musculoskeletal, visual, gastrointestinal, and neurological, genitourinary, psychiatric, and behavioral disorders (p = 0.001). Schoolchildren demonstrated a decrease in the proportion of healthy individuals and an increase in the number of children with structural and functional impairments (p = 0.001). The overall incidence decreased by 24.7% (p = 0.001), yet the prevalence of psychiatric disorders (p = 0.03), congenital anomalies, deformities, and chromosomal abnormalities increased (p = 0.0011). The study found a significant increase in school-related diseases throughout the years of school (p = 0.001).

CONCLUSION: Between 2018 and 2022, a decline in the overall health of preschool and school-age children in the Novo-Savinovsky district of Kazan was observed, as indicated by a decrease in the proportion of healthy children, an increase in the incidence of structural and functional impairments, and a higher prevalence of school-related diseases.

Background: Conflicts of interest (COI) of contributors to a guideline project and the funding of that project can influence the development of the guideline. Comprehensive reporting of information on COIs and funding is essential for the transparency and credibility of guidelines.

Objective: To develop an extension of the RIGHT statement for the reporting of COIs and funding in policy documents of guideline organizations and in guidelines: the RIGHT-COI&F checklist.

Design: The recommendations of the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) network were followed. The process consisted of the following steps: 1) registration of the project and setting up working groups; 2) generation of the initial list of items; 3) achieving consensus on the items; and 4) formulating and testing the final checklist.

Setting: International collaboration.

Participants: 44 experts.

Measurements: Consensus on checklist items.

Results: The checklist contains 27 items: 18 about the COIs of contributors and nine about the funding of the guideline project. Of the 27 items, 16 are labelled as policy-related as they address the reporting of COI and funding policies that apply across an organization’s guideline projects. These items should be described ideally in the organizations’ policy documents, otherwise in the specific guideline. The remaining 11 items are labelled as implementation-related and they address the reporting of COI and funding of the specific guideline.

Limitations: The RIGHT-COI&F checklist requires testing in real-life use.

Conclusion: The RIGHT-COI&F checklist can be used to guide the reporting of COIs and funding in guideline development, and to assess the completeness of reporting in published guidelines and policy documents.