Vol 105, No 5 (2024)

BACKGROUND: Ovarian cancer is the most aggressive gynecological tumor with high mortality. The ambivalent, both helper and suppressive effects of neutrophils on the cells of innate and adaptive immunity determines their important immunoregulatory role in the development of malignant tumors.

AIM: Evaluation of the effect of serum interleukin-1β and circulating neutrophils CD16⁺ on progression-free time in advanced ovarian cancer.

MATERIAL AND METHODS: In 42 primary patients with serous ovarian adenocarcinoma (median age 54 years) with ascites and 15 patients with benign ovarian tumors (median age 60 years) admitted for examination and treatment to the Regional Clinical Oncology Dispensary before receiving neoadjuvant antitumor treatment (2015–2020), the level of interleukin-1β in the blood serum was determined using enzyme immunoassay, and the number of CD16⁺ neutrophils was determined by fluorescence microscopy using monoclonal antibodies. Statistical processing was performed using Statistica 13 and Jamovi 2.4.14 programs. Progression-free time analysis of patients was performed using the Cox and Kaplan–Meier regression methods.

RESULTS: It was found that the number of circulating CD16⁺ neutrophils in advanced ovarian cancer with ascites was lower than in benign ovarian tumors [48.0; 95% confidence interval (CI) 46.59–48.12 versus 50.0; 95% CI 48.51–49.76; p=0.017]. At the same time, the level of interleukin-1β in the blood serum in advanced ovarian cancer with ascites was higher than in benign ovarian tumors [2.52 (95% CI 2.50–3.37) versus 1.26 (95% CI 0.97–1.55) (p=0.0001)]. In multivariate Cox analysis in patients with ascites (odds ratio 4.334; 95% CI 1.83–10.23; p=0.001), both the CD16⁺ neutrophil count (odds ratio 0.73; 95% CI 0.62–0.86; p=0.0001) and serum interleukin-1β levels (odds ratio 1.90; 95% CI 1.41–2.57; p=0.0001) had prognostic significance for assessing progression-free time.

CONCLUSION: The number of circulating CD16⁺ neutrophils and serum interleukin-1β levels simultaneously affect progression-free time in advanced ovarian cancer.

BACKGROUND: There are reports of the negative impact of neuroleptics long-term use on bone metabolism. Dimephosphone is a drug with proven antirachitic effect.

AIM: To study under experimental conditions the effect of haloperidol on the microelement composition of the bone of experimental rats and the possibilities of its correction with dimephosphone.

MATERIAL AND METHODS: Wistar rats were divided into groups (10 animals in each): the first was the control group; the second group consisted of animals that were administered haloperidol; the third group used haloperidol with dimephosphone. Rats of the second and third groups were administered haloperidol intraperitoneally for 90 days, starting with 15 mg/day and reducing the dose to 5 mg/day. Rats of the third group were administered orally a 15% dimephosphone solution at a dose of 208 mg/kg/day. After the animals were withdrawn from the experiment, the lumbar vertebrae were dissected and the teeth were removed. The content of calcium, magnesium, strontium, zinc and copper ions in bone and teeth was determined by atomic absorption spectrophotometry. Statistical processing was performed using the SPSS 13.0 program.

RESULTS: Long-term use of therapeutic doses of haloperidol in the experiment caused a decrease in the content of calcium and zinc ions by 1.5 times, copper — by 1.7 times in the bones of animals, an increase in the concentration of strontium ions by 1.1 times, which indicated the resorptive effect of the neuroleptic. With the combined use of haloperidol and dimephosphone, the content of calcium ions (by 1.2 times), copper (by 1.4 times) and zinc ions (by 1.1 times) significantly increased; the amount of strontium ions decreased (by 1.1 times) only in bone tissue.

CONCLUSION: Dimephosphone reduces the negative effect of long-term haloperidol administration on the microelement composition of rat bones.

BACKGROUND: Gastrointestinal tract dysfunctions are a very common problem in patients with autism spectrum disorders, which aggravates the underlying course of the disease, and therefore there is a need to find safe drugs to correct gastrointestinal dysfunctions.

AIM: Evaluation of intestinal contractile activity in rats with an autism model after a course of intragastric administration of dimephosphone.

MATERIAL AND METHODS: The mechanical activity of the duodenum and ileum of rats with the valproate model of autism after the administration of dimephosphone was studied in vitro. To model autism, female rats were given a single subcutaneous injection of sodium valproate at a dose of 500 mg/kg in the withers area on the 13th day of pregnancy. The offspring of these rats were divided into two groups. The experimental group of rats (n=12) was given dimephosphone at a dose of 50 mg/kg for 30 days, starting from the age of 2 months, control rats (n=12) were given physiological saline in an equal volume. Another group of rats was intact (n=9), which were born from female rats not exposed to valproic acid. The effect of carbachol (10^–8–10^–5 M), ATP (10^–7–10^–4 M), 2-methylthio-ATP (10^–7–10^–5 M) and electrical stimulation (1–5 Hz) on the mechanical activity of isolated intestinal smooth muscle preparations was assessed. Statistical processing was performed in IBM SPSS Statistics 26.0 using one-way analysis of variance.

RESULTS: It was found that in rats with autism modeling, carbachol-induced intestinal contractions and ATP-induced intestinal relaxation increased. A course of intragastric administration of dimephosphone for 30 days normalized these changes, which became indistinguishable from the corresponding indices in intact animals. Thus, ATP at a concentration of 10^–4 caused relaxation of the smooth muscles of the duodenum of rats with autism modeling after a course of dimephosphone administration by 77.1±14.7%, which significantly differed from the corresponding indices in control animals — 34.4±9.4% (p <0.05) and did not differ from the indices in intact rats. Similar changes occurred in the mechanical activity of the ileum. Intestinal relaxation in rats caused by 2-methylthio-ATP did not change significantly either in the control or in the group of animals receiving dimephosphone.

CONCLUSION: Dimephosphone, when administered intragastrically, normalizes the disturbances in the mechanical activity of the intestines of rats with an autism model.

Cardiovascular diseases remain a common cause of morbidity and mortality in populations around the world, varying in incidence by age and gender. Every year, more than 7 million people around the world are diagnosed with acute coronary syndrome, which may be the first clinical manifestation of coronary heart disease. In the ranking of mortality causes in the Russian Federation, diseases of the circulatory system occupy a leading place. The purpose of the review was to analyze the clinical characteristics and spectrum of coronary lesions of patients with acute coronary syndrome depending on age and gender. Thus, according to the results of coronary angiography, young patients with myocardial infarction were rarely accompanied by multivessel or ostial lesions of the coronary arteries, in contrast to the elderly patients. It was revealed that multivessel lesions of the coronary arteries more often characterize males, and singlevessel lesions more often characterize females. It is obvious that the prognosis of patients with acute coronary syndrome will largely depend not only on age and gender, but also on the outcome of the syndrome, the quality and scope of diagnostic and treatment procedures. This is especially important since most patients under 60 years of age are exposed to some form of systematic work load in their field of activity. The influence of polypathy, characteristic of modern cardiac patients, can be expressed to varying degrees depending on the gender and age of the patient with acute coronary syndrome. The article presents data on the short-term and long-term prognosis of patients with acute coronary syndrome, taking into account gender and age periods, including depending on the tactics of their management. Determining the clinical characteristics of patients of different ages allows to take them into account for selecting effective and safe therapy, preventing wave-like atherosclerosis as the main cause of coronary heart disease, thereby improving prognosis and survival.

Conversion, somatoform and psychosomatic disorders have been the subject of study for many years. If severe conversion disorders were common among patients in the 19th century, somatoform and psychosomatic disorders were more common in the 20th century. They have not lost their importance at present time. The combination of theoretical and clinical aspects gives the problematic a stable relevance, therefore these disorders lead to the need for interdisciplinary interaction, psychological and psychiatric counseling. The article briefly reviews fragments of the history of studying conversion and somatoform disorders, modern concepts of somatoform and psychosomatic disorders and their features in childhood and adolescence in comparison with the mechanisms of neurotic disorders, as well as the pathodynamics of somatoform disorders. The concepts of the emergence of somatoform and psychosomatic disorders are presented — macrosocial and microsocial, individual and family, psychoanalytic and psychodynamic, allowing to assess the breadth of the range of the raised problems. From the standpoint of the systemic approach, a parallel with neurotic disorders is drawn, the similarity of the mechanisms of their formation is emphasized, and the community of models of family relationships through “neurotic” and “somatic” symptoms is indicated. Identification of the features of somatoform disorders’ mechanisms in childhood and adolescence also brings a certain novelty and explains the increase in the group of “frequently ill children”. The combination of theoretical (psychological) and clinical (psychiatric) aspects is an important factor in the unification of the raised topic, which is initially interdisciplinary. The practical value lies in the analytical and didactic presentation of the material, which can be used by various specialists.

Osteoarthritis is characterized by heterogeneity of clinical manifestations and, in some cases, a severe progressive course. In this regard, it is important to identify new molecular targets for the treatment of the disease. To determine the role of autoimmune processes, general genetic and epigenetic changes in osteoarthritis and rheumatoid arthritis, as well as to identify osteoarthritis-specific ribonucleic acids (microRNAs), potential targets for targeted therapy, information was searched using scientific platforms PubMed, Scopus, ResearchGate, RSCI over the past 10 years. Although the pathogenesis of rheumatoid arthritis and osteoarthritis differs, evidence has been obtained that identical pathological immune reactions are involved in the mechanism of osteoarthritis and disruption of the expression of 26 identical genes with identical changes in the levels of 13 of them. Changes in the expression of the same microRNAs (miR-140, miR-149, miR-25, miR-146a, miR-16, miR-23b) were detected in osteoarthritis and rheumatoid arthritis. Molecular genetic studies make it possible to find new markers of pathological immune reactions in osteoarthritis, which can be used to treat the disease and prevent its rapid progression, as well as to design targeted therapy using gene expression products as targets. MicroRNAs associated with osteoarthritis and rheumatoid arthritis and involved in the pathogenesis of both diseases may become promising targets for targeted therapy of osteoarthritis and rheumatoid arthritis.

BACKGROUND: Multiple chemical sensitivity syndrome is a set of adverse physiological reactions of the human body to exposure to common chemical agents in low doses, which are considered non-toxic to the population.

AIM: To study the frequency and characteristics of multiple chemical sensitivity syndrome manifestation using the Russified questionnaire Quick Environment Exposure and Sensitivity Inventory (QEESI).

MATERIAL AND METHODS: In the pilot study, 468 people undergoing a preventive medical examination were surveyed (232 men, average age 34.2±9.3 years, and 236 women, average age 42.9±13.8 years). To assess multiple chemical sensitivity, an analysis of three subscales of the Russified validated QEESI questionnaire (chemical intolerance, severity of symptoms, and impact on everyday life) was used. The statistical significance of differences in relative indicators was assessed using the Pearson χ² criterion. Absolute indicators were presented as M (SD). Relationships and differences in indicators were considered statistically significant at p <0.05.

RESULTS: The frequency of multiple chemical sensitivity syndrome was 45.5%, 51.7% of patients had concomitant diseases. The frequency of comorbidities with and without multiple chemical sensitivity syndrome was comparable: allergic diseases — 25.6 vs 17.5%, χ²=3.84, p=0.069; irritable bowel syndrome — 8.1 vs 10.9%, χ²=3.648, p=0.057; migraine — 11 vs 10.5%, χ²=0.642, p=0.424. Multiple chemical sensitivity syndrome was more often detected in women (74.3 vs 25.6%, χ²=5.76, p=0.001) and patients with a sedentary lifestyle (58.3 vs 24.8% χ²=11.9; p=0.01). In patients with multiple chemical sensitivity syndrome, the most common central nervous system complaints were mood lability (26.5 vs 11.3%, χ²=18.936, p=0.003), headaches (27.4 vs 10.5%, χ²=7.555, p=0.006); in the gastrointestinal tract — nausea (13.7 vs 7.6%, χ²=4.826, p=0.029), abdominal pain (10.9 vs 5.5%, χ²=4.178, p=0.041).

CONCLUSION: A high frequency of multiple chemical sensitivity syndrome (45.5%) was revealed, which was typical for women and patients with a sedentary lifestyle. Patients with this syndrome significantly more often reported complaints from the central nervous system and gastrointestinal tract.

BACKGROUND: Improving the strategy of surgical treatment of breast cancer is an important and urgent task for a physician at the present stage.

АIM: To evaluate the immediate results and quality of life indicators of patients using the two-stage reconstruction technique with symmetrizing operations.

MATERIAL AND METHODS: The retrospective study included the results of treatment of 126 patients with a diagnosis of breast cancer in the Samara Regional Clinical Oncology Dispensary in the period 2018–2022. Patients of the comparison group (n=72) underwent two-stage reconstruction with an expander, 54 patients of the main group — two-stage reconstruction with the performance of a symmetrizing operation. Patients from the comparison group and the main group were comparable in age, disease stage, biological subtypes of the tumor. Before the operation, at an appointment with an oncologist, the quality of life indicators’ assessment of patients of both groups was performed using the SF-36 questionnaire (which did not differ statistically significantly), then these parameters were assessed 6 months after the operation. Statistical processing of the obtained results was carried out using parametric (Student's t-test) and nonparametric (Mann–Whitney test, χ² test and Fisher's exact test) methods. The significance criterion in the study was p <0.05.

RESULTS: The immediate results of surgical treatment in the compared groups did not differ statistically significantly: the average operation time in the control and main groups was 125±25 and 153±33 min, respectively (p=0.874); intraoperative blood loss reached 50±17 and 65±21 ml (p=0.347); the duration of postoperative lymphorrhea was 12±4 and 14±3 days (p=0.621); postoperative bed-day was 12±2 and 13±3 days (p=0.541), respectively. According to the scale of physical condition, social functioning, psychological health and vital activity, assessed by patients using the SF-36 questionnaire by means of a survey, after 6 months, women who underwent two-stage reconstruction with symmetry surgery had a statistically significant advantage: in the control group, according to the scale of physical condition — 47.51±10.72 points, in the main group — 72.34±12.63 points (p=0.041); according to the scale of social functioning — 42.42±19.81 and 78.12±14.23 points (p=0.003); according to the scale of mental health — 44.31±21.32 and 81.42±8.81 points (p=0.008); according to the vital activity scale — 59.12±13.57 and 65.21±18.24 points (p=0.026), respectively.

CONCLUSION: Patients of the main group 6 months after the symmetrizing operation have better quality of life indicators compared to the comparison group.

11 октября 2024 г. исполняется 80 лет известному российскому учёному в области биохимии, генетики и биогеронтологии, доктору химических наук, профессору Ренаду Ибрагимовичу Жданову.

This publication is the Russian translation of the Plain Language Summary (PLS) of the Cochrane Systematic Review: Marques Antunes M, Nunes-Ferreira A, Duarte GS, Gouveia e Melo R, Sucena Rodrigues B, Guerra NC, Nobre A, Pinto FJ, Costa J, Caldeira D. Preoperative statin therapy for adults undergoing cardiac surgery. Cochrane Database of Systematic Reviews. 2024. Issue 7. Art. No.: CD008493. DOI: 10.1002/14651858.CD008493.pub5