Aim. To evaluate the efficacy of bone repair using xenogeneic native bone collagen (Bongraf COLLAGEN) as compared to other widely applied orthopaedic solutions (xenogeneic native bone mineral Geistlich Bio-Oss® and bone autograft).

Materials and Methods. We employed a conventional critical-sized (8 mm) rat calvarial defect model (48 Wistar or Sprague-Dawley rats). The artificial defect was repaired using Bongraf COLLAGEN, Geistlich Bio-Oss® utilised as a comparator, bone calvarial autograft, or remained unfilled (n = 6 per group). Rats were euthanised 4 or 12 weeks postimplantation (n = 3 per time point) with the subsequent examination (repair extent, volume, thickness and mineral density of the repaired tissue) by means of microcomputed tomography and hematoxylin and eosin staining.

Results. Expectedly, highest volume, thickness and mineral density of the repaired tissue have been observed in defects filled with autografts. Bongraf COLLAGEN and Geistlich Bio-Oss® also demonstrated a comparable and significant repair capability, yet the former option demonstrated higher bone regeneration rate.

Conclusion. Xenogeneic native bone collagen (Bongraf COLLAGEN) is comparable with xenogeneic native bone mineral (Geistlich Bio-Oss®).

Aim. To evaluate biocompatibility along with adhesion and aggregation of platelets on the surface of uncoated and fibrin-coated poly(3-hydroxybutyrate- co-3-hydroxyvalerate)/poly(ε-caprolactone) (PHBV/PCL) small-diameter vascular grafts.

Materials and Methods. 4 mm diameter grafts were fabricated by electrospinning from PHBV/ PCL (1:2) blend dissolved in 1,1,1,3,3,3-hexafluoro- 2-propanol. Inner wall of the grafts was produced using co-electrospinning of the polymer blend and collagen type I (5 mg/mL) from two different syringes. Fibrinogen was obtained from the blood of healthy donors by a cryoprecipitation procedure. Sterile polymer scaffolds were impregnated into a fibrinogen solution and immersed in a thrombin/calcium chloride blend for polymerization. To assess the biocompatibility of the grafts, primary human coronary artery endothelial cells were seeded on the luminal surface and counted under a fluorescence microscope after nuclear staining. Hemocompatibility was tested by incubation of the grafts with human platelet-rich plasma. Platelet aggregation was assessed using a platelet aggregation analyser. Surface morphology, platelet adhesion and activation were evaluated by scanning electron microscopy.

Results. Fibrin coating promoted cell adhesion and proliferation and improved the graft biocompatibility as evidenced by a higher number of endothelial cells. Fibrin coating did not increase platelet aggregation, adhesion, and activation and therefore did not reduce the thromboresistance of vascular graft.

Conclusion. The fibrin modification of polymer grafts from PHBV/PCL blend and collagen type I improves the surface biocompatibility and does not reduce its thromboresistance.

Aim. To evaluate basic clinicopathologicalcharacteristics of patients with atrial fibrillationand pharmacological anamnesis at the time of cardioembolicstroke.

Material and Methods. Study included 99 patientswith atrial fibrillation admitted to SeredavinSamara Regional Clinical Hospital due to cardioembolicstroke. The follow-up duration was 1year.

Results. The average age of the patients was69.1 ± 8.7 years. Patients with atrial fibrillationand acute cardioembolic stroke were characterizedby multimorbidity. Arterial hypertension, chronickidney disease, and diabetes mellitus were diagnosedin 96/99 (97.0%), 60/99 (60.6%), and 22/99(22.2%) patients, respectively. Average risk scoreaccording to the CHA2DS2-VASc scale before admissionwas 4.51 ± 1.2 points; therefore, 96 patientshad indications for anticoagulant therapy (≥2 points on the CHA2DS2-VASc scale). However,adequate prevention of thromboembolic complicationsbefore admission was carried out only in16/99 (16.2%) patients.

Conclusion. These results demonstrate a lowquality of outpatient care in patients with atrialfibrillation. Most likely, this can be explained bythe lack of awareness about the risks of potentialcomplications and low compliance.

Aim. To study the temporal pattern of cardiovascular risk factors and cardiovascular disease (CVD) in the adult cohort depending on outpatient care status.

Materials and Methods. We analyzed the incidence of CVD in the adult cohort (n = 1170) admitted to Research Institute – Ochapovsky Regional Clinical Hospital # 1 in 2015 (baseline) and after 3 years of follow-up. Groups were stratified according to the outpatient care status.

Results. After 3 years of follow-up, the proportion of patients adhered to unhealthy diet decreased by 32.2%, 28.8% and 28.0% in groups without regular outpatient care, with regular outpatient care, and with regular outpatient care and CVD, respectively, as compared to baseline. Similar trend was observed regarding low physical activity (reduction by 50.3%, 24.7% and 21.8%, respectively) and tobacco smoking (45.6%, 63.0% and 61.8%, respectively). However, patients without regular outpatient care demonstrated an increase in overweight and obesity by 19.2%. Notably, the frequency of arterial hypertension increased by 48.33% in patients without regular outpatient care but decreased by 24% in those with regular outpatient care and CVD.

Conclusion. During 3-year outpatient observation, we found a trend to a reduction in prevalence of cardiovascular risk factors, also in patients with CVD. Nevertheless, patients without regular outpatient care showed a statistically significant increase in prevalence of overweight, obesity and arterial hypertension.

Aim. To create a calculator for the annual personalised risk assessment of adverse cardiovascular events in patients after acute ST-segment elevation myocardial infarction (STEMI).

Materials and Methods. Here we performed a prospective data analysis of 1,000 patients diagnosed with STEMI during 2017 and 2018 and admitted to Regional Vascular Center. For evaluating the risk of adverse cardiovascular events after STEMI, we applied the GRACE scale. After 1 year of follow-up, the predicted outcomes were compared with the actual outcomes. We then created a personalised calculator of unfavorable outcome by using logistic regression.

Results. The calculator included six indicators that significantly correlated with outcomes and poorly correlated with each other: left ventricular ejection fraction (LVEF) < 40%, anterior STEMI, tachycardia upon admission, fasting blood glucose, high-sensitive C-reactive protein (CRP), and patient age.

Conclusion. We found a high reliability of our calculator for the annual personalised prognosis of adverse outcome in patients after STEMI.

Aim. To study the relationship between age-related androgen deficiency and the level of cardiovascular risk in healthy middle-aged men.

Materials and Methods. We enrolled 200 men of 44-55 (median 48.44, interquartile range 45.02- 52.50) years who underwent a routine medical examination, having additionally measured age-related androgen deficiency.

Results. A decrease in total testosterone of < 12.1 nmol/L indicative of age-related hypogonadism was detected in 98 (49.0%) men. In 42 (42.8%) men, a decrease in total testosterone was accompanied by loss of libido and erectile dysfunction. Relatively high prevalence of lipid metabolism disorders and subclinical atherosclerosis was diagnosed in men without established cardiovascular disease. Analysis according to the SCORE scale showed a predominance of patients with moderately increased risk, with only a small number of high-risk patients. Notably, all high-risk cases were identified in the age-related hypogonadism group. The distribution of cardiovascular risk score significantly differed in groups with and without age-related androgen deficiency.

Conclusion. We demonstrate a relatively high prevalence of age-related testosterone deficiency, which is also associated with increased cardiovascular risk, among healthy middle-aged men.

Aim. To estimate the frequency of ulcerative bleeding, pyloric stenosis, need for pyloroplasty and the justification of vagotomy for perforated duodenal ulcer.

Materials and Methods. We analyzed the surgical treatment of patients with perforated duodenal ulcer admitted to Podgorbunskiy Regional Clinical Emergency Hospital during 1999-2019.

Results. In 2018, the number of surgical interventions due to perforated duodenal ulcer decreased by 56.4% in comparison with 1998. In 8.6% and 2.1% of patients, perforated duodenal ulcer was combined with pyloric stenosis and bleeding, respectively, requiring Judd pyloroplasty (diamond- shaped transverse excision) or gastroduodenotomy followed by Heineke-Mikulicz pyloroplasty (transversely closed longitudinal incision across the pylorus) and vagotomy. Distal gastric resection by Billroth’s operation II was required in 2.8% of patients. Repeated admission of patients with duodenal ulcer complications has been observed after isolated suturing of perforated duodenal ulcer.

Conclusion. Over the last 20 years, the amount of surgical interventions because of perforated duodenal ulcer in Kemerovo Region decreased more than twofold. In > 10% patients, pyloric stenosis and bleeding require a gastric drainage. In > 8% patients, perforated duodenal ulcer is combined with pyloric stenosis; in these cases, Heineke-Mikulicz pyloroplasty may be a treatment of choice. In > 2% patients, perforated duodenal ulcer is combined with ulcerative bleeding requiring excision of the ulcer and optional distal gastric resection. Pyloroplasty may be combined with vagotomy to normalise the proteolytic activity of gastric acid.

Aim. To study the features of pregnancy and birth outcomes in young women.

Materials and Methods. We retrospectively analyzed birth histories of 400 women admitted to Regional Perinatal Center of Belyaev Kemerovo Regional Clinical Hospital during 2015-2018. All patients were stratified according to their age (< 18 years and 20-25 years of age, n = 200 per group).

Results. Pregnant women < 18 years of age had earlier menarche and sexual intercourse as well as less frequent use of contraceptives as compared with those 20-25 years of age; the proportion of married pregnant women was 13.0% and 86.0% in the former and latter group, respectively. The vast majority (96.0%) of women < 18 years of age were primiparous, in comparison with 64.0% in those aged 20-25. First visit to the prenatal care center was registered at 23 and 7 weeks in younger and older age group, respectively. The prevalence of extragenital pathology in patients < 18 years of age was 9.0%. No significant differences in pregnancy complications (gestational hypertension or preeclampsia) and placental insufficiency were found. Most of the patients in both groups had full-term labor, yet premature births and caesarean section were significantly more common in those < 18 years of age. There were no significant differences in weight, height, and Apgar scores among the newborns in regards to maternal age.

Conclusion. Despite pregnant adolescents are characterised by an earlier menarche, sexual intercourse, less frequent use of contraceptives and higher need in assisted delivery in comparison with parturient women of 20-25 years; however, age does not impact pregnancy course and birth outcomes.

Aim. To assess the incidence of malignancies in Omsk and Orenburg Regions.

Materials and Methods. We analyzed statistical reports (form # 7) from health authorities of Omsk and Orenburg Regions which contain the data on cancer incidence in the population during the last decade (2009-2018).

Results. The incidence of malignancies in Omsk and Orenburg Regions had a moderate upward trend. Cancer incidence in the urban population of Orenburg region was higher than in the corresponding rural population, with the opposite ratio in the Omsk region. Average long-term standardized incidence rate of malignancies in Omsk and Orenburg regions was 276,5 0/0000 and 273,0 0/0000, respectively. Cancer incidence prevailed among the male population regardless of the indicator type. The prevalence of males across all patients was 46.0% and 46.8% in Omsk and Orenburg Region, respectively.

Conclusion. Average long-term indicators of cancer incidence in Orenburg and Omsk Regions do not differ; however, different incidence pattern was detected in urban and rural populations in these regions over the decade.

Aim. To study current trends in the incidence and mortality of prostate cancer in Kemerovo Region.

Materials and Methods. We conducted a descriptive retrospective study by investigating cancer registry of Regional Clinical Oncology Dispensary collected in 2010-2018.

Results. During the study period, 4965 cases of prostate cancer have been documented. The average standardised incidence rate was 50,080/0000 (95% CI = 46.01; 54.43). We detected a trend towards an increase in standardized incidence from 32.410/0000 in 2010 (95% CI = 28.76; 36.05) to 73.000/0000 in 2018 (95% CI = 67.86 – 78.15) with the average annual increment of 10.22% (р < 0.0001). A significant proportion of cases (48.17% in 2018) occurred in elderly (≥ 70 years). Standardized mortality rates increased from 9.240/0000 in 2010 (95% CI = 7.29; 11.19) to 28,830/0000 in 2018 (95% CI = 25.51; 32.15), average annual increment 13.99% (р = 0.002). Component analysis showed that an incidence increase by 155.81% is primarily associated with existing risk factors (128.19%) rather than with population aging (16.71%) or their combined effect (10.91%).

Conclusion. Currently, there is a clear trend to increasing incidence and mortality from prostate cancer in Kemerovo Region, mainly due to existing risk factors.

Here we review current concepts in diagnosis and treatment of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (PPIGERD) which includes an insufficient response to daily PPI 8-week therapy in combination with pathological gastroesophageal reflux. Patients with PPI-GERD frequently suffer from non-acidic and asymptomatic gastroesophageal reflux. In developed countries, PPI-GERD accounts for 30-40% of all patients receiving PPIs. Diagnosis of PPIGERD is performed by means of clinical anamnesis, esophagogastroscopy and impedance-pH monitoring. PPI-GERD needs to be differentiated with functional heartburn, reflux hypersensitivity and nonerosive reflux disease. Functional heartburn is characterised by reference time with a esophageal pH < 4 and the absence of a link between reflux episodes and GERD symptoms. Reflux hypersensitivity is diagnosed with normal esophageal acid exposure and association of reflux episodes with symptoms of GERD. Nonerosive reflux disease can be diagnosed solely by evaluating pathological acid exposure (pH < 4 for > 6% of the time). Treatment of PPI-GERD includes diet and lifestyle modification to reduce weight in obese patients, optimization of PPI use, and administration of alginate, prokinetics, baclofen and other drugs. Surgical treatment is also widely used and provide good results.

This review encompasses current trends regarding the use of dual tasks in recovering of cognitive functions in patients with ageassociated cognitive decline, traumatic brain injury and brain ischemia. The dual task represents a cognitive rehabilitation approach which implies the simultaneous execution of physical activity (walking, running or postural training) and cognitive tasks (internal counting, short-term memory and attention tasks, divergent tasks). Dual tasks with the simultaneous involvement of motor and cognitive functions are associated with specific features of brain activity and permit evaluation of the brain compensatory resources both in the normal state and in ageassociated cognitive decline or ischemic/ traumatic injury. The review also describes the basic neurophysiological mechanisms of the dual task-associated action on cognitive functions including transfer and interference. Performing of complex, multidirectional tasks provides a more efficient coordination of cognitive processes and improves the opportunities for successful cognitive functioning. The work underlines the high prevalence of cognitive impairment in cardiac surgery patients and shows the prospects of using dual tasks for the postoperative cognitive recovery. We assume that the rehabilitation using dual tasks involving brain areas providing executive control, working memory, attention and motor control can result in a pronounced cognitive recovery in cardiac surgery patients with cognitive impairment.

The central role of glycosylation has been well confirmed in numerous studies. In particular, a change in the glycosylation profile of antibodies is observed in infectious diseases, autoimmune disorders and cancer. The analysis of antibody glycosylation can lead to a promising improvement of existing strategies for the disease diagnosis. Specific changes in immunoglobulin glycan molecules can be used in the targeted therapy of multiple diseases, emphasizing the importance of glycans in antibody effector function. Altogether, use of sialylated immunoglobulins may contribute to the next breakthrough in the development of therapeutic drugs and vaccines of the next generation.

Inflammatory bowel disease, a group of inflammatory conditions of the colon and small intestine, principally includes ulcerative colitis and Crohn's disease. Current attention to inflammatory bowel disease is promoted by worldwide increase in its incidence and morbidity as well as shortcomings of existing treatment. Extraintestinal (musculoskeletal, skin, renal, hepatic etc.) manifestations of inflammatory bowel disease significantly complicate the diagnosis and may predict the development of intestinal symptoms. In certain cases, the severity of extraskeletal manifestations may exceed that of the main diagnosis. Here we describe a clinical example of this scenario.