Aim. To evaluate the effect of dalargin, a peripheral opiate receptor agonist, on the adaptive strategy of rats with different stress tolerance after the myocardial contusion.

Materials and Methods. The experiment was performed on 216 male rats weighing 250-300 g which were ranked according to stress resistance using the forced-swim (Porsolt) test and the open feld test. Rats were divided into 3 groups: control animals and those with a blunt cardiac injury, with or without dalargin administration (100 µg/kg intramuscularly 2 hours before anesthesia, immediately before injury, and 2 hours post injury). Each group included 3 subgroups (n = 8 rats per each) with high, medium, and low stress tolerance. Myocardial contusion was simulated using an original device. Blood levels of glucose, lactic acid, triglycerides, corticosterone, total protein, albumin, white blood cell count, reduced glutathione and total antioxidant capacity were measured in all rats 24 hours post injury.

Results. Myocardial contusion altered the metabolic profle to the stress-related pattern. The most signifcant increase in rectal temperature, white blood cell count, corticosterone, glucose, lactic acid, and triglyceride levels as well as maximum decrease in reduced glutathione and total myocardial antioxidant capacity were documented in animals with low stress tolerance. Administration of dalargin alleviated the stress response regardless of animal stress resistance.

Conclusion. Blunt cardiac injury and myocardial contusion induce stress response characterised by hypercatabolism, systemic infammatory response syndrome, and myocardial oxidative stress in all rats, with a most signifcant response in animals with low stress tolerance. A peripheral opiate receptor agonist dalargin did not change the response pattern but curbed the stress response.

Aim. To defne the role of Enterococcus spp. in the gut microbiota ensemble in patients with pulmonary tuberculosis. Materials and

Methods. Inoculation of intestinal cultures was performed in 64 patients with multidrug-resistant tuberculosis before the specific therapy (30 patients and 55 strains) and after 1 month of the treatment (34 patients and 63 strains). We then assessed the production of haemolysins, gelatinase, phospholipase, adhesion factors, and organic acids.

Results. A high prevalence of intestinal dysbiosis (66.7%) were detected in patients before the start of anti-tuberculosis therapy. Specifc treatment was associated with a decrease in Lactobacillus spp. along with an increase in C. perfringens and Candida spp. titers as well as with higher prevalence of E. coli lac. Before the treatment, Enterococcus spp. showed pronounced adhesion properties, providing colonization of the intestinal mucosa in titers of 6 (4; 7) lg CFU/g, although not producing invasion enzymes. Upon the 1 month of anti-tuberculosis treatment, adhesion capability reduced and 36% of the strains were low-adhesive. An increase of lipase-producing strains to 18% suggested the adaptation of Enterococcus spp. to a high content of lipids and fatty acids in the intestine.

Conclusion. In patients with pulmonary tuberculosis having high prevalence of intestinal dysbiosis, Enterococcus spp. are frequent symbionts well integrated into the gut microbiota.

Aim. To evaluate the effectiveness of PCR tests to diagnose common pathological conditions associated with vaginal discharge (i.e. bacterial vaginosis, aerobic vaginitis, and vulvovaginal candidiasis) in patients with and without complaints.

Materials and Methods. The study enrolled 240 women which flled out an original questionnaire on demographic, social, behavioral, and reproductive features and underwent a vaginal examination. Real-time PCR of vaginal smears was used to detect bacterial vaginosis, aerobic vaginitis, vulvovaginal candidiasis, and sexually transmitted infections (Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Mycoplasma genitalium).

Results. Sexually transmitted infections have not been detected in women included into the study. Almost half (46%) of the patients had gynecological complaints; these patients also had higher prevalence of vaginal dysbiosis. PCR analysis determined vaginal dysbiosis in > 45% of women with complaints. In around 25% women without any complaints, microorganisms prevailed over lactobacteria that suggested vaginal dysbiosis. Among the behavioural factors, only douching was signifcantly associated with vaginal dysbiosis.

Conclusion. PCR tests were able to defne vaginal dysbiosis in almost half of the patients and were effcient in patients both with or without complaints.

Aim. To determine the level of estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene in women with cervical weakness.

Materials and Methods. We retrospectively analysed case histories of 200 women, including 100 patients with cervical weakness defned by an ultrasound examination at 18-21 weeks of gestation and 100 patients without cervical weakness. Serum estradiol, progesterone, IgA and IgG to these hormones, and IgA/IgG to benzo[a]pyrene were measured at 18-21 weeks of gestation using enzyme-linked immunosorbent assay.

Results. Patients with cervical weakness had a higher level of serum estradiol [12477 (1000; 31600) pg/mL], IgA to progesterone [2.15 (0.6; 8.3) a.u.] and benzo[a]pyrene [4.74 (0.4; 13.9) a.u.], IgG to estradiol [8.64 (1.2; 23.5) a.u.], progesterone [5.29 (0.2; 20.1) a.u.], and benzo[a] pyrene [11.89 (1.1; 28.5) a.u.] as compared with those without [10946 (2999; 19480) pg/mL, p = 0.034]; [1.42 (0.6; 2.6) a.u., p = 0.034]; [3.22 (0.7; 5.7) a.u., p = 0.032]; [4.78 (0.7; 8.7) a.u., p < 0.0001]; [2.55 (0.2; 5.1) a.u., p < 0.0001]; [4.72 (0.4; 10.1) a.u., p < 0.0001]. An association between the preterm birth and levels of IgA to progesterone (p = 0.00017) and benzo[a]pyrene (p = 0.0003) was established.

Conclusion. Patients with cervical weakness were characterized by higher levels of IgA and IgG to estradiol, progesterone, and benzo[a]pyrene; notably, increased IgA to progesterone and benzo[a] pyrene correlated with a higher risk of preterm birth.

Aim. To calculate epidemic incidence thresholds for community-acquired pneumonia in the Irkutsk Region and to identify irregularities in the annual incidence trends.

Materials and Methods. We carried out a cross-sectional epidemiological study evaluating the relevant data from the Irkutsk Region during 2013-2020. To calculate the epidemic thresholds, we used weekly information for 2013-2018 about newly diagnosed cases of community-acquired pneumonia. Similar data for 2019 and 2020 were used for retrospective comparison with the calculated thresholds.

Results. Computation of the community-acquired pneumonia epidemic incidence thresholds is based on the weekly and 4-week calculation of the median and quartiles (Q1 ; Q3 ), which is conducted differentially for the total population, children (≤ 17 years of age), working adults (18-64 years of age) and pensioners (≥ 65 years of age) per 100,000 population. When compared with the upper epidemic threshold (Q3 ), seasonal changes in the incidence of community-acquired pneumonia have been revealed in 2019 and 2020; they were associated with the spread of infuenza, COVID-19, and an epidemic of unknown origin which was observed mostly among children.

Conclusion. Calculation of epidemic thresholds for the incidence of community-acquired pneumonia can be used in epidemiological surveillance.

Aim. To evaluate the epidemiological trends in HIV infection in the Tyumen Region between 1993 and 2019.

Materials and Methods. We studied incidence and prevalence of HIV infection in the Tyumen Region and assessed the pathways of HIV transmission on ascending stages of the epidemic process using the Cramer’s V, a measure of an association between two nominal variables. Gender involvement into the epidemic process was assessed using the McNemar’s test for paired nominal data whilst age involvement was evaluated by means of Pearson’s chi-squared test. The statistical results of calculating the linear correlation were considered signifcant at p<0.05.

Results. We subdivided the entire period of HIV epidemic (1993−2019) into the fve time frames. During the frst interval (from 1993 to 1997), a moderate increase in HIV infection was recorded. The second interval (from 1998 to 2000) was notable for a remarkable increase in the incidence of HIV infection, while this increment was reduced from 2001 to 2005. Yet, the incidence of HIV infection showed a steady increase from 2006 to 2016, although being lower in 2017 to 2019. The average incidence of HIV infection from 1993 to 2019 was 67.35 ± 7.6 per 100,000 population. The proportion of women among the HIV infection cases increased from 25.0% in 1993-1997 to 40.5% in 2017-2019. Since 2004, there has been a decrease in the HIV infection incidence in the age group ≤ 29 years of age, with a concurrent increase in older age groups. Since 2014, the majority of new HIV infection cases are registered between 30 and 34 years of age. Currently, there is a clear trend to rise of HIV infection incidence in older age groups (21.8% between 30 and 34 years of age, 21.9% between 35 and 39 years of age, and 16.4% between 40 and 44 years of age).

Conclusions. Despite the lowering incidence of HIV infection in the Tyumen Region from 2017 to 2019, it still remains high. HIV infection is increasingly frequent in women and between 30 and 39 years of age.

Aim. To determine the attitude of medical students to the vaccination against COVID-19.

Material and Methods. We conducted an anonymous survey of 756 students and residents of Kazan State Medical University from December, 1st to December, 31th, 2021, using a specially designed Google questionnaire. The questionnaire included questions aimed at assessing the level of awareness about the prevention of COVID-19 and attitude to vaccination.

Results. The median age of the respondents was 22 (19; 24) years. The vast majority of the respondents (94.0%, 711/756) received at least one dose of the vaccine, while 92.6% (700/756) subjects underwent a full vaccination. Vaccination rates were similar in students and residents. Despite rather high reactogenicity of vaccine preparations, none of the respondents experienced a strong reaction requiring a hospital admission. The asymptomatic course of the post-vaccination period after the frst and the second doses of the vaccine was noted by 4.8% and 14.5% respondents, respectively. The majority of respondents (58.9%, 445/756) believed that vaccination signifcantly reduces the risk of COVID-19 and 70% (529/756) supposed that vaccination protects against severe COVID-19 and death. The majority of respondents (53.7%) considered appropriate to introduce a mandatory vaccination against COVID-19, and 71.6% of respondents disagreed with the physicians opposing the vaccination.

Conclusion. The study revealed a high level of adherence to vaccination among the medical students and residents.

Aim. To develop an algorithm for the prediction of the atrial fbrillation onset in patients with metabolic syndrome (MS) and premature atrial contractions (PACs) in a prospective study.

Materials and Methods. We enrolled 1,726 MS patients (age range 45-75 years) with ≥ 100 PACs per day. We measured cardiac chamber volumes, left ventricle contractility, parameters of the atrial electrocardiogram, P-wave dispersion, and the origin of PACs, further calculating the potential index of atrial fbrillation (PI) according to the CHARGEAF (RCHARGE-AF) model. The follow-up was 1-5 years. Maintenance of sinus rhythm or development of atrial fbrillation (AF) were the study endpoints.

Results. Paroxysmal or persistent AF was registered in 218 (12.41%) patients. Elderly patients with MS and RCHARGE-AF score ≥ 0.72 units or predictors of AF development of AF (e.g., PACs or atrial enlargement) belonged to AF risk group. Development of AF in patients with MS correlated (OR > 3) with left atrial end-diastolic volume index > 34 mL/m2 with its average increase of +5% per year (OR = 3.3), RCHARGE-AF ≥ 0.72 (OR = 4.2), and PI < 8 units followed by an average regression of -20%/ year (OR = 14.8). The accuracy of predicting atrial fbrillation within 3-5 years before its onset was ≈ 60%, reaching ≥ 86% for the 3-year time frame.

Conclusion. Our forecasting algorithm can identify the risk groups and predict the development of AF in patients with MS and PACs.

Aim. To study the associations between empathy, anxiety, and compliance in patients with chronic gastritis.

Materials and Methods. Here we recruited 302 patients with chronic gastritis, further stratifed into 4 groups: 1) 96 patients with H. pylori-associated gastritis and high compliance; 2) 110 patients negative for Helicobacter pylori and also having high compliance; 3) 36 patients with H. pylori-associated gastritis and low compliance; 4) 60 patients with Helicobacter pylori-associated gastritis and partial compliance. Empathy was evaluated using Consultation and Relational Empathy Measure (CARE Measure) questionnaire, whilst anxiety was determined using the Spielberger-Khanin questionnaire.

Results. The highest Helicobacter pylori eradication rate was observed in patients with high empathy and adherence and vice versa. Correlation analysis showed that physician interpersonal skills, therapeutic success, and adherence to treatment were positively associated with patient empathy and negatively associated with patient anxiety.

Conclusion. Doctor-patient relationship defnes the patient compliance, while patient empathy is a key factor determining adherence to treatment in patients with chronic gastritis.

Q fever is a zoonotic infection caused by Coxiella burnetii. Infected goats, sheep and cattle, materials of animal origin, meat and dairy products are the main sources of C. burnetii for humans. Dust C. burnetii infection is of particular importance due to the high resistance of this pathogen. C. burnetii is considered as a biological weapon and its use as an aerosol causes acute diseases with further disability. Chronic C. burnetii infection can cause endocarditis, leading to a chronic fatigue syndrome or even death. In the Netherlands, a pronounced increase in the incidence of Q fever in humans was detected from 2007 to 2010 (≥ 4,000 acute cases), mostly associated with goat farms. Analysis of 10 C. burnetii genomes allowed molecular epidemiology screening of coding and non-coding structures for studding the possible origin of the outbreak strains. Strains Z3055 (sheep placenta, Germany) and NL3262 (goat placenta, Netherlands) are the most closely related (84.9% homologous sequence). Formal order analysis distinguished 6 groups of C. burnetii strains. Adaptation to a new host emerged as a driving force for the reorganization of C. burnetii genome. The largest epidemic of Q fever could occur because of an inadequate veterinary supervision that led to the epizootic and further epidemic in the farmers producing the goat cheese. The transition of the «sheep» (Z3055-like) strain to the «goat» (NL3262) strains, characterised by a change of the host during the epizootic, could signifcantly contribute to the severity of that Q fever epidemic.

A multimodal approach to prevent the cognitive impairment in patients with cardiovascular diseases combines the control of major cardiovascular risk factors, cognitive recovery, and physical training. Here we discuss current advances in computer-aided (also called computer-assisted) cognitive recovery to prevent the cognitive impairment in patients with cardiovascular diseases, as this approach has a number of advantages in comparison with the conventional tools. We describe a cognitive training software to stimulate perception, attention, short-term memory, executive functions, speech, and thinking. Baseline neurological examination and neuropsychological testing are mandatory before starting a cognitive recovery. A particular attention is paid to the high prevalence of cognitive impairment in cardiac surgery patients. Around half of them have pre-operative cognitive impairments, and almost half of the patients suffer from a postoperative cognitive dysfunction. Among the brain regions, prefrontal and parietal cortex and hippocampus are the most sensitive to circulatory disorders as they are supplied by the terminal branches of the cerebral arteries. Therefore, cognitive rehabilitation of cardiac surgery patients should include computer-aided cognitive training tasks activating these brain regions.

NFKB1 — a product of the same-name gene – is a transcription factor that regulates the expression of target genes which encode a wide range of proteins with properties essential for functioning of the body. Numerous studies confrmed the NFKB1 gene's contribution of the polymorphism to the processes of adaptation to climatic and geographical conditions, protection from infectious agents, as well as the pathogenesis of multifactorial diseases. In the materials supplied with the article is a summary of the results of published population-genetic and cohort studies of NFKB1. Summary data on the requencies of NFKB1 gene alleles (rs28362491, rs230521, rs4648068, rs3774937, rs3774959) in the population of Europe, Africa, South and East Asia, America, Eastern Russia and Siberia (according to the open databases from 1000 Genomes and Siberian projects) illustrates the pronounced genetic differentiation of world populations by polymorphic variants of NFKB1, which indirectly confrms their selective role. The signifcance of the aforementioned polymorphisms in the etiology and pathogenesis in a number of socially signifcant nosological forms was studied according to an analysis of materials from articles posted on NCBI platform from 2008 to 2021. As a result of deconstructing the data, it was found that changes in the structure of the promoter (del) and introns (SNP polymorphism) are able to modify the activity of the transcription factor NFKB1, through a change in the expression of the gene and the activity of its product. This information forms an ambiguous picture of associations of the NFKB1 gene polymorphic variants with oncological (ovarian, stomach, breast, bladder, colorectal cancer, Hodgkin's lymphoma, melanoma), cardiovascular (coronary heart disease, acute coronary syndrome, myocardial infarction, varicose veins), autoimmune and chronic infammatory diseases (obesity, chronic hepatitis, rheumatoid arthritis, Behcet's disease, psoriasis, acute infammatory reactions to the graft). Ambiguity of the established associative relations could be due to the modifying infuence of ethnic and population characteristics, as well as intensity of the infuence of phlogogenic factors. Nevertheless, the summarized data and generalizations published in the materials of the article can be used in development of a strategy for basic and screening studies in context of the etiology and pathogenesis of multifactorial diseases.