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The article presents a theoretical rationale and a clinical case of relief of post-COVID ventilation failure by inhalation of Xe and O-2 gas mixture. Pneumonitis of coronavirus etiology transforms saturated phospholipids of surfactant into a solid-ordered phase, which disrupts surface tension, alveolar pneumatization, and alveolar-capillary gas exchange. Using molecular modeling (B3LYP/lanl2dz; GAUSSIAN09), we demonstrated that Xe atom due to the van der Waals dispersion interaction increases the distance between the phospholipid acyl chains providing a phase transition from the solid-ordered to liquid phase and restored the surface-active monolayer surfactant film. A clinical case confirmed that short-term inhalations of the Xe and O-2 gas mixture relieved manifestations of ventilation insufficiency and increased SpO(2) and pneumatization of the terminal parts of the lungs.

Hypertrophic cardiomyopathy (HCM) is the most common genetically determined heart pathology and is often accompanied by fatal complications. Today, the traditional view of the monogenic origin of HCM is being replaced by the idea of it as an oligogenic disease, the clinical phenotype of which is determined not only by mutations in the genes encoding sarcomere proteins in cardiomyocytes, but also by the contribution of other genes (other sarcomeric genes, non-sarcomeric protein-coding modifier genes, and regulatory non-coding RNA genes). Transcriptome analysis is an informative approach for elucidating the nature of HCM, which allows one to evaluate the expression of all genes, evaluate the effect of mutations in a gene on its transcript level, and reveal the mechanisms involved in the regulation of gene expression. This review presents an analysis of published data on the spectra of genes whose differential expression has been detected in the myocardium during the development of HCM in humans and model animals. Special attention is paid to the genes of non-coding regulatory RNAs: miRNAs and long non-coding RNAs, which may be involved in the pathogenesis of the disease. We analyzed studies devoted to the investigation of miRNA levels in the blood of HCM patients to explore the available diagnostic and prognostic biomarkers of the disease. The totality of the reviewed data, despite their relative scarcity, indicates the effectiveness of transcriptome profiling in studying the molecular mechanisms of HCM pathogenesis.

Objective: To study the effect of intense physical exertion on the normal physiology of the left ventricle (LV).Material and Methods. 146 professional athletes underwent a non-invasive assessment of LV systolic deformity in various directions. As a control group, 22 bowling athletes were surveyed.Results. In cyclists, eccentric hypertrophy of the LV myocardium was detected in 31.7% of men and in 29.5% of women. The values of global longitudinal strain were below 18% in male athletes from the cycling-BMX and cycling-highway groups (17.70±2.40% and 17.50±2.39%, respectively). Indicators of circular apical and circular global deformation were significantly lower in the group of cycling-BMX (men) compared with the corresponding values in the bowling group (14.50±6.23% and 14.70±6.42%; 18.40±6.32% and 16.90±6.43%, respectively, p

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This research was supported by FMBA of Russia Background. There are still very limited data about physiological cardiac adaptation in strength athletes. Purpose. To describe structural and functional features of left ventricular (LV) in a large cohort of healthy strength athletes. Methods. A total of 673 Caucasian athletes (weight-lifting, males/females = 238/157, and Martial Arts, males/females = 200/78) competing in Russian National and International level events were recruited within 2010-2017. Data of standard 2D echocardiography (Echo) and comprehensive medical history were analyzed. Data are presented as median (IQR) and compared by nonparametric tests (table). To assess LV geometry all athletes were divided into 6 groups according to 4-tiered classification based on mass index, concentricity and end-diastolic volume (EDV) index of LV (Figure). Results. Both absolute and indexed values of LV structural features were higher in males. Females exhibited higher functional parameters. Only 54 (8%) athletes had elevated LV mass (no sex difference), 23 (3.4%) – LV wall ≥ 12mm (only males) and 78 (11.6%) – changes in LV geometry. There was a prevalence of females in eccentric non-dilated LV hypertrophy (LVH) group (p = 0.088), which was previously accepted as a benign pattern of LV remodelling in non-athlete populations. Males had more often concentric types of LV remodelling (36 of 54 athletes). Among dilated types of LVH, there was a prevalence of males (p = 0.070). Conclusions. LV remodelling is not common in strength athletes and differs by sex with a more favourable profile in females. Clinical and Echo parameters Total n = 673 males n = 438 females n = 235 males vs females p-value Age, years 20(4) 20(4) 20(5) 0.06 BSA, m² 1.84(0.39) 1.96(0.39) 1.66(0.25) Abstract Figure. Types of LV geometry in athletes

To detect the reason of left ventricular hypertrophy (LVH) may be difficult in some cases especially in elite athletes. Object. To evaluate the efficiency of next generation sequencing (NGS) genetic test in differential diagnostics of pathological LVH in elite athletes. Material and methods. Analysis of echocardiographic data from 791 elite athletes revealed 15 individuals with LVH > 12 mm (1,9%). Based on the criteria of abnormality (asymmetric, severe and changes on electrocardiogram) 5 (0,6%) athletes were selected for genetic test. TruSight Cardio panel (“Illumina”) was used to identify variants of 174 genes with known associations to inherited cardiac conditions. Results. In 3 out of 5 athletes the pathogenic variants in MBPC3 and LMNA genes previously associated with HCM and other CMs were found. One athlete with negative genetic test result had severe untreated arterial hypertension as a possible cause for LVH. The second athlete didn’t have LVH in magnetic resonance imaging. Conclusions. In elite athletes, the asymmetric LVH should be considered as pathological finding which requires comprehensive clinical evaluation and NGS genetic test.

Identification of risk factors associated with presence of atrial fibrillation (AF) in patients with aortic valve stenosis (AS) remains to be unraveled.The aim of the study was to investigate relationship between profibrotic biomarkers and presence of AF in AS patientsMethods. 191 patients (29,8% male, 77,7±0,59 years) with AS (defined as aortic valve area (AVA) ≤ 2,0 sm2) were enrolled in the study. Clinical, echocardiographic and biochemical variables, including serum TGFβ1 and osteopontin levels were compared between 2 groups of patients: with and without AF. Results. 83(36,5%) of AS patients had AF. In logistic regression models independent associations between AVA index (p=0,040), left atrial volume (p=0,021), OPN (р=0,009) and presence of AF were found. Patients with serum OPN level > 10,05 ng/ml had twice more higher AF incidence comparedto patients with serum OPN level ≤ 10,05 ng/ml (53,8% and 29,2%, respectively, p=0,020).Conclusion. Serum OPN level was independently associated with presence of AF in AS patients, thus we speculate on it’s predominant profibrotic role in the left atrium.

The left three-atrial heart (LTH) is a rare congenital abnormality where the left auricle (LA) is divided into two chambers with an additional membrane. This article describes for the first time a clinical case of congenital heart defect with four atrial chambers. A 41-old man was hospitalized for newly diagnosed paroxysmal atrial fibrillation. On transthoracic echocardiogram (EchoCG), LA was considerably enlarged and divided into two equal interconnected parts with a membrane. Additional examination with contrast-enhanced EchoCG and computed tomography revealed two membranes dividing the LA into three chambers. Prediction for the patient was beneficial since there were no other developmental abnormalities of the heart, and the LA transmembrane pressure gradient (PG) was small. Data of literature on the incidence and prognosis of LTH are provided.

Background: Development and maintenance of registries of patients with rare diseases helps to determine the prevalence thereof, assess quality of medical care rendering, develop possible ways of optimizing patient management and calculate the necessary budget. Objective: Our aim was to study validity of including pediatric patients to the federal osteogenesis imperfecta registry and to determine disease characteristics, current or previous treatment. Methods: We conducted a retrospective study of the data on patients with ost eogenesis imperfecta included in the federal registry of the Ministry of Health of Russia. We provide results of the first registry audit. We analyzed the clinical and laboratory data provided in the medical documentation. Results: Validity of inclusion of patients with osteogenesis imperfecta in the registry was confirmed for 323 (96.4%) patients out of 335. In most cases (> 90%), bone fractures take place at the age of 6 months or later. Conclusion: It is reasonable to develop an electronic individual record form for patients with osteogenesis imperfecta for long-term monitoring of health condition and the conducted treatment.

The analysis was implemented concerning informational statistic data characterizing health of children population of different age groups in the Russian Federation on the basis of results of dispensarization in its federal okrugs and subjects in 2014. The purpose of the study was to discover ways and modes of developing and increasing efficiency of preventive examinations of underage population. The following indices were analyzed: coverage of children population by preventive medical examinations, distribution according health groups and medical groups for physical culture involvement, level and stricture of established total and primary morbidity, rate of dispensary registration, requirements in additional consultations, examinations and treatment in out-patient condition, day hospital, day-and-night hospital and also coverage with all these medical services. In the most of the subjects of the Russian Federation a high level of coverage of underage population with preventive medical examinations is registered. The percentage of healthy children population in the Russian Federation comprises more than one third of all covered by dispensarization. The significant variations in indices of rate of healthy children and children with functional disorders and chronic diseases in subjects of the Russian Federation is determined by quality and accessibility of medical care at the regional level. The established total and primary morbidity of children population in significant percentage (more than one third) of the subjects has a level higher than a national one. The leading causes of morbidity in children are diseases of respiratory system, musculoskeletal system, nervous system. In adolescents, these causes are diseases of musculoskeletal system, eye diseases and diseases of respiratory system. Despite high prevalence of chronic pathology in children population of the Russian Federation, the guidelines concerning treatment and rehabilitation on the basis of results of preventive medical examinations were developed in inadequate scope. The regional characteristics of the results of dispensarization are established. These results made it possible to sort out the most unfavorable territories and to determine defects in its organization and absence of continuity between medeical institutions providing the given type of medical services.

Aortic stenosis (AS) is one of the most prevalent valvular heart disorders in patients older than 65 years. Regardless the studied molecular mechanisms of development and progression of the disease, surgical treatment is recently the only successful method of help. Due to lots of comorbidities of older patients, there are obstacles to recommend surgical valve replacement, even knowing an adverse prognosis of conservative treatment. Search for new approaches to earlier assessment of adverse risk factors, speed of progression of this disease, would help to evaluate the necessity of earlier treatment and could make to slow down the progression of the disease. One of directions for this — is a search for genetic markers. This review focuses on the main known molecular mechanisms and genetic markers related to them, that are associated with AS.

The state support programs for rural areas of Samara region was analyzed. Changes in the rural infrastructure were assessed by rural residents.

The article deals with basic principles and features of the fast and slow reading. Recommendations about work with various references (a book, a magazine, a newspaper) as well as plan and abstract preparation while working out a lecture by the teacher are made.

The choline transport into synaptosomes obtained from the rat brain striatum was studied in the presence and absence of Na+ ions within the pH range 3.9-9.1. The intrinsic tryptophan fluorescence was investigated in synaptosomes at varying pH. Three pH ranges with different interpositions of the Na(+)-dependent and Na(+)-independent uptake curves were revealed: acid, alkaline, and weak-acid regions. It is assumed that pH 6-7 may be important in regulation of the cholinergic function because of the complicated interpositions of the two curves. The Km and Vmax values of both the Na(+)-dependent and Na(+)-independent processes for the striatal fraction were calculated using Lineweaver-Burk plots at three pH values. Some differences in the intrinsic tryptophan fluorescence of the synaptosomal membrane were observed in the presence and absence of Na+ ions in the pH range 6-7, but they were not statistically significant. At the variations of pH the alterations in the choline transport system did not correspond to the total structural changes in the synaptosomal membrane, when monitored by intrinsic tryptophan fluorescence. The pH-evoked choline transport changes may be due to specific alterations in the choline transport-related proteins.

There are several stratification scales of major cardiovascular events rate for patients have gone through acute coronary syndrome (ACS). None of them is perfect one. Arterial hypertension is included into some scales for post ACS patients but the features of it and its impact on coronary artery disease after ACS have never studied before. We studied the reasonability of Pulse Wave Velocity (PWV) measurement for fatal events rate in hypertensive patients have gone through ACS. 326 patients were examined. They were enrolled into the study in stable condition on 10th day after ACS has occurred. As a result of two years observation the increase PWV on carotid-femoral segment associated with the most negative (fatal) events in hypertensive patients have gone through ACS.

Left ventricular hypertrophy (LVH) in patients with hypertensive disease is associated with unfavorable prognosis. Long term and effective antihypertensive therapy is capable to cause reverse development of LVH. We included in this study 72 patients (27 men, 45 women, age from 34 to 72 years) with untreated 1st and 2nd degree arterial hypertension (systolic blood pressure 140-179 mm Hg and/or diastolic blood pressure 99-109 mm Hg) and echocardiographical signs of LVH (left ventricular myocardial mass index120 g/m2 in men and100 g/m2 in women). After that the patients were randomized into 2 groups: the study group (39 patients, mean age 53.0+/-11.6 years) received combination of perindopril and indapamide in initial dose of 2 mg/0.625 mg, and comparison group (33 patients, mean age 54.4+/-8.2 years) received monotherapy with enalapril (10 mg). Once daily dosing of the preparation provided high level of compliance of patients with treatment. During 12-month therapy with combination of perindopril and indapamide target blood pressure (140/90) was achieved in 74.4% of patients, during monotherapy with enalapril--in 27.3% of patients. Significant decrease of left ventricular myocardial mass index (LVMMI) with combination therapy was observed by 6th month of treatment (from 260 to 234 g), with monotherapy within same period of time--from 267 to 260 g. As a result of 12 months therapy of patients with I-II degree of hypertension with perindopril and indapamide LVMMI decreased by 17.5% while monotherapy with enalapril was associated with 5.6% decrease of LVMMI. Lowering of LVMMI occurred mainly at the account of decrease of left ventricular wall thickness.

Protease activities in serum and urine of 116 children with glomerulonephritis and 16 healthy children were tested using chromogenic peptide substrates Z-Dala_Leu-Arg-pNA and Glp-Ala-ALa-Leu-pNa. We found the dependence between activity of serine proteinases and clinical, morphological forms of primary glomerulonephritis and hypertension.

The transfer of choline through neuronal membranes for acetylcholine (Ach) synthesis is a specific, high affinity and sodium-dependent process (HACU)(8,10,19).

Female mongrel albino rats were administered orally carbophos in a dose of 10 mg/kg (1/100 of LD50) on the 11th, 13th, 15th and 17th days of pregnancy. The antenatal administration of carbophos was shown to produce combined disturbances of the postnatal development of the mongrel albino rats manifesting themselves in changes of the maturation of sensomotor reflexes, cholinesterase activity, increased addiction both to carbophos and ethanol.