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Introduction. There is evidence of a connection between infectious and inflammatory lesions of the lower urinary tract and bladder cancer (BCa). However, there is virtually no data on the urine microbiota of middle-aged and elderly men with suspected BCa. This knowledge is extremely important from the point of view of studying the role of the infectious-inflammatory hypothesis in the genesis of BCa.Objective. To conduct a comparative assessment of the microbiota of bladder urine obtained during natural urination and bladder catheterization through standard and extended cultural studies in men with a presumptive diagnosis of non-muscle-invasive bladder cancer (NMIBC).Materials & methods. The prospective comparative study with consecutive patient recruitment included 23 men older than 45 years with suspected NMIBC based on clinical, laboratory and sonographic data, as well as with no history of infectious and inflammatory diseases of the kidneys and urinary tract, including sexually transmitted infections and recurrent infections of other organs and systems. A midstream urine samples and catheter-drained urine immediately before urethrocystoscopy were subjected to bacteriological analysis. Urine culture study was carried out using a standard set of nutrient media under aerobic cultivation conditions and an expanded set of nutrient media under aerobic and anaerobic cultivation conditions.Results. An anaerobic spectrum of microorganisms was predominantly detected in the urine of patients with suspected NMIBC. Moreover, Peptococcus spp. was more often found among anaerobic taxa. (70%), Eubacterium spp., Propionibacterium spp. (45% each, respectively), among representatives of the aerobes — Corynebacterium spp. (60%), S. lentus (up to 45%), S. haemolyticus (35%) and E. faecalis (30%). Data from a comparative analysis of the detection frequencies of microorganisms depending on the method of collecting material and the set of media for cultivation showed that more isolates are isolated in the midstream urine samples than in the study of catheter urine (2.9- and 1.9-fold with the standard and extended sets of media, respectively). In addition, when performing an extended bacteriological study compared to the standard method, the detection of microorganisms is 3.5-fold higher when examining an average portion of urine and 5.1-fold higher when examining catheter urine. The average number of microorganisms per one patient is also higher when using the extended method (midstream portion — 4.7 ± 1.9; catheterised urine — 2.3 ± 1.0) in comparison with the standard one (midstream portion — 1.3 ± 0.9; catheterised urine — 0.3 ± 0.5).Conclusion. Middle-aged and older men with NMIBC are characterized by asymptomatic bacteriuria in the form of a wide range of aerobic and anaerobic microorganisms. The urine pattern obtained with a urethral catheter contains a significantly narrower range of bacteria compared to the sample obtained through natural urination. It is advisable to carry out an extended cultural urine examination to study the characteristics of the microbiota / microbiome of the urine of the bladder immediately before the urethrocystoscopy procedure by collecting urine with a urethral catheter.

Introduction. The tendency of microorganisms to develop resistance mechanisms is a widely discussed and significant problem worldwide. Studying regional differences in the qualitative characteristics of microorganisms provides valuable information for empirically preventing and treating infectious complications, as well as providing an enhanced understanding of the variability in microbial community properties within the clinical context of diseases and patients' comorbidity status.Objective. To assess the antibiotic resistance of microorganisms isolated in high titers from the urine samples of patients with benign prostate hyperplasia (BPH) prior to surgery.Materials & Methods. This single-center, retrospective study conducted from March 2016 to February 2023 included 59 suprapubic-draining BPH-patients (Group I), 46 drainage-free BPH-patients with leukocyturia (Group II), and 44 drainage-free BPH-patients and no leukocyturia (Group III). Inclusion criteria: indications for BPH surgery, no history of sexually transmitted diseases, no symptoms of urinary tract infection, and no prostate cancer. The patient's voluntary informed consents to participate were also obtained.Results. The rates of resistance to ciprofloxacin in patients of Group I were statistically significantly higher compared to Group II (85.7% vs 55.6%, p = 0.002). Resistance of gram-negative microorganisms to meropenem and imipenem was higher in Group III compared to Group I (31.1% vs 13.7%, p = 0.006 for meropenem and 44.5% vs 9.8%, p = 0.001 for imipenem, respectively). Resistance of Gram-positive microorganisms to ampicillin in Groups I to III was 13.6%,6.3% and 20.0%, respectively with no significant difference between groups (p > 0.05). However, there was extremely high resistance among verified Gram-positive organisms to all the drugs in the fluoroquinolone class (ciprofloxacin, norfloxacin, levofloxacin) ranged from 63.6% to 80.0%.Conclusion. The present study demonstrates that the isolation frequency of antibiotic-resistant microorganisms from the urine sample of drainage-free BPH-patients or no clinical and laboratory signs of inflammation in the urinary tract is high. The presence of antibiotic resistance provides risks for developing difficult-to-control infectious complications. Currently, assessment of urine-derived microbial antibiotic resistance should be considered in every BPH-patient with indications for surgical management of bladder outlet obstruction, regardless of the presence of risk factors.

Introduction. Infectious complications (ICs) after transurethral resection of the prostate (TURP) are significant and potentially life-threatening conditions with an incidence 0.5% – 20.0%. Most publications provide data regarding early infectious complications. At the same time, there are currently no studies aimed at a comprehensive assessment of long-term infectious complications after TURP. The problem of prevention and treatment of ICs is also accompanied by insufficient understanding of the role of undiagnosed inflammation in prostate tissues and the lack of representative laboratory markers.Objective. To assess the prostate-specific antigen density (PSAd) as a predictor of long-term infectious complications after transurethral resection of the prostate and to determine the optimal cut-off value.Materials & methods. This single-center study included 162 patients who underwent mono- and bipolar TURP between 2016 – 2023. Inclusion criteria for the study: prostate volume 30–80 cm3, no history of urinary tract infections (UTIs) at the time of hospitalization and antibiotic treatment at least one month before surgery, possible presence of latent UTIs before surgery, no prostate cancer. Exclusion criteria were failure to meet inclusion criteria. Infectious complications assessed included upper and lower UTIs, as well as epididymitis, orchitis and prostatitis, confirmed by clinical and laboratory data. Prostate-specific antigen (PSA) assessment was performed < 2 days before surgery.Results. The median PSAd value was 0.04 [0.03; 0.08] ng/ml2, the variable was significantly different in non-infection and infection groups (0.04 and 0.08 ng/ml2, respectively, p = 0.009). The area under the curve (AUC) was 0.67 (95% CI [0.546 – 0.791]). The optimal cut-off value of the PSAd in prediction of long-term ICs was > 0.07 ng/ml2, sensitivity / specificity: 58.3% and 76.1%, respectively. The analysis showed more than 4 times higher odds of developing an infectious complication in PSAd > 0.07 ng/ml2 patients: OR 4.3 (95% CI [1.7 – 10.5], p = 0.001).Conclusion. This study demonstrates data that defines a new clinical non-oncological significance of PSAd as a predictor of the development of long-term infectious complications after TURP.

The prospects for the use of artificial intelligence (AI) are one of the most discussed topics in medicine today. The very possibility of having an omniscient virtual assistant at hand soon seems incredibly tempting, so it seems quite normally to see numerous reports on the application of each newly emerging advanced neural network technology in various fields of medicine and biotechnology. Of course, the emergence of ChatGPT caused the greatest public outcry in recent times, because the new natural language processing algorithm underlying it has allowed human to bring communication between man and machine to a whole new level. Of course, despite the myriad benefits of using AI, the use of ChatGPT and other AI tools in medicine raises many ethical and legal questions. However, it is worth remembering the history of the emergence of any other breakthrough technology to accept the existing controversy as an integral part of progress. The desire of a person to make his work easier and shift part of the work onto a computer always makes him take a step forward in the development of technologies, which, in the end, do not allow a person to work less, but make him work in a new way.

Discussion of risk factors for infectious complications in the general population of patients undergoing transurethral resection of the prostate, antibiotic prophylaxis and therapy has been going on for decades. Up to date, the problem of the manifestation of bacteriuria in clinical infectious processes at various periods, as well as the factors of the introduction of bacterial agents with their further subclinical circulation in the urinary and reproductive systems, seems to be little discussed. The insufficient knowledge of these issues is confirmed by a small number of studies covering mainly electrosurgical mono and bipolar technologies as the most common and studied over a long period of their existence. This review raises the problem of insufficient knowledge of the clinical structure of infections during transurethral surgery, assessment of their risk factors, antibiotic prophylaxis regimens and therapy.

Performing surgical interventions for benign prostate hyperplasia against the background of chronic urinary tract infection or prostatitis can adversely affect the course of the postoperative period and mediate the development of complications. Therefore, it is important to understand the pre- and postoperative bacterial status of the patients in various endourological surgical techniques and its relationship with possible infectious complications. This review raises the problem of insufficient knowledge regarding the clinical structure of infections during transurethral surgery, assessment of their relationship with the course of the underlying pathology and the severity of symptoms.

Aim. To study the prevalence of comorbidity affecting the choice of antihypertensive treatment, as well as the efficacy and safety of the application of a single pill combination of lysinopril, amlodipine and rosuvastatin (SPC LAR) in hypertensive patients.Material and methods. Observational epidemiological study with the participation of 626 doctors and 13037 hypertensive patients with high cardiovascular risk and dyslipidemia treated with SPC LAR were held in 24 cities of Russia from November 2020 to March 2021. Prevalence and types of comorbidity, changes of blood pressure (BP), of total cholesterol (TC) and blood glucose levels and adverse events were studied during observation. Patients had 3 visits – initially, after 4 and 12 weeks. The obtained data was recorded by doctors through a web portal.Results. Concominant cardiovascular diseases found in all patients (in 38.7% of cases – from 2 to 5 diseases). The most commonly diseases were coronary artery disease (43.1%), metabolic syndrome (36.6%), diabetes (25.2%), chronic heart failure (24.9%), cerebrovascular diseases (12.3%) and chronic obstructive pulmonary disease (0.5%). SPC LAR with minimal doses of components (in 41.1% of patients) or with reinforced antihypertensive or hypocholesterolemic effects, based on the experience of treatment, the patient was prescribed as starting treatment with doctors. Reducing the level of systolic and diastolic BP, as well as the level Tc, respectively, by 20.9%, 16.9% and 29.7% found during the study. Target levels of systolic BP were achieved in 97.6% of patients, diastolic BP – in 99.6%, and target levels TC ≤5 mmol/l, ≤4 mmol/l and ≤3 mmol/l were achieved, respectively, in 94.5%, 68.6% and 23.5% patients. No significant dynamics of the level of glycemia were not found. The treatment was well tolerated by patients. Side effects found in 0.53% of patients (more often there was a dry cough, feet edema and headache). Commitment to treatment was 92.7%.Conclusion. The modern hypertension phenotype has cardiovascular atherosclerosis-associated diseases, which justifies the need to combine antihypertensive and hypolipidemic therapy. Triple SPC LAR, which effectively controlled the blood pressure and improved the violation of lipid metabolism was prescribed to patients in this observational study. The low frequency of side effects and good tolerance of treatment was accompanied by a high adherence of patients to treatment.

Atrial fibrillation is a serious adverse reaction associated with the use of anticancer drugs. The aim of the study was to analyse scientific literature on the prevalence, pathophysiological mechanisms, and risk factors of anticancer drug-induced atrial fibrillation, ways of its prevention and treatment. The results of the study showed that the incidence of drug-induced atrial fibrillation varies depending on a specific anticancer drug and ranges from 1 to 86%. It is associated with the use of herbal anticancer agents, alkylating agents, protein kinase inhibitors, monoclonal antibodies, immunosuppressants, antitumor antibiotics, antimetabolites, hormonal anticancer agents, hormone antagonists, etc. Most often, atrial fibrillation develops following the use of such drugs as gemcitabine (in combination with vinorelbine), cisplatin, melphalan, ibrutinib, cetuximab, trastuzumab, alemtuzumab, and doxorubicin. It was demonstrated that the pathophysiological mechanisms underlying the development of atrial fibrillation induced by anticancer drugs include electrophysiological abnormalities, myocardial injury, inflammation, immune response, apoptosis, and oxidative stress. Risk factors for the development of anticancer drug-induced atrial fibrillation are not clearly defined yet and continue to be the subject of research. Prevention of drug-induced atrial fibrillation in cancer patients requires a multidisciplinary approach involving participation of an oncohematologist and a cardiologist. The doctors in charge should also be vigilant regarding potential development of this adverse reaction.

Introduction. The neurocirculatory asthenia often meets at young men of military age, making 75% in structure of diseases of a cardiovascular system. The condition of microcirculation at patients with neurocirculatory asthenia depending on the nature of vegetative disturbances is insufficiently studied.The purpose of the real research was studying of a condition of microcirculation according to a thermovision research at young men of military age with neurocirculatory asthenia depending on the nature of vegetative dysfunction.Materials and methods of a research. 169 young men aged from 17 till 21 year with neurocirculatory asthenia of primary genesis are examined. The control group was made by 60 almost healthy young men of the same age. At young men of military age with a neurocirculatory asthenia according to a thermovision research the condition of microcirculation is studied and 3 degrees of disturbance of the thermal drawing are established. The method of cardiointervalographia was used to study a functional condition of the autonomic nervous system. The following parameters were studied: type of vegetative regulation, reactivity of departments of the autonomic nervous system and vegetative provision of cardiac activity.Results of a research and discussion. Frequency of disturbances of microcirculation according to a thermovision research at young men of military age with neurocirculatory asthenia depending on type of vegetative regulation is studied. Frequency of disturbances of thermal drawing of III degree was authentically higher at young men with sympathetic type of vegetative regulation in comparison with normotonic type (р < 0.05). The assessment of frequency of disturbances of microcirculation according to a thermovision research at young men of military age with neurocirculatory asthenia depending on type of vegetative regulation and vegetative provision of cardiac activity is carried out. At disadaptation of vegetative provision of cardiac activity in all groups the III degree of disturbance of the thermal drawing is defined authentically more often (p < 0.01-0.05).Conclusions. At young men of military age the III degree of disturbance of the thermal drawing in most cases decides on sympathetic type of vegetative regulation at disadaptation of vegetative provision of cardiac activity.

Introduction. To improve the vibrating rollers in order to increase sealing capacity, reliability and vibration safety, the interaction of vibrating roller parts between each other and with compacted soil is simulated mathematically. The developed models are validated, i.e. compared with the results of experimental studies. However, the known results of experimental studies were obtained based on a relatively small list of vibrating roller models and soil types, as well as in a steady vibration mode. The paper presents the results of experimental studies, which used a vibratory drum of a roller to study its vertical vibration accelerations both in the steady vibration, as well as transient mode at turning the vibration generator on (speedup) and off (halt). This expands the range of opportunities to validate the existing and newly developed mathematical models.Materials and methods. Experimental studies of vertical vibration accelerations of a drum were conducted using the DM-617 vibrating roller when compacting natural sand-gravel aggregate. The accelerometer readings show high-frequency harmonics, which makes it significantly more difficult to determine amplitude values of vibration accelerations, therefore a low-frequency filter with a boundary frequency of 200 Hz was used for digital processing.Results. It was determined that when the DM-617 vibrating roller is compacting soil with maximum driving force within the range of variation of dynamic modulus of soil deformation Evd=14…25 MPа, amplitude values of vertical vibration accelerations of the vibratory drum are from 65... 77 to -61... -69 m/s2 . At the start-up (speedup) of vibration generator, acceleration amplitudes are 1.1 times higher than vertical accelerations of steady operation mode of the vibrating drum and practically do not depend on the dynamic modulus of soil deformation Evd. At turning off (stop) of the vibration generator, amplitude of vertical accelerations do not exceed the vertical accelerations of the steady operation mode of the vibratory drum.Discussion and conclusion. The vertical acceleration amplitudes of vibratory drums of DM-617 do not depend on the dynamic soil deformation modulus Evd, and this is consistent with the results of experimental studies of the vibratory drum mounted on DM-614. The obtained vertical vibration accelerations of the drum mounted on DM-617 in the steady vibration mode, as well as at switching the vibration generator on (speedup) and off (halt) make it possible to verify the existing and developed mathematical models of interaction of vibrating rollers with compacted soil.Financial transparency: the authors have no financial interest in the presented materials or methods. There is no conflict of interest.

Аim. To study the efficacy, tolerability and safety of using a fixed dose combination of an ACE inhibitor lisinopril with a prolonged-action diuretic indapamide in patients with degree 1-2 hypertension.Material and methods. Patients (n = 32) with uncontrolled 1-2 degrees hypertension, moderate or high cardiovascular risk, without severe comorbid diseases, who were prescribed a fixed dose combination of lisinopril (5, 10 or 20 mg) and indapamide (1.5 mg) were included in the observational study. All patients had home monitoring of blood pressure and diuresis, as well as assessment of subjective tolerance of treatment and registration of adverse events within 3 months of observation. Assessment of changes in circadian fluctuations in blood pressure and diuresis, the frequency of achieving the target blood pressure at the outpatient stage, as well as the subjective tolerance of treatment and adverse events during a three-month follow-up.Results. Target blood pressure was achieved in 44.5% of patients taking the fixed dose combination of lisinopril 5 mg + prolonged-acting indapamide1.5 mg; 76.9% – in patients taking the combination of lisinopril 10 mg + indapamide 1.5 mg; 78,6% – in patients taking the combination of lisinopril 20 mg + indapamide 1.5 mg. The achieved antihypertensive effect was characterized by daily circadian stability, accompanied by an improvement in the initially impaired day and night diuretic profile (increase in the share of daytime diuresis by 29.6% and 22.3% with a decrease in the share of nighttime diuresis by 35% and 49% when using a combination with lisinopril 5 and 10 mg, respectively). The treatment was well tolerated by patients and did not cause the development of serious adverse events. Reported adverse events (non-intense dry cough, headache, general weakness) were transient and did not require correction or withdrawal of treatment.Conclusion. The fixed dose combination of the ACE inhibitor lisinopril (5, 10 or 20 mg) and the long-acting thiazide-like diuretic indapamide (1.5 mg) had good antihypertensive efficacy with improved circadian blood pressure and diuresis profiles, acceptable tolerance and safety of treatment, as well as a simple choice of doses of the drug components.

Background. The prevalence of urinary tract infections (UTIs) in general and recurrent lower UTIs, in particular, constantly remains at a high level. Currently, more and more researchers are attempting to study the microbial biocenosis of the urinary tract in patients with UTIs in terms of the relationship between UTIs and patient's colon microbiota in order to detail the etiology and pathogenesis of these conditions as an insufficiently studied issue.Objectives. To study the microbiota of urine and colon, as well as significant correlations in these biotopes.Materials and methods. 169 patients with recurrent lower UTIs from the Urology Clinic and the Department of Microbiology and Virology No. 1 (Rostov State Medical University) were examined. Average age: 36.2 ± 4.7 years. Midstream urine samples for bacteriological examination was taken in accordance with the rules set out in the Clinical recommendations (2014) exactly observing the preanalytical stage. The study of the colon microbiota as well as the collection of material was carried out in accordance with the rules set forth in the industry standard (OS) OST 915000. 11.0004 - 2003, Order of the Ministry of Health of the Russian Federation No. 231 of 09/09/03. Guided by this standard, the interpretation of the results was conducted. Results' statistical processing was implemented using the SPSS version 23 package.Results. In patients with recurrent lower UTIs two significant quantitative correlation coefficients were detected. The first correlation coefficient showed inverse correlation between typical E. coli isolated from urine and Eubacterium spp. isolated from feces (r = -0.434, p = 0.009). The second correlation coefficient showed a direct correlation between the amount of Lactobacilli isolated from urine and Coalulase-negative Staphylococci (CoNS) isolated from feces, accordingly (r = -0.434, p = 0.009).When comparing the frequencies of detection of various microbiota taxa, three significant correlation coefficient were found in the loci under study: between Lactobacilli or Peptococci isolated from urine and CoNS verified in feces (PCC - 0.342, p = 0.031 and PCC - 0.341, p = 0.018, respectively), as well as between Peptococci detected in urine and Enterococci in feces (PCC - 0.349, p = 0.028).Conclusion. The data we obtained on significant correlation coefficients between microorganisms isolated from urine and colon indirectly confirm the translocation mechanism. Undoubtedly, further research is needed to study the mechanism of translocation of microorganisms from the intestines and other biotopes into the organs of the urinary system in order to understand the pathogenesis of this common group of diseases.

Introduction. Urinary tract infections of any localization are rarely considered in the context of the endogenous relationship of patient's urine microbiota and the microbiota of nearby biotopes. Nowadays, there are attempts to study the microbial interrelationships of the urinary system with nearby biotope to find fundamentally new solutions in the study of the etiology and pathogenesis of diseases, but now this problem remains almost unexplored.Purpose of the study. Analysis of the correlations between various taxa of the microbiota isolated from urine, vagina and intestines in patients with upper urinary tract infection.Materials and methods. According to the inclusion criteria, bacteriological examination of cystic urine, feces and posterior vaginal fornix discharge was performed on 60 women (18-65 years old) with acute obstructive pyelonephritis. The material was taken, transported and examined by standard methods, but with some modifications of nutrient media. Statistical calculations were performed in R "R ver 3.2" ("R Foundation for Statistical Computing", Vienna, Austria) with generally accepted significance coefficients.Results. 26 significant correlation coefficients were found in the urinary tract and the vagina when conducting a comparative correlation analysis between the microbiota taxa, and 21 in the urinary tract and intestine. Significant correlations between the general taxa were direct and a large proportion of them were in optional anaerobic microbiota. 28 significant correlation coefficients were found in most cases between aerobic and anaerobic taxa of microorganisms in the vagina and intestines.Conclusion. The obtained significant correlation coefficients between various microbiota taxa in the three studied biotopes are evidence of the relationship of these loci. However, further research is needed on the phylotyping and genotyping of the microbiota taxa of the urinary tract, vagina and intestines of patients with urinary tract infection.

Tis review describes different virus taxa that are more prevalent in some variants of urological pathology. Te search of articles was conducted in the information portals of Te Cochrane Database, MEDLINE / PubMed Database, eLIBRARY, ClinicalKey for the period 2008-2018. As a result, the most current and representative studies, containing an interpretation of the dynamics of opinions indicating the involvement of viruses in various urological diseases were selected. Te bacterial component is the most studied in the etiology and pathogenesis of inflammatory diseases, but the viral component, as a rule, remains outside the scope of routine examination of patients, which stagnates conducting of adequate therapy and prevention of infectious and inflammatory diseases in urology.

Objective: to analyze the dynamics of quality of life (QOL) in patients with prior osteoporotic vertebral compression fracture during an 18-month follow-up study. Subjects and methods. The investigation enrolled 219 patients (mean age, 67.6 years) with vertebral fracture from seven centers of the Russian Federation. QOL was assessed four times using the EQ-5D (EuroQoL-5D) and TTO (Time Trade-Off) questionnaires during an 18-month prospective follow-up study. The work was done within the framework of the International Multicenter Study ICUROS (The International Costs and Utilities Related to Osteoporotic Fractures Study) organized by the International Osteoporosis Foundation (www.icuros.org).Results and discussion. The patients with vertebral compression fracture showed a statistically significant decrease in QOL throughout the follow-up period. Immediately after the fracture, there was a dramatic decrease in the total EQ-5D score, followed by its gradual increase. However, the emerging trend in QOL recovery proved to be unstable, and by the end of the 18th month, it was significantly lower than that before the fracture. On the contrary, the TTO questionnaire showed that QOL drastically decreased immediately after fracture, but at month 4 it reached the level that was before the fracture, and remained stable until the end of the follow-up period.Conclusion. The performed investigation enabled us to obtain data on QOL using the EQ-5D (QOL assessment from the social point of view) and TTO (individual QOL assessment) in the population of residents of the Russian Federation, in men and women aged 50 years and older with osteoporotic vertebral compression fracture.

Fixed combinations of antihypertensive drugs are more actively used in practice for therapy of arterial hypertension and on the whole are positively assessed by doctors and by patients. The accumulated experience of separate application of drugs allowed defining variants of their rational combination and to formulate the following major criteria of joint application: presence of different and mutually reinforcing mechanisms of actions; validity of the greater effectiveness of combination with proof of good tolerability and presence of the fewer side effects. Currently the process of development of new fixed combinations of antihypertensive drugs is going on and the strategy of their application is made more precise taking into account the degree of the disease severity and the cardiovascular risk.

This study is devoted to the problem of arterial hypertension (AH), developing with age in women with idiopathic arterial hypotension (IAH).In the survey of 650 women doctors revealed the high frequency of AHI (up to 24,8% ), accompanied by every second or third case of periodic increase in blood pressure with clinical vascular symptoms. An important role in the prevention of hypertension on the background of IAG given to therapy with beta blockers, in particular, bisoprolol. Conducted in 27 women daily monitoring of blood pressure showed that, to revent the increase in BP in the background of the IAG, it is advisable to choose the starting dose of bisoprolol 2.5 mg, increasing it as needed under the control of blood pressure, heart rate and clinical symptoms. The most pronounced hemodynamic changes have occurred in patients receiving bisoprolol dose of 5 mg. however, almost a threefold increase in episodes of hypotension (hypotonic index) and is probably associated with increasing variability of systolic, AP, was regarded as unwanted excessive effect of the drug. Reducing the dosage of bisoprolol to 2.5 mg/day was accompanied by an almost threefold decrease in hypotonicindex and two-time decrease in BP variability. These changes occurred against the backdrop of milder antihypertensive effects and pulseraduction without any negative influence on positive clinical dynamics. . A reduction in the dose of bisoprolol during the titration of therapeutic effect lowered the risk of side reactions and improves the adherence of women with labile AD to treatment.

The results of an osteoporosis survey held around 153 traumatologists-orthopaedics are analyzed in this article. The survey aim: the assessment of an awareness level and opinion record among traumatologists-orthopaedics about diagnostics and treatment of osteoporosis and their participation in solving these problems. An executed survey revealed low level of the osteoporosis registration as an independent nosologic unit with individual ICS code. The registration was held barely by 23% of interviewed doctors. Despite the fact that there is a sufficient provision of X-ray densitometers (91% respondents showed) and osteoporosis prophylaxis centers in the regions (75% respondents showed) only 34% patients with diagnosis «osteoporosis» are guided to the X-ray densitometry. According to doctors’ opinions the X-ray radiography appears to be the leading research for osteoporosis diagnostics. The FRAX method is used in a real clinical practice rarely. Due to the doctors’ opinions the following results confirm the necessity of creation of fracture liaison service in our country that would deal with secondary prevention of osteoporotic fractures. This service should mobilize traumatologists-orthopaedics in order to increase the knowledge level of osteoporosis diagnostics and treatment.

Aim. To compare urodynamic effects of beta-blockers with different selectivity (propranolol, metoprolol, nebivolol) in patients with arterial hypertension (HT) and concomitant benign prostatic hyperplasia (BPH).Material and methods. 32 patients (aged 67,5 y.o. in average) with HT of 1-2 stages were involved in the study. All patients had BPH (prostate volume >40 sm3 , increase of residual urine volume) with moderate or severe low urinary tract symptoms (IPSS 8-25) and reduction of maximum urine flow rate to 5-13 ml/s. The urodynamic effect of beta-blockers was estimated by changes of urination frequency and uroflowmetry indices after single taking and 14-day therapy.Results. Propranolol and metoprolol led to aggravation of urination disorders. Nebivolol resulted in soft urodilating and urostimulating effects. It led to urination improvement and reduced a risk of urodynamic disorders.Conclusion. Urodynamic effects of cardiovascular drugs should be considered by practitioners especially in treatment of elderly patients.

Aim. To develop a test on tolerability of small alcohol doses (SAD), to study hemodynamic and vestibular changes induced by SAD during mono- and combined antihypertensive therapy.Material and methods. 30 healthy volunteers and 292 patients with arterial hypertension 1-2 stages were involved in the study. Tolerance to SAD was estimated in untreated hypertensive patients (n=77), patients receiving one (n=218), two (n=46) and three (n=28) antihypertensive drugs. Tolerance to SAD was evaluated by blood pressure changes as well as change of upright body balance and subjective sensations of the patient.Results. Hypotension and circulatory vestibular disorders can be induced by alcohol consumption during antihypertensive therapy. These disorders appear more often due to peripheral vasodilators as well as combined antihypertensive therapy.Conclusion. It is necessary to inform the patient about risk of alcohol taking and necessity to restrict of its dose during antihypertensive therapy.

Myocardial infarction is an extremely rare disease in paediatrics, yet it has a broad spectrum of causes, including illnesses affecting myocardium, coronary vessels, and a whole spectrum of hereditary diseases. The article describes a case of myocardial infarction in a healthy teenager and analyzes all possible causes of the disease.

29 women with postmenopausal osteoporosis, complicated by compression vertebral fractures were treated by infusion of zoledronic acid, 5 mg. The results were assessed using dual-energy X-ray absorptiometry. By 12 months BMD increased both in lumbar spine (mean 5,2% (σ=0,17) and in femoral neck (mean 3,9% (σ=0,20)); by 24 month the mean increase were 6,3% и 4,0% (σ=0,33) respectively. No new compression vertebral fractures were found.

Scientific literature analysis shows that osteoporotic bone fractures appear to be actual and socially significant problem of modern medicine. Patients’ treatment with this pathology should be complex and include osteoporosis pharmacotherapy. The perspective drug for this case is strontium ranelate. Experimental and clinic researches show its positive influence on osteoporotic fractures healing, possibility to increase implants stability by osteosynthesis, moreover it can improve microarchitectonics of bone tissue and functional results of treatment of patients with such a pathology. However, strontium ranelate application efficiency with osteoporotic bone fractures patients requires further investigations.

The paper considers the devised author’s method of pulmonary hypertension assessment in children with congenital heart diseases. 51 patients were made the test. According to the ECG data two types of reaction were noted after sildenafil intake: positive and negative. Positive reaction indicates pulmonary hypertension reversibility. This fact is the main condition for successful surgical heart disease correction.

Daily monitoring arterial pressure (DMAP) and definition endotehelin 1-21 immunofermentat a method was perfermed in 79 children and teenagers with type 1 diabetes mellitus (DM1) in the age 10—18 years, with duration of disease 2—16 years auskultative a method on the apparate “Shiller BR-102 plus” (Switzerland). Depending on a degree of expressiveness diabetic nephropathy (DN) patients have been distributed on three groups: 1st — normalalbuminuria (n = 31), 2nd — microalbumiuria (n = 32), 3rd — proteinuria (n = 16) and 16 person the control group comparable on a floor and age. At children and teenagers with DM1 according to DMAP, attributes of a labile arterial hypertension (AH), met at 34,1%, stable at 25,5%. Frequency of revealing of stable forms АГ depend on expressiveness DN. The daily rhythm the AP at patients DM1 was characterized by a low degree of night decrease the AP. 47,1% patients 1st groups, 72,7% patients 2nd and 75% patients 3rd had no adequate decrease the AP at night. Communication between the raised level endotehelin 1-21 with development and progressing diabetic nephropathy, and also with indicators diastolic AP is revealed.

Based on the data from 17 healthy volunteers and 110 patients with arterial hypertension (AH) and chronic heart failure (CHF), who underwent combined 24-hour monitoring of diuresis and blood pressure (BP), with three-hour and functional intervals (morning, midday, evening, night-time, and circadian) assessed, a complex parameter “diuresis – tension ratio” (DTR) was developed. This parameter reflects the ratio between diuresis (percentage of excreted to consumed water) and mean systolic BP (SBP) during the time (t) of diuresis measurement (DTRt = diuresis, % / mean SBP, mm Hg). In healthy people, normal DTR values were in the range of 75-90% / 120-135 mm Hg. In AH patients, fluid retention and BP increase in morning, midday, and, to a lesser extent, evening intervals were observed. Compensatory increase in night-time diuresis was inadequate in patients with CHF, being associated with circadian diuresis reduction to

Aim. То evaluate the diagnostic potential of the combination of 24-hour blood pressure and diuresis monitoring (CBPDM), to study the associations between diuresis and blood pressure (BP), to compare diuretic and antihypertensive activity of thiazide diuretics (tD) — hydrochlorothiazide (Hct) and loop diuretics (ID) such as furosem-ide and torasemide.Material and methods. In 110 patients with arterial hypertension (AH) and congestive heart failure (HF), CBPDM was performed with 1-, 3-hour and functional intervals (morning, day, evening, and night), combined with a diuretic taken once a day: Hct, furosemide and torasemide (100, 20 and 5 mg/day, respectively).Results. CBPDM demonstrated a strong correlation (r=0,5—0,75) between BP and diuresis in the patients examined. CBPDM with functional intervals was recommended for clinical practice use. CBPDM potential for circadian fluid and electrolyte metabolism and BP assessment, diuretic choice and effectiveness control was demonstrated. Torasemide benefits are related to its earlier, longer and more effective diuretic activity, as well as with lower risk of arterial hypotension.Conclusion. CBPDM is an important method for studying renal mechanisms of HF and AH, diagnosing fluid metabolism disturbances, choosing diuretic therapy and controlling its effectiveness. Diuretic therapy choice should be based on fluid balance assessment, taking into consideration the benefits of a ID torasemide.

Radionuclide assessment of pulmonary hemodynamics was performed in 45 children with congenital heart valve pathology and increased pulmonary blood flow. Radionuclide angiopulmonography was performed at rest and during acute pharmacological tests, before and after valve surgery. Basal and enalapril-stimulated plasma concentrations of stable NO metabolites (nitrite and nitrate anions) were measured. Radionuclide bolus speed dynamics after vasodilatator (niphedipine, enalapril) administration demonstrated pulmonary circulation reserve. Plasma levels of NO metabolites were used in erectile dysfunction verification.

Correlation between peripheral circulation (PC) disturbances and autonomous regulation of heart function was examined in young men with hypertensive neurocirculatory dystonia (HNCD). The study involved 141 young males, aged 16-21, including 111 individuals with HNCD and 20 healthy participants. Rhythmocardiography method, including cardiointervalography and correlative rhythmography, was used. For PC assessment, upper extremity rheography was performed. Vessel tonus index (VTI), and volume blood flow rate (VBFR) were calculated. In controls, normotensive CP type was registered more often than in HNCD participants; sympathicotonic CP type was observed in HNCP individuals only. Autonomous support (AS) of heart function in HNSD patients was decreased, or provided by sympathic autonomous nervous system.

We report on a search for ultralow-mass axionlike dark matter by analyzing the ratio of the spin-precession frequencies of stored ultracold neutrons and ^{199}Hg atoms for an axion-induced oscillating electric dipole moment of the neutron and an axion-wind spin-precession effect. No signal consistent with dark matter is observed for the axion mass range 10^{-24}≤m_{a}≤10^{-17} eV. Our null result sets the first laboratory constraints on the coupling of axion dark matter to gluons, which improve on astrophysical limits by up to 3 orders of magnitude, and also improves on previous laboratory constraints on the axion coupling to nucleons by up to a factor of 40.

We have practiced courses of treatment with dipyridamol (Curantil, Berlin-Chemie), 25 to 225 mg daily, 1-3 months long, in 55 patients with congestive heart failure NYHA III-IV class in conjuction with baseline treatment with ACE inhibitors, prolonged nitrates and diuretics. Treatment efficacy was controlled by thromboelastography, ADP-induced platelet aggregation and bifunctional daily BP and ECG monitoring. A dose-dependent and modulating antiaggregating effect of dipyridamol has been shown in the study. The usage of 225 mg Curantil daily (75 mg 3 times a day) resulted in an antiaggregating action in the first day, however, it was characterized by a higher risk of hypotension with concomitant baseline vasodilating therapy. Considerable antiaggregating effect of 75 mg Curnatil daily (25 mg 3 times a day) and 50-25 mg daily developed by the end of the first and, respectively, second week of treatment; the risk of arterial hypotension was non-significant. We conclude that for long-term prevention in patients with CHF administration of Curantil 75-25 mg daily is preferable. Determining individual sensitivity to the chosen dose (by BP dynamics) is rational before initiating the treatment.