Analysis of the opinion of doctors about dental management of patients with heart rate disorders in the background of the application of anti-coagulant therapy

Diseases of the circulatory system are one of the main causes of death and disability in the population. The high prevalence of conditions associ-ated with heart rhythm disturbances is due to associated conditions and concomitant diseases, and this cohort of persons, as a rule, is on lifelong pharmacotherapy. In accordance with clinical guidelines, anticoagulant therapy is indicated for patients with heart rhythm disturbances, which can often pose a risk of microcirculation disturbance. Inflammatory processes in the oral cavity lead to endothelial dysfunction and microcirculation disorders, which is one of the predictors in the development of hypertension, which is associated with rhythm disturbances.Due to the possibility of developing microcirculation disorders and the risk of bleeding, it is important for a dentist to understand the features of the management and treatment of these patients, as well as approaches to the prevention of exacerbations of dental diseases.

Tanshinol Alleviates Microcirculation Disturbance and Impaired Bone Formation by Attenuating TXNIP Signaling in GIO Rats

Impaired bone formation is the main characteristics of glucocorticoid (GC)-induced osteoporosis (GIO), which can be ameliorated by tanshinol, an aqueous polyphenol isolated from Salvia miltiorrhiza Bunge. However, the underlying mechanism is still not entirely clear. In the present study, we determined the parameters related to microstructure and function of bone tissue, bone microcirculation, and TXNIP signaling to investigate the beneficial effects of tanshinol on skeleton and its molecular mechanism in GIO rats. Male Sprague-Dawley rats aged 4 months were administrated orally with distilled water (Con), tanshinol (Tan, 25 mg kg−1 d−1), prednisone (GC, 5 mg kg−1 d−1) and GC plus tanshinol (GC + Tan) for 14 weeks. The results demonstrated that tanshinol played a significant preventive role in bone loss, impaired microstructure, dysfunction of bone metabolism and poor bone quality, based on analysis of correlative parameters acquired from the measurement by using Micro-CT, histomorphometry, ELISA and biomechanical assay. Tanshinol also showed a significant protective effect in bone microcirculation according to the evidence of microvascular perfusion imaging of cancellous bone in GIO rats, as well as the migration ability of human endothelial cells (EA.hy926, EA cells). Moreover, tanshinol also attenuated GC-elicited the activation of TXNIP signaling pathway, and simultaneously reversed the down-regulation of Wnt and VEGF pathway as manifested by using Western-blot method in GIO rats, EA cells, and human osteoblast-like MG63 cells (MG cells). Collectively, our data highlighted that tanshinol ameliorated poor bone health mediated by activation of TXNIP signaling via inhibiting microcirculation disturbance and the following impaired bone formation in GIO rats.

Bladder neck stenosis after surgical treatment of patients with benign prostatic hyperplasia. Epidemiology. Modern treatment options

Introduction. With the development of modern technologies and treatment methods of benign prostatic hyperplasia (BPH), there is an increase in the number of operations performed for this disease. In this regard, the absolute number of complications is also growing. Bladder neck stenosis (BNS) is one of those complications. The purpose of this review is to update information about currently available methods of treatment of BNS and their effectiveness. Materials and methods. 352 articles from the PubMed database, the scientific electronic library elibrary.ru and the websites of professional urological associations were analyzed. After processing the data, 37 articles and one practical guide were selected for the review. Results. Chronic diseases that contribute to the violation of microcirculation in the area of bladder neck (BN) (diabetes mellitus, atherosclerosis), smoking are predisposing factors for the development of BNS. A small volume of the prostate (less than 30 ml) is an independent risk factor and requires special attention when choosing a treatment method for patients with BPH. The amount of thermal exposure to the BN area during surgery affects the degree of microcirculation disturbance and, accordingly, the risk of BNS. Endoscopic methods of correction of BNS have moderate effectiveness in its primary occurrence and low effectiveness in recurrent cases. Reconstructive methods of correction of BNS shown to be highly effective in recurrent cases. Conclusion. Etiopathogenesis of BNS is multifactorial and depends on endogenous and exogenous factors. Treatment options for BNS range from simple outpatient procedures to complex reconstructive interventions. Each of the treatment methods should be considered individually for each patient, taking into account the characteristics of the patient’s history.

Resveratrol Suppresses Severe Acute Pancreatitis-Induced Microcirculation Disturbance through Targeting SIRT1-FOXO1 Axis

Background. Resveratrol (RSV), one of the SIRT1 agonists, has the ability of alleviating severe acute pancreatitis (SAP); however, the concrete protective mechanism remains unknown. It is noteworthy that microcirculation disturbance plays a vital role in SAP, and the SIRT1/FOX1 axis can regulate microcirculation. Therefore, this study is aimed at ascertaining what is the underlying mechanism of the protective effect of RSV on SAP, and whether it is associated with alleviating microcirculation disturbance by regulating the SIRT1/FOX1 axis. Method. The model of SAP was induced by retrograde injection of sodium taurodeoxycholate into the bile duct of the rats. The pancreatic wet/dry weight, ET/NO, and TXB2/6-keto-PGF1α ratios; microcirculatory function; and SIRT1 activity were examined. ELISA was used to examine the serum level of lipase, amylase, hemorheology, ET, NO, TXB2, and 6-keto-PGF1α and the content of SIRT1, VEGF, Ang I, and Ang II in the pancreas. RT-PCR was used to examine the mRNA level of VEGF, Ang I, and Ang II. Western blotting was used to detect SIRT1, FOXO1, and acetyl-FOXO1. Immunoprecipitation was used to examine the interaction of SIRT1 and FOXO1. Results. Resveratrol can significantly decrease the expression of lipase, amylase, acetyl-FOXO1, VEGF, Ang II, ET, NO, TXB2, and 6-keto-PGF1α and the ratio of wet/dry weight, ET/NO, and TXB2/6-keto-PGF1α by improving microcirculatory dysfunction and blood viscosity in SAP. Moreover, resveratrol can also promote the interaction of SIRT1 and FOXO1 and increase SIRT1 activity and the expression of SIRT1 and Ang I. The SIRT1 inhibitor, Sirtinol (EX527), obliviously reversed the effects of RSV on SAP. Conclusion. Resveratrol can protect rats against SAP, and its protective mechanism is associated with suppressing microcirculation disturbance through activating SIRT1-FOXO1 axis.