The role of nutrients and probiotics in treatment of depression

Currently, a growing amount of data is emerging on the role of various environmental factors (nutrients, gut microbiota, etc.) on formation of depression. The impact on these factors can be effective not only in treatment of major depressive disorder, but also in its early prevention. Therefore, a more detailed study of environmental factors in depression can lead both to a better understanding of the etiology and pathogenesis of the disorder and to optimization of approaches to its treatment. The aim of the review was to assess the potential role of a number of environmental factors associated with nutritional aspects and characteristics of individual microflora, as well as to review the prospects of a strategy for affecting these factors in treatment and prevention of depression.

Work of a stroke team: experience of transferring ischemic stroke patients from district hospitals to Krasnoyarsk Regional Vascular Center for thrombectomy

Modern high-technology methods for ischemic stroke treatment (systemic thrombolysis, mechanical thrombectomy, thrombaspiration, stenting of cerebral arteries) can improve the rehabilitation potential and survival of patients. Important tasks here are selection for reperfusion and its performance on the greatest possible number of peracute patients. Mechanical thrombectomy combined with systemic thrombolysis is the most effective reperfusion strategy in the therapeutic window, but the availability of endovascular methods is limited to highly specialized centres. One way to solve this problem is to organize effective logistics with stroke patients, which will provide high-tech care for patients living far from large treatment centers due to regulated interaction between institutions at different levels.The aim of the study was to improve emergency interaction related to transfer of peracute stroke patients from primary vascular units and district hospitals of the Krasnoyarsk region to Krasnoyarsk Regional Vascular Center for thrombectomy.

The effect of antipsychotic-induced extrapyramidal disorders on patient’s compliance with schizophrenia (a clinical case)

Extrapyramidal disorders are common adverse events in antipsychotic therapy. However, their diagnosis is difficult due to broad differential diagnosis, and often their specific clinical variant is not recognized, and timely intervention is not performed, which leads to severe patient suffering. This affects the quality of life of patients with schizophrenia and leads to their refusal to receive therapy, which aggravates the course of the disease. The article presents a clinical case of a 33-year-old patient at a psychiatric hospital with schizophrenia combined with such rare severe extrapyramidal disorders as antipsychotic-induced tardive dyskinesia and tardive dystonia.The diagnosis was carried out in accordance with the criteria of the International Classification of Diseases, Tenth Revision (ICD-10). The intensity of clinical manifestations was assessed using the Positive and Negative Syndrome Scale (PANSS), the Abnormal Involuntary Movement Scale (AIMS), and the Barnes Akathisia Rating Scale (BARS). Compliance was assessed using the Method for Measuring Medication Adherence in Psychiatry. Detailed differential diagnosis of tardive dyskinesia and tardive dystonia with akathisia and Huntington’s disease was presented. Substantiated treatment strategy and positive clinical dynamics with increased compliance were described.

A clinical case of secondary hypertension in a young woman with coarctation of the aorta

The article presents a case of diagnosis and treatment of coarctation of the aorta in a 20-year-old woman, who previously received follow-up care with the diagnosis of hypertension. This case demonstrates the importance of qualitative examination of young patients with hypertension, including tonometry in the lower extremities and transthoracic echocardiography. The peculiarities of this clinical case encompass a rarer, isolated type of coarctation of the aorta and high physical fitness of the patient, which reduced doctors’ alertness regarding this anomaly. After surgical correction, a significant decrease in the blood pressure was achieved; however, such patients need longterm follow-up in order to detect complications, such as aneurysms, restenosis, or residual stenosis.

Epicutaneous sensitization. what do we know?

Background. According to the currently existing hypothesis, epicutaneous sensitization is one of the leading mechanisms in the development of food allergy.The aim of this review was to analyze immune mechanisms in epicutaneous sensitization and the role of skin barrier impairment.We performed a literature search using PubMed, UpToDate, Web of Science, and Scopus databases by the key words: epicutaneous sensitization, atopic dermatitis, skin barrier impairment, food allergy. Articles were to be in open access and present the most relevant information on the topic. Studies were selected by the largest sample size and the highest citation index. Once publications were identified, they were reviewed by all the authors to select the studies that specifically addressed the theme of the review. A total of 101 publications from 1998–2000 were included in the study.This review article discusses the data of experimental studies, sets out modern ideas about the hypothesis of a double exposure to an allergen, and presents research data proving the clinical significance of epicutaneous sensitization in relation to food allergy. Knowledge about the mechanisms of epicutaneous sensitization development is necessary to elaborate strategies for prevention of food allergy. One of the modern trends in prevention is the use of emollients, which are supposed to restore the skin response. However, studies on preventive intake of emollients do not present a similar viewpoint.There is not enough evidence for or against the mechanism of epicutaneous sensitization as an indispensable condition for the formation of food allergies. Further research in this area is required.

Artificial neural networks in cardiology: analysis of graphic data

Aim. To consider application of convolutional neural networks for processing medical images in various fields of cardiology and cardiac surgery using publications from 2016 to 2019 as an example.Materials and methods. In the study, we used the following scientific databases: PubMed Central, ArXiv, ResearchGate. The cited publications were grouped by the area of interest (heart, aorta, carotid arteries).Results. The general principle of work of the technology under consideration was described, the results were shown, and the main areas of application of this technology in the studies under consideration were described. For most of the studies, sample sizes were given. The author’s view on the development of convolutional neural networks in medicine was presented and some limiting factors for their distribution were listed.Conclusion. A brief overview shows possible areas of application of convolutional neural networks in the fields of cardiology and cardiac surgery. Without denying the existing problems, this type of artificial neural networks may help many doctors and researchers in the future.

Possibilities of conservative treatment of patients with lymphedema of the extremities (literature review)

The literature review describes various methods for treating patients with lymphedema of the extremities. Statistics show an increase in the incidence and disability of patients with this pathology. However, the possibilities of therapeutic measures in lymphedema are far from perfect.The analysis of literature data showed that the basis of treatment for lymphedema of the extremities is comprehensive conservative therapy with the use of pathogenetically grounded physical, mechanical, and medical methods. In complex schemes of conservative treatment for lymphedema, physiotherapy methods occupy a prominent place. The most common technique among them is regular combined decongestive therapy. This method is recognized by leading experts as the main one in treating patients with lower extremity lymphedema. Commitment of patients to treatment and their social and psychological counseling are of great importance. The choice of the volume and method of surgical intervention requires a difficult and individual assessment of pathological changes developing throughout the course of the disease.Despite certain improvements in treatment methods, lower extremity lymphedema is still an unsolved issue. The experience of most specialists involved in lymphedema treatment demonstrates a reasonable balance between basic conservative and surgical treatment methods. Undoubtedly, results of evaluation of these methods will improve the choice of an optimal technique for treating patients with lymphedema of the extremities.

Synaptic transmission molecules and their role in the pathogenesis of allergic rhinitis

Immune cells and molecules, as well as synaptic transmission molecules play a regulatory role in the communication pathways of the entire body when it is necessary to engage all body resources in the fight against infections or tumor cells wherever they appear. In potential allergy, the neuroimmune network controls allergen tolerance maintenance at both local and systemic levels.The review focuses on different neurotransmitters and our understanding of a balance and imbalance between the immune system and the nervous system in allergic inflammation, including allergic rhinitis. However, the pathogenesis of the two endotypes of rhinitis (conventional allergic rhinitis and local allergic rhinitis) and the impact of the neuroimmune network on it remain unresolved.

The role of herpes and human papillomavirus infection in prostate and bladder carcinogenesis

Human papillomavirus (HPV) is a small epithelial, non-enveloped, double-stranded DNA virus that belongs to the Papillomaviridae family. HPV infection is one of the most common sexually transmitted infections, and certain types of HPV are known to be carcinogenic to humans. According to the scientific literature, there is reliable information about the role of highly oncogenic HPV types in the development of cervical, anal, vulvar, vaginal, penile, and oropharyngeal cancer.Currently, a relevant and promising research area is the study of the role of HPV infection in prostate cancer (PC) and bladder cancer (BC), but scientific data on the potential pathogenetic relationship between these phenomena remain contradictory. An in-depth study of the question how herpes and human papillomavirus affect the origin of malignant tumors of the prostate and bladder, as well as the course of these diseases, and the prognosis of their development can become a source of information for development of new approaches to their diagnosis, prevention, and monitoring of morbidity. This literature review analyzes the results of modern studies on the role of oncogenic HPV types in the carcinogenesis of PC and BC.

“Kynurenine switch” and obesity

Aim. To assess the concentrations of bacterial and eukaryotic metabolites mainly involved in indole, kynurenine, and serotonin pathways of tryptophan metabolism in a cohort of patients with obesity. Materials and methods. Using high-performance liquid chromatography with mass spectrometric detection, the concentrations of several serum metabolites, such as kynurenine, kynurenic acid, anthranilic acid, xanthurenic acid, quinolinic acid, 5-hydroxyindole-3-acetate, tryptamine, serotonin, indole-3-lactate, indole-3-acetate, indole-3- butyrate, indole-3-carboxaldehyde, indole-3-acrylate, and indole-3-propionate, were analyzed in a cohort of obese patients compared with healthy volunteers.Results. It was found that serum levels of tryptophan metabolites of microbial and eukaryotic origin were significantly increased in obese patients. Therefore, the concentration of kynurenine in the blood serum in obese patients was 2,413 ± 855 nmol / l, while in healthy volunteers of the same age group, the level of kynurenine in the blood serum was 2,122 ± 863 nmol / l. In obese patients, two acids formed due to kynurenine metabolism; the concentrations of kynurenic and quinolinic acids were increased in the blood serum. The concentration of kynurenic acid in the blood serum in obese patients was 21.1 ± 9.26 nmol / l, and in healthy patients, it was 16.8 ± 8.37 nmol / l. At the same time, the level of quinolinic acid in the blood serum in obese patients was 73.1 ± 54.4 nmol / l and in healthy volunteers – 56.8 ± 34.1 nmol / l. Normally, the level of quinolinic acid is 3.4 times higher than the concentration of kynurenic acid, and in case of obesity, there is a comparable increase in these acids in the blood serum.From indole derivatives, mainly of microbial origin, the concentrations of indole-3-lactate, indole-3-butyrate, and indole-3-acetate were significantly increased in the blood serum of obese patients. In obese patients, the serum concentration of 5-hydroxyindole-3-acetate was elevated to 74.6 ± 75.8 nmol / l (in healthy volunteers – 59.4 ± 36.6 nmol / l); indole-3-lactate – to 523 ± 251 nmol / l (in healthy volunteers – 433 ± 208 nmol / l); indole-3-acetate – to 1,633 ± 1,166 nmol / l (in healthy volunteers – 1,186 ± 826 nmol / l); and indole-3-butyrate – to 4.61 ± 3.31 nmol / l (in healthy volunteers – 3.85 ± 2.51 nmol / l).Conclusion. In case of obesity, the utilization of tryptophan was intensified by both the microbiota population and the macroorganism. It was found that obese patients had higher concentrations of kynurenine, quinolinic and kynurenic acids, indole-3-acetate, indole-3-lactate, indole-3-butyrate, and 5-hydroxyindole-3-acetate. Apparently, against the background of increased production of proinflammatory cytokines by adipocytes in obese patients, the “kynurenine switch” was activated which contributed to subsequent overproduction of tryptophan metabolites involved in the immune function of the macroorganism.