Kazan State Medical University

We studied ex vivo effect of α2A/D-adrenoreceptor (α2A/D-AR) antagonist RX821002 at concentrations of 10–9-10–6 M on inotropy, chronotropy, and coronary flow in Langendorff-isolated rat heart. The minimum concentration of the antagonist did not affect the studied cardiac parameters. The α2A/D-AR antagonist at the concentrations of 10–8-10–6 M increased contraction pressure of the left ventricular myocardium and coronary flow. RX821002 exerted a positive and negative chronotropic effect depending on the concentration. Application of RX821002 at a concentration of 10–7 M caused dual-effect: both an increase and a decrease in heart rate were observed. The most pronounced changes in chronotropy and inotropy were revealed after application of α2A/D-AR blocker at a concentration of 10–7 M.

Primary Chiari malformation type 1 (CM1) and type 0 (CM0) appear to share features of overcrowding of the posterior cranial fossa (PCF) neural elements. We carried out the present study to identify anatomical features differentiating primary Chiari malformation type 1 (CM1) from Chiari malformation type 0 (CM0) and normal subjects, and then used those anatomic features for CM1 and CM0 phenotyping and diagnosis. This study included two groups of adult patients: CM0 with syringomyelia (SM) (CM0-SM) having cerebellar tonsillar descent ≤ 2 mm below the foramen magnum (FM), CM1 with syringomyelia (CM1-SM) with tonsillar herniation (TH) > 3 mm, and normal controls. Clinical data and MRI parameters were analyzed. CM1 and CM0 associated with SM share anatomic characteristics of PCF hypoplasia, size reduction, and flattening, and share clinical findings of occipital headache and cervical central myelopathy. CM1 has more pronounced PCF hypoplasia, narrower FM CSF pathways, and more expansive and extensive syringes than CM0, while CM0 has reduced FM size. Combining two MRI morphometric markers predicted CM1 with a sensitivity of 94

Introduction. SARS-CoV-2 infection during gestation is associated with dramatically increased incidence of major obstetrical syndromes (МOS). Aim: to evaluate a combined impact of COVID-19 contracted during the first or second trimester of pregnancy, baseline somatic history as well as the VDR gene rs2228570 polymorphism on МOS risk manifestation. Materials and Methods. This study involved 299 pregnant women. Initially, the participants were allocated into two groups: the primary cohort comprised patients who underwent SARS-CoV-2 infection during the first or second trimester of gestation (Group 1, n = 146), while the control group consisted of pregnant women with no history of infectious pathology (Group 2, n = 153). Based on the pattern of gestational outcomes, the cohorts were stratified into subgroups: 1a (МOS manifestation, n = 40) and 1b (physiological outcomes, n = 106) within the infected cohort; 2a (МOS presence, n = 16) and 2b (uncomplicated gestation, n = 137) within the control group. Molecular genetic testing of the VDR gene rs2228570 locus was performed by real-time PCR, followed by statistical data processing. Results. COVID-19 contracted during pregnancy increased the overall МOS incidence by 2.6-fold (p = 0.0002), with predominance of severe preeclampsia (p = 0.018; odds ratio (OR) = 5.55). The manifestation of placenta-associated complications was linked to the presence of respiratory (p = 0.018) and digestive (p = 0.022) system diseases. The VDR gene rs2228570 locus did not influence the risk of SARS-CoV-2 infection during gestation (p = 0.297) but acted as a significant МOS predictor of placental decompensation in the post-COVID period (p = 0.0007). The presence of the AG genotype increased the risk of MOS development by 4.2-fold (95 % confidence interval (CI) = 1.47–11.81; p = 0.0056), whereas the GG genotype elevated it by 7.3-fold (95 % CI = 2.22–23.93; p = 0.0009). Conclusion. The VDR gene rs2228570 polymorphism does not determine the risk of SARS-CoV-2 infection during pregnancy; however, under post-infectious conditions, the carriage of the G allele may serve as МOS predictor developing in concomitant respiratory and digestive system diseases.

Pancreaticoduodenectomy (PDR) is the primary surgical treatment for periampullary malignancies. Late complications after PDR occur in 31.5 % of cases. The most serious of these are biliary anastomotic strictures and bile duct stone formation (biliary complications), which can occur in up to 10.2 %.Aim: to analyze the literature concerning the causes of biliary complications, particularly stone formation in the bile ducts after PDR, and the treatment methods for these patients.Key points. Predisposing factors for stone formation after PDR include bile stasis (due to anastomotic stricture), remnants of suture material or clips, infection, and reflux of intestinal contents into the bile ducts. The choice of a minimally invasive treatment method for patients with bile duct stones after PDR depends on the qualifications of specialists and the technical resources of the medical institution. The endoscopic approach is characterized by rapid clinical success and shorter hospitalization but has a lower technical success rate due to altered anatomy. Percutaneous access is a highly effective minimally invasive treatment for late biliary complications, which can be used as a firstline option or in cases where endoscopic intervention has failed. The use of absorbable suture material, minimizing the number of anastomotic sutures, various hepaticoplasty techniques, and avoiding excessive bile duct mobilization may help prevent stone formation after pancreaticoduodenectomy.Conclusion. Bile duct stones as a complication of the late postoperative period of PDR require highly qualified surgical care, including minimally invasive techniques. Further research is needed to identify possible ways to prevent and improve treatment methods for biliary complications of postpartum biliary reflux.

OBJECTIVE:To evaluate the safety and efficacy of Fortelyzin during bridging therapy (thrombolysis followed by thrombectomy) in real-world clinical practice using data from the FORPI registry. MATERIAL AND METHODS:The FORPI registry is an open-label, prospective, non-interventional observational study of Fortelyzin in patients with acute ischemic stroke. In this article we analyzed the safety and efficacy of Fortelyzin in patients undergoing thrombolysis followed by thrombectomy. The safety outcomes were the rate of symptomatic intracranial hemorrhage (sICH) according to ECASS III and SITS-MOST definitions, as well as all-cause mortality on day 90. The efficacy outcome was a good functional recovery, defined by mRS score of 0-2 on day 90. RESULTS:The analysis included 1116 patients undergoing thrombolysis followed by thrombectomy who were enrolled in a registry at 120 medical cites in 55 regions of the Russian Federation. The median patient age was 69 (61-77) years. The median NIHSS score at admission was 15 (12-19) points. The sICH rate according to ECASS III was 13% (144/1116), and according to SITS-MOST was 9% (98/1116). In hospital mortality rate was 27% (301/1116 patients). All-cause mortality on day 90 was 29% (322/1116 patients). Good functional outcome (mRS 0-2) on day 90 was achieved in 38% (422/1116) of patients. CONCLUSION:This study demonstrates the safety and efficacy of Fortelizin in bridging therapy of acute ischemic stroke in real-world clinical practice.