Russian Medicine

BACKGROUND: Over the years, the birth rate in Russia has decreased due to a transformation in the family structure, a change in attitudes toward marriage and family, and economic and social reasons. The ratio of fertility and mortality determines the population reproduction regime, changing economic development and national security conditions. The analysis and assessment of the birth rate in the Chechen Republic is crucial because the results can be used to formulate a system of demographic policy measures considering national traditions of matrimonial behavior.

AIM: To develop recommendations for increasing the birth rate of the population in the Chechen Republic as a territory with strong traditions of the priority of family values.

MATERIALS AND METHODS: The study was conducted based on official statistics of the Chechen Republic for 2010–2021 and a sociological survey of mothers.

RESULTS: Medical and demographic processes in the territory of the Chechen Republic had a general unfavorable trend in the 12-year period from 2010 to 2021. The only positive aspect that can be considered is a threefold decrease in the birth rate in the same period among mothers aged >40 years, as older mothers carry a large burden of chronic pathology, causing a risk to the health of newborns.

CONCLUSION: Negative stable trends in age-specific decline in fertility in the reproductive period among women in the Chechen Republic indicated the unfavorable demographic situation in Russia, despite the priority of family values and stable traditions of large families. The reserves for improving the demographic situation in the region are hidden in the need for systematic information support for families to use their rights to state benefits aimed at protecting motherhood and childhood, monitoring and evaluating the effectiveness of these measures.

BACKGROUND: Biomonitoring is crucial for assessing the level of pollution in a population, identifying risks and studying the impact of changes in technology. Knowledge of the reference values of trace elements in biological material is critical in comparing exposed with non-exposed groups and accurate. The control values of trace elements are crucial for ensuring public health and occupational safety.

AIM: To study and analyze concentrations of priority chemical pollutants in the urine of adolescents aged 14–17 years in three zones in Kazan City and determine reference values for this age group.

MATERIALS AND METHODS: The concentration of elements in urine of 276 adolescents aged 14–17 years was measured by inductively coupled plasma mass spectrometry.

RESULTS: The upper 95 percentiles and their confidence intervals (RV95) were determined, which established the upper limit of the current background exposure to adolescents for 12 biomarkers, interpreted as “conditional” reference values for this age group. The following reference values for adolescents in Kazan City were obtained: Al, 12.80 µg/L; Cr, 1.02 µg/L; Mn, 3.53 µg/L; Hg, 0.65 µg/L; Cu, 110.91 µg/L, and Ni, 8.72 µg/L. In adolescents, the highest level of exceedance over background values was observed in zones 1 and 2 (Kirovsky and Privolzhsky Districts): Al exceeded by 1.4 times, Cr by 1.3 times in zone 1 (Kirovsky District), Mn by 1.5 times, Hg by 1.3 times, and Cu by 1.14 times in zone 2 (Privolzhsky district).The results are of interest for further analysis and identification of interrelations in the territory of the Republic of Tatarstan, Russia, where exposure levels may vary between regions or separate subgroups living in the same territory.

CONCLUSION: Research in the field of biomonitoring in Kazan established the levels of exposure to toxic elements among the studied population and provided means for comparing exposure for further research by population groups by age, sex, and ethnicity. Moreover, biomonitoring results can be used to determine research priorities, measure exposure trends over time, and verify effectiveness of individual measures to combat pollution and other measures in the field of the environment and public health. The study presents modern technologies for assessing exposure to chemical pollutants using human biomonitoring methods and demonstrates its advantages.

Obesity is considered as a noninfectious epidemic worldwide. Metabolic disorders associated with the accumulation of adipose tissue lead to obesity-associated diabetes mellitus and cardiovascular diseases. Diet is a component of treatment of diseases associated with obesity. The most commonly used diets are caloric restriction by reducing fat in the diet. Over the years, there have been several attempts to use diacylglycerol (DAG) as components of dietary oils owing to its ability to suppress the accumulation of visceral fat and reduce postprandial levels of triacylglycerol and cholesterol and glucose in the blood serum. However, in 2009, it was found that when oil was processed at high temperatures during physical refining, DAG-enriched oil had the highest levels of potentially harmful glycidyl esters compared to conventional refined fats and oils. The study of the negative effects of glycidyl esters has prompted the food industry, which has traditionally used oil, to focus on strategies in preventing or mitigating these effects by changing the refining process or modifying deodorization equipment to reduce or eliminate process contaminants.

Currently, laparoscopic mini-gastric bypass (LMGB) is a common bariatric surgical operation. One of the reasons for reoperations after LMGB is pathological bile reflux, which, in addition to a noticeable decrease in the quality of life of patients, poses a potential threat to the neoplastic processes in the stomach and esophagus.

This study aimed to systematize and analyze modern literature information on terminology, diagnosis and frequency of detection, pathophysiological significance, and methods of preventing bile reflux post-LMGB. Russian and English full-text studies on bile reflux after LMGB in the bibliographic databases of the Russian Science Citation Index, PubMed, Google Scholar, and ScienceDirect were analyzed.

The frequency of diagnosing bile reflux after LMGB varies from 2.0 to 57.9%, depending on the instrumental diagnostic methods used: flexible endoscopy, 24-hour pH impedance measurements, spectrophotometry of bilirubin in refluxate, and hepatobiliary scintigraphy. The pathogenetic effect of the contents of the small intestine on the mucous membrane of the stomach and esophagus after LMGB is noted because of the direct cytotoxic and receptor-mediated effects of bile acids. The safety of the main stages of LMGB (creation of a gastric pouch and formation of a single anastomosis) is currently being reviewed from the standpoint of minimizing the risk of developing bile reflux. Furthermore, novel techniques have been proposed to reduce the likelihood of intestinal contents entering the stomach and esophagus; however, their effectiveness remains controversial.

Currently, diseases of the urogenital system has acquired medical and social importance. This is primarily due to the significant prevalence of this group of diseases in the structure of general morbidity, disability, and mortality and their frequent recurrence and effect on the somatic and emotional state of the patient. In addition to socio-demographic problems, urogenital disorders have significant economic consequences. The total annual costs of treating uronephrological diseases, including accompanying therapy, are estimated at 40 billion US dollars. However, according to expert forecasts, by 2030, the prevalence of this group of diseases is expected to increase by 25%, as well as direct costs of disease treatment and indirect costs associated with partial or total disability due to disease development and premature death.

Thus, searching for and developing new drugs for the treatment of diseases of the urogenital organs are crucial. Chemical compounds, potentially significant in this aspect, can be obtained by organic synthesis and isolated from natural sources. Thus, exploring the potential of natural compounds that have high biological activity and favorable safety profile is a significant reason to realize and address this issue. An interesting but understudied groups of natural compounds of plant origin are humic substances. Recent preclinical studies have shown that they are able to exert antitumor, nephroprotective, and diuretic effects and exhibit antibacterial and antifungal properties.

This review aimed to summarize and systematize currently available information on the known pharmacological effects and possible mechanisms of action of humic acids and the prospects for their use in the treatment and prevention of genitourinary diseases.

BACKGROUND: Non-compact left ventricular myocardium is a rare heterogeneous pathology, which in the two-layer structure of the myocardium. There is no generally accepted definition of this form of pathology for both echocardiography and cardiac magnetic resonance imaging. Non-compact left ventricular myocardium can occur at any age and is often asymptomatic. Treatment of non-compact left ventricular myocardium is nonspecific and symptomatic.

DESCRIPTION: This study describes a clinical case of a young patient who was diagnosed with non-compact left ventricular myocardium. The disease debuted in the form of cardiac arrhythmia. Holter monitoring showed frequent ventricular extrasystole and atrioventricular block of the first and second degrees. Moreover, echocardiography revealed a decrease in global contractile function of the left ventricle. The diagnosis was made after magnetic resonance imaging of the heart, which revealed the presence of non-compact myocardium of the anterior, lateral, and inferior walls of the left ventricle in the apical and middle segments. Sustained rhythm disturbances were not induced in electrophysiological research by rapid and programmed stimulation. The patient was prescribed antiarrhythmic therapy, followed by echocardiography Holter monitoring. In the future, the patient needs regular monitoring by a cardiologist.

CONCLUSION: Non-compact left ventricular myocardium should be diagnosed at an early stage, so that life expectancy can be increased owing to timely treatment of heart failure and the use of oral anticoagulants, antiarrhythmic drugs, cardiac resynchronization therapy, cardioverter-defibrillator implantation, and heart transplantation when other treatment options are ineffective.