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2018 year, number 1

1.
MONOPHENOL TS-13 IMPROVES SURVIVAL IN MICE INFECTED WITH VIRULENT MYCOBACTERIUM TUBERCULOSIS

Peter Mikhaylovich KOZHIN1, Anna Vladimirovna KOVNER1, Nikolay Konstantinovich ZENKOV1, Tatyana Igorevna PETRENKO2, Natal’ya Valer’evna KANDALINTSEVA3, Elena Bronislavovna MENSHCHIKOVA1
1Research Institute for Experimental and Clinical and Medicine
2Novosibirsk Research Institute for Tuberculosis
3Novosibirsk State Pedagogical University
Keywords: синтетический монофенол ТС-13, туберкулез, H37Rv, система Keap1/Nrf2/ARE, synthetic monophenol TS-13, tuberculosis, H37Rv, Keap1/Nrf2/ARE system

Abstract >>
The aim of the study was to determine the dose of a virulent strain of Mycobacterium tuberculosis H37Rv that is optimal for modeling experimental tuberculosis granulomatosis in mice and to investigate the effect of the original inductor of the Keap1/Nrf2/ARE system TS-13 (sodium 3- (3'- tert -butyl-4'-hydroxyphenyl) propylthiosulfonate) on animal survival and the dynamics of granuloma formation. Material and methods. Generalized tuberculosis granulomatosis was modeled by a single injection into the tail vein of male BALB/c mice of the 2-month-old M. tuberculosis strain H37Rv at doses of 106, 107 and 108 microbial bodies. Another group of animals on the day of infection with M. tuberculosis (107 microbial bodies) began to receive TS-13 with drinking water (100 mg/kg body weight). Survival was fixed daily; after 5 weeks, mice were euthanized and liver samples were taken for histological examination. Results and discussion. The dose of 107 microbial bodies was found to be the most adequate when modeling in BALB/c mice the tuberculosis granulomatosis caused by the intravenous injection of virulent M. tuberculosis strain H37Rv. At the 36th day after the injection of 107 microbial bodies, mortality was significantly lower in the group of mice receiving the inducer of the signal system Keap1/Nrf2/ARE monophenol TS-13 with drinking water (44 and 15% mice survived, respectively). At the same time, these two groups did not differ in the number and diameter of liver granulomas. The results show a high prospect of studying the role of oxidative stress and the redox-sensitive signal system Keap1/Nrf2/ARE in tuberculosis granulomatosis.



2.
EXPERIMENTAL STUDY OF THE ACUTE TOXICITY OF THE ORAL FORM OF PEGYLATED INTERFERON О±2-b

Dmitriy Nikolaevich KINSHT1,2, Pavel Gennad’evich MADONOV1,2, Tatyana Sergeevna TARTYNOVA1, Alexey Alexandrovich CHURIN3, Eugeniy Yur’evich SHERSTOBOEV3
1Novosibirsk State Medical University of Minzdrav of Russia
2Siberian Center of Pharmacology and Biotechnology
3Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center of RAS
Keywords: интерферон О±-2b, пегилирование, иммобилизация, острая токсичность, доклинические исследования, interferon О±-2b, pegylation, immobilization, acute toxicity, preclinical trials

Abstract >>
The aim of the study is to investigate the acute toxicity of the oral finished dosage form of pegylated interferon α-2b, obtained with the help of electron-beam synthesis technology. Material and methods. The preparation was orally administered to mice and rats at calculated therapeutic doses and doses exceeding them. Recorded parameters: animal death, general condition and behavior, weight of animals. Results and discussion. The drug has no toxic effect when administered orally. No macroscopic signs of gastric damage were found. The definition of LD is not possible.



3.
PRECLINICAL STUDY OF THE TOXICITY OF THE ORAL FORM OF PEGYLATED INTERFERON О±-2b UNDER ITS LONG-TERM USE

Alexey Alexandrovich CHURIN1, Eugeniy Yur’evich SHERSTOBOEV1, Dmitriy Nikolaevich KINSHT2,3, Tatyana Sergeevna TARTYNOVA2, Pavel Gennad’evich MADONOV2,3
1Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center of RAS
2Novosibirsk State Medical University of Minzdrav of Russia
3Siberian Center of Pharmacology and Biotechnology
Keywords: interferon О±-2b, pegylation, electron-beam immobilization, chronic toxicity, preclinical trials, интерферон О±-2b, пегилирование, электронно-лучевая иммобилизация, хроническая токсичность, доклинические исследования

Abstract >>
The aim of the study is to investigate the chronic toxicity of the oral finished dosage form of pegylated interferon α-2b, obtained with the help of electron-beam synthesis technology. Materials and methods. The preparation was orally administered to rats and rabbits at the calculated therapeutic doses and doses exceeding them. The drug effect on the general condition and body weight, hematological parameters, myelogram, blood biochemical parameters, excretory and cardiovascular system, CNS were studied. As well as pathomorphological examination was carried out. Results and discussion. The drug has no toxic and locally irritating effect under its long-term use per os.



4.
INVERSE RELATIONSHIP BETWEEN THE ANTIOXIDANT ACTIVITY OF STRUCTURALLY RELATED SYNTHETIC MONOPHENOLS AND THEIR TOXICITY IN TUMOR CELLS

Pavel Igorevich GAYNUTDINOV1, Peter Mikhaylovich KOZHIN1, Anton Vladimirovich CHECHUSHKOV1, Grigoriy Grigorievich MARTINOVICH2, Sergey Viktorovich KHOLSHIN3, Natal’ya Valer’evna KANDALINTSEVA3, Nikolay Konstantinovich ZENKOV1, Elena Bronislavovna MENSHCHIKOVA1
1Research Institute for Experimental and Clinical and Medicine
2Belarusian State University
3Novosibirsk State Pedagogical University
Keywords: монофенольные антиоксиданты, клетки MCF-7, клетки U937, жизнеспособность, токсичность, антиоксидантная активность, monophenolic antioxidants, MCF-7 cell line, U937 cell line, viability, toxicity, antioxidant activity

Abstract >>
The aim of the study was to study investigate the relationship between the antioxidant activity of new synthetic structurally related water-soluble monophenols and their effect on the tumor cell viability in vitro. Material and methods. Five original hydrophilic sulfur- and selenium-containing monophenols with varying length of the hydrocarbon chain of the para -alkylthiosulfonate substituent, the amount of tert -butyl ortho -substituents and the «S-S» fragment structure are synthesized: sodium 3-(3'- tert -butyl-4'-hydroxyphenyl)ethyl thiosulfonate (TS-12), sodium 3-(3'- tert -butyl-4'-hydroxyphenyl)propyl sulfonate (S-13), sodium 3-(3'- tert -butyl-4'-hydroxyphenyl)propyl seleniumsulfonate (SeS-13), sodium 3-(3'- tert -butyl-4'-hydroxyphenyl)propyl thiosulfonate (TS-13), sodium 3-(3',5'-di- tert -butyl-4’-hydroxyphenyl)propyl thiosulfonate (TS-17). The antioxidant activity of the compounds was determined in a cell-free model test system by the ability to inhibit the luminol-dependent chemiluminescence of free radical-generating azo compound AAPH. Antitumor cytotoxicity was evaluated by their effect on the viability of human histiocytic lymphoma cell line U937 (monocyte/macrophage-like cells) and human breast adenocarcinoma cell line MCF-7 in the MTT test. Results and discussion. All tested phenolic compounds exerted antioxidant activity in the cell-free model system (inhibition of azo initiator radical AAPH) and cytotoxicity against U937 and MCF-7 cells, the effect depended on the dose and structure of the molecule. There was a direct relationship between the structure of monophenols and their ability to inhibit the viability of tumor cells of different lines, regardless of the origin of the latter, myeloid (U937) or epithelial (MCF-7), and growth type (respectively anchorage-independent and attached), as well as the concentration range of compounds (respectively from 100 to 500 μM and from 2 to 150 μM). At the same time, the relationship between the antioxidant activity of monophenols and their cytotoxicity was inverse (when SeS-13 was excluded from analysis), which may be related both to the ability of the tumor to self-defense against reactivate oxygen metabolites and to the indirect pro-oxidant effect of phenolic compounds.



5.
EFFECT OF SINGLE AND MULTIPLE IMPACT OF HYPOXIC HYPOXIA OF STRONG INTENSITY ON THE STATE OF THE HEMOSTATIC SYSTEM IN RATS

Svetlana Valer’yevna MOSKALENKO1, Igor Il’yich SHAKHMATOV1,2, Yuliya Alekseevna BONDARCHUK1,2, Oksana Mikhaylovna ULITINA1,2, Olga Vasilevna ALEKSEEVA1,2
1Altai State Medical University of Minzdrav of Russia
2Research Institute of Physiology and Fundamental Medicine
Keywords: гипоксическая гипоксия, гемостаз, тромбоэластография, hypoxic hypoxia, hemostasis, thromboelastography

Abstract >>
The aim of the study was to analyze the state of the reaction of the hemostasis system in rats to a single and multiple exposures to hypoxic hypoxia of strong intensity. Material and methods. Male rats (40 individuals) of the Wistar line were used in the work. Animals have been subjected to a single / daily multiple hypoxic hypoxia by chamber ascent for 1 hour. Hypoxic hypoxia was modeled with the input-outlet chamber. The air discharge created in the pressure chamber in the training mode corresponded to the liftoff to the «height» of 7000 m above sea level (41.105 kPa, 308.3 mm Hg, hypoxia of strong intensity). Results and discussion. A single exposure to the strong intensity of hypoxic hypoxia is characterized by the state of thrombotic readiness (based on the revealed hypercoagulation and high level of markers of intravascular coagulation). The shortening of clot formation start time, increase in the α angle and the maximum bunch density were revealed according to the thromboelastography data. The activation of hemostasis system thrombocytic part, hypercoagulation through the internal clotting path with the thrombinemia signs disappearance have been revealed after completion of the 30-day cycle of severe intensity hypoxia. In addition, the increase in the blood plasma antithrombin reserve was found in the group of experimental animals. The lengthening of clot formation time was recorded by the thromboelastogram results.



6.
CULTIVATION AND CHARACTERISTICS OF MESENCHyMAL STEM CELLS FROM THE BONE MARROW OF THE PATIENTS WITH ORTHOPEDIC PATHOLOGY

Nataliya Mikhaylovna ASTAKHOVA1,2, Anastasiya Viktorovna KOREL1, Konstantin Evgen’evich ORISHCHENKO3, Yaroslav Reyngol’dovich EFREMOV3,4, Gleb Aleksandrovich KUDROV KUDROV1, Irina Anatol’evna KIRILOVA1
1Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan of Minzdrav of Russia
2Innovative Medical Technology Center (Medical TechnoPark)
3Institute of Cytology and Genetics of SB RAS
4Novosibirsk State University
Keywords: мезенхимальные стромальные клетки, костный мозг, диспластический коксоартроз, митотический индекс, скорость миграции, дифференцировка, регенерация кости и хряща

Abstract >>
The article presents data on the cultivation and characteristics of mesenchymal stem cells (MSC) isolated from the bone marrow of patients with dysplastic coxarthrosis. Several morphological phenotypes were found in the fraction of adhesive MSC: spindle-shaped elongated cells, large flattened cells, and thin stellate cells in both samples of bone marrow. Immunophenotypic analysis showed that cells express surface antigens (CD90, CD73, CD105, CD45 and CD34), which are characteristic for typical stem cells. It was shown that the use of a new growth medium containing no components of animal origin for the cultivation of human MSC allowed to achieve confluence of the cell culture on the 16th-8th day of incubation without delaying the proliferative activity of the cells and without loss of ability to differentiate into chondro- and osteogenic types of tissues. Multipotency of MSC was confirmed by osteogenic and chondrogenic differentiation of cells, during prolonged cultivation of MSCs in induction media in vitro . The differentiation of MSC into osteoblasts was confirmed by immunocytochemical staining for alkaline phosphatase and alizarin red S. Specific differentiation of MSC in chondrogenic type was revealed by staining of cartilage deposits with alcian blue. For the first time, such characteristics of human MSC as: mitotic index, trajectory of cells migration and average speed of migration on culture plastics were determined. The mitotic index of actively proliferating MSC was from 2.7 to 3.4 % of the total cell number. The moving activity (speed of cell migration) was 38-42 μm/h. Thus, bone marrow aspirate from patients with orthopedic pathology is the source of stem cells that meet all the criteria for MSC as determined by the International Society of Cellular Therapy and can be used in regenerative therapy of bone and cartilage.



7.
STRUCTURAL AND FUNCTIONAL STATE OF POLYMER COATING OF CORONARY STENTS AFTER EFFECTS OF THE ACCELERATED ELECTRONS FLOW

Pavel Gennad’evich MADONOV1, Michail Rudolfovich MASHKOVTSEV2, Svetlana Vladimirovna MISHENINA1, Andrey Vladimirovich DUBROVIN1, Pavel Nikolaevich MIROSHNIKOV1, Konstantin Igorevich Yershov1, Svetlana Vasil’evna POZDNYAKOVA1
1Novosibirsk State Medical University of Minzdrav of Russia
2Budker Institute of Nuclear Physics of SB RAS
Keywords: коронарные стенты с лекарственным покрытием, радиационное воздействие на коронарные стенты, высвобождение антипролиферативного лекарственного средства, coronary stents with drug coating, radiation effect on coronary stents, release of antiproliferative drug

Abstract >>
The article presents the results of investigation of the electron-beam processing effect by a stream of accelerated electrons on coronary stents with a drug coating. Experiments on the visualization of the polymer coating have been carried out, the parameters of the kinetics of the antiproliferative substance as a function of the radiation dose have been determined. Integrity of the drug-coated stents has been visually assessed by scanning electron microscopy and optical microscopy. The release kinetic have been evaluated by high-performance liquid chromatography method. It has been established that electron beam treatment by the stream of accelerated electrons leads to non-dangerous deformations of the coronary stents drug coating and to the increased yield of antiproliferative substance. Deformation sites of the elution system appear on the surface of the drug-eluting stents after electron-beam treatment by the stream of accelerated electrons at a dose of 1.5 and 3 Mrad. Prolonged diffusion of rapamycin from the treated stent creates concentrations greater than those when used untreated stent and depends on the radiation load in a dose-dependent manner. Stent electron beam treatment by the stream of accelerated electrons provides a high gradient of release of the antiproliferative substance from the elution system, exceeding that without treatment, for 10 days. Comparison of efficiency and safety allows us to consider the technology of electron beam processing as promising for the introduction into coronary stents production.



8.
INFLUENCE OF PRIMARY POSTERIOR CAPSULOREXIS ON THE ACTIVITY OF LOCAL INFLAMMATORY PROCESS AT FACOEMULSIFICATION OF COMPLICATED CATARACT ON THE BACKGROUND OF THE PSEUDOEXPHOLIATION SYNDROME

Elena Vladilenovna EGOROVA1, Olga Olegovna OBUKHOVA2, Olga Mikhaylovna GORBENKO2, Alya Petrovna SHVAYUK2, CHERNYKH1, Аleksandr Nikolaevich TRUNOV1,2
1The S.N. Fyodorov Eye Microsurgery Complex of Minzdrav of Russia, Novosibirsk branch
Valeriy Vyacheslavovich
2Research Institute of Experimental and Clinical Medicine
Keywords: осложненная катаракта, псевдоэксфолиативный синдром, задний капсулорексис, воспаление, цитокины, complicated cataract, pseudoexfoliation syndrome, posterior capsulorhexis, inflammation, cytokines

Abstract >>
Purpose: to study the activity of the local inflammatory process in patients with complicated cataracts with pseudoexfoliation syndrome before and after phacoemulsification with the primary posterior capsulorhexis. 54 patients (54 eyes) aged 50 to 92 years (76 ± 7.43) appealed for surgical treatment of complicated cataracts with pseudoexfoliation syndrome were examined. The concentration of IL-6, IL-10, MMP-9, TGF-β1 was determined in the tear fluid of patients before and on the 5th day of the postoperative period. It was established that the activity of local inflammatory process (high concentrations of IL-6 and MMP-9) is determined in patients with complicated cataracts with pseudoexfoliation syndrome. The identified increase in TGF-1 concentrations is a significant factor in the formation of the pseudoexfoliation material. It has been established that the use of a modified surgical technique in patients with pseudoexfoliation syndrome does not lead to activation of the local inflammation process



9.
NEUROLOGICAL ASPECTS OF vertigo DIAGNOSTICS AND TREATMENT (REVIEW)

Sergey Yurevich LAVRIK1, Aleksey Sergeevich BORISOV2, Vladimir Viktorovich SHPRAKH1
1Irkutsk State Medical Academy of Postgraduate Education - Branch of Russian Medical Academy of Continuing Professional Education of Minzdrav of Russia
2Clinics of Irkutsk State Medical University of Minzdrav of Russia
Keywords: головокружение, постуральная неустойчивость, отоневрология, vertigo, postural instability, otoneurology

Abstract >>
The analysis of contemporary literature data considering main reason and mechanisms of vestibular vertigo development in neurological patients has been carried out. The method of clinical and device-based investigation of spontaneous and induced nystagmus, differential-diagnostic signs of internal ear diseases, and main neurologic syndromes of vestibular system irritation and damage have been reported. The clinical peculiarities in patients with psychogenic vertigo and postural instability have been presented; the demand of deep analysis of pharmacologic interaction between the taken drugs in light of possible undesirable effects of conducted treatment has been demonstrated. According to majority of literature researches, the sharp and chronic cerebrovascular diseases matched by incidence with vestibular migraine have predominated among the neurological reasons of central vestibular vertigo. The neurinoma of vestibulocochlear nerve (among newgrowth) the most frequently leads to vertigo, however the awareness concerning brain space-occupying lesion is as well important in case of cerebellar or brainstem localization of the process. The relevance of screening otoneurologic examination and videonystagmography conduction has been demonstrated in differential diagnostics of vertigo different types. The modern effective and secure methods of the patients’ treatment and rehabilitation have been reported in the review. The role of vestibular trainings, as well as the use of simulators based on biological feedback principles have been emphasized.



10.
COMPLICATIONS of surgical THORACOSCOPIC METHODS OF BULLOUS EMPHYSEMA TREATMENT

Yuriy Vladimirovich CHIKINEV, Evgeniy Alexandrovich DROBYAZGIN, Anatoliy Yuryevich LITVINTSEV
Novosibirsk State Medical University of Minzdrav of Russia
Keywords: буллезная эмфизема легких, методы лечения буллезной формы эмфиземы легких, спонтанный пневмоторакс, эндоскопические методы лечения в торакальной хирургии, bullous emphysema, methods of treatment of bullous emphysema, spontaneous pneumothorax, endoscopic treatment in thoracic surgery

Abstract >>
The objective of research: analysis of complications after performing thoracoscopic techniques of surgery procedure in patients with spontaneous pneumothorax with bullous emphysema. Material and methods. 125 medical histories of patients with performance of thoracoscopic techniques of spontaneous pneumothorax surgery (from January 2010 to December 2017) were selected to research. Bullous presence in patients was proved by multispiral computed tomography of thoracic organs. Results and discussion. Spontaneous pneumothorax was found mostly in middle-aged male patients. In the vast majority of medical histories the bullous were determined in the upper lobes of lungs, oftener in the right lung. Complications arose in 40 patients. The main complication was the prolonged air leakage. Various techniques and combinations of surgical treatment were performed to reverse this complication. It was possible to achieve positive effect in all cases of prolonged air leakage. The air leakage was stopped within 2 days, that was confirmed by the control X-ray thoracic organs monitoring. Conclusion. The complications further classifying and prevention algorithm development are essential.



11.
TREATMENT OF RHEGMATOGENOUS RETINAL DETACHMENT, COMPLICATED BY PROLIFERATIVE VITREORETINOPATHY (REVIEW)

Oleg L’vovich FABRIKANTOV FABRIKANTOV1,2, Dmitriy Aleksandrovich KONYAEV1, Ruslan Esedullaevich OSMANOV1
1The S.N. Fyodorov Eye Microsurgery Complex, Tambov Branch
2Tambov State University n.a. G.R. Derzhavin
Keywords: офтальмология, регматогенная отслойка сетчатки, пролиферативная витреоретинопатия, ophthalmology, rhegmatogenous retinal detachment, proliferative vitreoretinopathy

Abstract >>
We have summarized the results of national and foreign studies dealing with the questions of proliferative vitreoretinopathy (PVR) pathogenesis, treatment and prophylaxis. Rhegmatogenous retinal detachment (RRD) is one of the most severe ocular diseases that very often leads to the significant reduction of visual functions, disability and if untreated to irreversible blindness. Many studies have proved that the postoperative functional result depends on a number of factors including the severity of proliferative retinopathy. PVR is a term that is inseparably linked with the description of a wide spectrum of vitreoretinal pathology accompanied by the processes of pathological membrane formation on the retinal surface and in the vitreous body, leading eventually to the irreversible and inoperable changes. Currently surgical method of PVR treatment is considered the most effective. Surgical technique in PVR depends on the stage of the disease. PVR diagnosis in the early stages is problematic, and the disease is diagnosed when discovering the epi- and/or subretinal proliferative membranes been already formed. Currently there are no criteria for assessing the possibility of PVR development and progression followed surgical treatment. Despite modern advances in the study of PVR etiology and pathogenesis, the improvement of surgical techniques of treating RRD, the problem of proliferative disease prevention and treatment remains topical and requires further treatment.



12.
PHYSICAL ACTIVITY WITH presence AND ABSENCE OF ISCHEMIC HEART DISEASE IN THE OPEN POPULATION (GENDER DIFFERENCES)

Aleksandr Mikhaylovich AKIMOV, Ekaterina Ivanovna GAKOVA, Alesya Aleksandrovna AKIMOVA, Vadim Anatolyevich KUZNETSOV
Tyumen Cardiology Research Center, Tomsk National Research Medical Center of RAS, Tomsk, Russia
Keywords: физическая активность, ишемическая болезнь сердца, открытая популяция, гендерные различия, physical activity, coronary artery disease, open population, gender differences

Abstract >>
Aim of the study was to determine the association between prevalence of coronary artery disease and attitude toward physical activity among persons of both sexes in open population of 25-64 years. Cardiological screening was conducted on a representative sample of the population (the response of 77.7 %). The allocation of various forms of CHD was carried out on the basis of standard epidemiological methods, identifying the physical activity by the WHO questionnaire «MONICA-psychosocial». The results of the study showed the desire of women (unlike men) regardless of the presence or absence of coronary artery disease to increase physical activity if they had no such opportunity. Men in groups with «defined» CHD and CHD according to extended criteria have become less mobile over the last 12 months.



13.
CORRELATION BETWEEN OBESITY AND TESTOSTERONE LEVEL, ANXIETY SYMPTOMS, DEPRESSION AND ACCELERATED AGING IN MEN

Olga Vasil'evna VASILEVA, Vera Georgievna SELYATITSKAYA
Research Institute of Experimental and Clinical Medicine
Keywords: мужчины, тестостерон, андрогенный дефицит, тревога, депрессия, эректильная дисфункция, ожирение, ускоренное старение, men, alarm, depression, androgen deficiency, erectile dysfunction, obesity, accelerated aging

Abstract >>
The aim of the investigation was to study the relationship of blood testosterone levels with the severity of anxiety signs, depression and urological pathology symptoms in men of mature age with normal weight, overweight and obesity. Material and methods: 188 men of 36.7 average age participated in the study. Anthropometric examination was carried out, the HADS questionnaire (Hospital Anxiety and Depression Scale, 1983) was used to assess the level of anxiety and depression; the severity of urinary disorders symptoms was evaluated with the scale of IPSS (International Prostate Symptom Score). To study the sexual dysfunction the international index of erectile dysfunction (ICEF-5) was applied. AMS Men's Age Symptoms (Aging Males Symptoms) questionnaire was used to identify clinical signs of androgen deficiency. The content of testosterone and cortisol in blood serum was determined by EIA. Results and discussion: The growth of androgen deficiency along with the increase in the urinary disorders symptoms, extended anxiety, depression and enhanced signs of erectile dysfunction have been revealed in men with overweight and obesity relating to the men with normal body weight. The androgen deficiency growth influences the aging processes acceleration. In turn, the presence of urological pathology in men can plays an important role in the obesity pathogenesis through the increase in anxiety and depression.



14.
THE STROKE: COMPARATIVE CHARACTERISTICS OF IRKUTSK AND SAKHALINSK REGIONS

Vladimir Viktorovich SHPRAKH1, Lyudmila Vital’evna STAKHOVSKAYA2, Ol’ga Anatol’evna KLOCHIKHINA2, Tatyana Ivanovna SURZHA3, Oleg Alexeevich STRAKHOV4
1Irkutsk State Medical Academy of Postgraduate Education - Affiliation of Russian Medical Academy of Continuing Professional Education of Minzdrav of Russia
2Russian National Research Medical University n.a. N. I. Pirogov of Minzdrav of Russia
3Yuzhno-Sakhalinsk Regional Hospital
4Moscow University for Industry and Finance В«Synergy»
Keywords: инсульт, заболеваемость, смертность, Иркутская область, Сахалинская область, stroke, incidence rate, mortality rate, Irkutsk region, Sakhalinsk region

Abstract >>
The prospecting multicenter population-based stroke research provides scientific, medical and economic interests as a priority area for the study of stroke. The aim of study - to investigate and compare the dynamics of the stroke incidence and mortality in the Irkutsk and Sakhalin regions. Material and methods. The stroke study has been carried out in the Sverdlovsk district of Irkutsk and Yuzhno-Sakhalinsk for 2009-2014 using the population-based register method, according to the protocol of the international training course MONICA (1985-1995). In the regions studied, data collection was carried out in a uniform manner by unvarying researchers team during the 6-year period. The diagnosis of stroke met the criteria of ICD 10 revision. The diagnosis was established on the basis of CT/MRI and/or autopsy in the event of a lethal outcome. All cases of acute stroke (the first 28 days from the disease onset) that occurred in the studied populations in the age group 25-74 years were recorded and analyzed. The analysis involved 2196 cases of stroke in Irkutsk and 2619 cases of stroke in Yuzhno-Sakhalinsk. Results. In 2009 the incidence of stroke among men was 4.43 cases per 1000 in Yuzhno-Sakhalinsk and 3.97 cases in Irkutsk. During 2009 to 2014, the incidence rate among men decreased by 17 % in Irkutsk ( р > 0.05) and by 23 % in Yuzhno-Sakhalinsk. The incidence of stroke among women in Irkutsk dropped by 16 % ( р > 0.05), in Yuzhno-Sakhalinsk - by 11 % ( p > 0.05). The mortality rate from stroke among men was 1.11/1000 in Irkutsk, 1.68/1000 in Yuzhno-Sakhalinsk in 2009, the indicator showed a similar decrease of 47 and 53 % in 2014 ( p < 0.01). The death rate also decreased among women in Irkutsk by 58 % ( р < 0.01) and increased by 26 % ( р < 0.05 among women in Yuzhno-Sakhalinsk). Since 2009 the reorganization of care for patients with stroke was carried out in the regions studied within the framework of a unified national program, the results of the study were the criterion of the effectiveness of the integrated program. Conclusion. The comparison study of stroke incidence and mortality rate in the urban population among men and women in the 25-74 age group of the Irkutsk and Sakhalin regions demonstrated the effectiveness of integrated stroke management activities in two regions located in the Eastern part of the country. The results of the study showed general dynamics features of incidence and mortality from stroke and drew attention to the regional specific features of the stroke occurrence and course.