Background: Arterial hypertension (HTN) remains a key risk factor for cardiovascular disease burden and mortality. Efficacy of treatment differs across regions, depending on various medical facilities. Assessment of specific features of antihypertensive treatment (AHT) provided in cardiology outpatient care setting is of special interest.

Objective: To investigate comorbidity and cardiovascular risk factors and to determine the features of treatment in patients with HTN referred to federal cardiology center.

Design and methods: Retrospective analysis was conducted using 100 randomly selected electronic health records of patients who had attended to the Almazov National Medical Research Centre (former Federal Almazov North-West Medical Research Centre) seeking for doctor’s advice on cardiovascular diseases in the period from 2010-2013. Men (n=44) and women (n=56) aged 23 to 88 years (59 ± 13 years) represented a sample size. HTN was diagnosed as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or if patient had been receiving antihypertensive therapy. The efficacy of treatment was taken as target BP achievement by patients on AHT. Controlled hypertension shall mean the number of patients reached target BP levels among all hypertensives. AHT was analyzed with defining its type and groups of prescribed medications.

Results: In vast majority of cases HTN was associated with overt cardiovascular diseases. An incidence of tobacco smoking was minimal while obesity and diabetes mellitus were diagnosed typically in patients with HTN. Mean SBP and DBP levels were 143±23 mmHg and 87±11 mmHg, respectively. Antihypertensive treatment was prescribed for all hypertensive patients (n=82), 62% of them were taking medications (n = 51), while women were more adherent to doctors’ advices (p = 0.026). Effective treatment was observed in (n=40) 78% of cases, and in 65% (n = 53) of them HTN was controlled. Most patients were prescribed combination therapy (n = 65) 79%, more often – a threedrug combination (n=32, 48.5%). Antihypertensive drugs were mainly beta-adrenoblockers, ACE inhibitors and diuretics.

Conclusion: There is a strict association of HTN with overt cardiovascular diseases. More than half of the patients achieved adequate blood pressure control. Young female patients who take combination therapy regularly and those with concomitant chronic heart failure are likely to have HTN to be under control.

During the last two decades, endovascular technology has revolutionized the management of patients with abdominal aortic aneurysm (AAA). Today, endovascular aortic repair (EVAR) is the treatment of choice for the majority of patients with an AAA. Randomized controlled trials provide robust evidence for the indication of AAA repair and the rationale for the use of EVAR in selected patients. However, despite that, practice varies and several areas need further elucidation. Important future challenges and areas of research include the role of medical therapy in AAA, whether the indication for repair should be any different in women and in the elderly, and long-term follow-up of patients undergoing complex EVAR with adjuncts, both for elective treatment and for ruptured AAA. Continuous rapid technical and clinical development is to be expected. In this paper, we review the current practice and evidence of stenting in AAA.

Brugada syndrome is a rare hereditary arrhythmogenic disorder first described by Brugada brothers in 1992. Despite the large amount of clinical and experimental data, there is no complete understanding of genotype-phenotype relation in pathogenesis of the disease caused by missence mutations in SCN5A, which encodes the alpha-subunit of the major cardiac voltage-gated sodium channel Nav 1.5. The aim of this review is to summarize current knowledge on molecular, cellular and ionic mechanisms of the Brugada syndrome development. We focused on the clinical picture and physiological consequences of decreasing activity of Nav 1.5 and analyzed the impact of biophysical properties alterations on the pathological state. The mutation-specific influence of pharmacological agents and signalling proteins was described. 

Twin-to-twin transfusion syndrome – severe specific complication of monochorionic pregancy, which occurs in 10—15% monochorionic twins. The object of this paper is describing current treatment modalities of twin-totwin transfusion syndrome. Perinatal loss in case of conservative approach in twin-to-twin transfusion syndrome is more than 95%. Fetoscopic laser coagulation, amnioreduction, selective fetocide and preganancy termination are the current atreatment modalities of twin-to-twin transfusion syndrome. Fetoscopic laser coagulation is considered the most effective approach with highest rates of livebirth and the lowest maternal risks. In I stage twin-to-twin transfusion syndrome transabdominal amnioreductions can be effective, leading to resolving the disease. Intrauterine fetal surgery is the treatment of choice, preventing future morbidity in childhood and adolescence.

The purpose of the study was the testing of granular polymer materials (hypercross-linked polystyrene MN-202 (HPS) and two silica – coarse-grained silica gel large-pore 2 (CSL-2) and silochrome S-120 possessing sorption properties as activating hemocontact preparations.

Materials and methods. The hemocontact interaction was carried out under bench conditions using donor blood in a rotary mode. Blood samples were taken before the beginning of the experiment and after 5, 20, 40 and 60 minutes. Changes in cell and subcellular blood populations were assessed using the SySmex XT 1800i hematology analyzer (26 parameters), which made it possible to indirectly estimate the activation of blood cells. 45 experiments were conducted on 15 for each of the hemocontact preparations.

Results. Erythrocytes did not react to contact interaction with sorbents. The degree of expression of activation properties of sorbents for platelets falls in the series: Silochrom S-120> HPS > CSL-2. For leukocytes, this indicator increases from CSL-2 <SilochromS-120 < HPS. CSL-2 has practically no adhesive properties for leukocytes, i.e. it doesn’t activate leukocytes. The shift of the leukocyte formula (granulocytes / mononuclears) is most pronounced on the HPS granules (1,40→0,76), a bit less on Silochrome S-120 (1,41→ 0,97) and very weakly on CSL-2 (1,38→1,26).

Conclusion. Approved granular polymer materials can be used as hemocontact preparations for the activation of blood cells (platelets, leukocytes) and changes in the spectrum (qualitatively and quantitatively) of bioactive substances in the blood when carrying out low-volume hemoperfusion.

The paper investigated the fluorescence of two fluorescent dyes — fluorescein and indocyanine green bonded with magnetite and silica nanoparticles in comparison with colloidal quantum dots of nanocrystals of AgInS2 / ZnS in vitro on a fluorescent imager IVIS Lumina LT Series III. Studies showed that quantum dots have sufficient luminous efficiency, in comparison with fluorescent dyes, for this type of diagnosis. The effect of quenching of fluorescence in the mixture with blood was observed, which makes impossible the usage of colloidal quantum dots QD for in vivo diagnosis without the shell. The study of hemodynamics with intravenous injection of colloidal quantum dots in laboratory animals showed no changes in the heart rate. A decrease in mean arterial pressure with subsequent recovery to normal was discovered, which requires more detailed study.