In routine clinical practice, methods of radiation diagnostics are widely used in the provision of medical care to patients with common diseases of the brachiocephalic vessels (BCV). This article provides recommendations on methods for performing time-consuming and expensive radiological methods (ultrasound (US), computed tomography (CT), computed tomography angiography (CTA) arteries, CTA veins, magnetic resonance imaging (MRI)) in patients with diseases of the brachiocephalic vessels. Based on the recommendations of experts, literature sources and practical experience in the application of radiology methods. 

This guide contains structured information regarding the technology of US, CTA and MRI in patients with artery stenosis, artery dissection, vascular malformation, venous sinus thrombosis, and atherosclerosis. These recommendations are universal and are suitable for most medical institutions that perform US, CT and MRI of brachiocephalic vessels.  

Compliance with these rules will improve clinical and economic efficiency in the diagnosis, treatment and rehabilitation of patients with diseases of the brachiocephalic vessels by standardizing procedures of US, CT, MRI, and effectively use the resources of a Healthcare at all levels when performing radiological methods.  

The manual is intended for all categories of medical stuff performing radiological methods in diseases of brachiocephalic vessels (US doctors, functional diagnostics doctors, radiologists) and using their results in clinical practice (cardiologists, cardiovascular surgeons, neurologists, neurosurgeons, anesthesiologists, therapists). 

Myocardial bridge (MB) a congenital developmental anomaly of the coronary arteries (CA), in which the epicardial segment of the vessel passes under the myocardium. With this anomaly, any CA can be affected, but most often it is located in the left anterior descending artery. Most MB is associated with an asymptomatic course, however, in the available scientific literature about the problem of MB, there are a lot of publications describing and proving the relationship between MB and symptoms of myocardial ischemia, including cases of acute coronary syndrome and sudden cardiac death.  

In this review the authors summarize and present modern data of the frequency, pathophysiological mechanisms, anatomical, functional and clinical evaluation, as well as treatment of MB. Medical treatment is usually an effective therapy in patients with symptomatic MB. If it is ineffective, a comprehensive anatomical and functional assessment of the MM should be carried out to select the safest and most effective revascularization technique. Percutaneous coronary intervention with new generation stent, coronary artery bypass grafting and myotomy are currently being considered as a treatment strategy for MB.  

The lack of generally accepted recommendations obviously makes it necessary to conduct further research in the field of the problem under consideration in order to develop and validate unified algorithms for the diagnosis and treatment of patients with MB. 

Background. Familial hypercholesterolemia (FHC) is accompanied by a significant increase in the level of low-density lipoprotein cholesterol in the blood. The relevance of early diagnosis and treatment is due to the risk of premature development of atherosclerosis. Coronary heart disease due to atherosclerosis of the coronary arteries occurs among FHC patients up to 30 years. Currently, cardiac morphology and myocardial function in children with FHC are poorly understood. Objective. To assess global, segmental longitudinal deformation of the left ventricle and endothelial function in children with familial hypercholesterolemia. Design and methods. The study involved 25 healthy children and 34 children with FHC. Endothelin-1 and NO were determined by enzyme immunoassay. Echocardiographic study was carried. Assessment of global and segmental longitudinal deformation of the left ventricle was carried out in 4-chamber apical, 3-chamber and 2-chamber projections. Results. There were no statistically significant differences in global longitudinal strain (GLD) between groups. Individual analysis showed that 2 patients with FHC had a decrease in GLD. There was a statistically significant decrease in parameters in FHC patients at the level of the basal and apical anterior-septal, basal lower segments. Endothelin-1 and NO were increased in FHC compared to the control group. Conclusion. Speckle-tracking echocardiography allowed identifying patients with a decrease in global and segmental longitudinal deformation of the left ventricle among children with FHC. 

Cytochrome P450 enzymes play a key role in drug biotransformation. The expression and activity of each CYP450 is influenced by a unique combination of biochemical factors, species and genetic differences, age, sex, nutrition and etc.

Cytochromes P450 are a family of heme-containing proteins involved in the metabolism of xenobiotics, drugs, and endogenous compounds. Drugs could act as inducers or inhibitors of cytochrome P450 enzymes. Understanding the mechanisms of inhibition or induction of enzymes is extremely important in preclinical studies and prescribing complex therapy. One of the main challenges in the development of therapeutic agents is to determine which animal species reflects the human ability to metabolize certain drugs. The study of CYPs and their interaction with drugs is an urgent problem in preclinical studies. Thus, an adequate and maximally similar experimental preclinical models are necessary to study the pharmacokinetic and pharmacodynamic properties of promising chemicals and their effect on certain cytochrome P450 enzymes.

This review compares the main subfamilies and their enzymes of the cytochrome system of humans and laboratory animals involved in drug metabolism. The problems of choosing biological models in vivo in preclinical studies in the study of medicinal substances are considered. The predictive value of in vivo models of preclinical studies was analyzed from the point of view of the cytochrome P450 system in humans and laboratory animals.

Background. The thrombin generation test (TGT) as an integral method for analyzing the activation cascade of natural pro- and anticoagulants is of practical importance in assessing the risk of thrombotic conditions and bleeding, however its application is limited by the lack of standardization. Objective. To define reference intervals within the laboratory and assess inter-individual variation in TGT values for different technologies. Design and methods. The study included 20 donors. TGT was performed using two technologies: a calibrated automated thrombogram on a semi-automatic fluorometer (Technology 1) and automatic measurement of GT on a coagulometer (Technology 2). Obtained results were normalized to pooled normal plasma. Results. Thrombogram parameters showed a high CVG (coefficient of interindividual variation): 14–32 % for Technology 1 and 7–36 % for Technology 2. CVG did not change significantly after normalization. Significant differences in ETP (endogenous thrombin potential) were noted. The reference intervals for Technology 1 were: ETR 1478.0–2595.0 nmol/ min and peak thrombin concentration (Peak thr.) 221.6–412.0 nmol. RI for Technology 2: ETP 2451.00–3161.00 nmol/min and Peak thr. 161.60–479.30 nmol. Conclusion. Comparison of the two laboratory TGT technologies revealed high inter-individual variation. Thus, the use of a study in dynamics for each specific individual is likely to be more informative than the use of RI obtained in the general population. Dynamic monitoring of the patient must be performed using one technology.

Background. The use of nanotechnology achievements in medicine opens up prospects for the development and improvement of means and methods of prevention and treatment of diseases of various origins. Carbon nanotubes (CNTs) are a product of modern nanotechnologies, and in addition to their unique physical and chemical properties, they are promising for practical applications in medicine. CNTs are one of the most popular (comparable only with silver and titanium dioxide nanoparticles) objects of nanotoxicological research. Data on the effect of CNTs on blood cells are contradictory, so additional studies are necessary. Objective. To assess the activation capabilities of immobilized carbon nanotubes by the rate of adhesion of blood cell elements to their surface in vitro. Design and methods. Hemocontact interaction was carried out in bench conditions using donor blood in rotational mode. Blood samples were taken before the start of the experiment and after 5, 20, 40 and 60 min. Changes in the indicators of cell blood populations using the hematology analyzer SySmex XT 1800i (26 parameters). 50 experiments were conducted. To analyze the activation functions, a speed-time adhesive profile was used. Results. The highest rates of activation of cellular elements of the blood were recorded in contact with multi-walled carbon nanotubes SiloMUNT. Conclusion. The results of the study can be further implemented in the procedure of low-volume hemoperfusion in clinical practice.

Background. Molecular mechanisms of the development of pulmonary fibrosis are poorly understood. It is known that differentiation of resident lung cells into myofibroblasts plays a key role in this disease. The search for factors capable of regulating such differentiation is an urgent task. Objective. To evaluate the effect of Notch signaling pathway activation on resident lung fibroblasts by introducing the intracellular domains of each of the 4 Notch receptors (N1-4ICD). Design and methods. Primary cultures of pulmonary fibroblasts from donors (n = 4) were used. Notch-dependent activation of fibroblasts was carried out by introducing lentiviral vectors with/ without sequences of N1-4ICD domains. After 8 days, immunocytochemical staining was performed and the relative expression levels of the PDPN, HOPX, SLUG, SNAIL and ACTA2 genes were evaluated by qPCR. Results. Activation of the Notch signaling pathway by N1-4CD resulted in increased expression of SLUG, SNAIL and ACTA2. The most pronounced effect was observed with the introduction of Notch4-activating sequence. Induction of signaling by the introduction of N1-3ICD activating components contributed to an increase in PDPN expression, with the introduction of N4ICD, an increase in the level of HOPX expression was noted. Conclusion. Activation of each of the 4 intracellular Notch receptor domains is able to trigger the differentiation of resident alveolar fibroblasts into myofibroblasts, which are key players in the development of pulmonary fibrosis.