Репозиторий Университета

© 2018 GEOTAR Media. All rights reserved. Aim. Study of the remote results free flaps usage in treatment of patients with the late radiation injuries complicated by tibial bone osteomyelitis. Material and methods. Our work is based on a retrospective study of treatment of eight patients with late radiation tissue injuries and chronic osteomyelitis of the tibia. In them we performed 9 operations using free, vascularized flaps. According to RTOG/EORTC Late Radiation Morbidity Scoring Scheme, skin lesions corresponded to grade IV, bone damage – grade II–III. In the zone of the late radiation injuries, the lesion of the cortical plate of the tibia was detected in 5 patients, a lesion that occurred more than a third of the tibial circumference – in 3 patients. 6 patients had cicatricial osteomyelitis form, and 2 had osteomyelitis with the inclusion of a chronic draining fistula. Late radiation ulcer was emerged in all patients after previous radiotherapy in a total dose of 40 to 60 Gy for different types of neoplasms. For 7 patients, the timing of the previous radiotherapy ranged from 5 to 19 years before the appearance of a late radiation tissue injury. Three patients received radiotherapy in childhood. In one patient, with posttraumatic osteomyelitis of the tibia, in remission, squamous cell carcinoma was diagnosed. Patients underwent radiation therapy in a total dose of 60 Gy. Later it was associated a radiation ulcer with open defects of the tibia. The objectives of surgical treatment included the preservation of the limb, adequate surgical debridement and the replacement of the tissues defect. The surgical technique included a radical resection of the affected areas of the bone tissue. To fill dead space, a musculo-fasciocutaneous thoracodorsal flap was used in all paients. In 2 out of 3 patients with localized form of osteomyelitis, the autograft complex, supplementary to the thoracodorsal component, included additionally a fragment of the anterior serratus muscle for tamponade of the osteomyelitis cavity. For one patient with localized osteomyelitis, a tamponade method of the post osteomyelitis bone defects included use of the distal part of the fragment of the latissimus muscle flap. 1 patient originally addressed concerning a late radiation ulcer on the back surface of a crus without involvement of bone structures. Two years after elimination of cicatricial and ulcer defect the torakodorsal skin and muscular flap, created a late radiation ulcer on the forward surface of a shin with defeat of a cortical plate of a tibial bone. Discussion. Fundamental difference of patients with local radiation injury from patients with traumatic osteomyelitis and investing tissue extensive defects is the feature of a course of wound process against the background of the progressing depression of a reparation both in the focus, and in surrounding tissues with lack of a clear boundary defeat. Morphological basis of local late radiation defeat are permanent damages of blood and lymphatic vessels with tissue fibrosis progressing. In the conditions of local reserve opportunities decrease, free revascularised flaps application, with one's own axial blood supply, allows to save an extremity, to receive the best immediate and long-term results of tissues defects elimination in the irradiated zone. It can be confirmed with the fact that directly under the replaced skin and muscular revascularised flap the covered functional structures purulent defeat stopped and patients achieved osteomyelitic process permanent remission. Results. In all observations the full flap engraftment has received. All patients have achieved osteomiyelitic process remission. Conclusions. The radical debridement of the affected zones, followed by the filling of the bone defect with muscle tissue and the defect elimination of the tissues by the skin portion of the vascularized musculocutaneous autograft is the method of choice in the treatment of patients with local post radiation injuries, complicated by osteomyelitis of the tibia.

© 2018, Polish Urological Association. All rights reserved. Introduction Oncological remission along with high postoperative functionality [continence and erectile function (EF)] are the main aspects of prostate cancer (PCa) treatment. The aim of this study was to compare functional and oncological treatment results achieved after a nerve-sparing radical prostatectomy (RP) via transperitoneal (TPRP), extraperitoneal (EPRP) and robot-assisted (RARP) approach. Material and methods From March 2015 to March 2016, 507 RP were performed at the Institute for Urology and Reproductive Health (Moscow, Russia). A total of 264 patients with localized (cТ1а–2с) prostate cancer [prostate-specific antigen (PSA) <20 ng/ml, Gleason score ≤7], intact prostate capsule (according to MRI), International Index of Erectile Function (IIEF-5) ≥19 and a life expectancy >10 years were included into the retrospective study. All the surgeries were performed by a single surgeon. The outcomes were evaluated after urethral catheter removal and 3–6–12 months after RP. Results Nerve preservation (NP) was performed for 153 patients without significant distinctions in time (р = 0.064) and blood loss (р = 0.073). The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) score was lower for NP: 9.23 ±6.59 and 3.86 ±5.38 after 3 and 12 months respectively compared with continence after RP without nerve preservation (NP): 14.27 ±5.1 vs. 6.15 ±4.76 (р <0.001). Continent was 52.2% vs. 83.3% vs. 81.8% in TPRP, RARP and EPRP groups; р <0.001. IIEF-5 scores were 14.67 ±9.4, 4.2 ±4.26 and 4.0 ±2.07 after RARP, TPRP and EPRP respectively (р = 0.002). After 12 months the PSA: TPRP = 0.11 ±0.19, RARP = 0.03 ±0.05 and EPRP = 0.53 ±1.87 ng/ml (р <0.001). Outcomes depend on surgical approach and was better in the RARP-group (AUC = 0.768 ±0.034 (CI 95% 0,701–0.834; р <0.001). Conclusions We suggest RARP with NP as a method of choice for treatment of prostate cancer in patients interested in preservation of EF and quality of life in general.

© 2018 Silina et al. Aim: The purpose of this study was to examine the role of free radical oxygen and peroxide-lipid processes along with conducting the study of blood flow level and oxygen saturation of facial tissues in patients of different ages with varying degrees of involutional changes in the skin of the face and neck. Materials and methods: One hundred and fifty-three people (84.3% women and 15.7% men) aged from 26 to 78 years with varying degrees of involutional changes in facial skin were examined. The clinical and laboratory evaluation was carried out dynamically and included various indicators of free radical processes, objective and subjective clinical visualization, and laser Doppler flowmetry (LDF) of the facial skin and transcutaneous oximetry (TcpO2) performed at 10 points on the face. To assess the state of free radical processes, the authors investigated the basal indicator of chemiluminescence intensity (ICb), the intensity of chemiluminescence stimulated (ICs) by zymosan, the activity coefficient (AC) of chemiluminescence, antiperoxide activity of plasma, and malondialdehyde (MDA). Results: With aging, the imbalance of the oxygen constituents of free radical processes grows with the increase in ROS. Proportional to age, the ICs increased 2.1 times on average in people older than 55 years compared to that in people younger than 30 years and ICb decreased by 1.8 times. As a result, the AC increased by 5.6 times. This correlates with involuntary skin changes and with regression of microcirculation and TcpO2. According to LDF, it was established that average total blood flow in people younger than 30 years and people older than 55 years was 8.1 and 6.4 mL/min, respectively The difference between the indicators of TcpO2 in people younger than 30 years and people older than 55 years was 1.6 times (average 56 vs 35 mm Hg). The stability of the indicators of the peroxide-lipid link of oxidative stress in different age groups demonstrated that the activation of ROS formation in mitochondria is not a cause but a consequence of microcirculation and metabolic processes in the face and neck and aging in general. Conclusion: The tissue metabolism and microcirculation parameters naturally regress with aging, which is associated with the increase of ROS. The excess of species leads to the intensification of peroxide processes. This, in turn, is reflected in the aesthetic appearance manifested by aging.

© 2018, Dynasty Publishing House. All rights reserved. The objective. A comparative diagnosis of dispersion performance by the dynamic characteristics and dispersion composition of aerosol-spray forms of drugs for treatment of inflammatory disease of the throat in children (from the age of 3 years) and adults. Materials and methods. The objects of the study were 10 medications for treatment of inflammatory diseases of the throat, 9 of which have the drug form of a metered-dose spray and 1 drug has the form of undosed aerosol. A comparative diagnostics of the drugs was performed by the following dynamic spray characteristics: total length and length of particular spray phases, spray cone angle and a form of droplet population of the cone. The dispersion composition of spray was characterised by the mean and mass-median diameters of particles, particle size distribution. These characteristics were measured by a direct observation method – shadow photography – with digital processing of images using the «Actual Flow» software. Results. Diagnostics of spray dispersion by dynamic characteristics has shown that the most effective dispersion in the shape of a wide hollow cone was obtained in the drugs Tantum® Verde and Grammidin®. Diagnostics of sprays by their dispersion composition has confirmed the correspondence of all the examined preparations to pharmaceutical sprays for local treatment of the upper respiratory tract. Practically in all sprays, the maximal portion of the drug content is transferred by droplets of the optimal for spray sizes from 10 to 100 μm. The mass content of «hazardous» small droplets with sizes less than 10 μm is insignificant and amounts to less than 1%. Conclusion. Based on diagnostics of 10 sprays by the method of shadow photography on the basis of all examined parameters of the dynamics and fineness of dispersion the most effective dispersion from the viewpoint of drug delivery to throat mucous membranes is achieved in the drug Tantum® Verde.

© 2018 Media Sphera Publishing Group. All rights reserved. Aim. Analysis of the treatment response rates of different therapy regimens of functional constipation, including Ipidacrine, a cholinesterase inhibitor, based on assessment of adaptation and compensatory mechanisms in the therapy forecast. Materials and methods. 77 functional slow-transit constipation patients were examined after therapy regimens of functional constipation, the mean age is 44.30±14.58 y.o. Results and discussion. The treatment response rates of different therapies with Ipidacrine depends on the patient's initial adaptation and compensatory mechanisms (ACM index); certain aspects allowing to predict the expected result depending on the current mental state were identified; the severity of the state of functional constipation, ACM index and MMPI test psychometric indicators are correlated; adaptation and compensatory mechanisms of functional constipation patients were found to be reduced; the prognosis of the treatment response rates and, accordingly, the choice of the therapy regimen depend on the patient's adaptation potential (index). Conclusions. Therapy regimens for functional constipation patients should be selected on the basis of the original ACM index, behavioral pattern, degree of compliance and the patient’s age.

© 2018 Authors. The present work presents a description of various cutting devices with an emphasis on skin surgery for the optimal choice of instruments in plastic surgery. Physical principles of work with a description of the biological role of an ultrasonic scalpel, various laser cutting devices, electrosurgical instruments, including radiofrequency electrosurgery, are described. Studies of recent years, including systematic reviews and meta-analyzes, are devoted to comparative analysis of various cutting and coagulating devices among themselves and in comparison with the mechanical metal scalpel.

© 2018 Publishing House of the Union of Pediatricians. All rights reserved. Background. Tumour necrosis factor alpha inhibitors are widely used in the treatment of juvenile idiopathic arthritis (JIA). To achieve maximum efficiency of genetically engineered biologic drugs, it is necessary to study predictors of the response to therapy. Objective. Our aim was to identify early predictors of the response to adalimumab therapy in patients with JIA without systemic manifestations. Methods. A prospective cohort study analysed treatment results of patients with JIA without systemic manifestations, who were prescribed adalimumab for the period from August 2008 to August 2014. We studied the relationship between baseline demographic indicators as well as baseline and registered after one month of treatment clinical and laboratory parameters and the best (remission according to the Wallace criteria) response to therapy after one year. Results. In the first year of therapy, 94 (43.9%) of 214 patients achieved remission according to the Wallace criteria. In a multivariate analysis, predictors of achieving remission after one year of adalimumab therapy were the improvement according to the ACR70 criterion after one month of therapy [odds ratio (OR) 3.3; 95% confidence interval (CI) 1.7-6.7], a history of uveitis (OR 1.86; 95% CI 1.03-3.33), a decrease in the number of joints with active arthritis after one month of therapy (OR 1.09; 95% CI 1.02-1.16). During therapy, injection reactions in the form of pain were observed in 36 (16.8%) of 214 patients, infectious diseases of ENT organs - in 85 (39.7%), of the respiratory tract - in 17 (7.9%), and tubinfection - in 13 (6.1%) children. Conclusion. The presence of uveitis, rapid reduction in the number of joints with active arthritis and a high level of response to treatment after one month of adalimumab therapy are predictors for achieving remission during the first year of treatment.

© 2018 Media Sphera Publishing Group.All Rights Reserved. Aim. To study the oxidative damage of biopolymers (proteins and nucleic acids) in blood of patients with type 2 diabetes mellitus (DM). Materials and methods. In the blood of 50 patients with DM and 25 patients without disorders of carbohydrate metabolism were estimated: the level of oxidized low-density lipoprotein (oxLDL) by immunochemical method, the content of SH-groups in plasma proteins, the activity of Cu, Zn-superoxide dismutase (SOD) in erythrocytes, the length of telomere in leukocyte DNA, the level of 8-hydroxy-2'-deoxy-gunosine (8-oxo-dG) in plasma and urine. Results and discussion. It is shown that in DM patients the level of oxLDL increases and the content of SH-groups in proteins and peptides of the blood plasma decreases, which indicates the development of oxidative stress. In addition, a carbonyl-dependent modification of erythrocyte SOD was detected in DM patients, as well as oxidative DNA destruction (decrease in telomere length in leukocytes and an increase in the level of 8-oxo-dG in blood plasma and urine). Conclusion. On the basis of the definition of a complex of correct indicators, a multiple oxidative modification of biopolymers of blood (proteins and DNA) was detected in patients with DM.

© 2018, Media Sfera. All rights reserved. The article describes a newly developed and tested diffractive optical element (DOE) that converts non-uniform radiation of the laser output into a homogeneous ring. The Gerchberg-Saxton algorithm is shown to be well suited for achieving annular intensity distribution. Testing this ring transducer on threshold-plasticity cornea demonstrated the reversibility of axisymmetric changes in the cornea. Atomic-Force microscopy of the area of maximum stresses in the corneal periphery showed no significant changes in the structure of the cornea when irradiated in the selected mode. Measurement of Young’s modulus of the corneal surface areas after their irradiation also revealed no changes in the elastic properties, while examination of the corneal structure demonstrated the absence of significant structural changes in irradiated samples compared with intact ones.

© 2018 Copyright SPIE. The paper presents the results of the studies of influence of optical radiation with wavelengths of 520 and 780 nm on human glial cells (U251) at the range of exposure times ∼ 1-15 min. It was found that after the first minute of irradiation at the wavelength of 780 nm, the relative number of apoptotic cells significantly increased. The result corroborates the concept of biological hazard of optical radiation for tumor cells, and suggests that the approach has a great potential in clinical application for the treatment of human glioma.

© The authors team, 2018.All Rights Reserved. This is the first report of a clinical case of subcutaneous adiponecrosis of a newborn with acute early neonatal period from a mother with risk factors in the form of diabetes, hypoglycemia during pregnancy, chronic infections, emergency surgical delivery due to acute fetal hypoxia. The article contains algorithm of the differential diagnostics of diabetic embryo-fetopathy and metabolic disorders in a newborn from a mother with diabetes.

© 2018 Russian Electronic Journal of Radiology.All right reserved. Purpose: This scientific review of the literature presents the most relevant discussions in the world community, aimed at improving the implementation of the diagnostic algorithm in patients with severe combined trauma. Materials and methods: The work deals with the main traumatic injuries of various anatomical zones, the criteria of the Advanced Trauma Life Support (ATLS) protocol and diagnostic methods aimed at detecting acute traumatic pathology. Conclusion: The authors consider unsolved issues, as well as the improvement of the multislice computed tomography (MSCT) algorithm in the "whole body" mode, to optimize diagnostic activities aimed at managing patients with severe combined trauma.

© Ruslania 2018. All rights reserved. According many publications, rate and severity of various diseases of oral cavity are significantly increasing in drug-dependent patients. One of drugs using in many countries as a substitution therapy is methadone. However, last research data testifies that negative effect of methadone on human organism in general is more expressed as compared with case of heroin. So, significance is acquired by those studies that testify pathological alterations in organs and systems of patients, including effect on oral cavity. The article presents the results of analysis if crystallography of biological fluids of drug-dependent patients using heroin and methadone. Te study established dependence of character ofgrowth of crystals from type of used drug.

© Ima-Press Publishing House. All rights reserved. Objective: to investigate the efficiency of treatment for acute and subacute dorsalgia, by providing information to patients and by using nonsteroidal anti-inflammatory drugs (NSAIDs) without conducting physical therapy, reflexotherapy, and manual therapy. Patients and methods. A total of 140 patients (87 women and 53 men; mean age 50.7±17.6 years) with acute and subacute back pain were followed up. Out of them 127 (91%) patients were found to have nonspecific (musculoskeletal) pain; 13 (9%) had discogenic radiculopathy. All the patients were informed of the benign nature of the disease, the high probability of its rapid resolution, the feasibility of abandoning prolonged bedrest, and the lack of need for physical therapy, reflexotherapy, massage, and manual therapy. To reduce pain, the patients received meloxicam 15 mg/day orally or intramuscularly or first 15 mg/day intramuscularly and then orally. The investigators assessed pain intensity with the numerical rating scale and functional activity restrictions with the Roland-Morris disability (RMD) questionnaire. Results. After treatment, the visual analogue scale pain intensity scores decreased from an average of 6.4 to 1.0; the RMD scores dropped from 6.8 to 1.4 (p<0.001). The duration of treatment averaged 11.0±4.4 days. Comparison of different meloxicam dosage regimens showed no significant differences; a positive result was noted in all cases. No adverse events were observed during treatment. Conclusion. The investigation has shown the high efficiency of management in patients with acute and subacute dorsalgia, by providing information to patients (an education conversation), by using meloxicam, and by applying a personalized approach (treatment for concomitant diseases and conditions). Refusing physiotherapy, massage, acupuncture, and manual therapy substantially reduces the cost of treatment in patients with acute dorsalgia.

Copyright © 2018 by the MediaSphere. Assisted reproductive technologies (ART) are currently widely used around the world because of the increased prevalence of infertility (presently, about 15% of married couples suffer from infertility), as well as the increased access to treatment and public funding for this method. Hence, the number of children conceived by ART is steadily increasing every year. This review focuses on the pressing problem of the health status of children conceived by assisted reproductive technologies (ART) by analyzing modern publications on the state of physical, gonadal and psychosomatic development, features of the endocrine system and cardiometabolic diseases, the risk of imprinting changes, congenital malformations and oncological disorders. The data presented that there is no increased risk of childhood cancer or deterioration in quality of life. However, it is expected that the cardiovascular and metabolic risk factors found in childhood can worsen in later life and may ultimately be responsible for chronic cardiometabolic disease. Furthermore, the issue of fertility, especially in the male population conceived by ART, remains open, thus requiring additional longer-term research.

© 2018, Media Sphera Publishing Group. All rights reserved. Urothelial carcinoma is one of the most frequently diagnosed malignant tumors of the bladder and upper urinary tract, which ranks seventh in the pattern of cancer. Urothelial carcinoma of the renal pelvis is less common; but has a more aggressive clinical course and a worse prognosis than that of the bladder. This is due to the clinical and morphological features of this form of cancer, which, unlike bladder cancer, have not been studied enough. Objective — to comparatively analyze the morphological and immunophenotypic parameters of urothelial carcinomas of the renal pelvis and bladder. Subject and methods. Surgical specimens from 196 patients diagnosed with urothelial carcinoma of the renal pelvis and bladder were investigated. Paraffin sections were immunohistochemically examined using the standard protocol. Antibodies against CK5/6, CD138, CDX2 (≪Dako≫), CK7, CK14, CK20, CEA, CD10, CD117, EMA, E-Cadherin, HMWCK, p63, Uroplakin III, Vimentin (≪Novocastra≫), CD44, GATA-3, MUC1, MUC2, and MUC-5AC (≪Cell Marque≫) were used. Results. Most tumors (n=147 (75%)) were invasive. Of them, 65 (33%) cases had a histological structure of conventional urothelial cancer; and 3 (1.5%) had paradoxical differentiation. Divergent tumor zones were verified in 66 (34%) neoplasms; 4 (2%) cases showed an inverted growth pattern. Pseudosarcomatous stroma reaction in the invasion zones was verified in 9 (5%) cases. The tumor stage corresponded to pT2—pT4 in 128 (65%) tumors. Conclusion. Urothelial carcinomas of the renal pelvis and bladder show a broad spectrum of histological variants. The findings support that, unlike urothelial carcinomas of the bladder, the majority of primary urothelial carcinomas of the renal pelvis are high-grade and highly invasive.

© 2018, Media Sphera Publishing Group. All rights reserved. The development of autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is associated with the hyperergic reaction of the human immune system. The development of autoimmune inflammation is preceded by contact with internal or external trigger factors (adjuvants) of immune disorders. ASIA is associated with an individual genetic predisposition that is probably associated with the carriage of HLA-DRB1*01 or HLA-DRB4. The paper presents five possible options for the impact of adjuvants in the pathogenesis of autoimmune disorders. It gives diagnostic criteria for the syndrome, as well as its clinical, laboratory and morphological manifestations. Emphasis is laid on the importance of morphological changes in the diagnosis of autoimmune disorders. The spectrum of morphological changes in ASIA is extensive. The tissues show signs of immune inflammation, such as lymphohistiocytic infiltration, granulomatous inflammation, and scleroderma-like changes. The characteristic feature is the regression of clinical, laboratory, and morphological manifestations after adjuvant removal.

© 2018 Ima-Press Publishing House. All right reserved. In accordance with international and Russian guidelines for the management of patients with rheumatoid arthritis (RA), after its diagnosis, a synthetic disease-modifying antirheumatic drug is prescribed, among these drugs, methotrexate is anchor and, when the latter is impossible to use, leflunomide is commonly administered. Objective: to evaluate the efficacy and safety of a leflunomide generic (Elafra) during a multicenter follow-up. Subjects and methods. The investigation enrolled 347 patients aged over 18 years who met the 2010 ACR/EULAR criteria for RA, had its duration of less and more than 2 years, signed informed consent, and followed up in 29 centers of Russia. Elafra was prescribed at a saturating dose of 100 mg for the first 3 days, then 20 mg/day. There might be a temporary two-fold reduction in the dose when adverse events (AE) occurred. The patients were examined before and 4, 12 and 24 weeks after beginning leflunomide treatment. The treatment efficiency was evaluated with DAS28 and CDAI and by the physician global assessment. Results and discussion. The patients were divided into two groups: 1) 125 patients with RA of less than 2 years' duration and 2) 222 patients with RA of more than 2 years' duration. The mean age of patients in Group 1 was 48.7±12.9 years; that in Group 2 was 52.5±11.95 years; the mean disease duration was 11.9±7.8 and 90.99±54.28 months, respectively. During 24-week treatment, there was a highly significant decrease in all assessed clinical, laboratory parameters and indices of RA activity in both groups. At 4 weeks of treatment, the effect was observed in 91.8% of the patients in Group 1 and in 84.6% in Group 2, whereas at 12 weeks the effect was noted in almost all patients (99.1% and 96.9% in Groups 1 and 2, respectively). The highest rate of AE during Elafra therapy was recorded in the early periods: at 4 weeks, AE were noted in 6.5% of the patients in Group 1 and in 9.9% in Group 2, without needing to discontinue the drug. Treatment continuation decreased the rate of AE. Because of its intolerance, Elafra was discontinued due to in one case in Group 1 (diarrhea at 24 weeks of treatment) and in 6 cases in Group 2 (at 12 and 24 weeks of treatment). Conclusion. Treatment with leflunomide (Elafra) leads to the rapid development of its effect in early and late RA in most patients and is characterized by a good tolerability.

© 2018 Media Sphera Publishing Group.All Rights Reserved. Aim. To evaluate the presence and the severity of the complaints (headache, dizziness, memory loss, concentration of attention, sleep disturbances, decreased mood, increased anxiety), the state of cognitive functions, emotional status and quality of night sleep in treatmentnaïve middle-aged patients with mild to moderate EAH compared to healthy volunteers of the same age. Materials and methods. 103 treatment-naïve patients with EAH aged 40-59 years at the enrollment, who met the inclusion/exclusion criteria and provided written informed consent (46 men, mean age 53.6±0.8 years) and 50 healthy volunteers (17 men, mean age 51.5±1.0 years) with normal blood pressure (BP) level - control group - were enrolled to the study. Mean EAH duration was 2.9±5.7 years. Cognitive assessment included Montreal cognitive assessment, 10-words learning task, verbal fluency test, TMT, Stroop color and word test. Anxiety and depression were evaluated via Hamilton rating scales (HARS and HDRS). 24-hours ambulatory BP monitoring (ABPM) was performed according to European guidelines. Results. 70% of patients with EAH complained of memory disturbance, 68% - lack of attention, 22% - sleep disturbances, 12% - dizziness, 9% - headache. It took statistically significant more time for patients with EAH to perform on TMT B (p<0.05), they had significantly higher TMT B - TMT A difference score (p<0.01) and lower mean MoCA score (p<0.05). Patients with EAH had significantly higher mean score in Hamilton anxiety (2.1±3.7) and depression (1.1±2.4) rating scales compared to controls (0.3±0.9 points, p<0.01 and 0.1±0.5 points, p<0.001, respectively). Patients with EAH who complained of sleep disturbances had low sleep quality (8.7±2.8 points). Among patients with EAH who complained about headaches 66.6% had episodic migraine and chronic tension type headache (33.4%). Those patients had a substantial impact of headache on life and daily living according to HIT-6 (mean score - 57.5±6.1). Only 2 patients out of 12 with complains about dizziness had benign paroxysmal positional vertigo and Ménière's disease. Conclusion. Complaints about memory dysfunction, lack of attention, sleep disturbances, less common - dizziness and headaches, are most typical in patients with EAH on the early stages of the disease. They differ from healthy volunteers of the same age by having cognitive impairment and higher anxiety and depression scores. Patients with EAH who complained about sleep disturbances had low sleep quality. Headache in patients with EAH was due to episodic migraine and tension type headache which had a negative impact on life and daily living.

© 2018 Vserossiiskoe Obshchestvo Kardiologov. All rights reserved. Although on the first glance, the prevention of arterial hypertension (AH) is effective since childhood and adolescence, further research is needed, as it is not well known how to make it effective. Aim. Based upon the analysis of 32-year long dynamics of various levels of blood pressure (BP), to define the efficacy of screening investigations in children. Material and methods. A 32-year long prospective, cohort study conducted, the observation of males beginning at age 11-12 y.o. In 32 years, among 1005 participants, 303 (30,1%) were investigated, and the cohort consisted finally of 290 persons. The assessment included: surveying, triple BP measurement, pulse count, body mass and height measurement, triceps skin folds thickness measurement, as scapular and abdominal, waist and hip circumference, total cholesterol measurement, as the high density, and level of triglycerides, electrocardiogram. Results. Among the males that at the age 12 were in the upper 20% (5th quintile) by systolic BP, in 32 years almost one quarter remained in the same quintile. The stability of raised BP the parameters influence such as body mass and skin fold thickness. Combination of raised systolic BP in high body mass in 13 y.o. adolescents does increase the risk of AH at 43 y.o. the same grade that does an isolated body mass increase - this witness on the decrease of baseline BP values role in hypertension developemnt with remaining role of body mass. The risk of AH development with the baseline age 15 y.o. was significantly higher in combination of overweight and AH. Conclusion. For AH prevention, even in childhood and adolescence it necessary to monitor closely those with raised systolic BP and overweight, and active prevention should start before the age 20 y.o.