Selenium is an essential component of more than two dozen enzymes and other selenoproteins that play critical roles in reproduction, DNA synthesis, thyroid hormone metabolism, and protection from oxidative damage and infection. Selenium has a protective action against some forms of cancer and cardiovascular diseases, modulates levels of inflammatory mediators, promotes to maintain bone homeostasis and protects against bone loss. Selenium significance as a cardioprotective agent may be associated not only with its antioxidant properties, but also with its ability to prevent inflammation, autophagy, as well as the intrinsic and extrinsic apoptosis pathways. Signaling pathways, such as p-AMPK, PARP, Nrf2, STAT, are involved in the protective effects of selenium. Selenium protects against cardiovascular damage by increasing the survival rate of cardiomyocytes, including a mitochondria-dependent pathway and autophagy through peroxisome proliferator-activated receptors. Research demonstrating neuroprotective and cardioprotective effects of selenium preparations – selenoline, selenocysteine and selenomethionine – is growing at a rapid rate. It has been established that these compounds are able to normalize the levels of heat shock proteins (HSP70), which limit the cytotoxic effects of free radicals, produce energotropic action, prevent a decrease in the membrane mitochondria charge, and the opening of the mitochondrial pore. Also regulate the expression of transmembrane factors NF-kB, c-fos, which is associated with their main biological function of chaperone proteins, providing protection of neurons from damage. In this review, we want to emphasize pharmacological role of Selenium and its derivatives on human health is very complex and has yet to be fully understood.
The influence of selenium derivatives selenoline, cysteine selenate, and methionine selenate on the main indicators of HSP70-dependent mechanisms of endogenous neuroprotection under conditions of acute cerebrovascular accident (CVA) modeling has been investigated, and pathogenetic substantiation of prospects for their further study as potential neuroprotectors has been given. The experiments have been performed on white Wistar rats by bilateral irreversible ligation of the common carotid artery. Cysteine selenite and methionine selenite at a dose of 30 μg/kg, and selenoline at a dose of 50 μg/kg were introduced intraperitoneally to the experimental animals once-daily for 4 days. Every day for 4 days, the severity of neurological reactions was assessed in points on a stroke-index scale, and the mortality rate in animals was recorded. In the process of biochemical studies of brain tissue, the state of mRNA expression, HSP70 level, hypoxia-induced factors (HIF) -HIF1α and HIF-3α were evaluated using the method of polymerase chain reaction (PCR) with realtime reverse transcription. While false-operated animals developed mild neurological disorders, the control group developed bilateral ptosis, circling movements, paresis and paralysis of the limbs. On the 4th day the mean score on Stroke-index P. McGraw neurological deficit assessment scale was 16.7 ± 0.52, and 40 % of animals survived. In the cytosol and mitochondria of brain tissues, a decrease in HSP70 was detected by 47% and 59%, respectively. The administration of selenite cysteine, selenite methionine and selenoline contributed to the normalization of this indicator, to a greater extent under the action of selenite cysteine. In the control group there was a decrease in HSP70 mRNA expression. After administration of all the studied compounds, a tendency to increase the expression of HSP70 mRNA was observed compared to the controls. Under conditions of cerebral circulation insufficiency ACCI, in brain tissue, a decrease in the synthesis of HIF-1α at the
Changes in work of the clinical expert department of the Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution (the Khabarovsk branch) in the context of a pandemic of the novel coronavirus disease were analyzed in the article. The difficulties that have appeared in all sections of the work performed are described, both medical and expert: the time for checking the quality of filling out medical documentation has increased due to the identification of a larger number of defects; the time for medical control and discharge of patients from the hospital has increased due to the impossibility of accumulating patients in one place and the need to maintain social distance; difficulties arose in working with experts from insurance companies due to the lack of direct communication (medical records are checked outside the Khabarovsk branch). The concern of people about the possibility of carrying out surgical treatment in conditions of coronavirus infection was expressed in an increase in the information load of the «Question - Answer» section on the website of the Khabarovsk branch and, accordingly, on the doctors in the clinical expert department working with it. Key words: pandemic, COVID-19, SARSCoV-2, anti-epidemic measures, personal protective equipment, social distance, treatment control, medical documentation, medical and economic expertise.
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