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ObjectivesTo investigate the relationship between changes in circadian patterns of melatonin and clinical manifestations of polymorbid cardiovascular pathology (PCVP) in young men and to analyze the effectiveness of their complex treatment.Materials and methodsWe made the immunohistochemical (IHC) analysis of epiphysis tissues from autopsies of 25 men aged 32–44 with PCVP and metabolic syndrome (MS) who had died as a result of ischemic cardiomyopathy (IC) and 25 persons after the car accident as a control group. Then, 93 young men aged 35–44 with PCVP, metabolic syndrome, and depressive spectrum disorders (DSD) were divided into three groups: (1) standard therapy; (2) standard therapy and psychotherapy sessions; (3) standard therapy in combination with psychotherapeutic and psychophysiological visual and auditory correction sessions. The control group included 24 conditionally healthy male volunteers. Before and after the treatment, we studied the anthropometric status, lipid and carbohydrate metabolism indicators, the level of urinary 6-hydroxymelatonin sulfate, the degree of nocturnal decrease in blood pressure (BP), and the relationship of these indicators with circadian variations of melatonin excretion.ResultsYoung polymorbid patients who died from IC have a lower expression of melatonin type 1 and 2 receptors. All patients with PCVP showed a decrease in the nocturnal melatonin excretion fraction and a correlation with higher severity of depressive (r = −0.72) and anxiety (r = −0.66) symptoms. Reduced values of the 6-hydroxymelatonin sulfate (6-SM) in the 1st (r = 0.45), 2nd (r = 0.39), and 3rd (r = 0.51) groups before treatment was associated with periods of increased BP. The achievement of melatonin excretion reference values and normalization of biochemical parameters of carbohydrate and lipid metabolism, daily BP profile, and psychophysiological state were noted in all three patients’ groups, with a more pronounced effect in group 3.ConclusionLow nocturnal melatonin excretion levels are associated with greater severity of clinical symptoms and a higher risk of death in patients with PCVP. Therefore, comprehensive therapy may be more effective for correcting this disease.

Objective: Identify the diagnostic signs for chronic rhinosinusitis with nasal polyps (CRSwNP & resistant forms) with multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAd), hypertension, metabolic syndrome (MS). Identify effectiveness of photodynamic therapy in CRSwNP treatment. Design and methods: The study included 75 patients (mean age 35,8±7,93, 39,2% - female,60,8% - male) with CRSwNP and MCVP divided into 3 groups by simple random sampling. Patients in group 1 (n = 27) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks anti- bacterial and leukotriene receptor antagonists treatment. Surgical interventions history of the last 5 five years: from 1 to 2. Patients in group 2 (n = 28) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial and leukotriene receptor antagonists treatment. Surgical inter- ventions history of the last 5 five years: more than 3. Patients of group 3 (n = 20) received standard therapy CRSwNP, hypertension, CAd, NPMd, 8-weeks antibacterial treatment, 8-weeks leukotriene receptor antagonists treatment and sessions of photodynamic therapy of the paranasal sinuses. Surgical interventions history of the last 5 five years: more than 3. used in the study: complex psychological test methods, ENT and laboratory-instrumental evaluation of the cardiovascular system. Results: depres- sion was detected in 46,3%, 71,9%, 58,3% of patients, (first, second, third groups). Types «non-dipper» and «night-peaker» found in patients 2nd and 3rd groups- corresponds with (CRSwNP & resistant forms). Bone transformation zone as a result of chronic inflammation within the ethmoidal labyrinth and maxillary sinuses identified in the second and third patients group (85% of cases). The use of pho- todynamic therapy in the resistant CRSwNP forms treatment improves the functional indicators of the nasal cavity and paranasal sinuses. Conclusions: Patients with CRSwNP have symptoms of depression and «non-dipper» and «night-peaker» patterns. All CRSwNP patients are defined trigger points with areas of chronic osteitis and odontogenic osteomyelitis. The use of photodynamic therapy for CRSwNP treatment, reduces the number of CRSwNP recurrence.

Objective: To study the activity of apoptosis and premature aging in individuals of middle age with polymorbidity cardiovascular disease and non-psychotic mental disorders.Design and methods: The study included 78 men with MCVP and 20 healthy men. used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. definition p53 protein was performed by ELISA using kits BMS eBioscience BMS256 (BenderMedSys- tems, uSA). Results: n the group of patients with polymorbidity cardiovascular disease (PTS) of the p53 protein level was 4,89 uI / ml in the control group, p53 0,93 uI / ml. In all groups celebrated the acceler- ated pace of aging by an average of 10 years, compared with the control group. In the second phase of the study, patients were divided into three groups, depending on the planned treatment scheme. In the group of patients treated with standard therapy of p53 protein level was 3,51 uI / ml, from the group comprising in addition to standard therapy, psychotherapy - 2,34 uI / ml, in the third group, where the methodology of psycho-physiological and psychological visual and auditory correction - 1 8 uI / ml. After a course of treatment in all groups showed slowing premature aging . The first and second groups , a transition of V in class IV , the third group III to V of the functional class of aging . during the correlation analysis it was found a strong correlation between p53 protein and BV (r + 0,69; p < 0.05).Conclusions: Patients with polymorbidity cardiovascular disease marked increase in titer of apop- tosis protein p53 , accelerating premature aging 7-10 years. A direct correlation between p53 protein and biological age (r + 0,69; p < 0.05). Against the background of complex treatment with standard therapy with psycho-physiological and psychological visual and auditory correction decreased prema- ture aging, as compared with the groups that used the standard therapy for 8-10 years.

Evaluate melatonin (MT) patterns excretion at multimorbid cardiovascular pathology (MCVP) (coronary artery disease (CAD), hypertension, metabolic syndrome (MS)) with non-psychot- ic mental disorders (NPMD) anxiety/ depressive type. Identify the effectiveness of visual-auditory ef- fects in the treatment of these pathologies. Design and methods: The study included 70 men (mean age 37,46±6,74) with MCVP divided into 4 groups by simple random sampling, and 20 healthy men (mean age 38,3±6,73 g). Patients in Group 1 (n = 22) received standard therapy CAD, hypertension and NPMD, in group 2 (n = 25) standard therapy CAD, hypertension, NPMD and visual-auditory correction. Patients of group 3 (n = 23) received standard therapy CAD, hypertension, NPMD, visual-auditory correction and psychotherapy. Used in the study: complex psychological test methods and laboratory-instrumental evaluation of the cardiovascular system. Definition of 6-sulfatoxymelatonin (6-SMT) performed by ELI- SA using kits BÜHLMANNEK-M6S. Results: Identified change normal «dipper» pattern to «non- dip- per» and «night-peaker» (daily index blood pressure and 0-10% <0% (p <0,001) in all treatment groups. Patients 3 group observed achievement reference values of the night excretion after treatment 458±64-» 798±32 (before and after treatment, respectively) (p <0,001). In all groups after treatment was observed significantly change the type of NDP «severe depression», «clinical anxiety» to «mild depression»; «sub- clinical anxiety» (p <0,001). Conclusions: Patients with MCVP have abnormalities of MT content char- acterized by a decrease in nocturnal excretion of 6-SMT. Night pattern of 6-SMT excretion significantly correlated with severity of anxiety/ depression before and after treatment. Results of patients treated with visual auditory correction significantly better than patients of other groups (obtained reference intervals MT excretion, biochemical indices and normalization of psychological tests).