We hypothesize that cerebral microbleeds (CMB) in patients with different neuropsychological profiles (amnestic or non-amnestic) and MRI features of vascular damage could provide important information on the underlying pathological process in early Alzheimer's disease. The study was performed at two trial sites. We studied 136 outpatients with cognitive decline. MRI was performed using a magnetic field of 1.5 and 3 T. Neuropsychological assessment included Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Addenbrooke's Cognitive Examination (ACE-R), Cambridge Cognitive Examination battery (CAMCOG) (Part 3), Clock Drawing Test, fluency test and the visual memory test (SCT). CSF was examined for standard parameters such as tau, phosphorylated tau, amyloid-β 1-40 and 42 and Qalbumin, in accordance with established protocols and genotype. In 61 patients (45 %), at least 1 CMB was found. Most of the CMBs were described in the amnestic profile (67 %). In 86 % of the cases, multiple CMB were observed. The ratio of Aβ1-40/42 in non-amnestic patients with CMB was significantly lower (mean 0.6) than in patients without CMB (mean 1.2). A notable difference in the albumin ratio as an indicator of the BBB was observed between groups with and without CMB. In the CMP-positive group, the E2 genotype was observed more frequently, and the E4 genotype less frequently, than in the CMB-negative group. Based on the cerebrospinal fluid-serum albumin ratio, we were able to show that patients with CMB present several features of BBB dysfunction. According to logistic regression, the predictive factors for CMB in patients with cognitive decline were age, WMHs score and albumin ratio. We found a significant reduction in the Aβ-amyloid ratio in the non-amnestic profile group with CMB (particularly in the cortical region) in comparison to those without CMB. While this is an interesting finding, its significance needs to be assessed in a prospective follow-up.

We aimed to compare duration of uterine artery embolization, radiation exposure, safety and quality of life associated with the procedure in patients undergoing uterine artery embolization using transradial and transfemoral access. METHODSThis randomized controlled trial was conducted from February 2013 to March 2017 in three hospitals. Transradial access was used in 78 patients and transfemoral access in 75 patients. Clinical characteristics of the patients were comparable between the two groups. Patients were evaluated for the success and duration of the procedure, radiation exposure, major and minor complications. Quality of life associated with the procedure was assessed among patients with uterine fibroids. RESULTSEmbolization procedures were successfully performed in all patients in both groups. The duration of uterine artery embolization (32.27±7.99 vs. 39.24±9.72 minutes, p < 0.001), uterine artery catheterization time (12.36±5.73 vs. 19.08±6.06 minutes, p < 0.001) and radiation exposure (0.28±0.14 vs. 0.5±0.21 mZv, p < 0.001) were significantly lower in the transradial access group. The rate of major (0% vs. 2.7%, p = 0.37) and minor (11.53% vs. 17.3%, p = 0.42) complications was comparable between the two groups. Transradial access was associated with a statistically significant improvement in the quality of life associated with the procedure among patients with uterine fibroids. CONCLUSIONTransradial access in uterine artery embolization has the same efficacy and safety compared to transfemoral access. This access reduces radiation exposure and duration of the procedure.

Treatment of benign prostatic hyperplasia is an important and challenging problem of modern medicine. One of the most modern methods of the treatment of this disease is prostatic artery embolization. This procedure is most often done through transfemoral approach. Transradial vascular access has many advantages over the transfemoral access. Our study presents a comparative analysis of the use of transradial and transfemoral approach in this type of interventions. Transradial access was used in 13 patients, and transfemoral access - in 12 patients. The success of the procedure was 100% in both groups. The total duration of the procedure, the time needed for catheterization of internal iliac and prostatic arteries and the radiation exposure were significantly lower in the transradial approach group. There were no significant differences in the incidence of complications between two groups. The use of the transradial access was associated with a significant reduction of the frequency and severity of the discomfort associated with the procedure. Transradial approach has numerous advantages over the transfemoral approach and may have great clinical significance.

Aim: to study ophthalmological clinical functional parameters in patients with hypertension and coronary heart disease (CHD) with coronary artery stenosis. Patients and Methods: 30 patients (58 eyes) with hypertension and CHD with coronary artery stenosis (group A) and 30 healthy controls (60 eyes, group B) were examined. Best-corrected visual acuity (BCVA), macular sensitivity (MS) assessed by MAIA microperimetry, central macular thickness (CMT), foveal avascular zone (FAZ) area, vessel density of superficial capillary plexus (SCP VD) and deep capillary plexus (DCP VD) and choriocapillaris measured by optical coherence tomography angiography (OCTA) were evaluated. Results: FAZ area was 0.42±0.03 mm2 in group A and 0.28±0.03 mm2 in group B (p<0.05). SCP VD was 11.4±3.1% in group A and 25.4±2.5% in group B (p<0.05). DCP VD was 22.3±1.1% in group A and 39.2±3.5% in group B (p<0.05). Choriocapillaris VD was 51.2±1.1% in group A and 63.1±1.2% in group B (p<0.05). Correlations between ocular parameters and ejection fraction (EF) were revealed (BCVA: r=0.61, p<0.05; MS: r=0.68, p<0.05; CMT: r=-0.72, p<0.05; FAZ: r=-0.73, p<0.05; SCP VD: r=0.82, p<0.05; DCP VD: r=0.81, p<0.05; choriocapillaris VD: r=0.76, p<0.05). Conclusions: in patients with hypertension and CHD with coronary artery stenosis, significant (p<0.05) reduction in BCVA, MS, SCP VD, DCP VD, and choriocapillaris VD and increase in CMT and FAZ area were detected compared to healthy individuals. Additionally, strong correlations between ocular parameters (FAZ, SCP VD, DCP VD, and choriocapillaris VD) and EF (p<0.05) were identified. OCTA may be recommended to monitor fundus vessels in hypertension and CHD as an effective noninvasive valuable diagnostic tool to verify hypertension and CHD. Keywords: hypertension, coronary heart disease, coronary artery stenosis, hypertensive retinopathy, foveal avascular zone, vessel density, optical coherence tomography angiography. For citation: Moshetova L.K., Vorobyeva I.V., Dgebuadze A. et al. Ophthalmological monitoring in patients with hypertension and coronary heart disease. Russian Journal of Clinical Ophthalmology. 2021;21(2):51–57. DOI: 10.32364/2311-7729-2021-21-2-51-57.

BACKGROUND: Pancreatic cancer is one of the most aggressive malignant neoplasms, and the results of treatment of which remain extremely unsatisfactory. One of the methods to increase the effectiveness of surgical treatment of pancreatic cancer is selective oil chemoembolization of the pancreatic arteries. Transfemoral access is typically used as a vascular access during this type of intervention, in which complications from the vascular access are often observed. AIM: This study aimed to analyze the results of the use of transradial and transfemoral approaches for chemoembolization of pancreatic cancer. MATERIALS AND METHODS: We analyzed the results of chemoembolization of pancreatic arteries in 32 patients with pancreatic cancer. Transfemoral access was used in 16 (50%) patients and transradial access in 16 (50%) patients. According to the main clinical and anamnestic data, both groups were comparable. The endpoints of the study were technical success and complication rate of chemoembolization, total duration of the procedure, time needed for catheterization of the target artery, radiation exposure, and degree of discomfort for the patient. RESULTS: Chemoembolization of pancreatic arteries was successfully performed in 100% of patients in both groups. Major vascular complications were observed in three (18.8%) patients in the transfemoral access group and in one (6.3%) in the transradial access group (p=0.6). The total duration of the procedure and the time needed for catheterization of the target artery were 54.546.61 and 51.306.46 min (p=0.17) and 12.7 and 13.25 min (p=0.72), respectively. Radiation exposure was 0.680.10 mSv in the transfemoral access group and 0.650.10 mSv in the transradial access group (р=0.4). Transradial access was associated with a statistically significant reduction in all parameters of procedural discomfort. CONCLUSION: In terms of efficiency and safety of use, the transradial approach is not inferior to the traditional transfemoral approach, and in terms of patient comfort, it can be recommended as a priority for chemoembolization of the pancreatic arteries.