Статьи журнала - Saratov Medical Journal
Все статьи: 62
A novel approach to initial hearing assessment
Статья научная
Objective: justifying the possibility of using frequency-based hearing research via the web application ‘Automated System for Initial Hearing Assessment’. Materials and methods. The study was carried out at the Department of Otorhinolaryngology of the Samara State Medical University clinics in October 2019. It involved 91 patients 17 to 73 years old (average age 48±14.6 years). All study participants were divided into two age groups: Group I 17-59 years old), and Group II (over 60 years old). Patients were required to undergo two hearing assessment tests: using the Interacoustics AC-40 clinical audiometer and using our web application ‘Automated System for Initial Hearing Assessment’ (patent No. 2019664671). Results. The maximum difference in average hearing thresholds between pure-tone threshold audiometry and the web application in Group I was 3.3 dB at a frequency of 2 kHz on the right and 3.2 dB at frequencies of 2 and 4 kHz on the left; in Group II, it constituted 4.7 and 3.5 dB at 1 and 2 kHz, on the right, correspondingly, and 7.2 dB at 4 kHz on the left. The presented data were evaluated using the Cohen’s kappa coefficient, which confirmed high level of agreement between the results obtained using the clinical audiometer vs. our original web application. Conclusion. Based on the obtained results, a conclusion was made about the possibility of using the original web application for the initial hearing express assessment in general practice in conditions of limited availability of audiological care.
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Статья научная
Objective: to evaluate the bacteriostatic properties of the developed prototypes of thin-film coating for orthopedic implants made of titanium and its alloys. Materials and Methods. Using scanning electron microscopy, we examined the morphology of Ti-6AL-4V (ASTM F1472) samples with a thin-film coating containing cupric oxide nanoparticles with a dispersion of 50-70 nm applied to their surface by plasma electrolytic oxidation. Then we assessed the impact of prototypes of thin-film coating on the propensity of clinical strains of microorganisms to adhere and form biofilms, and on their growth properties. Results. The developed prototype of a thin-film coating caused a significant decrease in the mass of biofilms formed by clinical strains of various microorganisms by 11% (Staphylococcus aureus), 38% (Staphylococcus epidermidis) and 7% (Pseudomonas aeruginosa), along with a reduction in bacterial growth properties by 12.7 % (S. aureus), 13.3% (S. epidermidis) and 10% (P. aeruginosa). Conclusion. The developed prototype of a thin-film coating for products made of titanium and its alloys reduced the virulence factors of clinical microbial strains due to its pronounced bacteriostatic effect via inhibiting bacterial adhesive activity and their ability to form biofilms.
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Antimicrobial activity of toothpastes against early childhood caries
Статья научная
Objective: assessing antimicrobial activity of toothpastes with different ingredient composition recommended for infants and toddlers. Materials and Methods. The study object was dental plaque of children with decompensated form of caries under the age of 3 years old. Seven toothpastes with different composition designed for early childhood were studied. Identification of detected microorganisms was carried out via mass spectrometry. Antibacterial activity was determined by agar diffusion and serial dilution methods. Results. Toothpastes containing xylitol, lactic enzymes and ingredients of medicinal herbs exhibited the absence of a microbial growth inhibition zone. Fluoride toothpastes were active against all tested microorganisms, and the final fluoride inhibitory concentration was 0.00016-0.0025%, depending on the fluoride concentration in the toothpaste. Conclusion. The least pronounced antimicrobial activity was detected in complex toothpastes with lactic enzymes and ingredients of medicinal herbs, as well as in samples with xylitol. Simple toothpastes with organic and inorganic fluorine compounds demonstrated the best bactericidal effect.
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Automated map of reproductive losses in the Far North region of Russia
Статья научная
Objective: to compile an automated map of reproductive losses in the Far North regions of Russia. Material and methods: This article includes statistical analysis of the prevalence and structure of reproductive losses according to the worldwide, Russian, and regional statistics. After describing the general structure of a neural network with a radial basis and a model of a radial neuron, we proceeded to characterization of the error backpropagation algorithm. Hence, our study was based on the normal deviation function. Results. The article substantiates the problem of reproductive losses of the Russian population. On the basis of statistical data, the listing of a neural network program for an interactive map of reproductive losses in the Far North regions of the Russian Federation was built. The obtained data made it possible to identify risk zones in the region. Comparison of indicators for 2000 and 2022 helped revealing the dynamics of change and reporting valid information on the overall increase in the risk of reproductive losses in the region by 17%. Conclusion. We proposed to conduct monitoring of reproductive loss indicators in the regions of the Russian Federation on the basis of a neural information map construction. The compiled map is an interactive map with an assessment of reproductive loss dynamics over the years.
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Статья научная
The objective of our study was to evaluate the cerebroprotective effect of xanthohumol (ХN) on experimental models of acute ischemic stroke in vivo and in vitro. Materials and methods. We used middle cerebral artery occlusion (MCAO) and oxygen-glucose deprivation (OGD) as in vivo and in vitro models. Our study subjects were Sprague-Dawley rats, which were randomly assigned to three groups: the control group and two MCAO groups with and without XN. The primary culture of cortical neurons was obtained from newborn rats. We employed the Bederson test and the corner test to evaluate neurological disorders. Results. The preliminary results indicated a possible cerebroprotective effect of XN in an ischemic stroke model. Conclusion. Preventive administration of XN before cerebral ischemia in an experiment can effectively reduce the volume of cerebral infarction and improve neurologic deficit 24 hours after MCAO.
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Change in brain electrical activity connectivity in migraine patients without aura
Статья научная
Objective: In this study, we consider how the structure of the brain EEG activity changes in patients with migraine, compared with virtually healthy volunteers without complaints of acute or chronic headache. Materials and Methods. The study of the connectivity of EEG activity was carried out on the basis of an objective assessment of pairwise synchronization between different recording channels, for which we used a method based on wavelet bicoherence. Results. Within the framework of the performed experimental study, we demonstrated an increased reactivity in the structure of connections in brain electrical activity of the patients experiencing a weak visual impact. Conclusion. A prospective study could determine the value of the described diagnostic procedure in support of the clinical decision on appropriate pharmacological and non-pharmacological prophylactic measures.
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Статья научная
Objective: to conduct a comparative analysis of mitochondrial respiration in brain homogenates of rats with stepwise incomplete cerebral ischemia (SICI) with varying duration between ligations of both common carotid arteries (CCA). Material and methods. The experiments were performed on 24 male mongrel white rats weighing 260±20 g. All rats were distributed among three subgroups. Cerebral ischemia was simulated under intravenous thiopental anesthesia (40-50 mg/kg). The control group (n=6) comprised sham-operated rats of similar gender and weight. To study mitochondrial respiration, the brain was extracted in the cold environment (0-4 °C), dried with filter paper, weighed and homogenized sensu the modified technique in an isolation medium containing 0.32 M sucrose, 10 mM Tris-HCl, 1 mM EDTA, pH of 7.4 (in a ratio of 1:10), using Potter – Elvehjem homogenizer with Teflon pestle. Results. SICI with an interval of 1 and 3 days between ligation of both CCA led to neuronal damage in the parietal cortex and hippocampus of rats, which manifested itself in a reduction of the neuron size, deformation of the perikaryons, an increase in the number of shrunken neurons and shadow cells. The most pronounced changes were observed in the subgroup with one-day interval between ligations. These changes were similar to the changes in incomplete cerebral ischemia (ICI) (p=0.07), except for the absence of cells with pericellular edema in the hippocampus and a smaller number of those in the parietal cortex. ICI with seven-day interval between ССА ligations, on the contrary, was manifested by less pronounced histological changes, especially in the hippocampus. Conclusion. Comparative analysis of mitochondrial respiration in brain homogenates revealed that the severity of brain damage in SSIC depended on the interval between blood flow arrest in both CCA. At the same time, the highest level of energy metabolism disorder was observed during CCA ligation with an interval of one day, which implied insufficient implementation of compensatory mechanisms.
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Changes in the amino acid pool of cerebral hemispheres in rats with total cerebral ischemia
Статья научная
Objective: assessment of changes in the pool of amino acids (AA) in rats with totalcerebral ischemia (TCI). Materials and Methods. Experiments were performed on 16 male outbred white rats weighing 260±20 g. TCI was modeled by decapitation of animals. Brain tissue was sampled 1 hour after decapitation. Results. In the parietal lobe (PL) and hippocampus (HC) of TCIgroup animals 1 hour aftertheir decapitation, we detected an increase in the content of tyrosine (by 43%, p=0.044, and 40%, p=0.044, respectively) and tryptophan (by 24%, p=0. 036, and 23%, p=0.046, respectively). Similar trend was observed for methionine that increased by 32% in PL (p=0.046) and by 27% in HC (p=0.046). Analogous increase in the content of L-arginine was noted in PL and HC (by 20%, p=0.037, and 33%, p=0.037, correspondingly). Isoleucine content increased by 12% in PL (p=0.054), whilevaline content decreased by 15% in HC (p=0.053). The ratio of the combined total content of branched-chain amino acids (BCAA) to the combined content of aromatic AA in TCI significantly declined from 1.4 to 1.0 in PL (p=0.053) and from 1.6 to 1.0 in GC (p=0.053). We observed an increase in methionine content by 33% (p=0.046) in PL and an increase in tryptophan content by 24% (p=0.046) in HC. Conclusion. One-hour TCIcaused the following changes in the AA pool: an increase in the content of aromatic AA (tyrosine and tryptophan) and methionine; an increase in the content of L-arginine; and also, an increase in the concentration of the inhibitory neurotransmitter glycine.
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Статья научная
Objective: to evaluate the activity of oxidative stress in rats with stepwise incomplete cerebral ischemia (SICI). Material and methods. Experiments were performed on 24 male outbred rats weighing 260±20 g, allocated into 3 subgroups (6 animals in each) based on time of ligation of both common carotid arteries (CCA). The control group comprised of sham-operated rats of the same sex and similar weights (n=6). To identify the pro-oxidant–antioxidant state of the brain based on its homogenates, the activity of lipid peroxidation processes, the content of thiobarbituric acid reactive substances (TBARS), the concentration of reduced glutathione (GSH), total thiol groups (TSH), and the activity of glutathione peroxidase were determined. Results. SICI with ligation interval of both CCAs of 1 day and 3 days led to a significant decrease in the total SH groups of proteins and glutathione by 30% (p=0.038) and 46% (p=0.044), respectively, TBARS concentration by 29% (p=0.038) and 31% (p=0.043), respectively. SICI with the maximum interval between CCA ligations was manifested by less pronounced changes in the pro-oxidant–antioxidant state of the brain. Conclusion. In SICI with ligation of both CCAs 7 days apart, at which histological changes were the least pronounced, changes in the pro-oxidant–antioxidant balance were insignificant. The most pronounced disorders of the pro-oxidant–antioxidant balance in the brain were observed in the subgroup with the minimum interval between CCA ligations, which implied the highest activity of oxidative stress.
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Статья научная
The objective was to assess the effectiveness of the use of transcranial magnetic therapy in comprehensive non-drug recuperation of neonates with perinatal injury of the central nervous system. Materials and Methods. Our research involved 214 newborns with corrected age of 30 weeks of gestation and perinatal lesion of the central nervous system. Main group (n=79): neonates underwent standard pharmacotherapy in combination with comprehensive non-drug recuperation (which included dry immersion, music therapy and orolingual massage), and transcranial magnetic therapy. Comparison group (n=74): newborns underwent standard pharmacotherapy in combination with non-drug recuperation. Control group (n=61): infants received conventional pharmacotherapy. Results. In Main group, hyperexcitability syndrome was healed in 60% of infants, and autonomic visceral disorders were cured in 80% of children. CNS depression syndrome signs disappeared in 67% of neonates. A significant (p<0.05) decrease in the resistance index was noticed, along with reduction in elevated peripheral vascular resistance and expansion of physiological reflexes, especially of the oral automatism group. Odds ratio of normalization of oral reflexes by day 10 for Main group vs. Control group was 5.09 with 95% CI [1.8-13.8]; and for Main group vs. Comparison group, it was 3.0 with 95% CI [1.1-8.4]. Normalization of muscle tone and resistance index reduction by day 10 in Main group was observed 8 and 4 times more often, correspondingly, than in Control group. Odds ratios were 8.2 with 95% CI [1.8-16.3] and 4.05 with 95% CI [1.06-9.3], respectively. Conclusion. Non-drug recovery methods in combination with magnetic therapy generated the sedative effect; provided stimulation of respiratory movements and spontaneous motor activity; and contributed to restoring proper reflex action. Hence, they are recommended for inclusion in the perinatal CNS lesion therapy of neonates.
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Cognitive disorders in patients with chronic kidney disease in pre-dialysis period
Статья научная
Objective: to study the cognitive status of patients in the pre-dialysis period depending on the stage of chronic kidney disease (CKD) and the category of cardiovascular risk (CVR). Materials and Methods. We examined 98 patients with CKD in the pre-dialysis period (mean age 47.1±11.2 years). The patients were divided into three groups according to the criteria of CVR stratification. Group 1 consisted of 32 patients with a low or moderate CVR, and CKD stage C1 or C2; Group 2 included 34 patients with a high CVR and CKD stage C3a or C3b; Group 3 comprised 32 patients with a very high CVR and CKD stage C4. We used the SAGE test (Self-Administered Gerocognitive Examination) to evaluate cognitive functions. Results. Cognitive impairment (CI) was detected in 57% of the patients: 37.5% in Group 1, 44.1% in Group 2, and 90.5% in Group 3. Dementia was diagnosed in 19% of patients with CI. A correlation was found between the severity of CI, the degree of decrease in glomerular filtration rate, and the education level of CKD patients in the pre-dialysis period (p≤0.001). We established that the examined subjects with CKD were characterized by memory, constructive, spatial and logical thinking disorders. Conclusion. Chronic kidney disease is an independent risk factor for the development of CI. The latter progressed with both CKD stage and the patient’s CVR category, and was detected in 37.5% of patients with a low or moderate CVR, 44.1% of patients with a high CVR, and 90.5% of patients with a very high CVR.
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Статья научная
The objective of our study was to investigate the features of circulatory autonomic regulation in the patients with a coronary artery bypass graft surgery (CABG) or correction of a valvular heart disease (CVHD). Material and Methods. Our study enrolled 42 patients (including 12 women) aged 63 (57; 67), who underwent CABG; and 36 patients (including 16 women) aged 58 (47; 65), who underwent CVHD. Simultaneous 15-minute recordings of electrocardiograms and photoplethysmograms (PPG) were performed on all patients before and after the surgery. We assessed and analyzed statistical and frequency-related measures of heart rate variability (HRV) and index of synchronization (S) among low-frequency (LF) oscillations in HRV and PPG. Results. The values of most autonomic regulation indices in our study did not have statistically significant differences among the patients with CABG and CVHD at all stages of research. The exception was represented by the heart rate, which was higher before CVHD (p=0.013). Conclusion. In all patients with CABG, the values of HRV and S did not depend on the differences in their clinical statuses or performed cardiac surgical interventions.
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Comparative efficiency of various molecular genetic methods in diagnosing tuberculosis
Статья научная
Objective – to compare the efficacy of various molecular genetic methods for diagnosing tuberculosis and determining drug susceptibility to rifampicin (RIF). Materials and Methods. We conducted a retrospective study of the sputum analysis results on 1,992 patients with pulmonary tuberculosis treated at Saratov Oblast Clinical Tuberculosis (TB) Dispensary from 2014 through 2018. The following methods were used: real-time polymerase chain reaction (PCR), biological microarrays, automated Xpert® MTB/RIF technology. Statistical processing of the research results was carried out using the Bayes formula based on contingency tables (four-field table) and the χ2 test. When evaluating the significance of differences between relative values, we employed the critical significance level of 0.05. Results. In terms of etiological diagnosis of TB, higher diagnostic sensitivities of the real-time PCR and biological microarray methods (73.9% and 70.3%, correspondingly) were established, as compared with the Xpert® MTB/RIF method (34.2%) (p<0.001). The sensitivity of all methods depended on the massiveness of bacterial excretion and clinical form of TB. Conclusions: The Xpert MTB/RIF method exhibited lower diagnostic sensitivity in verifying the diagnosis of TB, whereas its operational characteristics in terms of determining RIF-resistance were sufficiently high (sensitivity at 89.7%, specificity at 89.1%, and efficacy at 89.4%), which was comparable with the characteristics of biological microarray method (93.9%, 71.8%, 82.9%; p=0.127, p<0.001, p=0.139, respectively).
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Comparative evaluation of bone defect replacement methods in revision total knee arthroplasty
Статья научная
Objective: to evaluate the immediate and long-term outcomes of revision total knee arthroplasty using porous metaphyseal sleeves and cones. Materials and Methods. The study included 134 patients who underwent revision total knee arthroplasty. The patients were distributed among two groups based on the type of metaphyseal fixator: sleeves (Group I, n=97 patients) and cones (Group II, n=37 patients). Surgical outcomes were assessed upon discharge from the hospital (after the hospital stay of 7-12 days), as well as after 6, 12 and 24 months after surgery. The survival rate of endoprostheses was analyzed using the Kaplan–Meier method. A revision with total replacement of the endoprosthesis or its components was considered a critical event. Results. The analysis of the survival rate of endoprostheses in the form of various metaphyseal fixators showed that the groups of sleeves and cones did not differ statistically significantly as suggested by the logrank test (Mantel–Cox): p=0.108. Conclusion. The midterm follow-up revealed no difference in clinical, functional, or radiological outcomes of revision total knee arthroplasty performed for types 2A, 2B, and 3 of bone defect replacement (sensu Anderson Orthopaedic Research Institute classification) using trabecular metal metaphyseal cones vs. sleeves.
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Статья научная
Objective: to evaluate the hospital outcomes of coronary artery bypass grafting using autoarterial and autovenous conduits. Materials and Methods. We conducted a randomized clinical trial. We used the left internal thoracic artery for bypassing the anterior interventricular branch in both groups. The remaining conduits were either only the radial artery or the radial artery and great saphenous vein (study group) or solely the great saphenous vein (control group). The investigated outcomes were, among others, in-hospital mortality, Type 5 myocardial infarction, cerebrovascular event, respiratory failure, bleeding, cardiac arrhythmias, and acute kidney injury (AKI). Results. A sample of 27 patients was randomly distributed among the study group (n=12) and the control group (n=15). According to the perioperative and early postoperative data, there were no statistically significant differences between the groups, except for the duration of stay on artificial ventilation in intensive care unit: in the study group, it was longer than in the control group: 14 (12; 18) h versus 9.3 (5.8; 13) h, p=0.034. The most common complications were cardiac arrhythmias and AKI. There were no statistically significant differences between groups regarding studied for outcomes. Postoperative hospital stay (expressed as number of bed days) also did not differ statistically significantly between groups. Conclusion. According to our data, in the first days after surgery, the use of the radial artery does not provide significant advantages compared to the use of the great saphenous vein.
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Статья научная
Objective: to identify the proportion of complications after suburethral implantation of polypropylene slings in women with stress urinary incontinence based on a seven-year experience. Material and Methods. We conducted the analysis of а seven-year experience in various implantation techniques of suburethral slings in 1260 women with stress urinary incontinence: inside-out and outside-in obturator sling fixation; suprapubic sling fixation and non-trocar mini-sling installment. Results. The highest incidence of complications was observed over the first two years after suburethral sling implantation was performed. Subsequently, the proportion of complications declined progressively to the lower limit values of 7-8% in the course of three last years. An incidence of early surgical complications among various suburethral sling implantation techniques had no statistically significant differences. However, after the suprapubic sling implantation, intraoperative and mesh-associated complications prevailed. Conclusion. Our study confirmed that suburethral sling implantation using suprapubic fixation method was associated with a higher incidence of complications and should have been performed exclusively for the target group of the patients, for whom safer surgical procedures were contraindicated.
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Статья научная
Objective: development of the technology of immediate sequential bilateral cataract surgery (ISВCS) and assessment of its clinical effectiveness. Materials and Methods. Our study was conducted in two stages. At stage I, we reviewed the published materials on traditional algorithm of conducting ISВCS, as a result of which, a modified algorithm for performing surgical intervention (mоISBCS) was developed. At stage II, 130 patients (mean age of 58.4±1.8 years) with uncomplicated binocular cataract were under observation. Patients were divided into two groups of similar age and eye condition. The main group included 67 people (134 eyes), who underwent mоISBCS. The control group comprised 63 subjects (126 eyes), who underwent surgery on the second eye (delayed sequential bilateral cataract surgery, DSВCS) 21–28 days after the first operation. Results. The analysis of traditional provisions served the basis for improving ISВCS technology by including a long (at least 60 min) pause between operations with a comprehensive examination of the patient in the algorithm of surgical intervention. The obtained data demonstrated similar clinical effectiveness of mоISBCS and DSВCS. Conclusion. The mоISBCS technology can be considered an effective and safe method of cataract surgical treatment, which is especially important for patients with occupation yielding a visual stress.
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Статья научная
Objective: to study the effect of different pancreatic stump closure techniques and diameter of the main pancreatic duct on frequency and severity of acute postoperative pancreatitis after distal pancreatectomy. Material and Methods. Distal pancreatectomy was performed on 126 patients with neoplasms of body and/or tail of the pancreas. Patients were distributed among four groups based upon the pancreatic stump closure technique applied after distal pancreatectomy: group 1 (control) included the patients with isolated suturing of the main pancreatic duct in the pancreatic stump with its subsequent sealing by the gastrocolic omentum or hemostatic sponge; group 2 patients underwent isolated suturing of the main pancreatic duct in the pancreatic stump with its subsequent sealing with 2-octyl cyanoacrylate biological glue; group 3 patients had their pancreatic stump closure performed with endoscopic linear cutter stapler; group 4 was composed of the patients with external transduodenal transnasal drainage of enlarged (D>3 mm) main pancreatic duct in the pancreatic stump. Results. The occurrence of acute postoperative pancreatitis in the control group amounted to 45.8%, while, in groups 2, 3 and 4, the frequencies were 44.4, 9.7 and 15.0(%), correspondingly. Besides, the control group was characterized by declined occurrence of the moderately severe form of acute postoperative pancreatitis. Use of endoscopic linear cutter stapler and external transduodenal transnasal drainage of the enlarged main pancreatic duct caused lower acute postoperative pancreatitis frequency in the patients with main pancreatic duct in their pancreatic stumps below 5 mm in diameter. Conclusion. Use of proposed pancreatic stump closure techniques after distal pancreatectomy resulted in lower frequencies of occurrence and severity of acute postoperative pancreatitis.
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Статья научная
Objective: to compare the condition of periodontium in three categories of patients: smokers of electronic cigarettes (EC), smokers of heated tobacco products (HTP) and nonsmokers vs, their age and gender. Materials and Methods. We carried out a comprehensive analysis of 1,754 patient records including EC smokers (n=1,122) and HTP smokers (n=632).Data from 566 nonsmokers were used as a comparison group (CG). Patients of all groups were distributed among subgroups depending on their age and gender. The clinical condition of the periodontium was assessed using dental indices and indicators. For statistical data analysis, we employed Microsoft Excel and STATISTICA 64 version 20.0 software. Results. Gingivitis prevailed in all three groups. Itsprevalence in EC smokers decreasedwith age; the opposite trend was observed in HTP smokers. As for CG, gingivitis was recorded in all age groups. The prevalence of acute periodontitis was the highest in EС and HTP smokers aged 35-39 years vs. 30–34-year-old individuals of the CG. In HTP and EC smokers, the prevalence of gingivitis and acute periodontitis was more pronounced in females, while we observed no statistically significant difference of the kind between men and women of the CG. The frequency of occurrence of localized chronic periodontitis was maximum in EC and HTP smokers at the age of 40–44 years vs. 45–50 years in the CG subjects. However, in the HTPGroup, it was more pronounced in females, while in the EC Group it was more characteristic in males. The frequency of occurrence of generalized chronic periodontitis in individuals of all groups was more pronounced in women. Conclusion. The results of our study confirmed that the use of EC and HTP is a harmful factor causing the occurrence of periodontal disease.
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Статья научная
The objective was to study the dose-dependent effects of glucagon-like peptide-1 receptor agonist, liraglutide, on microcirculation in white rats under the alloxan-induced insulin deficiency. Materials and Methods. Our study was carried out on 70 white rats, divided into four groups: 20 intact control animals; 20 animals of the comparison group with alloxan-induced diabetes; 10 animals with insulin deficiency, injected with liraglutide at a dose of 0.2 mg/kg per day (treatment group No. 1); and 20 animals with insulin deficiency treated with liraglutide at a dose of 0.4 mg/kg per day (treatment group No. 2). Diabetic status, skin perfusion of the posterior limb and mechanisms of blood flow modulation were assessed in all groups of animals. Results. It was established that administering liraglutide at a dose of 0.4 mg/kg per day allowed achieving complete normalization of carbohydrate metabolism in rats with alloxan-induced insulin deficiency, thereby more effectively improving the state of microcirculation, compared with a dose of 0.2 mg/kg per day. Conclusion. The efficacy of correcting the microcirculatory disorders with liraglutide correlates with correcting the carbohydrate metabolism in rats with insulin deficiency and depends on liraglutide dose. The dose-dependent effect is achieved by the endothelial mechanism of flow modulation in microcirculation. However, the restoration of the vascular tone neurogenic component is independent of liraglutide dose.
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