Level and correlations of soluble suppression of tumorigenicity 2 protein in heart failure and its relationship with clinical and paraclinical characteristics of patients

Aim. To establish the correlations of the soluble suppression of tumorigenicity 2 protein (sST2) and N-terminal pro-brain natriuretic peptide (NT-proBNP) with some clinical and paraclinical characteristics of patients with heart failure (HF).Material and methods. The study included 130 patients with HF (men — 54, women — 76, mean age, 64,3±8,3 years) from the regional registry of HF patients in the Voronezh Oblast. All patients underwent echocardiography and general clinical investigations. In addition, the serum levels of sST2 and NT-proBNP were determined and their correlations with other parameters were studied.Results. The blood level of sST2 in HF patients was 339,8 [266;405] pg/ml. In the study sample of patients with HF, sST2 levels correlated with right atrial (r=0,49) and right ventricular (r=0,32) sizes, left ventricular end-diastolic dimension (r=0,34) and volume (r=0,33), left ventricular early diastolic filling rate (r=-0,35), blood calcium level (r=-0,55) and functional class of exertional angina (r=-0,37).Conclusion. The data obtained may indicate a pathogenetic relationship between sST2 and systolic and diastolic dysfunction of the left ventricle and right heart

Психологические аспекты организации и проведения занятий в “Астма-школе”

We examined 228 bronchial asthma (BA) patients taught at an “Asthma-school” by means of the Toronto alexithymie scale (TAS), and a brief version of the personality multilateral investigation method (PMIM), and the Spilberger-Khanin’s scale. Alexithymia was found in 54.9% of the BA patients. They were significantly higher neurotized compared with non-alexithymic persons. Smoking and excessive alcohol consumption as harmful behaviour features were noted reliably more often in alexithymie persons compared with non-alexithymic ones. Individual training of the alexithymie patients were aimed to the formation of “emotion bank” and to stress removal and increased the efficacy of the training and asthma management.Обследовано 228 больных бронхиальной астмой (БА), проходивших обучение в “Астма-школе” , с помощью Торонтской алекситимической шкалы (TAS), сокращенного варианта методики многостороннего исследования личности (СМОЛ), теста Спилбергера-Ханина. Алекситимия выявлена у 54,9% пациентов с БА. Больные БА с алекситимией имели достоверно более высокий уровень невротизации личности, чем неалекситимичные индивиды. Курение и злоупотребление алкоголем как вредные поведенческие особенности у алекситимичных индивидов встречались достоверно чаще, чем у неалекситимичных. Индивидуальные занятия с алекситимичными больными по формированию банка “эмоций” и способам купирования стресса приводили к снижению общей невротизации и тревожности пациентов с БА, что способствовало повышению эффективности обучения и лечебно-профилактических мероприятий при астме

Bilirubin and cardiovascular risk

This literature review demonstrates the results of experimental and clinical studies, as well as data from meta-analyzes on the effect of bilirubin levels on cardiovascular system. Recent studies provided a new look at the role of bilirubin in cardiovascular disease. Modern concepts consider bilirubin as a powerful endogenous antioxidant with anti-inflammatory effects, capable of influencing the course of atherosclerotic cardiovascular diseases and reducing ischemic damage. The change in bilirubin levels affects the coronary blood flow, the development of collateral circulation and the morphology of coronary plaques. A low bilirubin level is associated with an increase in left ventricular mass and a decrease in its contractility, which, in turn, leads to heart failure and increases the risk of rehospitalizations. Taking into account the above effects of bilirubin, there was interest in assessing the effect of its blood level on the risk of atherosclerotic cardiovascular diseases. Recent studies have attempted to create risk stratification models for adverse cardiovascular events based on bilirubin levels

The Peculiarities of Six-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease, Some with Normal Weight and Some Overweight

Background: The combination of chronic obstructive pulmonary disease (COPD) and overweight/obesity is a common clinical situation in modern healthcare. The objective of this study was to conduct a comparative analysis of exercise tolerance in normal body weight (NBW) and overweight patients with COPD in the 6MWT using the original device for cardiorespiratory analysis and a method for assessing the cardiorespiratory condition. Methods and Results: The study included 194 patients with COPD. The patients were divided into two groups. Group 1 consisted of 96 COPD patients with NBW: 77(80.21%) men and 19(19.79%) women aged 41 to 73 years (mean age of 63.33 ± 8.44 years). Group 2 consisted of 98 overweight COPD patients: 74(75.51%) men and 24(24.49%) women aged 55 to 71 (mean age of 64.84 ± 5.46 years). To assess tolerance to physical activity and to objectify the functional status of patients, the 6MWT was used and carried out according to generally accepted principles. The distance covered in 6 minutes (6MWD) was measured in meters and compared with the proper 6MWD(i). The developed device for cardiorespiratory analysis was used to obtain the most accurate 6MWT result. All patients in the study groups underwent an analysis of the composition of the body by the bioelectrical impedance method using a fat mass analyzer BC-555 (Tanita Corporation, Tokyo, Japan). The percentages of fat, water, muscle mass (MM), and bone mass were evaluated. The average value of the 6MWD/6MWD(i) ratio in COPD patients with NBW was significantly lower than in COPD patients with overweight (P=0.0121). Before the test, the study groups did not differ in the level of SpO2. However, according to the results of comparative analysis, this parameter was significantly lower in patients with NBW immediately after the 6MWT (P=0.0000), which, along with a lower value of the distance traveled as a percentage of the proper value in Group 1 patients, may indicate a lower tolerance to physical activity in COPD patients with NBW than in patients with overweight. In COPD patients with NBW, the percentage of fat and MM were significantly lower than in COPD patients with overweight (P=0.0000 in both cases). There was a direct correlation between 6MWD and body mass index (r=0.56, P=0.003) and between 6MWD and MM percentage (r=0.59, P=0.016). Conclusion: Higher exercise tolerance is found in overweight COPD patients than in COPD patients with NBW. This phenomenon can be explained to some extent by the compositional components of the body, in particular, by a significantly lower percentage of lean MM in patients with NBW

Prognostic Value of Melatonin in Patients with Chronic Obstructive Pulmonary Disease

The article outlines a detailed examination of multiple scientific studies investigating how melatonin affects COPD's advancement and growth. The severity of oxidative stress in COPD, a complex disease with multiple factors, is significantly reduced by melatonin by activating intracellular antioxidants, as suggested by the data acquired. Considering the available data, we can conclude that melatonin has a protective role against oxidative stress in COPD patients in addition to regulating the circadian rhythm

Роль индивидуального обучения в достижении контроля над бронхиальной астмой

Summary. Sixty patients aged 18 to 60 years with bronchial asthma (BA) were examined. Clinical and psychological state was evaluated before and 1 month after an educational course. Implementation of individual education programs has led to a reliable increase in compliance and asthma control and in clinical and psychological improvement in comparison with BA patients involved in group education programs. Thus, the individual education programs allow increasing the efficiency of therapeutic and preventive measures in BA patients.Резюме. Были обследованы 60 человек в возрасте от 18 до 60 лет с диагнозом бронхиальная астма (БА). В результате индивидуального обучения у больных БА достоверно повысился уровень контроля над заболеванием, комплаенс, улучшились клинические и психологические показатели по сравнению с пациентами, прошедшими программу обучения в форме групповых занятий. Таким образом, применение индивидуальных образовательных программ позволяет повысить эффективность лечебно–профилактических мероприятий у больных БА

Some Aspects of Mast Cells Carboxypeptidase A3 Participation in the Pathogenesis of COVID-19

Background: This study aimed to determine the involvement of carboxypeptidase A3 (CPA3) in developing lung damage in patients with COVID-19. Methods and Results: The study included samples of autopsy material from the lungs of patients who died as a result of severe COVID-19 (the main group [MG] and persons who died from external causes (the control group [CG]). Immunohistochemical staining for CPA3 was carried out. A quantitative study of CPA3-positive mast cells (MCs) and the degree of their degranulation was carried out using a ×40 objective lens with an analysis of ≥50 fields of view with further conversion to 1 mm². Significant representation of CPA3-positive MCs per 1 mm2 of CPA3-positive MCs, CPA3-positive MCs with signs of degranulation (SD), and co-adjacent MCs was found in the MG compared to the CG (P=0.01 in all cases). In the main group, positive correlations were identified between the total number of CPA3-positive MCs, CPA3-positive MCs with SD and the blood hemoglobin level shortly before death (r=0.491 [P=0.008] and r=0.521 [P=0.004], respectively). Co-adjacent CPA3-positive MCs were negatively correlated with blood eosinophils at the beginning of hospitalization (r=-0.420 [P=0.023]). Also, the number of separately lying, CPA3-positive MCs negatively correlated with the blood monocyte shortly before death (r=-0.384 [P=0.044]). A positive correlation was established between the total number of CPA3-positive MCs, CPA3-positive MCs with SD, and adjacent CPA3-positive MCs with total blood protein in patients at the beginning of hospitalization (r=0.431 [P=0.020], r=0.449 [P=0.015] and r=0.456 [P=0.013], respectively). In addition, the study demonstrated a positive correlation between CPA3-positive MCs with SD and the total number of CPA3-positive MCs with blood aPTT levels (r=0.304 [P=0.045] and r=0.375 [P=0.045], respectively). A negative correlation was also found between the total number of CPA3-positive MCs and the blood INR level (r=-0.812 [P=0.050]). Finally, in patients at the beginning of hospitalization, a negative correlation was found between CPA3-positive MCs with SD, CPA3-positive MCs without SD, separately located CPA3-positive MCs, adjacent CPA3-positive MCs, and the total number of CPA3-positive MCs with blood amylase (r=-0.550 [P=0.002], r=-0.452 [P=0.045], r=-0.485 [P=0.030], r=-0.622 [P=0.008], and r=-0.590 [P=0.006], respectively). Conclusion: Our study identifies the potential involvement of CPA3 in the pathogenesis of severe COVID-19. However, many aspects of its participation remain unclear and require further study

Особенности психологического статуса больных бронхиальной астмой с алекситимией

One hundred and eighteen bronchial asthma (BA) patients were examined by means of the Toronto alexithymie scale (TAS), and a brief version of the personality multilateral investigation method (PMIM), and the Spilberg-Khanin’s anxiety scale. Among them 55.1% of the patients were recognized as alexithymie persons. Asthmatic patients with alexithymia were reliably more neurotized compared with non-alexithymic ones. The revealed peculiarities of an actual personal condition of the alexithymie bronchial asthma patients cause a necessity of including methods of psychotherapeutic correction of alexithymia to a prevention measures system.Обследовано 118 больных бронхиальной астмой (БА) с помощью Торонтской апекситимической шкалы (TAS), сокращенного варианта методики многостороннего исследования личности (СМОЛ), шкалы тревоги Спилберга-Ханина. Алекситимичными признаны 55,1% пациентов с БА. Больные БА с алекситимией имели достоверно более высокий уровень невротизации личности, чем неалекситимичные индивиды. Выявленные нами особенности актуального личностного состояния алекситимичных больных бронхиальной астмой обуславливают необходимость включения в систему профилактических мероприятий методов психотерапевтической коррекции алекситимии