ПРИМЕНЕНИЕ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ ДЛЯ ВЕРИФИКАЦИИ ПОЗДНИХ ОСТАТОЧНЫХ ИЗМЕНЕНИЙ В ЛЕГОЧНОЙ ТКАНИ У ВОДОЛАЗА СО СТАЖЕМ

Peculiar diving disorders are characterized by pathological changes of lungs that are not always easy to identify and verify through X-ray. The article presents the clinical case of a professional frogman. X-ray scanning has been demonstrating changes in his lungs for many years. However, it was not considered as implications brought by high pressure in water and gas environments. The article gives a retrospective analysis of chest X-ray for the recent 13 years: both CT and spirography. CT reveals a limited zone of pneumothorax and two air-containing zones (aerocele) typical of pulmonary barotrauma. While medical examination of frogman, saturation diver and aquanaut it is highly reasonable to undergo computed tomography screening to verify morphological changes in lungs tissue and evaluate lesion volume.Специфические водолазные заболевания характеризуются возникновением патологических изменений в легких, которые при рентгенографии не всегда возможно распознать и верифицировать. Более информативным методом диагностики поражения легких, является компьютерная томография (КТ). Однако КТ не входит в программу медицинского освидетельствования водолазов и, следовательно, данных об изменениях в легочной ткани в процессе профессиональной деятельности практически нет. В работе представлен разбор клинического случая, в котором выявляемые у водолаза при рентгенографии изменения в легких в течение многих лет профессиональной деятельности, не связывались с действием неблагоприятных факторов повышенного давления газовой и водной среды. В работе выполнен ретроспективный анализ рентгенографий органов грудной клетки за 13 лет, компьютерная томография и спирография. На КТ определяется участок ограниченного пневмоторакса и две воздушные полости, характерные для баротравмы легких. При медицинском освидетельствовании водолазов, водолазов-глубоководников, акванавтов целесообразно выполнять компьютерную томографию для верификации морфологических изменений легочной ткани и оценки объема поражения

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

ZONAL FOREST COMMUNITIES AND FOREST ZONING OF WESTERN SIBERIA (RUSSIA)

Forests of Siberia are heterogeneous in species composition, productivity, types and nature of renewability. They are also heterogeneous in patterns of forest distribution on different categories of land, marshes, bare mountains, meadows and percentage of forest cover. This research investigates the main types of woody plants and geographical distribution of forest communities in Western Siberia. The forest zoning of Western Siberia was analyzed to reveal the features of zonal formation of forest biogeocenoses. Forest zoning and ecological and economic assessment of the productivity of forest communities within zones and regions make the basis for outlining the strategic priorities in the given territory, and help to develop a system of forestry and timber processing activities aimed to improve ecological and economic efficiency of forest resources.</jats:p

ПРИМЕНЕНИЕ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ ДЛЯ ВЕРИФИКАЦИИ ПОЗДНИХ ОСТАТОЧНЫХ ИЗМЕНЕНИЙ В ЛЕГОЧНОЙ ТКАНИ У ВОДОЛАЗА СО СТАЖЕМ

Peculiar diving disorders are characterized by pathological changes of lungs that are not always easy to identify and verify through X-ray. The article presents the clinical case of a professional frogman. X-ray scanning has been demonstrating changes in his lungs for many years. However, it was not considered as implications brought by high pressure in water and gas environments. The article gives a retrospective analysis of chest X-ray for the recent 13 years: both CT and spirography. CT reveals a limited zone of pneumothorax and two air-containing zones (aerocele) typical of pulmonary barotrauma. While medical examination of frogman, saturation diver and aquanaut it is highly reasonable to undergo computed tomography screening to verify morphological changes in lungs tissue and evaluate lesion volume.Специфические водолазные заболевания характеризуются возникновением патологических изменений в легких, которые при рентгенографии не всегда возможно распознать и верифицировать. Более информативным методом диагностики поражения легких, является компьютерная томография (КТ). Однако КТ не входит в программу медицинского освидетельствования водолазов и, следовательно, данных об изменениях в легочной ткани в процессе профессиональной деятельности практически нет. В работе представлен разбор клинического случая, в котором выявляемые у водолаза при рентгенографии изменения в легких в течение многих лет профессиональной деятельности, не связывались с действием неблагоприятных факторов повышенного давления газовой и водной среды. В работе выполнен ретроспективный анализ рентгенографий органов грудной клетки за 13 лет, компьютерная томография и спирография. На КТ определяется участок ограниченного пневмоторакса и две воздушные полости, характерные для баротравмы легких. При медицинском освидетельствовании водолазов, водолазов-глубоководников, акванавтов целесообразно выполнять компьютерную томографию для верификации морфологических изменений легочной ткани и оценки объема поражения

Molecular aspects of creating vaccines for the prevention of poisoning ribosome-inactivating proteins of plant origin: current situation, problems of vaccine development

This article reviews the current understanding of the mechanism of action of the toxin, the clinical effects of ricin and abrin intoxication and how these relate to current and continuing prospects for vaccine development. The threat of bioterrorism worldwide has accelerated the demand for the development of therapies and vaccines against the ribosome-inactivating proteins. The diverse and unique nature of these toxins poses a challenge to vaccinologists. This paper will review the mechanism of toxicity and vaccines development to protect against the highly toxic plant-derived ribosomal toxins. Vaccine development is further complicated by the fact that as bioterrorism agents, abrin and ricin would most likely be disseminated as aerosols supplies. Our understanding of the mechanisms by which these toxins cross mucosal surfaces, and importance of mucosal immunity in preventing toxin uptake is only rudimentary. Research is now aimed at developing recombinant, attenuated vaccines based on a detailed understanding of the molecular mechanisms by which these toxins function. The evolution of the development of specific immunoprophylaxis of acute ricin poisoning from native toxoid to genetically engineered subunit vaccines based on the method of targeted mutagenesis is traced. The past several years have seen major advances in the development of a safe and efficacious ricin toxin vaccine. These vaccines are discussed in the context of the toxicity and structure of ricin. In this review we summarize ongoing efforts to leverage recent advances in the design and use of vaccines.</jats:p

Efficacy and safety of a novel dosing strategy for ruxolitinib in the treatment of patients with myelofibrosis and anemia: the REALISE phase 2 study

AbstractAnemia is a frequent manifestation of myelofibrosis (MF) and there is an unmet need for effective treatments in anemic MF patients. The REALISE phase 2 study (NCT02966353) evaluated the efficacy and safety of a novel ruxolitinib dosing strategy with a reduced starting dose with delayed up-titration in anemic MF patients. Fifty-one patients with primary MF (66.7%), post-essential thrombocythemia MF (21.6%), or post-polycythemia vera MF (11.8%) with palpable splenomegaly and hemoglobin &lt;10 g/dl were included. Median age was 67 (45–88) years, 41.2% were female, and 18% were transfusion-dependent. Patients received 10 mg ruxolitinib b.i.d. for the first 12 weeks, then up-titrations of up to 25 mg b.i.d. were permitted, based on efficacy and platelet counts. Overall, 70% of patients achieved a ≥50% reduction in palpable spleen length at any time during the study. The most frequent adverse events leading to dose interruption/adjustment were thrombocytopenia (17.6%) and anemia (11.8%). Patients who had a dose increase had greater spleen size and higher white blood cell counts at baseline. Median hemoglobin levels remained stable and transfusion requirements did not increase compared with baseline. These results reinforce the notion that it is unnecessary to delay or withhold ruxolitinib because of co-existent or treatment-emergent anemia.</jats:p