RELATIONSHIP OF LIPID PEROXIDATION PROCESSES AND CHRONIC INFLAMMATION WITH ATHEROSCLEROTIC VASCULAR CHANGES AND INDICATORS ENDOTHELIAL DYSFUNCTION IN PATIENTS WITH CKD STAGES II-IV

The aim of our study was to determine the relationship of processes of atherogenesis and indicators of endothelial dysfunction with the processes of activation of lipid peroxidation (LPO) and chronic inflammation in patients with CKD stages II-IV. Material and methods. Levels of proinflammatory and anti-inflammatory cytokines, indicators of lipid peroxidation, the thickness of the intima-media (IMT) of the carotid artery, ankle-brachial index (ABI) were measured in 90 patients with CKD stage II-IV (30 - CKD st. II, 31 patients with CKD st. III and 29 st. IV CKD patients) and 30 healthy subjects (control group). The correlation analysis was performed to identify the possible association between the obtained parameters of atherosclerotic vascular lesions and endothelial dysfunction and indices of lipid peroxidation and pro- and anti-inflammatory cytokines. Results. The average levels of interferon-y, interleukin (IL) -1p and IL-10 in patients with CKD II-IV Art. were significantly increased compared with the corresponding values in the control group. The average levels of malondialde- hyde (MDA) of serum and MDA of erythrocyte in CKD patients was significantly increased compared with the corresponding values in the control group, and the antioxidant system indices - total peroxidase activity of erythrocytes and serum levels of the sulfhydrylgroups was significantly reduced relative to the corresponding values in the group control. 39 (43%) patients with CKD st. II-IV were recorded carotid atherosclerotic changes. The IMT (from 0.91 to 1.29 mm) defined in 22 (56%) patients and atherosclerotic plaques (IMT > 1,3 mm) defined in 17 (44%) patients. Bilateral carotid atherosclerotic lesions was observed in 14 (36%) patients with CKD st. II-IV. Endothelial dysfunction was observed in 71 (79%) patients with CKD st. II-IV. There was a statistically significant association between indicators of chronic inflammation, lipid peroxidation and indicators of atherosclerotic vascular lesions and endothelial dysfunction. Conclusion. Pathological processes ofLPO activation, chronic inflammation are closely linked between themselves and progression of atherosclerotic vascular lesions in CKD

First Demonstration of a Higher Order Depolarizing Resonance

This research was sponsored by the National Science Foundation Grant NSF PHY-931478

Иммунологические аспекты определения правильной последовательности биологической терапии воспалительных заболеваний кишечника. Резолюция совета экспертов (Санкт-Петербург, 22 мая 2021 г.)

On May 22, 2021, the Expert Board met in St. Petersburg to discuss their position on immunological aspects of determination of an adequate biological treatment sequence for inflammatory bowel diseases (IBD). The Expert Board aimed at discussion of current strategies, development of a consensus on determination of an adequate biological treatment sequence for IBD. The main topics of the agenda were the contribution of immune system to the pathophysiology of Crohn's disease, ulcerative colitis and their complications, efficacy of genetically engineered biological agents (GEBA) at various stages of IBD management. Participation of the leading Russian experts in IBD, as well as involvement of other specialties, made it possible to consider the topic by a multidisciplinary team, with an in-depth analysis of IBD pathophysiology, to better understand the course of the disease in some contradictory situation, for instance, when clinical remission is not associated with an endoscopically confirmed remission. One of the expected effects of this Expert Board meeting would be an improvement of GEBA administration in clinical practice, mostly due to the modification of clinical guidelines. This would ascertain and confirm the algorithms for GEBA administration for IBD, including the optimal treatment sequence depending on an agent’s mechanism of action and the patient profile. The clarification of the optimal GEBA sequence in the clinical guidelines could lead to more frequent GEBA administration in local medical clinics and institutions in the regions, where GEBA are used insufficiently due to little experience and absence of their precise positioning in the clinical guidelines.22 мая 2021 г. в Санкт-Петербурге состоялся совет экспертов на тему «Иммунологические аспекты определения правильной последовательности биологической терапии воспалительных заболеваний кишечника». Цeлью совета экспертов было обсуждение современных подходов к определению последовательности назначения биологической терапии воспалительных заболеваний кишечника (ВЗК) и выработка единой точки зрения по этому вопросу. Основными темами дискуссии стали участие иммунной системы в развитии болезни Крона и язвенного колита и их осложнений, эффективность генно-инженерных биологических препаратов (ГИБП) на разных этапах лечения ВЗК. Участие в заседании ведущих экспертов России по вопросам лечения ВЗК, а также привлечение более узких специалистов позволило рассмотреть проблему с позиций мультидисциплинарности, глубже взглянуть на патогенез ВЗК, лучше понять процессы течения заболевания в противоречивых ситуациях, когда клиническая ремиссия не сопровождается ремиссией эндоскопической. Одним из ожидаемых эффектов данного заседания совета экспертов должно стать улучшение практики назначения ГИБП, что достижимо прежде всего за счет внесения изменений в клинические рекомендации. Это позволило бы уточнить и закрепить алгоритмы назначения ГИБП при ВЗК, в том числе и оптимальную последовательность терапии в зависимости от механизма действия препарата и профиля пациента. Следствием закрепления оптимальной последовательности ГИБП в клинических рекомендациях может также стать расширение практики применения ГИБП на уровне локальных учреждений в субъектах, в которых, по причине малого опыта назначения ГИБП и отсутствия их четкого позиционирования в клинических рекомендациях, назначение ГИБП находится на недостаточном уровне

Практикум по педиатрии: учебное пособие для студентов 5-го курса

Practicum in Pediatrics includes 132 clinical cases of diseases of newborns, infants and older children. In the cases, there are discharge reports from the medical records of real patients with common diseases in pediatric practice (perinatal and neonatal diseases, deficiency conditions, anemia, as well as diseases of lungs, heart, joints, gastrointestinal tract, kidney and allergy). After discharge reports, there are questions and at the end of each section – diagnostic keys. The method of case studies refers to a non-gaming simulation methods of interactive learning and allows to apply theoretical knowledge to solve practical problems, trains making the right decisions in particular situations. Cases are designed to discuss them at classroom practice sessions, for self-study and for control of knowledge at the exam. The manual is aimed at students, residents, graduate students, pediatricians. Prepared by the Department of Pediatrics, Medical Faculty of Peoples' Friendship University of Russia