Sequelae of COVID-19 at long-term follow-up after hospitalization

Aim. To assess long-term sequelae of COVID-19 in hospitalized patients at 3 to 7 months after discharge.Material and Methods. The whole of 700 patients hospitalized to the temporary COVID-19 treatment center hosted by the FSBI “National Medical Research Center of Cardiology” of the Ministry of Health of Russia from April to June 2020 were invited to participate in a follow-up study. At 3-7 months after the index hospitalization, patients or their proxies were contacted via telephone in order to obtain information on their vital status, cardiovascular and other conditions or their complications, and new hospitalizations. In addition, patients were invited to an outpatient visit under the "COVID-19-follow-up" program, encompassing physical examination and a comprehensive battery of laboratory and instrumental tests, including spirometry, chest computed tomography (CT) and the six minute walk test (6MWT). Further, dyspnea was assessed using the mMRC (Modified Medical Research Council) Dyspnea Scale. Results: We were able to contact 87.4% (612/700) of patients or their proxies. At follow-up, 4.4% (27) patients died, of which 96.3% (26) had cardiovascular diseases (CVD). A total of 213 patients aged 19 to 94 years old (mean age 56.8±12.5, median 57 years [49.0; 64.0]; men, 55.4%) agreed come for an outpatient visit and to participate in the “COVID-19-follow-up” program. Since discharge, 8% (17) of patients required new hospitalizations, and more than a half of these patients (58.8%; 10/17) had CVD-related hospitalizations. A total of 8.4% (18) patients experienced worsening of hypertension, 9 (4.2%) patients had newly diagnosed hypertension, 2 (0.9%) – coronary artery disease patients experienced new/recurrent angina symptoms. 4 (1.9%) patients had newly diagnosed coronary artery disease, and one patient had an ischemic stroke. At the outpatient visit, 114 (53.5%) patients had some symptoms, most frequently, shortness of breath (33%), fatigue (27.4%), chest pain (11.3%), and abnormal heartbeats (8.5%). Based on the mMRC Scale, 59% of patients had dyspnea of varying severity. Most patients had a normal vital capacity (VC), which was moderately reduced in 3.3% and severely reduced in 0.5% of patients. Chest CT scans were obtained in 78 (36.6%) patients, whose worst lung damage scores during hospitalization were CT3 or CT4. One in ten patients (10.8%) with severe lung damage during acute infection had persisting ground glass opacities, 35.9% developed fibrotic changes, 79.6% of patients had linear or fine focal opacities. According to the 6MWT data, 12.3% of patients walked less than 70% of the predicted distance, 67% walked 71 to 99% of the predicted distance, and 20.7% of patients were able to walk 100% of their predicted distance.Conclusion. These data suggest long-term negative sequelae of COVID-19 in more than half of hospitalized patients

Comparative DNA Cytometry of Primary and Recurrent Soft Tissue Sarcomas

The goal of comparative investigation was to reveal the distinctive features of the DNA content and cell distribution in the phases of the cell cycle of recurrent STS. DNA cytometry in the tumor tissue of 30 primary soft tissue sarcomas (t2a-2bn0M0) and 30 STS recurrences (t2-3n0M1) was carried out using the method of flow cytofluorometry. the tumor ploidy and cell distribution in the cell cycle phases were analyzed. Results. A number of differences in the DNA cytometric parameters of primary and recurrent STS have been revealed, they include: an increase in the proportion of aneuploid tumors in case of recurrence, the number of tumors with DNA index within the mitotic cycle, an increase in the proportion of cells in G2+M- phase of diploid and aneuploidy tumors and a decrease in S- phase of aneuploid ones. It has been shown that with a G2 differentiation degree, the proportion of cells in G2+M, S- and IP of recurrent STS is significantly lower than the primary parameters. An increase in the proportion of cells in G2+M- phase and a decrease in the rate of proliferation of recurrent STS, depending on the stage, are shown only in case of stage III. Conclusion. The revealed features of DNA content and cell cycle of tumor cells of soft tissue sarcomas will allow to approach to understanding of biological bases of recurrence of this malignant disease.Целью исследования было выявить в сравнительном аспекте отличительные особенности содержания ДНК и распределения клеток по фазам клеточного цикла рецидивных СМТ. Методом проточной цитофлуориметрии проводили ДНК-цитометрию в опухолевой ткани 30 первичных сарком мягких тканей (T2a-2bN0M0) и 30 – рецидивов СМТ (t2-3n0M1). анализировали плоидность опухоли и распределение клеток по фазам клеточного цикла. результаты. Выявлен ряд различий ДНК-цитометрических показателей первичных и рецидивных СМТ, которые заключаются: в увеличении доли анеуплоидных опухолей при рецидивах, числа опухолей с ИДНК в пределах митотического цикла, увеличение доли клеток в G2+M- фазе диплоидных и анеуплоидных опухолей и снижение в S-фазе анеуплоидных. Показано, что при степени дифференцировки G2 доля клеток в фазах G2+M, S- и ИП рецидивных СМТ значимо ниже параметров первичных. Увеличение доли клеток в G2+M-фазе и снижение темпов пролиферации рецидивных СМТ в зависимости от стадии показаны только при III стадии. Выводы. Выявленные особенности содержания ДНК и параметров клеточного цикла опухолевых клеток сарком мягких тканей позволят приблизиться к пониманию биологических основ рецидивирования этого злокачественного заболевания

BIOTECHNOLOGICAL ASPECTS IN ENSURING MICROBIOLOGICALLY PURE WHEAT BREAD

Development of technology for sustainable wheat bread to microbiological spoilage. To study of the influence of prescription components on microbiological spoilage and quality indicators

Biologically active substances in bakery products

Development of technology for muffins functionality based on biologically active composition comprising lyupinovo-melangehydrolyzatetykvoproteina, soy protein isolate, mustard oil and mineral fortifier calcium

Possibility of predicting the efficiency of soft tissue sarcoma treatment on the basis of features of their immunological microenvironment

Aim. To study the possibility of using the evaluation of local cellular immunity factors for predicting the efficiency of soft tissue sarcoma treatment. Methods. The study included 38 patients with soft tissue sarcoma: 22 with primary and 16 with recurrent tumors, admitted for surgical treatment in 2014-2016. In all patients, the intraoperative tumor tissue samples, peritumoral zone and relatively intact tissue samples corresponding to the resection lines (a total of 114 samples) were studied to assess the local immunity indices. The tissue samples were homogenized, lymphocyte subsets were detected with a flow cytometer. Results. Characteristics of immunological lymphocytic microenvironment of soft tissue sarcomas were studied in connection with the clinical effect of complex treatment of patients. In primary sarcomas, event-free survival at over 12 months after the surgery was related to higher level of NK-cells in tumor tissue and higher level of NKT-lymphocytes in peritumoral zone and tumor, as well as lower Tregs level than in patients with event-free survival for less than 12 months. In recurrent sarcomas, poor event-free survival was associated with high level of DN-cells in the tumor and peritumoral zone/tumor ratio for CD3+ lymphocytes. All the detected differences were statistically significant (

DNA-cytometric characteristics of recurrent soft tissue sarcomas

Aim. To determine the content of deoxyribonucleic acid (DNA) and distribution of cells in mitotic phases in patients with recurrent soft tissue sarcomas for the assessment of malignancy of the process. Methods. Tumor tissues of patients with recurrent soft tissue sarcomas were studied. Research methods included histological, DNA-cytometric and statistical methods. Results. Proliferative activity and proliferative index of recurrent sarcomas differed depending on the tumor grade and stage. Differences in the number of diploid, aneuploid and polyploid cells were determined in each group and between the groups depending on the cell cycle phases. Cell cycle parameters were as following: 100% of G1 (well-differentiated) cancer were diploid, as well as 33.3% of G2 (moderately differentiated) and 15% of G3 (poorly differentiated) tumors. Aneuploid tumors prevailed in G2 and G3, the ratio of which was 66.7 and 85%, respectively. The analysis of kinetic parameters of the cell cycle allowed establishing a decrease in the number of cells in G1/G0 phase of the cell cycle from G1 to G3, which was accompanied by a statistically significant increase in the proportion of cells in S-phase (p ˂0.05). Conclusion. The DNA-cytometric study of cell cycle parameters showed high biological potential of recurrent soft tissue sarcomas, which was determined by two indices - the proportion of cells in G2+M-phase and the cell loss factor; 100% of well-differentiated (G1) tumors, 33.3% of moderately differentiated (G2) and 15% of poorly differentiated (G3) tumors were diploid; aneuploid tumors prevailed in G2 and G3

PSYCHOSOCIAL FACTORS AND LIFE QUALITY IN CORONARY HEART DISEASE PATIENTS: RESULTS OF THE RUSSIAN PART OF INTERNATIONAL MULTICENTER STUDY EUROASPIRE IV

Aim. Analysis of psychosocial risk factors in coronary heart disease (CHD) patients among Russian centers of the EUROASPIRE IV study, comparing to overall study population.Material and methods. In the cross-sectional study, 24 European countries participated, including Russian Federation (3 centers). In the study, patients were included of the age 18-80 y.o., who, during the period ≥6 months to <3 years before the inclusion, had been hospitalized with myocardial infarction (MI) or other acute coronary syndromes (ACS) or for myocardial revascularization. To the study protocol, the analysis of medical charts was included, with following visit and structured interview. During the study, long-term results were evaluated, presence and level of the risk factors, including psychosocial, life quality parameters, adequacy of the acquired by patients recommendations and the grade of adherence. Prevalence of anxiety and depression symptoms was assessed with the Hospital Anxiety and Depression Scale (HADS).Results. Overall, in the Russian centers, 746 patients were included, of those to the interview visit 424 admitted (mean age 63,4±9,0 y.o., 25,2% females). Educational level of the Russian cohort was higher than of overall study population (higher education in 44,3% and 22,3%, respectively). Prevalence of the anxiety symptoms in Russian patients and in overall population almost matched: 8-10 points by HADS-A in Russia and overall had 15,7% and 15,0% of participants, respectively, the ≥11 points — 12,4% and 11,3%, respectively. Contrary, the prevalence of depression symptoms in Russia was slightly higher: 8-10 by HADS had 16,4% and 14,6%, and ≥11 — 10,9% and 7,8%, respectively. Both anxiety and depression symptoms were more common among women; depression symptoms were more common for post-MI/ ACS patients than in the re-vascularized.Conclusion. By the data from European monitoring center of EUROASPIRE IV, in Russian cohort of CHD post MI/ACS, and revascularized patients there are specific differences in comparison with overall study population in psychosocial risk factors. Prevalence of clinically significant anxiety and depression symptoms in Russian cohort of EUROASPIRE IV was significantly lower than in earlier trials, including EUROASPIRE III, and was just slightly higher than in overall study population

Secondary prevention in patients with coronary artery disease in Russia and Europe: results from the Russian part of the EUROASPIRE V survey

Aim. To assess the secondary prevention in Russian patients with coronary artery disease in the long-term period after acute myocardial infarction, acute coronary syndrome (ACS), percutaneous coronary intervention and/or coronary artery bypass grafting, obtained in the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in comparison with the general population of the study.Material and methods. EUROASPIRE V is a cross-sectional study with 27 countries, including Russia, which involved patients with ACS or indications for myocardial revascularization. At participating centers, patients admitted to hospital due to ACS or for percutaneous coronary intervention or coronary artery bypass grafting were identified. After 6 months and <2 years after discharge, patients were examined.Results. In total, 699 patients were identified in Russia, 399 of which visit an interview (women, 27,1%; mean age, 62,8±8,7 years). In the general population of the study, 16,208 patients were identified, 8,261 of which were interviewed (women, 25,8%; mean age, 63,6±9.6 years). At the time of the interview, 18,5% of Russian patients continued to smoke (16,8% in the general study population), the prevalence of overweight or obesity – 85,4 and 81,7%, abdominal obesity – 60,4 and 58,5%, diabetes – 21,9 and 29,3% of patients, respectively. In 19,7 and 16,4% of patients, respectively, diabetes was first diagnosed with a glucose tolerance test in the study. The target glycated hemoglobin was achieved in 47,1 and 54,4%, blood pressure – in 64,0 and 53,7%, low-density lipoprotein cholesterol – in 27,6 and 29,0% of patients, respectively.Conclusion. There were significant differences between the Russian cohort and the general study population. Some key secondary prevention parameters were more favorable in the Russian cohort, and some parameters – in the general group. In both compared populations, significant reserves are retained for further optimization

Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries

WOS: 000468732700018PubMed ID: 31054483Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient.ESC - EORP; AmgenAmgen; Eli LillyEli Lilly; PfizerPfizer; SanofiSanofi-Aventis; Ferrer; Novo NordiskNovo NordiskThe EUROASPIRE V survey was carried out under the auspices of the ESC - EORP. Since the start of EORP, the following companies have supported the programme: Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript

Rivaroxaban with or without aspirin in stable cardiovascular disease

BACKGROUND: We evaluated whether rivaroxaban alone or in combination with aspirin would be more effective than aspirin alone for secondary cardiovascular prevention. METHODS: In this double-blind trial, we randomly assigned 27,395 participants with stable atherosclerotic vascular disease to receive rivaroxaban (2.5 mg twice daily) plus aspirin (100 mg once daily), rivaroxaban (5 mg twice daily), or aspirin (100 mg once daily). The primary outcome was a composite of cardiovascular death, stroke, or myocardial infarction. The study was stopped for superiority of the rivaroxaban-plus-aspirin group after a mean follow-up of 23 months. RESULTS: The primary outcome occurred in fewer patients in the rivaroxaban-plus-aspirin group than in the aspirin-alone group (379 patients [4.1%] vs. 496 patients [5.4%]; hazard ratio, 0.76; 95% confidence interval [CI], 0.66 to 0.86; P<0.001; z=−4.126), but major bleeding events occurred in more patients in the rivaroxaban-plus-aspirin group (288 patients [3.1%] vs. 170 patients [1.9%]; hazard ratio, 1.70; 95% CI, 1.40 to 2.05; P<0.001). There was no significant difference in intracranial or fatal bleeding between these two groups. There were 313 deaths (3.4%) in the rivaroxaban-plus-aspirin group as compared with 378 (4.1%) in the aspirin-alone group (hazard ratio, 0.82; 95% CI, 0.71 to 0.96; P=0.01; threshold P value for significance, 0.0025). The primary outcome did not occur in significantly fewer patients in the rivaroxaban-alone group than in the aspirin-alone group, but major bleeding events occurred in more patients in the rivaroxaban-alone group. CONCLUSIONS: Among patients with stable atherosclerotic vascular disease, those assigned to rivaroxaban (2.5 mg twice daily) plus aspirin had better cardiovascular outcomes and more major bleeding events than those assigned to aspirin alone. Rivaroxaban (5 mg twice daily) alone did not result in better cardiovascular outcomes than aspirin alone and resulted in more major bleeding events