149 research outputs found

    On the Stabilizing Effect of Surfactants Adsorption Layers

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    Cohesion forces in contacts of discrete spherical particles (having either hydrophilic or hydrophobic surface) were measured directly in aqueous or heptane solutions. It is shown that the stabilizing action of tensides in the hydrophobic particle system was brought about by a two-dimensional pressure of the adsorbed tenside which is easily removed Β· from the contact zone of the particle. The stabilizing action of tensides in the hydrophilic particle systems is a consequence of the formation of a mechanical barrier which has a high apparent strength due to the adsorbed layer on the solid surface

    Statins interfere with the attachment of S. cerevisiae mtDNA to the inner mitochondrial membrane

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    The 3-hydroxy-3-methylglutaryl-CoA reductase, a key enzyme of the mevalonate pathway for the synthesis of cholesterol in mammals (ergosterol in fungi), is inhibited by statins, a class of cholesterol lowering drugs. Indeed, statins are in a wide medical use, yet statins treatment could induce side effects as hepatotoxicity and myopathy in patients. We used Saccharomyces cerevisiae as a model to investigate the effects of statins on mitochondria. We demonstrate that statins are active in S.cerevisiae by lowering the ergosterol content in cells and interfering with the attachment of mitochondrial DNA to the inner mitochondrial membrane. Experiments on murine myoblasts confirmed these results in mammals. We propose that the instability of mitochondrial DNA is an early indirect target of statins

    ΠŸΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΠΈΠΌΠΏΡƒΠ»ΡŒΡΠ½ΠΎΠΉ осцилломСтрии Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом

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    Impulse oscillometry (IOS) measures the total respiratory system impedance (Z) at incremental frequencies during normal tidal breathing. Our aim was to establish the total respiratory impedance and how IOS measurements relate to conventional lung function indices in patients with cystic fibrosis (CF). Results from spirometry, static lung volumes and IOS (R, X, Z, resonant frequency (FR) and reactance area 5Hz β€” FR (AX)) were compared in 66 adult CF patients recruited from CF Care Centre of Moscow. Patients had airway obstruction (FEV1 = 57 % pred.), hyperinflation (RV = 253 % pred., FRC = 158 % pred., RV / TLC = 52 %). IOS demonstrated a frequency dependent increase in R (R5 = 173 % pred., R20 = 140 % pred.) and a decrease in X (X5 = –0,23 kPa/L / s) with a shift in FR to higher frequencies (FR = 18 Hz, AX = 1,4 kPa / L). There were significant correlations between FR, X20, R5, R20, AX and conventional lung function indices (FEV1 = – 0,74; 0,78; –0,42; –0,31 and –0,76 respectively). The data indicate that measurement of reactance and FR may reflect the degree of airway obstruction. IOS is an effort independent measurement that could be used in clinical routine especially in patients with severe lung diseases.Π˜ΠΌΠΏΡƒΠ»ΡŒΡΠ½Π°Ρ осцилломСтрия (ИОБ) являСтся Π½Π΅ΠΈΠ½Π²Π°Π·ΠΈΠ²Π½Ρ‹ΠΌ ΠΌΠ΅Ρ‚ΠΎΠ΄ΠΎΠΌ для опрСдСлСния ΠΎΠ±Ρ‰Π΅Π³ΠΎ рСспираторного сопротивлСния (Ρ‚Π°ΠΊΠΆΠ΅ Π½Π°Π·Ρ‹Π²Π°Π΅ΠΌΠΎΠ³ΠΎ рСспираторным импСдансом β€” Z) ΠΏΡ€ΠΈ спокойном Π΄Ρ‹Ρ…Π°Π½ΠΈΠΈ. ЦСлью Ρ€Π°Π±ΠΎΡ‚Ρ‹ явилась ΠΎΡ†Π΅Π½ΠΊΠ° рСспираторного импСданса ΠΈ Π΅Π³ΠΎ ΡΠΎΡΡ‚Π°Π²Π»ΡΡŽΡ‰ΠΈΡ…; ΠΎΠΏΡ€Π΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ взаимосвязи этих ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€ΠΎΠ² с ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Π°ΠΌΠΈ, Ρ‚Ρ€Π°Π΄ΠΈΡ†ΠΈΠΎΠ½Π½ΠΎ ΠΈΡΠΏΠΎΠ»ΡŒΠ·ΡƒΠ΅ΠΌΡ‹ΠΌΠΈ для ΠΎΡ†Π΅Π½ΠΊΠΈ рСспираторной Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ, Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом. БпиромСтрия, общая бодиплСтизмография ΠΈ ИОБ (Z, рСзистивный (R) ΠΈ Ρ€Π΅Π°ΠΊΡ‚ΠΈΠ²Π½Ρ‹ΠΉ (X) Π΅Π³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ‚Ρ‹, рСзонансная частота (FR), ΠΏΠ»ΠΎΡ‰Π°Π΄ΡŒ ΠΏΠΎΠ΄ ΠΊΡ€ΠΈΠ²ΠΎΠΉ X (частота осцилляций) Π² частотном Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½Π΅ 5 Π“Ρ† β€” FR (AX) ΠΏΡ€ΠΈ спокойном Π΄Ρ‹Ρ…Π°Π½ΠΈΠΈ) Π±Ρ‹Π»ΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½Ρ‹ Ρƒ 66 Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом, Π½Π°Π±Π»ΡŽΠ΄Π°Π΅ΠΌΡ‹Ρ… Π² Ρ†Π΅Π½Ρ‚Ρ€Π΅ муковисцидоза взрослых Π½Π° Π±Π°Π·Π΅ НИИ ΠΏΡƒΠ»ΡŒΠΌΠΎΠ½ΠΎΠ»ΠΎΠ³ΠΈΠΈ, Москва. Π£ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом Π±Ρ‹Π»ΠΈ выявлСны обструктивныС Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡ (ΠžΠ€Π’1 β€” 57 %Π΄ΠΎΠ»ΠΆ.) ΠΈ гипСринфляция Π»Π΅Π³ΠΊΠΈΡ… (ΠžΠžΠ› β€” 253 %Π΄ΠΎΠ»ΠΆ., Π€ΠžΠ• β€” 158 %Π΄ΠΎΠ»ΠΆ., ΠžΠžΠ›/ΠžΠ•Π› β€” 52 %). ΠŸΡ€ΠΈ ΠΏΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠΈ ИОБ Π±Ρ‹Π»ΠΎ ΠΎΠ±Π½Π°Ρ€ΡƒΠΆΠ΅Π½ΠΎ ΡƒΠ²Π΅Π»ΠΈΡ‡Π΅Π½ΠΈΠ΅ R, ΠΊΠΎΡ‚ΠΎΡ€ΠΎΠ΅ ΠΈΠΌΠ΅Π»ΠΎ Ρ‡Π°ΡΡ‚ΠΎΡ‚Π½ΡƒΡŽ Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΡŒ (R5 β€” 173 % Π΄ΠΎΠ»ΠΆ., R20 β€” 140 %Π΄ΠΎΠ»ΠΆ.) ΠΈ сниТСниС Ρ€Π΅Π°ΠΊΡ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ ΠΊΠΎΠΌΠΏΠΎΠ½Π΅Π½Ρ‚Π° X5 (–0,23 кПа / л–1 / с), Ρ‡Ρ‚ΠΎ ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΠ»ΠΎ ΠΊ ΡΠΌΠ΅Ρ‰Π΅Π½ΠΈΡŽ рСзонансной частоты Π² Π±ΠΎΠ»Π΅Π΅ высокий частотный Π΄ΠΈΠ°ΠΏΠ°Π·ΠΎΠ½ (FR β€” 18 Π“Ρ†, AX β€” 1,38 кПа / л–1). БущСствуСт достовСрная коррСляционная Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡ‚ΡŒ ΠΌΠ΅ΠΆΠ΄Ρƒ ΠΏΠ°Ρ€Π°ΠΌΠ΅Ρ‚Ρ€Π°ΠΌΠΈ ИОБ (FR, X20, R5, R20, AX) ΠΈ Π³Π»Π°Π²Π½Ρ‹ΠΌ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΌ тяТСсти обструктивных Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΠΉ (ΠžΠ€Π’1 β€” 0,74; 0,78; –0,42; –0,31 ΠΈ –0,76 соотвСтствСнно). ΠŸΠΎΠ»ΡƒΡ‡Π΅Π½Π½Ρ‹Π΅ Π΄Π°Π½Π½Ρ‹Π΅ продСмонстрировали, Ρ‡Ρ‚ΠΎ ΠΈΠ·ΠΌΠ΅Ρ€Π΅Π½ΠΈΠ΅ рСспираторного импСданса позволяСт ΠΎΡ†Π΅Π½ΠΈΡ‚ΡŒ ΡΡ‚Π΅ΠΏΠ΅Π½ΡŒ Π±Ρ€ΠΎΠ½Ρ…ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ обструкции. ИОБ Π½Π΅ зависит ΠΎΡ‚ усилий ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Π° ΠΈ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ использован Π² клиничСской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅, Π² Ρ‚. Ρ‡. Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… с тяТСлыми рСспираторными Π½Π°Ρ€ΡƒΡˆΠ΅Π½ΠΈΡΠΌΠΈ

    Π˜Π½Π³Π°Π»ΡΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΉ Ρ‚ΠΎΠ±Ρ€Π°ΠΌΠΈΡ†ΠΈΠ½ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ хроничСской синСгнойной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ΠΏΡ€ΠΈ муковисцидозС

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    Tobramycin inhalations in therapy of chronic infection Pseudomonas aeruginosa in cystic fibrosis.Π˜Π½Π³Π°Π»ΡΡ†ΠΈΠΎΠ½Π½Ρ‹ΠΉ Ρ‚ΠΎΠ±Ρ€Π°ΠΌΠΈΡ†ΠΈΠ½ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ хроничСской синСгнойной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ΠΏΡ€ΠΈ муковисцидозС

    ΠžΡΡ‚Π΅ΠΎΠΏΠΎΡ€ΠΎΠ· Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом: новая ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠ° ΠΈ Π½Π΅Ρ€Π΅ΡˆΠ΅Π½Π½Ρ‹Π΅ вопросы

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    Osteoporosis in cystic fibrosis patients: a new problem and unresolved issues.ΠžΡΡ‚Π΅ΠΎΠΏΠΎΡ€ΠΎΠ· Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом: новая ΠΏΡ€ΠΎΠ±Π»Π΅ΠΌΠ° ΠΈ Π½Π΅Ρ€Π΅ΡˆΠ΅Π½Π½Ρ‹Π΅ вопросы

    РСтроспСктивный Π°Π½Π°Π»ΠΈΠ· клиничСского статуса ΠΈ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ взрослых Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом Π·Π° 1993β€” 1997 Π³Π³

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    The aim of study was to describe clinical and functional characteristics of adult patients with cystic fibrosis, who underwent hospital and outpatient treatment in 1994β€” 1997. Seven subjects (2 males and 5 fem ales, aged 24.0Β±1.9 years) participated in the study. The diagnosis of cystic fibrosis was confirmed by positive sweat test in all the patients, 6 of them were heterozygous for DF 508 mutation (the most common disease-causing mutation in Russia). All of them underwent regular treatment in accordance with internertional guidlines. Body mass index (BM I) and lung function were evaluated during 1994β€” 1997. The evaluation of Schwachman score demonstrated mild to moderate clinical state of the patients in 1997 (the mean value was 57.4Β±1.5). There was a trend toward lower BMI in 1997 (17.5Β±1.2 kg/m at 1994 versus 17.2Β±1.4 k g /m2 at 1997). The differences in lung function during 1994β€” 1997 years were not significant. The retrospective analysis of lung function and BMI in 1994 did not reveal any statistically significant changes the result, that could be attributed to regular treatment during 1994β€” 1997 years.ЦСль исслСдования β€” описаниС клиничСских ΠΈ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… особСнностСй взрослы Ρ… Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом, ΠΊΠΎΡ‚ΠΎΡ€Ρ‹Π΅ ΠΏΠΎΠ»ΡƒΡ‡Π°Π»ΠΈ стационарноС ΠΈ Π°ΠΌΠ±ΡƒΠ»Π°Ρ‚ΠΎΡ€Π½ΠΎΠ΅ Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π² 1994β€” 1997 Π³Π³. Π’ исслСдованиС Π±Ρ‹Π»ΠΈ Π²ΠΊΠ»ΡŽΡ‡Π΅Π½Ρ‹ 7 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² (2 ΠΌΡƒΠΆΡ‡ΠΈΠ½ ΠΈ 5 ΠΆΠ΅Π½Ρ‰ΠΈΠ½, возраст 24Β±1,9 Π³ΠΎΠ΄Π°). Π”ΠΈΠ°Π³Π½ΠΎΠ· муковисцидоза Ρƒ всСх Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… Π±Ρ‹Π» ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½ ΠΏΠΎΠ»ΠΎΠΆΠΈΡ‚Π΅Π»ΡŒΠ½Ρ‹ΠΌ ΠΏΠΎΡ‚ΠΎΠ²Ρ‹ΠΌ тСстом; 6 ΠΈΠ· Π½ΠΈΡ… Π±Ρ‹Π»ΠΈ Π³Π΅Ρ‚Π΅Ρ€ΠΎΠ·ΠΈΠ³ΠΎΡ‚Π½Ρ‹ ΠΏΠΎ ΠΌΡƒΡ‚Π°Ρ†ΠΈΠΈ DF 508 (это Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ распространСнная мутация Π² России, ΠΎΠ±ΡƒΡΠ»ΠΎΠ²Π»ΠΈΠ²Π°ΡŽΡ‰Π°Ρ Ρ€Π°Π·Π²ΠΈΡ‚ΠΈΠ΅ заболСвания). ВсС ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΠΏΠΎΠ»ΡƒΡ‡Π°Π»ΠΈ рСгулярноС Π»Π΅Ρ‡Π΅Π½ΠΈΠ΅ Π² соотвСтствии с ΠΌΠ΅ΠΆΠ΄ΡƒΠ½Π°Ρ€ΠΎΠ΄Π½Ρ‹ΠΌΠΈ ΠΏΡ€ΠΎΠ³Ρ€Π°ΠΌΠΌΠ°ΠΌΠΈ. Π’ Ρ‚Π΅Ρ‡Π΅Π½ΠΈΠ΅ 1994β€” 1997 Π³Π³. ΠΎΡ†Π΅Π½ΠΈΠ²Π°Π»ΠΈΡΡŒ индСкс массы Ρ‚Π΅Π»Π° ΠΈ лСгочная функция. Богласно тСсту Π¨Π²Π°Ρ…ΠΌΠ°Π½Π°, клиничСскоС состояниС Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… соотвСтствовало Π»Π΅Π³ΠΊΠΎΠΌΡƒ Π»ΠΈΠ±ΠΎ срСднСтяТСлому (срСднСС Π·Π½Π°Ρ‡Π΅Π½ΠΈΠ΅ 57,4 Β± 1,5). Π’ 1997 Π³. ΠΎΡ‚ΠΌΠ΅Ρ‡Π°Π»Π°ΡΡŒ тСндСнция ΠΊ сниТСнию индСкса вСса Ρ‚Π΅Π»Π° (17,5Β±1,2 ΠΊ Π³/ΠΌ2 Π² 1994 Π³. ΠΈ 17,2Β±1,4 ΠΊΠ³/ΠΌ Π² 1997 Π³). ИзмСнСния Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ… Π·Π° ΠΏΠ΅Ρ€ΠΈΠΎΠ΄ 1994β€”1997 Π³Π³. Π±Ρ‹Π»ΠΈ нСдостовСрными. Π’Π°ΠΊΠΈΠΌ ΠΎΠ±Ρ€Π°Π·ΠΎΠΌ, рСтроспСктивны ΠΉ Π°Π½Π°Π»ΠΈΠ· Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ Π»Π΅Π³ΠΊΠΈΡ… ΠΈ индСкса массы Ρ‚Π΅Π»Π° Π·Π° 1994β€” 1997 Π³Π³. Π½Π΅ выявил Π½ΠΈΠΊΠ°ΠΊΠΈΡ… статистичСски достовСрных Ρ€Π°Π·Π»ΠΈΡ‡ΠΈΠΉ, Ρ‡Ρ‚ΠΎ ΠΌΠΎΠΆΠ΅Ρ‚ Π±Ρ‹Ρ‚ΡŒ Ρ€Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚ΠΎΠΌ рСгулярного лСчСния, ΠΏΠΎΠ»ΡƒΡ‡Π°Π΅ΠΌΠΎΠ³ΠΎ Π±ΠΎΠ»ΡŒΠ½Ρ‹ΠΌΠΈ Π² этот ΠΏΠ΅Ρ€ΠΈΠΎΠ΄

    Whole exome sequencing links dental tumor to an autosomal-dominant mutation in ANO5 gene associated with gnathodiaphyseal dysplasia and muscle dystrophies

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    Tumors of the jaws may represent different human disorders and frequently associate with pathologic bone fractures. In this report, we analyzed two affected siblings from a family of Russian origin, with a history of dental tumors of the jaws, in correspondence to original clinical diagnosis of cementoma consistent with gigantiform cementoma (GC, OMIM: 137575). Whole exome sequencing revealed the heterozygous missense mutation c.1067G \u3e A (p.Cys356Tyr) in ANO5 gene in these patients. To date, autosomal-dominant mutations have been described in the ANO5 gene for gnathodiaphyseal dysplasia (GDD, OMIM: 166260), and multiple recessive mutations have been described in the gene for muscle dystrophies (OMIM: 613319, 611307); the same amino acid (Cys) at the position 356 is mutated in GDD. These genetic data and similar clinical phenotypes demonstrate that the GC and GDD likely represent the same type of bone pathology. Our data illustrate the significance of mutations in single amino-acid position for particular bone tissue pathology. Modifying role of genetic variations in another gene on the severity of the monogenic trait pathology is also suggested. Finally, we propose the model explaining the tissue-specific manifestation of clinically distant bone and muscle diseases linked to mutations in one gene

    Π¦Π΅Ρ„Ρ‚Π°Π·ΠΈΠ΄ΠΈΠΌ/Π°Π²ΠΈΠ±Π°ΠΊΡ‚Π°ΠΌ Π² Π»Π΅Ρ‡Π΅Π½ΠΈΠΈ обострСния хроничСской рСспираторной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Ρƒ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… муковисцидозом: Π΄ΠΈΠ½Π°ΠΌΠΈΠΊΠ° клиничСских, микробиологичСских ΠΈ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΎΠ½Π°Π»ΡŒΠ½Ρ‹Ρ… ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ

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    Multidrug resistance of pulmonary pathogens in patients with cystic fibrosis (CF) requires new therapeutic solutions.The aim. To assess the effect of ceftazidime/avibactam (cef/avi) on clinical outcomes of pulmonary exacerbation of cystic fibrosis.Methods. This open single-group observational prospective non-interventional study was conducted in the routine clinical practice settings. Patients over 18 years with a confirmed diagnosis of CF and an exacerbation of a pulmonary infection were included into the study after physician’s decision to prescribe cef/avi. The examinations were performed at baseline and on Days 5 to 7, 21, and 30.Results. The analysis included data from 32 patients, 12 (38%) males and 20 (63%) females. The mean age was 31.6 years. Symptoms of exacerbation persisted in 97 % of patients on Days 5 to 7 of therapy and only in 3% at Day 21. FEV1, FVC, SpO2 also improved by Day 21 of the study (all – p < 0.001). By Day 21, proportion of patients with CRP above 10 mg/ml grew from 71 to 9%. The average density of sputum contamination decreased from 7.2 to 5.5 CFU/ml. Quality of life according to Cystic Fibrosis QuestionnaireRevised (CFQ-R) questionnaire also improved.Conclusion. In patients with CF, exacerbation of lung infection in most cases is caused by multidrug resistant strains of Pseudomonas aeruginosa sometimes in combination with Staphylococcus aureus. Infectious agents (P. aeruginosa) remain highly sensitive to cef/avi (up to 91%) in this population so this justifies the use of cef/avi in treatment of a CF exacerbation. cef/avi administration led to relief of the exacerbation symptoms in 97% CF patients, as well as to significant improvement in spirometry parameters, increase in the oxygenation index, decrease in CRP and density of sputum contamination, and improved the quality of life. cef/avi administration was not associated with lethal outcomes, ICU admission, or serious adverse drug reactions.ΠŸΠΎΠ»ΠΈΡ€Π΅Π·ΠΈΡΡ‚Π΅Π½Ρ‚Π½ΠΎΡΡ‚ΡŒ Π²ΠΎΠ·Π±ΡƒΠ΄ΠΈΡ‚Π΅Π»Π΅ΠΉ Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Ρƒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с муковисцидозом (ΠœΠ’) Ρ‚Ρ€Π΅Π±ΡƒΠ΅Ρ‚ поиска Π½ΠΎΠ²Ρ‹Ρ… тСрапСвтичСских Ρ€Π΅ΡˆΠ΅Π½ΠΈΠΉ.ЦСлью исслСдования явилась ΠΎΡ†Π΅Π½ΠΊΠ° влияния Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ†Π΅Ρ„Ρ‚Π°Π·ΠΈΠ΄ΠΈΠΌΠΎΠΌ/Π°Π²ΠΈΠ±Π°ΠΊΡ‚Π°ΠΌΠΎΠΌ (Ρ†Π΅Ρ„/Π°Π²ΠΈ) Π½Π° клиничСскиС исходы обострСния Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ΠΏΡ€ΠΈ ΠœΠ’.ΠœΠ°Ρ‚Π΅Ρ€ΠΈΠ°Π»Ρ‹ ΠΈ ΠΌΠ΅Ρ‚ΠΎΠ΄Ρ‹. ΠŸΡ€ΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΎΡ‚ΠΊΡ€Ρ‹Ρ‚ΠΎΠ΅ Π½Π°Π±Π»ΡŽΠ΄Π°Ρ‚Π΅Π»ΡŒΠ½ΠΎΠ΅ проспСктивноС Π½Π΅ΠΈΠ½Ρ‚Π΅Ρ€Π²Π΅Π½Ρ†ΠΈΠΎΠ½Π½ΠΎΠ΅ исслСдованиС Π² ΠΎΠ΄Π½ΠΎΠΉ Π³Ρ€ΡƒΠΏΠΏΠ΅ Π² Ρ€ΡƒΡ‚ΠΈΠ½Π½ΠΎΠΉ мСдицинской ΠΏΡ€Π°ΠΊΡ‚ΠΈΠΊΠ΅. ПослС Ρ€Π΅ΡˆΠ΅Π½ΠΈΡ Π»Π΅Ρ‡Π°Ρ‰Π΅Π³ΠΎ Π²Ρ€Π°Ρ‡Π° ΠΎ Π½Π°Π·Π½Π°Ρ‡Π΅Π½ΠΈΠΈ Ρ†Π΅Ρ„/Π°Π²ΠΈ Π² ΠΏΡ€ΠΎΡ‚ΠΎΠΊΠΎΠ» Π²ΠΊΠ»ΡŽΡ‡Π°Π»ΠΈΡΡŒ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚Ρ‹ ΡΡ‚Π°Ρ€ΡˆΠ΅ 18 Π»Π΅Ρ‚ с ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π΅Π½Π½Ρ‹ΠΌ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΠœΠ’ ΠΈ обострСниСм Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ. ОбслСдованиС ΠΏΡ€ΠΎΠ²ΠΎΠ΄ΠΈΠ»ΠΎΡΡŒ исходно, Π·Π°Ρ‚Π΅ΠΌ Π½Π° 5–7-ΠΉ, 21-ΠΉ ΠΈ 30-ΠΉ Π΄Π½ΠΈ.Π Π΅Π·ΡƒΠ»ΡŒΡ‚Π°Ρ‚Ρ‹. ΠΠ½Π°Π»ΠΈΠ·ΠΈΡ€ΠΎΠ²Π°Π»ΠΈΡΡŒ Π΄Π°Π½Π½Ρ‹Π΅ 32 ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ²: 12 (38 %) ΠΌΡƒΠΆΡ‡ΠΈΠ½, 20 (63 %) ΠΆΠ΅Π½Ρ‰ΠΈΠ½; срСдний возраст – 31,6 Π³ΠΎΠ΄Π°. На 5–7-ΠΉ дСнь Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ ΠΏΡ€ΠΈΠ·Π½Π°ΠΊΠΈ обострСния ΡΠΎΡ…Ρ€Π°Π½ΡΠ»ΠΈΡΡŒ Ρƒ 97 % ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ², ΠΊ 21-ΠΌΡƒ дню – Ρƒ 3 %. На 21-ΠΉ дСнь исслСдования ΡƒΠ»ΡƒΡ‡ΡˆΠΈΠ»ΠΈΡΡŒ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»ΠΈ объСма форсированного Π²Ρ‹Π΄ΠΎΡ…Π° Π·Π° 1-ю сСкунду, форсированной ΠΆΠΈΠ·Π½Π΅Π½Π½ΠΎΠΉ Смкости Π»Π΅Π³ΠΊΠΈΡ… ΠΈ насыщСния Π³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π° Π°Ρ€Ρ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠΉ ΠΊΡ€ΠΎΠ²ΠΈ кислородом (SpO2 ) ΠΏΡ€ΠΈ Ρ€ < 0,001. Доля ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΡƒΡ€ΠΎΠ²Π½Π΅ΠΌ Π‘-Ρ€Π΅Π°Ρ‚ΠΈΠ²Π½ΠΎΠ³ΠΎ Π±Π΅Π»ΠΊΠ° (Π‘Π Π‘), ΠΏΡ€Π΅Π²Ρ‹ΡˆΠ°Π²ΡˆΠΈΠΌ 10 ΠΌΠ³ / ΠΌΠ», снизилась с 71 Π΄ΠΎ 9 %. БрСдняя ΠΏΠ»ΠΎΡ‚Π½ΠΎΡΡ‚ΡŒ обсСмСнСнности ΠΌΠΎΠΊΡ€ΠΎΡ‚Ρ‹ снизилась с 7,2 Π΄ΠΎ 5,5 ΠšΠžΠ• / ΠΌΠ». Π£Π»ΡƒΡ‡ΡˆΠΈΠ»ΠΎΡΡŒ качСство ΠΆΠΈΠ·Π½ΠΈ (ΠšΠ–), согласно ΠŸΠ΅Ρ€Π΅ΡΠΌΠΎΡ‚Ρ€Π΅Π½Π½ΠΎΠΌΡƒ опроснику ΠΏΠΎ муковисцидозу (Cystic Fibrosis Questionnaire-Revised – CFQ-R).Π—Π°ΠΊΠ»ΡŽΡ‡Π΅Π½ΠΈΠ΅. Π£ ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠœΠ’ обострСниС рСспираторной ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ассоциировано с полирСзистСнтными ΡˆΡ‚Π°ΠΌΠΌΠ°ΠΌΠΈ Pseudomonas aeruginosa, ΠΈΠ½ΠΎΠ³Π΄Π° Π² сочСтании с Staphylococcus aureus. Π’ этой Π³Ρ€ΡƒΠΏΠΏΠ΅ Π±ΠΎΠ»ΡŒΠ½Ρ‹Ρ… сохраняСтся высокая Ρ‡ΡƒΠ²ΡΡ‚Π²ΠΈΡ‚Π΅Π»ΡŒΠ½ΠΎΡΡ‚ΡŒ ΠΊ Ρ†Π΅Ρ„/Π°Π²ΠΈ – Π΄ΠΎ 91 % случаСв, Ρ‡Ρ‚ΠΎ ΠΏΠΎΠ΄Ρ‚Π²Π΅Ρ€ΠΆΠ΄Π°Π΅Ρ‚ показания ΠΊ ΠΏΡ€ΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡŽ Π΄Π°Π½Π½ΠΎΠ³ΠΎ Π°Π½Ρ‚ΠΈΠ±Π°ΠΊΡ‚Π΅Ρ€ΠΈΠ°Π»ΡŒΠ½ΠΎΠ³ΠΎ ΠΏΡ€Π΅ΠΏΠ°Ρ€Π°Ρ‚Π° Π² Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ обострСния Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ ΠΏΡ€ΠΈ ΠœΠ’. ΠšΡƒΡ€Ρ Ρ†Π΅Ρ„ / Π°Π²ΠΈ ΠΏΡ€ΠΈΠ²ΠΎΠ΄ΠΈΠ» ΠΊ ΠΊΡƒΠΏΠΈΡ€ΠΎΠ²Π°Π½ΠΈΡŽ проявлСний обострСния Π»Π΅Π³ΠΎΡ‡Π½ΠΎΠΉ ΠΈΠ½Ρ„Π΅ΠΊΡ†ΠΈΠΈ Ρƒ 97 % ΠΏΠ°Ρ†ΠΈΠ΅Π½Ρ‚ΠΎΠ² с ΠœΠ’, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΠΊ достовСрному ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ ΠΏΠΎΠΊΠ°Π·Π°Ρ‚Π΅Π»Π΅ΠΉ Ρ„ΡƒΠ½ΠΊΡ†ΠΈΠΈ внСшнСго дыхания ΠΈ SpO2 , сниТСнию уровня Π‘Π Π‘, ΡƒΠΌΠ΅Π½ΡŒΡˆΠ΅Π½ΠΈΡŽ плотности обсСмСнСнности ΠΌΠΎΠΊΡ€ΠΎΡ‚Ρ‹ ΠΈ ΡƒΠ»ΡƒΡ‡ΡˆΠ΅Π½ΠΈΡŽ ΠšΠ–. На Ρ„ΠΎΠ½Π΅ Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ Ρ†Π΅Ρ„/Π°Π²ΠΈ Π½Π΅ наблюдались случаи смСрти, госпитализации Π² ΠΎΡ‚Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Ρ€Π΅Π°Π½ΠΈΠΌΠ°Ρ†ΠΈΠΈ ΠΈ интСнсивной Ρ‚Π΅Ρ€Π°ΠΏΠΈΠΈ, Π° Ρ‚Π°ΠΊΠΆΠ΅ ΡΠ΅Ρ€ΡŒΠ΅Π·Π½Ρ‹Π΅ Π½Π΅ΠΆΠ΅Π»Π°Ρ‚Π΅Π»ΡŒΠ½Ρ‹Π΅ лСкарствСнныС Ρ€Π΅Π°ΠΊΡ†ΠΈΠΈ.
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