Acute Coronary Syndrome during the Pandemic New Coronavirus Infection

The experience of managing patients with COVID-19 around the world has shown that, although  respiratory symptoms predominate  during the manifestation of infection, then many patients can develop serious damage  to the cardiovascular system. However, coronary artery disease (CHD) remains the leading cause of death worldwide. The purpose of the review is to clarify the possible pathogenetic links between COVID-19 and acute coronary syndrome (ACS), taking into account which will help to optimize the management of patients with comorbid  pathology. Among the body's responses to SARS-CoV-2 infection, which increase the likelihood of developing  ACS,  the role of systemic inflammation, the quintessence  of which is a "cytokine storm" that can destabilize  an atherosclerotic  plaque is discussed.  Coagulopathy, typical for patients with Covid-19, is based on immunothrombosis, caused by a complex  interaction between neutrophilic  extracellular  traps and von Willebrandt  factor in conditions  of systemic inflammation. The implementation  of a modern strategy  for managing patients with ACS,  focused on the priority of percutaneous interventions (PCI), during  a pandemic is experiencing great  difficulties  due to the formation  of time delays  before  the start of invasive  procedures  due to the epidemiological situation. Despite this, the current European,  American and Russian recommendations for the management of infected patients with ACS confirm the inviolability of the position of PCI as the first choice for treating patients with ACS and the undesirability  of replacing  invasive treatment with thrombolysis

Диагностическое значение биомаркеров при обострении хронической обструктивной болезни легких

An acute exacerbation of chronic obstructive pulmonary disease (COPD) plays an important role in the disease progression and significantly reduces the patients' quality of life. The aim of this review was to summarize published findings about a possible role of biomarkers in diagnosis, management and predicting outcomes in COPD patients. Creactive protein and serum amyloid A are the most investigated biomarkers in this field. Measurement of copeptin and proadrenomedullin may be useful in predicting shortterm outcomes. Biomarkeroriented management of patients with acute exacerbation of COPD could be important for choosing medications.Обострения хронической обструктивной болезни легких (ХОБЛ) играют важную роль в прогрессировании заболевания, значительно снижают качество жизни больных. Целью настоящего обзора явилось обобщение результатов исследований о возможной роли биомаркеров в диагностике, выборе тактики ведения больных, а также прогнозировании исходов обострений заболевания. Наиболее изученными биомаркерами являются Среактивный белок и сывороточный амилоид А. Оценка уровня копептина и проадреномедуллина может быть полезной в прогнозировании краткосрочных исходов. Биомаркернаправленное ведение пациентов с обострениями ХОБЛ имеет большое значение при выборе лекарственных препаратов

COVID-19 и хроническая обструктивная болезнь легких: известное о неизвестном

The article reviews 60 publications and addresses key aspects of concurrent COVID-19 and chronic obstructive pulmonary disease (COPD). It presents data stating that COPD patients have higher expression of the receptor of angiotensin-converting enzyme 2 in the lungs and this may contribute to a greater susceptibility to COVID-19. In COPD, signs of endothelial cell dysfunction and tendency to thrombus formation have been identified which can present the risk of unfavorable outcomes of COVID-19. Cohort study data do not confirm that COPD patients are more susceptible to SARS-CoV-2 infection, but their clinical outcomes of COVID-19 appear to be worse including the need for mechanical ventilation and lethality. There is no clinical evidence about the role of inhaled glucocorticosteroids used to manage COPD in the development and course of COVID-19.Обзор 60 источников литературы посвящен ключевым аспектам, касающимся коморбидности COVID-19 и хронической обструктивной болезни легких (ХОБЛ). Содержит сведения, что у больных ХОБЛ повышена экспрессия рецептора ангиотензин-превращающего фермента 2 в легких, это может способствовать большей предрасположенности к COVID-19. При ХОБЛ выявлены признаки дисфункции эндотелиальных клеток и склонность к тромбообразованию, что может быть риском неблагоприятных исходов COVID-19. Данные когортных исследований не подтверждают, что пациенты с ХОБЛ в большей степени подвержены заражению SARS-CoV-2, но, по-видимому, клинические исходы COVID-19 у них хуже, включая потребность в искусственной вентиляции легких и летальность. Пока не получены клинические доказательства роли ингаляционных глюкокортикостероидов, используемых при ХОБЛ, в развитии и течении COVID-19

Targeted kinase inhibition relieves slowness and tremor in a Drosophila model of LRRK2 Parkinson’s disease

Disease models: A reflex reaction A simple reflex in flies can be used to test the effectiveness of therapies that slow neurodegeneration in Parkinson’s disease (PD). Christopher Elliott and colleagues at the University of York in the United Kingdom investigated the contraction of the proboscis muscle which mediates a taste behavior response and is regulated by a single dopaminergic neuron. Flies bearing particular mutations in the PD-associated gene leucine-rich repeat kinase 2 (LRRK2) in dopaminergic neurons lost their ability to feed on a sweet solution. This was due to the movement of the proboscis muscle becoming slower and stiffer, hallmark features of PD. The authors rescued the impaired reflex reaction by feeding the flies l-DOPA or LRRK2 inhibitors. These findings highlight the proboscis extension response as a useful tool to identify other PD-associated mutations and test potential therapeutic compounds

To Be or Not to Be a Flatworm: The Acoel Controversy

Since first described, acoels were considered members of the flatworms (Platyhelminthes). However, no clear synapomorphies among the three large flatworm taxa - the Catenulida, the Acoelomorpha and the Rhabditophora - have been characterized to date. Molecular phylogenies, on the other hand, commonly positioned acoels separate from other flatworms. Accordingly, our own multi-locus phylogenetic analysis using 43 genes and 23 animal species places the acoel flatworm Isodiametra pulchra at the base of all Bilateria, distant from other flatworms. By contrast, novel data on the distribution and proliferation of stem cells and the specific mode of epidermal replacement constitute a strong synapomorphy for the Acoela plus the major group of flatworms, the Rhabditophora. The expression of a piwi-like gene not only in gonadal, but also in adult somatic stem cells is another unique feature among bilaterians. These two independent stem-cell-related characters put the Acoela into the Platyhelminthes-Lophotrochozoa clade and account for the most parsimonious evolutionary explanation of epidermal cell renewal in the Bilateria. Most available multigene analyses produce conflicting results regarding the position of the acoels in the tree of life. Given these phylogenomic conflicts and the contradiction of developmental and morphological data with phylogenomic results, the monophyly of the phylum Platyhelminthes and the position of the Acoela remain unresolved. By these data, both the inclusion of Acoela within Platyhelminthes, and their separation from flatworms as basal bilaterians are well-supported alternatives

PATHOGENESIS, ACTUAL ASPECTS OF PREVENTION AND TREATMENT OF THE ANTIBIOTIC-ASSOCIATED DIARRHOEA

The article provides an overview of current Russian and foreign literature devoted to the problem of pathogenesis, and of the treatment and prevention of antibiotic-associated diarrhea. Antibiotic-associated diarrhea is one of the most relevant aspects of modern drug therapy in due to the frequent prescription of antibacterial agents. Antibiotic-associated diarrhea (according to WHO) is defined as the presence of three or more episodes of an unformed stool for two or more consecutive days that occurred during or after the end of antibiotic therapy. The risk of developing this disorder is highest when using aminopenicillins, as well as their combinations with clavulanic acid, cephalosporins, clindamycin. Despite the presence of a common etiologic factor — the intake of antibacterial agents, the immediate causes and mechanisms of antibiotic-associated diarrhea development in patients may be different. The article describes the main issues of the etiology and pathogenesis of this pathology, the risk factors for the development of antibiotic-associated diarrhea are named, that allows to predict this complication in certain categories of patients. Тhe virulence factors of Clostridium difficile, Klebsiella oxytoca, Candida spp. and the clinical manifestations associated with their effects are highlighted. The clinical variants of this disease are described: 1) pseudomembranous colitis; 2) segmental hemorrhagic colitis; 3) “mild illness”. Contemporary literature data on the possibilities of prevention, as well as effective methods of treatment of antibiotic-associated diarrhea, are presented. For the treatment and prevention of all clinical forms of antibiotic-associated diarrhea, most authors suggest the use of drugs that make up the deficiency of normal intestinal microbiota — probiotics and prebiotics. The problem of the benefits of adjuvant therapy with probiotics during the course of antibiotics for the prevention of antibiotic-associated diarrhea remains controversial, the effectiveness and safety of the use of various probiotic cultures for this purpose is being studied. The information presented in this review is intended to target physicians to the rational use of antibacterial agents, and to early diagnosis of their most frequent side effect, antibiotic-associated diarrhea

PREDICTIVE VALUE OF CARDIAC CACHEXIA IN CHRONIC HEART FAILURE

Regardless  current achievements  of medicine, chronic heart  failure (CHF) is  still the  leading  cause   of  cardiovascular  morbidity and mortality.  A   special  cohort   in  CHF mortality  are   patients  with progressive body mass loss. Recently the assessment of cachexia is restricted  only with the  tests  revealing present  atrophy,  but not to predict it. Therefore, of the most significant investigation directions is search   for  reliable  biomarkers  of  early  diagnostics   and  efficacy assessment. The article focuses  on the main biomarkers having potential  prediction  value and  recommended for cardiac  cachexia assessment