Mucociliary clearance and microbiota of the nasal passages, sinuses in patients with chronic rhinosinusitis associated with gastroesophageal reflux disease

The aim of our investigation was to estimate the mucociliary clearance (MC), the spectrum of bacterial communities discharged from the middle meatus and sinus aspirates in patients with chronic rhinosinusitis (CRS) associated with gastroesophageal reflux disease (GERD), patients with CRS without GERD and healthy volunteers. The study included 30 patients with CRS and GERD, 34 patients without GERD аnd 30 healthy volunteers. Association with CRS and GERD was characterized by statistically significant slowing of MC and quantitative and qualitative changing of characteristics of the nasal mucosa microflora, but not of the paranasal sinuses. In the group of patients with CRS with GERD, MC amounted to 28.5 ± 4.7 min, in the group without GERD - 23.6 ± 2.7 min, in the healthy group - 5.8 ± 1 min. S. аureus (р = 0.009), E. mli (р = 0.029) and Candida albicans (р = 0.013) were detected in the mucosa of the middle meatus of patients with CRS and GERD more than in patients with CRS without GERD. No significant differences in the microflora of the paranasal sinus aspirate were revealed

Prevalence and risk factors of irritable bowel syndrome in Irkutsk

Introduction. The study of the problem of irritable bowel syndrome (IBS) in recent years has been very dynamic. In the Rome IV criteria, new criteria for the diagnosis of this pathology were proposed. Along with the existence of ethnic and geographic differ­ences, this has led to an increase in the activity of studies on the prevalence of IBS.Aim. To study the prevalence and risk factors of irritable bowel syndrome in Irkutsk.Materials and methods. A single-stage observational non-randomized study was performed on the basis of three medical institu­tions in Irkutsk. Interviewing and clinical examination were performed in 1 529 people: 724 men and 805 women, average age 51.0 years. The questionnaire contained questions to determine the presence of alarm symptoms. The diagnosis of IBS was based on the Rome IV criteria. IBS with a predominance of diarrhea, IBS with a predominance of constipation and mixed and undiffer­entiated IBS were distinguished. Taking into account the position of the Rome IV criteria and the recommendations of the American College of Gastroenterology (2021), we used a positive diagnosis of IBS in our study and did not perform an instrumental examination of patients.Results. The prevalence of IBS was 12.3%. Among the subtypes of IBS, IBS prevailed with a predominance of constipation (preva­lence 5.7%) and IBS of mixed and undifferentiated type (prevalence 4.6%). Risk factors for IBS were female sex (OR = 0.73; CI 0.53-0.99; p = 0.05), age over 50 years (OR = 0.66; CI 0.48-0.90; p = 0.01) and obesity (OR = 0.46; CI 0.31-0.69; p < 0.001). Risk factors for IBS with a predominance of constipation were female sex (OR = 0.46; CI 0.29-0.73; p = 0.001), age over 50 years (OR = 0.46; CI 0.29-0.73; p = 0.001) and obesity (OR = 0.41; CI 0.23-0.72; p = 0.002).Conclusions. In general, our results are consistent with data from other regions of the world. It should be emphasized that the prevalence of IBS in Irkutsk is quite high, which requires careful attention to this problem

Safety of modified stair climbing test in the early period of rehabilitation of patients with acute myocardial infarction

Aim: safety evaluation of modified stair climbing test in the physical rehabilitation program for patients with old acute myocardial infarction. Materials and methods. Score of physical rehabilitation indices, its effectiveness and safety, comparison of physical rehabilitation indices of patients with AMI without reperfusion treatment and patients who had reperfusion interventions (bare-metal stents - in 21 persons, fibrinolysis - 1 patient, fibrinolysis and percutaneous coronary intervention - 1 patient) were estimated for 43 patients (6 women and 37 men) with old AMI using modified loading tests (stair climbing test and test with six-minute's walk). Results. HR (heart rate) fell short of submaximum values during modified stair climbing test in patient population. The condition was monitored using continuous ECG monitoring apparatus «Kardiotekhnika-04» (СС «Incart», Saint-Petersburg) None of patients showed ischemic changes of ST-segment. No significant differences were revealed in exercise tolerance between patients with old acute myocardial infarction with Q-wave who experienced stenting and patients with acute myocardial infarction without Q-wave. Results of six-minute's step test after the hospital rehabilitation stage completion show exercise tolerance increasing. Conclusion. Modified stair climbing test conducting for intensification of physical rehabilitation using subjective control was safe in examined patient population. According to six-minute's step test results, the exercise tolerance increased during rehabilitation process

Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Experience of using ursodeoxycholic acid to dissolve gallstones

Objective of the study. A 5-year prospective study was aimed to evaluate the efficacy of Ursosan treatment for dissolving gallstones.Material and methods. Patients who had single gallbladder stones were randomized to group A, in which 47 people completed the study (16 men and 31 women, median age is 67.6 years), and group B – 41 people 14 men and 27 women, median age is 68, 1 years). All patients of group A continuously received continuous treatment with ursodeoxycholic acid drug Ursosan at a dose of 10 mg /kg per day for 5 years. The patients of group D did not receive Ursosan; these individuals received periodic courses of spasmodic drugs. The patients passed clinical examination, laboratory tests, transabdominal ultrasound of the liver and biliary tract before the study, 2 times a year for 5 years and after the study.Results. After 5 years of treatment, stones were detected in 10.6% of patients in group A. In group B, the incidence of gallstones did not change after 5 years of treatment, that is, calculi were detected in all patients (p <0.001). At the end of the study, no muldoi tiple stones were observed in any of the patients of group A, while multiple stones were detected in 2/3 of group B patients after 5 years of treatment. A distinct decrease in pain syndrome frequency and improvement in contractile function of the gallbladder were recorded in patients of group A as compared to the patients of group B by the end of the observation period. The side effect profile did not differ in groups A and B. The study showed good tolerance of Ursosan for 5 years of continuous administration of the drug.Findings. The 5-year prospective study showed that Ursosan’s efficacy in dissolving gallstones accounted for 90%. Ursosan also prevented the formation of new calculi and reduced the frequency of pain, improved the gall-bladder contractile function and reduced the need for cholecystectomy by the end of the observation period

Shans - new red clover variety

The article presents results of breeding activity (1990.2012) on creation of early, winter hardiness, productive red clover (Trifolium pratense L.) variety ‘Shans’ having high fodder quality. Originators of the variety - Falenki breeding station and North-East Agricultural Research Institute Variety ‘Shans’ (breeding line 804/90) created by a method of multiple biotypic selection from middle-ripening adaptive variety ‘Dymkovsky’. According to the results of competitive tests in Falenki breeding station (2008.2012), the variety had advantage over standard variety ‘Trio’ by main economic traits and distinguished with earliness (55.75 days from spring re-growth till beginning of flowering; 110.128 days for seed ripening), high winter hardiness (96.100 %), dry matter yield - 11.3 t/ha and raw protein yield - 1.53 t/ha, high seed yield - 0.2 t/ha, resistance against root rot (index of disease development IDD = 18.2 %). According to data of ecological test (2012) under agro-climatic conditions of Kirov city (North-East Agricultural Institute) variety ‘Shans’ shown high potential productivity of dry matter - 21.22 t/ha (significantly higher than standard ‘Trio’ on 2.80 t/ha or 15.2%). In 2012 the variety was passed to State varietal test, since 2017 - was included into State Register of breeding achievements allowed to use in Volga-Vyatka region (patent № 8916 from February 13, 2017)

Results of red clover breeding for aluminum tolerance under conditions of North-East of European part of Russia

Results of perennial (1991-2016) experimental work carried out in Kirov region on creation of new breeding material and varieties of red clover combining aluminum tolerance and high productivity and other valuable parameters under conditions of North-east of European Russia are presented in the article. Methods are presented of creation of breeding material with tolerance to ions of aluminum and hydrogen. Characteristic of provocative edaphic background is done. Aluminum tolerant variety Grin is created with method of multiple two-stage selection of genotypes resistant to H+ and Al3+ (in laboratory towel culture and on hard field background). The variety is included in State Register of breeding achievements of Russian Federation in 2010 for 4 regions. As a result of selection in vitro for resistance to toxic ions of aluminum and hydrogen in combination with selection on field provocative background 60 breeding lines were obtained having value for creation of aluminum- and acid-resistant varieties of red clover. High resistance is revealed to edaphic stress-factors in perspective clone population P-15: in nursery of preliminary test on aluminum acid background under drought of 2016 the population statistically exceed standard variety Dymkovsky and early variety Trio on productivity of green mass on 6.5 and 9.5 t/ha or 23.0 and 37.7%. 79 breed- ing lines were created by the method of direct selection of genotypes on hard aluminum acid field background, 20 perspective lines were chosen combining resistance to edaphic stress factors with winter hardiness and high productivity of green mass (17.5-64.1% higher than variety Grin)

Non-pharmacological Approaches to Treatment of Patients over 60 Years as a Way to Improve Pharmacotherapy Safety and Prevent Polypharmacy

Abstract. The demographic aging of the population of the earth observed in recent years is associated, inter alia, with the advent of new effective and safe medicines. However, the availability of highly effective drugs on the market also has a reverse side — the appearance of adverse drug reactions (ADRs), in particular as a result of drug-drug interactions. The use of non-pharmacological methods of treatment and prevention of diseases seems particularly relevant for patients of the older age group, as it allows not only to reduce the drug burden, to reduce the risk of ADRs but also to improve the patient’s state in case of diseases that have no effective pharmacotherapy and pharmacological prophylaxis. The aim of the study was to systematize and analyze data on non-pharmacological treatment methods in order to increase the safety of pharmacotherapy and prevent polypragmasia in elderly patients by informing health care providers about non-drug methods of correcting significant geriatric problems. The approaches to the correction of some major geriatric problems (delirium, sarcopenia, pain syndrome), including cognitive training, physical activity, diet, frequent reorientation of patients, placement of patients in specially equipped rooms («delirium room») were presented. The use of non-pharmacological approaches can significantly improve the safety of drug therapy, reduce the risks of ADRs, improve the patient’s prognosis and quality of life, and also effectively prevent polypharmacy