РАСПРОСТРАНЕННОСТЬ ПИЩЕВОЙ АЛЛЕРГИИ У ДЕТЕЙ В МИРОВОМ ОЧАГЕ ОПИСТОРХОЗА: ПЛАНИРОВАНИЕ И МЕТОДОЛОГИЯ ЭПИДЕМИОЛОГИЧЕСКОГО ИССЛЕДОВАНИЯ EUROPREVALL

According to numerous surveys food allergy affects up to 2–6% of population in different countries and varies due to numerous factors including the prevalence of helminths infestation. The food allergy prevalence data in Russia are based on official medical statistics. The study was performed as part of «The Prevalence, Cost and Basis of Food Allergy Across Europe» (EU funded project № FP6-2006-TTC-TU-5 Proposal 045879 EuroPrevall). The aim is to create the concept of food allergy in children in opisthorchiasis endemic area based on epidemiological study of the prevalence, risk factors and clinical features. The main objective of the study will be the working out of the food safety regulations. This article describes the study design and its methodology. Согласно данным ряда исследователей, распространенность пищевой аллергии в мире составляет 2–6%, варьируя в зависимости от многочисленных факторов, включая пораженность населения гельминтными инвазиями. Сведения о распространенности пищевой аллергии в России основаны на данных официальной статистики. Настоящая работа выполнена в рамках «Исследования распространенности, социально-экономического значения и основ пищевой аллергии в Европе» («The Prevalence, Cost and Basis of Food Allergy Across Europe»; грант VI рамочной программы Евросоюза № FP6-2006-TTC-TU-5 Proposal 045879 EuroPrevall). Цель исследования состоит в формулировке новой концепции пищевой аллергии у детей в мировом очаге описторхоза на основании эпидемиологического исследования распространенности, факторов риска, клинических особенностей болезни, а также в создании научной базы для разработки регламентов безопасности продуктов питания. Статья посвящена вопросам планирования и методологии исследования.

ФОРМИРОВАНИЕ ПИЩЕВОЙ СЕНСИБИЛИЗАЦИИ У ДЕТЕЙ НА ФОНЕ ИНВАЗИИ OPISTHORCHIS FELINEUS

Aim: to determine the mechanism of food sensitization in children with chronic Opisthorchis felineus invasion. Patients and methods: during the epidemiological study the groups of patients (7–10 years) with chronic opisthorchiasis (n =237) and children without chronic opisthorchiasis (n =496) were formed. The investigation included interviewing of parents / guardians, measurement of total IgE, specific IgE to food allergens and component-resolved diagnostic, real-time PCR in stool samples. Results: the chronic opisthorchiasis invasion in children is associated with reduced risk of food sensitization, compared with non-infected group (9,7 vs 16,94%, OR =0,53; 95% CI 0,31–0,88; p =0,01). Opisthorchiasis of high intensity negatively correlated with increased level of specific IgE to food allergens in serum (OR =0,46; 95% CI 0,24–0,91; p =0,023). The association between level of total IgE and intensity of opisthorchiasis combinated with food sensitization was found. The sensitization to allergens class I (cyp c1, cor a11, gal d2, pru p3) is more prevalent in patients with opisthorchiasis, in uninfected children the sensitization to bet v1-homologues (mal d1, pru p1, cor a1, ara h8) is most common. Conclusions: the epidemiological data on the effect of the Opisthorchis felineus invasion on mechanisms of food sensitization in children were obtained.Цель исследования: установить механизмы развития пищевой сенсибилизации на фоне хронической инвазии Opisthorchis felineus у детей. Пациенты и методы: в ходе эпидемиологического исследования сформированы группы больных хроническим описторхозом (n =237) и детей, не имеющих описторхоза (n =496). В исследовании использовали интервьюирование родителей / опекунов, измерение концентрации общего и специфического IgE к пищевым аллергенам в сыворотке крови, компонентную аллергодиагностику, метод полимеразной цепной реакции в режиме реального времени в образцах стула. Результаты: наличие хронической описторхозной инвазии у детей ассоциировано со снижением риска развития пищевой сенсибилизации в сравнении с неинвазированными лицами (9,7 против 16,94%, OR =0,53; 95% CI 0,31–0,88; p =0,01). Высокая интенсивность описторхозной инвазии отрицательно коррелирует c повышением содержания специфического IgE к пищевым аллергенам в сыворотке крови (OR =0,46; 95% CI 0,24–0,91; p =0,023). Установлена зависимость между повышением концентрации общего IgE в сыворотке крови и интенсивностью описторхозной инвазии в сочетании с пищевой сенсибилизацией. В группе больных описторхозом преобладает сенсибилизация к термостабильным аллергенам класса I (cyp c1, cor a11, gal d2, pru p3), у детей, не имеющих описторхоза — к термолабильным гомологам bet v1 (mal d1, pru p1, cor a1, ara h8). Выводы: получены эпидемиологические данные о значимом влиянии гельминтной инвазии Opisthorchis felineus на механизмы формирования пищевой сенсибилизации у детей.

Changes in the parameters of thrombodynamics and blood clot contraction in patients with rheumatoid arthritis

© 2020 Ima-Press Publishing House. All rights reserved. Autoimmune diseases, including rheumatoid arthritis (RA), are risk factors for thrombotic events. Understanding the pathogenetic role of hemostatic changes in RA can assist in developing measures for prevention, prognosis, early diagnosis, and treatment of immune thromboses. Objective: to investigate the state of platelet and plasma hemostasis in patients with RA, as compared to other laboratory parameters and clinical manifestations of the disease. Subjects and methods. Hemostasis was investigated using two relatively new laboratory tests: thrombodynamics and kinetics of blood clot contraction (BCC). Examinations were made in 60 patients with RA and in 50 apparently healthy individuals of the control group. Results and discussion. In patients with RA, the parameters of thrombodynamics and BCC were found to be significantly different from the normal values. According to thrombodynamics, there was an increase in plasma clot growth rate, size, and density, which indicates chronic hypercoagulation. The rate and completeness of BCC were substantially reduced due to platelet dysfunction in patients with RA compared to healthy individuals. The changes in the parameters of thrombodynamics and BCC correlated with the laboratory signs of systemic inflammation and depended on the radiographic stage of the disease. Conclusion. The results of this investigation confirm that hemostatic disorders are present in RA and indicate the informative value of thrombodynamics and BCC tests as indicators of a pre-thrombotic state, including autoimmune pathology

Принципы нутритивной поддержки у детей в условиях стационара

Nutritional deficiency (ND) is a condition that develops due to insufficient intake, consumption or assimilation of nutrients, which leads to a change in body weight and body composition, a change in immunological resistance, a decrease in physical and psychomotor deve-lopment, and a deterioration in the clinical outcome of the disease. Nutritional support (NS) provides the nutrient enrichment through the use of specialized mixtures when it is not possible to meet the nutrient requirements with conventional foods or a healthy diet. The stages of NS from screening for ND to prevention and correction of its possible complications are presented. It is emphasized that timely and adequate correction of ND is the key to maintaining health and improving the quality of life of children and their families.Нутритивная недостаточность (НН) - состояние, развивающееся в связи с недостаточным поступлением, потреблением или усвоением пищевых веществ, что приводит к изменению массы и состава тела, изменению иммунологической резистентности, снижению физического и психомоторного развития, ухудшению клинических исходов заболевания. Нутритивная поддержка (НП) предусматривает обеспечение поступления пищевых веществ за счет использования специализированных смесей при невозможности удовлетворения потребностей в нутриентах с помощью обычных продуктов питания или лечебного рациона. Представлены этапы НП от скрининга НН до профилактики и коррекции возможных ее осложнений. Подчеркивается, что своевременная и адекватная коррекция НН является залогом сохранения здоровья и повышения качества жизни детей и их семей

Accelerated spatial fibrin growth and impaired contraction of blood clots in patients with rheumatoid arthritis

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Rheumatoid arthritis (RA) is an autoimmune disease associated with thrombotic complications. To elucidate pathogenic mechanisms, hemostatic disorders in RA were correlated with other laboratory and clinical manifestations. Hemostasis was assessed using relatively new complementary tests, the spatial growth of a plasma clot (Thrombodynamics assay), and contraction of whole blood clots. Platelet functionality was assessed with flow cytometry that quantified the expression of P-selectin and the fibrinogen-binding capacity of platelets before and after activation with a thrombin receptor-activating peptide. Parameters of fibrin clot growth and the kinetics of contraction of blood clots were significantly altered in patients with RA compared to the control group. In Thrombodynamics measurements, an increase in the clot growth rate, size, and optical density of plasma clots altogether indicated chronic hypercoagulability. The rate and extent of blood clot contraction in patients with RA was significantly reduced and associated with platelet dysfunction revealed by an impaired response to activation. Changes in the parameters of clot growth and contraction correlated with the laboratory signs of systemic inflammation, including hyperfibrinogenemia. These results confirm the pathogenic role of hemostatic disorders in RA and support the validity of fibrin clot growth and the blood clot contraction assay as indicators of a (pro)thrombotic state

ANALYSIS OF АСТ ADHERENCE DURING PATIENT MANAGEMENT IN THE PRIMARY CARE

The article provides the data on the implementation of Childhood Asthma Control Test in the primary care. The authors showed the attitude of children, parents and doctors towards the questionnaire. They demonstrated dynamics of control over the disease assessed in ACT points. They found out that 45% of children, who received the combined therapy, may reveal the total control over asthma. For the very first time, they highlighted information on the arising difficulties during the work with ACT at the ambulatory stage.Key words: bronchial asthma, control, ACT

ANALYSIS OF АСТ ADHERENCE DURING PATIENT MANAGEMENT IN THE PRIMARY CARE

The article provides the data on the implementation of Childhood Asthma Control Test in the primary care. The authors showed the attitude of children, parents and doctors towards the questionnaire. They demonstrated dynamics of control over the disease assessed in ACT points. They found out that 45% of children, who received the combined therapy, may reveal the total control over asthma. For the very first time, they highlighted information on the arising difficulties during the work with ACT at the ambulatory stage.Key words: bronchial asthma, control, ACT

АНАЛИЗ ПРИВЕРЖЕННОСТИ АСТ В ПРОЦЕССЕ ВЕДЕНИЯ БОЛЬНЫХ В ПЕРВИЧНОМ ЗВЕНЕ ЗДРАВООХРАНЕНИЯ

The article provides the data on the implementation of Childhood Asthma Control Test in the primary care. The authors showed the attitude of children, parents and doctors towards the questionnaire. They demonstrated dynamics of control over the disease assessed in ACT points. They found out that 45% of children, who received the combined therapy, may reveal the total control over asthma. For the very first time, they highlighted information on the arising difficulties during the work with ACT at the ambulatory stage.Key words: bronchial asthma, control, ACT.В статье представлены данные по внедрению Childhood Asthma Contrоl Test на амбулаторном этапе. Отражено отношение к опроснику детей, родителей и врачей. Показана динамика контроля над болезнью, оцениваемая по баллам АСТ. Установлено, что у 45% детей, получающих комбинированную терапию, возможен полный контроль над астмой. Впервые представлена информация о возникающих трудностях при работе с АСТ на поликлиническом этапе.Ключевые слова: бронхиальная астма, контроль, тест по контролю над астмой у детей. (Педиатрическая фармакология. – 2009;6(2):36-39