Нитрозивный стресс и растворимые дифференцировочные молекулы при обострении хронической обструктивной болезни легких

Summary. The aim of this study was to investigate nitrite blood levels (NO2 –) and the total nitrite and nitrate concentration (Σ NO2 – / NO3 –) in the exhaled breath condensate (EBC) and to evaluate interrelationships between NO metabolites and serum sCD50, sCD54, sHLA-I, sCD95 soluble differentiation molecules in patients with exacerbation of chronic obstructive pulmonary disease (COPD). We examined 110 patients with exacerbation of COPD stages I–III and 28 healthy non-smokers. Exacerbation of COPD stages II and III was found to be related to a significant increase in NO2 level in the blood and (Σ NO2 – / NO3 –) in EBC, increased concentrations of sCD50, sCD54, sHLA-I molecules and decreased concentration of sCD95 molecules. Statistically significant strong relationships were found between nitrous stress parameters and serum concentrations of soluble differentiation molecules in exacerbation of COPD. These data could indicate a role of soluble sCD50, sCD54, sHLA-I, sCD95 molecules and nitrous stress in the pathogenesis of COPD progression. These biomarkers could be used as predictors of poor prognosis of early-stage COPD and as diagnostic criteria of exacerbation of COPD stages II–III.Резюме. Целью исследования было изучение содержания нитритов в крови (NO2 –), суммарной концентрации нитритов и нитратов (Σ NO2 – / NO3 –) в конденсате выдыхаемого воздуха (КВВ), оценка взаимосвязей между уровнем метаболитов оксида азота и сывороточным содержанием растворимых дифференцировочных молекул sCD50, sCD54, sHLA-I, sCD95 у больных с обострением хронической обструктивной болезни легких (ХОБЛ). Были обследованы 110 пациентов с обострением ХОБЛ I–III стадии и 28 здоровых некурящих лиц. Показано, что обострение ХОБЛ II и III стадии связано с достоверным повышением уровня NO2 в крови (Σ NO2 – / NO3 –) и в КВВ, увеличением в циркуляции содержания sCD50, sCD54, sHLA-I и снижением сывороточной концентрации sCD95 молекул. Обнаружены сильные статистически значимые связи между параметрами нитрозивного стресса и сывороточным содержанием растворимых дифференцировочных молекул при обострении ХОБЛ. Полученные данные свидетельствуют о патогенетической роли нитрозивного стресса и растворимых форм молекул sCD50, sCD54, sHLA-I, sCD95 в прогрессировании ХОБЛ. Изученные маркеры можно использовать в качестве предикторов неблагоприятного прогноза ХОБЛ на ранних стадиях и в качестве критериев в диагностике обострений ХОБЛ II и III стадии

Overuse of short-acting β2-agonists in the Russian population with asthma: the persisting threat

Short-acting β2-agonists (SABA) overuse is associated with negative outcomes in asthma patients. There is a lack of actual data about patterns of SABA overuse in the Russian population with asthma. The aim. To investigate patterns of SABA overuse in the Russian population with asthma. Methods. Data from the Russian population of “SABA use IN Asthma (SABINA) III” study were analyzed. SABINA III was a cross-sectional observational study covering 24 countries. Adults and adolescents with a documented diagnosis of asthma for at least 12 months were enrolled in the study. Data on disease characteristics and asthma treatments during previous 12 months were collected using real-time electronic case report forms and were analyzed with methods of descriptive statistics. Results. Majority of the Russian population (n = 618) consisted of patients with moderate/ severe asthma (78.5%). Asthma was uncontrolled or partly controlled in 70% of patients. SABA over-prescription (≥ 3 canisters per year) was seen in 37% of patients. The frequency of SABA over-prescription was similar in patients with mild (35%) and moderate/severe (38%) asthma. SABA was purchased over-the-counter (OTC) in the past 12 months by 30% of all patients, while 14% purchased ≥ 3 canisters of SABA per year. More than 90% of patients who purchased SABA OTC, already received prescriptions for SABA, of whom 59% were prescribed ≥ 3 canisters per year. Conclusion. Russia is faced with very high level of SABA overuse. Over-prescription is the main cause for SABA overuse. To reduce SABA overuse, it is necessary to educate both patients and doctors, and actively implement up-to-date asthma treatments.Избыточное использование β2-агонистов короткого действия (КДБА) ассоциировано с неблагоприятными исходами у пациентов с бронхиальной астмой (БА). Актуальные данные о распространенности избыточного использования КДБА в российской популяции больных БА отсутствуют. Целью исследования явилось изучение распространенности избыточного использования КДБА у пациентов с БА в России. Материалы и методы. В статье представлен анализ данных, полученных в российской популяции исследования SABINA (SABA use IN Asthma) III. Поперечное наблюдательное исследование SABINA III проводилось в 24 странах. В него включались взрослые и подростки с установленным диагнозом БА, наблюдаемые ≥ 12 мес. Данные о характеристиках заболевания и лекарственной терапии собирались ретроспективно за предыдущие 12 мес. и вносились в электронную базу данных в режиме реального времени. Применялись методы описательной статистики. Результаты. В российской группе больных БА (n = 618) большинство (78,5 %) имели среднетяжелую или тяжелую БА. Контроль над БА не был достигнут у 70 % пациентов. Избыточное назначение КДБА (≥ 3 ингаляторов в течение 12 мес.) выявлено у 37 % больных. Частота избыточного назначения КДБА была сходной с таковой при легкой (35 %) и более тяжелой (38 %) БА. Приобретали КДБА без назначения врача в течение года 30 % пациентов, при этом 14 % приобрели ≥ 3 ингаляторов за 12 мес. Из числа пациентов, покупавших КДБА самостоятельно, 90 % также получали рецепты на эти препараты, причем для 59 % пациентов рецепты были выписаны не менее чем на 3 ингалятора в год. Заключение. В России уровень избыточного использования КДБА очень высок. Главная причина этого – чрезмерное назначение КДБА врачами. Чтобы снизить уровень избыточного применения КДБА, необходимо обучать пациентов и врачей, а также активно внедрять современные подходы к терапии БА

Хронические фиброзирующие интерстициальные заболевания легких с прогрессирующим фиброзным фенотипом: резолюция Междисциплинарного Совета экспертов

Introduction. The natural course of some interstitial lung diseases (ILD) is characterized by progressive fibrosing phenotype resembling idiopathic pulmonary fibrosis (IPF). Until recently, the antifibrotic drug nintedanib was approved for treatment of the only fibrosing ILD which was IPF. A new indication for this drug which has been registered in Russian Federation in 2021 includes other fibrosing ILDs with progressive phenotype (PF-ILDs) and ILD associated with systemic scleroderma (SS-ILD).The aim of this publication is to describe general considerations of the decision of Multidisciplinary Expert Board on diagnosis and treatment of PF-ILDs including SS-ILD.Results. According to the extension in nintedanib use mentioned above, the Expert Board created an algorithm for diagnosis and treatment of patients with PF-ILDs and criteria for nuntedanib administration in PF-ILDs.Conclusion. Antifibrotic therapy is needed for patients with PF-ILDs with the failure of the stanrard therapy. In those patients antifibrotic treatment should be initiated as early as possible to better preserve the lung function.При формировании фибротических изменений в легких многие интерстициальные заболевания легких (ИЗЛ) могут приобретать прогрессирующее течение. По прогнозу выживаемости, риску летальности и обострений такой фенотип ИЗЛ при отсутствии антифибротической терапии очень близок к идиопатическому легочному фиброзу. В 2020 г. в Российской Федерации разрешено использование антифибротического препарата нинтеданиб при фиброзирующих ИЗЛ с прогрессирующим фиброзным фенотипом (ПФФ) и при ИЗЛ, связанных с системной склеродермией.Целью работы Междисциплинарного Совета экспертов явилось ознакомление с основными положениями резолюции Междисциплинарного Совета экспертов о диагностике и лечении ИЗЛ ПФФ.Результаты. В декабре 2020 г. состоялся Междисциплинарный Совет экспертов, по результатам работы которого разработаны алгоритм диагностики и ведения пациентов с ИЗЛ ПФФ и критерии отбора больных для назначения антифибротической терапии.Заключение. Установлено, что в случае, когда при стандартной терапии ИЗЛ ПФФ клиническое состояние пациента и легочная функция и / или фибротические изменения в легких по данным компьютерной томографии высокого разрешения не стабилизируются, показана антифибротическая терапия нинтеданибом. Начиная антифибротическую терапию в возможно более ранние сроки заболевания, можно замедлить прогрессирующее снижение легочной функции при более сохранных исходных показателях

Избыточное использование β2 -агонистов короткого действия у больных бронхиальной астмой в России: угроза сохраняется

Short-acting β2 -agonists (SABA) overuse is associated with negative outcomes in asthma patients. There is a lack of actual data about patterns of SABA overuse in the Russian population with asthma.The aim. To investigate patterns of SABA overuse in the Russian population with asthma.Methods. Data from the Russian population of “SABA use IN Asthma (SABINA) III” study were analyzed. SABINA III was a cross-sectional observational study covering 24 countries. Adults and adolescents with a documented diagnosis of asthma for at least 12 months were enrolled in the study. Data on disease characteristics and asthma treatments during previous 12 months were collected using real-time electronic case report forms and were analyzed with methods of descriptive statistics.Results. Majority of the Russian population (n = 618) consisted of patients with moderate/ severe asthma (78.5%). Asthma was uncontrolled or partly controlled in 70% of patients. SABA over-prescription (≥ 3 canisters per year) was seen in 37% of patients. The frequency of SABA over-prescription was similar in patients with mild (35%) and moderate/severe (38%) asthma. SABA was purchased over-the-counter (OTC) in the past 12 months by 30% of all patients, while 14% purchased ≥ 3 canisters of SABA per year. More than 90% of patients who purchased SABA OTC, already received prescriptions for SABA, of whom 59% were prescribed ≥ 3 canisters per year.Conclusion. Russia is faced with very high level of SABA overuse. Over-prescription is the main cause for SABA overuse. To reduce SABA overuse, it is necessary to educate both patients and doctors, and actively implement up-to-date asthma treatments. Избыточное использование β2 -агонистов короткого действия (КДБА) ассоциировано с неблагоприятными исходами у пациентов с бронхиальной астмой (БА). Актуальные данные о распространенности избыточного использования КДБА в российской популяции больных БА отсутствуют.Целью исследования явилось изучение распространенности избыточного использования КДБА у пациентов с БА в России.Материалы и методы. В статье представлен анализ данных, полученных в российской популяции исследования SABINA (SABA use IN Asthma) III. Поперечное наблюдательное исследование SABINA III проводилось в 24 странах. В него включались взрослые и подростки с установленным диагнозом БА, наблюдаемые ≥ 12 мес. Данные о характеристиках заболевания и лекарственной терапии собирались ретроспективно за предыдущие 12 мес. и вносились в электронную базу данных в режиме реального времени. Применялись методы описательной статистики.Результаты. В российской группе больных БА (n = 618) большинство (78,5 %) имели среднетяжелую или тяжелую БА. Контроль над БА не был достигнут у 70 % пациентов. Избыточное назначение КДБА (≥ 3 ингаляторов в течение 12 мес.) выявлено у 37 % больных. Частота избыточного назначения КДБА была сходной с таковой при легкой (35 %) и более тяжелой (38 %) БА. Приобретали КДБА без назначения врача в течение года 30 % пациентов, при этом 14 % приобрели ≥ 3 ингаляторов за 12 мес. Из числа пациентов, покупавших КДБА самостоятельно, 90 % также получали рецепты на эти препараты, причем для 59 % пациентов рецепты были выписаны не менее чем на 3 ингалятора в год.Заключение. В России уровень избыточного использования КДБА очень высок. Главная причина этого – чрезмерное назначение КДБА врачами. Чтобы снизить уровень избыточного применения КДБА, необходимо обучать пациентов и врачей, а также активно внедрять современные подходы к терапии БА

Rehabilitation after COVID-19. Resolution of the International Expert Council of the Eurasian Association of Therapists and the Russian Society of Cardiology

By the middle of 2021, the official global number of coronavirus disease 2019 (COVID-19) patients was close to 230 million, but the number accounting for asymptomatic patients was much higher. Consequences and rehabilitation after COVID-19 are of particular interest and raise many controversial and unresolved issues. On May 18, 2021, the Eurasian Association of Therapists organized an international panel of experts to analyze challenges associated with the post-COVID-19 period. This panel aimed to develop approaches to identify gaps in the discussed issues. This interdisciplinary team of leading experts reviewed the current literature and presented their data to formulate practical guidance on management of patients after COVID-19. The panel of experts also presented recommendations on how to implement the gained knowledge into health care practices

Is the meiofauna a good indicator for climate change and anthropogenic impacts?

Our planet is changing, and one of the most pressing challenges facing the scientific community revolves around understanding how ecological communities respond to global changes. From coastal to deep-sea ecosystems, ecologists are exploring new areas of research to find model organisms that help predict the future of life on our planet. Among the different categories of organisms, meiofauna offer several advantages for the study of marine benthic ecosystems. This paper reviews the advances in the study of meiofauna with regard to climate change and anthropogenic impacts. Four taxonomic groups are valuable for predicting global changes: foraminifers (especially calcareous forms), nematodes, copepods and ostracods. Environmental variables are fundamental in the interpretation of meiofaunal patterns and multistressor experiments are more informative than single stressor ones, revealing complex ecological and biological interactions. Global change has a general negative effect on meiofauna, with important consequences on benthic food webs. However, some meiofaunal species can be favoured by the extreme conditions induced by global change, as they can exhibit remarkable physiological adaptations. This review highlights the need to incorporate studies on taxonomy, genetics and function of meiofaunal taxa into global change impact research

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period

JOB MOTIVATION AMONG SENIOR, GENERATION X AND MILLENNIALS RUSSIAN EMPLOYEES

The purpose is to examine how workers Senior, Generation X and Generation Y are being motivated by their Jobs in view of the labor market of Russian specifics. The study was conducted on the basis of Bent-Wood Company, engaged in the manufacture and sale of furniture (Russia, Moscow). 90 Russian professionals (45 men and 45 women), 17-66 years old were engaged (30 Senior, 30 Gen X and 30 of Gen Y professionals). There were used the following self-reported techniques: "The motives of choice of profession", R.V. Ovcharova; "Determination of the main motives of choice of profession", E.M. Pavlutenkov; "Diagnosis of motivation of professional work", C. Zamfir, modificated by A. Rean. For processing of the obtained data Kruskal-Wallis H-test, Mann-Whitney U-test, factorial analysis were used. The calculations were done using the SPSS 22.0 computer program. Analysis of the three groups of subjects shows that for generation Senior characterized by internal professional motivation with the motives of utility and knowledge aimed at achieving a high social status and prestige; internal individually and socially significant motives to the improvement of the creative and moral qualities, driven by negative stimuli; motives "stick instead of the carrot". For Gen X is characterized by cognitive, creative and aesthetic motives of labor with low external negative motivation; internal moral motivation of professional work with the desire of public recognition and power, poorly oriented to the external positive and negative incentives; domestic social and individually significant motives with the installation of prestige and wealth. For Gen Y motives characteristic of creativity, due to internal moral attitudes for profit and public recognition; labor motivation content with external rewards positive and negative character, excluding labor aesthetics; internal socially and personally meaningful reasons. The revealed peculiarities can be used in psychological trainings conducted in order to increase motivation and job satisfaction of employees of different age groups, taking into account Russian specifics

SABA Overuse in Russia – Burden and Possible Causes: An Analysis of the Russian Population in the SABINA III (SABA use IN Asthma) Study

BACKGROUND: Short-acting β2-agonists (SABA) overuse is associated with asthma morbidity and mortality. The SABA use IN Asthma (SABINA) program aimed to describe the global use of SABA in patients with asthma. SABINA III study was a cross-sectional study covering 24 countries. METHODS: We performed statistical analysis of the Russian population (618 patients recruited in 12 centers) from the SABINA III study. In this study in patients aged ≥12 years, data on disease characteristics and asthma treatments were collected using real-time electronic case report forms. Patients were classified by asthma severity and control according to the 2017 GINA. All variables (asthma severity and control, number of severe exacerbations, SABA and other medications use) were analyzed descriptively only, no hypothesis was tested. RESULTS: Majority of the study population consisted of patients with moderate/severe asthma (78.5%), while mild asthma was seen in 21.5%. Asthma was uncontrolled in 36.1% of patients and partly controlled in 33.5%. More than 80% of patients were treated with ICS/LABA fixed-dose combination. Almost half of all patients (47.0%) had at least 1 severe exacerbation in the previous 12 months. SABA over-prescription (≥3 canisters per year) was seen in 37% of patients. The frequency of SABA over-prescription was similar in patients with mild (35%) and moderate/severe (38%) asthma. SABA was purchased over-the-counter (OTC) in the past 12 months by 30.1% of all patients, and 14% purchased ≥3 canisters of SABA per year. About 91% of patients who purchased SABA OTC already received prescriptions for SABA, of whom 59% were prescribed ≥3 canisters per year. CONCLUSION: Russia is seeing very high level of SABA over-prescription. This is potentially associated with poor asthma control and frequent severe exacerbations. Over-prescription may serve as the main cause for SABA overuse in Russia. To reduce SABA overuse and improve overall asthma control in Russia, it is necessary to educate not just the patients but also the doctors, while actively implementing up-to-date asthma treatments

VALIDATION OF UV-SPECTROMETRY ASSAY METHOD FOR DISSOLUTION PROFILE TEST FOR MOXIFLOXACINE TABLETS

Validation of UV-spectrometry assay method for dissolution profile test for levofloxacine tablets was carried out. The evaluated validation characteristics were: specificity, linearity, accuracy, precision, and analytical range. It was shown than main validation characteristics meet the Russian State Pharmacopoeia XIII requirements