L-arginine is an effective medication for prevention of endothelial dysfunction, a predictor of anthracycline cardiotoxicity in patients with acute leukemia

Aim: To evaluate the effectiveness of L-arginine in the prevention of endothelial dysfunction, which may be a predictor of anthracycline-induced myocardial injury, in patients with acute leukemia (AL) on the background of anthracycline antibiotics low cumulative doses from 100 to 200 mg/m2. Materials and Methods: A total of 81 adult AL patients (38 males and 43 females with the age of 16–59 years) were studied. The patients were divided into two groups: group I (n = 34), AL patients treated with chemotherapy (CT) and L-arginine hydrochloride; group II (n = 47) — AL patients treated with CT only. Cardiac evaluation and endothelial function assessment were performed at baseline and after second CT. Electrocardiography (ECG) parameters, lipid peroxidation activity, antioxidant protection and NO system state were evaluated. Results: The bioelectric activity abnormalities of the myocardium were observed in studied patients with low cardiac risk after induction CT. In case of L-arginine administration, only minimal daily ECG changes were recorded. A significant difference in the lipid peroxidation and antioxidant defense system activity in patients of groups I and II was determined. We noticed deepening of endothelial dysfunction on the background of cytostatic therapy with anthracycline antibiotics compared with baseline values in patients of group II. It was found that prophylactic L-arginine increases superoxide dismutase level and reduces the total NOS activity due to its inducible isoform. Conclusion: The leading factor of anthracycline-induced cardiotoxicity is the imbalance between free radical generation and their inactivation that leads to endothelial dysfunction development. L-arginine eliminates the prooxidant-antioxidant imbalance and improves the endothelial function

The Competence Approach as a Methodological Tool for Shaping the Professional Competence of Future Music Teachers

The article considers the role, importance and features of the competence approach as strong trend in the development of art education in the context of global integration and globalisation trends. The key properties of professional competency of a future art teacher are characterised; the significance of the system of thinking actions and operations as the basic foundation for its development is established. The specificity of methodological support for the teaching of art disciplines, aimed at using the maximum number of mental operations, is described. The conducted research allowed generalising the definition of professional competency of future art teachers as an integrated qualitative characteristic of an art teacher, which is a complex of knowledge, abilities and skills acquired as a result of professional art training, selfstudy, own teaching and performing experience in the areas of teaching art disciplines, art history, pedagogy, psychology, etc., and pedagogical and artistic communication, the ability to operate freely with certain knowledge and skills and to apply them effectively in the course of practical professional activities

Quality of life evaluation in acute leukemia patients receiving induction chemotherapy

Background: Over the past decades, special attention has been paid to study of quality of life (QoL) indicators in hematological patients receiving chemotherapy (CT). Nowadays QoL is conceptually viewed as an important complement to traditional objective evaluation measures. Aim. To assess QoL in patients with acute leukemia (AL) depending on the presence of concomitant ischemic heart disease (1HD) during the induction CT. Methods: Our study involved 83 patients with newly diagnosed AL, of which 19 were lymphoblastic, 64-myeloid leukemia, aged 16-72,43 (51.8%) men, 40 (48.2%) women, according to ECOG l-II. Patients received standard induction CT. According to concomitant IFID patients were divided into groups: I (n — 47) - AL without cardio­ logical diseases; II (n = 36) - AL with concomitant IHD. Patients were evaluated using SF-36 questionnaire to calculate physical and mental health components before treatment and after 2 induction courses of CT reaching remission

Modern approaches to optimization of the anthracycline cardiotoxicity prevention in oncohematological patients with concomitant ischemic heart disease

Застосування сучасних протоколів ведення пацієнтів з гострими лейкеміями дозволяє істотно змінити ранні та віддалені результати лікування. Основною проблемою проведення поліхіміотерапії, що включає антрациклінові антибіотики, залишається висока кардіологічна токсичність. У статті наведені сучасні напрямки вирішення проблеми щодо зниження ризику розвитку антрациклініндукованих уражень серця - це застосування менш токсичного препарату серед представників групи антрациклінів і облік їх кумулятивної дози, пошуки нових перспективних форм лікарських препаратів антрациклінів, що володіють максимальною ефективністю і високим профілем безпеки, призначення ефективного кардіопротектора на тлі ПХТ. Проведено аналіз результатів досліджень щодо застосування різних препаратів, що мають антиоксидантну дію - дексразоксана, кверцетину, ресвератролу, коензиму Q 10, триметазидину, тіотриазоліну - з метою профілактики антрациклінової кардіотоксичності. Наведено можливості і результати профілактичного застосування інгібіторів АПФ, блокаторів рецепторів ангіотензину і β-адреноблокаторів на тлі поліхіміотерапії, що включає антрацикліни. Запропоновано призначення L-аргініну пацієнтам високого кардіологічного ризику в якості профілактики розвитку антрациклініндукованої кардіотоксичності. Продемонстровано клінічне спостереження випадку проведення курсу індукції ремісії пацієнтові з гострою монобластною лейкемією і супутньою ішемічною хворобою серця. Призначення L-аргініну на тлі поліхіміотерапії дозволило зменшити кількість скарг з боку серцево-судинної системи, а також отримати зменшення частоти і вираженості порушень біоелектричної активності міокарда, за даними стандартної ЕКГ та добового ЕКГ-моніторингу ; Применение современных протоколов ведения пациентов с острыми лейкемиями позволяет существенно изменить ранние и отдаленные результаты лечения. Основной проблемой проведения полихимиотерапии, включающей антрациклиновые антибиотики, остается высокая кардиологическая токсичность. В статье наведены современные направления решения проблемы по снижению риска развития антрациклин-индуцированных поражений сердца – это применение менее токсичного препарата среди представителей группы антрациклинов и учет их кумулятивной дозы, поиски новых перспективных форм лекарственных препаратов антрациклинов, обладающих максимальной эффективностью и высоким профилем безопасности, назначение эффективного кардиопротектора на фоне ПХТ. Проведен анализ результатов исследований по применению различных препаратов, обладающих антиоксидантным действием – дексразоксана, кверцетина, ресвератрола, коэнзима Q 10, триметазидина, тиотриазолина – с целью профилактики антрациклиновой кардиотоксичности. Приведены возможности и результаты профилактического применения ингибиторов АПФ, блокаторов рецепторов ангиотензина и β-адреноблокаторов на фоне полихимиотерапии, включающей антрациклины. Предложено назначение L-аргинина пациентам высокого кардиологического риска в качестве профилактики развития антрациклин-индуцированной кардиотоксичности. Продемонстрировано клиническое наблюдение случая проведения курса индукции ремиссии пациенту с острой монобластной лейкемией и сопутствующей ишемической болезнью сердца. Назначение L-аргинина на фоне полихимиотерапии позволило уменьшить количество жалоб со стороны сердечно-сосудистой системы, а также получить уменьшение частоты и выраженности нарушений биоэлектрической активности миокарда, по данным стандартной ЭКГ и суточного ЭКГ-мониторинга ; Using modern treatment protocols for patients with acute leukemia can significantly change early and late results of the therapy. The major problem of chemotherapy including anthracycline antibiotics remains high cardiac toxicity. The article presents the modern ways of solving this problem by reducing the risk of development of anthracycline-induced heart injury – to use a less toxic drug among the group of anthracyclines and taking into account their cumulative dose, the search for new promising forms of anthracyclines with maximum efficiency and high safety profile, the effective cardioprotector assignment on polychemotherapy background. The research results on use of various drugs with antioxidant effect (dexrazoxane, quercetin, resveratrol, coenzyme Q10, trimetazidine, thiotriazoline) in the prevention of anthracycline cardiotoxicity have been analyzed. The opportunities and results of the prophylactic use of ACE inhibitors, angiotensin receptor blockers and β-blockers on the background of chemotherapy including anthracyclines are presented. The assignment of L-arginine to high cardiac risk patients, as the prevention of anthracycline-induced cardiotoxicity is proposed. The clinical case of patient with acute monoblastic leukemia and concomitant ischemic heart disease during induction of remission treatment course is demonstrated. The L-arginine assignment on the background of chemotherapy allowed to reduce the cardiovascular complaints, frequency and severity of myocardium bioelectric activity violations according to the standard ECG and daily ECG-monitoring

In Vivo Evaluation of Cervical Stiffness Evolution during Induced Ripening Using Shear Wave Elastography, Histology and 2 Photon Excitation Microscopy: Insight from an Animal Model

Prematurity affects 11% of the births and is the main cause of infant mortality. On the opposite case, the failure of induction of parturition in the case of delayed spontaneous birth is associated with fetal suffering. Both conditions are associated with precocious and/or delayed cervical ripening. Quantitative and objective information about the temporal evolution of the cervical ripening may provide a complementary method to identify cases at risk of preterm delivery and to assess the likelihood of successful induction of labour. In this study, the cervical stiffness was measured in vivo in pregnant sheep by using Shear Wave Elastography (SWE). This technique assesses the stiffness of tissue through the measurement of shear waves speed (SWS). In the present study, 9 pregnant ewes were used. Cervical ripening was induced at 127 days of pregnancy (term: 145 days) by dexamethasone injection in 5 animals, while 4 animals were used as control. Elastographic images of the cervix were obtained by two independent operators every 4 hours during 24 hours after injection to monitor the cervical maturation induced by the dexamethasone. Based on the measurements of SWS during vaginal ultrasound examination, the stiffness in the second ring of the cervix was quantified over a circular region of interest of 5 mm diameter. SWS was found to decrease significantly in the first 4–8 hours after dexamethasone compared to controls, which was associated with cervical ripening induced by dexamethasone (from 1.779 m/s ± 0.548 m/s, p < 0.0005, to 1.291 m/s ± 0.516 m/s, p < 0.000). Consequently a drop in the cervical elasticity was quantified too (from 9.5 kPa ± 0.9 kPa, p < 0.0005, to 5.0 kPa ± 0.8 kPa, p < 0.000). Moreover, SWE measurements were highly reproducible between both operators at all times. Cervical ripening induced by dexamethasone was confirmed by the significant increase in maternal plasma Prostaglandin E2 (PGE2), as evidenced by the assay of its metabolite PGEM. Histological analyses and two-photon excitation microscopy, combining both Second Harmonic Generation (SHG) and Two-photon Fluorescence microscopy (2PF) contrasts, were used to investigate, at the microscopic scale, the structure of cervical tissue. Results show that both collagen and 2PF-active fibrillar structures could be closely related to the mechanical properties of cervical tissue that are perceptible in elastography. In conclusion, SWE may be a valuable method to objectively quantify the cervical stiffness and as a complementary diagnostic tool for preterm birth and for labour induction success

L-ARGININE IS AN EFFECTIVE MEDICATION FOR PREVENTION OF ENDOTHELIAL DYSFUNCTION, A PREDICTOR OF ANTHRACYCLINE CARDIOTOXICITY IN PATIENTS WITH ACUTE LEUKEMIA

Aim: To evaluate the effectiveness of L-arginine in the prevention of endothelial dysfunction, which may be a predictor of anthracycline-induced myocardial injury, in patients with acute leukemia (AL) on the background of anthracycline antibiotics low cumulative doses from 100 to 200 mg/m2. Materials and Methods: A total of 81 adult AL patients (38 males and 43 females with the age of 16–59 years) were studied. The patients were divided into two groups: group I (n = 34), AL patients treated with chemotherapy (CT) and L-arginine hydrochloride; group II (n = 47) — AL patients treated with CT only. Cardiac evaluation and endothelial function assessment were performed at baseline and after second CT. Electrocardiography (ECG) parameters, lipid peroxidation activity, antioxidant protection and NO system state were evaluated. Results: The bioelectric activity abnormalities of the myocardium were observed in studied patients with low cardiac risk after induction CT. In case of L-arginine administration, only minimal daily ECG changes were recorded. A significant difference in the lipid peroxidation and antioxidant defense system activity in patients of groups I and II was determined. We noticed deepening of endothelial dysfunction on the background of cytostatic therapy with anthracycline antibiotics compared with baseline values in patients of group II. It was found that prophylactic L-arginine increases superoxide dismutase level and reduces the total NOS activity due to its inducible isoform. Conclusion: The leading factor of anthracycline-induced cardiotoxicity is the imbalance between free radical generation and their inactivation that leads to endothelial dysfunction development. L-arginine eliminates the prooxidant-antioxidant imbalance and improves the endothelial function

IBS in a CAM-Dominated Electron Beam

We report on the performance and planned upgrades to the Fermilab Accumulator Stacktail Stochastic Cooling System. The current system has achieved a maximum flux of 16.5e10/hour, limited by the input flux of antiprotons. The upgrades are designed to handle flux in excess of 40e10/hour