Logistic regression model for predicting failure of dual antihypertensive therapy: a prospective comparative non-randomized clinical trial

Background. Initial dual antihypertensive therapy is currently considered as the first management step for the majority of patients with arterial hypertension. However, it often fails to achieve the target blood pressure levels. An approved algorithm for predicting the failure of dual antihypertensive therapy is still to be developed. Objectives. To establish predictors of dual antihypertensive therapy failure in patients with high and very high cardiovascular risk and to create a model for predicting negative outcome of dual antihypertensive therapy. Methods. The paper presents a prospective comparative non-randomized clinical trial. The recruiting of participants and recording of results were carried out in March–December 2019 with 3 months of the follow-up period. The trial involved examination of 88 patients with poor blood pressure control, stage II and III arterial hypertension, high and very high cardiovascular risk of stages 1–3. Clinical and laboratory examination was carried out in compliance with the current regulatory documents. Additional examination included tests for uric acid, high-sensitivity C-reactive protein, as well as respiratory polygraphy and computerized capillaroscopy. All patients were prescribed dual antihypertensive therapy. The primary search for predictors was performed using the binary logistic regression. The predictive model was developed by stepwise variable selection. The diagnostic significance of the binary classifier was assessed by means of ROC-curve analysis; the calculation was performed using MedCalc 20.218 software (MedCalc Software Ltd., Belgium). Results. Administration of two hypotensive drugs appears to be effective in 33% of patients. The final model for predicting negative outcomes of dual antihypertensive therapy included such independent predictors as interventricular septal thickness, daily mean systolic blood pressure, and area density of the capillary network. The odds ratio accounted for 9.1 (95% confidence interval 3.12; 26.82). The area under the ROC curve based on the multiple binary logistic regression model comprised 0.805±0.05 with 95% confidence interval: 0.707-0.882 (p<0.0001). The sensitivity and specificity of the method amounted to 83.1 and 69.0%, respectively. The prediction accuracy comprised 77.3%. Conclusion. The development of patient-oriented algorithms for selection of hypotensive treatment is considered to be essential due to poor blood pressure control during dual antihypertensive therapy. The developed prognostic model may be applied when managing hypertension

Дослідження впливу фітозбору лікарських рослин на функціональні показники серцево-судинної системи

A phytocomposition based on roots of wild rose for the treatment of functional disorders of the cardiovascular system is designed, the application performance is improved vascular tone and cardiac students with special physical training group who were registered with diagnosis of vegetative-vascular dystonia and neurocirculatory dystonia.Предложен фитосбор для лечения функциональных нарушений сердечно-сосудистой системы, применение которого улучшало показатели сосудистого тонуса и сердечной деятельности у студентов специальной группы по физической культуре, находившихся на учете с диагнозами вегетососудистая и нейроциркуляторная дистонии.Запропоновано фітозбір на основі коренів шипшини для лікування функціональних порушень серцево-судинної системи, застосування якого покращувало показники судинного тонусу та серцевої діяльності у студентів спеціальної групи з фізичної культури, що знаходилися на обліку з діагнозами вегето-судинна та нейроциркуляторна дистонії.

Experience in the control of nematodirosis of calves on the Ivanovo Region farms and the economic justification of anthelmintics

The purpose of the research is to evaluate the anthelmintic efficacy against gastrointestinal Strongylata infections of cattle and to give an economic justification for their use in Yaroslavl calves.Materials and methods. The studies were performed on the Ivanovo Region farms in 2018–2020. To determine the helminth infection in cattle, 604 animals undergone a coprological survey. The faeces were examined by the Fülleborn and Berman- Orlov methods. To determine the therapeutic efficacy of anthelmintics, 4 groups of animals spontaneously infected with Nematodirus sp. were formed. The first group of calves was dewormed with a drug containing 20% albendazole. The second group of animals received a drug containing eprinomectin, and the third, a combined anthelmintic containing praziquantel and ivermectin. The fourth group of calves was dewormed with an ivermectin containing drug. Results and discussion. On the Ivanovo Region farms, nematodirosis was recorded in the calves aged 6–12 months; the infection prevalence was 75.3% with an average intensity of 31.04±0.77 egg specimens in 1 g of faeces. The diets for calves on all of the farms were approximately the same; the average daily weight gain of the calves was 251.10±0.54 g. Drugs with the active substance of 20 % albendazole, eprinomectin, praziquantel + ivermectin, and ivermectin showed 100% extenseeffectiveness and intense-effectiveness. The release of the calves from Nematodirus spp. allowed to increase the average daily gain in the body weight of the Yaroslavl calves to 650±0.40 g. The applied anthelmintics showed an economic efficacy of RUB 12.7-13.1 for RUB 1 of costs

Эпидемиологические исследования миастении: обзор литературы

The review of domestic and foreign literature devoted to epidemiological studies of myasthenia gravis has been reviewed. The article presents data on the prevalence and incidence of myasthenia gravis in several regions of Russia and abroad. The prevalence of myasthenia gravis in the world varies, according to different authors, in a very wide range – from 2.17 to 32.0 per 100 thousand people. There are few epidemiological studies of myasthenia gravis in large cities and regions of Russia. Meanwhile, studies of the prevalence and incidence of myasthenia gravis are a necessary stage in the work to increase the effectiveness of diagnosis and treatment of this pathology, to determine the need for specialized types of medical care. The results of these studies can be used to optimize the management of myasthenia gravis patients.В статье приводятся данные о распространенности и заболеваемости миастенией в ряде регионов России и стран ближнего и дальнего зарубежья. Показатели распространенности миастении в мире варьируют, по данным разных авторов, в весьма широких пределах – от 2,17 до 32,0 на 100 тыс. населения. Эпидемиологические исследования миастении в различных регионах России немногочисленны. При этом исследования распространенности и заболеваемости миастенией являются необходимым этапом работы по повышению эффективности диагностики и лечения этой патологии, для определения потребности населения в специализированных видах медицинской помощи. Результаты данных исследований могут быть использованы для оптимизации ведения больных миастенией

Опыт борьбы с нематодирозом телят в хозяйствах Ивановской области и экономическое обоснование применения антигельминтиков

The purpose of the research is to evaluate the anthelmintic efficacy against gastrointestinal Strongylata infections of cattle and to give an economic justification for their use in Yaroslavl calves.Materials and methods. The studies were performed on the Ivanovo Region farms in 2018–2020. To determine the helminth infection in cattle, 604 animals undergone a coprological survey. The faeces were examined by the Fülleborn and Berman- Orlov methods. To determine the therapeutic efficacy of anthelmintics, 4 groups of animals spontaneously infected with Nematodirus sp. were formed. The first group of calves was dewormed with a drug containing 20% albendazole. The second group of animals received a drug containing eprinomectin, and the third, a combined anthelmintic containing praziquantel and ivermectin. The fourth group of calves was dewormed with an ivermectin containing drug. Results and discussion. On the Ivanovo Region farms, nematodirosis was recorded in the calves aged 6–12 months; the infection prevalence was 75.3% with an average intensity of 31.04±0.77 egg specimens in 1 g of faeces. The diets for calves on all of the farms were approximately the same; the average daily weight gain of the calves was 251.10±0.54 g. Drugs with the active substance of 20 % albendazole, eprinomectin, praziquantel + ivermectin, and ivermectin showed 100% extenseeffectiveness and intense-effectiveness. The release of the calves from Nematodirus spp. allowed to increase the average daily gain in the body weight of the Yaroslavl calves to 650±0.40 g. The applied anthelmintics showed an economic efficacy of RUB 12.7-13.1 for RUB 1 of costs.Цель исследований – оценить эффективность антигельминтиков при стронгилятозах желудочно-кишечного тракта крупного рогатого скота и дать экономическое обоснование их применению у телят ярославской породы.Материалы и методы. Исследования проведены в хозяйствах Ивановской области в 2018–2020 гг. Для определения зараженности крупного рогатого скота гельминтами копрологическому исследованию подвергли 604 животных. Фекалии исследовали методами Фюллеборна и Бермана-Орлова. Для определения терапевтической эффективности антигельминтиков было сформировано 4 группы животных, спонтанно зараженных нематодирусами. Первую группу телят дегельминтизировали препаратом, содержащим 20% альбендазол. Вторая группа животных получала препарат, содержащий эприномектин, третья – комбинированный антигельминтик, содержащий празиквантел и ивермектин. Четвертую группу телят дегельминтизировали препаратом, содержащим ивермектин.Результаты и обсуждение. В хозяйствах Ивановской области нематодироз зарегистрирован у телят 6–12-месячного возраста; экстенсивность инвазии составила 75,3% при средней интенсивности инвазии 31,04±0,77 экз. яиц в 1 г фекалий. Рационы кормления телят во всех хозяйствах были примерно одинаковыми; среднесуточный привес телят составил 251,10±0,54 г. Препараты с ДВ 20% альбендазол, эприномектин, празиквантел + ивермектин и ивермектин показали 100%-ную экстенсэффективность и интенсэффективность. Освобождение телят от нематодирусов позволило увеличить среднесуточный прирост живой массы телят ярославской породы до 650±0,40 г. Применяемые антигельминтные препараты показали экономическую эффективность 12,7–13,1 руб. на 1 руб. затрат

Анализ клинических проявлений и диагностики миастении с дебютом в пожилом возрасте

Introduction. Myasthenia gravis is one of the most common autoimmune neuromuscular diseases, the peak incidence is in the age of 20–40 years. However, studies show that throughout the world in recent decades there has been an increase in the prevalence and incidence of myasthenia gravis among older people.Purpose of the study – to evaluate the clinical manifestations and diagnostic features of myasthenia gravis in patients with an onset of diseases in the elderly.Materials and methods. The retrospective, non-interventional study included 315 patients over 18 years old with a reliable (3 out of 4 criteria) and an undoubted (4 out of 4 criteria) diagnosis of myasthenia gravis, the duration of the disease for up to 5 years, undergoing inpatient treatment from 2001 to 2017 years. The severity of the clinical manifestations of myasthenia gravis was assessed using the Myasthenia Gravis Foundation of America scale. We were taken into account the information about the first symptoms, duration of the period from the onset of the disease to the verification of the diagnosis, results of the examinations, the presence of concomitant diseases and treatment methods.Results. The most common symptom of myasthenia gravis in the group of patients with debut disease aged 60 years and older was ptosis (p <0.001). The crises and pathology of the thymus were less common in elderly patients (p <0.0001). The concentration of antibodies to acetylcholine receptors was the same (p = 0.05) among all patients. The level of antibodies to titin was increased in patients with lateonset (p = 0.0014). The presence of bronchopulmonary pathology made worse the course of myasthenia gravis in elderly people (p = 0.01), while cardiovascular and cerebrovascular diseases, as well as diabetes mellitus, did not occur (p >0.005). At the first examination in the group of elderly patients among the incorrectly diagnoses prevailed: stroke or decompensation of chronic cerebral ischemia (p = 0.0002). With a comparable duration and severity of myasthenia gravis in different age groups, the combination of anticholinesterase drugs, glucocorticosteroids and azathioprine (p = 0.01) at a lower daily dose (100 mg) was more often used for the treatment of elderly patients compared with young and middle-aged groups (150 mg) (p = 0.03).Conclusion. Diagnosis of myasthenia gravis in elderly patients presents the greatest difficulties, and symptoms of manifestation during initial treatment are often regarded as a manifestation of vascular pathology. Despite the presence of concomitant diseases characteristic of this age group, myasthenia gravis does not differ in the severity of the course. To achieve remission and compensation of symptoms, elderly patients do not need large doses of symptomatic and pathogenetic drugs.Введение. Миастения является одним из наиболее распространенных аутоиммунных нервно-мышечных заболеваний, пик заболеваемости приходится на возраст 20–40 лет. Однако, как показывают исследования, во всем мире в последние десятилетия наблюдается увеличение распространенности и заболеваемости миастенией среди лиц старшей возрастной группы.Цель исследования – оценить клинические проявления и особенности диагностики миастении у пациентов с дебютом заболевания в пожилом возрасте.Материалы и методы. В ретропроспективное, неинтервенционное исследование были включены 315 пациентов старше 18 лет с достоверным (3 из 4 критериев) и несомненным (4 из 4 критериев) диагнозом «миастения», длительностью заболевания до 5 лет включительно, проходивших стационарное лечение в период с 2001 по 2017 г. Тяжесть клинических проявлений миастении оценивалась по шкале Myasthenia Gravis Foundation of America. Были учтены данные о симптомах дебюта, длительности периода от начала заболевания до верификации диагноза, проведенных исследованиях, наличии сопутствующих заболеваний и методах лечения.Результаты. Наиболее распространенным симптомом миастении в группе пациентов с дебютом заболевания в возрасте от 60 лет и старше оказался птоз (p <0,001). Кризовое течение и патология тимуса реже встречались у пациентов пожилого возраста (р <0,0001). Концентрация антител к ацетилхолиновым рецепторам была сопоставима (р = 0,05) среди пациентов разных возрастных групп, а уровень антител к титину был повышен у пациентов с дебютом миастении в пожилом возрасте (p = 0,0014). Наличие бронхолегочной патологии отягощало течение миастении у лиц пожилого возраста (р = 0,01), тогда как сердечно-сосудистые и цереброваскулярные заболевания, а также нарушения углеводного обмена такого влияния не оказывали (p >0,005). На этапе первичного осмотра в группе пожилых пациентов среди неверно установленных диагнозов превалировал инсульт или декомпенсация хронической ишемии мозга (р = 0,0002). При сопоставимой длительности и тяжести миастении в разных возрастных группах для терапии пожилых пациентов чаще использовалась трехкомпонентная схема с включением антихолинэстеразных, глюкокортикостероидных препаратов и азатиоприна (р = 0,01), суточная доза которого была ниже (100 мг) по сравнению с группами молодого и среднего возраста (150 мг) (р = 0,03).Заключение. Диагностика миастении у пожилых пациентов представляет наибольшие трудности, и симптомы манифестации при первичном обращении зачастую расцениваются как проявление сосудистой патологии. Несмотря на наличие характерных для этой возрастной группы сопутствующих заболеваний, миастения не отличается тяжестью течения. Для достижения ремиссии и компенсации симптомов пациенты пожилого возраста не нуждаются в больших дозах симптоматических и патогенетических лекарственных препаратов

The Genome of the Toluene-Degrading Pseudomonas veronii Strain 1YdBTEX2 and Its Differential Gene Expression in Contaminated Sand.

The natural restoration of soils polluted by aromatic hydrocarbons such as benzene, toluene, ethylbenzene and m- and p-xylene (BTEX) may be accelerated by inoculation of specific biodegraders (bioaugmentation). Bioaugmentation mainly involves introducing bacteria that deploy their metabolic properties and adaptation potential to survive and propagate in the contaminated environment by degrading the pollutant. In order to better understand the adaptive response of cells during a transition to contaminated material, we analyzed here the genome and short-term (1 h) changes in genome-wide gene expression of the BTEX-degrading bacterium Pseudomonas veronii 1YdBTEX2 in non-sterile soil and liquid medium, both in presence or absence of toluene. We obtained a gapless genome sequence of P. veronii 1YdBTEX2 covering three individual replicons with a total size of 8 Mb, two of which are largely unrelated to current known bacterial replicons. One-hour exposure to toluene, both in soil and liquid, triggered massive transcription (up to 208-fold induction) of multiple gene clusters, such as toluene degradation pathway(s), chemotaxis and toluene efflux pumps. This clearly underlines their key role in the adaptive response to toluene. In comparison to liquid medium, cells in soil drastically changed expression of genes involved in membrane functioning (e.g., lipid composition, lipid metabolism, cell fatty acid synthesis), osmotic stress response (e.g., polyamine or trehalose synthesis, uptake of potassium) and putrescine metabolism, highlighting the immediate response mechanisms of P. veronii 1YdBTEX2 for successful establishment in polluted soil

Biological function in the twilight zone of sequence conservation

Abstract Strong DNA conservation among divergent species is an indicator of enduring functionality. With weaker sequence conservation we enter a vast ‘twilight zone’ in which sequence subject to transient or lower constraint cannot be distinguished easily from neutrally evolving, non-functional sequence. Twilight zone functional sequence is illuminated instead by principles of selective constraint and positive selection using genomic data acquired from within a species’ population. Application of these principles reveals that despite being biochemically active, most twilight zone sequence is not functional

Enhanced EGFP Fluorescence Emission in Presence of PEG Aqueous Solutions and PIB1000-PEG6000-PIB1000 Copolymer Vesicles.

An EGFP construct interacting with the PIB1000-PEG6000-PIB1000 vesicles surface reported a ~2-fold fluorescence emission enhancement. Because of the constructs nature with the amphiphilic peptide inserted into the PIB core, EGFP is expected to experience a "pure" PEG environment. To unravel this phenomenon PEG/water solutions at different molecular weights and concentrations were used. Already at ~1 : 10 protein/PEG molar ratio the increase in fluorescence emission is observed reaching a plateau correlating with the PEG molecular weight. Parallel experiments in presence of glycerol aqueous solutions did show a slight fluorescence enhancement however starting at much higher concentrations. Molecular dynamics simulations of EGFP in neat water, glycerol, and PEG aqueous solutions were performed showing that PEG molecules tend to "wrap" the protein creating a microenvironment where the local PEG concentration is higher compared to its bulk concentration. Because the fluorescent emission can be perturbed by the refractive index surrounding the protein, the clustering of PEG molecules induces an enhanced fluorescence emission already at extremely low concentrations. These findings can be important when related to the use of EGFP as reported in molecular biology experiments

Epidemiologic studies of myasthenia gravis: literature review

The review of domestic and foreign literature devoted to epidemiological studies of myasthenia gravis has been reviewed. The article presents data on the prevalence and incidence of myasthenia gravis in several regions of Russia and abroad. The prevalence of myasthenia gravis in the world varies, according to different authors, in a very wide range – from 2.17 to 32.0 per 100 thousand people. There are few epidemiological studies of myasthenia gravis in large cities and regions of Russia. Meanwhile, studies of the prevalence and incidence of myasthenia gravis are a necessary stage in the work to increase the effectiveness of diagnosis and treatment of this pathology, to determine the need for specialized types of medical care. The results of these studies can be used to optimize the management of myasthenia gravis patients