Benefits chronotherapy calcium antagonist and beta-blockers in patients with arterial hypertension under the conditions of circumpolar shift work

We studied under conditions ot the Extreme North on the basis ot Medical Unit "GAZPROM DOBYCHA YAMBURG" 331 males at the age from 30 till 59 years, mean age 45,8 ± 6,9 years. The results of 12 - month study of 201 males with 1,2 degree AH treated with chronotherapy and treated with usual antihypertensive therapy ( amlodipin 5-10 mg \ day or bisoprolol 5-10 mg\ day). 24-hour ambulatory blood pressure monitoring (ABPM) was performed in all patients, individual cosinor-analysis with the definition chronotype circadian rhythm of BP. In therapy used chronotherapy approach, which includes the method of preventive chronotherapy and method of “pacing”. The study showed that under the conditions of circumpolar shift work mainly atypical chronotype BP (50 % of evaluable patients), which leads to the importance chronocorrection therapy of AH. Chronotherapy interventions under the conditions of circumpolar shift work for a year has a pronounced hypotensive and chrono stabilizing effects.В условиях вахтового поселка на базе медико-санитарной части ООО «ГАЗПРОМ ДОБЫЧА ЯМБУРГ» обследованы 331 мужчина 30-59 лет, средний возраст составил 45,8 + 6,9 лет. Представлены результаты 12- месячного исследования 201 мужчин с АГ 1,2 степени, пролеченных в условиях хронотерапии и традиционного назначения гипотензивных препаратов (амлодипин 5-10 мг/сут или бисопролол 5-10 мг\сутки). Всем обследованным проведено суточное мониторирование АД (СМАД), индивидуальный косинор-анализ данных с определением хронотипов суточных ритмов АД. В терапии использован хронотерапевтический подход, включающий в себя 2 метода: «превентивный» и метод «навязывания ритма». Проведенное исследование показало, что в условиях заполярной вахты преобладают атипичные хронотипы АД (у 50% обследованных пациентов), что обуславливает значимость хронокоррекции терапии АГ. Хронотерапевтическое вмешательство в условиях заполярной вахты в сравнении с обычным лечением в течение года оказывает выраженный гипотензивный и хроностабилизирующий эффект

Effective annual chronoterapy ACE inhibitor (lisinopril) in patients with arterial hypertension under the conditions of circumpolar shift work

We studied under conditions of the Extreme North on the basis of Medical Unit “GAZPROM DOBYCHA YAMBURG” 93 males at the age from 20 till 59 years, mean age 45,8 ± 6,9 years. The results of 12 - month study of 93 males with 1,2 degree AH treated with chronotherapy and treated with usual antihypertensive therapy ( lisinopril 5 mg \ day). 24-hour ambulatory blood pressure monitoring (ABPM) was performed in all patients, individual cosinor-analysis with the definition chronotype circadian rhythm of BP. In therapy used chronotherapy approach, which includes the method of preventive chronotherapy and method of “pacing”. The study showed that under the conditions of circumpolar shift work mainly atypical chronotype BP (50 % of evaluable patients), which leads to the importance chronocorrection therapy of AH. Chronotherapy interventions under the conditions of circumpolar shift work for a year has a pronounced hypotensive and chrono stabilizing effects.В условиях вахтового поселка на базе медико-санитарной части ООО «ГАЗПРОМ ДОБЫЧА ЯМБУРГ» обследованы мужчины 20-59 лет, средний возраст составил 45,8 + 6,9 лет. Представлены результаты 12- месячного исследования 93 мужчин с А Г1,2 степени, пролеченных в условиях хронотерапии и традиционного назначения гипотензивных препаратов (лизиноприл 5 мг\сутки). Всем обследованным проведено суточное мониторирование АД (СМАД), индивидуальный косинор-анализ данных с определением хронотипов суточных ритмов АД. В терапии использован хронотерапевтический подход, включающий в себя 2 метода: «превентивный» и метод «навязывания ритма». Проведенное исследование показало, что в условиях заполярной вахты преобладают атипичные хронотипы АД (у 50% обследованных пациентов), что обуславливает значимость хронокоррекции терапии АГ. Хронотерапевтическое вмешательство в условиях заполярной вахты в сравнении с обычным лечением в течение года оказывает выраженный гипотензивный и хроностабилизирующий эффект

Prognostic significance of atypical normotonsive chronotypes blood pressure in the development of hypertension in shift workers of the Arctic polar region

During the prospective one-year study in conditions of shift work in the Arctic 173 men with normal BP and with a negative history of hypertension (mean age 40.2+4.1 years) were examined. In total north experience was 16.5i6.8 years; work experience 11.2±3.8 years and office BP 123.4±7.5\80.5±5.5. All patients underwent ABPM, individual cosinor-data analysis to determine circadian rhythms chronotypes 1 time every 3 months. Based on the results of the study of chronobiological parameters in individuals with normal BP the role of DS in the formation of chronotypes of blood pressure diurnal rhythms in normotensive subjects was assessed, moreover tipepidine chronotypes AD highlighted as the main disturbances of circadian rhythm in the conditions of polar watches. Atypical normotensive chronotypes were characterized by more evident structural changes of heart and vessels. Chronobiological approach in comparison with standard analysis of ABPM showed higher diagnostic sensitivity, specificity and efficiency. Logistic regression revealed prognostic significance of normotensive atypical chronotypes compared to the main risk factors (smoking, low phisical activity, body mass index, dyslipidemia, age, duration of North and camp experience, the mode and type of watch).В течение проспективного годового наблюдения в условиях вахтового режима труда в Заполярье обследованы 173 мужчины с нормальным АД и с отрицательным анамнезом по гипертонии, средний возраст — 40,2±4,1 лет; северный стаж -16,5+6,8 лет; стаж работы вахтой • 11,2±3,8 лет; офисное АД 123.4±7,5\80,5±5,5(ммрт. ст.). Всем пациентам выполнено СМАД, индивидуальный косинор-анализ данных с определением хронотипов суточных ритмов АД 1 раз в 3 месяца. На основе результатов изучения хронобиологических параметров у лиц с нормальным АД показана роль десинхроноза в формировании хронотипов суточных ритмов АД у нормотензивных лиц, атипипичные хронотипы АД выделены, как ведущие нарушения суточной ритмики в условиях заполярной вахты. Атипичные нормотензивные хронотипы характеризовались более выраженными структурными изменениями сердца и сосудов. Хронобиологический подход в сравнении со стандартным анализом СМАД показал более высокие диагностические чувствительность, специфичность и эффективность. Метод логистической регрессии выявил прогностическую значимость нормотензивных атипичных хронотипов АД в сравнении с основными ФР (курение, НФА, ИМТ, дислипидемия, возраст, длительность северного и вахтового стажа, режим и тип вахты)

Human Papillomavirus Genotype Distribution in Czech Women and Men with Diseases Etiologically Linked to HPV

The HPV prevalence and genotype distribution are important for the estimation of the impact of HPV-based cervical cancer screening and HPV vaccination on the incidence of diseases etiologically linked to HPVs. The HPV genotype distribution varies across different geographical regions. Therefore, we investigated the type-specific HPV prevalence in Czech women and men with anogenital diseases.We analyzed 157 squamous cell carcinoma samples, 695 precancerous lesion samples and 64 cervical, vulvar and anal condylomata acuminate samples. HPV detection and typing were performed by PCR with GP5+/6+ primers, reverse line blot assay and sequencing. samples. HPV types 6 and/or 11 were detected in 84% samples of condylomata acuminate samples.The prevalence of vaccinal and related HPV types in patients with HPV-associated diseases in the Czech Republic is very high. We may assume that the implementation of routine vaccination against HPV would greatly reduce the burden of HPV-associated diseases in the Czech Republic

Vaginal microbiome and metabolome highlight specific signatures of bacterial vaginosis

In this study, we sought to find novel bacterial and metabolic hallmarks for bacterial vaginosis (BV). We studied the vaginal microbiome and metabolome of vaginal fluids from BV-affected patients (n = 43) and healthy controls (n = 37) by means of an integrated approach based on quantitative polymerase chain reaction (qPCR) and proton nuclear magnetic resonance ((1)H-NMR). The correlations between the clinical condition and vaginal bacterial communities were investigated by principal component analysis (PCA). To define the metabolomics signatures of BV, 100 discriminant analysis by projection on latent structure (PLS-DA) models were calculated. Bacterial signatures distinguishing the health condition and BV were identified by qPCR. Lactobacillus crispatus strongly featured the healthy vagina, while increased concentrations of Prevotella, Atopobium and Mycoplasma hominis specifically marked the infection. (1)H-NMR analysis has led to the identification and quantification of 17 previously unreported molecules. BV was associated with changes in the concentration of metabolites belonging to the families of amines, organic acids, short chain fatty acids, amino acids, nitrogenous bases and monosaccharides. In particular, maltose, kynurenine and NAD(+) primarily characterised the healthy status, while nicotinate, malonate and acetate were the best metabolic hallmarks of BV. This study helps to better understand the role of the vaginal microbiota and metabolome in the development of BV infection. We propose a molecular approach for the diagnosis of BV based on quantitative detection in the vaginal fluids of Atopobium, Prevotella and M. hominis, and nicotinate, malonate and acetate by combining qPCR and (1)H-NMR

Dysbiosis of upper respiratory tract microbiota in elderly pneumonia patients

Bacterial pneumonia is a major cause of morbidity and mortality in elderly. We hypothesize that dysbiosis between regular residents of the upper respiratory tract (URT) microbiome, that is balance between commensals and potential pathogens, is involved in pathogen overgrowth and consequently disease. We compared oropharyngeal microbiota of elderly pneumonia patients (n=100) with healthy elderly (n=91) by 16S-rRNA-based sequencing and verified our findings in young adult pneumonia patients (n=27) and young healthy adults (n=187). Microbiota profiles differed significantly between elderly pneumonia patients and healthy elderly (PERMANOVA, P<0.0005). Highly similar differences were observed between microbiota profiles of young adult pneumonia patients and their healthy controls. Clustering resulted in 11 (sub)clusters including 95% (386/405) of samples. We observed three microbiota profiles strongly associated with pneumonia (P<0.05) and either dominated by lactobacilli (n=11), Rothia (n=51) or Streptococcus (pseudo)pneumoniae (n=42). In contrast, three other microbiota clusters (in total n=183) were correlated with health (P<0.05) and were all characterized by more diverse profiles containing higher abundances of especially Prevotella melaninogenica, Veillonella and Leptotrichia. For the remaining clusters (n=99), the association with health or disease was less clear. A decision tree model based on the relative abundance of five bacterial community members in URT microbiota showed high specificity of 95% and sensitivity of 84% (89% and 73%, respectively, after cross-validation) for differentiating pneumonia patients from healthy individuals. These results suggest that pneumonia in elderly and young adults is associated with dysbiosis of the URT microbiome with bacterial overgrowth of single species and absence of distinct anaerobic bacteria. Whether the observed microbiome changes are a cause or a consequence of the development of pneumonia or merely coincide with disease status remains a question for future research

Mycoplasma genitalium: from Chrysalis to Multicolored Butterfly

Summary: The history, replication, genetics, characteristics (both biological and physical), and factors involved in the pathogenesis of Mycoplasma genitalium are presented. The latter factors include adhesion, the influence of hormones, motility, possible toxin production, and immunological responses. The preferred site of colonization, together with current detection procedures, mainly by PCR technology, is discussed. The relationships between M. genitalium and various diseases are highlighted. These diseases include acute and chronic nongonococcal urethritis, balanoposthitis, chronic prostatitis, and acute epididymitis in men and urethritis, bacterial vaginosis, vaginitis, cervicitis, pelvic inflammatory disease, and reproductive disease in women. A causative relationship, or otherwise strong association, between several of these diseases and M. genitalium is apparent, and the extent of this, on a subjective basis, is presented; also provided is a comparison between M. genitalium and two other genital tract-orientated mollicutes, namely, Mycoplasma hominis, the first mycoplasma of human origin to be discovered, and Ureaplasma species. Also discussed is the relationship between M. genitalium and infertility and also arthritis in both men and women, as is infection in homosexual and immunodeficient patients. Decreased immunity, as in HIV infections, may enhance mycoplasmal detection and increase disease severity. Finally, aspects of the antimicrobial susceptibility and resistance of M. genitalium, together with the treatment and possible prevention of mycoplasmal disease, are discussed