Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci.

Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

THE PROBLEM OF NEUTRALIZING ANTIBODIES IN MANAGEMENT OF MULTIPLE SCLEROSIS

It is known that the interferon beta therapy is more effective for multiple sclerosis. The literature review focuses on the problem of neutralizing antibodies (NAbs) in interferon beta therapy of multiple sclerosis for children and adolescents. The authors provide domestic and foreign data concerning therapy of multiple sclerosis, NAbs negative effects on bioactivity and bioavailability of diseasemodifying treatment, methods of NAbs detection and their impact on multiple sclerosis clinical course, and approaches to management of NAbs high titers. Key words: multiple sclerosis, disease-modifying treatment, interferon beta, interferon beta-1a, interferon beta-1b, neutralizingantibodies, children. (Pediatric Pharmacology. — 2011; 8 (5): 61–64.

PATHOGENIC MECHANISMS OF PRIMARY HEADACHE IN CHILDREN

The article reflects current viewpoints of Russian and foreign scientists on a problem of pathology of primary headaches (migraine and tension headache) in children, it's frequency in adults and children, diagnostic aspects and characteristic features of clinical course in children. Much attention is paid to the role of nitric oxide in pathogenesis of primary headaches.Key words: headache, primary headache, tension headache, migraine, nitric oxide, children

The russian agricultural sector in the innovative component of the country’s food security

Achieving competitiveness in the global world economy system requires strengthening the innovative direction of representatives of the domestic agro-industrial sector. The innovative component of the agricultural sector also plays an important role in solving the country’s food security. The article considers the basics of the development of innovative activity of agro-industrial enterprises and the impact of innovative activity in the agro-industrial complex on the country food security. Obstacles are analyzed and priority directions of innovative development of agro-industrial enterprises are reflected

NEUROPEDIATRIC ASPECTS OF SEDATIVE MEDICINES USING IN THE TREATMENT OF CHILDREN AND ADOLESCENTS

Authors consider the possibilities of using phytomedicine Persen in child neurology and in various fields of pediatrics. Publications from medical periodic press dating from 2000-s and associated with problems of Persen application are cited.Key words: psychosomatic disorders, anxiety, depression, sleep disorders, Persen, infants, children, adolescents

Acute hypertension: A systematic review and appraisal of guidelines

Background: Few clinical practice guidelines provide management recommendations for acute hypertensive episodes except in the context of specific conditions such as pregnancy and stroke.Methods: We performed a systematic search to identify guidelines addressing acute hypertension and appraised the guidelines using the Appraisal of Guidelines for Research and Evaluation (AGREE II) validated quality assessment tool. Two reviewers independently appraised and one extracted key recommendations. Literature on secondary hypertension, hypertension in pregnancy, preeclampsia/eclampsia, stroke, aortic dissection, and pheochromocytoma was excluded.Results: Three guidelines were identified, sponsored by the American College of Emergency Physicians (ACEP), the National Heart, Lung, and Blood Institute (NHLBI), and the European Society of Hypertension (ESH) in conjunction with the European Society of Cardiology (ESC). AGREE II yielded mean domain (%) and overall assessment scores (1-7) as follows: NHLBI: 73%, 5.5; ACEP: 67%, 5.5; and ESH/ESC: 56%, 4.5. In hypertensive emergencies, the NHLBI guideline recommends reducing mean arterial pressure by_25% for the first hour, and then to 160/100-110 mmHg by 2-6 hours with subsequent gradual normalization in 24-48 hours. The ESH/ESC has similar recommendations. The ACEP does not address guidelines for hypertensive emergency but focuses on whether screening for target organ damage or medical intervention in patients with asymptomatic elevated blood pressure in emergency departments reduces the rate of adverse outcomes, concluding that routine screening does not reduce adverse outcomes, but patients with poor follow-up may benefit from routine screening.Conclusion: NHLBI and ESH/ESC guidelines are high quality and provide similar recommendations for management of asymptomatic acute hypertensive episodes and hypertensive emergencies. Additional research is needed to inform clinical practice guidelines for this common condition

ПРОБЛЕМА НЕЙТРАЛИЗУЮЩИХ АНТИТЕЛ В ТЕРАПИИ РАССЕЯННОГО СКЛЕРОЗА

It is known that the interferon beta therapy is more effective for multiple sclerosis. The literature review focuses on the problem of neutralizing antibodies (NAbs) in interferon beta therapy of multiple sclerosis for children and adolescents. The authors provide domestic and foreign data concerning therapy of multiple sclerosis, NAbs negative effects on bioactivity and bioavailability of diseasemodifying treatment, methods of NAbs detection and their impact on multiple sclerosis clinical course, and approaches to management of NAbs high titers. Key words: multiple sclerosis, disease-modifying treatment, interferon beta, interferon beta-1a, interferon beta-1b, neutralizingantibodies, children. (Pediatric Pharmacology. — 2011; 8 (5): 61–64.)В настоящее время наиболее эффективным методом терапии рассеянного склероза считается применение препаратов интерферона бета. Обзор литературы посвящен проблеме образования нейтрализующих антител (НАТ) при лечении рассеянного склероза препаратами интерферона бета у детей и подростков. Авторы приводят результаты российских и зарубежных исследований по лечению рассеянного склероза, а также о влиянии НАТ на биоактивность и биодоступность иммуномодулирующей терапии, методы определения НАТ, их влияние на течение рассеянного склероза, подходы к коррекции высоких титров НАТ. Ключевые слова: рассеянный склероз, иммуномодулирующее лечение, интерферон-бета, интерферон бета-1а, интерферон бета-1b, нейтрализующие антитела, дети. (Педиатрическая фармакология. — 2011; 8 (5): 61–64

НЕЙРОПЕДИАТРИЧЕСКИЕ АСПЕКТЫ ПРИМЕНЕНИЯ СЕДАТИВНОГО ПРЕПАРАТА В ЛЕЧЕНИИ ДЕТЕЙ И ПОДРОСТКОВ

Authors consider the possibilities of using phytomedicine Persen in child neurology and in various fields of pediatrics. Publications from medical periodic press dating from 2000-s and associated with problems of Persen application are cited.Key words: psychosomatic disorders, anxiety, depression, sleep disorders, Persen, infants, children, adolescents.В статье рассматриваются возможности применения растительного препарата в детской неврологии и различных областях педиатрии. Приводятся данные основных публикаций в медицинской периодике по проблемам применения фитопрепарата седативного действия за период 2000–2010 гг. Ключевые слова: психосоматические расстройства, тревога, депрессия, нарушения сна, дети, подростки.(Педиатрическая фармакология 2011;8(1):105-107