Prevalence of familial hypercholesterolemia and hyperlipoproteinemia(a) in patients with premature acute coronary syndrome

Aim. To evaluate the prevalence of familial hypercholesterolemia (FH) and hyperlipoproteinemia(a) (HLP(a)) in patients with premature acute coronary syndrome (ACS).Material and methods. The study included 120 patients with ACS up to 60 years (mean age, 53±7 years, 104 (87%) men) and 44 people from the comparison group without atherosclerotic cardiovascular diseases and dyslipidemia (mean age, 48±11 years, 19 (43%) men). All patients with ACS underwent coronary angiography. The lipid profile and lipoprotein(a) (Lp(a)) were determined in all patients.Results. The prevalence of HLP(a) in patients with premature manifestation of ACS was 41% (n=49), possible FH — 25% (n=30), combination of FH and HLP(a) — 13% (n=15). In the comparison group, an increased concentration of Lp(a) was detected in 14% (n=6). Based on the analysis of operating characteristic curves, Lp(a) ≥30 mg/dL had the maximum significance for ACS with a sensitivity of 40% and a specificity of 86% (area under the curve, 0,6; 95% confidence interval (CI), 0,5-0,7, p<0,05), and Lp(a) >15 mg/dl was associated with two or more coronary artery lesions with a sensitivity of 67% and a specificity of 65% (area under the curve, 0,7; 95% CI, 0,6-0,7, p<0,01). On logistic regression analysis, age (odds ratio (OR). 1,1; 95% CI, 1,0-1,2, p<0,05), smoking (OR, 7,5; 95% CI, 2,5-22,0, p<0,001) and Lp(a) ≥30 mg/dl (OR, 6,7; 95% CI, 1,1-39,7, p<0,05) are independently associated with premature ACS. Only Lp(a) ≥15 mg/dL was associated with multivessel coronary artery disease in these patients (OR, 3,8; 95% CI, 1,52-9,74, p<0,01).Conclusion. Every fourth patient with premature ACS has FH, while almost every second has HLP(a), and every eighth has a combination of FH and HLP(a). HLP(a) is associated with ACS up to 60 years of age and multivessel coronary artery disease in these patients

Association of various lipid parameters with premature coronary artery disease in men

Aim. To assess the relationship between premature coronary artery disease (CAD) and various lipid parameters.Material and methods. This retrospective longitudinal study included 166 men aged 57±9 years with coronary CAD with onset before age of 55. The control group consisted of 62 men (60±8 years old) who did not have CAD and peripheral arterial disease. In all patients, data on following lipid profile parameters were collected: total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and lipoprotein(a) (Lp(a)) at the time of CAD onset, while in control group patients — at the first visit to the A.L. Myasnikov Institute of Clinical Cardiology. These indicators were measured in blood plasma at the time of enrollment in all patients. In addition, the concentration of LDL-C corrected for Lp(a)-cholesterol (LDL-Ccorr) was calculated. Hypercholesterolemia was diagnosed with an initial level of TC >5 mmol/l, or LDL-C ≥3,0 mmol/l, or non-HDL-C ≥3,8 mmol/l, while hyperlipoproteinemia(a) (HLP(a)) — at the level of Lp(a) ≥30 mg/dl.Results. Lipid metabolism disorders were significantly more common in patients with premature CAD compared to the control group. Lp(a) concentration ≥30 mg/dl, along with elevated levels of non-HDL-C or LDL-Ccorr, were associated with premature CAD, regardless of heredity and smoking, in the general cohort of examined men. Kaplan-Meier survival analysis showed that any type of lipid metabolism disorder was associated with an increased risk of premature CAD. In addition, patients with isolated elevated Lp(a) concentrations lived to the CAD onset 8 years earlier — 47 vs 55 years, p<0,02. The probability of premature CAD was maximum when the elevated level of non-HDL-C and HLP(a) was combined (hazard ratio, 2,91 (95% CI 1,96-4,33), p<0,0001).Conclusion. HLP(a) is an independent factor of premature CAD, even with normolipidemia, which confirms the need for routine measurement of Lp(a) in clinical practice

Classical approach in quantum physics

The application of a classical approach to various quantum problems - the secular perturbation approach to quantization of a hydrogen atom in external fields and a helium atom, the adiabatic switching method for calculation of a semiclassical spectrum of hydrogen atom in crossed electric and magnetic fields, a spontaneous decay of excited states of a hydrogen atom, Gutzwiller's approach to Stark problem, long-lived excited states of a helium atom recently discovered with the help of Poincar$\acute{\mathrm{e}}$ section, inelastic transitions in slow and fast electron-atom and ion-atom collisions - is reviewed. Further, a classical representation in quantum theory is discussed. In this representation the quantum states are treating as an ensemble of classical states. This approach opens the way to an accurate description of the initial and final states in classical trajectory Monte Carlo (CTMC) method and a purely classical explanation of tunneling phenomenon. The general aspects of the structure of the semiclassical series such as renormgroup symmetry, criterion of accuracy and so on are reviewed as well. In conclusion, the relation between quantum theory, classical physics and measurement is discussed.Comment: This review paper was rejected from J.Phys.A with referee's comment "The author has made many worthwhile contributions to semiclassical physics, but this article does not meet the standard for a topical review"

Антигенное разнообразие вирусов гриппа А и В, выделенных от детей в г. Санкт-Петербурге в период с 2013 по 2015 г.

Purpose of the study: study of the circulation, isolation and antigenic analysis of influenza viruses A and B in St.-Petersburg in the children aged 0–18 in the seasons 2013–2015.Materials: nasal swabs from children-inpatients from Saint-Petersburg.Methods: virus isolation in MDCK cell culture and chicken embryos, antigenic analysis with the hemagglutination inhibition (HAI) test with the set of hyper-immune rat antisera to the epidemic and reference strains, antigenic cartography.Results: The epidemic seasons 2013–2015 were characterized by the co-circulation in children in St.-Petersburg of influenza sub-types А(H1N1)pdm09, A(H3N2), and B of Yamagata lineage (B yam). In the season 2014–2015 the low activity of epidemic process was observed with the predominant sub-type A(H3N2) and in the next season – 2014–2015 with the more pronounced epidemic activity – the pre-dominance of B yam viruses. Antigenic analysis of influenza viruses А(H1N1)pdm09 which circulated in children revealed their antigenic homogeneity and full correspondence with vaccine strain A/California/07/09. As for А(H3N2) viruses, two antigenic groups were established: strains similar to A/St.-Petersburg/80/14 (sub-clade 3C.2a) and strains similar to A/Switzerland/9715293/13 (sub-clade 3C.3a). А(Н3N2) strains of the season 2013-2014 were similar to the vaccine strain. However isolates of the season 2014-2015 did not fit to the vaccine strain because in the children were predominant strains similar to the evolution branch A/St.-Petersburg/80/14 while according the WHO recommendations the influenza vaccine contained the strain A/Texas/50/12. Antigenic analysis of influenza viruses B showed their homogeneity and all they were B/Phuket/3073/13-like. Influenza strains B also incompletely corresponded to the vaccine strain – B/Massachusetts/2/12 belonging to the different genetic sub-clade. That might be the reason of enhanced morbidity of children with influenza B in the last season.Conclusion: The obtained results stress the urgency for the wide coverage of human population with the epidemic studies, virus isolation in different time periods and geographic regions and their etiological studies with the modern techniques. Only in these conditions we can assure high efficiency of flu seasonal vaccines.Цель исследования: особенности циркуляции, выделение и антигенный анализ вирусов гриппа А и В в Санкт-Петербурге в 2013–2015 гг. от детей от 0 до 18 лет.Материалы исследования: назальные мазки от детей из стационаров и закрытых детских учреждений Санкт-Петербурга.Методы: выделение вирусов на культуре клеток MDCK и куриных эмбрионах, антигенный анализ методом реакции торможения гемагглютинации (РТГА) с набором гипериммунных крысиных антисывороток к эталонным и эпидемическим штаммам гриппа, антигенная картография.Результаты: в эпидемические сезоны 2013–2015 гг. в г. Санкт-Петербурге среди детей была выявлена совместная циркуляция вирусов гриппа А(H1N1)pdm09, A(H3N2), B Ямагатской линии (B yam), причем в сезоне 2013–2014 гг. при общей невысокой активности эпидемического процесса преобладали вирусы A(H3N2), а в следующем эпидемическом сезоне – 2014–2015 гг. – при более высокой интенсивности эпидемии – вирусы В yam. Антигенный анализ вирусов А(H1N1)pdm09, циркулировавших среди детей, выявил их антигенную однородность и полное соответствие вакцинному штамму А/Калифорния/07/09. Зафиксирован антигенный дрейф вирусов А(H3N2), выявлены 2 антигенные группы: вирусы, подобные А/Санкт-Петербург/80/14 (генетическая подгруппа 3С.2а) и вирусы, подобные А/Швейцария/9715293/13 (подгруппа 3С.3а). Вирусы А(Н3N2) сезона 2013–2014 гг. были подобны вакцинному штамму. В то же время изоляты сезона 2014–2015 гг. не соответствовали вакцинному штамму, поскольку среди детей в основном выявлены штаммы, подобные эволюционной ветви А/Санкт-Петербург/80/14, а в вакцину по рекомендации ВОЗ был включен штамм А/Техас/50/12. Антигенный анализ вирусов гриппа В yam показал их однородность, они были подобны эталонному вирусу В/Пхукет/3073/13. Вирусы В также антигенно не полностью соответствовали вакцинному компоненту, поскольку данные вирусы были подобны штамму В/Пхукет/3073/13, а в состав вакцины входил штамм В/Массачусетс/2/12, принадлежащий к другой генетической подгруппе, что могло привести к повышению заболеваемости детей гриппом типа В в данном сезоне. Заключение: для своевременного правильного выбора штаммов, входящих в состав сезонных противогриппозных вакцин, по-прежнему актуальной остается задача как можно более широкого охвата населения эпидемиологическими исследованиями, выделения вирусов в разные периоды эпидемического сезона и в разных географических регионах, их антигенный и генетический анализ современными методами

Diet supplementation for 5 weeks with polyphenol-rich cereals improves several functions and the redox state of mouse leucocytes

BACKGROUND: Cereals naturally contain a great variety of polyphenols, which exert a wide range of physiological effects both in vitro and in vivo. Many of their protective effects, including an improvement of the function and redox state of immune cells in unhealthy or aged subjects come from their properties as powerful antioxidant compounds. However, whether cereal-based dietary supplementation positively affects the immune function and cellular redox state of healthy subjects remains unclear. AIM OF THE STUDY: To investigate the effects of supplementation (20% wt/wt) for 5 weeks with four different cereal fractions on healthy mice. METHODS: Several parameters of function and redox state of peritoneal leukocytes were measured. The cereals, named B (wheat germ), C (buckwheat flour), D (fine rice bran) and E (wheat middlings) contained different amounts of gallic acid, p-hydroxybenzoic acid, vanillic acid, sinapic acid, p-coumaric acid, ferulic acid, quercetin, catechin, rutin and oryzanol as major polyphenols. RESULTS: In general, all cereal fractions caused an improvement of the leukocyte parameters studied such as chemotaxis capacity, microbicidal activity, lymphoproliferative response to mitogens, interleukin-2 (IL-2) and tumor necrosis factor (TNFα) release, as well as oxidized glutathione (GSSG), GSSG/GSH ratio, catalase (CAT) activity and lipid oxidative damage. We observed similar effects among the cereal fractions. CONCLUSIONS: The results suggest that some of these effects may due, at least partially, to the antioxidant activity of the polyphenols naturally present in cereals. Since an appropriate function of the leukocytes has been proposed as marker of the health state, a short-term intake of cereals seems to be sufficient to exert a benefit in the health of the general population. However, further studies are needed to assess the optimal doses and to find out which active polyphenols are able to mediate the observed physiological effects before recommending their regular consumption

The use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in patients with differentiated thyroid cancer after initial treatment

Establishment of new centers for nuclear medicine in our country made diagnostic and treatment procedures more accessible for patients with differentiated thyroid cancer (DTC). It includes radioiodine therapy, considered as a non-alternative method of treatment, and positron emission tomography combined with computed tomography (PET/CT), which is essential in some clinical cases. For many years suspected tumor relapse with increased level of thyroglobulin and negative radioiodine scan was the only indication for PET/CT use among patients with DTC. But over the last decade the indications for PET/CT use in DTC cases expanded significantly. This review is aimed to analyze currently available data on PET/CT in DTC patients, its indications for use, advantages and limitations, new trends and recommendations

Diagnostic features of lung metastases differentiated thyroid cancer

Background. The worldwide increasing incidence of thyroid cancer (TC) is mainly due to a rise in its major form of differentiated TC (DTC): papillary. Most patients with DTC have a good prognosis; 10-year survival overall rates are as high as 85 %, but not greater than 40 % in a group of patients with distant metastases. At the same time, the lung is the most frequent target for distant metastases, accounting for 70 % of all sites.Objective: to estimate and compare the capabilities of different diagnostic techniques to detect lung metastases of DTC. Materials and methods. The results of diagnosing lung metastases were retrospectively analyzed in 36 patients (33 women and 3 men; mean age 53 years) with DTC (29 patients with papillary TC and 7 with follicular TC) treated at the department of radiotherapy with systemic therapy, Chelyabinsk Regional Clinical Oncology Center from 2011 to 2014.Results. Chest X-ray could reveal pulmonary metastases in 13 (36 %) patients; lung pathology foci were absent in 23 (64 %) patients. 131I whole-body scintigraphy (WBS) proved to be of informative value in 24 (66.7 %) patients, it displayed no increased accumulation of the radiopharmaceutical in the lung of 12 (33.3 %) cases. Multislice spiral computed tomography (MSCT) of the chest was carried out in 22 (61 %) patients; out of them 21 (95.5 %) were found to have 1.4-to-20-mm lung cancer foci. 18Fluorodeoxyglucose (18FDG) positron emission tomography / computed tomography (PET / CT) was performed in 18 (50 %) patients, which showed 3–26-mm lung pathology foci in all the patents; out of them 16 (88.9 %) were detected to have metastases owing to the CT component of this method. Thus, the highest sensitivity was exhibited by MSCT (95.5 %), 18FDG PET / CT (100 % due to its CT component), and 131I WBS (66.7 %).Conclusion. When lung metastases of DTC are suspected, 1) chest X-ray should be used as a screening test; 2) 131I WBS should be performed in all patients; 3) MSCT of the chest is the gold standard for diagnosis; 4) 18FDG PET / CT should not be employed in routine practice