Anemia of chronic diseases in patients with dilated and ischemic cardiomyopathy

Aim. To estimate the effect of anemia of chronic diseases on the processes of cardiovascular system remodeling in patients with dilated cardiomyopathy and ischemic cardiomyopathy. Methods. The study included 27 patients with dilated cardiomyopathy with anemia, 19 with dilated cardiomyopathy without anemia, 11 with ischemic cardiomyopathy with anemia, 34 with ischemic cardiomyopathy without anemia, and 30 healthy individuals. In these comparison groups, peripheral blood, mean corpuscular hemoglobin and mean cell hemoglobin concentration, reticulocytes, serum iron and ferritin were examined. Electrocardiography, echocardiography, scintigraphy and coronary angiography were performed. Results. In all groups identical signs of chronic heart failure class 3 and 4 were found to be predominant, which was confirmed by a significant decrease of blood pressure, stroke volume, ejection fraction, increase of end systolic and diastolic volumes and sizes, as well as left and right atrial size. Patients with dilated and ischemic cardiomyopathy with anemia had decreased hemoglobin, number of erythrocytes and platelets, positive correlation between hemoglobin and serum iron (r=0.49, p=0.000), red blood cells and ferritin (r=0.61, p=0.000), negative correlation between hemoglobin and ferritin (r=-0.51, p=0.02). In ischemic cardiomyopathy with anemia positive correlation was found between hemoglobin and serum iron (r=0.54, p=0.000), erythrocytes and ferritin (r=0.49, p=0.03), negative correlation - between hemoglobin and ferritin (r=0.54, p=0.03). Conclusion. In patients with dilated and ischemic cardiomyopathy no significant effect of anemia of chronic diseases on heart remodeling processes was revealed

Characteristics of mukoviscisidosis in the southern regions of Russia

Introduction. Cystic fibrosis (CF) is a  hereditary disease with genetic heterogeneity and clinical polymorphism. Expanding the range of knowledge about the characteristics of the course of the disease in different regions is important to achieve the goal of improving the quality and life expectancy.Purpose. Comparative analysis of the features of the course of CF in the subjects of the Southern Federal District, Stavropol Territory.Methods. Data from the National Register of Patients of the RF MV 2016 were used. Results: there are clinical and genetic features between the regions of the Southern Federal District and the Stavropol Territory of the North Caucasus Federal District and in general with the Russian Federation. Analysis of the data showed differences in indicators: the proportion of patients aged ≥ 18 is the lowest in the Republic of Crimea (14.9%), in the Rostov region the lowest average age of patients (9.0 ± 6.3), and the lowest age of diagnosis 2.2 ± 3.1 years. Late terms of diagnosis were revealed in the Stavropol Territory (4.0 ± 8.0 years), but here there is one of the highest average age of CF patients (14.1 ± 11.5), the proportion of adult patients (23.3%) and the lowest allelic frequency of F508del, which is determined by the high number of patients with a “soft” genotype. There is a high proportion of patients with an undetermined genotype. A low proportion of two identified genetic variants of the CFTR gene is registered in patients of the Republic of Crimea. A low frequency of Burkholderia cepacia complex and Achromobacter spp was revealed, and a high infection with non-tuberculous mycobacteria was revealed in the Rostov region. FEV1 in children and adults was lower in Rostov Region and Stavropol Territory. In all regions, there is a discrepancy between the seeding of flora and azithromycin therapy and the severity of the genotype with the use of pancreatic enzymes.Conclusions. Analysis of the data of the registry, which allows substantiating the need to study the regional characteristics of the course of CF in order to differentiate the planning of measures to improve the quality of medical care for patients with CF

Клиническая эффективность флутиказона/сальметерола по сравнению с беклометазоном и флутиказоном при лечении бронхиальной астмы у детей

The aim was to compare effects of salmeterol/fluticasone propionate 50/100 μg bd (FSL) via Discus™ device with fluticasone propionate (FP) 100 pg bd via Dischaler or beclomethasone dipropionate (BDP 200 pg bid) via Dischaler in 12-week multtcentre randomised controlled trial involved 250 symptomatic children aged 4 to 10 yrs with moderate to severe asthma who had previosly received beclomethasone dipropionate less than 400 pg daily or cromones. The treatment effectiveness was assessed using a dairy card including measurement of asthma symptoms, peak expiratory flow (PEF), need in short-acting β2-agonists, and a patient's consideration of treatment. The patients receiving FSL had significantly more symptom-free days (64.8 ± 21.8) versus the patients receiving FP (55 ± 23.9, p < 0,05) or BDP (52 ± 24.8, p < 0.05). The FSL patients had fewer days with rescue medication (10.2 ± 12.6) in comparison with the FP (24.9 ± 21.7, p < 0.001) and the BD patients (23.8 ±20.1 p < 0.001). During first 4 weeks of the treatment the morning PEF rates were slightly higher in the FSL patients (114 ±7 % pred.) versus the FP ones (107 ± 8 %) and BDP (106 ± 8 %). Significantly more FSL children and their parents were satisfied with the treatment (97 %) compared with 82 % of the FP and 68 % of the BDP patients (p < 0.001). Children did not have problems using the dry powder inhalers Discus and Dischaler. Adverse events were found in 4 FSL, 7 FP and 12 BDP patients (cold, cough after inhalation, sore throat). These effects were not severe. Thus, the combined treatment with low-dose FP and SL was more effective than two-fold higher dose BDP and the single therapy with low-dose FP in pediatric asthma patients.Цель исследования — сравнить эффективность комбинированной терапии низкими дозами флутиказона в сочетании с пролонгированным р2-агонистом сальметеролом (Серетид 100/50 дважды в день — 1-я группа) с монотерапией флутиказона пропионатом в той же дозе (Фликсотид Ротадиск 100 мкг дважды в день — 2-я группа) или беклометазона дипропионатом в 2 раза большей дозе (Бекодиск 200 мкг дважды в день — 3-я группа) у детей 4-10 лет со среднетяжелой и тяжелой бронхиальной астмой (БА).Метод — многоцентровое открытое рандомизированное исследование в 3 параллельных группах в течение 12 нед. Все пациенты до включения в исследование имели симптомы БА и получали ингаляционные кортикостероиды (ИКС) или кромоны.Результаты: за 12 нед. лечения у детей 1-й группы было достоверно больше дней без симптомов БА (64,8 ± 21,8), чем во 2-й (52 ± 24,8, р < 0,05) и 3-й (55 ± 23,9, р < 0,05) группах; в 1-й группе было меньше дней, когда требовался прием короткодействующих β2-агонистов для купирования симптомов БА (1-я группа — 10,2 ± 12,6 дней, по сравнению со 2-й — 24,9 ± 21,7, и 3-й — 23,8 ± 20,1, р < 0,001). К концу лечения в 1-й группе, получавшей комбинированную терапию, показатели утренней ПСВ были выше (114 ± 7% от должного, по сравнению со 2-й и 3-й группами — 107 ±8 % и 106 ±8 % соответственно). Значительно больше родителей пациентов с БА были удовлетворены лечением Серетидом (97 %), чем в 2 других группах (во 2-й — 82 %, в 3-й — 68 %). За время лечения нежелательных явлений, возможно, связанных с приемом лекарств, в группе детей, получавших Серетид, не отмечено. Несерьезные нежелательные явления отмечены у 4 пациентов из 1-й группы, у 7 — из 2-й, у 12 — из 3-й группы (ОРЗ, кашель, першение в горле после ингаляции, усиление атопического дерматита). Отмены препаратов не потребовалось. Использование порошковых ингаляторов не вызывало трудностей у детей 4-10 лет.Заключение: у детей с со среднетяжелой и тяжелой БА лечение комбинированным препаратом флутиказон пропионат + сальметерол в низкой дозе более эффективно, чем лечение одним флутиказоном в той же дозе или беклометазоном в 2 раза большей дозе

Изучение эффективности, безопасности и оценка удовлетворенности ингаляционной терапией препаратом Тобрамицин-Гобби при синегнойной инфекции у детей с муковисцидозом

Study of efficacy, safety, and patient satisfaction with inhaled tobramycin (Tobramycin-Gobbi) in children with cystic fibrosis and pseudomonas infectionAim of the study was to assess efficacy and safety of Tobramycin-Gobbi in CF, as well as the patients’ satisfaction with the treatment.Methods. 35 children from 6 to 18 years with CF were enrolled in this non-interventional prospective cohort multicenter study. All children had P. aeruginosa in the respiratory tract (newly diagnosed, recurrent, or chronic infection). The children received inhalation treatment with Tobramycin-Gobbi in the following cycles: 28-day treatment/28-day break, for 6 months. The studied parameters included respiratory function, bacterial cultures of the respiratory tract with a bacterial count, growth and body weight, antibiotic therapy for the respiratory episodes. The children and parents filled in a questionnaire “Treatment satisfaction assessment” and assessed their state of health on the visual-analog scale before and after each treatment cycle.Results. P. aeruginosa was eradicated in 17.7% of cases (6 patients, including 2 newly diagnosed, 3 recurrent infections, and 1 chronic infection), reduced bacterial count, decreased number of courses of antibiotic therapy, improvement of FEV1. Adverse reactions were reported by one patient.Conclusion. The efficacy, safety, and tolerability of Tobramicine Gobbi were confirmed in the patients with newly diagnosed, recurrent, and chronic infection caused by P. aeruginosa.Антибактериальная терапия (АБТ) синегнойной инфекции при муковисцидозе (МВ) остается основным фактором, определяющим функцию легких и продолжительность жизни больных. Основным патогеном, который определяет степень тяжести течения МВ, продолжительность и качество жизни пациентов, является Pseudomonas aeruginosa.Целью исследования явилось изучение эффективности, безопасности и оценка удовлетворенности ингаляционной терапии препаратом Тобрамицин-Гобби при синегнойной инфекции у детей с МВ.Материалы и методы. В неинтервенционном проспективном когортном многоцентровом исследовании принимали участие дети (n = 35; возраст – 6–18 лет) с установленным диагнозом МВ, наличием синегнойной инфекции (первый высев, рецидивирующая и хроническая инфекция), наблюдавшиеся в 8 российских центрах МВ. В течение 6 мес. дети получали ингаляционную терапию указанным препаратом циклами по 28 дней ингаляций / 28 дней перерыв. Контролировались показатели респираторной функции, бактериальная флора дыхательных путей с оценкой степени обсемененности, показатели массы тела и роста, применяемая АБТ по поводу респиратор- ных эпизодов. Дети и их родители заполняли анкету пациента «Оценка удовлетворенности препаратом», при этом отмечалось самочувствие по визуальной аналоговой шкале до начала лечения и после каждого цикла приема препарата.Результаты. На фоне терапии в 6 (17,7 %) случаях (2 – с первичным высевом, 3 – с рецидивирующим, 1 – с хронической синегнойной инфекцией) выявлено отсутствие высева P. аeruginosa, уменьшение степени обсемененности, сокращение числа курсов АБТ, улучшение показателей объема форсированного выдоха за 1-ю секунду. Зарегистрированы нежелательные побочные реакции (n = 1).Заключение. Показана эффективность препарата Тобрамицин-Гобби при первичном высеве, интермиттирующей и хронической инфекции, вызванной P. аeruginosa, его безопасность и хорошая переносимость

Бурение осадков оз. Каракель (долина р. Теберда) и перспективы реконструкции истории оледенения и климата голоцена на Кавказе

Lacustrine sediments represent an important data source for glacial and palaeoclimatic reconstructions. Having a number of certain advantages, they can be successfully used as a means of specification of glacier situation and age of moraine deposits, as well as a basis for detailed climatic models of the Holocene. The article focuses on the coring of sediments of Lake Kakakel (Western Caucasus) that has its goal to clarify the Holocene climatic history for the region, providing the sampling methods, lithologic description of the sediment core, obtained radiocarbon dating and the element composition of the sediments. The primary outlook over the results of coring of the sediments of the Lake Karakyol helped to reconsider the conventional opinion on the glacial fluctuations in the valley of Teberda and to assume the future possibility for high-definition palaeoclimatic reconstruction for Western Caucasus.Озёрные отложения – важный источник данных для реконструкции колебаний ледников и изменений климата. Рассмотрены первые результаты бурения осадков оз. Каракель (долина р. Теберда, Западный Кавказ), выполненного для реконструкции голоценовой истории оледенения и климата в регионе. Описаны методика отбора образцов и особенности стратиграфии керна донных отложений оз. Каракель, приведены три радиоуглеродные датировки, позволившие оценить скорости осадконакопления в верхней части толщи (поздний голоцен). Датировка нижнего слоя озёрных отложений – 11 700 л.н. (календарный возраст) – одновременно представляет собой оценку минимального возраста морены, подпруживающей оз. Каракель

Purification, characterization, gene cloning and preliminary X-ray data of the exo-inulinase from Aspergillus awamori.

Extracellular exo-inulinase has been isolated from a solid-phase culture of the filamentous fungus Aspergillus awamori var. 2250. The apparent molecular mass of the monomer enzyme was 69 +/- kDa, with a pI of 4.4 and a pH optimum of 4.5. The enzyme hydrolysed the beta-(2-->1)-fructan (inulin) and beta-(2-->6)-fructan (levan) via exo-cleavage, releasing fructose. The values for the Michaelis constants K(m) and V(max) in the hydrolysis of inulin were 0.003 +/- 0.0001 mM and 175 +/- 5 micromol.min(-1).mg(-1). The same parameters in the hydrolysis of levan were 2.08 +/- 0.04 mg/ml and 1.2 +/- 0.02 micromol/min per mg, respectively. The gene and cDNA encoding the A. awamori exo-inulinase were cloned and sequenced. The amino acid sequence indicated that the protein belongs to glycoside hydrolase family 32. A surprisingly high similarity was found to fructosyltransferase from Aspergillus foetidus (90.7% on the level of the amino acid sequence), despite the fact that the latter enzyme is unable to hydrolyse inulin and levan. Crystals of the native exo-inulinase were obtained and found to belong to the orthorhombic space group P2(1)2(1)2(1) with cell parameters a=64.726 A (1A=0.1 nm), b=82.041 A and c=136.075 A. Crystals diffracted beyond 1.54 A, and useful X-ray data were collected to a resolution of 1.73 A

The effectiveness of combination therapy of bronchial asthma in children in everyday outpatient practice: results of the six-month multicenter prospective observational study

Asthma is a topical issue in pediatrics and clinical medicine in general. Asthma in children reduces the quality of life and may cause disability. According to official statistics, the total number of children and adolescents with asthma in Russia is over 350 thousand. The introduction of uniform criteria of severity and elective therapy changed the severity pattern of asthma towards increased incidence of mild and moderate forms. The proportion of critically ill patients, their disability and mortality decreased

Coring of Karakel’ Lake sediments (Teberda River valley) and prospects for reconstruction of glaciation and Holocene climate history in the Caucasus

Lacustrine sediments represent an important data source for glacial and palaeoclimatic reconstructions. Having a number of certain advantages, they can be successfully used as a means of specification of glacier situation and age of moraine deposits, as well as a basis for detailed climatic models of the Holocene. The article focuses on the coring of sediments of Lake Kakakel (Western Caucasus) that has its goal to clarify the Holocene climatic history for the region, providing the sampling methods, lithologic description of the sediment core, obtained radiocarbon dating and the element composition of the sediments. The primary outlook over the results of coring of the sediments of the Lake Karakyol helped to reconsider the conventional opinion on the glacial fluctuations in the valley of Teberda and to assume the future possibility for high-definition palaeoclimatic reconstruction for Western Caucasus