Safety of modified stair climbing test in the early period of rehabilitation of patients with acute myocardial infarction

Aim: safety evaluation of modified stair climbing test in the physical rehabilitation program for patients with old acute myocardial infarction. Materials and methods. Score of physical rehabilitation indices, its effectiveness and safety, comparison of physical rehabilitation indices of patients with AMI without reperfusion treatment and patients who had reperfusion interventions (bare-metal stents - in 21 persons, fibrinolysis - 1 patient, fibrinolysis and percutaneous coronary intervention - 1 patient) were estimated for 43 patients (6 women and 37 men) with old AMI using modified loading tests (stair climbing test and test with six-minute's walk). Results. HR (heart rate) fell short of submaximum values during modified stair climbing test in patient population. The condition was monitored using continuous ECG monitoring apparatus «Kardiotekhnika-04» (СС «Incart», Saint-Petersburg) None of patients showed ischemic changes of ST-segment. No significant differences were revealed in exercise tolerance between patients with old acute myocardial infarction with Q-wave who experienced stenting and patients with acute myocardial infarction without Q-wave. Results of six-minute's step test after the hospital rehabilitation stage completion show exercise tolerance increasing. Conclusion. Modified stair climbing test conducting for intensification of physical rehabilitation using subjective control was safe in examined patient population. According to six-minute's step test results, the exercise tolerance increased during rehabilitation process

Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Narusheniya ritma serdtsa u patsientov s sakharnym diabetom 2 tipa

Цель исследования: оценить распространенность различных НРС у пациентов с СД 2 и определить структурно-функциональные нарушения миокарда, тяжесть и частоту наиболее часто встречаемого НРС при СД 2, а также взаимосвязь с изменениями углеводного обмена и ИР. Материалы и методы. В исследование было включено 70 пациентов с различными НРС и СД 2 и 41 больной с НРС без СД 2. Определяли содержание общего холестерина и триглицеридов, уровень гликемии, С-пептида, ИР (НОМА2-IR index, норма 1,0) и функциональную способность -клетки поджелудочной железы (HOMA2-%В, нормальное значение 100%), уровень HbA1c (%). Проводили суточное мониторирование ЭКГ. Оценивали тяжесть приступов ФП. Результаты. Наиболее встречаемым НРС в выборочной группе больных СД 2 была ФП со средней частотой рецидивов. Для пациентов с НРС и СД 2 в сравнении с группой больных НРС без СД 2 характерно более выраженное ремоделирование сердца с преобладанием КГМ ЛЖ. ГИ и ИР, обусловливая активацию симпатической нервной системы, способствуют формированию КГМ ЛЖ у больных с ФП и СД 2. ГИ и ИР, обусловливая активацию симпатической нервной системы, увеличивают частоту встречаемости ФП у пациентов с длительностью СД 2 менее 5 лет и способствуют увеличению тяжести рецидивов ФП при СД 2

Shans - new red clover variety

The article presents results of breeding activity (1990.2012) on creation of early, winter hardiness, productive red clover (Trifolium pratense L.) variety ‘Shans’ having high fodder quality. Originators of the variety - Falenki breeding station and North-East Agricultural Research Institute Variety ‘Shans’ (breeding line 804/90) created by a method of multiple biotypic selection from middle-ripening adaptive variety ‘Dymkovsky’. According to the results of competitive tests in Falenki breeding station (2008.2012), the variety had advantage over standard variety ‘Trio’ by main economic traits and distinguished with earliness (55.75 days from spring re-growth till beginning of flowering; 110.128 days for seed ripening), high winter hardiness (96.100 %), dry matter yield - 11.3 t/ha and raw protein yield - 1.53 t/ha, high seed yield - 0.2 t/ha, resistance against root rot (index of disease development IDD = 18.2 %). According to data of ecological test (2012) under agro-climatic conditions of Kirov city (North-East Agricultural Institute) variety ‘Shans’ shown high potential productivity of dry matter - 21.22 t/ha (significantly higher than standard ‘Trio’ on 2.80 t/ha or 15.2%). In 2012 the variety was passed to State varietal test, since 2017 - was included into State Register of breeding achievements allowed to use in Volga-Vyatka region (patent № 8916 from February 13, 2017)

Results of red clover breeding for aluminum tolerance under conditions of North-East of European part of Russia

Results of perennial (1991-2016) experimental work carried out in Kirov region on creation of new breeding material and varieties of red clover combining aluminum tolerance and high productivity and other valuable parameters under conditions of North-east of European Russia are presented in the article. Methods are presented of creation of breeding material with tolerance to ions of aluminum and hydrogen. Characteristic of provocative edaphic background is done. Aluminum tolerant variety Grin is created with method of multiple two-stage selection of genotypes resistant to H+ and Al3+ (in laboratory towel culture and on hard field background). The variety is included in State Register of breeding achievements of Russian Federation in 2010 for 4 regions. As a result of selection in vitro for resistance to toxic ions of aluminum and hydrogen in combination with selection on field provocative background 60 breeding lines were obtained having value for creation of aluminum- and acid-resistant varieties of red clover. High resistance is revealed to edaphic stress-factors in perspective clone population P-15: in nursery of preliminary test on aluminum acid background under drought of 2016 the population statistically exceed standard variety Dymkovsky and early variety Trio on productivity of green mass on 6.5 and 9.5 t/ha or 23.0 and 37.7%. 79 breed- ing lines were created by the method of direct selection of genotypes on hard aluminum acid field background, 20 perspective lines were chosen combining resistance to edaphic stress factors with winter hardiness and high productivity of green mass (17.5-64.1% higher than variety Grin)

The Role of Lactobacillus reuteri DSMZ17648 for Helicobacter pylori eradication therapy (Review of literature and advisory council resolution, February 28, 2018)

Aim of review. To analyze the options of application of Lactobacillus reuteri DSMZ17648 (Pylopass™) within Helicobacter pylori eradication. Summary. H. pylori eradication therapy is considered as one of the optional spheres for clinical application of probiotic medications. According to available data certain strains of probiotics are effective in decreasing of gastrointestinal adverse effects rates, associated with eradication therapy while the other can potentiate the efficacy of H. pylori eradication itself. L. reuteri strain DSM17648 which was chosen from over 700 wildtype strains of Lactobacillus spp. possess the ability for selective adhesion to H. pylori in vivo in the gastric media. DSM17648 strain of L. reuteri form coaggregates with various H. pylori strains and serotypes both in vivo and in vitro. It was revealed that lyophilizate of this strain (PylopassTM) blocks adhesion of H. pylori to epithelial cells as well. Clinical trials demonstrate the effect of PylopassTMon gastric mucosa colonization by H. pylori according to the 13C urea breath test data and as well the increase in H. pylori eradication rate when the productis added the to triple therapy modes. Conclusion. Potential of PylopassTM combination to various H. pylori eradication therapy modes is a subject offutnet multicenter randomized clinical trials for assessment of optimal combination to antibiotic drugs, treatment duration and adverse effect rates. The value of monotherapy by this metabiotic at chronic H. pyloriassociated gastritis is a subject of further studies

The Role of Lactobacillus reuteri DSMZ17648 for Helicobacter pylori eradication therapy

Aim of review. To analyze the options of application of Lactobacillus reuteri DSMZ17648 (Pylopass™) within Helicobacter pylori eradication. Summary. H. pylori eradication therapy is considered as one of the optional spheres for clinical application of probiotic medications. According to available data certain strains of probiotics are effective in decreasing of gastrointestinal adverse effects rates, associated with eradication therapy while the other can potentiate the efficacy of H. pylori eradication itself. L. reuteri strain DSM17648 which was chosen from over 700 wildtype strains of Lactobacillus spp. possess the ability for selective adhesion to H. pylori in vivo in the gastric media. DSM17648 strain of L. reuteri form coaggregates with various H. pylori strains and serotypes both in vivo and in vitro. It was revealed that lyophilizate of this strain (PylopassTM) blocks adhesion of H. pylori to epithelial cells as well. Clinical trials demonstrate the effect of PylopassTMon gastric mucosa colonization by H. pylori according to the 13C urea breath test data and as well the increase in H. pylori eradication rate when the productis added the to triple therapy modes. Conclusion. Potential of PylopassTM combination to various H. pylori eradication therapy modes is a subject offutnet multicenter randomized clinical trials for assessment of optimal combination to antibiotic drugs, treatment duration and adverse effect rates. The value of monotherapy by this metabiotic at chronic H. pyloriassociated gastritis is a subject of further studies