THE SPECIFIC FEATURES OF HEART AND VESSELS REMODELING IN PATIENTS WITH CHRONIC HEART FAILURE TREATED WITH LISINOPRIL DURING 6 MONTHS

Background. Being able to attenuate pathological remodeling, ACE inhibitors are considered to be first line medications for chronic heart failure (CHF) treatment.Aim. To study the influence of the 6-month combined therapy with lisinopril on the heart and vessels remodeling in patients with ischemic CHF.Material and Methods. 40 patients with CHF after Q-myocardial infarction were treated with lisinopril (Listril, Dr.Reddy’s, India) as a part of complex therapy. Initially and after 6 months of therapy the following findings were evaluated: the 6-minute walk test results, echocardiography parameters, main arteries rigidity, endothelium-dependent and independent vasodilatation, anticoagulant and fibrinolytic function of vascular endothelium, von Willebrand factor (VWF).Results. 6-month treatment with lisinopril showed reduction in CHF functional class in 30 % of patients and increase in left ventricle (LV) stroke volume by 3,8% and LV ejection fraction by 1%. Pulse-wave velocity reduced insignificantly from 10,2 to 9,2 m/sec and augmentation indices of aorta from 31,4% to 29,9% as well as this of brachial artery from -2,6% to -6%. Endothelium-dependent vasodilatation increased from 6,4% to 8,6% and independent vasodilatation – from 13,8% to 16,6%. VWF activity decrease was observed in 40% of CHF patients. Significant changes in anticoagulant and fibrinolytic function of vascular endothelium were not revealed.Conclusion. Lisinopril administration as a part of complex therapy of CHF patients during 6 months resulted in favorable effect on heart and vessels remodeling and was well tolerated

CHANGES IN THE LEVELS OF ANGIOTENSIN II, ALDOSTERONE, AND FIBROBLAST GROWTH FACTOR IN PATIENTS WITH RHEUMATOID ARTHRITIS IN RELATION TO CLINICAL FEATURES

Angiotensin II, aldosterone, and fibroblast growth factor (FGF) stimulate neoangiogenesis, fibroblast proliferation, and elaboration of proinflammatory cytokines, which in turn contributes to increased pannus mass and the development of joint tissue destruction in rheumatoid arthritis (RA).Objective: to establish the specific features of changes in the blood levels of angiotensin II, aldosterone, and FGF in patients with RA in relation to the duration and severity of the disease.Subjects and methods. Examinations were made in 194 patients diagnosed with RA without comorbidity; the patients’ mean age was 47.7±10.2 years; the disease duration was 3.82±3.43 years. DAS28 scores for RA were calculated based on C-reactive protein levels. An enzyme immunoassay was used to determine the serum levels of anti-cyclic citrullinated peptide antibodies (ACCPA), angiotensin II, aldosterone, and FGF.Results and discussion. All the examinees were ascertained to have increases in the concentration of angiotensin II and aldosterone in blood by twice and in that of FGF by 2.5 times compared to the controls (p < 0.05). In patients with a RA duration of < 2 years, the blood level of angiotensin II was 25% higher than in those with a RA duration of > 5 years and the concentrations of aldosterone and FGF in patients with long-term RA were twice as high as in those with early RA. In patients with high RA activity, the blood level of angiotensin II was 1.5-fold higher than in those with low and moderate disease activity (p < 0.05). In patients with a high blood ACCPA level, the concentrations of angiotensin II, aldosterone, and FGF were 20, 30, and 25%, respectively, higher than in those with low ACCPA levels. The correlation of DAS28 with blood angiotensin II levels increased with enhanced RA activity. The high aldosterone and FGF values in RA patients are associated with the progression of joint radiographic changes

Reply to «Comments to the paper “Diagnosis of spondyloarthritis: Should we need new criteria?”» published in the journal «Sovremennaya Revmatologiya»

В первом номере журнала «Современная ревматология» за 2015 г. была опубликована статья И.З. Гайдуковой, А.И. Акуловой, А.В. Апаркиной, А.П. Реброва «Диагностика спондилоартрита: нужны ли нам новые критерии?». В ответ на публикацию статьи в третьем номере журнала вышли комментарии профессора Ш.Ф. Эрдеса

Third and fourth degree collisional moments for inelastic Maxwell models

The third and fourth degree collisional moments for $d$-dimensional inelastic Maxwell models are exactly evaluated in terms of the velocity moments, with explicit expressions for the associated eigenvalues and cross coefficients as functions of the coefficient of normal restitution. The results are applied to the analysis of the time evolution of the moments (scaled with the thermal speed) in the free cooling problem. It is observed that the characteristic relaxation time toward the homogeneous cooling state decreases as the anisotropy of the corresponding moment increases. In particular, in contrast to what happens in the one-dimensional case, all the anisotropic moments of degree equal to or less than four vanish in the homogeneous cooling state for $d\geq 2$.Comment: 15 pages, 3 figures; v2: addition of two new reference

The daily arterial stiffness profile in rheumatoid arthritis patients with and without hypertension

Patients with rheumatoid arthritis (RA) have an increased risk for cardiovascular diseases. To determine their daily arterial stiffness (AS) as an indicator of cardiovascular risk is of unquestionable interest.Objective: to evaluate the features of daily AS in RA patients with or without hypertension.Patients and methods. Twenty-four hour AS monitoring (24-h ASM) was done in 75 women with a valid diagnosis of RA. The patients were randomized into 3 groups: 1) 39 RA patients with hypertension; 2) 24 RA patients without hypertension; 3) 12 RA patients with masked hypertension. A comparison group consisted of 30 hypertensive patients without RA and a control group included 22 apparently healthy women who were age-matched with the patients with RA and those from the comparison group. 24-h ASM readings were studied using a BPlab device with Vasotens software (Russia).Results. All the patients with RA were found to have higher 24-h ASM readings than the controls; and, in the presence of hypertension, these changes were even more pronounced. Group 1 was noted to have higher ambulatory AS index than the comparison group; more than 70% of the patients in Group 2 were observed tohave increased aortic pulse wave velocity when reducing to a blood pressure (BP) of 100 mm Hg. The patients in Groups 1 and 2 had increases in augmentation index, in the latter normalized for a heart rate of 75 beats/min, in the propagation time of a reflected wave when reducing to a BP of 100 mm Hg, and in AS index at night. The patients with RA showed an association between daily AS and major cardiovascular risk factors (hypertension, age, body mass index, menopause duration), RA-specific risk factors (RA duration, erythrocyte sedimentation rate, and C-reactive protein), and psychoemotional status. Conclusion. 24-h ASM revealed that the patients with RA had higher vascular wall stiffness than the individuals in the comparison and control groups. Taking into consideration the pronounced changes in AS not only during the daytime, but also during the night, it is appropriate to perform daily monitoring in patients with RA in order to obtain more objective data

Pulmonary hypertension: reasonable selection of specific therapy

Pulmonary hypertension is characterized with persistent increase in pulmonary vascular resistance leading to progressive worsening of right ventricular failure and death. The basis for pulmonary arterial hypertension is structural changes in pulmonary arteries and arterioles caused by endothelial dysfunction. Endothelin-1 is the main pathogenic trigger of pulmonary hypertension and potential target for therapeutic exposure. The efficacy of endothelin receptor antagonists is proved in various preclinical and clinical studies. In patients with pulmonary arterial hypertension, the efficacy of dual and selective endothelin receptor antagonists is comparable despite the varied activity against various receptors. Bosentan is the most widely used pulmonary vasodilator which improves exercise tolerance and decelerates disease progression

Diagnosis of spondyloarthritis: should we need new criteria?

A large number of classification criteria for spondyloarthritis (SpA) are simultaneously used in modern rheumatology in the almost complete absence of diagnostic criteria. This poses a number of problems, among which there are two most important ones: 1) the frequent use of classification criteria to make a diagnosis in real clinical practice; 2) the possibility of stating different nosological entities of SpA in one patient in the presence of the same clinical picture.Objective: to investigate the specific features of the diagnosis of SpA and the use of its classification criteria in clinical practice.Subjects and methods. The investigation enrolled 119 patients with the established diagnosis of ankylosing spondylitis (AS), psoriatic arthritis (PsA), undifferentiated axial or peripheral SpA. Whether their clinical picture complied with the modified New York criteria, the European Spondyloarthropathy Study Group (ESSG) criteria, the Amor criteria, and the Assessment of Spondyloarthritis International Society (ASAS) classification criteria for axial and peripheral SpA and whether the Russian version of the modified New York criteria complied with the Classification criteria of Psoriatic ARthritis (CASPAR) were determined in the patients.Results. Sixty-three patients diagnosed with AS (M45), 44 with PsA (M07.0-07.3), 8 with undifferentiated SpA (M46.9), and 4 with nonradiographic axial SpA (M46.8) were followed up by attending physicians. The latter diagnosed AS in 10 patients who met the ASAS criteria for axial PsA but not the modified New York criteria. Twenty-one patients diagnosed as having PsA simultaneously met both the CASPAR criteria and the modified New York criteria, which could establish the diagnosis of AS in these cases. Eighty-one (68.0%) out of the 119 patients met the Amor criteria; 98 (82.3%) patients, the ESSG criteria; 91 (76.5%), the ASAS criteria for axial SpA; 18 (15.1%), the ASAS criteria for peripheral SpA; 76 (63.8%), the modified New York criteria; 88 (73.9%), the Russian version of the modified New York criteria; 42 (32.3%), the CASPAR criteria. No intersection of criteria was observed in only 5 patients; 113 (94.9%) patients met ≥2 criteria; 96 (80.7%), ≥3 criteria; 81 (68.1%), ≥4 criteria; 66 (55.5%), simultaneously ≥5 criteria; and 18 (15.1%), simultaneously 6 criteria.Conclusion. Most patients with SpA meet ≥2 classification criteria, which gives the chance to state ≥2 nosological entities in the same patient. This demonstrates the elaboration of diagnostic criteria that can make a clear distinction between different forms of SpA in clinical practice

Опыт работы астма-кабинета в областном стационаре

At present asthma-rooms system is developed in regional polyclinics mainly and it is intended for patients’ education in remission. However, such approach excludes patients living in provinces and patients in exacerbation from modern programmes of treatment and education of bronchial asthma patients.This situation is due to remote places of patients’ residence, insufficient doctors' training in provinces, inadequate asthma treatment that lead to severe course and frequent exacerbations. According to that, education of patients living in provinces becomes crucial. This article showes the experience of organization and work of asthma-room in regional in-patient department; the study methods, the particularities of education of patients living in provinces. Nowadays such form of patients’ education allows to realize modern programmes of asthma treatment. Simultaneously asthma-room of regional in-patient department becomes the methodic centre for doctors’ education and for the control of quality of asthmatic patients’ treatment, for adoption of new diagnostic and treatment technologies.В настоящее время сеть астма-кабинетов развертывается преимущественно на базе поликлиник областного центра и предназначена для обучения пациентов, находящихся в стадии ремиссии заболевания. Однако при таком подходе из современной программы лечения и обучения больных бронхиальной астмой выпадают пациенты — жители районов области, пациенты в стадии обострения заболевания. Это обусловлено отдаленностью проживания больных, недостаточной подготовленностью врачей на местах, неадекватностью терапии, что обусловливает тяжелое течение и частые обострения. В связи с этим задача обучения больных становится чрезвычайно актуальной. В статье приводится опыт организации и работы астма-кабинета в условиях областного стационара, методика проведения занятий, особенности обучения пациентов — жителей районов области. В настоящее время такая форма обучения больных позволит быстрее реализовать современную программу лечения бронхиальной астмы. Одновременно астма-кабинет областного стационара становится методическим центром по обучению врачей и контролем за качеством ведения больных бронхиальной астмой, внедрению новых технологий диагностики и лечения

Mechanistic Insights into the Desorption of Methanol and Dimethyl Ether Over ZSM-5 Catalysts

Acknowledgements Financial support from the Petroleum Technology Development Fund of Nigeria (PTDF/ED/PHD/OO/766/15) and from the European Commission in the scope of the 7th Framework program BIOGO project (Grant Number: 604296) https://www.biogo. eu/ is acknowledged.Peer reviewedPublisher PD