Профессиональная бронхолегочная патология, развившаяся под воздействием хризотилового асбеста

Investigation of various asbestos-induced lung diseases caused by exposure of chrysotile and chrysotile dust allowed description clinical, radiological, and functional features of occurrence, presentation, course, and outcomes of respiratory pathology, such as chrysotile asbestosis, occupational bronchitis and lung carcinoma in workers at asbestos industry. There is a reduction in morbidity of chrysotile asbestosis together with increasing prevalence of chronic bronchitis in modern asbestos industry. Morbidity of asbestosis-induced lung diseases is strongly and directly related to the length of service and level of pollution at the workplace. Preventive measures should include prevention of development of asbestos-induced diseases and rehabilitation of workers aimed to keeping health and restore adaptive reserve.В статье исследуются различные формы асбестообусловленных заболеваний легких, вызванных воздействием хризотила и хризотилсодержащей пыли. Их изучение позволило выявить клинико-рентгено-функциональные особенности формирования, проявления и течения бронхолегочной патологии – хризотилового асбестоза, профессионального бронхита и рака легких – и их исходы у работников асбестовых предприятий. В условиях современных асбестовых предприятий наряду со снижением частоты хризотилового асбестоза нарастает частота хронического бронхита. Выявлена прямая зависимость частоты асбетообусловленных заболеваний легких от стажа работы и уровня запыленности рабочих зон. Профилактические мероприятия должны включать предупреждение формирования асбестообусловленных заболеваний и превентивную реабилитацию рабочих с целью сохранения здоровья и восстановления адаптационного резерва

Патоморфоз заболеваний бронхолегочной системы у работающих в контакте с аэрозолями цветных металлов

Etiopathogenic features and diagnostic criteria of occupational diseases studying in workers engaged in colored metallurgy have been given in the paper. Polyvalent sensitization to metal allergens (nickel, chrome, beryllium, manganese) was found. A toxic effect of nickel on DNA was shown that could be used as a biomarker of exposure for biological monitoring in colored metallurgy workers. Biochemical investigations determined the main pathogenic mechanisms underlying pathomorphology of bronchopulmonary diseases caused by the exposure of colored metals, such as activation of lipid peroxidation, "proteolysis – antiproteolysis" imbalance, growing significance of infection. This is the first study demonstrating clinical and biochemical parallels between characteristics of development and course of respiratory pathology caused by the exposure of colored metals. Infectious, inflammatory, toxico-allergic, and destructive processes predominated in this pathology. Preventive and rehabilitation strategies have been developed.В статье представлены результаты изучения этиопатогенетических особенностей формирования профессиональных, производственно обусловленных заболеваний у работающих в цветной металлургии, определены критерии их диагностики. Выявлена поливалентная сенсибилизация к основным металлам-аллергенам (никель, хром, марганец, бериллий). Установлено токсическое влияние никеля на ДНК, что может служить биомаркером экспозиции и использоваться для биологического мониторинга у работающих в цветной металлургии.Результаты биохимических исследований определили основные патогенетические механизмы, лежащие в основе патоморфоза бронхолегочной патологии при воздействии аэрозолей цветных металлов: активация перекисного окисления липидов и дисбаланс в системе "протеолиз-антипротеолиз", возрастание роли инфекционного фактора. Впервые выявлены клинико-биохимические параллели между особенностями формирования и течением бронхолегочной патологии, сформировавшейся под воздействием аэрозоля цветных металлов с преобладанием инфекционно-воспалительного, токсико-аллергического, воспалительно-деструктивного компонентов, и биохимическим профилем организма. Разработаны методы профилактики и реабилитации

Московский опыт применении ингибиторов рецептора интерлейкина 6 в терапии ревматоидного артрита в условиях пандемии C0VID-19

Objective: to confirm the efficacy and safety of levilimab in patients with rheumatoid arthritis (RA) switched from other interleukin 6 receptor inhibitors (iIL6R) for non-medical reasons.Patients and methods. A retrospective analysis of data from the register of patients with RA who during the COVID-19 pandemic were switched from foreign iIL6Rs to the Russian drug levilimab. Treatment regimens with levilimab in combination with synthetic diseasemodifying antirheumatic drugs (sDMARDs) and/or glucocorticoids (GCs) were used, as well as a monotherapy regimen in case of DMARDs intolerance.Results and discussion. In 150 patients with RA, a successful non-medical switch to levilimab was demonstrated with the preservation and intensification of the clinical effect achieved on previous therapy with iIL6R. After switching to levilimab, the DAS28-CRP index decreased by an average of 0.098 at 3 months and by 0.25 at 6 months (p=0.214 for both time points). There was a decrease in the proportion of patients with elevated levels of CRP, as well as with high RA activity. In a number of patients who showed high efficacy of levilimab, it became possible to reduce the dose or number of DMARDs, as well as cease GCs intake. Good tolerability and a favorable safety profile of levilimab were noted, including in relation to the new coronavirus infection that developed during therapy.Conclusion. Therapy with Russian iIL6R levilimab is effective and safe, including in patients switched from other drugs for non-medical reasons, as well as in relation to the novel coronavirus infection that developed during therapy.Цель исследования — подтвердить эффективность и безопасность препарата левилимабу пациентов с ревматоидным артритом (РА), переключенных на него с других ингибиторов рецепторов интерлейкина 6 (иИЛ6Р) по немедицинским причинам.Пациенты и методы. Проведен ретроспективный анализ данных регистра пациентов с РА, которые в условиях пандемии COVID-19 были переключены с зарубежных иИЛ6Р на отечественный препарат левилимаб. Были использованы схемы терапии левилимабом в комбинации с синтетическими базисными противовоспалительными препаратами (БПВП) и/или глюкокортикоидами (ГК), а также режим монотерапии в случае непереносимости БПВП.Результаты и обсуждение. У 150 больных РА продемонстрировано успешное немедицинское переключение на левилимаб с сохранением и увеличением клинического эффекта, достигнутого на предшествующей терапии иИЛ6Р. После переключения на левилимаб индекс DAS28-СРБ уменьшился в среднем на 0,098 через 3 мес и на 0,25 через 6 мес (р=0,214 для обеих временных точек). Наблюдалось снижение доли пациентов с повышенным уровнем СРБ, а также с высокой активностью РА. У ряда пациентов, у которых отмечалась высокая эффективность левилимаба, появилась возможность снизить дозу или количество БПВП, а также отменить ГК. Установлены хорошая переносимость и благоприятный профиль безопасности левилимаба, в том числе в отношении развившейся на фоне терапии новой коронавирусной инфекции.Заключение. Терапия отечественным иИЛ6Р левилимабом является эффективной и безопасной, в том числе у пациентов, переключенных с других препаратов по немедицинским причинам, а также в условиях высокой заболеваемости COVID-19

Disposable sensors in diagnostics, food and environmental monitoring

Disposable sensors are low‐cost and easy‐to‐use sensing devices intended for short‐term or rapid single‐point measurements. The growing demand for fast, accessible, and reliable information in a vastly connected world makes disposable sensors increasingly important. The areas of application for such devices are numerous, ranging from pharmaceutical, agricultural, environmental, forensic, and food sciences to wearables and clinical diagnostics, especially in resource‐limited settings. The capabilities of disposable sensors can extend beyond measuring traditional physical quantities (for example, temperature or pressure); they can provide critical chemical and biological information (chemo‐ and biosensors) that can be digitized and made available to users and centralized/decentralized facilities for data storage, remotely. These features could pave the way for new classes of low‐cost systems for health, food, and environmental monitoring that can democratize sensing across the globe. Here, a brief insight into the materials and basics of sensors (methods of transduction, molecular recognition, and amplification) is provided followed by a comprehensive and critical overview of the disposable sensors currently used for medical diagnostics, food, and environmental analysis. Finally, views on how the field of disposable sensing devices will continue its evolution are discussed, including the future trends, challenges, and opportunities

Parathyroid function and cardiovascular remodeling in arterial hypertension patients

Aim. To investigate structure and function of left ventriculum (LV) and brachial artery (BA) in arterial hypertension (AH) patients, according to blood levels of parathyroid hormone (PTH).Material and methods. In total, 95 untreated patients with Stage I-III AH were examined. Blood PTH, total calcium levels, and 24-hour urine calcium excretion were measured. All participants underwent Doppler echocardiography, 24-hour blood pressure monitoring (BPM), and BA ultrasound. According to PTH levels, the patients were divided into three groups: Group I – 0-25 pg/ml, Group II – 26-50 pg/ml, and Group III – 51 pg/ml.Results. LV hypertrophy prevalence in Group III was 80,6%, in Group I – 43,7%. In “dippers” (24-hour BPM data), PTH level and 24-hour urine calcium excretion were 1,5 times lower than in “non-dippers”. Comparing to Group I, Group III demonstrated significantly greater intima-media thickness (+17,8%) and linear blood flowvelocity (+19,7%), but lower BA diameter (417,3%) and endothelium-dependent vasodilatation (415,5%).Conclusion. PTH levels correlated with prevalence and severity of LV and BA remodeling

Combination of dihydropyridine and non-dihydropyridine calcium antagonists in patients with arterial hypertension and coronary heart disease: efficacy and safety

Aim. To study antihypertensive and anti-ischemic effects on structural and functional heart status, and assess treatment safety for combination of dihydropyridine and non-dihydropyridine calcium antagonists (CA). Material and methods. The authors examined 31 patients with Stage II-III, level II arterial hypertension (AH) (Society of Cardiology of the Russian Federation, 2001), and coronary heart disease (CHD), effort angina, Functional Class (FC) II-III. Twenty-four-hour electrocardiography (ECG) and blood pressure (BP) monitoring, Doppler echocardiography (EchoCG) were performed. Combined therapy with amlodipine and verapamil retard lasted for 24 weeks. Results. During the treatment, in 77.4% of the patients, complete antihypertensive effect (BP<140/90 mm Hg) was observed; in 22.6%, this effect was partial (diastolic BP decrease by 10 mm Hg). Mean decrease in left ventricular myocardial mass index was 24.9±2.3 g/m2 (p<0.01). Diastolic function improved: early and late flow velocity ratio (E/A) increased by 10.3% (p<0.05); isovolumic relaxation time reduced by 13.6% (p<0.01). Maximal depth of ST segment depression decreased from 2.3±0.2 to 1.5±0.1 mm. Duration and frequency of painless myocardial ischemia decreased, too. Adverse effect rate was by 1.5-4 times lower than for monotherapy. Conclusion. Combination of dihydropyridine and non-dihydropyridine CA demonstrated its antihypertensive, anti-ischemic, and cardioprotective effects, and was well tolerated

Cardiovascular remodeling and calcium-regulating function of parathyroid glands in arterial hypertension

In 95 patients with arterial hypertension (AH), left ventricular (LV) and brachial artery (BA) remodeling, as well as parathyroid hormone (PTH) level, was studied. Increased PTH level was associated with more prevalent and manifested LV and BA remodeling, and with decreased diastolic function and endothelium-depended vasodilatation. In 21,6% of AH patients, asymptomatic PTH hyper-secretion was registered. In these individuals, pathological types ofcircadian blood pressure profile were typical