Triple antihypertensive therapy: Focus on efficacy and prognosis
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01.01.2018 |
Ostroumova O.
Kochetkov A.
Starodubova A.
Goloborodova I.
Smolyarchuk E.
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Rational Pharmacotherapy in Cardiology |
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0 |
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© 2018 Stolichnaya Izdatelskaya Kompaniya. In the article, with regard to current clinical recommendations, the place of combined antihypertensive therapy, especially triple drugs regimens, is considered in the treatment of patients with arterial hypertension. Special focus is given to the body of evidence for the efficacy of valsartan and amlodipine, as the reference drug of angiotensin II receptor blockers and calcium channel blockers, respectively. Not only their high antihypertensive properties are demonstrated, but also a favorable effect on target-organ protection and prognosis is described. In particular, the possibilities of valsartan in reducing the severity of left ventricular hypertrophy and microalbuminuria are described, and its unique properties in the class of sartans that allow the use of this drug in patients with ischemic heart disease and chronic heart failure are emphasized. Data on the antiatherosclerotic effects of amlodipine and its proven ability to reduce cardiovascular risk are presented. Current data are presented about their use in a fixed-dose combination with hydrochlorothiazide, including real clinical practice settings. The evidence base of high clinical efficacy, safety and metabolic neutrality of the triple combination of antihypertensive drugs valsartan, amlodipine and hydrochorothiazide is presented. The issues of increasing adherence of patients to treatment when prescribing fixed-dose combinations are considered. An algorithm for the selection of antihypertensive drugs in the form of monotherapy and combination therapy of two or three drugs depending on the clinical situation (the presence of certain target-organs damages and associated clinical conditions, primarily ischemic heart disease, atherosclerosis of carotid arteries and chronic heart failure) and the severity of the additional risk of cardiovascular complications..
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Scleromyxedema as a systemic disease of glycosaminoglycan accumulation
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01.01.2018 |
Radenska-Lopovok S.
Volkova P.
Gorodetsky V.
Egorova O.
Ananyeva L.
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Arkhiv Patologii |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. Scleromyxedema is a rare mucinosis with a primary skin lesion due to diffuse mucin deposition, sclerosis, and lichenoid eruptions in the absence of hypothyroidism. The paper describes scleromyxedema cases and gives recommendations for the histological diagnosis of the disease by histochemical reactions to detect acid and neutral glycosaminoglycans.
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New aspects of sepsis and septic shock pathogenesis in children. The complement system as target for an effective therapy
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01.01.2018 |
Prodeus A.
Ustinova M.
Korsunskiy A.
Goncharov A.
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Russian Journal of Infection and Immunity |
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0 |
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© 2018 Saint Petersburg Pasteur Institute. All rights reserved. Nowadays sepsis is grave complication of infection end the cause of death reanimation. In this survey, we would like to emphasize the importance of the control over the activation over the compliment system. It has been proved of animal model a complement one of the key role in the development of hyperactive immunity response, later resulting in violation of immunity homeostasis. Mice which had C3-/-, C4-/-deficit, aft receiving a LPS dose intraperitoneallis showed a better survival to compare with the control group of animals. There exist clinical data which confirm active participation of the compliment in the chain of the septic process. The research showed the patient affected by sepsis, had protein C3 and C4 concentration correlating which mortality at the time of diagnosis. The is chemoattractants, protein C3a and C5a, turn tube the result of complements pathway activation. The chemoattractants, provoke the extraction a big number of cytokines. Vessels permeability increase and DIC-syndrome activation wis it, multiple organ dysfunction develops. Ishemiareperfusion launch triggers aseptic inflammation, which appears decentralization and DIC-syndrome. C1-INH controls the work of classical way complement and Hemostasis System. Researchers the deficit in C1-INH animals and patients affected bay sepsis, which is proved in laboratory and clinics. The remedy C1-INH (Berinert, CSL Behring) appeared over 25 years ago and was used and therapy hereditary angioedema. For the lasted years we accumulated a considerable quantity of fasts of C1-INH use which after pathologies: heart attack, Ischemia-reperfusion injury, trauma provoked by cardiopulmonary bypass. The use of C1-INH on animal models septic in clinical research their efficacy and safety.
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Bruxism as a neurological problem (literature review)
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01.01.2018 |
Orlova O.
Alekseeva A.
Mingazova L.
Konovalova Z.
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Nervno-Myshechnye Bolezni |
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1 |
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© 2018 ABV-Press Publishing House. All rights reserved. Bruxism is stereotypical movements of the mandibula accompanied by grinding or clenching of teeth. Bruxism has 2 circadian manifestations: during sleep (nocturnal bruxism) and during wakefulness (diurnal bruxism). Etiology of the disease is unclear but occlusal disharmony, stress management, basal ganglia dysfunction, and genetic factors are being discussed. An association between bruxism and other motor disorders such as Parkinson's disease, oromandibular dystonia, Huntington's disease, as well as some drugs, is observed. For bruxism diagnosis, questionnaires, clinical examination, polysomnography, electromyography, and brux checkers are used. The leading treatment method for bruxism and accompanying dysfunction of the temporomandibular joint is local administration of botulinum neuroprotein into the temporal, masseter, and lateral pterygoid muscles.
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Theories of personality traits and essential arterial hypertension: History and modern times
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01.01.2018 |
Zinchenko Y.
Pervichko E.
Ostroumova O.
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Nevrologiya, Neiropsikhiatriya, Psikhosomatika |
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0 |
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© 2018 Ima-Press Publishing House. All rights reserved. The paper analyzes the concepts of personality profiles and demonstrates the possibility of applying this approach to comparatively assessing the psychological characteristics of patients with essential arterial hypertension (EAH). It sets forth the fundamentals of the concepts by F. Alexander, H.F. Dunbar, M. Friedman, and R. Rosenman, which emphasize the importance of emotional, personal, and behavioral factors for the etiology and pathogenesis of EAH and analyzes in detail the psychological study of the characteristics of the so-called type D (distressed) personality that is characterized by a combination of the predominance of negative emotions, social isolation, and inability to regulate these factors. The authors present the results of their own empirical study of personal characteristics (through the Cattel's 16 personality factors questionnaire) in patients with office hypertension (OH) versus those with classical EAH and healthy individuals. OH patients are shown to be significantly less sociable, less emotionally stable, more overwrought and shy, and more prone to self-control and feelings of guilt. The experimental psychological study (by simulating of emotional stress and by using the modified variant of the procedure developed by S. Rosenzweig to examine frustration reactions) has revealed that the patients with OH tend to experience the most intense negative sthenic emotions and they significantly more frequently resort to repression of these emotions. The findings prove that the EAH group is e heterogeneous and confirm the assumption that OH patients show negative affectivity and lower social activity.
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Cognitive impairment in anxiety disorders
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01.01.2018 |
Volel B.
Petelin D.
Akhapkin R.
Malyutina A.
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Nevrologiya, Neiropsikhiatriya, Psikhosomatika |
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1 |
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© 2018 Ima-Press Publishing House. All rights reserved. Anxiety disorders are an important biomedical problem due to the high prevalence and significant negative impact on the quality of life and the course of concomitant somatic and neurological diseases. Cognitive impairment (CI) is one of the most intensively studied aspects of pathological anxiety. Impairments in attention, executive functions, memory, cognitive deficit, as well as abnormal cognitions and metacognitions are identified in anxiety disorders. Moreover, the treatment of the latter with the most frequently used drugs (antidepressants, atypical antipsychotics, anticonvulsants, tranquilizers) does not lead to a significant improvement in cognitive functions, and often contributes to their worsening. In this connection, in addition to psychotherapy, cognitive function-improving agents play a large role in treating anxiety diseases associated with cognitive dysfunction. Ginkgo Biloba extract (EGb 761, Tanakan®) that positively affects cognitive functions, especially in the domains of memory, concentration and attention deserves special attention.
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The dynamics of the dimensional characteristics of the sella turcica in the subjects above 20 years of age
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01.01.2018 |
Pigolkin Y.
Ametrin M.
Zolotenkova G.
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Sudebno-Meditsinskaya Ekspertiza |
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0 |
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© 2018 Media Sphera Publishing Group. All rights reserved. The objective of the present study was to determine the biological age of the unidentified dead subjects based on the morphometric characteristics of the sella turcica in comparison with other methods available for the purpose in order to narrow the range of the alleged ages of the human remains being examined. The parameters of the sella turcica were measured in the corpses immediately after cephalotomy provided no pathological changes could be identified in the sellar region. A total of 86 skulls of the Caucasoid subjects representing the Eastern-Slavic group at the age varying from 22 to 87 years were available for the examination. The study has demonstrated the undulating dynamics of dimensional characteristics of the sellae turcica during the course of a lifetime. The regression analysis was employed to predict the age of the subjects above 22 years of age based on the measurements of the length and depth of the sella turcica and to classify the sample of interest within a given age period. It is concluded that the morphometric characteristics of the sells turcica can be used as the additional clues for the purpose of age determination in forensic medical investigations.
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Genotype-phenotype correlations of the course of cystic fibrosis in Russian children. the first description of eleven new mutations
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01.01.2018 |
Gorinova Y.
Savostyanov K.
Pushkov A.
Nikitin A.
Pen'Kov E.
Krasovskiy S.
Simonova O.
Namazova-Baranova L.
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Voprosy Sovremennoi Pediatrii - Current Pediatrics |
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0 |
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© 2018 Publishing House of the Union of Pediatricians. All rights reserved. Background. Cystic fibrosis is a hereditary disease that occurs as a result of mutations in the regulator gene of chloride ion transmembrane transport (CFTR). Finding mutations in the CFTR gene is necessary for identification of the clinical features of cystic fibrosis. Objective. Our aim was to identify genotype-phenotype correlations between mutations of the first class of pathogenicity and clinical manifestations of cystic fibrosis based on studying the prevalence and structure of CFTR gene mutations. Methods. The study included children under 18 years with cystic fibrosis admitted to hospital between 2013 and 2017. Biallelic mutations in the CFTR gene were the non-inclusion criterion. The CFTR gene variants were analyzed by next-generation sequencing method. Results. In 125 patients with cystic fibrosis, 59 different variants of the CFTR gene were detected, 11 of them not previously described. The most common was the deletion c.1521-1523del found in 98 (39.2%) of the 250 analyzed CFTR gene alleles and the deletion c.1545-1546del found in 22/250 (8.8%) alleles. It has been shown that the mutation c.1545-1546del, p.Y515∗ was more often found in children of the Chechen nation-odds ratio (OR) 139 (95% confidence interval 15-1,257). It has been established that meconium ileus, pancreatic deficiency and cirrhosis are more common in patients with mutations of the first category of pathogenicity: OR 3.9 (95% CI 1.0-15.0), 4.4 (95% CI 1.8-11.1), and 351 (95% CI 17.5-7,046), respectively. The association of CFTR gene mutations with the development of bronchiectases and polypous pancinusitis has not been found. Conclusion. Correlations between the genotype and clinical manifestations of cystic fibrosis in Russian children with CFTR gene mutations of the first class of pathogenicity have been established.
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Systemic lupus erythematosus: Clinical recommendations. Part 1
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01.01.2018 |
Alexeeva E.
Dvoryakovskaya T.
Nikishina I.
Denisova R.
Podchernyaeva N.
Sukhorukikh O.
Shubina L.
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Voprosy Sovremennoi Pediatrii - Current Pediatrics |
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1 |
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© 2018 Publishing House of the Union of Pediatricians. All rights reserved. The article presents current data on the etiology, pathogenesis, and epidemiology of systemic lupus erythematosus (SLE). The SLE diagnosis details are considered with a description of each examination technique. Moreover, an assessment of reliability level of both evidence and recommendations for each thesis-recommendation are discussed thoroughly. The aspects of differential diagnosis and criteria for the diagnostic quality of SLE are revealed.
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Food allergy in children with inherited epidermolysis bullosa. the results of the observational study
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01.01.2018 |
Makarova S.
Namazova-Baranova L.
Murashkin N.
Epishev R.
Chumbadze T.
Kogevnikova O.
Snovskaya M.
Vishneva E.
Ereshko O.
Balabekova F.
Yasakov D.
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Vestnik Rossiiskoi Akademii Meditsinskikh Nauk |
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0 |
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© 2018 Izdatel'stvo Meditsina. All rights reserved. Background: Inherited epidermolysis bullosa (EB) refers to a group of rare inherited disorders characterized by severe damage of skin and in most patients - the gastrointestinal mucosa, what leads to a violation of skin and mucosal barrier properties in relation to allergens. However, the issues of food sensitization and food allergy in this category of patients have not been studied, and the study of this problem is important. Aim: To evaluate the clinical manifestations of food allergy (FA) and IgE-response to food proteins in children with EB. Methods: 82 patients with EB aged from 2 months to 16 years were entered this open non-randomized observational prospective study, including 20 patients with simple form of EB and 62 patients with dystrophic form of EB. We analyzed allergic history and clinical manifestations of the FA in all the patients. Every patient in this study underwent of determination of the concentration of total serum IgE and specific serum IgE to the most important food allergens, as well as to mixtures of household allergens in some cases (UniCAP System, Phadia AB). Results: Skin lesion in patients with EB masks allergic skin manifestations, causing a hypodiagnosis of the FA in this category of patients, which in turn leads to erroneous organization of nutritional support. FA (clinical manifestations) was identified in 20.7% of children with EB (in 10% of cases with simple form of EB and in 24.2% - in patients with dystrophic form of EB). Products containing cow's milk protein, cereals, and eggs were identified as etiologic factors of FA in most cases. In the group of children with comorbidity FA and EB high and very high levels of total IgE (>1000 kUA / l) were detected most frequently. The main cause-significant allergens are cow's milk proteins, cereals, eggs. Conclusions: Comorbidity with FA is high in patients with dystrophic form of EB. The main cause-significant allergens are cow's milk proteins, cereals, eggs.
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The role of interleukin-33 in pathogenesis of bronchial asthma. New experimental data
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01.01.2018 |
Khaitov M.
Gaisina A.
Shilovskiy I.
Smirnov V.
Ramenskaia G.
Nikonova A.
Khaitov R.
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Biochemistry (Moscow) |
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9 |
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© 2018, Pleiades Publishing, Ltd. Interleukin-33 (IL-33) belongs to the IL-1 cytokine family and plays an important role in modulating immune system by inducing Th2 immune response via the ST2 membrane receptor. Epithelial cells are the major producers of IL-33. However, IL-33 is also secreted by other cells, e.g., bone marrow cells, dendritic cells, macrophages, and mast cells. IL-33 targets a broad range of cell types bearing the ST2 surface receptor. Many ST2-positive cells, such as Th2 cells, mast cells, basophils, and eosinophils, are involved in the development of allergic bronchial asthma (BA). This suggests that IL-33 directly participates in BA pathogenesis. Currently, the role of IL-33 in pathogenesis of inflammatory disorders, including BA, has been extensively investigated using clinical samples collected from patients, as well as asthma animal models. In particular, numerous studies on blocking IL-33 and its receptor by monoclonal antibodies in asthma mouse model have been performed over the last several years; IL-33-and ST2-deficient transgenic mice have also been generated. In this review, we summarized and analyzed the data on the role of IL-33 in BA pathogenesis and the prospects for creating new treatments for BA.
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Self-perception and cognitive features of students with different sociometric status
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01.01.2018 |
Miroshkin D.
Shulga T.
Melamud M.
Maslova V.
Lazareva O.
Vrublevskiy A.
Kochetkov I.
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Eurasian Journal of Analytical Chemistry |
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5 |
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© 2018 by the authors. The article contains the results of an empirical study on self-perception and cognitive style of students. The issue of what psychological variables accompany the process of interpersonal interaction in small groups is considered from a viewpoint of cognitive structures of individual members that comprise such groups. The article also presents a theoretical and methodological analysis of personal and cognitive features of students with different sociometric status. The novelty of this work consists in studying self-perception of group members with different sociometric status, and personal and cognitive characteristics and features given to group members through a system of their opinions about each other. It was concluded from the results of the study that the subjects with different sociometric status are perceived differently by the group: leaders appear to be more aggressive and authoritarian than outsiders. The subjects-leaders when coming across the circumstances that subjectively experienced as unpleasant ones, are able to minimize negative experience and find positive moments in such situations. The outsiders are unable to see the positive aspects of situations they subjectively experience as unpleasant. The cognitive space of the subjects-leaders includes the binary opposition construct “optimistic – pessimistic” what can be determined as cognitive complexity. While the subjects-outsiders perceive the cognitive field of the construct as a one-sided structure, and in unpleasant situations they see the surrounding reality not from the positive side, but only from the negative one. The results presented in this article can be useful to optimize interpersonal relations in student groups, as well as to be a source of additional information to develop measures of a psychological impact.
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Validation of the modified rankin scale in Russia
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01.01.2018 |
Suponeva N.
Yusupova D.
Zhirova E.
Melchenko D.
Taratukhina A.
Butkovskaya A.
Ilyina K.
Zaitsev A.
Zimin A.
Klochkov A.
Lyukmanov R.
Kalinkina M.
Piradov M.
Kotov-Smolensky A.
Khizhnikova A.
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Nevrologiya, Neiropsikhiatriya, Psikhosomatika |
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0 |
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© 2018 Ima-Press Publishing House. All Rights Reserved. Objective: to develop a Russian version of the modified Rankin Scale (mRS) and to assess its psychometric properties. Patients and methods: The investigation involved 50 patients (25 women, 25 men) over 18 years of age (mean age, 56 years) with an acute cerebrovascular accident diagnosis. During the validation procedure, the authors carried out the linguocultural ratification of mRS, prepared its Russian-language version, and then assessed its psychometric properties (reliability, sensitivity, validity). Results and discussion: Translation and linguistic adaptation of mRS was successfully completed. The results obtained in assessing the psychometric properties of the developed Russian version of the scale reflect its high reliability and the valid and reliable indicators of its sensitivity. A statistical study of constructive and content validity also determined the high significance of differences. Conclusion: The investigation has resulted in the official Russian version of mRS, which is recommended for use by neurologists and rehabilitation specialists in both daily clinical practice and in clinical trials.
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Human umbilical cord tissue cryopreservation: Prospects for clinical application
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01.01.2018 |
Strokova S.
Arutyunyan I.
Mullabaeva S.
Fatkhudinov T.
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Akusherstvo i Ginekologiya (Russian Federation) |
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0 |
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© Bionika Media Ltd. The paper analyzes the data available in the modern scientific literature on the possibility of human umbilical cord tissue cryopreservation and its further clinical application. It describes protocols to obtain various biomedical products (vascular matrix, Wharton jelly-based grafts, and multipotent stromal cells) from the frozen umbilical cord, as well as prospects of their clinical use. The analysis of the literature data may be indicative of the active development of a promising cell biotechnology area, such as human umbilical cord cryopreservation.
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Psychophysiologic features and personal-adaptive potential of students with limited abilities
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01.01.2018 |
Kalenik E.
Salakhova V.
Mikhaylovsky M.
Zhelezniakova M.
Bulgakov A.
Oshchepkov A.
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Electronic Journal of General Medicine |
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11 |
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© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The article contains the results of studying homeostasis of the cardiovascular system by the method of cardiointervalography in students with limited abilities of various programs of study at university. A psychological assessment of the attitude of students with limited abilities to their health was made. The problem of the components of the personal-adaptive potential has been studied. A study of the level of human potential of students on a separate component of “health” and in the aggregate has been conducted, as well as conclusions based on this research work have been drawn. Method: To solve the objectives set in the study, the following methods were used: the review of scientific and methodological literature, instrumental and calculated physiological research methods: variational pulsometry; mathematical analysis of the heart rate variability; calculation method for assessing adaptive capacity-adaptive capacity offered by Bayevsky; the questionnaire “Psychological features of a person’s attitude to his health”, in the framework of a study of the human potential index (health component), a questionnaire was developed based on a questionnaire for assessing the quality of life, developed at the Institute of Stress Medicine (USA) in 1993, methods-descriptive mathematical statistics and testing the hypothesis by Student’s t-test. Results: The analysis of the activity index of the sympathic regulation link-mode amplitude (AMo%) according to the standards of homeostasis, in view of variation pulsograms, is characterized in the studied groups, as moderate sympathicotonia. The AMo index in the groups is not statistically different, reflects the stabilizing effect of centralization of the heart rate control, and indicates the activation of the sympathic division of the autonomic nervous system (ANS). AMo 1 year = 40.8 ± 8.1%; AMo 2 year = 44.9 ± 4.8%; AMo 3 year = 43.9 ± 8.8% the index is in the upper limits of the norm, the index is normal only in the group of first year students. It can be stated that the body of students with limited abilities reacts with a nonspecific adaptive response to the study load, and this depends on the specifics of the diseases and functional reserves that are low in this category of students. The indicator of urgent adaptation-vagosympathetic balance (LF / HF) shows the greatest stress in the group of first-year students. The index is statistically reliably different from the LF / HF1 year = 2.074 ± 0.39 * (according to the paired Student’s t-criterion of dependent indices p ≤ 0.5) from that of students in the second LF / HF2 year = 1.174 ± 0.25 and the third LF / HF3 year = 1.308 ± 0.26 years of study, indicating an increase in sympathic influences. A decrease in the ratio of the LF / HF index in the groups of second and third year students can be interpreted as a positive effect. There was general adaptation to the educational process at the university, and the correct construction of training and health-related workloads, in accordance with the medical diagnosis, led to a balanced regulation of the sympathic and parasympathic nervous system. Conclusion: The stress level of regulatory systems is assessed by the value of the adaptation potential. The higher is the adaptive capacity of the circulatory system, the lower the values of the adaptive potential. The adaptive potential is an indicator that determines the interrelation of two opposite concepts: “health” and “disease”, morpho-functional changes. In case of illness, a shift towards disadaptation takes place.
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Prenatal Atrioventricular Septal Defect (AVSD) as a planned congenital heart disease with different outcome depending on the presence of the coexisting extracardiac abnormalities (ECA) and/or malformations (ECM)
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01.01.2018 |
Słodki M.
Soroka M.
Rizzo G.
Respondek-Liberska M.
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Journal of Maternal-Fetal and Neonatal Medicine |
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0 |
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© 2018, © 2018 Informa UK Limited, trading as Taylor & Francis Group. Introduction: Prenatal atrioventricular septal defect (AVSD) on frequent occasions coexists with other cardiac or extracardiac abnormalities or malformation which may change the prognosis and the management with the fetus and the newborn. The aim of the research was to assess the prognosis and the outcome of prenatally diagnosed AVSD based on the classification which also includes coexisting extracardiac abnormalities and malformations as well as its influence on the prenatal consultation. Methods: It was a retrospective analysis of 113 patients with prenatally diagnosed AVSD. The group was selected out of 871 patients with CHD. Out of 113 fetuses with AVSD we exclude those in whom AVSD was coexistent with other cardiac malformations (n = 41). Extracardiac abnormalities [ECA] were defined as problems which do not require surgical intervention after delivery, they were usually markers of a genetic syndrome. Extracardiac malformations [ECM] were defined as problems requiring surgical interventions after delivery or lethal malformations. All 72 fetuses with an isolated AVSD were classified to one of the three groups: (1) Simple AVSD–(sAVSD)–a fetus with isolated AVSD without coexisting ECA and ECM (n = 6), (2) sAVSD + ECA–a fetus with isolated AVSD, with coexisting ECA (n = 28), (3) sAVSD + ECM–a fetus with isolated AVSD, with coexisting ECM (n = 38). Results: The pregnancy from the groups sAVSD + ECM were, in fact, more often referred to the prenatal cardiology centers on account of the existing ECM (p=.03). There were no differences between the two subgroups in regard to: the mean age of the pregnancy, the mean age of the fetus at the time of diagnosis and during diagnostic testing at the referral center, the gender of the fetus. An increased nuchal translucency (NT) was most often found in fetuses from the group AVSD + ECA (n = 13/23), which was connected with more frequent occurrence of abnormal karyotype (p=.048). The trisomy 21 more frequently referred to pregnancy with sAVSD + ECA than those with sAVSD + ECM (p=.0006). In the group sAVSD + ECM there was the highest number of fetuses small for the gestational age detected −48.65% (p=.01). Most often premature deliveries were found in the group sAVSD + ECM (72.73%). The duration of gestation in the group sAVSD + ECM turned out to be much shorter than that in the group with the isolated sAVSD (p=.01) and sAVSD + ECA (p=.03). The lowest Apgar score was in the newborns from the group sAVSD + ECM (p=.002). Longer period of gestation was connected with the higher score on Apgar scale (R = 0.541; p=.001). The average delivery weight of the newborns was the lowest in the group sAVSD + ECM (p=.04). sAVSD + ECM was connected with the significantly higher death rate than the isolated sAVSD (p=.0047) or sAVSD + ECA (p<.00001). The fatality rate of the newborns/ fetuses from the pregnancies lasting less than 37 weeks turned out to be much higher than in the case of the remaining pregnancies (sAVSD p=.002). Conclusions: (1) The majority of fetuses with AVSD remained the patients of just obstetricians and prenatal cardiologists because of highly heterogeneous of the coexisting malformations and abnormalities and since they perish in the period of fetal or neonatal life usually they are not seen by the pediatricians or cardiac surgeons. (2) The classification of the AVSD in fetus to a particular group of the prognostic classification of the fetal heart defects helps to plan perinatal management and supplies information regarding the prognosis. (3) The highest mortality rate was in a group of AVSD + ECM, probably due to shorter time of pregnancy duration, fetuses grow restriction and low Apgar score in 1 minute of life.
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Synthesis and biological activity of 7(7,11)-hydroderivatives of oligomycin A
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01.01.2018 |
Omelchuk O.
Lysenkova L.
Belov N.
Korolev A.
Dezhenkova L.
Grammatikova N.
Bekker O.
Danilenko V.
Shchekotikhin A.
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Macroheterocycles |
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© ISUCT Publishing. Macrolide antibiotics represent a valuable class of broad-spectrum, high active natural compounds with polyketide structure. A well-known FOF1 ATP-synthase inhibitor,[1] namely oligomycin A (1), is a 26-membered α,β-unsaturatedpolyketide lactone with conjugated diene, fused to spiroketal moiety. Oligomycin A possesses strong antifungal, antiactinomycotic and cytotoxic activity, but lacks antibacterial activity. According to recent investigations, the development of anti-cancer drugs based on oligomycin A is quite perspective due to its high cytotoxic activity toward tumor cells, ability to inhibit a multidrug resistance protein p-gp and to prevent an activation of oncogenic K-Ras by inhibition of its localization at the plasma membrane.[2-4] However, high toxicity for mammalian cells and low water solubility are significant limitations of oligomycin A, making it unacceptable for clinical application. Chemical modification is a promising way to improve pharmacological properties of natural compounds. Recently we have found that site-selective modifications of oligomycin A afforded semi-synthetic derivatives with high antiproliferative activity against tumor cell lines[5-7] or selective antifungal activity against Candida spp.[8] and, at the same time, with lower toxicity toward mammalian cells. Also, semi-synthetic oligomycin A derivatives are useful tools for molecular genetic studies of additional targets for this family of antibiotics.[9,10] Previously Ramirez F. et al. have described the reaction of oligomycins with sodium borohydride resulting in mixture of diastereomeric 7-dihydro-and 7,11-tetrahydro derivatives without further separation and characterization of individual products.[11] Also, there is no data on biological activity of these reduced oligomycins against fungal/actinomycetes strains and tumor cell lines in article mentioned above. Thus, in this paper we report regio-and stereoselective methods for borohydride reduction of oligomycin A, structure determination of obtained derivatives and investigation of theirs antiproliferative, antifungal and antiactinomycotic properties. The feasibility of regio-and stereoselective reduction of C7-carbonyl group in a core structure of oligomycin A was proposed due to the presence of haptophilic hydroxyl groups[12] at C5 and C9 positions and sterical hindrance of C-11 carbonyl group. Actually, treatment of oligomycin A with bulky sodium triacetoxyborohydride in acetic acid according to the method[13] led to (7S)-dihydrooligomycin A (2) in a good yield. The second carbonyl group (C-11) reduced in more harsh conditions: only the extended treatment of (7S)-dihydrooligomycin A with sodium borohydride in ethanol give (7S,11R)-7,11-tetrahydrooligomycin A (3) as major product. Reaction proceeds with acceptable stere-oselectivity and gives tetrahydro derivative 3, but in low yield (35 %), which associated with low stability of oligomycins in basic conditions.[14] Structure of compounds 2 and 3 was confirmed by high resolution mass spectrometry (HRMS ESI) and NMR spectroscopy. Absolute configurations at C7 and C11 positions of obtained derivatives were unambiguously confirmed by observed interactions between neighboring protons in corresponding1H-1H ROESY spectra. Testing of antimicrobial properties of oligomycins 2 and 3 against Candida spp., filamentous fungi and S. fradiae (strain, extremely sensitive to oligomycins) that of the parent antibiotic in comparison with starting oligomycin A revealed that reduction of carbonyl groups led to decreasing of activity (except strain M. canis). Also, reduced derivatives 2, 3 were less potent against human colon carcinoma cell line HCT116 and its doxorubicin-resistant subline HCT116(-/-), while activity against leukemia cell line K562 and doxorubicin-resistant subline K562/4 retained at the same level as for 1. It might be pointed that biological properties of (7S)-dihydrooligomycin A and (7S,11R)-7,11-tetrahydrooligomycin A are quite similar, consequently C7-carbonyl group has a greater influence on biological activity of oligomycin A than C-11 carbonyl group.
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Association between polymorphic markers in candidate genes and the risk of manifestation of endocrine ophthalmopathy in patients with Graves' disease
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01.01.2018 |
Petunina N.
Martirosian N.
Trukhina L.
Saakyan S.
Panteleeva O.
Burdennyy A.
Nosikov V.
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Terapevticheskii Arkhiv |
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0 |
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© 2018 Media Sphera Publishing Group.All Rights Reserved. Aim. To analyze the association between the polymorphic markers in CTLA4, TNF, IL10 and IL16 genes and the risk of manifestation of endocrine ophthalmopathy (EO) in patients with Graves' disease (GD). Materials and methods. Case-control study included 248 patients with GD. Using polymerase chain reaction we studied the distribution of alleles and genotypes of polymorphic markers such as A60G (rs3087243) in CTLA4 gene, G(-308)A (rs1800629) in TNF gene, G(-1082)A (rs1800896) in IL10 gene, T3249C (rs4778641) in IL16 gene among 141 patients with Graves' disease and EO and 107 patients with GD without EO. Results and discussion. The frequencies of A alleles and the AA genotypes were significantly increased and the frequencies of G alleles and the GG genotype polymorphic markers rs3087243 of CTLA4 gene and rs1800896 of IL10 gene, as well as the GG genotype polymorphic marker rs1800629 of TNF gene were reduced in patients with GD and EO. The polymorphism in CTLA4 gene was also associated with the activity and the severity of EO. The comparative analysis of the allele and genotype frequency distribution of polymorphic markers of IL16 gene did not show the significant difference. Conclusion. The risk of manifestation and the development of EO in patients with Graves' disease can be caused by not only environmental, but also genetic risk factors.
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Mesenchymal stem cell therapy for ischemic heart disease: Advances and challenges
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01.01.2018 |
Konoplyannikov M.
Kotova S.
Baklaushev V.
Konoplyannikov A.
Kalsin V.
Timashev P.
Troitskiy A.
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Current Pharmaceutical Design |
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© 2018 Bentham Science Publishers. Ischemic Heart Disease (IHD) has been recognized as the main cause of mortality in the modern world. Application of cell therapy technologies for the IHD treatment has been actively studied from the beginning of 2000s. The review is dedicated to the use of mesenchymal stem cells (MSC) in the therapy of IHD. The strategies of the MSC modification in vitro for improvement of their regenerative potential are extensively discussed, including preconditioning to enhance the cell survival, boosting their paracrine effect and manipulating their car-diomyogenic differentiation. The optimization of the MSC delivery and opportunities related to the use of biomaterials as cell carriers are also discussed. The results of the most important clinical studies on the MSC-based IHD therapy are presented, including those completed and published in the literature and the ongoing clinical trials registered at clinicaltrials.gov by June 2018.
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Сross-analysis of big data in accreditation of health specialists
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01.01.2018 |
Chelyshkova M.
Semenova T.
Naydenova N.
Dorozhkin E.
Malygin A.
Akhunov V.
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Electronic Journal of General Medicine |
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© 2018, Modestum Ltd.. All rights reserved. Objective: The relevance of this study is due to the mass accreditation of health professionals that is developing in Russia, which requires innovative measurement tools and opens new opportunities for a well-founded cross-analysis of specialists’ professional readiness quality. Purpose of the study: The purpose of this article is to present approved methodical approaches to the transformation of accreditation data into a format suitable for secondary analysis of medical schools graduates quality based on the requirements of Professional Standards. Method: The leading methods of secondary data analysis are: a) codification of indicators in the primary data accumulation array; b) statistical processing of study results (evaluation of the relationships between the arrays of primary data accumulation and instrumental data, the correlation of test scores obtained by accreditation results with the labor functions of Professional Standards); c) the creation of representative samples for data analysis. The implementation of methods is carried out in the mode of working with arrays of big data, which also uses the method of cross-analysis to identify additional factors that affect to specialists’ professional readiness quality. Results: As a results of the research, there were: 1) approaches to the codification of data in the array and their secondary analysis were developed; 2) three samples were constructed with an estimation of representativeness for different strata, including subjects, assignments and corresponding labor functions; 3) the matrix of primary data in the specialty “Pediatrics” was verified using the example of the results of students from 50 medical universities in Russia. Conclusion: Approbation of methods of secondary data analysis conducted on representative samples of the subjects showed the effectiveness of the developed approaches that should be used when analyzing large data sets in the procedures of certification or accreditation. The materials of the article can be useful for specialists in the field of assessing the quality of education or assessing the professional readiness of health professionals, managers, professors and pedagogical staff of medical schools, specialists of centers for independent assessment of qualifications.
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