[Problems of a physician-patient interaction and control of arterial hypertension in Russia. Main results of scientific-practical program ARGUS-2].

OBJECTIVE: To study the problems of physician-patient cooperation, patient- and physician related barrieres to target blood pressure (BP) achievement and to demonstrate improvement of BP control with indapamide SR 1.5 mg, when given to patients remaining uncontrolled while receiving antihypertensive therapy without thiazide diuretics (TD). METHODS: The trial Improvement of Arterial Hypertension Control in High-Risk Hypertensive Patients (ARGUS-2) run in 15 Russian centres during the year 2006. Retrospective analysis of medical notes of 684 outpatients and 575 inpatients with arterial hypertension. Validated questionnaires were used for interview of 373 physicians and 1298 patients. The study of Arifon retard efficacy was carried out in 1438 outpatients with difficult-to-control hypertension. RESULTS: BP was above the goal level in 97.1% pts at the first analyzed visit to an outpatient department. Antihypertensive therapy was unchanged in 20.5% cases, the drug dose was increased in 46,6%, additional medication was administered in 36,8%. In 30.8% pts antihypertensive agent was substituted by another class drug. At the last analyzed visit target BP was found in 24.4% pts. BP control was poorer in pts with BP goal <130/80 mmHg (20.1%) than in those with higher target BP (25.9%). Achievement of BP goal was associated with combination therapy, higher rate of TD administration and with more frequent visits to physician. During hospitalization target BP <140/<90 mmHg was achieved in 87.1%,<130/<80 mmHg in. 76.2%. Arifon retard administration resulted in target BO achievement in 84.5% patients. Physicians percept low adherence to antihypertensive treatment, lack of patients knowledge about risk related to arterial hypertension, economical problems as main barriers to improvement of arterial hypertension management. Patients considered economical problems related to antihypertensive treatment more much less important than physicians did. CONCLUSION: The study results suggest the importance of therapeutic inertia overcome to improve arterial hypertension management in Russia. Low rate of multiple combination therapy and TD prescription are important features of therapeutic inertia. Polar perception of problems related to arterial hypertension by physicians and patients should be considered as influencing factors for educational programs development.

[Mononuclear cell response to fetoproteins in patients with pulmonary tuberculosis in dysregenerative bronchial epithelial changes].

A relationship was studied between the response of mononuclear cells (MNC) to fetoproteins (FP) and the bronchial changes in patients with pulmonary tuberculosis. The response was evaluated by the change in the relative count of CD8+ lymphocytes after MNC incubation with FP as compared with the controls. The value of the response (in scores) was compared with the pathohistological pattern of the bronchial epithelium and interstitial tissue. The studies show that the values of a MNC response to FP are criteria for the presence and absence of dysplasia as one of the types of bronchial epithelial atypia. It is not improbable that patients with chronic inflammatory processes in the lung in the presence of a positive MNC response to FP should be regarded as persons at risk for malignancies.

[The prevalence of asthma-related symptoms among children in three Ukrainian cities with environmental problems (preliminary results)].

In 2002 authors initiated a US-Ukraine collaborative study on bronchial asthma among 2177 6-8 year old children who resided in Kyiv, Dniprodzerzhinsk and Mariupol, Ukraine in 2002 and who were participants in the Family and Children of Ukraine Longitudinal Cohort Study. The overall goal of the study is to investigate the epidemiology and risk factors for asthma and asthma--related symptoms among these children. The study design comprises of three phases. During the first phase Questionnaires including the International Study of Asthma and Allergies in Childhood (ISAAC) core module on wheeze, as well as questions about other respiratory symptoms (including night cough and phlegm) were given to parents of 2177 children aged 6-8 years. The authors examined the prevalence of wheezing and dry cough at night not associated with colds during the past year among the surveyed children. The parent-reported prevalence of wheezing was significantly different among these three Ukrainian cities: 14.4% in Kyiv, 19% in Mariupol and 5.7% in Dniprodzerzhinsk. The prevalence of dry cough at night not associated with colds was also different in Kyiv, Mariupol and Dniprodzerzhinsk and was 11.4%, 6.9% and 6.9% respectively). The authors conclude that the prevalence of wheezing illness and dry cough at night not associated with colds during the past year varies among Ukrainian cities with the highest prevalence in kyiv, the most "westernized" of these cities.

[Distribution and activity of microorganisms in the deep repository for liquid radioactive waste at the Siberian Chemical Combine].

The physicochemical conditions, composition of microbial communities, and the rates of anaerobic processes in the deep sandy horizons used as a repository for liquid radioactive wastes (LRW) at the Siberian Chemical Combine (Seversk, Tomsk oblast), were studied. Formation waters from the observation wells drilled into the production horizons of the radioactive waste disposal site were found to be inhabited by microorganisms of different physiological groups, including aerobic organotrophs, anaerobic fermentative, denitrifying, sulfate-reducing, and methanogenic bacteria. The density of microbial population, as determined by cultural methods, was low and usually did not exceed 10(4) cells/ml. Enrichment cultures of microorganisms producing gases (hydrogen, methane, carbon dioxide, and hydrogen sulfide) and capable of participation in the precipitation of metal sulfides were obtained from the waters of production horizons. The contemporary processes of sulfate reduction and methanogenesis were assayed; the rates of these terminal processes of organic matter destruction were found to be low. The denitrifying bacteria from the underground repository were capable of reducing the nitrates contained in the wastes, provided sources of energy and biogenic elements were available. Biosorption of radionuclides by the biomass of aerobic bacteria isolated from groundwater was demonstrated. The results obtained give us insight into the functional structure of the microbial community inhabiting the waters of repository production horizons. This study indicates that the numbers and activity of microbial cells are low both inside and outside the zone of radioactive waste dispersion, in spite of the long period of waste discharge.

[The structure of rat pinealocytes in stress and after unilateral intranasal administrations of oxytocin]. / Struktura pinealotsitov krysy pri stresse i posle unilateral'nykh intranazal'nykh vvedenii oksitotsina.

Stress-induced functional changes in the light pinealocytes and signs of stress-limiting effect of oxytocin were revealed in white non-linear rats. The data obtained suggests involvement of oxytocinergic systems in the stress modulation of pinealocytes.

[The reaction of the neocortical structures in the seal Pusa sibirica to a prolonged stay under water]. / Reaktsiia struktur neokorteksa nerpy Pusa sibirica na dlitel'noe prebyvanie pod vodoi.

Using light and electron microscopic techniques, structural and functional changes in the neurones and glia of the Baikal seal neocortex were revealed during diving. These changes include shifts in tinctorial properties of cells, in the number of dendritic spines, cell ultrastructure (condensation and redistribution of nuclear chromatin, swelling of organoids, etc.). These changes are both non-specific and reversible, indicating high reserve capacities of the brain in this species.

[The structural characteristics of the auditory portion of the cerebral cortex in the Baikal seal (Pusa sibirica) and the neuronal reaction to hypoxia]. / Strukturnaia kharakteristika slukhovogo otdela kory bol'shogo mozga baikal'skogo nerpa (Pusa sibirica) i reaktsiia neironov na gipoksiiu.

Methods of light (Nissl, Golgi-Kopsch) and electron microscopy were used for studying the structural organization of the auditory portion of the cerebral cortex of Pusa sibirica. The auditory port of this kind of cortex is characterized by pyramidization of all the layers (layer IV included), thick layer I, two sublayers in layer III which is typical of other semiaquatic and aquatic mammals. Synaptoarchitechtonics of this part of the neocortex may be compared with that of other aquatic, semiaquatic and terrestrial mammals. The investigation of the state of neurons of the auditory portion of the cortex of Pusa sibirica during induced 18-min hypoxia has shown that the alterations in the neurons are of functional and reversible character. The axosomatic synapses remained most intact. The alterations in the auditory portion of the neo-cortex of Pusa sibirica evidences high level of adaptive reactions to hypoxia associated with the adaptation of these mammals to diving and fixed in the evolutionary process.

[Structure of the endotheliocytes of cerebral vessels of aquatic mammals]. / Struktura éndoteliotsitov krovenosnykh sosudov mozga vtorichnovodnykh mlekopitaiushchikh.

By means of scanning microscopy the relief of luminal surface of endotheliocytes, lining microvessels of various parts of the brain in the Pusa sibirica, Phoca vitulina and Delphinapterus leucas have been studied. Specialized formations of the cellular surface--various processes, projections, toruli have been revealed; their character in various parts of the brain in diving animals is determined by the blood stream conditions and their different sensitivity to oxygen deficiency during diving. The peculiarities, revealed in the structure of the cerebral vessels intima, are considered as one manifestations of the adaptive properties in the organism of diving animals, which had been developed in them during the process of a long evolution, while they adapted to the aquatic environment.