[Clinic and functional features of chronic obstructive pulmonary disease after virus-induced acute exacerbations.]

AIM: To establish symptoms, lung function and to evaluate subsequent exacerbations of chronic obstructive pulmonary disease (COPD) during a year after virus-induced COPD exacerbations. MATERIALS AND METHODS: Patients hospitalized with viral (n=60), bacterial (n=60) and viral-bacterial (n=60) COPD exacerbations were enrolled to single-center prospective observational study. COPD was diagnosed according spirography criteria. Viral infection was established in bronchoalveolar lavage fluid or sputum by real-time reverse transcription-polymerase chain reaction for RNA of influenza A and B virus, rhinovirus, respiratory syncytial virus and SARS-CoV-2. Symptoms, lung function, COPD exacerbations were assessed. Patients were investigated at the hospitalization onset and then 4 and 52 weeks following the discharge from the hospital. RESULTS: After 52 weeks in viral and viral-bacterial COPD exacerbations groups the rate of forced expiratory volume in one second (FEV1) decline were maximal - 71 (68; 73) ml/year and 69 (67; 72) ml/year versus 59 (55; 62) ml/year after bacterial exacerbations. Low levels of diffusion lung capacity for carbon monoxide (DLco/Va) - 52.5% (45.1%; 55.8%), 50.2% (44.9%; 56.0%) and 75.3% (72.2%; 80.1%) respectively, of 6-minute walk distance; p<0.001 in relation to bacterial exacerbations. In Cox proportional hazards regression analyses viral and viral-bacterial exacerbations were associated with increased risk of subsequent COPD exacerbations by 2.4 times independent of exacerbations rate before index event and FEV1. In linear regression models the relationships between airflow limitation and respiratory syncytial virus, rhinovirus and influenza virus infection, between low DLco/Va and rhinovirus, influenza virus and SARS-CoV-2 infection. CONCLUSION: COPD after virus-induced exacerbations were characterized by progression of airflow limitation, low DLco/Va, low 6-minute walking test distance, subsequent COPD exacerbations risk.

[Diagnostic and Prognostic Markers of Chronic Heart Failure in Patients with Occupational Chronic Obstructive Pulmonary Disease].

Aim      Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are a common comorbidity. Professional chronic obstructive pulmonary disease (PCOPD) is a specific phenotype, which suggests peculiarities in the development of HF. Difficulties of HF diagnosis in such patients determine the relevance of searching for additional markers. The aim of the study was identifying HF markers in patients with PCOPD.Material and methods  This single-site, cohort, prospective, observational study included 345 patients. The main group consisted of PCOPD patients; the comparison group consisted of patients with COPD induced by tobacco smoking; and the control group included conventionally healthy individuals. The groups were matched by the index of coincidence; pairs were matched at 1:1 by the "nearest neighbor index"; covariates for matching included COPD duration, sex, and age. Each group included 115 patients. The major professional adverse factors were silica-containing dust and organic solvents. COPD was diagnosed according to GOLD criteria; HF was diagnosed in accordance with Russian clinical guidelines. The markers were determined by multifactorial logistic regression. Likelihood of events with allowance for the time to the event was analyzed by the Kaplan-Meier method.Results HF in PCOPD patients was characterized by biventricular damage, preserved left ventricular ejection fraction, and frequent hospitalizations for decompensation (17.5 % vs. 9.5 % for COPD in smokers). HF markers in patients with PCOPD included the length of work of more than 20 years, pulmonary artery systolic pressure (PASP) higher than 35 mm Hg according to data of Doppler echocardiography, diffusing capacity of lungs for carbon monoxide (DLCO) less than 50 %, increased serum concentrations of CC-chemokine ligand 18 (CCL18), S-100­beta protein, and N-terminal pro-brain natriuretic peptide (NT-pro-BNP). Diagnostic sensitivity of the multifactorial model was 84 % and specificity was 81 %. Two models were proposed for purposes of screening, which included the following parameters: length of work, exposure to aromatic hydrocarbons, decreased distance in 6-min walk test by more than 60 m per year and length of work, exposure to inorganic dust, and decreased forced expiratory volume during the first second by more than 55 ml per year.Conclusion      The markers for development of HF in PCOPD patients are length of work >20 years, PASP >35 mm Hg, DLCO <50 %, and increased serum concentrations of CCL18, S-100­beta protein, and NT-pro-BNP.

[Organization of forensic medical service work in case of fires with massive number of victims]. / Organizatsiia raboty sudebno-meditsinskoi sluzhby pri pozharakh s massovym chislom zhertv.

A complex algorithm is proposed for the forensic medical service response in emergency situations marked by a large number of deaths from fire. Its use will promote increased efficiency in the work of forensic medical units while limiting the consequences to human victims in emergency situations.

[Comparative analysis of post-translational modifications in plasma proteome of patients with cerebral ischemia based on HPLC-MS/MS method]. / Sravnitel'nyi analiz modifikatsii proteoma plazmy krovi bol'nykh tserebral'noi ishemiei na osnove metoda VÉZhKh-MS/MS.

The relative differences between post-translational modifications (PTM) of proteins in blood plasma samples of patients with cerebral ischemia (CI) and healthy people were investigated using of the method of label-free comparative proteomic analysis based on the technology of tandem HPLC-MS/MS. For PTM detection we used multiple MS/MS search in the database Mascot for variable PTM and Progenesis LS-MS software. In the CI plasma samples, we observed an increase in the proportion of peptides with such PTM as phosphorylation of serine, threonine, and tyrosine, acetylation of lysine and protein N-term, ubiquitination of lysine and deamidation of glutamine related to clinically significant processes were revealed.

Analysis of Blood Plasma Protein Composition in Patients with Cerebral Ischemia.

Blood plasma proteome in patients with cerebral ischemia and healthy individuals was studied using comparative proteomic analysis based on tandem HPLC-MS/MS. Mass spectra were analysed in an automated mode using Progenesis LS-MS software and 256 proteins were identified. Significant quantitative differences were revealed for 20 proteins. It was found that changes in the blood plasma proteome in subjects with cerebral ischemia involved a wide range of proteins: molecular chaperones, fibrinolysis, angiogenesis, and immune system proteins, proteins involved in homeostasis maintenance, cell differentiation and proliferation, regulators of apoptosis, and cytoskeleton proteins.

Efficacy of 13-valent pneumococcal conjugate vaccine in healthcare workers.

AIM: To establish the efficacy of 13-valent pneumococcal conjugate vaccine (PCV13) for healthcare workers protection from occupational acquired infection and impact of healthcare staff vaccination on the risk of transmission to patients. MATERIALS AND METHODS: Healthcare personnel (n=157 of whom 105 critical care department staff) and 1770 patients of that critical care department observed. Healthcare workers received PCV13. Infections caused by Str. pneumoniae, respiratory infections regardless of etiology, work absenteeism in healthcare workers during 12 month before and after vaccination assessed. In the same time monitoring of hospital-acquired infections in patients of critical care department performed. Statistical analysis was done using SPSS 24, relationships were assessed by rate ratio, Cox regression, logistic regression and Kaplan-Meier estimator. RESULTS: Healthcare workers' vaccine coverage in critical care department was 97.2%. In healthcare personnel the rate of all pneumococcal infections, asymptomatic carriage of Str. pneumoniae and respiratory pneumococcal infections were decreased after vaccination by 2.1, 2.2 and 2.1 times accordingly. The rate of respiratory infections regardless of etiology was decreased by 30%, р<0.05. Cumulative percent of subjects without pneumococcal respiratory infections during 12 month was 87.9 before and 94.3 after vaccination, р=0.015. Work absenteeism due to respiratory infections was reduced. In patients of critical care department decreasing of all respiratory infections by 58%, pneumococcal respiratory infections by 66%, hospital acquired pneumonias by 46% were seen, р<0.05. CONCLUSION: Healthcare personnel vaccination with PCV 13 is effective in protection from occupational acquired pneumococcal respiratory infections and asymptomatic carriage and promotes decreasing of hospital acquired infections among patients.

[Comparative proteome analysis of blood plasma of patients with early-stage chronic cerebral ischemia]. / Sravnitel'nyi analiz proteoma plazmy krovi bol'nykh na rannei stadii khronicheskoi tserebral'noi ishemii.

In the present study, we explored the technology of liquid chromatography-mass spectrometry (HPLC-MS/MS) for the proteome analysis of blood plasma of patients with early chronic cerebral ischemia. Analysis of mass-spectrometer data carried out in automatic mode using the software Progenesis LS-MS. As a result of this study identified 43 proteins. The differences identified in the study group compared with the control in 7 proteins. It was found that in the early stages of chronic cerebral ischemia proteome changes in blood plasma affect proteins related to the immune system, the system for the maintenance of hemostasis and lipid metabolism.

[FEDERAL CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS, PREVENTION AND TREATMENT OF PNEUMOCONIOSIS].

The purpose of development of this clinical practice guidelines was to provide evidence-based protocols that help the practitioner and the patient make the right decision for the health assessment, treatment and prevention of pneumoconiosis. Pneumoconiosis is the interstitial lung disease of occupational origin caused by prolonged inhalation of inorganic dust, characterized by chronic diffuse aseptic inflammation in lung tissue with the development of pulmonary fibrosis. Currently, thereare no treatment that provide a cure pulmonary fibrosis and changes in the dynamics of decline in lung function. Regular, individually tailored treatment should be directed to the pathogenic mechanisms and some clinical symptoms of pneumoconiosis, as well as the prevention of complications. To enhance the effect of pharmacotherapy is recommended to use non-drug therapies that enhance the functionality of the respiratory system.

[FREQUENCY-TEMPORAL STRUCTURE OF HUMAN ELECTROENCEPHALOGRAM IN THE CONDITION OF ARTIFICIAL HYPOGRAVITY: DRY IMMERSION MODEL].

Frequency-temporal electroencephalogram (EEG) reactions to hypogravity were studied in 7 male subjects at the age of 20 to 27 years. The experiment was conducted using dry immersion (DI) as the best known method of simulating the space microgravity effects on the Earth. This hypogravity model reproduces hypokinesia, i.e. the weight-bearing and mechanic load removal, which is typical of microgravity. EEG was recorded by Neuroscan-2 (Compumedics) before the experiment (baseline data) and at the end of day 2 in DI. Comparative analysis of the EEG frequency-temporal structure was performed with the use of 2 techniques: Fourier transform and modified wavelet analysis. The Fourier transform elicited that after 2 days in DI the main shifts occurring to the EEG spectral composition are a decline in the alpha power and a slight though reliable growth of theta power. Similar frequency shifts were detected in the same records analyzed using the wavelet transform. According to wavelet analysis, during DI shifts in EEG frequency spectrum are accompanied by frequency desorganization of the EEG dominant rhythm and gross impairment of total stability of the electrical activity with time. Wavelet transform provides an opportunity to quantify changes in the frequency-temporal structure of the electrical activity of the brain. Quantitative evidence of frequency desorganization and temporal instability of EEG wavelet spectrograms may be the key to the understanding of mechanisms that drive functional disorders in the brain cortex in the conditions of hypogravity.

[Analysis of proteomic profile changes of zebrafish embryos during exposure to doxorubicin, built-in the phospholipid transport nanosystem].

The proteome profile of Danio rerio embryos grown in the medium containing doxorubicin, included in the phospholipid transport nanosystem (doxolip) has been investigated using combination of 1D-electrophoresis with subsequent MALDI-TOF-PMF mass spectrometry. Cultivation of growing of D. rerio embryos in the medium with doxolip caused a substantial increase in expression of the cytoskeletal proteins, a decrease in the number of nuclear proteins involved in DNA and RNA synthesis and disappearance of vitellogenin 2 in comparison with control (the cultivation medium containing the phospholipid transport nanosystem). Analysis of the proteomic profiles of doxolip-treated embryos suggests lower toxicity of doxorubicin incorporated in the phospholipid nanosystem.

[Promoting pharmacovigilance monitoring in health care organization].

The article considers the practical aspects of the organization of the pharmacovigilance of medicines at the level of healthcare institutions.

Effects of fullerene C60 on proteomic profile of Danio rerio fish embryos.

The effects of phosphatidylcholine-based phospholipid nanoparticles containing fullerene C60 on Danio rerio fish embryos were studied. Exposure of the embryos with the nanoparticles for 48 h did not lead to appreciable changes in the number of protein bands in SDS-PAGE in comparison with the control (exposure in medium with phosphatidylcholine). Mass spectrometric identification of proteins showed differences in the proteomic profiles of the samples. The content of vitellogenins changed after exposure with phosphatidylcholine-based nanoparticles with C60 fullerenes. This could indicate low toxicity of the nanoparticles towards D. rerio embryos under experimental conditions.

[The influence of probiotic fermented milk product on colon microbiota, hematological parameters and cell immunity in rats].

Influence of probiotic fermented milk product on the intestinal microbiota, hematological parameters and immune status of the experiment in vivo at Wistar rats was studied. It was shown, that entering of probiotic strains of Bifidobacterium bifidum 791, Bifidobacterium longum B-379M and Lactobacillus acidophilus NK1 u Streptococcus thermophilus in composition fermented milk products in the total quantity of 2,1 x 10(7) CFU/ sm3 in digestive tract within three weeks has a positive influence on the resident of colon microbiota. Significant increasing of population levels of Bifidobacterium, Enterobacteriaceae with normal biochemical properties, registered a strong tendency to increase the content of Lactobacteria, which led to a decreasing the number of potential pathogenic transient flora with pathogenic factors. Monitoring of body mass in experimental animals has shown that including of fermented milk product with probiotic strains in diet has a positive influence on the feed uptake. Probiotic properties of the product also have stimulated effect on the immune status of the rat: improvements in cell immunity (increasing the relative amount of T-helper cells, immuneregulatory index) and hematological parameters (increase

[Experimental approaches to investigation into the role of the genotype by the locus TAG 1A of dopamine D2-receptors in epileptogenesis].

The effect of genotype in locus TAG 1A of gene receptor dopamine second type on characteristics of peak-and-wave EEG pattern in somatosensory, parietal and occipital areas of the cortex was studied in two groups of rats. Quantitative analysis showed that the peak-wave discharge of the first type in rats with A1/A1 genotype had a significantly longer duration, occurred more frequently leading to a significant increase in their peak-wave index. The results are of clinical interest creating a theoretical basis for improved diagnosis of absence epilepsy and selection of anticonvulsants.

[The influence assessment of probiotic fermented milk products on intestinal microflora, hematological indices and cellular immunity in rats (report 1)].

Influence of probiotic fermented milk products on the intestinal flora, hematological parameters and immune status of the experiment in vivo at rats is studied. Entering in digestive tract of probiotic strains of Lactobacillus acidophilus NK-1 and Bifidobacterium bifidum 791 at the level of hundreds of millions CFU in a day (from 1,7 x 10(8) to 9 x 10(8) CFU) in composition fermented milk products renders on the whole positive, but not significant statistically influence on the indexes of colon microflora and immune status of rats, and it must be extended for the achievement of reliable effect.

[Influence of lactobacillus strains used in the production of dairy products on the agents of food poisoning].

Study of antagonistic activity of 33 strains of Lactobacillus isolated from the industrial preparation of fermented milk products, starter cultures and biologically active additives and products of natural fermentation. Antagonistic activity was studied by agar diffusion method with holes. Strains isolated from products of natural fermentation showed high degree of antagonistic action together with industrial strains.

[Study composition of lactoflora of the large intestine in patients with food allergy and irritable bowel syndrome].

Patients of different ages with various forms of food allergy and also with the irritable bowel syndrome with locks are studied. The quantitative levels of bifido- and lactoflora of large intestine, the qualitative characteristics of lactoflora population, including specific gravity of individual representatives in the sum of the isolates, are investigated, species composition is identified. Shown that food allergy, irrespective of the disease manifestation form induces the balance disturbance of bifido- and lactoflora in large intestine, significantly affects the reduction in the number of species of Lactococcus and Leuconostoc spp. and on the narrowing of the enzymatically active species of Lactobacillus spp.

[Depending on exposure, functional state of left ventricle in combined cardiovascular disease among chronic uranium intoxication patients].

State of left heart contractility in patients having IHD and AH during long-term period of chronic uranium intoxication depends on duration of exposure to toxic radiation factor. The authors revealed left ventricle myocardium weight decreased by 11.7% on exposure up to 10 years and that decreased by 18.9% on the exposure over 10 years, when compared to the reference group. Longer length of service was connected with higher share of patients with pathologic remodelling of left ventricle, mostly due to increased concentric remodelling.

[Prospects of hi-tech medicine development in occupational pathology (exemplified by joints diseases model)].

Recommendations for patients with occupational locomotory disorders include ultrasonography, diagnostic and therapeutic arthroscopy, target therapy of systemic osteoporosis with monohydrate zoledronic acid (aclasta)--that enables prolong remission (up to 46.2 months).