[Impact of nordic walking on rehabilitation of the patients after COVID-19]. / Vliyanie skandinavskoi khod'by na reabilitatsiyu patsientov, perenesshikh COVID-19.

In the modern world, one of the biggest challenges to the global health system is the pandemic caused by coronavirus infection. Coronavirus infection (HCoV) is an acute infectious disease of viral nature, which is characterized by severe intoxication and predominant damage to the upper respiratory tract. Therefore, the urgent task is to rehabilitate patients after pneumonia associated with coronavirus infection (COVID-19). The basis of rehabilitation for many diseases, including COVID-19, is therapeutic physical culture (exercise therapy). In order to achieve a more pronounced positive effect of patients recovery and on the basis of the available scientific justification of the positive effect of walking with sticks (Scandinavian walking) on the human body, it was proposed to supplement the rehabilitation of such patients with Nordic walking classes. OBJECTIVE: To study the influence of Nordic walking on some indicators of the somatic status of patients who have had a coronavirus infection. MATERIAL AND METHODS: The study involved 33 people aged 30-70 years, with different stages of the disease. To assess rehabilitation, indicators such as heart rate, oxygen saturation in the blood and peak exhalation rate were selected, and the indicators of the 6-minute walk test (6-minute test), which is the main method for determining exercise tolerance in various chronic diseases, were compared. Changes in indicators were observed in dynamics, before and after the 7-day course of physical therapy, supplemented by Nordic walking classes. RESULTS: Based on the analysis of the data obtained during the 7-day follow-up, 91% of patients showed an increase in oxygen saturation; peak exhalation rate increased by 17% on average; bronchial patency increased. Also, the subjects showed positive dynamics of the results of the 6-minute test, the body's tolerance to physical activity increased, the patients themselves noted a significant improvement in their condition. CONCLUSIONS: Thus, the results obtained can be used to develop rehabilitation programs for patients who have undergone COVID-19 and need restorative treatment.

[The information support of oncological service of the Krasnodar kray].

The clinical oncologic dispensary No 1 of the health Department of the Krasnodar kray, 350040 Krasnodar, Russia The article presents substantiation of actuality of fast receiving of reliable information about prevalence of malignant neoplasms. The characteristic of population cancer registry and results of its implementation in the Krasnodar kray are presented.

[The actual issues and means of development of oncological service of the Krasnodarskiy kraiy].

The article presents substantiation of actuality of oncological diseases. The results of the regional preventive program "Oncopatrol" are presented. The actual issues of oncological service of the Krasnodarskiy kraiy are emphasized.

MMP expression in rheumatoid inflammation: the rs11568818 polymorphism is associated with MMP-7 expression at an extra-articular site.

Matrix metalloproteinases (MMPs) contribute to the joint damage in rheumatoid arthritis (RA). Less is known of the involvement of MMPs at extra-articular sites of rheumatoid inflammation. We assessed the relative contribution from MMP-1, MMP-3, MMP-7 and MMP-12 to joint and extra-articular tissue destruction and inflammation by comparing gene expression in joint synovia and subcutaneous rheumatoid nodules from RA patients. Expression of MMP-1 and MMP-3 predominated in synovia, whereas MMP-12 expression was significantly higher in rheumatoid nodules. Markedly higher MMP-7 expression distinguished a subgroup of nodules that featured infiltrating monocyte/macrophage-producing MMP-7 protein. The high MMP-7 expression in nodules was associated with the single-nucleotide polymorphism (SNP) rs11568818 (-181A>G, MMP-7 promoter) and more active inflammation within the nodule lesions. Patients with such nodules had significantly earlier age of RA onset. Our findings indicate that the expression of MMP-1 and MMP-3 occurs relatively independent of the tissue microenvironment with substantial expression also at extra-articular sites. MMP-12 expression reflects the involvement of monocyte/macrophages in rheumatoid inflammation. Evidence for the association between the rs11568818 SNP and increased MMP-7 expression is restricted to nodules, which indicates that consequences of the MMP-7 polymorphism are likely to manifest within aspects of immune/inflammatory activity that are monocyte/macrophage-mediated.

[Physiological significance and normative parameters of rate adaptation of QT-interval during holter monitoring in healthy persons of young age].

Aim of the investigation consisted in to study parameters of " QT-dynamics " in healthy children and adolescents. We examined 26 children aged 7 - 17 years (mean 11,6 +/- 7 years) - 7 girls (9,3 +/- 2,3 years) and 19 boys (12,5 +/- 3,6 years). Holter monitoring with manual and automatic estimation of QT and QTc intervals. Dynamics of magnitude of QT interval was determined with the use of equation of linear regression Y = aX+b, where aX - coefficient of linear regression QT/RR (slope QT/RR), b - shear coefficient (intercept QT/RR). Values of QT interval at automatic analysis were 368,8 +/- 18,04 (340 - 410) ms for absolute QT and 424 +/- 14,99 (390 - 450) ms - for QTc, 289,4 +/- 14,6 (260 - 320). Mean values of " QT dynamics " were for slope QT/RR: 0,18 +/- 0,03 (0,13 - 0,24) for 24 hours, 0,16 +/- 0,03 (0,10 - 0,22) for daytime period, and 0,11 +/- 0,13 (0,05 - 0,18) for night time period; for intercept: QT/RR - 230,4 +/- 20,7 (192 - 282) for 24 hours, 299 +/- 25,5 (258 - 364) for day time period, and 242,7 +/- 21,8 (204 - 295) for night time period. Coefficient of correlation of intervals QT and RR (r QT/RR) was 0,79 +/- 0,05 (0,69 - 0,89) for 24 hours; 0,68 +/- 0,07 (0,52 - 0,82) for day time period, and 0,52 +/- 0,13 (0,19 - 0,74) for night time period. All values of " QT-dynamics " significantly differed from each other during various periods of day (p < 0,05). Negative relation was noted between 24 hour slope and intercept QT/RR (r= -0,88, p < 0,05), diurnal (r= -0,87, p < 0,05) and nocturnal slope and intercept QT/RR (r= -0,72, p < 0,05), positive relation was noted between 24 hour values of slope QT/RR and QT (r=0,49, p < 0,05), and intercept QT/RR with absolute QT (r=0,41, p < 0,05). Significantly higher values (p < 0,01) of slope QT/RR were in girls. Thus, increase of slope QT/RR is noted during augmentation of tone of sympathetic part of vegetative nervous system, lowering - when vagal influences are also enhanced. Intercept QT/RR appears to be combination parameter, increase of which reflects both lengthening of absolute mean value of QT interval and reciprocal nocturnal lowering of the slope parameter. It is necessary to assesses clinical and diagnostic significance of changes of novel parameters of " QT-dynamics " on the basis of normative sexual-aging values and physiological mechanisms, determining their variability.

[Immunoinflammatory factors in unstable angina. Possibility of influence of atorvastatin].

In 101 patients with ischemic heart disease (unstable angina class I and II-III) with hypercholesterolemia at the background of standard therapy (51 patients) and after administration of atorvastatin (50 persons) prescribed from first day of hospitalization in mean dose 10.8 +/- 0.1 mg/day immune status was studied in accordance with 3 stage scheme of examination. In dynamics (before onset of treatment and after 6 months of therapy) a concentrations of a row of cytokines was studied: alpha-factor of tumor necrosis (TNFalpha) and C-reactive protein (CRP). At correlation analysis of parameters of plasma lipid composition and immune profile it has been established that in patients with unstable angina (in the presence of hypercholesterolemia) together with elevation of CRP level substantial signs of dysbalance in immune system are observed. These signs appear as elevation of levels of TNFalpha, interleukin-4, and especially interferon gamma with simultaneous depression of cells of immune defense. In has been demonstrated that atorvastatin not only exerts good hypolipidemic effect, but is capable to diminish immunoinflammatory shifts in patients with acute coronary pathology.

Evaluation of dosing regimen of respirable rifampicin biodegradable microspheres in the treatment of tuberculosis in the guinea pig.

OBJECTIVES: The efficacy of rifampicin-loaded polymeric microspheres (RPLGA) delivered to guinea pigs infected with Mycobacterium tuberculosis (H37Rv) was compared with a daily dose of nebulized rifampicin suspension. METHODS: Aerosol-infected animals were subjected to multiple dose or single dose treatment with RPLGA, PLGA microspheres or micronized rifampicin suspension aerosols. For comparison with treatment with suspensions of microspheres, additional groups received daily doses of rifampicin-only suspensions for 20 (20-RIF) and 10 (10-RIF) days. RESULTS: Drug and polymer treated multiple dose groups exhibited significantly lower wet lung weights than untreated animals. Spleen wet weights and viable bacterial counts (VBCs) were much lower for drug microsphere treated animals than for all other groups. In multiple dose studies with rifampicin-only suspensions, wet lung weights for 10-RIF and 20-RIF treated animals were much smaller than controls. Likewise, wet spleen weights of 10-RIF and 20-RIF treated animals were much smaller than controls, consistent with reduced inflammation. Spleen VBC of 20-RIF treated animals was much smaller than controls. No statistical differences were observed in the lung VBC among single dose groups. However, a trend similar to that of the wet weights was observed. CONCLUSIONS: Aerosolized RPLGA reduced most measures of tuberculosis (TB) infection. These studies are further evidence for the potential of inhaled aerosol therapy for the treatment of TB. However, additional studies are required to elucidate underlying mechanisms of action and optimize this route of drug delivery.

[Identification of risk factors for respiratory diseases in adolescents from an industrial city].

The prevalence of respiratory disease and the spread of risk factors were studied in adolescents living in Saratov. Respiratory diseases held the lead among other classes of diseases in young people; these diseases were more prevalent in adolescents than in children and adults. Examination of their outpatient cards revealed defects in the management of pulmonological patients. Screening could identify the most important risk factors of respiratory diseases (such as poor housing and living conditions, smoking, and recurrent acute respiratory viral infections (ARVI)) and make up three groups of patients: 1) those at risk for respiratory diseases and frequently ARVI; 2) those with acute respiratory diseases; and 3) those with chronic respiratory diseases.

[Heart rate turbulence in patients with ventricular tachy arrhythmias of noncoronary genesis].

AIM: To assess parameters of heart rate turbulence in patients with ventricular extrasystoles (VES). MATERIAL AND METHODS: Patients with VES during Holter ECG monitoring (n=65, age 1-17 years, 32 girls, 33 boys) including 3 with long QT syndrome, 4 with catecholaminergic ventricular tachycardia, 1 with arrhythmogenic right ventricular dysplasia, 4 with dilated cardiomyopathy, 2 with Brugada syndrome, 3 with Duchenne myopathy, and 48 with idiopathic VES. Parameters HRT onset and slope were calculated for 1678 VES. During follow-up (6+/-4.9 years) deaths, sudden deaths, and such complications as syncope, cardiac dilatation, heart failure were registered in 26 patients. RESULTS: HRT slope exceeded 2.5 ms/RR in all patients. HRT onset was >0 in patients with catecholaminergic ventricular tachycardia, dilated cardiomyopathy, and Duchenne myopathy. The following complications occurred in 7 of 8 patients (87.5%) with HRT onset >0: syncope, sudden deaths (2 patients with dilated cardiomyopathy), dilatation of cardiac chambers, tolerance to antiarrhythmic therapy. Patients with long QT syndrome and arrhythmogenic right ventricular dysplasia (including 2 who afterwards died suddenly) had normal HRT onset. The sensitivity and specificity of HRT onset measurement for unfavorable prognosis of VES was 27 and 97%, respectively. No relationship was found between HRT slope and onset (r=-0.057). CONCLUSION: Pathological HRT (mainly represented by changes of HRT onset) are characteristic for organic myocardial diseases. Therefore detection of abnormal HRT dictates necessity of exclusion of organic cardiac pathology.

Respirable PLGA microspheres containing rifampicin for the treatment of tuberculosis: screening in an infectious disease model.

PURPOSE: Targeted delivery of rifampicin loaded microspheres to the alveolar macrophage, the host cell for Mycobacterium tuberculosis (MTB), may be an effective targeted approach to pulmonary tuberculosis therapy. A guinea pig infection model has been adopted as a post-treatment screening method for antimicrobial effect. Insufflation and nebulization methods of drug delivery were evaluated. METHODS: Rifampicin alone (RIF, 1.03-1.72 mg/kg), within poly(lactide-co-glycolide) microspheres (R-PLGA, equivalent to 1.03-1.72 mg/kg) or polymer microparticles alone (PLGA) were administered by insufflation or nebulization, 24 h before bacterial aerosol exposure. Animals were infected with an aerosol containing a small number (2 x 10(5) cfu/mL) of virulent H37Rv strain of MTB. Lung and spleen tissue samples were collected 28 days after infection for quantitative bacteriology and histopathological analysis. RESULTS: There was a dose-effect relationship between insufflated R-PLGA and burden of bacteria in the lungs. In addition, guinea pigs treated with R-PLGA had a significantly smaller number of viable bacteria (P < 0.05), reduced inflammation and lung damage than lactose or saline control, PLGA or RIF treated animals. CONCLUSIONS: These studies indicate the potential of R-PLGA, delivered by insufflation or nebulization directly to the lungs, to affect the early development of pulmonary TB.

Airways delivery of rifampicin microparticles for the treatment of tuberculosis.

A Mycobacterium tuberculosis (H37Rv)-infected guinea pig model was used to screen for targeted delivery to the lungs by insufflation (with lactose excipient) or nebulization, of either rifampicin alone, rifampicin within poly(lactide-co-glycolide) microspheres (R-PLGA) or polymer microparticles alone (PLGA). Animals treated with single and double doses of R-PLGA microspheres exhibited significantly reduced numbers of viable bacteria, inflammation and lung damage compared with lactose-, PLGA- or rifampicin-treated animals 28 days post-infection (P < 0.05). Two doses of R-PLGA resulted in reduced splenic enlargement. These studies support the potential of R-PLGA delivered to the lung to treat pulmonary tuberculosis.

The influence of suspension nebulization or instillation on particle uptake by guinea pig alveolar macrophages.

Phagocytosis represents a crucial event in the host defense against pathogens. Experimental methods are required that allow a range of particle doses to be delivered. However, it is not clear that these methods result in the same sites of deposition or mechanisms of clearance. The effect of particle administration by nebulization or instillation on the uptake by guinea pig alveolar macrophages (AMs) has been studied. Suspensions of escalating quantities of 1-microm fluorescent polystyrene latex microspheres were delivered by 15 min of nebulization (1.4 x 10(7)-11.1 x 10(7) particles) or instillation (19 x 10(7)-152 x 10(7) particles) into the lungs of guinea pigs. These doses were selected to maximize delivery using each of these methods. Macrophages were collected by alveolar lavage 6 h postadministration. The total number of cells recovered was 3 x 10(6) and the cell viability was >97%, which was measured by trypan blue exclusion. Differential cell counts of lavaged cell suspensions were conducted and results showed no difference for the two methods of administration with various concentrations of latex particles and control samples. The uptake of particles was measured using epifluorescence, confocal microscopy, and flow cytometry. AMs showed a dose-dependent increase in associated particles measured by microscopy and flow cytometry. There was a direct correlation (R(2) =.99) in the phagocytic indices (PIs) measured by flow cytometry and fluorescence microscopy. The PI was 15 times higher after instillation than that obtained after particle nebulization. The percentage of AMs involved in phagocytosis observed after instillation was 55% and after nebulization 23%. The uptake of aerosolized particles by AMs and the number of cells involved in phagocytosis were dependent on the particle dose and the efficiency of aerosol delivery to the lungs.