[What do we Mean by "Ideal" Blood Pressure Control?]

Arterial hypertension (AH) is one of the most important risk factors for development of myocardial infarction, chronic heart failure, stroke, cognitive disorders and dementia, and chronic kidney disease. Currently, special attention is paid to increased blood pressure variability (BPV) as a new risk factor for development of cardiovascular and cerebrovascular complications. The available evidence-based body of clinical studies demonstrates the importance of reducing not only the blood pressure itself but also the increased BPV to provide significant improvement of the prognosis and limits the risk of complications. This notion has been validated in consensus documents on the management of patients with AH. Among antihypertensive drugs, the fixed-dose combination (FC) amlodipine/perindopril has demonstrated a unique capability for reducing all types of BPV (visit-to-visit, day-to-day, during 24 h). According to current clinical guidelines, this combination belongs to first-line FCs indicated for most patients with AH. A distinctive feature of the FC amlodipine/perindopril is numerous data from real-life clinical practice, which support both its high antihypertensive efficacy and the ability to decrease high BPV. Therefore, the FC amlodipine/perindopril can be recommended for a broad range of AH patients to achieve BP control and to improve the prognosis.

Phenotypic and phylogenetic segregation of Alternaria infectoria from small-spored Alternaria species isolated from wheat in Germany and Russia.

AIMS: To identify the taxonomic differences between phytopathogenic small-spored Alternaria strains isolated from wheat kernels in Germany and Russia by a polyphasic approach. METHODS AND RESULTS: Ninety-five Alternaria (A.) strains were characterized by their colony colour, their three-dimensional sporulation patterns, mycotoxin production and phylogenetic relationships based on sequence variation in translation elongation factor 1-α (TEF1-α). The examination of toxin profiles and the phylogenetic features via TEF1-α resulted in two distinct clusters, in each case containing Alternaria infectoria isolates (92 and 96% respectively) in the first and the Alternaria alternata, Alternaria arborescens and Alternaria tenuissima isolates (77 and 79% respectively) in the other combined cluster. The production of Alternariol, Altertoxin and Altenuene has not been reported previously in the A. infectoria species group. The isolates from Germany and Russia differ slightly in species composition and mycotoxin production capacity. CONCLUSIONS: We identified that the A. infectoria species group can be differentiated from the A. alternata, A. arborescens and A. tenuissima species group by colour, low mycotoxin production and by the sequence variation in TEF1-α gene. SIGNIFICANCE AND IMPACT OF THE STUDY: These results allow a reliable toxic risk assessment when detecting different Alternaria fungi on cereals.

[EFFECT OF ANTI-CANCER DRUG DOXORUBICINE ON CYTOMEGALOVIRUS INFECTED HUMAN FIBROBLASTS].

The anticancer antibiotic doxorubicine (DOX) is highly toxic and induces functional complications in vital organs. The effect of DOX on normal cells has not been examined in sufficient detail, and the search for compounds reducing DOX toxicity did not lead to success so far. It has been suggested that DOX induces death of cancer cells via p53-dependent apoptosis, however, the information regarding the role of p73 protein, a member of p53 tumor suppressor family, is scanty. Cytomegalovirus (CMV) induces an antiapoptosis program that allows its replication until death of the target cell. Our objectives were to examine the effect of DOX on normal cells (human fibroblasts), analyze the ability of CMV-induced antiapoptosis program to reduce DOX toxicity, and to evaluate the involvement of p73 protein and its isoforms in the regulation of death of CMV-infected and DOX-treated cells. Within a 24-h time period DOX caused death of about 70% human embryonic lung fibroblasts (HELF) in cell culture, this parameter decreased significantly in CMV-infected DOX-treated HELF cells. TUNEL has shown that the number of cells with DNA fragmentation decreases from 5.2% under the effect of DOX to 3.2% (P < 0.05) after combined CMV-DOX treatment. Analysis of mitotic figures revealed that DOX causes accumulation of mitotic cells, which was not observed in CMV-infected DOX-treated cells. PCR analysis of mRNA of two p73 protein isoforms (TAp73 and dNp73) has shown that in uninfected cells the expression of TAp73 isoform was low, while in CMV-infected cells level of TAp73 was significant and expression of dNp73 was demonstrated for the first time. Expression of TAp73 associated with lack of mitosis block. The activation of caspases 8, 9 and 3 in CMV-infected cells was registered but cell death was not, however, as massive as that caused by DOX. From these findings it can be concluded that CMV attenuates DOX-related damage to normal cells. It can be suggested that induction of TAp73 and dNp73 isoforms provides conditions for reduction of DOX effect which leads to DNA damage and death of normal cells.

[The renal artery resistive index is an integral marker of renal dysfunction in patients with chronic heart failure].

OBJECTIVE: to study renal hemodynamic disorders in patients with Functional Classes (FC) II-IV chronic heart failure (CHF), by estimating the peripheral renal artery resistive index (RI), to reveal relationships to other hemodynamic parameters and markers of chronic kidney diseases and with the presence of infectious, inflammatory, and metabolic renal comorbidity in the patient. SUBJECTS AND METHODS: Sixty-eight patients with FC II-IV CHF were examined. Renal hemodynamics was studied using renal artery duplex scanning; cardiac morphofunctional parameters were explored by echocardiography (EchoCG). The markers of renal lesion were examined using laboratory tests and the Cockcroft-Gault and abridged Modification of Diet in Renal Disease 1 (MDRD1) formulas for estimating the glomerular filtration rate. RESULTS: The patients with FC II-IV CHF were noted to have renal blood flow disorder that was progressive with higher FC CHF. Tubulointerstitial renal comorbidity in patients with CHF has a statistically significant impact both on the degree of proteinuria, the reduction of renal filtration function, and the parameters of distal renal blood flow. RI showed a stronger correlation with the degree of renal dysfunction and the markers of endothelial dysfunction than with the parameters of central hemodynamics and EchoCG.

[Mechanism of action and clinical use of ticlopidine].

The literature review contains date on mechanisms of action, pharmacokinetics of ticlopidine, its antithrombotic efficacy in various clinical conditions (ischemic heart and brain diseases, diabetic microangiopathy, occlusive disease of arteries of lower extremities) as well as main adverse effects.

[The use of moexipril in postmenopausal women with hypertension and associated changes of bone mineral density].

Moexipril was given to 35 postmenopausal women with mild and moderate hypertension, menopausal syndrome and decreased bone mineral density. Blood pressure (BP) was measured before and in 1, 3, 6, and 12 months, while ultrasonic bone densitometry was carried out before and in 12 months of moexipril use. Significant lowering of systolic and diastolic BP, reduction of severity of climacteric syndrome occurred after 1, 3 and 6 months of moexipril use, respectively. After 12 months parameters of bone densitometry in moexipril treated women became better than in control group (p<0.01). Treatment was also associated with significant improvement of quality of life, diminished reactive anxiety and depression.

[Antihypertensive efficacy and tolerability of nebivolol]. / Antigipertenzivnaia éffektivnost' i perenosimost' nebivolola.

Nebivolol was given to 59 patients with hypertension for 8 weeks. This was accompanied by augmentation of amplitude of photoplethysmogram in all and normalization of blood pressure in 67% of patients. Nebivolol did not cause orthostatic hypotension or bronchial spasm.

[Experience in treating patients with chronic obstructive bronchitis with fenspirid]. / Opyt lecheniia fenspiridom bol'nykh khronicheskim obstruktivnym bronkhitom.

AIM: To study a clinical effect of fenspirid and its impact on external respiration function in patients with chronic obstructive bronchitis (COB) in the exacerbation phase. MATERIAL AND METHODS: 30 COB patients participated in the trial (20 males, 10 females, age 39-80 years). The severity of clinical symptoms (cough, sputum, dyspnea) was studied using special scales. External respiration function was examined by a spirometric system "Tamrac system spiro sense Y2 14". Fenspirid treatment was conducted in a dose 80 mg twice a day for 3 months. Control examinations were made 2 weeks, 1 and 3 months after the treatment start. RESULTS: A 3-month treatment with fenspirid resulted in regression of COB symptoms: cough and sputum ceased, dyspnea decreased. This led to improvement in external respiration function, especially in patients with mixed ventilatory disorders with prevailing restriction. CONCLUSION: Fenspirid is an effective and well tolerated treatment of chronic obstructive bronchitis.

[Effect of the treatment with femoston on the cardiovascular system in postmenopausal women]. / Vliianie lecheniia femostonom na serdechno-sosudistuiu sistemu u zhenshchin v postmenopauze.

AIM: To assess femoston effects on the cardiovascular system in postmenopause. MATERIAL AND METHODS: Cardiovascular effects of femoston were studied in 20 postmenopausal women with menopausal syndrome. 70% patients had arterial hypertension. Cardiovascular system was examined before the treatment and after three treatment months using 24-h monitoring of arterial pressure, echocardiography, photoplethysmography, conjunctival biomicroscopy, central hemodynamics tests. RESULTS: In the course of femoston treatment menopausal manifestations relieved, arterial pressure was lowering. 3-month treatment has improved parameters of central and peripheral hemodynamics: total peripheral vascular resistance significantly fell, stroke and minute blood volumes, cardiac indexrose, tissue blood flow and microcirculation improved. CONCLUSION: Femoston produces positive changes in cardiovascular system, vascular tone, microcirculation and arterial pressure.

[The efficacy of ticlid in treating intermittent claudication in atherosclerotic stenosis of the arteries of the lower extremities]. / Effektivnost' tiklida pri lechenii peremezhaiushcheisia khromoty u bol'nykh s ateroskleroticheskim stenozirovaniem arterii nizhnikh konechnostei.

Serious affections of hemostasis were found in hemostatic examinations involving 67 intermittent claudication patients resistant to longterm vasodilative drugs. A 4-6-month course of tiklid (500 mg daily) induced a significant fall in platelet aggregation and an increase in the blood fibrinolytic activity, decreased foot chilliness, pain while walking. 73% of the patients could cover longer distances without pain complaints.

[Streptodecase-2 in the treatment of acute myocardial infarct, unstable stenocardia, thromboembolism and thrombosis]. / Streptodekaza-2 pri lechenii ostrogo infarkta miokarda, nestabil'noi stenokardii, tromboémbolii i trombozov.

Eleven patients underwent thrombolytic therapy with streptodekase-1 and 19 with streptodekase-2. Of these, 11 patients suffered acute myocardial infarction, 10 had unstable angina pectoris, 6 thromboembolism of the pulmonary artery, 2 thromboembolism of the peripheral arteries and 1 thrombosis of the femoral vein. Administration of streptodekase-2 brought about an increase of the total blood fibrinolytic activity (the fibrinolysis time dropped from 248.8 +/- 82.1 to 137.5 +/- 42.5 min after 12 h), plasmin activation (from 0.00 +/- 0.00 to 23.5 +/- 7.5 mg after 24 h), reduction of the plasminogen content (from 94.0 +/- 2.5 to 46.8 +/- 5.3% after 12 h). The parameters of the coagulation hemostasis did not undergo any appreciable changes. Fibrinolysis activation following streptodekase-2 administration was unchanged within the first 48 hours. No material differences were identified in fibrinolysis activation in patients given streptodekase-2 and streptodekase-1. Administration of streptodekase-2 was found to exert a marked beneficial clinical effect on acute myocardial infarction, unstable angina pectoris, thromboembolism of the pulmonary and peripheral arteries.