Readiness of clinical laboratory diagnostics and cardiologists to implement the recommendations of the fourth universal definition of myocardial infarction.

This study describes the problems of the implementation of the fourth universal definition of myocardial infarction in the medical institutions of four cities: Volgograd (with Volzhsky), Yekaterinburg, Perm, Ufa, and districts of the Volgograd region. The multicenter study was conducted in the form of a questionnaire of specialists in cardiology and laboratory services. After a survey of cardiac specialists, it was found that a third of them did not see the benefits of the hs-cTn test recommended for the diagnosis of myocardial infarction, and almost half of the specialists surveyed believed that myoglobin was a necessary test for detecting myocardial infarction. Probably, this is due to the fact that 16 clinical diagnostic laboratories from the 5 above regions still perform the determination of myoglobin in patients with suspected myocardial infarction. The material and technical support of medical and diagnostic institutions generally meets the requirements of the fourth universal definition of myocardial infarction. However, there is a problem of «qualitative¼ equipment of the regions of the Volgograd region, since only 3 out of 31 districts declared the possibility of carrying out a quantitative determination of hs-cTn , and qualitative analysis was carried out on platforms that are not monitored by the IFCC. It is worrying that almost half of the specialists of the clinical and diagnostic laboratories of the central district hospitals of the Volgograd region did not indicate the manufacturer of reagents for determining troponins. Thus, in the educational programs of advanced training of specialists in cardiology and laboratory services, it is necessary to include aspects related to the explanation of analytical characteristics, the characteristics of the technology for performing troponin tests and the related interpretation options for the results.

[The effect of sulodexide on placental mitochondria function in rats with experimental preeclampsia]. / Vliianie sulodeksida na funktsional'noe sostoianie mitokhondrii platsenty samok krys s éksperimental'noi preéklampsiei.

Substitution of drinking water for 1.8% NaCl in pregnant rats caused a pronounced increase in arterial pressure by 24,3% and urinary protein by 117% to day 21 of pregnancy. State 4 respiration of isolated placental mitochondria in the group of negative control was 3- and 1.5-fold higher with malate/glutamate and succinate as substrates than in placental mitochondria isolated from uncomplicated pregnant animals. This led to a decrease of the respiratory control ratio. These results suggest that development of experimental preeclampsia is accompanied by mitochondrial dysfunction through uncoupling of oxidative phosphorylation. Daily administration of sulodexide to females with experimental preeclampsia (EP) per os at a dose of 30 LE during the whole period of gestation decreased manifestations of the disease as evidenced by a slight increase in blood pressure (by 8,6%) and less pronounces increase in urinary protein (by 58,9%). Sulodexide decreased development of mitochondrial dysfunction in EP rats as shown a decrease of non-stimulated ADP respiration with malate/glutamate and succinate (4.5- and 2.5-fold, respectively) as compared with the negative control group and the corresponding increase in the respiratory control ratio (2.5- and 1.5-fold, respectively). Thus, sulodexide reduces uncoupling of oxidative phosphorylation and enhances the functional activity of mitochondria in EP animals, possibly due to its antioxidant and endotelioprotective effects.

Comparative controlled study of Andrographis paniculata fixed combination, Kan Jang and an Echinacea preparation as adjuvant, in the treatment of uncomplicated respiratory disease in children.

A three-arm study comparing the efficacy of Kan Jang, a fixed herbal combination containing standardized Andrographis paniculata (N.) SHA-10 extract, with Immunal, a preparation containing Echinacea purpurea (L.) extract, in uncomplicated common colds was carried out in 130 children aged between 4 and 11 years over a period of 10 days. The study was designed as an adjuvant treatment of Kan Jang and Immunal with a standard treatment. The patients were assigned to one of the three groups. In control group C; 39 patients received only standard treatment. Kan Jang and Immunal were used as an adjuvant to this therapy in the other two groups. Adjuvant group A; 53 patients treated with Kan Jang tablets concomitant to standard treatment, and adjuvant control group B; 41 patients treated with concomitant Immunal. It was found that the adjuvant treatment with Kan Jang, was significantly more effective than Immunal, when started at an early stage of uncomplicated common colds. The symptoms of the disease were less severe in the Kan Jang group. The effect of Kan Jang was particularly pronounced in two objective parameters, amount of nasal secretion g/day and nasal congestion. Kan Jang also accelerated the recovery time, whereas Immunal did not show the same efficacy. The use of standard medication was significantly less in the Kan Jang adjuvant group than in either the Immunal or standard treatment group. Kan Jang treatment was well tolerated and no side effects or adverse reactions were reported.

Double-blind, placebo-controlled pilot and phase III study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infection.

Two randomized double-blind, placebo-controlled parallel group clinical trials were performed to investigate the effect of a standardized extract (SHA-10) of Andrographis paniculata fixed combination (Kan jang) in the treatment of uncomplicated upper-respiratory tract infections. 46 patients in the pilot study and 179 patients in the phase III study completed the study according to the protocol. Medication was taken three times daily for a minimum of 3 days and a maximum of 8 days for the pilot study, and for exactly three days in the phase III study. The primary outcome measures in the patients self-evaluation were: related to pain in the muscle, cough, throat symptoms, headache, nasal symptoms and eye symptoms and temperature. The physician's fixed score diagnosis was based mainly on sign/symptoms: ears, nose, oral cavity, lymph glands-tonsils and eyes. The total symptom score showed a tendency toward improvement in the pilot study (p = 0,08), while both the total symptom score and total diagnosis score showed highly significant improvement (p < or = 0.0006 resp. 0.003) in the verum group as compared with the placebo. In both studies throat symptoms/signs, were found to show the most significant improvement.