Systemic Inflammatory Reaction Research Articles

Insights into the Scenario of SARS-CoV-2 Infection in Male Reproductive Toxicity.

COVID-19 has become a significant public health concern that has catastrophic consequences for society. Some preliminary evidence suggests that the male reproductive system may be an infection target for SARS-CoV-2. SARS-CoV-2 may be transmitted sexually, according to preliminary research. Testicular cells exhibit a high level of the angiotensin-converting enzyme 2 (ACE2) receptor, which enhances the entry of the SARS-CoV-2 into host cells. Some instances of COVID-19 have been documented to exhibit hypogonadism during the acute stage. Furthermore, systemic inflammatory reactions triggered by SARS-CoV-2 infection may cause oxidative stress (OS), which has been shown to have profoundly deleterious consequences on testicular functioning. This work gives a clear picture of how COVID-19 may affect male reproductive systems and calls attention to the many unanswered questions about the mechanisms by which this virus can be linked to men's health and fertility.

Acute Microbleeds and Microinfarcts Within the Perihematomal Area After Intracerebral Hemorrhage.

To further our understanding of the pathophysiology of spontaneous intracerebral hemorrhage (ICH) and related injury, we provided a postmortem neuropathological examination of acute microvascular lesions (microbleeds and microinfarcts) within the perihematomal area. We included all consecutive cases (2005-2019) from the Lille University Hospital brain bank of ICH patients who died within the first month. Paraffin-embedded tissue sections from the perihematomal area were processed for several stainings and immunolabelings to investigate the presence of acute microbleeds and microinfarcts in the perihematomal area and to characterize surrounding neuronal and systemic inflammatory reaction (macrophages and neutrophils). We included 14 ICH cases (median age, 78 years; 10 females). Acute microbleeds were observed in the perihematomal area in 12/14 patients (86%, ranging from 1 through >10) and microinfarcts in 5/14 (36%, ranging from 1 through 4). Microbleeds were observed whatever the delay from ICH onset to death was, while most cases with acute microinfarcts were observed between day 3 and day 7 (n=3/5). Both lesions were characterized by an abundant accumulation of systemic inflammatory cells and necrotic areas. Acute microbleeds and microinfarcts might contribute to the propagation of secondary brain tissue damages after ICH. Our examinations also question the potential role of massive systemic inflammatory cells recruitment in the genesis of these microvascular injuries.

Blood Count-Derived Inflammatory Markers and Acute Complications of Ischemic Heart Disease in Elderly Women.

Coronary artery disease (CAD) in women occurs later than in men. Underlying atherosclerosis, a chronic process of lipoprotein deposition in arterial walls with a prominent inflammatory component, is influenced by several risk factors. In women, commonly used inflammatory markers are generally found to be related to the occurrence of acute coronary syndrome (ACS), as well as the development of other diseases that influence CAD. New inflammatory markers derived from total blood count-systemic inflammatory response index (SII), systemic inflammatory reaction index (SIRI), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and neutrophil-lymphocyte ratio (NLR)-were analyzed in the group of 244 elderly, postmenopausal women with the diagnosis of ACS or stable CAD. SII, SIRI, MLR, and NLR were significantly higher in women with ACS compared to those with stable CAD (p < 0.05 for all)-the highest values were observed in women with NSTEMI. MLR from new inflammatory markers, HDL, and history of MI turned out to be significant factors associated with ACS. These results suggest that MLR as representative of blood count-derived inflammatory markers may be considered as additional CVD risk factors in women with suspected ACS.

Nephrological complications in patients after COVID-19 infection

In this review, we looked for correlations and health consequences between COVID-19 infection and kidney health. Although the main symptoms of COVID-19 are respiratory failure and hypoxemia, kidney involvement is also common. In an attempt to decipher how COVID-19 infection affects the kidneys, this review focuses on the pathophysiological and clinical links between COVID-19 infection and the kidneys. The aim of this work was to find long-term health consequences in patients who were discharged from the hospital and to investigate risk factors. COVID-19-related kidney disease is reported not only in infected patients with chronic kidney disease, but also in people with no previous history of kidney disease. The disease caused by the coronavirus (COVID-19) is a threat to public health. Chronic kidney disease (CKD) has been shown to be a risk factor for side effects. Although initial reports from China showed a low incidence (5%-10%) of acute kidney injury (AKI), subsequent articles documented a much higher incidence of AKI in hospitalized COVID-19 patients. Overall, renal biopsies showed a variety of histopathology, including acute glomerulonephritis and acute tubular injury. The pathophysiology of COVID-19-associated AKI is believed to include local and systemic inflammatory and immunological reactions, endothelial damage, and activation of coagulation pathways and the renin-angiotensin system. Histopathology results revealed both similarities and differences between AKI in COVID-19 patients and AKI patients in non-COVID-19 sepsis. Acute tubular injury is common, although it is often mild despite greatly reduced kidney function. Systemic haemodynamic instability most likely contributes to renal tubular damage. Despite the description of COVID-19 as a cytokine storm syndrome, circulating cytokine levels are often lower in patients with COVID-19 than in patients with acute respiratory distress syndrome from causes other than COVID-19. Also, an impaired response to type I interferon has been detected in patients with severe COVID-19. In the light of these observations, the potential pathophysiological mechanisms of COVID-19-associated AKI may provide knowledge to construct therapeutic strategies.

Structural placental changes in women with intra-pregnancy novel coronavirus infection COVID-19 (review)

Introduction. During the COVID-19 pandemic, the question regarding an effect of related infection on the body of pregnant women and the fetoplacental complex has emerged, with many aspects of this issue still being unknown. At the moment, it has been proven that in some cases the course of COVID-19 can be accompanied by severe systemic inflammatory reaction leading to hypercoagulable state.Aim: to search for evidence of a direct and/or indirect effect of SARS-CoV-2 infection on human placenta structure.Materials and Methods. Taking into account the goal, this review was compiled according to the type of a narrative review of publications on a topic of interest. A search for English-language publications dated of 01.12.2019 till 01.12.2021 in PubMed/MEDLINE, Cochrane, Web of Science databases was made. The search queries included the following keywords: combinations of «coronavirus» and «infection during pregnancy», «placental structure» and «2019-nCoV», «COVID-19 and pregnancy», «SARSCoV-2 and pregnancy». In the process of writing the article, in order to improve the reader's understanding of the essence of debated issue, there was a need to discuss some of the results with literary sources published earlier 2019 that were not directly related to the topic of the new coronavirus infection (there are 6 such sources). We analyzed full-text publications, both reports on original research and meta-analyses on relevant topics. In total, 351 full-text publications met the query criteria, of which 54 were selected as meeting the objectives of the study. The select reports were discussed by the co-authors, duplicates were excluded and 34 of them were included in this review. In those that were excluded from the review, information about the clinical course of pregnancy and its outcome during novel coronavirus infection prevailed, or isolated cases of studying insignificant placental structural changes were discussed. Studies with a small number of observations were selected only in the case of the uniqueness of the published data, the absence of scientific papers where similar studies would have been conducted in larger sample.Results. Pregnancy complicated by COVID-19 may be accompanied by placental structural changes, which represent both a manifestation of compensatory-adaptive reactions and a consequence of the damaging effect to the placenta due to infectious process. In case of late (in the III trimester) disease in pregnant woman with mild COVID-19, placental disorders are predominantly of compensatory-adaptive nature, specific cytological signs of viral cell damage are uncharacteristic. During COVID-19 infection, chronic histiocytic intervillositis and syncytiotrophoblast necrosis occur more often than in average population, and adverse fetal outcomes are characterized by additional marked increase in intervillous fibrinoid deposition. Before COVID-19 pandemic, chronic histiocytic intervillositis was described in about 6 out of 10,000 placentas (0.6 %) in II and III trimesters.Conclusion. The high frequency of chronic histiocytic intervillositis, both in the placenta of paired women with live-born infants infected prenatally due to maternal virus transmission, and in the placentas of stillborn infected infants, allows us to cautiously assume that such placental structural changes are more characteristic for damage by SARS-CoV-2 rather than other infectious agents. It is necessary to study a relationship between placental structural changes occurred at different gestation ages, as well as clinical course and outcome of pregnancy during COVID-19.

Analysis of congenital pneumonia incidence in newborns from high-risk mothers

Objective. To detect the incidence of congenital pneumonia in newborns from mothers with placental insufficiency in combination with premature amniotic fluid discharge&#x0D; Materials and methods. A retrospective analysis of 57 stories of newborn infants and their mothers was carried out. The newborns were divided into 3 groups: group 1 37 newborns from mothers with placental insufficiency and premature amniotic fluid discharge, group 2 9 infants from mothers with premature amniotic fluid discharge, group 3 11 infants born from mothers with placental insufficiency. The obstetric and gynecological history, the presence of extragenital pathology, the peculiarities of the course of pregnancy and childbirth, and the outcomes for newborns were analyzed.&#x0D; Results. Congenital pneumonia was more common in newborns from mothers with placental insufficiency and premature amniotic fluid discharge. In newborn infants of the first group, severe asphyxia occurred more often, being a risk factor. At the same time, the identification of markers of the systemic inflammatory reaction did not always reflect the presence of infectious-inflammatory pathology in newborns. In addition, in the presence of inflammation of the fetal part of placenta, in a large number of newborns pathological microflora is detected during microbiological examination.&#x0D; Conclusions. As a result of the study, the role of maternal pathology on the development of intrauterine infection and implementation of infection in the early neonatal period was revealed. The obtained data justify the need for pregravid preparation and prevention of perinatal complications in women with placental insufficiency.

Increased Plasma Concentrations of Extracellular Vesicles Are Associated with Pro-Inflammatory and Pro-Thrombotic Characteristics of Left and Right Ventricle Mechanical Support Devices.

Mechanical circulatory support (MCS) allows for functional left and right heart ventricle replacement. MCS induces a systemic inflammatory reaction and prothrombotic state leading to an increased risk of thrombus formation. The extracellular vesicles (EVs) are nanoparticles released from active/injured cells characterized by prothrombotic properties. Simple inflammatory parameters from whole blood count analysis have established a clinical role in everyday practice to describe immune-inflammatory activation. We hypothesized that increased plasma concentrations of EVs might be associated with the proinflammatory and pro-thrombotic characteristics of left ventricle assist device (LVAD) and right ventricle assist device (RVAD) devices. We presented a pilot study showing the concentration of peripheral blood serum, right and left ventricle mechanical assist device extracellular concentration in relation to thrombotic complication in patients treated with a biventricular pulsatile assist device (BIVAD). The observation was based on 12 replacements of pulsatile pumps during 175 days of observation. The proinflammatory characteristics of LVAD were noted. The proinflammatory and procoagulant activation by RVAD was observed. The results may provide possible explanations for the worse results of right-sided mechanical supports observed in clinical practice.

ПАТОГЕНЕТИЧНІ АСПЕКТИ ПОСТ КОВІДНИХ УСКЛАДНЕНЬ У СИСТЕМІ ЗГОРТАННЯ КРОВІ

Disorders in the blood coagulation system play an important role in the pathogenesis and clinical manifestations of COVID-19 both during the acute phase of the disease and in the post-infectious period. The coronavirus disease is associated with a high risk of thrombotic and thromboembolic complications due to a prolonged state of hypercoagulation, which can occur even after recovery. Despite the extremely large amount of scientific data, the pathophysiological aspects of SARS-CoV-2 infection remain uncertain. The presented review summarizes the results of modern scientific research on pathological changes in the hemostasis system that can occur against the background of the transferred coronavirus disease, and considers the main mechanisms of the development of COVID-19-associated coagulopathies. From scientometric databases PubMed, Scopus, Web of science, ScienceDirect, Google Scholar, etc. the latest publications devoted to this issue were selected and analyzed. Hemostasis is a dynamic, tightly regulated process which is provided by three closely interrelated links: coagulation, anticoagulation, and fibrinolytic. Activation of the coagulation cascade and the platelet link of hemostasis, which causes a prothrombotic state in convalescent patients with COVID-19, is primarily associated with dysregulation of the renin-angiotensin system, a long-term local and systemic inflammatory reaction, an increase in the immune response due to the release of pro-inflammatory mediators that interact with platelets, stimulate the expression of tissue factor, suppress the fibrinolytic system and lead to dysfunction of the endothelial cells of blood vessels, triggering thrombogenesis. Understanding the pathogenetic mechanisms of post-COVID-19 complications and monitoring the main markers of hemostasis (level of D-dimer, fibrinogen, prothrombin time, platelet count, etc.) are important for the timely detection of disorders in the blood coagulation system, and make it possible, depending on the clinical situation, to take timely measures for their correction at various stages of pathology development.

How Extracellular Nano-Vesicles Can Play a Role in Sepsis? An Evidence-Based Review of the Literature.

Sepsis is a systemic inflammatory reaction caused by infection. Severe sepsis can lead to multiple organ dysfunction, with a high incidence rate and mortality. The molecular pathogenesis of sepsis is complex and diverse. In recent years, with further study of the role of extracellular vesicles (EVs) in inflammatory diseases, it has been found that EVs play a dual role in the imbalance of inflammatory response in sepsis. Due to the great advantages such as lower toxicity, lower immunogenicity compared with stem cells and better circulation stability, EVs are increasingly used for the diagnosis and treatment of sepsis. The roles of EVs in the pathogenesis, diagnosis and treatment of sepsis were summarized to guide further clinical studies.

Research progress on the effect of intestinal flora changes on liver and kidney function in AIDS patients

HIV, also known as HIV, infects the body's immune cells, causing immune deficiencies. The intestine is not only the immune organ of the human body, but also includes a large number of intestinal flora, and the intestinal microecology composed of these flora is closely related to immunity. HIV infection itself and its infection caused by intestinal flora imbalance, intestinal mucosal barrier destruction, causing the body's systemic inflammatory cascade reaction, the production of various inflammatory cytokines and metabolites, and eventually cause certain damage to liver and kidney function. This article reviews the mechanism and relationship between the effects of intestinal microbiota changes on liver and kidney function in AIDS patients, and changes the regulation of intestinal microbiota disorders on the microinflammatory state of the body, thereby providing a new entry point for the improvement of liver and kidney function in AIDS patients.

Математическая модель прогнозирования риска аспиринорезистентности и сердечно-сосудистых осложнений у пациентов с ИБС после коронарного шунтирования

Математическая модель прогнозирования риска аспиринорезистентности и сердечно-сосудистых осложнений у пациентов с ИБС после коронарного шунтирования

Ernährung und Nahrungsergänzungsmittel

Nutritional problems occur very frequently in patients with cancer and different problems are associated with separate phases of the disease. Therefore, it is principally recommended to regularly screen all patients with cancer for nutritional disorders and in the case of conspicuous results meticulous diagnostics should be carried to clarify the underlying causes. The focus is on food intake and possible disturbing complaints, the physical performance index, nutritional status including weight change and body composition, the metabolic pattern and the presence of a systemic inflammatory reaction. As anti-cancer treatments frequently induce gastrointestinal derangements which endanger adequate food intake, individualized nutritional care should be offered routinely. After successful curative treatment patients are at risk of developing a metabolic syndrome; therefore, abalanced diet and regular physically activity are recommended. During palliative treatment special attention should be paid to the development of malnutrition. Patients are particularly endangered by cachexia with the combination of inadequate food intake, inactivity and prevailing catabolism. The treatment of cachexia requires amultiprofessional approach to ensure adequate food intake, guiding and supporting physical activity and interventions for normalization of the metabolic situation. In addition, the need for psychological and social support should be discussed. Dietary supplements are of minor relevance; however, deficits in micronutrients, such as vitamins and trace elements need to be balanced. At the end of life, care should primarily be focused on alleviating debilitating symptoms. To reliably support all patients affected by nutritional disorders, clear structures need to be established, responsibilities assigned and standardized procedures codified.

MARKERS OF INFLAMMATION IN RATS UNDER TOXIC INJURY AGAINST DIETARY PROTEIN DEFICIENCY

The paper presents studies of biomarkers of the development of inflammatory reactions in the blood serum of rats under the conditions of toxic damage with acetaminophen against the background of dietary protein deficiency. The animals consumed a semi-synthetic diet during the experiment according to the recommendations of the American Institute of Nutrition. In order to simulate alimentary protein deprivation, rats received a low-protein diet containing 1/3 of the standard daily protein requirement daily for 28 days. The animals were modeled acute toxic damage with acetaminophen after four weeks of experimental diet. The administration of the toxin was carried out at doses of 1250 mg/kg animal body weight in suspension in 2 % starch gel solution once a day for 2 days by gavage. Determination of the level of C-reactive protein, procalcitonin, tumor necrosis factor-alpha, interleukin-6 in the blood serum of rats was carried out by the method of immunoenzymatic analysis. We have established that toxic damage by the drug xenobiotic - acetaminophen against the background of dietary protein deficiency is accompanied by a maximum increase in the level of C-reactive protein (15.5 times) and procalcitonin (10 times) in the blood serum of rats compared to the control value, which can be considered as prognostic biomarkers of the systemic inflammatory reaction under these experimental conditions. At the same time, under these experimental conditions, hyperproduction of tumor necrosis factor-alpha and interleukin-6 was registered in the blood serum of experimental groups of rats with maximum values when toxic doses of acetaminophen were administered to protein-deficient animals, which is consistent with changes in the level of C-reactive protein and procalcitonin. The fact we found makes it possible to assume that dietary protein deprivation increases the production of TNF-α and IL-6 as pro-inflammatory mediators in toxic liver damage, thus inducing primary damage to liver parenchymal cells..

KORELASI NILAI LAJU ENDAP DARAH (LED) DENGAN HIGH SENSITIVITY C-REACTIVE PROTEIN (hs-CRP) PADA PEROKOK AKTIF DI WARUNG KOPI WILAYAH SURABAYA TIMUR

Background Smoking has become one of the leading causes of death worldwide. The negative impact of smoking usually occurs after a few years when a person starts actively smoking can harm the body's organs and become a major risk factor for diseases with inflammatory components. Systemic inflammatory reactions are characterized by an increase in inflammatory cytokines, blood cell counts and blood viscosity. Examination CRP and ESR are the two most frequently measured laboratory tests in assessing the response of a systemic inflammatory process. This study aims to determine and analyze the correlation between ESR values ​​and hs-CRP in active smokers at coffee shops, East Surabaya.&#x0D; Methods: The type of research used is correlation research with cross sectional. The sample used is 30 active smokers who meet the inclusion criteria. This research was carried out on February 21 – April 11, 2022. The examination of ESR values ​​and hs-CRP levels was carried out at Balai Besar Laboratorium Kesehatan (BBLK) Surabaya.&#x0D; Results: It was found that 30 respondents had been actively smoking &gt;5 years with a percentage of 100%. as many as 8 respondents consumed 1-10 cigarettes/day with a percentage of 27%, 19 respondents consumed 10-20 cigarettes per/with a percentage of 63%, and 3 respondents consumed &gt;20 cigarettes/day with a percentage of 10%. The average value of ESR is 8.37 mm/Hr and The The average value of the of hs-CRP 1.11 mg/L.&#x0D; Conclusion: Based on statistical tests, There is no correlation between the value of ESR and hs-CRP in active smokers in a coffee shop in the East Surabaya area (p value = 0.099) with a sufficient relationship and a positive direction of relationship (r = 0.307).

Transcatheter Closure of Atrial Septal Defect with Carag Bioresorbable Septal Occluder™: First-in-Child Experience with 12-MonthFollow-Up.

Nowadays, transcatheter device closure of an atrial septal defect (ASD) is a standard approach in children. Potential early and long-term side effects or complications related to the metal framework of the devices are a known issue. A bioresorbable device such as the Carag Bioresorbable Septal Occluder™ (CBSO) could resolve such complications. Material and Results. The Carag Bioresorbable Septal Occluder™ (CBSO; Carag AG, Baar, Switzerland) is a self-centering double disk, repositionable, and retractable device with a bioresorbable framework (polylactic-co-glycolic acid), which is almost completely resorbed by 18-24 months postimplantation. This manuscript reports the four first-in-child ASD device closures using a CBSO. The patients' age was median (IQ1-IQ3), 4.5 years (4-7.25). Weight was 21.3 kg (17.6-32.7). We demonstrated procedural feasibility and safety. Effective defect closure with the device was 100%. Echocardiographic measurements of the thickness of the interatrial septum did not show any relevant increase over a 12-monthfollow-up period. There were no residual defects found after the procedure or later during the resorption process. The patients showed no evidence of any local or systemic inflammatory reaction. The CBSO device system could offer a new treatment option for transcatheter ASD device closure in the pediatric and adult fields. In our first-in-child experience, it was effectively and safely implanted. During the first 12 months of follow-up, no complications occurred.

Features of hematological and immune disorders in the combined treatment of breast cancer patients with the risk of development of late radiation damage

Background. Breast cancer (BC) is one of the most common forms of malignant neoplasms among the female population of Ukraine. The widespread use of radiation therapy in the treatment of BC, along with the improvement of treatment efficiency, inevitably leads to an increase in the probability of early and/or late radiation injuries (LRI), which puts before scientists the task of a detailed study of this problem and the search for ways to prevent the development of LRI.The body’s reaction to the development of a malignant neoplasm and to antitumor treatment is largely determined by the state of homeostatic mechanisms, in the regulation of which one of the key roles is played by the immune system. Recently, special attention has been focused on the role of immune inflammatory responses in the pathogenesis of LRI in cancer patients. All of the above determines the urgency of finding a differential approach to immunocorrective therapy as a prevention of the development of LRI. Рurpose – to determine the characteristics of changes in hematological indicators and the subpopulation composition of lymphocytes during immunocorrective therapy as a prevention of the development of LRI in patients with BC. Materials and Methods. 55 patients with BC were examined. The patients were divided into groups: the comparison group (n=13) – patients with BC with the risk of developing LRI who were given standard therapy, the main group (n=15) – patients with BC with the risk of developing LRI who were given immunocorrective therapy against the background of standard treatment. The control group (n=27) consisted of patients with BC without the risk of developing LRI. The groups were comparable in terms of age and disease stage. Results. Immunocorrective therapy increased the number of erythrocytes, hemoglobin level, CD19+-, CD3+CD8+-lymphocytes, NK-cells, CRP, IL-6, IL-2 and TNF-α in patients of the main group. In patients of the comparison group, after treatment, lower levels of erythrocytes, hemoglobin, lymphocytes, the relative number of CD8+-T-lymphocytes, CD19+-B-lymphocytes and higher levels of the relative number of eosinophils, monocytes, neutrophils, cytokine levels, and CRP were found in comparison with the indicators of patients, who underwent immunocorrective treatment. In patients with BC of the main group, immunocorrection reduces systemic changes that can contribute to the development of late radiation damage and recurrence of the oncological process. The inclusion of immunocorrective therapy with the use of melatonin had a positive effect on the hematological and immune indicators of patients. Conclusions. Immunocorrective therapy in patients at risk of developing LRI optimized immune and hematological parameters: it contributed to an increase in the number of erythrocytes by 1.25 times, hemoglobin level by 1.6 times, CD19+- (1.5 times), CD3+CD8+-lymphocytes (1.1 times), and a decrease in NK cells (1.77 times), CRP by 2.19 times, IL-6 by 1.8 times, IL-2 by 2.13 times, and TNF-α by 3 times, 22 times. It was found that in patients with BC with the possibility of developing LRIwithout immunotherapy, lower levels of erythrocytes (by 1.15 times), hemoglobin (by 1.13 times), lymphocytes (by 1.3 times), and the relative number of CD8+ were observed after treatment - T lymphocytes (1.4 times), CD19+ B lymphocytes (6.5 times) and higher levels of relative numbers of eosinophils, monocytes, neutrophils, cytokine levels (1.5 times) and CRP (2.1 times) in comparison with the indicators of patients who underwent immunocorrective treatment. The appointment of immunocorrective therapy with melatonin in a daily dose of 9 mg during radiation treatment for patients with BC with the risk of developing LRI led to the normalization of hematoimmune indicators, a significant decrease in the systemic inflammatory reaction.

Immuno-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection

Aim. To give immune-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection (CMVI).Ma­terials and methods. The concentration of IL-ie, IL-2 and progesterone was studied in the blood serum, and the pulsation index (PI) in the right uterine artery (RUA) was determined in 80 patients at 21-24 weeks of gestation, uncomplicated and complicated by exacerbation of chronic simple bronchitis due to reactivation of CMVI. In a retrospective analysis, 3 groups were formed. The first group - 30 women with CMV-seronegative physiological pregnancy; the second - 25 patients with chronic bronchitis in the acute stage, initiated by the acute phase of CMVI, leading to chronic compensated placental in­sufficiency (CCPI); the third - 25 women with exacerbation of chronic bronchitis CMVI etiology, causing the development of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.Results. In the first group, the concentration of IL-ie was 22.8±0.02 pg/mL, IL-2 - 30.6±2.34 pg/mL, progesterone - 130.8±8.19 nmol/L, and the value of PI in RUA - 0.83±0.04 rel. units. In patients of the second group, compared with the first, the level of IL-ie in­creased by 3.82 times (p&lt;0.00i), IL-2 - by 2.55 times (p&lt;0.00i) and PI in the RUA - by i.40 times (p&lt;0.00i) against the background of a decrease in the progesterone concentration by i.47 times (p&lt;0.00i). The third group compared with the first was characterized by an increase in the concentration of IL-ie by 6.87 times (p&lt;0.001), IL-2 - by 3.19 times (p&lt;0.001) and PI in RUA by i.66 times (p&lt;0.00i) with lower levels of progesterone (i.93 times, p&lt;0.00i). In the third group, in contrast to the second one, an increase in IL-ie was observed by 1.79 times (p&lt;0.001), IL-2 - by 1.24 times (p&lt;0.05) and PI in RUA - by i.i7 times (p&lt;0.05), as well as a decrease in progesterone levels by i.3i times (p&lt;0.0i). There was an in­crease in the relationship of PI in RUA with the concentration of IL-ie (r=0.69; p&lt;0.001), IL-2 (r=0.75; p&lt;0.001) and progesterone (r=-0.55; p&lt;0.01).Conclusion. A more pronounced systemic inflammatory reaction, leading to inhibition of progesterone synthesis and increased resistance to blood flow at RUA develops in exacerbation of chronic bronchitis in the second trimester of gestation against the background of reactivation of CMVI, which initiates the development of CCPI, in comparison with the exacerbation of bronchopulmonary pathology of a similar etiology, which determines the formation of subsequent CCPI.

Pre-operative systemic inflammatory response index influences long-term survival rate in off-pump surgical revascularization.

Coronary artery bypass revascularization is still the optimal treatment for complex coronary artery disease with good long-term results. The relation between inflammatory activation in the post-operative period and the long-term prognosis was already postulated. The possible predictive role of preoperative inflammatory indexes after the off-pump coronary artery bypass grafting technique on long term survival was the aim of the study. Study population included 171 patients with a median age of 64 years (59-64) operated on using off-pump technique between January and December 2014. Patients enrolled in the current study were followed-up for 8 years. We conducted a multivariable analysis of pre-operative and post-operative inflammatory markers based on analysis of the whole blood count. The overall survival rate was 80% for the total follow-up period, while 34 deaths were reported (30-days mortality rate of 1%). In the multivariable analysis, a pre-operative value of systemic inflammatory response index (SIRI) >1.27 (HR = 6.16, 95% CI 2.17-17.48, p = 0.012) revealed a prognostic value for long-term mortality assessment after off-pump surgery. Preoperative inflammatory activation evaluated by systemic inflammatory reaction index (SIRI) possess a prognostic value for patients with complex coronary artery disease. The SIRI value above 1.27 indicates a worse late prognosis after off-pump coronary artery bypass (AUC = 0.682, p<0.001).

Adult-onset Still's disease : Diagnosis and treatment according to the new S2e guidelines of the German Society of Rheumatology (DGRh)

Adult-onset Still's disease (AOSD) is arare autoinflammatory disease characterized by intermittent fever and acombination of symptoms, such as an evanescent rash synchronous with fever, arthralgia/arthritis, lymphadenopathy and hepatosplenomegaly. The diagnosis is based on acharacteristic constellation of symptoms and the exclusion of infections, hemato-oncological diseases, infectious diseases and alternative rheumatological causes. The systemic inflammatory reaction is reflected by high levels of ferritin and C‑reactive protein (CRP). The pharmacological treatment concept includes glucocorticoids often in combination with methotrexate (MTX) and ciclosporine (CSA) for reduction of steroids. The interleukin 1 (IL-1) receptor antagonist anakinra, the IL-1beta antibody canakinumab or an IL‑6 receptor blockage with tocilizumab (off label for AOSD) are used where there is no response to MTX or CSA. Anakinra or canakinumab can be used as aprimary option in AOSD in cases of moderate and severe disease activity.

Analysis of the effectiveness of smoking cessation in patients with pulmonary tuberculosis in a hospital setting

According to the WHO, tobacco use is currently the leading cause (16%) of all adult deaths. Studies conducted in many countries and in the Russian Federation have revealed the association between smoking and pulmonary tuberculosis (PT). Due to the negative impact of tobacco smoking on the course of tuberculosis and the effectiveness of treatment, there is a need to develop approaches to smoking cessation in patients with PT. Aim. To evaluate the effectiveness of the treatment of PT in smoking patients in combination with nicotine replacement therapy in an inpatient setting. Methods. The study included 27 patients with a confirmed diagnosis of PT. The inclusion criteria for the study were: age 18 years and older, patients who are currently active smokers, and a confirmed diagnosis of PT. The exclusion criteria were the presence of asthma and oncological diseases, unconfirmed diagnosis of PT, and earlier history of tobacco use. In the study group, an analysis of the smoking status was carried out. This status was based on the length of smoking period, number of cigarettes per day, and calculation of the smoking patient index. The degree of nicotine addiction, the presence of withdrawal symptoms, and the motivation of patients to quit smoking were assessed. The principle of nicotine dependence treatment was to prescribe nicotine-containing drugs in a dose depending on the degree of nicotine addiction. The duration of treatment was 12 weeks. Results. After 4 months of PT treatment, the cessation of bacterial excretion was detected 2 times more often, the closure of decay cavities in the lung tissue - 2.5 times more often, the relief of systemic inflammatory reactions - 2 times more often in patients who quit smoking than in patients who continue to smoke. Conclusion. This study showed that the treatment of PT in smokers was more effective in combination with nicotine replacement therapy for smoking cessation than when the patients continued to smoke.