[Cardiorenal syndromes: historical aspects and current challenges].

The article describes major milestones in acknowledgment of pathophysiological relationship between heart and kidneys since Ancient Egypt till our time and history of term "cardiorenal syndrome" (CRS). First references about kidney and heart functions could be dated to 13 BC when Hippocrates mentioned them. In the XIV century Gentile da Foligno proposed a hypothesis about functional interconnection between heart and kidneys. In the XVIII century Richard Bright described the link between myocardial hypertrophy and kidneys diseases. Frederic Justin Collet was the first one who used the term "cardiorenal" in his article in 1903. In Russia, I.I. Stolnikov conducted his experiments about myocardial hypertrophy and kidneys ischemia in 1880. Famous Russian internist, E.M. Tareev, devoted several paragraphs to cardiorenal interactions in his fundamental manuals "Anemia in Bright's disease" (1929) and "Hypertension" (1948). The research on this topic was continued by Tareev's followers: N.A. Mukhin, V.S. Moiseev, more recent successors - Zh.D. Kobalava, S.V. Moiseev, V.V. Fomin, S.V. Villevalde and others. Their contribution resulted in development of first Russian clinical guidelines on cardio and nephroprotection in CRS in 2014. In 2008 consensus of Acute Disease Quality Initiative summarized current experience on CRS. Today, research on controversial classification questions, biomarkers and other aspects of CRS continues.

[Rheumatoid factor: study history and concept evolution].

Rheumatoid factor became the first laboratory marker of rheumatoid arthritis and one of the first serological markers used to recognize the major autoimmune diseases. Details of the discovery with special regard to contribution of E. Waaler and H. Rose are presented in this historical review. Same assays used to exam the rheumatoid factor, its frequency and modern view on diagnostic significance in different diseases are described in this article.

[Kidney damage caused by lead exposure: historical aspects].

The article presents an historical analysis of publications devoted lead intoxication to kidney damage developing during contact with lead. It is shown that one of the manifestations of occupational intoxication with this metal can be toxic nephropathy.

[Role of the intestinal MALT in pathogenesis of the IgA-nephropathy].

Modern view on pathogenesis of immunoglobulin (Ig)A-nephropathy and possible relation to intestinal MALT-system activity is presented in the article. Aberrant glycosylation of IgA and increased association of IgA-nephropathy with intestinal diseases or abnormal intestinal permeability are discussed in details. Based on supposed entero-renal pathogenesis of the disease future treatment modalities are considered. Relevant worlds literature is cited.

[The state of cytokine regulation and endothelial dysfunction in the combined course of vibration disease and arterial hypertension].

BACKGROUND: The article presents data on the state of cytokine regulation, indicators of endothelial damage when exposed to industrial vibration (general, local) and in combination with arterial hypertension. AIM: To improve the quality of early diagnosis and prevention of vibration disease in an isolated course and its combination with arterial hypertension based on a study of the cytokine profile, biomarkers of endothelial dysfunction in this pathology. MATERIALS AND METHODS: A comprehensive survey of 84 patients with isolated vibration disease from the effects of local, general, first, second degree and 61 patients with a combined course of vibration disease from the effects of local, general second degree vibration and arterial hypertension, 30 people in the control group without contact with industrial vibration and found healthy by medical examination. The levels of pro-inflammatory (IL-1, IL-8, TNF-) and anti-inflammatory cytokines (IL-4), biomarkers of endothelial damage (EDN-1, TGF-1, VEGF-A, PDGF-BB, fibronectin, Willebrand factor) were determined using the enzyme immunoassay method. RESULTS: The response of the immune system to the effects of industrial vibration is characterized by a cytokine imbalance an increase in the level of pro-inflammatory cytokines (IL-1, IL-8, TNF-) and a decrease in the level of anti-inflammatory cytokine (IL-4). With a combined course of vibratory disease and arterial hypertension, the cytokine imbalance is characterized by an even more significant increase in serum IL-1, IL-8, TNF- and a decrease in serum IL-4 concentration. Endothelial dysfunction with WB from the action of both local and general vibration in combination with hypertension is characterized by a significant increase in serum EDN-1, TGF-1, VEGF-A, PDGF-BB, fibronectin, Willebrand factor. CONCLUSION: The study of the cytokine profile, biomarkers of damage to the vascular endothelium in this pathology will allow for the early diagnosis of vascular disorders and to optimize preventive measures for workers in vibration-hazardous industries.

[Osteoarthrosis in the clinic of internal and occupational diseases: differential diagnostic aspects].

Osteoarthritis is a common pathology, which indicates the great medical and social significance of this disease. The article discusses the issues of pathogenesis, risk factors and diagnosis of professional and professionally caused osteoarthritis: the age of onset of the disease, the specifics of work, the localization of joint damage. Differential diagnosis issues are discussed.

[Chronic kidney disease in the context of toxic effects the working chemical factors (literature review)].

The article analyzes the publications devoted to the problem of professional renal lesions caused by chemical factors. Classification, prevalence, peculiarities of the clinical picture, diagnosis of professional renal lesions caused by chemical factors of the production environment are reviewed. The frequency of professional renal lesions remains underestimated due to low manifestation of symptoms and the influence of environmental factors, which require further investigation of this issue.

Pneumoconiosises: modern view.

The article is devoted to the actual problem - dust diseases of the lungs. The peculiarities of occurrence and course of pulmonary lesions that have a significant place in the overall structure of occupational morbidity are considered. Modern approaches to treatment, diagnostics and prevention issues in pneumoconiosis are discussed.

From Schönlein-Henoch purpura to IgA-vasculitis: pathogenetic aspects of the disease.

Investigation's history and nomenclature's evolution of the IgA-vasculitis are presented in the article. Pathogenesis of the renal and skin damages is discussed in details, particularly abnormalities of the IgA-immunity and systemic endotoxemia. Relevant world's literature is cited.

Arterial hypertension at the workplace: risk factors and the population value.

The article presents data of domestic and foreign authors on the relationship between occupational factors and arterial hypertension. The role  of latent arterial hypertension, its frequency in the population, the lesion of the target organs and the prognosis in comparison with normotensive individuals, arterial hypertension of the "white coat" and stable arterial hypertension have been analyzed. Arterial hypertension in the workplace is a form of latent arterial hypertension. The authors review the influence of harmful production factors (physical, chemical), as well as psychosocial stress on the risk of developing arterial hypertension.The risk of developing hypertension in specified groups of workers has been analyzed separately. The place of production-related diseases in modern occupational pathology in the Russian Federation. A wider implementation of measures aimed at early diagnosis and prevention of arterial hypertension in workers is proposed.

Clinical features of cardiac lesion in patients with generalized sarcoidosis.

The article presents a clinical observation of two patients with generalized sarcoidosis. The woman typical granulomatous changes in the lungs and lymph nodes combined with atrial fibrillation, kidney failure and hereditary thrombophilia, men with atherosclerotic coronary arteries, re-myocardial infarction, cholestasis, tubulointerstitial nephritis. The accession of systemic manifestations was accompanied by increase of level of angiotensin-converting enzyme in the blood serum, morphological examination of lung tissue in both cases there were high histological activity of vasculitis and granulomatous inflammation. Extrapulmonary symptoms regressed when conducting immunosuppressive therapy. Discusses modern aspects of diagnosis of sarcoidosis in clinical practice.

Bilateral thalamic stroke in patient with patent foramen ovale and hereditary thrombophilia.

Patent foramen ovale and hereditary thrombophilia are both known risk factors for ischemic stroke. Artery of Percheron is a rare anatomical variant in which vast areas of the midbrain and thalamus have a single source of blood supply. This case report presents a 45-years old female patient with bilateral thalamic stroke due to Percheron artery occlusion, with a combination of hereditary thrombophilia and patent foramen ovale as the risk factors. Modern approaches to the diagnosis and secondary prevention of this pathology are also discussed herein.

[Difficulties in the differential diagnosis of kidney injury in a patient with infective endocarditis associated with antineutrophil cytoplasmic antibodies]. / Trudnosti differentsial'noi diagnostiki porazheniia pochek u bol'nogo infektsionnym éndokarditom, assotsiirovannym s antineitrofil'nymi tsitoplazmaticheskimi antitelami.

Infective endocarditis (IE) may be accompanied by the production of a broad spectrum of autoantibodies, including antineutrophil cytoplasmic antibodies (ANCA). ANCA detection creates difficulties in the differential diagnosis of IE, especially in relation to kidney injury, the determination of the mechanism of which is important for choosing a treatment policy and estimating a prognosis. The paper describes a clinical case of a 57-year-old man who was found to have higher proteinase-3 (PR-3) ANCA titers along with the symptoms of anemia, purpura, and kidney injury during his hospitalization; echocardiography revealed vegetation on the aortic valve. IE was diagnosed; 2-week antibiotic therapy was ineffective; there was progressive aortic insufficiency necessitating aortic valve replacement. In the postoperative period, there was progression of renal failure and higher PR-3 ANCA titers, which made it possible to regard kidney injury as a manifestation of ANCA-associated glomerulonephritis. Intensive immunosuppressive therapy with intravenous and oral prednisolone was initiated, which showed positive effects in reducing proteinuria, erythrocyturia, serum creatinine levels, and simultaneously PR-3 ANCA titers. The paper gives the data available in the literature on the frequency of an association of IE with ANCA, the clinical features, diagnostic criteria, and treatment approaches. It discusses the mechanisms of ANCA formation in patients with IE.

[Giant cell arteritis: Genetic and epigenetic aspects]. / Gigantokletochnyi arteriit: geneticheskie i épigeneticheskie aspekty.

The paper describes clinical cases in 2 patients (brothers) with giant cell arteritis. It analyzes the genetic and epigenetic aspects of the disease. The data available in the Russian and foreign literature are given.

[Occupational factors and a risk of cardiovascular diseases]. / Professional'nye faktory i risk razvitiia serdechno-sosudistykh zabolevanii.

The paper gives Russian and foreign authors' data on a relationship between occupational factors and cardiovascular diseases. It considers the impact of psychosocial stress on the risk of hypertension, coronary heart disease, and cardiovascular events in representatives of different professional groups.

[Myocardial injury associated with chronic hepatitis C: Clinical types and pathogenetic components]. / Porazhenie miokarda, assotsiirovannoe s khronicheskim gepatitom S: klinicheskie varianty i patogeneticheskie zven'ia.

Heart injury is one of the extrahepatic manifestations of chronic hepatitis C (CHC). The paper gives Russian and foreign authors' data on a relationship between CHC and myocardial injury. It discusses different pathogenetic components (the direct effect of the virus, immunological components), through which hepatitis C virus can induce myocarditis and cardiomyopathies in patients with CHC.

[THE INFLUENCE OF CHRONIC HEPATITIS C ON ATHEROSCLEROSIS PROGRESSION].

We analysed the data of domestic andforeign authors on the relationship between hepatitis C and atherosclerosis. The possible role of the former condition as a risk factor of atherosclerosis even in very young patients is due to the properties of hepatitis C virus, mediators of inflammation, and metabolic disorders.

[Severe adverse events from treatment with genetically engineered biological agents in patients with rheumatic diseases].

AIM: To assess the risk of severe adverse events (AEs) within 6 months after treatment with biological agents in patients with rheumatic diseases (RD). SUBJECTS AND METHODS: The 6-month open-label trial included 107 patients with rheumatoid arthritis, antineutrophil cytoplasmic antibody-associated vasculitides, systemic lupus erythematosus, and other RDs who received genetically engineered biological agents (GEBAs), primarily rituximab (n = 66) and infliximab (n = 31). RESULTS: The majority of patients were noted to have improvements, including complete and partial remission in 62 (57.9%) and 42 (39.3%), respectively. There were mild or moderate AEs in 22 (20.6%) of the 107 patients, severe AEs in 6 (5.6%): grade IV neutropenia in 2 patients (after the use of rituximab), severe infusion reactions in 2 (after the administration of infliximab and rituximab), and systemic infections in 2 (fatal nocardial sepsis after rituximab treatment and unspecified sepsis after infliximab treatment). CONCLUSION: The rate of serious AEs, mainly infusion AEs and infections during treatment with infliximab, rituximab, and other GEBAs proved to be relatively low in patients with different RDs. At the same time, the use of biological agents could lower RD activity in the presence of severe visceral injuries refractory to conventional immunosuppressive therapy.

[Signs of hypercoagulation and activation of fibrinolysis in patients with Wegeners's granulomatosis and Schoenlein-Genoch's purpura].

The patients with Wegener's granulomatosis and Schoenlein-Genoch's purpura included in this study were examined in the E.A.M. Tareev Clinic during 2006-2008. They showed signs of hypercoagulation and activation of fibrinolysis, viz. enhanced SFMC, D-dimer and antiphospholipid antibody levels, platelet aggregation. Hypercoagulation correlated with the activity of both Wegeners's granulematosis and Schoenlein-Genoch's purpura.