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BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by a high level of morbidity and mortality and is associated with significant social and economic damage to the health system and society. COPD and COVID-19 have many potentially negative relationships that can lead to worse outcomes of COVID-19, including impaired lung function, old age and the presence of concomitant diseases Aim. To assess efficacy and safety of the drug Tixagevimab + Cilgavimab for the pre-contact prevention of COVID-19 infection in patients with COPD. MATERIAL AND METHODS: A total of 324 male patients were included in the study, who were treated or monitored at the Regional Clinic Hospital â3 and the Regional Pulmonological Center of Chelyabinsk in April-May 2022. The main endpoints of observation, for 3 and 6 months, to assess the effectiveness were the dynamics of shortness of breath according to The Modified Medical Research Council Dyspnea Scale - mMRC, the The forced expiratory volume in 1 second, the number of exacerbations, emergency calls, hospitalizations, polymerase chain reaction for SARS-CoV-2. Local and general reactions after immunization were evaluated. The drug Evusheld (150 mg Tixsagevimab +150 mg Cilgavimab, AstraZeneca) was used for immunization. RESULTS AND CONCLUSION: The effectiveness of pre-contact prevention of COVID-19 was 88.8%. The administration of the drug does not provoke an exacerbation of the underlying disease. The main clinical and functional indicators have positive dynamics by the 6th month of follow-up. The drug is well tolerated and has no significant both early and late complications.
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COVID-19 , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Masculino , COVID-19/prevención & control , SARS-CoV-2 , Enfermedad Pulmonar Obstructiva Crónica/terapia , Inmunización , Anticuerpos Monoclonales/uso terapéuticoRESUMEN
The article presents data on the analysis of the clinical efficacy of vaccination against pneumococcal infection in patients with chronic obstructive pulmonary disease (COPD) in combination with type 2 diabetes mellitus during a 5 years follow-up period. MATERIALS AND METHODS: The study included patients (n=103) with COPD in combination with type 2 diabetes. Primary endpoints were changes dyspnea mMRC score, FEV1, number of exacerbations of COPD, hospitalizations, and a rate of pneumonia. The prognostic indices BODE, DOSE, ADO were also calculated. 13-valent conjugate pneumococcal vaccine PCV-13 and 23-valent polysaccharide vaccine PPV-23 were used for vaccination. RESULTS: It has been established that when vaccination is included in the management plan for patients with COPD in combination with diabetes, the severity of dyspnea decreases, the lung function stabilize both for short-term and 5-years follow-up. Vaccination with PCV-13 and PPV-23 reduce number of exacerbations, a rate of pneumonia and hospitalizations, but long-term efficacy has been demonstrated only for PCV-13. Vaccination with PCV-13 can improve the quality of life and prognosis for patients with COPD in combination with type 2 diabetes. CONCLUSION: Vaccination of pneumococcal infection in patients with COPD and type 2 diabetes mellitus can reduce the number of exacerbations, incidence of pneumonia and the number of hospitalizations, improve the prognosis and survival of patients using PCV-13 by maintaining efficacy for 5 years of follow-up.
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Diabetes Mellitus Tipo 2 , Infecciones Neumocócicas , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Diabetes Mellitus Tipo 2/complicaciones , Calidad de Vida , Vacunas Neumococicas , Infecciones Neumocócicas/epidemiología , Infecciones Neumocócicas/prevención & control , Vacunación , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Resultado del Tratamiento , DisneaRESUMEN
BACKGROUND: Community-acquired pneumonia (СÐÐ ) and chronic obstructive pulmonary disease (COPD) are among the main causes of mortality worldwide, and, in addition, they also lead to great economic losses for the health system of all countries. Currently, there is an increase in cases of recurrent pneumonia, both in the general population and, in particular, in patients with COPD. One of the most important risk factors for the development of pneumonia is the previous episode of СÐÐ . Potential risk factors for recurrent pneumonia are concomitant diseases such as heart failure, COPD, diabetes mellitus, neurological disorders, swallowing dysfunction, immune deficiency. AIM: To conduct a retrospective analysis of the effect of vaccine prophylaxis with conjugated pneumococcal vaccine (PCV13) and polysaccharide pneumococcal vaccine (PPV23) on the risk of recurrent pneumonia in patients with COPD. MATERIALS AND METHODS: A total of 302 male patients were included in the retrospective study. When analyzing the data, the fact of the development of pneumonia of any etiology during the 5th observation period was taken into account. For the recurrence of pneumonia, more than two episodes of CAP were taken during the year. 13-valent conjugated pneumococcal vaccine Prevenar-13 and 23-valent polysaccharide vaccine Pneumo23 were used for vaccine prophylaxis. The relative risk of the event was calculated. A 95% confidence interval was used. RESULTS AND CONCLUSION: A retrospective analysis showed that, firstly, CAP is a fairly frequent complication of COPD: initially, the average percentage of cases of СÐÐ was 19.3%. Secondly, the risk of developing repeated episodes of pneumonia remains quite high in unvaccinated patients and tends to increase within 5 years: from 17 to 22%. Thirdly, the pneumococcal vaccines used have different effects on the risk of recurrent pneumonia in patients with COPD, a significant decrease in the number of recurrent pneumonia is observed only with the use of conjugated vaccines.
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Infecciones Neumocócicas , Neumonía , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Masculino , Infecciones Neumocócicas/prevención & control , Estudios Retrospectivos , Neumonía/epidemiología , Neumonía/etiología , Neumonía/prevención & control , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Vacunas Neumococicas/uso terapéutico , Vacunación/métodos , Vacunas ConjugadasRESUMEN
The article provides data on modern approaches to the treatment of patients with severe uncontrolled bronchial asthma with an emphasis on the use of dupilumab, a human recombinant monoclonal antibody to the alpha subunit of the interleukin (IL)-4 receptor, which inhibits signal transmission from both IL-4 and IL-13. The results of dupilumab pivotal randomized clinical trials DRI12544, QUEST and VENTURE are summarized. Indications for use of this medicinal product are listed in Federal Clinical Guidelines on the management of asthma (year of revision 2019). Clinical cases with various clinical course of bronchial asthma are described, including cases with frequent exacerbations. In conclusion, dupilumab could be a treatment of choice for the patients with severe bronchial asthma and it is reasonable from an economic, clinical and pathogenetic point of view.
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Anticuerpos Monoclonales Humanizados , Asma , Anticuerpos Monoclonales/farmacología , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Asma/tratamiento farmacológico , Humanos , Inyecciones SubcutáneasRESUMEN
Most subjects with the COVID-19 experience mild to moderate symptoms, but approximately 10% of cases suffer from severe course of disease. IL-6 inhibitors are actively used to neutralize and prevent the cytokine storm. Olokizumab is a humanized monoclonal antibody belonging to the G4/Kappa immunoglobulin isotype that selectively binds to human IL-6 and effectively neutralizes it. AIM: To evaluate the efficacy and safety of Artlegia (olokizumab) for the treatment of subjects with a disease caused by the SARS-COV-2 virus in a real-world clinical setting. MATERIALS AND METHODS: The analysis included data of 610 subjects aged 55.0812.68 years who received olokizumab at a single dose of 160 mg/mL 0.4 mL subcutaneously as a preemptive anti-inflammatory therapy. The comparison group included 511 subjects aged 55.2311.23 years who received standard therapy without IL-6 inhibitors. Control Endpoints: 1. Positive clinical changes on Day 7. 2. Changes in the CRP levels on Days 1, 2, and 7. 3. Duration of oxygen therapy. 4. Number of days in hospital. 5. Number of adverse events. 6. Disease outcome. RESULTS: If a cytokine storm occurs, immune regulatory events will trigger the development of either a protective immune response or an exacerbated inflammatory response. The use of preemptive anti-inflammatory therapy has both a short-term and, most importantly, a long-term effect on the T and B parts of the immune process. These aspects definitely require further research and observation. CONCLUSION: The use of olokizumab to treat the new COVID-19 coronavirus disease has demonstrated a positive effect on clinical and laboratory parameters. Primarily, it affects the severity of clinical parameters by improving the general condition already on the first day of observation, and decreasing body temperature to normal values. The changes in the C-reactive protein levels show a significant effect of the IL-6 inhibitor on the systemic inflammatory response.
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COVID-19 , Anticuerpos Monoclonales Humanizados , Humanos , Persona de Mediana Edad , SARS-CoV-2 , Resultado del TratamientoRESUMEN
AIM: The article presents data on the evaluation of the clinical efficacy of using a conjugated pneumococcal vaccine in patients with COPD in combination with 2-type diabetes during a 3-year follow - up period. MATERIALS AND METHODS: The study included 309 patients with an isolated course of COPD and in combination with diabetes. The main parameters for evaluating the effectiveness were: the dynamics of clinical symptoms - shortness of breath on the mMRC scale, CAT test, FEV1, the number of exacerbations, hospitalizations, the number of pneumonia, the state of carbohydrate metabolism (HbA1c) and the lipid profile. For vaccine prevention 13-valent conjugated pneumococcal vaccine Prevenar-13 was used. RESULTS AND CONCLUSIONS: The use of PСV13 helps to reduce the severity of respiratory symptoms, reduce the number and duration of exacerbations of COPD, reduce the number of pneumonia. Both in isolated course of COPD and in combination with diabetes. Vaccination PCV13 in patients with comorbid course contributes to the compensation of carbohydrate metabolism and improve the lipid profile.
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Diabetes Mellitus , Infecciones Neumocócicas , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Vacunas Neumococicas , Vacunación , Vacunas ConjugadasRESUMEN
One of the extremely important problems of managing patients with chronic obstructive pulmonary disease (COPD) is to prevent exacerbations. The article presents data on the clinical and economic efficiency of joint vaccine prevention of conjugate pneumococcal vaccine Prevenar 13 (PCV13) and SOVIGRIPP flu vaccine in patients with COPD. MATERIAL AND METHODS: 153 patients were included in the study. They were divided into three groups. The first group (n=53) - consisted of patients who were vaccinated with PCV13. The second group (n=51) included patients who were vaccinated with PCV13 and influenza vaccine simultaneously or with an interval of not more than 2 weeks. The third group (n=49) included not vaccinated patients. The observation period is 1 year. RESULTS AND DISCUSSION: Combined vaccine prevention of pneumococcal conjugate and influenza vaccines reduces the degree of clinical impairment and stabilizes the main functional parameters of the respiratory system at a significantly lower level compared to monovaccination with only pneumococcal vaccine. Single - stage vaccination with PCV13 and influenza vaccine reduces the risk of adverse events in COPD, reduces the number of exacerbations associated with this hospitalization of patients and the incidence of pneumonia. CONCLUSION: Combined vaccination with the use of two vaccines minimizes the costs of the health care system. The budget savings can reach an average of 80-83% per year or up to 26 967 - 28 001 rubles per patient with COPD.
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Vacunas contra la Influenza , Infecciones Neumocócicas , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas , Streptococcus pneumoniae , VacunaciónRESUMEN
AIM: The analysis of the dynamics of compliance in patients with chronic obstructive pulmonary disease (COPD) on a background of vaccination. MATERIALS AND METHODS: A total of 394 male patients are covered by this study. The main endpoints of observation are as follows: 1. To evaluate the effectiveness It's important the dynamics of scores for mMRC, FEV1, the number of exacerbations, hospitalizations, the number of pneumonia cases. 2. To assess compliance it's necessary to conduct a test for adherence to the Moriska-Green questionnaire. For vaccine prophylaxis, 13-valent conjugated pneumococcal vaccine Prevenar-13 and a 23-valent polysaccharide vaccine Pnevmo23 were used. The dynamics of changes in the parameters studied was evaluated within 4 years of the therapy initiation. RESULTS: The inclusion of vaccine prophylaxis of PCV13 in the patient management plan allows to reduce a degree of dyspnea and stabilize the main functional parameters of the respiratory system not only in the short term, but also for at least next 4 years. PCV13 vaccination of can be considered as a basic therapy along with bronchodilator therapy. The use of vaccine prophylaxis PCV13 significantly increases the compliance and adherence of patients to a therapy. CONCLUSION: The use of vaccine prophylaxis PKV13 significantly increases patients ' compliance and adherence to the therapy.
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Cooperación del Paciente , Infecciones Neumocócicas , Vacunas Neumococicas , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Masculino , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/uso terapéutico , Enfermedad Pulmonar Obstructiva Crónica/terapia , Vacunación , Vacunas ConjugadasRESUMEN
AIM: The article uses the analysis of clinical and pharmacoeconomic effectiveness of 13-valent conjugated pneumococcal vaccine in patients with combined course of chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and chronic heart failure (CHF). MATERIALS AND METHODS: 429 male patients with diagnoses of COPD, IHD, CHF were included in the study. The main endpoints of observation, for 5 years, for evaluation of effectiveness were dynamic assessment for class CHF, the number of exacerbations, hospitalizations, the number of pneumonias. The 13-valent conjugated pneumococcal vaccine (PCV13) Prevenar-13 was used for vaccine prophylaxis. RESULTS: The increase in age with the combined course of COPD and cardiovascular pathology leads to a deterioration in the basic clinical and functional indicators. With the increase in the clinical symptoms of the defeat of the respiratory system. There is an increase in the functional class of heart failure. Inclusion of vaccine prophylaxis PCV13 in the management plan of patients with combined pathology. Reduce the degree of dyspnea and stabilize the main functional indicators. CONCLUSION: Vaccination of patients with COPD using PCV13 combined with CHF and IHD made it possible to manage the health system expenses by 74-84%.
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Insuficiencia Cardíaca/inmunología , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/administración & dosificación , Enfermedad Pulmonar Obstructiva Crónica/inmunología , Enfermedad Crónica , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/diagnóstico , Pruebas de Función Cardíaca , Humanos , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Pruebas de Función Respiratoria , Resultado del Tratamiento , VacunaciónRESUMEN
Superconducting quantum systems (artificial atoms) have been recently successfully used to demonstrate on-chip effects of quantum optics with single atoms in the microwave range. In particular, a well-known effect of four wave mixing could reveal a series of features beyond classical physics, when a non-linear medium is scaled down to a single quantum scatterer. Here we demonstrate the phenomenon of quantum wave mixing (QWM) on a single superconducting artificial atom. In the QWM, the spectrum of elastically scattered radiation is a direct map of the interacting superposed and coherent photonic states. Moreover, the artificial atom visualises photon-state statistics, distinguishing coherent, one- and two-photon superposed states with the finite (quantised) number of peaks in the quantum regime. Our results may give a new insight into nonlinear quantum effects in microwave optics with artificial atoms.
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The paper considers current approaches to mucoregulatory therapy for various inflammatory diseases of the respiratory system. It gives the advantages and disadvantages of common drugs used in their treatment. Emphasis is laid on the use of inhaled hypertonic saline of NaCl in combination with hyaluronic acid (Hyaneb). Clinical examples of its use in chronic obstructive pulmonary disease, acute and chronic bronchitis, and severe asthma are considered.
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Ácido Hialurónico/farmacología , Inflamación , Enfermedades Pulmonares Obstructivas , Terapia Respiratoria/métodos , Solución Salina Hipertónica/farmacología , Adyuvantes Inmunológicos/farmacología , Humanos , Inflamación/inmunología , Inflamación/fisiopatología , Enfermedades Pulmonares Obstructivas/inmunología , Enfermedades Pulmonares Obstructivas/fisiopatología , Enfermedades Pulmonares Obstructivas/terapia , Depuración Mucociliar/efectos de los fármacos , Depuración Mucociliar/inmunología , Resultado del TratamientoRESUMEN
AIM: To investigate the effect of 13-valent pneumococcal conjugate vaccine (PCV-13) on the clinical and functional manifestations of systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) and coronary heart disease (CHD). SUBJECTS AND METHODS: The protocol included 36 patients with COPD and 36 patients with COPD concurrent with CHD. The number of COPD exacerbations, hospital admissions, pneumonia cases, degree of dyspnea, and functional indicators were analyzed. The levels of markers for inflammation, such as C-reactive protein (CRP), fibrinogen, and procalcitonin (PCT), were investigated. RESULTS: A year after vaccination, the COPD group showed decreases in the level of CRP, fibrinogen, and PCT by 11, 6, and 2%, respectively; the COPD + CHD group did by 12, 24, and 19%. PCT levels demonstrated the closest correlation with clinical and functional parameters; the other indicators showed moderate (CRP) and low (fibrinogen) correlations. CONCLUSION: PCV-13 vaccination can reduce systemic inflammation just a year later.
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Proteína C-Reactiva/análisis , Calcitonina/análisis , Enfermedad Coronaria , Fibrinógeno/análisis , Inflamación , Vacunas Neumococicas/administración & dosificación , Enfermedad Pulmonar Obstructiva Crónica , Anciano , Biomarcadores/análisis , Capacidad Cardiovascular , Enfermedad Coronaria/metabolismo , Enfermedad Coronaria/fisiopatología , Enfermedad Coronaria/terapia , Femenino , Pruebas de Función Cardíaca/métodos , Humanos , Factores Inmunológicos/administración & dosificación , Inflamación/metabolismo , Inflamación/fisiopatología , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/metabolismo , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/terapia , Pruebas de Función Respiratoria/métodos , Estadística como AsuntoRESUMEN
In this joint experimental and ab initio study, we investigated the influence of chemical composition and martensitic phase transition on the electronic, magnetic, optical and magneto-optical properties of ferromagnetic shape-memory Ni-Mn-Sn alloys. Optical properties and polar magneto-optical Kerr effect (MOKE) spectra for Ni-Mn-Sn alloy film of composition Ni54.3Mn31.9Sn13.8 deposited epitaxially on MgO(0 0 1) substrate were measured over the photon energy range [Formula: see text] eV, and the complete set of optical conductivity tensor elements were determined. To explain the microscopic origin of the optical and magneto-optical spectra, extensive first-principles calculations were made, using the spin-polarized fully relativistic linear-muffin-tin-orbital method. The electronic, magnetic and magneto-optical properties of Ni-Mn-Sn Heusler alloys were investigated for the cubic austenitic and 4O orthorhombic martensitic phases, in stoichiometric and off-stoichiometric compositions. The MOKE properties of Ni-Mn-Sn systems are very sensitive to deviation from stoichiometry. It was shown that the ab initio calculations reproduce experimental spectra well, and help to explain the microscopic origin of Ni-Mn-Sn optical and magneto-optical responses. The interband transitions responsible for the prominent structures in the Ni-Mn-Sn MOKE spectra have been identified-they come from relatively narrow energy intervals at several well-defined vicinities of high-symmetry directions of the Brillouin zone. Significant modification of the MOKE spectra can be considered as a fingerprint of martensitic phase transition in Ni-Mn-Sn alloys.
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The most well-studied, but not single factor of COLD development is smoking. Occupational hazards as organic and inorganic dust are underevaluated risk factor of COLD. Smoking increased unfavorable effects of occupational hazards. Interesting for the study are the patients with combination of pneumoconiosis and COLD, severe concomitant diseases and decompensated complications--chronic cardiac failure and chronic lung failure. These patients have lower life quality, more frequent infectious exacerbations of COLD and pneumonias--that remains a significant medical and social problem. At present, pneumonia occupies 4-5th place in lethal outcomes structure. Pneumo 23--polysaccharide 23-valent vaccine--covers main serotypes of pneumococcus causing diseases of severe clinical course. In the study, the patients were injected with Pneumo 23 along with basic COLD therapy, were observed over 5 years and demonstrated reliable decrease of acute respiratory infections, COLD exacerbations and pneumonias. Those exacerbations and pneumonias had less severe course. Number of the exacerbations requiring hospitalization also decreased.
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Vacunas Neumococicas/farmacología , Neumoconiosis/terapia , Enfermedad Pulmonar Obstructiva Crónica/terapia , Infecciones del Sistema Respiratorio/prevención & control , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vacunas Neumococicas/administración & dosificación , Neumoconiosis/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Resultado del TratamientoRESUMEN
The low energy electronic structure of Gd has been investigated experimentally by infrared reflectance spectroscopy, and theoretically from first principles, using the fully relativistic Dirac linear-muffin-tin-orbital (LMTO) method in the local spin density approximation (LSDA) as well as within the LSDA + U approach. The reflectance of a Gd single crystal was measured with the electric field in the plane perpendicular to the c-axis for temperatures between 50 K and slightly above the Curie temperature (293 K) in the frequency range between 100 and 12 000 cm(-1) (0.013-1.5 eV). As Gd enters the ferromagnetic state, the dissipative part of the optical conductivity exhibits interesting spectral weight transfers over the whole spectral range measured. It is shown that the ab initio calculations reproduce well the experimental spectra for the ferromagnetic state and allow one to explain the microscopic origin of the optical response of Gd in terms of interband transitions.
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Gadolinio/química , Imanes/química , Modelos Teóricos , Teoría Cuántica , Espectrofotometría Infrarroja , Cristalografía por Rayos X , Temperatura , VibraciónRESUMEN
The outstanding discrepancy between the measured and calculated (local-density approximation) Fermi surfaces in the well-characterized, paramagnetic Fermi liquid Sr2RhO4 is resolved by including the spin-orbit coupling and Coulomb repulsion. This results in an effective spin-orbit coupling constant enhanced 2.15 times over the bare value. A simple formalism allows discussion of other systems. For Sr2RhO4, the experimental specific-heat and mass enhancements are found to be 2.2.
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The electronic structure and x-ray magnetic circular dichroism (XMCD) spectra of UGe(2) at the U N(4,5), N(2,3) and Ge K and L(2,3) edges are investigated theoretically from first principles, using the fully relativistic spin-polarized Dirac linear muffin-tin orbital (LMTO) band structure method. The electronic structure is obtained with the local spin-density approximation (LSDA), as well as the LSDA+U method. The origin of the XMCD spectra in the compound is examined.
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Charge and orbital ordering in the low-temperature monoclinic structure of magnetite (Fe3O4) is investigated using the local spin density approximation with Coulomb interaction correction method. While the difference between t(2g) minority occupancies of Fe(2+)(B) and Fe(3+)(B) cations is large and gives direct evidence for charge ordering, the screening is so effective that the total 3d charge disproportion is rather small. The charge order has a pronounced [001] modulation, which is incompatible with the Anderson criterion. The orbital order agrees with the Kugel-Khomskii theory.