THE INCIDENCE OF MULTIPLE MYELOMA IN THE DNIPROPETROVSK REGION. / ZAKhVORIuVANIST' NA MNOZhYNNU MIIeLOMU V DNIPROPETROVS'KIY̆ OBLASTI.

OBJECTIVE: To conduct a comparative analysis of the incidence of MM in the population of the Dnipropetrovsk region, taking into account the possible impact of various adverse environmental factors (air, water and soil con- tamination). MATERIALS AND METHODS: Epidemiological indicators of multiple myeloma (MM) morbidity in the 12-year observation period from 2006 to 2017 are analyzed in polluted and conventionally clean areas of the Dnipropetrovsk region. RESULTS: In assessing the dynamics of morbidity in MM for years 2006-2017 there was an increase in the incidence in 2011, 2015 and quite stable indicators for 2006-2010. The analysis of morbidity in the industrial cities of the region showed consistently high rates for the entire period of observation. A marked increase in the incidence rate in the Zhovti Vody (2007, 2012, 2016), Nikopol (2016), Novomoskovsk (2016), Marganets (2008, 2009 and 2017), Pokrov (2016, 2017) from 4.35 to 6.25 was noted. This may indicate a fluctuation in the incidence of MM in sepa- rate large cities of Dnipropetrovsk. The analysis of the dynamics of morbidity in the most polluted cities showed a clear increase in the number of cases in the MM in Zhovti Vody, which is characterized by radiation pollution. According to the average annual morbidity rate among cities of Dnipropetrovsk region, Pokrov takes the first place, the second - Zhovti Vody. CONCLUSIONS: The obtained data testify to the fluctuation in the incidence of MM in the Dnipropetrovsk region during the period 2006-2017 and the negative environmental factors clearly affect the growth of morbidity in large industrialized cities contaminated with radioactive and chemical substances.

[Dilatation of the Chambers of the Heart Caused by a Mutation of Lamin Gene (LMNA)].

Dilated cardiomyopathy (DCM) caused by mutations in the lamin A/C (LMNA) gene is often associated with conduction disorders, cardiac arrhythmias and various skeletal muscle abnormalities. We present here a case of severe form of DCM with overlapping phenotype.

[Electrocardiographic predictors of response to cardiac resynchronization therapy of heart failure in patients with dilated cardiomyopathy].

UNLABELLED: The aim of our study was to identify electrocardiographic predictors of response to cardiac resynchronization therapy (CRT) in patients with dilated cardiomyopathy (DCM). METHODS: 46 patients with DCM (76% men; mean age 48.8+/-12 years; mean NYHA class 3.09+/-0.3; mean QRS duration 167+/-30.1 ms; left ventricular ejection fraction 23.5+/-6%) had CRT implanted. Assessment of clinical, laboratory and echocardiographic (including TDI) and 12-lead surface ECG parameters was performed at baseline, in 24 hours post CRT implantation and after 6 months of follow-up. Multivariate logistic regression analysis selected the following independent predictors of response to CRT: two pre-implantation - baseline RS width in lead V1 ≥ 113.5 ms (OR 0.94, 95% CI 0.814-1.00; p=0.000), BNP ≤ 456 g/ml (OR 0.92, 95% CI 0.797-1.00; p=0.001); and two post-implantation: shortening of QRS width - ΔQRS ≥ -24.5 ms (OR 0.80, 95% CI 0.586-1.00; p=0.01) and shortening of RS V1 width - ΔRSV1 ≥ -21.8 ms (S: 0.87, 95% CI 0.72-1.00; p= 0.002) in 24 hours after CRT.

[Noninvasive diagnosis of acute cellular rejection of transplanted heart].

Endomyocardial biopsy remains the gold standard of diagnosis of acute cellular rejection after heart transplantation. However, routine biopsies are of major inconvenience to patients and are also risky and costly. In the present research we considered possibility of non-invasive diagnosis of acute cellular rejection in patients after orthotopic heart transplantation. Results of research are based on studying 34 endomyocardial biopsys in combination with Holter monitoring and ECHO findings in 21 heart recipients. It is demonstrated that case follow-up with Holter monitoring and ECHO is mandatory for diagnosis of acute cellular rejection and optimal treatment tactics.

Assessing methods for characterising local and global structural and biomechanical properties of the trabecular bone network.

We apply noval techniques, the Scaling Index Method (SIM), which reveals local topology of the structure, and the Minkowski Functionals (MF), which provide four global topological characteristics, to assess strength of the trabecular network of the human bone. We compare capabilities of these methods with the standard analysis, biomechanical Finite Element Method (FEM) and morphological parameters, in prediction of bone strength and fracture risk. Our study is based on a sample of 151 specimens taken from the trabecular part of human thoracic and lumbar vertebrae in vitro, visualised using µCT imaging (isotropic resolution 26µm) and tested by uniaxial compression. The sample of donors is heterogeneous, consisting of 58 male and 54 female cadavers with a mean age of 80 ±10 years. To estimate the predictive power of the methods, we correlate texture measures derived from µCT images with the maximum compressive strength (MCS) as obtained in biomechanical tests. A linear regression analysis reveals that the failure load estimated by FEM shows the highest correlation with MCS (Pearson's correlation coefficient r=0.76). None of the methods in current study is superior to the FEM: morphometric parameters give r<0.5, global topological characteristics show r=0.73 for the first Minkowski Functional MF1, which coincides with bone volume fraction BV/TV and r=0.61 for the second Minkowski functional MF2, which coincides with bone surface BS. Although scaling indices provided by SIM correlate only moderately with MCS (r=0.55), texture measures based on the nonlinear combination of local (SIM) and global (MF) topological characteristics demonstrate high correlation with experimental MCS (r=0.74) and with failure load estimated by FEM (r=0.95). Additional advantage of the proposed texture measures is possibility to reveal the role of the topologically different trabecular structure elements for the bone strength.

Once daily fluticasone furoate nasal spray is effective in seasonal allergic rhinitis caused by grass pollen.

BACKGROUND: Fluticasone furoate is a new enhanced-affinity glucocorticoid with a unique combination of pharmacodynamic and physicochemical properties suitable for topical activity. METHODS: In this multicentre, randomized, double-blind, placebo-controlled, parallel-group study, patients [adults and adolescents >or=12 years of age with seasonal allergic rhinitis (SAR)] received once-daily (od) treatment for 2 weeks with either fluticasone furoate nasal spray 110 microg (n = 141) or placebo nasal spray (n = 144) administered in a unique, side-actuated device. Efficacy measures included total nasal symptom score (TNSS) and total ocular symptom score (TOSS). Patients also reported their overall response to therapy and rated their quality of life using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). RESULTS: Fluticasone furoate significantly improved the mean change from baseline in daily reflective TNSS compared with placebo (treatment difference of -1.757; P < 0.001). Fluticasone furoate was also significantly more effective in improving the morning predose instantaneous TNSS (treatment difference of -1.898; P < 0.001) and daily reflective TOSS (treatment difference of -0.741; P = 0.001). A significant treatment effect was observed as early as day 1. Compared with placebo-treated patients, fluticasone furoate-treated patients showed significantly greater improvements in overall evaluation of response to therapy (P < 0.001), as well as in overall RQLQ score (P < 0.001). Fluticasone furoate was well tolerated. CONCLUSION: Fluticasone furoate nasal spray 110 mug od was effective in improving the nasal symptoms of SAR. It also produced significant improvements in ocular symptoms.

Non-newtonian viscosity of complex-plasma fluids.

Investigations of shear flows in three-dimensional complex-plasma fluids produced in a dc discharge were carried out. The shear was induced either by an inhomogeneous gas flow or by a laser beam. The viscosity of complex plasmas was measured over a broad range of shear rates, up to the hydrodynamic limit when the discreteness becomes important. Analysis of the measurements reveals non-Newtonian behavior of complex plasmas accompanied by substantial shear thinning.

[Gastroduodenoscopy at diagnosis and treatment of ulcerous gastroduodenal bleedings].

Results of treatment of 458 patients with ulcerous gastroduodenal bleedings are analyzed. It is demonstrated that argon-plasma coagulation (APC) is the most effective at primary endoscopic hemostasis and amounts to 92.5% compared with 87.5% at radio-wave coagulation and 79.7% at injection method. Treatment and diagnostic algorithm based on patients state severity assessment (by SAPS scale) and risk of bleeding (by Forrest) was developed. Use of this algorithm led to decrease of lethality due to acute blood less from 6.1 to 2.7% (including at conservative treatment from 4.5 to 2.2%) and postoperative lethality from 14.5 to 5.6%.

[Pattern of ENT problems in patients with primary defects of humoral immunity]. / Kharakter porazheniia LOR-organov u bol'nykh s pervichnymi defektami gumoral'nogo zvena immuniteta.

Fibroendoscopy, otomicroscopy, rhinomanometry, CT of the paranasal sinuses, examination of mucociliary transport in the nasal cavity and ENT microflora, threshold tonal audiometry, impedance audiometry were performed in 20 patients with primary immunodeficiency. The patients were found to have paranasal inflammation, slow mucociliary transport, abnormal nasal breathing, acoustic tube dysfunction, chronic inflammation or exudation in the middle ear, conductive hipoacusis, etc. The findings confirm that ENT are target organs in primary immunodeficiency.

A health-related quality-of-life comparison of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone and noncorticosteroid treatment in asthma: a randomized clinical study in Russia.

BACKGROUND: In Russia, current therapy for the long-term management of asthma is mainly nonsteroidal. This situation provides the opportunity to evaluate new asthma treatments in a patient cohort with little previous exposure to inhaled corticosteroids. OBJECTIVES: To compare the effect of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone, on the health-related quality of life (HRQL) of patients with mild to moderate asthma. METHODS: A double-blind, parallel-group, randomized, 12-week study compared formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone with an open control group of the investigator's choice of noncorticosteroid therapy. Patients completed the Short Form 36 (SF-36) and the Asthma Quality of Life Questionnaire (AQLQ). RESULTS: The improvement in HRQL scores for patients treated with noncorticosteroids was significantly less (p < 0.05) than those treated with formoterol plus budesonide and budesonide alone in all domains of the SF-36 and AQLQ with one marginal exception (budesonide versus investigator's choice, SF-36, Mental Component Scale, p = 0.053). Improvements in HRQL scores of formoterol plus budesonide, compared with budesonide alone, although generally higher, were not significantly different. Formoterol plus budesonide was more effective in improving lung function and reducing both symptoms and the need for relief terbutaline inhalation. CONCLUSION: Formoterol Turbuhaler plus budesonide Turbuhaler and budesonide Turbuhaler alone significantly improved the HRQL of patients with mild to moderate asthma compared with noncorticosteroid treatment.

The safety and efficacy of formoterol (Oxis) turbuhaler plus budesonide (Pulmicort) turbuhaler in mild to moderate asthma: a comparison with budesonide Turbuhaler alone and current non-corticosteroid therapy in Russia.

Current therapy in Russia for long-term management of asthma is mainly non-steroidal. This provided the opportunity to compare the efficacy and safety of formoterol (Oxis) Turbuhaler plus budesonide (Pulmicort) Turbuhaler with budesonide Turbuhaler alone in adults (n=338) with mild to moderate asthma who had little previous exposure to inhaled corticosteroids. The 12-week study followed a randomised, double-blind, parallel group design and included an open control group of patients who were treated with conventional non-corticosteroid therapy. Patients treated with formoterol plus budesonide benefited from a significantly greater improvement in their pulmonary function and asthma symptoms compared with budesonide alone (95% Cl of difference in mean morning peak expiratory flow [PEF] 8.7-36.3 l/min, p=0.0015). Non-corticosteroid treatment was significantly less effective than formoterol plus budesonide and budesonide alone (95% CIs of differences in mean morning PEF were 36.4-63.6 l/min and 14.1-41.1 l/min, respectively, both p=0.0001). Although the incidence and frequency of adverse events was not significantly different between the groups, formoterol plus budesonide and budesonide alone were better tolerated than non-corticosteroid treatment, and there were fewer incidences of asthma deterioration. Overall, formoterol Turbuhaler plus budesonide Turbuhaler was the safest and most effective treatment.

Isolation, enzymatic properties, and mode of action of an exo-1,3-beta-glucanase from Trichoderma viride.

An exo-1,3-beta-glucanase has been isolated from cultural filtrate of T. viride AZ36. The N-terminal sequence of the purified enzyme (m = 61 +/- 1 kDa) showed no significant homology to other known glucanases. The 1,3-beta-glucanase displayed high activity against laminarins, curdlan, and 1,3-beta-oligoglucosides, but acted slowly on 1,3-1,4-beta-oligoglucosides. No significant activity was detected against high molecular mass 1,3-1,4-beta-glucans. The enzyme carried out hydrolysis with inversion of the anomeric configuration. Whereas only glucose was released from the nonreducing terminus during hydrolysis of 1,3-beta-oligoglucosides, transient accumulation of gentiobiose was observed during hydrolysis of laminarins. The gentiobiose was subsequently degraded to glucose. The Michaelis constants Km and Vmax have been determined for the hydrolysis of 1,3-beta-oligoglucosides with degrees of polymerization ranging from 2 to 6. Based on these data, binding affinities for subsites were calculated. Substrate binding site contained at least five binding sites for sugar residues.

[Ebastine in the treatment of seasonal allergic rhinitis]. / Ebastin pri lechenii sezonnogo allergicheskogo rinita.

AIM: To test the efficiency and tolerance of the second generation antihistamine drug ebastin (kestine) in patients with seasonal allergic rhinitis (SAR). MATERIALS AND METHODS: Kestin was given for 3 weeks in doses 10 and 20 mg/day to 226 patients with SAR running for 6.8 +/- 6.1 years. SAR symptoms relief, subjective effects, side effects were studied. RESULTS: The total index of rhinitis symptoms diminished from 11.6 to 1.2 scores. Subjective response was registered in 82% of the patients, objective in 77%. Neither treatment aggravations nor serious side effects occurred. 2 patients had drowsiness, head aches, dizziness and discontinued treatment. CONCLUSION: Kestin is effective in SAR, had no serious side effects, is well tolerated.

[Changes in the dynamic surface tension of the blood and urine during the development of visceritis in patients with rheumatoid arthritis]. / Izmeneniia dinamicheskogo poverkhnosnogo natiazheniia krovi i mochi pri razvitii vistserita u bol'nykh revmatoidnym artritom.

The condition was studied of the dynamic surface tension of biologic fluids in patients with rheumatoid arthritis using a method of maximum pressure in the vesicle with the aid of computerized tensiometer MPT-1 "Lauda" (Germany). Rise in indices of blood serum surface tension with diminution of the slope of tensiogram curves may suggest the development of pathology of the heart and liver, while increase in the same parameters of urine might be indicative of the coming nephropathy.

[The dynamic surface tension of the blood and urine in chronic glomerulonephritis]. / Dinamicheskoe poverkhnostnoe natiazhenie krovi i mochi pri khronicheskom glomerulonefrite.

Dynamic surface-tension (S-T) was investigated of blood and urine of healthy individuals and patients with chronic glomerulonephritis by the proposed method of maximum pressure in a bubble with the aid of the computer-assisted device tensometer MPT-1 (Lauda, Germany). Patterns of changes in dynamic and static S-T were found out as were those of the slope of the curve in patients with mesangioproliferative and mesangiocapillary variants of the condition, in nephrotic syndrome and chronic renal insufficiency. Correlation type comparison was performed of physical-and-chemical properties of biological fluids to parameters characterizing protein and fat exchange. Relationship between dynamic S-T and biochemical composition of blood and urine was revealed. Diagnostic value of results of the studies made is discussed.

[Characteristics of the set-up of the lymphocyte blast transformation reaction using whole blood]. / Osobennosti postanovki reaktsii blasttransformatsii limfotsitov s ispol'zovaniem tsel'noi krovi.

The authors analyze the specific features of the technique of lymphocyte blastogenesis test (LBGT) with whole blood and of interpreting its results in examinations of healthy donors, patients with hypogammaglobulinemia, chronic bronchitis or pneumonia, and bronchial asthma. The suggested LBGT variant is a sensitive and reproducible technique fit for assessing the immunity status, making use of small volumes (up to 0.1 ml) of the blood; it is recommended for clinical examinations and mass immunologic screenings.

[The results of the use of porcelain crowns prepared on refractory models]. / Rezul'tay primeneniia farforovykh koronok, izgotovlennykh na ogneupornykh modeliakh.

The authors describe the technique for making porcelain crowns without platinum matrices. A two-year clinical follow-up of 170 crowns has shown that such crowns are in full accord with the esthetic, functional, and biological requirements of dental prosthetics.

[Prophylactic medical examination of patients with chronic pulmonary heart]. / Dispansernoe nabliudenie za bol'nymi khronicheskim legochnym serdtsem.

Results are analysed of the efficiency of complex treatment of patients with chronic cor pulmonale including cardiac glycosides, agents stimulating metabolism processes in the myocardium, immunoactive drugs and antiaggregants. The efficacy was evaluated of cardiotonic therapy with different glycosides in hospital and outpatient treatment. The necessity is substantiated of including into complex treatment drugs of metabolic action, immunoactive and antiaggregant agents with the purpose of reducing the threshold of sensitivity of the myocardium to the toxic effect of cardiac glycosides.