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.

[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.

[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.

[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.