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Background No data exist on obesity or the accuracy of body mass index (BMI) in Russian Federation firefighters. Aims To determine the prevalence of obesity and rates of misclassification of BMI-based obesity status. Methods Career firefighters in the Moscow region completed anthropometric assessments including height, weight, BMI, body fat per cent (BF%) and waist circumference (WC). Using these three methods, we defined obesity as BMI ≥30, BF% >25 and WC >102, respectively. Results The study group consisted of 167 male firefighters. Obesity prevalence was 22% for BMI [95% confidence interval (CI) 16.9-28.5], 60% for BF% (95% CI 52.5-67.3) and 28% for WC (95% CI 21.3-34.9). False positive rates for BMI-based obesity status were low, with 3% (95% CI -1.1 to 7.1) and 6% (95% CI 1.6-9.9) of non-obese participants defined by BF% and WC standards misidentified as obese using BMI. However, 65% (95% CI 55.7-77.4) of BF%-defined obese participants and 36% (95% CI 22.5-49.9) of WC-defined obese participants were misclassified as nonobese using BMI (i.e. false negatives). Conclusions Rates of BMI-based obesity in Russian male firefighters were similar to that of males in the general Russian adult male population. Compared with BF% or WC standards, BMI-based obesity classification produced low rates of false positives but demonstrated high rates of false negatives. [ABSTRACT FROM AUTHOR]

Let us attempt to imagine the personality of a person in whom the most important tasks of education and communist upbringing have been successfully resolved. This is a person who possesses up-to-date, profound, and durable knowledge; he strives to improve this knowledge continuously; he has a Marxist-Leninist world view; his moral cast is irreproachable; his cultural, aesthetic, and physical development are at a high level. [ABSTRACT FROM AUTHOR]

There can be no doubt that the individual psychological distinctions among human beings and, in particular, one area of these differences - the psychological manifestations of the intensity, lability, and equilibrium of nervous processes - are manifested in one form or another in work, that activity which most completely expresses the nature of man. Therefore, study of these peculiarities is a matter of pressing importance in labor psychology. "Investigation of the individual differences among men," writes B.M. Teplov, "is one of the most important tasks of psychology. The importance of this undertaking has become particularly obvious since psychology undertook to become a science of practical value (educational and child psychology, labor psychology, pathopsychology)." (19; p. 108) [ABSTRACT FROM AUTHOR]

The demographic profile of patients transitioning from chronic kidney disease to kidney replacement therapy is changing, with a higher prevalence of aging patients with multiple comorbidities such as diabetes mellitus and heart failure. Cardiovascular disease remains the leading cause of mortality in this population, exacerbated by the cardiovascular stress imposed by the HD procedure. The first year after transitioning to hemodialysis is associated with increased risks of hospitalization and mortality, particularly within the first 90-120 days, with greater vulnerability observed among the elderly. Based on data from clinics in Fresenius Medical Care Europe, Middle East, and Africa NephroCare, this review aims to optimize hemodialysis procedures to reduce mortality risk in stable incident and prevalent patients. It addresses critical aspects such as treatment duration, frequency, choice of dialysis membrane, dialysate composition, blood and dialysate flow rates, electrolyte composition, temperature control, target weight management, dialysis adequacy, and additional protocols, with a focus on mitigating prevalent intradialytic complications, particularly intradialytic hypotension prevention.

(1) Purpose: Recent studies indicate that advanced imaging parameters such as prostate PSMA tumor volume may have a value in predicting response to treatment of castration-resistant prostate cancer patients. In this study, we examine whether a relationship can be found between advanced imaging parameters such as prostate PSMA-TV and the presence of metastatic disease in newly diagnosed prostate cancer patients undergoing PSMA-PET/CT for staging purposes; (2) Methods: We retrospectively analyzed PET/CT studies of 91 patients with newly diagnosed prostate cancer. Prostate PSMA-TV was measured using the MIRADA-XD software. PET/CT results were recorded, as well as additional clinical parameters such as the Gleason score, etc.; (3) Results: Prostate PSMA-TV measurements were found to be able to significantly differentiate metastatic from the non-metastatic patient groups (13.7 vs. 5.5, p -value < 0.05). Overall, 54% percent of patients with levels of over 8.1 PSMA-TV had metastatic lesions found on their PSMA-PET/CT. A model based on this cutoff attained a sensitivity of 80%, a specificity of 68.3%, and a negative predictive value of 93.5% for identifying metastatic disease. Another bin model was found statistically capable of assessing the likelihood of the presence of metastatic disease with a p -value of 0.001; (4) Conclusions: Prostate PSMA-TV measurement has the potential to predict the presence of metastatic disease at staging and thus may impact further treatment decision and patient management.

Background and Objectives: In ice hockey, the major physical workload comes from acceleration in all planes of motion and transitions between skating trajectories. Hockey players' anthropometric characteristics correlate with performance. In team sports, the use of ergogenic drugs for recovery is relevant to avoid athletes' overtraining. It is very important to protect athletes' health and allow them to maintain high-performance levels. Cytoflavin is an ergogenic drug whose action is based on the combined effects of its active ingredients (succinic acid, inosine, nicotinamide and riboflavin), which are naturally occurring metabolites that stimulate tissue respiration. The study aimed to assess the 6-week Cytoflavin consumption effects on body composition (body weight, body mass index, body fat percentage and bioimpedance phase angle) and aerobic performance., Methods: This study included 60 male professional hockey players (aged 19 to 36 years) divided into two groups of 30 subjects: group I (body weight 87.90 ± 7.44 kg, BMI 25.86 ± 2.04 kg/m 2 ) and group II (body weight 87.04 ± 6.22 kg, BMI 25.52 ± 2.38 kg/m 2 ). Athletes in group I received Cytoflavin, whereas athletes in group II did not., Results: In group I, statistically significant reductions in body weight and body mass index were not observed until 14 and 35 days, respectively. In contrast, in group II, both body weight and BMI significantly decreased both times. Aerobic performance significantly increased in both groups, with significantly greater increases in group I., Conclusions: Cytoflavin can be considered an ergogenic drug that improves body composition parameters, especially in the control of weight reduction and improvement in aerobic performance.

Protecting the health of railway workers of various professional groups is an important and integral part of the work of primary health care. The incidence of circulatory diseases is a significant problem among some groups of railway workers, given the considerable number of occupational risk factors. Among the most unfavorable complications of cardiovascular disease may be sudden cardiac death.Purpose of the study - сonducting an analysis of typical risk factors for sudden death among the main occupational groups of railway workers in Russia., Materials and Methods: A retrospective analysis was carried out of all cases of sudden death of employees of Russian Railways in the period from 2009 to 2021. All deceased workers were conditionally divided into 6 groups depending on the professions and positions of workers., Results: All 411 deceased patients worked on 16 railways, subordinate to 15 medical directorates of Russian Railways. 84.7% of patients felt the first symptoms during working hours and only 15.3% during non-working hours. The prevalence of cases of sudden death during working hours was noted - 81%. Among the occupational groups under consideration, death at home or outside the home was more often observed in groups I and VI, and at the workplace, from groups II to V (p < 0.001). 6.8% of those who died had high levels of ethyl alcohol in their blood, and 3 out of 4 of them died at the workplace. Among the deceased, 70.3% of the patients were smokers. 68.1% were overweight or obese. The level of total cholesterol exceeded 5 mmol/l in 20.7% of cases, and the largest number of patients (65%) had a moderate risk according to the SCORE scale., Conclusion: The study sample showed that cardiovascular diseases are the main cause of sudden death. Among the risk factors in the study group, smoking and obesity prevailed.

While participating in an intensive training process, the athlete's body requires not only energy, but also specific macro- and microelements. The purpose of this study was to show the meaning of monitoring the level of mineral trace elements in athletes-wrestlers during physical activity. As an experimental group, 66 male wrestlers aged 18-20 years with at least 3 years of intensive wrestling experience were examined. The control group consisted of 92 young cadets of military school aged 18-20 years, who had previous sports training, but were not engaged in wrestling. To determine the quantitative content of trace elements, the hair was cut from the back of the head for the entire length in an amount of at least 0.1 g. an examined using the mass spectrometer ICP-MS Agilent 7900. Strong positive correlations were found for sodium with potassium and rubidium, magnesium with calcium, potassium with rubidium, and rubidium with caesium among wrestlers. Wrestlers were found to have higher levels of a number of macro- and microelements, including toxic ones., (Copyright © 2022 Zaborova, Zolnikov, Dzhakhaya, Bueverova, Sedova, Kurbatova, Putilo, Yakovleva, Shantyr, Kastyro, Ozimek, Korolev, Krikheli, Gurevich and Heinrich.)

The purpose of this investigation was to assess the acute effects of partial range of motion (pROM) exercises, on the accuracy of soccer penalty kicks on goal. This method limits the joint from moving through the complete length of a motion, creates an occlusion effect, and thus causes the type 1 muscle fibers to work anaerobically. Thirty-six soccer players, with 5-8 years of soccer playing experience, were pretested for accuracy then retested (rtt = 0.92) and divided into random groups from the Associação Banco do Brasil Futebol Clube-Group A, Paraná Futebol Clube-Group P, and Coritiba Futebol Clube-Group C. Groups were composed of 12 people performing full range of motion (fROM) exercises or pROM exercises. Both groups performed 5 sets of back squats at 50% of body weight in sets of 40 seconds with metronome tempo of 56 bpm for an average of 10-12 repetitions per 40-second set. Blood samples were collected post-warm-up, after the 3rd set, and following the 5th set for both groups, within 3-5 minutes of cessation of exercise. Athletes performing fROM exercises showed increased blood lactate from 2.69 ± 0.2 to 4.0 ± 1.2 mmol/L ( p < 0.05), and in pROM, blood lactate increased from 2.48 ± 0.42 to 10.29 ± 1.3 mmol/L ( p < 0.001). In fROM, accuracy decreased from 42.96 ± 13.39% to 41.37 ± 17.25% ( p > 0.1), a slight decrease, while in the pROM groups, accuracy decreased from 45.42 ± 14.93% to 24.53 ± 10.2% ( p < 0.001). The calculations demonstrating average percentages of accuracy are presented in the tables. These findings support that pROM exercises significantly increase blood lactate resulting in a reduction in soccer kick accuracy. This decrease in accuracy directly correlates to the accumulation of lactic acid and hydrogen ions (H+) and demonstrates that pROM strength training should not be utilized prior to a sport-specific session in order to avoid interference with the development of special skills., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Mariusz Ozimek et al.)

Balance disorders are complications of stroke survivors. Aim of this study was the establish effectiveness of the biofeedback approach. In this intervention study 245 patients with early diagnosis of acute disturbance of cerebral circulation (ADCC) were examined. Patients able to move independently were treated by standard conservative ADCC therapy on an outpatient approach, but they continued to have problems with coordination of movement in upright position. Then they were submitted to an increasing physical activity based on five sessions of biofeedback, i.e., a complex rehabilitation of patients with motor pathology "Trust-M" according to TU 9442-001-63704475-2010. Mobility rates were assessed using a web camera. Patients' quality of life was evaluated by SF-36 questionnaire and the Hospital Anxiety and Depression Scale (HADS). All parameters were recorded before and after 5 sessions of biofeedback. After treatment, the stability indicators improved and all patients showed a significant increase in motion rate and quality of life. At the same time, the severity of pain and of depression and anxiety decreased. Negative correlations of average strength between the quadrant and patient HADS scaling rates were obtained. In conclusion, our work shows effectiveness of the biofeedback technique for correcting coordination in stroke survivors.

Purpose: determination of the risk factors increasing the probability of development of non-communicable diseases at employees of the railway industry and also value of a condition of conditions for maintaining the healthy lifestyle by employees., Materials and Methods: 13,595 people were interviewed (1.5% of the staff). The questionnaire contained 49 questions on the main components of healthy lifestyle, compiled on the basis of the STEPS toolkit., Results: More than 93% of respondents agree that the person himself is responsible for his health, while only 11% of respondents correspond to the full extent of healthy lifestyle. The price factor when choosing products is decisive for 54% of respondents. 80% of the company's employees feed on what they brought from home. Less than half of the company's employees are engaged in physical education, sports, recreational gymnastics; would like to do, but now 40% do not do it. The proportion of persons involved in physical activity is slightly higher among young employees (54% versus 44% among workers aged 36 years and over). More than 2/3 of the survey participants do not smoke (while 30% smoked earlier, but were able to quit). Among women, the proportion of non-smokers is higher (86%) compared to men (64%)., Conclusion: Based on the data obtained, it is possible to conclude that the company employees responsible attitude towards their health prevails. At the same time, a number of negative practices are quite widespread. These results point to the need to advance the values and practices of healthy lifestyle.

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Over the past decades, a small yet convincing evidence base has accumulated that demonstrates the effectiveness of dental care for patients in health-resort (HR) settings. In addition to a positive local effect, complex HR care increases nonspecific resistance and promotes desensitization., Objective of the Review: Addressing the HR rehabilitation in patients with various maxillofacial diseases for further consideration of the possibility of the increased use of HR care in dental practice., Material and Methods: Russian and English-language publications were analyzed without specifying the search timeframe. The search keywords were the following: «health-resort care», «balneotherapy», «peloid therapy», «physiotherapy», «magnet therapy», «laser therapy» in combination with «dental diseases», «maxillofacial diseases», «periodontal diseases», «temporomandibular joint diseases», «postoperative rehabilitation» «balneotherapy», «mud therapy», «peloid therapy», «spa therapy», «physiotherapy». A total of 21 articles were analyzed, including 10 related to periodontal disease, 5 to temporomandibular joint pathology, and 6 to rehabilitation in the postoperative period. Seventeen original studies (3855 patients) were selected, including 47.62% with evidence level C, due to lack of information on comparison group or randomization., Results and Discussion: Available data from clinical studies suggest the effectiveness of natural and physiotherapeutic factors in the medical rehabilitation of patients with various dental diseases. Further randomized clinical trials and the development of clinical guidelines for various techniques in dental diseases are warranted.

Background: Evidence suggests that online hemodiafiltration (OL-HDF) is associated with improved survival. Whether the dose-response relationship between convective volume and mortality may be confounded by selection bias or descends from practice patterns is not clear. We sought to evaluate the role of patients' characteristics and practice patterns on OL-HDF dose and mortality in a large private dialysis network in the Republic of Russia., Methods: In this multicenter, historical cohort study, we included adult incident patients on OL-HDF with at least 90 days of survival on renal replacement therapy in centers belonging to the Russian Federation Fresenius Medical Care network (January 1, 2011, to December 31, 2016). We evaluated predictors and outcomes (survival) of substitution volume target achievement (Qsub > 21 L/session)., Results: Among 1,081 enrolled patients, the average Qsub was 22.9 (±3.2) L/session; the mean ultrafiltration volume was 1.6 (±0.8) L/session. The mean age was 55.8 ± 13.2; 42% were woman. Most common comorbidities were congestive heart failure (39.7%) and peripheral vascular disease (21.7%). The average hemoglobin was 9.3 ± 1.3. The case-mix adjusted center effect accounted for 20% of variance in Qsub. The top 10 most important variables associated with higher Qsub were effective Qb, serum protein, Charlson's comorbidity index, hemoglobin, year of dialysis initiation (proxy of high Qsub treatment policy in the clinic network), predialysis heart rate, serum bicarbonate, serum phosphate, age, serum sodium, and dry body weight. In addition, we found that the association of Qb with Qsub is moderated by year of enrollment, intradialytic weight gain, and coronary artery disease, whereas higher hemoglobin concentration moderated the relationship between treatment time and Qsub. Finally, Qsub between 21 and 25 L/session was associated with longer 5-year survival., Conclusions: Both center-dependent clinical practice standards and patient clinical conditions substantially contributed to the risk of low Qsub. We confirmed previous evidence indicating better survival among patients with Qsub ≥ 21 L/session., (© 2020 S. Karger AG, Basel.)

Background: The iron-based phosphate binder (PB), sucroferric oxyhydroxide (SFOH), demonstrated its effectiveness for lowering serum phosphate levels, with low daily pill burden, in clinical trials of dialysis patients with hyperphosphatemia. This retrospective database analysis evaluated the real-world effectiveness of SFOH for controlling serum phosphate in European hemodialysis patients., Methods: De-identified patient data were extracted from a clinical database (EuCliD®) for adult hemodialysis patients from France, Italy, Portugal, Russia and Spain who were newly prescribed SFOH for up to 1 year as part of routine clinical care. Serum phosphate and pill burden were compared between baseline (3-month period before starting SFOH) and four consecutive quarterly periods of SFOH therapy (Q1-Q4; 12 months) in the overall cohort and three subgroups: PB-naïve patients treated with SFOH monotherapy (mSFOH), and PB-pretreated patients who were either switched to SFOH monotherapy (PB → mSFOH), or received SFOH in addition to another PB (PB + SFOH)., Results: 1096 hemodialysis patients (mean age: 60.6 years; 65.8% male) were analyzed, including 796, 188 and 53 patients in, respectively, the PB + SFOH, mSFOH, and PB → mSFOH groups. In the overall cohort, serum phosphate decreased significantly from 1.88 mmol/L at baseline to 1.77-1.69 mmol/L during Q1-Q4, and the proportion of patients achieving serum phosphate ≤1.78 mmol/L increased from 41.3% at baseline to 56.2-62.7% during SFOH treatment. Mean PB pill burden decreased from 6.3 pills/day at baseline to 5.0-5.3 pills/day during Q1-Q4. The subgroup analysis found the proportion of patients achieving serum phosphate ≤1.78 mmol/L increased significantly from baseline during SFOH treatment in the PB + SFOH group (from 38.1% up to 60.9% [Q2]) and the mSFOH group (from 49.5% up to 75.2% [Q2]), but there were no significant changes in the PB → mSFOH group. For the PB + SFOH group, serum phosphate reductions were achieved with a similar number of PB pills prescribed at baseline prior to SFOH treatment (6.5 vs 6.2 pills/day at Q4). SFOH daily pill burden was low across all 3 subgroups (2.1-2.8 pills/day)., Conclusion: In this real-world study of European hemodialysis patients, prescription of SFOH as monotherapy to PB-naïve patients, or in addition to existing PB therapy, was associated with significant improvements in serum phosphate control and a low daily pill burden.

Diseases of intestines are among the most widespread in this connection their effective prevention and treatment represents a priority problem of practical health care. Nowadays the set of the indisputable evidence that the microbiota of intestines played a key role in pathogenesis of many diseases has been obtained. Aim - the analysis of the available data on a role of microflora and efficiency of probiotic cultures for treatment of irritable bowel syndrome, the necrotic enterocolitis, Krone's disease. Based on the data, which is available in literature, the main aspects of biological properties of probiotic bacteria, first in the context of their regulating influence on inflammatory immune reaction have been discussed. The question of strain-specific effect of probiotics has been considered. The basic provisions concerning change of a fecal microbiota, prospect and difficulty of realization of this technique have been presented in the article. Conclusion. Despite of wide use of pro- and prebiotics in clinic for treatment of diseases of digestive tract, a large number of the questions connected with selection of concrete strains for each patient, a dosage and duration of therapy for achievement of steady remission still remains., Competing Interests: The authors declare no overt and potential conflict of interest related to the publication of this article., (Copyright© GEOTAR-Media Publishing Group.)

Research Objective: studying of features of nutrition in elderly patients with removable stomatologic orthopedic constructions. 1388 patients aged from 60 up to 75 years which addressed in a city dental out-patient department were examined. Patients were divided into three groups: group 1 - the persons having only fixed stomatologic orthopedic constructions (n=419); group 2 - the persons having at least one partially removable stomatologic orthopedic construction and not having full-removable orthopedic constructions (n=512); group 3 - the persons having at least one full-removable stomatologic orthopedic construction (n=457). Patients were interviewed about nutrition features (frequency of consumption). Anthropometric researches were conducted. There were 2.2 and 1.3 fold more persons in group 3 with a concomitant increase in waist circumference and waist-hip ratio compared to groups 1 and 2 (p=0.0013). Persons from group 3 consumed meat significantly less often than patients in groups 1 and 2. A similar trend was observed for meat products, vegetables and fruits (p<0.05). Compared to patients in groups 1 and 2, patients from group 3 more often consumed cereals, potatoes, rice, pasta, as well as sauces, mayonnaises, margarines. All examined elderly patients rarely consumed fish and seafood (76.0-89.9% persons consumed once a month and less often)., (Copyright© GEOTAR-Media Publishing Group.)

The purpose was to study features of a drinking regimen and signs of deficiency of magnesium at elderly patients with removable stomatologic orthopedic constructions. Questioning of 1 388 elderly patients who coming for the dentistry office. Patients were divided into three groups: the 1st was characterized by existence only of fixed stomatologic orthopedic constructions (n=419); the 2nd group was characterized by existence of partially removable constructions (n=512); the 3rd group was characterized by existence of full-removable constructions (n=457). We defined symptoms of the central obesity as rising of BMI and a circle of a waist. Patients were tested for possible deficiency of magnesium. At patients of the 3rd group have more often symptoms of the central obesity, than at the 1st and 2nd groups (52,5% against 21,5 and 41,8%, p<0.05). Patients of the 3rd group have more often signs of deficiency of magnesium, than other patients (62,3% against 11,7 and 22,3%, p<0.05). Patients of the 3rd group more often than others intake cocoa (54,1% against 5,7 and 10,4%, p<0.05), carbonated drinks (24,5% against 7,6 and 4,3%, p<0,05), hard alcoholic beverages (23% against 10 and 10,2%, p<0,05). All elderly patients extremely seldom use bottled water.

The article presents data of a survey of 11 850 persons of both sexes and various age groups (from 12 to 60 years) conducted in all Federal Districts of Russia, from 2013 to 2016. The analysis of consumption by the population of various widely consumed beverages, including different types of tea, low-calorie and dietary carbonated soft drinks and waters from various sources, was conducted and an analysis of the possible correlation between their frequency of consumption and body mass index (BMI) was carried out. It has been established that practically in all groups questioned about 10-15% of persons of various Federal districts and ages consume tap water. At the same time, the number of people consuming filtered, bottled water has significantly increased. In all age groups, except for a group of people aged 12-17 years, the consumption of tea by female obese women was 10-13% less than in the male group, and almost all groups with normal BMI consumed tea more often, than men. At the same time, there were no gender differences in the consumption of tea by individuals with a BMI of 25-30. There was no correlation between consumption of low-calorie, dietary carbonated soft drinks and BMI. Only in the group of people aged 31-45 years, gender differences were found, while in this group of people it was shown that obese men were about 3 times more likely than women to use these drinks (67.7 vs 25.0%)., (Copyright© GEOTAR-Media Publishing Group.)

Purpose To analyze the prevalence of risk factors among Russian students. Methods In this study, 834 students were included from five Federal universities which were localized in four Federal regions of Russian Federation. Future doctors, school teachers, and wellness trainers were included in this study. Students were specifically asked about smoking, physical activity International Physical Activity Questionnaire (IPAQ), and food preference. Waist, hip, weight, and height were measured. Results The region of study and ethnic group were not influenced with respect to age and body mass index ( p > .1), while all other factors had a significant influence ( p < .05). High levels of smoking, hypodynamia, and motivation to intake of unhealthy food were found in medical students in comparison with those in future teachers and wellness instructors ( p < .05). The indicators of central obesity (due to levels of body mass index and waist-hip ratio) were found in medical students. Perspective Special programs to prevent the most common behavior risk factors in future medical doctors have to be designed.

Purpose To analyze the prevalence of select behavioral risk factors among Russian university students majoring in medicine, education, and exercise science. Methods A total of 834 students from five Federal universities located in four federal regions of Russia were included in the study. The purposive sample included future doctors, school teachers, and fitness trainers. Students were asked specifically about smoking, level of physical activity, and food preferences. To calculate body mass indices (BMIs), waist, hip, weight, and height were also measured. Results Smoking rates, level of activity, and nutritional habits were significantly different by age, but BMI was not. Smoking rates and BMI were significantly different by gender, but level of activity and nutritional habits were not. Like the differences found by age, smoking rates, level of activity, and nutritional habits were significantly different by ethnicity, but BMI was not. There were significant difference across all behavioral health risk factors by region. The results show significantly higher levels of physical inactivity, consumption of unhealthy foods, and high BMIs among medical students compared with future teachers and wellness instructors ( p < .05). In the same time, the smoking levels are the highest among future teachers. The highest prevalence of smoking was found to be associated with gender (for females living Moscow and for males in rural regions), and Russian ethnic group. Conclusion Tailored programs to prevent common health behavior risk factors among future medical doctors are urgently needed in the Russian Federation.

Safety concerns with erythropoietin analogues and intravenous (IV) iron for treatment of anemia in CKD necessitate development of safer therapies. Roxadustat (FG-4592) is an orally bioavailable hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitor that promotes coordinated erythropoiesis through HIF-mediated transcription. We performed an open-label, randomized hemoglobin (Hb) correction study in anemic (Hb≤10.0 g/dl) patients incident to hemodialysis (HD) or peritoneal dialysis (PD). Sixty patients received no iron, oral iron, or IV iron while treated with roxadustat for 12 weeks. Mean±SD baseline Hb was 8.3±1.0 g/dl in enrolled patients. Roxadustat at titrated doses increased mean Hb by ≥2.0 g/dl within 7 weeks regardless of baseline iron repletion status, C-reactive protein level, iron regimen, or dialysis modality. Mean±SEM maximal change in Hb from baseline (ΔHb(max)), the primary endpoint, was 3.1±0.2 g/dl over 12 weeks in efficacy-evaluable patients (n=55). In groups receiving oral or IV iron, ΔHb(max) was similar and larger than in the no-iron group. Hb response (increase in Hb of ≥1.0 g/dl from baseline) was achieved in 96% of efficacy-evaluable patients. Mean serum hepcidin decreased significantly 4 weeks into study: by 80% in HD patients receiving no iron (n=22), 52% in HD and PD patients receiving oral iron (n=21), and 41% in HD patients receiving IV iron (n=9). In summary, roxadustat was well tolerated and corrected anemia in incident HD and PD patients, regardless of baseline iron repletion status or C-reactive protein level and with oral or IV iron supplementation; it also reduced serum hepcidin levels., (Copyright © 2016 by the American Society of Nephrology.)

Objective: In patients with advanced kidney disease, metabolic and nutritional derangements induced by uremia interact and reinforce each other in a deleterious vicious circle. Literature addressing the effect of dialysis initiation on changes in body composition (BC) is limited and contradictory. The aim of this study was to evaluate changes in BC in a large international cohort of incident hemodialysis patients., Methods: A total of 8,227 incident adult end-stage renal disease patients with BC evaluation within the initial first 6 months of baseline, defined as 6 months after renal replacement therapy initiation, were considered. BC, including fat tissue index (FTI) and lean tissue index (LTI), were evaluated by Body Composition Monitor (BCM, Fresenius Medical Care, Bad Homburg, Germany). Exclusion criteria at baseline were lack of a BCM measurement before or after baseline, body mass index (BMI) < 18.5 kg/m(2), presence of metastatic solid tumors, treatment with a catheter, and prescription of less or more than 3 treatments per week. Maximum follow-up was 2 years. Descriptive analysis was performed comparing current values with the baseline in each interval (delta analysis). Linear mixed models considering the correlation structure of the repeated measurements were used to evaluate factors associated with different trends in FTI and LTI., Results: BMI increased about 0.6 kg/m(2) over 24 months from baseline. This was associated with increase in FTI of about 0.95 kg/m(2) and a decrease in LTI of about 0.4 kg/m(2). Female gender, diabetic status, and low baseline FTI were associated with a significant greater increase of FTI. Age > 67 years, diabetes, male gender, high baseline LTI, and low baseline FTI were associated with a significant greater decrease of LTI., Conclusions: With the transition to hemodialysis, end-stage renal disease patients presented with distinctive changes in BC. These were mainly associated with gender, older age, presence of diabetes, low baseline FTI, and high baseline LTI. BMI increases did not fully represent the changes in BC., (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)

We investigated contribution mediator mechanism in the development of the phenomenon of inhibition induced by barium sulfate luminol-dependent chemiluminescence (SLCHL) of blood under the influence of nonsteroidal anti-inflammatory drugs (NSAIDs) in patients with intolerance to these drugs. It was found that the phenomenon of suppression SLCHL blood under the influence of NSAIDs in patients with intolerance is mediated by the participation of mediators, and the contribution of H1--and H2--histamine receptors, 5-HT2 serotonin receptors and Cys-leukotriene receptors in the development of that phenomenon depends on the chemical nature of NSAIDs and the clinical manifestations of intolerance.

Background and Objectives: Cinacalcet and vitamin D are often combined to treat secondary hyperparathyroidism (SHPT) in patients on dialysis. Independent effects on fibroblast growth factor-23 (FGF-23) concentrations in patients on hemodialysis administered cinacalcet or vitamin D analogs as monotherapies during treatment of SHPT are evaluated., Design, Setting, Participants, & Measurements: A multicenter, randomized, open-label study to compare the efficacy of cinacalcet versus traditional vitamin D therapy for management of secondary hyperparathyroidism among subjects undergoing hemodialysis (PARADIGM) was a prospective, phase 4, multicenter, randomized, open-label study conducted globally. Participants (n=312) were randomized 1:1 to cinacalcet (n=155) or vitamin D analog (n=157) for 52 weeks. Levels of FGF-23 were measured at baseline and weeks 20 and 52. The absolute and percentage changes from baseline in plasma FGF-23, parathyroid hormone (PTH), calcium (Ca), phosphorus (P), and calcium-phosphorus product (Ca×P) were assessed. Correlations and logistic regression were used to explore relationships between changes in FGF-23 and changes in PTH, Ca, P, and Ca×P from baseline to week 52 by treatment arm., Results: Median (quartiles 1, 3) decrease in FGF-23 concentrations was observed in the cinacalcet arm (-40%; -63%, 16%) compared with median increase in the vitamin D analog arm (47%; 0%, 132%) at week 52 (P<0.001). Changes in FGF-23 in both arms were unrelated to changes in PTH (cinacalcet: r=0.17, P=0.11; vitamin D analog: r=-0.04, P=0.70). Changes in FGF-23 in the vitamin D analog but not the cinacalcet arm were correlated with changes in Ca (cinacalcet: r=0.11, P=0.30; vitamin D analog: r=0.32, P<0.01) and P (cinacalcet: r=0.19, P=0.07; vitamin D analog: r=0.49, P<0.001). Changes in FGF-23 were correlated with changes in Ca×P in both arms (cinacalcet: r=0.26, P=0.01; vitamin D analog: r=0.57, P<0.001). Independent of treatment arm, participants with reductions in P or Ca×P were significantly more likely to show reductions in FGF-23., Conclusions: During treatment of SHPT, cinacalcet use was associated with a decrease in FGF-23 concentrations, whereas vitamin D analogs were associated with an increase. The divergent effects of these treatments on FGF-23 seem to be independent of modification of PTH. It is possible that effects of cinacalcet and vitamin D analogs on FGF-23 may be mediated indirectly by other effects on bone and mineral metabolism., (Copyright © 2015 by the American Society of Nephrology.)

Background and Objectives: Direct comparison of cinacalcet and vitamin D analogs as monotherapies to lower parathyroid hormone (PTH) levels has not been undertaken., Design, Setting, Participants, & Measurements: This was a prospective, multicenter, phase 4, randomized, open-label study that enrolled participants from 2010 to 2012. Adult participants (n=312) on hemodialysis with PTH >450 pg/ml were randomized 1:1 to 12 months of treatment with either cinacalcet (n=155) or vitamin D analogs (n=157) to evaluate the mean percentage change in plasma PTH level (primary end point) and the proportion of participants achieving plasma PTH <300 pg/ml or a ≥30% decrease in PTH (secondary end points). A preplanned analysis to determine whether there were important region-by-treatment interactions was also undertaken., Results: Baseline mean PTH was 846 pg/ml (n=155) for cinacalcet and 816 pg/ml (n=157) for vitamin D analog therapy. The mean (95% confidence interval) percentage change from baseline in PTH was -12.1% (-20.0% to -4.1%) in the cinacalcet arm and -7.0% (-14.9% to 0.8%) in the vitamin D analog arm, a difference of -5.0% (-15.4% to 5.4%) (P=0.35). Similarly, there was no difference in achievement of secondary efficacy end points between arms (19.4% and 15.3% of participants with PTH≤300 pg/ml and 42.6% and 33.8% of participants had a PTH reduction >30% in the cinacalcet and vitamin D analog arms, respectively). A prespecified analysis revealed a large treatment-by-region interaction, with nominally greater response to cinacalcet compared with vitamin D analogs in non-United States participants (US versus non-US participants, P<0.001). Hypocalcemia was more common in the cinacalcet arm, whereas hypercalcemia and hyperphosphatemia occurred more often in the vitamin D analog arm., Conclusions: Participants had similar modest reductions in PTH with either cinacalcet or vitamin D analog monotherapy over 52 weeks of treatment, but effects varied by region. Treatments differed with regard to effect on calcium and phosphorus levels., (Copyright © 2015 by the American Society of Nephrology.)

The study involved 110 adolescents from 15 to 22 years (35 boys, 75 girls). To assess eating habits and physical activity we used WHO questionnaires. We also analyzed anthropometry, bioimpedance data, parameters of the cardiovascular system: systolic and diastolic blood pressure, heart rate. It has been shown, that body mass index (BMI) in adolescents didn’t correlate with the content of both total and visceral adipose tissue in the body and shoud not be used as a major diagnostic criterion of obesity. An excessive content of total adipose tissue was shown in 15% of the puberty and postpuberty teens. Visceral fat content was significantly higher in male, than female (3.03±3.31 vs 2.11±1.57%), independently of the total fat percentage (18.91±16.83 and 31.72±19.24% respectively). The visceral fat in the body begins to increase in age of 16. According to the authors, such an effect in boys and girls is associated with the final changes of puberty (concentration of sex steroids). Such hormons like testosterone and progesterone and estradiol have different effects on the white adipose tissue and play a key role in proceses of its differentiation and metabolism. Percentage of total adipose tissue depends on dietary habits in the first place – the predominance of fast food. A significant relationship of physical activity and the percentage of visceral fat was shown.

Background: Haemodiafiltration (HDF) is the preferred dialysis modality in many countries. The aim of the study was to compare the survival of incident patients on high-volume HDF (HV-HDF) with high-flux haemodialysis (HD) in a large-scale European dialysis population., Methods: The study population was extracted from 47,979 patients in 369 NephroCare centres throughout 12 countries. Baseline was six months after dialysis initiation; maximum follow-up was 5 years. Patients were either on HV-HDF (defined as with ≥21 litres substitution fluid volume per session) or on HD if on that treatment for ≥75% of the 3 months before baseline. The main predictor was treatment modality. Other parameters included country, age, gender, BMI, haemoglobin, albumin and Charlson comorbidity index. Propensity score matching and Inverse Probability of Censoring Weighting (IPCW) were applied to reduce bias by indication and consider modality crossover, respectively., Results: After propensity score matching, 1,590 incident patients remained. Kaplan-Meier and proportional Cox regression analyses revealed no significant survival advantage of HV-HDF. Results were biased by modality crossover: during the 5-year study period, 7% of HV-HDF patients switched to HD, and 55% of HD patients switched to HV-HDF. IPCW uncovered a statistically significant survival advantage of HV-HDF (OR 0.501; CI 0.366-0.684; p < 0.001). A higher benefit of HV-HDF for some subgroups was revealed, for example, non-diabetics, patients 65-74 years, patients with obesity or high blood pressure., Conclusions: This large-scale study supports the generalizability of previous RCT findings regarding the survival benefit of HV-HDF. Sub-group analysis showed that some sub-cohorts appear to benefit more from HV-HDF than others.

Infectious pathology in the neonatal period is of the leading causes of neonatal morbidity and mortality. Urinary tract infection occurs in 23% of all infectious diseases. The treatment of infectious diseases mainly employs eradication therapy, mostly with anti-bacterial drugs. In practice, the therapy of infants frequently employs prescribing off-label drugs (cephalosporins 1 and 4 generation, macrolides, carbapenem, sulfonamides), which extends the duration of therapy on the average by 37.1% and increases the incidence of adverse reactions on the average by 11.4%. We believe that neonatologists should use drugs in accordance with prescription labeling. Elucidation of age-related restrictions, dosing, administration ways, and therapy duration must be carried out in the framework of clinical investigations. This is important for increasing the efficacy and safety of practical drug therapy.

We investigated the intensity of barium sulfate stimulated luminol-dependent chemiluminescence (SLCL) of pre-incubated blood with various concentrations of sodium salicylate, sodium metamizol or sodium diclofenac. Blood was received from healthy donors and patients with intolerance to aspirin and/or sodium metamizol and/or sodium diclofenac. Revealed valid differences in SLCL of blood received from healthy donors and patients with intolerance to these drugs allows us to use chemiluminescence method for the diagnosis of intolerance to non-steroidal anti-inflammatory drugs.

Periodontal disease is a pathological condition that involves inflammation of the tooth supporting structures. Accumulated lines of evidence suggest that hyperimmune responses to periodontal bacteria result in the destruction of periodontal connective tissue and alveolar bone. In this review, we discuss several aspects of the immune-inflammatory host response that ultimately results in loss of alveolar bone and stimulates osteoclastogenesis.

As part of research project translation and validation of Oral Health Impact Profile (OHIP) quality of life questionnaire has been administered. 25 patients have been interviewed (8 men and 17 women), the average age was 40+/-8 years, with evidence of chronic generalized periodontitis. The clinical picture of the disease development in those patients was common. All patients perceived questions of the pilot questionnaire version correctly. The relations between the quality of life and the sex of patients, social status and other factors have been found statistically significant.

The method of cell-associated antibiotic therapy consists of extracorporal exposure of the autoblood formed elements to antibiotic solution followed by their reinfusion. Pharmacokinetics of erythromycin after its intravenous and cell-associated administration in patients with community-acquired pneumonia and the clinical efficacy of the method were evaluated. HPLC of the erythromycin pharmacokinetic pattern in 20 patients showed that after the antibiotic target transport the pharmacokinetic model changed from one-compartment to two-compartment one and the antibiotic maximum concentration and elimination rate were lower vs. the intravenous administration. It was also shown that the clinical efficacies of the erythromycin intravenous administration and target transport did not significantly differ, whereas after the cell-associated transport of the antibiotic the therapeutic effect was observed earlier and the side effects were less frequent.

Aim: To examine lymphocyte ability to synthetize interferon-gamma in patients with mitral prolapse (MP)., Material and Methods: The diagnosis of MP was made in 75 patients at echocardiography. ECG monitoring was made and the study of the ability of blood lymphocytes to produce IFN-gamma (If-g)., Results: The ability to produce If-g was diminished. This phenomenon is associated with chronic inflammation, autonomic disregulation of cardiac activity, depends on gender., Conclusion: Cytokine modulates metabolism of connective tissue in MP so If-g may participate in MP pathogenesis. Therefore, If-g and/or its inductors may prevent some MP-related complications due to its deficiency.