Vol 25, No 3 (2021): PULMONOLOGY

Relevance . Respiratory infections are the most common in the world. In order to prevent epidemics, there is a need to improve the strategies for organizing medical care and develop new approaches in order to increase the nonspecific resistance, mobilize innate immunity. Objective . The aim of this study was to investigate the effect of glucosaminylmuramyldipeptide (GMDP) on the level of expression of markers of differentiation and activation of functionally significant subpopulations of dendritic cells in peripheral blood mononuclear cells of healthy donors,the second aim was to assess the effectiveness of GMDP in the prevention of acute respiratory infections in an unfavorable epidemiological period of the COVID-19 pandemic. Materials and Methods . An open comparative study included 309 apparently healthy participants, aged 19-22 years. At the first stage of the study, 42 participants (22 female and 20 male) took the drug Licopid 1 mg for 10 days according to the instructions, 1 tablet 3 times a day in order to prevent acute respiratory infections. Peripheral blood sampling was performed before taking the drug (day 0) and the next day after the last dose of the drug (day 12). Evaluation of the expression of markers of differentiation and activation of dendritic cell subpopulations HLA-DR, CD11c, CD123, CD80, CD83, CCR7, CD3, CD14, CD20 was assessed by flow cytometry. At the same time, mRNA was isolated from mononuclear cells of perfusion blood and, after reverse transcription, the level of gene expression was determined by RT PCR. At the next stage, the effectiveness of the prophylactic use of the drug Licopid in 267 students of the Institute of Physical Culture was assessed in order to prevent acute respiratory infections in an unfavorable epidemiological period; the observation period was 12 months. Results and Discussion . A study of the relative quantitative composition of DCs in the peripheral blood of healthy donors by flow cytometry revealed the possibility of an increase in their total number, as well as subpopulations of MDC and PDC under the influence of GMDP. There was a statistically significant increase in the receptors for the chemokine CCR7, which is responsible for the recruitment of DCs to the secondary lymphoid organs. Analysis of the levels of expression of genes XCR1, CD11b , and CD103 showed a statistically significant effect of GMDP on an increase in their expression compared to the baseline level (before GMDP intake), with the mean value being higher in participants undergoing moderate exercise. It was found that the use of the drug Licopid 1mg for the purpose of preventing and reducing the seasonal incidence of acute respiratory infections at the stage of basic training of students of the Institute of Physical Culture contributed to a decrease in the incidence of acute respiratory infections within 12 months of observation after taking the drug. The number of episodes of acute respiratory infections decreased 3.7 times, while the group with 3 or more episodes of acute respiratory infections during the year, which constituted 14.5 % of participants, completely disappeared. The maximum efficiency of GMDP was observed in the track and field command, in which the number of participants who had no episodes of acute respiratory infections during the year increased by 7 times. Conclusion . Our data complement the modern understanding of the molecular mechanism of action of GMDP and substantiate the possibility of its experimental and clinical use in order to develop new strategies for organizing medical care in order to increase the nonspecific resistance of the organism.

Relevance . Oxygen therapy is commonly used in the emergency and critical cases which is the first line treatment in many critical conditions. Oxygen therapy is a medical treatment prescribed mainly for hypoxic patients, which provides oxygen at higher concentrations than that found in atmosphere (>21%). Oxygen administering depends on the needs of the patients’ conditions and in some cases medical treatment. The present study aims to assess the level of awareness on oxygen therapy among nurses and examine the association between level of knowledge, attitude and selected socio-demographic variables. Materials and Methods . A quantitative descriptive cross-sectional study design was used. A non-probability purposive sampling technique was used to select 125 samples. The data were collected for 6 weeks using a semi-structured self-administered questionnaire. Descriptive statistics (frequency, percentage, mean, standard deviation) was used for quantitative data analysis and inferential statistics (chi-square) were used to find out the association between level of knowledge, attitude and selected socio-demographic characteristics of the respondents. Results and Discussion . The study revealed that 74.4% of the nurses had unsatisfactory level of knowledge, 20% had average knowledge and 5.6% had satisfactory level of knowledge regarding oxygen therapy. A significant association was found between the knowledge level and age, educational status and experience of the respondents (p=0.001, 0.000, 0.016). Conclusion . The study concluded that the level of knowledge among nurses regarding oxygen therapy has lower than expected and is unsatisfactory. The results of the study can provide a framework for the healthcare policymakers to develop and implement educational programs on oxygen therapy for nurses in hospital setting.

Relevance . Epilepsy is a common neurological disease in tropical countries, especially in Africa. Its prevalence in African countries is almost twice as high as in Asia, Europe and North America. Objective: to investigate the characteristics of the spread and risk factors of epilepsy in the countries of the African continent. Materials and Methods : Based on WHO data, an epidemiological analysis of the prevalence and structure of mortality from epilepsy among the inhabitants of continental Africa was carried out. The African continent was clustered into five different regions with conventionally homogeneous sociocultural, climatic and geographic and environmental conditions and, as a consequence, similar dynamics of endemic diseases and infections. Demographic data, etiological factors, risk factors such as infectious diseases (including neglected diseases) with neurological consequences in the form of deaths from epilepsy were compared in five centers in the region. Mathematical and statistical processing of the results was carried out using the SPSS-19 statistical package (SPSS Inc., USA). Results and Discussion . Analysis of socio-demographic characteristics made it possible to establish that mortality from epilepsy is higher: in the countries of the African continent south of the Sahara in comparison with northern Africa; in women compared to men; in the age group younger than 14 compared to older groups and also in countries of subregions with an unsatisfactory state of national health systems and a low level of socio-economic situation in general. Conclusion . State programs aimed at reducing various factors of injury, violence, the prevalence of maternal mortality and hunger, the frequency of suicide among the population can help reduce the prevalence and mortality from epilepsy. In addition, a significant number of risk factors for epilepsy in African countries are virulent and potentially preventable. First of all, these include: neurocysticercosis, schistosomiasis, HIV infection and various forms of meningitis. Health care interventions to prevent these diseases can also significantly reduce the prevalence of epilepsy.

Relevance. Scars are multi-tissue structures that significantly reduce the quality of life of the young, able-bodied population. The most socially significant variants are represented by hypertrophic and keloid postoperative scars and scars after burns, atrophic scars after acne vulgaris and striae. Growth factors, which are also used for their treatment, play a significant role in their formation and progression. The aim of this work is to summarize data on the participation of growth factors (transforming growth factor beta-1 and vascular endothelial growth factor) in the formation of a hypertrophic or atrophic scar. Materials and Methods. The study of literary sources of scientometric scientific bases was carried out. Results and Discussion . The study showed that the duration of the scarring phases preceding it is of great importance in scar formation, their prolongation leads to chronic inflammation and the attachment of an autoimmune component, an increase in the number of myofibroblasts due to inhibition of apoptosis and an increase in the synthesis of intercellular substance and immature forms of collagen, as well as thinning of the epidermis over scar. Growth factors such as growth factor beta-1 and vascular endothelial growth factor are capable of shifting the balance of these two main pathways or towards proliferative processes, contributing to an increase in the number of blood vessels in the hemomicrocirculatory bed, the number of mast cells and total cellularity, as well as, in some cases, the synthesis of keloid - that is, the formation of a hypertrophic or keloid scar. On the contrary, the prevalence of inflammatory processes leads to a decrease in cellularity, a decrease in blood vessels and intercellular substance, as well as damage to elastin and collagen fibers, forming the phenotype of an atrophic scar or striae. Conclusion. Growth factors play a key role in scar formation, contributing to an increase in the number of blood vessels in the hemomicrocirculatory bed, the number of mast cells and total cellularity, as well as, in some cases, the synthesis of keloid - that is, the formation of a hypertrophic or keloid scar.

Relevance. The topicality of the work is determined by the wide spread of hypomagnesemia among the people, which makes it necessary to correct it. The aim of the work is to elucidate the cell-mediated response of the thymus mastocytic link to magnesium deficiency and its correction by the mechanoactivated form of magnesium orotate. Materials and Methods . Animals with drug-induced magnesium deficiency (administration of furosemide 30 mg/kg for 14 days) were administered either the initial preparation Magnerot (Magnerot©, Vervag Pharma, Germany), or its mechanoactivated form. The level of magnesium in the blood was determined by test systems «ARKREY» (Japan). The concentration of magnesium in the thymus tissue was determined by the method of emission spectroscopy with inductively coupled (argon) plasma on an atomic emission spectrometer. Density of mastocytes and the indices of degranulation and granulolosis were calculated on paraffin sections of the thymus after coloration with toluidine blue. Results and Discussion . It was shown that furosemide administration the amount of magnesium decreased in the blood (from 1,75±0,08 to 0,902±0,18 mmol/l, p<0,05), but increased in the thymus (from 1,6±0,6 in the control to 3,7±1,2 mg/l); in the gland tissue, the number of mastocytes of morphotype «A» decreased and the number of mastocytes of morphotype «D», after active degranulation, increased (by 7,1 times, p<0,05). The type of mastocyte secretion in hypomagnesemia is represented by the merocrine variant. The administration of the initial magnesium orotate led to an increase in the concentration of magnesium in the blood to 1,15±0,25 mmol/l, which is 65,7% of the initial level, the amount of magnesium in the thymus remained elevated (3,4±1,1 mg/l), the number of actively degranulating cells (morphotype «D») was increased. Mechanoactivated magnesium orotate restored the concentration of Mg2+ in the blood to 89,1% (1,56±0,18 mmol/l, p>0,05) and decreased in the thymus (to 2,3±0,7 mg/l), restored the subpopulation of mastocytes saturated with heparin (type «A»), reduced the number of mastocytes of morphotype «D». Conclusion . The mechanoactivated form of magnesium orotate has a normalizing effect on the population of thymic mastocytes, shows pronounced immunomodulatory activity, which allows us to consider it as a potential therapeutic agent for clinical testing in the complex therapy of hypomagnesemia and associated immunodeficiency.