Резолюция экспертного совета “Актуальные вопросы железодефицита в Российской Федерации”

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a significant public health concern, affecting millions of people worldwide. This study aims to use Surface-Enhanced Raman Scattering (SERS) technology to detect the presence of respiratory conditions, with a focus on COPD. Methods: The samples of human serum from 41 patients with respiratory diseases (11 patients with COPD, 20 with bronchial asthma (BA), and 10 with asthma–COPD overlap syndrome) and 103 patients with ischemic heart disease, complicated by chronic heart failure (CHF), were analyzed using SERS. A multivariate analysis of the SERS characteristics of human serum was performed using Partial Least Squares Discriminant Analysis (PLS-DA) to classify the following groups: (1) all respiratory disease patients versus the pathological referent group, which included CHF patients, and (2) patients with COPD versus those with BA. Results: We found that a combination of SERS characteristics at 638 and 1051 cm⁻¹ could help to identify respiratory diseases. The PLS-DA model achieved a mean predictive accuracy of 0.92 for classifying respiratory diseases and the pathological referent group (0.85 sensitivity, 0.97 specificity). However, in the case of differentiating between COPD and BA, the mean predictive accuracy was only 0.61. Conclusions: Therefore, the metabolic and proteomic composition of human serum shows significant differences in respiratory disease patients compared to the pathological referent group, but the differences between patients with COPD and BA are less significant, suggesting a similarity in the serum and general pathogenetic mechanisms of these two conditions.

The earliest correction of behavioral risk factors for chronic non-communicable diseases will reduce the rates of premature mortality of the population. Currently, the relationship between the altered spectrum of intestinal microflora in various indicators of suboptimal health status and body mass index is not sufficiently studied. When they are in a state of suboptimal health status, patients consider themselves healthy and do not go to the doctor for a long time, which makes it difficult to implement early preventive measures in this group of patients. Goal. To determine the qualitative and quantitative composition of the intestinal microflora before and 1 month after taking a metaprebiotic complex containing dietary fiber (inulin) and oligosaccharides (oligofructose) in outpatient patients who consider themselves healthy, have behavioral risk factors for chronic non-communicable diseases or chronic non-communicable diseases in remission, and/or do not consult a doctor within the last 3 months. Materials and methods. Outpatient patients were examined (114 people: 36 men, 78 women aged 18 to 72 years). A survey was conducted, including a detailed active collection of complaints (including using the international SHSQ-25 questionnaire) and anamnesis, as well as a thorough physical examination with an anthropometric study. Using the MALDI-ToF mass spectrometry method, the degree of microbiotic disorders, the structure of the intestinal microflora were determined with the identification of microorganisms isolated from feces before and after taking the course of the metaprebiotic complex with various indicators of suboptimal status and body mass index. Results. New data were obtained on the intestinal biocenosis of patients who consider themselves healthy at different levels of suboptimal status. When using a metaprebiotic complex containing inulin and oligofructose, an improvement in the composition of the intestinal microflora was found due to a decrease in the frequency of release of conditionally pathogenic enterobacteria and other gram-negative microorganisms (median degree of contamination: from 0.45 (0.3-0.98) to 0.3(0.21-0.7) at low suboptimal status and from 0.5(0.7-1.7) to 0.31 (0.2-1.3) at high) and increase the frequency of enterococcal excretion (median degree of contamination: from 5,58 (4,16-7,0) tо 6,3 (4,8-7,8) at low suboptimal status and from от 4,5 (2,8-6,3) tо 5,1 (3,8-6,4) at high). Conclusion. The importance of studying the microbiotic complex of the intestine in increasing the indicators of suboptimal health status and body mass index in patients who consider themselves healthy is proved, which will allow for the earliest detection and rational individual prevention of chronic non-communicable diseases.

Bronchial asthma is a widespread disease that is becoming increasingly costly to the medical and financial systems of many countries with each passing year. The rising prevalence of bronchial asthma necessitates a search for the most efficient diagnostic and treatment strategies for various asthma phenotypes, including some that are relatively uncommon. From this point of view, glycomics appears to be one of the most interesting and perspective branches of medicine. This research area studies various carbohydrate complexes and their roles in the development of various diseases. Researchers are interested in the study of the receptors for advanced glycation end products and their soluble variants with regard to bronchial asthma. Furthermore, sialic acid-binding immunoglobulin-type lectins (Siglecs) may play a vital role in the principal novel strategies of the treatment. By affecting Siglecs, a decrease in the proinflammatory activity of immunocompetent cells results, and the bronchial walls are protected. Finally, N- and O-glycans remain almost unresearched. These molecules, on the other hand, have the potential to play a significant role not only in the diagnosis and confirmation of asthma but also in the allergenicity of various molecules. Scientists are interested in N-glycans, not only in the diagnostic context but also in their role as a molecule that can reduce allergenicity, for example, egg white vaccines. Glycomics and glycoproteomics are cutting-edge disciplines of medical science that are opening up new perspectives in the management of patients with diseases of various organs and systems, including diseases of the respiratory tract in general and bronchial asthma in particular. Despite the fast-paced nature of the development of glycoscience, theories about the role of the molecules investigated in the pathophysiology of respiratory disorders are only beginning to emerge.

The functional responsibilities of general practitioners (family doctors) (GPs) have changed significantly over the past decade. The number of GP functions has expanded. Despite the increasingly complex professional activities of GPs, there is no scientific evidence for the qualification characteristics of GPs expressed in knowledge, skills, abilities, and competencies in the theory and practice in training. In this regard, a study was conducted to determine the priority of GP competencies that make up the qualification characteristics of a specialist. Aim. To analyze, generalize and rationale the research results, as well as to develop preliminary guidelines for GP training. Material and methods. The information base for the study was the results of ranking competencies according to their importance in the professional activities of GPs in Russia. It was obtained during the ascertaining experiment, implemented using the Delphi method as a method of expert assessment and strategic planning of training specialists. Conclusion. The analysis of competencies developed and agreed upon by experts showed its compliance with the job functions of GPs, the requirements of the Federal State Educational Standard for the General Medical Practice (Family Medicine) and the WONCA guidelines. A summary of the study results to determine the priority of competence in GP activities showed the following: — all competencies (25) were defined as necessary and constitutive of GP qualification; — 21 competencies were considered significant and highly significant for GPs; — 4 competencies were considered as of moderate significance and below moderate significance. The analysis of the priority of competences revealed insufficient methodological support for GP training in accordance with the social order. The results obtained showed the need to continue the study within the project "Quality Management of Training of General Practitioners (Family Doctors)".

Роль опросников по оценке физической активности и субоптимального статуса здоровья для первичного скрининга сердечно-сосудистых заболеваний