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Ehrlich A.D.,Federal Medical Biology Agency
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk | Year: 2012

The term registry in individual application to patients with acute coronary syndrome (ACS) is discussed in this review. The author performs a detailed analysis of literature concerning objectives and goals of registries and their significance in clinical practice. The marked differences can be found between registries and randomized clinical trials (RCT). After the example of ACS registries the author shows the influence of information received according to registries limits on the formation of recommendations on treatment of patients with ACS. Source


Oradovskaya I.V.,Federal Medical Biology Agency | Pashchenkova Y.G.,Federal Medical Biology Agency | Feoktistov V.V.,Federal Medical Biology Agency | Nikonova M.F.,Federal Medical Biology Agency | And 3 more authors.
Biophysics | Year: 2011

It was demonstrated that malignant neoplasms (MNs) most frequently develop in the liquidators involved in the cleanup activities after the Chernobyl nuclear accident (ChNA) in 1986 (43.75%) and the liquidators involved in long-term activities, one-quarter of whom also participated in the cleanup in 1986. The specific features of the immune status (IS) depending on the period and year of the cleanup activities in the ChNA area were determined. In the cohort with a confirmed MN diagnosis, the observed deviations in the people who participated in these activities only in 1986 and on a permanent basis, including 1986, coincided in their pattern but differed in the magnitude of changes in immunological characteristics. Long-term participation during the extreme period and, correspondingly, higher exposure caused an increase in the contents of CD8+ T cells, CD16+ lymphocytes, and activated T lymphocytes, as well as decreases in the total immunoregulatory index, percentage of CD3-16/56+ (NK), and total IgE and a more pronounced deficiency in B lymphocytes. Differences between the groups of liquidators who participated in the cleanup activities in 1986 and 1987 were detected. The liquidators-1987 display the most pronounced deviations in the IS characteristics. Permanent presence in the ChNA area in 1986 and 1987 caused a similar effect but the magnitude of changes in the content of CD4+ T lymphocytes (↓), content of CD8+ T lymphocytes (↑), and immunoregulatory index (↓) was considerably higher in liquidators-1987. The permanent cleanup activities in Chernobyl in 1987 caused a deficiency in CD4+ T lymphocytes; more pronounced increase in the content of CD8+ T lymphocytes; decrease in CD4+/CD8+ index; change in the ratio of NK-T to NK cells; elevation in the counts of CD95+, HLA-DR+, and activated T lymphocytes; and decrease in the level of total IgE. Any increase in the expression of cell activation markers was undetectable in the liquidators-1986 involved in the cleanup activities on a long-term basis. The specific features of the IS changes depending on the dose of external γ-irradiation were determined. It was shown that the MN rate in liquidators increases with age relative to the number of examined people in each age cohort. The differences in the IS age-related dynamics in liquidators with and without MNs were detectable in stable contents of CD3+, CD4+, and CD8+ T lymphocytes; immunoregulatory index; and contents of CD95+ cells and serum IgA at ages of 40 to 70 years old with a subsequent decrease in these parameters and elevation in the content of CD8+ T lymphocytes with age in the absence of MNs; continuous increase in CD3-16/56+ (NK) cells in the presence of MNs; and decreases in these values after 70 years in the absence of MNs. In both groups of liquidators older than 70 years (with and without MNs), a deficiency in the T-cell component (CD3+ and CD4+ T lymphocytes and CD4+/CD8+ ratio) and an increase in the counts of CD8+ T lymphocytes are characteristic of the IS. A growing deficiency in CD4+ T lymphocytes during the monitoring on the background of increasing content of CD8+ T lymphocytes, which additionally contributes to the weakening of immune regulation due to progressing abnormalities in the ratio of regulatory T-lymphocyte subpopulations, can be regarded as one of the characteristics that suggest an adverse life expectancy prognosis for people with MNs. © 2011 Pleiades Publishing, Ltd. Source


Oradovskaya I.V.,Federal Medical Biology Agency | Pashchenkova Y.G.,Federal Medical Biology Agency | Feoktistov V.V.,Federal Medical Biology Agency | Nikonova M.F.,Federal Medical Biology Agency | And 3 more authors.
Biophysics | Year: 2011

Ionizing radiation is one of the major risk factors for cancer diseases. The question on the rate of malignant neoplasms (MNs) and their early detection in Chernobyl nuclear accident (ChNA) liquidators is still open. In this work, the results of a long-term immunological monitoring of the ChNA liquidators who live in the northwestern region of Russia have been analyzed with an attempt to detect the predictors of cancer in this population cohort. The rate of newly detected MN cases in the cohort of followup ChNA liquidators monitored in 1990-2009 was 8.856% (89 cases per 1005 persons), which is somewhat higher as compared with the average rate for the total population. As for the rate of individual MN types, lung, gastric, and prostate cancers were prevalent, which matches the worldwide trend in MN abundance. It was shown that 1-3 years before the MN diagnosis, liquidators displayed detectable changes in their immune status, including a decrease in the percentages of CD3+ and CD4+ T lymphocytes, and, to a lesser degree, B lymphocytes; a decrease in the CD4+/CD8+ ratio; increase in the relative and absolute contents of CD16+ lymphocytes; increase in the absolute CD8+ T lymphocyte counts; prevalence of CD3+16/56+ (NK-T) cells over CD3-16/56+ (NK) cells; and increase in the activity of phagocytes. The patients who displayed one or several of the listed characteristics should be ascribed to the MN risk group to be assessed for cancer markers, be more comprehensively examined, and be the subjects of dynamic observation. © 2011 Pleiades Publishing, Ltd. Source

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