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The aim of the investigation was to assess the significance of the content of metabolites of the nitric oxide, sICAM-1 and sICAM-3 in blood serum and in exhaled breath condensate, the serum level of endothelin-1 as systemic and topical markers of inflammation in patients with COPD, and their correlations with the parameters of lung ventilation function. Materials and Methods. 91 patients with COPD, aged from 46 to 67, and 21 healthy, non-smoking volunteers took part in the study. The material for investigation was blood serum and exhaled breath condensate.Results. The severity of progression of COPD was linked with an increase in the serum content of sCD50, sCD54, ET-1, as well as in the concentrations of metabolites of nitric oxide in blood and in exhaled breath condensate. For the patients with COPD we determined the associations between the function of pulmonary ventilation and the levels of ET-1, sICAM-1, sICAM-3 and the value of ΣNO 2 -/NO 3 -. The resulting correlations between the concentration of soluble adhesion molecules, the values of nitrosative stress, and ET-1 level indicate that they are involved in the genesis of chronic inflammation in COPD patients.Key words: chronic obstructive pulmonary disease; COPD; endothelin-1; ET-1; nitrosative stress; soluble molecules of adhesion ICAM-1 and ICAM-3; exhaled breath condensate. Markers of progression of inflammation in COpDThe steady increase in the prevalence of chronic obstructive pulmonary disease (COPD) and the mortality rate associated with this pathology indicate the importance of studying the pathogenic mechanisms of development of this disease [1]. The identification of new activity markers and the progression of inflammation are key tasks in the studies of these mechanisms.The result of the immune-mediated mechanisms of inflammation in response to damaging factors is the excessive migration of effector cells to the

Changes in nitric oxide metabolism in co morbidity of chronic obstructive pulmonary disease and chronic cerebral ischemia SummaryThe study was aimed at investigation of nitric oxide (NO) metabolism including total and separate concentrations of stable NO metabolites (nitrate anions and nitrite anions) and 3 nitrotirosine concentration in stable chronic obstructive pulmonary disease (COPD) and in COPD with concomi tant chronic cerebral ischemia (CCI). The study involved 55 patients aged 51 to 67 years divided into 2 groups: 28 patients with COPD II-III stage (the 1 st group) and 27 patients with COPD II-III stage and concomitant CCI II-III stage (the 2 nd group). The control group included 25 healthy non smoking volunteers. A significant increase in nitrate anion concentration and in the total nitrite and nitrate concentration was found in the blood of patients of both groups compared to the controls. A statistically significant inverse relationship was found between the blood nitrite anion concentration and FEV1 (r = -0.77; p < 0.05) in COPD patients. These results demonstrate that changes in NO metabolism related to nitrous stress could emerge even in stable COPD. In co existing COPD and CCI, changes in these biomarkers could be also related to functional particularities of nitrite reductase apart from the nitrous stress.

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The emergence of SARS-CoV-2 and its worldwide spread has become a challenge for healthcare professionals related to rapid diagnosis of infection caused by the new coronaviruses, provision of specialized medical care, rehabilitation and secondary prevention. Currently, there is limited information on primary, secondary prevention and medical rehabilitation of this disease. The most common clinical manifestation of the new variant of coronavirus infection is bilateral pneumonia, with 34% of patients developing acute respiratory distress syndrome (ARDS). Given the unusual pandemic situation and the peculiar COVID-19 pathogenesis, the stereotyped application of generally accepted methods may be unsafe or ineffective. The Union of Rehabilitologists of Russia has prepared Temporary guidelines that are based on the advice on medical rehabilitation of patients with COVID-19 at various stages of special medical care published by WHO specialists, analysis of reports from clinics currently involved in rehabilitation of COVID-19 patients, as well as on the results of clinical studies conducted earlier on the rehabilitation of patients with Post-intensive care syndrome and adult respiratory distress syndrome (ARDS) of non-coronavirus etiology, regulatory documents of the Russian Ministry of Health and Federal Service on Surveillance for Consumer rights protection and human well-being. A syndrome-based approach to the use of means and methods of physical and rehabilitation medicine is also considered. The guidelines are intended for heads of medical organizations and their structural divisions, general practitioners, physicians, infectious disease doctors, pediatricians, emergency physicians of intensive care units in infectious hospitals, physiotherapy and sports medicine doctors, physiotherapists, medical psychologists, physical therapy instructors, nurses and other specialists of multidisciplinary rehabilitation teams working in the field of medical care for patients with COVID-19 at various stages.