Цель работы - сопоставление показателей СКФ, рассчитанных на основании сывороточных концентраций креатинина и цистатина С у 86 пациентов 60-92 лет (средний возраст - 75±7 лет) с ХСН и саркопенией. СКФ рассчитывали по формулам на основе креатинина ( CKD-EPIСr ), цистатина С ( CKDEPIСys ) крови и обоих маркеров ( CKD-EPIСr-Cys ). Концентрацию цистатина С в сыворотке крови определяли иммунотурбидиметрическим методом, креатинина - Яффе-кинетическим методом. У всех больных исследован композитный состав тела с помощью двуэнергетической рентгеновской абсорбциометрии с расчетом индекса саркопении (по критериям FNIH, 2014 г.) и измерена общая жировая масса. Проведены тест с 6-минутной ходьбой, оценка по шкале ШОКС, трансторакальная эхо-КГ с измерением конечного диастолического размера, конечного систолического размера, ФВ ЛЖ, массы миокардаЛЖ, индекса массы миокарда ЛЖ, показателей диастолической функции ЛЖ. В зависимости от критериев диагностики саркопении пациенты были разделены на две группы: 1-я ( n =42) - сочетание ХСН и саркопении; 2-я ( n =44) - ХСН без саркопении. У больных с ХСН и саркопенией наблюдали переоценку СКФ, рассчитанной по уровню креатинина, на 23% (абсолютная разница - более 18 мл/мин на 1,73 м) по сравнению с СКФ, оцененной по уровню цистатина С . У больных с ХСН и саркопенией при использовании сывороточной концентрации креатинина имеет место гиподиагностика выраженности хронической болезни почек. В этой связи при наличии признаков саркопении для расчета СКФ рекомендуется использовать формулу CKD-EPIСys . The purpose of the research is comparison of glomerular filtration rate calculated on the basis of serum concentrations of creatinine and cystatin C in patients with chronic heart failure and sarcopenia. In this research 86 patients with chronic heart failure and sarcopenia aged 60 to 92 years (mean age 75±7 years) were examined. GFR calculation was determined using formulas based on creatinine ( CKD-EPIC ), cystatin C ( CKD-EPICys ) in blood and both markers ( CKD-EPICr-Cys ). The concentration of cystatin C in blood serum was determined by the immunoturbidimetric method, and creatinine by the Jaffe kinetic method. Composite body composition was studied in all patients using dual-energy X -ray absorptiometry with calculation of the sarcopenia index (according to FNIH criteria, 2014) and measurement of total fat mass. A test with a 6-minute walk, an assessment according to the SHOKS scale (clinical condition assessment scale for CHF), transthoracic echocardiography with the measurement of EDD, ESD, LVEF, LVМ, LVIM, indicators of LV diastolic function was performed. Depending on the diagnostic criteria for sarcopenia, patients were divided into 2 groups: the first - a combination of heart failure and sarcopenia; the second - CHF without sarcopenia. In patients with CHF and sarcopenia, GFR was reassessed as calculated by the creatinine level by 23 % (the absolute difference is more than 18 ml/min/1,73 m) compared with GFR estimated by the level of cystatin C . In patients with heart failure and sarcopenia, when using a serum concentration of creatinine, there is a hypodiagnostics of the severity of chronic kidney disease. In this regard, if there are signs of sarcopenia, it is recommended to use the formula CKD-EPICys to calculate GFR.

Introduction. At present, global prevalence of celiac disease attracts increasingly greater attention of researchers. The study of its extraintestinal manifestations is a crucial task for early and timely diagnosis of the disease, as well as the identification of new risk groups. To date, there are only isolated publications concerning the study of celiac disease incidence in patients with acne. This topic is of particular interest since systemic retinoids with a hepatotoxic effect and antibiotics significantly affecting the intestinal microflora are the first-line drugs in the treatment of moderate and severe acne. Undoubtedly, these side effects influence on the course of acne in celiac patients. So, to prevent the complications of the treatment, it is necessary to search, develop and introduce into practice safe combinations, including drugs having a protective effect both for the intestinal microflora and for the liver. It is known that psyllium (Plantago ovata seed shells/Ispaghula husks) have similar effects.Objective. To study the effect of psyllium on the tolerability and effectiveness of systemic therapy with isotretinoin and doxycycline in patients with moderate acne with celiac disease. Material and methods. We examined 65 patients with celiac disease suffering from moderate acne, who were randomized into two groups – group 1 (taking an antibiotic – doxycycline) and group 2 (taking a systemic retinoid – isotretinoin), then each group was divided into two subgroups A and B, depending on the prebiotic intake (powder of oval plantain seeds shells Plantago ovata Forssk (psyllium). The patients were followed up for 8 and 24 weeks, respectively. All patients received adjuvant topical therapy. In each group, a medical check-up was done before treatment, 2 months after the onset and then after the treatment completion.Conclusion. Patients in both subgroups who received psyllium in addition to antibiotics and systemic retinoids treatment showed better results after treatment in terms of skin condition, overall health and quality of life.

Выполнено лабораторное исследование цитокинового профиля и содержания молекул межклеточной адгезии у 38 пациентов с начальными признаками кальциноза аортальных полулуний. Определено, что содержание IL -6 и IL -8 имело достоверно более высокие значения по сравнению с контрольной группой, что свидетельствует о непосредственной роли неспецифического хронического воспаления при развитии кальцинирующего поражения клапана аорты. Также было выявлено значимо более низкое содержание sE -селектина, что может говорить об отсутствии активации молекул адгезии на начальном этапе формирования кальциноза клапана аорты. Необходимо дальнейшее изучение динамики содержания sE -и sP -селектинов в процессе развития ускорения кровотока на аортальном клапане и формировании стеноза. A laboratory study of the cytokine profile and the content of the intercellular adhesion molecules was performed in 38 patients with initial signs of aortic hemilunus calcification. It has been determined that the content of IL -6 and IL -8 had significantly higher values compared with the control group, which indicates the direct role of nonspecific chronic inflammation in the development of calcifying aortic valve damage. A significantly lower content of sE -selectin was also identified, which may indicate the absence of activation of adhesion molecules at the initial stage of aortic valve calcification. Further study of the dynamics of sE - and sP -selectins content in the process of development of acceleration of blood flow in the aortic valve and the formation of stenosis is needed.