Objectives Sodium zirconium cyclosilicate (SZC) is a novel, highly selective potassium binder currently approved in the United States and European Union for treatment of hyperkalemia. This pilot evaluation explored the efficacy of SZC with insulin and glucose as hyperkalemia treatment in the emergency department (ED). Methods This exploratory, phase II, multicenter, randomized, double‐blind, placebo‐controlled study (NCT03337477) enrolled adult ED patients with blood potassium ≥ 5.8 mmol/L. Patients were randomized 1:1 to receive SZC 10 g or placebo, up to three times during a 10‐hour period, with insulin and glucose. The primary efficacy outcome was the mean change in serum potassium (sK+) from baseline until 4 hours after start of dosing. Results Overall, 70 patients were randomized (SZC n = 33, placebo n = 37), of whom 50.0% were male. Their mean (± standard deviation [±SD]) age was 59.0 (±13.8) years and mean initial sK+ was similar between groups (SZC 6.4 mmol/L, placebo 6.5 mmol/L). The least squares mean (±SD) sK+ change from baseline to 4 hours was –0.41 (±0.11) mmol/L and –0.27 (±0.10) mmol/L with SZC and placebo, respectively (difference = –0.13 mmol/L, 95% confidence interval [CI] = –0.44 to 0.17). A greater reduction in mean (±SD) sK+ from baseline occurred with SZC compared with placebo at 2 hours: –0.72 (±0.12) versus –0.36 (±0.11) mmol/L (LSM difference = –0.35 mmol/L, 95% CI = –0.68 to –0.02), respectively. A numerically lower proportion of patients in the SZC group required additional potassium‐lowering therapy due to hyperkalemia at 0 to 4 hours versus placebo (15.6% vs. 30.6%, respectively; odds ratio = 0.40, 95% CI = 0.09 to 1.77). Comparable proportions of patients experienced adverse events in both treatment groups at 0 to 24 hours. Conclusions This pilot study suggested that SZC with insulin and glucose may provide an incremental benefit in the emergency treatment of hyperkalemia over insulin and glucose alone.

Контактная информация:Вишнёва Елена Александровна, кандидат медицинских наук, заместитель директора НИИ педиатрии по научной работе, заведующая отделом стандартизации и клинической фармакологии, врач аллерголог-иммунолог отделения восстановительного лечения детей с аллергическими болезнями и заболеваниями органов дыхания НИИ педиатрии ННПЦЗД Адрес: 119991, Москва, Ломоносовский пр-т, д. 2, стр. 1, тел.: +7 (499) Ротавирусная инфекция (РВИ) -антропонозное высококонтагиозное острое инфекционное заболева-ние, характеризующееся преимущественным поражени-ем желудочно-кишечного тракта в виде гастроэнтерита с симптомами диареи и рвоты, развитием общей инток-сикации, дегидратации и нередко наличием респира-торного (катарального) синдрома в начальном периоде болезни. Вирион ротавируса имеет диаметр 65-75 нм и состоит из электронно-плотного центра (сердцевины) и двух белковых оболочек -внутреннего и наружного капсида [1]. Сердцевина содержит внутренние белки и фрагментированную цепь рибонуклеиновой кислоты (РНК), состоящую из 11 сегментов, которые кодируют продукцию белков -6 структурных (Viral Proteins, VP1-VP7: VP1, VP2, VP3, VP4, VP6, VP7) и 5 неструктур-ных (NSP1-NSP5). Основным компонентом внутреннего капсида является структурный белок VP6 (основная группоспецифическая антигенная детерминанта рота-вируса). В зависимости от его строения ротавирусы подразделяют на 7 серологических групп -A, B, C, D, E, F, G. Наружный капсид вириона образован двумя струк-турными белками, к которым в организме человека ХАРАКТЕРИСТИКА ВОЗБУДИТЕЛЯ

The aim of the study was the improvement and gain in the efficiency of preventive medical examinations of minors. There were studied the information and statistical materials of the dispanserization of the children population of the Russian Federation in 2014 concerning the health of various age groups in terms of Federal districts and subjects. There were analyzed indices of the coverage of the children’s population with preventive routine medical examination; level and structure of the revealed general and primary prevalence; frequency of the dispensary registration; neediness in additional consultations, examinations and treatment in the conditions of out-patient clinic, a day hospital, a hospital of the round-the-clock stay, the sanatorium organizations, as well as the coverage by these medical services. There was recorded the high level of the coverage of minors by routine medical examinations. The ration of healthy children's population was more than one third from all cases who passed medical examination. The revealed general and primary prevalence rate of the children's population in large part (more than one third) subjects has level above the Russian one. The main reasons of children’s morbidity are diseases of respiratory organs, bone and muscular and nervous systems while teenagers mostly have diseases of bone and muscular system, an eye, appendages of the eye and respiratory organs. The high prevalence of chronic diseases among the children’s population in preventive medical examinations failed to be followed by recommendations for treatment and rehabilitation in sufficient volume. Regional features of results of medical examination allowed to identify the most disadvantaged areas, to identify defects in its organization and the lack of continuity between medical institutions providing this type of services.

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Длинноцепочечные полиненасыщенные жирные кислоты классов -3 и -6 как эссенциальный нутриент в разные периоды детства Адекватное питание подразумевает под собой доста-точное поступление всех макро-и микронутриентов, необходимое человеку в соответствии с его возрастом, физической активностью, функциональным состоянием всех органов и систем [1]. Систематические эпидемио-логические исследования состояния фактического пита-ния и здоровья взрослых и детей в различных регионах России, проводимые НИИ питания РАМН, у большей части населения выявляют нарушения пищевого ста-туса, наиболее распространенными из которых явля-ются дефицит животных белков, достигающий 15-20% от рекомендуемых величин; дефицит полиненасыщен-ных жирных кислот на фоне избыточного поступле-ния животных жиров; дефицит большинства витами-нов, обнаруживаемый повсеместно и круглогодично у большей части населения [2][3][4]. Проведенные в ФГБУ «НЦЗД» РАМН исследования фактического питания детей и подростков, занимающихся спортом, показали,

A507 lization data. Results: The review allowed retrieving 4,768 studies and 11 fulfilled the eligibility criteria. Two articles presented their results in terms of correlation coefficient that were all statistically significant. The first one determined a correlation between FEV1 and inhaled corticosteroids (ICS) use with an R-value of-0.42 and between sputum eosinophils and ICS use with an R-value of 0.3. The second article evaluated the correlation between PEF and hospitalization rates and concluded to a correlation with an R-value of-0.51. A total of 9 articles presented raw data that could be used to establish a correlation between lung function or eosinophil levels and resource utilization. Seven studies presented data that indicate an inverse correlation between FEV1 and hospitalizations with decreased hospitalization rates, when FEV1 increases. Three studies indicate decreased emergency departments visit rates when FEV1 increases. Two studies also indicate an increased emergency department visit rates, when blood eosinophil levels increase. ConClusions: The correlation coefficients found in the systematic review indicate that when lung function improves or sputum eosinophil decreases, the resource utilization decreases. Furthermore, non-correlation studies that look at the same parameters support this hypothesis and suggest there may be a correlation between emergency department's visits and blood eosinophil levels.

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