Clinical types (classification) of the right ventricle arrhythmogenic dysplasia: Specifics of diagnostics and management
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01.01.2018 |
Lutokhina Y.
Blagova V.
Nedostup V.
Shestak G.
Zaklyazminskaya V.
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Russian Journal of Cardiology |
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© 2018, Silicea-Poligraf. All rights reserved. Aim. To classify established clinical types of the right ventricle arrhythmogenic dysplasia (RVAD) taken a variety of genetic and inflammatory mechanisms, and to analyze the specifics of differential diagnostics and management of the respective types. Material and methods. Main group consisted of 50 patients with evident (n=26), probable (n=13) and possible (n=11) RVAD diagnosis, mean age 38,1±14,6 y. o., males — 20 (40%), follow up time 13,5 [4; 34] months. Comparison group consisted of 58 patients with some of the RVAD criteria insufficient for evident diagnosis. All patients underwent ECG, Holter ECG 24 hours, EchoCG; in the main group additionally — DNA-diagnostics (n=46), cardiac MRI (n=44), high definition ECG (n=16), endomyocardial biopsy of the RV (n=2), autopsy (n=2). In comparison group, MRI was done in 32 patients, biopsy to 7, and in 1 case — autopsy. Results. Based upon the clinical data and specifics of the disease course, 4 types of established clinical RVAD were selected, that do not tend to overlap: latent arrhythmic (50% patients), manifest arrhythmic (20%), RVAD with predominant biventricular chronic heart failure (CHF, 16%), and RVAD with non-compaction left ventricle myocardium (14%). The development of one or another type is based on genetic factors, as on comorbid myocarditis (in percent in the following, respectively). In diagnostics of the latent arrhythmic type (frequent right ventricle extrasystoly, VE and/or non-sustained right ventricular tachicardia, VT) the key role played female sex, syncopes in anamnesis (16%), family history of sudden death (12%), ECG-criteria and positive results of DNA diagnostics (24%). For manifest arrhythmic type (sustained VT) — sudden death family anamnesis (in 20%), MRI-criteria (enlarged RV with lower EF), ECG-criteria and positive DNA tests (50%). For RVAD with progressing CHF — sustained VT (50%), syncopes (37,5%), predominance of RV failure with its severely reduced EF (25,7±15,0%), major MRI-and ECG-criteria, decreased QRS-voltage and positive DNA test (38%). Comorbidity of RVAD and non-compaction myocardium differ by frequent VE, aggressive VT (57,1%), syncope (42,9%) and CHF with significantly lower than in DCMP EF LV. Mortality rate in I-IV types was, respectively, 0%, 10%, 25%, 14,3%, and relevant shocks in 8 of 13 (61,5%) patients with ICD. Conclusion. It is worthy to use the proposed RVAD classification in clinical practice to define the spectrum of diagnostical and management events and assess the individual patient prognosis.
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Placental dysfunction in HIV-infected pregnant women
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01.01.2018 |
Voevodin S.
Shemanayeva T.
Schegolev A.
Parkhomenko Y.
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Akusherstvo i Ginekologiya (Russian Federation) |
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1 |
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© 2018, Bionika Media Ltd. All rights reserved. Aim. To investigate the clinical features of the course and outcomes of pregnancy and placental morphology in HIV-infected pregnant women. Material and methods. This study is a retrospective analysis of 29 pregnant women. The study group comprised 14 pregnant women with antenatal human immunodeficiency virus infection. Fifteen women with a physiological course of pregnancy made up a control group. The mean age of patients in the study and control group was 28.0 ± 2.6 and 21.1±2.3 years, respectively. The analysis included gynecological history, the course of pregnancy and childbirth, and perinatal outcomes of newborns. The morphological study of placenta included macroscopic and histological examinations, and immunohistochemical studies using antibodies targeting CCR5 receptors. Results. Pregnant women in the study group had a gynecological history of sexually transmitted infections. The most frequent complications of the second and third trimesters of pregnancy were anemia (78.6%), the threatened preterm birth (35.7%), and preeclampsia (28.6%). Complications of labor were premature rupture of membranes (35.7%) and uncoordinated uterine activity (14.3%). Placental morphology showed signs of inflammation and hypoxia. Immunohistochemical studies identified a higher expression of CCR5 in chorionic villi. Conclusion. The findings indicate increased levels of CCR5 expression and the development of chronic placental insufficiency in HIV-infected pregnant women, which indicates the need for dynamic monitoring of this group of patients.
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Internal motivation among doctoral students: Contributions from the student and from the student's environment
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01.01.2018 |
Lynch M.
Salikhova N.
Salikhova A.
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International Journal of Doctoral Studies |
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1 |
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© 2018 Informing Science Institute. All rights reserved. Aim/Purpose The present quantitative, cross-sectional study aimed to investigate objective and subjective factors in the self-determination of doctoral students in their educational activities. Objective determinants included major discipline and forms of academic and scholarly activity (that is, attending classes and writing papers), and subjective determinants included personal characteristics of the doctoral students, including dispositional autonomy and perceptions of environmental supports for students' basic psychological needs. Background The quality of students' motivation for learning has been linked with many different outcomes. Specifically, students who are more internally motivated (that is, who engage in learning activities for reasons that are personally important and freely chosen) demonstrate better performance outcomes and are more likely to choose and to persist in challenging tasks, to enjoy learning, to exhibit greater creativity, and in general to experience greater psychological well-being. Important questions remain, however, regarding the sources that affect student motivation, in particular at the level of graduate school. The present study expands on existing research by exploring contributions to students' motivation both from the students, themselves, and from supports stemming from two interpersonal contexts: close relationships and the university environment. Methodology Participating in the study were 112 doctoral students from various natural sci-ences departments of a major university in the Volga region of Russia. Self-report measures included dispositional autonomy, motivation for various types of academic and scholarly activity, and satisfaction of basic needs for autonomy, competence, and relatedness in various interpersonal contexts. Analyses includ-ed descriptive statistics, comparison of mean differences, correlation, and struc-tural equation modeling. Contribution The present study goes beyond existing research by considering both disposi-tional and situational factors that influence the motivation of doctoral students for their scholarly and academic activities, and by comparing the impact on mo-tivation of close personal relationships with that of various interpersonal con-texts in the university setting. Findings Doctoral students reported greater supports for their basic needs (for compe-tence, autonomy, and relatedness) from their close personal relationships than in their university contexts. Students felt less support for their autonomy and competence with their research supervisor than in other university settings. The early stages of a scholarly activity, such as gathering sources and analyzing mate-rials, were more likely to be characterized by external motivation, whereas the later stages, like the actual writing of a manuscript, were more likely to be inter-nally motivated. When competing for variance, need supports from university-based but not from close personal relationships were significant contributors to students internal motivation for scholarly and academic activity; this effect, however, was fully mediated through students own dispositional autonomy. Recommendations for Practitioners The present study underscores the importance of creating an environment in the university that supports doctoral students needs for autonomy, competence, and relatedness. Educators, and in particular research supervisors, should attend to the ways in which their policies and practices support versus undermine these needs, which are shown to play an important role in promoting doctoral stu-dents own internal motivation for their scholarly and academic activities. Recommendations for Researchers Although in this sample need supports from university-based interpersonal con-texts outweighed the role of need supports from close personal relationships, in terms of doctoral students scholarly and academic motivation, it seems im-portant to keep both contexts in mind, given the general importance of close relationships for motivation and other educational and well-being outcomes. As well, accounting for students own dispositional attributes, such as their own personal tendency toward autonomy, seems a critical counterpoint to looking at environmental contributions. Future Research Future research should examine whether the mediational model tested in the present study applies to other samples of doctoral students, for example, to those from other disciplines, such as the humanities, and those in other cultural or geographic locations, where it is possible that close personal relationships may contribute more substantially to students motivation than was the case in the present sample. As well, future studies would do well to include other rele-vant outcomes, such as academic grades, successful degree completion, and measures of well-being, in order to confirm previous findings of the link be-tween internal motivation and various educational outcomes.
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Methods to assess Vitamin B<inf>12</inf> bioavailability and technologies to enhance its absorption
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01.01.2018 |
Brito A.
Habeych E.
Silva-Zolezzi I.
Galaffu N.
Allen L.
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Nutrition Reviews |
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1 |
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© The Author(s) 2018. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. Vitamin B12 (B-12) deficiency is still relatively common in low-, medium-, and high-income countries, mainly because of dietary inadequacy and, to a lesser extent, malabsorption. This narrative review is based on a systematic search of evidence on methods to assess B-12 bioavailability and technologies to enhance its absorption. A total of 2523 scientific articles identified in PubMed and 1572 patents identified in Orbit Intelligence were prescreened. Among the reviewed methods, Schilling's test and/or its food-based version (using cobalamin-labeled egg yolk) were used for decades but have been discontinued, largely because they required radioactive cobalt. The qualitative CobaSorb test, based on changes in circulating holo-transcobalamin before and after B-12 administration, and the14C-labeled B-12 test for quantitative measurement of absorption of a low-dose radioactive tracer are currently the best available methods. Various forms of B-12 co-formulated with chemical enhancers (ie, salcaprozate sodium, 8-amino caprylate) or supplied via biotechnological methods (ie, microbiological techniques, plant cells expressing cobalamin binding proteins), encapsulation techniques (ie, emulsions, use of chitosan particles), and alternative routes of administration (ie, intranasal, transdermal administration) were identified as potential technologies to enhance B-12 absorption in humans. However, in most cases the evidence of absorption enhancement is limited.
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The morphological substrate and molecular mechanisms of impaired pregnancy outcomes in women with hereditary thrombophilias and undifferentiated connective tissue dysplasia
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01.01.2018 |
Demura T.
Kogan E.
Zanozin A.
Kolosovsky D.
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Arkhiv Patologii |
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© 2018, Media Sphera Publishing Group. All rights reserved. Hereditary thrombophilias (HT) and undifferentiated connective tissue dysplasia (uCTD) are important causes of female infertility. Moreover, there are signs of their common pathogenesis: a number of proteins, such as PAI-1, play an important role in the pathogenesis of both conditions, as well as in the development of infertility in patients with HT and uCTD Objective — to determine the morphological substrate and molecular mechanisms of impaired pregnancy outcomes in women with uCTD and HT. Subject and methods. A study group included 130 reproductive-aged female patients with primary infertility and a control group consisted of 11 patients (surrogate mothers). An endometrial pipelle biopsy sample was taken from each patient on days 6—8 after ovulation according to the ultrasound findings. The study group patients were divided into subgroups: 1A) infertility and HT (n=91); 1B) infertility, NT, and uCTD (n=19); 1C) infertility and uCTD (n=20). The investigators examined obstetric/gynecological history data, determined the levels of PAI-1 and homocysteine in the blood samples of patients in the subgroups with HT (1A and 1B); assessed the results of the methionine test, and identified the polymorphism or mutations of the following genes: FII, FV (Leiden), FVII, FXII, FXIII, GpIa, GpIb (-5), GpIb (T145M), GpIIIa, PAI-1, FBGb, MTHFR, MTRR, MTR, SLC19A1, angiotensin gene (M235T and T145M), angiotensin-converting enzyme, and their homo-or heterozygosity. Endometrial morphological and immunohistochemical examinations were carried out using primary antibodies to sex hormone receptors, LIF, PAI-1, and osteopontin. Results. The number of pregnancies in the study group was comparable to the number of patients in each subgroup. Childbirth was considered to be a favorable pregnancy outcome; missed miscarriage was an unfavorable one. There were the most favorable outcomes in Subgroup 1C with uCTD and the least one in Subgroup 1B. Comparison of hemostatic system indicators revealed statistically significant differences only in the incidence of disaggregated thrombopathy (88% in Group 1B and 55% in Group 1A). In the endometrium of the study group, there was delayed maturation; sclerotic foci and dyscirculatory disorders were more frequent in the stroma. Conclusion. In HT, uCTD, and, to a greater extent, its concurrence, a genetically determined predisposition to impaired implantation develops due to genetically determined endometrial remodeling that leads to infertility and impaired pregnancy outcomes.
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The internal system for quality assessment of education results at a medical university
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01.01.2018 |
Litvinova T.
Kasimovskaya N.
Petrova V.
Volkova M.
Kalinina N.
Kochetkov I.
Kostina Y.
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Electronic Journal of General Medicine |
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1 |
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© 2018 by the authors; licensee Modestum Ltd., UK. Objective: The problem of devising an education quality assessment system at a medical higher educational institution has been analyzed in the article. The authors compare the views on the interpretation of the concept of “quality of education”, as well as examine the principles and criteria for the quality of education. A new approach to the internal system for assessing the quality of education at a medical higher education is offered in the article on the basis of the integration of all the components of the pedagogical system. The following components of the internal system of education quality assessment are considered: the conceptual component (forecasting, planning the strategic areas of the educational process development to achieve the quality of education, the mission and objectives), the procedural content component (monitoring at the initial and final stages of the education quality assessment), the self-analysis component (the analysis of students, teachers, department chairs’ activity); the analytical component (visualization of information obtained on the basis of transparency, informational openness of learning and upbringing results, the analysis and elimination of identified shortcomings, the introduction of advanced pedagogical experience into the educational process). Method: The study was conducted at the FSAEI HE I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenov University) in the period from February 2011 to March 2017. The sample group size was determined with the use of a special formula. Based on the sample size, 450 respondents were included in the study, and the number of people who would drop out was determined in the sample (n = 429), so the sample was representative in terms of quality and quantity. The students from 1 to 6 years were involved in the study in five training programs of the university who were randomly selected. An original questionnaire was devised. The questionnaire contained some standard questions and special questions on the research topic. Results: The main contingent of students is satisfied with the quality of education at Sechenov University and the level assessment of the quality of education is higher in comparison to other universities, but among the final-year students the assessment of the quality of education compared with other universities does not differ significantly. To attract applicants to FSAEI HE I.M. Sechenov First Moscow State Medical University the significant factors were: preserving a good reputation of the university (64.7%), prestige (53%) and the quality of education (50.7%). The most popular competencies among students of all the faculties and courses were the following: willingness to work with modern medical equipment (45% ± 2,3%), knowledge of innovative medical technologies (31,9% ± 2,2%). Almost every second student (55% ± 2.3%) believes that the quality of education at Sechenov University corresponds to the requirements of the current labor market. Conclusion: The conclusion has been drawn on the basis of the conducted research, that the internal system of assessing the quality of education is directed to increasing prestige of Russian higher medical education, its integration into the international educational space.
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Contribution of the academician Vladimir Sergiev to the development of the Russian parasitology (on 75<sup>th</sup> anniversary)
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01.01.2018 |
Baranova A.
Kozlov S.
Morozov E.
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Jurnal Infektologii |
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0 |
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© 2018 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All Rights Reserved. Academician of the Russian Academy of Sciences, Professor, Doctor of Science (Med) Vladimir Petrovich Sergiev is a famous scientist who made a significant contribution to the Russian epidemiology and parasitology. After graduating from the Sechenov First Moscow medical institute in 1966, he worked at the Martsinovsky Institute of medical parasitology and tropical medicine (Moscow), where he defended his thesis on the created vaccines against zoonotic cutaneous leishmaniasis. In 1974 he was transferred to the Ministry of health of the USSR by the head of the main Department of quarantine infections. In 1988 he was appointed Director оf the Martsinovsky Institute of medical parasitology and tropical medicine, since 2002 he is head of the Chair of tropical medicine and parasitic diseases of Sechenov University. He combines educational work with research activities to study the problems of epidemiology of helminthiasis and tropical diseases, their prevention, as well as medical geography and molecular parasitology. Professor Sergiev is the author of 15 monographs and manuals, more than 400 scientific publications, Editor-in-Chief of the journal «Medical Parasitology and Parasitic Diseases», consultant of the World Health Organization on malaria and leishmaniasеs. Under his leadership, 5 doctoral and 7 masters theses were defended.
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Features of the phenotype of regulatory T cells in early and advanced rheumatoid arthritis
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01.01.2018 |
Avdeeva A.
Rubtsov Y.
Popkova T.
Dyikanov D.
Aleksankin A.
Nasonov E.
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Nauchno-Prakticheskaya Revmatologiya |
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© 2018 Ima-Press Publishing House. All right reserved. Objective: to analyze the levels of CD3+, CD3+CD4+, CD3+CD8+, and CD3-CD56+ T lymphocytes, FoxP3+ regulatory T cells (Treg), and CD19+ B lymphocytes in patients with early and advanced rheumatoid arthritis (RA). Subjects and methods. The investigation enrolled 45 patients previously untreated with methotrexate (MTX-naive) who had early RA and 15 patients who had advanced RA. Immunofluorescence staining and multicolor flow cytome-try assays were used to estimate the percentage and absolute (abs) counts of CD3+, CD3+CD4+, CD3+CD8+, CD3-CD16+CD56+, CD19+, Treg (FoxP3+CD25+; surface CD152+; intracellular CD152+; FoxP3+CD127; CD25+CD127-; FoxP3+ICOS+; FoxP3+CD154+; and FoxP3+CD274+. Results and discussion. The patients with early RA were found to have a lower percentage of FoxP3+CD25+ cells and lower percentages and abs counts of FoxP3+ ICOS+ cells, FoxP3+CD154+ cells, and FoxP3+ CD274+ T cells than healthy donors (p0.05 in all cases). The patients with advanced RA were also recorded to have a lower percentage of FoxP3+CD25+ cells and lower percentages and abs contents of FoxP3+ ICOS+ cells, FoxP3+CD154+ cells, and FoxP3+ CD274+ T cells (p0.05 in all cases). The patients with advanced RA compared to those with early RA had a higher content of CD4+ lymphocytes (50.7 [44.4; 53.1] and 45.0 [38.0; 49.2]) and lower percentages of CD25+CD127- T lymphocytes (5.0 [4.0; 5.7] and 6.5 [5.1; 7.9] respectively; p0.05 in all cases). Conclusion. Patients with RA (with the early or advanced stage of the disease) show a decrease in both the counts and functional activity of Treg. The patients with advanced RA compared with those with early RA showed an increase in CD4+ lymphocyte counts and a decrease in CD25+CD127- cell levels, which suggests that there are more pronounced impairments in Treg homeostasis in advanced RA.
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Factors influencing the efficiency of therapy in patients with rheumatoid arthritis: The role of comorbid mental and somatic diseases
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01.01.2018 |
Abramkin A.
Lisitsyna T.
Veltishchev D.
Seravina O.
Kovalevskaya O.
Glukhova S.
Nasonov E.
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Nauchno-Prakticheskaya Revmatologiya |
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1 |
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© 2018 Ima-Press Publishing House. All right reserved. The response rate to therapy for rheumatoid arthritis (RA) rarely exceeds 60%. Mental disorders (MDs) of the anxiety-depressive spectrum (ADS) and cognitive impairment (CI) substantially affect the evaluation of the efficiency of RA therapy. Adequate psychopharmacotherapy is one of the possible approaches to optimizing the treatment of RA. The factors influencing the efficiency of RA therapy with standard disease-modifying antirheumatic drugs (DMARDs) and biological agents (BAs) in combination with adequate psychopharmacotherapy have not been previously identified. Objective: to determine the predictors of response to therapy in patients with RA receiving DMARDs and BAs with or without adequate psychopharmacotherapy for ADS disorders. Subjects and methods. The investigation included 128 patients (13% men and 87% women) with a reliable diagnosis of RA. At baseline, 75.1% of patients received DMARDs; 7.8% - BAs. ADS disorders were detected in 123 (96.1%) patients. Psychopharmacotherapy was offered to all the patients with MDs; 52 patients agreed to treatment and 71 refused. The following therapeutic groups were identified according to the performed therapy: 1) DMARDs (n = 39); 2) DMARDs + psychopharmacotherapy (n = 43); 3) DMARDs + BAs (n = 32); 4) DMARDs + BAs + psychopharmacotherapy (n = 9). The changes of MDs symptoms and the outcomes of RA were assessed in 83 (67.5%) patients at five-year follow-up. The efficiency of RA therapy was evaluated with DAS28 (EULAR criteria). Predictors of response to therapy were determined using linear regression modeling. Results and discussion. At 5 years, 22 (26.5%) and 37 (44.6%) patients were recorded to show good and moderate responses to therapy, respectively; 24 (28.9%) patients were non-respondents. The linear regression model included 14 factors (p<0.001). The high values of DAS28 (β=0.258) at the inclusion; belonging to therapeutic groups 2 (β=0.267), 3 (β=0.235), and 4 (β=0.210), the absence of diabetes mellitus (β=-0.230), and experience in using glucocorticoids (β=-0.230) were associated with a high likelihood of response to therapy; high body mass index (β=-0.200) and long RA duration (β=-0,181), a high level of rheumatoid factor (β=-0.176), a history of myocardial infarction (β=-0.153), schizotypic disorder (β=-0.132), and extra-articular manifestations of RA (β=-0.106), and older age (β=-0.102) were related to a low probability of response. The area under the ROC curve for the model was 0.99 (p<0.001). Conclusion. BA therapy and psychopharmacotherapy, along with younger age, shorter duration and high activity of RA, a low level of rheumatoid factor, lower body mass index, the absence of diabetes mellitus, myocardial infarction, and extra-articular manifestations of RA in the history, schizotypic disorder, and experience in using glucocorticoids are associated with a greater likelihood of a good and moderate treatment response.
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SERS of A-C thin film on Ag, Au, Ag <inf>0.52</inf> -Au <inf>0.48</inf> alloy nanoparticle arrays with normal particles size distribution formed by vacuum thermal evaporation
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01.01.2018 |
Dubkov S.
Trifonov A.
Shaman Y.
Kitsyuk E.
Savitskiy A.
Polokhin A.
Gromov D.
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Defect and Diffusion Forum |
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0 |
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© 2018 Trans Tech Publications, Switzerland This paper presents the results of experimental studies of arrays of Ag 0.52 Au 0.48 alloy nanoparticles. Arrays were formed by vacuum-thermal evaporation on an unheated substrate and subsequent low-temperature vacuum annealing. The TEM images of the obtained nanoparticle arrays and corresponding histograms of particle size distribution are shown. The transmission spectra of these arrays showing the displacement of the plasma frequency as a function of the mean particle size are obtained. Spectra of Raman scattering from a thin film of amorphous carbon in presence of AgAu particles are obtained, and a comparative analysis of Raman scattering amplification factors for pure Ag, pure Au and Ag 0.52 Au 0.48 alloy nanoparticles is presented.
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The perfusion of cisplatin and cisplatin structural analogues through the isolated rat heart: The effects on coronary flow and cardiodynamic parameters
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01.01.2018 |
Stojic I.
Jakovljevic V.
Zivkovic V.
Srejovic I.
Nikolic T.
Jeremic J.
Jeremic N.
Djuric D.
Radonjic K.
Labudovic-Borovic M.
Bugarcic Z.
Bogojeski J.
Novokmet S.
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General Physiology and Biophysics |
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© 2018, Slovak Academy of Sciences. All rights reserved. The therapeutic use of cisplatin for the treatment of solid tumours is associated with organ toxicity. Amongst those, the cardiotoxicity is an occasional but very serious and severe side effect. To prevent or reduce these negative effects, many cisplatin analogues have been synthesized and evaluated in terms of being a less toxic and more effective agent. In present study, we examined the effects of cisplatin and its three analogues in the isolated rat heart to determine whether changes in the structure of the platinum complexes (changing of carrier ligands – ethylenediamine; 1,2-diaminocyclohexane; 2,2’:6’,2’’-terpyridine) can influence their cardiotoxic effects. The results of our research indicate that the introduction of aromatic rings in the structure of the platinum complexes has a negative influence on the heart function. Conversely, the other two examined complexes had less negative effects on heart function compared to cisplatin. Our findings may be of interest for a possible synthetic strategy of introducing a carrier ligand that will exert a less cardiotoxic effect.
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Efficiency of atorvastatin and simvastatin in improving cardiac function during the different degrees of hyperhomocysteinemia
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01.01.2018 |
Nikolic Turnic T.
Jakovljevic V.
Djuric D.
Jeremic N.
Jeremic J.
Milosavljevic I.
Srejovic I.
Selakovic D.
Zivkovic V.
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Canadian Journal of Physiology and Pharmacology |
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1 |
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© 2018, Canadian Science Publishing. All rights reserved. The aim of this study was to assess the impact of atorvastatin and simvastatin on myocardial contractility during the different degrees of hyperhomocysteinemia (HHcy) in rats. Study was conducted on adult male Wistar albino rats (n = 90; 4 weeks old; 100 ± 15 g body mass) in which HHcy was achieved by dietary manipulation. Animals were exposed to pharmacology treatment with atorvastatin in dose of 3 mg/kg per day i.p. or simvastatin in dose of 5 mg/kg per day i.p. at the same time every day, according to equivalent therapeutic doses of these statins (10 mg atorvastatin = 20 mg simvastatin). After the dietary manipulation and pharmacological treatment and confirmation of HHcy, all animals were sacrificed, hearts were isolated, and cardiac function was tested according to the Langendorff technique. Size of recovery of maximum rate of left ventricular development (dp/dtmax), minimum rate of left ventricular development (dp/dtmin), systolic left ventricular development, diastolic left ventricular development, heart rate, and coronary flow at the 40, 60, 80, 100, and 120 cmH2O coronary perfusion pressure were measured in state of physiological condition (homocysteine less than 15 μmol/L), mild HHcy, and moderate HHcy. Atorvastatin treatment significantly attenuated homocysteine-induced impairment of myocyte contractility and dominantly decreased dp/dtmax, dp/dtmin, and heart rate and induced greater changes in systolic left ventricular development compared with simvastatin. Treatment with atorvastatin seems able to revert systolic abnormalities and improve contractility during the different degrees of HHcy.
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Atrial fibrillation as risk factor for development of cognitive function impairment and dementia. potential of anticoagulant therapy in their prevention
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01.01.2018 |
Ostroumova O.
Cherniaeva M.
Golovina O.
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Kardiologiya |
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2 |
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© 2018 Media Sphera Publishing Group. All rights reserved. This article presents an overview of data of Russian and foreign literature on possible associations between cognitive impairment and atrial fibrillation (AF). It includes modern classification of cognitive impairment, mechanisms of the effect of AF on cognitive functions and development of dementia, recommendations for the prevention of cognitive impairment in patients with AF. Special attention is paid to the assessment of cognitive status, and safe anticoagulant therapy, which is a priority in the prevention of cognitive impairment in patients with AF. Analysis of literature showed greater efficacy and safety of drugs from the group of Non-Vitamin K Antagonist Oral Anticoagulants (NOAC), rivaroxaban in particular, in comparison with warfarin. Drugs from the NOAC group can be recommended for prevention stroke, cognitive impairment and dementia in elderly patients with AF.
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Homocysteine and homocysteine-related compounds: An overview of the roles in the pathology of the cardiovascular and nervous systems
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01.01.2018 |
Djuric D.
Jakovljevic V.
Zivkovic V.
Srejovic I.
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Canadian Journal of Physiology and Pharmacology |
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1 |
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© 2018, Canadian Science Publishing. All rights reserved. Homocysteine, an amino acid containing a sulfhydryl group, is an intermediate product during metabolism of the amino acids methionine and cysteine. Hyperhomocysteinemia is used as a predictive risk factor for cardiovascular disorders, the stroke progression, screening for inborn errors of methionine metabolism, and as a supplementary test for vitamin B12 deficiency. Two organic systems in which homocysteine has the most harmful effects are the cardiovascular and nervous system. The adverse effects of homocysteine are achieved by the action of several different mechanisms, such as overactivation of N-methyl-D-aspartate receptors, activation of Toll-like receptor 4, disturbance in Ca2+ handling, increased activity of nicotinamide adenine dinucleotide phosphate-oxidase and subsequent increase of production of reactive oxygen species, increased activity of nitric oxide synthase and nitric oxide synthase uncoupling and consequent impairment in nitric oxide and reactive oxygen species synthesis. Increased production of reactive species during hyperhomocysteinemia is related with increased expression of several proinflammatory cytokines, including IL-1α, IL-6, TNF-α, MCP-1, and intracellular adhesion molecule-1. All these mechanisms contribute to the emergence of diseases like atherosclerosis and related complications such as myocardial infarction, stroke, aortic aneurysm, as well as Alzheimer disease and epilepsy. This review provides evidence that supports the causal role for hyperhomocysteinemia in the development of cardiovascular disease and nervous system disorders.
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Preparation of liposomes containing benzophenanthridine alkaloid sanguinarine and evaluation of its cytotoxic activity
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01.01.2018 |
Feldman N.
Kuryakov V.
Sedyakina N.
Gromovykh T.
Lutsenko S.
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International Journal of Nanotechnology |
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1 |
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© Copyright 2018 Inderscience Enterprises Ltd. Sanguinarine is a plant alkaloid with relatively low toxicity and high antiangiogenic, antitumour and antiviral potential. In order to increase its bioavailability and effectiveness, sanguinarine liposomes were prepared by a reverse phase evaporation method and characterised. Dynamic light scattering showed mean liposome size of 65 ± 11 nm, zeta-potential equal to -54 ± 1.2 mV, and polydispersity index equal to 0.26. The encapsulation efficiency was 78.6 ± 5.1%. The study on experimental models showed a prolonged sanguinarine release from liposome preparations. Liposomal sanguinarine showed dose-dependent cytotoxic activity in vitro on B16 (murine melanoma) and HeLa (human cervical carcinoma) cell lines. The highest cytotoxicity was observed on B16 cell line (IC50 6.5 μM). HeLa cell line cytotoxicity was relatively lower, equal to 8.03 μM. Compared with free sanguinarine, liposomal sanguinarine may have advantages for in vivo anticancer therapy, due to its lower toxicity and 'passive targeting' as a result of enhanced permeability of tumour vessels.
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High sympathetic tone in development of the left ventricle hypertrophy and beta-blockers for regression
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01.01.2018 |
Ostroumova O.
Kochetkov A.
Lopukhina M.
Pavleeva E.
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Russian Journal of Cardiology |
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0 |
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© 2018, Silicea-Poligraf. All rights reserved. The review is focused on clinical significance of the left ventricle hypertrophy (LVH) — presentation of heart lesion as a target organ for systemic hypertension (SH). Various LVH development mechanisms are presented, and special attention is paid to sympathic nervous system and β-adrenoreceptors in pathogenesis. Fundamental methods of diagnostics are described for LVH, in comparison. The pathology is classified from the perspective of recent guidelines on echocardiographic diagnostics. Epidemiology provided. Taken current evidence, the prognostic role of LVH is described as a factor increasing the risk of fatal and non-fatal cardiovascular, cerebrovascular and renal complications in SH patients. Trials data presented that points on LVH regression with highly selective β1-blocker bisoprolol treatment. Pathophysiology of LVH regression is discussed for β1-blocker treatment.
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Set-up of the electronic database of pediatric cancer patients in pilot medical facilities: A prospective cohort study
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01.01.2018 |
Rykov M.
Turabov I.
Zheludkova O.
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Onkopediatria |
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7 |
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© 2018 Paediatrician Publishers, LLC. All rights reserved. At present, there is no reliable statistical data (morbidity, mortality, one-year mortality, etc.) that characterize the state of medical care for children with cancers in the Russian Federation seen in due to the lack of an universal electronic database of patients. Objective. Improve the reliability of statistical data. Methods. In the clinical practice of two pilot medical facilities, an electronic database of pediatric cancer patients was introduced which allows: keep patient records with a diagnosis, key dates, follow-up data; analyze the treatment received earlier and assess its quality; make a treatment plan; obtain information on the availability of beds and the number of patients in various medical facilities; perform medical consultations involving the of specialists of the third level medical institutions. Patient (or legal representatives of the patient), has access to the «private cabinet » which provides information on the treatment plan including a schedule for taking medicines, as well as routing possibilities. Results. In the period of 6 months (09.17-02.18), information on 75 patients who received treatment from 2017 to the present was put into the electronic database. Conclusion. The electronic database provides reliable statistical data, helps monitoring the quality of medical care and routing patients. This results in reducing the budget costs and improving the survival of patients.
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Certolizumab pegol in the treatment of takayasu arteritis
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01.01.2018 |
Novikov P.
Smitienko I.
Sokolova M.
Alibaz-Oner F.
Kaymaz-Tahra S.
Direskeneli H.
Moiseev S.
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Rheumatology (United Kingdom) |
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5 |
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© The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objectives. Certolizumab pegol (CZP) is a PEGylated antigen-binding fragment-fragment of a humanized mAb neutralizing TNF. It lacks Fc-fragment and has a very low potential to cross the placenta. We aimed to report the efficacy and safety of CZP in a case series of patients with refractory Takayasu arteritis (TA). Methods. Ten females of reproductive age (1835 years) with TA were treated with CZP (at a dose of 400 mg at weeks 0, 2 and 4 and at 200 mg every 2 weeks thereafter) for a median of 10 months (range 328). Prior to CZP administration all patients received glucocorticoids and ± MTX, CYC, AZA, HCQ, LEF or MMF. Six patients were previously treated with other biological anti-cytokine drugs. The National Institutes of Health criteria and the Indian Takayasu Clinical Activity Score 2010 were used to define disease activity. Results. All patients rapidly responded to treatment with CZP and were able to taper prednisone and MTX doses. Treatment with CZP resulted in a significant decrease in median serum CRP levels and normalization of Indian Takayasu Clinical Activity Score 2010 score in 9 of 10 patients. Remission of systemic vasculitis was achieved in all patients. Seven patients maintained remission for at least 4 months, while one patient developed relapse after 2 years of CZP treatment. Side effects included mild infections (n = 5). Conclusion. Our case series suggests that CZP may be an effective and steroid-sparing treatment option in patients with active TA even if they did not previously respond to other TNF inhibitors or tocilizumab.
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CO<inf>2</inf> transoral microsurgery for supraglottic squamous cell carcinoma
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01.01.2018 |
Carta F.
Mariani C.
Sambiagio G.
Chuchueva N.
Lecis E.
Gerosa C.
Puxeddu R.
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Frontiers in Oncology |
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0 |
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© 2018 Carta, Mariani, Sambiagio, Chuchueva, Lecis, Gerosa and Puxeddu. The present study analyzed the results of the endoscopic approach to T1, T2 and selected T3 supraglottic carcinoma with the aim of reviewing functional and oncologic outcomes after different types of endoscopic supraglottic laryngectomies. This is a retrospective clinical study of 42 consecutive patients (mean age of 61.8 years, 33 males, 9 females) treated by the senior author for supraglottic squamous cell carcinoma with a transoral CO2 laser approach and reviewed from November 2010 to September 2017. Surgical procedures were classified according to the European Laryngological Society. In addition to the standardized transoral supraglottic laryngectomies, we introduced a modified type IVb by sparing the inferior third of the arytenoid if not directly involved in the tumor. Swallowing was evaluated with the Swallowing Performance Status Scale reported by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. Survival probabilities were estimated using Kaplan-Meier curves. Two type I, 2 type IIa, 2 type IIb, 3 type IIIa, 12 type IIIb, 13 type IVa, 3 type modified IVb, and 5 type IVb supraglottic laryngectomies were performed. Twenty-one patients (50%) underwent primary neck dissection. The pathologic TNM classification according to the 8th edition of the American Joint Committee on Cancer system was as follows: 9 pT1cN0, 2 pT1N0, 1 pT1N1, 7 pT2cN0, 1 rypT2cN0, 9 pT2N0, 4 pT2N1, 2 ypT2N1, 2 pT3cN0, 2 rypT3cN0, 1 pT3N1, and 2 pT3N2b. Mean follow-up was 3.4 years (range of 9 months to 6 years). According to the Kaplan-Meier analysis, 5-year disease-specific survival, local-relapse-free survival, nodal-relapse-free survival, overall laryngeal preservation and overall survival of patients without previous head and neck radiotherapy/open surgery were 100%, 95.2%, 87.8%, 100%, and 64.6%, respectively. Patients who underwent type I, IIa, and IIb resections (n = 6) started oral feeding the day after surgery, patients who underwent type III-IVb modified resections (n = 31) started oral feeding 3-4 days after surgery, and patients who underwent standard type 4b resections (n = 5) started oral feeding 7 days after surgery. Threemonths after surgery, patients without a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed significantly better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing in 8 and 66.7% of cases, respectively (p = 0.006072); patients with a clinical history of previous head and neck radiotherapy/open surgery who underwent type III, IVa, and modified IVb resections showed not statistically significant better swallowing compared to patients who underwent standard type IVb resection: grade 4-6 impairment of swallowing at 3 months in 16.7% and 50% of cases, respectively (p = 0.23568). Transoral CO2 laser supraglottic laryngectomy is an oncologic sound alternative to traditional open neck surgery and chemo-radiotherapy. Recovery of swallowing is significantly worsened after total resection of the arytenoid. Modified type IVb procedure leaving intact, when possible, the inferior third of the arytenoid and consequently the glottic competence, improves functional outcome.
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The history of collaboration between the bureau of forensic medical expertise of the Moscow health department and the department of forensic medicine of the sechenovsky university
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01.01.2018 |
Pigolkin Y.
Shigeev S.
Lomakin Y.
Leonova E.
Nagornov M.
Barinov E.
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Sudebno-Meditsinskaya Ekspertiza |
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0 |
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© 2018, Media Sphera Publishing Group. All rights reserved. This article presents the materials devoted to the long-term history of collaboration between the Bureau of Forensic Medical Expertise of the Moscow Health Department and the Department of Forensic Medicine of the Sechenovsky University. Special attention is given to the contribution made by the Department of Forensic Medicine to the scientific and practical activities, methodological and staffing support first of the Moscow forensic medical services and thereafter of the Bureau of Forensic Medical Expertise operating under the auspices of the Moscow Health Department. Simultaneously, the influence of the work of the Moscow Bureau of Forensic Medical Expertise on the development and improvement of the scientific, methodological, and pedagogical activities of the Russia’s oldest Department of Forensic Medicine is overviewed. The personal contribution of the most prominent forensic medical experts and physicians of Moscow to medical science and practice is illustrated by concrete examples.
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