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Archives of Razi Institute Nov 2021Nowadays, it is difficult to find a more complicated inflammatory disease of the abdominal organs in its pathogenesis than acute pancreatitis (AP). The application of...
Nowadays, it is difficult to find a more complicated inflammatory disease of the abdominal organs in its pathogenesis than acute pancreatitis (AP). The application of antimediatory drugs and antimetabolites is the most promising direction in the correction of inflammatory pathological processes. The study of possible applications of a new group of drugs (monoclonal antibodies) that may trigger inflammation is also of great interest. The present study aimed to study the effect of infliximab on the lethality, volume, and nature of pancreatic lesions in severe necrotizing ductal pancreatic necrosis. The study was conducted on female Wistar rats (n=30) of similar age in the weight range of 200-250g. All manipulations were performed under general anesthesia by intraperitoneal injection of zoletil at a dose of 60 mg/kg, as well as chloral hydrate at a dose of 125 mg/kg. Model of severe acute necrotizing pancreatitis was performed through the injection of 0.5 ml of a buffer solution containing a bile acid salt-sodium taurocholate introductory. The animals were divided into the following groups: Group A (n=6): normal values; Group B (n=6): the mortality study was conducted in acute destructive pancreatitis in a period of 24 h; Group C (n=6): the simulation of acute severe necrotic pancreatitis was performed in this group along with the study of the volume of pancreatic lesions for a period of 6 h from the moment of modeling; Group D (n=6): in this group, the effect of infliximab (at a dose of 60 mkg/kg) was studied on mortality in severe destructive pancreatitis for a period of 24 h from the moment of modeling; Group E (n=6): in this group, the effect of infliximab (at a dose of 120 mkg/kg) was studied on the volume of pancreatic lesions in severe destructive pancreatitis for a period of 6 h from the moment of modeling. During the assessment of pancreatic damage, the mean±SD volume of pancreatic lesions was determined to be 34.8%±1.2% in a period of 6 h after modeling. Assessment of pancreatic damage in group E and the protective effect of infliximab at a dose of 60 mg/kg showed that the total volume of the necrotic pancreatic lesion was determined to be 21.3%±1.4% after a period of 6 h from the moment of AP modeling. In the course of this study, it was revealed that the application of infliximab at a dose of 60 mcg/kg led to a pronounced positive effect on the pancreatic lesion, manifested by up to 50% decrease in mortality for one day in group D. Infliximab had a definite protective effect in AP, decreasing the volume of the injury, as well as the mortality rate by half for 24 h. Therapy with anti-tumor necrosis factor with infliximab could significantly reduce the volume of pancreatic lesions in severe forms of pancreatic necrosis, which contributed to a pronounced decrease in mortality for 1 day from the moment of pathology reproduction.
Topics: Animals; Female; Rats; Acute Disease; Infliximab; Pancreatitis, Acute Necrotizing; Rats, Wistar
PubMed: 35355779
DOI: 10.22092/ari.2021.355845.1726 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2022To examine the characteristics of the event related potentials during the attention network test in patients with schizophrenia depending on the severity of positive and...
OBJECTIVE
To examine the characteristics of the event related potentials during the attention network test in patients with schizophrenia depending on the severity of positive and negative symptoms.
MATERIAL AND METHODS
The study included 20 patients with schizophrenia, 10 of them with a predominance of positive symptoms and 10 patients with a predominance of negative symptoms. All patients were diagnosed with paranoid schizophrenia (F20.0). Attention function was assessed using the attention network test with parallel recording of evoked responses. Differences in the amplitude and latency of N100 potential when presented with different types of cues, as well as P300 potential when identifying a congruent and incongruent flanker were analyzed.
RESULTS
A comparative analysis of N100 potential for neutral cues and flankers showed significantly lower amplitude and longer latency in the group of patients with a predominance of negative symptoms (Cz channel).The amplitude of the evoked N100 response upon presentation of central and spatial cues was significantly higher in the group of patients with a predominance of positive symptoms. An analysis of P300 potential in Fz channel with congruent and incongruent flankers revealed no differences in the amplitude of both stimuli in the group of patients with a predominance of negative symptoms, while the amplitude of the evoked response to congruent and incongruent flankers was significantly higher in the group with a predominance of positive symptoms. In the group of patients with a predominance of positive symptoms, an inverse flanker response was established - P300 amplitude was significantly higher upon presentation of an incongruent flanker.
CONCLUSION
The specific characteristics of evoked responses describing the features of such systems of attention as vigilance, orientation and conflict resolution have been established.
Topics: Evoked Potentials; Humans; Reaction Time; Schizophrenia, Paranoid
PubMed: 35271242
DOI: 10.17116/jnevro202212202188 -
Kardiologiia Jan 2022Aim To evaluate the diagnostic capacity of left ventricular (LV) postsystolic shortening (PSS) values obtained by speckle-tracking stress-echocardiography...
Diagnostic value of postsystolic shortening of the left ventricular myocardium assessed during speckle tracking stress echocardiography on the treadmill in patients with coronary artery disease.
Aim To evaluate the diagnostic capacity of left ventricular (LV) postsystolic shortening (PSS) values obtained by speckle-tracking stress-echocardiography (stress-EchoCG) using a treadmill test in determining the functional significance of the degree of coronary artery (CA) stenosis.Material and methods The study included 132 patients (80 men aged 65.0±9.3 years) with suspected or previously verified diagnosis of ischemic heart disease. Stress-EchoCG with the treadmill test was performed for all patients. Strain parameters were determined by two-dimensional speckle-tracking on gray-scale images before and after the exercise. Values of LV postsystolic index (PSI) and LV mean postsystolic time (PST) were calculated. Coronary angiography was performed for all patients. Patients were divided into 3 groups based on the severity of CA stenosis according to the G. G. Gensini score.Results LV PSS values at rest did not significantly differ between the patient groups. After completion of the exercise, the mean LV PSI was significantly higher for patients with pronounced CA stenosis than in the group without CA stenosis or with moderate CA stenosis: 8.9 % [3.8; 10.7 %] vs. 3.8 % [2.2; 6.8 %] (p=0.012) and 3.4 % [2.2; 6.2 %] (p=0.012), respectively. The mean LV PSI after completion of the exercise indicated the presence of pronounced CA stenosis with a sensitivity of 75 % and a specificity of 61 % (area under the curve, AUC, 0.74±0.06; р<0.001). After completion of the exercise, the mean LV PST was significantly greater for patients with pronounced CA stenosis than in the group without CA stenosis or with moderate CA stenosis: 27.4 [18.7; 34.7] ms vs. 18.4 [10.8; 26.5] ms (p=0.036) and 20.9 [14.2; 29.5] ms (p=0.036), respectively. The mean LV PST after completion of the exercise exceeding 23.5 ms suggests pronounced CA stenosis with a sensitivity of 71 % and a specificity of 65 % (AUC 0.69±0.06; p=0.004). A complex evaluation of the LV PSI, the LV local contractility disorder (LCD) index, the LV PST, and LV LCD index allows enhancement of the test sensitivity in diagnozing pronounced CA stenosis.Conclusion Determination of LV PSS in speckle-tracking stress-EchoCG may be useful for evaluating the functional significance of the degree of CA stenosis to enhance the sensitivity of stress-EchoCG in patients with pronounced CA stenosis.
Topics: Aged; Coronary Artery Disease; Echocardiography; Echocardiography, Stress; Exercise Test; Humans; Male; Middle Aged; Myocardium; Reproducibility of Results
PubMed: 35168534
DOI: 10.18087/cardio.2022.1.n1724 -
Problemy Sotsial'noi Gigieny,... Jan 2022Over the last decades, with purpose of increasing efficiency of medical and preventive activities, the search, development, implementation and improvement of new methods... (Review)
Review
Over the last decades, with purpose of increasing efficiency of medical and preventive activities, the search, development, implementation and improvement of new methods and models of health care system functioning and management of medical organizations is carried out. Purpose of the study - to analyze mechanisms of implementing strategies of medical prevention in the Russian Federation. The publications on implementation of strategies of medical prevention in the Russian Federation were analyzed. The data analysis testifies that improvement of preventive activities at the level of ambulatory polyclinic care is initiated in many subjects of the Russian Federation. However, efficiency of these innovations remains relatively low. The conclusion is made that high morbidity and mortality of non-communicable diseases testify the most urgent need in optimizing prevention system.
Topics: Ambulatory Care; Delivery of Health Care; Humans; Organizations; Russia
PubMed: 35157374
DOI: 10.32687/0869-866X-2022-30-1-10-16 -
Problemy Sotsial'noi Gigieny,... Nov 2021The article presents results of sociological survey of district psychiatrists that revealed actual difficulties and shortcomings in organization of medical care for...
The article presents results of sociological survey of district psychiatrists that revealed actual difficulties and shortcomings in organization of medical care for mental patients. The problem of personnel high workload, inopportuneness and inadequate completeness of necessary medical care of mental patients are explained by a number of difficulties in organization of functioning of psychoneurological organizations. They included not only shortage of personnel and unsatisfactory material technical support of mental institutions, but also incompleteness of normative legal support mental care organization. The physicians identified the following priority targets to be implemented in practice will eliminate a number of actual problems in district psychiatrist work: organization of procedure of interdepartmental interaction of various services (GUFSIN, the Ministry of Internal Affairs, social protection agencies, passport office), development and approval of procedure of dispensary observation of mental patients, approval of procedure of interaction with territorial polyclinics and full implementation of medical care standards for patients with mental disorders. The administration of neuropsychiatric organizations from position of systemic approach is a priority direction of improving quality of medical care for mental patients.
Topics: Humans; Mental Disorders; Organizations; Patient Care; Physicians; Psychiatry
PubMed: 34882338
DOI: 10.32687/0869-866X-2021-29-6-1584-1587 -
Kardiologiia Nov 2021This document is a consensus document of Russian Specialists in Heart Failure, Russian Society of Cardiology, Russian Association of Specialists in Ultrasound...
This document is a consensus document of Russian Specialists in Heart Failure, Russian Society of Cardiology, Russian Association of Specialists in Ultrasound Diagnostics in Medicine and Russian Society for the Prevention of Noncommunicable Diseases. In the document a definition of focus ultrasound is stated and discussed when it can be used in cardiology practice in Russian Federation.
Topics: Cardiology; Consensus; Heart Failure; Humans; Russia; Ultrasonography
PubMed: 34882074
DOI: 10.18087/cardio.2021.11.n1812 -
Kardiologiia Aug 2021Aim To evaluate the prognostic significance of the left ventricular global function index (LV GFI) in patients with acute coronary syndrome (ACS) using... (Observational Study)
Observational Study
Aim To evaluate the prognostic significance of the left ventricular global function index (LV GFI) in patients with acute coronary syndrome (ACS) using echocardiography (EchoCG).Material and methods The LV GFI is an index that integrates LV cavity volumes, stroke volume, and myocardial volume. This study included 2169 patients with ACS (1340 (61.8%) men) aged 64.1±12.6 years from two observational multicenter studies, ORACLE I and ORACLE II. 1800 (83 %) cases were associated with increased concentrations of myocardial injury markers, including 826 (38.1 %) cases of ST segment elevation myocardial infarction (MI). The observation was started on the 10th day of clinical condition stabilization and lasted for one year. EchoCG was performed with evaluation of LV GFI, which was calculated as a ratio of LV stroke volume to LV global volume. The LV global volume was calculated as a sum of mean LV cavity volume (LV end-diastolic volume + LV end-systolic volume / 2) and LV myocardial volume.Results The main outcome of the study was all-cause death (n=193); recurrent coronary complications (n=253) were analyzed separately. The only EchoCG parameter indicating an adverse outcome during the one-year follow-up was a LV GFI decrease to below 22.6 % with a sensitivity of 72 % and a specificity of 60% (area under the curve, AUC=0.63). A LV GFI <22.6 % was an independent predictor of all-cause death (p=0.019) along with age (p=0.0001), history of MI (p=0.034), and presence of heart failure (HF) (p=0.044), diabetes mellitus (p=0.012), and peripheral atherosclerosis (p=0.001). The LV GFI <22.6 %, (p=0.044), heart rate upon discharge from the hospital (p=0.050), history of MI (p=0.006), presence of HF (p=0.014), and peripheral atherosclerosis (p=0.001) were also independent predictors for recurrent coronary complications. Decreased LV GFI was associated with the risk of fatal outcomes independent of the LV ejection fraction at baseline.Conclusion In patients with ACS, the left ventricular global function index is an independent predictor for all-cause death and recurrent coronary complications and may be used for risk stratification.
Topics: Acute Coronary Syndrome; Echocardiography; Humans; Male; ST Elevation Myocardial Infarction; Stroke Volume; Ventricular Function, Left
PubMed: 34549690
DOI: 10.18087/cardio.2021.8.n1508 -
Problemy Sotsial'noi Gigieny,... Jul 2021Currently, the characteristic of dynamics of morbidity of mental disorders of population of the Russian Federation is its increasing simultaneously with changing in...
Currently, the characteristic of dynamics of morbidity of mental disorders of population of the Russian Federation is its increasing simultaneously with changing in structure of contingents in the direction of decreasing number of patients subjected to dispensary monitoring. The study of influence of medical organizational factors on morbidity of mental disorders demonstrated the role of provision with psychiatrists in dynamics of prevalence of mental disorders. The improvement of management of patients with mental disorders should be supported by appropriate resources and adaptation of mental service to actual conditions, in particular, solving the problem of manpower deficiency of psychiatrists.
Topics: Humans; Mental Disorders; Morbidity; Prevalence; Psychiatry; Workforce
PubMed: 34486860
DOI: 10.32687/0869-866X-2021-29-4-928-932 -
Acta Naturae 2021The coronavirus disease outbreak in 2019 (COVID-19) has now achieved the level of a global pandemic and affected more than 100 million people on all five continents and...
The coronavirus disease outbreak in 2019 (COVID-19) has now achieved the level of a global pandemic and affected more than 100 million people on all five continents and caused over 2 million deaths. Russia is, needless to say, among the countries affected by SARS-CoV-2, and its health authorities have mobilized significant efforts and resources to fight the disease. The paper presents the result of a functional analysis of 155 patients in the Moscow Region who were examined at the Central Clinical Hospital of the Russian Academy of Sciences during the first wave of the pandemic (February-July, 2020). The inclusion criteria were a positive PCR test and typical, computed tomographic findings of viral pneumonia in the form of ground-glass opacities. A clinical correlation analysis was performed in four groups of patients: (1) those who were not on mechanical ventilation, (2) those who were on mechanical ventilation, and (3) those who subsequently recovered or (4) died. The correlation analysis also considered confounding comorbidities (diabetes, metabolic syndrome, hypertension, etc.). The immunological status of the patients was examined (levels of immunoglobulins of the M, A, G classes and their subclasses, as well as the total immunoglobulin level) using an original SARS-CoV-2 antibody ELISA kit. The ELISA kit was developed using linear S-protein RBD-SD1 and NTD fragments, as well as the N-protein, as antigens. These antigens were produced in the prokaryotic system. Recombinant RBD produced in the eukaryotic CHO system (RBD CHO) was used as an antigen representing conformational RBD epitopes. The immunoglobulin A level was found to be the earliest serological criterion for the development of a SARS-CoV-2 infection and it yielded the best sensitivity and diagnostic significance of ELISA compared to that of class M immunoglobulin. We demonstrated that the seroconversion rate of "early" N-protein-specific IgM and IgA antibodies is comparable to that of antibodies specific to RBD conformational epitopes. At the same time, seroconversion of SARS-CoV-2 N-protein-specific class G immunoglobulins was significantly faster compared to that of other specific antibodies. Our findings suggest that the strong immunogenicity of the RBD fragment is for the most part associated with its conformational epitopes, while the linear RBD and NTD epitopes have the least immunogenicity. An analysis of the occurrence rate of SARS-CoV-2-specific immunoglobulins of different classes revealed that RBD- and N-specific antibodies should be evaluated in parallel to improve the sensitivity of ELISA. An analysis of the immunoglobulin subclass distribution in sera of seropositive patients revealed uniform induction of N-protein-specific IgG subclasses G1-G4 and IgA subclasses A1-A2 in groups of patients with varying severity of COVID-19. In the case of the S-protein, G1, G3, and A1 were the main subclasses of antibodies involved in the immune response.
PubMed: 33959390
DOI: 10.32607/actanaturae.11374 -
Kardiologiia Mar 2021Aim To determine diagnostic capabilities of left ventricular (LV) global longitudinal systolic strain (GLSS) in stress echocardiography (stress-EchoCG)...
Aim To determine diagnostic capabilities of left ventricular (LV) global longitudinal systolic strain (GLSS) in stress echocardiography (stress-EchoCG) with a treadmill test for diagnosing the functional significance of the degree of coronary stenosis.Material and methods The study included 121 patients (73 men aged 68.3±7.7 years) with suspected or previously diagnosed ischemic heart disease (IHD). Speckle-tracking stress-EchCG (method of tracking speckles on two-dimensional gray-scale ultrasonic images) with a treadmill test and coronarography was performed for all patients. The patients were divided into 3 groups based on the severity of coronary artery (CA) stenosis according to the Gensini scale.Results LV GLSS at rest did not significantly differ between the study groups. After the exercise, LV GLSS was significantly lower in patients with pronounced CA stenosis than in patients without or with moderate CA stenosis (15.9±4.6 % vs. 20.6±3.7 % (p<0.001) and 19.6±3.0 % (p=0.003), respectively). Postexercise LV GLSS <16.9% suggested a pronounced CA stenosis with a sensitivity of 80% and a specificity of 70% (area under the curve, AUC, 0.76±0.06 at 95 % confidence interval, CI, 0.63-0.89; р<0.001). In the patient group without CA stenosis, LV GLSS showed a significant increase after completion of the exercise (from 19.1±3.1 to 20.6±3.7; p=0.04).Conclusion Evaluation of LV GLSS and its dynamics in stress-EchoCG with a treadmill test may be promising in patients with IHD, since in most patients with pronounced CA stenosis, LV GLSS is reduced at baseline and further reduces in response to exercise. In patients without CA stenosis, LV GLSS increases after completing the exercise.
Topics: Aged; Coronary Artery Disease; Coronary Stenosis; Echocardiography; Echocardiography, Stress; Exercise Test; Humans; Male; Middle Aged; Reproducibility of Results; Ventricular Dysfunction, Left
PubMed: 33849412
DOI: 10.18087/cardio.2021.3.n1462