Vol 26, No 4 (2023)

Features of cardiac arrhythmias in patients with acute st-segment elevation myocardial infarction who underwent COVID-19

Vadim P. Mikhin, Anna I. Gindler, Natalia V. Zaikina, Margarita P. Zaikina, Tamara A. Nikolenko, Valentina V. Savelyeva, Marina A. Chernyatina

PDF (Rus)

4-19 399

Abstract

Objective: to conduct a comparative assessment of the parameters of heart rhythm and conduction in patients with Covid-19 with acute ST-segment elevation myocardial infarction (STEMI) in the hospital and post-hospital treatment periods. Materials and methods. The study included 140 patients with STEMI, stratified into 2 groups: I - the main (52 people) patients with STEMI who had COVID-19 for 1.5-6 months before the development of acute coronary syndrome (ACS), II - the comparison group (88 people) with STEMI without COVID-19 in the anamnesis. All patients underwent percutaneous coronary intervention with stenting of a single infarct-related artery in the first 24 hours. Daily ECG monitoring was performed with an assessment of traditional heart rate and conduction parameters for 2-3 days, 9-11 days and after 6 months from the moment of the accident. Results. In the main group, in contrast to the control group, a shortening of the QT interval (7.7% vs. 0.0%), ventricular extrasystole (VES) of Lown grade IV A (25.0% vs. 7.9%) was more often recorded on 2-3 days. Supraventricular extrasystole (SVE; 92.0% vs. 65.4%), sinus arrhythmia (37.5% vs. 0.0%), supraventricular tachycardia (SVT; 7.9% vs. 0.0%) were more often recorded in group II on 2-3 days. During the hospital follow-up period, the retention of shortened QT (7.7% vs. 0.0%), predominance SVE (90.4% vs. 76.1%), sinus arrhythmia (48.1% vs. 29.5%), migration of the rhythm driver along the atria (15.3% vs. 0.0%), VES Lown grade IV A (9.6 % vs. 0.0%). In the control group, AV blockade of 1 deg. (15.9% vs. 3.8%), AV blockade of 2 deg. (4.5% vs. 0.0%), CA blockade (3.4% vs. 0.0%), QT prolongation (12.5% vs. 0.0%) were more often determined. By 6 months after STEMI, patients in the main group were more likely to have SVT (9.6% vs. 0.0%) and VES Lown grade IV A (7.6% vs. 0.0%). In the control group, AV blockade of 1 deg. (9.0% vs. 0.0%), CA blockade (3.4% vs. 0.0%) were registered. Conclusion. Patients with STEMI who had a history of COVID-19 and without COVID-19 had a multidirectional dynamics of heart rate and conduction parameters during the hospital and post-hospital follow-up periods. In patients who underwent COVID-19, there was a predominance of ventricular arrhythmias of high Lown gradations on 2-3 days of STEMI, an increase in supraventricular arrhythmias on days 9-11, an increase in supraventricular and ventricular arrhythmias of high Lown gradations and the absence of CA and AB disorders after 6 months. In the control group, there was a predominance of supraventricular and ventricular arrhythmias of low gradations according to Lown, a predominance of CA and AB conduction disorders on days 9-11 and 6 months after STEMI.

Chronic heart failure with moderately low ejection fraction

Olga A. Osipova, Elena V. Gosteva, Ruslan N. Shepel, Anna V. Serdyukova, Anastasia A. Kryshka, Kristina Y. Inshakova, Anna Y. Ulyanova, Anastasia S. Brizhaneva, Igor A. Saraev

PDF (Rus)

20-27 390

Abstract

Chronic heart failure (CHF) as one of the cardiovascular complications is among the most frequent causes of death and repeated hospitalizations of patients, representing a great burden on the health care system. Currently, the assessment of left ventricular (LV) ejection fraction (EF) is the cornerstone of classification of patients with CHF, the main criterion for diagnosis, phenotyping, prognosis and decision on the choice of pharmacotherapy strategy. Traditionally, patients with heart failure were divided according to a threshold value of PV greater than or <50%. In 2016, CHF was divided into three subgroups depending on LVEF: CHF with low LVEF (HFrEF; LVEF <40%), CHF with moderately low LVEF (HFmrEF 40-49%), and preserved LVEF (HFрEF≥50%). At the same time, to date, the data on HFmrEF are extremely limited and are represented by single publications in this area. Therefore, the research aimed at studying this category of patients is very promising. The aim of the review is to analyze the current data on CHF, in particular epidemiology, etiology, clinical characteristics and prognosis of patients.

Surgical treatment of valvular aortic stenosis in combination with a narrow aortic root. The site of posterior aortoplasty in adults. An overview of the need for this operation, its execution techniques and our experience. Literature review

Maxim A. Sazonenkov, Andrey M. Tatarintsev, Khushbakhtdzon Kh. Ismatov, Andrey S. Moskalev

PDF (Rus)

28-41 326

Abstract

Aim: to describe the current state of the problem of surgical expansion of the aortic root during aortic valve replacement. Aortic valve replacement is a radical operation aimed at reducing the symptoms of chronic heart failure, reducing left ventricular overload, regressing its hypertrophy, and thereby increasing the quality and life expectancy of the patient. For the greatest success of the operation, the replacement should be made with the appropriate valve size suitable for the particular patient. Materials and methods. The latest literature data on the place of surgical expansion of the aortic root in the problem of treating aortic stenosis were studied. The own experience of these operations during the implantation of mechanical and biological prostheses in the aortic position in the practice of the cardiosurgical department of the Belgorod Regional Clinical Hospital is presented. Results. The study is devoted to the actual problem of choosing the right size of the prosthesis, the frequency of additional surgical procedures for its placement. Many studies have established an association between prosthesis-patient mismatch (PPM) and surgical outcome. The association of prosthesis-patient mismatch with long-term survival is inverse, although sometimes reported as ambiguous. We reviewed the literature and our experience with the surgical management of narrow aortic root situations to determine the incidence of PPM and the need for an additional surgical procedure of posterior aortoplasty to accommodate the appropriate size of the prosthesis. The results of modern meta-analyses, multicenter studies and limited series of operations presented in the literature are reviewed. The experience of the cardiosurgical department of the Belgorod Regional Clinical Hospital for the period 01.01.2015-30.04.2023 in aortic valve replacement with a small size of the aortic ring (17-20 mm) is presented. The study material consisted of 303 patients. As prosthesis-patient mismatch, we defined all cases of posterior aortoplasty with implantation of an appropriately sized aortic prosthesis. According to modern studies, the incidence of prosthesis-patient mismatch in aortic valve replacement without aortic root plasty is 11-33%. The frequency of posterior aortoplasty in adults is, according to different authors, 5-40%. Our experience has shown that the situation of PPM, which required aortic plasty, occurred in 14.8% of cases of implantation of stented biological prostheses, in 17.3% of cases of implantation of mechanical bicuspid prostheses. In general, on average, aortic plasty was performed in 15.8% of cases. Prosthetic-patient mismatch in aortic valve replacement occurs at a relatively constant rate. Posterior aortoplasty allows implanting the calculated size of the prosthesis and avoiding this problem. Conclusion. Surgery to patch the aortic root to accommodate an adequately sized prosthesis in the aortic position is required in 15-30% of patients with narrow aortic annulus. It allows you to get good hemodynamic results. The surgical risk of the operation is low.

Food Allergy in Children with Atopic Dermatitis (Possibilities of Laboratory Diagnosis)

Olga A. Trunova, Eduard A. Maylyan, Evgeny V. Prokhorov, Alexander S. Prilutsky, Andrey E. Bagriy

PDF (Rus)

42-53 265

Abstract

Objective - determination of the frequency of manifestation of allergic reactions of reaginic and cellular types in vitro to food allergens in children with atopic dermatitis (AD). Materials and methods. We examined 284 children aged 0 to 14 years: 200 children with AD in 4 age groups and 84 control children. Investigated total IgE, histamine and serotonin in the blood. A semi-quantitative method in ELISA identified specific IgE antibodies to 67 food allergens, and in leukocyte migration capillary tube technique (LMCT) the presence of delayed-type sensitization to 42 food allergens. Results. The levels of total Ig E, histamine and serotonin in children with AD were significantly higher than the control. The average value of positive results for the presence of specific IgE antibodies to any food allergens was 46.2±4.57%. Banana, goat's milk, tomatoes, egg protein and cow's milk casein topped the ranking. According to the results of LMCT, delayed sensitization of the cell type was determined on average in 40.38±4.81% of tests. The leaders were allergens of hake, black coffee, glucose, peas, rye flour, orange, corn flour and peanuts. Conclusions.AD develops in children already at an early age (up to 3 years), with an excess of control values of total serum IgE by 4.8 times (p<0.01), histamine - by 1.3 times (p<0.01), serotonin - 1.2 times (р<0.001). Reaginic and cellular reactions are involved in the occurrence of food sensitization. Methods of laboratory diagnosis of food allergy are preferable to skin tests and allow young children to simultaneously determine sensitization to a large number of allergens.

Oral manifestations of HIV-infection in patients based on CD4+ T-lymphocyte counts

Alexander V. Lyogkih, Elena F. Gaisina, Maria N. Dobrinskaya, Ekaterina A. Omelkova, Polina I. Astryukhina

PDF (Rus)

54-64 483

Abstract

Objective - analysis and generalization of the available data on the manifestations of human immunodeficiency virus in the oral cavity depending on the number of CD4+ T-lymphocytes in the blood. Materials and methods. A search of clinical studies, systematic reviews, and online meta-analyses was conducted from 2004-2023 in the PubMed, Elsiever, Scopus, Cochrane, and Elibrary databases, which described oral manifestations of HIV infection as a function of CD4+ T-lymphocyte count. Results. Pseudomembranous candidiasis, hairy leukoplakia, Kaposi's sarcoma, and non-Hodgkin's lymphoma develop against a background of severe immunodeficiency when the CD4+ T-lymphocyte count is <200 cells/μL blood. Kaposi's sarcoma also develops in people with a high CD8+ T-lymphocyte count (>1000 cells/μL of blood) or with a low CD4+ to CD8+ ratio (CD4+:CD8+ ≤0.5). Non-Hodgkin's lymphoma develops not only with CD4+ T-cells <200/μL, but also with a high number of CD8+ T-cells (≥2000 cells/μL of blood). Specific periodontal disease develops with moderate to severe immunodeficiency (CD4+ T-cells 200-500 cells/μL of blood). Necrotic ulcerative gingivitis is more often seen in severe immunodeficiency (CD4+ T-lymphocytes <200 cells/μL). Conclusion. The development of pseudomembranous candidiasis (p<0,05), "hairy" leukoplakia (p<0,01), Kaposi sarcoma (p<0,0001) statistically significantly correlates with CD4+ T-lymphocyte count <200 cells/μl blood. In addition, the development of Kaposi's sarcoma, in addition to the low number of CD4+ T-cells, is affected by a high number of CD8+ cytotoxic lymphocytes >1000 cells/μL (p=0.0003) and a low CD4+:CD8+ ratio ≤0.5 (p<0.0003), which is statistically significant.

System relationships of the thoracic vertebrae anatomy and surrounding muscles in overweight men

Michail A. Ivanov, Irina N. Yashina, Svetlana V. Klochkova, Fedor D. Yashin

PDF (Rus)

65-71 295

Abstract

Objective - to identify patterns of structure and relationship of elements of the thoracic spine and surrounding muscles in males of the 2nd period of adulthood with overweight and obesity of the 1st degree. Materials and methods. The study was performed on computed tomograms of the thoracic spine of 63 healthy men aged 36 to 60 years with a height of 170 to 186 cm and a body weight of up to 74.3 to 110 kg. The vertebral dimensions and the width of the paravertebral muscle mass were evaluated ((Me; IQ-IIIQ), factor analysis by the principal component method). Results. With an increase in the ordinal number of the vertebra, the increase in the width and anterior-posterior size of the bodies occurs unevenly, two points of decrease in the median value of the size of the vertebral bodies are determined - ThV and ThX. A narrowing of the spinal canal ThI to ThVII was revealed, followed by an increase in size to ThXII. A decrease in the median values of the anterior and posterior heights of bodies ThIII and IX was found. The median values of the height of the legs increase with an increase in the ordinal number of the vertebra, however, a decrease in the median values was found in ThIV, ThVI, ThVIII 1 and ThX. A decrease in size was found between the vertices of the transverse processes of the vertebrae and the vertices of the transverse and spinous processes. The decrease in their median value is most pronounced in the upper thoracic vertebrae from ThI to ThVII. Analysis of the width of the muscle arrays revealed a wave-like decrease in the median width, with three rises at the level of ThIII, ThVI and ThXI and declines at the level of ThV, ThIX and ThXII. The results of factor analysis revealed two segments in the thoracic spine. The maximum influence on the structure of the first segment of ThI-VII is exerted by the width of the paravertebral muscle array. In the second segment from ThVIII to ThXII, the width and angle of inclination of the spinous process have the maximum effect. Conclusion. The thoracic spine in men includes two segments that differ in function: the cranial segment, which depends on the activity of the paravertebral muscles, and the caudal segment, which reflects the supporting function.

Correlation of heart rate variability and behavioural indicators in Wistar rats

Igor I. Bobyntsev, Victoria N. Korobova, Anton O. Vorvul, Yaroslav I. Bobyntsev, Anastasia V. Stepanova

PDF (Rus)

72-87 388

Abstract

The aim - to study the correlation relationship between the parameters of heart rate variability and behavioural indicators of anxiety, emotionality and pain sensitivity in Wistar rats. Materials and methods. The study was carried out on 25 male and 25 female Wistar rats weighing 180-300 g. Methods for assessing the functional state of animals included analysis of heart rate variability (HRV), elevated plus-maze (EPM) and open field (OF), hot plate, and tail-flick tests. Results. It was found that for a comprehensive assessment of the functional state of Wistar rats according to HRV data, it is necessary to take into account the initial level of spectral characteristics (low or high spectral values - LSV and HSV), and for behavioural indicators - the sex of the animal. In this connection, the following groups were identified: a common group (males and females), a common group with LSV, a common group with HSV, a common group of males (with LSV and HSV), a group of males with LSV, a group of males with HSV, a common group of females (with LSV and HSV), a group of females with LSV, a group of females with HSV. Correlation analysis between HRV, EPM, OF and pain sensitivity indicators allowed us to identify the most significant relationships in each group. The most versatile for assessing anxiety, locomotor and research activity, as well as pain sensitivity are SDNN, RMSSD, pNN3, CV, Mo, HF and LF. Conclusion. Thus, the relationship of HRV with behavioural indicators has been proved and the prospects for further study of the studied parameters as prognostic criteria.

Study of the effect of the "Antiseptic Dorogov's stimulator" (ASD 2B-drops) on the growth of Mycobacterium tuberculosis strain

Sergey V. Engashev, Vladimir G. Kukes, Aleksandr V. Poddubikov, Nikita G. Sidorov, Anna Yu. Leonova, Olga K. Parfenova, Albina A. Gazdanova, Olga A. Dorogova

PDF (Rus)

88-92 422

Abstract

Objective - to study the effect of three different concentrations of the drug "ASD-2B drops" on the growth of M. tuberculosis strain № 22063. Materials and methods. The effect of three different concentrations of "ASD-2B drops" on the growth of M. tuberculosis strain № 22063 with a single addition of the drug into the reaction mixture was evaluated. Cultivation was carried out in Dubos broth for growing mycobacteria at 37°C for 20 days with periodic assessment of the turbidity index using a densitometer. Results. "ASD-2B drops" at a concentration of 750 µl in 10 ml of the reaction mixture after a single addition at the zero point inhibited the growth and accumulation of biomass of M.tuberculosis strain № 22063 for 10 days compared with the control. "ASD-2B drops" in lower concentrations (37.5 µl and 75 µl) contributed to an increase in the growth and accumulation of biomass of M.tuberculosis strain № 22063 compared with the control. Conclusion. The experiment demonstrated the ability of "ASD-2B drops" with a single addition to influence the growth and accumulation of biomass of M. tuberculosis strain № 22063, depending on the concentration of the drug. The presence of an inducing effect on the M. tuberculosis strain № 22063 provides a basis for further studies of the drug "ASD-2B drops".

Standardization and comparative analysis of the quality of acetylsalicylic acid tablets

Natalia D. Ogneshchikova, Tamara V. Orlova, Alla V. Nesterova

PDF (Rus)

93-98 314

Abstract

Currently, the pharmaceutical industry offers a fairly large number of acetylsalicylic acid (ASA) tablets. Relevant is their high quality, regardless of the manufacturer, the stability of indicators in the process of mass production. Objective: comparative analysis of the main quality indicators of ASA tablets of domestic pharmaceutical manufacturers, improvement of the test «Dissolution». Materials and methods. ASA uncoated tablets, 500 mg, 4 series from two pharmaceutical manufacturers. Evaluation of the quality of tablets and statistical processing of the results of a chemical experiment were carried out according to the relevant methods of the State Pharmacopoeia of the Russian Federation. Results. ASA tablets were standardized according to the following indicators: description, identity, mass uniformity of dosage forms, disintegration, abrasion, quantitative determination of the active substance, dissolution, impurities (salicylic acid). The dissolution profiles of ASA were studied depending on the dissolution medium. Compliance of all samples with the requirements of regulatory documentation was established. A unified test method "Dissolution" for ASA tablets is proposed. Conclusions. The identical composition of the excipients used, the high quality and pharmaceutical equivalence of ASA tablets of different production series and manufacturers have been established.

Analysis of the amino acid and elemental composition of white mistletoe leaves

Nadezhda M. Chervonnaya, Similla L. Adzhiakhmetova, Dmitry I. Pozdnyakov, Eduard T. Oganesyan

PDF (Rus)

99-107 280

Abstract

Objective: comparative study of the amino acid and elemental composition of leaves Viscum album L. and host plants. Materials and methods. The amino acid and elemental composition in raw materials and extracts from leaves Viscum album and the corresponding host plant, obtained by extraction with 50% ethyl alcohol, was determined by capillary electrophoresis. Results. Glycine, alanine, leucine, proline, methionine, valine, asparagine, aspartic and glutamic acids were previously identified in the leaves Viscum album by ascending paper chromatography. By capillary electrophoresis, it was found that the raw materials and extracts contained proline, valine, alanine, threonine and methionine in the greatest amount. It has been established that in a semi-parasitic plant, the content of proline is 16 times higher than in Malus domestica Borkh. leaves and 5 times higher than in Pyrus communis L. leaves In alcohol-water extracts, the proline content is 5 and 1,5 times higher, respectively. It should be noted that in raw materials and extracts from Viscum album, obtained by extraction with 50% ethyl alcohol, potassium ions predominates quantitatively. Compared to leaves Malus domestica, leaves Viscum album accumulate 4,5 times more potassium, and 1,5 times more than in Pyrus communis leaves; in extracts, the content is also higher by 3 and 2 times, respectively. Conclusion. In raw materials and extracts from Viscum album, 13 free amino acids were found, of which 6 are essential (Arg, Phe, Leu, Met, Thr, Val). It was found that potassium predominates quantitatively in raw materials and extracts from Viscum album.

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Humans and their health

CLINICAL MEDICINE

PREVENTATIVE MEDICINE

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PHARMACEUTICAL SCIENCES

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Humans and their health

CLINICAL MEDICINE

PREVENTATIVE MEDICINE

MEDICOBIOLOGICAL SCIENCES

PHARMACEUTICAL SCIENCES

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