Original research. Рубрика в журнале - Cardiometry
Статья научная
Objective: To evaluate if switching therapy from an angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) to sacubitril/valsartan induces incremental left ventricular (LV) reverse remodeling and the effect of switching on quality of life (QOL) in heart failure with reduced ejection fraction (HFrEF). Methodology: This prospective multicenter study included 100 patients with HFrEF. The patients were subdivided into two equal groups: Group one included patients who were switched to sacubitril/valsartan and group two included patients continued on ACEIs or ARBs as control group. The patients were subjected to medical history taking, clinical examination, heart failure related data, New York Heart Association (NYHA) functional classification, blood samples and chemistry, transthoracic echocardiography (TTE) and quality of life assessment. Results: There was marked improvement in all two dimensional (2D) echocardiography parameters, as left ventricular end systolic volume (LVESVI), left ventricular end diastolic volume index (LVED-VI) and left atrium volume index (LAVI) which significantly reduced after 3 months of therapy with significant improvement in LV function (P-value 0.05). Moreover, mitral regurgitation (MR) severity significantly decreased (P-value 0.05). Regarding quality of life, there was a significant improvement in QOL. KCCQ score was significantly improved after 3 months of treatment (P-value function show_abstract() { $('#abstract1').hide(); $('#abstract2').show(); $('#abstract_expand').hide(); }
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Background: Patients with chronic heart failure (CHF) experience marked reduction in their exercise capacity which has detrimental effects on their activities of daily living, health- related quality of life (HRQoL), and ultimately their hospital admission rate and mortality. This study aimed to determine the correlation between right ventricular echocardiographic variables, functional status assessed by 6 min walk distance (6MWD) and quality of life assessed by MLHFQ in HF patients. Methods Methods 70 patients with chronic stable HF with (EF ≤40%) presenting with grade I to III NYHA classification. Each patient performed a 6 min walk test (6MWT) and completed a form of MLHFQ. Patients classified into 2 groups according to the results of 6MWD (group A including those who walked >300meters, While group B including those who walked
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Role of hypothalamic-pituitarygonadal regulatory axis in growth of melanoma B16/F10 in C57/Bl6 mice
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Aim: to study the role of the hypothalamic-pituitary-gonadal (HPG) regulatory axis and its dermal analogue in C57BL/6 mice of both sexes with the growth of B16/F10 grafted melanoma. The studies were carried out in mice of both sexes of the C57BL/6 line, which were transplanted with B16/F10 melanoma by subcutaneous injection of 0.5 ml of a suspension of tumor tissue. In intact animals and in the animals 14 days after the tumor inoculation, the levels of gonadal releasing hormone (GnRH), LH and FSH, and estradiol (E2), total testosterone (T) and free testosterone (Tfr), progesterone (P4), as well as ERα and ERβ estrogen receptors, progesterone receptor (RP4) and androgen receptor (RA) were determined. Results. In the males, compared with the females, after melanoma transplantation, the latent period and average life spans were shorter, while their tumor volumes were larger. A 2.1-fold decrease in GnRH in the hypothalamus in males led to a 2.7- fold increase in the level of LH in the pituitary gland, while in females a 1.4-fold (p
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Role of mindfulness meditation for enhancement of self- efficacy in alcoholism
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Mindfulness meditation is an effective tool to create mental awareness and has been used in meditation practice for many decades. Mindfulness meditation is the practice that bringing clear awareness to the present not on the pastor future without evaluation. Many research studies have proved the benefits of mindfulness meditation in psychological and bodily health. Mindfulness meditation interventions is highly effective in reducing the level of anxiety, and depression, prevention of alcohol relapse, controlling of craving and enhancement of self efficacy. Mindfulness meditation technique helps to awareness of once self-efficacy. The connection between mindfulness meditation and self-efficacy helps to focus on set goals and performance. People with high self-efficacy approach obstacles in life as challenges. They set challenging goals for themselves and work hard to achieve them. People with low self- efficacy view life obstacle as life threats and instead to overcome they will focus on their own deficiencies. They rarely set goals and do not commit for that. Self-efficacy is defined as a person’s conviction in his or her ability to carry out the behaviours required to achieve certain performance goals. A self-efficacy is a reflection of once confidence in the ability to control own motivation, behaviour, and responses to the environment.. High level of self-efficacy often has high motivation. In alcoholism It refers to the strength to stop or minimize addiction and manage craving, temptation and maintain behavioural changes. These changes might be the strongest predictors of recovery from alcoholism.
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Role of power distance phenomena in blended learning in higher education post-COVID-19
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COVID has posed several challenges for higher education. There is a rise in blended teaching and learning models that can improve the quality of education, observed Raman. Classroom interaction vital in quality of education is affected by power distance between the teacher and students, states Kasuya. Much research has been done on blended learning but hardly any on the role of power distance in blended learning in higher education, specifically post COVID. Keeping in mind the growing significance of blended learning shortly, it becomes strategically important to understand the role of power distance in blended learning in higher education post-COVID-19. This research paper tries to address the research gap. The study is exploratory, exploring the role of power distancing in blended learning formats during post-COVID-19. The findings indicate that there is a relationship between power distance and the autonomy of an individual. The higher the power distance between a teacher and a student from the teacher’s perspective, it becomes teacher-centred learning. So blended learning with the best of low power distances in terms of the media and delivery mechanism of offline and online ensures the mitigation of power between the teacher and the taught. The research will help the universities create a perfect blended learning format that enhances the quality of higher education. Due to the paucity of time and resources and a ban on respondent interaction due to pandemics, this research is based on secondary data analysis.
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Background; Atrial septal defect (ASD) is one of the most common congenital heart diseases. Right ventricular (RV) dysfunction is closely related to patient outcome in open and closed ASD closure. Aim of work; to quantify RV function in patients with chronic RV volume overload due to an ASD before and after its percutaneous closure. Subjects & methods; In this prospective study which included 40 patients with secundum type ASD and normal sinus rhythm who underwent successful percutaneous ASD closure procedure at Cardiology Department, Faculty of Medicine, Benha University; and Cardiology Department, national-heart-institute. All patients underwent full history taking, clinical examination, ecg & echocardiography including assessment of LA, LV, RA & RV functions & dimensions with special emphasis on TAPSE, RV MPI & 2D speckle tracking.
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Background: Patients who exhibit signs and indicators of heart failure (HF) but usual or near to ordinary left ventricular ejection fraction are said to have HFpEF, which is an abbreviation for heart failure with preserved ejection fraction. Our goal was to assess the role that 2D-STE plays in the identification of RV dysfunction in HFpEF patients. Methods: Benha Teaching and Benha University Hospitals were both involved in the research for this study. It was carried out on a total of 100 individuals, each of whom was randomly assigned to one of two groups: group I involving 50 patients diagnosed with HFpEF. The patients who acted as control group were compared to another set of fifty healthy individuals who were the same age and gender. Result: No substantial changes were reported between both groups concerning Tricuspid annular plane systolic excursion (TAPSE), right ventricular diameter (RVD)(mid, basal, longitudinal)(P = 0.473), and right ventricular fractional area change (RVFAC)(P = 0.12). Conclusion: Patients with HFpEF who have features that are detected by 2D-STE have a much higher risk of experiencing a negative outcome. This is in contrast to the results of traditional
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Aims Cardiovascular diseases are among the most important causes of mortality and morbidity worldwide. There are different risk factors explained for cardiovascular diseases and diabetes mellitus (DM) is notable among them. There are different modalities for diagnosis and risk assessment of cardiovascular diseases such as myocardial perfusion imaging (MPI) but considering high price and low accessibility of this modality we decided to assess any possible association between MPI findings and Rose angina score (RAS) in both diabetic and non-diabetic patients. Materials and methods In this descriptive-analytic study we enrolled 585 diabetic and non-diabetic patients with angina pectoris referred to nuclear medicine department of Shahid Sadoughi hospital, Yazd, Iran for MPI. Patients demographic information along with MPI results and Rose angina questionnaire were obtained. Data were finally analyzed using SPSS ver.21 software using appropriate statistical tests. Results in this study, there were 294 diabetic and 291 non diabetic patients enrolled. 61.9% of non-diabetic patients had normal MPI results but this amount was only 38.8% among diabetic patients. Our study population did not differ based on age, gender and Rose angina score between diabetic and non-diabetic patients. Our results indicate that there is a statistically significant association between RAS and MPI findings in both diabetic (P-value=0.001) and non-diabetic (P-value=0.001) patients.Conclusion In present study we found a significant association between simple RAS questionnaire and MPI findings. We do not deny high accuracy and diagnostic value of MPI but we want to focus on clinical judgement of physicians prior to imaging modalities. We believe that in many cases, with a good clinical assessment such as RAS, many unnecessary and expensive modalities can be avoided.
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Scope of Big Data analytics in green supply chain management: a review
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In the modern era, the specialists working in the supply chain arenas are engulfed with enormous amounts of data, which has made them think out of the box and probe more into the sources of the data and techniques of analyzing and organizing the unstructured data. The new bud scholars and professionals have endorsed big Data Analytics (BDA) lately as a decisive green supply chain management facilitator. Research in this particular area is still to be explored to the fullest. The findings of the research are still in the introductory stages. Our study comprises an organized literature review of 42 significant papers published in the previous 18 years, which performs thorough reasoning and outlines three types of GSCM field: green product innovation, reverse logistics, and green procurement. The study presents the scope of BDA in these respective areas of GSCM. The study helps to portray the extent of usage of BDA tools in distinct GSCM fields. The literature review also sheds light on certain gaps in the research work. It caters to the directions for future work in the dedicated field.
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The original herbal formula of homeostasis regulator Multiphytoadaptogen (MPhA) for preventive oncology developed by the N.N. Blokhin Center of Oncology containing phytocomponents from Schizandra chinensis has been investigated in vitro, in vivo and in clinical studies. The MPhA multi-target effects are achieved by optimizing the functioning of the nervous, immune and endocrine defense systems that regulate homeostasis under stress. Everything that has been previously studied for MPhA can be considered as preclinical testing, including clinical research, which can be regarded as the pilot studies. This was allowed because MPhA in Russia is registered as a parapharmaceutical agent and therefore standardized according to established requirements. However, due to the high efficiency of MPhA, a detailed study of the chemical composition and standardization of it is required, including the composition of Schisandra chinensis Baill (Schisandraceae) active components, which turned out to be translocated into MPhA as a result of the extraction technology developed. So, for MPhA identification and standardization we detected the secondary metabolites in the herbal formula MPhA as well as in fruits extract of Schisándra chinénsis using high-performance liquid chromatography in combination with mass spectrometry. Chromatography was performed on an ACQUITY UPLC BEH C18 column in a gradient mode. A TSQ Vantage triple quadrupole mass spectrometer with electrospray ionization was used. Lignans Schizandrin and Schizantherin A were identified in the MPhA as well as in Schisándra chinénsis fruits extract obtained by the technology developed. The determined secondary metabolites can be used for standardization and quality testing of the herbal formula MPhA. In addition, we performed in silico analyzes of Schizandrin and Schizantherin A biological activity spectra using computer program PASS (Prediction of Activity Spectra for Substances). Schizandrin and Schizantherin A activities, according the scientific literature and in silico analysis, correspond to the properties studied for MPhA which therefore fits into the concept of a drug - homeostasis regulator adaptogen for preventive oncology.
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Self-dependent antitumor effects produced by metal-containing nanoparticles in experiments in vivo
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The most of numerous studies devoted to the therapeutic effects of NPs in oncology still don’t go beyond experiments and are carried out in two main directions - the development of methods for targeted delivery of various antitumor factors (cytostatics and other agents) combined with NPs precisely into the tumor tissue as well as development of magnetic fluid hyperthermia methods. At the same time in the last decade new direction dealt with the self-dependent antitumor effects of metal-containing NPs is being formed. It may be considered as a new option of cancer immunotherapy. And the possibility of complete regression of already formed, developed experimental tumors under the influence of metal-containing NPs was shown for the first time in the researches carried out at the National Medical Research Center for Oncology in Rostov-on-Don (Russia) in 2007- 2016.
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The paper considers individual approaches to the provision of emergency psychiatric care in emergency situations. The authors believe that emergency psychological, psychiatric and psychotherapeutic care is an important component of the healthcare system and plays an important role in providing timely assistance to people facing crisis situations, including mental disorders, suicidal thoughts, traumatic events and other problems. The main task of emergency psychological, psychiatric and psychotherapeutic care is to provide quick and effective assistance in an emergency situation when every minute matters and can save a life. In addition, emergency psychological, psychiatric and psychotherapeutic care can also help prevent the development of mental health-related diseases and provide patients with access to the necessary resources and treatment. It is important to note that urgent psychological, psychiatric and psychotherapeutic care should be available to everyone who needs it, regardless of age, gender, social status and other factors. At the same time, it is important to take into account the cultural and ethical characteristics of each patient and provide them with an individual approach and high-quality care.
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Signal morphological criteria for cardiotoxicity in breast cancer chemotherapy
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Aims A high incidence of breast cancer is observed in all countries throughout the world, and this dictates the use of aggressive antitumor drugs. The toxogenic effect of anthracycline drugs on the cardiovascular system under conditions of oncological pathology determines the need to expand the diagnostic capabilities for detecting cardiotoxicity, including searching for signal morphological markers in blood serum. The aim of this work is to study the structure of solid-state films of blood serum in patients with breast cancer at the stages of their chemotherapeutic treatment to identify signal criteria for cardiotoxicity. Materials and methods Studies were conducted in 25 patients with primary breast cancer (BC) with an extent of spread of the tumor process corresponding to T2-4N0-1M0. Polychemotherapy (PCT) was carried out in a neoadjuvant regimen, which included doxorubicin (60 mg/m2) and cyclophosphamide (600 mg/m2) supported by echocardiography examinations and ECG monitoring. Morphological testing of solid-state blood serum samples was carried out using the Shatokhina-Shabalin method of wedge-shaped dehydration both before PCT and in the course thereof. Samples were visualized with the Leica DMLS2 microscope with a magnification from x20 to x90. Results Before starting the PCT course, in the serum facias, in 55% of the cases detected has been the loss of the radial symmetry system and the formation of pathological types, including the “double” facias that is a criterion of systemic intoxication. Local markers of comorbid states with a detection rate of up to 40% of intoxication21.05.2020impaired vascular elasticity, sclerosis, hypertension and ischemia have been identified. After 3 courses of PCT including anthracyclines, the occurrence rate of formation of these pathological criteria increased by 1.7 times; the occurrence rate of myocardial trophic disorder markers was found to be higher. At stages 5-6 of the treatment course, in 80% of the cases, some signal signs of the cumulative effect of anthracyclines associated with impaired cardiac rhythmogenesis were detected in the facias structure. Conclusions Inhibition of tumor growth under PCT including anthracyclines is accompanied by structural deformation of the systemic and local self-organization of blood serum. An intensification of crystallogenesis of inflammation pathological proteins, sclerosis, intoxication, hypertension, stagnation angiospasm and cardiac arrhythmias makes it possible to assess the intensity of drug cardiotoxicity using the identifying markers, predict long-term effects of PCT and a possibility of their prevention.
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Significance of coping strategies on the outcome of surgical treatment of patients with prosoplegia
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Aim: to evaluate the impact of coping strategies on the outcomes of surgical treatment of patients with prosoplegia. Material and methods: the analysis of the results of surgical treatment of 50 patients with prosoplegia that developed after removal of tumors of the posterior part of the skull, the lateral part of the skull base, and the parotid-masticatory region involved in reconstructive interventions on the facial nerve was performed. At the preoperative stage a clinical examination of patients was performed according to the House-Brackmann scale, Sunnybrook Facial Grading System (SFGS) scale, and a neurophysiological study was performed. A survey was carried out with the use of the Heim’s questionnaire, WCQ (version by Lazarus), CSI as an indicator of coping strategies before surgery and the Aaron Antonovsky’s Sense of Coherence Scale (SOC). Outcomes were evaluated according to the Johnny Chuieng-Yi Lu subjective scale “Satisfaction with surgical treatment”. Results: all patients from 6 to 10 months after surgery showed signs of muscle recovery, which in the majority (88%, n=44) was accompanied by an improvement in their condition. In 12% of cases (n=6) there were no positive dynamics, which caused unsatisfactory results of treatment. Such painful conditions are often interrupted or recommendations for self-rehabilitation are not followed. The above-described predominance of maladaptive coping strategies in patients with unsatisfactory initial operations is reliable. Adaptive treatment strategies were better developed in patients with favorable treatment outcomes. A high direct correlation was established between the outcomes of treatment, assessed by the Johnny Chuieng-Yi Lu scales, SGFS and SOC coherence scale, Conclusion: Systemic complex rehabilitation and self-rehabilitation have a significant impact on treatment outcomes. Prosoplegia leads to a violation of facial and emotional expression, causing social maladjustment and depressive disorders, minimizing the effects of reinnervation in combination with negative coping strategies. As a result, full-fledged surgical treatment of the facial muscles is currently a very difficult and sometimes insurmountable task.
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Aims The aim of the paper is to show the significance of the fractal approach to scientific discovery in the context of interrelations between the modern natural sciences and medicine in order to increase an efficiency of applications of most advanced medical devices. Materials and methods Herein used is the fractal approach as methodology and logics of scientific discovery as a fundamental component of scientific cognition that allows demonstrating an objective interrelation between modern natural sciences and medicine, first of all, cardiology. Also used are the methods for mathematical modeling of measuring and computing systems as methodology for biomedical signals studies. Results For the first time demonstrated is the role of fractal approach as methodology and logics of scientific discovery, which is the basis of the scientific cognition, that allows detecting the interrelations between the modern natural sciences and medicine, cardiology, in particular. For the first time denoted is an area of possibilities of applications of the methods for mathematical modeling of measuring and computing systems as a methodology for studying biomedical signals (electrocardiosignals). Conclusions The way out of the crisis in medicine is offered herein; prospects for overcoming the crisis are discussed in connection with the use of different methodologies such as tensor methodology, quantum mechanics, artificial intelligence, transdisciplinary research and others.
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Socio-cultural factors of human surviving under the conditions of the Leningrad blockade
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Aim The aim of the article is to show the significance of the axiological approach in explaining the place of socio-cultural factors, such as social status, ethical values and art, in survival of human population under the conditions of the Leningrad blockade, which reveal in a new methodological viewpoint the significance of the fundamental discoveries, made by Soviet scientists, still underestimated, in biology and medicine (high viability of a part of the population under extremely severe conditions, possibility of activating the hidden reserves of the organism on the verge of life and death, dysregulation pathology, high life potential of the human body, dependence of severity and outcomes of alimentary dystrophy on the psychoemotional status), which have an enduring value and are very topical in our days of significant growth rate of occurrence of extreme situations like environmental and anthropogenic disasters, local armed conflicts and criminal events. Materials and methods In this article the following theoretical tools are applied: a widely used in science neurobiological approach; a new approach to the nature of art as a means of human survival; a cosmological model of the «world of many worlds»; a concept of space ethics and the corrected «hierarchy of needs” by A...
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This survey presents the material of neuroradiologic methods of investigation brain structures and function which changes during space flight. It’s taken to attention from inspection of cerebral blood circulation, reversibility of changes in the volumes of gray and white matter, features of neuroplasticity and the formation of new connectivity properties not previously discovered on Earth. The results of magnetic resonance imaging studies, changes in the balance of body fluids, indicators of the cardiovascular system under orthostatic testing, and features of the formation of blood circulation regulation during sleep, which is an integral component of adaptation to microgravity conditions, are presented.
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The review outlines modern aspects of studying some car-diometric characteristics, the changes of which are asso-ciated with ensuring adaptation of central, peripheral he-modynamics, and cerebral blood flow under conditions of an altered gravity vector in the state of weightlessness and its ground-based modeling. The results of studies reflect-ing the characteristic role of the cardiovascular system and its components are presented: autoregulation of cerebral blood flow, reconfiguration of the regulatory mechanisms of the circulatory system, and starting from the features of myocardial remodeling to changes in large vascular beds. The features of the restructuring of central and peripher-al blood flow, microcirculation, as well as manifestations of changes in the reflex regulation of the functions of the car-diorespiratory system in response to gravitational influenc-es, are considered.
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Speckle images of the vessels and hydrodynamic phantoms in optical coherence tomography
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The results of a study of a series of sequential images of a vessel and a hydrodynamic phantom of biological tissues obtained using a Spectral Domain Optical Coherence Tomography (SP OCT) are presented. Acquired data were processed and histograms of speckle distributions were created. They demonstrated differences in the intensity distribution for three different areas of the OCT image: (1) free space, (2) wall of the vessel, and (3) the flow of scatterers. Using an optimization algorithm the histograms were approximated by various distribution functions, best result was demonstrated by the beta distribution with the determination coefficient R2 ~ 0.95. The resulting distributions quantitatively demonstrate effect of tissue heterogeneity. They show significant differences in the values of the shape and scale parameters, corresponding to the obtained beta distribution parameters, which were α ~ 1.7, β ~ 20.5 for free space, α ~ 3.1, β ~ 5.5 for the wall region of the phantom, α ~ 2.6, β ~ 1.7 for the flow of the scattering liquid. Variance matrices of the OCT images, which show correlation of speckles between adjacent pixels and those of the successive images were also obtained. Brighter areas of the variance matrix indicate a dynamic speckle structure in OCT images, while low brightness of the areas indicates static speckle structure, on the contrary.
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Stellanin: a promising medical drug for accompanying therapy in lung cancer treatment
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One of the cancer prevention measures involves the correction of the altered functions of the body’s regulatory systems. Many malignant tumors are accompanied by the thyroid system dysfunction. The aim of our study was to reveal an effect of an iodine-containing drug on the development of a tumor process in the lungs and the level of thyroid hormones in blood and the thyroid gland in male rats. Material and methods. Outbred white male rats were divided into the following groups: a group of intact animals (n=7); a comparison group – 5 weeks after an intravenous inoculation of sarcoma 45 (S45) at 2*106 (n=7); a main group – 5 weeks after an intravenous inoculation of S45 and intragastric administration of Stellanin at a single dose of 0.4 mg/kg within an hour after the inoculation (n=10). RIA was used to determine levels of free (F) and total triiodothyronine (T3) and thyroxine (T4) in the blood serum and the thyroid. Results. The lungs of rats in the comparison group were totally affected by the tumor, and the thyroid gland showed a sharp decrease in the levels of all hormone forms: T4 – by 18.7 times, T3 – by 8.5 times, FТ4 – by 8.1 times, FТ3 – by 21.3 times, while only FТ4 and FТ3 decreased in blood by 2.5 and 1.5 times, respectively (p<0.05). No tumor lesions were detected in the lungs of rats of the main group, and the hormone levels exceeded the levels in the comparison group: in the thyroid, FT4 by 3.7, T4 by 15.0 and T3 by 6.0 times; in blood, FT4 by 3.3 and FT3 by 1.7 times Conclusions. The effect of Stellanin inhibiting malignant growth of S45 in the lungs is accompanied by the restoration of low levels of thyroid hormones in the thyroid and blood.
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