Original research. Рубрика в журнале - Cardiometry
Personal profile of systemic hemodynamics in solving global problems of public health.
Статья научная
The study of systemic hemodynamics has been conducted in individuals who suffer from arterial hypertension. Regularities of formation of the personal profiles of the systemic hemodynamics have been determined in this category of patients. A fresh method of antihypertensive therapy is offered which is based on establishment of relationship between the personal profile of the systemic hemodynamics and the hemodynamic drug effect. The clinical effectiveness of the proposed method has been proven.
Бесплатно
Статья научная
Background: Pediatric heart surgery, particularly for cyanotic congenital heart conditions, commonly requires the utilization of cardiopulmonary bypass(CPB)to assist with surgical interventions. The choice of priming solution for the CPB circuit can influence postoperative outcomes. This study aimed to assess the impact of two different priming solutions, Plasmalyte and Ringer’s Lactate, on postoperative outcomes, blood biochemistry, pulmonary and renal function, bleeding, and hemostasis in children undergoing open cardiac surgery with CPB. Methods: This randomized prospective study was conducted on 80 pediatric patients aged 1 to 10 years, undergoing elective cardiac surgery with CPB. Patients were randomly assigned to receive either Plasmalyte (Group A) or Ringer’s Lactate (Group B) as their CPB circuit priming solution. Standardized protocols for anesthesia, CPB circuit components, and surgical techniques were maintained. Postoperative parameters including blood chemistry, perfusion indicators, and physiological measurements were recorded and analyzed. Results: After CPB initiation, lactate levels were significantly higher in Group B (Ringer’s Lactate) compared to Group A (Plasmalyte)(P-value function show_abstract() { $('#abstract1').hide(); $('#abstract2').show(); $('#abstract_expand').hide(); }
Бесплатно
Prediction of kidney disease using machine learning algorithms
Статья научная
The loss of renal function occurs gradually in diabetic kidney disease (DKD), which is associated with a high death rate. India is second only to China in the number of people living with DKD and it is expected that one million new cases arise in India each year. If diagnosed at an early stage, DKD may be effectively treated. DKD is more dangerous since it often has no early warning signs in its infancy. From a healthcare provider's standpoint, it is crucial to take preventative measures by using a machine-first model to foresee the beginning of DKD. The likelihood that a patient may acquire DKD can be estimated using their health records, and there are open source machine learning methods available to do this. The amount of clinical factors and the number of datasets used to train the algorithm both affect the prediction accuracy. A machine learning method and a booster algorithm were used in this work to increase the accuracy of DKD prediction. The strategy utilized in boosting algorithm produced more reliable outcomes than models used without boosting such as random tree, KNN and support vector machine.
Бесплатно
Predictors of residual coronary artery disease after PPCI in diabetic patients with STEMI
Статья научная
To describe the patients’ characteristics and risk factors of diabetic and non-diabetic patients presenting with ST-elevation myocardial infarction (STEMI) in relation to residual SYNTAX score after PPCI (primary PCI). Material and Method: Prospective observational study using data from all comers in NHI with STEMI and underwent PPCI over one month. Results: The present study consisted of 290 patients with ST-elevation myocardial infarction over one month period. About 50% of the patients with diabetes were more often female, with a greater prevalence of hypertension and dyslipidemia. In the diabetic group, the eGFR
Бесплатно
Статья научная
Background: Predictors of Suboptimal reperfusion are still unclear. Aim: This study aimed to determine the factors that may indicate suboptimal reperfusion and short-term mortality in patients who were diagnosed with acute ST-segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI). Patients and methods: This multicenter prospective comparative study, conducted at Benha University hospitals and National Heart Institute, included 400 patients (age1, heavy thrombus burden, prediltation, multiple stents insertion and longer stent length are predictors of the SOR after PPCI. While, Patients on long term beta blockers (BB) and angiotensin-converting enzyme inhibitor (ACEI) are less likely to develop SOR. Furthermore, patients with SOR are more likely to develop in-hospital arrhythmias, heart failure, acute mitral regurge and inhospital mortality. Additionally, it increases 6-months risk of reischemia and mortality. Conclusions: Predicting the occurrence of no-reflow following pPCI can be achieved by considering various factors, such as clinical data, laboratory results, angiographic features, and procedural characteristics. Heavy thrombus burden, prediltation, dyslipidemia, longer stent length, pain to PCI time and RBG >300 (mg/dL) at the time of presentation were found to be the most predictable variables to SOR. Long term use of BB and ACEI were found to be significant independent factors that decreased the likelihood of TIMI9h were considered the most predictable variables to mortality in no reflow.
Бесплатно
Статья научная
At present, to develop new, scientifically justified, technologies of an accompanying therapy to improve the oncological situation is a challenge to health care. A therapy to accompany a specific cancer treatment in case of a malignant process in an organism is dictated by the necessity to raise the nonspecific resistance of the organism in cancer patients. In this case, original methodological approaches to initiate the mechanisms of the nonspecific resistance have been developed on the basis of the theory of the adaptational reactions. Within the framework of the above theory, some concepts of relationship between the specific and nonspecific anti-tumor processes have been extensively developed that may be successfully applied to solving tasks of the National Health Care Program. Aim. The aim hereof is to introduce the theoretical basics of the nonspecific adaptation regulation and control by a tumor- bearing organism into practice for an integrated treatment of malignant tumors with the use of the activation therapy technologies. Materials and methods. Our research work has involved clinical data on 1310 patients, who have been diagnosed with cancer of different localization: breast cancer (n = 170), cervical cancer (n = 60), lung cancer (n = 760), bladder cancer (n = 120), brain gliomas of high grade of malignancy and metastatic damage (n = 170) and extended colorectal cancer (n = 30) and who have completed their treatment at the National Medical Research Centre of Oncology of the Ministry of Health of the Russian Federation. Results and Discussion. We have used at different stages of the cancer treatment some technologies of the accompanying therapy, designed and developed on the basis of the approaches and principles of adaptive responding by a human organism. The above line of attack has provided a time- and intensity- scheduled functional loading (some factors of the electromagnetic and pharmacological nature) under control over formation of the desired stable reactions of the anti-stressor type. Following the principles of the activation therapy, the designed programmable regimes of extra actions and exposures have resulted in improvement of immediate outcomes of the treatment of malignant tumors, raise in quality and prolongation of life in our cancer patients.
Бесплатно
Статья научная
The aim is to study the incidence rate of anxiety and depressive disorders and their relationship with the everyday activity at the H.M. Berbekov Kabardino-Balkarian State University (KBSU) medical faculty students a year after the start of the Covid-19 pandemic. As a part of a cross-sectional observational study, a survey of 425 students at the Faculty of Medicine was conducted. The average age of the surveyed students was 20.9±2.1 years. The Spielberger-Khanin questionnaire, the HADS anxiety and depression scale, as well as a questionnaire specially developed by the authors to clarify some indicators of students’ activity were used. Results. The prevalence of high levels of situational anxiety (SA) was 1.4%, personal anxiety (PA) 30.8%, anxiety 29%, depression 21.6%. High levels of SA were statistically significantly more common among students with higher education (p = 0.0417), living in rented apartments (p = 0.0136), countryside residents (p = 0.0005), with debts (p = 0.0122 ); high levels of PA were identified among students who assessed their living conditions as satisfactory (p=0.0001). Clinically pronounced depression was statistically significantly more common among students with higher education (p=0.0258), who assess their living conditions as good (p=0.028), have debts (p=0.0001), employed (p=0.0001) and practiced low physical activity (p=0.0001). Associative relationships were detected between the levels of SA, PA, anxiety, depression and students’ activity parameters included in the study. Conclusion. The results obtained can be used to improve the academic process and preserve the mental health of the KBSU medical faculty students.
Бесплатно
Статья научная
Objectives: There are numerous opportunistic bacterial spe-cies that are unusual and rarely found in laboratory samples, most are challenging to routinely identify, some of them even being documented very little in clinical samples. Also, the role of these species in the coordinates of the disease is no less av-erage and important than the common bacterial species.
Бесплатно
Статья научная
The article discusses the areas of work in the field of prevention of ophthalmic diseases in children against the background of certain intestinal pathologies. The authors note the importance of understanding the need to reduce the risk of developing inflammatory bowel diseases (IBD), which not only negatively affect the functioning of the gastrointestinal tract, but also contribute to the development of ophthalmic diseases in children. Experts have determined that exposure to the human microbiome through the use of probiotics and prebiotics can both ef-fectively reduce the level of inflammation of the intestinal tract, and prevent or reduce the degree of development of various ophthalmological diseases. Accordingly, preventive measures related to the use of probiotics and prebiotics will allow special-ists in the field of ophthalmology to increase the effectiveness of specialized therapy for eye diseases by reducing the nega-tive effect of IBD on the child’s body.
Бесплатно
Статья научная
It is known that is an ambiguous phenomenon in medicine. There is no generally accepted definition of the concept, and approaches to the interpretation of the essence of the category in question are also different, since polypragmasia, being vital for certain diseases, can become extremely dangerous in certain conditions of the human body, as well as negatively affect the health of patients of certain age groups. In particular, elderly and senile patients, often in a state of comorbidity or polymorbidity and taking a significant amount of medications (both prescribed by a doctor and without one), are at risk of a possible deterioration in their health. Accordingly, the identification of problematic aspects of polypragmasia in the development of comorbidity in elderly and senile patients, as well as the identification of ways to reduce the negative impact on the state of health of extended drug therapy is quite relevant in modern conditions.
Бесплатно
Problematic aspects of the use of artificial intelligence capabilities in modern medical diagnostics
Статья научная
Modern medical diagnostics makes it possible to establish the presence of signs of a particular disease and enable specialists to prescribe a complex of therapeutic and medicinal measures to patients in a timely manner in accordance with the established diagnosis. However, in some cases, it is not always possible to diagnose a particular disease at an early stage due to the imperfection of diagnostic tools. In the recent period, the possibilities of artificial intelligence have been used in medical diagnostics, which significantly expands the capabilities of specialists in the field of establishing early key symptoms of the disease. However, the use of artificial intelligence capabilities in medical diagnostics is associated with a number of problems, the presence of which does not allow to realize the possibilities of digital technologies in full. The solution of these problems, according to the authors of the article, is highly relevant, since it can give a significant impetus to the development of diagnostic medical technologies, which will allow timely provision of high-quality medical care to patients.
Бесплатно
Статья научная
The paper presents an analysis of some promising lines of developing off-office telemonitoring. Some applications of expert systems designed on the basis of algorithms used for medical decision making are discussed herein. The whys and wherefores of the design of automated hardware & software systems in CVD therapy, which can be used for prevention and off-office follow-up telemonitoring in elderly individuals, are given herein. Methods We evaluated a total of 1078 consecutive anterior STEMI patients who underwent PPCI with deployment of new generations DES. The patients were divided according to the number of implanted stents into 2 groups; multiple-stents group having ≥2 overlapping stents (n =388) and single-stent group (n =690). We compared the rates of major adverse cardiovascular events (MACEs; composite of cardiac death, reinfarction, ischemia-driven target vessel revascularization (TVR), definite stent thrombosis (ST), and stroke) between the 2 study groups. Results There was a non-significant trend toward increased in-hospital mortality in the multiple-stents group [3.4% vs 1.7%; P=0.096] related to a significant higher rate of cardiogenic shock [9.5% vs 6.1%; P=0.037] and post-procedural suboptimal TIMI flow [26.3% vs 19.4%; P=0.009] as compared to the single-stent group. Yet, there were no significant differences between the 2 groups in the incidence of 6-month MACEs: [9% vs 7.1%;The paper presents an analysis of some promising lines of developing off-office telemonitoring. Some applications of expert systems designed on the basis of algorithms used for medical decision making are discussed herein. The whys and wherefores of the design of automated hardware & software systems in CVD therapy, which can be used for prevention and off-office follow-up telemonitoring in elderly individuals, are given herein. Methods We evaluated a total of 1078 consecutive anterior STEMI patients who underwent PPCI with deployment of new generations DES. The patients were divided according to the number of implanted stents into 2 groups; multiple-stents group having ≥2 overlapping stents (n =388) and single-stent group (n =690). We compared the rates of major adverse cardiovascular events (MACEs; composite of cardiac death, reinfarction, ischemia-driven target vessel revascularization (TVR), definite stent thrombosis (ST), and stroke) between the 2 study groups. Results There was a non-significant trend toward increased in-hospital mortality in the multiple-stents group [3.4% vs 1.7%; P=0.096] related to a significant higher rate of cardiogenic shock [9.5% vs 6.1%; P=0.037] and post-procedural suboptimal TIMI flow [26.3% vs 19.4%; P=0.009] as compared to the single-stent group. Yet, there were no significant differences between the 2 groups in the incidence of 6-month MACEs: [9% vs 7.1%;
Бесплатно
Prospects for the application of mathematical modeling in clinical medicine
Статья научная
Aims The aims of the study are to follow the correlation of СAD development with various clinical and laboratory parameters and risk factors in a cohort of patients with multiple medical conditions and evaluate the effect of various parameters in the development of the disease using a new mathematical model approach. Materials and methods This study covers a limited patient cohort (n = 12) formed according to the rules of a local register. We have applied the methods of probabilistic mathematical modeling of cardiovascular disease with the formation of an aggregated matrix. Matrix fields were presented the instrumental methods of diagnosis and clinical and biochemical blood tests of patients. Results When using various methods of mathematical and statistical analysis (including cluster and factor analysis), created has been a graphic model of interaction of clinical, biochemical and instrumental parameters with the development of CAD. The mathematical and statistical completeness of the description of the patient’s condition by the parameters of pathology on the basis of the measure of reliability of the completeness of the description was R=0,98-1,0, the coefficient of determination was equal to R2=92,0-98,0%...
Бесплатно
Protein system of bacillus anthracis antigens
Статья научная
In our research work, we have considered the structures of some anthrax antigens, their design and functions, as well as the genetic apparatus encoding them. The study is of interest to those practicing microbiologists and researchers whose area of interest includes knowledge of the regulation of infection processes and subsequent transformations of Bacillus anthracis spores in the host organism. Pathways for the expression of B. anthracis pathogenic genes, the factors influencing them, as well as ways to use patterns in gene expression to increase the immunization in experimental animals by combining various experimental vaccines, which are currently used in preventive practice in different countries of the world and in particular in the Russian Federation, are considered in detail herein. In addition, the article may be of interest to scientists and researchers conducting research in the field of creating new immunizing agents based either on the anthrax genome or some parts thereof.
Бесплатно
Relation of antistress and geroprotective effects of deuterium depleted water in aging female rats
Статья научная
The use of deuterium depleted water (DDW) in a dosing regimen of 25-30 ml per day for five weeks in aging female rats (20-22 months) contributed to the overall correction of agerelated disorders of the adaptive status, estrous cycle regulation and nonspecific resistance, as well as the appearance of visually distinct signs of rejuvenation of the animals. The obtained results show the relation between the geroprotective effect of DDW and the development of the general nonspecific antistress adaptation reactions of calm and elevated activation that can serve as an experimental basis for the development of an effective method of geriatrics and prevention of cardiovascular diseases and degenerative processes in women in the peri and postmenopausal period.
Бесплатно
Статья научная
Topicality. An increase in the incidence of malignant tumors progressing against the background of various comorbid pathologies determines the need to study the mutual influence of pathological processes using experimental modeling. Such models, for example, can reproduce the tumor growth modified by the comorbid condition of diabetes mellitus, the incidence rate of which is now increasing exponentially. In this case, a clear demonstration of changes in the structure of organs outside the zone of the primary tumor node, using data on the direct growth of the tumor and the content of diabetes markers therein and in the perifocal zone, can serve as an evidence-based argument for the implementation of the mechanism of modified tumor progression. The aim of our research work is to assess the state of the histological structure of some internal organs (the kidneys, the ovaries, the peritoneum) when modeling the main pathological process in animals, the growth of Guerin's carcinoma, against the background of a comorbid state of experimental diabetes. Materials and methods. We used 32 outbred male and female rats weighing 180-220 g to reproduce the model of experimental diabetes by a single intraperitoneal injection of alloxan at a dosage of 150 mg/kg of body weight. One week after the production of persistent hyperglycemia in the range of 25.4±1.2 mmol/l, the animals were transplanted with Guerin's carcinoma subcutaneously in the region of the right shoulder blade. Upon expiration of 2 weeks, the animals were decapitated, and the harvested organs were prepared according to the practice stages of morphological preparation for staining sections with hematoxylin-eosin, followed by morphological examination of the structure with the use of the Leica DM LS2 microscope with the Olympus optical. C-5050 Zoom video camera and the Morfotest software. Photographing was carried out with magnification x10, x40, x100. Results. Our study of the morphological portrayal of the ovary, the kidney, the visceral and parietal peritoneum bears witness to the identity of the changes, consisting in a total metastatic lesion and abnormal transformation of the normal structure of all the studied organs only in the female rats, when modeling the comorbid state of diabetes mellitus. At the same time, the aggressive nature of the tumor progression was manifested in the blood filling of the vessels and hemorrhage, followed by the release of tumor cells, their settlement, the enhanced proliferation, the formation of strands and compaction of cell aggregations throughout the volume of the organ. Some gender specific features of the tumor progression were noted, which were found in the female rats along the path of active metastasizing in case of small primary tumors, and in the male rats along the path of stimulating the growth of the primary focus without metastasizing. It was revealed that these differences are associated with different degrees of saturation of the tumor and perifocal zone with glucose, and they are determined by the state of the insulin/insulin-like growth factor (IGF) axis. Conclusion. Morphological examination of the organs affected by metastatic Guerin's carcinoma in the female rats with diabetes mellitus makes it possible to detect not only the synergy of both pathological processes, but also a powerful pro-oncogenic effect of the comorbid state of diabetes in the implementation of the tumor growth program.
Бесплатно
Relationship between spiritual intelligence (SI) & job satisfaction (JS) in millennials
Статья научная
In this fast-paced lifestyle with escalating cases of anxiety and depression, millennial are trying to find meaning in life and at work. The presence of high-octane electronic media both in millennial' personal & professional life is making them more anxious about their career and personal beliefs. There is a belief that a person who exhibits spiritual intelligence is most likely to achieve a sense of job satisfaction in life. Various MNCs are organizing many programs to develop and enhance the employee's spiritual intelligence. This paper focuses on millennial working in the Defense and IT field with empirical study to analyze the influence of spiritual intelligence on their job satisfaction. Dhamodharan and Ravikumar mention that millennial, born in the period between 1981-1995, witnessed consumerism and technological advancement worldwide. People born in this era were less exposed to traditional religious teaching due to changing social-cultural values; hence they indulge in spirituality to balance their lifestyle to optimize the basic value of life. Emmons mentions that “SI is a blend of internal & external structure: spirituality being an internal structure and intelligence as an external structure to create a new structure which evolves the person with remarkable capacities to practically use their spirituality on their everyday basis.”
Бесплатно
Статья научная
COVID-19 has not just affected the health of citizens. However, the world’s economic wheel stopped. All the import-export activities were sieged, schools, colleges, malls, and any other similar place, where there is a chance of gathering, has been locked down. A major section of the global economy was closed down for a period of two to three months. Still, they are operating with minimum permitted capacity. The service sector is opening up stage-wise, and people have started to work in their respective offices. Before this, most people, right from teachers to CEOs of top companies, worked from home. 100% of IT and ITES based organizations were working from their homes in the recent past; rather, these people were working from home before the COVID-19 situation. This present study will evaluate the interest areas of people working from home and try to evaluate the scenario of working from home even after the pandemic of COVID-19 is over.
Бесплатно
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(); }
Бесплатно
Статья научная
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
Бесплатно
