The experience of using the personal electrocardiograph "ECG-Express"

The article describes the results of testing ECG-Express devices, previously developed at the Tomsk Polytechnic University. The testing was carried out on the basis of Tomsk Scientific Research Institute of Cardiology. Here we show the argumentation for application of such a devices in medical practice as well as number of cases of successful use

Догоспитальная внезапная смерть от острого инфаркта миокарда в Томске (1984 и 2018 гг.): что изменилось за 34 года

Aim. To compare the circumstances of the prehospital deaths among patients with acute myocardial infarction (AMI) in Tomsk in 1984 and 2018.Methods. Population-level data were collected from the WHO project “Acute Myocardial Infarction Registry”. In 1984, 739 cases of AMI were recorded, in 2018 - 924 ones. 262 (35.5%) and 359 (38.9%) deaths occurred in the acute phase, respectively. Of them, 158 (60.3%) and 148 (41.2%) patients died in the prehospital setting. 66 (41.8%) and 46 (31.1%) cases of deaths were selected for further analysis.Results. In 2018, the number of patients who did not receive timely medical care decreased from 74.2% to 52.2%, compared to 1984 (p <0.05). The number of cases when patients failed to call the ambulance due to a rapid loss of consciousness (cardiac arrest) or managed to call, but died before the ambulance arrived, was similar. The number of death among patients who received emergency medical services (EMS) increased from 25.8% to 47.9% (p <0.05).Conclusion. Prehospital mortality from AMI in Tomsk has improved over thirty years, but not drastically. Despite the number of patients who died before the first medical contact has decreased, they still make up about half of all cases. Every 4th-5th patient fails to contact EMS. In terms of reducing prehospital mortality, measures focused on the regular clinical examination of patients with cardiovascular diseases seem to be more promising for effective secondary prevention of coronary artery disease and AMI.Цель. Сравнить обстоятельства смерти больных острым инфарктом миокарда (ОИМ) на догоспитальном этапе в Томске в 1984 и 2018 гг.Материалы и методы. Исследование проведено на основе анализа базы данных многолетнего наблюдения острой коронарной патологии программы ВОЗ «Регистр острого инфаркта миокарда». В 1984 г. в Томске отмечено 739 случаев ОИМ, в 2018 г. - 924. В остром периоде заболевания в указанные годы погибли 262 (35,5%) и 359 (38,9%) больных соответственно, из которых 158 (60,3%) и 148 (41,2%) умерли на догоспитальном этапе. Для дальнейшего анализа отобраны 66 (41,8%) случаев смерти от ОИМ на догоспитальном этапе в 1984 г. и 46 (31,1%) случаев в 2018 г.Результаты. В сравнении с 1984 г. в 2018 г. количество больных, у которых смерть наступила в отсутствие медицинской помощи, сократилось (с 74,2% до 52,1; p<0,05). Мало изменилось число эпизодов, при которых больные не успевали вызвать скорую медицинскую помощь в связи с быстрой потерей сознания (остановкой сердца) или успели обратиться за помощью, но погибли до ее приезда. Выросло число случаев смерти больных в присутствии врачей скорой медицинской помощи (с 25,8 до 47,9%; p<0,05).Заключение. Ситуация с летальными исходами от ОИМ на догоспитальном этапе в Томске за более чем тридцатилетний период улучшилась, но радикальных изменений не произошло. Снизилось число больных, погибших в отсутствие медицинской помощи, хотя таких случаев по-прежнему более половины: каждый 4-5-й пациент не успевает вызвать скорую медицинскую помощь. Более перспективными в снижении догоспитальной летальности являются мероприятия, связанные с диспансеризацией пациентов с сердечнососудистыми заболеваниями для вторичной профилактики ишемической болезни сердца и острого инфаркта миокарда

Studyng the effects of Cantharellus cibarius fungi on Opisthorchis felineus trematode and on parasite host - C57BL/6 inbred mice

Opisthorchiasis is a dangerous parasitic disease caused by trematodes in the family Opisthorchiidae. One of the causes of this infection is the species Opisthorchis felineus, which is common in the Russian Federation and Western Europe. The disease has a large number of complications and relatively few effective treatments, so nowadays it is relevant to look for new drugs for the treatment of opisthorchiasis, with the maximum antiparasitic and minimal side effect. In this work, a potentially anthelmintic effect of the methanol extract of the golden chanterelle mushroom (Cantharellus cibarius) was investigated. In in vitro experiments, the significantly reduced mobility and survival rates of juvenile O. felineus specimens with increasing concentrations (10-1000 pg/ml) of the C. cibarius extract were shown. In in vivo studies, administration of the C. cibarius extract on the first day after parasitic infection of inbred C57BL/6 mice resulted in a decrease of the number of helminths in the bile ducts of the liver, evaluated 6 weeks after infection. In another series of experiments, administration of the C. cibarius extract for 7 days to mice infected with O. felineus for five weeks had no anthelmintic effect. In both cases, the state of the infected hosts, evaluated by a number of physiological and biochemical parameters (relative weight of organs, blood indices), did not deteriorate, indicating that there was no adverse effect of the C. cibarius extract. The results obtained suggest that the C. cibarius extract might have anthelmintic properties if applied as parasite larvae excyst

Experimental opisthorchiasis: a study of blood cells, hematopoiesis and startle reflex in laboratory animals

One of the species of the family Opisthorchiidae, Opisthorchis felineus (O. felineus), causes severe disturbances in humans and animals, and so it is the subject of important research studies. Two weeks after infection we compared the impact of O. felineus invasion on the changes in blood cells composition, bone marrow hematopoiesis and behavioral startlereflex in inbred C57BL/6 male mice and Syrian hamsters (Mesocricetus auratus). Considerable interspecies differences were revealed for many parameters estimated. It was found that the relative weight of the main organ of the peripheral immune system – spleen, is significantly larger in mice than in hamsters. Moreover, the infection with O. felineus caused a significant enlargement of the spleen only in mice. More pronounced changes in the blood cells composition, which was accompanied by activation of hematopoietic stem cells of myeloid and erythroid set, were determined in hamsters. Blood changes in the response to infection in mice were less severe and were not accompanied by the changes in colony formation. Mouse acoustic startle reaction differed from hamster one too. The expression of the startle reaction and the value of pre-pulse inhibition were discriminated in animals of two species. Infected hamsters had no reaction of habituation  to the sound stimulus. In addition, the maturation of O. felineus worms was faster in hamsters than in mice. Data obtained suggest a greater resistance of mice to O. felineus infection, but do not exclude the availability of mice as a model in the study of processes taking place in the host during the development of experimental opisthorchiasis

Estimation of black carbon emissions from Siberian fires using satellite observations of absorption and extinction optical depths

Black carbon (BC) emissions from open biomass burning (BB) are known to have a considerable impact on the radiative budget of the atmosphere at both global and regional scales; however, these emissions are poorly constrained in models by atmospheric observations, especially in remote regions. Here, we investigate the feasibility of constraining BC emissions from BB using satellite observations of the aerosol absorption optical depth (AAOD) and the aerosol extinction optical depth (AOD) retrieved from OMI (Ozone Monitoring Instrument) and MODIS (Moderate Resolution Imaging Spectroradiometer) measurements, respectively. We consider the case of Siberian BB BC emissions, which have the strong potential to impact the Arctic climate system. Using aerosol remote sensing data collected at Siberian sites of the AErosol RObotic NETwork (AERONET) along with the results of the fourth Fire Lab at Missoula Experiment (FLAME-4), we establish an empirical parameterization relating the ratio of the elemental carbon (EC) and organic carbon (OC) contents in BB aerosol to the ratio of AAOD and AOD at the wavelengths of the satellite observations. Applying this parameterization to the BC and OC column amounts simulated using the CHIMERE chemistry transport model, we optimize the parameters of the BB emission model based on MODIS measurements of the fire radiative power (FRP); we then obtain top-down optimized estimates of the total monthly BB BC amounts emitted from intense Siberian fires that occurred from May to September 2012. The top-down estimates are compared to the corresponding values obtained using the Global Fire Emissions Database (GFED4) and the Fire Emission Inventory–northern Eurasia (FEI-NE). Our simulations using the optimized BB aerosol emissions are verified against AAOD and AOD data that were withheld from the estimation procedure. The simulations are further evaluated against in situ EC and OC measurements at the Zotino Tall Tower Observatory (ZOTTO) and also against aircraft aerosol measurement data collected in the framework of the Airborne Extensive Regional Observations in SIBeria (YAK-AEROSIB) experiments. We conclude that our BC and OC emission estimates, considered with their confidence intervals, are consistent with the ensemble of the measurement data analyzed in this study. Siberian fires are found to emit 0.41±0.14&thinsp;Tg of BC over the whole 5-month period considered; this estimate is a factor of 2 larger and a factor of 1.5 smaller than the corresponding estimates based on the GFED4 (0.20&thinsp;Tg) and FEI-NE (0.61&thinsp;Tg) data, respectively. Our estimates of monthly BC emissions are also found to be larger than the BC amounts calculated using the GFED4 data and smaller than those calculated using the FEI-NE data for any of the 5 months. Particularly large positive differences of our monthly BC emission estimates with respect to the GFED4 data are found in May and September. This finding indicates that the GFED4 database is likely to strongly underestimate BC emissions from agricultural burns and grass fires in Siberia. All of these differences have important implications for climate change in the Arctic, as it is found that about a quarter of the huge BB BC mass emitted in Siberia during the fire season of 2012 was transported across the polar circle into the Arctic. Overall, the results of our analysis indicate that a combination of the available satellite observations of AAOD and AOD can provide the necessary constraints on BB BC emissions.</p

Treatment Patterns and Use of Resources in Patients With Tuberous Sclerosis Complex: Insights From the TOSCA Registry

Tuberous Sclerosis Complex (TSC) is a rare autosomal-dominant disorder caused by mutations in the TSC1 or TSC2 genes. Patients with TSC may suffer from a wide range of clinical manifestations; however, the burden of TSC and its impact on healthcare resources needed for its management remain unknown. Besides, the use of resources might vary across countries depending on the country-specific clinical practice. The aim of this paper is to describe the use of TSC-related resources and treatment patterns within the TOSCA registry. A total of 2,214 patients with TSC from 31 countries were enrolled and had a follow-up of up to 5 years. A search was conducted to identify the variables containing both medical and non-medical resource use information within TOSCA. This search was performed both at the level of the core project as well as at the level of the research projects on epilepsy, subependymal giant cell astrocytoma (SEGA), lymphangioleiomyomatosis (LAM), and renal angiomyolipoma (rAML) taking into account the timepoints of the study, age groups, and countries. Data from the quality of life (QoL) research project were analyzed by type of visit and age at enrollment. Treatments varied greatly depending on the clinical manifestation, timepoint in the study, and age groups. GAB Aergics were the most prescribed drugs for epilepsy, and mTOR inhibitors are dramatically replacing surgery in patients with SEGA, despite current recommendations proposing both treatment options. mTOR inhibitors are also becoming common treatments in rAML and LAM patients. Forty-two out of the 143 patients (29.4%) who participated in the QoL research project reported inpatient stays over the last year. Data from non-medical resource use showed the critical impact of TSC on job status and capacity. Disability allowances were more common in children than adults (51.1% vs 38.2%). Psychological counseling, social services and social worker services were needed by <15% of the patients, regardless of age. The long-term nature, together with the variability in its clinical manifestations, makes TSC a complex and resource-demanding disease. The present study shows a comprehensive picture of the resource use implications of TSC

Natural clusters of tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND): new findings from the TOSCA TAND research project.

BACKGROUND: Tuberous sclerosis complex (TSC)-associated neuropsychiatric disorders (TAND) have unique, individual patterns that pose significant challenges for diagnosis, psycho-education, and intervention planning. A recent study suggested that it may be feasible to use TAND Checklist data and data-driven methods to generate natural TAND clusters. However, the study had a small sample size and data from only two countries. Here, we investigated the replicability of identifying natural TAND clusters from a larger and more diverse sample from the TOSCA study. METHODS: As part of the TOSCA international TSC registry study, this embedded research project collected TAND Checklist data from individuals with TSC. Correlation coefficients were calculated for TAND variables to generate a correlation matrix. Hierarchical cluster and factor analysis methods were used for data reduction and identification of natural TAND clusters. RESULTS: A total of 85 individuals with TSC (female:male, 40:45) from 7 countries were enrolled. Cluster analysis grouped the TAND variables into 6 clusters: a scholastic cluster (reading, writing, spelling, mathematics, visuo-spatial difficulties, disorientation), a hyperactive/impulsive cluster (hyperactivity, impulsivity, self-injurious behavior), a mood/anxiety cluster (anxiety, depressed mood, sleep difficulties, shyness), a neuropsychological cluster (attention/concentration difficulties, memory, attention, dual/multi-tasking, executive skills deficits), a dysregulated behavior cluster (mood swings, aggressive outbursts, temper tantrums), and an autism spectrum disorder (ASD)-like cluster (delayed language, poor eye contact, repetitive behaviors, unusual use of language, inflexibility, difficulties associated with eating). The natural clusters mapped reasonably well onto the six-factor solution generated. Comparison between cluster and factor solutions from this study and the earlier feasibility study showed significant similarity, particularly in cluster solutions. CONCLUSIONS: Results from this TOSCA research project in an independent international data set showed that the combination of cluster analysis and factor analysis may be able to identify clinically meaningful natural TAND clusters. Findings were remarkably similar to those identified in the earlier feasibility study, supporting the potential robustness of these natural TAND clusters. Further steps should include examination of larger samples, investigation of internal consistency, and evaluation of the robustness of the proposed natural clusters

Determination of the melting temperature, heat of fusion, and purity analysis of different samples of zidovudine (AZT) using DSC

The determination of chemical purity, melting range, and variation of enthalpy in the process of characterizing medicines is one of the principal requirements evaluated in quality control of the pharmaceutical industry. In this study, the method of purity determination using DSC was outlined, as well as the application of this technique for the evaluation of commercial samples of zidovudine (AZT) (raw material) supplied by different laboratories. To this end, samples from six different laboratories (A, B, C, D, E, and F) and the standard reference (R) from the United States Pharmacopeia (USP) were analyzed. The DSC curves were obtained in the temperature range of 25 to 200 ºC under the dynamic atmosphere of N2 (50 mL min-1), heating rate of β=2 ºC min-1, using an Al capsule containing approximately 2 mg of sample material. The results demonstrated that the standard reference presented a proportion of 99.83% whereas the AZT samples presented a variation ranging from 97.59 to 99.54%. In addition, the standard reference was found to present a temperature of onset of melting point of 122.80 °C. Regarding the samples of active agents provided by the different laboratories, a variation ranging from 118.70 to 122.87 °C was measured. In terms of ΔHm, the samples presented an average value of 31.12 kJ mol-1._________________________________________________________________________________________ RESUMO: A determinação da pureza química, a faixa de fusão e a variação de entalpia envolvida no processo de caracterização de fármacos é um dos principais requisitos avaliados no controle de qualidade em indústrias farmacêuticas. Neste trabalho é feita uma breve abordagem sobre o método de determinação de pureza utilizando DSC, assim como a aplicação desta técnica para avaliação de amostras comerciais de zidovudina (AZT) (matéria-prima) fornecida por diferentes laboratórios. Para tal, foram analisadas amostras de seis diferentes laboratórios (A,B,C,D,E e F) e a substância química de referência (R) da United States Pharmacopeia (USP). As curvas DSC foram obtidas na faixa de temperatura entre 25 a 200 ºC, sob atmosfera dinâmica de N2 (50 mL min-1), β=2 ºC min-1, utilizando cápsula de Al contendo aproximadamente 2 mg de amostra. De acordo com os resultados, pode-se observar que a substância química de referência apresentou teor igual a 99,83% e que as amostras de AZT apresentaram uma faixa de variação entre 97,59 e 99,54%. Pode-se verificar, ainda, que a substância química de referência apresentou uma temperatura onset de fusão igual a 122,80 °C. Para as amostras dos princípios ativos fornecidos pelos diferentes laboratórios, pode-se verificar uma faixa de variação entre 118,70 e 122,87 °C. No que se refere ao ΔHm, as amostras apresentaram valor médio de 31,12 kJ.mol-1

Burden of Illness and Quality of Life in Tuberous Sclerosis Complex: Findings From the TOSCA Study

Research on tuberous sclerosis complex (TSC) to date has focused mainly on the physical manifestations of the disease. In contrast, the psychosocial impact of TSC has received far less attention. The aim of this study was therefore to examine the impact of TSC on health, quality of life (QoL), and psychosocial well-being of individuals with TSC and their families. Questionnaires with disease-specific questions on burden of illness (BOI) and validated QoL questionnaires were used. After completion of additional informed consent, we included 143 individuals who participated in the TOSCA (TuberOus SClerosis registry to increase disease Awareness) study. Our results highlighted the substantial burden of TSC on the personal lives of individuals with TSC and their families. Nearly half of the patients experienced negative progress in their education or career due to TSC (42.1%), as well as many of their caregivers (17.6% employed; 58.8% unemployed). Most caregivers (76.5%) indicated that TSC affected family life, and social and working relationships. Further, well-coordinated care was lacking: a smooth transition from pediatric to adult care was mentioned by only 36.8% of adult patients, and financial, social, and psychological support in 21.1, 0, and 7.9%, respectively. In addition, the moderate rates of pain/discomfort (35%) and anxiety/depression (43.4%) reported across all ages and levels of disease demonstrate the high BOI and low QoL in this vulnerable population