The result of the treatment of atrial fibrillation using left atrial and biatrial or radiofrequency ablation procedures in patient's mitral valve surgery

Radiofrequency ablation is a method of atrial fibrillation treatment for. There are many publications on the effectiveness of this method, which sometimes include conflicting data. This paper presents a retrospective analysis of the treatment of mitral valve defects with the help of valve replacement and the use of RFA procedure for the recovery of permanent sinus rhythm in 131 patients. The ablation lines were laid with the help of ablators along the LA posterior wall, the mouths of the pulmonary veins (PVM) and in the right atrium (RA) according to the interpretation of "Labyrinth - 4" procedure. Patients were divided into two groups: those having undergone left atrial RFA only - 97 patients (74%), and biatrial RFA - 34 patients (26%). Operation time including RFA procedure in the general group, on average, was extended only by 13.5±1.3 minutes, the exposure time for each line corresponded to the achievement of transmural myocardial damage, and repeated three times. Postoperatively, 11 (8.4%) complications occurred. A correlation analysis showed that neither the preoperational size nor volume of the left atrium affect postoperatively the AF induction. All patients in the postoperative period had a significant reduction in the LA size, thereby leveling the possibility of occurrence of AF. In our group, regardless of bilateral or left atrial RFA, sinus rhythm was restored in 71% and 91% of cases, respectively. After two years, 65% of patients had sinus rhythm in bilateral RFA and 78% - in left atrial RFA

Surgical treatment of aortic stenosis in patients with low ejection fraction

A retrospective study of the results of surgical treatment of severe aortic valve stenosis with a low left ventricular ejection fraction was conducted. The study included 38 patients with left ventricular systolic dysfunction (LVSD = 40%) and the maximum transvalvular gradient of 40 mm Hg against the aortic stenosis of various etiology. Patients underwent examination of changes in functional cardiac parameters after the aortic valve replacement under cardiopulmonary bypass. All patients underwent echocardiography that included an integrated 2D and Doppler examination of the heart prior to surgery and 3 months after surgery. A high risk of surgery was expected, according to Euroscore II, nearly 4 to 5%, the average score was 5.8 ± 2.4. The main high-risk factors were low cardiac output, pulmonary hypertension and a heart failure class. Hospital mortality was 0%. The result was the improvement in left ventricular ejection fraction by 10% (p=0.003), and the beginning of the reverse cardiac remodeling. Patients with low LVSD and severe aortic stenosis have a potential clinical effect after surgery with the possible absence of mortality. Surgical treatment of patients with severe aortic stenosis with low left ventricular ejection fraction has shown good results in contrast to the proposed stratification of the surgery risk

Main method of diagnosis of silent myocardial ischemia

© 2016, International Journal of Pharmacy and Technology. All rights reserved.The presence of “silent” myocardial ischemia is an unfavorable prognostic factor increasing the risk of coronarogenic complications by 2-19 times, the risk of sudden death by 3-9 times. Early and timely diagnosis of ischemic heart disease is a strategic objective, and a clinical, social and economic problem. The analysis of recent publications devoted to the diagnosis of SMI was conducted. The SMI diagnosis is based on various instrumental methods of research that can objectify the presence of myocardial ischemia. The most common and available SMI diagnostic techniques are electrocardiographic methods. SMI can be rarely detected with standard ECG at rest, more often - with Holter ECG, one can identify the number of SMI episodes and their duration, draw parallels with the nature of the patient’s activity during the day, conduct the analysis of ischemic episodes circadian variability, and their correlation with the heart rate and ectopic activity. In case of insufficient data of ECG at rest and Holter ECG, the exercise tests are performed: exercise stress test (EST), treadmill test. Cardioselective test with transesophageal atrial electrical stimulation (TEES), excluding a number of peripheral factors, in which the imposition of artificial frequent heart rhythm causes an increase in myocardial oxygen demand. The assessment of coronary flow reserve, myocardial perfusion can be conducted with the use of coronary angiography (CAG), perfusion tomoscintigraphy (method of single photon emission computed tomography), and electron beam computed tomography. There is a direct correlation between the presence of the SMI phenomenon and detection of stenosis of coronary arteries (CA). A multislicecomputed tomography (MSCT) - coronary angiography is a noninvasive technique for evaluation of the CA state, which allows identifying pathological changes and clarifying the indications for the choice of preventive or treatment method for coronary heart disease. The local myocardial contractility is determined with: echocardioscopy (ECHOCS), stress-ECHOCS, stress-ECHOCS with tissue Doppler imaging, and the radiopaque or radionuclide ventriculography. Heart imaging with the help of magnetic-resonance imaging (MRI) provides a detailed assessment of structural features of the cardiac and vascular chambers, allows investigating the intracardiac hemodynamics, functional performance of the heart, measuring the velocity of blood flow in large vessels. In most cases, cardiac MRI can serve as a method of a second-line diagnosis upon obscure results of other methods of research (especially ECHOCS). Knowing the basic methods of diagnosis allows identifying patients with SMI and starting early treatment, preventing thereby the adverse outcome

LANTANUM AND CERIUM SEPARATION ON SULFONIC CATION-EXCHANGER PUROLITE C-160

Values of full dynamic exchange capacity of sulfonic cation-exchanger Purolite C-160 on La and Ce during sorption from sulfuric acid solutions at pH 2,5 were determined. These values were 33,97 kg La/m3 и 35,53 kg Се/m3

DEPOSITION OF URANIUM FROM PRODUCTIVE SOLUTIONS OBTAINED BY HYDROLIC ACID LEACHING OF URANIUM-CONTAINING SLUDGE

The precipitation process has carried out with ammonia by a semi-continuous method at pH 6.9-7.0, temperature 45-50 °C from a productive solution (278 mgL-1 U, 60 gL-1 HCl). The precipitate is an amorphous structure and represented by one phase - CaF2, the mass fraction of uranium was 0.73%

PHYSICAL AND CHEMICAL CHARACTERISTICS OF THE INSOLUBLE RESIDUE OF HYDRANIC ACID LEACHING OF URANIUM FROM SLUDGE

Leaching of sludge by solutions of 120-160 gL-1 HCl at 80 °C provides a decrease in the mass of insoluble residue in 2-3 times. The moisture content is 12-26% the average particle diameter is 60-100 μm. The insoluble residue consists of CaSO4*2H2O, CaF2, graphite and two modifications of SiO2

SEPARATION OF CESIUM AND ALUMINUM BY CATION-EXCHANGER PUROLITE C-160

The possibility of cesium separation from aluminum during conversion of waste of catalysts processing by use of сation-exchanger Purolite C-160 at different pH was studied. The separation of these elements was not possible in the pH range of (2,0 – 10,0)

LEACHING OF URANIUM FROM SOLID RADIOACTIVE WASTE BY HYDROCHLORIC ACID SOLUTIONS

The maximum degree of uranium extraction of 99% was obtained by HCl an excess con-centration of more than 74 gL-1, the uranium content in the PR is 255 mgL-1. According to the results of XRD, the insoluble residue of leaching consists of CaSO4*2H2O 62-84%, CaF2 10-31%, graphite 3-7% and SiO2 1-5%

SORPTION PROCESSING OF PRODUCTIVE SOLUTIONS OBTAINED BY SULFURIC ACID LEACHING OF URANIUM FROM SLUDGE

Uranium sorption has carried out in a dynamic mode using the Purolite A660/4759 ani-onite; the total dynamic exchange capacity for uranium was 17.9 kg/m3. The mass fraction of uranium in the concentrate obtained after precipitation with ammonia from the commercial regenerate was 68.54%

Clinical features of post-COVID-19 period. Results of the international register “Dynamic analysis of comorbidities in SARS-CoV-2 survivors (AKTIV SARS-CoV-2)”. Data from 6-month follow-up

Aim. To study the clinical course specifics of coronavirus disease 2019 (COVID-19) and comorbid conditions in COVID-19 survivors 3, 6, 12 months after recovery in the Eurasian region according to the AKTIV register. Material and methods.The AKTIV register was created at the initiative of the Eurasian Association of Therapists. The AKTIV register is divided into 2 parts: AKTIV 1 and AKTIV 2. The AKTIV 1 register currently includes 6300 patients, while in AKTIV 2 — 2770. Patients diagnosed with COVID-19 receiving in- and outpatient treatment have been anonymously included on the registry. The following 7 countries participated in the register: Russian Federation, Republic of Armenia, Republic of Belarus, Republic of Kazakhstan, Kyrgyz Republic, Republic of Moldova, Republic of Uzbekistan. This closed multicenter register with two nonoverlapping branches (in- and outpatient branch) provides 6 visits: 3 in-person visits during the acute period and 3 telephone calls after 3, 6, 12 months. Subject recruitment lasted from June 29, 2020 to October 29, 2020. Register will end on October 29, 2022. A total of 9 fragmentary analyzes of the registry data are planned. This fragment of the study presents the results of the post-hospitalization period in COVID-19 survivors after 3 and 6 months. Results. According to the AKTIV register, patients after COVID-19 are characterized by long-term persistent symptoms and frequent seeking for unscheduled medical care, including rehospitalizations. The most common causes of unplanned medical care are uncontrolled hypertension (HTN) and chronic coronary artery disease (CAD) and/or decompensated type 2 diabetes (T2D). During 3- and 6-month follow-up after hospitalization, 5,6% and 6,4% of patients were diagnosed with other diseases, which were more often presented by HTN, T2D, and CAD. The mortality rate of patients in the post-hospitalization period was 1,9% in the first 3 months and 0,2% for 4-6 months. The highest mortality rate was observed in the first 3 months in the group of patients with class II-IV heart failure, as well as in patients with cardiovascular diseases and cancer. In the pattern of death causes in the post-hospitalization period, following cardiovascular causes prevailed (31,8%): acute coronary syndrome, stroke, acute heart failure. Conclusion. According to the AKTIV register, the health status of patients after COVID-19 in a serious challenge for healthcare system, which requires planning adequate health system capacity to provide care to patients with COVID-19 in both acute and post-hospitalization period