Dynamics of global and segmental strain as a marker of right ventricular contractility recovery in patients after COVID-19 pneumonia

Aim. To study the changes of morphological and functional right ventricular (RV) parameters depending on the severity of coronavirus infection 2019 (COVID-19) pneumonia over long-term follow-up.Material and methods. A total of 200 patients (men, 51,5%, mean age, 51,4±10,9 years) were examined at 2 control visits (3, 12 months after receiving two negative polymerase chain reaction tests). Patients were divided into following groups: group I (n=94) — lung tissue involvement ≥50% according to inhospital chest computed tomography (chest CT), group II (n=106) — lung tissue involvement˂50% according to chest CT.Results. The groups were comparable in key clinical and functional parameters 3 months after COVID-19 pneumonia. Speckle tracking echocardiography (STE) revealed a significant increase in following global longitudinal strain (LS) parameters: RV free wall endocardial LS (-22,7±3,2% and -24,3±3,8% in group I, p<0,001; -23,2±3,5% and -24,5±3,4% in group II, p><0,001), and RV endocardial LS (-21,0±3,1% and -22,5±3,7% in group I, p><0,001, -21,5±3,2% and -22,6±3,3% in group II, p=0,001 ). Significant increase of segmental endocardial LS was revealed in group I in the basal segments of RV free wall (-26,2±5,1% and -28,1±5,1%, p=0,004) and interventricular septum (IVS) (-16,2 [13,9; 19,5]% and -17,5 [14,6; 21,4]%, p=0,024), IVS middle segment (-20,3±4,1% and -21,5±4,8%, p=0,030), as well as in group II in the apical segments of RV free wall (-21,9±6,7% and -24,4±5,2%, p=0,001) and IVS (-23,7±4,7% and -24,9±4,8%, p=0,014). Conclusion. Recovery of RV function during a 12-month follow-up period in patients with both severe and moderate/mild lung involvement in COVID-19 was detected using the STE method.>˂0,001; -23,2±3,5% and -24,5±3,4% in group II, p˂0,001), and RV endocardial LS (-21,0±3,1% and -22,5±3,7% in group I, p˂0,001, -21,5±3,2% and -22,6±3,3% in group II, p=0,001 ). Significant increase of segmental endocardial LS was revealed in group I in the basal segments of RV free wall (-26,2±5,1% and -28,1±5,1%, p=0,004) and interventricular septum (IVS) (-16,2 [13,9; 19,5]% and -17,5 [14,6; 21,4]%, p=0,024), IVS middle segment (-20,3±4,1% and -21,5±4,8%, p=0,030), as well as in group II in the apical segments of RV free wall (-21,9±6,7% and -24,4±5,2%, p=0,001) and IVS (-23,7±4,7% and -24,9±4,8%, p=0,014).Conclusion. Recovery of RV function during a 12-month follow-up period in patients with both severe and moderate/mild lung involvement in COVID-19 was detected using the STE method

Training and methodological support to the process of future teachers' readiness formation to implement the younger generation civic education

© The authors. The relevance of this problem study is due to the fact that main disadvantage of many manuals and textbooks in teachers training high schools is the lack of definition and solution of civic education problems, as well as undeveloped effective, methodologically competent, comprehensive system of civil education of the younger generation. In this regard, this article is aimed at the development of training and methodological support to the process of future teachers' readiness formation for the younger generation civil education implementation. A leading approach to this problem study is a systematic approach aimed at interdependence and interdependence ensuring in the development of civil meaningful personal and professional qualities of students. The article presents the structure and content of training and methodological support to the process of future teachers' readiness formation to implement the students' civic education, consisting of a comprehensive curriculum, of special course "Civic education of the younger generation" and diagnostic tools to assess the levels of future teachers' readiness formation for the younger generation civil education implementation. The article can be used in the system of retraining and advanced training of teachers and in education process of teachers training high schools and pedagogical colleges

Влияние спиртового экстракта большой восковой моли (Galleria mellonella) на внутренние органы мышей

The paper highlights the effect of 40% alcohol extract of large bee- moth (Galleria mellonella) on the organs of mice. The researchers used white mice, arranged in groups of 5. The control group consisted of mice that did not receive the extract. The researchers applied the specimen in mice of groups 1, 2 and 3, when the specimen was applied during 21 days dozed 6, 12, 24 ml per 100 ml (0.3, 0.6 and 0.9%), respectively. The authors found out that in histological examination of the myocardium in all experimental groups, the structure of the endocardium, myocardium and epicardium corresponded to physiological parameters. The authors observed the tendency to increase the size of renal bodies and a slight increase in urinary space in the kidney tissues of all experimental animals. This may indicate some increase in renal filtration. The authors observed less thickness of the glomerular zone of the adrenal cortex in the animals of the 2nd and 3rd experimental groups. Higher thickness of the beam zone was observed only in animals of the 1st experimental group, which could indicate stress effects. This lower index was observed in other experimental groups of mice, which could be caused by depletion of compensatory mechanisms. After applying the extract dozed 0.3 %, the authors found out an increase in the thickness of the adrenal brain zone, while 0.6 and 0.9% dozes led to the decrease of the index. Changes in the liver certify the impact of ethyl alcohol on hepatocytes. The authors observed higher number of dual-core hepatocytes and vacuolazed ones in proportion to higher concentration of the extract in the experimental animals. Studying the spleen, the researchers found an increase in the area of the white pulp and signs of blast transformation in the animals of the 2nd experimental group. Thus, oral application of G. mellonella extract in different dosage provokes histological changes that characterize compensatory reactions, severity of which was determined by specimen doze. The authors didn’t prove specimen toxicity. The specimen dozed 0.3 % has a frank adaptogenic effect on the internal organs of mice.Представлены результаты исследования воздействия препарата 40 %-го спиртового экстракта большой восковой моли (Galleria mellonella) на внутренние органы мышей. В опыте использовали белых мышей, подобранных в группы по 5 голов. Контрольную группу составляли мыши, не получавшие экстракт. Мышам 1, 2 и 3-й групп препарат вводили путем выпаивания в течение 21 дня в дозировке 6, 12, 24 мл на 100 мл (0,3; 0,6 и 0,9 %) соответственно. При гистологическом исследовании миокарда во всех опытных группах структура эндокарда, миокарда и эпикарда соответствовала физиологическим показателям. В тканях почек у животных всех опытных групп наблюдалась тенденция к увеличению размеров почечных телец и незначительному увеличению мочевого пространства, что может свидетельствовать о некотором усилении почечной фильтрации. У животных 2-й и 3-й опытных групп наблюдалось уменьшение толщины клубочковой зоны коры надпочечников. Увеличение толщины пучковой зоны отмечали лишь у животных 1-й опытной группы, что могло свидетельствовать о стрессогенном воздействии. У мышей остальных опытных групп наблюдалось уменьшение данного показателя, что могло быть связано с истощением компенсаторных механизмов. После введения экстракта в дозе 0,3 % наблюдалось увеличение толщины мозговой зоны надпочечников, тогда как дозировка 0,6 и 0,9 % приводила к понижению показателя. Изменения в печени свидетельствовали о воздействии этилового спирта на состояние гепатоцитов. У животных опытных групп увеличивалось число двуядерных и вакуолизированных гепатоцитов пропорционально увеличению концентрации экстракта. При исследовании селезенки увеличение площади белой пульпы и признаки бластной трансформации обнаруживали у животных 2-й опытной группы. Таким образом, пероральное введение экстракта G. mellonella в различной дозировке провоцирует гистологические изменения, характеризующие картину компенсаторных реакций, выраженность которых определялась дозировкой вводимого препарата. Токсичность препарата не доказана. Дозировка экстракта 0,3 % оказывает выраженный адаптогенный эффект на внутренние органы мышей

Echocardiographic characteristics of COVID-19 pneumonia survivors three months after hospital discharge

Coronavirus disease 2019 (COVID-19) is an infectious disease that affects almost all organs and systems. The main target is the respiratory system, but cardiovascular involvement is also common. Today, it is relevant to study the effect of complicated COVID-19 course on the patient’s cardiovascular system after hospital discharge — in particular, echocardiographic parameters.Aim. To study the echocardiographic parameters of patients with COVID-19 pneumonia 3 months after discharge from the hospital.Material and methods. The study included 106 patients with documented COVID-19 pneumonia. Patients underwent a comprehensive examination during hospitalization and 3 months ± 2 weeks after hospital discharge. The mean age of participants was 47±16 years (from 19 to 84 years), while 49% were women.Results. Three months after discharge, the average body mass index of the subjects was 28,2±5,7 kg/m2. Obesity was noted in 37,1%, cardiovascular diseases — in 52%. According to echocardiography, the prevalence of right ventricular (RV) dilatation was 2,9%, a decrease in tricuspid annular plane systolic excursion (TAPSE) — 9,5%, grade ≥2 tricuspid regurgitation — 1,9%, pulmonary hypertension (pulmonary artery systolic pressure >36 mm Hg) — 3,8%. The mean value of RV global longitudinal myocardial strain (GLMS RV) and global longitudinal myocardial strain (GLES RV) was 19,6±4,5 and 20,6±4,6, respectively. We found moderate correlations between GLMS RV and blood flow time through the left ventricular outflow tract (OT) (r=-0,436), through the mitral valve (r=-0,390; both p<0,0001) and through the RVOT (r=-0,348; р=0,004), with cardiac index (CI) (r=0,316; p=0,009), as well as between GLES RV and blood flow time through the LVOT (r=-0,411; p<0,0001) and RVOT (r=-0,300; p=0,005), and with CI (r=0,302; p=0,004). At the same time, the correlation of GLES RV with RV fractional area change (FAC) was weak (r=-0,283; p=0,007), while there was no correlation with the TAPSE. In addition, correlation of GLMS RV with these parameters were not defined.Conclusion. Three months after COVID-19 pneumonia, RV strain parameters were shown to have stronger relationships with time characteristics of flows in LVOT and RVOT, as well as with CI, than with such generally accepted characteristics of RV function as FAC and TAPSE

Cardiovascular status and echocardiographic changes in survivors of COVID-19 pneumonia three months after hospital discharge

Coronavirus disease 2019 (COVID-19) affects the function of all organs and systems. Today, studying the effect of COVID-19 on cardiovascular system, including on echocardiographic characteristics, is relevant.Aim. To study the prevalence of symptoms, cardiovascular disease and changes in echocardiographic data in persons after documented COVID-19 pneumonia 3 months after discharge from the hospital.Material and methods. The study included 106 patients after documented COVID-19 pneumonia. The patients underwent a comprehensive examination during hospitalization and 3 months±2 weeks after discharge from the hospital. The mean age of participants was 47±16 years (19-84 years); 49% of subjects were women.Results. Three months after hospital discharge, the symptoms persisted in 86% of examined patients. There were significant echocardiographic changes as follows: a decrease in LV end-diastolic, end-systolic and stroke volume (113,8±26,8 ml vs 93,5±29,4 ml; 37,7±13,0 ml vs 31,3±14,2 ml; 77,2±17,8 ml vs 62,2±18,7 ml, respectively, p<0,001 for all). The right ventricular anteroposterior dimension and the pulmonary trunk diameter decreased over time (26,0 [24,0-29,3] mm vs 25,0 [23,0-27,0] mm, p=0,004; 21,7±3,6 mm vs 18,7±2,5 mm, p<0,001), the same as the pulmonary artery systolic pressure, estimated by tricuspid regurgitation gradient (28,0 [25,0-32,25] mm Hg vs 21,5 [17,0-25,0] mm Hg). The right atrial volume (42,0 [37,0-50,0] m><0,001), the same as the pulmonary artery systolic pressure, estimated by tricuspid regurgitation gradient (28,0 [25,0-32,25] mm Hg vs 21,5 [17,0-25,0] mm Hg). The right atrial volume (42,0 [37,0-50,0] ml vs 31,0 [22,0-36,5] ml, p<0,001) a><0,001) and maximum width (36,1±4,6 mm vs 34,5±6,5 mm, p=0,023) decreased, while the right atrial maximum length increased (46,7±6,8 mm vs 48,6±7,1 mm, p=0,021).Conclusion. In survivors of COVID-19 pneumonia three months after hospital discharge, complaints persisted in 86% of cases. Cardiovascular diseases were detected in 52% of participants, including hypertension in 48,1% and coronary artery disease in 15,1%. Compared with in-hospital data, the echocardiographic characteristics improved, which was expressed mainly in a decrease in right heart load

Analysis of radial artery occlusion causes and methods of its prevention after interventions using radial access. Results of the APRIORI study

Aim. To study predictors of radial artery occlusion (RAO) and ways to prevent it after interventions using radial access.Material and methods. The study consisted of prospective and retrospective parts. The total number of included patients was 2284. Patients undergoing interventions by radial access in various medical organizations were retrospectively considered. The prospective study included 1284 patients who were subject to interventional treatment. Patients were randomized into two groups as follows: in group 1, hemostasis was performed within 4 hours, in group 2 — >6 hours. All patients underwent a bedside Barbeau test with a pulse oximeter and an ultrasound of access arteries to determine the radial artery patency/occlusion.Results. The RAO rate in the retrospective part was 21,8%, while in the prospective one — 10,1% with long-term hemostasis and 1,4% with short-term hemostasis (p<0,001). Predictors of RAO were type 2 diabetes (odds ratio (OR), 1,9, 95% confidence interval (CI), 1,1-3,4, p=0,03) and an increase in hemostasis duration by 1 hour (OR, 1,2, 95% CI, 1,1-1,3, p<0,001). When analyzing the retrospective part, the predictors of RAO were body mass index (OR, 1,06, 95% CI, 1,02-1,09, p=0,002), female sex (OR, 0,6, 95% CI, 0,4-0,9, p=0,02), smoking (OR, 1,38, 95% CI, 1-1,91, p=0,047). The administration of statins in different dosages, as well as antihypertensive and anti-ischemic agents, did not have a significant effect on the RAO rate.Conclusion. The main predictors of RAO were type 2 diabetes, an increase in hemostasis duration, female sex, smoking, and the artery-to-introducer diameter ratio. Taking statins, anti-ischemic and antihypertensive agents does not have a protective effect on RAO rate

Coronary atherosclerosis progression in patients after coronary stenting, depending on a cardiology follow-up strategy

Aim. To compare the prevalence of coronary atherosclerosis in patients after coronary stenting (CS) receiving outpatient and remote cardiology follow-up during a one-year study.Material and methods. We enrolled 279 patients aged 61,5±9,5 years with class ≥II stable angina or silent ischemia after CS. Three groups were formed: group 1 (n=96) — outpatient visits before CS, 1, 3, 6 and 12 months after CS. Group 2 (n=95) — remote monitoring: patients were followed up by a primary care physician with the involvement of a cardiologist via remote communication (e-mail, telephone, Skype) 1, 3, 6 and 12 months after CS. Group 3 (n=88) were followed up by a primary care physician and contacted with the study coordinator before and 12 months after CS. After 12 months, all patients underwent stress-induced myocardial ischemia testing. In case of a positive or uncertain test result, coronary angiography (CA) was performed.Results. Stress-induced myocardial ischemia 12 months after CS was verified in 58 patients (21%): 19 patients (19,8%) — group 1; 9 patients (9,5%) — group 2; 30 patients (34,1%) — group 3 (p<0,05). Repeat CA was performed in 96 patients (34,4% of the total number of patients). Restenosis was detected in 8 (2,9%) patients, coronary atherosclerosis progression — in 38 (13,6%), combination of restenosis and atherosclerosis progression — in 4 (1,4%) patients. Coronary atherosclerosis progression was significantly more frequent in group 3: 10,4%, 9,5% and 21,6% in groups 1, 2 and 3, respectively (p<0,05). The incidence of stent restenosis was comparable: 2,1%, 3,2% and 3,5% in groups 1, 2, and 3, respectively.Conclusion. Coronary atherosclerosis progression was the main reason for repeated revascularizations 12 months after the CS. Outpatient and remote cardiology follow-up is associated with a lower incidence of coronary atherosclerosis progression and repeated CA during 12-month follow-up after CS

The Erotic and the Vulgar: Visual Culture and Organized Labor's Critique of U.S. Hegemony in Occupied Japan

This essay engages the colonial legacy of postwar Japan by arguing that the political cartoons produced as part of the postwar Japanese labor movement’s critique of U.S. cultural hegemony illustrate how gendered discourses underpinned, and sometimes undermined, the ideologies formally represented by visual artists and the organizations that funded them. A significant component of organized labor’s propaganda rested on a corpus of visual media that depicted women as icons of Japanese national culture. Japan’s most militant labor unions were propagating anti-imperialist discourses that invoked an engendered/endangered nation that accentuated the importance of union roles for men by subordinating, then eliminating, union roles for women

Случай тяжёлого течения аутохтонного гепатита Е у пожилого мужчины

The article presents an analysis of the first clinical cases of acute hepatitis E autochtonic on the territory of the Kirov region. HEV-infection was diagnosed in 76 year old male, not to travel outside the region and the country for a long time, eat a lot of fresh fruit. A feature of the disease in non-endemic region was: severe course of hepatitis E in the elderly, with the development of clinic of acute liver failure and encephalopathy, the presence of the expressed syndrome cytolysis, cholestasis, hepatic-cell failure.Timely treatment of a patient for medical care, the lack of severe somatic diseases, chronic liver disease and adequate pathogenetic therapy helped to keep the patient’s life. In deciphering undifferentiated acute hepatitis in the elderly should be included in the scheme of examination and determination HEV RNA, a/HEV IgM and G.В статье представлен анализ первого клинического случая аутохтонного острого гепатита Е на территории Кировской области. HEV-инфекция была диагностирована у 76-летнего мужчины, не выезжавшего за пределы области и страны в течение длительного времени, употреблявшего много свежих фруктов. Особенностью заболевания в неэндемичном регионе явилось: тяжёлое течение гепатита Е в пожилом возрасте, с развитием клиники острой печёночной недостаточности и энцефалопатии, наличие выраженного синдрома цитолиза, холестаза, печёночно-клеточной недостаточности.Своевременное обращение больного за медицинской помощью, отсутствие тяжёлых соматических заболеваний, хронической патологии печени и адекватная патогенетическая терапия позволили сохранить жизнь больного. При расшифровке недифференцированных острых гепатитов у пожилых необходимо включать в схему обследования определение HEVRNA и а/HEV IgM и G

Lower Bound on the Magnetic Field Strength of a Magnetar from Analysis of SGR Giant Flares

Based on the magnetar model, we have studied in detail the processes of neutrino cooling of an electron--positron plasma generating an SGR giant flare and the influence of the magnetar magnetic field on these processes. Electron--positron pair annihilation and synchrotron neutrino emission are shown to make a dominant contribution to the neutrino emissivity of such a plasma. We have calculated the neutrino energy losses from a plasma-filled region at the long tail stage of the SGR 0526--66, SGR 1806--20, and SGR 1900+14 giant flares. This plasma can emit the energy observed in an SGR giant flare only in the presence of a strong magnetic field suppressing its neutrino energy losses. We have obtained a lower bound on the magnetic field strength and showed this value to be higher than the upper limit following from an estimate of the magnetic dipole losses for the magnetars being analyzed in a wide range of magnetar model parameters. Thus, it is problematic to explain the observed energy release at the long tail stage of an SGR giant flare in terms of the magnetar model.Comment: 18 pages, 5 figure