Digital Technologies in Providing Development of Algorithms Surgical Treatment of Supraventricular Arrhythmias

The aim of the study was the development and clinical application of patient selection algorithm for surgical treatment of longlasting persistent atrial fibrillation. The study included 235 patients with acquired heart disease and coronary artery disease, which in the period from 1999 to 2015 performed surgical treatment of long-term persistent atrial fibrillation (RF “MAZE III” procedure) in conjunction with the correction of the underlying heart disease. The patients were divided into 2 groups according to the method of operation: the group 1 – 135 patients (76 women and 59 men) who have applied an integrated approach to surgery for atrial fibrillation, including penetrating method of RF effects on atrial myocardium and the study of the function of the sinus node before and after the operation (these patients were operated on from 2008 to 2015). The group 2 – 100 patients (62 women and 38 men) with a “classical” method of monopolar RF “MAZE III”, which the sinus node function was not studied. We used the combined (epi- and endocardial) method of RF "MAZE". This algorithm is decreasing of possible permanent pacemaker postoperatively. The initial sinus node function in these patients, measured using the original method, the basic line of this algorithm was taken. The results showed that use this algorithm for selection of patients allows significantly reduce the possibility of pacemaker implantation in the postoperative perio

A case of xenon inhalation therapy for respiratory failure and neuropsychiatric disorders associated with COVID-19

Acute respiratory distress syndrome (ARDS) is the main danger to the life of patients with pneumonia caused by SARS-CoV-2. At the same time, respiratory failure (RF) after ARDS can persist for a long time despite intensive therapy. Therefore, it is important to develop new effective approaches for restoring the ventilation function of the lungs after COVID-19. Here, we present a case report of effective application of short-term inhalations of xenon-oxygen (Xe/O2) gas mixture for treatment of RF and neuropsychiatric disorders (NPD) associated with COVID-19. The patient inhaled a gas mixture of 70 % Xe and 30 % O2. We used multispiral computed tomog-raphy, evaluated psychometry, studied hematological and biochemical blood parameters, and applied some other methods of clinical studies to assess the therapeutic effectiveness of Xe inhalation. Also, we studied the mecha-nism of action of xenon with computer modeling. The clinical case showed the high efficacy of Xe/O2 mixture for treating severe RF and NPD after SARS-CoV-2 infection. Xenon inhalations dramatically increased oxygen saturation and the degree of pneumatization of the lungs. We found out that in coronavirus pneumonia, saturated phospholipids of surfactant are transferred to the solid-ordered phase, which disrupts the surface tension of the alveoli and alveolar gas exchange. Using molecular modeling methods, we demonstrated that the xenon atom in-creases the distance between the acyl chains of phospholipids due to the van der Waals dispersion interaction. These changes allow for the phase transition of phospholipids from the solid-ordered phase to the liquid phase and restore the functional activity of the surfactant. The findings suggest the feasibility of conducting studies on the effectiveness of Xe/O2 inhalations for treating ARDS in SARS-CoV-2 infection

Трудности диагностики метастатического рака молочной железы у пациентки после минимально инвазивного протезирования аортального клапана: клинический случай

HighlightsThe article describes a clinical case of a patient with metastatic breast cancer detected after aortic valve replacement. The case was initially treated as sternal osteomyelitis due to ministernotomy performed during aortic valve surgery. However, the diagnosis of metastatic breast cancer with sternal and spinal (third thoracic vertebra) metastatses, and ribs lesion was established upon further study. Adjuvant endocrine therapy was prescribed to the patient due to her age and previous surgery. AbstractBreast cancer is an urgent problem in oncology as it remains the most frequent type of cancer in the Russian Federation and world wide. Long-term treatment success and survival of patients depend on selected treatment modality, and long-term postopertive monitoring of patients as the means of the early detection of metastatic recurrence. Furthermore, concominant somatic ilness could change or mask the symptoms of local recurrence or metastasis, resulting in difficulties with establishing the proper diagnosis. We report a clinical case of metastatic breast cancer in a patient with severe aortic stenosis who underwent aortic valve replacement. We have not found analogious cases in domestic and foreign literature.Основные положенияВ статье описан клинический случай метастатического рака молочной железы у пациентки после протезирования аортального клапана. Ввиду выполненной министернотомии при операции на аортальном клапане данный случай изначально трактовался, как подозрение на остеомиелит грудины, однако при детальном изучении диагностирован метастатический рак молочной железы с поражением грудины, ребер и тела третьего грудного позвонка. С учетом возраста и перенесенной операции пациентке назначена адъювантная гормональная терапия. АннотацияРак молочной железы представляет серьезную проблему современной онкологии, занимая лидирующую позицию среди всех злокачественных новообразований не только в РФ, но и мире. Долгосрочный успех в лечении и выживаемость данной категории пациентов зависят не только от выбранного варианта терапии, но и дальнейшего длительного мониторирования состояния больных с целью своевременной диагностики рецидивирующего или метастатического процесса. Кроме того, сопутствующие соматические заболевания могут менять или маскировать симптомы развития локальных рецидивов и метастазов, что ведет к затруднению интерпретации клинической картины и поздней диагностике прогрессирования опухоли. В данной статье описан клинический случай сочетания метастатического рака молочной железы с ранее выполненным протезированием аортального клапана биопротезом по поводу тяжелого аортального стеноза. Наличие стернотомного доступа в анамнезе сыграло решающую роль в трудности дифференциальной диагностики в амбулаторном звене. При анализе отечественной и зарубежной литературы не обнаружено подобных публикаций

A new endosymbiotic bacterium species associated with a nematode species of the genus Xiphinema (Nematoda, Longidoridae)

2021 virtual edition of the Conference Microscopy at the Frontiers of Science, september 29 and October 1st.Nematodes are the third largest group of metazoans; among them, the Family Longidoridae comprises two main genera of plant parasitic nematodes, Xiphinema and Longidorus, which contain several virus-vector species, e.g. the species X. index, the vector of grape fanleaf virus (GFLV), a serious pathogen of grapes. Bacterial endosymbionts of plant-parasitic nematodes represent a field of research that has become active in recent years. In this work we present a detailed characterization of the endosymbiont bacterium found in the nematode X. pachtaicum from the rhizosphere of sour orange trees (Citrus x aurantium L.) from Cordoba, Spain, and, based on morphological, phylogenetic and genomic characteristics propose a novel candidate genus and species for this uncultured bacterium (strain IAST). An intracellular bacterium, strain IAST, was observed to infect several species of the plant-parasitic nematode genus Xiphinema (X. astaregiense, X. incertum, X. madeirense, X. pachtaicum, X. parapachydermum and X. vallense). The bacterium could not be recovered on axenic medium. The localization of the bacterium (via light and fluorescence in situ hybridization microscopy) is in the X. pachtaicum females clustered around the developing oocytes, primarily found embedded inside the epithelial wall cells of the ovaries, from where they are dispersed in the intestine. Transmission electron microscopy (TEM) observations supported the presence of bacteria inside the nematode body, where they occupy ovaries and occur inside the intestinal epithelium. Ultrastructural analysis of the bacterium showed cells that appear as mostly irregular, slightly curved rods with rounded ends, 0.8–1.2 μm wide and 2.5–6.0 μm long, possessing a typical Gram-negative cell wall. The peptidoglycan layer is, however, evident only occasionally and not detectable by TEM in most cells. Another irregularly occurring shell surrounding the endosymbiont cells or the cell clusters was also revealed, probably originating from the host cell membrane. Flagella or spore-like cells do not occur and the nucleoid is diffusely distributed throughout the cell. This endosymbiont is transmitted vertically through nematode generations. These results support the proposal of IAST as a new species, although its obligate intracellular and obligate endosymbiont nature prevented isolation of a definitive type strain. Strain IAST is therefore proposed as representing ‘Candidatus Xiphinematincola pachtaicus’ gen. nov., sp. nov

‘Candidatus Xiphinematincola pachtaicus' gen. nov., sp. nov., an endosymbiotic bacterium associated with nematode species of the genus Xiphinema (Nematoda, Longidoridae)

An intracellular bacterium, strain IAST , was observed to infect several species of the plant-parasitic nematode genus Xiphinema (Xiphinema astaregiense, Xiphinema incertum, Xiphinema madeirense, Xiphinema pachtaicum, Xiphinema parapachydermum and Xiphinema vallense). The bacterium could not be recovered on axenic medium. The 16S rRNA gene sequence of IAST was found to be new, being related to the family Burkholderiaceae, class Betaproteobacteria. Fungal endosymbionts Mycoavidus cysteinexigens B1-EBT (92.9% sequence identity) and ‘Candidatus Glomeribacter gigasporarum’ BEG34 (89.8% identity) are the closest taxa and form a separate phylogenetic clade inside Burkholderiaceae. Other genes (atpD, lepA and recA) also separated this species from its closest relatives using a multilocus sequence analysis approach. These genes were obtained using a partial genome of this bacterium. The localization of the bacterium (via light and fluorescence in situ hybridization microscopy) is in the X. pachtaicum females clustered around the developing oocytes, primarily found embedded inside the epithelial wall cells of the ovaries, from where they are dispersed in the intestine. Transmission electron microscopy (TEM) observations supported the presence of bacteria inside the nematode body, where they occupy ovaries and occur inside the intestinal epithelium. Ultrastructural analysis of the bacterium showed cells that appear as mostly irregular, slightly curved rods with rounded ends, 0.8–1.2µm wide and 2.5–6.0µm long, possessing a typical Gram-negative cell wall. The peptidoglycan layer is, however, evident only occasionally and not detectable by TEM in most cells. Another irregularly occurring shell surrounding the endosymbiont cells or the cell clusters was also revealed, probably originating from the host cell membrane. Flagella or spore-like cells do not occur and the nucleoid is diffusely distributed throughout the cell. This endosymbiont is transmitted vertically through nematode generations. These results support the proposal of IAST as a new species, although its obligate intracellular and obligate endosymbiont nature prevented isolation of a definitive type strain. Strain IAST is therefore proposed as representing ‘Candidatus Xiphinematincola pachtaicus’ gen. nov., sp. nov

Assessment of Left Ventricular Mechanics in Patients with Ischemic Heart Disease

The paper presents new ultrasound technology for assessment of left ventricular (LV) strain in the longitudinal, radial, and circumferential directions and the LV area strain at rest and during dobutamine stressechocardiography in patients with intermediate pretest probability of ischemic heart disease (IHD). Analysis was performed for the first time using real-time three-dimensional echocardiography (4D Strain). It was shown that in patients with single-artery left anterior descending artery (LAD) and left circumflex coronary artery (LCX) stenosis of 50% and more, the decreases in the global LV strain in the longitudinal, radial, and circumferential directions as well as in the LV strain area were observed at peak dobutamine stress in 4D Strain mode. Assessment of global LV strain in 4D Strain mode during dobutamine test had low sensitivity, specificity, and diagnostic accuracy in diagnosing single-vessel coronary artery disease

Digital Technologies in Providing Development of Algorithms Surgical Treatment of Supraventricular Arrhythmias

The aim of the study was the development and clinical application of patient selection algorithm for surgical treatment of longlasting persistent atrial fibrillation. The study included 235 patients with acquired heart disease and coronary artery disease, which in the period from 1999 to 2015 performed surgical treatment of long-term persistent atrial fibrillation (RF “MAZE III” procedure) in conjunction with the correction of the underlying heart disease. The patients were divided into 2 groups according to the method of operation: the group 1 – 135 patients (76 women and 59 men) who have applied an integrated approach to surgery for atrial fibrillation, including penetrating method of RF effects on atrial myocardium and the study of the function of the sinus node before and after the operation (these patients were operated on from 2008 to 2015). The group 2 – 100 patients (62 women and 38 men) with a “classical” method of monopolar RF “MAZE III”, which the sinus node function was not studied. We used the combined (epi- and endocardial) method of RF «MAZE». This algorithm is decreasing of possible permanent pacemaker postoperatively. The initial sinus node function in these patients, measured using the original method, the basic line of this algorithm was taken. The results showed that use this algorithm for selection of patients allows significantly reduce the possibility of pacemaker implantation in the postoperative period

Neurohumoral Markers of Cardiac Autonomic Denervation after Surgical Ablation of Long-Standing Persistent Atrial Fibrillation

Although the autonomic nervous system has an evident impact on cardiac electrophysiology and radiofrequency ablation (RFA) is the conventional technique for treating persistent atrial fibrillation, the specific effects of RFA have been insufficiently studied to date. Here, we investigated whether RFA affects neurohumoral transmitter levels and myocardial 123I-metaiodobenzylguanidine (123I-MIBG) uptake. To perform this task, we compared two groups of patients with acquired valvular heart disease: patients who had undergone surgical AF ablation and patients with sinus rhythm. The decrease in norepinephrine (NE) level in the coronary sinus had a direct association with the heart-to-mediastinum ratio (p = 0.02) and a negative correlation with 123I-MIBG uptake defects (p = 0.01). The NE level decreased significantly after the main surgery, both in patients with AF (p = 0.0098) and sinus rhythm (p = 0.0039). Furthermore, the intraoperative difference between the norepinephrine levels in the ascending aorta and coronary sinus (ΔNE) of –400 pg/mL was determined as a cut-off value to evaluate RFA efficacy, as denervation failed in all patients with ΔNE < –400 pg/mL. Hence, ΔNE can be utilized to predict the efficacy of the “MAZE-IV” procedure and to assess the risk of AF recurrence after RFA

Effect of extremely low-frequency magnetic fields on light-induced electric reactions in wheat

Magnetic field oscillations resulting from atmospheric events could have an effect on growth and development of plants and on the responsive reactions of plants to other environmental factors. In the current work, extremely low-frequency magnetic field (14.3 Hz) was shown to modulate light-induced electric reactions of wheat (Triticum aestivum L.). Blue light-induced electric reaction in wheat leaf comprises depolarization and two waves of hyperpolarization resulting in an increase of the potential to a higher level compared to the dark one. Fluorescent and inhibitory analysis demonstrate a key role of calcium ions and calcium-dependent H+-ATPase of the plasma membrane in the development of the reaction. Activation of H+-ATPase by the increased calcium influx is suggested as a mechanism of the influence of magnetic field on light-induced electric reaction

Hypertrophy and Insulin Resistance of Epicardial Adipose Tissue Adipocytes: Association with the Coronary Artery Disease Severity

Changes in the structural and functional characteristics of the epicardial adipose tissue (EAT) are recognized as one of the factors in the development of cardiometabolic diseases. However, the generally accepted quantitative assessment of the accumulation of EAT does not reflect the size of adipocyte and presence of adipocyte hypertrophy in this fat depot. Overall contribution of adipocyte hypertrophy to the development and progression of coronary atherosclerosis remains unexplored. Objective: To compare the morphological characteristics of EAT adipocyte and its sensitivity to insulin with the CAD severity, as well as to identify potential factors involved in the realization of this relationship. The present study involved 24 patients (m/f 16/8) aged 53–72 years with stable CAD, who underwent coronary artery bypass graft surgery. Adipocytes were isolated enzymatically from EAT explants obtained during the operation. The severity of CAD was assessed by calculating the Gensini score according to selective coronary angiography. Insulin resistance of EAT adipocytes was evaluated by reactivity to insulin. In patients with an average size of EAT adipocytes equal to or exceeding the median (87 μm) the percentage of hypertrophic adipocytes was twice as high as in patients in whom the average size of adipocytes was less than 87 μm. This group of patients was also characterized by the higher rate of the Gensini score, lower adiponectin levels, and more severe violation of carbohydrate metabolism. We have revealed direct nonparametric correlation between the size of EAT adipocytes and the Gensini score (rs = 0.56, p = 0.00047). The number of hypertrophic EAT adipocytes showed a direct nonparametric correlation with the Gensini score (rs = 0.6, p = 0.002). Inverse nonparametric correlations were found between the serum adiponectin level and size (rs = −0.60, p = 0.001), hypertrophy of adipocytes (rs = −0.67, p = 0.00), and Gensini score (rs = −0.81, p = 0.00007). An inverse nonparametric correlation was found between the Gensini score and sensitivity of EAT adipocytes to insulin, estimated by the intracellular redox response (rs = −0.90, p = 0.037) and decrease in lipolysis rate upon insulin addition (rs = −0.40, p = 0.05). The intracellular redox response of adipocytes to insulin was directly correlated with fasting insulin and inversely with postprandial insulin. Our data indicate that the size and degree of hypertrophy of the epicardial adipocytes are related to the CAD severity. According to our results, insulin resistance of adipocytes may be considered as one of the factors mediating this relationship