Peculiarities of electronic heat capacity of thulium cuprates in pseudogap state

Precise calorimetric measurements have been carried out in the 7 - 300 K temperature range on two ceramic samples of thulium 123 cuprates TmBa2Cu3O6.92 and TmBa2Cu3O6.70. The temperature dependence of the heat capacity was analyzed in the region where the pseudogap state (PGS) takes place. The lattice contribution was subtracted from the experimental data. The PGS component has been obtained by comparing electronic heat capacities of two investigated samples because the PGS contribution for the 6.92 sample is negligible. The anomalous behavior of the electronic heat capacity near the temperature boundary of PGS was found. It is supposed that this anomaly is due to peculiarities in N(E) function where N is the density of electronic states and E is the energy of carriers of charge.Comment: 12 pages, 3 Postscript figure

Ademetionine treatment cost analysis of patients with intrahepatic cholestasis and non-alcoholic fatty disease

Relevance. Ademetionine is a hepatoprotective drug, is included in the  draft Russian clinical guidelines for the  diagnosis and treatment of non-alcoholic fatty liver disease (NAFLD) and in the  clinical guidelines for treating intrahepatic cholestasis (ITH), the cost analysis of treating patients with ITH and NAFLD is topical. Aim. The cost analysis of treatment with ademetionine for ITH and NAFLD in the Russian Federation. Methods. This clinical and economic analysis was conducted in accordance with the requirements of GOST R 57525–2017 and the methodological recommendations of the  Center for Expertise and Quality Control of Medical Care. At the  first stage, to determine the  structure and number of costs, a review of legal acts and publications on the  pharmacoeconomic analysis of clinical situations and drugs of interest in the  e-Library and ConsultantPlus databases was carried out. The  source of prices for medical services was the tariffs of the compulsory medical insurance system and data from the tariff agreement in Moscow within the framework of the compulsory medical insurance system, and in the absence of tariffs, the  prices for paid medical services. Prices for drugs were obtained from an open source — the  Russian Pharmaceutical Portal (Pharmindex.rf). In the  absence of data on the  cost structure, a survey of physicians conducted through a questionnaire. Results. Because of the literature review, 34 publications were found in the  e-Library database on the use of ademetionine in NAFLD and ITH. Additionally, outside the scope of the literature review, a study was found in 2011, which provides a comparative clinical and economic analysis of the  use of ademetionine (Heptral®) and essential phospholipids (Essentiale) in alcoholic liver damage and in infectious hepatitis. A review of legal acts in the  ConsultantPlus database initially identified 93 documents, of which 25 turned out to be irrelevant to the current purpose of the study, that is, they didn’t allow analyzing the costs of ademetionine therapy. Of the 20 identified standards of medical care, only 2 are devoted to diseases of the liver and biliary tract. Because of the analysis, it was revealed that the cost per case of NAFLD treatment in a round-the-clock hospital amounted to 24.6 thousand rubles; in a day hospital, the  cost per case of both NAFLD and ITH in adults amounted to 19.8 thousand rubles each. The average total cost of treating one patient during the year on an outpatient basis for NAFLD amounted to 65.3 thousand rubles, of which only 14.3 thousand rubles. covered by the compulsory medical insurance system, 16.9 thousand rubles outside the compulsory medical insurance system and 34.1 thousand rubles — drug costs. The average total costs for treating one patient during the year on an outpatient basis from ITH amounted to 65.4 thousand rubles, of which 23.9 thousand rubles. covered by the compulsory medical insurance system, 17.6 thousand rubles outside the compulsory medical insurance system and 23.9 thousand rubles — drug costs. Conclusion. Because of the study, the average costs for treating patients with NAFLD and ITH were calculated, which can later be used to conduct other types of pharmacoeconomic analysis

Маркеры повреждения головного мозга при тяжелой сочетанной травме

The paper describes a clinical case of early enteral feeding with an immune formula in a patient with significant heart failure after cardiosurgical intervention who is on venoarterial extracorporeal membrane oxygenation. The safety and efficiency of nutritional support were monitored, by estimating blood acid-base balance and oxygenation level and by controlling the residual gastric volume, which enabled the volume of the given enteral mixture to be increased up to 2600 kcal by day 3, by providing the body’s energy needs determined by calculation techniques. On postoperative day 4 when hemodynamic parameters were satisfactory, extracorporeal membrane oxygenation was disconnected; following 7 days the patient was weaned from artificial ventilation. The length of intensive care unit stay was 14 days. The patient was discharged from hospital in a satisfactory condition. Thus, early enteral feeding may be a safe and effective method of nutritional support in patients on extracorporeal circulation. Key words: extracorporeal membrane oxygenation, early enteral feeding, immune nutrition, cardiosurgery.Представлен обзор литературы о механизмах формирования энцефалопатии при тяжелой сочетанной травме без превалирования тяжелой ЧМТ: гемодинамические нарушения, повреждение эндотелия, апоптоз и антиапоптоз. Предложенные маркеры тяжести повреждения головного мозга могут быть использованы в качестве компонентов комплексной диагностики посттравматической энцефалопатии. Ключевые слова: сочетанная травма, энцефалопатия, диагностика, маркеры повреждения головного мозга

Bond graph modelling of chemoelectrical energy transduction

Energy-based bond graph modelling of biomolecular systems is extended to include chemoelectrical transduction thus enabling integrated thermodynamically-compliant modelling of chemoelectrical systems in general and excitable membranes in particular. Our general approach is illustrated by recreating a well-known model of an excitable membrane. This model is used to investigate the energy consumed during a membrane action potential thus contributing to the current debate on the trade-off between the speed of an action potential event and energy consumption. The influx of Na+ is often taken as a proxy for energy consumption; in contrast, this paper presents an energy based model of action potentials. As the energy based approach avoids the assumptions underlying the proxy approach it can be directly used to compute energy consumption in both healthy and diseased neurons. These results are illustrated by comparing the energy consumption of healthy and degenerative retinal ganglion cells using both simulated and in vitro data

Pressure and Flow Properties of Cannulae for Extracorporeal Membrane Oxygenation I: Return (Arterial) Cannulae

Adequate extracorporeal membrane oxygenation support in the adult requires cannulae permitting blood flows up to 6-8 L/minute. In accordance with Poiseuille's law, flow is proportional to the fourth power of cannula inner diameter and inversely proportional to its length. Poiseuille's law can be applied to obtain the pressure drop of an incompressible, Newtonian fluid (such as water) flowing in a cylindrical tube. However, as blood is a pseudoplastic non-Newtonian fluid, the validity of Poiseuille's law is questionable for prediction of cannula properties in clinical practice. Pressure-flow charts with non-Newtonian fluids, such as blood, are typically not provided by the manufacturers. A standardized laboratory test of return (arterial) cannulae for extracorporeal membrane oxygenation was performed. The aim was to determine pressure-flow data with human whole blood in addition to manufacturers' water tests to facilitate an appropriate choice of cannula for the desired flow range. In total, 14 cannulae from three manufacturers were tested. Data concerning design, characteristics, and performance were graphically presented for each tested cannula. Measured blood flows were in most cases 3-21% lower than those provided by manufacturers. This was most pronounced in the narrow cannulae (15-17 Fr) where the reduction ranged from 27% to 40% at low flows and 5-15% in the upper flow range. These differences were less apparent with increasing cannula diameter. There was a marked disparity between manufacturers. Based on the measured results, testing of cannulae including whole blood flows in a standardized bench test would be recommended.info:eu-repo/semantics/publishedVersio

International longitudinal registry of patients with atrial fibrillation and treated with rivaroxaban: RIVaroxaban Evaluation in Real life setting (RIVER)

Background Real-world data on non-vitamin K oral anticoagulants (NOACs) are essential in determining whether evidence from randomised controlled clinical trials translate into meaningful clinical benefits for patients in everyday practice. RIVER (RIVaroxaban Evaluation in Real life setting) is an ongoing international, prospective registry of patients with newly diagnosed non-valvular atrial fibrillation (NVAF) and at least one investigator-determined risk factor for stroke who received rivaroxaban as an initial treatment for the prevention of thromboembolic stroke. The aim of this paper is to describe the design of the RIVER registry and baseline characteristics of patients with newly diagnosed NVAF who received rivaroxaban as an initial treatment. Methods and results Between January 2014 and June 2017, RIVER investigators recruited 5072 patients at 309 centres in 17 countries. The aim was to enroll consecutive patients at sites where rivaroxaban was already routinely prescribed for stroke prevention. Each patient is being followed up prospectively for a minimum of 2-years. The registry will capture data on the rate and nature of all thromboembolic events (stroke / systemic embolism), bleeding complications, all-cause mortality and other major cardiovascular events as they occur. Data quality is assured through a combination of remote electronic monitoring and onsite monitoring (including source data verification in 10% of cases). Patients were mostly enrolled by cardiologists (n = 3776, 74.6%), by internal medicine specialists 14.2% (n = 718) and by primary care/general practice physicians 8.2% (n = 417). The mean (SD) age of the population was 69.5 (11.0) years, 44.3% were women. Mean (SD) CHADS2 score was 1.9 (1.2) and CHA2DS2-VASc scores was 3.2 (1.6). Almost all patients (98.5%) were prescribed with once daily dose of rivaroxaban, most commonly 20 mg (76.5%) and 15 mg (20.0%) as their initial treatment; 17.9% of patients received concomitant antiplatelet therapy. Most patients enrolled in RIVER met the recommended threshold for AC therapy (86.6% for 2012 ESC Guidelines, and 79.8% of patients according to 2016 ESC Guidelines). Conclusions The RIVER prospective registry will expand our knowledge of how rivaroxaban is prescribed in everyday practice and whether evidence from clinical trials can be translated to the broader cross-section of patients in the real world