Thermograms of High-Frequency Capacitive Discharge Between Solid and Liquid Electrodes

© 2018, Pleiades Publishing, Inc. Abstract: We present the experimental results on thermograms and plots of temperature distributions along the streamer and spark discharges in a high-frequency capacitive field between solid and liquid electrodes for different electrode geometries

Evaluation of clinical efficacy of prostanoid therapy for Raynaud’s phenomenon in rheumatic diseases

Aim. On the basis of clinical manifestations of Raynaud’s phenomenon (RP) to determine the RP expression level and to evaluate the long-term efficacy of treatment of RP in patients with rheumatic diseases (RD) with iloprost and alprostadil. Methods. Treatment for indications with prostanoids (intravenous iloprost, alprostadil or their combinations) was administered to 40 patients with secondary RP in RD. During 3-year follow up, clinical instrumental parameters (frequency of attacks of Raynaud's, digital ulcers (DU) formation, pain intensity on visual analogue scale (VAS) were evaluated. The control group included 30 patients with RP in RD who did not receive prostanoid therapy. The method of factor analysis was used to determine the index of generalized expression of RP, on the basis of which the expression levels of the RP were determined. Results. The “expression of RP” scale revealed in the course of factor analysis as an indicator of generalized manifestation of RP, is the average value of two subscales, the first one of which consisted of four indices - “digital ulcer”, “digital pitting scars”, “phalange amputation” and “Raynaud's attack frequency”, and the second one included “intensity of pain”, “duration of illness”, “whitening of fingers”. Verification of the correlation revealed during the study of subscales, showed its reliability (r = 0.294, p = 0.053). The final expression of RP was 1.51 ± 0.86. The low level of RP expression had values up to 0.65, high - over 2.37. When included in the study, a high level of RP expression was defined in 16 (22.9 %) patients, medium - in 43 (61.4 %), low - in 11 (15.7 %). The use of iloprost in the treatment of RP was effective for healing of DU and a statistically significant decrease of the generalized expression of RP from 2.25 [1; 3] to 1.75 [1; 2] (p = 0.012) was observed. On alprostadil treatment, statistically significantly decreased frequency of attacks from multiple daily (more than once a day) to once a month and reduced numbness during RP attack were observed as well as a decrease of the level of generalized index of RP expression from 1.26 ± 0.71 to 0.97 ± 0.57 (р = 0.038). The combination of prostanoids had a contradictory clinical effect: the pain and frequency of RP attacks decreased, but the formation of DU and new cases of amputations of phalanges were registered, the treatment had no effect on the value of RP expression. Conclusion. Based on the clinical manifestations of RP, a generalized index of RP severity was identified and the levels of RP severity were determined. Treatment with iloprost and alprostadil has a significant effect on reducing the clinical manifestations of RP with a corresponding decrease in its severity

PG 1115+080: variations of the A2/A1 flux ratio and new values of the time delays

We report the results of our multicolor observations of PG 1115+080 with the 1.5-m telescope of the Maidanak Observatory (Uzbekistan, Central Asia) in 2001-2006. Monitoring data in filter R spanning the 2004, 2005 and 2006 seasons (76 data points) demonstrate distinct brightness variations of the source quasar with the total amplitude of almost 0.4 mag. Our R light curves have shown image C leading B by 16.4d and image (A1+A2) by 12d that is inconsistent with the previous estimates obtained by Schechter et al. in 1997 - 24.7d between B and C and 9.4d between (A1+A2) and C. The new values of time delays in PG 1115+080 must result in larger values for the Hubble constant, thus reducing difference between its estimates taken from the gravitational lenses and with other methods. Also, we analyzed variability of the A2/A1 flux ratio, as well as color changes in the archetypal "fold" lens PG 1115+080. We found the A1/A2 flux ratio to grow during 2001-2006 and to be larger at longer wavelengths. In particular, the A2/A1 flux ratio reached 0.85 in filter I in 2006. We also present evidence that both the A1 and A2 images might have undergone microlensing during 2001-2006, with the descending phase for A1 and initial phase for A2. We find that the A2/A1 flux ratio anomaly in PG 1115 can be well explained both by microlensing and by finite distance of the source quasar from the caustic fold.Comment: 14 pages, 7 figures, 8 tables, Accepted for publication in MNRA

Эффективность интермиттирующего режима ингаляционного илопроста при неоперабельной хронической тромбоэмболической легочной гипертензии

PH (pulmonary hypertension) targeted therapy may play an essential role in chronic thromboembolic pulmonary hypertension (CTEPH) patients considered inoperable. Given the limited number of PH-targeted drugs approved for CTEPH, reliable long-term data are necessary on the effects of PH-targeted drugs in patients with inoperable CTEPH. We aimed to evaluate the efficacy and safety of intermittent inhaled iloprost in inoperable CTEPH. Methods. The open randomized controlled trial included 22 inoperable CTEPH patients (aged (Me (25%; 75%)) 48,3 (38,4; 59,5) years; 63.6% females; 9.1% with WHO functional class (FC) IV, 72.7% with WHO-FC III, 18.2% with WHO-FC II; 6-minute walking test (6-MWT) distance of 348 (145; 443) m; mean pulmonary artery pressure (mPAP) of 41.8 (29.3; 52.8) mmHg; tricuspid annular plane systolic excursion (TAPSE) of 16.3 (14.5; 18.2) mm; plasma NT-proBNP of 853.8 (562.2; 1124.2) pg/mL). The patients were enrolled 3 – 6 months after acute pulmonary embolism and were randomized 1:1 to receive either standard therapy with vitamin K antagonists and, if indicated, oxygen and diuretics or inhaled iloprost 5.0 µg / inhalation 4 times a day for 2 weeks every 3 months for 2 years in addition to the standard of care. Efficacy endpoints included changes from baseline in 6-MWT, WHO-FC, echo-parameters, inflammatory markers, time to clinical worsening, and all-cause mortality. Results. At baseline (prior to therapy), there were no significant differences between iloprost and control groups. Levels of C-reactive protein and the interleukin (IL)-1b, IL-6, IL-8, γ-IF, and TNF-α cytokines were increased. At month 24, a mean 6-MWT distance increased by 215 m (p < 0.001) in the patients receiving inhaled iloprost and by 137 m in the control patients (p < 0.01). The control-adjusted difference was +78 m (p = 0.03). WHO-FC improved by two classes in 63.6% in iloprost group vs 0% in the control group (p = 0.028), by one class in 36.4% vs 30% (p = 0.091), and remained the same in 0% vs 70 % (p = 0.018), respectively. Inhaled iloprost delayed the time to clinical worsening (p = 0.0064). Improvements were noted in control-adjusted changes in ePASP (–18.6 mmHg; p = 0.0065), TAPSE (+2.4 mm; p = 0.028), and plasma NT-proBNP (–256.9 pg/mL; p < 0.01). The levels of inflammation decreased significantly in the iloprost group, while remained unchanged in the control group. Combination therapy with inhaled iloprost was tolerated well. One patient died in the control group (p = 0.093). Conclusion. Long-term intermittent inhaled iloprost for patients with inoperable CTEPH may improve their clinical status, hemodynamics, and anti-inflammatory status.Специфическая лекарственная терапия легочной артериальной гипертензии (ЛАГ) может играть важную роль у неоперабельных пациентов с хронической тромбоэмболической (ХТЭ) легочной гипертензией (ЛГ). Число препаратов, относящихся к ЛАГ-специфической терапии и рекомендованных для лечения ХТЭ ЛГ, ограничено, поэтому является актуальным анализ длительного использования ЛАГспецифических препаратов при неоперабельной ХТЭ ЛГ. Целью работы явилась оценка эффективности и безопасности интермиттирующего режима применения ингаляционного илопроста у пациентов с неоперабельной ХТЭ ЛГ. Материалы и методы. В открытое рандомизированное контролируемое исследование включены неоперабельные пациенты с ХТЭ ЛГ (n = 22: 63,6 % – женщины; возраст – 48,3 (38,4; 59,5) года; медиана (Me) возраста – 25–75 %). ЛГ IV функционального класса (ФК) по классификации Всемирной организации здравоохранения (ВОЗ) отмечена у 9,1 % больных, III – у 72,7 %, II – у 18,2 %; дистанция при выполнении 6-минутного шагового теста (6-МШТ) составила 348 (145; 443) м; среднее давление в легочной артерии – 41,8 (29,3; 52,8) мм рт. ст.; плоскость систолической экскурсии трикуспидального кольца (ПСЭТК) – 16,3 (14,5; 18,2) мм; уровень N-концевого фрагмента предшественника мозгового натрийуретического пептида плазмы (NT-proBNP) – 853,8 (562,2; 1 124,2) пг / мл. Через 3–6 мес. после острой тромбоэмболии легочной артерии (ТЭЛА) пациенты были рандомизированы 1 : 1 в 2 группы: больные 1-й группы получали стандартную терапию антагонистами витамина К и по показаниям – кислород и диуретические препараты, 2-й – илопрост 5,0 мкг ингаляционно 4 раза в день в течение 2 нед. каждые 3 мес. в течение 2 лет в комбинации со стандартным лечением. Критериями эффективности являлись изменения дистанции при выполнении 6-МШТ, ФК по ВОЗ, эхокардиографические параметры, воспалительные маркеры, время до клинического ухудшения и летальность от всех причин. Результаты. Исходно (до начала терапии ЛГ) существенных различий между группами не отмечалось, однако наблюдалось повышение уровней С-реактивного белка и провоспалительных цитокинов – интерлейкина (IL)-1β, IL-6, IL-8, интерферона-γ и фактора некроза опухоли-α. Через 24 мес. у больных, получавших илопрост (n = 11), средняя дистанция 6-МШТ увеличилась на 215 м (p < 0,001); у пациентов контрольной группы (n = 11) – на 137 м (p < 0,01), межгрупповая разница составила +78 м (p = 0,03). ФК по ВОЗ ЛГ улучшился на 2 класса у 63,6 % больных 2-й группы (илопрост) vs 0 % – у пациентов контрольной группы (p = 0,028), на 1 класс – у 36,4 % vs 30 % (p = 0,091), остался без изменений – у 0 % vs 70 % (p = 0,018) соответственно. При назначении ингаляционного илопроста отмечено увеличение времени до клинического ухудшения ЛГ (p = 0,0064). Также отмечены улучшения в сравнительной разнице динамики расчетного систолического давления в легочной артерии (–18,6 мм рт. ст.; p = 0,0065), ПСЭТК (+2,4 мм; p = 0,028) и NT-proBNP (–256,9 пг / мл; p < 0,01). Уровни показателей воспаления существенно снизились у получавших илопрост и остались без изменений – в контрольной группе. Комбинированная терапия ингаляционным илопростом хорошо переносилась больными. В контрольной группе отмечен 1 летальный исход (p = 0,093). Заключение. При длительной интермиттирующей терапии ингаляционным илопростом у пациентов с ХТЭ ЛГ отмечено улучшение клинического и противовоспалительного статуса и гемодинамических показателей

Approaches to the therapy of heart failure with reduced ejection fraction. Resolution of an online meeting of the Volga Federal District experts

At an online meeting of experts held on May 14, 2021 additional research results on a sodium-glucose co-transporter-2 (SGLT2) inhibitor empagliflozin in patients with heart failure with reduced ejection fraction were considered. According to the data from the EMPEROR-Reduced international study, cardiovascular and renal effects of empagliflozin therapy in patients with and without type 2 diabetes (T2D) were analyzed. A number of proposals and recommendations was accepted regarding the further study of cardiovascular and renal effects of empagliflozin and its use in clinical practice in patients with heart failure, regardless of the T2D presence

Influence of socioeconomic factors on pregnancy outcome in women with structural heart disease

OBJECTIVE: Cardiac disease is the leading cause of indirect maternal mortality. The aim of this study was to analyse to what extent socioeconomic factors influence the outcome of pregnancy in women with heart disease.  METHODS: The Registry of Pregnancy and Cardiac disease is a global prospective registry. For this analysis, countries that enrolled ≥10 patients were included. A combined cardiac endpoint included maternal cardiac death, arrhythmia requiring treatment, heart failure, thromboembolic event, aortic dissection, endocarditis, acute coronary syndrome, hospitalisation for cardiac reason or intervention. Associations between patient characteristics, country characteristics (income inequality expressed as Gini coefficient, health expenditure, schooling, gross domestic product, birth rate and hospital beds) and cardiac endpoints were checked in a three-level model (patient-centre-country).  RESULTS: A total of 30 countries enrolled 2924 patients from 89 centres. At least one endpoint occurred in 645 women (22.1%). Maternal age, New York Heart Association classification and modified WHO risk classification were associated with the combined endpoint and explained 37% of variance in outcome. Gini coefficient and country-specific birth rate explained an additional 4%. There were large differences between the individual countries, but the need for multilevel modelling to account for these differences disappeared after adjustment for patient characteristics, Gini and country-specific birth rate.  CONCLUSION: While there are definite interregional differences in pregnancy outcome in women with cardiac disease, these differences seem to be mainly driven by individual patient characteristics. Adjustment for country characteristics refined the results to a limited extent, but maternal condition seems to be the main determinant of outcome

Thermograms of High-Frequency Capacitive Discharge Between Solid and Liquid Electrodes

© 2018, Pleiades Publishing, Inc. Abstract: We present the experimental results on thermograms and plots of temperature distributions along the streamer and spark discharges in a high-frequency capacitive field between solid and liquid electrodes for different electrode geometries