Omega-3 polyunsaturated fatty acids in the prevention of postoperative atrial fibrillation in open heart surgery: a systematic review and meta-analysis

Aim. To evaluate the literature data on the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of postoperative atrial fibrillation (POAF) in elective cardiac surgery, including onor off-pump coronary artery bypass grafting and/or valve replacement and/or repair.Material and methods. The search for studies was carried out using the PubMed database and Google Scholar from 2005 to January 31, 2022. From the initially identified search results, 19 articles were analyzed. The design of articles corresponded to randomized clinical trials. Omega-3 PUFAs was selected as an interventional effect. The studies were to include, as an end point, the assessment of new POAF cases in the early period after open heart surgery.Results. The meta-analysis included 15 studies with 3980 patients, of which 1992 (50,0%) patients took omega-3 PUFAs. POAF occurred in 587 (29,5%) patients receiving omega-3 PUFAs and 679 (34,2%) patients on standard therapy (hazard ratio, 0,8, 0,68-0,93, p=0,004). There is a variation in effect size for POAF patients in the presented randomized clinical trials relative to the axis of the central trend and heterogeneity of studies with a significant number of patients included (I2=51%, p=0,01).Conclusion. Our systematic review and meta-analysis showed the effectiveness of omega-3 PUFAs in the prevention of POAF during open heart surgery

Марфаноидная внешност ь как фактор риска фибрилляции предсердий у пациенто в с о стеопорозом

Objective: to investigate the relationship between some signs of hereditary connective tissue disorders (HCTDs) as a Marfanoid appearance (MA) and the risk of atrial fibrillation (AF) in female patients with osteoporosis (OP).Subjects and methods. In 2014–2015, the investigation enrolled consecutively 104 women aged 58 to 70 years (mean age, 64.7±3.8 years) who had a verified diagnosis of primary OP and a body mass index of ≤25.0 kg/m2. The entries in the outpatient medical records and in the automated information system «Polyclinic» were retrospectively analyzed to divide the patients into 2 groups according to the sign of the documented diagnosis of AF. A study group consisted of 53 women (mean age, 65.6±5.2 years) with AF and OP; a control group included 38 patients (mean age, 64.9±4.7 years) with OP without AF; a control group comprised 38 patients (mean age, 65.1±3.9 years) without OP and AF. Anthropometric and phenotypical parameters and cardiovascular visceral signs were analyzed; the levels of transforming growth factor-β1 (TGFβ1) and interleukin (IL) 1β and 6 in the serum and those of deoxypyridinoline (DPD) in the urine were measured.Results. Analysis of the phenotypical signs of HCTDs in the patients with OP has shown that those with OP and AF have external signs of dysmorphogenesis and meet the criteria of MA. Statistically significant correlations were found between the frequency of MA signs and the magnitude of all cardiac morphometric parameters and the visceral signs of HCTDs in the study group. The serum levels of IL-1β, IL-6, and TGFβ1 in these patients were significantly higher than in the comparison and control groups. There was also a high correlation between the signs of MA and the content of DPD in the study group.Conclusion. The patients with OP and AF was found to have a statistically significant correlation of the phenotypical signs of dysmorphogenesis with the frequency of visceral signs of HCTD, the morphofunctional parameters of the heart, and the high concentration of cytokines and DPD. It may be suggested that there exists a genetically determined mechanism of connective tissue dysembryogenesis in OP, which is associated with the risk of AF.Цель исследования – изучение связи между отдельными признаками наследственных нарушений соединительной ткани (ННСТ) в виде марфаноидной внешности (МВ) и риском развития фибрилляции предсердий (ФП) у пациенток с остеопорозом (ОП).Материал и методы. В 2014–2015 гг. в исследование последовательно включены 104 женщины с верифицированным диагнозом первичного ОП в возрасте от 58 до 70 лет (средний возраст – 64,7±3,8 года) с индексом массы тела І25,0 кг/м2. Проведен ретроспективный анализ записей в медицинской карте амбулаторного больного, а также в автоматизированной информационной системе «Поликлиника» с целью разделения пациенток на две группы по признаку документально подтвержденного диагноза ФП. Основную группу составили 53 женщины с ФП и ОП (средний возраст – 65,6±5,2 года); группу сравнения – 51 женщина с ОП без ФП (64,9±4,7 года); группу контроля – 38 пациенток без ОП и ФП (65,1±3,9 года). Проанализированы антропометрические, фенотипические показатели, сердечно-сосудистые висцеральные признаки, определено содержание трансформирующего фактора роста β1 (TGFβ1), интерлейкина (ИЛ) 1β и 6 в сыворотке крови и дезоксипиридинолина (ДПИД) в моче.Результаты. Анализ фенотипических признаков ННСТ у больных ОП показал, что пациентки с ОП и ФП имеют внешние признаки дизморфогенеза и отвечают критериям МВ. Выявлены статистически значимые корреляционные связи между частотой признаков МВ и выраженностью всех морфометрических показателей сердца и висцеральными признаками ННСТ у пациенток основной группы. Содержание в сыворотке крови ИЛ1β, ИЛ6, TGFβ1 у этих пациенток было достоверно выше, чем у лиц групп сравнения и контроля. Также отмечена высокая корреляция между признаками МВ и содержанием ДПИД у пациенток основной группы.Заключение. У пациенток с ОП и ФП выявлена статистически значимая корреляция фенотипических признаков дизморфогенеза с частотой висцеральных признаков ННСТ, морфофункциональными показателями сердца, а также с высокой концентрацией цитокинов и ДПИД. Можно предположить, что при ОП имеется генетически детерминированный механизм дизэмбриогенеза соединительной ткани, сопряженный с риском развития ФП

Creating and observing N-partite entanglement with atoms

The Mermin inequality provides a criterion for experimentally ruling out local-realistic descriptions of multiparticle systems. A violation of this inequality means that the particles must be entangled, but does not, in general, indicate whether N-partite entanglement is present. For this, a stricter bound is required. Here we discuss this bound and use it to propose two different schemes for demonstrating N-partite entanglement with atoms. The first scheme involves Bose-Einstein condensates trapped in an optical lattice and the second uses Rydberg atoms in microwave cavities.Comment: 12 pages, 4 figure

Ionization of Rydberg atoms by blackbody radiation

We have studied an ionization of alkali-metal Rydberg atoms by blackbody radiation (BBR). The results of the theoretical calculations of ionization rates of Li, Na, K, Rb and Cs Rydberg atoms are presented. Calculations have been performed for nS, nP and nD states which are commonly used in a variety of experiments, at principal quantum numbers n=8-65 and at the three ambient temperatures of 77, 300 and 600 K. A peculiarity of our calculations is that we take into account the contributions of BBR-induced redistribution of population between Rydberg states prior to photoionization and field ionization by extraction electric field pulses. The obtained results show that these phenomena affect both the magnitude of measured ionization rates and shapes of their dependences on n. A Cooper minimum for BBR-induced transitions between bound Rydberg states of Li has been found. The calculated ionization rates are compared with our earlier measurements of BBR-induced ionization rates of Na nS and nD Rydberg states with n=8-20 at 300 K. A good agreement for all states except nS with n>15 is observed. Useful analytical formulas for quick estimation of BBR ionization rates of Rydberg atoms are presented. Application of BBR-induced ionization signal to measurements of collisional ionization rates is demonstrated.Comment: 36 pages, 16 figures. Paper is revised following NJP referees' comments and suggestion

Параметры периферической крови как маркеры неспецифического адаптационного ответа при острых инфекционных заболеваниях с синдромом тонзиллита

Evaluation of nonspecific adaptive response of the body in children with acute infectious diseases associated with tonsillitis syndrome was the aim of this research. This prospective study included clinical, anamnestic and laboratory examination of children with acute infectious diseases with tonsillitis syndrome. A systemic multiple factor analysis was conducted (significance level р<0.05). The evaluation of peripheral blood parameters (specific gravity of lymphocytes and indices of reactive protective potential (RPP) - specific immune lymphocytic-monocytic parameter (SILMP) and coefficient of phagocytic defense (CPD)) gives the possibility to determine the condition of nonspecific adaptation in children with acute infectious diseases associated with tonsillitis syndrome. Children with tonsillitis syndrome show significant increase of integral RPP parameters, i.e. decrease of RPP, which is more pronounced on discharge (on admission - in 57% of children, on discharge - in 87%). The most unfavourable initial nonspecific adaptative body response (NABR) (according to the percentage of lymphocytes) is the reaction of increased activation, as it is associated with the transition to the overactivation by the time of discharge (37% of children). Systemic multiple factor analysis determined which peripheral blood parameters have more influence on children’s adaptation during the course of infectious disease: RPP indices showed high influence coefficients in all diseases (CPD was the highest in bacterial infection - Рi 198.3; SILMP was the highest in viral infection - Рi 147.81; in mixed infection CPD and SILMP were roughly the same - Рi – 107.25 and Рi - 78.11, respectively), which proves the feasibility of RPP evaluation for prognostic purposes in the treatment of this category of patients.Целью настоящего исследования явилась оценка неспецифической адаптационной реакции организма у детей с острыми инфекционными заболеваниями, ассоциированными с синдромом тонзиллита. Данное проспективное исследование включало клинико-анамнестическое и лабораторное обследование детей с острыми инфекционными заболеваниями с синдромом тонзиллита. Проведен системный многофакторный анализ (уровень значимости р<0,05). Оценка показателей периферической крови (удельного веса лимфоцитов и показателей реактивно-протективный потенциал (РПП) - специфического иммунного лимфоцитарно-моноцитарного параметра (ИЛМП) и коэффициента фагоцитарной защиты (КФЗ) дает возможность определить состояние неспецифической адаптации у детей с острыми инфекционными заболеваниями, ассоциированными с синдромом тонзиллита. У детей с синдромом тонзиллита отмечается достоверное повышение интегральных показателей РПП, т. е. снижение РПП, которое более выражено при выписке (при поступлении - у 57% детей, при выписке - у 87%). Наиболее неблагоприятной исходной неспецифической адаптационной реакцией организма (по проценту лимфоцитов) является реакция повышенной активации, так как она связана с переходом к гиперактивации к моменту выписки (37% детей). Системный многофакторный анализ определил, какие показатели периферической крови оказывают большее влияние на адаптацию детей в течение инфекционного заболевания: показатели РПП показали высокие коэффициенты влияния при всех заболеваниях, что доказывает целесообразность оценки РПП в прогностических целях при лечении данной категории больных

Role of homocysteine metabolism in the development of endothelial dysfunction and hypertension in patients with multiple myeloma

The article is devoted to the modern understanding of endothelial dysfunction development, the role of hyperhomocysteinemia, and, as a consequence, hypertension in patients with multiple myeloma receiving multiagent chemotherapy. Considering that the potential of a standard examination does not allow identifying subclinical endothelial dysfunction, using specific techniques is necessary, in particular, to determine the homocysteine level to monitor the endothelial function.The aim of this review was to summarize the current understanding of hypertension etiology and prospects for detecting early, subclinical endothelial changes, including in patients with multiple myeloma.Assessment of endothelial dysfunction can be useful for detecting precisely the subclinical cardiovascular disease in order to stratify the risk of developing cardiovascular events in patients receiving multiagent chemotherapy

Genetic polymorphisms associated with the development of arrhythmic type of cardiovascular events

The review analyzes the global agenda on mutational status of genes associated with adverse cardiovascular events of arrhythmic type. Whole exome sequencing will identify a risk group for the likelihood of early or delayed cardiovascular events of arrhythmic type, especially among patients receiving anticancer therapy with cardiotoxic drugs. The dedicated up-to-date panel of genetic polymorphisms will provide an opportunity to optimize management of patients, based on not only clinical, paraclinical and anamnestic data

Omega-3 Polyunsaturated Fatty Acids: the Role in Prevention of Atrial Fibrillation in Patients with Coronary Artery Disease after Coronary Artery Bypass Graft Surgery

Aim. To estimate the role of omega-3 polyunsaturated fatty acids (PUFAs) administration in atrial fibrillation (AF) prevention after planned coronary artery bypass graft (CABG) surgery.Material and Methods. Studied were 306 patients divided into two groups: patients of group I didn’t receive PUFAs (158 patients, 82.7% males) and patients of group II received PUFAs (148 patients, 89.3% males). PUFAs were prescribed in daily dose 2000 mg 5 days before surgery and in daily dose 1000 mg in postoperative period during 21 days.Results. Postoperative AF (POAF) occurred in 29.7% patients in group I and in 16.9% patients in group II (р=0.009). We found that after CABG in patients of the I group median IL-6 level was 39.3% higher (p=0.001), interleukin-10 – 20.2% higher (p=0.01), superoxide dismutase – 78.9% higher (р<0.001), malondialdehyde – 33.8% higher (p=0.03), docosahexaenoic acid – 31.8% lower (p=0.01) and omega-3 index – 43.4%    lower (p=0.04) than in patients of the II group.According to multivariate regression analysis we found significant association between the factors of inflammation, oxidative stress and the risk POAF development.Conclusions. In patients who took PUFAs, we found less activation of inflammation, oxidative stress, the increasing of docosahexaenoic acid and omega-3 index accompanied by the decreasing of POAF development rates up to 12.8%

The problem of the processes research of microcirculation blood rheology in the internal diseases’ clinic

Тhe issues of studying the processes of microcirculalion and blood rtiecriogy in the clinic of internal diseases were studied. Modem data from researchers on the study of mtoocralatay and hemorheological disorders in patients with various pathologies of internal organs are presented. The mail regiianbes of regulatory mechanisms and methods of clinical and functional assessment of the microvasculature and theological properties of blood are reflected. Indicators of the state of the microvasculature and the theological properties of blood can serve as prognostic criteria not only in assessing the disease itself.but also in assessing the risk ofthrombotic and other complicalions in the cfeiic of internal diseases.В статье рассмотрены вопросы изучения процессов микроциркуляции и реологии крови в клинике внутренних болезней. Представлены современные данные ряда исследователей по изучению микроциркуляторных и гемореолотческих нарушений у пациентов с различными патологиями внутренних органов. Отражены основные закономерности регуляторных механизмови методы клинико-функциональной оценки состояния микроциркуляторного русла и реологических свойств крови. Показатели состояния микроциркуляторного русла и реологических свойств крови могут служить прогностическими критериями не только для оценки течения основного заболевания, но и при анализе рисков кардио-васкулярных осложнений в клинике внутренних болезней