Hematological parameters of rheumatoid arthritis patients undergoing total hip replacement

Abstract. Background Patients with rheumatoid arthritis (RA) and baseline anemia may have an increased risk of complications after total hip replacement (THR). Inflammation in RA is the main factor manifesting anaemia, neutropenia, thrombocytosis and eosinophilia. The changes in blood components are important for the outcomes of major orthopaedic surgery. The purpose was to identify hematological parameters in RA patients undergoing THR and assess the effect on intraoperative blood loss. Material and methods Outcomes of 44 THR patients treated for grade III degenerative coxarthrosis (n = 21, OA group) and RA coxarthrosis (n = 23, RA group) in Ekaterinburg regional hospital № 1 between 2018 and 2019 were reviewed. The patients' age ranged from 41 to 70 years. Clinical, radiological, laboratory examinations, computed tomography and statistical analysis were used for the study. Cell counting was produced with the Sysmex XT-4000i automated hematology system. Statistical analysis was performed using the tools of Statistica software. Nonparametric Mann-Whitney test was used to compare cell counts between the groups. The Spearman Rank correlation was used to analyse the correlation between the the cell counts in the groups. For calculations, a significance level of р < 0.05 was adopted. Results There were no significant differences in the preoperative white blood cell (WBC), neutrophil, lymphocyte, monocyte, eosinophil counts between RA and OA groups. The RA group showed an evident decrease in red blood cell (RBC) count and haemoglobin level as compared to OA group. The RA group demonstrated the higher platelet count with mean platelet volume (MPV) being significantly lower than that in the OA group. WBC count, neutrophils, in particular, was shown to increase with lymphocyte, RBC, platelet count and hemoglobin, plateletcrit levels decreased at 24 hours postoperatively. There were no significant differences in WBC and RBC counts in the groups postoperatively. The differences in the MPV were leveled up in the groups with the platelet count being higher in the RA group as compared to the OA group. Conclusions Hematological parameters of RA patients who had undergone specific preoperative preparation were not shown to be associated with greater blood loss during hip replacement surgery. The leukocyte count leveled up in the preoperative and early postoperative periods can be indicative of the absence of a significant effect of RA on the postoperative inflammation

The first TIPS surgery performed in the Udmurt Republic in a young patient with secondary biliary cirrhosis

Treatment of patients with iatrogenic injuries of the biliary tract is the most difficult and important section in hepatobiliary surgery. When analyzing the causes, it was found that in 70–94 % of cases this type of injury is observed during cholecystectomy. We present a rare clinical case of the development of secondary biliary cirrhosis due to iatrogenic trauma of the biliary tract. This injury caused long-term suffering for the patient due to the further development of complications of cirrhosis, specifically of portal hypertension. The latter caused repeated recurrent profuse bleeding from varicose veins of the esophagus. The use of a minimally invasive transjugular intrahepatic portosystemic shunt procedure for the first time in the Udmurt Republic was of particular relevance in solving this problem. This procedure has become a key one in solving the abovementioned problems and will become the preventive measure for the cirrhosis progression in the future. It is also important to focus on prophylactic measures aimed at preventing iatrogenic injuries of the biliary tract, as this problem can cause irreversible complications. Prevention should include adequate examination and visualization of the bile ducts and gallbladder before surgery, their careful mobilization, compliance with the rules of operation with electrosurgical instruments, as well as the use of additional minimally invasive techniques such as choledoscopy, cholangiography and intraoperative ultrasound. Besides that, all manipulations should be carried out under strict control and clear visualization of instruments and anatomical structures of organs. The article provides a detailed description of the technique of transjugular intrahepatic portosystemic shunt surgery, as well as presents X-ray images obtained during this operation

The Relationship of Emotional Intelligence and Cohesion in the Girls’ Synchronized Figure Skating Team

Рукопись поступила в редакцию: 09.09.2023. Принята к публикации: 23.10.2023.Received: 09.09.2023. Accepted: 23.10.2023.Цель исследования заключалась в том, чтобы выявить влияние эмоционального интеллекта на сплоченность в спортивной команде девушек, занимающихся синхронным фигурным катанием. В исследовании были применены следующие психологические тесты: тест «Эмоциональный интеллект» Д. В. Люсина, тест для определения индекса групповой сплоченности Сишора. Исследование проводилось на базе спортивной школы «Юность» в г. Екатеринбурге. В эксперименте приняло участие 2 команды разных возрастных групп: 16 спортсменок, выступающих в разряде «новисы» (12–15 лет), 16 девушек выступающих в команде «КМС» (15–19 лет). Тестирование проводилось два раза: в начале и после соревновательного сезона. В ходе исследования выявлена положительная динамика развития сплоченности в обеих командах, выявлены достоверные взаимосвязи между межличностным эмоциональным интеллектом и уровнем сплоченности в коллективе. Дальнейшие исследования могут быть направлены на разработку стратегии повышения эмоционального интеллекта как фактора повышения сплоченности спортивного коллектива.The aim of the study was to determine the relationship between emotional intelligence and cohesion in a sports team of girls engaged in synchronized figure skating. The following psychological tests were used in the study: the Emotional Intelligence test by D. V. Lyusin, a test to determine the index of group cohesion of the Sisor. The study was conducted on the basis of the sports school “Yunost” in Yekaterinburg. Two teams of different age groups took part in the experiment: 16 athletes performing in the category of “novices” (12–15 years old), 16 girls performing in the team of “CMS” (15–19 years old). Testing was conducted twice: at the beginning of the season and after the competitive season. The study revealed positive dynamics of the development of cohesion in both teams. It also revealed reliable relationships between interpersonal emotional intelligence and the level of cohesion in the team. Further research may be aimed at developing a strategy to increase emotional intelligence as a factor in increasing the cohesion of a sports team

Acute myocardial damage in new coronavirus infection (COVID-19)

Introduction. Acute respiratory distress syndrome (ARDS) and cardiovascular events, acute myocardial injury being the most frequent of the latter, are among the leading causes of death in COVID-19 patients. The lack of consensus on acute myocardial injury pathogenesis mechanisms, the patients management, treatment an rehabilitation logistics, the anticoagulant treatment in identified SARS-CoV-2 or suspected COVID-19 patients setting indicates the need to assess, analyze and summarize the available data on the issue.Введение. Острый респираторный дистресс-синдром и сердечно-сосудистые осложнения, наиболее частым из которых является острое повреждение миокарда (ОПМ), занимают ключевое место в структуре причин смерти больных с новой коронавирусной инфекцией. Отсутствие единого мнения о механизмах развития острого поражения миокарда, обоснованной тактики ведения пациентов с ОПМ, применении антикоагулянтной терапии у лиц с идентифицированным SARS-CoV-2 или подозрением на COVID-19 отражают необходимость поиска, анализа и обобщения имеющихся литературных данных по данной проблем

Predictors of hypertension in women with rheumatoid arthritis

Aim. To determine the set of significant risk factors for arterial hypertension (AH) in women with rheumatoid arthritis (RA).Material and methods. The study included two groups of patients with RA: group 1 — women with AH (n=162), group 2 women without AH (n=61). Clinical, laboratory, instrumental examination of patients and determination of risk factors (RF) for cardiovascular diseases (CVD) in RA were provided according to Association of Rheumatologists of Russia (ARR 2017) and the Russian Society of Cardiology (RSC, 2017) guidelines. Salt taste sensitivity threshold (STST) was studied with R. J. Henkin’s modified method. The analysis of the internal body fluids was made with bioimpedance analysis. The glomerular filtration rate (GFR) was estimated with MDRD equation (K/DOQI, 2002). Statistical data were obtained with “Statistica 10” software. Logit regression analysis was used to identify the correlation between RF and AH.Results. The predictors of AH in RA were: age over 55 years (p=0,001), early menopause (p=0,001), increased total blood cholesterol (р=0,001), prednisolone intake more than 10 mg/day (p=0,001), early family history of CVD (p=0,01), decreased GFR less than 60 ml/min/1,73 m. (p=0,01), high STST (p=0,01), unbalanced nutrition (p=0,01), pregnancy pathology (p=0,01), high activity of the inflammatory process (p=0,01), psychosocial factors (stress, anxiety, depression) (p=0,01), obesity (p=0,01), duration of RA more than 10 years (p=0,01). There were 2 times more salt-sensitive patients among women with RA and AH than those with RA and without AH (87 and 48%, respectively). Increased fluid in the body was observed with decreased natriuresis; it implied the presence of volume-dependent hypertension (VDH).Conclusion. The study demonstrated the significance of determining the set of predictors such as cardiometabolic, gender, psychosocial, disease-mediated, renal ones. The importance of STST in RA is evident. The information about AH predictors allows to create individual recommendations to correct modifiable RF and prescribe therapy for women with RA. The conducted research will enable to optimize the follow-up process of the patients and reduce the mortality from cardiovascular complications

State of target organs in young people with high-normal arterial pressure and untreated essential arterial hypertension

Objective of the study was to assess hypertension-mediated organ condition in young people with high normal blood pressure (HNBP) and with hypertension. Material and methods. The study included 112 patients with HNBP or hypertension, aged 25–44. The glomerular filtration rate (eGFR) was estimated according to the CKD-EPI formula for serum creatinine (eGFRcre) and cystatin C content. Microalbuminuria was established in a daily urine sample. Patients underwent echocardiography and dopplerography examination, duplex scanning of the brachiocephalic arteries. Results. eGFRCre in the range of 89–60 ml/min/1.73 m2 was observed in 37.1 % patients. There were no cases of a decrease eGFRCre less than 60 ml/min/1.73 m2. Renal hyperfiltration (eGFRcre) was detected in 10.3 % examined persons. eGFR by cystatin C content allowed to determine 23 % (p = 0.02) more cases of decreased renal function within 89-60 ml/min/1.73 m2, than eGFRcre. Also, patients with eGFR less than 60 ml/min/1,73 m2 were identified. Renal hyperfiltration was found to be 2 times more (p = 0.002) in patients with HNBP than in patients with hypertension, and frequency of decreasing eGFR below 60 ml/min/1.73 m2 was 11 % less (p <0.050). Microalbuminuria more than 30 mg/day was detected only in patients with hypertension. It was found concentric remodeling was more common in patients with hypertension (p = 0.02), a concentric type of left ventricular hypertrophy was detected only in patients with hypertension, patients did not differ in the frequency of eccentric left ventricular hypertrophy. Patients with HNBP and arterial hypertension had a comparable frequency of increasing arterial thickness. Conclusion. Young patients with high normal blood pressure have signs of organ damage, often hyperfiltration and an increase in the thickness of arteries. Revealed changes indicate the need to identify this category of people and develop preventive and/ or therapeutic practices

Risk factor prevalence and target organ damage in working-age men with stress-induced arterial hypertension

Aim. To investigate risk factors (RF) and target organ damage (TOD) prevalence in working-age men with stressinduced arterial hypertension (AH). Material and methods. The study included 100 males, working as machinists and machinist assistants, with blood pressure (BP) above 140/90 mm Hg. Control group included males working as railway assemblers (n=40). General physical, laboratory, and instrumental examinations were performed, including psycho-mental test (PMT). Results. TOD was quite prevalent among normotensive males. Twenty-four hour BP monitoring (BPM) demonstrated the difference in mean BP levels at workplace and during weekend, that confirmed stress-induced AH diagnosis. Psychoemotional stress tests are highly sensitive in stress reactivity assessment among individuals with high professional stress levels. These tests can help in identifying AH risk groups. Conclusion. For early diagnostics and adequate therapy choice in patients with high psychoemotional stress levels, not only RF and TOD control, but also 24-hour BPM at workplace and during weekend, and PMT, are necessary