АССОЦИАЦИИ НЕКОТОРЫХ ВАРИАБЕЛЬНЫХ САЙТОВ ГЕНА АРОЕ С КЛИНИКО-АНАМНЕСТИЧЕСКИМИ ХАРАКТЕРИСТИКАМИ ТЯЖЕЛОГО ТЕЧЕНИЯ ИНФАРКТА МИОКАРДА С ПОДЪЕМОМ СЕГМЕНТА ST

Purpose. To evaluate the association between polymorphisms APOE rs7412+rs429358 and traditional risk factors for CHD in patients with myocardial infarction with ST-segment elevation.Materials and Methods. 358 patients admitted with STEMI and undergoing diagnosis and treatment at the Kemerovo Cardiology Clinic were included in the study. Blood samples were collected at days 2–14 for genotyping. Clinical and demographic data, laboratory and instrumental findings were assessed. Data analysis was performed using the STATISTICA program (version 8.0; StatSoft, Tulsa, Oklahoma) and SPSS Statistics 17.0.Results. The carriers of the e4 allele of gene APOE was associated with adverse anamnestic characterisics, such as myocardial infarction in anamnesis, severe chronic heart failure and prior angina. The carriers of the e4 allele had a higher level of LDL and severe coronary arterial sclerotic disease (SYNTAX ≥23 score (OR=2.10, 95 % CI=1.26–3.51, p=0.005). The carriers of the e4 allele had signs of multifocal atherosclerosis (OR=2.44, 95 % CI=1.17–5.12, p=0.02) and reduction of left ventricular ejection fraction less 40 % (OR=5.25, 95 % CI=1.06–27.39, p=0.04).Conclusion. Was demonstrated, that gene APOE associated not only with lipid metabolism disorders, but also to the clinical criteria of severe STEMI and can to be used as a marker adverse clinical progression of STEMI.Цель. Изучить связь генетического полиморфизма rs7412+rs429358 АРОЕ с наличием факторов риска ишемической болезни сердца, нарушений липидного обмена и тяжестью течения инфаркта миокарда.Материалы и методы. В исследование были включены 358 пациентов, поступивших с диагнозом ИМ с подъемом сегмента ST в Кемеровский кардиологический диспансер (ККД) с января по декабрь 2010 года. Всем пациентам при поступлении проводились коронароангиография (КАГ), общий анализ крови, липидограмма крови, электрокардиография (ЭКГ), эхокардиография (ЭХОКГ), для оценки наличия мультифокального атеросклероза – ультразвуковое цветное дуплексное сканирование (ЦД С) брахиоцефальных артерий. На 2–14-е сутки был проведен забор крови с последующим генотипированием полиморфизма rs7412+rs429358 гена АРОЕ. Оценивались анамнестические, клинические, лабораторные и инструментальные показатели в течение госпитализации. Статистическая обработка материала осуществлялась с помощью программ STATISTICA 8.0 for Windows компании StatSoft, Inc (USA) и SPSS Statistics 17.0.Результаты. Наличие аллеля е4 гена АРОЕ коррелировало с неблагоприятными анамнестическими характеристиками, такими как наличие постинфарктного кардиосклероза, предшествующих инфаркту миокарда стенокардии и хронической сердечной недостаточности высоких функциональных классов. Также у носителей аллеля е4 наблюдались более высокие концентрации липопротеинов низкой плотности (ЛПНП) крови. Наличие тяжелого поражения коронарных артерий (SYNTAX ≥23 баллам) ассоциировалось с наличием аллеля е4 (ОШ=2,10; 95 % ДИ=1,26–3,51; р=0,005). У пациентов, имеющих аллель е4 гена АРОЕ, чаще встречались признаки мультифокального атеросклероза (ОШ=2,44; 95 % ДИ=1,17– 5,12; р=0,02), а также чаще наблюдалось снижение фракции выброса левого желудочка (ФВ ЛЖ) менее 40 % при поступлении в стационар (ОШ=5,25; 95 % ДИ=1,06–27,39; р=0,04).Заключение. Выявлено, что ген АРОЕ ассоциируется не только с нарушениями липидного обмена, но и с клиническими критериями неблагоприятного течения ИМ, что может использоваться для уточнения клинической тяжести ИМ

Клиническая эффективность преабилитации у пациентов, подвергшихся коронарному шунтированию

Aim. To evaluate clinical efficacy of high-intensity exercise training included in the prehabilitation program for elective coronary artery bypass grafting (CABG).Methods. 38 male patients were included in the study before on-pump CABG. After fulfilling the inclusion/exclusion criteria, patients were randomized into two groups: Group 1 patients (n = 20) underwent supervised treadmill exercise, and Group 2 patients (n = 18) were referred to surgery without any exercise training. Patients underwent a 7-day exercise training with daily measurements of hemodynamic parameters and electrocardiogram (ECG) monitoring. The load intensity was measured with cardiopulmonary exercise testing and accounted for 80% of the maximal oxygen uptake. Postoperative complications were recorded in the in-hospital period and analyzed. Quality of life indicators were measured by the SF-36 standard version 7–10 days prior to surgery and on days 7-10 of the postoperative period. Adherence to drug and non-drug therapy was assessed during the 6-month follow-up.Results. There was a significantly lower incidence of postoperative complications during the in-hospital period in patients undergoing prehabilitation program with supervised high-intensity exercise training, compared with patients without any exercise training (p = 0.002). Group 1 patients had reliably better mental health (MH) scores compared with Group 2 patients (48.9±7.60 vs. 39.1±6.80 scores, respectively; p = 0.03) on days 7–10 after CABG. Six months after the CABG, patients who underwent prehabilitation exercise training were less likely to resume smoking than patients without any exercise training (p = 0.04). The tendency towards improved adherence to drug therapy and compensation in arterial hypertension has been determined among Group 1 patients.Conclusion. Exercise training included in the prehabilitation program proved to be safe and effective in terms of improved clinical outcomes after CABG, quality of life and adherence to treatment in this group of patients.Цель. Оценить клиническую эффективность включения физических тренировок высокой интенсивности в программу преабилитации пациентов перед коронарным шунтированием (КШ).Материалы и методы. В исследование включено 38 пациентов мужского пола перед КШ в условиях искусственного кровообращения. После оценки критериев включения и исключения пациенты были рандомизированы на две группы: группа 1 (n = 20) с включением контролируемых тренировок на тредмиле и группа 2 (n = 18) без включения физических тренировок. Тренировки проводились под контролем параметров гемодинамики и мониторированием электрокардиограммы ежедневно в течение 7 дней. Интенсивность нагрузки определялась по показателям кардиопульмонального нагрузочного теста и составляла 80% от максимального потребления кислорода. Анализ послеоперационных осложнений проводился в госпитальном периоде, оценка показателей качества жизни выполнялась с помощью стандартного опросника SF-36 за 7–10 суток до операции и в послеоперационном периоде на 7–10-е сутки. Параметры приверженности к медикаментозной и немедикаментозной терапии оценивались в течение 6 месяцев после операции.Результаты. В группе пациентов с включением контролируемых физических тренировок высокой интенсивности в программу преабилитации отмечена значимо более низкая частота развития послеоперационных осложнений в госпитальном периоде по сравнению с пациентами без использования физических тренировок (р = 0,002). Пациенты группы физических тренировок перед операцией имели значимо лучшие значения при оценке психологического компонента здоровья (MH) по сравнению с группой без использования физических тренировок (48,9±7,60 и 39,1±6,80 баллов соответственно; р = 0,03) на 7–10 сутки после КШ. Через 6 месяцев после операции среди пациентов с активной программой преабилитации достоверно реже встречались курильщики по сравнению с пациентами без тренировок (р = 0,04), а также отмечалась тенденция к улучшению приверженности к медикаментозной терапии и достижению компенсации артериальной гипертензии.Заключение. Продемонстрирована безопасность и эффективность включения физических тренировок в программу преабилитации с позиции улучшения клинических исходов КШ, а также повышения показателей качества жизни и приверженности к лечению данной категории пациентов

Revisiting the Relationship Between Fault Detection,Test Adequacy Criteria, and Test Set Size

The research community has long recognized a complex interrelationship between test set size, test adequacy criteria, and test effectiveness in terms of fault detection. However, there is substantial confusion about the role and importance of controlling for test set size when assessing and comparing test adequacy criteria. This paper makes the following contributions: (1) A review of contradictory analyses of the relationship between fault detection, test suite size, and test adequacy criteria. Specifically, this paper addresses the supposed contradiction of prior work and explains why test suite size is neither a confounding variable, as previously suggested,nor an independent variable that should be experimentally manipulated. (2) An explication and discussion of the experimental design and sampling strategies of prior work, together with a discussion of conceptual and statistical problems, and specific guidelines for future work. (3) A methodology for comparing test-adequacy criteria on an equal basis, which accounts for test suite size by treating it as a covariate. (4) An empirical evaluation that compares the effectiveness of coverage-based and mutation-based testing to one another and random testing. Additionally, this paper proposes probabilistic coupling, a methodology for approximating the representativeness of a set of test goals for a given set of real fault

Syntactic processing in Turner's syndrome

A significant controversy concerning language development in Turner's syndrome has been found. Whereas some authors have observed that girls with Turner's syndrome maintain their verbal abilities intact, others have reported significant differences in Wechsler Verbal IQ when compared with normal controls. However, little has been studied about the linguistic characteristics of these patients when using tests to evaluate different linguistic levels. With the aim of assessing syntactic processes, 15 patients with Turner's syndrome (aged 8 to 19 years) were compared with 15 healthy girls, matched by age, Wechsler Full-Scale IQ range, type of school (private or public), and school grade. A syntactic processing battery including 11 different subtests was developed. Compared with controls, the participants with Turner's syndrome obtained a fewer number of correct answers in most of the subtests and shorter latencies in some of them. We concluded that the subjects with Turner's syndrome have difficulties in using syntactic structures. It is suggested that some of these language difficulties are related to disturbances in using spatial-language relationships

Syntactic processing in Turner's syndrome

A significant controversy concerning language development in Turner's syndrome has been found. Whereas some authors have observed that girls with Turner's syndrome maintain their verbal abilities intact, others have reported significant differences in Wechsler Verbal IQ when compared with normal controls. However, little has been studied about the linguistic characteristics of these patients when using tests to evaluate different linguistic levels. With the aim of assessing syntactic processes, 15 patients with Turner's syndrome (aged 8 to 19 years) were compared with 15 healthy girls, matched by age, Wechsler Full-Scale IQ range, type of school (private or public), and school grade. A syntactic processing battery including 11 different subtests was developed. Compared with controls, the participants with Turner's syndrome obtained a fewer number of correct answers in most of the subtests and shorter latencies in some of them. We concluded that the subjects with Turner's syndrome have difficulties in using syntactic structures. It is suggested that some of these language difficulties are related to disturbances in using spatial-language relationships

In Situ XPS Studies of Solid Electrolyte Electroreduction Through Graphene Electrode

The current interest in research and development of solid electrolytes for battery systems dictates a necessity to evaluate their electrochemical stability in a wide potential range. It is supposed that the stability and properties of the interface formed between the electrode and solid electrolyte at the applied potential (the analog of solid electrolyte interphase (SEI) in liquid electrolytes) are of great importance for the battery operation. While the electrochemical techniques can provide the knowledge of a stability window of the solid electrolyte, a direct method, which helps to trace chemical changes, is still missing, due to the difficulty to reach the interface between the solid electrolyte and thick electrode material. In this paper, we propose to use two-layer graphene transferred directly on the solid electrolyte as the electrode transparent for photoelectrons. Such an electrode is thin enough to probe the interface by X-ray photoelectron spectroscopy to trace the occurring chemical changes. To demonstrate this possibility, we have investigated the electrochemical reduction of Li1.5Al0.5Ge1.5(PO4)3 (LAGP) glass-ceramic electrolyte by in situ XPS

EFFICACY OF PHYSICAL TRAININGS AS CARDIOPROTECTION METHOD FOR CORONARY BYPASS SURGERY

Aim. To assess efficacy and safety of inclusion of physical trainings to the program of patients prehabilitation before coronary bypass (CBG) on-pump, from the perspective of cardioprotection.Material and methods. Totally, 38 patients included, randomized to 2 group depending on prehabilitation program. Group 1 patients (n=20, mean age 57,9±7,2 y. o.) at the stage of prehabilitation, underwent serial physical trainings of high intensity; in group 2 (n=18, mean age 60,4±7,01 y. o.) there were none. Evaluation of the target parameters of myocardial perfusion was done before the training and in post-operation period with single photon emission tomography (SPECT).Results. In the group with included exercises, during post-surgery period there was significantly higher level of radiopharmacological marker capture comparing to nontrained group in some basal segments (74,9±3,98% and 70,3±7,40%, respectively, р=0,04), middle (86,7±5,24% and 79,6±10,43%, resp., р=0,03) and apical (85,8±5,03% and 79,0±8,67%, resp., р=0,02) portions of myocardium, by SPECT. Integral value of the stress-induced temporary ischemia (SDS) after CBG in training group was significantly lower than in non-training group (0 and 0,9±0,53 pts., resp., р=0,04). Dynamics analysis of the parameters of myocardial perfusion demonstrated significant decrease of the parameter characterizing perfusion defect with adenosin load (SSS) (р=0,013), and SDS (р=0,018) in the group of exercises after operation comparing to pre-operational values. In non-training group the dynamics was nonsignificant.Conclusion. According to the data obtained, inclusion of physical trainings of high intensity to the program of prehabilitation of patients before CBG leads to improvement of myocardial perfusion parameters in post-operation period, that possibly optimizes the outcomes of surgery

THE RELATIONSHIP BETWEEN PSYCHOLOGICAL CHARACTERISTICS OF THE ATTITUDE TO THE DISEASE, COPING BEHAVIOR OF PATIENTS WITH ISCHEMIC HEART DISEASE, AND THEIR COGNITIVE STATUS

The paper presents the study of the relationship between the attitude to the disease, coping behavior of patients with coronary heart disease prior to coronary bypass grafting (CABG), and indicators of cognitive status. Bekhterev Institute Personality Questionnaire, Ways of Coping Behavior test by R. Lazarus, Mini-Mental State Examination scale, Frontal Dysfunction Battery test, and Clock- Drawing test were used in the study. The sample included 132 patients. The results of study show that in patients with coronary artery disease prior to CABG the most frequently observed type of attitude to the disease is either the harmonious type or a combination of harmonious and ergopathic types. Confrontation, Distancing, and Problem Solution Planning were identified as the preferred coping strategies. Correlation analysis revealed positive associations between cognitive status and harmonious, ergopathic, and hypochondriac types of attitude to the disease, and negative associations between cognitive status and anosognostic and sensitive types of attitude to the disease. Furthermore, positive correlations between cognitive status and Confrontation, Self-control, Responsibility taking, Problem Solution Planning, Positive revaluation coping strategies and negative correlations between cognitive status and Distancing and Escape-avoidance coping strategies were found. The results of this study will help to improve the level of diagnostic and rehabilitation psychological care of patients with coronary artery disease in preparation for CABG