Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

SPECIALASSESSMENT OF WORKING CONDITIONS FOR MERCEDES BENZ DRIVERS AND GAZ DRIVERS

This article informs about the measurement of noise and vibration at the workplace of a car driver, as well as the determination of the hazard class of a given workplace as part of a special assessment of working conditions

СРАВНИТЕЛЬНОЕ ИЗУЧЕНИЕ ВЛИЯНИЯ НОВЫХ ПРОИЗВОДНЫХ НЕЙРОАКТИВНЫХ АМИНОКИСЛОТ НА ПОСТНАТАЛЬНОЕ РАЗВИТИЕ ПОТОМСТВА КРЫС С ЭКСПЕРИМЕНТАЛЬНЫМ ГЕСТОЗОМ

Background: Our aim was to investigate the effect of derivatives of GABA and glutamate on the postnatal development of the offspring of rats with experimental preeclampsia. Methods: The experiments were performed on 35 albino female rats aged 5–7 months, weighing 220–240 g, and their offspring in the amount of 284 individuals. Experimental preeclampsia was modeled by replacing the drinking water by 1.8% NaCl solution to pregnant females from 7 to 21 days of gestation. Glutamic acid — compound RSPU-135 at a dose of 26 mg/kg, GABA derivative — compound RSPU-242 at a dose of 23 mg/kg and the reference drug sulodexide in a dose of 30 mg/kg administered to female orally daily, since the 7th day of gestation prior to delivery. Evaluated the physical development of offspring, sensory-motor reflexes, mental functions. Results: It was found that the experimental preeclampsia causes a delay in physical development and maturation of sensory-motor reflexes in the offspring, as indicated by the later periods of eruption of the incisors and eye opening, response to the emergence of audio and olfactory stimuli, forming vestibular stability and coordination of movements compared to pups from females with physiological pregnancy. Offspring from females with experimental preeclampsia were noted for lagging behind in mental development, as evidenced by the decline of the orienting-exploratory activity, learning and memory, increase of anxiety level. Compound RSPU-135, to a greater extent, improves physical development, increases the rate of maturation of sensory-motor reflexes, RSPU-242 — stimulation of cognitive functions, keeping the memory trace, orienting-exploratory, spontaneous locomotor activity, and reduce of anxiety level. Conclusion: The neuroactive amino acid derivatives limit the negative effects of experimental preeclampsia on the offspring. Цель исследования: изучить влияние производных γ-аминомасляной и глутаминовой кислоты на постнатальное развитие потомства крыс с экспериментальным гестозом. Методы: эксперименты выполнены на 35 белых беспородных крысах-самках в возрасте 5–7 мес массой 220–240 г и их потомстве числом 284 особи. Экспериментальный гестоз моделировали заменой питьевой воды на 1,8% раствор натрия хлорида беременным самкам с 7 по 21-е сут гестации. Производное глутаминовой кислоты — соединение РГПУ-135 в дозе 26 мг/кг, производное γ-аминомасляной кислоты — соединение РГПУ-242 в дозе 23 мг/кг и препарат сравнения сулодексид в дозе 30 мг/кг вводили самкам перорально ежедневно с 7-х сут гестации и до родов. Оценивали показатели физического развития потомства, сенсорно-двигательных рефлексов, психических функций. Результаты: установлено, что экспериментальный гестоз вызывает задержку физического развития и созревания сенсорно-двигательных рефлексов у потомства, на что указывают более поздние сроки прорезывания резцов и открытия глаз, появления реакции на аудио- и обонятельные стимулы, формирования вестибулярной устойчивости и координации движений по сравнению с крысятами от самок с физиологической беременностью. У потомства от самок с экспериментальным гестозом отмечается отставание в психическом развитии, о чем свидетельствует снижение ориентировочно-исследовательской активности, обучаемости и памяти, увеличение уровня тревожности. Соединение РГПУ-135 в большей степени способствует улучшению показателей физического развития, увеличению скорости формирования сенсорно-двигательных рефлексов, РГПУ-242 — стимуляции когнитивных функций, сохранности памятного следа, ориентировочно-исследовательской, спонтанной двигательной активности, снижению уровня тревожности. Выводы: производные нейроактивных аминокислот ограничивают негативное действие экспериментального гестоза на потомство.

Neutron-Dosimetric Support of Experiments Carried Out at RIAR Reactors

The paper presents methodical and technical developments combined to solve tasks related to neutron dosimetry at research reactors of different types

Коррекция нарушения биоценоза влагалища у женщин с несостоятельностью тазового дна

Background. Pelvic organ prolapse is one of the widely spread nosologies in gynecological practice, which has no tendency to level. Any pelvic organs prolapses begin with the failure of the pelvic floor, the causes and diagnosis of which are given unreasonably little attention, including such a risk factor as the vaginal biocenosis. Conclusion. The pelvic floor disorders leads to a gaping genital slit. This provokes to disruption of vaginal biocenosis. Vaginal biocenosis leads to changes in the pelvic floor tissue. This develop the pelvic floor disorders. Improving the biocenosis with oral probiotics, as Vagilak capsules, we battle with bacterial vaginosis. This will allow us to safely correct the genital prolapse.Актуальность. Пролапс органов малого таза (ПТО) представляет собой огромную проблему в области здравоохранения, затрагивающую миллионы женщин во всем мире. Несмотря на то что в современном мире образ жизни и статус женщины за последние три тысячелетия сильно изменились, проблема пролапса гениталий продолжает оставаться актуальной и не имеет тенденции к снижению. Несостоятельность тазового дна (НТД) можно рассматривать продромом ПТО. Проявление НТД часто пропускается врачами амбулаторного звена из-за неспецифических жалоб и недостаточного знания анатомии промежности и подлежащих структур. В этой связи следует дополнительно отметить, что в норме даже у многорожавшей женщины половая щель зиять не должна. Зияние половой щели, возникающее за счет дефекта мышечно-фасциальных структур тазового дна, увеличивает риск развития изменения нормальной микробиоты влагалища. Нарушение биоценоза влагалища является фактором риска травмы промежности в родах, а соответственно, и развития в последующем НТД. При этом сомкнутая половая щель является одним из барьеров для патогенов как заведомо извне, так и из кишечника. Женщины с НТД лишены данного барьера, а нарушение биоценоза приводит к изменению pH и эластических свойств тканей. Заключение. Подводя итоги, следует отметить, что НТД, являясь продромом ПТО, ведет к зиянию половой щели, тем самым провоцируя нарушение биоценоза влагалища. В свою очередь биоценоз влагалища приводит к изменениям структур тазового дна, ускоряя НТД и ухудшая его прогноз. Улучшая биоценоз оральным пробиотиком, таким как Вагилак® капсулы, мы эффективно боремся с бактериальным вагинозом, что в свою очередь позволит безопасно проводить коррекцию НТД. Понятно, что анатомические нарушения тазового дна, вызванные травмой, могут быть поправимы только хирургическим вмешательством. Проведение леваторопластики в первые 6-8 лет после травматичных родов позволяет создать предпосылки для надежного восстановления вагинального биотопа. Но хирургическое вмешательство, проведенное на тканях с бактериальным вагинозом, чревато интра- и постоперационными осложнениями. Выйти из этого тупика можно благодаря применению пробиотиков на этапе подготовки пациентки к оперативному вмешательству

Severity assessment of community9acquired pneumonia in real clinical practice in a multi9profile hospital in Russia

We aimed to assess the criteria used by physicians in routine clinical practice to assess severity of communityacquired pneumonia (CAP) in adults. Methods. A survey of 165 physicians from multi-profile hospitals was performed at six Russian cities. Results. Chest X-ray data were considered by 80% of respondents as an important marker to identify severe / non-severe CAP. Clinical features, comorbidity, laboratory abnormalities, and history data were noted by 78.8%; 66.1%; 55.8% and 23.6% of physicians, respectively. Severe dyspnea or tachypnea and confusion were the most often mentioned clinical criteria of severe CAP (78.8% of respondents for each, respectively). Lung tissue destruction was chosen as radiologic criterion of severe CAP in 80.6% of cases. Hyperleukocytosis and leukopenia were pointed as the most frequent laboratory abnormality related to severe CAP (89.7%). Only 10.3% of respondents used CAP prognostic scales. CAP prognostic scales recommended by national guidelines for adult patients (e.g. PORT ? CURB/CRB-65) were not usually used. Conclusion. Generally, physicians are aware of CAP prognostic criteria and key risk factors of poor prognosis. Additional efforts are needed for more efficient implementation of CAP prognostic scales recommended by national guidelines

Sr-Nd-Pb isotopic systematic and geochronology of ultramafic alkaline magmatism of the southwestern margin of the Siberian Craton: Metasomatism of the sub-continental lithospheric mantle related to subduction and plume events

© 2020 To provide new insights into the origin and evolution of ultramafic lamprophyres (UMLs) and their mantle source, we examined two UML (aillikite and damtjernite) occurrences of different ages in the western portion of the Siberian Craton (Ilbokich and Chadobets). New age, mineral and rock geochemistry, along with Sr–Nd–Pb–C–O isotope data was obtained. Our new 206Pb/238U perovskite age (399 ± 4 Ma) confirms the previously published Early Devonian age of the Ilbokich aillikite. Rb[sbnd]Sr isochron and 40Ar/39Ar dating yielded a Middle Triassic age (243 ± 3 Ma and 241 ± 1 Ma, respectively) for the Chadobets aillikites, indicating post-Trap emplacement of these rocks. Both UMLs are characterized by incompatible elements, including light rare earth element (LREE) enrichments (La is up to ×200 chondrite concentration), and strong fractionation of REEs ((La/Yb)n: 33–84). Despite the close geochemical affinity of both UMLs, the Nd isotopic compositions of aillikites, as well as the Pb isotopic composition of Chadobets and Ilbokich UMLs, do not overlap and are distinctly different from each other. The initial Sr and Nd isotopic compositions of the Ilbokich UMLs fall in within a narrow 87Sr/86Sr0 range (0.7032–0.7042) and εNd(T) (4.03–3.97). Chadobets UMLs have a similar Sr isotopic signature (87Sr/86Sr0: 0.7031–0.7043) and a more depleted Nd isotopic signature (εNd(T) 4.09–5.08). The initial Pb isotope compositions of the Chadobets UMLs are moderately radiogenic, ranging between 206Pb/204Pb = 18.4–19.0, 208Pb/204Pb = 38.3–38.8, and are characterized by a narrow 207Pb/204Pb ratio between 15.5 and 15.6. The Ilbokich Pb isotope compositions are less variable and range between 206Pb/204Pb = 18.0–18.4, 208Pb/204Pb = 37.8–38.4 and 207Pb/204Pb ratios between 15.5 and 15.6. The oxygen isotopic composition of carbonate from both UMLs is characterized by highly variable δ18O values from +12.1 and up to +20.5‰ (SMOW). The isotopic composition of δ13C values range from −1.3‰ to −7.1. Based on the minor impact of crustal contamination in both aillikites, it is inferred that their radiogenic isotope composition reflects a mantle source signature. The mantle source of the Chadobets aillikites is likely to include carbonatitic magma as a metasomatic agent. In contrast, phlogopite-rich metasomes within the lithospheric mantle could have contributed more significantly to the Ilbokich aillikites. These metasomes could be formed during the Caledonian orogeny, which did not only affect the southwestern boundary of the Siberian Craton, but also expanded to the craton interior. This study provides additional support for the evolution of the south-western portion of the Siberian SCLM, ranging from mantle containing phlogopite enrichment domains during the Early Devonian to hydrous-phase reduced mantle in the Triassic due to the thermal impact of the Siberian Traps

Severity assessment of community9acquired pneumonia in real clinical practice in a multi9profile hospital in Russia

We aimed to assess the criteria used by physicians in routine clinical practice to assess severity of communityacquired pneumonia (CAP) in adults. Methods. A survey of 165 physicians from multi-profile hospitals was performed at six Russian cities. Results. Chest X-ray data were considered by 80% of respondents as an important marker to identify severe / non-severe CAP. Clinical features, comorbidity, laboratory abnormalities, and history data were noted by 78.8%; 66.1%; 55.8% and 23.6% of physicians, respectively. Severe dyspnea or tachypnea and confusion were the most often mentioned clinical criteria of severe CAP (78.8% of respondents for each, respectively). Lung tissue destruction was chosen as radiologic criterion of severe CAP in 80.6% of cases. Hyperleukocytosis and leukopenia were pointed as the most frequent laboratory abnormality related to severe CAP (89.7%). Only 10.3% of respondents used CAP prognostic scales. CAP prognostic scales recommended by national guidelines for adult patients (e.g. PORT ? CURB/CRB-65) were not usually used. Conclusion. Generally, physicians are aware of CAP prognostic criteria and key risk factors of poor prognosis. Additional efforts are needed for more efficient implementation of CAP prognostic scales recommended by national guidelines