CONDITIONS FOR MENTAL-DISORDERS FORMATION IN MYOCARDIAL-INFARCTION

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and affective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatizing factors preceding the disease exert a noticeable effect on the development of depressive and asthenohypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatizing factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology

CONDITIONS FOR MENTAL-DISORDERS FORMATION IN MYOCARDIAL-INFARCTION

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and affective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatizing factors preceding the disease exert a noticeable effect on the development of depressive and asthenohypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatizing factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology

Conditions for mental disorders formation in myocardial infarction

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and effective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatizing factors preceding the disease exert a noticeable effect on the development of depressive and asthenohypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatizing factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology

Logical-probabilistic and simulation modeling as a toolkit for complex analysis and risk management of a cargo port

The paper presents a structural model of the risk of failure to achieve the strategic goal of a cargo port, supplemented by several levels of consideration. The model of scenarios of all existing significant risks is developed. The hybrid logical-probabilistic model, the cascade logicalprobabilistic model and the multi-level cascade hybrid LP-model of the risk of failure to achieve the main strategic goal of the port are proposed. The main idea is to link together the technology of formalizing risks using the constructed logical and probabilistic models and simulation modeling, the interpretation of the results of which is possible using LP-models and scenarios. The proposed models allow to carry out a comprehensive analysis of the risk of failure to achieve the strategic goal of a cargo port based on the scenario formalization of risks of various management levels, as well as to simplify the process of interpreting the results of simulation modeling taking into account external factors of influence. Complex using of all this models allows to develop timely informed management decisions

CONDITIONS FOR MENTAL-DISORDERS FORMATION IN MYOCARDIAL-INFARCTION

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and affective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatizing factors preceding the disease exert a noticeable effect on the development of depressive and asthenohypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatizing factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology

Conditions for mental disorders formation in myocardial infarction

Conditions for mental disorders formation at different stages of the underlying disease have been specified as a result of clinico-psychopathological, clinico-catamnestic and experimental psychological studies carried out in 55 patients with myocardial infarction. The authors show an important role of the clinical features of myocardial infarction in the formation of asthenic symptomatology and effective pathology in the acute period of myocardial infarction. In the subacute period of the illness, the premorbid characteristics and psychotraumatizing factors preceding the disease exert a noticeable effect on the development of depressive and asthenohypochondriac disorders. In the clinical picture of acute myocardial infarction, a less significant role is played by age-associated factor. At the outpatient stage of myocardial infarction treatment, the psychotraumatizing factors due to chronic disease and related situations assume a particular significance in the formation of depressive hypochondriac symptomatology

Случай успешного хирургического лечения рабдомиомы правого желудочка у новорожденного

Primary cardiac tumors are very rare in children. Rhabdomyoma is the most common benign tumor in fetuses and neonates. Most cases do not require any surgical intervention due to absence of clinical symptoms and a high rate of spontaneous regression within the first year of life. However, some neonates can have significant abnormalities of intracardial hemodynamics related to the obstruction of the left and right ventricle outflows; this is an indication to emergency surgery. As a rule, complete or partial resection of the tumor mass provides uneventful postoperative course and is not associated with a relapse of rhabdomyoma in the long-term.We present a clinical case of a 15-days old neonate who underwent an emergency surgery due to advanced tumor obstruction of the blood flow in the right ventricle outflow tract (RVOT). At preoperative echocardiography, there was a pulmonary artery systolic pressure gradient of 90 mm Hg. Moderate hypoxemia (SaO2 90%), breathing rate of up to 55 per minute, together with echocardiographic results, indicated the impaired pulmonary blood flow and the need for the tumor resection. The tumor was completely resected through the right ventricle access with cardiopulmonary bypass and cardioplegia, with subsequent autologous pericardium patching of the right ventricle. The postoperative period was uneventful; the patient was extubated at day 2 and discharged at day 11 after surgery. The diagnosis of rhabdomyoma was confirmed histologically. At one month after surgery, no additional tumor masses were found in the heart chambers and septum.Rhabdomyoma causing severe obstruction of the RVOT in a newborn is a rare life-threatening complication of the natural course of benign heart tumors in children. The presence of dyspnea at rest, moderate desaturation, and echocardiographic data determined the rejection of the conservative management commonly adopted in most cases of cardiac rhabdomyomas, and were indications for an emergency surgery. In the long-term postoperative period, magnetic resonance imaging should be done to exclude tuberous sclerosis.Первичные опухоли сердца обнаруживаются у детей крайне редко. Наиболее распространенная доброкачественная опухоль сердца у плодов и новорожденных – рабдомиома. В большинстве случаев хирургические вмешательства не требуются по причине отсутствия клинических симптомов и высокой частоты спонтанной регрессии опухоли в течение первого года жизни. В то же время у ряда новорожденных могут регистрироваться выраженные нарушения внутрисердечной гемодинамики, обусловленные обструкцией выходного отдела правого и левого желудочков сердца, что служит показанием для неотложных хирургических вмешательств. Полная или частичная резекция опухолевых масс, как правило, обеспечивает неосложненный послеоперационный период и не приводит к рецидиву рабдомиомы в отдаленном периоде.Описано клиническое наблюдение новорожденного 15 дней жизни, который подвергся неотложному хирургическому вмешательству по причине выраженной обструкции кровотока опухолью в выходном отделе правого желудочка. По данным предоперационного эхокардиографического исследования зарегистрирован систолический градиент давления в стволе легочной артерии, равный 90 мм рт. ст. Умеренная гипоксемия (SaO2 – 90%), одышка до 55 в минуту в совокупности с данными эхокардиографии свидетельствовали об измененном легочном кровотоке и послужили показаниями для резекции опухоли. В условиях искусственного кровообращения и кардиоплегии доступом через выходной отдел правого желудочка опухоль была полностью удалена, дефект в стенке правого желудочка закрыт заплатой из аутоперикарда. Послеоперационный период протекал без осложнений: ребенок был экстубирован на 2-е сутки и выписан из клиники на 11-е сутки после операции. Гистологическое исследование удаленного новообразования подтвердило диагноз рабдомиомы. Через месяц после операции в полостях и перегородках сердца дополнительных новообразований не обнаружено.Рабдомиома, приводящая к выраженной обструкции выходного отдела правого желудочка у новорожденного, представляет собой редкое жизнеугрожающее осложнение естественного течения первичных опухолей сердца у детей. Наличие одышки в покое, умеренной десатурации в совокупности с данными эхокардиографического исследования определили отказ от консервативной тактики, принятой для большинства случаев рабдомиом сердца, и послужили показаниями для неотложного хирургического вмешательства. В отдаленном послеоперационном периоде следует выполнить магнитно-резонансную томографию для исключения туберозного склероза