MULTIMORBID AND POLYPHARMACY IN CLINICAL CARDIOLOGY IN TERMS OF THE CLINICAL CASE

In this article is raised the topic of multimorbidity and polypharmacy on the example of a clinical case with the main diagnosis of Ischemic Heart Disease: Systemic atherosclerosis with predominance of coronary arteries sclerosis. Stable angina class III. Hypertensive heart disease III stage 3rd degree. Aortocoronary bypass. Sick sinus syndrome, tachy-brady form. Constant form of atrial fibrillation-flutter. AV node catheter ablation with pacemaker implantation. Infarction pneumonia of the lingual segments of the upper lobe of the right lung. CHF II-B stage with preserved systolic function of the left ventricle (EF LV 53 %). Very high additional cardiovascular risk. Concomitant conditions: Chronic obstructive pulmonary disease: Chronic obstructive bronchitis 2 degrees severity. Chronic pulmonary insufficiency III degree. Obesity III degree. Diabetes mellitus type 2, medium severity, decompensated. Chronic renal failure, III stage. The ongoing therapy is discussed and recommendations are given to minimize it in order to avoid polypharmacy

HYPERTROPHIC CARDIOMYOPATHY IN MULTIMORBIDITY

Aspects of diagnosis, difficulties in the diagnosis and optimal therapeutic strategies in patient with hypertrophic cardiomyopathy and comorbid conditions such as arterial hypertension, ischemic heart disease, dyslipidemia, diabetes mellitus type 2, stenosis of the left renal artery, obesity are reviewed on the example of clinical case. Hypertrophic cardiomyopathy combined with multimorbidity conditions requires a high-quality medical management, where the main goal is to improve the quality and duration of patient's life. This goal is being achieved by optimizing patient's lifestyle and assigning only the minimum amount of medications. Necessity of careful diagnosis of hypertrophic cardiomyopathy, evaluation of the risk of sudden death and search of optimal treatment in patients with multimorbidity pathology are demonstrated in clinical case

Cognitive and sociocultural aspects of robotized technology: innovative processes of adaptation

The paper dwells upon interaction between socio-cultural phenomena and cognitive characteristics of robotized technology. The interdisciplinary approach was employed in order to cast light on the manifold and multilevel identity of scientific advance in terms of robotized technology within the mental realm. Analyzing robotized technology from the viewpoint of its significance for the modern society is one of the upcoming trends in the contemporary scientific realm. The robots under production are capable of interacting with people; this results in a growing necessity for the studies on social status of robotized technological items. Socio-cultural aspect of cognitive robotized technology is reflected in the fact that the nature becomes 'aware' of itself via human brain, a human being tends to strives for perfection in their intellectual and moral dimensions

Effect of Systemic Hypertension With Versus Without Left Ventricular Hypertrophy on the Progression of Atrial Fibrillation (from the Euro Heart Survey).

Hypertension is a risk factor for both progression of atrial fibrillation (AF) and development of AF-related complications, that is major adverse cardiac and cerebrovascular events (MACCE). It is unknown whether left ventricular hypertrophy (LVH) as a consequence of hypertension is also a risk factor for both these end points. We aimed to assess this in low-risk AF patients, also assessing gender-related differences. We included 799 patients from the Euro Heart Survey with nonvalvular AF and a baseline echocardiogram. Patients with and without hypertension were included. End points after 1 year were occurrence of AF progression, that is paroxysmal AF becoming persistent and/or permanent AF, and MACCE. Echocardiographic LVH was present in 33% of 379 hypertensive patients. AF progression after 1 year occurred in 10.2% of 373 patients with rhythm follow-up. In hypertensive patients with LVH, AF progression occurred more frequently as compared with hypertensive patients without LVH (23.3% vs 8.8%, p = 0.011). In hypertensive AF patients, LVH was the most important multivariably adjusted determinant of AF progression on multivariable logistic regression (odds ratio 4.84, 95% confidence interval 1.70 to 13.78, p = 0.003). This effect was only seen in male patients (27.5% vs 5.8%, p = 0.002), while in female hypertensive patients, no differences were found in AF progression rates regarding the presence or absence of LVH (15.2% vs 15.0%, p = 0.999). No differences were seen in MACCE for hypertensive patients with and without LVH. In conclusion, in men with hypertension, LVH is associated with AF progression. This association seems to be absent in hypertensive women

Progression From Paroxysmal to Persistent Atrial Fibrillation. Clinical Correlates and Prognosis

Objectives: We investigated clinical correlates of atrial fibrillation (AF) progression and evaluated the prognosis of patients demonstrating AF progression in a large population. Background: Progression of paroxysmal AF to more sustained forms is frequently seen. However, not all patients will progress to persistent AF. Methods: We included 1,219 patients with paroxysmal AF who participated in the Euro Heart Survey on AF and had a known rhythm status at follow-up. Patients who experienced AF progression after 1 year of follow-up were identified. Results: Progression of AF occurred in 178 (15%) patients. Multivariate analysis showed that heart failure, age, previous transient ischemic attack or stroke, chronic obstructive pulmonary disease, and hypertension were the only independent predictors of AF progression. Using the regression coefficient as a benchmark, we calculated the HATCH score. Nearly 50% of the patients with a HATCH score >5 progressed to persistent AF compared with only 6% of the patients with a HATCH score of 0. During follow-up, patients with AF progression were more often admitted to the hospital and had more major adverse cardiovascular events. Conclusions: A substantial number of patients progress to sustained AF within 1 year. The clinical outcome of these patients regarding hospital admissions and major adverse cardiovascular events was worse compared with patients demonstrating no AF progression. Factors known to cause atrial structural remodeling (age and underlying heart disease) were independent predictors of AF progression. The HATCH score may help to identify patients who are likely to progress to sustained forms of AF in the near future. \ua9 2010 American College of Cardiology Foundation

Philosophical analysis of models of engineering education in Russia

This article defines the principles of the philosophical approach to the problems of engineering education. Ontological, epistemological and axiological components of the proposed approach are distinguished. Assessment criteria of engineering education models are specified. Basing on the presented principles and criteria, the analysis of Russian engineering education models is performed. The authors distinguish the following models: classical (tsarism), soviet transitional, soviet industrial, physicotechnical model, soviet mass (reproductive) and Russian transitional models. In addition among developing models it is possible to recognize the following ones: methodological (creative) and outrunning (advanced) models. On the basis of the performed analysis, positive and negative aspects of the distinguished models are determined, and, it is possible to make a conclusion that every accomplished model emergence was reasoned by particular issues raised in the state at the particular period of time. The talking point of the necessity to design a proactive model of engineering education is formulated

Philosophical analysis of models of engineering education in Russia

This article defines the principles of the philosophical approach to the problems of engineering education. Ontological, epistemological and axiological components of the proposed approach are distinguished. Assessment criteria of engineering education models are specified. Basing on the presented principles and criteria, the analysis of Russian engineering education models is performed. The authors distinguish the following models: classical (tsarism), soviet transitional, soviet industrial, physicotechnical model, soviet mass (reproductive) and Russian transitional models. In addition among developing models it is possible to recognize the following ones: methodological (creative) and outrunning (advanced) models. On the basis of the performed analysis, positive and negative aspects of the distinguished models are determined, and, it is possible to make a conclusion that every accomplished model emergence was reasoned by particular issues raised in the state at the particular period of time. The talking point of the necessity to design a proactive model of engineering education is formulated

Philosophical analysis of models of engineering education in Russia

This article defines the principles of the philosophical approach to the problems of engineering education. Ontological, epistemological and axiological components of the proposed approach are distinguished. Assessment criteria of engineering education models are specified. Basing on the presented principles and criteria, the analysis of Russian engineering education models is performed. The authors distinguish the following models: classical (tsarism), soviet transitional, soviet industrial, physicotechnical model, soviet mass (reproductive) and Russian transitional models. In addition among developing models it is possible to recognize the following ones: methodological (creative) and outrunning (advanced) models. On the basis of the performed analysis, positive and negative aspects of the distinguished models are determined, and, it is possible to make a conclusion that every accomplished model emergence was reasoned by particular issues raised in the state at the particular period of time. The talking point of the necessity to design a proactive model of engineering education is formulated

ФИЛОСОФСКИЙ ПОДХОД К ИНЖЕНЕРНОМУ ОБРАЗОВАНИЮ

The article problematizes the modern engineering education in the context of a philosophical approach. The specificity is formulated of this approach to the studied phenomenon: completeness, historicity, interrelation, anthropological character. The following issues of our time influencing the modern engineering education are distinguished: the Bologna declaration, introduction of the CDIO innovative educational framework, fundamentality, interdisciplinary character, humanity, openness, continuity. The application of the philosophical approach allows making a conclusion about the necessity of making the future engineers aware of the fact that they will generate personal, communicational, technological and material public needs in the future; hence establishing responsibility and awareness of the inherent worth of human life becomes one of the crucial tasks for the engineering education.В статье рассматривается современное инженерное образование в контексте философского подхода. Сформулирована специфика указанного подхода к исследуемому явлению: целостность, историчность, взаимосвязь, антропологичность. Выделены следующие аспекты современности, оказывающие существенное влияние на современное инженерное образование: Болонская декларация, формирование концепции совершенствования инженерного образования CDIO, фундаментальность, междисциплинарность, гуманистичность, открытость, непрерывность. В результате применения философского подхода сделан вывод о необходимости в процессе образования ориентировать будущих инженеров на то, что именно они в будущем будут формировать личностные, коммуникативные, технологические и материальные потребности общества, а значит, одной из основных задач инженерного образования становится формирование ответственности и осознания самоценности человеческой жизни