Novel full-flow valves, impact on early mitral post-replacement period: a non-randomised controlled cohort trial

Background. Among cardiovascular diseases, valve pathology of various aetiology comprises a primary factor of chronic heart failure. Mitral valve diseases afflict over half of all patients with acquired heart defects. Today’s long-term outcomes of mitral valve replacement are not quite satisfactory, which urges the invention of novel vales. Such a modern artificial valve is the nationally developed bivalve full-flow MedInzh-ST prothesis.Objectives. Assessment of advantages of the novel MedInzh-ST full-flow mechanical valve vs. MedInzh-2 model in analyses of short-term postoperative outcomes.Methods. Over a five-year period, 116 patients underwent indicated mitral replacement with MedInzh valves. The full-flow MedInzh-ST was implanted in 55 patients, and MedInzh-2 — in 61. All patients had transthoracic echocardiography for structural and functional heart and implant control prior to surgery and discharge from hospital. Clinical and echocardiographic analyses were performed in the early postoperative period.Results. The choice of valve model had no effect on the rates of postoperative complications and hospital mortality. All lethal cases were not associated with the valve malfunction. All patients with predominant mitral stenosis revealed the reliably lower peak and mean transmitral pressure gradient and pulmonary artery systolic pressure, irrespective of the valve model. The novel full-flow valve implantation significantly more often associated with a reduced right ventricle size. All patients with predominant insufficiency were observed to reduce mitral regurgitation and the left ventricular size upon defect correction. Patients with full-flow protheses significantly more often had a reduced end-systolic dimension.Conclusion. The MedInzh-ST full-flow mechanical valve satisfies the modern requirements for efficacy and safety. Mitral stenosis correction with full-flow valves is shown to exert a greater effect on reverse right ventricular remodelling compared to the classical model

Evaluation of the nutritional and energy value of glazed curd cheese, their impact on population health

The aim of the study – to assess the nutritional and energy value of glazed cheese curds from different manufacturers, their compliance with balanced nutrition standards.Цель исследования – провести оценку пищевой и энергетической ценности творожных глазированных сырков разных производителей, соответствие их стандартам сбалансированного питания

Динамика уровней пепсиногенов у кардиохирургических пациентов с эрозивно-язвенными изменениями гастродуоденальной зоны

The pepsinogenemia level is examined as a risk factor of atrophy and inflammation activity in gastroduodenal region mucous region in 20 patients with erosive and ulcerous changes this localization as before as after operations with cardiopulmonary bypass. It is marked that the values of pepsinogen 1 ((209,58 ± 14,41) μg/l) and pepsinogen 1 ((30,01 ± 4,00) μg/l) in plasma are exceeded than normal magnitudes. It is revealed that using omeprazole intravenous and peroral after that can prevent of acute ulcers and gastric bleeding in these patients and associated with decrease of pepsinogen 1 (in 1,2 times) and pepsinogen 2 (in 2,1 times) plasma levels comparing values before operation. In spite of acute ulcers and gastroduodenal bleeding default, gastropaty with erosions in antrum of stomach persists in 35% of cardiosurgical patiewnts.Исследован уровень пепсиногенемии как фактора риска атрофии и активности воспаления слизистой оболочки гастродуоденальной зоны у 20 пациентов с эрозивно-язвенными изменениями этой локализации до и после операции в условиях искусственного кровообращения. Отмечено превышение нормальных значений уровней пепсиногенов-1 ((209,58 ± 14,41) мкг/л) и -2 ((30,01 ± 4,00) мкг/л) в плазме крови в исследуемой группе. Установлено, что применение омепразола внутривенно с последующим назначением его внутрь у данной категории больных позволяет профилактировать образование острых язв, желудочные кровотечения и ассоциировано с уменьшением плазменных уровней пепсиногенов-1 (в 1,2 раза) и -2 (в 2,1 раза) по сравнению с дооперационными показателями. Несмотря на отсутствие острых язв и желудочно-кишечных кровотечений, у 35% кардиохирургических больных в послеоперационном периоде сохраняется гастропатия с наличием эрозий антрального отдела желудка

Using off analogous ph-test and pepsinogenemia study for noninvasive estimation of stress-related erosions and ulcers prevention in cardiosurgical patients

Based on 40 clinic cases the important diagnostic role of analogous pH-test and dynamic pepsinogenemia study was validated for effect estimation of the antisecretory drugs, which were dedicated for prevention and treatment of stress-related gastroduodenal mucosal damage in cardiosurgical patients. It was defined, that getting therapy have to objective the control pH in interval 4,0 and more during planned interventions, 6,0 and more - during emergency interventions. The data about important clinical role of pepsinogenemia in diagnosis of stress-related gastroduodenal mucosal damage was received.На основании 40 клинических случаев обоснована важная диагностическая роль аналогового pH-теста и динамического исследования пепсиногенемии для оценки эффективности антисекреторной активности препаратов, назначаемых для профилактики и лечения стрессового повреждения гастродуоденальной зоны у кардиохирургических больных. Определено, что проводимая терапия должна иметь целью контроль pH в диапазоне 4,0 и более при выполнении плановых операций, 6,0 и более - при неотложных операциях. Полученны данные о важном клиническом значении избыточной пепсиногенемии для диагностики стресс-зависимого поражения гастродуоденальной слизистой оболочки

Integrins as therapeutic targets: lessons and opportunities.

The integrins are a large family of cell adhesion molecules that are essential for the regulation of cell growth and function. The identification of key roles for integrins in a diverse range of diseases, including cancer, infection, thrombosis and autoimmune disorders, has revealed their substantial potential as therapeutic targets. However, so far, pharmacological inhibitors for only three integrins have received marketing approval. This article discusses the structure and function of integrins, their roles in disease and the chequered history of the approved integrin antagonists. Recent advances in the understanding of integrin function, ligand interaction and signalling pathways suggest novel strategies for inhibiting integrin function that could help harness their full potential as therapeutic targets

Infectious endocarditis course after ascending aorta replacement with a valved conduit

Objective. To demonstrate the peculiarities of infectious endocarditis course in patients after ascending aorta replacement using a valved conduit based on the personal observations.Material and methods. Six cases of delayed infectious endocarditis after ascending aorta replacement using a valved conduit are presented.Results. The pathological process was represented by aortic root abscess, paraprosthetic phlegmon, fistula penetrated into the conduit wall and cardiac chambers. There was no vegetation on the prosthesis therefore the diagnosis was complicated. Period from fever onset to final diagnosis lasted from 1 week to 2.5 months. The first pathologic changes in all cases were detected using transesophageal echocardiography, but this method was not informative in the early stages of the disease.Conclusion. Infectious endocarditis in patients after ascending aorta replacement using a valved conduit has its own peculiarities. The most frequently, the process leads to the development of aortic root abscess. Diagnosis of infectious endocarditis in such cases is difficult. Infectious endocarditis should be suspected in patients - carriers of valved conduit with unexplained fever and treatment should be started in accordance with the diagnosis. In this case, structural changes visualization to confirm the disease is not necessary

Aspirin effectiveness in patients with rheumatoid arthritis and coronary heart disease who receive non-steroidal anti-inflammatory drugs

Aim. To study coagulation and vascular-platelet haemostasis in patients with rheumatoid arthritis (RA) and coronary heart disease (CHD), who receive various non-steroidal anti-inflammatory drugs (NSAID) in combination with low doses of aspirin. Material and methods. The study included 79 patients (59 women and 20 men; mean age 61,0 years; mean disease duration 8,5 years) with confirmed RA diagnosis. All participants received disease-modifying anti-inflammatory therapy and NSAID, as well as standard pharmacological CHD therapy. The parameters of coagulation and vascular-platelet haemostasis were compared by the type of administered NSAID (diclofenac, tenoxicam, nimesulide, or meloxicam). In total, 40 patients with increased platelet aggregation but no previous antiaggregant therapy were administered aspirin (100 mg/day). Platelet aggregation was reassessed at Day 7–8 of aspirin therapy. The control group included 25 untreated healthy men (mean age 55 years). Results. Activated coagulation haemostasis was observed in 58,2% of patients with RA and CHD, as manifested in increased levels of fibrinogen, soluble fibrin monomer complexes (SFMC), factor XII-dependent fibrinolysis, and von Willebrand factor, compared to controls. The therapy with most NSAID was linked to similar changes in coagulation haemostasis. The patients receiving diclofenac, nimesulide, and meloxicam demonstrated an activation of vascular-platelet haemostasis, as manifested in a significant increase of spontaneous platelet aggregation and ADPinduced platelet aggregation, compared to controls. Among patients receiving tenoxicam, there was a tendency towards a reduction in ADP-induced platelet aggregation (aspirin-like effect). Among patients already receiving diclofenac, nimesulide, or meloxicam, aspirin administration typically resulted in reduced platelet aggregation. In total, 42,4% of the patients did not respond to aspirin therapy. Conclusion. Patients with RA and CHD who receive NSAID are also in need of antiaggregant therapy. The latter should be administered under control of vascularplatelet haemostasis, as in a substantial proportion of these patients (42,4%), aspirin effectiveness is not adequate