Role of myocardial properties and pacing lead location on ECG in personalized paced heart models

Personalised cardiac models were built from the computed tomography imaging data for two patients with implanted cardiac resynchronisation therapy devices. The cardiac models comprised a biventricular model of myocardial electrophysiology coupled with a model of the torso to simulate the body surface potential map. The models were verified against electrocardiogams (ECG) recorded in the patients from 240 leads on the body surface under left ventricular pacing. The simulated ECG demonstrated a significant sensitivity to the myocardial anisotropy and location of the pacing electrode tip in the models. An apicobasal cellular heterogeneity was shown to be less significant for the ECG pattern at the paced-ventricle activation than that showed earlier by Keller and co-authors (2012) for the normal activation sequence. © 2017 IEEE Computer Society. All rights reserved.This study was supported by the RAS Presidium Programme I.33Π, and Government of the Russian Federation (agreement 02.A03.21.0006). We used the computational clusters of Ural Federal University and ”URAN” of Institute of Mathematics and Mechanics (Ekaterinburg)

The rationale for antidepressants in the treatment of schizophrenia: A modern view on the problem in the context of evidence-based medicine

The paper discusses whether antidepressant treatment is rational in schizophrenics. It analyzes the results from trials evaluating the efficiency of the therapy in patients with depressive, negative, or obsessive-phobic symptoms. The validity of results of these trials is assessed. The results of demonstrative trials of the efficiency of therapy with different representatives of antidepressants (selective serotonin reuptake inhibitors) in the above patient groups are given separately and compared with the data obtained in observational studies. Emphasis is placed on the criticism of shortages of procedures and results of demonstrative trials conducted in foreign countries. Prospects for further trials evaluating the efficiency of antidepressant therapy for schizophrenia are depicted

Check of knowleadge using score-rating system and independent test control

Анализируется проблема дублирования балльно-рейтинговой системы оценивания и независимого тестового контроля в системе подготовки специалистов. Предложены мероприятия по устранению недостатковIn article it is told about duplication of score-rating system and independent test controlin training system of specialists. Actions for elimination of shortcomingsare offere

Real World Effectiveness of fixed combination of glargine 100 U/ml and lixisenatide therapy in outpatients with Type 2 Diabetes: A Retrospective Cohort Study SOLO

Background: The effectiveness and safety of a fixed combination of insulin glargine 100 ME/ml and lixisenatide for treatment of patients with type 2 diabetes (T2DM) has been demonstrated in randomized clinical trials, but there are still not enough data of it`s usage of it real clinical practice.Aim: To describe the baseline characteristics of patients with T2DM who started treatment with a fixed ratio combination of insulin glargine 100 ME/ml and lixisenatide in the period from November 2018 to July 2020, and to evaluate the effectiveness of using fixed combination of insulin glargine 100 ME/ml and lixisenatide in for 6–12 months of therapy in a real outpatient practice.Materials and methods: SOLO was a retrospective cohort multicentre study conducted in Russia, Moscow. Adults (≥18 years) with T2DM and HbA1c≥7% in case of availability of medical records during ≥180 days before and ≥1 HbA1c level during 150–210 days after start of treatment with Soliqua SoloStar® were eligible.Results: A total of 383 people with T2DM were included. Baseline characteristics were the following (mean±SD): age 59.9±8.3 years; BMI 36.4±6.3 kg/m2; proportion of patients with BMI≥35 kg/m2 — 52.2%; HbA1c 9.14±1.08%. 65% of patients received oral antidiabetic drugs (OAD) before start of treatment with fixed combination of insulin glargine 100 ME/ml and lixisenatide ; 31.3% of patients were switched from combination of OAD with basal insulin, 1.04% of patients received other therapy (GLP-1 RA, basal-bolus insulin treatment, basal insulin monotherapy), and 2.61% of patients did not receive any hypoglycemic therapy. HbA1c level was 7.78±0.8% after 6 months of treatment and 7.4±0.61% after 12 months. There was a significant decrease of body weight from the baseline value 101.62±20.64 kg by 1.96±4.03 kg at month 6 and by 3.13±4.71 kg at month 12 (p<0.001) Overall, 4 patients (1.04%) reported symptomatic hypoglycemia (glycemia ≤3.9 mmol/L); no episodes of severe hypoglycemia were registered.Conclusion: In a real-life setting in Russia, initiation of a fixed combination of insulin glargine 100 ME/ ml and lixisenatide in people with T2DM uncontrolled on OADs or combination of OADs with basal insulin resulted resulted in an improved glycemic control and body weight change with low risk of hypoglycemia compared to baselin

Twenty-year clinical progression of dysferlinopathy in patients from Dagestan

© 2017 Umakhanova, Bardakov, Mavlikeev, Chernova, Magomedova, Akhmedova, Yakovlev, Dalgatov, Fedotov, Isaev and Deev.To date, over 30 genes with mutations causing limb-girdle muscle dystrophy have been described. Dysferlinopathies are a form of limb-girdle muscle dystrophy type 2B with an incidence ranging from 1:1,300 to 1:200,000 in different populations. In 1996, Dr. S. N. Illarioshkin described a family from the Botlikhsky district of Dagestan, where limb-girdle muscle dystrophy type 2B and Miyoshi myopathy were diagnosed in 12 members from three generations of a large Avar family. In 2000, a previously undescribed mutation in the DYSF gene (c.TG573/574AT; p. Val67Asp) was detected in the affected members of this family. Twenty years later, in this work, we re-examine five known and seven newly affected family members previously diagnosed with dysferlinopathy. We observed disease progression in family members who were previously diagnosed and noted obvious clinical polymorphism of the disease. A typical clinical case is provided

Corrigendum: Twenty-year clinical progression of dysferlinopathy in patients from Dagestan [Front Neurol, 8, (2017) (77)] doi: 10.3389/fneur.2017.00077

The "Funding" section should be: This work was funded by Human Stem Cells Institute PJSC and Roman V. Deev. Theoretical part of this work was supported by Russian Scientific Foundation grant (14-15-00916). Ivan A. Yakovlev and Mikhail O. Mavlikeev were supported by the Russian Government Program of Competitive Growth of Kazan Federal University. The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way

The clinical case of limb-girdle muscle dystrophy 2Q associated with myasthenic syndrome and lung damage

Limb-girdle muscle dystrophy 2Q is one of the rarest forms of plectinopathies and is represented by an isolated muscular dystrophic syndrome, according to two previously described literature reports. There are five forms of plectinopathies, including limb-girdle muscle dystrophy 2Q, are caused by mutations in the PLEC gene, the alternative splicing of which determines the synthesis of 9 isoforms of the plectin protein (1, 1a, 1b, 1c, 1d, 1e, 1f, 1g, 3) performing cytolinker function in the neuronal, epithelial and muscle tissue.The article describes the family observation of three sick siblings with the limb-girdle muscle dystrophy 2Q phenotype due to the presence of a new homozygous mutation (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter) in the isoform 1f PLEC revealed by whole-exome sequencing. Clinical, electromyography, visualization and histopathological features of limb-girdle muscle dystrophy 2Q were analyzed in detail. The onset of clinical manifestations in all the described siblings was observed in early childhood with moderate weakness mainly in the pelvic girdle muscles and proximal lower limbs with minimal involvement of the muscles of the shoulder girdle. A distinctive aspect is the stagnation of the myodystrophic process until 20—21 years, followed by the progression and development of episodes of respiratory failure, as well as the formation of rigidity of the cervical, thoracic spine and moderate contracture of the Achilles tendons. Typical features are marked atrophy of paravertebral muscles with the formation of pterygoid scapula and the presence of hypertrophy m. gastrocnemius, m. quadriceps femoris, m. deltoideus and m. triceps brachii. Histopathological examination m. vastus lateralis revealed myodystrophic process without inflammatory infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss.Electrocardiography signs of the early repolarization syndrome, focal cardiosclerosis and sinus tachycardia are described. For the first time, involvement in the pathological process of pulmonary tissue in the form of noninfectious bronchiolitis, atelectasis, and the development of the myasthenic syndrome causing episodes of respiratory failure resulted in the death of two described siblings aged 29 and 31 years. Discussed pathogenetic role of PLEC 1f isoform in the development of described syndromes, expands understanding of rare nosology limb-girdle muscle dystrophy 2Q

Клинико-эпидемиологическая характеристика гепатитов В и дельта в Республике Дагестан

Aim: The analysis of the incidence of hepatitis B in the Republic of Dagestan (RD) and clinical and epidemiological characteristics of HBV/HDV coinfection in the region.Materials and Methods. The dynamics of the hepatitis B incidence rates and the coverage of vaccination against this infection in the RD in 2008-2022 were analyzed based on the data from of the statistical forms of Rospotrebnadzor. The clinical and epidemiological characteristics of delta hepatitis were analyzed in 371 patients under dispensary observation at the Republican Center for Infectious Diseases named after S.-А.М. Magomedov.Results. Over the past 10 years, the incidence of CHB in the RD has increased more than 4.5 times, from 1.4 per 100 thousand population in 2008 to 6.7 per 100 thousand population in 2022. A decrease in the rates of hepatitis B child immunization in the RD is observed since 2009. Hepatitis B vaccination coverage rates in adult population fell sharply after 2010, both in the RD and in the Russian Federation  on average. The frequency of HDV co-infection in persons infected with HBV in the RD is 13.8%, but reaches 15% in some regions of the republic, indicating the moderate level   of endemicity. Patients with HBV/HDV coinfection are predominantly males aged 25–45 years with advanced fibrosis or cirrhosis. All cases of HDV infection in the RD are caused by viral genotype 1.Conclusions. The obtained results testify to the significance of the problem of hepatitis B and delta in the RD. The number of identified patients and, accordingly, the rate of co-infection, apparently, will increase with the expansion of screening for markers of HDV infection, when patients who were registered as HBsAg carriers will be examined according to the patient routing guidelines. The late diagnosis of delta hepatitis in RD and the limited possibilities of antiviral therapy are another significant issues.Цель: анализ заболеваемости гепатитом В в Республике Дагестан и клинико-эпидемиологическая характеристика ко-инфекции HBV/HDV в регионе.Материалы и методы: проведен анализ динамики заболеваемости гепатитом В и охвата вакцинацией против этой инфекции в Республике Дагестан в 2008–2022 гг. по материалам форм статистического учета Роспотребнадзора. Проанализированы клинико-эпидемиологические  характеристики  гепатита   дельта  у 371 пациента, находящихся на диспансерном наблюдении в Республиканском центре инфекционных болезней им. С.-А.М. Магомедова.Результаты: за последние 14 лет заболеваемость хроническим гепатитом В в Республике Дагестан увеличилась более чем в 4,5 раза, с 1,4 на 100 тыс. населения в 2008 г. до 6,7 на 100 тыс. населения в 2022 г. Результаты анализа охвата вакцинацией против гепатита В свидетельствуют о снижении уровня иммунизации детского населения в Республике Дагестан после 2009 г. Показатели охвата вакцинацией против гепатита В взрослого населения резко упали после 2010 г., как в Республике Дагестан, так и в Российской Федерации в среднем. Частота ко-инфекции HDV у лиц, инфицированных HBV, в Республике Дагестан составляет 13,8%, но достигает 15% в отдельных районах республики, что позволяет отнести ее к регионам с умеренной эндемичностью. Среди пациентов с ко-инфекцией HBV/HDV преобладают мужчины в возрасте 25–45 лет, с продвинутыми стадиями фиброза или циррозом. Во всех случаях HDV-инфекция была вызвана 1 генотипом вируса.Заключение:  полученные  результаты  свидетельствуют о значимости проблемы гепатитов В и дельта в Республике Дагестан. Количество выявленных больных и, соответственно, показатель частоты ко-инфекции, повидимому, будут увеличиваться при расширении скрининга на маркеры HDV-инфекции, когда пациенты, находившиеся на диспансерном учете как носители HВsAg, будут обследованы по алгоритму согласно приказу о маршрутизации. Не меньшей проблемой является поздняя диагностика гепатита дельта в Республике Дагестан и ограниченные возможности противовирусной терапии

Характеристика лямблиоза и энтеробиоза у детей Астраханской области

Purpose: assessment of the clinical and epidemiological situation of current invasions in children of the Astrakhan region. 315 outpatient cards of children were analyzed in 2016.The diagnosis of Giardiasis was made to 151 children, the diagnosis of Enterobiasis — 164. The age of all observed children ranged from 9 months to 17 years. The largest part was made up of children aged 3 to 14 years of age — 80.3%, among them enterobiasis was identified — in 46.7%, giardiasis — in 33.6% of cases. Most of the children  — 90.5% were from organized groups (they attended preschool institutions or school). The reasons for the examination of all children were varied. Some children — 63.5% went to the doctor with complaints  or clinical symptoms. Another part of the children — 33% of the diagnosis was made as a result of preventive examinations.In most cases — 78.7% various bad habits were identified. Thus, geophagy (the habit of eating the earth) was noted in 33.3% of children, and onigophagy (the habit of biting the nails) in 24.8%. In 21.3% of cases, bad habits were absent. Contact with pets was established in 22.9% of children. According to the ultrasound, most children with giardiasis (83.8%) had pathology (reactive changes of the pancreas, liver, gallbladder dyskinesia, etc.)In case of giardiasis niferator, albendazole was administered. In case of enterobiasis albendazole, pyrantel, and mebendazole were administered in age dosages. After antiparasitic treatment, in 91.4% of cases, the clinical symptoms of the disease completely disappeared, with giardiasis — in 85.4%, with enterobiasis — in 97% of cases.In 1.3% of children with giardiasis, after several courses of antiparasitic drugs, Giardia was found in feces in the absence of complaints and clinical symptoms, indicating a possible Giardia carrier parasite in children.С целью оценки клинико-эпидемиологической ситуации по актуальным инвазиям у детей Астраханской области было проанализировано 315 амбулаторных карт детей, обратившихся в 2016  г. Диагноз Лямблиоз был поставлен 151 ребенку, диагноз Энтеробиоз — 164.Возраст всех наблюдаемых детей составлял от 9 месяцев до 17 лет. Наибольшую часть составили дети в возрасте от 3 до 14 лет жизни — 80,3%, среди них энтеробиоз был выявлен в 46,7%, лямблиоз — в 33,6% случаев. Большинство детей — 90,5% были из организованных коллективов (посещали  детские дошкольные учреждения или школу). Причины обследования всех детей были разнообразными.  Часть  детей  — 63,5% обратились к специалисту в связи с наличием у них тех или иных клинических симптомов и жалоб. Другой части  детей  — 33% диагноз был выставлен в результате профилактических осмотров.В большинстве  случаев — 78,7% были выявлены различные вредные привычки. Так, геофагия (привычка есть землю) отмечалась у 33,3% детей, а онигофагия (привычка грызть ногти) — у 24,8%. В 21,3% случаев вредные привычки отсутствовали. Котакт с домашними животными был установлен  у 22,9% детей. По данным УЗИ, у большинства детей с лямблиозом (83,8%) отмечалась патология (реактивные изменения поджелудочной железы, печени, дискинезия желчного пузыря и др.).В качестве антипаразитарной  терапии при лямблиозе назначался нифуратель, альбендазол, при энтеробиозе — альбендазол, пирантел и мебендазол в возрастных дозировках. После лечения в 91,4% случаев клинические симптомы заболевания полностью исчезли, при лямблиозе — в 85,4%, при энтеробиозе — в 97% случаев.У 1,3% детей с лямблиозом после нескольких курсов антипаразитарными препаратами обнаруживались лямблии в фекалиях при отсутствии жалоб и клинических симптомов, что свидетельствует о возможном паразитоносительстве лямблий у детей

Опыт хирургического лечения пациента с хроническим послеоперационным остеомиелитом грудины и ребер

The article presents the experience of successful complex treatment in a patient of high anesthetic risk with chronic postoperative sternum and ribs osteomyelitis developed after sternotomy for cardiac tamponade (perforation during radiofrequency ablation of the pulmonary veins mouths and cavotricuspidal isthmus) and retrosternal abscess associated with the presence of foreign bodies.В статье представлен опыт успешного комплексного лечения пациента высокого анестезиологического риска с хроническим послеоперационным остеомиелитом грудины и ребер, развившимся после стернотомии по поводу тампонады сердца (перфорация при проведении радиочастотной абляции устьев легочных вен и кавотрикуспидального истмуса) и ретростернального абсцесса, связанного с наличием инородных тел