Сравнительная оценка результатов измерения емкости вдоха с помощью побудительного спирометра и метода ультразвуковой спирографии в раннем послеоперационном периоде у кардиохирургических пациентов

Incentive spirometry is one of the most common methods used for respiratory rehabilitation in the early period after cardiac surgery. Inspiratory capacity values, obtained by a patient using spirometer, are not reliably trusted.Objectives. To compare volumetric parameters measured with incentive spirometer and results obtained with bedside ultrasound-based spirometer to assure the feasibility of the use of incentive spirometry to assess the inspiratory capacity and effectiveness of postoperative respiratory rehabilitation.Materials and methods. The study included 50 patients after elective cardiac surgery. Pulmonary rehabilitation involved the use of various respiratory therapy methods. Spirography was performed before and after each session. Both approaches were used simultaneously to obtain the spirometry maximum inspiratory capacity (SMIC) with a bedside ultrasonic spirography and maximum inspiratory capacity (MIC) index using an incentive spirometer. Patient’s discomfort and adverse events during the procedures were recorded.Results. The absolute values of the MIC measured before and after each session by the two methods were dissimilar, however, the average increment values (6) did not show statistically significant differences. The correlation analysis revealed a strong positive statistically significant relationship between 6 SMIC and 6 MIC (R = 0.74 before the session, R = 0.79 after the session, R = 0.77 across the whole data set, P < 0.01), also consistent with the Bland–Altman analysis, evidencing that more than 95% of all values fell within ± 1.96 SD of the mean difference. The inspiratory spirometry method showed good diagnostic accuracy (sensitivity 87%, specificity 85%, area under the curve (AUC) 0.8 (95% CI: [0.76; 0.83]), P < 0.001). Refusals of procedure were more often documented with ultrasonic spirography.Conclusion. The increment in the inspiratory capacity index measured with incentive spirometer shows good agreement with ultrasonic spirography measurements. Therefore, incentive spirometry can be reliably used to assess the effectiveness of respiratory rehabilitation interventions in cardiac surgery patients during early postoperative period.Побудительная спирометрия относится к наиболее распространенным методам, применяемым для респираторной реабилитации в ранние сроки после кардиохирургических вмешательств. Процедура основана на самостоятельном измерении объема вдоха пациентом, однако остается неясным, насколько можно доверять результатам этих измерений.  Цель исследования. Сравнить волюметрические показатели, измеренные с помощью побудительного спирометра с данными прикроватной ультразвуковой спирометрии и оценить возможность использования побудительной спирометрии для оценки емкости   вдоха и эффективности послеоперационной респираторной реабилитации.Материалы и методы.  В исследование вошли 50 пациентов после плановых кардиохирургических операций. Реабилитацию проводили с использованием различных респираторных методов. До и после каждого сеанса выполняли спирографию с использованием прикроватного ультразвукового спирометра. Оценивали максимальную емкость вдоха (СМЕВд), одновременно определяли  показатель максимальной емкости вдоха (МЕВд) с помощью побудительного спирометра. Регистрировали  нежелательные явления и дискомфорт при проведении процедур.Результаты. Абсолютные величины максимальной емкости вдоха, измеренные до и после каждого сеанса с помощью сравниваемых методов, отличаются, однако средние значения их прироста (Δ) не имели статистически достоверных различий. По результатам корреляционного анализа выявлена сильная положительная статистически достоверная взаимосвязь между Δ СМЕВд и Δ МЕВд (до сеанса r = 0,74, после сеанса r = 0,79, по всему массиву данных r = 0,77,  р<0,01), которая имеет хорошую согласованность по анализу Блэнда–Альтмана, о чем свидетельствует то, что  более 95% значений  находились в пределах  ± 1,96 SD от средней разницы. Метод побудительной спирометрии показал хорошую диагностическую точность при ROC-анализе (чувствительность 87%, специфичность 85%, площадь под кривой (AUC) 0,8 (95% ДИ: [0,76;0,83]), р<0,001). Отказ от процедуры чаще наблюдали при использовании метода ультразвуковой спирографии.Заключение. Прирост показателя емкости вдоха, измеренной с помощью побудительного спирометра, хорошо согласуется с измеренным методом ультразвуковой  спирографии и может использоваться для оценки эффективности реабилитационных мероприятий в раннем послеоперационном периоде у кардиохирургических пациентов

Prospects for Creation of Cardioprotective and Antiarrhythmic Drugs Based on Opioid Receptor Agonists

It has now been demonstrated that the μ, δ(1), δ(2), and κ(1) opioid receptor (OR) agonists represent the most promising group of opioids for the creation of drugs enhancing cardiac tolerance to the detrimental effects of ischemia/reperfusion (I/R). Opioids are able to prevent necrosis and apoptosis of cardiomyocytes during I/R and improve cardiac contractility in the reperfusion period. The OR agonists exert an infarct‐reducing effect with prophylactic administration and prevent reperfusion‐induced cardiomyocyte death when ischemic injury of heart has already occurred; that is, opioids can mimic preconditioning and postconditioning phenomena. Furthermore, opioids are also effective in preventing ischemia‐induced arrhythmias

Activation of a glioma-specific immune response by oncolytic parvovirus Minute Virus of Mice infection

Rodent autonomous parvoviruses (PVs) are endowed with oncotropic properties and represent virotherapeutics with inherent oncolytic features. This work aimed to evaluate the capacity of Minute Virus of Mice (MVMp) to act as an adjuvant stimulating a mouse glioblastoma-specific immune response. MVMp was shown to induce cell death through apoptosis in glioma GL261 cells. Antigen-presenting cells (APCs) provide the initial cue for innate and adaptive immune responses, and thus MVMp-infected GL261 cells were tested for their ability to activate dendritic cells (DCs) and microglia (MG), two distinct cell types that are able to act as APCs. MG and discrete DC subsets were activated after co-culture with MVMp-infected glioma GL261 cells, as evidenced by upregulation of specific activation markers (CD80, CD86) and release of proinflammatory cytokines (tumor necrosis factor-a and interleukin-6). The in vivo analysis of immunodeficient and immunocompetent mice revealed a clear difference in their susceptibility to MVMp-mediated tumor suppression. Immunocompetent mice were fully protected from tumor outgrowth of GL261 cells infected ex vivo with MVMp. In contrast, immunodeficient animals were less competent for MVMp-dependent tumor inhibition, with only 20% of the recipients being protected, arguing for an additional immune component to allow full tumor suppression. In keeping with this conclusion, immunocompetent mice engrafted with MVMp-infected glioma cells developed a level of anti-tumor immunity with isolated splenocytes producing elevated levels of interferon-gamma. In rechallenge experiments using uninfected GL261 cells, we could show complete protection against the tumor, arguing for the induction of a T-cell-mediated, tumor-specific, long-term memory response. These findings indicate that the anticancer effect of PVs can be traced back not only for their direct oncolytic effect, but also to their ability to break tumor tolerance

New materials for adsorption heat transformation and storage

Great current progress in the materials science offers an enormous choice of novel adsorbents which may be promising for transformation and storage of low temperature heat, e.g. from renewable heat sources. This paper gives an overview of recent trends and achievements in this field. We consider possible optimization of zeolites by dealumination, further development on aluminophosphates, composites salt in porous host matrice and metal-organic frameworks which are currently receiving the largest share of scientific attention. The particular attention is focused on the chemical nano-tailoring and tunable adsorption behavior of these materials to satisfy the demands of appropriate heat transformation cycles. We hope that this review will give new impact on target-oriented research on the novel adsorbents for heat transformation and storage

Human Retrotransposons and the Global Shutdown of Homeostatic Innate Immunity by Oncolytic Parvovirus H-1PV in Pancreatic Cancer

Although the oncolytic parvovirus H-1PV has entered clinical trials, predicting therapeutic success remains challenging. We investigated whether the antiviral state in tumor cells determines the parvoviral oncolytic efficacy. The interferon/interferon-stimulated genes (IFN/ISG)-circuit and its major configurator, human endogenous retroviruses (HERVs), were evaluated using qRT-PCR, ELISA, Western blot, and RNA-Seq techniques. In pancreatic cancer cell lines, H-1PV caused a late global shutdown of innate immunity, whereby the concomitant inhibition of HERVs and IFN/ISGs was co-regulatory rather than causative. The growth-inhibitory IC50 doses correlated with the power of suppression but not with absolute ISG levels. Moreover, H-1PV was not sensitive to exogenous IFN despite upregulated antiviral ISGs. Such resistance questioned the biological necessity of the oncotropic ISG-shutdown, which instead might represent a surrogate marker for personalized oncolytic efficacy. The disabled antiviral homeostasis may modify the activity of other viruses, as demonstrated by the reemergence of endogenous AluY-retrotransposons. This way of suppression may compromise the interferogenicity of drugs having gemcitabine-like mechanisms of action. This shortcoming in immunogenic cell death induction is however amendable by immune cells which release IFN in response to H-1PV

The cryopuncture method in treating patients with psoriatic arthritis

Метод криопунктуры предложен для лечения пациентов с псориатическим артритом. Использование криопунктуры способствует улучшению течения заболевания и уменьшает болевой синдром. Method of cryopuncture therapy were proposed to treat patients with psoriatic arthritis. The use of cryotherapy contributes to improving the course of the disease, decreasing the pain syndrome