CARDIAC ARRHYTHMIA AS A CAUSE OF SYNCOPE IN CHILDREN. CLINICAL OBSERVATION

The article is devoted to problem of syncope with cardiac arrhythmias in children. In pediatric patients, arrhythmogenic syncope represent the greatest threat to life and health. Arrhythmogenic syncope may be associated with weakness of sinus node, impaired atrioventricular conduction, paroxysmal tachycardia, syndrome of Wolff - Parkinson - White, long QT syndrome, Brugad's syndrome. Arrhythmogenic syncope are divided into 2 groups - bradiarrhythmical and tahiarrhythmical. The most common cause of arrhythmogenic syncope are ventricular tachyarrhythmia. Ventricular tachyarrhythmias occur in severe organic disease of the myocardium. Ventricular tachycardia with the transition to ventricular fibrillation is often the cause of sudden cardiac death. Syncope associated with bradycardia often occur in children with complete atrioventricular block, atrioventricular block of 2nd degree (2:1, 3:1 etc.). Weakness of sinus node causes syncope much less frequently. During sharp slowing of sinus rhythm the underlying atrium sinus nodes switch on which can provide a rate of 30-40 per minute. Syncope with weakness of sinus node occurs more often with bradycardia less than 30 per minute, and the presence of asystole periods of up to 2 seconds or more. The article presents clinical case of our own observation of a child with syncope. The cause of syncope was the syndrome of sinus node weakness with rhythm pauses to 9-14 seconds. It is not always possible to register syncope during daily Holter ECG monitoring. In this case, it is impossible to identify arrhythmogenic causes of syncope

Chemistry for Sustainable Development 15 (2007) 305-312 Primary Toxicological Parameters of Fluorine-Containing Organic Compounds of Practical Significance

Abstract Primary toxicological parameters of fluorine-containing alcohols, dialkyl ethers, acetales, acrylates, esters of carboxylic and dicarboxylic aliphatic acids, epoxides and olefins used as the materials and intermediate products of organofluoric synthesis are considered. The regularities of the effect of fluorine atoms on the toxicity of the compounds are revealed. All the investigated compounds belong to the III and IV class of danger and are safe for developing fluorinated materials on their basis. Some examples of the application of these classes of compounds are discussed

Anabolic activity of leuzea and cranberry meal plant extracts composition

Еhe anabolic properties of a new composition of leuzea and cranberry meal extracts in a ratio of 7:50, containing ecdisten and ursolic acid, respectively, have been investigates on a model of isolated overload of the skeletal muscle of the rats leg by the method of excision. Material and methods. The experiment was conducted on Wistar stock rats of both sexes weighing 220–250 g. At the beginning of the experiment, all animals underwent musculus gastrocnemius tenotomy (m.gastrocnemius), and then the composition has been intragastrically administered for 14 days. At the end of the experiment, the rats were decapitated, blood was taken to determine biochemical parameters (creatine phosphokinase activity, glucose and lactate level) and muscles from both legs were separated to determine the difference between the mass of the musculus soleus (m. soleus) operated on and the mass m.soleus of a non-operated paw. Results and discussion. A dose-dependent anabolic effect was established for the composition of leuzea and cranberry meal extracts. A gender difference was found, which was confirmed by the obtained values of creatine phosphokinase activity and glucose/lactate ratio. Conclusions. The composition of leuzea and cranberry meal extracts exhibits a dose-dependent anabolic effect in males and increase physical endurance in female rats on the model of isolated overload of the skeletal muscle of the leg of rats with tenotomy operation

Off-Label Prescribing in Paediatric Cardiology: Regulatory Aspects and Safety Assessment by Spontaneous Reporting

In paediatrics, it is a common practice to use pharmaceuticals outside the approved Summary of Product Characteristics (i.e. off-label). According to the literature, up to 45% of inpatient paediatric prescriptions and 10–20% of outpatient ones are for off-label uses. It is essential to analyse such uses, as it helps medical practitioners act reasonably and professionally.The aim of the study was to explore the possibility of using spontaneous reports to assess the risks of the off-label use of cardiac medicinal products in children in the Irkutsk region.Materials and methods. The authors analysed 25 reporting forms on adverse drug reactions (ADRs) in paediatric cardiac patients from the database of the Regional Centre for Drug Safety Monitoring of the Irkutsk Region and regional data from the Automated Information System (AIS) of the Federal Service for Surveillance in Healthcare of the Russian Federation (Roszdravnadzor) submitted in 2009–2020. The inclusion criterion for reporting forms was a causal relationship between the off-label use of a medicinal product and the ADR that was scored as “possible” or higher on the Naranjo probability scale.Results. According to the reporting forms, the off-label use of cardiac medicinal products in children was associated with ADRs, such as angiooedema, cutaneous symptoms, and bronchospasm. The majority of ADRs (84%) were considered severe. The medicinal products were prescribed for heart failure, arterial hypertension, and cardiac arrhythmias. The majority of ADR reports (75%) were submitted by inpatient medical organisations.Conclusions. The analysis of spontaneous ADR reporting databases is a simple and informative method for studying the safety of medicinal products. It is necessary to raise awareness of ADRs associated with off-label prescribing amongst paediatric cardiologists in order to reduce the incidence of ADRs. The following contributions will improve the quality of medical care: all parties involved with pharmaceuticals should adhere to good pharmacovigilance practices, medical practitioners should be actively involved in treatment safety monitoring, and the professional training curricula of paediatric cardiologists and paediatricians should include specific units on the practical functioning of pharmacovigilance

Silver containing sorbents: Physicochemical and biological properties

New silver containing sorbents, based on mineral carriers, such as alumina and silica systems with a meso- and macro- porous structure, have a higher mechanical resistance and, hydrophilic and hydrophobic chemical composition of the surface. These sorbents are easy to find and relatively inexpensive, compared to their known equivalents. They are furthermore characterised by high specific surface and simple preparation, whilst the addition of silver considerably increases their antiseptic activity. The results of research of the physical, chemical and biological properties of the developed substances, as well as bio-comparability of sorbents with biological tissues, are presented in this paper. The modified material acts simultaneously as the carrier for active substances to the area of therapeutic application and as a sorbent used to remove toxic agents from such areas. This approach led us to modify the sorbent, and prolong the delivery of substances such as silver, as an effective antibacterial and antimycotic agent

Reduction of hepatotoxicity of nimesulide in mechanochemically obtained composition with disodium salt of glycyrrhizic acid

Nimesulide (NIM) is a nonsteroid anti-inflammatory drug which acts as a selective cyclooxygenase 2 inhibitor and is widely used for acute pain treatment. In medical practice, a large amount of data has been collected describing the effect of NIM on the body, while a hepatotoxic side effect of the drug has been found. The exact mechanisms of such NIM-induced hepatotoxicity largely remain unknown but likely involve the intermediate reaction of its metabolism. Reduction of the hepatotoxic side effect of NIM is an actual problem for pharmacology. The aim of the present research was to evaluate the hepatotoxicity of the mechanochemically obtained composition of NIM with glycyrrhizic acid disodium salt (Na2GA) compared to pure NIM and a physical mixture of NIM with Na2GA. Material and methods. CD-1 mice were orally administered for 14 days: 1 group – mechanochemical composition NIM/Na2GA (1:10, m/m) at a dose of 1650 mg/kg; 2 group – physical mixture of NIM with Na2GA (1:10, m/m) at a dose of 1650 mg/kg; 3 group – pure NIM at a dose of 600 mg/kg (which pharmacokinetically corresponds to 1650 mg/kg of NIM/Na2GA); 4 group – vehicle (distilled water). The liver damage was assessed using histological studies and enzymatic activity of the alanine aminotransferase and aspartate aminotransferase in blood serum. Results. Histological analysis did not detect any changes in the liver of NIM/Na2GA-treated animals in comparison with a water-treated group. On the opposite, NIM given alone or as a physical mixture with Na2GA induced severe hepatotoxicity in experimental mice. Biochemical analysis of the blood serum revealed that mechanochemical NIM/Na2GA composition significantly reduced activity of the alanine aminotransferase (about 1.5 times) and aspartate aminotransferase (1.3 times) as compared with the pure NIM. Conclusions. The results obtained indicate a high potential for the practical application of the NIM/Na2GA mechanochemical composition

The morphofunctional and biochemical characteristics of opisthorchiasis-associated cholangiocarcinoma in a Syrian hamster model

The validity of experimental models of pathologies is one of the key challenges in translational medicine. Cholangiocarcinoma, or bile duct cancer, ranks second among oncological diseases of the liver. There is a strong association between bile duct cancer and parasitic infestation of the liver caused by trematodes in the family Opisthorchiidae. We have recently demonstrated that cholangiocarcinoma can develop in Syrian hamsters (Mesocricetus auratus) infected by Opisthorchis felineus and administered with dimethylnitrosamine. However, there is still no description of how this experimental model can possibly be used in translational research. The aim of this work was to study the morphological, functional and biochemical characteristics during cholangiocarcinoma development in Syrian hamsters infected by O. felineus and administered with dimethylnitrosamine. The experi­ment lasted 30 weeks with combined exposure to dimethylnitrosamine in drinking water at a dose of 12.5 ppm and a single injection of 50 metacercariae O. felineus. It was shown that the development of cholangiocarcinoma (18 weeks) increased the total number of basophils, eosinophils and monocytes, the relative number of granulocytes, the amount of total and direct bilirubin, and cholesterol and ALT levels, but reduced the relative number of lymphocytes. Based on pathological, morphometric and biochemical analyses, our model has characteristics similar to those in patients with opisthorchiasisassociated cholangiocarcinoma. Thus, this model can be used to test anticancer drugs, to study the mechanisms of cholangiocarcinogenesis and to search for molecular markers for early diagnosis of bile duct cancer