[The treatment efficacy of disturbed swallowing function in patients with ischemic stroke and neurogenous dysfagia in the intensive care unit]. / Éffektivnost' lecheniia narushennoi funktsii glotaniia u patsientov s ishemicheskim insul'tom i neirogennoi disfagiei v ramkakh otdeleniia reanimatsii i intensivnoi terapii.

AIM: To evaluate the efficacy of the training method of rehabilitation of patients with neurogenic dysphagia in ischemic stroke carried out with the use of special nutrient mixtures as part of combination therapy. MATERIAL AND METHODS: The study included 65 patients (35 men and 30 women, aged 45 to 80 years) with dysphagia in the acute period of ischemic stroke. Thirty patients were treated with special binding compounds as part of a combination therapy. Thirty-five patients did not use the mixture. The dynamics of the recovery function of swallowing using PAS (the Penetration-Aspiration Scale) and FEDSS (the Fiberoptic Endoscopic Dysphagia Severity Scale), as well as the transition from tube to independent feeding were studied. RESULTS AND CONCLUSION: The training method of rehabilitation with the help of special nutritional mixtures allows achieving significantly better indicators of restoration of swallowing function assessed with PAS and FEDSS in patients with ischemic stroke and neurogenic dysphagia. This trend is most pronounced in the group of patients with pseudobulbar syndrome. The application of the training method leads to a significantly better transition from tube to independent feeding. Tracheal intubation and mechanical ventilation are an additional factor aggravating swallowing disorders.

[Remodeling myocardium and skeletal muscle in chronic heart failure]. / Remodelirovanie miokarda i skeletnoi myshtsy pri khronicheskoi serdechnoi nedostatochnosti.

The spread and progression of chronic heart failure (CHF) is viewed presently from the standpoint of remodeling the myocardium and skeletal peripheral vessels. However, it is not clear yet, if such remodeling is a common adaptive mechanism in CHF for the myocardium and skeletal muscle. The study aim was to investigate the morphological changes in the myocardium and their interrelations with the skeletal muscle condition in CHF patients. For this purpose the biopsy materials of the left ventricle and pectoral muscles obtained from 36 patients with CHF (functional classes I-IV according to NYHA) of various etiologies as well as biopsy materials of the rectus abdominal muscle obtained from 8 patients without CHF were examined by light and electron microscopy. It was established that the development and progression of CHF is accompanied by similar changes in the morphology of the myocardium and skeletal muscle at the tissue, cellular and subcellular levels. As CHF aggravates, the manifestations of hypertrophy and heteromorphism of tissue fibers equally progress in the myocardium and skeletal muscle. A reliable correlation was detected between changes of cellular-stromal ratio in the myocardium and in the skeletal muscle (r = 0.57; p < 0.05).

[Left ventricular remodeling in chronic heart failure: clinical-morphological parallels]. / Kliniko-morfologicheskie paralleli remodelirovaniia levogo zheludochka pri khronicheskoi serdechnoi nedostatochnosti.

AIM: To study morphofunctional state of left ventricular and right atrial myocardium in chronic heart failure at tissue, cellular and subcellular levels and to assess relationship between observed morphological changes and echocardiographical characteristics of left ventricular remodeling. RESULTS AND CONCLUSION: Myocardial remodeling in chronic heart failure was characterized by impaired cellular-stromal balance, enhanced processes of degeneration of cardiomyocytes, lowered energy availability in these cells, and insufficient intracellular regeneration. Fairly close relationship was observed between morphological myocardial changes and echocardiographical parameters of left ventricular remodeling.