[Circular Sympathetic Pulmonary Artery Denervation in Cardiac Surgery Patients With Mitral Valve Defect, Atrial Fibrillation and High Pulmonary Hypertension].

Objective Investigate the influence of the sympathetic denervation of the pulmonary trunk and the orifices of the pulmonary arteries on the degree of pulmonary hypertension (PH) and outcomes of the surgical treatment of atrial fibrillation (AF) in patients with mitral valve defects, complicated AF, and high PH.Material and methods We analyzed the surgical treatment of 140 patients with mitral valve defect, concomitant AF, and high PH - pulmonary artery systolic pressure (PASP) gradient more than 40 mm Hg. The group of interest included 51 patients (46 patients with severe mitral stenosis and five patients with grade 4 mitral valve regurgitation). All patients underwent mitral valve correction (47 valve replacement surgeries and 4 valve-sparing interventions), biatrial Maze IV procedure, and additionally, denervation of the pulmonary trunk and the orifices of the pulmonary arteries. The control group included 89 patients diagnosed with mitral valve defect, AF, and PH with PASP > 40 mm Hg. However, unlike in patients of interest, denervation of the pulmonary arteries was not performed.Results Circular radiofrequency denervation of the pulmonary trunk and the orifices of the pulmonary arteries using a clamp-destructor is an effective and safe method, significantly reduces secondary PH (p=0.018), promotes reverse remodeling of the heart chambers, left atrium in particular (p=0.01), and improves outcomes of the Maze IV procedure (p=0.022) by restoring sinus rhythm in patients with mitral valve defects, complicated AF, and high PH.Conclusion This technique must be studied further involving a more significant number of patients, analyzing long-term results, and using this technique in patients with non-valvular causes of secondary PH.

[The alcohol effect on natural chronobiological rhythms of suicidal activity in patients supervised by addiction treatment specialists and psychiatrists]. / Vliyanie priema alkogolya na khronobiologicheskie ritmy suitsidal'noi aktivnosti u patsientov, nakhodivshikhsya pod nablyudeniem narkologa i psikhiatra.

AIM: To study the alcohol effect on chronological rhythms of suicidal activity in patients supervised by addiction treatment specialists and psychiatrists. MATERIAL AND METHODS: We have analyzed 1094 cases of suicides committed by men who lived in Cheboksary and Novocheboksarsk. The suicide committers were divided into two groups by presence or absence of blood and/or urine alcohol; each group was subdivided into three subgroups: a) mentally healthy suicide committers (MHSC), b) those who were under the supervision of the psychiatrist (PS), c) those who were supervised by addiction treatment specialists (ATS). Chronobiological rhythms were assessed using z-scores, frequency biological rhythms were evaluated with Kolmogorov-Smirnov's test with the Lilliefors correction and rank correlation. The trends of each chronobiological number were computed, the differences of obliquing angle of the trend were evaluated using 2×2 contingency tables (c2 with Mac-Namara's amendment). RESULTS: All suicide committers of the 1st group showed daily rising suicide trend, which had highs in the active wakefulness period. In the 2nd group, the trend did not change in MHSC and ATS, but in PS it significantly changed to descending with two peaks at 6-8:59 and 18-20:59. Upward weekly trend in PS in both groups was almost the same (in the 1st group the obliquing angle of the trend was 19° and in the 2nd group - 21°), the maximum was observed on Saturday and Sunday. In MHSC of the 1st group, the trend was moving downward, and in the 2nd group it was low. Both MHSC and ATS had the maximum on Monday. Annual trend in the 1st group in all samples was low. In the 2nd group, the trend remained low at MHSC and ATS and changed up in PS (16°) with the maximum in November-December. CONCLUSION: Chronobiological characteristics of deaths confirmed by peaks exceeding the average proportion of suicides from 1.5 to 2.5 times were noted in all groups of suicide committers. Alcohol intake significantly changed the suicidal chronobiological rhythm in PS.

[The influence of alcohol consumption on the chronological patterns of sudden cardiac death].

The objective of the present study was the retrospective analysis of the materials collected by the Republican Bureau of Forensic Medical Expertise, Ministry of Health and Social Development of Chuvash Republic, during the period from 1997 till 2002 for the elucidation of the chronological patterns of sudden cardiac death (SCD) associated with alcohol consumption depending on the sex and age of the victims, days of the week and months of the year as well as weather conditions. It was shown that the peak of mortality among men and women taking no alcohol fell on Monday. It was highest in May and decreased by February. The alcohol consumption significantly changes the chronological patterns of mortality from cardiovascular pathology. It was highest among the women abusing alcohol in August and October. The study has demonstrated a weak negative correlation between the frequency of sudden cardiac death among non-consumers of alcohol and dew-point temperature among the persons having alcohol in blood.

[Efficacy of metformin in abdominal obesity].

AIM: To study the effect of metformin on metabolic parameters, body weight (BW), and waist circumference (WC) in patients with abdominal obesity (AO). SUBJECTS AND METHODS: The results of using metformin 2000 mg daily for 3 months in 46 patients with AO. The comparison group consisted of 50 people. BW, WC, and blood pressure (BP) were measured; lipid profile parameters and blood insulin concentrations were determined; and Homeostasis Model Assessment (HOMA) estimates were calculated. Metabolic syndrome (MS) and AO were judged by the 2005 International Diabetes Federation (IDF) criteria. RESULTS: The study and comparison groups showed were reductions in BW by 4.2 and 1.7 kg and in WC by 4.2 and 1.1 cm, respectively. Metformin used in the patients with AO contributed to a more significant improvement in the lipid profile than in those who received no medication. A decrease in the HOMA index was observed only in the metformin group. The effects of the drug were more pronounced in MS and insulin resistance. The use of metformin in the patients with AO decreased lower BW and HOMA index and improved lipid metabolism even in the absence of MS. CONCLUSION: The trial has demonstrated that the people with AO may take metformin could be used in to reduce BW and WC and to treat and prevent MS.

[Hormonal aspects of the development of obesity and metabolic syndrome in ethnic groups (by the population of the Chuvash Republic)].

AIM: To study the specific features of the hormonal status in the development of obesity and metabolic syndrome (MS) in different ethnic groups. MATERIALS AND METHODS: The prevalence of obesity and MS was studied in Russian and Chuvash people, the relationship of MS to body mass index (BMI), the levels of insulin, dehydroepiandrosterone sulfate (DHEAS), and testosterone, and insulin resistance (IR) was assessed. RESULTS: The prevalence of obesity and MS depends on ethnicity and gender (these are more common in the Russians than in the Chuvashes, in the women than in the men). Overweight and obesity versus normal weight are characterized by the higher rate of MS, hyperinsulinemia, and low DHEAS concentrations. The obese men have decreased testosterone levels. The lower DHEAS levels are associated with the presence of MS (association factor +0.36) rather than with the development of obesity (association factor +0.07). In the Russians versus the Chuvashes, the development of MS is more frequently associated with the fall of DHEAS levels and less frequently with the development of IR. CONCLUSION: The incidence of MS increases with higher BMI, accompanies by IR and hyperinsulinemia. MS in the Russians is associated with the lower DHEAS concentration.

[Recombinant activated factor VII use for the bleeding implications prevention during central venous catheterization in pediatric patients with acute leucosis and thrombocytopenia].

UNLABELLED: Research objective was to develop an algorithm of the recombinant activated Factor VII (rFVIIa) prophylactic use for the bleeding implications prevention during central venous catheterization in Pediatric patients with acute leucosis and thrombocytopenia. METHODS: 30 Pediatric patients with acute leucosis and thrombocytopenia received rFVIIa 30-120 microg kg(-1) before the internal jugular vein catheterization with ultrasound control. Comparative group 1 included 39 Pediatric patients without preventive haemostatic treatment; comparative group 2 included 30 patients received platelet concentrate. RESULTS: the first attempt catheterization numbers increased, the time of the catheterization was reduced, platelet aggregation was improved and the bleeding implications frequency was 6.6% in patients received rFVIIa before the internal jugular vein catheterization. 23.1%--in the comparative group 1; 26.7% in the comparative group 2. CONCLUSION: Ultrasound navigation and rFVIIa preventive use together improve internal jugular vein catheterization results.

[Adaptive systems of the body in metabolic syndrome].

The aim of the work was to study the state of adaptive systems in patients with metabolic syndrome. This cross-sectional randomized trial included 99 women and 32 men. The measured variables were blood levels of dehydroepiandrosterone sulfate (DGEAS), cortisol, total T3 and T4, lymphocyte count, and muscle endurance (number of squats/min). 43 patients presented with metabolic syndrome (MS) and 88 without it. MS was associated with decreased blood DGEAS and T3 levels, increased lymphocyte count, reduced activity of sympathetic nervous system and muscle endurance.

[The prevalence of eating behavior disorders in patients with overweight and obesity].

The prevalence of food behavior abnormalities among people with overweight and obesity. The AIM OF INVESTIGATION: To estimate characteristics of food behaviour among people with overweight and obesity. MATERIALS AND METHODS: We examined 188 human of Chuvashia. Anthropometric data was estimated, bodyweight index and waist-hip index were calculated. Infringements of food behaviour were evaluated according to T.G. Voznesenskoj's recommendations. THE RESULTS AND CONCLUSION: Food behavior abnormalities appeared more often among people with overweight and obesity than among people with normal weight. The prevalence of food behavior abnormalities depended on the presence of abdominal obesity. The frequency of all types of food behavior abnormalities rose among individuals with overweight and obesity. The groups with overweight and obesity turned out comparable in prevalence and structure of food behavior abnormalities.

[The predictive value of thyroid function in patients with respiratory tuberculosis].

Enzyme immunoassay was used to determine the levels of thyrotropric hormone (TTH), total and free fractions of thyroxine, and triiodothyronine in patients with respiratory tuberculosis. 61.8% of the patients were found to have type 3 euthyroid pathology that was characterized by the elevated levels of thyroxine and triiodothyronine with the unchanged level of TTH and by the absence of clinical manifestations of thyrotoxicosis. The levels of the total and free fractions of triiodothyronine and thyroxine were higher in patients with lung destruction, dissemination, or bacterial isolation than in those without these manifestations. The positive clinical and X-ray changes were followed up by regression of thyroid shifts in patients with the baseline high values of thyroid hormones. Antituberculous drugs did not affect thyroid function.

[Use of microcomputers in epidemiological analysis]. / Primenenie mikro-EVM pri épidemiologicheskom analize.

The possibility of the effective use of microcomputers in the practical work of a sanitary and epidemiological station for the purpose of organizing epidemiological surveillance has been shown. The programs developed in this investigation are recommended for introduction into the practical work of sanitary and epidemiological stations servicing districts with a population of 100,000-200,000 and more.

[Epidemiological monitoring in salmonellosis]. / Epidemiologicheskii monitoring pri sal'monellezakh.

The use of a model DZ-26 computer for the current analysis of salmonellosis and for processing laboratory data is analyzed.