Prevalence of Heart Failure in a Megalopolis.

Aim      To assess the prevalence of heart failure (HF) in St. Petersburg from 2019 through 2021 based on medical reports.Material and methods  Medical records of 146 912 patients with HF who were managed in St. Petersburg from 2019 through 2021 were analyzed. Prevalence of HF was assessed using a standard ICD-10 I 50.x code for this disease. Also, expanded HF coding was used with ICD-10 codes I09.9, I11.0, I13.0, I13.2, I25.5, I42.0, I42.9, I43.0, I43.1, I43.8, I42.5, I42.7, and I42.8. An additional analysis was performed for mortality from cardiovascular diseases (CVD) as a whole and from HF in particular (n=192 133).Results From 2019 through 2021, the number of both male and female patients with HF increased by 18.14 %. The greatest number of HF patients was in the age group of 75-89 years in 2019-2020 and 60-74 years in 2021, with females prevailing. The HF incidence increased in the age group of 45-59 years with a peak morbidity at age of 60-74 for men and 75-89 for women, which was consistent with the life expectancy of each gender. The expanded coding allowed a more complete presentation of HF prevalence and also to take into account patients with HF caused not only by myocardial infarction or acute cardiac pathology but also by rheumatic heart disease, arterial hypertension, myocarditis, and cardiomyopathies. Cardiovascular mortality significantly increased by 20.1% during the period from 2019 through 2021. The HF prevalence for deceased patients also was steadily increasing during 3 years. Analysis of associated pathology in HF patients revealed, in most cases, hypertension, ischemic heart disease, cerebrovascular diseases, diabetes mellitus, and obesity.Conclusion      The increase in HF prevalence and mortality draws attention and calls for managing measures to change the current situation in health care. A registry is required to characterize a typical patient with HF and to present an unbiased picture of HF prevalence. It is also necessary to develop programs for outpatient follow-up of patients in this category and for providing current, highly effective medicines. Education of patients and improving the knowledge of therapists in diagnosis and treatment of HF are most relevant for enhancing the quality and duration of patients' life and for reducing the number of hospitalizations and the HF mortality.

[Noninvasive spinal cord electrical stimulation in the complex rehabilitation of patients with spinal cord injury]. / Neinvazivnaia élektricheskaia stimuliatsiia spinnogo mozga v kompleksnoi reabilitatsii bol'nykh so spinnomozgovoi travmoi.

BACKGROUND: Spinal cord injury causes significant impairments of both motor and pelvic organ functions. Latest studies have shown impressive potentials for using transcutaneous spinal cord electrical stimulation (TcSCES) in the late period of injury to restore motor functions. All results were obtained in a limited number of patients in the specific conditions of a physiological experiment. It remains unclear how effective a TcSCES cycle is in restoring motor activity in patients after spinal cord injury in real clinical conditions. AIM: The main objective of this investigation was to study the effectiveness of TcSCES in combination with the standard rehabilitation of patients after a spinal cord injury. An additional objective was to evaluate the effect of TcSCES to excretory functions in patients with spinal cord injury. SUBJECTS AND METHODS: The studies were conducted at Saint Petersburg City Hospital Forty, which included 15 patients with thoracic spinal injury at 2.4±2.06 years after injury; the severity of the latter was American Spinal Injury Association (ASIA) Grades B and C. All the patients underwent a 2-week standard cycle of rehabilitation treatment; of them 7 patients (a study group) received additionally TcSCES. Standard scales were used to assess neurological status and muscle strength and sensitivity. The patients filled out a urinary diary; residual urine volume was monitored using bladder catheterization or ultrasound. RESULTS: An increase in muscle strength was recorded in 6 patients of the study group and in 1 patient of the control one. The end of the treatment cycle was marked by a 1-score spasticity increase in 1 patient of the study group and in 2 patients in the control one. In the study group, the level of anesthesia decreased per segment in 1 patient; an improvement in deep and proprioceptive sensitivity was recorded in 2 patients; no change in sensitivity was observed in the control group. In the study group, 2 patients showed a reduction in the severity of injury from ASIA Grade B to ASIA Grade C. In three patients of the study group, the residual urine volume decreased and control and a sensation of urgency to urinate appeared; in the control group, these parameters remained unchanged after the treatment cycle. DISCUSSION: The main result of the study is evidence for the efficiency of using TcSCES in the complex therapy of motor neurorehabilitation. The performed cycle of TcSCES in patients was noted to result in better motor and excretory functions. CONCLUSION: The use of a short-term TcSCES cycle in the motor rehabilitation program for patients with spinal cord injury contributes to recovery of severe motor disorders and is accompanied by an improvement in urinary functions.

Experimental Substantiation of Inhalation Administration of Pathogenic Therapy of Toxic Convulsive Disorder for Correction of External Respiration Disorders.

We studied the dynamics of respiratory function in rats during intratracheal poisoning with diisopropyl fluorophosphate and pentylenetetrazole in doses corresponding to the LD50 in humans. The maximum of external respiration impairment was recorded in 30 min after poisoning. Administration of diazepam and atropine both separately and in combination during the development of the first signs of poisoning did not significantly affect the respiration parameters, but reduced the incidence of seizures and contributed to a decrease in the rate of animal death. Intratracheal administration of cholinolytic, ß2-adrenomimetic, or glutamate receptors antagonist promoted correction of the respiratory function. It was found that the maximum therapeutic effect in case of diisopropyl fluorophosphates poisoning was achieved after intratracheal administration of ipratropium bromide (0.086 mg/kg), salbutamol (0.086 mg/kg), and MK-801 (0.1 mg/kg), while in case of pentylenetetrazole poisoning, intratracheal administration of ipratropium bromide (0.086 mg/kg) was most effective.

[Clinical and organizational way of innovative development of regenerative medicine in security agencies].

The article covers organizational aspects of development of innovative technologies in the field of regenerative medicine. It is shown that for the effective design and implementation into medical practice of regenerative medicine requires a united complex of military health care, military medical research and education. The main goal is to formate a biological insurance of personnel to treat different consequences of radiological incidents, burn disease, identification of the remains of the victims; the maximum returning to action after disturbed as a result of health services. Proposes the creation of "Interdepartmental Clinical Research and Education Center for Regenerative Medicine", combining research, clinical, industrial and educational potential of the leading institutions of various departments that will enhance the national security of the Russian Federation.

[Pharmacological tolerance to medical therapy of organophosphate poisoning and ways of tolerance management].

Authors consider causes of low efficiency of antidote therapy and ways of pharmacological tolerance management during medical treatment of organophosphate poisoning. One of the promising ways is a preventive antidote on the base of enzyme agents and allosteric modulators of a cholinesterase activity. Authors showed a expediency of a study of new acetylcholinesterase reactivators, its compositions and ways of drug delivery. Authors specified ways of searching for anticonvulsants from classes of quick-closing benzodiatines and NMDA-antagonists. Authors defined ways of improvement of methods of special antidotes delivery with targeted transport system. Authors made an assumption about the necessity of symptomatic treatment.

[Concept of the biological register of the Ministry of Defense as a biological insurance system of the health of soldiers at the present stage of the development of Russian armed forces].

The concept of regenerative medicine has acquired a considerable progress especially in NATO armies. Regenerative medicine with its innovative technologies becomes a powerful tool in solving ensuring problems of military medical institutions with medicines on the basis of donor blood, tissues and artificial skin. The centers of regenerative medicine and cell therapy developed by many of the leading research institutions in our country and abroad. Foundation of a Biological Register of Russian Armed Forces with a Centre of Cellular and Genetic technologies based at the Military Medical Academy will satisfy needs of military medicine in cellular technologies. Scientific research works in experimental biology and clinical studies of stem cells will enable to generate biological safety of servicemen.