Kasatkin A.A.,Izhevsk State Medical Academy |
Urakov A.L.,Izhevsk State Medical Academy |
Nigmatullina A.R.,Clinical Hospital
Indian Journal of Critical Care Medicine | Year: 2017
Context: It is believed that 15°-25° head-down tilt position increases the internal jugular vein cross-sectional area (IJV CSA). The increase in IJV CSA before puncture reduces the risk of its perforation. This pattern was not observed in all patients. We assumed that the absence of respiratory-based IJV excursion is one of the criteria of head-down tilt position effectiveness. Aims: The aim of this study is to determine the head-down tilt angle, which ensures the absence of the respiratory-based IJV excursion. Subjects and Methods: Prospective study included twenty adult patients. The IJVs scanning was carried out in 1 min after placing the patients in a horizontal position on their back and in 1 min after placing them in the head-down tilt position at 5°, 10°, 15°, and 20° tilt angles. Results: We found that collapsibility index of <9% indicating the absence of respiratory-based IJV excursion was recorded in 25% of patients in the horizontal supine position. In this case, placing the patients in the Trendelenburg position for IJV catheterization may not be indicated. In 65% of the patients, the respiratory-based excursion was not observed at 10° head-down tilt position. Only 35% of the patients required 15° head-down tilt position. Conclusions: In clinical settings, the disappearance of respiratory-based vein excursion on the ultrasound scanner screen can be considered as criteria of the head-down tilt position effectiveness. © 2017 Indian Journal of Critical Care Medicine.
Malinin O.V.,Izhevsk State Medical Academy |
Platonov A.E.,Central Research Institute of Epidemiology
Infectious Diseases | Year: 2017
Background: Intravenous ribavirin has been reported to be an effective treatment for haemorrhagic fever with renal syndrome (HFRS) caused by Hantaan virus in Asia. However, its therapeutic benefits for HFRS caused by Puumala virus (PUUV) in Europe are still unknown. Methods: A randomized, open-label study of efficacy and safety of intravenous ribavirin in the treatment of HFRS was conducted in the European part of Russia. Seventy-three patients with suspected HFRS within 4 d of the onset of the disease were randomized to receive either intravenous ribavirin (33 mg/kg, followed by 16 mg/kg given every 6 h for 4 d and by 8 mg/kg given every 8 h for 3 d) plus standard therapy (n = 37) or standard therapy alone (n = 36). The primary outcome was the average change from baseline in viral load over time estimated as area under the viral load curve minus baseline (AUCMB). Fifty-five patients with HFRS confirmed by nested reverse transcriptase – polymerase chain reaction (PCR) assay were included in the assessment of the efficacy. All patients entered into the clinical trial were included in the assessment of the safety. Results: PUUV was detected in all cases of confirmed HFRS. Viral load kinetics were similar in both treatment groups. Significantly more patients receiving ribavirin than standard therapy experienced low haemoglobin level (95% vs 36%), hyperbilirubinemia (81% vs 3%), sinus bradycardia (43% vs 14%), and rash (19% vs 0%). Conclusions: Results of the study showed insufficient efficacy and safety of intravenous ribavirin in the treatment of HFRS caused by PUUV. © 2017 Society for Scandinavian Journal of Infectious Diseases
Ruys T.P.E.,Erasmus Medical Center |
Roos-Hesselink J.W.,Erasmus Medical Center |
Pijuan-Domenech A.,Hebron University |
Vasario E.,SantAnna Hospital |
And 8 more authors.
Heart | Year: 2015
Objectives In the general population, planned caesarean section is thought to be safer in high-risk situations as it avoids the greater risk of an emergency caesarean section. Only limited data exist on the optimal mode of delivery in women with structural heart disease. We investigated the relationship between mode of delivery and pregnancy outcome in women with preexisting heart disease. Methods The Registry on Pregnancy and Cardiac Disease is an on-going, global, prospective observational registry of women with structural heart disease. We report on 1262 deliveries, between January 2007 and June 2011. Results The caesarean section was planned in 393 women (31%): 172 (44%) for cardiac and 221 (56%) for obstetric reasons of whom 53 delivered by emergency caesarean section. Vaginal delivery was planned in 869 (69%) women, of whom 726 (84%) actually delivered vaginally and 143 (16%) had an emergency caesarean section. Perinatal mortality(1.1 vs 2.7, p=0.14) and low apgar score (11.9 vs 10.1, p=0.45) were not significantly different in women who had a caesarean section or vaginal delivery; gestational age(37 vs 38 weeks p=0.003) and birth weight (3073 vs 2870 g p<0.001) were lower in women delivered by caesarean section compared with women delivered by vaginal delivery. In those delivered by elective or emergency caesarean section, there was no difference in maternal mortality (1.8% vs 1.5%, p=1.0), postpartum heart failure (8.8% vs 8.2% p=0.79) or haemorrhage (6.2% vs 5.1% p=0.61). Conclusions These data suggest that planned caesarean section does not confer any advantage over planned vaginal delivery, in terms of maternal outcome, but is associated with an adverse fetal outcome.
Iryanov Y.M.,Russian Ilizarov Scientifi nter for Restorative Traumatology and Orthopaedics |
Kiryanov N.A.,Izhevsk State Medical Academy
Vestnik Rossiiskoi Akademii Meditsinskikh Nauk | Year: 2015
Background: Non-drug correction of reparative bone tissue regeneration in different pathological states - one of the most actual problems of modern medicine. Objective: Our aim was to conduct morphological analysis of the influence of electromagnetic radiation of ultra-high frequency and low intensity on reparative osteogenesis and angiogenesis in fracture treatment under transosseous osteosynthesis. Methods: A controlled nonrandomized study was carried out. In the experiment conducted on rats we modeled tibial fracture with reposition and fixation of the bone fragments both in control and experimental groups. In the animals of the experimental group the fracture zone was exposed to low intensity electromagnetic radiation of ultra-high frequency. Exposure simulation was performed in the control group. The operated bones were examined using radiography, light and electronic microscopy, X-ray electronic probe microanalysis. Results: It has been established that electromagnetic radiation of ultra-high frequency sessions in fracture treatment stimulate secretory activity and degranulation of mast cells, produce microcirculatory bed vascular permeability increase, endotheliocyte migration phenotype expression, provide endovascular endothelial outgrowth formation, activate reparative osteogenesis and angiogenesis while fracture reparation becomes the one of the primary type. The full periosteal, intermediary and intraosteal bone union was defined in 28 days. Conclusion: Among the therapeutic benefits of electromagnetic radiation of ultra-high frequency in fracture treatment we can detect mast cell secretory activity stimulation and endovascular angiogenesis activation.
Justification of a systemic approach in the sudden cardiac death prevention: A possible solution to the problem of excessive mortality in Russia (literature review) Part I. Cardiovascular aspects of excessive morality in Russia: The state of the problem and potential for prevention
Dimov A.S.,Izhevsk State Medical Academy |
Maksimov N.I.,Izhevsk State Medical Academy
Cardiovascular Therapy and Prevention (Russian Federation) | Year: 2013
The review of the existing evidence on the problem of excessive mortality in Russia has demonstrated that the country is at the initial stage of the irreversible depopulation process. The current healthcare situation, in regard to cardiovascular disease (CVD), does not provide much hope for the effectiveness of existing measures for fatal CVD prevention. It is clear that a large-scale focussed analysis of the clinical and organisational limitations of the existing prevention systems is urgently needed. This discussion should be started in the nearest future.
Dimov A.S.,Izhevsk State Medical Academy
Cardiovascular Therapy and Prevention (Russian Federation) | Year: 2015
Prevention of the diseases, particularly cardial pathology, has its very significant controversies. The idea of the risk factors did not give the expected results. Causality of the majority of diseases is still unknown or not fully understood. This leads to inability of predicting. The article provides the reader with theoretical and practical experience evaluation of the XX century upon the problem of causality (etiology) of diseases. The original definition of causality is expressed and vindicated as its applied significance.
Zajnaeva T.P.,Izhevsk State Medical Academy |
Yegorkina S.B.,Izhevsk State Medical Academy
Human Ecology | Year: 2016
The impact of the isolated low-frequency rotating electric field (the REF) and the one combined with animal immobilisation on the "mother-placenta-fetus" system in rats with various prognostic stress resistance was studied. The research showed that on the 10th experiment day stress hormone content in the blood plasma increased in experimental rats compared to the control group; the increase degree was dependant on individual species stress-resistance. Thus, on isolated action of technogeneous rotating electric field the level of 11-oxocorticosteroids increased by 7,8 % (p > 0,05) in "active" female rats and by 71,7 %in "passive" ones. In conditions of action of combined rotating electric field with immobilization of experimental animals the level of corticosteroids increased by 63,8 % (p < 0,05) in stress-resistant rats and by 35,4 % (p < 0,05) in stress-non-resistant rats. The results of the pathomorphological study of the afterbirth and fetuses from the experimental female rats indicated that the REF leads to the structural plasenta changes, hemodynamical disturbances and are accompanied by the late fetus growth and high embrional mortality rate. The most marked functional and structural changes in the afterbirth were seen under the REF combined with animal immobilisation. © 2016, Springer New York LLC. All rights reserved.
Gaisin I.R.,Izhevsk State Medical Academy
Terapevticheskii Arkhiv | Year: 2012
Aim. To investigate cardiorenal correlations in pregnant patients with arterial hypertension. Material and methods. Risk factors (RF), initial stages, progression, andfinal stage of both cardiovascular disease (CVD) and chronic kidney disease (CKD) were analysed in a cohort of 159pregnant women with hypertensive disorders versus a cohort of 32 healthy pregnant controls. Cardiorenal continuum factors were investigated in patients with different ways of gestational hypertension (HT) diagnosis: 13 with isolated clinic HT (ICHT), 11 - isolated ambulatory HT (IAHT), and 18 - HT found by all three blood pressure (BP) measurement modalities (clinic, ambulatory, and home BP).Results. A novel cardiorenal continuum exists in pregnant women with HT where chronic IIT (essential HT) on the one hand and pre-eclampsia on the other hand may lead through the common RF and initial stages (subclinical organ damage) to the stage ofprogression (CVD, CKD) and to the final stage (cardiovascular events and renal failure). The number of RF, signs of subclinical organ damage, and total cardiovascular risk progressively increase from the condition of being normotensive on clinic, home, and 24-hour definitions to the condition of being found hypertensive by one, two and all three BP measurement methods, forming the continuum "healthypregnant women - ICHT- IAHT-gestational HT" in which each item is almost the same as the ones next to it hut the last is veiy different from the first. Conclusion. Assessment of the cardiorenal state in all pregnant women allows to compose the cline "healthy pregnants - gestational HT- stage I essential HT- stage II essential HT-pre-eclampsia - essential HT with superimposed pre-eclampsia" with growing risk of CVD and CKD and a potential danger of cardiovascular events (complications) and chronic renal failure.
Urakov A.L.,Izhevsk State Medical Academy
IOP Conference Series: Materials Science and Engineering | Year: 2016
The paper states that assigning certain physical and chemical characteristics to pills and medical drugs solutions can substitute for the development of new drugs (which is essentially equivalent to the creation of new medicines). It is established that the purposeful change of physical and chemical characteristics of the standard («old») materials (in other words, the known substances) is fundamental for the production of solid and liquid medicines, which allows us to get «new» structures and materials. The paper shows that assigning new physical and chemical properties to «old» materials and their further usage for the production of tablets and solutions from the «old» and well-known medicines can turn even very «old» medicine into very «novel» (moreover, even very fashionable) one with unprecedented (fantastic) pharmacological activity and new mechanisms of action. © Published under licence by IOP Publishing Ltd.
Urakov A.,Izhevsk State Medical Academy |
Urakova N.,Izhevsk State Medical Academy
Journal of Physics: Conference Series | Year: 2015
In the laboratory studied the dynamics of rheology of water solutions with plasma- inflammatory and antiseptic funds when mixing them with blood, plasma and pus under the influence of the following physical and chemical factors of local interaction: gravity, specific gravity, temperature, relative viscosity, internal pressure, sparkling water, total concentration of the ingredients, surface activity, volume of acid and osmotic activity of medicines. Found that the rheology of biological liquids improve hyperthermic, highly alkaline and highly carbonated solution medicines. For the dilution of pus, dense festering mass of sulfur plugs and tear stones invited to apply heated to +39 - +42°C with aqueous solution of 0.5 - 3% hydrogen peroxide and 0.5 - 10% sodium bicarbonate saturated with carbon dioxide to excess pressure 0.2 ATM. © Published under licence by IOP Publishing Ltd.