The aim of the study was a comparative assessment of the results of various mental stress-tests (MT) and the development of a common MT protocol to assess the contribution of psychogenic factors in arrhythmogenesis in patients with ventricular arrhythmias (VA) in the absence of structural heart disease. There were 66 patients with idiopathic VA and anxiety neurotic disorders (AND) drawn from 400 patients after examination (ECG, Holter ECG monitoring, echocardiography, treadmill exercise test, coronary angiography and MRI when necessary; psychological examination and a consultation by a psychotherapist). MT were performed all patients according to the study protocol. Results. Correlation analysis of hemodynamic parameters in a rest period between all MT showed there were no differences in the period of rest between MT. Consequently, the test sequence does not affect its results. According to a comparative and correlation analysis there were stasistically significant differences between MT only in hemodynamic parameters changes. There were not stasistically significant differences in the change of VA during the conduct of MT. Conclusion. Use of MT allows to evaluate the contribution of psyhoemotional factor in the genesis of VA in patients with idiopathic arrhythmia and AND. The whole complex of MT must be used to evaluate the psychoemotional factors in the genesis of VA considering that the more tests we spend, the more likely to get a patient’s response to some test.

We evaluated possible predictors of recurrence of atrial fibrillation (AF) after the interventional treatment with subsequent modeling of patient prognosis. On the large cohort of patients (148 pts, mean age 52.3 + 9.2 years) the correlation analysis revealed significant predictors of AF recurrence after radiofrequency ablation (RFA): left atrium (LA) dilation (r = -0,58, p < 0.001), patient age (r = 0,66, p < 0.001), type of RFA (r = -0.69, p < 0.001), time after RFA (r = -0,63, p < 0.001), post-operative in hospital recurrence of AF (r = 0,64, p < 0.001), the number of reference points (r = -0, 71 , p < 0 .001), the number of RF applications (r = -0,59, p < 0.001), prior antiarrhythmic therapy (r = 0,40, p < 0.001), aortic (r = 0,55, p < 0.001 ) and mitral regurgitation (r = 0,41 , p < 0.001). In view of described correlations we performed discriminant analysis to create two mathematical risk prediction models for AF recurrence after RFA.

This article describes questions of expert’s examination of medical care by patients with atrial fiblillation at a stationary stage. Objective. To search the typical defects of medical care for patients with atrial fibrillation and methods of expert’s review. Authors defined defects of medical care. Defects of medical care showed, than a part of typical defects determine negative effects for patient’s health. Authors create the special method for exams of medical care and effects.

This article presents the preliminary results of the study (RACSMI-Uz) conducting at the moment in one of Tashkent districts. The purpose of this study is assessment of renal function and clinical and anamnesis in patients with acute coronary syndrome and acute myocardial infarction (ACS / MI) in the experimental area of the city of Tashkent. In this fragment the study analyzed the data of 67 patients admitted to the relevant medical institutions of the pilot district of Tashkent with a diagnosis of ACS / AMI for the period from 01.01.2015 to 01.10.2015 year. As the ongoing hospital treatment and stabilization diagnoses configuration changed. Depending on this, the patients were divided into two groups: 1g. - 32 patients who had a diagnosis of the discharge summary AMI with / without Q and 2g. - 35 patients who was recorded in extracts from hospital the stable exertional angina II-III functional class (FC). Analysis of anamnestic data found that myocardial infarction and percutaneous coronary intervention (PCI), as well as the presence of concomitant chronic kidney disease and type 2 diabetes mellitus were the prerogative of individuals with acute coronary artery disease, whereas for patients with stable disease was characterized by the presence of coronary stenoses more than 50% and transferred coronary artery bypass grafting (CABG); most often taken on outpatient drugs groups were β-blockers and acetylsalicylic acid, however, quantitative daily diet drugs more than 1,5 times was higher in patients with stable coronary artery disease. Patients with AMI with / without Q have relatively low values of the lipid spectrum of the blood and elevated levels of factor de Rytis. Despite the fact that the glomerular filtration rate was comparable in both groups of patients, however, end-stage chronic renal disease was the prerogative of the respondents with acute course of disease.

In order to assess the impact of chronic kidney disease (CKD) in patients with myocardial infarction (MI) in the development of acute tubular damage, 53 postmortem report protocols analyzed the deceased was receiving treatment over MI in 2012-2013. in Institute for Emergency Medical Care of I.I. Dzhanelidze. All dead patients were divided into two groups: the first (I) includes 26 deaths in the acute phase of MI with CKD, the second (II) - 27 patients with MI without CKD. A comparison of clinical and laboratory data with morphological changes in the kidney tissue was done. The representativeness of the data, the accuracy of the differences between the figures in the samples estimated using nonparametric criterion - the angular transformation of Fisher index, univariate analysis. It was found that in patients with CKD who died during the acute phase of MI was significantly more frequent acute tubular damage 2-3 degrees, as well as recurrent MI.

Measurement of blood pressure, beat to beat interval and arterial baroreceptor reflex is a basic procedure in studies of experimental hypertension. Objective. The purpose of this work was to compare the results of the hemodynamics parameters derived from invasive (anaestheia and wake) and non-invasive (wake) measurements in Wistar rats before and after development of renovascular hypertension. Design and methods. In our experiments we used renovascular hypertension model 2 kidneys, 1 clip. During invasive measurements (anesthetized (pentobarbital sodium) and waking state) mean arterial pressure, beat to beat interval and arterial baroreceptor reflex were recorded. Direct measurements were made before and 8 weeks after placing the clamp on the left renal artery. On the tail registration of systolic blood pressure and beat to beat interval (with spectral analysis of heart rate variability) was carried out for all 8 weeks of observation 1 times per week. Results. The results of the invasive and non-invasive measurements did not contradict each other. Herewith the correct conclusion about the state of the arterial baroreceptor reflex can be done only through direct measurement in wake animal. While the dynamics of renovascular hypertension development can be observed only using non-invasive tail method. Conclusions. Based on the results of our work, we have concluded that the invasive and non-invasive hemodynamic parameters registration methods complement each other in studies of experimental hypertension.

We studied 12-16 nm spherical silicone dioxide nanoparticles chronic toxicity on Wistar male rats (middle weight 250-300 g). We intravenously injected 1 ml silicone dioxide nanoparticles suspension and evaluated histological modifications in organs after 7, 21 and 60 days after injection. We detected mast cell migration into lungs, myocardium and liver tissues. Also we revealed macrophage granulomas around foreign bodies formation and liver tissue fibrous remodeling. This remodeling took place without precedence of destruction. We noticed that silicone dioxide nanoparticles injection was accompanied by evolution of chronic aseptic productive inflammation. The same type of inflammation take place in case of non-modified nanoparticles silicone dioxide intervention in sylicosis.

Objective. To determine hemocompatibility of N-succinyl-chitosan (SC) and N-glutaryl-chitosan (GC). Materials and methods. Effect of SC and GC on the vascular-platelet hemostasis (adhesion and agonist-induced aggregation) and anticoagulation properties (APTT, PT and TT) of SC and GC was evaluated with donor blood. The acute toxicity of SC and GC was evaluated on anesthetized rats, which was subjected to intravenous administration of 1 % solutions of SC and GC. The effect on systemic hemodynamics and the presence of hemolysis was evaluated. Cell viability assay (MTT-test) in the presence of SC and GC was carried out with HL-1 cell line for evaluation of cytotoxic potential of chitosan derivatives. Results. Intravenous administration of aqueous solutions of SC and GC (molecular weight 83,000, deacetylation degree 0.93) in acute experiments on anesthetized rats did not cause hemolysis, changes in the parameters of systemic hemodynamics and respiratory rate. The data from the platelet aggregation assays and the coagulation assays with human blood indicate that chitosan derivatives possess anticoagulant and antiplatelet properties. In the test for cytotoxicity (MTT-test) addition of SC (degree of substitution 0.85) in cell medium did not affect the viability of HL-1 cell culture within 3 days of incubation, while GC (degree of substitution 0.71) showed toxic effect after cell exposure to different concentrations (0,1 %, 0,01 % и 0,001 %) of the one after two days of incubation. Conclusion. The results show the low toxicity of SC and possibility of its use in biomedical applications and in the development on its base parenteral formulations. The observed toxicity of GC does not allow to recommend its parenteral administration. However, given the lack of influence of GC on the systemic hemodynamics, further modification of the GC is needed to reduce the effects on platelet function and cell viability.

The clinical case of some endocrine disturbances accompanied by Niemann-Pick type B syndrome is presented in this article. There are short stature due to growth hormone deficiency, delay of puberty onset in a girl who was diagnosed with Niemann-Pick type B syndrome that belonging to group of lysosomic diseasescharacterized by severe hepatolienal syndrome. The clinical implications, features of a course of a disease at this patient entering into structure of a syndrome of Niemann-Pick type B, and algorithm of differential diagnosis of the endocrine pathology are described.

In the present study we described the case report of antenatal fetal death associated with multiagent chemotherapy to cure an acute myelogenous leukemia. We analyzed the risks of pregnancy prolongation and its termination, impact of contemporary oncology drugs on the fetus, and possibilities for leukemia treatment and its complications in the pregnancy period. Assessment of possible decreasing of the risk of life-threatening complications depending on clinical progression was also performed. In the present article we described the complexities associated with a choice of delivery method under antenatal fetal death.

Despite some successes in the surgical treatment of atrial fibrillation, the question remains about choosing the best techniques that can be implemented universally with maximum efficiency and minimal complications. Performing radiofrequency ablation of the Atria seems to be preferred in all patients with heart valve disease who have any form of atrial fibrillation at the time of surgery. In this regard, the search for science-based criteria, which were absolute indications for the use of bioelectrical methods for intraoperative isolation of the Atria as a component of surgical treatment of patients, is an important component in the improvement of quality of rendering of hi-tech medical aid to patients with acquired heart defects.

In this article we evaluated the relationship of specific capillaroscopic changes with clinical and immunological subtypes and endothelial function in patients with systemic sclerosis. Characteristic changes in the capillaries were found in 98 % of subjects with systemic sclerosis. The association capillaroscopic patterns with the presence of pulmonary hypertension, lung damage and the level of N-terminal peptide natriuretic peptide in the blood was found.