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Translational Medicine

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Vol 8, No 4 (2021)
View or download the full issue PDF (Russian)
https://doi.org/10.18705/2311-4495-2021-8-4

CARDIOVASCULAR MEDICINE

6-17 681
Abstract

Background. The processes of inflammation and repair in the area of myocardial infarction (MI) are carried out and regulated by various populations of immune cells, including monocytes, lymphocytes, and NK-cells. The success of myocardial recovery after infarction and the risk of developing acute heart failure (AHF) depend on their adequate interaction. The presence of type 2 diabetes mellitus (T2DM), in which chronic low-gradient inflammation occurs, can affect the monocytic and lymphocytic response in MI, which may contribute to the development of AHF.
Objective. to assess the features of monocytic and lymphocytic responses in patients with MI T2DM complicated by the development of AHF.
Design and methods. The study included 121 patients with MI T2DM (38 of them with AHF). The control group included 59 patients without diabetes mellitus (including 13 patients with AHF). For all patients within 1 day, on days 3, 5 and 12 of MI, the total number of monocytes and lymphocytes, the monocytes-to-lymphocytes ratio (MLR), subpopulations of monocytes and T-lymphocytes with NK cells (T&NK-cells) were determined by flow cytometry.
Results. In patients with T2DM, the number of monocytes of different subpopulations did not differ depending on the development of AHF. In patients without T2DM with MI, complicated by AHF, compared with patients without AHF, on day 3, the number of CD14(+)CD16(-)monocytes was higher: 1018 (824; 1144) vs 593 (557; 677) cells/μL, p <0,01, and on days 3 and 5, the number of CD16(+) T&NK-cells was lower: 122 (95; 275) cells/μL and 307 (220; 406) cells/μL, respectively (p = 0,03); (117 (61; 228) and 437 (408; 545) cells/μL, respectively, p < 0,01. On the 12th day of MI in patients with T2DM and AHF lymphocytes and CD16(+)T&NK-cells counts were lower in comparison with patients without AHF: 1856 (1245; 1975) cells/μL and 2294 (1827; 2625) cells/μL, respectively, p = 0,04; 268 (128; 315) cells/μL and 344 (226 ; 499) cells/ μL, respectively, p = 0,04.
Conclusion. In patients with T2DM, the development of AHF is associated with a low number of lymphocytes in the absence of a pronounced monocytic response. In non-diabetic patients, the development of AHF is associated with an increase in CD16(-)monocytes and a lower number of CD16 (+) T&NК-cells.

18-26 457
Abstract

Background. Most complications of vascular access for hemodialysis require surgical treatment and if ineffective lead to fistula loss and depletion of the vascular resource for the new fistula creation.
Objective. To identify complications of permanent vascular access for hemodialysis which require surgical treatment and evaluate its results using duplex scanning.
Design and methods. Ultrasonography, clinical and laboratory examinations were performed in 550 patients undergoing hemodialysis.
Results. Complications of vascular access for hemodialysis were detected in 154 (28.0 %) patients, surgical treatment was performed in 96 (62.3 %) patients. The main indications for surgical treatment were: significant stenosis, occlusive thrombosis, non-occlusive thrombosis in combination with significant vein stenosis, aneurysm with increased access flow, ischemic steal syndrome of the hand and pulsating hematoma. The analysis of surgical interventions showed that the creation of a new access was more often performed (41.7 %) compared to other types of fistula reconstructions which leads to a decrease in the number of vessels in the upper extremities that can be used to create access in the future.
Conclusion. Duplex ultrasound allows diagnosing vascular access for hemodialysis complications and evaluating the results of their surgical treatment.

RADIOLOGY

27-34 618
Abstract

Background. Spastic diplegia (Little’s disease) is the most common form of infantile cerebral palsy (ICP), leading to persistent motor and functional impairments. One promising area of rehabilitation is a combination of physical therapy with methods of stimulation of various parts of the nervous system, among which functional electrical stimulation of muscles and nerves is the most prominent.
Objective. To study structural changes of cerebral white matter conduction pathways in patients with spastic diplegia after translingual neurostimulation using magnetic resonance tractography.
Materials and Methods. An open single center-controlled study was conducted. A total of 18 children were examined. All patients underwent comprehensive MRI in two time points, before and after a course of translingual neurostimulation, on a tomograph with magnetic field induction 3.0 Tesla, which included a traditional protocol in 3 mutually perpendicular planes), and diffusion-weighted imaging — DWI (Diffusion-Weight Imaging).
Results. All patients after neurostimulation showed clinical improvement of movement coordination and decrease of muscle tone with formation of new motor skills, improvement of limb motor function. Statistically significant decrease of spasticity index was revealed up to 17% for arms and 23% for legs, improvement of motor skills on all three scales.
Conclusion. Translingual neurostimulation allows to affect all components of motor activity, as a result of which neuroplasticity processes are activated and the brain of patients with spastic diplegia becomes more receptive to motor rehabilitation aimed at restoration of motor control and formation of new motor skills.

АКУШЕРСТВО И ГИНЕКОЛОГИЯ

35-46 1630
Abstract

Aldosterone is the main mineralocorticosteroid hormone of the human adrenal cortex. It plays a key role in the regulation of kidney and cardiovascular function. Its role especially increases in the adaptation of the woman’s body during pregnancy, and consists in maintaining the balance of electrolytes, blood pressure, ensuring sufficient trophoblast invasion and adequate placental perfusion. This article describes the mechanism of synthesis and action of aldosterone, its biological role and place in the structure of the renin-angiotensin-aldosterone system (RAAS). A special place is given to aldosterone in maintaining hemodynamics during physiological pregnancy, and to violations of the RAAS, as a key to understanding the links in the pathogenesis of preeclampsia.

PEDIATRICS

47-56 6382
Abstract

Background. Electroencephalography is the main technique for assessing the functional state of the brain. Indications for EEG are diagnosis of paroxysmal states, prediction of the outcome of a pathological state, evaluation of bioelectrical activity if brain death is suspected. Up to 90 % of the native EEG in calm wakefulness in healthy individuals is occupied by “alpha activity”. In children in active wakefulness, the EEG pattern depends to a great extent on their age.
Objective. The aim of the work was to assess EEG parameters in children aged 3–4 years in eyes-open resting state. Design and methods. 31 healthy participants aged 3–4 years were enrolled. EEG was registered for 30 minutes in a state of passive wakefulness in the supine position with open eyes. Average values of the power of the spectra for the alpha-rhythm, delta-rhythm and theta-rhythm in the frontal and temporal leads, as well as the ratio of the average power of alpha/theta and alpha/delta rhythms in the frontal and temporal leads were calculated.
Results. Average power of the alpha-rhythm was significantly higher over the right frontal lobe than over the right frontal-temporal area, as well as average amplitude of it was significantly higher in F3-A1 than F7-A1, F4-A2 than F8-A2, which is associated with the articulatory praxis. Average alpha-rhythm power was significantly higher in T5-A1 than T3-A1 and T6-A2 than T4-A2, which corresponds to the recognition and naming of objects optically. Significant differences according to the total average power of the alpha- and theta-rhythms above the frontal and frontal-temporal regions reflect the relationship between the frontal cortex temporal lobes and the premotor zones, i.e. arcuate bundle, responsible for the “speech system”.
Conclusion. The identified patterns can reflect the characteristics of the state of active wakefulness in a 3–4-year-old child and can be used for comparison in the future (both in the course of behavioral experiments and observation of patients with certain pathological processes).



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ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)