Background. The use of antiarrhythmic (AA) drugs requires constant monitoring due to the risk of arrhythmic and side effects. It is impossible to quickly identify and respond to emerging adverse events using 24-hour monitoring of the electrocardiogram (ECG), due to the method technical features. The introduction into practice of multi-day telemonitoring (MTM) of ECG contributes to an increase in the detection of rare and asymptomatic arrhythmias, and improves control over the AA therapy effectiveness.

Objective. To study the possibilities and advantages of MTM in the selection of AA therapy and the prevention of its complications in patients with ventricular arrhythmias (VA).

Design and methods. The study included 73 patients with frequent symptomatic high-grade VA (44 women and 29 men) aged 28 to 86 years (56.6 ± 28.3 years), in whom MTM ECG was performed for the purpose of individual selection of AA therapy.

Results. In 19 % patients using MTM, the psychogenic nature of VA and a necessity to avoid prescribing was suspected. In 63 % patients with VA the optimal AA therapy in the minimum effective doses was selected using MTM, in 18 % patients the futility of drug therapy was proven and radiofrequency ablation was recommended.

Conclusion. MTM ECG is justified for the selecting AA therapy in patients with VA. MTM has undoubted advantages over daily monitoring and helps to reduce the time for AA agent choosing.

Background. The main problem in the patient selection for cardiac resynchronization therapy (CRT) is the lack of unified approaches to the definition of mechanical dyssynchrony (MD) and selection criteria.

Objective. To reveal the dependence of the criteria of dyssynchrony in patients on the method and point of stimulation and to reveal the correlation of these data with the width of the QRS complex and the percentage of global two-dimensional longitudinal deformation.

Design and methods. The study involved 12 patients with drug-compensated CHF of class II-IV, LVEF< 35 % and a QRS duration >130 ms, having CRT indications. All patients were intraoperatively injected with a retrograde transaortically guided electrode. During stimulation of each point (88 points), transesophageal Echo-KG (PE Echo-KG) was performed. TomTec and Philips Qlab 3DQ Advanced software was used for data analysis.

Results. The segmental excursion and myocardial contractility differed significantly depending on the stimulation point. A moderate inverse correlation was found between ExcAvg, LVEF and QRS duration. There were a direct correlation of the SDI-16 and the QRS duration was shown, and an inverse correlation of SDI-16 with ExcAvg and LVEF. 2D longitudinal global strain was inversely correlated with the EF.

Conclusion. The technique is useful for regional LV myocardial contractility assessment and patient selection and comparison of alternative approaches to LV pacing to improve response to CRT.

Background. In recent years, the prognosis of survival after treatment for breast cancer (BC) has improved significantly, leading to an increase in the life expectancy of patients and the incidence of long-term side effects of therapy. reducing the risks of complications and developing a unified algorithm for diagnosing cerebral complications are necessary to improve the quality of life of patients.

Objective. To correlate the CNS and endothelium damage biomarkers concentration and the functional connectivity of the brain in patients with newly diagnosed vestibulo-atactic syndrome (VAS) and without it in the late period of radical treatment of breast cancer.

Design and methods. The study involved 21 patients with VAS in the late postoperative period after radical treatment of breast cancer, as well as a group of healthy volunteers — 17 people. Biomarkers were determined by ELISA. Functional MRI was performed.

Results. An increase in markers of CNS damage and endothelial damage (ICAM, PECAM) was noted in patients with post-mastectomy syndrome (PMES) and VAS, compare with control group and PMES without VAS group. The processes of disorganization and the formation and strengthening of interand intrahemispheric connections were noted using fMRI.

Conclusion. The development of novel diagnostics methods, including the use of fMRI and the determination of different biomarkers are promising for improvement of the VAS treatment effectiveness in patients with PMES.

Aortic dissection is a type of acute aortic syndrome characterized by a high mortality rate in the first 48 hours. The problem of early diagnosis of acute aortic dissection is still relevant and due to a high risk of severe complications, as well as a non-specific clinical features. If left untreated, aortic dissection can be complicated by the formation of an aortic aneurysm and its rupture. Sometimes, the rupture of an aortic aneurysm is accompanied by the fistula formation. The article discusses the use of computed tomography (CT) scans for visualization of DeBakey type III aortic dissection complicated by aortic rupture and the formation of an aorto-esophageal fistula.

A 60 y.o. male diagnosed with aortic dissection was urgently transferred from the city hospital for surgical treatment. As part of the preoperative preparation, the patient underwent computed tomography angiography (CT angiography), that demonstrated not only an acute DeBakey type III dissection with a thoracic aortic aneurysm of the descending aorta, but also its complication in the form of aortic rupture with the formation of aorto-esophageal fistula.

The patient underwent a successful endovascular thoracic aortic stent grafting with unmarkable postoperative period. Follow-up CT angiography showed complete isolation of the false lumen and closure of the aorto-esophageal fistula. The patient showed clinical improvement and was discharged home on 14 day.

Background. Redox reactions are an important part of metabolism and are necessary both for replenishing energy needs and for delivering and utilizing oxygen. In the progression of bronchopulmonary pathology, an important role belongs to the excess amount of various compounds accumulated as a result of activation of lipid peroxidation, which leads to disruption of the membrane structure, lipid metabolism and toxic effects on cells and tissues of various organs and systems. The article summarizes current knowledge about the role of antioxidant enzymes in the pathogenesis of community-acquired pneumonia and non-obstructive bronchitis in children. They are of key importance in the stabilization of oxidative stress in the respiratory system pathology. A regulatory role in the antioxidant defense system of the enzyme superoxide dismutase (SOD) has been shown.

Design and methods. The study involved 68 children (10–16 years old): 37 children with bronchitis, 31 with community-acquired pneumonia and 25 healthy children. Blood samples were taken for the subsequent SOD level determination.

Results. A significant decrease in the SOD level and a low rate of normalization of its parameters in children with pneumonia were revealed. In children with bronchitis, the initial change in the SOD level was less significant, with a higher rate of its recovery.

Conclusion. A significant SOD decrease in pneumonia indicates decompensation of oxidative stress processes in this group.

Background. The translating of individual preclinical studies (PCTs) results into clinical practice is accompanied by a significant number of failures and is associated with significant time and financial costs. The unsatisfactory design of individual non-clinical studies and the reports submitted after having done in vivo experiments at one laboratories do not allow overcoming translational barriers and increasing the results reproducibility. To conduct multicenter non-clinical trials is relevant to to confirm the effectiveness of medicines and increase the chances of successful translation of non-clinical results into clinical practice.

Objective. To analyze the scientific literature devoted to multicenter non-clinical studies in the research of the pharmacological activity of new drugs.

Design and methods. The research was done using PubMed and Google Scholar databases. The review included available publications as of October 16, 2022.

Results. It was discovered that single-center studies did not allow predicting the magnitude of the effect accurately, and large sample sizes made the estimation of the magnitude of the effect even less precise.

Conclusions. The main purpose of multicenter non-clinical studies rather should be assessing the direction of the effect, including its “stability”, as well as to identify sources of heterogeneity between studies conducted in different laboratories (centers) than performing a quantitative assessment of the effect on several laboratories, as it tend to be in foreign non-clinical practice.