Blood Circulation In Patients Research Articles

Diffusion-derived vessel density (DDVD) computed from a simple diffusion MRI protocol as a biomarker of placental blood circulation in patients with placenta accreta spectrum disorders: A proof-of-concept study

ObjectivesIncreasing trend of PAS (placenta accreta spectrum disorders) incidence is a major health concern as PAS is associated with high maternal morbidity and mortality during cesarean section. Prenatal identification of PAS is crucial for delivery planning and patients management. This study aims to explore whether diffusion-derived vessel density (DDVD) computed from a simple diffusion MRI protocol differs in PAS from normal placenta. MethodsWe enrolled 86 patients with PAS disorders and 40 pregnant women without PAS disorders. Each patient underwent intravoxel incoherent motion (IVIM) MRI sequence with 11 b-values. Placenta diffusion-derived vessel density (DDVD-b0b50) was the signal difference between b = 0 and b = 50 s/mm2 images. DDVD(b0b50) A/N was calculated as [accreta lesion DDVD(b0b50)]/ [normal placenta DDVD(b0b50)]. The correlation between DDVD and gestational age was explored using Spearman rank correlation. Differences of DDVD(b0b50) A/N in patients with normal placentas and with PAS, and in patients with different subtypes of PAS were explored. ResultsDDVD was negatively correlated with gestational age (p = 0.023, r = −0.359) in patients with normal placentas. DDVD(b0b50) A/N was significantly higher in patients with PAS (median:1.16, mean: 1.261) than normal placenta (median:1.02, mean: 1.032, p < 0.001) and especially higher in patients with placenta increta (median:1.14, mean: 1.278) and percreta (median: 1.20, mean: 1.396, p < 0.001). ConclusionAs a higher DDVD indicates higher physiological volume of micro-vessels in PAS, this study suggests DDVD can be a potential biomarker to evaluate the placenta perfusion.

Pathological findings in respiratory organs and blood circulation in patients with isolated DRTB and DRTB/HIV/AIDS co-infection (according to autopsy data)

Pathological findings in respiratory organs and blood circulation in patients with isolated DRTB and DRTB/HIV/AIDS co-infection (according to autopsy data)

Assessing the Efficacy of Cardiac Catheterization in Enhancing Blood Circulation in Patients with Coronary Heart Disease: A Systematic Literature Review

Assessing the Efficacy of Cardiac Catheterization in Enhancing Blood Circulation in Patients with Coronary Heart Disease: A Systematic Literature Review

Choroidal vascular changes in silicone oil-filled eyes after vitrectomy for rhegmatogenous retinal detachments

IntroductionThe tamponade of silicone oil (SO) can affect both the structure and blood flow of the retina. However, there are few studies on the effect of SO tamponade on choroidal blood flow. Our study aimed to compare the effects of SO tamponade on the choroidal vascular index (CVI) and choroidal thickness (CT) in patients with unilateral rhegmatogenous retinal detachment (RRD) with operated eyes and fellow healthy eyes.MethodsWe retrospectively collected demographic and clinical data from 36 patients who underwent 23G pars plana vitrectomy and SO tamponade for unilateral complicated RRD. Enhanced depth imaging-optical coherence tomography (EDI-OCT) scans were performed both within 1 week before SO removal and at the last follow-up visit after SO removal. Using ImageJ software, images were binarized to segment the total choroidal area, luminal area, and stromal area, respectively. The CVI was calculated as CVI=(luminal area)/(total choroidal area), and CT was also evaluated.ResultsDuring SO tamponade, the CVI and luminal area in operated eyes were significantly lower compared to fellow eyes (57.616 ± 0.030 vs. 60.042 ± 0.019, P < 0.0001; 0.909 [0.694; 1.185] vs. 1.091 [0.785; 1.296], P = 0.007). Even after SO removal, the CVI remained lower in operated eyes than in fellow eyes (59.530 ± 0.018 vs. 60.319 ± 0.020, P = 0.031). Both CVI and luminal area were lower in operated eyes before SO removal than after SO removal (57.616 ± 0.030 vs. 59.530 ± 0.018, P = 0.0003; 0.909 [0.694; 1.185] vs. 0.994 [0.712; 1.348], P = 0.028). The duration of SO tamponade was positively correlated with the difference in CVI between fellow eyes and operated eyes during SO tamponade (P = 0.035). Total choroidal area, stromal area, and CT did not differ significantly between fellow eyes and operated eyes or between pre- and post-SO removal.ConclusionsSO tamponade reduces CVI and decreases choroidal blood circulation in patients with retinal detachments required vitrectomy combined with SO tamponade. The longer the SO tamponade time, the more CVI reduction. In future work, we will aim to reduce these side effects by shortening the duration of silicone oil filling.

COURSE OF INHALATION ANAESTHESIA WITH SEVOFLURANE DURING SURGICAL TREATMENT OF PATIENTS WITH MALIGNANT LUNG TUMOURS

Abstract. Aim. Study of the effect of pain intensity on the energy efficiency of blood circulation in patients with lung malignancies after operations under anesthesia using sevoflurane.&#x0D; Materials and methods. 29 patients with malignant lung formations have been examined, who underwent open surgical interventions on the volume of lob- or pneumonectomy or resection of part of the lung. The average age of the examined patients was (55±5.6) years, among them men – 17, women – 12. Pain intensity, perfusion systemic pressure, cardiac index, blood flow power, arteriovenous difference in oxygen content, blood lactate concentration, oxygen reserve, circulatory reserve have been determined. These indicators have been determined in four stages: 1) before the operation; 2) awakening; 3) the first day after surgery; 4) the fifth day after surgery.&#x0D; Results and their discussion. The intensity of pain determined by the visual analog scale (VAS) was maximum on the 1st day after surgery (4.8±0.8 points), and on the 5th day it returned to the level of the awakening stage. Analgesia was performed with morphine (0.27±0.04 mg/kg on the 1st day) and infusion of infulgan at a dose of 1 g 3 times a day. The circulatory reserve was minimal at the stage of awakening and on the 1st day after surgery (from (381±66) to (390±71) mW/m2), on the 5th day it reached the preoperative level (448±82 mW/m2). Separate indicators of blood circulation do not have a strong dependence on the level of pain that was determined by VAS, but indicators of the energy component of circulation are closely related to the severity of pain.&#x0D; Conclusions. The maximum severity of pain in patients with malignant lung formations operated under inhaled anesthesia with sevoflurane is observed on the first day after surgery. Different indicators of hemodynamics and oxygen transport are associated with the intensity of pain measured by VAS with different strengths, which makes it impossible to evaluate the effectiveness of anesthesia. Indicators of circulatory energy efficiency are closely related to the intensity of pain measured using VAS, which proves the value of using monitoring of circulatory energy indicators in assessing the quality of anesthesia.

[Extracorporeal cardiopulmonary resuscitation-When the heart no longer functions].

Extracorporeal cardiopulmonary resuscitation (ECPR) is an option for restoring blood circulation in patients with refractory circulatory failure. While conventional resuscitation measures are being continued, venoarterial extracorporeal membrane oxygenation (VA ECMO) is established in patients with cardiac arrest. This bypass can compensate for the functions of the heart and lungs until recovery of organ function. The benefit of ECPR compared to conventional resuscitation appears to be evident, especially after aprolonged resuscitation period; however, in three prospective randomized controlled studies an advantage has not yet been conclusively proven for widespread use in clinical routine. ECPR systems are complex and resource-intensive and should therefore be limited to specialized centers where sufficient numbers of patients are treated to ensure ahigh level of expertise in the teams.

The effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy.

Butylphthalide can improve blood circulation in patients with acute cerebral infarction. Complement 3a receptor 1 (C3aR1) is involved in the regulation of innate immune response and pathogen monitoring, which is closely related to the pathophysiological processes of breast cancer, neurogenesis and lipid catabolism. Our study explored the therapeutic effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy, and evaluated the correlation between serum C3aR1 and butylphthalide on improving the neurological function after mechanical thrombectomy. 288 patients with acute anterior circulation cerebral infarction who were admitted to our hospital from January 2019 to November 2022 and were treated with mechanical thrombectomy for the first time were included in this retrospective study and divided into the butylphthalide group and control group that they received treatment methods. The National Institutes of Health Stroke Scale (NIHSS) scale was used to evaluate the patient neurological function treatment efficacy, and the modified Rankin Scale (mRS) scale was used to measure the patient neurological function status 3 months after surgery. Enzyme-linked immunosorbent assay method was used to determine the content of C3aR1 in serum. Two weeks after thrombus removal, the NIHSS efficacy of the butylphthalide group and the control group were 94.44% and 72.22%, respectively. The butylphthalide group was significantly higher than the control group (P < .001). Three months after the operation, the mRS score of the butylphthalide group was significantly lower than that of the control group (P = .001), and the excellent and good rate was significantly higher than that of the control group (P < .001). The serum C3aR1 level of the butylphthalide group was significantly lower than that of the control group 2 weeks after operation and 3 months after operation (P < .001). The serum C3aR1 was positively correlated with the efficacy of NIHSS (R = 0.815, P = .004), which was positively correlated with mRS score (R = 0.774, P = .007). Butylphthalide can improve the therapeutic effect of neurological function in patients with acute anterior circulation cerebral infarction after mechanical thrombus removal. The patient serum C3aR1 is related to the patient neurotherapy efficacy and neurological function status, and its level can reflect the patient neurological function recovery to a certain extent.

Analisis Foot Spa Diabetic terhadap Sirkulasi Darah Perifer Kaki Pasien DM Tipe 1 dan 2

This study aims to determine the effectiveness of diabetic foot spa on foot peripheral blood circulation in patients with type 1 and 2 DM. The method used was a pre-experimental study with a one-group pre-post test design. The population in this study were 32 respondents. Sampling technique with purposive sampling technique. The results showed that the statistical test paired t-test obtained a p value = 0.001 which means that diabetic foot spa is effective in improving the peripheral blood circulation of the feet in patients with type 1 and 2 DM.  Health Center. Conclusion Diabetic foot spa is effective in improving the peripheral blood circulation of the feet. in type 1 and 2 DM patients.&#x0D;  &#x0D; Keywords: Blood Circulation, Diabetes Mellitus, Diabetic Foot Spa,

Evaluation of the index of resistance and excretion of uromodulin in patients with predialysis chronic kidney disease, taking into account the index of comorbidity

Background. The purpose of this study was to investigate urinary uromodulin (uUmod) excretion, reactivity of the autonomic nervous system and impaired renal blood circulation in patients with predialysis chronic kidney disease (CKD), and the effect of antioxidant therapy on these parameters. Materials and methods. Ninety-one patients with CKD stage 1–5 took part in the ROLUNT (UROmoduLin UbiquinoNe GlutaThione) study, their average age was 47.00 ± 12.12 years. Thirty (32.97 %) men and 61 (67.03 %) women were divided into two groups, which were representative in terms of age and gender composition: the first one (n = 46) — patients with CKD stage1–5 who had Charlson Comorbidity Index ≤ 2, the second one (n = 45) — patients with CKD stage1–5 who had Charlson Comorbidity Index ≥ 3. The first and second groups were divided into subgroups A and B. Subgroup A included patients with impaired vegetative status, subgroup B — without impaired vegetative status. Subgroups 1A and 2B took glutathione 100 mg twice a day with food for 3 months; subgroups 1B and 2A received ubiquinone 100 mg once a day with food for 3 months. In patients with CKD stage1–5, uUmod, albumin to creatinine ratio (ACR), glomerular filtration rate (GFR) were evaluated. Ninety-one ultrasound duplex color scans of the kidneys were performed and the index of resistance (IR) was determined in patients with CKD stage1–5. Results. The results of the paired t-test showed that there is a significant difference between the indicators at the beginning and at the end of the study, with the exception of the following: in subgroup 1A: hemoglobin (Hb) (T = –1.5863 [–2.0739, 2.0739] 95% confidence interval (CI) [–2.4077, 0.3207], p = 0.127); in subgroup 1B: Hb (T = –0.382 [–2.0739, 2.0739], 95% CI [–1.3977, 0.963], p = 0.706); ACR (T = –1.5899 [–2.0739, 2.0739], 95% CI [–16.7323, 2.2105], p = 0.126); systolic blood pressure (SBP) (T = –0.5625 [–2.0739, 2.0739], 95% CI [–2.2414, 1.2849], p = 0.579); diastolic blood pressure (DBP) (T = –1.7936 [–2.0739, 2.0739], 95% CI [–2.3437, 0.1698], p = 0.087); Chernov questionnaire (T = 1.5071 [–2.0739, 2.0739], 95% CI [–0.6083, 3.8431], p = 0.146); Kérdö index (T = 0.9392 [–2.0739, 2.0739], 95% CI [–1.1083, 2.9431], p = 0.358); in subgroup 2A: ACR (T = –2.0147 [–2.0796, 2.0796], 95% CI [–39.1946, 0.6219], p = 0.057); in subgroup 2B: ACR (T = –1.3328 [–2.0739, 2.0739], 95% CI [–17.4695, 3.7999], p = 0.196). The Pearson correlation results showed that in subgroup 1A, there is a significant average positive relationship between uUmod and eGFR (r(21) = 0.418, p = 0.047); a significant very small negative relationship between uUmod indicators and age (r(21) = 0.438, p = 0.037); in subgroup 1B, there is a significant large positive relationship between uUmod and Hb indicators (r(21) = 0.513, p = 0.012); a significant positive relationship between uUmod and Morisky Medication Adherence Scale-8 (MMAS-8) indicators (r(21) = 0.515, p = 0.012); a significant very small negative relationship between uUmod and ACR indicators (r(21) = 0.441, p = 0.035); in subgroup 2A, there is a significant very small negative relationship between uUmod indicators and Kérdö index (r(20) = 0.427, p = 0.048); in subgroup 2B, there is a significant very small negative relationship between the uUmod indicators and Chernov questionnaire score (r(21) = 0.421, p = 0.045); a significant very small negative relationship between uUmod indicators and Charlson Comorbidity Index (r(21) = 0.481, p = 0.020); a significant very small negative relationship between uUmod and age (r(21) = 0.471, p = 0.023). In subgroup 1A at the end of the study, the following independent variables are not significant as predictors for uUmod: IRd, IRs, SBP, DBP, Hb, ACR, age, Vein and Chernov questionnaires score, MMAS-8, Charlson Comorbidity Index and Kérdö index. In subgroup 1B at the end of the study, the following independent variables are not significant as predictors for uUmod: eGFR, IRs, SBP, DBP, Hb, Vein and Chernov questionnaires score, MMAS-8, Charlson Comorbidity Index and Kérdö index. In subgroup 2A at the end of the study, the following independent variables are not significant as predictors for uUmod: eGFR, IRd, IRs, SBP, DBP, Hb, ACR, age, Vein questionnaire score, MMAS-8, Charlson Comorbidity Index. In subgroup 2B at the end of the study, the following independent variables are not significant as predictors for uUmod: eGFR, IRd, IRs, SBP, DBP, Hb, ACR, age, Vein questionnaire score, ­MMAS-8, Kérdö index. Conclusions. Antioxidant therapy with glutathione and ubiquinone significantly affects the examination parameters of patients with CKD. Considering the safety and effectiveness of antioxidant therapy, we suggest including antioxidant therapy into the treatment protocols for patients with CKD. Further research is recommended to establish a standard protocol.

Role of oxidase and antioxidant enzymes in neutrophils and blood circulation in patients with acute coronary syndrome

Acute coronary syndrome (ACS), a subcategory of cardiovascular diseases, has become a major cause of mortality and morbidity worldwide. Oxidative stress resulting from increased production of reactive oxygen species and decreased antioxidants plays a major role in the pathophysiology of ACS. This study evaluated the activities of certain oxidase and antioxidant enzymes in circulation and neutrophils to determine their roles in increased oxidative stress in patients with ACS. A total of 52 patients with ACS admitted in the coronary care unit of two tertiary hospitals and 52 healthy controls were enrolled. Blood samples were collected from all subjects, and various oxidase and antioxidant enzymes in neutrophils and circulation were assayed. The patients had significantly higher white blood cell and neutrophil counts than the controls. In patients, the mean (±SD) serum activities of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (12.83±6.6 U/L) and superoxidase dismutase (4.34±1.41 U/mL) were significantly higher than in the control group (4.88±3.03 U/L and 3.02±1.7 U/mL, respectively) while the catalase had significantly lower activities (33.36±13.16 U/mL vs. 63.98±31.86 U/mL). In neutrophils, the activities of myeloperoxidase, NADPH oxidase and catalase were significantly higher in ACS patients, while superoxidase dismutase was significantly lower. Further, significant positive correlations were found between activities of myeloperoxidase and catalase, and NADPH oxidase and superoxidase dismutase in neutrophils of ACS patients. These findings revealed that higher activities of myeloperoxidase and NADPH oxidase, both in serum and neutrophils, lead to increased oxidative stress and form the inflammatory basis of ACS, and the antioxidant enzymes combat the events.

Патогенетические связи цитокинового и оксидативного статусов пациентов с клещевым риккетсиозом, обусловленным R. heilongjiangensis

The purpose — to determine pathogenetic connections between the level of pro-inflammatory immunocytokines and oxidative stress indicators in the systemic blood circulation in patients with tick-borne rickettsiosis. Material and methods. The levels of some interleukins and indicators of the oxidant-prooxidant system in patients with a moderate form of tick-borne rickettsiosis caused by R. heilongjiangensis were researched and analyzed. Results. At the height of the disease, we found a statistically significant increase (p &lt; 0.01) in the blood serum of all pro-inflammatory cytokines studied (IL-6, IL-8, TNF), combined with a significantly pronounced activation of free radical oxidation processes (p ˂ 0.0002). During the early convalescence period, there was a decrease in the level of IL-6 and TNF by 7 and 2.6 times, respectively (p &lt; 0.0001), while the level of IL-8 statistically significantly increased twofold by the time of discharge relative to the height of the disease (p &lt; 0.05). In the same period, oxidative stress indicators increased statistically significantly (p ˂ 0.0001) compared to the acute period: Ssp — 6 times; h — 1.3 times; Sind-1 — 1.3 times; Slum — 1.4 times; Sind-2 — 1.3 times. A correlation analysis revealed a significant direct relation between the content of the studied interleukins and chemiluminescence indices in the blood serum. Conclusion. Changes in cytokine status identified during the study in patients with tick-borne rickettsiosis caused by R heilongjiangensis, indicate the participation of interleukins in the disease pathogenesis. The increase in the level of reactive oxygen species during early convalescence may indicate that clinical recovery does not reflect the pathogenetic completion of the infection. The revealed correlation between indicators of cytokine and oxidative status testifies to their joint participation in the pathogenesis of tick-borne rickettsiosis caused by R. heilongjiangensis.

Сhronic heart failure impact on stroke index and ejection fraction during polytrauma

Study of the effect of heart failure on the course of hypovolemia during polytrauma with the absence of traumatic myocardial injury. The study involved 95 patients, who were divided into 3 groups. The first Control group (C), 29 patients had no heart failure. The second group was Standard (S), 33 patients suffered from chronic heart failure and received standard therapy according to the protocol. The third group (E) of 33 patients with chronic heart failure who, in addition to standard therapy according to protocol, received Ethylmethihydroxypyridine succinate.  Patients of groups S and E had equal inclusion criteria, namely the main disease leading to chronic heart failure was arterial hypertension, which had existed for more than 5 years. Three groups of patients had no traumatic myocardial injury. The stroke index (SI) during admission of group C is 24.7±4.8 ml/m2, on the 3rd day 32.8±5.0 ml/m2, (p &lt;0.001), and on the 7th day - up to 39.1±6.0 ml/m2, (p &lt;0.001). SI of group S during admission was 22,9±3,7 ml/m2, on the 3rd day 26,9±4,7 ml/m2 (p &lt;0,001), and on the 7th day — 34,6±5,5 ml/m2 (p &lt;0,001). SI of group E patients during admission was 23.4±2.7 ml/m2, on the 3rd day 26.1±1.5 ml/m2 (p &lt; 0.01), and on the 7th - up to 36.8±2.2 ml/m2 (p &lt; 0.01).  Cardiac index (CI) of group C within admission was 2,26±0,35 l/min∙m2, on the 3rd day - 2.73±0.37 l/min∙m2 (p &lt;0,001), and by the end of the study - up to 3.08±0.40 l/min∙m2 (p &lt;0,001). CI of group S during admission amounted to 1,99±0,39 l/min∙m2, on the 3rd day - 2,22±0,31 l/min∙m2 (p &lt;0,02), on 7th — up to 2.67±0.33 l/min∙m2 (p &lt;0.001). CI of group E - 2,0±0,38 l/min∙m2. Until the 3rd day — 2,06±0,30 l/min∙m2 (p&gt; 0.4), at the 7th reached 2.97±0.32 l/min∙m2 (p &lt;0,001). Ejection fraction (EF) of group C within admission amounted to 53.7±3.4%.  In the future, EF has significantly increased, reaching 59.6±5.2% (p &lt;0.001) and 63.3±6.4% by the 7th day (p &lt;0.01). EF of group S during admission was 47,9±4.7%, on the 3rd day it increased to 52.2±5.2% (p &lt;0.001), and on the 7th - to 56.8±6.9% (p &lt;0.001). EF of patients group E within the admission was - 47.5±6.9%. On the 3rd day, the EF authentically increased to 52.3±5.3% (p&lt;0.003), and on the 7th day - to 61.5±6.4% (p &lt;0.001). The inclusion of Ethylmethylhydroxypyridine succinate (EMGPS) in the intensive care scheme of E group patients with chronic heart failure during polytrauma without acute myocardial injury gradually improves myocardial contractility activity (MCA). On the 3rd day after patient’s admission, a significant impact of EMGPS on the study of mechanics and energy indicators was not observed. But from the 7th day there was an increase in SI on 6.4% (36.8±1.2 contrary 34.6±5.5 ml/m2, p = 0.03), an increase in EF on 8.3% (61.5± 6.4 contrary 56.8±6.9%, p = 0.005), CI increased on 11.2% (2.94±0.32 contrary 2.67±0.33 l/min∙m2, p &lt; 0.001). Thus, the addition of EMGPS to the intensive care scheme to patients with chronic heart failure during polytrauma without acute myocardium injury optimizes blood circulation and its energy efficiency.  Ethylmethylhydroxypyridine succinate optimizes the energy efficiency of blood circulation in patients with chronic heart failure during polytrauma without acute myocardial injury.

Instrumental methods and technical means for assessing the results of osteopathic correction in patients after lower limb amputation

The article provides an overview of instrumental methods and technical means allowing to evaluate some of the proven effects of osteopathic correction, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect and improvement of blood circulation in patients with amputation defects of the lower extremities. The article provides an overview of instrumental methods and technical means used for diagnostic purposes in the rehabilitation of patients with amputation defects of the lower extremities. The possibility of it to verify some of the osteopathic correction effects, such as an increase in the range of motion in the joints, normalization of muscle tone, postural balance and walking, anti-inflammatory effect, and improvement of blood circulation, has been evaluated.Purpose — to present instrumental methods applicable to assess the results of osteopathic correction in the rehabilitation process of patients with amputation defects of the lower extremities.

Intensive care of acute hypovolemia in combination with chronic heart failure in patients with polytrauma without acute myocardial injury

The impact effect assessment of ethylmethylhydroxypyridine succinate on the energy efficiency of blood circulation in patients with polytrauma without traumatic myocardial injury during chronic heart failure. The state of blood circulation was studied in 66 patients with polytrauma without myocardial injury on the background of CHF. Troponin I levels in all patients did not exceed 0.3 ng/ml, and NT-proBNP – was above 100 pg/ml, which confirmed the presence of chronic heart failure. Patients has been divided into 2 groups. Group S (n=33) – patients receiving standard intensive care, group E (n=33) – patients who were additionally injected with ethylmethylhydroxypyridine succinate 600 mg/day during a week. NT-proBNP, hemodynamics, oxygen and energy budget within the admission, on the 3rd and 7th day were investigated. The indicators of the energy budget, estimated by the circulatory reserve (CR), has been improved in all patients. Upon admission and on the 3rd day, it was not differ between groups, on the 7th day the CR in groups C and E was accordingly 286±94 and 392±173 mW/m2 (p&lt;0.003). The level of NT-proBNP on the 7th day in groups C and E decreased to (109.1±8.5) and (65.8±23.3) pg/ml (p&lt;0.001). Chronic heart failure aggravates the course of acute hypovolemia in patients with polytrauma without myocardial damage. The main cause of aggravation of circulatory failure during polytrauma without traumatic myocardial damage is energy deficiency in the myocardium. Ethylmethylhydroxypyridine succinate reduces the myocardial energy requirement. The effect of ethylmethylhydroxypyridine succinate begins to develop after 3 days, reaching a maximum on the 7th day. Keywords: polytrauma, heart failure, NT-proBNP, ethylmethylhydroxypyridine succinate, energy of blood circulation.

Evaluation of Botulinum Toxin Type A and its Potential Effect on Exacerbated Raynaud's Phenomenon in Hospitalized Scleroderma Patients.

Raynaud's phenomenon by episodically reversible constriction of the arteries in the fingers and toes causes pain, numbness, sores, and gangrene. However, the treatment of Raynaud's phenomenon is one of the clinical issues. Recent studies have shown that botulinum toxin is considered a potential and effective therapeutic option for improving finger blood circulation in patients with Raynaud's syndrome. In this study, we sought to investigate the therapeutic effect of botulinum toxin type A on exacerbated Raynaud's phenomenon in patients with scleroderma. In this prospective study, 11 patients with systemic scleroderma who were referred due to aggravated Raynaud's were included. For all patients, questionnaires were filled up, and physical examination was performed separately for both treatment and control hands, and then similar volumes of botulinum toxin type A (Botox) and normal saline were randomly injected. The results showed that there was a significant difference in Raynaud's score (P = 0.001), Quick-Dash score (P = 0.01), Mc-Cabe cold score (P = 0.003), the mean frequency of recurrences arracks (P = 0.01), pain (0.005) (P = 0), skin color (P = 0.01), and duration of Raynaud's phenomenon (P = 0.006) between the intervention and control groups after two months. Following Botox injection, a significant improvement in terms of various Raynaud's parameters as well as the clinical manifestations was observed in the intervention group. Together, botulinum toxin type A could retrieve the hand function, the cold sensitivity, and the painful feeling caused by Raynaud's syndrome.

IL-13 Genetic Susceptibility to Bullous Pemphigoid: A Potential Target for Treatment and a Prognostic Marker.

BackgroundBullous pemphigoid (BP) is a senile chronic autoimmune bullous skin disease with a high relapse rate, which significantly impairs patients’ quality of life and contributes to disease mortality. This observational case-control study explores the gene polymorphisms of cytokines and their clinical significance in Chinese patients with BP.MethodsIL-1α (rs1800587), IL-1β (rs16944, rs1143627, rs1143634), IL-4 (rs2243250), IL-6 (rs1800795), IL-10 (rs1800896, rs1800871, rs1800872), IL-13 (rs1800925, rs20541), TNF-α (rs1799964, rs1800630, rs1799724, rs361525), IFN-γ (rs1799964, rs1800630, rs361525, rs1800629, rs4248160, rs1800750), and TGF-β1 (rs2317130, rs1800469, rs4803457) genes were genotyped in the healthy controls and BP patients, respectively. Expression of these cytokines in serum was measured. Medical profiles of patients, including baseline characteristics and prognosis, were statistically analyzed.ResultsWe found that IL-1 β and IL-13 concentrations were higher in the BP patients’ sera compared to those in the controls. For IL-13, significant differences were found in the nucleotide ratio/genotype/haploid frequency/haplotype, respectively. IL-13 (rs20541, rs1800925) is related to gender, and the IL-13 genotype was significantly associated with recurrence.ConclusionsBP is associated with IL-13 gene polymorphism and IL-13 concentration is elevated in blood circulation in patients with BP. Our results support that IL-13 is relevant in the pathogenesis of BP, suggesting that IL-13 could potentially represent a promising target for BP therapy and a prognostic marker.

Influence of Lower Extremity Deep Venous Thrombosis in Cerebral Infarction on Coagulation Index and Thromboelastogram and Its Risk Factors.

Cerebral infarction is a serious brain injury disease, which is mainly caused by the blockage of blood circulation in patients' brains; thus, the patient's brain appears ischemia and hypoxia state, and large-scale nerve cell death occurs immediately. The aim of this study was to explore the influence of lower extremity deep venous thrombosis (LEDVT) on coagulation indexes and thromboelastogram (TEG) after cerebral infarction. Altogether, 67 patients with cerebral infarction complicated with LEDVT in our hospital from April 2017 to August 2019 were collected as the observation group (OG) and 58 patients with cerebral infarction without lower extremity deep venous thrombosis as the control group (CG). The R, K, angle, and MA values in PT, APTT, TT, FIB, and TEG indexes were compared between the two groups. The ROC curve was applied to analyze the diagnostic value of R value, K value, angle value, and MA value in the occurrence of LEDVT in patients with cerebral infarction. Logistic regression analysis was applied to analyze the independent risk factors of lower extremity deep venous thrombosis in cerebral infarction. PT, APTT, and TT in the OG were evidently lower than those in the CG, while FIB in the OG was evidently higher than that in the CG, R value and K value of the OG were evidently lower than those of the CG, and angle and MA values were higher than those in the CG. The AUC of R value, K value, angle value, and MA value of the ROC curve of LEDVT in patients with cerebral infarction was 0.735, 0.713, 0.790, and 0.819. Multivariate analysis showed that high FIB, angle, and MA were risk factors, while R and K values were protective factors. PT, APTT, and TT are lower and FIB is higher in patients with cerebral infarction with LEDVT. TEG has a certain diagnostic value. FIB value, angle value, and MA value are independent risk factors of LEDVT in patients with cerebral infarction, while R value and K value are protective factors.

Effectiveness of Messenger Plants (Peperomia Pellucida L.) and Tai Chi Exercise as Modality Therapy for Gout Sufferers: Literature review

Hyperuricemia correlated with an increase in monosodium urate crystals, which was a precipitating factor for gout arthritis. In Indonesia, this disease was more common in individuals over 34 years of age. The elderly who had gout can be associated with metabolic syndrome and increase the risk of cardiovascular disease. Pharmacological therapy of gout, such as allopurinol, had a greater potential to cause side effects in patients than complementary therapy. This article aimed to determine the effectiveness of the messenger plant (Peperomia pellucida) and Tai Chi exercise in overcoming hyperuricemia. The writing method used was a literature review. Articles were obtained through search sites: Google Scholar, Science-Direct, and NCBI, and the criteria used in the search were Indonesian and English with a range of publication years 2014-2020. Eight main journals were used as references; from these journals, it was concluded that Peperomia pellucida could inhibit the formation of uric acid with xanthine oxidase activity through its quercetin-type flavonoid content, while Tai Chi exercise could increase joint flexibility and blood circulation in patients with gout. Therefore, these therapies can be used as a reference for complementary therapy for individuals with hyperuricemia to help manage uric acid levels and reduce the risk of developing gouty arthritis.

Spectral analysis of signals of autonomic regulation of blood circulation in patients with COVID-19 and arterial hypertension

The work aims to carry out a comparative analysis of the spectral indices of the photoplethysmogram signals and RR-intervals of healthy volunteers, patients with COVID-19, as well as patients with COVID-19 and chronic arterial hypertension of 1-2 degrees. The study included 45 records of pairs of electrocardiogram and photoplethysmogram signals. Each sample included 15 pairs of 20-minute experimental signals. The study revealed an increase in the integrated power of the low-frequency (LF) band over the integrated power of the high-frequency (HF) band in the photoplethysmogram signals in patients with COVID-19, burdened with hypertension. In the signals of the RR-intervals, the largest values of the ratio of the LF to HF indices are associated with patients without cardiovascular diseases. In turn, this may be an indicator of the different effects of viral infection and arterial hypertension on the loops of autonomic control of heart rate and vascular tone.

Quantitative analysis and clinical application of iris circulation in ischemic retinal disease

BackgroundTo evaluate quantitative changes in iris blood circulation in patients with ischemic risk.MethodsThis observational case-control study included 79 patients with diabetic retinopathy (DR) and retinal vein occlusion (RVO). The RVO group included 21 patients; the monocular proliferative diabetic retinopathy (PDR) group included 19 patients; the nondiabetic retinopathy (NDR) group included 18 patients; and the healthy control group included 21 healthy controls. In the RVO group, we analyzed RVO affected eyes, RVO contralateral eyes, and healthy control eyes. We also compared eyes with PDR and contralateral eyes without PDR, patients with diabetes mellitus (DM) without DR, and healthy control eyes. The microvascular networks of the iris and retina were analyzed using optical coherence tomography angiography. The analysis included vessel area density (VAD) and vessel skeleton density (VSD) of iris and retina.ResultsIn the RVO group, the VAD and VSD of iris in the affected eye were higher than those in contralateral and healthy control eyes, and the VAD and VSD of contralateral eyes were higher than those of healthy control eyes. The retinal blood flow of the RVO eyes was less than that of the contralateral and healthy control eyes, but there were no difference between the contralateral eyes and healthy control eyes. The VAD and VSD of iris in PDR were larger than nonproliferative diabetic retinopathy (NPDR) and the NPDR were larger than NDR. There were no differences between NDR and healthy control eyes. Also, there were no differences among the four groups with respect to retinal blood flow.ConclusionsCompared with the retina, iris blood circulation quantitative analysis data seem to be more sensitive to ischemia and may be used as a new predictor of ischemic disease, even if further research is needed to better understand the clinical value and importance of this analysis.Trial registrationThe trial is registered with the clinical trial registration number nct03631108.