Occurrence Of Heart Research Articles

Anesthesia for thyroid surgery in heart transplant patients - first case study in Serbia

Introduction. The number of patients in the world who have undergone heart transplantation is increasing, with better and longer survival rates, and therefore the number of patients who undergo various surgical interventions after transplantation is also increasing. This presents a challenge for anaesthesiologists. Case outline. A 45-year-old female patient underwent a total thyroidectomy due to suspected thyroid cancer. She had a heart transplant three years earlier. Preoperative preparation included evaluation of cardiac function, consultative examinations by a transplant cardiologist, laboratory and other diagnostic procedures, as well as a detailed analysis of all 20 medications that the patient uses in daily therapy. Common drugs were used for premedication and general endotracheal anaesthesia, with careful dose titration. Medicines were also prepared for the occurrence of heart rhythm disorders, bearing in mind that the heart is denervated, but there was no need for their use. The operation and postoperative course went smoothly and on the third postoperative day the patient was discharged from the hospital in good general condition. Conclusion. Preoperative preparation, anaesthesia, and postoperative treatment of this patient represented a challenge for our team, which was successfully overcome, considering that this is the first case of operative treatment of a patient with a transplanted heart in Serbia.

RISK OF CIRCULATORY DISEASES ON THE EXAMPLE OF HEART RHYTHM DISORDERS IN PATIENTS WITH SEROLOGICAL MARKERS OF EPSTEIN – BARR INFECTION

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens.The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly). These detected peculiarities require further more profound study and development of activities aimed at risk minimization.

РИСК РАЗВИТИЯ БОЛЕЗНЕЙ СИСТЕМЫ КРОВООБРАЩЕНИЯ НА ПРИМЕРЕ НАРУШЕНИЙ РИТМА СЕРДЦА У ПАЦИЕНТОВ С СЕРОЛОГИЧЕСКИМИ МАРКЕРАМИ ЭПШТЕЙНА – БАРР ВИРУСНОЙ ИНФЕКЦИИ

To reduce a burden of circulatory diseases (CD) is among primary tasks the state has to solve. There are available data on a contribution made by chronic inflammation on occurrence of heart and vascular diseases. Given that, it seems especially interesting to examine impacts exerted by Epstein-Barr virus infection on CD development. The paper focuses on analyzing morbidity with infectious mononucleosis and CD in the Russian Federation over 1995–2018. 103 patients with heart rhythm disorders and 92 blood donors were examined to determine whether they had immunoglobulins to EBV antigens The results were statistically processed involving calculation of Pearson’s linear correlation coefficient, error of cor- relation coefficient, validity coefficient, determination coefficient, and frequencies of EBV markers detection per 100 exam- ined people and their confidence intervals. Differences were considered to be authentic when confidence probability was equal to 95 % and confidence significance was p<0.05. Relative risks of heart rhythm disorders in patients with active EBV- infection were calculated as per results obtained via creating a fourfold table. EBV was established to make a significant contribution into circulatory pathology occurrence and it was confirmed by an overall ascending trend in morbidity with infectious mononucleosis and CD in the Russian Federation in 1995-2018 and an authentic strong direct correlation between these two processes (r=0.94; m=0.02; t=47; p<0.01) with determination be- ing equal to 0.88. Risk of developing heart rhythm disorders was determined by active EBV-infection in case history com- bined with detected M-immunoglobulins to capsid EBV antigen and G-immunoglobulins to early EBV antigen, as well as an increase in concentration of G-immunoglobulins to capsid antigen in blood serum (RR=5.8 and 2.3 accordingly).

Development of the composition and technology of effervescent tablets for the prevention of cerebral circulation disorders in the elderly

Increasing the level of antioxidants in the human body plays an important role in increasing longevity. Studies on small laboratory animals showed that in the main group with an increased content of antioxidant enzymes, life expectancy was 20% higher than in the comparison group with age and heart diseases. Thus, the hypothesis is confirmed that a high content of active free radical molecules causes aging and the data obtained on small laboratory animals will increase the human lifespan. This fact is associated with the occurrence of heart and oncological diseases, as well as other age-related pathologies. In order to prevent the development of the above diseases, a drug was developed with an innovative composition of complex-compatible components. The experimental drug contains substances with an increased content of antioxidants for the prevention of cerebrovascular accidents, such as dihydroquercetin and black grape extract. And also vitamins and amino acids: succinic acid, ascorbic acid, glycine. The choice of the composition of the experimental drug was carried out on the basis of the antioxidant properties of these groups of substances, which are widely known, and their combined use will become a potentiated synergy of the selected components and complement their effect. Due to the fact that the classical technology for the production of effervescent dosage forms does not allow combining the components of the composition of the experimental drug, the task of developing an individual technology for combining the acid and alkaline fractions of the formulation by separating the components at the stage of the technological process of drying the raw material was solved. Thanks to this, it became possible to separate the granulation of acid and alkaline components, which made it possible to stabilize the tabletting mixture (3 tables, bibliography: 8 refs.).

Features of the glucose influence on the heart activity and the changes in the potentials of the stomach and the intestines at the heart insufficiency conditions

In acute rat experiments (thiopental sodium narcosis), it is established that introducing a 5 % glucose solution into the stomach lowers a frequency of heart rates (HR) and an amplitude of potentials of smooth muscles of the stomach and simultaneously raises doubtfully and shortly the potentials of sooth muscles (PSM) of the colon. Food additives used in the glutamate sodium, benzoate, tartrazine complex do not influence HR, but as before, reduces PSM of the stomach, and in the thick gut precise exciting or brake responses are marked. In the preliminarily developed heart insufficiency conditions, the glucose infusion into the stomach does not change HR. At the same time, the action of glucose, as well as of food additives, still results in reliable reactions of the stomach and the thick gut. Important is the present work information on the ability of glucose and food additives to modulate the heart activity estimated through the indicators of modification of electrocardiogram teeth. As appeared, the infusion of the specified irritants in the stomach of rats in control and heart insufficiency is accompanied by precise enough changes in such indicators as the RST duration, the amplitude and duration of the Т-wave, i. e. the prognostic attributes of the opportunity of occurrence of heart аrrhythmia, fibrillations.

Characteristics and outcomes of primary angiosarcoma

Objective: The study was designed to analyze the clinicopanthologic characteristics, treatments and outcomes of a series of patients with primary angiosarcoma. Methods: The clinical, surgical and pathological data and treatment of 68 patients with pathologically confirmed angiosarcoma admitted to Peking Union Medical College Hospital from January 1990 to June 2017 was retrospectively analyzed. Kaplan-Meier method and Log rank test were used for univariate survival analysis and Cox regression model was used for multivariate survival analysis. Results: A total of 68 patients were enrolled, 38 were male, 30 were female. The median age at diagnosis was 50.5 years. The time from symptom onset to diagnosis was (7.5±7.5) months. The primary sites included face and scalp, breast, chest wall, lung, heart, liver, spleen, extremities, bones and so on. At diagnosis, the mean size of tumors were (7.4±7.3) cm, 28 patients (41.2%) had localized disease (stage Ⅰ+ Ⅱ) and 40 patients had metastatic disease (stage Ⅲ+ Ⅳ). There were 37 patients treated with surgery alone, three receiving radiotherapy alone, five receiving chemotherapy alone and sixteen receiving comprehensive treatment with 5 underwent surgery plus radiotherapy, three treated by surgery plus chemotherapy, four had surgery plus interventional therapy, two had chemoradiotherapy, one had radiotherapy and interventional therapy and 1 had surgery plus chemoradiotherapy and targeted therapy. Five patients received only palliative treatment, and 2 patients lost follow-up after diagnosed. Fifty patients were followed up with a median overall survival time of 8.5 months. The median survival time of patients with metastatic angiosarcoma was 6.6 months, significantly shorter than that of patients with localized disease (15.0 months, P=0.020). The median survival time of patients with cardiac angiosarcoma was 3.0 months, significantly shorter than that of patients with angiosarcoma at other sites (11.5 months, P=0.010). The median survival time of patients receiving comprehensive treatment was 31.0 months, significantly longer than that of patients without comprehensive treatment (5.6 months, P=0.007). Multivariate analysis showed that staging, heart occurrence and comprehensive treatment were independent factors for the prognosis of primary angiosarcoma (all P<0.05). Conclusions: Angiosarcoma is a rare malignancy, and patients with metastatic disease or cardiac occurence have poor prognosis. Comprehensive treatment can improve the prognosis of patients with angiosarcoma.