Protection Of Vital Organs Research Articles

Antidiabetic, Antihyperlipidemic, and Antioxidant Evaluation of Phytosteroids from Notholirion thomsonianum (Royle) Stapf.

Diabetes mellitus (DM) is a metabolic complication and can pose a serious challenge to human health. DM is the main cause of many life-threatening diseases. Researchers of natural products have been continuously engaged in treating vital diseases in an economical and efficient way. In this research, we extensively used phytosteroids from Notholirion thomsonianum (Royle) Stapf for the treatment of DM. The structures of phytosteroids NtSt01 and NtSt02 were confirmed with gas chromatography-mass spectrometry (GC-MS) and nuclear magnetic resonance (NMR) analyses. Through in vitro studies including α-glucosidase, α-amylase, and DPPH assays, compound NtSt01 was found to be comparatively potent. An elevated dose of compound NtSt01 was also found to be safe in an experimental study on rats. With a dose of 1.0 mg/kg of NtSt01, the effect on blood glucose levels in rats was observed to be 519 ± 3.98, 413 ± 1.87, 325 ± 1.62, 219 ± 2.87, and 116 ± 1.33 mg/dL on the 1st, 7th, 14th, 21st, and 28th, days, respectively. The in vivo results were compared with those of glibenclamide, which reduced the blood glucose level to 107 ± 2.33 mg/dL on the 28th day. On the 28th day of NtSt01 administration, the average weights of the rats and vital organs (liver, kidney, pancreas, and heart) remained healthy, with a slight increase. The biochemical parameters of the blood, i.e., serum creatinine, blood urea, serum bilirubin, SGPT (or ALT), and serum alkaline phosphatase, of rats treated with NtSt01 remained in the normal ranges. Similarly, the serum cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels also remained within the standard ranges. It is obvious from our overall results that the phytosteroids (specifically NtSt01) had an efficient therapeutic effect on the blood glucose level, protection of vital organs, and blood biochemistry.

The novelties of adult advanced life support and post-resuscitation therapy

The fourth element of chain-of-survival contains advanced life support and post-resuscitation treatment. Both treatment options influence the outcome of patients suffering cardiac arrest. Advanced life support includes all interventions that require special medical equipment and expertise. High-quality chest compressions and early defibrillation (if indicated) compose the main elements of advanced life support. Clarifying and treating the cause of cardiac arrest have also high priority, in which point-of-care ultrasound plays an important role. In addition, securing higher level of airway and capnography, securing intravenous or intraosseous line, and the parenteral administration of drugs - such as epinephrine or amiodarone - are the most important steps of advanced life support. If conventional therapy is unsuccessful, extracorporeal circulatory support can be used in special patient populations. The protection of vital organs that are sensitive to hypoxia (brain and heart) has a high priority after the return of spontaneous circulation beside the causative treatment of cardiac arrest. The most important parts of the supportive post-resuscitation treatment are: targeting normoxia, normocapnia, normotension, normoglycemia, and the application of target temperature management. Orv Hetil. 2023; 164(12): 454-462.

Comparison of cases with and without additional lower body perfusion in newborns undergoing aortic arch reconstruction with antegrade selective cerebral perfusion method.

Background The aim of this study was to analyze the effect of additional lower body perfusion, compared to antegrade selective cerebral perfusion, on early postoperative outcomes after aortic arch repair in neonates with biventricular morphology. Methods Between January 2017 and April 2020, a total of 46 neonates (34 males, 12 females; median age: 10 days; range, 7 to 14 days) with biventricular morphology underwent an aortic arch reconstruction were retrospectively analyzed. The effects of antegrade selective cerebral perfusion and additional lower body perfusion techniques on vital organ preservation and mortality were evaluated in these patients who underwent arch reconstruction. Results In the univariate analysis of the whole cohort, postoperative creatinine level was lower in the additional lower body perfusion group, while there was no significant difference between the other parameters. In the multivariate analysis, intraoperative highest lactate level (odds ratio: 1.7; 95% confidence interval: 1.07-2.68; p=0.02) and postoperative 4th t o 6 th h lactate levels (odds ratio: 2.34; 95% confidence interval: 1.08-5.09; p=0.03) were independent predictors of early mortality. Mortality rate was higher in the antegrade selective cerebral perfusion group (22% vs. 7%), although it did not reach statistical significance. In the receiver operating characteristic curve analysis, the cut-off value for intraoperative lactate was 6.2 mmol/L (sensitivity: 85.7%, specificity: 71.1%) and the cut-off value for the lactate level at the postoperative 4th to 6th h was 4.9 mmol/L (sensitivity: 85.7%, specificity: 73.7%). Above these lactate levels were found to be associated with mortality. Conclusion Additional lower body perfusion may have a role in vital organ protection in aortic arch repair of neonates, compared to antegrade selective cerebral perfusion.

Molecular Mechanisms Involved in Hypoxia-Induced Alterations in Bone Remodeling.

Bone is crucial for the support of muscles and the protection of vital organs, and as a reservoir of calcium and phosphorus. Bone is one of the most metabolically active tissues and is continuously renewed to adapt to the changes required for healthy functioning. To maintain normal cellular and physiological bone functions sufficient oxygen is required, as evidence has shown that hypoxia may influence bone health. In this scenario, this review aimed to analyze the molecular mechanisms involved in hypoxia-induced bone remodeling alterations and their possible clinical consequences. Hypoxia has been associated with reduced bone formation and reduced osteoblast matrix mineralization due to the hypoxia environment inhibiting osteoblast differentiation. A hypoxic environment is involved with increased osteoclastogenesis and increased bone resorptive capacity of the osteoclasts. Clinical studies, although with contradictory results, have shown that hypoxia can modify bone remodeling.

Optimal Parameters of Laser Therapy to Improve Critical Calvarial Defects

Body bones play diverse pivotal roles, including the protection of vital organs. For instance, the integrative functions of the brain controlling diverse peripheral actions can be affected by a traumatic injury on the calvaria and the reparative process of a large defect is a challenge in the integrative physiology. Therefore, the development of biomaterials and approaches to improve such defects still requires substantial advances. In this regard, the most attractive approaches have been covering the cavity with inorganic bovine bone (IBB) and, more recently, also using low-level laser therapy (LT), but this issue has opened many questions. Here, it was determined the number of LT sessions required to speed up and to intensify the recovery process of two 5-mm-diameter defects promoted in the calvaria of each subgroup of six adult Wistar rats. The quantitative data showed that 30 days post-surgery, the recovery process by using blood clot-filling was not significantly influenced by the number of LT sessions. However, in the IBB-filled defects, the number of LT sessions markedly contributed to the improvement of the reparative process. Compared to the Control group (non-irradiated), the percentage of mineralization (formation of new bone into the cavities) gradually increased 25, 49, and 52% with, respectively, 4, 7, and 11 sessions of LT. In summary, combining the use of IBB with seven sessions of LT seems to be an optimal approach to greatly improve the recovery of calvarial defects. This translational research opens new avenues targeting better conditions of life for those suffering from large bone traumas and in the present field could contribute to preserve the integrative functions of the brain.

Interplay between Inflammation and Pathological Bone Resorption: Insights into Recent Mechanisms and Pathways in Related Diseases for Future Perspectives.

Bone is a mineralized and elastic connective tissue that provides fundamental functions in the human body, including mechanical support to the muscles and joints, protection of vital organs and storage of minerals. Bone is a metabolically active organ that undergoes continuous remodeling processes to maintain its architecture, shape, and function throughout life. One of the most important medical discoveries of recent decades has been that the immune system is involved in bone remodeling. Indeed, chronic inflammation has been recognized as the most significant factor influencing bone homeostasis, causing a shift in the bone remodeling process toward pathological bone resorption. Bone osteolytic diseases typified by excessive bone resorption account for one of the greatest causes of disability worldwide, with significant economic and public health burdens. From this perspective, we discuss the recent findings and discoveries highlighting the cellular and molecular mechanisms that regulate this process in the bone microenvironment, in addition to the current therapeutic strategies for the treatment of osteolytic bone diseases.

Mechanical properties of the mouse femur after treatment with diclofenac and running exercises

Purpose: The flexible properties of the bone are essential for the movement and protection of vital organs. The ability of a bone to resist fractures under the influence of large muscles and physical activity depends on its established mechanical properties. This article discusses how exercise such as treadmill running and taking non-steroidal anti-inflammatory drugs (NSAIDs), such as diclofenac, affect the musculoskeletal system by modifying the elastic and thermal properties of the left femur of a mouse. Methods: The research was conducted using 9-week-old C57BL/6J female mice. In order to investigate the elastic and thermal properties of bones, dynamic mechanical analysis (DMA) and differential scanning calorimetry (DSC) were performed. Results: The study of elastic properties, followed by in-depth statistical analysis, shows that taking diclofenac slightly reduces the elastic parameters of the bones under study. These changes are more pronounced in DSC studies, the shift of the observed endothermic peaks is on the order of several degrees with a simultaneous increase in the enthalpy of this process. Conclusions: The opposite effect of the applied factors – diclofenac and running – on the elastic properties of the bones of the examined mice was found. The external factors – running and diclofenac – modify the basic parameters of the endothermic process associated with the release of water.

Eff2Net: An efficient channel attention-based convolutional neural network for skin disease classification

The primary layer of protection for vital organs in the human body is the skin. It functions as a barrier to protect our internal organs from different sources. However, infections caused by fungus, viruses, or even dust can damage the skin. A tiny lesion on the skin can grow into something that can cause serious health problems. A good diagnosis can help the person suffering from a skin disease to recover quickly. This research aims to develop a system for detecting skin diseases using a Convolution Neural Network (CNN). The proposed model named Eff2Net is built on EfficientNetV2 in conjunction with the Efficient Channel Attention (ECA) block. This research attempts to replace the standard Squeeze and Excitation (SE) block in the EfficientNetV2 architecture with the ECA block. By doing so, it was observed that there was a significant drop in the total number of trainable parameters. The proposed CNN learnt around 16 M parameters to classify the disease, which is comparatively less than the existing deep learning approaches reported in the literature. This skin disease classification was performed on four classes: acne, actinic keratosis (AK), melanoma, and psoriasis. The model achieved an overall testing accuracy of 84.70%.

Multiscale modeling of bone tissue mechanobiology.

Mechanical environment has a crucial role in our organism at the different levels, ranging from cells to tissues and our own organs. This regulatory role is especially relevant for bones, given their importance as load-transmitting elements that allow the movement of our body as well as the protection of vital organs from load impacts. Therefore bone, as living tissue, is continuously adapting its properties, shape and repairing itself, being the mechanical loads one of the main regulatory stimuli that modulate this adaptive behavior. Here we review some key results of bone mechanobiology from computational models, describing the effect that changes associated to the mechanical environment induce in bone response, implant design and scaffold-driven bone regeneration.

Hormonal regulation of biomineralization

Biomineralization is the process by which organisms produce mineralized tissues. This crucial process makes possible the rigidity and flexibility that the skeleton needs for ambulation and protection of vital organs, and the hardness that teeth require to tear and grind food. The skeleton also serves as a source of mineral in times of short supply, and the intestines absorb and the kidneys reclaim or excrete minerals as needed. This Review focuses on physiological and pathological aspects of the hormonal regulation of biomineralization. We discuss the roles of calcium and inorganic phosphate, dietary intake of minerals and the delicate balance between activators and inhibitors of mineralization. We also highlight the importance of tight regulation of serum concentrations of calcium and phosphate, and the major regulators of biomineralization: parathyroid hormone (PTH), the vitamin D system, vitamin K, fibroblast growth factor 23 (FGF23) and phosphatase enzymes. Finally, we summarize how developmental stresses in the fetus and neonate, and in the mother during pregnancy and lactation, invoke alternative hormonal regulatory pathways to control mineral delivery, skeletal metabolism and biomineralization.

Hormonal regulation of biomineralization.

Biomineralization is the process by which organisms produce mineralized tissues. Thiscrucial process makes possible the rigidity and flexibility that the skeleton needs for ambulation and protection of vital organs, and the hardness that teeth require to tear and grind food. The skeleton also serves as a source of mineral in times of short supply, and the intestines absorb andthe kidneys reclaim or excrete minerals as needed. This Review focuses on physiological and pathological aspects of the hormonal regulation of biomineralization. We discuss the roles of calcium and inorganic phosphate, dietary intake of minerals and the delicate balance between activators and inhibitors of mineralization. We also highlight the importance of tight regulation of serum concentrations of calcium and phosphate, and the major regulators of biomineralization: parathyroid hormone (PTH), the vitamin D system, vitamin K, fibroblast growth factor 23 (FGF23) and phosphatase enzymes. Finally, we summarize how developmental stresses in the fetus and neonate, and in the mother during pregnancy and lactation, invoke alternative hormonal regulatory pathways to control mineral delivery, skeletal metabolism and biomineralization.

Biomaterials for bone regeneration: an orthopedic and dentistry overview.

Because bone-associated diseases are increasing, a variety of tissue engineering approaches with bone regeneration purposes have been proposed over the last years. Bone tissue provides a number of important physiological and structural functions in the human body, being essential for hematopoietic maintenance and for providing support and protection of vital organs. Therefore, efforts to develop the ideal scaffold which is able to guide the bone regeneration processes is a relevant target for tissue engineering researchers. Several techniques have been used for scaffolding approaches, such as diverse types of biomaterials. On the other hand, metallic biomaterials are widely used as support devices in dentistry and orthopedics, constituting an important complement for the scaffolds. Hence, the aim of this review is to provide an overview of the degradable biomaterials and metal biomaterials proposed for bone regeneration in the orthopedic and dentistry fields in the last years.

Evaluating the Therapeutic Efficacy and Safety of Landiolol Hydrochloride for Management of Arrhythmia in Critical Settings: Review of the Literature.

BackgroundLandiolol hydrochloride, a highly cardio-selective beta-1 blocker with an ultra-short-acting half-life of 4 minutes, was originally approved by Japan for treatment of intraoperative tachyarrhythmias. This review aims to provide an integrated overview of the current state of knowledge of landiolol hydrochloride in the management of arrhythmia in critical settings.MethodsWe searched MEDLINE, EMBASE, and the Cochrane Library to retrieve relevant articles with a total of 65 records identified.ResultsThe high β1 selectivity (β1/β2 ratio of 255:1) of landiolol causes a more rapid heart rate (HR) decrease compared to esmolol while avoiding decreases in mean arterial blood pressure. Recently, it has been found useful in left ventricular dysfunction patients and fatal arrhythmia requiring emergency treatment. Recent random clinical trials (RCT) have revealed therapeutic and prophylactic effects on arrhythmia, and very low-dose landiolol might be effective for preventing postoperative atrial fibrillation (POAF) and sinus tachycardia. Likewise, landiolol is an optimal choice for perioperative tachycardia treatment during cardiac surgery. The high β1 selectivity of landiolol is useful in heart failure patients as a first-line therapy for tachycardia and arrhythmia as it avoids the typical depression of cardiac function seen in other β-blockers. Application in cardiac injury after percutaneous coronary intervention (PCI), protection for vital organs (lung, kidney, etc.) during sepsis, and stabilizing hemodynamics in pediatric patients are becoming the new frontier of landiolol use.ConclusionLandiolol is useful as a first-line therapy for the prevention of POAF after cardiac/non-cardiac surgery, fatal arrhythmias in heart failure patients and during PCI. Moreover, the potential therapeutic effect of landiolol for sepsis in pediatric patients is currently being explored. As positive RCT results continue to be published, new clinical uses and further clinical studies in various settings by cardiologists, intensivists and pediatric cardiologists are being conducted.

Paediatric Metabolic Bone Disease: A Lifetime Ahead.

Beyond its functions in locomotion, support and protection of vital organs, bone also interacts with other organs to adjust mineral balance in response to physiological requirements. Bone remodelling is a continuous process of bone resorption and formation for the purpose of maintaining healthy bone mass and growth. Any derangement in this process can cause bone disorders with important clinical consequences. The most prominent features of bone diseases in children include early bone fractures, deformities and pain, which can persist and worsen later in life if an accurate and timely diagnosis is not achieved. Biochemical and genetic testing usually help to discriminate the aetiology of the disease, which determines the subsequent management and follow-up. This review focuses on major genetic metabolic bone diseases in children, their pathophysiological mechanisms, the potential therapeutic interventions and the possible consequences in adulthood of the disease and its treatments.

Correlation of Maternal BMI with Foetal Liver Blood Flow and Neonatal Adiposity in Normal Pregnancies and Pregnancies Complicated by Gestational Diabetes Mellitus and Foetal Growth Restriction

Introduction: The foetus exhibits a wide array of structural and functional adaptations in response to intrauterine conditions, towards protection of vital organs and maintaining the supply of essential nutrients. When oxygen is limited, foetal adaptations prioritise brain growth, irrespective of whether other essential nutrients are limited or not. The hypothesis for this study was that fatty acid synthesis occurs in foetal liver therefore if adaptive changes occur in the hepatic and umbilical flow it will affect fat deposition which will manifest as neonatal adiposity. Aim: Correlation of maternal Basal Metabolic Index (BMI) with Foetal liver blood flow and neonatal adiposity in normal pregnancies and pregnancies complicated by Gestational Diabetes Mellitus (GDM) and Foetal Growth Restriction (FGR) .Materials and Methods: An observational pilot study was carried out in a tertiary care referral hospital of Northern India. Antenatal women were recruited in three groups of singleton uncomplicated pregnancies (40), Women with GDM (31) and women with FGR (29). Maternal characteristics including pre-pregnancy BMI and obstetric ultrasound doppler study were recorded at 35 weeks gestation. The time-averaged maximum velocity (TAMX) was calculated for Umbilical Vein (UV) and Ductus Venosus (DV) as (Vmax) UV and (Vmax) DV. Blood flow (Q) was calculated as Q=h×(D/2)2×p×TAMX. The neonatal biometry and Skin Fold Thickness (SFT) was measured. Statistical techniques used were t-tests for analyses of dichotomous outcomes, Pearson’s correlation (r) and multivariate regression. Results: In mothers with higher DV shunting neonatal adiposity was significantly lower in the FGR group. In the uncomplicated group about 46% of variation in adiposity was explained by all the study variables and overall regression equation was statistically significant (p=0.004). Conclusion: Mothers with low BMI and normal umbilical and middle cerebral doppler flow had higher foetal hepatic flow to improve substrate deposition. DV shunting was significantly higher in hypoxic foetuses with reduced hepatic flow.

Effect of Remote Ischemic Preconditioning on Myocardial Infarction During Open Surgery for Ruptured Abdominal Aortic Aneurysm, A Randomized Controlled Trial

Introduction - Within the last 20 years there has been a focus on the importance of ischemic reperfusion injury (IRI) following periods of low or completely abolished perfusion, particularly of the myocardium. Studies have shown that, by inducing repeated transient ischemia and subsequent reperfusion of an organ or an extremity, it is possible to induce protection of vital organs from IRI. This is the principle of remote ischemic preconditioning (RIPC).1-3 Our objective was to examine whether (RIPC) can reduce the incidence of perioperative myocardial infarction (MI) during open surgery for ruptured abdominal aortic aneurysm (AAA). In addition, to examine whether RIPC can reduce 30-day mortality, multi- organ failure (MOF), acute intestinal ischemia, acute kidney injury (AKI) and ischemic stroke. Methods - A randomized, non-blinded controlled trial. Patients from three vascular surgery centres in Denmark, treated with open surgery for ruptured AAA, were randomised to intervention with RIPC or control in 1:1 ratio. Postoperative complications and mortality were registered and electrocardiogram and blood samples were obtained daily during hospitalization. Results are primarily reported as per protocol analysis, while MI and mortality were further analyzed by intention to treat. Clinicaltrial.gov id. number: NCT00883363. Results - A total of 200 patients were randomized. Fifty-two patients died prior to vascular reconstruction, and 5 were excluded, leaving 143 patients included for per protocol analysis. A total of 72 patients received RIPC, and 71 were controls. There was no reduction of perioperative MI between the two groups, 42.3% (controls) versus 37.5% (RIPC). Odds ratio (OR) 0.77 (95% confidence interval (CI); 0.39-1.51), p=0.45, for patients receiving RIPC versus control patients in per protocol analysis. Thirty-day mortality in per protocol analysis was significantly reduced, OR 0.44 (95% CI: 0.21-0.95) p=0.036, but this difference disappeared on the intention to treat analysis, OR 0.64 (95% CI: 0.37-1.12), p=0.12. There were no differences in MOF, AKI and intestinal ischemia. (see figure) Conclusion - In this randomized, open label controlled trial, RIPC did not reduce the incidence of perioperative myocardial infarction in patients undergoing open surgery for ruptured abdominal aortic aneurysm. There was no reduction in multi- organ failure, intestinal ischemia, acute kidney injury and ischemic stroke. Thirty-day mortality was significantly reduced by per protocol analysis, but not by intention to treat analysis. Substantially larger studies are necessary, if a potential protective effect of RIPC is to be demonstrated.

Концептуальный подход к созданию комплексной системы радиационной защиты в условиях воздействия высокодозных полей ионизирующего излучения

The general approaches and criteria for substantiating the complex system of radiation protection (RP) of a human operator in the conditions of work in high-dose fields of ionizing radiation are considered. When planning work in such conditions, it is advisable to consider a set of measures of an organizational, technical and medical nature. Each activity has its measures own limits to reduce the dose load on the human operator or the development of adverse effects of radiation, and in some cases only a combination of them can give a certain protective effect, allowing to carry out the necessary activities in such conditions. If an operator works in mobile technical facilities (for example, a bulldozer, a caterpillar all-terrain vehicle, a helicopter, etc.) an important place is occupied by the issue of strengthening the technical component of the RP, primarily by engineering the design of additional shield elements. The biomedical rationale for the optimality of such protection is givenensuring maximum protection of vital organs, in the first place, red bone marrow, a significant volume of which is concentrated in the bones in the lumbar vertebrae, sacrum and pelvis. Several examples of the performance of professional activity of operator in the conditions of high-dose ionizing radiation fields and an expert evaluation of the limiting capabilities of the technical and medical component of the integrated RP are considered.

Deep Hypothermic Circulatory Arrest Does Not Show Better Protection for Vital Organs Compared with Moderate Hypothermic Circulatory Arrest in Pig Model.

Background Continued debates exist regarding the optimal temperature during hypothermic circulatory arrest in aortic arch repair for patients with type A aortic dissection. This study seeks to examine whether the use of moderate hypothermic circulatory arrest in a pig model provides comparable vital organ protection outcomes to the use of deep hypothermic circulatory arrest. Methods Thirteen pigs were randomly assigned to 30 minutes of hypothermic circulatory arrest without cerebral perfusion at 15°C (n = 5), 25°C (n = 5), and a control group (n = 3). The changes in standard laboratory tests and capacity for protection against apoptosis in different vital organs were monitored with different temperatures of hypothermic circulatory arrest management in pig model to determine which temperature was optimal for hypothermic circulatory arrest. Results There were no significant differences in the capacity for protection against apoptosis in vital organs between 2 groups (p > 0.05, respectively). Compared with the moderate hypothermic circulatory arrest group, the deep hypothermic circulatory arrest group had no significant advantages in terms of the biologic parameters of any other organs (p > 0.05). Conclusions Compared with deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest is a moderate technique that has similar advantages with regard to the levels of biomarkers of injury and capacity for protection against apoptosis in vital organs.

Ischaemic and hypoxic conditioning: potential for protection of vital organs.

What is the topic of this review? Remote ischaemic preconditioning (RIPC) and hypoxic preconditioning as novel therapeutic approaches for cardiac and neuroprotection. What advances does it highlight? There is improved understanding of mechanisms and signalling pathways associated with ischaemic and hypoxic preconditioning, and potential pitfalls with application of these therapies to clinical trials have been identified. Novel adaptations of preconditioning paradigms have also been developed, including intermittent hypoxia training, RIPC training and RIPC-exercise, extending their utility to chronic settings. Myocardial infarction and stroke remain leading causes of death worldwide, despite extensive resources directed towards developing effective treatments. In this Symposium Report we highlight the potential applications of intermittent ischaemic and hypoxic conditioning protocols to combat the deleterious consequences of heart and brain ischaemia. Insights into mechanisms underlying the protective effects of intermittent hypoxia training are discussed, including the activation of hypoxia-inducible factor-1 and Nrf2 transcription factors, synthesis of antioxidant and ATP-generating enzymes, and a shift in microglia from pro- to anti-inflammatory phenotypes. Although there is little argument regarding the efficacy of remote ischaemic preconditioning (RIPC) in pre-clinical models, this strategy has not consistently translated into the clinical arena. This lack of translation may be related to the patient populations targeted thus far, and the anaesthetic regimen used in two of the major RIPC clinical trials. Additionally, we do not fully understand the mechanism through which RIPC protects the vital organs, and co-morbidities (e.g. hypercholesterolemia, diabetes) may interfere with its efficacy. Finally, novel adaptations have been made to extend RIPC to more chronic settings. One adaptation is RIPC-exercise (RIPC-X), an innovative paradigm that applies cyclical RIPC to blood flow restriction exercise (BFRE). Recent findings suggest that this novel exercise modality attenuates the exaggerated haemodynamic responses that may limit the use of conventional BFRE in some clinical settings. Collectively, intermittent ischaemic and hypoxic conditioning paradigms remain an exciting frontier for the protection against ischaemic injuries.

THE PROPAGATION OF THE TEMPERATURE WAVE IN MYOCARDIUM

The method for estimating the rate of propagation of temperature waves in the myocardium during hypothermia and hyperthermia of the heart based on noninvasive temperature control on the heart surface in conditions of cardiopulmonary bypass is proposed. The solution of the heat conduction equation for temperature waves in the myocardium is presented, which allows determining at each point of the medium the temperature change function, as well as the amplitude and phasing velocity of the temperature wave upon cooling and warming of the heart in conditions of cardiopulmonary bypass. The velocity distribution for the temperature field on the surface of the myocardium and in the depth of tissues during the hypothermia and hyperthermia of the heart is obtained. The thermographic images of the heart during controlled hypothermia and hyperthermia of the heart under cardiopulmonary bypass are obtained. The study of the conditions for spreading the temperature wave in the myocardium is performed, which allows to improve the means of intraoperative protection of vital organs and tools for controlling its effectiveness. The results of introduction of methods of non-invasive temperature control in cardiac surgery and the process of intraoperative cardiac protection in the temperature range from +10°С to +38°С are presented.