Hypercapnic hypoxia as a rehabilitation method for patients after ischemic stroke.

INTRODUCTION: Experimental studies on animals have demonstrated a higher neuroprotective efficacy of hypercapnic hypoxia compared to normocapnic hypoxia. Respiratory training with hypercapnic hypoxia has shown a positive impact on the functional state of the nervous system in children with cerebral palsy (CP). It can be presumed that the combined effect of moderate hypercapnia and hypoxia will be promising for clinical application within the context of early rehabilitation after ischemic stroke. METHODS: A randomized triple-blind placebo-controlled study was conducted on 102 patients with ischemic stroke, aged 63.07 ± 12.1 years. All patients were diagnosed with ischemic stroke based on neuroimaging criteria and/or clinical criteria within the 48-72 hour timeframe. The experimental group (n = 50) underwent daily respiratory training with hypercapnic hypoxia (FetCO2 5-6%, FetO2 15-16%) using the 'Carbonic' device for 7-11 sessions of 20 minutes each day during the treatment process. The control group (placebo, n = 52) underwent training on a similar device modified for breathing atmospheric air. Neurological examinations were conducted on all patients before the study and on the day after completing the training course. RESULTS: The standard treatment demonstrated effectiveness in terms of neurological status scales in both groups. Intermittent exposure to hypercapnic hypoxia proved more effective in improving neurological function indicators in patients compared to the placebo group: NIHSS scale scores were 40% lower than in the placebo group (p < 0.001); mRS scale scores were 35% lower (p < 0.001); B-ADL-I and RMI indices were higher by 26% (p < 0.01) and 36% (p < 0.001), respectively; MoCA scale results were 13% higher (p < 0.05); HADS and BDI-II scale scores were lower by 35% (p < 0.05) and 25% (p < 0.05), respectively. The increase in MMSE scale scores in the intervention group was 54% higher (p < 0.001), and MoCA scale scores increased by 25% (p < 0.001). CONCLUSION: Respiratory training with hypercapnic hypoxia improves the functional state of the nervous system in patients with ischemic stroke. After conducting further clarifying studies, hypercapnic hypoxia can be considered as an effective method of neurorehabilitation, which can be used as early as 48-72 hours after the onset of stroke.

[Epidemiology, clinical manifestations and efficiency of different methods of treatment of acromegaly according to the United Russian Registry of Patients with Pituitary Tumors].

BACKGROUND: The registry is the main source of information about patients with acromegaly for assessing the quality of medical care, effectiveness of treatment, determining the compliance of real clinical practice with existing standards and patient management protocols. AIMS: To evaluate epidemiological, demographic and clinical characteristics of acromegaly in Russian Federation and effectiveness of treatment modalities. MATERIALS AND METHODS: The object of the study was the database of the united Russian registry of patients with pituitary tumors with specific analysis of patients with acromegaly only. We analyzed the data of 4114 patients with acromegaly stored on the online system in February 2019. RESULTS: Based on the data 32% of patients had complete clinical and laboratory remission of acromegaly; the percentage of patients with no remission was 68%, among them 22.5% had significant improvements in clinical symptoms and a decrease in growth hormone (GH) and insulin-like growth factor-1 (IGF-1) without IGF-1 normalization. The average age of patients at the onset of the disease was 42.7 years and at diagnosis – 45.8 years. The ratio of men to women was 1:2.6. In patients with acromegaly hypopituitarism was registered in 14.7% of cases and among them hypothyroidism (66%) and hypogonadism (52%) were registered more often. Among other complications the leading were diabetes mellitus (15.7%) and acromegalic arthropathy (15%). The proportion of patients receiving neurosurgical treatment increased from 35.7% to 49.6% in 2012–2019; the portion of patients undergoing radiation therapy decreased significantly from 17.7% in 2012 to 0.8% in 2019. Remission was achieved in 40.47% after neurosurgery and 28.95% after medical treatment as a first line therapy p<0.01. The number of patients receiving medical treatment at the time of the study was 1209. Among them 51% of patients treated with long-acting lanreotide and 24% receiving long-acting octreotide achieved remission (p<0.0001) CONCLUSIONS: The remission rate of acromegaly remains suboptimal despite increased surgical activity, which corresponds to global trends. Long-acting lanreotide was significantly superior versus long-acting octreotide in the rate of acromegaly remission, which does not correspond with clinical trials.

Effect of soil properties on pure and formulated mesotrione adsorption onto vertisol (Limagne plane, Puy-de-Dôme, France).

The fate of ionisable pesticides in the environment is complex as it is importantly related to many soil properties: pH, mineralogy, organic matter content and other soil characteristics. The adsorption of a weak acid herbicide, mesotrione, was studied in detail on whole and peroxide-treated vertisol topsoil and also on its granulometric fractions (clay, silt, sand) to evaluate the role of mineralogy and different organic matter pools. The soil studied is alkaline silty loam with smectite as the main clay mineral. It contains 1.7% organic carbon, mostly stabilized as a complex with smectite. Humus is of fulvic type. Mesotrione adsorption occurs on both mineral and organic constituents. Adsorption is weak and mesotrione can be easily and totally desorbed. As shown with (13)C NMR experiments, adsorption best correlates with the alkyl and carboxylic carbon content, and occurs on both bound and free organic matter. No difference of mesotrione sorption was observed with the formulation Callisto®.

Enhancing atrazine biodegradation by Pseudomonas sp. strain ADP adsorption to Layered Double Hydroxide bionanocomposites.

To mimic the role of hydroxide minerals and their humic complex derivatives on the biodegradability of pesticides in soils, synthetic Mg(R)Al Layered Double Hydroxides (LDH) and Mg(R)Al modified by Humic substances (LDH-HA) were prepared for various R values (2, 3 and 4) and fully characterized. Adsorption properties of LDH and LDH-HA toward Pseudomonas sp. strain ADP were evaluated. The adsorption kinetics were very fast (<5 min to reach equilibrium). The adsorption capacities were greater than previously reported (13.5×10(11), 41×10(11) and 45.5×10(11) cells/gLDH for Mg(2)Al, Mg(3)Al and Mg(4)Al, respectively) and varied with both surface charge and textural properties. Surface modification by HA reduced the adsorption capacities of cells by 2-6-fold. Biodegradation kinetics of atrazine by Pseudomonas sp. adsorbed on both LDHs and LDH-HA complexes were measured for various solid/liquid ratios and adsorbed cell amounts. Biodegradation activity of bacterial cells was strongly boosted after adsorption on LDHs, the effect depending on the quantity and properties of the LDH matrix. The maximum biodegradation rate was obtained in the case of a 100 mg/mL Mg(2)Al LDH suspension (26 times higher than that obtained with cells alone).

Atrazine biodegradation modulated by clays and clay/humic acid complexes.

The fate of pesticides in the environment is strongly related to the soil sorption processes that control not only their transfer but also their bioavailability. Cationic (Ca-bentonite) and anionic (Layered Double Hydroxide) clays behave towards the ionisable pesticide atrazine (AT) sorption with opposite tendencies: a noticeable sorption capacity for the first whereas the highly hydrophilic LDH showed no interactions with AT. These clays were modified with different humic acid (HA) contents. HA sorbed on the clay surface and increased AT interactions. The sorption effect on AT biodegradation and on its metabolite formation was studied with Pseudomonas sp. ADP. The biodegradation rate was greatly modulated by the material's sorption capacity and was clearly limited by the desorption rate. More surprisingly, it increased dramatically with LDH. Adsorption of bacterial cells on clay particles facilitates the degradation of non-sorbed chemical, and should be considered for predicting pesticide fate in the environment.