Serial assessment of somatic and cardiovascular development in patients with single ventricle undergoing Fontan procedure.

BACKGROUND: The palliation of patients with single ventricle (SV) undergoing Fontan procedure led to improved long-term survival but is still limited due to cardiovascular complications. The aim of this study was to describe the somatic and cardiovascular development of Fontan patients until adolescence and to identify determining factors. METHODS: We retrospectively assessed somatic growth, vascular growth of pulmonary arteries, and cardiac growth of the SV and systemic semilunar valve from 0 to 16 years of age using transthoracic echocardiography. The Doppler inflow pattern of the atrioventricular valve was quantified by E-, A-wave and E/A ratio. All data were converted to z-scores and analyzed using linear mixed effect models to identify associations with age at Fontan procedure, gender, and ventricular morphology. RESULTS: 134 patients undergoing Fontan procedure at a median age of 2.4 (IQR 2.12 to 2.8) years were analyzed. A catch-up of somatic growth after Fontan procedure until school age was found, with lower body height and weight z-scores in male patients and patients with systemic right ventricles. An early time of Fontan procedure was favorable for somatic growth, but not for vascular growth. Cardiac development indicated a decrease of SV end-diastolic diameter z-score until adolescence. Despite a trend towards normalization, E-wave and E/A ratio z-scores were diminished over the entire period. CONCLUSIONS: There is a catch-up growth of somatic, vascular and cardiac parameters after Fontan procedure, which in our cohort depends on the time of Fontan procedure, ventricular morphology, and gender. Beside other factors, diastolic function of the SV remains altered.

[Planning of esthetic oral rehabilitation according to correlative analysis of clinical and morphological features of the marginal gingiva].

The orthopedic restoration and related to its clinical stages (preparation, gingival retraction, impression) is often associated with complications which arise from the marginal gingiva. The technology of indirect ceramic restoration requires an assessment of the clinical and morphological parameters of periodontal tissues. The study outlines correlation between the type of periodontal histhology and inflammatory and degenerative complications that has been established after the analysis of morphofunctional state of periodontal tissue. Results of clinical studies and correlation analysis of clinical and morphological parameters of marginal gingiva has shown that important parameter influencing the choice of manufacturing technology are the position of restoration margin relatively to marginal gingiva and periodontal morphotype.

Cerebrosides from a Far-Eastern Glass Sponge Aulosaccus sp.

Nine new cerebrosides 1a-d, 2a, 2b, 3a-c were found in the extract of a Far-Eastern glass sponge Aulosaccus sp. (class Hexactinellida). These ß-D-glucopyranosyl-(1 → 1)-ceramides contain sphingoid bases (2S,3S,4R,11Z)-2-aminoeicos-11-ene-1,3,4-triol (in 1a-d), (2S,3S,4R,13Z)-2-aminoeicos-13-ene-1,3,4-triol (in 2a, b) and (2S,3S,4R,13S*,14R*)-2-amino-13,14-methylene-eicosane-1,3,4-triol (in 3a-c), which are N-acylated by (2R,15Z)-2-hydroxydocos-15-enoic (in 1a, 2a, 3a), (2R,16Z)-2-hydroxytricos-16-enoic (in 1b, 2b, 3b), (2R,17Z)-2-hydroxytetracos-17-enoic (in 1d) and (2R)-2-hydroxydocosanoic (in 1c, 3c) acids. The monoenoic and cyclopropane-containing sphingoid bases of compounds 1a-d, 2a, 2b, 3a-c have not been found previously in any sphingolipids. The structures of the cerebrosides were elucidated on the basis of (1)H-, (13)C-NMR spectroscopy, mass spectrometry, optical rotation data and chemical transformations. A simplified method for the assignment of the absolute configuration of 2-hydroxy fatty acids by GC analysis of their (2R)- and (2S)-oct-2-yl esters was proposed.

[The assessment of accumulated internal irradiation doses of the inhabitants of the populated areas in Republik Belarus after Chernobyl accident].

A new system of evaluation methods has been developed for the assessment of the accumulated internal irradiation doses in the inhabitants of the populated areas of the Republic of Belarus that were contaminated by the Chernobyl radionuclides. The system is based on the results of WBC measurements. The model is based on the WBC-results of the State Dosimetric Register for the period of 1987-2010. The dose assessment model is based on the classification of the populated areas, on the regional features of the soils through which 137Cs can enter into the locally grown and produced foods. The model is also based on building the regressive correlations of accumulated internal doses to the contamination density of the territory of a populated area. Such regressive correlations are made for each region. The influence of indirect factors of dose forming was taken into consideration in the dose assessment. Among these factors are the population of the area, and the amount of forested territory around it, which were taken as correction coefficients. The coefficients were determined from the regressive correlation of the correction coefficients to a specific area of forest for each region. So called "countermeasure factor" was used for specification of other model results.

[A statistical analysis of the data acquired from WBC measurements for internal irradiation dose assessment of the inhabitants of rural areas years after the Chernobyl accident].

The method for the assessment of the rural inhabitants internal dose lived in areas of the Republic of Belarus contaminated by the Chernobyl radionuclides was developed. The model is based on the individual internal doses, calculated by the WBC measurements. The data of WBC measurements of the State Dosimetric Register are used for direct assessment of internal irradiation dose, and as a basis for the model development. The dose assessment model is based on the classification of contaminated territories on the regional features of the soils, which cause 137Cs intaking with locally produced foods. The model is also based on regression of daily 137Cs intake on the density contamination of the soil. Such regression model had been made for each region. The influence of indirect factors had been taken into consideration in the dose assessment. These factors are: the number of settlement population, and the forest area around it. Its influents had been taken as correction factors. The factors had been determined from the regression model of the correction factors on a specific forest area for each region.

[Introduction of tele-medical electrocardiographic system in regional general hospital]. / Opyt vnedreniia telemeditsinskoi élektrokardiograficheskoi sistemy v oblastnoi mnogoprofil'noi klinicheskoi bol'nitse.

The paper reviews the experience in setting up and functioning of telemedical electrocardiographic system in a regional hospital with utilization of current potential of telephone ECG transmission-reception: individual ECG registers-transmitters including devices with "a reverse loop". It is shown that ECG registration by patients themselves with its transmission by telephone facilitates diagnosis of rare paroxysmal conditions and follow-up of cardiological outpatients. Changes in the number of ECGs made for 25 years in the regional center of remote cardiological diagnosis is analysed.

Wireless ECG monitoring by telephone.

The objective of this work was to study a wireless one channel limited (3-lead) home electrocardiogram (ECG) transmission system and ambulatory devices data transmission using telephone lines. ECG screenings were conducted in two groups. The first group consisted of construction workers examined at first aid stations at construction sites in Moscow, Russia. The second group was a selected set of patients admitted to a hospital in Tblisi, Republic of Georgia. All patients were on constant monitoring and follow-up after hospitalization. Patients themselves connected the ECG leads at home or with the help of paramedics at ambulatory stations. The ECG signals were transmitted to receiving stations where doctors interpreted them. Frequency modulation was used for ECG transmission over regular telephone lines. Of 231 readings in 74 patients--70 male and 4 female (age 21-56)--in the first group, 33 patients were abnormal. In the second group, 15 out of 165 readings in 8 patients--5 male and 3 female (age 31-70)--were abnormal. ECG screening can be significantly simplified and made widely acceptable at home and distant sites using wireless monitoring tools and telephone line transfer of the signal. This project has been implemented under the auspices of the International Telecommunication Union and the Russian Telemedicine Foundation.

[Autonomic regulation of cardiac activity in patients with ischemic heart disease and neurocirculatory dystonia: asymmetry of cardiac rhythmograms]. / Vegetativnaia reguliatsiia serdechnoi deiatel'nosti u bol'nykh ishcemicheskoi bolezn'iu serdtsa i neirotsirkuliatornoi distoniei: asimmetriia ritmogrammy serdtsa.

Thirty-six males with the cardiologic syndrome were examined to compare the autonomic regulation of cardiac performance in patients with coronary heart disease and neurocirculatory dystonia. The standard analysis of autonomic specimens indicated a relative reduction in a response of the parasympathetic link of the autonomic nervous system in patients with coronary heart disease than in those with neurocirculatory dystonia. A new approach was proposed to analyze the specimens with deep slow respiration, which included the construction of rhythmograms, followed by the determination of an asymmetry coefficient and a reduction index. Patients with coronary heart disease were found to have an asymmetric rhythmogram while those with neurocirculatory dystonia had a symmetric one.

[Changes in indicators of the antioxidant defense system in patients with ischemic heart disease treated conventionally]. / Izmenenie pokazatelei sistemy antioksidantnoi zashchity organizma u bol'nykh ishemicheskoi bolezn'iu serdtsa na fone traditsionnoi terapii.

Parameters of antioxidant defense including superoxide dismutase, catalase and spontaneous chemiluminescence were studied in 68 patients with ischemic heart disease and 20 control patients. The above parameters decreased with the disease aggravation. Conventional therapy has improved antioxidant defense, the effect being dependent on effect of therapy irrespective of its variant.

[Nosogeny in "silent" myocardial ischemia]. / Nozogenii pri "nemoi" ishemii miokarda.

Psychical reactions to ischemic cardiac disease (ICD) without angina pectoris in 29 patients with "silent" myocardial ishemia were investigated. It was demonstrated that both hypo- and hypernosognosias were observed in such patients. The former were presented by antihypochondria in individuals with hyperthymic or expansive schizoid personal features meanwhile the latter--by neurotic hypochondria in patients with hysterical characteristics. The severity of somatic state as well as myocardial ischemia manifestation were the same both in hypo- and hypernosognosias patients. There were no syndromal differences in reactions both to "silent" ischemia and on manifested forms of ICD. Psychological studies resulted in conclusion that hypernosognosias were associated with high personal anxiety as far as hyponosognosias were not bound with such individual feature. It was supposed that low preoccupation about own health may be associated with different combinations of other individual features as well as with functioning of psychological protection mechanisms.

[Protracted hypochondriacal reactions (based on the type of hypochondriacal development) in myocardial infarct patients]. / Zatiazhnye ipokhondricheskie reaktsii (po tipu ipokhondricheskogo razvitiia) u bol'nykh infarktom miokarda.

Clinical follow-up, MPT, clinical and instrumental cardiological evidence is available for 30 postmyocardial infarction patients. They exhibited hypochondriac reactions which persisted for more than 6 months. Three types of such reactions were recognized: somatization (I), cenesthetic (II), overvalued (III). I reactions were associated with homonomous body sensations, anxious and conversion disorders, avoidance behavior. II reactions cover heteronomous sensations with attendant autoaggressive behavior. Patients with reactions III had dominant ideas of complete health recovery, delirium-like fantasies. It is established that I reactions arise in personalities with neurotism radical, reactions II in those with rigidity and eccentric behavior, reactions III in patients with rigidity and conformity.

[Changes of the immunologic indices in patients with hypertension combined with obesity]. / Izmenenie nekotorykh immunologicheskikh pokazatelei u bol'nykh gipertonicheskoi bolezn'iu v sochetanii s ozhireniem.

A study of the immunological indices in patients with association of hypertensive disease and obesity revealed absolute and relative lymphocytosis, increased numbers of B-lymphocytes, immunoglobulins A, G, while the content of O-lymphocytes and immunoglobulins M did not change essentially. Due to lymphocytosis, absence of immunodeficiency, obese patients should keep hypocaloric diet for short time as one of the main methods of obesity treatment.